2.50
Hdl Handle:
http://hdl.handle.net/10755/159457
Type:
Presentation
Title:
Longitudinal patterns of resource use in chronically critically ill
Abstract:
Longitudinal patterns of resource use in chronically critically ill
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2004
Author:Daly, Barbara, PhD, RN, FAAN
Title:Associate Professor
Contact Address:SON, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA
Co-Authors:Sara L. Douglas, PhD, RN, Research Associate; Carol Genet Kelley, RN, PhD, Project Manager
Purpose: to describe changes in patterns of resource use (hospital LOS, days of mechanical ventilation, discharge dispositions, ECF stay, home care) identified from 10 years of data collection with the chronically critically ill. Theoretical Framework: Donabedian’s structure-process-outcome framework. Subjects: critically ill adults undergoing >3 days mechanical ventilation in the ICU. Methods: descriptive summary of data from three studies, including one descriptive study and two randomized clinical trials of nurse-centered interventions. Results: the proportion of ICU patients who become chronically critically ill has increased from 5% to 15%; the percent of ICU days used by this population ranges from 30% to 45%. Hospital LOS over the 10 years of data collection has decreased from a mean of 49 days to 21 days, with a concomitant decrease in in-patient days of ventilation from 29 to 12. However, the percent of patients able to return directly to home from the hospital has decreased from 30 to 13%, and the percent of patients discharged on mechanical ventilation has increased from 2% to 12%. In-hospital as well as post-discharge mortality and readmission remain unchanged, despite changes in in-patient management and intensive follow-up interventions. Estimated costs for acute in-patient care have significantly decreased, while overall cost of care remains the same. Conclusions: the trajectory of chronic critical illness is relatively insensitive to advances in medical therapy and patient management strategies. Apparent improvements in LOS and cost of in-patient care reflect changes over time in location of care but are not associated with decreases in estimated national expenditures for care. These findings have implications for assisting families and patients in decision making and care planning. Acknowledgement: NINR NRO 2248, NRO 4318, NRO 5207
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLongitudinal patterns of resource use in chronically critically illen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159457-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Longitudinal patterns of resource use in chronically critically ill </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Daly, Barbara, PhD, RN, FAAN</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">SON, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Sara L. Douglas, PhD, RN, Research Associate; Carol Genet Kelley, RN, PhD, Project Manager </td></tr><tr><td colspan="2" class="item-abstract">Purpose: to describe changes in patterns of resource use (hospital LOS, days of mechanical ventilation, discharge dispositions, ECF stay, home care) identified from 10 years of data collection with the chronically critically ill. Theoretical Framework: Donabedian&rsquo;s structure-process-outcome framework. Subjects: critically ill adults undergoing &gt;3 days mechanical ventilation in the ICU. Methods: descriptive summary of data from three studies, including one descriptive study and two randomized clinical trials of nurse-centered interventions. Results: the proportion of ICU patients who become chronically critically ill has increased from 5% to 15%; the percent of ICU days used by this population ranges from 30% to 45%. Hospital LOS over the 10 years of data collection has decreased from a mean of 49 days to 21 days, with a concomitant decrease in in-patient days of ventilation from 29 to 12. However, the percent of patients able to return directly to home from the hospital has decreased from 30 to 13%, and the percent of patients discharged on mechanical ventilation has increased from 2% to 12%. In-hospital as well as post-discharge mortality and readmission remain unchanged, despite changes in in-patient management and intensive follow-up interventions. Estimated costs for acute in-patient care have significantly decreased, while overall cost of care remains the same. Conclusions: the trajectory of chronic critical illness is relatively insensitive to advances in medical therapy and patient management strategies. Apparent improvements in LOS and cost of in-patient care reflect changes over time in location of care but are not associated with decreases in estimated national expenditures for care. These findings have implications for assisting families and patients in decision making and care planning. Acknowledgement: NINR NRO 2248, NRO 4318, NRO 5207</td></tr></table>en_GB
dc.date.available2011-10-26T22:02:03Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:02:03Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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