An initial comparison of intensive care in Japan and the United States
| Autor: | Choichiro Tase, Hiroyuki Hirasawa, Kimitaka Tajimi, Carl A. Sirio, Douglas P. Wagner, Nobue Sakanishi, William A. Knaus, Nobuyuki Taenaka, Hirotada Katsuya |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Gerontology
Cross-Cultural Comparison medicine.medical_specialty Population Critical Care and Intensive Care Medicine Severity of Illness Index law.invention Case mix index Japan law Intensive care Severity of illness Outcome Assessment Health Care medicine Humans Hospital Mortality Prospective Studies education Hospitals Teaching education.field_of_study Chi-Square Distribution APACHE II business.industry Public health Intensive care unit United States Intensive Care Units Logistic Models Emergency medicine Cohort Female business |
| Zdroj: | Critical care medicine. 20(9) |
| ISSN: | 0090-3493 |
| Popis: | Objective The objective of this study was to compare the utilization of, and outcome from, critical care services in selected medical centers providing secondary and tertiary care in the United States and Japan. Design Prospective data collection on 1,292 patients from each of the participating Japanese study hospitals in 1987 to 1989 and compared with the 5,030 patients in the United States 1982 Acute Physiology and Chronic Health Evaluation (APACHE II) database used to develop the APACHE II equation. Detailed organizational characteristics of the participating ICUs and hospitals were also obtained. Setting Data collection took place in the ICUs of 13 U.S. hospitals and six Japanese hospitals. Patients Data were collected on consecutive, unselected patients from medical, surgical, and mixed medical/surgical critical care units, with a spectrum of medical and surgical diagnoses. Measurements and main results U.S. and Japanese ICUs have a similar array of diagnostic and therapeutic modalities. Only 2% (range 0.6 to 3.5) of beds in Japanese hospitals were designated to intensive care. The organization of the Japanese and U.S. ICUs varied by hospital. There were significantly fewer women admitted to Japanese ICUs and a substantially lower proportion of low-risk-of-death patients. Despite a rapidly aging population, there were relatively fewer elderly patients with chronic health ailments in the Japanese ICU population (8%) compared with the U.S. cohort (18%). Conclusions In this sample of hospitals, similar high-technology critical care is available in the United States and Japan. Variations in utilization between the two countries represent differences in case mix and bed availability. The APACHE II equation stratified patients in the Japanese patient cohort across the full spectrum of increasing severity of illness. |
| Databáze: | OpenAIRE |
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