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Critically Examining Intensive Care

Published online by Cambridge University Press:  14 October 2009

Dinis Reis Miranda
Dinis Reis Miranda
Affiliation:
University Hospital, Groningen
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Abstract

The economic recession of the last decade brought intensive care systems under the light of cost-effectiveness analysis, making use of several instruments available in medical practice, and others adapted from for-profit enterprises. The present concept of intensive care, particularly its functional and organizational interactions with traditional specialties, is at the brink of an important revaluation. Studies of the cost-effectiveness of therapeutic actions may be grossly biased if they do not consider the complete process of care (before, during, and after treatment), analyzing even its smallest elements.

Type
Special Section: Intensive Care: Where Are We?
Information
International Journal of Technology Assessment in Health Care , Volume 8 , Issue 3 , Summer 1992 , pp. 444 - 456
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

1.Bekes, C., Fleming, S., & Scott, W. E.Reimbursement for intensive care services under diagnosis-related groups. Critical Care Medicine, 1988, 16, 478–81.CrossRefGoogle ScholarPubMed
2.Bloom, B. S., & Peterson, O. L.End results, costs and productivity of coronary-care units. New England Journal of Medicine, 1973, 288, 72–78.CrossRefGoogle ScholarPubMed
3.Brown, J. J., & Sullivan, G.Effect on ICU mortality of a full-time critical care specialist. Chest, 1989, 1, 127–29.CrossRefGoogle Scholar
4.Burchardi, H., & Atkinson, B. Education and training. In Reis Miranda, D., Williams, A., & Loirat, P. (eds.), Management of intensive care; guidelines for better use of resources. Dordrecht: Kluwer Academic Publishers, 1990, 125–64.CrossRefGoogle Scholar
5.Cairns, J. A., Singer, J., Gent, M., et al. One year mortality outcome of all coronary and intensive care unit patients with acute myocardial infarction, unstable angina or other chest pain in Hamilton, Ontario, a city of 375, 000 people. Canadian Journal of Cardiology, 1989, 5, 239–46.Google ScholarPubMed
6.Cerra, F. B., Negro, F., & Abrams, J.APACHE II score does not predict multiple organ failure of mortality in postoperative surgical patients. Archives of Surgery, 1990, 125, 519–22.CrossRefGoogle Scholar
7.Chan, N. S., Hughes, M., Irvine, N. A., & Kenmure, A. C. F.Long-term prognosis after resuscitation from primary ventricular fibrillation complicating acute myocardial infarction in the North East of Scotland. Scottish Medical Journal, 1989, 34, 430–33.CrossRefGoogle Scholar
8.Chang, R. W. S., Jacobs, S., & Lee, B.Predicting outcome among intensive care unit patients using computerised trend analysis of daily APACHE II scores corrected for organ failure. Intensive Care Medicine, 188, 14, 558–66.CrossRefGoogle Scholar
9.Charles, E. D., Kronenfeld, J. J., & Wayne, J. B.Unstable angina pectoris: A comparison of the costs of medical and surgical treatment. American Journal of Cardiology, 1979, 44, 112–27.CrossRefGoogle ScholarPubMed
10.Charles, E. D., Wayne, J. B., Oberman, A., et al. Costs and benefits associated with treatment for coronary artery disease. Circulation, 1982, 66(suppl. Ill), 87–90.Google ScholarPubMed
11.Chassin, M. R.Costs and outcome of medical intensive care. Medical Care, 1982, 2, 165–79.CrossRefGoogle Scholar
12.Clementy, J., Delpech, M. C., Mazean, C., et al. Difficultes et limites de l'evaluation du cout des affections coronarienes en France. Archives Maladies du Coeur, 1983, 76, 55–67.Google Scholar
