Lead
Persons at the end of life are often admitted to intensive care units (ICUs). This study examines how physicians make the decision to admit or not admit a seriously ill hospitalized patient to the ICU.

Lay summary

Background
Intensive care is a special and costly medical service. A patient in the ICU is under a great deal of physical and emotional burden. The aim is to significantly increase survival rates and quality of life. At the same time, transfers to the ICU must be done with the patients' agreement. The patients are mainly frail and elderly persons and persons with serious illnesses and therefore poor prognoses. The decision-making process has to be fair. When the circumstances are assessed, all patients should be treated equitably.

Aim
This study aims to find out what factors form the basis for physicians' decisions to transfer or not transfer a hospital patient to the ICU. Interviews with internists and intensive care physicians form one part of the study. In addition, decision criteria will be evaluated by questionnaire. The study aims to find out, for one, whether ICU physicians’ assessments of the likelihood of death of patients planned to be transferred to the ICU are the same as ward physicians' assessments. For another, the aim is to uncover what factors these assessments are based on.

Significance
The results of the study should contribute towards discovering possible improvements in admission of patients to the ICU and towards developing strategies for equitable distribution of these health care resources.