Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities
Abstract Purpose Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LT...
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| Veröffentlicht in: | Journal of critical care 2015-12, Vol.30 (6), p.1400-1402 |
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| creator | Greenough, William B., MD Ahmed, Maaz Finucane, Thomas, MD Galiatsatos, Panagis, MD Weiss, Carlos, MD Bellantoni, Michele, MD |
| description | Abstract Purpose Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LTCVs) to SNFs in Maryland began in 2006. The safety of these transfers needs to be assessed. Methods We retrospectively followed up all patients designated as eligible by their insurance for transfer from our LTCV units to SNF from July 1, 2008 through June 30, 2010 looking only at survival. Those patients who refused transfer and appealed and remained in our LTCV were compared to those who were transferred to SNF ventilator units. The analysis was by Kaplan-Meier statistics. Results There was an increased mortality ( P = .025) of those transferred to SNF ventilator facilities as compared to those remaining in the LTCV. Conclusion We recognize that bias may occur in patients choosing to remain in our LTCV compared to those accepting transfers, the magnitude of the difference in mortality indicates the need for more comprehensive well designed analysis investigating the outcome of all transfers occurring to and from LTCVs. |
| doi_str_mv | 10.1016/j.jcrc.2015.08.006 |
| format | Article |
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A small scale observation of transfer results from chronic to skilled ventilator facilities</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><source>ProQuest Central UK/Ireland</source><creator>Greenough, William B., MD ; Ahmed, Maaz ; Finucane, Thomas, MD ; Galiatsatos, Panagis, MD ; Weiss, Carlos, MD ; Bellantoni, Michele, MD</creator><creatorcontrib>Greenough, William B., MD ; Ahmed, Maaz ; Finucane, Thomas, MD ; Galiatsatos, Panagis, MD ; Weiss, Carlos, MD ; Bellantoni, Michele, MD</creatorcontrib><description>Abstract Purpose Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LTCVs) to SNFs in Maryland began in 2006. The safety of these transfers needs to be assessed. Methods We retrospectively followed up all patients designated as eligible by their insurance for transfer from our LTCV units to SNF from July 1, 2008 through June 30, 2010 looking only at survival. Those patients who refused transfer and appealed and remained in our LTCV were compared to those who were transferred to SNF ventilator units. The analysis was by Kaplan-Meier statistics. Results There was an increased mortality ( P = .025) of those transferred to SNF ventilator facilities as compared to those remaining in the LTCV. Conclusion We recognize that bias may occur in patients choosing to remain in our LTCV compared to those accepting transfers, the magnitude of the difference in mortality indicates the need for more comprehensive well designed analysis investigating the outcome of all transfers occurring to and from LTCVs.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2015.08.006</identifier><identifier>PMID: 26404958</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Chronic ; Continuity of Patient Care ; Costs ; Costs and Cost Analysis ; Critical Care ; Critical Illness - economics ; Critical Illness - mortality ; Data Collection ; Death ; Female ; Geriatrics ; Health Care Costs ; Humans ; Illnesses ; Intensive care ; Kaplan-Meier Estimate ; Long term health care ; Male ; Maryland ; Middle Aged ; Mortality ; Nursing homes ; Ostomy ; Patient safety ; Patient Transfer ; Respiration, Artificial - economics ; Respiration, Artificial - methods ; Retrospective Studies ; Risk Assessment ; Skilled ; Skilled Nursing Facilities - economics ; Skilled Nursing Facilities - organization & administration ; Ventilation ; Ventilator ; Ventilators ; Ventilators, Mechanical - economics</subject><ispartof>Journal of critical care, 2015-12, Vol.30 (6), p.1400-1402</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-2944bdb4a34d656ae044fb2a313207f3002a7dda5ec1e865f2395fb7400bf98a3</citedby><cites>FETCH-LOGICAL-c509t-2944bdb4a34d656ae044fb2a313207f3002a7dda5ec1e865f2395fb7400bf98a3</cites><orcidid>0000-0003-1457-0461</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1728623633?