診察時間外コンサルタントの保険料と,集中治療室でのケースミックス調整による死亡率
Lancet (London, England)
|November 21, 2000
まとめ
集中治療科 (ICU) の集中治療科での治療は,患者の生存率を大幅に改善します. 研究によると,24時間集中治療の可用性は,非専門医療と比較して標準化された死亡率を低下させる.
科学分野:
- クリティカルケア・メディシン
- 病院の管理 病院の管理 病院の管理
- 患者のアウトカムについて
背景:
- 英国の国家ガイドラインは,集中治療室 (ICU) で24時間集中治療師の可用性を推奨しています.
- 一部のICUにおける現在の慣行では,非専門家麻酔医が,他の部門と共に重症病棟をカバーしています.
研究 の 目的:
- 患者の死亡率に対する24時間集中治療師の可用性の影響を評価する.
- 集中治療科と非専門医のICUの間で標準化された死亡率 (SMR) を比較する.
主な方法:
- ケースミックス調整された病院死亡率を分析した比較研究.
- 専門医が率いるICUと非専門医が率いるICUの患者のSMRの比較.
主要な成果:
- 集中治療群は,非専門治療群 (1.11) と比較して,ケースミックス調整 SMR (0.81) が有意に改善したことを示した.
- 0.73の比率 (95%CI 0.55-0.97) は,集中治療での死亡率の大幅な減少を示した.
結論:
- ICUでの24時間集中治療スタッフの導入は,患者のアウトカムを大幅に改善するように見えます.
- 集中治療室での専用の専門医療は,死亡率の低下と関連しています.
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