JAMA : the journal of the American Medical Association
-
Randomized Controlled Trial Multicenter Study
Effects of care coordination on hospitalization, quality of care, and health care expenditures among Medicare beneficiaries: 15 randomized trials.
Medicare expenditures of patients with chronic illnesses might be reduced through improvements in care, patient adherence, and communication. ⋯ Viable care coordination programs without a strong transitional care component are unlikely to yield net Medicare savings. Programs with substantial in-person contact that target moderate to severe patients can be cost-neutral and improve some aspects of care.
-
Randomized Controlled Trial Multicenter Study Comparative Study
Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial.
Gamma-aminobutyric acid receptor agonist medications are the most commonly used sedatives for intensive care unit (ICU) patients, yet preliminary evidence indicates that the alpha(2) agonist dexmedetomidine may have distinct advantages. ⋯ There was no difference between dexmedetomidine and midazolam in time at targeted sedation level in mechanically ventilated ICU patients. At comparable sedation levels, dexmedetomidine-treated patients spent less time on the ventilator, experienced less delirium, and developed less tachycardia and hypertension. The most notable adverse effect of dexmedetomidine was bradycardia.