干旱区生态环境知识资源中心(Arid): Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals

Arid

DOI	10.1177/00031348211062653
	Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals
	Dudas, Lauren M.; Bardes, James M.; Wagner, Afton K.; White, Teresa; Wilson, Alison M.
通讯作者	Dudas, LM (corresponding author)，West Virginia Univ Med, Dept Surg, Div Trauma Emergency Surg & Surg Crit Care, 1 Med Ctr Dr,POB 9238, Morgantown, WV 26506 USA.
来源期刊	AMERICAN SURGEON
ISSN	0003-1348
EISSN	1555-9823
出版年	2021-12
英文摘要	Background Tele-consults provide access to specialized care for a specific question and single point in time. eICU models utilize remote monitoring and ordering but have significant financial burden. We developed a virtual intensive care unit (VICU) for daily input of an intensivist working with local physicians. The purpose was to expand the acute care ability of the critical access hospital (CAH). The study evaluates the impact on the CAH and system. Methods The CAH developed an ICU team, led by a hospitalist, who staffed the intensive care unit (ICU). The CAH ICU team rounds daily via a secure video link to provide care in consultation with intensivists based at a university, tertiary care center (TC). A retrospective analysis was conducted 6 months before and after implementation (4/2018-3/2019). Fisher's exact test was used to compare pre- and post-intervention with significance at P < .04. Results After VICU implementation, there were 265 initial daily and 35 follow-up consults. Monthly transfers to a higher level of care decreased from 63 to 57 (P = .03). Transfers to TC increased from 49.6 to 62.0% (P = .001). Critical access hospital average monthly census and average monthly inpatient days increased (69 to 130 (P < .0001) and 158 to 319 (P < .0001), respectively). Critical access hospital physicians report increased comfort to admit ICU and non-ICU patients due to the program. The total startup cost was $5180. CAH hired 11 providers. There were no unanticipated deaths. Discussion VICU implementation resulted in new CAH jobs. The CAH experienced increased inpatient census and revenues (ICU and non-ICU) while decreasing patients transferred out of the system.
英文关键词	telemedicine tele-intensive care unit rural hospital health care desert critical access hospital
类型	Article ; Early Access
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000737942000001
WOS关键词	TELEMEDICINE ; OUTCOMES ; STATES
WOS类目	Surgery
WOS研究方向	Surgery
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/377045
作者单位	[Dudas, Lauren M.; Bardes, James M.; Wilson, Alison M.] West Virginia Univ Med, Dept Surg, Div Trauma Emergency Surg & Surg Crit Care, 1 Med Ctr Dr,POB 9238, Morgantown, WV 26506 USA; [Wagner, Afton K.] West Virginia Univ Med, Jon Michael Moore Trauma Ctr, Morgantown, WV USA; [White, Teresa] WVU Potomac Valley Hosp, Keyser, WV USA
推荐引用方式 GB/T 7714	Dudas, Lauren M.,Bardes, James M.,Wagner, Afton K.,et al. Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals[J],2021.
APA	Dudas, Lauren M.,Bardes, James M.,Wagner, Afton K.,White, Teresa,&Wilson, Alison M..(2021).Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals.AMERICAN SURGEON.
MLA	Dudas, Lauren M.,et al."Cost Effective Virtual Intensive Care Unit Expanding Capabilities in Critical Access Hospitals".AMERICAN SURGEON (2021).