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Related Concept Videos

Issues And Trends In Healthcare Delivery System01:29

Issues And Trends In Healthcare Delivery System

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The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
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Circadian rhythms are cyclic changes that are crucial in plasma drug concentrations. Various standard circadian parameters, including core body temperature, heart rate, and other cardiovascular factors, directly impact disease states and the therapeutic response to drug therapy.
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Integrated Healthcare System01:20

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An integrated healthcare system (IHS) is a set of organizations that provides for or arranges to provide coordinated and continuous service to a defined population. The IHS takes responsibility for that particular population's health status and outcome, both clinically and fiscally. An integrated healthcare system is a well-organized, well-coordinated, and collaborative network. The integrated delivery system is a network that connects different healthcare providers to deliver organized,...
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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
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Management of Insomnia

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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Nursing Implementation01:15

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Implementation is the execution of the nursing care plan developed during the planning phase.
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Related Experiment Video

Updated: Dec 3, 2025

Improving IV Insulin Administration in a Community Hospital
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ICU Telemedicine Implementation and Risk-Adjusted Mortality Differences Between Daytime and Nighttime Coverage.

Mario V Fusaro1, Christian Becker1, Daniel Miller1

  • 1eHealth Center, Westchester Medical Center Health Network, Valhalla, NY; Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center Health Network, Valhalla, NY.

Chest
|October 31, 2020
PubMed
Summary

ICU telemedicine implementation reduced risk-adjusted mortality, primarily in evening admissions. This suggests a link between higher pre-implementation standardized mortality ratios (SMR) and improved outcomes with telemedicine.

Keywords:
ICU mortalityICU telemedicinecritical caretelemedicine

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Area of Science:

  • Critical Care Medicine
  • Health Services Research
  • Telemedicine

Background:

  • ICU telemedicine has shown mixed results regarding clinical and financial outcomes.
  • Understanding discrepancies in ICU telemedicine effectiveness is crucial due to its impact and cost.
  • Prior meta-analysis indicated reduced mortality with ICU telemedicine when pre-implementation standardized mortality ratio (SMR) exceeded 1.

Purpose of the Study:

  • To investigate the effect of ICU telemedicine implementation on adjusted mortality outcomes.
  • To determine the specific contexts in which ICU telemedicine influences mortality.

Main Methods:

  • A retrospective pre-post analysis compared ICU mortality before and after telemedicine implementation.
  • Risk-adjusted ICU mortality was analyzed for both am and pm admissions.
  • Objective measures of ICU telemedicine involvement were assessed.

Main Results:

  • Overall risk-adjusted ICU mortality decreased from 8.7% before to 6.5% after telemedicine implementation (P < .01).
  • The reduction in mortality was significant in the pm admission group (10.8% to 7.0%, P < .01), but not in the am group.
  • Pre-implementation SMR was 0.95 for am admissions and 1.30 for pm admissions.

Conclusions:

  • ICU telemedicine implementation led to reduced risk-adjusted mortality, predominantly in the pm admission group.
  • The findings support an association between higher pre-implementation SMR (>1) in pm admissions and mortality reduction post-telemedicine.
  • Further research is needed to confirm these findings and explore other ICU telemedicine outcomes using observed-to-expected ratios.