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2000, Number 2

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Med Crit 2000; 14 (2)

Clinical performance and cost-effectiveness of three mexican critical care units included in the multicenter data base of intensive care

Cerón DUW, Esponda PJ, Borboya PM, Vázquez MJP

Language: Spanish
References: 22
Page: 41-49
PDF size: 178.92 Kb.


ABSTRACT

Objective: To describe the performance of three units included in the Multicenter Database utilizing the Rapoport method.
Design: A prospective cohort study.
Setting: Three Mexican intensive care units.
Patients: 771 adult patients.
Interventions: None.
Measurements and main results:
n IRCE* IRURE*
Unit 1 356 -0.719 1.66
Unit 2 276 0.45 1.68
Unit 3 139 -0.572 4.2
Total 771 -0.273 2.13

IRCE = standarized clinical performance index; a positive value reflects less mortality than expected.
IRURE = standarized resource use performance index; a positive value reflects less resource utilization than expected.
* The units are the standard deviation of the mean of participant units in the Rapoport’s original study.
Conclusion: The evaluated unite have similar clinical performance and less resource utilization than the reference units.


REFERENCES

  1. Jacobs P, Nosewerthy TW. National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 1990; 18: 1282.

  2. Gyldmark M, Polit C. A review of cost studies of intensive care units: Problems with the cost concept. Crit Care Med 1995; 23: 964-972.

  3. Rapoport J, Teres D, Lemeshow S, Gehlbach S. A method for assessing the clinical performance and cost-effectiveness of intensive care units: a multicenter inception cohor study. Crit Care Med 1994; 22: 1385-1391.

  4. Cerón U, Sierra A, Martínez R, Vázquez JP. Base de datos para el control de calidad y utilización de recursos en la Unidad de Terapia Intensiva. Rev Mex Med Crit y Ter Int 1996; 10: 105-201.

  5. Lemeshow S, Teres D, Klar J el al. Mortality Probability Models (MPM II) Based on an International Cohor of Intensive Care Unit Patients.

  6. Knaus WA, Draper EA, Wagner DP et al. APACHE II: A everity of disease classification system. Crit Care Med 1985; 13: 818-829.

  7. Zimmerman JE, Shortell SM, Rousseau DM, et al. Improving intensive care: Observations based on organizational case studies in nine intensive care units: A prospective, multicenter study. Crit Care Med 1993; 21: 1443-1451.

  8. Detsky AS, Nablie IG. A clinician’s Guide to Cost-Effectiveness Analysis. Ann Int Med 1990; 113: 147-154.

  9. Zimmerman JE, Shortell SM, Kanus W et al. Value and cost of theaching hospitals: A prospective, multicenter, inception sohort study. Crit Care Med 1993; 21: 1432-1442.

  10. Chernow B. The practice of critical care-Describing who we are, evaluating what we do, and computing the cost. Crit Care Med 1993; 21: 1413-1414.

  12. Jacobs P, Nosewerthy TW. National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 1990; 18: 1282.

  13. Gyldmark M, Polit C. A review of cost studies of intensive care units: Problems with the cost concept. Crit Care Med 1995; 23: 964-972.

  14. Rapoport J, Teres D, Lemeshow S, Gehlbach S. A method for assessing the clinical performance and cost-effectiveness of intensive care units: a multicenter inception cohor study. Crit Care Med 1994; 22: 1385-1391.

  15. Cerón U, Sierra A, Martínez R, Vázquez JP. Base de datos para el control de calidad y utilización de recursos en la Unidad de Terapia Intensiva. Rev Mex Med Crit y Ter Int 1996; 10: 105-201.

  16. Lemeshow S, Teres D, Klar J el al. Mortality Probability Models (MPM II) Based on an International Cohor of Intensive Care Unit Patients.

  17. Knaus WA, Draper EA, Wagner DP et al. APACHE II: A everity of disease classification system. Crit Care Med 1985; 13: 818-829.

  18. Zimmerman JE, Shortell SM, Rousseau DM, et al. Improving intensive care: Observations based on organizational case studies in nine intensive care units: A prospective, multicenter study. Crit Care Med 1993; 21: 1443-1451.

  19. Detsky AS, Nablie IG. A clinician’s Guide to Cost-Effectiveness Analysis. Ann Int Med 1990; 113: 147-154.

  20. Zimmerman JE, Shortell SM, Kanus W et al. Value and cost of theaching hospitals: A prospective, multicenter, inception sohort study. Crit Care Med 1993; 21: 1432-1442.

  21. Chernow B. The practice of critical care-Describing who we are, evaluating what we do, and computing the cost. Crit Care Med 1993; 21: 1413-1414.




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