For the study, researchers analyzed clinical notes for 46,146 admissions to the intensive care unit at Boston-based Beth Israel Deaconess Medical Center between June 1, 2001, and Oct. 31, 2012. About 1,936 patients (4 percent) had at least one clinical note highlighting financial considerations.
Researchers found longer hospital stays were significantly associated with financial notes. Of the 46,146 total admissions, 142 involved clinical notes that highlighted a change in the discharge plan, 142 outlined a change in the treatment plan, and 303 described a medication change or past nonadherence due to financial restraints.
“In this study, among patients in the ICU, clinical notes document the association of financial considerations with care decisions,” the researchers concluded. “Although such notes likely underestimate the frequency of such considerations, they highlight the need to develop better systematic approaches to understanding how financial constraints may alter care decisions in U.S. health systems.”
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