Huang David T
The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Laboratory, Department of Critical Care Medicine, Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Crit Care. 2004 Dec;8(6):498-502. doi: 10.1186/cc2920. Epub 2004 Aug 3.
Critical care is both expensive and increasing. Emergency department (ED) management of critically ill patients before intensive care unit (ICU) admission is an under-explored area of potential cost saving in the ICU. Although limited, current data suggest that ED care has a significant impact on ICU costs both positive and negative. ICU practices can also affect the ED, with a lack of ICU beds being the primary reason for ED overcrowding and ambulance diversion in the USA. Earlier application in the ED of intensive therapies such as goal-directed therapy and noninvasive ventilation may reduce ICU costs by decreasing length of stay and need for admission. Future critical care policies and health services research should include both the ED and ICU in their analyses.
重症监护成本高昂且不断增加。在重症监护病房（ICU）收治之前，急诊科（ED）对重症患者的管理是ICU潜在成本节约方面一个尚未充分探索的领域。尽管现有数据有限，但目前的数据表明，急诊科护理对ICU成本有着显著的正负两方面影响。ICU的做法也会影响急诊科，在美国，ICU床位短缺是急诊科过度拥挤和救护车改道的主要原因。在急诊科更早地应用诸如目标导向治疗和无创通气等强化治疗，可能通过缩短住院时间和减少入院需求来降低ICU成本。未来的重症监护政策和卫生服务研究应在分析中纳入急诊科和ICU。
