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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Editorial The sound of silence: rationing resources for critically ill patients. | Please note This paper has not been approved for publication at present Editorial R1 Editorial The sound of silence rationing resources for critically ill patients Deborah Cook and Mita Giacomini Address Departments of Medicine and Clinical Epidemiology and Center for Health Economics Policy Analysis McMaster University Hamilton Ontario Canada. Correspondence Dr DJ Cook Department of Medicine St Joseph s Hospital 50 Charlton Avenue East Hamilton Ontario Canada L8N 4A6. Tel 905-521-6079 Fax 905-521-6068 email debcook@fhs.csu.mcmaster.ca Received 15 April 1998 Accepted 16 February 1999 Published March 1999 Crit Care 1999 3 R1-R3 The original version of this paper is the electronic version which can be seen on the Internet http ccforum.com . The electronic version may contain additional information to that appearing in the paper version. Current Science Ltd ISSN 1364-8535 Introduction Thirty years ago the rationing of healthcare was invisible and silent. Recently however healthcare expenditures have become a major focus of public policy. As we look for ways to control spending we become more aware of the economic trade-offs involved in every healthcare decision. Allocating resources to one service means less left for other services allocating resources to one patient means less resources available for others. Rationing is becoming more publicly visible and explicit at every level of the healthcare system. However in many intensive care units ICUs rationing still remains silent - implicitly conducted and inadequately discussed. If we agree that healthcare resources are fixed and the needs and demands for health resources are not 1 then all resource allocation decisions are rationing decisions. Rationing implies that because of cost constraints not everyone will get every service they need want or even deserve. Encouraging clinicians to become aware of rationing in their own practice 2 Ubel and Goold suggested that three conditions must be met to label an activity as .
