It's not the patients but the hospitals that cause wide variations in intensive care unit admissions. According to new research released yesterday from the Health Services Research, the difference in ICU use in hospitals in two states was due to practice patterns and not the types of patients they attract. Researchers looked at 90 short-term acute hospitals in Maryland and Washington State and found 12 percent of hospitalized patients on average were admitted to ICUs, with the proportion of patients admitted to an ICU ranging from 3 to 55 percent. For the past two decades, hospitals have cut the number of non-critical-care beds by 35 percent while increasing the number of intensive care beds by roughly the same percentage, but it's not clear why intensive care has gone up, as experts don't necessarily view the increase as a good thing, according to the research announcement.
"Their analysis seems to suggest that if you tease out the patient factors, about 20 percent of the difference is related to some factor from within the hospital that might be fixable," Stephen M. Pastores, director of critical care research at New York's Memorial Sloan-Kettering Cancer Center, said. "It'll hopefully spur folks into looking at the elements that could be modified, like moving to better triaging of patients and finding other ways to take care of them." Press release