PMID- 19239596
OWN - NLM
STAT- MEDLINE
DCOM- 20090817
LR  - 20181201
IS  - 1365-2753 (Electronic)
IS  - 1356-1294 (Linking)
VI  - 15
IP  - 1
DP  - 2009 Feb
TI  - Prehospital pain treatment: an economic productivity factor in emergency 
      medicine?
PG  - 152-7
LID - 10.1111/j.1365-2753.2008.00973.x [doi]
AB  - RATIONALE AND OBJECTIVES: Analgesia is a recommended practice for pain treatment 
      in prehospital emergency medicine, but all experts note suboptimal pain relief or 
      oligoanalgesia. The increase in the Care Workload (CW) and the Medical Treatment 
      Duration (MTD) linked to analgesia are two explanatory factors, and they are 
      representative of the unavailability of a prehospital team. The unavailability of 
      a team is an opportunity cost which is probably the most important cost within 
      the framework of prehospital emergency. The aim of this study was to analyse the 
      influence of analgesia use on the availability of prehospital emergency teams. 
      METHODS: This study was a prospective, multicentre cohort study conducted in 10 
      French Mobile Emergency and Resuscitation Services (MERS) between September 2001 
      and June 2003. A case-control study was performed including 568 case patients who 
      received analgesia matched with controls based on diagnosis and severity. The 
      pairs were compared for MTD and CW. RESULTS: No significant difference between 
      cases and controls was found concerning MTD (P = 0.134). Conversely, a difference 
      was found for CW (P < 10(-4)), with a mean value of 53.7 Project Recherche 
      Nursing (PRN) points for the cases and 45.8 PRN points for the controls. 
      CONCLUSIONS: This study shows that analgesia generates an additional CW without 
      increasing the MTD, and does not hinder the MERS teams' availability. This 
      economic result should improve adherence to these clinical practice guidelines. 
      Thus, analgesia appears to be a factor of productivity in the current context of 
      economic pressures in terms of the funding of the healthcare system.
FAU - Hubert, Herve
AU  - Hubert H
AD  - Institute of Engineering in Health of Lille (EA2694), University of Lille, Lille, 
      France. herve.hubert@univ-lille2.fr
FAU - Guinhouya, Comlavi
AU  - Guinhouya C
FAU - Ricard-Hibon, Agnes
AU  - Ricard-Hibon A
FAU - Wiel, Eric
AU  - Wiel E
FAU - Durocher, Alain
AU  - Durocher A
FAU - Goldstein, Patrick
AU  - Goldstein P
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - J Eval Clin Pract
JT  - Journal of evaluation in clinical practice
JID - 9609066
SB  - IM
MH  - Adult
MH  - Aged
MH  - Analgesia/*statistics & numerical data
MH  - Case-Control Studies
MH  - Cohort Studies
MH  - Emergency Medical Services/*economics
MH  - Female
MH  - France
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain/*drug therapy/nursing
MH  - *Patient Care Team
MH  - Prospective Studies
EDAT- 2009/02/26 09:00
MHDA- 2009/08/18 09:00
CRDT- 2009/02/26 09:00
PHST- 2009/02/26 09:00 [entrez]
PHST- 2009/02/26 09:00 [pubmed]
PHST- 2009/08/18 09:00 [medline]
AID - JEP973 [pii]
AID - 10.1111/j.1365-2753.2008.00973.x [doi]
PST - ppublish
SO  - J Eval Clin Pract. 2009 Feb;15(1):152-7. doi: 10.1111/j.1365-2753.2008.00973.x.