The amount one health system spent on intensive care unit patients who received care perceived to be futile by physicians totaled an estimated $2.6 million over three months, according to a study in JAMA Internal Medicine.
Every day from December 2011 through March 2012, researchers surveyed critical care specialists in five ICUs at an academic healthcare system on their perceptions of which of their patients were receiving futile care — interventions that will not yield meaningful benefits. Of 1,136 patients assessed, physicians perceived 8.6 percent to be receiving probably futile treatment, 11 percent to be receiving futile treatment and 1 percent to be receiving futile treatment only on the day they transitioned to palliative care.
Patients receiving perceived futile care had 464 days of treatment, representing 6.7 percent of all patient days in the ICUs. The cost of futile treatment, calculated by summing the charges of each day and converting to costs, was estimated at $2.6 million, 3.5 percent of the total hospital costs for the ICU patients in the study.
In a commentary on the study in JAMA Internal Medicine, authors urged caution on interpreting and applying these findings. They noted that perceptions of futile care for each patient were from only one physician, and were not corroborated with perceptions from other healthcare team members, the patient or the patient's family members. In addition, the costs of caring for patients receiving perceived futile care were not compared with the costs of not treating these patients. According to the authors, previous research has shown that approximately 85 percent of ICU-related costs are fixed. The authors suggested four steps for physicians to take when responding to requests for treatment they believe is futile.
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