Literature DB >> 25410664

[Rationing, prioritisation, rationalizing: Significance in everyday intensive care].

P Gretenkort1.   

Abstract

BACKGROUND: Rationing, even in the treatment of critically ill patients, is the reality on intensive care units. Severity of illnesses and urgency of care are posing high ethical barriers for explicit cost-saving orders. Nevertheless, implicit rationing decisions are a daily ethical minefield, which is not always appreciated by healthcare providers.
METHODS: In this article, typical decision-making situations are described, where limitation of resources plays a role.
RESULTS: The idea of saving resources by rationalising rather than rationing results from the fact that not every patient benefits from the full scope of services available in the intensive care unit, and not every patient desires the full scope of care to be supplied to them. Thus, the irrational use of resources can sometimes be avoided to save them for cases where they are necessary.

Entities:  

Keywords:  End of life care; Ethical issues; Prognosis; Resource allocation; Triage

Mesh:

Year:  2014        PMID: 25410664     DOI: 10.1007/s00063-014-0437-1

Source DB:  PubMed          Journal:  Med Klin Intensivmed Notfmed        ISSN: 2193-6218            Impact factor:   0.840


  17 in total

Review 1.  Rationing critical care beds: a systematic review.

Authors:  Tasnim Sinuff; Kamayar Kahnamoui; Deborah J Cook; John M Luce; Mitchell M Levy
Journal:  Crit Care Med       Date:  2004-07       Impact factor: 7.598

Review 2.  Critical care rationing: international comparisons.

Authors:  Timothy W Evans; Stefano Nava; Guillermo Vazquez Mata; Bertrand Guidet; Elisa Estenssoro; Robert Fowler; Leslie P Scheunemann; Douglas White; Constantine A Manthous
Journal:  Chest       Date:  2011-12       Impact factor: 9.410

Review 3.  Utilization strategies for intensive care units.

Authors:  P E Kalb; D H Miller
Journal:  JAMA       Date:  1989-04-28       Impact factor: 56.272

4.  AMA Code of Medical Ethics' opinions on allocating medical resources.

Authors: 
Journal:  Virtual Mentor       Date:  2011-04-01

5.  [Therapy goal modification and therapy limit in intensive care medicine].

Authors:  U Janssens; H Burchardi; G Duttge; R Erchinger; P Gretenkort; M Mohr; F Nauck; S Rothärmel; F Salomon; P Schmucker; A Simon; H Stopfkuchen; A Valentin; N Weller; G Neltzke
Journal:  Med Klin Intensivmed Notfmed       Date:  2013-02       Impact factor: 0.840

6.  ICU bed supply, utilization, and health care spending: an example of demand elasticity.

Authors:  Rebecca A Gooch; Jeremy M Kahn
Journal:  JAMA       Date:  2014-02-12       Impact factor: 56.272

7.  The doctor as double agent.

Authors:  M Angell
Journal:  Kennedy Inst Ethics J       Date:  1993-09

8.  A costly separation between withdrawing and withholding treatment in intensive care.

Authors:  Dominic Wilkinson; Julian Savulescu
Journal:  Bioethics       Date:  2012-07-05       Impact factor: 1.898

9.  The ethics of rationing of critical care services: should technology assessment play a role?

Authors:  Eric L Bloomfield
Journal:  Anesthesiol Res Pract       Date:  2009-11-10

10.  ICU physician's ethical role in distributing scarce resources.

Authors:  B E Zawacki
Journal:  Crit Care Med       Date:  1985-01       Impact factor: 7.598

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  2 in total

1.  [Quo vadis, modern intensive care medicine? Outdated considerations regarding risks and side effects].

Authors:  G Duttge
Journal:  Med Klin Intensivmed Notfmed       Date:  2016-01-27       Impact factor: 0.840

2.  [Pre-operative documentation of individual in-patient therapy goals : A medical staff questionnaire].

Authors:  K Umgelter; J Landscheidt; K Jäger; M Blobner; E Kochs
Journal:  Anaesthesist       Date:  2016-06-20       Impact factor: 1.041

  2 in total

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