Decreases in mortality on a large urban medical service by facilitating access to critical care. An alternative to rationing
- 1 June 1988
- journal article
- research article
- Published by American Medical Association (AMA) in Archives of internal medicine (1960)
- Vol. 148 (6) , 1403-1405
- https://doi.org/10.1001/archinte.148.6.1403
Abstract
The admission and case family rate (CFR) on a large urban medical service for 12 months before and after the creation of an intermediate care unit were examined. In the year after the intermediate care unit was opened, total administrations to the ICU/CCU decreased by 7.1% as a result of a 14.6% decrease in admission of low-risk patients who did not require critical care services. The CFR of patients on the medical service decreased by 13.3% in the year after implementation of the intermediate care unit. The decrease in mortality was accounted for by a 25.0% decrease in general ward deaths and a 38.8% decrease in ward cardiac arrests. There was no significant difference in the ICU/CCU CFR. The admission of low-risk patients to an intermediate care unit provided greater access to intensive care and was associated with an overall lower medical service CFR.This publication has 7 references indexed in Scilit:
- Utilization of critical care units. A prospective study of physician triage and patient outcomeArchives of internal medicine (1960), 1987
- Intensive Care Units, Scarce Resources, and Conflicting Principles of JusticeJAMA, 1986
- Rationing of intensive care unit services. An everyday occurrenceJAMA, 1986
- A Predictive Instrument to Improve Coronary-Care-Unit Admission Practices in Acute Ischemic Heart DiseaseNew England Journal of Medicine, 1984
- Rationing Intensive Care — Physician Responses to a Resource ShortageNew England Journal of Medicine, 1983
- The Course of Patients with Suspected Myocardial InfarctionNew England Journal of Medicine, 1980
- Medical Intensive Care: Indications, Interventions, and OutcomesNew England Journal of Medicine, 1980