MARC details
| 000 -LEADER |
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| fixed length control field |
04260nam a22005537a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
221027s20222022 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
2574-3805 |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
10.1001/jamanetworkopen.2022.33649 [doi] |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
2796812 [pii] |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
PMC9520346 [pmc] |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
36169958 |
| 245 ## - TITLE STATEMENT |
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| Title |
Cost-effectiveness of an Emergency Department-Based Intensive Care Unit. |
| 251 ## - Source |
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| Source |
JAMA Network Open. 5(9):e2233649, 2022 09 01. |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
JAMA netw. open. 5(9):e2233649, 2022 09 01. |
| 253 ## - Journal Name |
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| Journal name |
JAMA network open |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2022 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2023 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Publication date |
2022 09 01 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
epublish |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Medline status |
MEDLINE |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2022-10-27 |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Conclusions and Relevance: Implementation of an ED-ICU was associated with no significant change in inflation-adjusted total direct cost per ED encounter. Holding delivery costs constant while improving quality demonstrates improved value via the ED-ICU model of care. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Design, Setting, and Participants: This retrospective economic analysis evaluated the cost of care delivery to patients in the ED before and after deployment of the Joyce and Don Massey Family Foundation Emergency Critical Care Center, an ED-ICU, on February 16, 2015, at a large academic medical center in the US with approximately 75000 adult ED visits per year. The pre-ED-ICU cohort was defined as all documented ED visits by patients 18 years or older with a complete financial record from September 8, 2012, through June 30, 2014 (660 days); the post-ED-ICU cohort, all visits from July 1, 2015, through April 21, 2017 (660 days). Fiscal year 2015 was excluded from analysis to phase in the new care model. Statistical analysis was performed March 1 through December 30, 2021. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Exposures: Implementation of an ED-ICU. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Importance: Value in health care is quality per unit cost (V = Q/C), and an emergency department-based intensive care unit (ED-ICU) model has been associated with improved quality. To assess the value of this care delivery model, it is essential to determine the incremental direct cost of care. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Main Outcomes and Measures: Inflation-adjusted direct cost of care, net revenue, and direct margin per patient encounter in the ED. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Objective: To determine the association of an ED-ICU with inflation-adjusted change in mean direct cost of care, net revenue, and direct margin per ED patient encounter. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
Results: A total of 234884 ED visits during the study period were analyzed, with 115052 patients (54.7% women) in the pre-ED-ICU cohort and 119832 patients (54.5% women) in the post-ED-ICU cohort. The post-ED-ICU cohort was older (mean [SD] age, 49.1 [19.9] vs 47.8 [19.6] years; P < .001), required more intensive respiratory support (2.2% vs 1.1%; P < .001) and more vasopressor use (0.5% vs 0.2%; P < .001), and had a higher overall case mix index (mean [SD], 1.7 [2.0] vs 1.5 [1.7]; P < .001). Implementation of the ED-ICU was associated with similar inflation-adjusted total direct cost per ED encounter (pre-ED-ICU, mean [SD], |
| -- |
875 [ |
| -- |
5 175]; post-ED-ICU, |
| -- |
877 [ |
| -- |
7 400]; P = .98). Inflation-adjusted net revenue per encounter increased by 7.0% (95% CI, 3.4%-10.6%; P < .001), and inflation-adjusted direct margin per encounter increased by 46.6% (95% CI, 32.1%-61.2%; P < .001). |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Emergency Service, Hospital |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Intensive Care Units |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Adult |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Cost-Benefit Analysis |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Critical Care |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Female |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Humans |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Male |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Middle Aged |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Retrospective Studies |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
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| Department |
Critical Care |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Research Support, Non-U.S. Gov't |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Sefa, Nana |
| Institution Code |
MWHC |
| 790 ## - Authors |
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| All authors |
Bassin BS, Burrum D, Cranford JA, Dunn P, Gegenheimer-Holmes J, Gunnerson K, Haas NL, Havey R, Laurinec S, Loof R, Maxwell S, Medlin R, Neumar RW, Olis C, Peterson TA, Sefa N |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1001/jamanetworkopen.2022.33649">https://dx.doi.org/10.1001/jamanetworkopen.2022.33649</a> |
| Public note |
https://dx.doi.org/10.1001/jamanetworkopen.2022.33649 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