13.Cullen, D. J., Civetta, J. M., Briggs, B. A., et al. Therapeutic intervention scoring system: A method for quantitative comparison of patient care. Critical Care Medicine, 1974, 2, 57.CrossRefGoogle ScholarPubMed
14.Day, H. W.An intensive coronary care area. Diseases of the Chest, 1983, 44, 423.CrossRefGoogle Scholar
15.Diagnosis related groups (DRGs). Medical Care, 1990, (suppl.), 1–53.Google Scholar
16.Dragsted, L., & Qvist, J.Outcome from intensive care I: A 5-year study of 1308 patients. European Journal of Anaesthesia, 1989, 6, 23–37.Google Scholar
17.Eisenberg, M. S., Cumins, R. O., Damon, S., et al. Survival rates from out-of-hospital cardiac arrest: Recommendations for uniform definitions and data to report. Annals of Emergency Medicine, 1990, 222, 1, 1–8.Google Scholar
18.Finberg, H. V., Scadden, D., & Goldmen, L.Care of patients with low probability of acute myocardial infarction. Cost effectiveness of alternatives to coronary-care-unit admission. New England Journal of Medicine, 1984, 310, 1301–07.CrossRefGoogle Scholar
19.Fuchs, R., & Scheidt, S.Improved criteria for admission to cardiac care units. Journal of the American Medical Association, 1981, 246, 2037–41.CrossRefGoogle ScholarPubMed
20.Goldman, E. S., Easterling, M. J., & Sheiner, L. B.Improving the homogeneity of diagnosis related groups (DRGs) by using clinical laboratory demographic and discharge data. American Journal of Public Health, 1989, 79, 4, 441–44.CrossRefGoogle ScholarPubMed
21.Grenvik, A., Leonard, J. J., Arends, J. F., et al. Critical care medicine: Certification as a multidisciplinary subspecialty. Critical Care Medicine, 1981, 9, 117–25.CrossRefGoogle ScholarPubMed
22.Grines, C. L., & DeMaria, A. N.Optimal utilization of thrombolytic therapy for acute myocardial infarction: Concepts and controversies. Journal of the American College of Cardiology, 1990, 16, 223–31.CrossRefGoogle Scholar
23.Hemenway, D., Sherman, H., Mudge, G. H., et al. Comparative costs versus symptomatic and employment benefits of medical and surgical treatment of stable angina pectoris. Medical Care, 1985, 23, 133–41.CrossRefGoogle ScholarPubMed
24.Hill, J. D., Hampton, J. R., & Mitchell, J. R. A.A randomised trial of home-versus-hospital management for patients with suspected myocardial infarction. Lancet, 1978, i, 837–41.CrossRefGoogle Scholar
25.Hughes, J.S., Lichtenstein, J., Magno, L., & Fetter, R. B.Improving DRGs. Use of procedure codes for assisted respiration to adjust for complexity of illness. Medical Care, 1989, 27, 7, 750–57.CrossRefGoogle ScholarPubMed
26.ISIS-2, Second International Study of Infarct Survival Collaborative Group. Randomised trial of intravenous streptokinase, oral asprin, both or neither among 17, 187 cases of suspected acute myocardial infarction. Lancet, 1988, ii, 351–60.Google Scholar
27.Keene, A. R., & Cullen, D. J.Therapeutic intervention scoring system: Update 1983. Critical Care Medicine, 1983, 11, 1–3.CrossRefGoogle ScholarPubMed
28.Knaus, W. A., Draper, E. A., Wagner, D. P., et al. APACHE II, a severity of disease classification system. Critical Care Medicine, 1985, 13, 818–29.CrossRefGoogle ScholarPubMed
29.Knaus, W. A., Wagner, D., Zimmerman, J. E., et al. APACHE II study design: Analytic plan for evaluation of severity and outcome in intensive care patients. Critical Care Medicine, 1989, 17(suppl. 12), S169–S221.Google Scholar
30.Knaus, W. A., Zimmerman, J. E., Wagner, D. P., et al. APACHE, acute physiology and chronic health evaluation: A physiologically based classification system. Critical Care Medicine, 1981, 9, 591–97.CrossRefGoogle ScholarPubMed
31.Kruse, J. A., Thill-Baharozian, M. C., & Carlson, R. W.Comparison of clinical assessment with APACHE II for predicting mortality risk in patients admitted to a medical intensive care unit. Journal of the American Medical Association, 1988, 260, 12, 1739–42.CrossRefGoogle ScholarPubMed
