Articles: intensive-care-units.
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Int J Technol Assess Health Care · Jan 1992
ReviewNeonatal intensive care. When and where is it justified?
There is a wide panorama of disorders in the newborn infant where neonatal intensive care has been proven effective in reducing mortality. Although modern neonatal intensive care can be very costly, short and simple interventions for support and resuscitation still can be highly beneficial. In reviewing the field of neonatal intensive care during the 1980s, it becomes evident that a major challenge for the future will be to apply physiological principles of great and proven value for the newborn baby to more simple devices. Only thereby can the technology of neonatal care defined as a complex of actions-not only equipment and techniques-become justified for future generations.
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It is difficult to study the epidemiology of ICUs, as they lack a uniform nomenclature and/or classification. The organization and distribution of intensive care medicine depend on the size and function of the hospital. The patients in ICUs are predominantly men, with a high proportion of elderly patients (greater than or equal to 70 years) constituting 25-30% of the total. ⋯ Most survivors of intensive care seem to return to normal or near normal functional level within one year. Compared to Western Europe, the United States has more ICU beds and a nearly ten times higher admission rate to intensive care. These variations can be seen as a result of a fundamental difference in the attitudes toward withdrawing or withholding life support.
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Int J Technol Assess Health Care · Jan 1992
ReviewProblems in assessing the technology of critical care medicine.
Technology assessment is becoming increasingly important in the area of critical care due both to the explosion of technology associated with this discipline and to the realization that future demand for these health care resources will undoubtedly exceed the ability to pay. Technology assessment remains both confusing and controversial to many physicians. ⋯ From there, problems and prospects for the evaluation of critical care as a program are presented, followed by the assessment of components within the area of critical care. Finally, recommendations are made on how technology assessment could proceed in the future to best achieve the efficient provision of this service.
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Clin Intensive Care · Jan 1992
Comparative StudyPhysician and nursing (personnel) requirements for ICUs. Therapeutic Intervention Scoring System (TISS) versus time requirements for patient care--a comparative study in an interdisciplinary surgical intensive care unit.
To measure total physician manoeuvres and total nursing manoeuvres in intensive care patients and to compare the results with calculated personnel requirements on the basis of TISS scores. ⋯ Physician activities on a surgical ICU averaged 3.9 hours/patient-day. Nursing manoeuvres average 17.9 hours/patient-day. Individual measurements must be made before calculating personnel requirements on the basis of TISS scores.
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Qual Assur Util Rev · Jan 1992
Quality assessment in the medical intensive care unit. Continued evolution of a data model.
Quality assessment and assurance activities in the intensive care unit are complex processes that begin with the definition of the scope of services delivered in the unit with further identification of the important aspects of care. There is also a need to establish indicators of quality, gather data, and finally to organize the data into useful information. ⋯ In this paper, we focus on the application of the concept of patient days of service for quantification of the utilization of resources as an element of quality. Efficient utilization of resources cannot be effected until data on actual utilization are collected and analyzed.