title: Clinical review: impact of emergency department care on intensive care unit costs.
abstract: Critical care is both expensive and increasing. Emergency department (ED) management of critically ill patients before intensive care unit (ICU) admission is an under-explored area of potential cost saving in the ICU. Although limited, current data suggest that ED care has a significant impact on ICU costs both positive and negative. ICU practices can also affect the ED, with a lack of ICU beds being the primary reason for ED overcrowding and ambulance diversion in the USA. Earlier application in the ED of intensive therapies such as goal-directed therapy and noninvasive ventilation may reduce ICU costs by decreasing length of stay and need for admission. Future critical care policies and health services research should include both the ED and ICU in their analyses.
authors.affiliation: The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Laboratory, Department of Critical Care Medicine, Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. huangdt@ccm.upmc.edu
authors.forename: David T
authors.initials: DT
authors.lastname: Huang
mesh_terms: D016638:Critical Illness; D004636:Emergency Service, Hospital / Q000592:standards*; D017721:Hospital Costs; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000706:statistics & numerical data; D015274:Interdepartmental Relations; D007902:Length of Stay; D011785:Quality Assurance, Health Care