[重症监护和急救药物的过度使用和可持续性]。

IF 1.3 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL
M Kochanek, M Berek, U Janssens, V Kitz, F M Wilkens
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引用次数: 0

摘要

本文综述了重症监护和急诊医学背景下的过度治疗和过度诊断问题及其与可持续性的关系。报告显示,人力和技术资源的密集使用往往伴随着过度使用的风险,特别是在危急的医疗情况下。通常采取的诊断和治疗措施比必要的多,导致患者压力和资源的大量消耗。其中一个主要问题是往往难以区分必要治疗和过度治疗。急性护理的不确定性,加上法律问题,往往导致防御性医疗。这意味着,出于安全考虑,医生会启动比临床所需更多的诊断测试和治疗。医疗体系中也存在鼓励过度治疗的经济抑制因素。本文还讨论了指南的作用,特别是在患者偏好方面。这些可以帮助避免不必要的入住重症监护病房,从而有助于可持续发展。讨论表明,可持续性不应与高质量的患者护理相冲突。相反,治疗方案也应考虑其对可持续性的贡献,而不忽视患者的个人需求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Intensive care and emergency medicine overuse and sustainability].

This review examines the issue of overtreatment and overdiagnosis in the context of intensive care and emergency medicine and its relationship to sustainability. It shows that the intensive use of resources, both human and technology, is often associated with risks of overuse, especially in critical medical situations. More diagnostic and therapeutic measures are often taken than necessary, leading to both stress for the patient and a high consumption of resources. One of the main problems is the often difficult distinction between necessary and excessive treatment. Uncertainty in acute care, coupled with legal concerns, often leads to defensive medicine. This means that, for safety reasons, physicians initiate more diagnostic tests and treatments than are clinically necessary. There are also economic disincentives in the healthcare system that encourage overtreatment. The paper also discusses the role of guidelines, particularly with respect to patient preferences. These can help to avoid unnecessary admissions to the intensive care unit and thus contribute to sustainability. The discussion shows that sustainability should not be at odds with high-quality patient care. Rather, treatment options should also be considered in terms of their contribution to sustainability, without neglecting the individual needs of patients.

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来源期刊
CiteScore
2.60
自引率
9.10%
发文量
93
审稿时长
6-12 weeks
期刊介绍: Medizinische Klinik – Intensivmedizin und Notfallmedizin is an internationally respected interdisciplinary journal. It is intended for physicians, nurses, respiratory and physical therapists active in intensive care and accident/emergency units, but also for internists, anesthesiologists, surgeons, neurologists, and pediatricians with special interest in intensive care medicine. Comprehensive reviews describe the most recent advances in the field of internal medicine with special focus on intensive care problems. Freely submitted original articles present important studies in this discipline and promote scientific exchange, while articles in the category Photo essay feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. In the rubric journal club well-respected experts comment on outstanding international publications. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice. The rubrics "Nursing practice" and "Physical therapy" round out the information.
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