New guidelines for ICU admissions aim to curb inflated bills and ensure ethical treatment

In welcome relief to millions of people who get duped by unscrupulous hospitals, the Government has finally woken up to certain malpractices and issued guidelines for ICU admissions. It is common knowledge that many private hospitals overcharge patients by admitting them into intensive care units (ICU) even if the patient does not need it or is terminally ill. In a bid to regulate and put a check on such malpractices, the Union Health Ministry has recently issued comprehensive guidelines for ICU admissions. These guidelines, developed by a panel of 24 eminent physicians, aim to ensure transparency, ethical practices and prioritised care based on medical criteria.The new guidelines emphasise that these admissions be determined by objective medical criteria, specifically focusing on organ failure and the need for organ support. Parameters such as blood pressure, respiratory rate, breathing pattern, heart rate, oxygen saturation, urine output and neurological status should be constantly monitored in patients awaiting an ICU bed. Furthermore, the guidelines explicitly state that critically ill patients should not be admitted to the ICU if there is refusal from the patient or relatives. Additionally, patients with a treatment limitation plan due to any existing disease, those with a living will or advanced directive against ICU care, and terminally ill patients with a medical judgment of futility should also be excluded from ICU admission.

The guidelines extend to the discharge criteria from the ICU, emphasising the importance of returning physiological aberrations to near-normal or baseline status. The resolution and stability of the acute illness that led to ICU admission are deemed necessary for discharge. Moreover, patient and family agreement for ICU discharge for either a treatment-limiting decision or palliative care is considered crucial. The Government’s decision to rein in errant private hospitals is a much-awaited move that should have come much earlier. During the pandemic, there were numerous cases when hospitals admitted patients in ICUs without caring for them and charging them exorbitantly. While the guidelines are aimed at improving the overall healthcare system, there is need to go deeper. Many a time, unnecessary tests are prescribed which must be done at a hospital itself or its partner lab. But the latest is a step in the right direction. The guidelines are a response to the growing concern of exorbitant bills and unjustified ICU admissions. Inflating ICU bills has become a prevalent issue, and the guidelines seek to address this by promoting transparency, accountability and patient-centric practices. The Ministry's guidelines for ICU admissions mark a significant step towards ensuring ethical practices in hospitals. By placing strong emphasis on objective medical criteria and obtaining prior consent from patients, the guidelines aim to prioritise patient well-being over financial considerations. It is hoped that these measures will lead to a more transparent and patient-centric healthcare system, fostering trust between public and healthcare providers.