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Summary: A study was performed to determine how many patients were receiving treatment considered “futile” or “probably futile” while in the ICU and how much money hospitals lose as a result. The study used an objective definition of ‘futile’ by allowing doctors to make this judgment. A controlled study showed that 11% of ICU patients received futile treatment and 9% received probably futile. The cost of ‘futile’ treatment was $4,000 per day or $21,000 per patient or $2.6 million per three months. The majority of these patients did not lead better lifestyles within 6 months of the treatment. 68% of futile care patients died before being discharged, 16% died within 6 months, and remaining 16% required life-sustaining devices to remain alive. This study shows that better doctor-patient communication is necessary in defining “futile” and determining treatment.

Think About:

1. What can physicians do to improve their communication on futile treatments?
2. What percentage of these patients should go into hospice? How knowledgeable are they about hospice?
3. What conversations should physicians have with the patient and the patient’s family?
4. In the study, did the families consider the treatments to be ‘futile’ as well?

2013 17 9 Post 31b Expensive ICU Cartoon Futile Treatment Given to 1 in 5 ICU Patients

Original Articles, For More Information:

– Journal Article (JAMA): http://archinte.jamanetwork.com/article.aspx?articleid=1735897&resultClick=1
– News: http://thehealthcareblog.com/blog/2013/09/15/what-to-do-about-futile-critical-care/#more-65351
– News: http://www.forbes.com/sites/howardgleckman/2013/09/11/almost-one-in-five-intensive-care-patients-may-be-getting-futile-treatment/

Photos:
http://ksr.wpengine.netdna-cdn.com/wp-content/uploads/2013/01/heartrate.jpg
http://accountablehealthcare.files.wordpress.com/2011/02/ear0372l.jpg