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.

Related Articles


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 December 21, 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 December 21, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Sunday, December 21, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Existing Chemical Compounds Could Revive Failing Antibiotics, Says Danish Scientist

Reuters - Innovations Video Online (Dec. 21, 2014) A team of scientists led by Danish chemist Jorn Christensen says they have isolated two chemical compounds within an existing antipsychotic medication that could be used to help a range of failing antibiotics work against killer bacterial infections, such as Tuberculosis. Jim Drury went to meet him. Video provided by Reuters
Powered by NewsLook.com
Hugging It Out Could Help You Ward Off A Cold

Hugging It Out Could Help You Ward Off A Cold

Newsy (Dec. 21, 2014) Carnegie Mellon researchers found frequent hugs can help people avoid stress-related illnesses. Video provided by Newsy
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