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Impact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care

The 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the pa... Full description

Journal Title: The Lancet (British edition) 2001-02-10, Vol.357 (9254), p.445-446
Main Author: Goh, Adrian Yu-Teik
Other Authors: Lum, Lucy Chai-See , Abdel-Latif, Mohd El-Amin
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Impact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care
format: Article
creator:
  • Goh, Adrian Yu-Teik
  • Lum, Lucy Chai-See
  • Abdel-Latif, Mohd El-Amin
subjects:
  • Abridged Index Medicus
  • Adult
  • Analysis. Health state
  • Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
  • Availability
  • Biological and medical sciences
  • Child
  • Child, Preschool
  • Consultants
  • Critical care
  • Critical Illness - mortality
  • Developing Countries
  • Diagnosis-Related Groups - statistics & numerical data
  • Emergency and intensive care: neonates and children. Prematurity. Sudden death
  • Emergency services
  • Epidemiology
  • Female
  • General aspects
  • Hospitals
  • Humans
  • Illnesses
  • Infant
  • Intensive care
  • Intensive care medicine
  • Intensive care units
  • Intensive Care Units, Pediatric - manpower
  • LDCs
  • Malaysia
  • Male
  • Medical sciences
  • Medical Staff, Hospital - supply & distribution
  • Mortality
  • Patient outcomes
  • Pediatric intensive care
  • Pediatrics
  • Pediatrics - manpower
  • Personnel Staffing and Scheduling - statistics & numerical data
  • Physicians
  • Public health. Hygiene
  • Public health. Hygiene-occupational medicine
  • Risk groups
  • Supply and demand
  • Survival Analysis
  • Tropical medicine
  • Workforce planning
ispartof: The Lancet (British edition), 2001-02-10, Vol.357 (9254), p.445-446
description: The 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1·57 (95%CI 1·25–1·95) with non-specialist care to 0·88 (95%CI 0·63–1·19) with intensivist care (rate ratio 0·56, 95% CI 0·47–0·67). Mortality odds ratio decreased by 0·234, 0·246 and 0·266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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descriptionThe 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1·57 (95%CI 1·25–1·95) with non-specialist care to 0·88 (95%CI 0·63–1·19) with intensivist care (rate ratio 0·56, 95% CI 0·47–0·67). Mortality odds ratio decreased by 0·234, 0·246 and 0·266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country.
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languageeng
publisherLondon: Elsevier Ltd
subjectAbridged Index Medicus ; Adult ; Analysis. Health state ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Availability ; Biological and medical sciences ; Child ; Child, Preschool ; Consultants ; Critical care ; Critical Illness - mortality ; Developing Countries ; Diagnosis-Related Groups - statistics & numerical data ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Emergency services ; Epidemiology ; Female ; General aspects ; Hospitals ; Humans ; Illnesses ; Infant ; Intensive care ; Intensive care medicine ; Intensive care units ; Intensive Care Units, Pediatric - manpower ; LDCs ; Malaysia ; Male ; Medical sciences ; Medical Staff, Hospital - supply & distribution ; Mortality ; Patient outcomes ; Pediatric intensive care ; Pediatrics ; Pediatrics - manpower ; Personnel Staffing and Scheduling - statistics & numerical data ; Physicians ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Risk groups ; Supply and demand ; Survival Analysis ; Tropical medicine ; Workforce planning
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descriptionThe 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1·57 (95%CI 1·25–1·95) with non-specialist care to 0·88 (95%CI 0·63–1·19) with intensivist care (rate ratio 0·56, 95% CI 0·47–0·67). Mortality odds ratio decreased by 0·234, 0·246 and 0·266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country.
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17General aspects
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37Physicians
38Public health. Hygiene
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40Risk groups
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44Workforce planning
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13Emergency and intensive care: neonates and children. Prematurity. Sudden death
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17General aspects
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atitleImpact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care
jtitleThe Lancet (British edition)
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volume357
issue9254
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pages445-446
issn0140-6736
eissn1474-547X
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abstractThe 24 h availability of intensive care consultants (intensivists) has been shown to improve outcomes in adult intensive care units (ICU) in the UK. We tested whether such availability would improve standardised mortality ratios when compared to out-of-hours cover by general paediatricians in the paediatric ICU setting of a medium-income developing country. The standardised mortality ratio (SMR) improved significantly from 1·57 (95%CI 1·25–1·95) with non-specialist care to 0·88 (95%CI 0·63–1·19) with intensivist care (rate ratio 0·56, 95% CI 0·47–0·67). Mortality odds ratio decreased by 0·234, 0·246 and 0·266 in the low, moderate and high-risk patients. 24 h availability of intensivists was associated with improved outcomes and use of resources in paediatric intensive care in a developing country.
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pubElsevier Ltd
pmid11273070
doi10.1016/S0140-6736(00)04014-9