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  1. Learning to not know : Results of a program for ancillary cost reduction in surgical critical care.

    Article, Communication - En anglais

    Annual Meeting of the Eastern Association for the Surgery of Trauma. Orlando, Florida USA, 1996/01/10.


    Compelling internal and external influences are stimulating global re-evaluations of care standards for efficacy and cost.

    Critical care uses huge amounts of resources despite widespread shortages of beds and nurses.

    This study tested the hypothesis that ancillary expenditures can be decreased without compromising care.


    Costs for laboratory tests, radiographs, blood products, nutritional supplements, and drugs were compared prospectively for all surgical intensive care unit care for two 4-month periods (January 1 to April 30,1994 and January 1 to April 30,1995) at a urban university center.

    A systematic, multidisciplinary cost-reduction program began May 1,1994, with emphasis on laboratory and radiographic testing and procedures, and blood product, nutritional, and drug therapies.

    Cohorts were compared by age, Acute Physiology and Chronic Health Evaluation (APACHE) II and III admission scores, and case mix.

    Outcome variables were hospital mortality, days in the intensive care unit and hospital, the development of multiple organ dysfunction syndrome, and expenditures.

    Cost data were taken weekly from the hospital's clinical information system.

    No new equipment was introduced during the study period except for pumps for patient-controlled analgesia, and there were no new critical pathways or other patient care guidelines.


    Case mix and all noncost variables were identical. (...)

    Mots-clés Pascal : Milieu hospitalier, Chirurgie, Unité soin intensif, Réduction, Coût, Nutrition, Laboratoire, Radiologie, Traitement, Influence, Hospitalisation, Complication, Epidémiologie, Mortalité, Homme

    Mots-clés Pascal anglais : Hospital environment, Surgery, Intensive care unit, Reduction, Costs, Nutrition, Laboratory, Radiology, Treatment, Influence, Hospitalization, Complication, Epidemiology, Mortality, Human

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

    Cote : 96-0487956

    Code Inist : 002B30A04B. Création : 10/04/1997.