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ICU doctors in the UCLA Health System said they were certain they provided futile care for 11 percent of the critically ill patients they saw over a recent three month period, and they strongly suspected that they had provided futile treatment for another 8.6 percent of patients.
Treatment could never reach the patient's goals (51 percent).
at a major teaching hospital believe they provided futile treatment to about one in five intensive care unit patients, needlessly prolonging their lives.
By Dennis ThompsonTUESDAY, Sept. 10 (HealthDay News) Critical care doctors Adidas Long Sleeve Mens
The reported episodes of definite futile care cost the health system about $2.6 million during the study period, according to an article published online Sept. 9 in JAMA Internal Medicine. Neil Wenger, a professor of medicine and director of the UCLA Healthcare Ethics Center in the David Geffen School of Medicine. "These data suggest that some patients are so sick that even with these tools, doctors recognize they can't make them much better."
Death was imminent (37 percent).
The questionnaire did not go deeper into why "futile" care occurs, and the researchers will next work to identify those factors and consider how they might be minimized.
Wenger offered some possible explanations. "Very often, there hasn't been good enough communication about the fact that a patient won't survive," he said. "Families may be pushing for continued aggressive care, hoping against hope."
Futile Care in ICU a Common Occurrence
The patient would never be able to survive outside an ICU (36 percent).
The average cost for a day of futile treatment in the ICU was about $4,000, the researchers reported. For the 123 patients perceived as definitely receiving futile ICU care, total costs during the three months of the study amounted to $2.6 million.
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"The term 'futile' is one I really abhor," Epstein said. "Instead of 'futile,' I use 'non beneficial care' or 'low yield treatment.' Because futility, like beauty, is in the eye of the beholder. It's totally dependent on your perspective. If you're a loved one at the bedside with someone near and dear to you, your perspective on futility may be different."
At least one expert disagrees with the Adidas T Shirt Long Sleeve study conclusions, however.
Other reasons given included:
The findings are limited because they are based solely on physician perceptions at one academic institution, said Dr. Howard Epstein, chief health systems officer at the Institute for Clinical Adidas Hoodies For Boys
Patients who received futile care "tended to be the patients who were sicker and the patients who were older, and particularly patients who had been transferred in from nursing homes and long term care hospitals," Wenger said.
The study focused on 1,125 patients who received care between Dec. 15, 2011 and March 15, 2012 at one of the UCLA system's five ICUs.
"If this is happening in hospitals across the country, then consumers of health care are not always getting the treatments that are best targeted to their prognosis, and sometimes resources are used inappropriately," Wenger said.
The most common reason doctors perceived an instance of care as futile was that the burdens to the patients, their families and their care providers grossly outweighed the benefits. Doctors cited this as a reason 58 percent of the Black Adidas Tracksuit Men
Doctors were certain that 123 patients had received futile care, and time bore out their assessment 68 percent of those patients died during the hospitalization. Survivors were left in severely compromised health and often dependent on life support.
The critical care specialists treating these patients filled out a brief daily questionnaire asking whether they were providing futile care, defined as intensive care interventions that sustain life without achieving an outcome that the patient can meaningfully appreciate.
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