U.K. Intensivists' Preferences for Patient Admission to ICU: Evidence From a Choice Experiment.

Bassford, Christopher R and Krucien, Nicolas and Ryan, Mandy and Griffiths, Frances E and Svantesson, Mia and Fritz, Zoe and Perkins, Gavin D and Quinton, Sarah and Slowther, Anne-Marie (2019) U.K. Intensivists' Preferences for Patient Admission to ICU: Evidence From a Choice Experiment. Critical care medicine. ISSN 1530-0293. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

OBJECTIVES

Deciding whether to admit a patient to the ICU requires considering several clinical and nonclinical factors. Studies have investigated factors associated with the decision but have not explored the relative importance of different factors, nor the interaction between factors on decision-making. We examined how ICU consultants prioritize specific factors when deciding whether to admit a patient to ICU.

DESIGN

Informed by a literature review and data from observation and interviews with ICU clinicians, we designed a choice experiment. Senior intensive care doctors (consultants) were presented with pairs of patient profiles and asked to prioritize one of the patients in each task for admission to ICU. A multinomial logit and a latent class logit model was used for the data analyses.

SETTING

Online survey across U.K. intensive care.

SUBJECTS

Intensive care consultants working in NHS hospitals.

MEASUREMENTS AND MAIN RESULTS

Of the factors investigated, patient's age had the largest impact at admission followed by the views of their family, and severity of their main comorbidity. Physiologic measures indicating severity of illness had less impact than the gestalt assessment by the ICU registrar. We identified four distinct decision-making patterns, defined by the relative importance given to different factors.

CONCLUSIONS

ICU consultants vary in the importance they give to different factors in deciding who to prioritize for ICU admission. Transparency regarding which factors have been considered in the decision-making process could reduce variability and potential inequity for patients.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WB Practice of medicine > WB400 Intensive care
Divisions: Clinical Support > Critical Care
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 09 Aug 2019 15:11
Last Modified: 09 Aug 2019 15:11
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2300

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