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ICUs: Are we making the best use of critical care?

Critical care costs the nation about $80 billion per year.  Observers predict a coming shortage of intensive care unit beds and of intensivists.  In this commentary, the authors draw upon the findings of their study of over 100,000 non-surgical patients admitted to 121 Veterans Affairs (VA) hospitals in FY2009.  They found, not surprisingly, that sicker patients tended to be admitted to ICUs.  But this held true for noncardiac patients; for cardiac patients, severity of illness was not strongly related to CCU admission decisions.   The authors conclude that there are factors other than severity of illness that also guide the use of critical care — such as peace of mind, staffing issues, bed availability.  The VA has developed an ICU severity score, which has proved to be a reliable predictor of a patient’s risk of death within 30 days of admission.  Routine incorporation of this tool at patient admission to the hospital is suggested as a way to help plan the overall care process and address the appropriate use of ICU resources.

Source: Chen, L.M., and others.  Use of health IT for higher-value critical care.  The New England Journal of Medicine;368(7):594-597, Feb. 14, 2013.  Click here for full text: http://www.nejm.org/doi/pdf/10.1056/NEJMp1213273  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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