MARC details
| 000 -LEADER |
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| fixed length control field |
04132nam a22006257a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
210607s20212021 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0012-3692 |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
10.1016/j.chest.2020.11.022 [doi] |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
S0012-3692(20)35305-8 [pii] |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
33253754 |
| 245 ## - TITLE STATEMENT |
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| Title |
A Minority of Patients on Mechanical Ventilation Consume Disproportionate Resources: A Retrospective Cohort Study. |
| 251 ## - Source |
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| Source |
Chest. 159(5):1854-1866, 2021 05. |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
Chest. 159(5):1854-1866, 2021 05. |
| 252 ## - Abbreviated Source |
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| Former abbreviated source |
Chest. 2020 Nov 28 |
| 253 ## - Journal Name |
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| Journal name |
Chest |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2021 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2021 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
aheadofprint |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
ppublish |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2021-02-17 |
| 268 ## - Previous citation |
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| -- |
Chest. 2020 Nov 28 |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
BACKGROUND: The Pareto principle states that the majority of any effect comes from a minority of the causes. This property is widely used in quality improvement science. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
INTERPRETATION: Patients undergoing MV in the highest quintiles according to duration of MV consume a disproportionate amount of resources, as evidenced by MV duration, hospital LOS, and costs, making them a potential target for streamlining MV care. Copyright (c) 2020. Published by Elsevier Inc. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESEARCH QUESTION: Among patients requiring mechanical ventilation (MV), are there subgroups according to MV duration that may serve as potential nodes for high-value interventions aimed at reducing costs without compromising quality? |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESULTS: A total of 691,961 patients were included in the analysis. Median [interquartile range] duration of MV in days by quintile was as follows: quintile 1 (Q1), 1 [1, 1]; Q2, 2 [2, 2]; Q3, 3 [3, 3]; Q4, 6 [6, 7]; and Q5, 13 [10, 19]. Median [interquartile range] post-MV onset LOS (Q1, 2 [0, 5]; Q5, 17 [12, 26]) and hospital costs (Q1, |
| -- |
5,671 [ |
| -- |
,180, |
| Source |
7,901]; Q5, |
| -- |
0,133 [ |
| -- |
7,136, |
| -- |
08,032]) rose from Q1 through Q5. Patients in Q5 consumed 47.7% of all post-MV initiation hospital days among all patients requiring MV, and the mean per-patient hospital costs in Q5 exceeded the sum of costs incurred by Q1 to Q3. Adjusted marginal mean (95% CI) hospital costs rose exponentially from Q1 through Q5: Q2 vs Q1, |
| Materials specified |
,976 ( |
| -- |
,354, |
| -- |
,598); Q3 vs Q2, |
| -- |
,532 ( |
| -- |
,103, |
| -- |
,961); Q4 vs Q3, |
| -- |
1,705 ( |
| -- |
1,071, |
| -- |
2,339); and Q5 vs Q4, |
| Source |
6,416 ( |
| -- |
5,215, |
| -- |
7,616). |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
STUDY DESIGN AND METHODS: This multicenter retrospective cohort study included approximately 780 hospitals in the Premier Research Database (2014-2018). Patients receiving MV were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification, and International Classification of Diseases, Tenth Revision, codes. They were then divided into quintiles according to MV duration; their hospital costs, post-MV onset length of stay (LOS), ICU LOS, and cumulative post-MV onset hospital days per quintile were compared. |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Resource Allocation/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
*Respiration, Artificial/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Anti-Bacterial Agents/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Bronchoscopy/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Comorbidity |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Cross Infection/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Databases, Factual |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Female |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Hospital Costs |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Humans |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Length of Stay/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Male |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Middle Aged |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Pneumonia, Ventilator-Associated/dt [Drug Therapy] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Pneumonia, Ventilator-Associated/ec [Economics] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Pneumonia, Ventilator-Associated/mi [Microbiology] |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Quality Assurance, Health Care |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Retrospective Studies |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
Tracheostomy/ec [Economics] |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
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| Department |
Medicine/Pulmonary-Critical Care |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Shorr, Andrew F |
| 790 ## - Authors |
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| All authors |
Nathanson BH, Shorr AF, Ways J, Zilberberg MD |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1016/j.chest.2020.11.022">https://dx.doi.org/10.1016/j.chest.2020.11.022</a> |
| Public note |
https://dx.doi.org/10.1016/j.chest.2020.11.022 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
