Notes reflecting financial considerations ID'd in ICU

(HealthDay)—Among patients in the intensive care unit (ICU), 4.2 percent of admissions have at least one note reflecting financial considerations, according to a study published online Nov. 2 in JAMA Network Open.

Deborah D. Gordon, M.B.A., from the Harvard Kennedy School in Cambridge, Massachusetts, and colleagues characterized the prevalence and nature of financial considerations documented in narrative clinical records. Data were analyzed from individuals hospitalized from June 1, 2001, to Oct. 31, 2012; 46,146 index ICU admissions were included.

The researchers found that 4.2 percent of the admissions had at least one note reflecting financial considerations during the ICU stay. Mean length of stay was 21.7 and 9.2 days for patients with at least one note and for those without a note, respectively. Of the total admissions, 0.3, 0.3, and 0.7 percent, respectively, included notes describing a change in the discharge plan, a change in the treatment plan, and a change in medication or previous nonadherence to medication associated with financial considerations. Longer hospital stays were significantly associated with the presence of financial notes after adjustment for age, sex, marital status, and insurance type (odds ratio, 1.01; 95 percent confidence interval, 1.01 to 1.01).

"This study represents a necessary first step in understanding how frequently financial considerations explicitly alter care in hospital settings and how such considerations may be associated with sociodemographic features," the authors write.

One author disclosed financial ties to medical startup, biotechnology, and venture capital companies.

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