Risk of Death Influences Regional Variation in Intensive Care Unit Admission Rates among the Elderly in the United States

Colin R Cooke

PLOS ONE, 2016, vol. 11, issue 11, 1-12

Abstract: Rationale: The extent to which geographic variability in ICU admission across the United States is driven by patients with lower risk of death is unknown. Objectives: To determine whether patients at low to moderate risk of death contribute to geographic variation in ICU admission. Methods: Retrospective cohort of hospitalizations among Medicare beneficiaries (age > 64 years) admitted for ten common medical and surgical diagnoses (2004 to 2009). We examined population-adjusted rates of ICU admission per 100 hospitalizations in 304 health referral regions (HRR), and estimated the relative risk of ICU admission across strata of regional ICU and risk of death, adjusted for patient and regional characteristics. Measurement and Main Results: ICU admission rates varied nearly two-fold across HRR quartiles (quartile 1 to 4: 13.6, 17.3, 20.0, and 25.2 per 100 hospitalizations, respectively). Observed mortality for patients in regions (quartile 4) with the greatest ICU use was 17% compared to 21% in regions with lowest ICU use (quartile 1) (p

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0166933

DOI: 10.1371/journal.pone.0166933

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