Postgraduate Medicine · 2009 · 116 citations · 20 references
NursingHealth SystemsHealth Systems EvaluationHospital AdministrationRural HealthRural TelehealthTelehealth PracticeTelemedicineIn-hospital MortalityMortality RatesPatient Satisfaction With TelehealthProgram Impact EvaluationTelehealth Outcomes EvaluationTelehealth SatisfactionTelemedicine Systems
In the tertiary hospital, actual‑to‑predicted ICU and hospital mortality and LOS ratios decreased. The study evaluated the impact of a 15‑hospital, rural, multi‑state ICU telemedicine program. The program’s effectiveness was assessed using APACHE® III scores, raw mortality rates, actual‑to‑predicted LOS and mortality ratios, and surveys of staff satisfaction at smaller facilities. Staff at smaller facilities reported improved critical‑care quality and fewer transfers, while regional hospitals retained sicker patients with unchanged or lower mortality, reduced LOS ratios, and the tertiary hospital saw decreased mortality and LOS ratios.
AbstractWe evaluated the impact of a 15-hospital, rural, multi-state intensive care unit (ICU) telemedicine program. Acute Physiology, Age, and Chronic Health Evaluation (APACHE® III) scores, raw mortality rates, and actual-to-predicted length of stay (LOS) ratios and mortality ratios were used. Surveys evaluated program impact in smaller facilities and satisfaction of the physicians staffing the remote center. Smaller facilities' staff reported improvements in the quality of critical care services and reduced transfers. In regional hospitals, acuity scores increased (retention of sicker patients) while raw mortality was the same or lower. Length of stay ratios were reduced in these hospitals. In the tertiary hospital, actual-to-predicted ICU and hospital mortality and LOS ratios decreased.Keywords: health economicsintensive care unittelemedicineruralhealth care system
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The APACHE III Prognostic System
Marilyn Bergner, P. G. Bastos, Carl Sirio et al. · CHEST Journal · 1991 · 3.5K citations