Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act英文文献资料.docVIP

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Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act英文文献资料.doc

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Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act英文文献资料

HindawiPublishingCorporation CriticalCareResearchandPractice Volume2011,ArticleID170814,7pages doi:10.1155/2011/170814 ReviewArticle Bene?tsofHigh-IntensityIntensiveCareUnitPhysicianStaf?ng undertheAffordableCareAct SachinLogani,AdamGreen,andJamesGasperino SectionofCriticalCareMedicine,DepartmentofMedicine,DrexelUniversityCollegeofMedicine,Philadelphia,PA19102,USA CorrespondenceshouldbeaddressedtoJamesGasperino,james.gasperino@ Received28July2011;Accepted4September2011 AcademicEditor:StephenM.Pastores Copyright?2011SachinLoganietal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. TheA?ordableCareActsignedintolawbyPresidentObama,withitsvalue-basedpurchasingprogram,isdesignedtolinkpayment toqualityprocessesandoutcomes.Treatmentofcriticallyillpatientsrepresentsnearly1%ofthegrossdomesticproductand25% ofatypicalhospitalbudget.Datasuggestthathigh-intensitysta?ngpatternsintheintensivecareunit(ICU)areassociatedwith costsavingsandimprovedoutcomes.Weevaluatetheliteratureinvestigatingthecost-e?ectivenessandclinicaloutcomesofhigh- intensityICUphysiciansta?ngasrecommendedbyTheLeapfrogGroup(aconsortiumofcompaniesthatpurchasehealthcare fortheiremployees)andidentifywaystoovercomebarrierstonationwideimplementationofthesestandards.Hospitalsthathave implementedtheLeapfroginitiativehavedemonstratedreductionsinmortalityandlengthofstayandincreasedcostsavings. High-intensitysta?ngmodelsappeartobeanimmediatecost-e?ectivewayforhospitalstomeetthechallengesofhealthcare reform. 1.Introduction The concept of an organized multidisciplinary team accountableforpatientcareisnotnewtothe?eldofcritical care medicine. In fact, critical care medicine appears to havehada10-yearheadstartonmeetingthechallengesof healthcarereform.However,itwastheprivatesectorrather thanthefederalgovernmentthatchampionedthesee?orts. Perhapsthemostin?uentialforcefromtheprivatesectoris The