Critical care medicine in the United States 1985-2000: An analysis of bed numbers, use, and costs
Critical care medicine in the United States 1985-2000: An analysis of bed numbers, use, and costs
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DOI：
10.1097/01.ccm.0000128577.31689.4c
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发表时间：
2004-06-01
影响因子：
8.8
通讯作者：
Greenstein, RJ
中科院分区：
文献类型：
--
作者：
Halpern, NA;Pastores, SM;Greenstein, RJ
目的：建立一个数据库，描述和分析1985年至2000年美国重症监护医学（CCM）的演变作用、使用模式和成本。设计：回顾性研究，结合来自联邦的数据（医院成本报告信息系统，医疗保险和医疗补助服务中心，巴尔的摩，MD）和私人（医院统计，美国医院协会，芝加哥，IL）数据库，以分析美国医院、医院和CCM床位以及占用率。CCM成本计算罗素方程和比较与国家卫生保健和财政indexs.Setting：非联邦，急性护理医院与CCM单位在美国。主题：无。干预措施：无。测量和主要结果：我们分析了医院与CCM单位，并集中在医院和CCM病床，CCM占用率和CCM成本。CCM成本与国家成本指数进行了比较。1985年至2000年，美国医院总数减少了8.9%（6，032至5，494），提供CCM的急诊医院减少了13.7%（4，150至3，581）。拥有CCM单位的医院的床位总数减少了26.4%（889，600张至654，400张）。相比之下，CCM床位增加了26.2%（69，300至87，400）。CCM占用率恒定在65%。CCM每天的床位费用增加了1261%。（1，185美元至2，674美元）。虽然CCM成本增加了190.4%（191亿美元至555亿美元），但分配给CCM的国家卫生支出比例下降了5.4%。2000年，CCM成本占医院成本的13.3%，占国家卫生支出的4.2%，占国内生产总值的0.56%。结论：CCM在不断缩小的美国医院系统中越来越多地使用和突出。CCM入住率低于预期。尽管CCM的使用和成本不断增加，但CCM在国家卫生支出和国内生产总值中的使用比例低于先前的估计。
Objective: To establish a database that permits description and analysis of the evolving role, patterns of use, and costs of critical care medicine (CCM) in the United States from 1985 to 2000.Design: Retrospective study combining data from federal (Hospital Cost Report Information System, Center for Medicare and Medicaid Services, Baltimore, MD) and private (Hospital Statistics, American Hospital Association, Chicago, IL) databases to analyze U.S. hospitals, hospital and CCM beds, and occupancy. CCM costs were calculated by the Russell equation and compared with national health care and financial indexes.Setting: Nonfederal, acute care hospitals with CCM units in the United States.Subjects: None.Interventions:None.Measurements and Main Results: We analyzed hospitals with CCM units and focused on hospital and CCM beds, CCM occupancy, and CCM costs. CCM costs were compared with national cost indexes. Between 1985 and 2000, the total number of U.S. hospitals decreased by 8.9% (6,032 to 5,494) and acute care hospitals offering CCM decreased by 13.7% (4,150 to 3,581). The total number of beds in hospitals with CCM units decreased by 26.4% (889,600 to 654,400). In contrast CCM beds increased by 26.2% (69,300 to 87,400). CCM occupancy was constant at 65%. CCM bed costs per day increased by 1261%. ($1,185 to $2,674). Although CCM costs increased by 190.4% ($19.1 billion to $55.5 billion), the proportion of national health expenditures allocated to CCM decreased by 5.4%. In 2000, CCM costs represented 13.3% of hospital costs, 4.2% of national health expenditures, and 0.56% of the gross domestic productConclusions: CCM is increasingly used and prominent in a shrinking U.S. hospital system. CCM occupancy is lower than expected. Despite its increasing use and cost, CCM is using proportionally less of national health expenses and the gross domestic product than previously estimated.