ICU end-of-life care rated better than in other VA hospital units

Families of patients who died rate the quality of end-of-life care in the intensive care unit higher than in other hospital units, according to a study in the American Journal of Respiratory and Critical Care Medicine.

Researchers from Philadelphia-based Penn Medicine analyzed clinical data and bereavement surveys from the family members of more than 28,000 patients who died in Veterans Administration acute care hospitals between 2010 and 2016. The patients received care in and
outside the ICU, and some received care in both.

They found that 56.6 percent of family members of deceased patients who received care only in the ICU rated overall care as excellent versus 48.1 percent of family members of deceased patients who did not receive ICU care. Additionally, care in the ICU was associated with more reports of patients having their pain controlled (51.3 percent) compared to those outside the ICU (46.7 percent).

Among patients who received care both in and outside the ICU, an increase in ICU time was linked to better ratings for care quality.

"That actually provides the most compelling evidence that ICU care is associated with better end-of-life quality because we found that the greater the proportion of time spent in the ICU, the higher the quality of end-of-life care," said Scott D. Halpern, MD, PhD, senior study author and director of the Palliative and Advanced Illness Research Center at Penn Medicine.


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