The costs of nonbeneficial treatment in the intensive care setting

The costs of nonbeneficial treatment in the intensive care setting

Gilmer T; Schneiderman LJ; Teetzel H; Blustein J; Briggs K; Cohn F; Cranford R; Dugan D; Kamatsu G; Young E

Health Affairs

2005

Female; Humans; Male; United States; Patient Discharge; Adult; Medical Futility; Middle Aged; Length of Stay; Dissent and Disputes; Survival Analysis; Empirical Approach; Death and Euthanasia; decision making; ICU Decision Making; Health Care and Public Health; Hospital Costs/statistics & numerical data; Ethics Consultation/utilization; Intensive Care Units/economics/ethics; Intensive Care/economics/ethics/utilization; Life Support Care/economics/ethics/utilization

Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU). In this paper we estimated the costs of nonbeneficial treatment using the results from a randomized trial of ethics consultations. We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge. We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.

2005

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