Health Affairs · 2005 · 86 citations · 13 references
NursingHealth Services AdministrationCost-effectiveness AnalysisCritical Care EthicsMedical EthicsConsultation-liaison MedicineEnd-of-life Care EthicsEthical Issues In End-of-life CareHealthcare EthicsHospital EthicsComfort Care OnlyComfort Care PlanningCommunication About Life-sustaining TreatmentCommunication About Nonbeneficial TreatmentDirect Treatment CostsEthics Of Comfort CareEthics Of Nonbeneficial TreatmentUse Of Life-sustaining Treatment
Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU). In this paper we estimated the costs of nonbeneficial treatment using the results from a randomized trial of ethics consultations. We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge. We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.
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