University of Chicago Medicine, Chicago, Illinois.
Surgery and Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
Curr Opin Pediatr. 2020 Jun;32(3):424-427. doi: 10.1097/MOP.0000000000000893.
The purpose of this review is to describe quality and financial economic principles that form the foundation for complex care delivery systems for the critically ill pediatric surgical population.
Advances in neonatology along with innovation in surgical techniques in children led to the need to care for more complex postoperative surgical patients. Several studies have demonstrated improved outcomes in specialized pediatric centers. Furthermore, there is some evidence to suggest that there is overall financial benefit with decreased costs and more efficient resource use to pediatric subspecialty critical care.
As more becomes known regarding the impact of specialized ICU environments, pediatric surgical critical care, and pediatric surgical ICUs have the potential to improve the value of care delivered to these complex patients. Well-designed, prospective, observational studies are needed to assist in defining appropriate outcome and quality measures to inform the development of these specialized units. Currently, there are a variety of models used in children's hospitals to care for critically ill surgical patients. This represents a tremendous opportunity for a collaborative, multidisciplinary effort amongst pediatric medical and surgical intensivists.
本文旨在描述质量和财务经济原则，为危重症儿科手术患者的复杂护理提供基础。
新生儿医学的进步和儿童外科技术的创新，导致需要照顾更多复杂的术后外科患者。多项研究表明，在专门的儿科中心可改善治疗效果。此外，有证据表明，儿科亚专科重症监护的成本降低和资源利用效率提高具有整体经济效益。
随着人们对专门的 ICU 环境、儿科外科重症监护和儿科外科 ICU 对这些复杂患者治疗效果的影响了解的越来越多，这些科室具有提高治疗价值的潜力。需要精心设计、前瞻性、观察性研究来帮助确定适当的结果和质量指标，为这些专科病房的发展提供信息。目前，儿童医院有多种模式用于危重症外科患者的治疗。这为儿科内科和外科重症监护医生之间的协作、多学科努力提供了巨大的机会。
