Featured Research

from universities, journals, and other organizations

Providing futile treatment prevents other patients from receiving the critical care they need

Date:
August 20, 2014
Source:
University of California, Los Angeles (UCLA), Health Sciences
Summary:
Providing futile treatment in the intensive care unit sets off a chain reaction that causes other ill patients needing medical attention to wait for critical care beds, according to a study. The study is the first to show that when unbeneficial medical care is provided, others who might be able to benefit from treatment are harmed, said the study's lead author.

Providing futile treatment in the intensive care unit sets off a chain reaction that causes other ill patients needing medical attention to wait for critical care beds, according to a study by researchers from UCLA and RAND Health.

The study is the first to show that when unbeneficial medical care is provided, others who might be able to benefit from treatment are harmed, said study lead author Dr. Thanh Huynh, an assistant professor of medicine in the division of pulmonary and critical care medicine at the David Geffen School of Medicine at UCLA.

The findings also have implications for the fairness of the American healthcare system, and points toward needed policy improvements to more efficiently use limited healthcare resources, said senior author Dr. Neil S. Wenger, a UCLA professor of medicine, a RAND Health scientist and director of the UCLA Health Ethics Center at the David Geffen School of Medicine at UCLA.

"Many people do not realize that there is a tension between what medicine is able to do and what medicine should do. Even fewer realize that medicine is commonly used to achieve goals that most people, and perhaps most of society, would not value - such as prolonging the dying process in the intensive care unit when a patient cannot improve," Wenger said. "But almost no one recognizes that these actions affect other patients, who might receive delayed care or, worse, not receive needed care at all because futile medical treatment was provided to someone else."

The study appears in the August issue of the peer-reviewed journal Critical Care Medicine.

For the study, the research team surveyed critical care physicians in five ICUs in one health system to identify patients that the clinicians identified as receiving treatment that would not help them get better. They then identified days when an ICU was full and contained at least one patient receiving futile treatment and looked at the number of patients waiting for ICU admission for more than four hours in the emergency department or more than one day for transfer from an outside hospital.

The study showed that on 16% of days when an ICU was full, it contained at least one patient receiving futile treatment. During those days, 33 patients were kept in the emergency department for more than four hours, nine patients waited more than one day to be transferred from an outside hospital and 15 patients canceled their transfer request after waiting more than one day. Two patients died at outside hospitals while waiting to be transferred into the academic medical center ICU.

"These findings should contribute to the public debate about the use of limited healthcare resources and whether limitations should be placed on using those resources for treatments that physicians feel will not benefit patients," Wenger said. "To date, healthcare payers have been willing to pay for any life-sustaining treatment that has already been started and the public has been unwilling to discuss the trade-offs silently made between patients receiving futile treatment and patients not receiving the treatment they need. This study demonstrates that those trade-offs occur and can be measured."

Huynh said that going forward, the research team hopes to develop interventions to decrease instances of hospitals providing critical care to patients for whom there will be no benefit.

"With advances in medicine and technology, the ICU is now able to save lives as well as prolong the dying process," Huynh said. "Because resources are not unlimited, patients receiving futile treatment can mean delayed or even denied access to care for other patients in need. This needs to change."

"It is unjust when a patient is unable to access intensive care because ICU beds are occupied by patients who cannot benefit from such care. Our findings are particularly relevant in the U.S., but are also instructive elsewhere given universal concerns regarding providing treatments that are non-beneficial," the study states. "The ethic of 'first come, first served' is not only inefficient and wasteful, but it is contrary to medicine's responsibility to apply healthcare resources to best serve society. In the context of healthcare reform, which aims to more justly distribute medical care to the nation, opportunity cost is one more reason that futile treatment should be minimized."


Story Source:

The above story is based on materials provided by University of California, Los Angeles (UCLA), Health Sciences. Note: Materials may be edited for content and length.


Journal Reference:

  1. Thanh N. Huynh, Eric C. Kleerup, Prince P. Raj, Neil S. Wenger. The Opportunity Cost of Futile Treatment in the ICU*. Critical Care Medicine, 2014; 42 (9): 1977 DOI: 10.1097/CCM.0000000000000402

Cite This Page:

University of California, Los Angeles (UCLA), Health Sciences. "Providing futile treatment prevents other patients from receiving the critical care they need." ScienceDaily. ScienceDaily, 20 August 2014. <www.sciencedaily.com/releases/2014/08/140820091054.htm>.
University of California, Los Angeles (UCLA), Health Sciences. (2014, August 20). Providing futile treatment prevents other patients from receiving the critical care they need. ScienceDaily. Retrieved October 1, 2014 from www.sciencedaily.com/releases/2014/08/140820091054.htm
University of California, Los Angeles (UCLA), Health Sciences. "Providing futile treatment prevents other patients from receiving the critical care they need." ScienceDaily. www.sciencedaily.com/releases/2014/08/140820091054.htm (accessed October 1, 2014).

Share This



More Health & Medicine News

Wednesday, October 1, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Ebola Cases Keep Coming for Monrovia's Island Hospital

Ebola Cases Keep Coming for Monrovia's Island Hospital

AFP (Oct. 1, 2014) A look inside Monrovia's Island Hospital, a key treatment centre in the fight against Ebola in Liberia's capital city. Duration: 00:34 Video provided by AFP
Powered by NewsLook.com
Ebola Puts Stress on Liberian Health Workers

Ebola Puts Stress on Liberian Health Workers

AP (Oct. 1, 2014) The Ebola outbreak is putting stress on first responders in Liberia. Ambulance drivers say they are struggling with chronic shortages of safety equipment and patients who don't want to go to the hospital. (Oct. 1) Video provided by AP
Powered by NewsLook.com
Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Doctors Reassure Public Ebola Patient Won't Cause Outbreak

Newsy (Sep. 30, 2014) After the announcement that the first U.S. patient had been diagnosed with Ebola, doctors were quick to say a U.S. outbreak is highly unlikely. Video provided by Newsy
Powered by NewsLook.com
TX Hospital Confirms Patient Admitted With Ebola

TX Hospital Confirms Patient Admitted With Ebola

AP (Sep. 30, 2014) Medical officials from Texas Health Presbyterian Hospital confirm they are treating a patient with the Ebola virus, the first case found in the US. (Sept. 30 Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins