ICU sedation, delirium & recovery
Outcome, Process, Utilization, and Cost Measurements of Patients Admitted to the ICU in Hospitals With Vs. Without an Intermediate Care Unit: A Nationwide Inpatient Database Study
Authors' conclusion
The presence of an IMCU in ICU-equipped hospitals was associated with improved patient outcomes and more efficient ICU utilization, with only modest increase in hospitalization costs.
Study context
- Population
- Adults admitted to the ICU in Japanese acute-care hospitals (Diagnosis Procedure Combination database), April 2016–March 2023
- Participants
- 2,278,521 adults · 557 hospitals
- Exposure
- ICU admission to hospitals with vs without an intermediate care unit (IMCU)
- With IMCUn = 1,771,000
- Outcome
- Patient-level outcomes
Methodological detailsnationwide, inpatient database
- Nationwide
- Inpatient database
Main finding
As reported in the abstract
With IMCU vs Without IMCUEstimate (95% CI)
In-hospital mortality
aOR 0.94(0.89–0.99)
ICU mortality
aOR 0.87(0.83–0.92)
ICU readmission
aOR 0.92(0.85–1.00)
ICU LOS
adjusted rate ratio 0.98(0.98–0.99)
Observational data: associations, not effects.
Further findings
| Outcome | Mean difference (%) (95% CI) | |
|---|---|---|
| Hospital-level utilization and costsWith IMCU vs Without IMCU · ICU bed occupancy · cluster-average treatment effect | 5.5 (3.3–7.7%) | |
| −50510Difference, % (linear scale) |
| Outcome | Estimate |
|---|---|
| Hospital-level utilization and costsWith IMCU vs Without IMCU · occupancy for life-sustaining therapies · cluster-average treatment effect | 8.6 % (95% CI 7.7–9.5%) |
| Hospital-level utilization and costsWith IMCU vs Without IMCU · reimbursement rates · cluster-average treatment effect | 5.4 % (95% CI 4.0–6.8%) |
| Hospital-level utilization and costsWith IMCU vs Without IMCU · annual revenue per ICU bed · cluster-average treatment effect | 25 million JPY (95% CI 19-31 million JPY) |
Transfer between ICU and IMCU
- Patients transferred between ICU and IMCU, large variability between hospitals
- 14.3%
Original publication
Outcome, Process, Utilization, and Cost Measurements of Patients Admitted to the ICU in Hospitals With Vs. Without an Intermediate Care Unit: A Nationwide Inpatient Database Study. Crit Care Med. Published 11 November 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →