Critical care patients have major health and financial problems 12 months after discharge, finds study

BMJ 2013; 346 doi: (Published 28 May 2013) Cite this as: BMJ 2013;346:f3451
  1. Zosia Kmietowicz
  1. 1BMJ

Patients who have been treated in a high dependency unit for more than two days face serious social and medical problems 12 months after their discharge, a study has found.

Nearly three quarters (73%) of 293 patients who were surveyed said that they had moderate or severe pain a year after leaving hospital, and nearly half (44%) had significant anxiety or depression. About half of the patients had some problems with mobility 12 months after discharge that they didn’t have before they went to hospital.1

The patients had been admitted to one of 22 UK hospitals between August 2008 and February 2010 and been treated for at least 48 hours in level 3 dependency care, defined as critical care for multi-system organ failure. They completed two questionnaires about their health, social, and economic circumstances six and 12 months after being discharged. The study was carried out by the Intensive Care Aftercare Network, a group of healthcare professionals with an interest in improving the long term outlook for survivors of critical illness.

Most of the patients did not experience a change in their relationship or housing after their time in hospital, but a third (33%) reported an effect on their earning ability six months later, because they lost their job, took early retirement, switched to working part time, or took long term sick leave. Twelve months after discharge this was still the case for 28% of patients.

Critical illness also affected the earning ability of other family members, with a third (32%) of families reporting a reduction in their monthly income at 12 months.

Care needs of the patients after discharge from hospital were also found to be high. A quarter of patients (25%) needed help with activities of daily living at six months after discharge, and this proportion had fallen only slightly to 22% at 12 months.

Most of the care to these patients (80%) was provided by a family member, and in 23 cases (8%) a family member was unable to work or had to reduce their working hours 12 months after the patient came home. About a third of patients who needed care had to delve into their savings, borrow money, or sell their house to pay for care.

Commenting on the findings, Barry Williams, a member of the critical care patient liaison committee of the Intensive Care Society, said, “There is often little or no support for these people once discharged from hospital.”

He urged the Department of Health for England and the UK Department for Work and Pensions to work with the society to “produce a policy to deal with the problems documented by a well designed and properly conducted survey.”


Cite this as: BMJ 2013;346:f3451


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