Surplus ICU Beds May Create Demand

The high ratio of intensive care unit beds to population may be inflating the demand for ICU care, driving up costs of care in the U.S., according to a viewpoint in the Journal of the American Medical Association.

The article compares the cost of intensive care in the United States ($80 billion, or 3 percent of healthcare spending per year and 1 percent of the GDP) and its availability with the cost of intensive care in the United Kingdom (.01 percent of its GDP) and its availability. While the U.S. has 25 ICU beds per 100,000 population, the UK has only one-fifth of that number.

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Patients in U.S. ICUs are more often admitted for observation or for less serious conditions, while U.K. ICU patients are more seriously ill and at a higher risk for death. However, more patients in the U.S. die in the ICU.

The article suggests a reduced number of beds would change the case mix of patients in the U.S. to improve the utility of ICU care; that is, fewer ICU beds would mean intensive care would go to those who would benefit most from intensive care, incentivizing care teams to place patients on the wards most appropriate for their care.

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