Critical care clinics
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Sepsis, severe sepsis, and septic shock impose a growing economic burden on health care systems globally. This article first describes the epidemiology of sepsis within the United States and internationally. It then reviews costs associated with sepsis and its management in the United States and internationally, including general cost sources in intensive care, direct costs of sepsis, and indirect costs of the burden of illness imposed by sepsis. Finally, it examines the cost-effectiveness of sepsis interventions, focusing on formal cost-effectiveness analyses of nosocomial sepsis prevention strategies, drotrecogin alfa (activated),and integrated sepsis protocols.
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Critical care clinics · Jan 2012
ReviewEconomics of mechanical ventilation and respiratory failure.
For patients with acute respiratory failure, mechanical ventilation provides the most definitive life-sustaining therapy. Because of the intense resources required to care for these patients, its use accounts for considerable costs. There is great societal need to ensure that use of mechanical ventilation maximizes societal benefits while minimizing costs, and that mechanical ventilation, and ventilator support in general, is delivered in the most efficient and cost-effective manner. This review summarizes the economic aspects of mechanical ventilation and summarizes the existing literature that examines its economic impact cost effectiveness.
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Critical care clinics · Jan 2012
ReviewHealth economics and health technology assessment: perspectives from Australia and New Zealand.
Formal health economics and health technology assessment (HTA)processes, including cost-effectiveness and cost-utility analysis, are variably used to inform decisions about public and private health service funding and service provision. In general, pharmaceuticals have been subject to more sophisticated health economic analyses and HTAs and for a longer time than either devices or procedures. ⋯ While HTA shares many common features across the world, its uses, approaches, applications,and impact differ throughout the world. This article will discuss some of the general attributes of HTA and will focus on its specific applications in Australia and New Zealand.
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Critical care clinics · Jan 2012
ReviewThe economics of cardiovascular disease in the United States.
Cardiovascular disease is the leading cause of death in the United States,and thus its clinical and economic implications are enormous. In an increasingly cost-conscious economic environment, it is important to understand not only the effectiveness of treatments and technologies but also their cost-effectiveness. The authors review and summarize the evidence on cost-effectiveness of surgical versus medical treatments. This evidence should prove useful at the patient bedside as well as assist policymakers and third party payers in deciding what treatments to cover.
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Critical care clinics · Jan 2012
ReviewThe economics of renal failure and kidney disease in critically ill patients.
The kidney is an organ of opportunity cost in the sense that its function is often sacrificed in exchange for the preservation of function of another organ, organ system, or multiorgan process. The ICU setting represents the intersection of multiple organ systems that may result in kidney disease. When the severity of acute kidney injury warrants consideration of renal replacement therapy (RRT), multiple modalities such as peritoneal dialysis, intermittent hemodialysis, and continuous RRT are considered. In this article, the economic issues germane to AKI and its treatment in the ICU setting are presented.