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Does space make waste? The influence of ICU bed capacity on admission decisions

Mery, E and Kahn, JM (2013) Does space make waste? The influence of ICU bed capacity on admission decisions. Critical Care, 17 (3). ISSN 1364-8535

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Abstract

Background: Intensive care unit (ICU) beds are a scarce resource, and admissions may require prioritization when demand exceeds supply. However, there are few empiric data on whether the availability of ICU beds influences triage and processes of care for hospitalized patients who develop sudden clinical deterioration.Methods: Results: The cohort consisted of 3,494 patients. Reduced ICU bed availability was associated with a decreased likelihood of ICU admission within 2 hours of MET activation (P = 0.03) and with an increased likelihood of change in patient goals of care (P <0.01). Patients with sudden clinical deterioration when zero ICU beds were available were 33.0% (95% confidence interval (CI), -5.1% to57.3%) less likely to be admitted to the ICU and were 89.6% (95% CI, 24.9% to 188.0%) more likely to have their goals of care changed compared with when more than two ICU beds were available. However, hospital mortality did not vary significantly by ICU bed availability (P = 0.82).Conclusions: For hospitalized patients with sudden clinical deterioration, ICU bed scarcity decreases the probability of ICU admission and increases the probability of initiating comfort measures on the ward but does not influence hospital mortality. © 2013 BioMed Central Ltd.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mery, E
Kahn, JMjeremykahn@pitt.eduJMK1900000-0001-9688-5576
Date: 8 May 2013
Date Type: Publication
Journal or Publication Title: Critical Care
Volume: 17
Number: 3
DOI or Unique Handle: 10.1186/cc12688
Schools and Programs: Graduate School of Public Health > Health Policy & Management
School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1364-8535
Date Deposited: 07 Oct 2016 15:30
Last Modified: 01 Jul 2019 14:55
URI: http://d-scholarship.pitt.edu/id/eprint/29729

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