Articles: intensive-care-units.
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Critical care medicine · Feb 1984
Results, charges, and benefits of intensive care for critically ill patients: update 1983.
Objective and quantitative methods were used to measure severity of illness and outcome of intensive care in critically ill patients, in terms of success or failure of therapy within the ICU, survival or death at 1 yr, quality of life in survivors, and utilization of resources. One hundred ninety-nine consecutive Class IV critically ill surgical patients hospitalized between 1977 and 1978 at the Massachusetts General Hospital comprised the study population. Although the mortality rate of 69% was close to the 73% rate we recorded for 1972-1973, the survivors' quality of life was significantly better. ⋯ Survival rates and quality of life in survivors did not vary with age. The disease process for which the patient was hospitalized was an important determinant of outcome. Intensive care medicine for critically ill surgical patients does prolong life and enable some patients to return to a productive lifestyle; however, the costs of these benefits are extremely high.
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Although sophisticated intensive care units have become universal in major public hospitals in Australia, this complex and expensive form of patient care is usually not available in independent private hospitals. Such a unit was recently established in a large private hospital which had expanded its facilities to encourage major surgery and its admission policies to include complex specialist medical problems. The unit's organisation included an appropriate physical area, comprehensive equipment, skilled nursing staff, resident medical staff, accredited medical specialists, and a common set of policies and protocols. ⋯ Unit mortality was 3.3% and hospital mortality 6%. Patients were similar in age and sex distribution to those admitted to an intensive care unit in a public hospital but their numbers, type of illness, duration of admission and mortality differed. Despite the feasibility of establishing a sophisticated intensive care unit in a private hospital, there were potential problems related to staffing (especially insufficient numbers of trained nurses), funding (especially inadequacy of hospital and medical insurance and unavailability of many drugs on the Government's Schedule of Pharmaceutical Benefits) and relations with medical staff outside the unit.
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Scand J Plast Reconstr Surg · Jan 1984
Case ReportsThe burn situation in Gizan. Planning and implementation of a Burns Unit at the King Fahd Central Hospital, Gizan, the Kingdom of Saudi-Arabia.
A 500-bed referral hospital was designed in 1975 in the health region of Gizan , the Kingdom of Saudi-Arabia. According to an agreement of 1981 between the Danish Ministry of the Interior and the Ministry of Health for the Kingdom of Saudi-Arabia, Danish cooperation to start and run this hospital was initiated. At the end of 1982 an investigation was made as to whether there was a need for a Burns Ward, a Burns Unit or a Burns Center. ⋯ During the first 5-month period 46 patients with burns and 77 other patients requiring plastic surgery were treated. It seems therefore that the need for a Unit for Burns and Plastic Surgery has been proved. The number of inhabitants in the Gizan health region corresponds to that of the municipality of Copenhagen (500 000), and in the future the epidemiology, treatment and results of treatment will be compared in these two areas.