Designing and Evaluating the Establishment of Admission Criteria for Patients in an Intensive Care Unit: A Descriptive Study in Iran

Fariba  Hosseinpour; Mahyar  Sedighi; Fariba Hashemi; Sima  Rafiei

doi:10.18502/jebhpme.v5i2.6554

Fariba Hosseinpour Student Research Center, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
Mahyar Sedighi School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Fariba Hashemi School of Para-medicine, Qazvin University of Medical Sciences, Qazvin, Iran
Sima Rafiei Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran

DOI: https://doi.org/10.18502/jebhpme.v5i2.6554

Keywords: ICU admission, Prioritization, Cost, Mortality, Length of stay

Abstract

Background: A few studies have reviewed and revised ICU admission criteria based on specific circumstances and local conditions. The aim was to develop ICU admission criteria and compare the cost, mortality, and length of stay among identified admission priorities.

Methods: This was a cross-sectional study conducted in an intensive care unit of a training hospital in Qazvin, Iran. The study was conducted among 127 patients admitted to ICU from July to September 2019. The data collection tool was a self-designed checklist, which included items regarding patients' clinical data and their billing, type of diagnosis, level of consciousness at the time of hospitalization based on GCS scale or Glasgow Coma Scale, length of stay, and patient status at the time of discharge. Descriptive statistical tests were used to describe study variables, and in order to determine the relationship between study variables, ANOVA and Chi-square test were used.

Results: A set of criteria were designed to prioritize patient admissions in ICU. Based on the defined criteria, patients were categorized into four groups based on patient's stability, hemodynamic, and respiration. Study findings revealed that a significant percentage of patients were admitted to the ward while in the second and third priorities of hospitalization (26.8 % and 32.3 %, respectively). There was a statistically significant difference in the four groups in terms of patients' age, total cost, and insurance share of the total cost (P-value < 0.05).

Conclusion: Study results emphasize the necessity to classify patients based on defined criteria to efficiently use available resources.