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Potentially Preventable Intensive Care Unit Admissions in the United States, 2006-2015.


ABSTRACT: Rationale: Increasing intensive care unit (ICU) beds and the critical care workforce are often advocated to address an aging and increasingly medically complex population. However, reducing potentially preventable ICU stays may be an alternative to ensure adequate capacity.Objectives: To determine the proportions of ICU admissions meeting two definitions of being potentially preventable using nationally representative U.S. claims databases.Methods: We analyzed claims from 2006 to 2015 from all Medicare Fee-for-Service (FFS) beneficiaries and from a large national payer offering a private insurance (PI) plan and a Medicare Advantage (MA) plan. Potentially preventable hospitalizations were identified using existing definitions for ambulatory care sensitive conditions (ACSCs) and life-limiting malignancies (LLMs).Results: We analyzed 420,369,434 person-years of insurance coverage, during which there were 99,793,416 acute inpatient hospitalizations, of which 16,646,977 (16.7%) were associated with an ICU admission. Of these, the proportions with an ACSC were 12.9%, 12.7%, and 15.8%, and with an LLM were 5.2%, 5.4%, and 6.4%, among those with PI, MA, and FFS, respectively. Over 10 years, the absolute percentages of ACSC-associated ICU stays declined (PI?=?-1.1%, MA -6.4%, FFS -6.4%; all P?P?Conclusions: An appreciable proportion of U.S. ICU admissions may be preventable with community-based interventions. Investment in the outpatient infrastructure required to prevent these ICU admissions should be considered as a complementary, if not alternative, strategy to expanding ICU capacity to meet future demand.

SUBMITTER: Weissman GE 

PROVIDER: S-EPMC6944341 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Potentially Preventable Intensive Care Unit Admissions in the United States, 2006-2015.

Weissman Gary E GE   Kerlin Meeta Prasad MP   Yuan Yihao Y   Kohn Rachel R   Anesi George L GL   Groeneveld Peter W PW   Werner Rachel M RM   Halpern Scott D SD  

Annals of the American Thoracic Society 20200101 1


<b>Rationale:</b> Increasing intensive care unit (ICU) beds and the critical care workforce are often advocated to address an aging and increasingly medically complex population. However, reducing potentially preventable ICU stays may be an alternative to ensure adequate capacity.<b>Objectives:</b> To determine the proportions of ICU admissions meeting two definitions of being potentially preventable using nationally representative U.S. claims databases.<b>Methods:</b> We analyzed claims from 20  ...[more]

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