Learning to not know: Results of a program for ancillary cost reduction in surgical critical care

Journal of Trauma - Injury, Infection and Critical Care

Volumn 41, Issue 4, 1996, Pages 714-720

  Barie, Philip S ^a,b   Hydo, Lynn J ^a  

^a WEILL CORNELL MEDICAL COLLEGE   (United States)

^b WEILL CORNELL MEDICAL CENTER   (United States)

Author keywords

Cost containment; Critical care; Critical pathways; Drug therapy; Laboratory testing; Outcomes; Patient management guidelines

Indexed keywords

ARTICLE; CLINICAL PROTOCOL; COST CONTROL; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH CARE QUALITY; HUMAN; INTENSIVE CARE; LABORATORY TEST; MAJOR CLINICAL STUDY; PRIORITY JOURNAL; TREATMENT OUTCOME;

EID: 0029998072     PISSN: 00225282     EISSN: 15298809     Source Type: Journal    
DOI: 10.1097/00005373-199610000-00020     Document Type: Article

References (50)

1. Becker GJ, Strauch GO, Saranchak HJ: Outcome and cost of prolonged stay in the surgical intensive care unit. Arch Surg 119:1338, 1984
2. Singer M, Myers S, Hall G, et al: The cost of intensive care: A comparison on one unit between 1988 and 1991. Intensive Care Med 20:542, 1994
3. Ridley S, Biggam M, Stone P: Cost of intensive therapy. A description of methodology and initial results. Anaesthesia 46:523, 1991
4. Buist M: Intensive care unit resource utilisation. Anaesth Intensive Care (Australia) 22:46, 1994
5. Chelluri L, Grenvik A, Silverman M: Intensive care for critically ill elderly: Mortality, costs, and quality of life. Review of the literature. Arch Intern Med 155:1013, 1995
6. Cohen IL, Booth FVMcL: Cost containment and mechanical ventilation in the United States. New Horizons 2:283, 1994
7. Morris C, Jacobs P, Rapoport J, et al: ICU and non-ICU cost per day. Can J Anaesth 42:192, 1995
8. Halpern NA, Bettes L, Greenstein R: Federal and nationwide intensive care units and healthcare costs: 1986-1992. Crit Care Med 22:2001, 1994
9. Marschner JP, Thurmann P, Harder S, et al: Drug utilization review on a surgical intensive care unit, Int J Clin Pharmacol Ther 32:447, 1994
10. Civetta JM, Hudson-Civetta JA, Nelson LD: Evaluation of APACHE II for cost containment and quality assurance. Ann Surg 212:266, 1990
11. Civetta JM, Hudson-Civetta JA: Maintaining quality of care while reducing charges in the ICU. Ten Ways. Ann Surg 202:524, 1985
12. Kreis DJ, Augenstein D, Civetta JM, et al: Diagnosis Related Groups and the critically injured. Surg Gvnecol Obstet 165:317, 1987
13. Borlase BC, Baxter JT, Benotti PN, et al: Surgical intensive care resource use in a specialty referral hospital: I. Predictors of early death and cost implications. Surgery 109:987, 1991
14. Borlase BC, Baxter JK, Kenney PR, et al: Elective intrahospital admissions versus acute interhospital transfers to a surgical intensive care unit: Cost and outcome prediction. J Trauma 31:915, 1991
15. Malstam J, Lind L: Therapeutic intervention scoring system (TISS) - a method for measuring workload and calculating costs in the ICU. Acta Anaesthesiol Scand 36:758, 1992
16. Cullen DJ, Keene R, Waternaux C, et al: Results, charges, and benefits of intensive care for critically ill patients: Update 1983. Crit Care Med 12:102, 1984
17. Ridley S, Biggam M, Stone P: A cost-benefit analysis of intensive therapy. Anaesthesia 48:14, 1993
18. Gyldmark M: A review of cost studies of intensive care units: Problems with the cost concept. Crit Care Med 23:964, 1995
19. Zimmerman JE, Wagner DP, Knaus WA, et al: The use of risk predictions to identify candidates for intermediate care units. Implications for intensive care utilization and cost. Chest 108:490, 1995
20. Barie PS, Hydo LJ, Fischer E: Utility of illness severity scoring for prediction of prolonged surgical critical care. J Trauma 40:513, 1996
21. Knaus WA, Draper EA, Wagner DP, et al: APACHE-II: A severity of disease classification system. Crit Care Med 13:818, 1985
22. Knaus WA, Wagner DP, Draper EA, et al: The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 100:1619, 1991
23. Barie PS, Hydo L, Fischer E: Comparison of APACHE II and III scoring systems for mortality prediction in critical surgical illness. Arch Surg 130:77, 1995