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26404958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Greenough, William B., MD</creatorcontrib><creatorcontrib>Ahmed, Maaz</creatorcontrib><creatorcontrib>Finucane, Thomas, MD</creatorcontrib><creatorcontrib>Galiatsatos, Panagis, MD</creatorcontrib><creatorcontrib>Weiss, Carlos, MD</creatorcontrib><creatorcontrib>Bellantoni, Michele, MD</creatorcontrib><title>Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>Abstract Purpose Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LTCVs) to SNFs in Maryland began in 2006. The safety of these transfers needs to be assessed. Methods We retrospectively followed up all patients designated as eligible by their insurance for transfer from our LTCV units to SNF from July 1, 2008 through June 30, 2010 looking only at survival. Those patients who refused transfer and appealed and remained in our LTCV were compared to those who were transferred to SNF ventilator units. The analysis was by Kaplan-Meier statistics. Results There was an increased mortality ( P = .025) of those transferred to SNF ventilator facilities as compared to those remaining in the LTCV. Conclusion We recognize that bias may occur in patients choosing to remain in our LTCV compared to those accepting transfers, the magnitude of the difference in mortality indicates the need for more comprehensive well designed analysis investigating the outcome of all transfers occurring to and from LTCVs.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chronic</subject><subject>Continuity of Patient Care</subject><subject>Costs</subject><subject>Costs and Cost Analysis</subject><subject>Critical Care</subject><subject>Critical Illness - economics</subject><subject>Critical Illness - mortality</subject><subject>Data Collection</subject><subject>Death</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Health Care Costs</subject><subject>Humans</subject><subject>Illnesses</subject><subject>Intensive care</subject><subject>Kaplan-Meier Estimate</subject><subject>Long term health care</subject><subject>Male</subject><subject>Maryland</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nursing homes</subject><subject>Ostomy</subject><subject>Patient safety</subject><subject>Patient Transfer</subject><subject>Respiration, Artificial - economics</subject><subject>Respiration, Artificial - methods</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Skilled</subject><subject>Skilled Nursing Facilities - economics</subject><subject>Skilled Nursing Facilities - organization & administration</subject><subject>Ventilation</subject><subject>Ventilator</subject><subject>Ventilators</subject><subject>Ventilators, Mechanical - economics</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kkuL1jAUhosozufoH3AhATduWk9uvYA4DIM3GHCh4jKk6YmTTtqMSfrJ_HtbOirMwlUgPO_LSZ5TFM8pVBRo_XqsRhNNxYDKCtoKoH5QHKiUTdnWVD4sDtC2vOyEoCfFk5RGANpwLh8XJ6wWIDrZHorl-xVGJEMgv5D8CMTGMJHt6oyckzRp70ky2iMJfcJ41NmFmQRLctRzshhJxLT4nPaguYphdobkQNK18x4HcsQ5O69ziMRq47zLDtPT4pHVPuGzu_O0-Pb-3deLj-Xl5w-fLs4vSyOhyyVbZ--HXmguhlrWGkEI2zPNKWfQWA7AdDMMWqKh2NbSMt5J2zcCoLddq_lp8WrvvYnh54Ipq8klg97rGcOSFG1YWzdcNN2KvryHjmGJ8zrdTjFec75SbKdMDClFtOomuknHW0VBbVLUqDYpapOioFWrlDX04q566Scc_kb-WFiBNzuA618cHUaVjMPZ4OAimqyG4P7f__Ze3Hi3atD-Gm8x_XuHSkyB-rKtxbYVVAII3gr-G_nNsq8</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Greenough, William B., MD</creator><creator>Ahmed, Maaz</creator><creator>Finucane, Thomas, MD</creator><creator>Galiatsatos, Panagis, MD</creator><creator>Weiss, Carlos, MD</creator><creator>Bellantoni, Michele, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1457-0461</orcidid></search><sort><creationdate>20151201</creationdate><title>Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities</title><author>Greenough, William B., MD ; Ahmed, Maaz ; Finucane, Thomas, MD ; Galiatsatos, Panagis, MD ; Weiss, Carlos, MD ; Bellantoni, Michele, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-2944bdb4a34d656ae044fb2a313207f3002a7dda5ec1e865f2395fb7400bf98a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chronic</topic><topic>Continuity of Patient