ReviewThe Lancet. Respiratory medicine2019
Understanding irresponsible use of intensive care unit resources in the USA.
Review in The Lancet. Respiratory medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Impact of Different COVID-19 Pandemic Phases on Emergency Department Length of Stay and Intensive Care Unit Admission Risk: Single-Center Retrospective Cohort Study.JMIR public health and surveillance · 2026Article
- Beyond bed counts: equity and access to adult intensive care in middle-income countries, the Brazilian case.Critical care science · 2026Article
- Applying journey mapping and human-centered design to improve critical care delivery for patients with acute respiratory failure.BMC health services research · 2025Article
- Building the future of ICU care: Is our digital foundation strong enough? A multicentre survey of Australian and New Zealand intensive care units.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2025Article
- Trends in use of intensive care during hospitalizations at the end-of-life among older adults with advanced cancer.Journal of the American Geriatrics Society · 2024Article
- Triage of Critically Ill Patients: Characteristics and Outcomes of Patients Refused as Too Well for Intensive Care.Journal of clinical medicine · 2023Article
- Among-Hospital Variation in Intensive Care Unit Admission Practices and Associated Outcomes for Patients with Acute Respiratory Failure.Annals of the American Thoracic Society · 2023Article
- Association of ICU Admission and Outcomes in Sepsis and Acute Respiratory Failure.American journal of respiratory and critical care medicine · 2022Article
- Evaluation of Time-Limited Trials Among Critically Ill Patients With Advanced Medical Illnesses and Reduction of Nonbeneficial ICU Treatments.JAMA internal medicine · 2021Article
- Sharing ICU Patient Data Responsibly Under the Society of Critical Care Medicine/European Society of Intensive Care Medicine Joint Data Science Collaboration: The Amsterdam University Medical Centers Database (AmsterdamUMCdb) Example.Critical care medicine · 2021Article
- Association of an Emergency Department-embedded Critical Care Unit with Hospital Outcomes and Intensive Care Unit Use.Annals of the American Thoracic Society · 2020Article
- Long-term mortality and costs following use of Impella® for mechanical circulatory support: a population-based cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2020Article
- Association of a Novel Index of Hospital Capacity Strain with Admission to Intensive Care Units.Annals of the American Thoracic Society · 2020Article
- The Urge to Build More Intensive Care Unit Beds and Ventilators: Intuitive but Errant.Annals of internal medicine · 2020Article
- Long-term survival and costs following extracorporeal membrane oxygenation in critically ill children-a population-based cohort study.Critical care (London, England) · 2020Article
- Ethical considerations about artificial intelligence for prognostication in intensive care.Intensive care medicine experimental · 2019Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Use of intensive care unit (ICU) resources in the USA far outpaces that of other countries. This increased use is not accompanied by superior clinical outcomes and is at times discordant with patient desires. This Series paper seeks to identify major drivers of ICU resource use in the USA, and to offer steps towards better aligning ICU resource use with clinical needs and patient preferences. After considering several factors, such as organisational, ethical, and economic factors, we suggest that there are four intersecting drivers of irresponsible use of ICU resources in the USA: first, excess ICU bed capacity and a scarcity of data to understand which patients that truly benefit from ICU compared with ward care; second, clinicians misinterpreting the goals and means of patient autonomy; third, an extreme fear of rationing by the general public; and fourth, fee-for-service driven use of advanced medical technologies and procedures that beget ICU expansion.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.