The costs of nonbeneficial treatment in the intensive care setting

Health Aff (Millwood). 2005 Jul-Aug;24(4):961-71. doi: 10.1377/hlthaff.24.4.961.

Abstract

Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU). In this paper we estimated the costs of nonbeneficial treatment using the results from a randomized trial of ethics consultations. We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge. We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Critical Care / economics*
  • Critical Care / ethics
  • Critical Care / statistics & numerical data
  • Decision Making
  • Dissent and Disputes
  • Ethics Consultation / statistics & numerical data*
  • Female
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Intensive Care Units / economics*
  • Intensive Care Units / ethics
  • Length of Stay
  • Life Support Care / economics*
  • Life Support Care / ethics
  • Life Support Care / statistics & numerical data
  • Male
  • Medical Futility*
  • Middle Aged
  • Patient Discharge
  • Survival Analysis
  • United States