Poorer, less educated patients have 60% higher ICU death risk, Dutch study finds

Patients from lower socioeconomic backgrounds are nearly 60% more likely to die in the intensive care unit than those with higher social status, according to a study analyzing over half a million Dutch ICU admissions between 2014 and 2022. The research, conducted by intensivists from Maastricht UMC+ and Amsterdam UMC, found that even after accounting for factors like age, gender, and illness severity, socioeconomic status remained a significant predictor of survival.

Intensivist Bas van Bussel noted the stark disparity: "Where someone lives partly determines whether they survive the ICU, even though the patient receives all necessary ICU treatments. That is quite strange? There is a part that we as doctors cannot control." Initially, researchers considered lifestyle factors like smoking and drinking, or pre-existing conditions such as COPD, as potential explanations. However, a significant difference persisted even when these factors were excluded, pointing to deeper societal influences.

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Where someone lives partly determines whether they survive the ICU, even though the patient receives all necessary ICU treatments. That is quite strange? There is a part that we as doctors cannot control.

Van Bussel hopes the findings will prompt public reflection on the health gap. "Patients go to the hospital and think: we will be made better." While doctors strive to provide the best care, he emphasized that society must also consider the "person in the hospital bed, who may experience much more stress due to financial worries, which could lead to a less healthy life." The study's publication in an American scientific journal is particularly noteworthy, as it reveals similar disparities in the Dutch healthcare system as those observed in the U.S., where access to care is often tied to wealth.

The research also revealed regional variations within the Netherlands, with higher mortality rates observed in Limburg and Southwest Netherlands. This geographic breakdown adds another layer to the complex interplay of socioeconomic factors and health outcomes.

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Patients go to the hospital and think: we will be made better. But we must also, as a society, look at the person in the hospital bed, who may experience much more stress due to financial worries, which could lead to a less healthy life.