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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:
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
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
Zum Text:
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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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titleImpact of 24 hour critical care physician staffing on case-mix adjusted mortality in paediatric intensive care
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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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1EISSN: 1474-547X
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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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1Adult
2Analysis. Health state
3Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
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6Child
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8Consultants
9Critical care
10Critical Illness - mortality
11Developing Countries
12Diagnosis-Related Groups - statistics & numerical data
13Emergency and intensive care: neonates and children. Prematurity. Sudden death
14Emergency services
15Epidemiology
16Female
17General aspects
18Hospitals
19Humans
20Illnesses
21Infant
22Intensive care
23Intensive care medicine
24Intensive care units
25Intensive Care Units, Pediatric - manpower
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27Malaysia
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29Medical sciences
30Medical Staff, Hospital - supply & distribution
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32Patient outcomes
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34Pediatrics
35Pediatrics - manpower
36Personnel Staffing and Scheduling - statistics & numerical data
37Physicians
38Public health. Hygiene
39Public health. Hygiene-occupational medicine
40Risk groups
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42Survival Analysis
43Tropical medicine
44Workforce planning
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1Adult
2Analysis. Health state
3Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
4Availability
5Biological and medical sciences
6Child
7Child, Preschool
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9Critical care
10Critical Illness - mortality
11Developing Countries
12Diagnosis-Related Groups - statistics & numerical data
13Emergency and intensive care: neonates and children. Prematurity. Sudden death
14Emergency services
15Epidemiology
16Female
17General aspects
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20Illnesses
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44Workforce planning
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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
spage445
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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.
copLondon
pubElsevier Ltd
pmid11273070
doi10.1016/S0140-6736(00)04014-9