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Member Research and Reports

Member Research and Reports

Pneumonia Findings Surprise Michigan Researchers; More Research Needed to Figure Out Which Patients Need ICU Care Most

When an older person gets hospitalized for pneumonia, where’s the best place to care for them? New research findings about deaths and health care costs in such patients fly in the face of conventional wisdom – and could change where doctors decide to treat them.

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[Photo: Dr. Andrew Ryan]

Seniors with this common lung infection, the researchers show, had a better chance of surviving if they went to an intensive care unit rather than a general hospital bed.

And despite the ICU’s reputation as a high-cost place to care for patients, the costs to Medicare and hospitals were the same for both groups.

The research, published in the new issue of JAMA by a University of Michigan team including Dr. Andrew Ryan, University of Michigan SPH associate professor, focuses on those patients on the “bubble” – those who doctors could send to either an ICU bed or a general bed depending on their judgment.

Since pneumonia sends hundreds of thousands of seniors to the hospital each year, costing taxpayers billions of dollars, even a small difference in mortality risk and cost for some of those patients could make a big difference. The researchers looked at data from 1.1 million hospital stays at 2,988 hospitals between 2010 and 2012.

“With several recent studies suggesting that too many people are going to the ICU when their risk of death is low, we were surprised that there was a benefit to ICU admission for these patients,” says Dr. Colin Cooke, the study’s senior author and an intensive care specialist and health care researcher at U-M. “Now, our challenge is to do further work to determine just which patients will get the greatest benefit, and to determine what about ICU care makes a difference.”

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