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Pneumonia findings surprise researchers



Surprisingly, the intensive care unit may be a cost-effective place to care for some pneumonia patients, according to a recent VA-University of Michigan study.
Surprisingly, the intensive care unit may be a cost-effective place to care for some pneumonia patients, according to a recent VA-University of Michigan study. (Photo: ©iStock/XiXinXing)

Surprisingly, the intensive care unit may be a cost-effective place to care for some pneumonia patients, according to a recent VA-University of Michigan study. (Photo: ©iStock/XiXinXing)

Pneumonia is common among older Americans, and sends hundreds of thousands of seniors to the hospital each year.

A recent study by VA researchers and researchers with the University of Michigan Medical School, featured on EurekAlert, found that many seniors with this lung infection had a better chance of surviving if they went to an intensive care unit instead of a general hospital bed—and that despite ICUs' reputation as a high-cost place to care for patients, the costs to Medicare and hospitals were the same for both groups.

The research, funded by VA, NIH, and the Agency for Healthcare Research and Quality, was published in the Sept. 22/29 issue of the Journal of the American Medical Association. Researchers looked at data from 1.1 million hospital stays at nearly 3,000 hospitals between 2010 and 2012. They focused on patients on the "bubble"—those whom doctors could send to either an ICU bed or a general bed, depending on their judgment.

The findings do not apply to patients who clearly need an ICU, such as those who cannot breathe on their own, or to those who have low risk of developing complications from pneumonia in the hospital.

Dr. Colin Cooke of the VA Ann Arbor Healthcare System and the University of Michigan Medical School, the study's senior author, was quoted as saying, "With several recent studies suggesting that too many people are going to the ICU when their risk of death is low, we were surprised that there was a benefit to ICU admission for these patients."

He added: "It's very rare in medicine that we find something that saves lives and doesn't cost more. But perhaps this is one of them."

The team is now evaluating if the ICU is beneficial for other conditions, including chronic obstructive pulmonary disease, congestive heart failure, and heart attack. They hope to do more to determine what characteristics made pneumonia patients most likely to do well after an ICU stay, and what factors make hospitals more or less likely to put "discretionary" pneumonia patients in an ICU bed.


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