The evolution of the intensivist: from health care provider to economic rationalist and ethicist

In contrast to many open intensive care units (ICUs) in the United State, where "parent" units (sometimes with few intensive care skills) admit and manage their own patients, Australia has closed units in which the intensivist has primary control of patient care while the patient remains i...

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Bibliographic Details
Published inMedical journal of Australia Vol. 164; no. 5; p. 310
Main Author Scheinkestel, C D
Format Journal Article
LanguageEnglish
Published Australia 04.03.1996
Subjects
Australia
Cost Control
Delivery of Health Care - trends
Ethics, Medical
Hospitalization
Humans
Intensive Care Units - economics
Intensive Care Units - standards
Intensive Care Units - statistics & numerical data
Patient Selection
Resource Allocation
Withholding Treatment
Professional Patient Relationship
Health Care and Public Health
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Summary:In contrast to many open intensive care units (ICUs) in the United State, where "parent" units (sometimes with few intensive care skills) admit and manage their own patients, Australia has closed units in which the intensivist has primary control of patient care while the patient remains in the ICU. This difference is important because in Australia, by virtue of having control of the ICU, the intensivist can be made responsible not only for patients care, but for resource allocation and financial constraint. Australian intensivists are called upon daily to make difficult decisions about who will be admitted, prematurely discharged or transferred from ICUs, and when treatment will be restricted or withdrawn.
ISSN:0025-729X
DOI:10.5694/j.1326-5377.1996.tb94200.x