High ICU use increases costs, number of invasive procedures

hospital

Hospitals with high volumes of intensive care unit patients perform more invasive procedures at higher costs, but mortality rates do not improve compared to those hospitalized elsewhere, according to a study published in JAMA Internal Medicine.

Researchers from LA BioMed and UCLA examined more nearly 160,000 hospitalization records from 94 hospitals that provided ICU care for four conditions where it may not be medically necessary: diabetic ketoacidosis, pulmonary embolism, upper gastrointestinal hemorrhage and congestive heart failure. Providing care in the ICU for such conditions was more costly and did not mortality risk, according to the study.

The increased costs ranged, according to the study. The team found it cost an average of $647 more to treat patients with upper gastrointestinal bleeding in the ICU, and treating patients with heart failure cost an average of $3,412 more.

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“The study begins to tell the story of how the inappropriate use of ICUs can be harmful for patients and costly for the healthcare system,” Dong W. Chang, M.D., a LA BioMed researcher and co-author of the study, said in an announcement of the findings.

The likelihood that a patient with one of the four studied conditions was sent to the ICU fluctuated depending on the type of hospital, with smaller facilities and teaching hospitals more likely to do so, according to the study. The number of invasive procedures--and the associated costs--was greater at the hospitals that were likely to send patients with all four conditions to the ICU.

The study team concluded that more research is needed to fully understand the impacts of ICU overuse, according to the announcement, but recommended hospitals examine if their ICU policies are effective.

“Hospital policies and institutional protocols in non-ICU settings that lead to overutilization of ICU care should be examined because they represent the best opportunities for reducing invasive procedures and lowering costs while ensuring the best possible care for the patient,” Chang said in the announcement.

- here’s the study abstract
- read the announcement

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