We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Comparison of the 'Open' vs 'Closed' Intensive Care Unit Formats

Mark J. Alberts, MD
JAMA. 1996;276(21):1720. doi:10.1001/jama.1996.03540210028017.
Text Size: A A A
Published online


To the Editor.  —The recent article by Dr Carson and colleagues1 is an interesting and timely study of an important issue—namely, a comparison of the cost-effectiveness of 2 different organizational structures for an intensive care unit (ICU). However, several limitations in the study design and data interpretation make the conclusions suspect. For example, it is stated that all patients admitted to the ICU during the study period were eligible for enrollment, but not that consecutive patients were actually enrolled in the study. Perhaps there was a systematic bias in patient referral, as is alluded to in the paper.It is of note that the actual mortality for patients in the open period was lower than in the closed period, although the difference was not statistically significant. The comparison of actual to predicted mortality based on Acute Physiology and Chronic Health Evaluation II (APACHE II) scores is error prone, and


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.