Based on these guidelines developed by a team of 24 experts, it is now up to the family to decide whether to admit a patient to the ICU or not. Understanding these guidelines can help you navigate hospitalization, assert your rights, and engage in meaningful discussions with your doctor. ICU admission criteria include organ failure, worsening medical condition, impaired consciousness, abnormal symptoms, need for ventilator support for respiratory distress, need for continuous monitoring, worsening of illness, or past major surgery.
On the other hand, some patients cannot be admitted to the ICU if the family objects, if the patient wishes not to be admitted, if medical facilities are unlikely, or in emergency situations with limited beds where priority is required.
These guidelines, developed by a team led by critical care expert Dr RK Mani, provide insight into how ICU beds differ from regular beds and the basis for admitting patients. It was in response to cases like Kolkata where denial of a patient’s ICU admission led to tragic consequences, prompting the government to establish these guidelines in 2016.
The guidelines clearly state that if the family believes that hospitalization will not improve the patient’s condition, they have the option of taking the patient home, although financial constraints may influence this decision. The hospital is responsible for monitoring vital signs until an ICU bed becomes available.
In India, of over 20 lakh hospital beds, there are only 1.25 lakh ICU beds. Despite the government fixing a maximum of Rs 5400 for ICU care for central government employees in April 2023, the average cost of an ICU bed in a private hospital ranges from Rs 30,000 to Rs 1 lakh per day.
These guidelines, though not a definitive solution, provide some empowerment to patients’ families to address the challenges of obtaining ICU admission and the associated financial burden in India, where more than 48 percent of people take loans for treatment.