Fair allocation of intensive care unit resources

P. N. Lanken, P. B. Terry, D. C. Adler, J. A. Brooks-Brunn, S. W. Crawford, M. Danis, A. J. Fedullo, J. E. Gottlieb, J. Hansen-Flaschen, M. H. Kollef, F. Lemaire, J. M. Luce, Molly Osborne, H. L. Paz, Jr Popovitch J., T. A. Raffin, C. L. Rice, T. R. Rogers, M. J. Rosen, G. D. RubenfeldJ. H. Shelhamer, W. J. Sibbald, G. L. Snider, J. L. Stauffer, R. D. Truog, J. E. Vincent, B. S. Wilfond

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

American Thoracic Society (ATS) members, as health care practitioners caring for critically ill patients in intensive care units (ICUs) or as ICU directors commonly must make decisions that allocate ICU resources. Some decisions necessitate prioritization of iCU beds while others limit access to particular scarce resources. Although these decisions arise when providing medical care for ICU patients, they occur in a larger context that includes ethical, economic, social, and legal considerations. In this context health care systems in the United States and in other countries face the consequences of increasing demand for expensive health care services in times of limited financial resources and competing societal needs. If one accepts the premise that demand for health care resources will inevitably outstrip financial constraints one then must face the basic question of how to allocate those resources fairly. How health care organizations will meet increasing demand for services within financial constraints raises specific questions relating to the fair allocation of ICU resources: 1. What criteria should be used to select patients for ICU ad- mission and discharge? 2. How will heath care institutions deal with the non-reimbursed costs of treating uninsured patients in an ICU? 3. How should a health care system decide to allocate its resources for ICUs? 4. Critical care physicians and ICU directors may find themselves with personal economic incentives to limit costs by restricting access to ICU resources. How should they deal with this potential conflict of interest?.

Original languageEnglish (US)
Pages (from-to)1282-1301
Number of pages20
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume156
Issue number4 I
StatePublished - 1997
Externally publishedYes

Fingerprint

Intensive Care Units
Delivery of Health Care
Economics
Costs and Cost Analysis
Conflict of Interest
Health Resources
Critical Care
Critical Illness
Health Services
Motivation
Patient Care
Organizations
Physicians

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Lanken, P. N., Terry, P. B., Adler, D. C., Brooks-Brunn, J. A., Crawford, S. W., Danis, M., ... Wilfond, B. S. (1997). Fair allocation of intensive care unit resources. American Journal of Respiratory and Critical Care Medicine, 156(4 I), 1282-1301.

Fair allocation of intensive care unit resources. / Lanken, P. N.; Terry, P. B.; Adler, D. C.; Brooks-Brunn, J. A.; Crawford, S. W.; Danis, M.; Fedullo, A. J.; Gottlieb, J. E.; Hansen-Flaschen, J.; Kollef, M. H.; Lemaire, F.; Luce, J. M.; Osborne, Molly; Paz, H. L.; Popovitch J., Jr; Raffin, T. A.; Rice, C. L.; Rogers, T. R.; Rosen, M. J.; Rubenfeld, G. D.; Shelhamer, J. H.; Sibbald, W. J.; Snider, G. L.; Stauffer, J. L.; Truog, R. D.; Vincent, J. E.; Wilfond, B. S.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 156, No. 4 I, 1997, p. 1282-1301.

Research output: Contribution to journalArticle

Lanken, PN, Terry, PB, Adler, DC, Brooks-Brunn, JA, Crawford, SW, Danis, M, Fedullo, AJ, Gottlieb, JE, Hansen-Flaschen, J, Kollef, MH, Lemaire, F, Luce, JM, Osborne, M, Paz, HL, Popovitch J., J, Raffin, TA, Rice, CL, Rogers, TR, Rosen, MJ, Rubenfeld, GD, Shelhamer, JH, Sibbald, WJ, Snider, GL, Stauffer, JL, Truog, RD, Vincent, JE & Wilfond, BS 1997, 'Fair allocation of intensive care unit resources', American Journal of Respiratory and Critical Care Medicine, vol. 156, no. 4 I, pp. 1282-1301.
Lanken PN, Terry PB, Adler DC, Brooks-Brunn JA, Crawford SW, Danis M et al. Fair allocation of intensive care unit resources. American Journal of Respiratory and Critical Care Medicine. 1997;156(4 I):1282-1301.
Lanken, P. N. ; Terry, P. B. ; Adler, D. C. ; Brooks-Brunn, J. A. ; Crawford, S. W. ; Danis, M. ; Fedullo, A. J. ; Gottlieb, J. E. ; Hansen-Flaschen, J. ; Kollef, M. H. ; Lemaire, F. ; Luce, J. M. ; Osborne, Molly ; Paz, H. L. ; Popovitch J., Jr ; Raffin, T. A. ; Rice, C. L. ; Rogers, T. R. ; Rosen, M. J. ; Rubenfeld, G. D. ; Shelhamer, J. H. ; Sibbald, W. J. ; Snider, G. L. ; Stauffer, J. L. ; Truog, R. D. ; Vincent, J. E. ; Wilfond, B. S. / Fair allocation of intensive care unit resources. In: American Journal of Respiratory and Critical Care Medicine. 1997 ; Vol. 156, No. 4 I. pp. 1282-1301.
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AU - Terry, P. B.

AU - Adler, D. C.

AU - Brooks-Brunn, J. A.

AU - Crawford, S. W.

AU - Danis, M.

AU - Fedullo, A. J.

AU - Gottlieb, J. E.

AU - Hansen-Flaschen, J.

AU - Kollef, M. H.

AU - Lemaire, F.

AU - Luce, J. M.

AU - Osborne, Molly

AU - Paz, H. L.

AU - Popovitch J., Jr

AU - Raffin, T. A.

AU - Rice, C. L.

AU - Rogers, T. R.

AU - Rosen, M. J.

AU - Rubenfeld, G. D.

AU - Shelhamer, J. H.

AU - Sibbald, W. J.

AU - Snider, G. L.

AU - Stauffer, J. L.

AU - Truog, R. D.

AU - Vincent, J. E.

AU - Wilfond, B. S.

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