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  1. Lowering hospital charges in the trauma intensive care unit while maintaining quality of care by increasing resident and attending physician awareness.

    Article, Communication - En anglais

    Western Trauma Association. Annual meeting. Big Sky MT USA, 1995/02/26.

    Objective 

    The goal of this study was to determine if trauma intensive care unit (TICU) charges could be reduced through informal daily bedside resident-attending physician discussions regarding relative patient costs of diagnostic and therapeutic alternatives.

    Design 

    This was a prospective pre-and postinterventional study.

    Setting 

    The study took place in a TICU in a level I, community-based, university-affiliated teaching hospital.

    Patients 

    Ninety-one consecutive patients were admitted to the TICU during a 6-month period.

    Materials and Methods 

    The TICU charges were tracked over two consecutive 3-month periods.

    The first 3 months served as control.

    No attempt was made to alter cost of care, and residents were unaware that a study was in progress.

    During the ensuing 3-month period, attendings explicitly discussed with residents relative costs of diagnostic and therapeutic interventions in an attempt to lower charges.

    Composition of the surgical trauma team remained constant throughout the study.

    Measurement and Main Results 

    The median and mean age, Injury Severity Score, intensive care unit length of stay, and sex ratio were not statistically different between the two study groups.

    Total median daily charges of the postintervention group were reduced over the control group by $818/intensive care unit day (p=0.0002).

    The major categories in which charges were reduced included medications ($151/day, p=0.003), laboratory tests ($120/day, p=0.072), c...

    Mots-clés Pascal : Traumatisme, Homme, Evaluation, Caroline du Sud, Etats Unis, Amérique du Nord, Amérique, Economie santé, Analyse avantage coût, Unité soin intensif, Milieu hospitalier, Information, Personnel sanitaire, Médecin, Prise conscience

    Mots-clés Pascal anglais : Trauma, Human, Evaluation, South Carolina, United States, North America, America, Health economy, Cost benefit analysis, Intensive care unit, Hospital environment, Information, Health staff, Physician, Awareness

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

    Cote : 96-0081019

    Code Inist : 002B27B08. Création : 199608.