Investigation of inappropriate use of intensive care units: A study on a university hospital

With the increasing globalization, societies tend to age, and the increase in diseases causes the need for intensive care units to increase continuously. The primary purpose of this study is to determine the factors affecting this by examining unnecessary hospitalizations, prolonged intensive care unit durations, and hospitalization periods of patients in Hacettepe University Hospital, Department of Internal Medicine and Anesthesiology Department. The study examined unnecessary intensive care hospitalization according to priority, diagnosis, and objective parameters models, and prolonged intensive care duration was determined as ≥14 days. The study was conducted retrospectively on 343 patients hospitalized in Hacettepe University Anesthesiology and Reanimation Department and Internal Medicine intensive care units. A stratified random sampling method was used to select the sample. According to the priority model, 7.3% of the patients; according to the diagnostic model, 14.6%; and according to the objective parameters model, 16.3% of the patients were found to be inappropriate. According to the priority model, the patient's suitability for hospitalization is determined by the gender of the patient, the time of admission to the intensive care unit and the referring unit, the title, and gender of the physician according to the diagnosis model, the time of access to the intensive care unit and the referring unit, and the identification and gender of the physician according to the objective parameters model, the age of the patient and the referring team. Was found to be significantly affected (p<0.05). In terms of unacceptable intensive care level, 72.3% of the patients received service at the inappropriate intensive care level, and this was significantly affected by the title of the physician (p<0.05), and 14.6% of the patients were 14 days or more in terms of prolonged hospitalization. He was hospitalized for a long time, significantly affected by the duration of the mechanical ventilator and antibiotic/mycotic treatment (p<0.05). It was observed that the mean hospitalization period of intensive care patients was 7.1 ± 9.1, and it was affected by mechanical ventilation status, automatic ventilation duration, duration of hospitalization before intensive care, vasoactive agent usage status, blood transfusion time, course of antibiotic/mycotic treatment. It is thought that the study's findings will be important in understanding the problem of unnecessary and prolonged hospitalization among intensive care patients and developing appropriate managerial and clinical measures.