Influence of political power, medical provincialism, and economic incentives on the rationing of surgical intensive care unit beds

Rationing critical care beds: A systematic review*

“…Five studies compared cohorts of patients either admitted to ICU or refused ICU admission (triaging studies) (9,14,17,19,21), three studies compared patients admitted to an ICU (13,16,20) during periods of variable ICU bed availability (rationing studies), one study included patients refused ICU admission during a period of bed closure (18) (single cohort study), and in one study a cohort of patients studied was admitted to the ICU during a period of bed closure (15) (single cohort study).…”

Intensive Care Unit Bed Availability and Outcomes for Hospitalized Patients With Sudden Clinical Deterioration

“…Patient age, illness severity, and medical diagnosis were noted to be associated with decisions not to admit patients to the ICU. 5,[31][32][33][34][35] Our study adds to the literature in several ways. First, we demonstrate that the decision to admit a hospitalized patient with sudden clinical deterioration to the ICU is influenced by the number of ICU beds available.…”

Triage decisions for intensive care in terminally ill patients

“…ICU triage decision making may also be problematic because of the intensivists' conflict of interest as the ICU patient's advocate and as the institutional gatekeeper [41]. Bed allocation across surgical services has been shown to be influenced by factors other than medical suitability including political power, medical provincialism, and income maximization [55].…”