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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1377/hlthaff.24.4.961" target="_blank" rel="noreferrer">http://doi.org/10.1377/hlthaff.24.4.961</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The costs of nonbeneficial treatment in the intensive care setting
Publisher
An entity responsible for making the resource available
Health Affairs
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Female; Humans; Male; United States; Patient Discharge; Adult; Medical Futility; Middle Aged; Length of Stay; Dissent and Disputes; Survival Analysis; Empirical Approach; Death and Euthanasia; decision making; ICU Decision Making; Health Care and Public Health; Hospital Costs/statistics & numerical data; Ethics Consultation/utilization; Intensive Care Units/economics/ethics; Intensive Care/economics/ethics/utilization; Life Support Care/economics/ethics/utilization
Creator
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Gilmer T; Schneiderman LJ; Teetzel H; Blustein J; Briggs K; Cohn F; Cranford R; Dugan D; Kamatsu G; Young E
Description
An account of the resource
Ethics consultations have been shown to reduce the use of "nonbeneficial treatments," defined as life-sustaining treatments delivered to patients who ultimately did not survive to hospital discharge, when treatment conflicts occurred in the adult intensive care unit (ICU). In this paper we estimated the costs of nonbeneficial treatment using the results from a randomized trial of ethics consultations. We found that ethics consultations were associated with reductions in hospital days and treatment costs among patients who did not survive to hospital discharge. We conclude that consultations resolved conflicts that would have inappropriately prolonged nonbeneficial or unwanted treatments in the ICU instead of focusing on more appropriate comfort care.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1377/hlthaff.24.4.961" target="_blank" rel="noreferrer">10.1377/hlthaff.24.4.961</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
Adult
Backlog
Blustein J
Briggs K
Cohn F
Cranford R
Death and Euthanasia
Decision Making
Dissent And Disputes
Dugan D
Empirical Approach
Ethics Consultation/utilization
Female
Gilmer T
Health Affairs
Health Care and Public Health
Hospital Costs/statistics & numerical data
Humans
ICU Decision Making
Intensive Care Units/economics/ethics
Intensive Care/economics/ethics/utilization
Journal Article
Kamatsu G
Length Of Stay
Life Support Care/economics/ethics/utilization
Male
Medical Futility
Middle Aged
Patient Discharge
Schneiderman LJ
Survival Analysis
Teetzel H
United States
Young E
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=1524334&site=ehost-live&scope=site" target="_blank" rel="noreferrer">http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=1524334&site=ehost-live&scope=site</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Effects of offering advance directives on medical treatments and costs
Publisher
An entity responsible for making the resource available
Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1992
Subject
The topic of the resource
Humans; Personal Autonomy; Withholding Treatment; Prospective Studies; California; Hospitals; Empirical Approach; Professional Patient Relationship; Death and Euthanasia; DNAR Outcomes; Resource Allocation; Health Care and Public Health; Veterans; University; Advance Directives/ec [Economics]; Advance Directives/psychology; California Durable Power of Attorney for Health Care; Control Groups; Cost Control/methods; Life Support Care/utilization; Life Support Care/economics; Patient Satisfaction/statistics & numerical data; Risk Assessment
Creator
An entity primarily responsible for making the resource
Schneiderman LJ; Kronick R; Kaplan RM; Anderson JP; Langer RD
Description
An account of the resource
Objective: To examine the effects of advance directives on medical treatments and on patient satisfaction and well-being and to determine whether the enhancement of patient autonomy through advance directives provides a more ethically feasible approach to cost control than does the imposition of limits through rationing.; Design: Randomized, controlled trial.; Setting: University and Veterans Affairs medical center.; Patients: Two hundred and four patients with life-threatening illnesses, 100 of whom died after enrollment in the study.; Intervention: Patients randomly assigned to the experimental group were offered the California Durable Power of Attorney (a typical proxy-instruction directive), and patients assigned to the control group were not offered the advance directive. Hospital admissions were monitored to assure that a summary of the document was present in the active medical record at each hospitalization.; Measurements: Cognitive function, patient satisfaction, psychological well-being, health locus of control, sense of coherence, health-related quality of life, receipt of medical treatments, and medical treatment charges.; Results: No significant differences were found between advance-directive and control groups regarding psychosocial variables, health outcome variables, and medical treatments or charges. Patients offered an advance directive had an average hospital stay of 40.8 days (95% CI, 32.2 to 49.4 days), compared with an average of 33.1 days (95% CI, 26.0 to 40.2 days) for controls. Patients offered an advance directive were charged an average of $19,502 (95% CI, $13,030 to $25,974) for medical treatments in the last month of life compared with $19,700 (95% CI, $13,704 to $25,696) for controls.; Conclusions: Despite claims that public demand for longer life accounts for rising medical costs, most surveys suggest that patients are calling for less, not more, of the expensive, high-technology treatment often used in terminal phases of illness. Executing the California Durable Power of Attorney for Health Care and having a summary copy placed in the patient's medical record had no significant positive or negative effect on a patient's well-being, health status, medical treatments, or medical treatment charges.;
1992-10
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1992
Advance Directives/ec [Economics]
Advance Directives/psychology
Anderson JP
Annals Of Internal Medicine
Backlog
California
California Durable Power of Attorney for Health Care
Control Groups
Cost Control/methods
Death and Euthanasia
DNAR Outcomes
Empirical Approach
Health Care and Public Health
Hospitals
Humans
Journal Article
Kaplan RM
Kronick R
Langer RD
Life Support Care/economics
Life Support Care/utilization
Patient Satisfaction/statistics & Numerical Data
Personal Autonomy
Professional Patient Relationship
Prospective Studies
Resource Allocation
Risk Assessment
Schneiderman LJ
University
Veterans
Withholding Treatment