Care</topic><topic>Costs</topic><topic>Costs and Cost Analysis</topic><topic>Critical Care</topic><topic>Critical Illness - economics</topic><topic>Critical Illness - mortality</topic><topic>Data Collection</topic><topic>Death</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Health Care Costs</topic><topic>Humans</topic><topic>Illnesses</topic><topic>Intensive care</topic><topic>Kaplan-Meier Estimate</topic><topic>Long term health care</topic><topic>Male</topic><topic>Maryland</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Nursing homes</topic><topic>Ostomy</topic><topic>Patient safety</topic><topic>Patient Transfer</topic><topic>Respiration, Artificial - economics</topic><topic>Respiration, Artificial - methods</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Skilled</topic><topic>Skilled Nursing Facilities - economics</topic><topic>Skilled Nursing Facilities - organization & administration</topic><topic>Ventilation</topic><topic>Ventilator</topic><topic>Ventilators</topic><topic>Ventilators, Mechanical - economics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greenough, William B., MD</creatorcontrib><creatorcontrib>Ahmed, Maaz</creatorcontrib><creatorcontrib>Finucane, Thomas, MD</creatorcontrib><creatorcontrib>Galiatsatos, Panagis, MD</creatorcontrib><creatorcontrib>Weiss, Carlos, MD</creatorcontrib><creatorcontrib>Bellantoni, Michele, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of critical care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greenough, William B., MD</au><au>Ahmed, Maaz</au><au>Finucane, Thomas, MD</au><au>Galiatsatos, Panagis, MD</au><au>Weiss, Carlos, MD</au><au>Bellantoni, Michele, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities</atitle><jtitle>Journal of critical care</jtitle><addtitle>J Crit Care</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>30</volume><issue>6</issue><spage>1400</spage><epage>1402</epage><pages>1400-1402</pages><issn>0883-9441</issn><eissn>1557-8615</eissn><abstract>Abstract Purpose Skilled nursing facility ventilator units (SNF) are a recent attempt to reduce the costs of an increasing number of patients who are in acute intensive care units and are not able to be liberated from ventilators. Transfers of such patients from long-term care chronic vent units (LTCVs) to SNFs in Maryland began in 2006. The safety of these transfers needs to be assessed. Methods We retrospectively followed up all patients designated as eligible by their insurance for transfer from our LTCV units to SNF from July 1, 2008 through June 30, 2010 looking only at survival. Those patients who refused transfer and appealed and remained in our LTCV were compared to those who were transferred to SNF ventilator units. The analysis was by Kaplan-Meier statistics. Results There was an increased mortality ( P = .025) of those transferred to SNF ventilator facilities as compared to those remaining in the LTCV. Conclusion We recognize that bias may occur in patients choosing to remain in our LTCV compared to those accepting transfers, the magnitude of the difference in mortality indicates the need for more comprehensive well designed analysis investigating the outcome of all transfers occurring to and from LTCVs.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26404958</pmid><doi>10.1016/j.jcrc.2015.08.006</doi><tpages>3</tpages><orcidid>https://orcid.org/0000-0003-1457-0461</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Chronic Continuity of Patient Care Costs Costs and Cost Analysis Critical Care Critical Illness - economics Critical Illness - mortality Data Collection Death Female Geriatrics Health Care Costs Humans Illnesses Intensive care Kaplan-Meier Estimate Long term health care Male Maryland Middle Aged Mortality Nursing homes Ostomy Patient safety Patient Transfer Respiration, Artificial - economics Respiration, Artificial - methods Retrospective Studies Risk Assessment Skilled Skilled Nursing Facilities - economics Skilled Nursing Facilities - organization & administration Ventilation Ventilator Ventilators Ventilators, Mechanical - economics |
| title | Where do we go from here? A small scale observation of transfer results from chronic to skilled ventilator facilities |
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