ICU admissions among Medicare beneficiaries on a decade-long downward trend

1. Intensive care unit (ICU) admission rates decreased from 2006 to 2015.

2. No association was found between percentage change in ICU beds and admissions to ICUs across states.

Evidence Rating Level: 2 (Good)

Study Rundown: ICU admissions require significant resources and are costly for healthcare systems. Therefore, large-scale data regarding admission rates to the ICU is important in order to help hospitals plan for emergencies and to ensure appropriate resources are allocated. The authors of this study aimed to evaluate nationally representative data of ICU admissions and determine geographic differences in admission incidence. Generally, they found that ICU admissions among Medicare beneficiaries are on a decade-long downward trend. One of the limitations of the study was that it utilizes Medicare data, which does not represent all populations that are utilizing other insurance plans or do not have health insurance. Therefore, it may not be generalizable to all patient populations.

Click to read the study in Annals of Internal Medicine

Relevant Reading: Trends in Severity of Illness on ICU Admission and Mortality among the Elderly

In-Depth [retrospective cohort]: The authors of this study evaluated hospitalizations involving acute and ICU care between 2006 and 2015 apart of the Medicare Provider Analysis and Review file. Data was utilized from all 50 states, and the authors assessed the relationship between the incidence of ICU admissions and the total number of ICU beds. A decrease in ICU admissions was observed from 2006 to 2015, with 6117 per 100 000 person years in 2006 (95% CI, 5965 to 6272) and 4247 per 100 000 person-years in 2015 (CI, 4120 to 4377) (P < 0.001). Furthermore, proportion of hospitalizations that included ICU care similarly decreased from 2006 to 2015 (17.0% to 16.3%, P < 0.001). There was a positive association found between state-level ICU admission rates and number of total beds allocated. This correlation increased between 2006 to 2015.

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