NATIONAL PROGRAM TO IMPROVE THE QUALITY OF ICU SERVICES

对更好的工具的需求持续增长，以评估 现代医疗的功效和效果。这个项目将 扩展APACHE(急性生理学和应用)的开发和应用 慢性健康评估)疾病严重程度分类系统对 现代ICU与急诊医院救治的分析研究 病人。该项目的成功完成不仅将改善 治疗许多重病患者，它可以帮助减少 卫生保健资源被无益地花掉了。 为了做到这一点，我们将使用一位独特且细节丰富的6500名患者， 15个医院数据库，包括人口统计、诊断、信息 关于疾病严重程度(APACHE)、治疗努力和住院结果。 具体目标有四个： A.确定低风险ICU患者的疾病和 病情的严重程度表明他们可以得到充分和安全的治疗 在重症监护室外。 B.为医生提供更好的客观预后能力 关于严重多器官系统衰竭的后果，可能是 用于临床决策。 C.调查变化并估计…的增量价值 危重患者的肺动脉插管。 D.将该数据库与DRG定义相关联，并分析医院间 ICU入院DRG类别内每个病例的成本稳定性。 除上述目标外，该项目还将提供数据 为请求协助的医院提供处理和分析支持 改善他们对ICU的使用或评估治疗结果。这 将有助于从阿帕奇的研究开发过渡到其 专业人员在改善其对现代医院服务的使用方面的使用。

There is a continued and growing need for better tools to evaluate the efficacy and effectiveness of modern medical care. This project will extend the development and application of the APACHE (Acute Physiology and Chronic Health Evaluation) severity of illness classification system to the analysis and study of modern ICU and hospital treatment of acutely ill patients. Successful completion of the project will not only improve the treatment of many severely ill patients, it could help reduce the amount of health care resources spent without benefit. To accomplish this, we will use a unique and richly detailed 6,500-patient, 15-hospital data base which includes demographics, diagnosis, information on severity of illness (APACHE), therapeutic effort, and hospital outcome. There will be four specific aims: a. Identification of profiles of low-risk ICU patients whose disease and severity of illness indicate they could be adequately and safely treated outside an ICU. b. Provide physicians with improved objective prognostic ability concerning outcome from severe multi-organ system failure that could be used in clinical decision making. c. Invstigate the variations and estimate the incremental value of pulmonary artery catheterization amoung severely ill patients. d. Link this data base with DRG definitions and analyze the interhospital stability of cost per case within DRG categories of ICU admissions. In addition to the above aims, this project will also provide data processing and analytic support for hospitals who request assistance in improving their use of ICUs or evaluating outcome from treatment. This will help make the transition from research development of APACHE to its use by professionals in improving their use of modern hospital services.