1999, Number 6
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Med Crit 1999; 13 (6)
Proposal of a model to improve the quality of medical care and the cost-effectiveness in the intensive care units of the Mexican Institute of Social Security (IMSS)
Hidalgo PA, Méndez LM, Postnett J, Sheldom T
Language: Spanish
References: 27
Page: 190-196
PDF size: 106.08 Kb.
ABSTRACT
Objective: To provide guidelines to improve the quality of medical care and the cost-effectiveness in the IMSS´ICUs.
Data sources: a) Publications relevant to the provision of critical care and cost-effectivenes; and b) data obtained of a preliminary study about the features of ICU’s IMSS.
Conclusion: a) The preliminary study showed that the quality of medical care is appropriate in the IMSS ICUs but the effectiveness is poor. b) The proposed guidelines in this paperprovide a framework in which IMSS hospitals of varyng levels may optimize the quality of medical care and the cost-effectiveness.
REFERENCES
Kappstein Y, Schulgen G, Beyer U, Geiger K, Schumacher M, Daschner FD. Prolongation of hospital stay and extra costs due to ventilator-associated pneumonia in an intensive care unit. Eur J Clin Microbiol Infect Dis 1992; 11: 504-8.
Finerberg HV, Hiatt HH. Evaluation of Medical Practices: The case of Technology Assesssment. N Engl J Med 1979; 301: 1086-91.
Laupacis A, Feeney D, Detsky AS, Tugwell PX. How attractive does a new technology have to be warrant adoption and utilization? Tentative guidelines for using clinical and economic evaluations. Can Med Assoc J 1992; 146: 473-81.
Rappaport J, Teres D, Barnett R et al. A comparison of intensive care unit utilization in Alberta and western Massachusetts. Crit Care Med 1995; 23: 1336-46.
Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Int Med 1986; 104; 410-18.
Weinstein MC, Statson WB. Foundations of costeffectiveness analysis for health and medical practices. N Engl J Med 1977; 296: 716-21.
Knaus WA, Draper EA, Wagner DP et al. APACHE II, a severity of disease classification system. Crit Care Med 1985; 13: 818.
Lee DK, Swinburne AJ, Fedullo AJ, Whal GW. Withdrawing care. Experience in a medical intensive care unit. JAMA 1994; 271: 1358-61.
Inman KJ, Sibbald WJ, Rutledge FS, Clarke BJ. Clinical utility and cost-effectiveness of an air suspension bed in the prevention of pressure ulcers. JAMA 1993; 369: 1139-43.
Cheng DCH. Pro early extubation after cardiac surgery decreases intensive care unit stay and cost. J Cardiothor Vasc Anaesth 1995; 9: 460-4.
Chaudhri S, Kenny GN. Sedation after cardiac surgery: Comparison of propofol and midazolam in the presence of a computerized closed loop arterial pressure controller. Br J Anaesth 1992: 68: 98-9.
Sheps A, Mindel C. Approaches to the quality of hospital care. Pub Health Rep 1955: 877-86.
Rosenfels A, Leonard S. Quality of medical care in hospitals. Am J Pub Health 1957; 47: 405-414.
Donabedian A. Evaluación de la calidad de la atención médica. The Milbank Memorial Fund Quaterly 1966; 44: 166203.
Morehead MA. La auditoría médica como instrumento operativo. Am J Pub Health 1967; 57: 1643-56.
Martin SP, Donaldson MC, London CD, Peterson OL, Colton T. Inputs in to cornary care during 30 years: A costeffectiveness study. Ann Int Med 1974; 81: 289-93.
Souilla B, Paganini JM, Sonis A, Gianatonio CA. Calidad y eficiencia de la atención médica. Estudio comparativo de recursos y resultados en atención pediátrica entre hospitales de distinta complejidad. Atención Médica 19741975; 3: 1-4.
Rustein DD, Berenberg W, Chalmers TC et al. Measuring the quality of medical care: A clinical method. N Engl J Med 1976; 294: 582-88.
Dubois RW, Brook RH, Rogres WH. Tasas de mortalidad hospitalaria ajustadas: Un índice potencial de la calidad de la atención médica. Am J Pub Health 1987; 77: 1162-66.
Special Care Units. Accreditation Manual for Hospitals. Joint Comission on Accreditation of Health Care Organizations. Oakbrooke Terrace, III, 1990: 243.
Cullen DJ, Civetta JM, Briggs BA et al. Therapeutic intervention scoring system a method for cuantitative comparison of patient care. Crit Care Med 1974; 2: 57.
Catella X, Artigas A, Bion J, Kari A. A comparison of severity illnes scoring system of intensive care unit patients: Results of a multicenter, multinational study. Crit Care Med 1995; 23: 1327-35.
Pittet D, Tarara D, Wenzel RP. Nosocomial bloodstream infection in critically ill patients. J Am Med Assoc 1994; 271: 1598-601.
National Institutes of Health. NIH Consensus Development Conference statement on critical care medicine. In: Parillo JE, Ayers SM, eds. Major issues in critical care medicine. 1st ed. Baltimore: Williams and Wilkins; 1984: 277-89.
Pollack MM, Katz RW, Ruttiman UE, Getson PR. Improving the outcome and efficiency of intensive care: The impact of an intensivist. Crit Care Med 1988; 16: 11-17
Singer D, Carr P, Mulley A, Thibault G. Rationing intensive care-physician responses to a resource shortage. N Engl J Med 1983; 309: 115-60.
Osborne M, Evans TW. Allocation of resources in intensive care: A transatlantic perspective. Lancet 1994; 343: 778-80.