Considerable Proportion of ICU Admissions May Be Preventable
FRIDAY, Oct. 4, 2019 -- A considerable proportion of intensive care unit (ICU) admissions may be preventable, according to a study published online Oct. 4 in the Annals of the American Thoracic Society.
Gary E. Weissman, M.D., from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues used nationally representative U.S. claims databases to examine the proportions of ICU admissions meeting two definitions of being potentially preventable (ambulatory care-sensitive conditions [ACSCs] and life-limiting malignancies [LLMs]). Claims were analyzed from 2006 to 2015 from all Medicare Fee-for-Service (FFS) beneficiaries and from a large national payer offering a private plan (PI) and a Medicare Advantage (MA) plan.
The researchers found that the proportions of hospitalized patients with an ICU admission with an ACSC were 12.9, 12.7, and 15.8 percent among those with PI, MA, and FFS, respectively; the corresponding proportions with an LLM were 5.2, 5.4, and 6.4 percent. There was a decrease in the absolute percentages of ASCS-associated ICU stays over 10 years (−1.1, −6.4, and −6.4 percent for PI, MA, and FFS, respectively). Among LLM-associated ICU stays, smaller changes were observed, with a −0.8 percent decrease in the MA cohort and increases in the FFS and PI cohorts (+0.3 and +0.2 percent, respectively).
"Investing in outpatient, preventive, and palliative services should therefore be viewed as important complementary, if not alternative, strategies to increasing the critical care workforce in seeking [the] best care for the nation's sickest patients," the authors write.
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Posted: October 2019
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