The future of hospital economic health.

Objective: To evaluate factors which may influence the economic future of academic medical centers (AMCs).

Data Source And Selection: A literature search was performed to identify publications which reviewed the areas of revenue sources for AMCs, costs and expenses incurred by these institutions, and mechanisms for optimizing institutional economic stability.

Data Extraction And Synthesis: Data were reviewed and evaluated in two primary contexts: hospital revenues and organizational and administrative factors influencing hospital economic health.

Economics of critical care: Medicare part A versus part B payments.

Objective: To review the effect of Medicare part A payments (to hospitals) and part B payments (to providers) on critical care in the United States.

Data Source And Selection: Sources included U.S.

Critical care medicine as a distinct product line with substantial financial profitability: the role of business planning.

Objective: As academic health centers face increasing financial pressures, they have adopted a more businesslike approach to planning, particularly for discrete "product" or clinical service lines. Since critical care typically has been viewed as a service provided by a hospital, and not a product line, business plans have not historically been developed to expand and promote critical care. The major focus when examining the finances of critical care has been cost reduction, not business development.

Guidelines on critical care services and personnel: Recommendations based on a system of categorization of three levels of care.

Objectives: To describe three levels of hospital-based critical care centers to optimally match services and personnel with community needs, and to recommend essential intensive care unit services and personnel for each critical care level.

Participants: A multidisciplinary writing panel of professionals with expertise in the clinical practice of critical care medicine working under the direction of the American College of Critical Care Medicine (ACCM).

Data Sources And Synthesis: Relevant medical literature was accessed through a systematic Medline search and synthesized by the ACCM writing panel, a multidisciplinary group of critical care experts.

Ethical issues in hospital medicine.

The medical ethics of the new millennium will be fascinating and fast moving in our pluralistic Western society. This will be particularly true in ethics in the hospital setting and under hospitalist models. Ethical decisions are ubiquitous in medical practice, at the microlevel of the patient-physician relationship and at the macro-level of the allocation of resources and other ethical decisions.