The High Cost of Acute Health Care: A Review of Escalating Costs and Limitations of Such Exposure in Intensive Care Units

Spivack, David

doi:10.1164/ajrccm/137.2.493b

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2001

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“…The rate of growth of expenditure in this area is often greater than that of the health care system, as a whole (Birnbaum, 1986;Singer et al 1983;Edbrooke et al 1999). The increase in resources devoted to intensive care is, in part, because of the relatively high operating costs of intensive care units (Spivack 1987). Zussman (1992) in a study of medical ethics in intensive care units notes that medicine is more constrained by the law than was once the case.…”

Section: Methods Of Investigationmentioning

confidence: 99%

Clinical actions and financial constraints: the limits to rationing intensive care

Lapsley

Melia

2001

Sociology Health & Illness

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This paper is concerned with the nature of rationing in intensive care. It reports a study of three intensive care units (ICUs) where resources were limited. We describe two conceptualisations of rationing: hard rationing, where there are absolute physical or financial constraints in place and soft rationing, in which clinicians and clinical managers, key actors in the organisation, can relax or remove apparently binding constraints. This paper demonstrates that, for the ICUs in this study, soft rationing was the norm. The existence of soft rationing was a function of three main factors: the nature of intensive care, the current state of modelling of means-end relationships in intensive care and network activity within and between ICU teams.

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Section: Methods Of Investigationmentioning

confidence: 99%