Health care use before and after intensive care unit admission-A nationwide register-based study

Area of Science:

• Critical Care Medicine
• Health Services Research
• Epidemiology

Background:

• Healthcare utilization patterns in patients admitted to intensive care units (ICUs) are not fully understood.
• Previous studies have not comprehensively assessed pre- and post-ICU admission healthcare use.
• Understanding these patterns is crucial for resource allocation and patient management.

Purpose of the Study:

• To describe and compare healthcare utilization of patients before and after intensive care unit (ICU) admission.
• To identify differences in healthcare use between ICU patients and a matched general population.
• To analyze trends in primary and secondary healthcare use following ICU discharge.

Main Methods:

• A register-based study design was employed.
• Included adult patients discharged from the ICU between January 1, 2011, and December 31, 2014.
• A sex- and age-matched reference population not admitted to ICU was used for comparison. Outcomes included hospital admissions, general practitioner contacts, emergency service use, and municipality services up to 3 years post-ICU.

Main Results:

• The study included 82,384 ICU patients and an equal number of reference individuals.
• ICU patients had higher rates of hospital admission (51% vs. 15%) and general practitioner contact (97% vs. 89%) in the year preceding ICU admission.
• Significantly more ICU patients had a Charlson comorbidity score of 5+ (18% vs. 4%) compared to the reference group.

Conclusions:

• Intensive care unit (ICU) patients exhibit increased primary and secondary healthcare utilization.
• This heightened healthcare use is evident both before ICU admission and for several years afterward.
• The observed increase in healthcare utilization remains significant even after adjusting for comorbidities and socioeconomic factors.