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Related Experiment Videos

Contracting for intensive care services

S Dorman

    Nursing in Critical Care
    |January 1, 1996
    PubMed
    Summary
    This summary is machine-generated.

    Intensive care units (ICUs) require objective outcome data to justify funding. More research is needed on clinical effectiveness and cost-effectiveness, considering patient variations, to guide service development and purchasing decisions.

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    Area of Science:

    • Health services research
    • Critical care medicine
    • Health economics

    Background:

    • Healthcare purchasers demand evidence of clinical benefits and cost-effectiveness for funding.
    • Limited scientific evidence exists on the clinical effectiveness of intensive care services regarding mortality and morbidity.
    • Intensive care is a high-cost medical service requiring rigorous evaluation.

    Purpose of the Study:

    • To highlight the need for objective measures of intensive care unit (ICU) benefits and cost-effectiveness.
    • To emphasize the requirement for outcome studies to inform decisions on ICU service development and rationalization.
    • To identify areas for improvement in the purchasing function for effective contracting of critical care services.

    Main Methods:

    • The study reviews the current state of evidence for intensive care effectiveness.

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  • It discusses the complexities in assessing cost-effectiveness, including case-mix and unit policy variations.
  • It calls for outcome studies on well-defined patient groups.

    • Main Results:

    • There is a significant gap in scientific evidence demonstrating the clinical effectiveness of intensive care.
    • Cost-effectiveness studies must account for variations in case-mix, admission, and discharge policies.
    • The purchasing function needs enhancement to effectively contract for critical care services.

    Conclusions:

    • Decisions regarding the development or rationalization of intensive care services should be based on robust outcome studies.
    • Objective measures of benefit and cost-effectiveness are crucial for securing funding in the NHS internal market.
    • Further research and development in outcome measurement and purchasing are essential for optimizing critical care delivery.