ArticleAmerican journal of respiratory and critical care medicine2016
Rising Billing for Intermediate Intensive Care among Hospitalized Medicare Beneficiaries between 1996 and 2010.
Article in American journal of respiratory and critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
What it found
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The trial behind it
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Who cites it
34 citing papers in PubMed.
- Outcomes of patients with hypertensive emergency managed in intensive vs intermediate care settings: a multihospital retrospective cohort study.Annals of the American Thoracic Society · 2026Observational
- Intensive Care Unit Admissions Purchased or Delivered by Veterans in the VA Health Care System.JAMA health forum · 2025Article
- Health Insurance and Interhospital Transfer for Critically Ill Patients With Respiratory Failure.JAMA network open · 2025Article
- Heterogeneity of Intermediate Care Organization Within a Single Healthcare System.Critical care explorations · 2025Article
- Rural-Urban Differences in Mortality among Mechanically Ventilated Patients in Intensive and Intermediate Care.Annals of the American Thoracic Society · 2024Article
- Comparison of Critical Illness Score in Patients Admitted to Intermediate Care Units of a Tertiary Care Hospital: A Comparative Cross-Sectional Study from Karachi, Pakistan.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2024Article
- [A clinical study of high dependency units to reduce ICU readmission rates in patients with severe liver disease].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.Intensive care medicine · 2023Article
- Delay in ICU transfer is protective against ICU readmission in trauma patients: a naturally controlled experiment.Trauma surgery & acute care open · 2021Article
- Performance of Critical Care Outcome Prediction Models in an Intermediate Care Unit.Journal of intensive care medicine · 2020Article
- Goldilocks, the Three Bears and Intensive Care Unit Utilization: Delivering Enough Intensive Care But Not Too Much. A Narrative Review.Pulmonary therapy · 2020Review
- The Impact of Step-Down Unit Care on Patient Outcomes After ICU Discharge.Critical care explorations · 2020Article
- Medical surveillance unit: patient characteristics, outcome, and quality of care in Saskatchewan, Canada.BMC research notes · 2020Article
- Measuring racial segregation in health system networks using the dissimilarity index.Social science & medicine (1982) · 2019Article
- Effects of Changes in ICU Bed Supply on ICU Utilization.Medical care · 2019Article
- Intensive care use and mortality among patients with ST elevation myocardial infarction: retrospective cohort study.BMJ (Clinical research ed.) · 2019Article
- Observational
- ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.Critical care medicine · 2019Article
- Observational
- Estimating ICU Benefit: A Randomized Study of Physicians.Critical care medicine · 2019Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
rationaleIntermediate care (i.e., step-down or progressive care) is an alternative to the intensive care unit (ICU) for patients with moderate severity of illness. The adoption and current use of intermediate care is unknown.
objectivesTo characterize trends in intermediate care use among U.S. hospitals.
methodsWe examined 135 million acute care hospitalizations among elderly individuals (≥65 yr) enrolled in fee-for-service Medicare (U.S. federal health insurance program) from 1996 to 2010. We identified patients receiving intermediate care as those with intensive care or coronary care room and board charges labeled intermediate ICU. MEASUREMENTS AND MAIN
resultsIn 1996, a total of 960 of the 3,425 hospitals providing critical care billed for intermediate care (28%), and this increased to 1,643 of 2,783 hospitals (59%) in 2010 (P < 0.01). Only 8.2% of Medicare hospitalizations in 1996 were billed for intermediate care, but billing steadily increased to 22.8% by 2010 (P < 0.01), whereas the percentage billed for ICU care and ward-only care declined. Patients billed for intermediate care had more acute organ failures diagnoses codes compared with general ward patients (22.4% vs. 15.8%). When compared with patients billed for ICU care, those billed for intermediate care had fewer organ failures (22.4% vs. 43.4%), less mechanical ventilation (0.9% vs. 16.7%), lower mean Medicare spending ($8,514 vs. $18,150), and lower 30-day mortality (5.6% vs. 16.5%) (P < 0.01 for all comparisons).
conclusionsIntermediate care billing increased markedly between 1996 and 2010. These findings highlight the need to better define the value, specific practices, and effective use of intermediate care for patients and hospitals.
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