Study: One In Six ICU Admissions May Be Prevented

‘Prevention is better than cure’ — the most appropriate adage that sums up the latest study by researchers at the Palliative and Advanced Illness Research Center at the University of Pennsylvania in Philadelphia. Over 16 million ICU admissions were analyzed in this study and it was estimated that anywhere between one in six admissions may be prevented.

The data from 2006 to 2015 covered three sources: Medicare Fee-for-Service, a Medicare Advantage plan and a private national insurer, of which nearly two-thirds of U.S. adults were aged 65 and older and roughly 13 percent of the total U.S. population. Nearly 100 million were admitted to the hospital during this period and 16.7 percent were ICU admissions.

"This study was motivated by my experiences caring for patients in the medical ICU who required maximal life support because, a few weeks or months before, they couldn't afford basic preventive medical services," said lead author Gary E. Weissman, MD, MSHP, a researcher at the Palliative and Advanced Illness Research Center.

The authors included a disclaimer in the article stating that there is no "gold standard" for ICU admission that may be prevented.

For this study, they categorized patients into two groups: those with an "ambulatory care sensitive condition" and those with a "life-limiting malignancy" who are approaching the end of their life.

High blood pressure, urinary tract infection (UTI) and uncontrolled diabetes are all examples of chronic or medical conditions common in the first group. Such conditions usually do not require hospitalization, but only timely outpatient care.

The second group comprises patients diagnosed with cancer, having a year or less to live and for whom palliative care may be appropriate. Researchers noted that ICU admissions for other serious illnesses such as chronic lung disease, heart failure and neurodegenerative disorders may also be avoided.

The study also found that there was an eight-fold difference among U.S. states in the rates of ICU admissions.