24. Marshall JC, Sibbald WJ, Cook DA, et al: The multiple organ dysfunction (MOD) score: A reliable indicator of a complex clinical outcome (Abstract). Crit Care Med 20:S90, 1992
25. Barie PS, Hydo L, Fischer E: A prospective comparison of two different multiple organ failure/dysfunction scoring systems for prediction of mortality in critical surgical illness. J Trauma 37:660, 1994
26. Heffner JE: Nosocomial sinusitis: Den of multiresistant thieves? Am J Respir Crit Care Med 150:608, 1994
27. Rogers FB, Shackford SR, Wilson J, et al: Prophylactic vena cava filters in severely injured trauma patients: Indications and preliminary results. J Trauma 35:637, 1993
28. Moore FA, Feliciano DV, Andrassy RJ, et al: Early enterai feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis. Ann Surg 216:172, 1992
29. Roberts DE, Bell DD, Ostryzniuk T, et al: Eliminating needless testing in intensive care-an information-based team management approach. Crit Care Med 21:1452, 1993
30. Cook DJ: Physicians' perceptions of laboratory costs in the intensive care unit. Hamilton Regional Critical Care Group. Clin Invest Med (Canada) 15:476, 1992
31. Sachdeva RC, Jefferson LS, Coss-Bu J, et al: Effects of availability of patient-related charges on practice patterns and cost containment in the pediatric intensive care unit. Crit Care Med 24:501, 1996
32. Bone RC, Field T, Butler P: Prospective payment guidelines for the critically ill patient: Time for reassessment. J Intensive Care Med 1:2, 1986
33. Low LL, Harrington GR, Stollzfus DP: The effect of arterial lines on blood-drawing practices and costs in intensive care units. Chest 108:216, 1995
34. Walleck CA: Nursing and labor cost reduction. New Horizons 2:291, 1994
35. Gilbertson AA, Smith JM, Mostafa SM: The cost of an intensive care unit; A prospective study. Intensive Care Med 17:204, 1991
36. Pittet D, Tarara D, Wenzel RP: Nosocomial bloodstream infection in critically ill patients. Excess length of stay, extra costs, and attributable mortality. JAMA 271:1598, 1994
37. Kappstein I, Schulgen G, Beyer U, et al: Prolongation of hospital stay and extra costs due to ventilator-associated pneumonia in an intensive care unit. Eur J Clin Microbiol Infect Dis 11:504, 1992
38. Rosenbaum CL, Fant WK, Miyagawa CI, et al: Inability to justify a part-time clinical pharmacist in a community hospital intensive care unit. Am J Hosp Pharm 48:2154, 1991
39. Nugent WC, Schults WC: Playing by the numbers: How collecting outcomes data changed my life. Ann Thorac Surg 58:1866, 1994
40. Davis JT, Allen HD, Felver K, et al: Clinical pathways can be based on acuity, not diagnosis. Ann Thorac Surg 59:1074, 1995
41. Page CP, Bohnen JMA, Fletcher JR, et al: Antimicrobial prophylaxis for surgical wounds. Guidelines for clinical care. Arch Surg 128:79, 1992
42. Pohlman AS, Simpson KB, Hall JB: Continuous intravenous infusions of lorazepam versus midazolam for sedation during mechanical ventilatory support: A prospective, randomized study. Crit Care Med 22:1241, 1994
43. Schumock GT, Raber SR, Crawford SY, et al: National survey of once-daily dosing of aminoglycoside antibiotics. Pharmacotherapy 15:201, 1995
44. Earl P, Sisson PR, Ingham HR: Twelve-hourly dosage schedule for oral and intravenous metronidazole. J Antimicrob Chemother 23:619, 1989
45. Bunz D, Gupta S, Jewesson P: Metronidazole cost containment: A two-stage intervention. Hosp Formal 25:1167, 1990
46. Moore FA, Moore EE, Kudsk KA, et al: Clinical benefits of an immune-enhancing diet for early postinjury enteral feeding. J Trauma 37:607, 1994
47. Fong Y, Whalen GF, Hariri RJ, et al: Utility of daily chest radiographs in the surgical intensive care unit: A prospective study. Arch Surg 130:764, 1995
48. Reed CR, Sessler CN, Glauser FL, et al: Central venous catheter infections: Concepts and controversies. Intensive Care Med 21:177, 1995
49. Kollef MH: Antibiotic use and antibiotic resistance in the intensive care unit: Are we curing or creating disease? Heart Lung 23:363, 1994
50. Swartz MN: Hospital-acquired infections: Diseases with increasingly limited therapies. Proc Natl Acad Sci USA 91:2420, 1994