Dataset Information

Effects of Changes in ICU Bed Supply on ICU Utilization.

ABSTRACT:

Background

The availability of intensive care unit (ICU) beds may influence the demand for critical care. Although small studies support a model of supply-induced demand in the ICU, there is a paucity of system-wide data.

Objective

The objective of this study was to determine the relationship between ICU bed supply and ICU admission in United States hospitals.

Research design

Retrospective cohort study using all-payer inpatient records from Florida, Massachusetts, New Jersey, New York, and Washington from 2010 to 2012, linked to hospital data from Medicare's Healthcare Cost Reporting Information System.

Subjects

Three patient groups with a low likelihood of benefiting from ICU admission-low severity patients with acute myocardial infarction and pulmonary embolism; and high severity patients with metastatic cancer at the end of life.

Measures

We compared the risk-adjusted probability of ICU admission at hospitals that increased their ICU bed supply over time to matched hospitals that did not, using a difference-in-differences approach.

Results

For patients with acute myocardial infarction, ICU supply increases were associated with an increase in the probability of ICU admission that diminished over time. For patients with pulmonary embolism, there was a trend toward an association between change in ICU supply and ICU admission that did not meet statistical significance. For patients with metastatic cancer, admission to hospitals with an increasing ICU supply was not associated with changes in the probability of ICU admission.

Conclusions

Increases in ICU bed supply were associated with inconsistent changes in the probability of ICU admission that varied across patient subgroups.

SUBMITTER: Barbash IJ

PROVIDER: S-EPMC6565460 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Effects of Changes in ICU Bed Supply on ICU Utilization.

Barbash Ian J IJ Wallace David J DJ Kahn Jeremy M JM

Medical care 20190701 7

<h4>Background</h4>The availability of intensive care unit (ICU) beds may influence the demand for critical care. Although small studies support a model of supply-induced demand in the ICU, there is a paucity of system-wide data.<h4>Objective</h4>The objective of this study was to determine the relationship between ICU bed supply and ICU admission in United States hospitals.<h4>Research design</h4>Retrospective cohort study using all-payer inpatient records from Florida, Massachusetts, New Jerse ...[more]

PMID: 31107397

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Project description:BackgroundDemand for Physiotherapy is on the rise due to increasing ageing population and consequent disability and morbidity. However, the costs of healthcare in developing countries are rising, and healthcare resources are limited making the supply of Physiotherapy services challenging in rural communities. Availability of Physiotherapy may help to reduce the burden of disability and enhance efficiency of healthcare systems. This study investigated the characteristics and associations of utilization and supply of community Physiotherapy in Nigeria.MethodsCross-sectional survey of 336 consenting community dwelling individuals from three selected communities in Nigeria was carried out. A three-section validated self-developed questionnaire which sought information on socio-demographics, utilization and supply of community Physiotherapy, as well as how to improve community Physiotherapy services was used. A household was used as the primary sampling unit in the study. Inferential and Descriptive statistics were used to assess the data.ResultsLifetime, 12-month and point utilization of physiotherapy was 21.7, 7.4 and 2.7% respectively. Physiotherapy utilization was significantly associated with level of education (p = 0.007), belief on pain as "spiritual" (p = 0.020) and religious belief (p = 0.001). The respondents with primary, secondary and tertiary education were 14.3, 13.9 and 26 times more likely to utilize physiotherapy services, respectively. Those who 'agree' or were 'not sure' that their religious belief was against physiotherapy were 92 and 83% less likely to utilize physiotherapy services, respectively compared with those who 'disagree'. Availability and supply of Physiotherapy services were mostly at the township teaching hospital (47.9%) and private hospitals (20.5%). The supply of Physiotherapy services within the communities was mostly on temporary basis (24.7%) and through visiting Physiotherapists (21.4%). Physiotherapy services utilized was mainly exercise (46.6%) and soft tissue mobilization (41.1%). Travel costs (32.6%), time constraints (27.9%) and work commitments (24.8%) were the constraints for Physiotherapy utilization while positive beliefs and higher education improved Physiotherapy utilization.ConclusionsUtilization and supply of Physiotherapy services in Nigerian rural community was low. Low utilization of Physiotherapy services in Nigerian rural communities were most significantly influenced by low educational status and beliefs about pain.

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Dataset Information

Effects of Changes in ICU Bed Supply on ICU Utilization.

Background

Objective

Research design

Subjects

Measures

Results

Conclusions

Publications

Effects of Changes in ICU Bed Supply on ICU Utilization.

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