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ICU May Up Invasive Procedures, Costs, Without Mortality Benefit

Hospital-level ICU utilization rate not linked to hospital mortality for four common conditions

MONDAY, Aug. 8, 2016 (HealthDay News) — Hospitals with higher intensive care unit (ICU) utilization for four common conditions have greater use of invasive procedures and costs of hospitalization, but do not have improved hospital mortality, according to a study published online Aug. 8 in JAMA Internal Medicine.

Dong W. Chang, M.D., from the Los Angeles Medical Center, and Martin F. Shapiro, M.D., Ph.D., from the University of California, Los Angeles, conducted a retrospective cohort study involving 156,842 hospitalizations in 94 acute-care nonfederal hospitals for diabetic ketoacidosis (DKA), pulmonary embolism (PE), upper gastrointestinal bleeding (UGIB), and congestive heart failure (CHF). For the four study conditions, the authors determined the predicted hospital-level ICU utilization during hospitalization.

The researchers found that ICU admission rates varied, from 16.3 to 81.2 percent for DKA, 5.0 to 44.2 percent for PE, 11.5 to 51.2 percent for UGIB, and 3.9 to 48.8 percent for CHF. Among hospitals there were significant correlations in ICU utilization for these four medical conditions (P < 0.01 for all comparisons). The hospital-level ICU utilization rate was not associated with hospital mortality for any of the conditions. Institutions with higher ICU utilization had greater use of invasive procedures and costs of hospitalization for all four conditions.

“Institutions that utilize ICUs more frequently are more likely to perform invasive procedures and have higher costs but have no improvement in hospital mortality,” the authors write.

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