VALUE AND COST OF TEACHING HOSPITALS - A PROSPECTIVE, MULTICENTER, INCEPTION COHORT STUDY
VALUE AND COST OF TEACHING HOSPITALS - A PROSPECTIVE, MULTICENTER, INCEPTION COHORT STUDY
复制标题
DOI：
10.1097/00003246-199310000-00009
复制
发表时间：
1993-10-01
影响因子：
8.8
通讯作者：
DEVERS, K
中科院分区：
文献类型：
--
作者：
ZIMMERMAN, JE;SHORTELL, SM;DEVERS, K
目的：研究教学和非教学重症监护病房（ICU）的病例组合、结构、资源使用和结果表现的差异。设计：前瞻性初始队列研究。35家医院的15，297名患者的连续样本，比较了18家医院20个教学ICU的8，269名患者与17家医院17个非教学ICU的7，028名患者。干预措施：无。我们选择了每个ICU平均415例患者的人口统计学、生理学和治疗信息，并收集了医院和ICU结构的数据。使用观察到的死亡率与风险调整后的预计住院死亡率的比值、ICU住院时间和资源使用情况对结局进行比较。与非教学ICU相比，教学ICU有两倍的医生定期提供服务，并照顾明显年轻和更严重的疾病（p
Objective: To examine variations in case-mix, structure, resource use, and outcome performance among teaching and nonteaching intensive care units (ICU).Design: Prospective inception cohort study.Patients. A consecutive sample of 15,297 patients at 35 hospitals, which compared 8,269 patients admitted to 20 teaching ICUs at 18 hospitals vs. 7,028 patients admitted to 17 nonteaching ICUs at 17 hospitals.Interventions: None.Measurements. We selected demographic, physiologic, and treatment information for an average of 415 patients at each ICU, and collected data on hospital and ICU structure. Outcomes were compared using ratios of observed to risk-adjusted predicted hospital death rates, ICU length of stay, and resource use.Main Results. When compared to nonteaching ICUs, teaching ICUs had twice the number of physicians who regulary provided services and cared for significantly younger and more severely ill (p