Articles: intensive-care-units.
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To determine short and longterm outcomes and prognostic factors for patients with systemic rheumatic diseases admitted to intensive care units in 4 teaching hospitals. ⋯ The short term outcome for patients with systemic rheumatic diseases in intensive care units was poor. The longterm prognosis after hospital discharge appeared fair, although the standardized mortality ratio was 5-fold that of a nonselected population. Short and longterm prognoses were similar for different systemic rheumatic disease groups.
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This article draws on international experience to explore the ethical and legal aspects of performing clinical studies on patients in intensive care units. It discusses aspects of consent relevant to clinical studies in this medical environment, it considers the involvement of ethical committees, and the role and appropriate level of intensive cover.
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Intensive care medicine · Jun 1997
A new method of accurately identifying costs of individual patients in intensive care: the initial results.
To analyse the patient-related and non-patient-related costs of intensive care using an activity-based costing methodology. ⋯ The use of average costs or scoring systems to cost intensive care is limited, as these methods cannot determine actual resource usage in individual patients. The methodology described here allows all the resources used by an individual patient or group of patients to be identified and thus provides a valuable tool for economic evaluations of different treatment modalities.
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Critical care services are an identified, resource-intensive component of health-care provision. Examining cost containment and clinical effectiveness in this specialty is therefore highly appropriate, although difficult to achieve in practice. The studies reviewed in this paper utilised various methodologies to capture different components of service and patient costs. ⋯ Differing methods and data collection resulted in a limited comparative analysis, but issues requiring further research are highlighted. Funding of ICU services in Australia and nursing staff costs are also discussed. Future research will be aided by further sophistication in clinical information systems and the desire for clinicians to examine the link between costs and outcomes of the different activities pursued within the ICU.