32.Le Gall, J. R., Loirat, P., & Alperovitch, A.Simplified acute physiologic score for intensive care patients. Lancet, 1983, ii, 741.CrossRefGoogle Scholar
33.Lemeshow, S., Teres, D., & Avrunin, M. S., et al. A comparison of methods to predict mortality of intensive care unit patients. Critical Care Medicine, 1987, 15, 715–22.CrossRefGoogle ScholarPubMed
34.Lemeshow, S., Teres, D., & Pastides, H.A method for predicting survival and mortality of ICU patients using objective derived weights. Critical Care Medicine, 1985, 13, 519–25.CrossRefGoogle ScholarPubMed
35.Loirat, P., Spangenberg, J. F. A., & Dragsted, L. Evaluation in intensive care. In Reis Miranda, D., Williams, A., & Loirat, P. (eds.), Management of intensive care; Guidelines for better use of resources. Dordrecht: Kluwer Academic Publishers, 1990, 165–98.CrossRefGoogle Scholar
36.Mather, H. G., Pearson, N. G., Read, K. L. Q., et al. Acute myocardial infarction: Home and hospital treatment. British Medical Journal, 1971, 3, 334–38.CrossRefGoogle ScholarPubMed
37.Mayer-Oakes, S., Oye, R. K., Leake, B., et al. The early effect of Medicare's prospective payment system on the use of medical intensive care services in three community hospitals. Journal of the American Medical Association, 1988, 21, 3146–49.CrossRefGoogle Scholar
38.Munoz, E., Josephson, J., Tenenbaum, N., et al. Diagnosis-related groups, costs, and outcomes for patients in the intensive care unit. Heart & Lung, 1989, 18, 627–33.Google ScholarPubMed
39.Pollack, M. M., Ruttiman, V. E., Getson, P. R., et al. Accurate prediction of outcome of pediatric intensive care: A new quantitative method. New England Journal of Medicine, 1987, 316, 134–37.CrossRefGoogle ScholarPubMed
40. Reis Miranda, D. ICUs in Europe. In Reis Miranda, D. & Langrehr, D. (eds.), The ICU-A cost-benefit analysis. Amsterdam: Elsevier Science Publishers, Excerpta Medica, Congress Series 709, 1986, 207–19.Google Scholar
41.Reis Miranda, D. Costs and economizing policies in the intensive care. In Bergman, (ed.), Proceedings of the Vllth European Congress ofAnaesthesiology. Wilhelm Memdrick Verlag, 1987, 104–10.Google Scholar
42.Siegel, D. M.The high cost of medical technology; getting at the heart of the matter. Medical Care, 1987, 25, 979–87.CrossRefGoogle ScholarPubMed
43.Slayter, M. A., James, O. F., Moore, P. G., et al. Costs, severity of illness and outcome in intensive care. Anaesthesia and Intensive Care, 1986, 14, 381–89.CrossRefGoogle Scholar
44.Thoner, J.Outcome and costs of intensive care. A follow-up study on patients requiring prolonged mechanical ventilation. Ada Anaesthesia Scandanavia, 1987, 31, 693–98.CrossRefGoogle ScholarPubMed
45.Tresch, D. D., Thakur, R. K., Hoffman, R. G., et al. Should the elderly be resuscitated following out-of-hospital cardiac arrest? American Journal of Medicine, 1989, 86, 145–50.CrossRefGoogle ScholarPubMed
46.Weinstein, M. C., & Stason, W. B.Cost-effectiveness of coronary artery bypass surgery. Circulation, 1982, 66(suppl. Ill), 56–65.Google ScholarPubMed
47.Wilcox-Gork, V. L.Survival from out-of-hospital cardiac arrest. A multivariate analysis. Medical Care, 1991, 29, 104–14.CrossRefGoogle Scholar
48.Williams, A.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed
49.Yu, P. N., Bielski, M. T., Edwards, A., et al. Resources for the optimal care of patients with acute myocardial infarction. Study group on coronary heart disease. Circulation, 1971, 53, A, 171–83.Google Scholar
50.Zaren, B., & Bergstrom, R.Survival of intensive care patients I: Prognostic factors from the patient's medical history. Acta Anaesthesia Scandinavia, 1988, 32, 93–100.CrossRefGoogle ScholarPubMed