Current Venues of Care and Related Costs for the Chronically Critically Ill
Current Venues of Care and Related Costs for the Chronically Critically Ill
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DOI：
10.4187/respcare.01656
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发表时间：
2012-06-01
期刊：
影响因子：
2.5
通讯作者：
Donahoe, Michael P.
中科院分区：
文献类型：
--
作者：
Donahoe, Michael P.
慢性危重症（CCI）患者群体的特点是长期需要高成本的医疗干预，1年死亡率高，对急性后护理服务的需求非常高。CCI患者群体最具特征的是长期机械通气（PMV）患者。这篇综述将集中在目前的知识成本和护理场所的护理这一患者群体。PMV患者的急性护理住院时间较长，住院费用中位数是短期呼吸机患者的3-4倍，病程中护理地点经常更换，出院回家的可能性很小，但医院死亡率与短期呼吸机患者组没有显著差异。预计到2020年，PMV人口将增加一倍。鉴于PMV患者的急性护理费用负担比较巨大，管理护理负担和护理费用的社会影响是惊人的。提高这一患者群体医疗保健效率的战略至关重要。美国现有护理模式的局限性将通过关注我们当前的研究缺陷来确定，这些缺陷限制了医疗保健提供者和管理人员为这一患者群体提供以患者为中心的护理。
The chronically critically ill (CCI) patient population is characterized by a prolonged need for high cost medical interventions, a high 1-year mortality rate, and a very high demand for post acute care services. The best characterized CCI patient population is patients on prolonged mechanical ventilation (PMV). This review will focus on the current knowledge of costs and care venues for the care of this patient population. The PMV population suffers from a prolonged length of acute care hospital stay, median hospital costs 3-4 times the cost of short-term ventilator patients, frequent care venue changes during the course of illness, a small likelihood of discharge to the home environment, yet a hospital mortality that does not differ significantly from the short-term ventilated patient group. The PMV population is projected to double in size by the year 2020. Given the dramatic comparative acute care cost burden of PMV patients, the societal implications for managing both the care burden and the costs of care are staggering. Strategies to improve the efficiency in healthcare for this patient population will be essential. Limitations to the existing care models in the United States will be identified with a focus on our current research deficiencies, which limit healthcare providers and administrators in providing patient focused care for this patient population.