Premium
The evolution of the intensivist: from health care provider to economic rationalist and ethicist
Author(s) -
Scheinkestel Carlos D
Publication year - 1996
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1996.tb94200.x
Subject(s) - intensivist , intensive care , medicine , constraint (computer aided design) , health care , nursing , control (management) , intensive care medicine , medical emergency , management , economic growth , mechanical engineering , engineering , economics
In contrast to many open intensive care units (ICUs) in the United States, where “parent” units (sometimes with few intensive care skills) admit and manage their own patients, Australia has closed units in which the intensivist has primary control of patient care while the patient remains in the ICU. This difference is important because in Australia, by virtue of having control of the ICU, the intensivist can be made responsible not only for patient care, but for resource allocation and financial constraint. Australian intensivists are called upon daily to make difficult decisions about who will be admitted, prematurely discharged or transferred from ICUs, and when treatment will be restricted or withdrawn.