Rationing of Intensive Care Unit Services
Strauss, Michael J.
LoGerfo, James P.
Yeltatzie, James A.
Hudson, Leonard D.
JAMA. 1986 Mar 7; 255(9): 1143-1146.
A study was conducted in the intensive care unit (ICU) of the Harborview Medical Center, operated by the University of Washington, to determine how bed availability affects admission and discharge practices. During times of bed shortage patients admitted were more severely ill, had shorter stays, and were discharged while sicker than when more beds were available. Bed availability had no affect on ICU mortality or readmission rates. The study did not encompass data on the mortality and morbidity of patients who may have been denied admission to the ICU when beds were scarce. Nevertheless, the investigators conclude, physicians at Harborview effectively rationed ICU beds. They recommend that further studies should seek to identify additional hospital, physician, and patient factors that allow for an equitable rationing process. (KIE abstract)
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