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  1. Potentially ineffective care : a new outcome to assess the limits of critical care.

    Article - En anglais

    Objective

    - To examine the limits of the effectiveness of critical care through the study of patients for whom it was ineffective.

    Design

    - We studied the relationship between resource use and long-term outcome (2-year follow-up) in 402 consecutively admitted critical care patients to develop a benchmark for ineffective applications of critical care.

    We defined an outcome called potentially ineffective care (PIC), developed and evaluated a model with an independent data set to predict PIC from a patient's response to treatment, and estimated the economic effects of limiting care after a prediction of PIC.

    Setting

    The combined medical and surgical intensive care unit at a 600-bed university teaching hospital.

    Patients

    - Two groups of 402 consecutively admitted critical care patients, one from 1989, the other from 1991.

    For the hospital studied, reduction of intensity of treatment after a prediction of a PIC outcome would result in a reduction of hospital charges in the range of $1.8 million to $5 million per year.

    Conclusion

    - Patients in the PIC category consumed a large portion of the resources devoted to critical care at an academic teaching hospital.

    We suggest a change in focus from assessment of the quality of critical care and risk-adjusted mortality to an assessment of ineffective care based on outcome and resource use and a patient's response to treatment ov.

    Mots-clés Pascal : Soin, Urgence, Efficacité, Triage, Malade, Méthode, Economie santé, Attitude, Homme

    Mots-clés Pascal anglais : Care, Emergency, Efficiency, Sorting, Patient, Method, Health economy, Attitude, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0024522

    Code Inist : 002B30A05. Création : 01/03/1996.