Intensive care use has ramifications on health care costs, Mayo Clinic study finds

July 12, 2006

Rochester, Minn. -- Spending on intensive care, which today comprises 30-40 percent of hospital costs, may go even higher as the population ages, according to a new Mayo Clinic study.

Published in the July issue of Mayo Clinic Proceedings, the study found that older people and those with chronic illnesses have the highest rates of end-of-life intensive care unit (ICU) use. Given that the country's aging population has an increasing prevalence of chronic diseases, the ICU may be treating more and more people at the end of life, the study's authors say.

Edward Seferian, M.D., a Mayo Clinic researcher, pediatric critical care physician and first author of the study, says the findings demonstrate the importance for patients to discuss their end-of-life treatment preferences with their physicians.

Health care policy makers should also take note in considering how to fund end-of-life care, Dr. Seferian says. ICU care has been estimated at 1 percent of the U.S. gross domestic product and consumes 30 to 40 percent of hospital costs. While many factors affect intensive care use at the end of life, expanding alternative health care settings, such as nursing homes or hospice care, might be a more cost-effective use of federal health care funding, Dr. Seferian says. Often patients prefer to spend their final days in a nonhospital setting.

The population-based study was set in Olmsted County, Minn., home of Mayo Clinic Rochester, and included 818 residents who had an ICU admission in 1998. Of those, one in five residents died having received ICU care in the last six months of life. Overall, those patients in their last year of life accounted for more than one-fourth of the ICU days used by Olmsted County, Minn., residents during the year. End-of-life ICU use for patients in other regions may be even greater, Dr. Seferian says, as evidenced by higher Medicare spending for inpatient care in other areas of the country. This study may increase policy makers' concerns, and those of the medical community, about increased demand on health resources by the country's aging population.

The proportion of ICU use by residents in their last year of life increased with advancing age. That's no surprise, but Dr. Seferian calls the degree to which this occurred "striking." People age 85 and older in their last year of life used 70 percent of ICU days among that age group, the study found.

Among Mayo study patients who died in the ICU, the most common chronic illnesses were congestive heart failure, cancer and renal disease. Chronic heart disease patients had the highest end-of-life ICU admission rate.
-end-
The other author of the intensive care use study was Bekele Afessa, M.D., from Mayo Clinic's Division of Pulmonary and Critical Care Medicine.

A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 75 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com.

To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. MayoClinic.com (www.mayoclinic.com) is available as a resource for your health stories.

Mayo Clinic

Related Intensive Care Articles from Brightsurf:

Hospital COVID-19 risk lowest among intensive care staff
Contrary to expectations, the risk of COVID-19 infection among hospital staff at the height of the coronavirus pandemic was lowest among intensive care clinicians, reveals a study of one major UK medical centre, published in the journal Thorax.

Muscle weakness in patients in intensive care: Potential approach to treatment
Critical Illness Myopathy (CIM) has taken on a new relevance as a result of the Corona virus.

Pregnant women with COVID-19 may more likely need intensive care and give birth early
Pregnant women seen in hospitals with covid-19 are less likely to show symptoms, and seem to be at increased risk of needing admission to an intensive care unit than non-pregnant women of similar age, finds a study published by The BMJ today.

Many children in intensive care may not be getting rehabilitation therapy, study shows
Adult patients in hospital intensive care units (ICUs) are often given rehabilitation therapy and urged to keep mobile from an early point in their hospital stays.

Cognitive impairment after intensive care linked to long-lasting inflammation
People who have been treated in intensive care commonly suffer from residual cognitive impairment, but the reason for this is unknown.

New guidelines for hepatic failure in the intensive care unit
For critical care specialists, hepatic failure poses complex challenges unlike those of other critical illnesses.

Trial suggests babies in intensive care can be better protected from parental bacteria
Now, a Johns Hopkins Medicine research team reports it has developed and tested a relatively simple strategy for reducing the chance of parents exposing their babies in the NICU to one of the most commonly diagnosed and potentially deadly microbial scourges in a hospital: Staphylococcus aureus.

Artificial intelligence-based algorithm for intensive care of traumatic brain injury
A recent Finnish study, published in Scientific Reports, presents the first artificial intelligence (AI) based algorithm that may be utilized in the intensive care unit for treating patients with severe traumatic brain injury.

Once scarce, neonatal intensive care proliferates
Is NICU care being driven by medical need or competition?

Flu vaccine reduces risk of dying for elderly intensive care patients
An influenza vaccine does not just work when it comes to influenza.

Read More: Intensive Care News and Intensive Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.