Journal of Intensive and Critical Care Open Access

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Editorial - (2015) Volume 1, Issue 1

Critical Care: Dilemma Issue on Cost Management

Viroj Wiwanitkit*

Surin Rajabhat University, Thailand

Corresponding Author:

Viroj Wiwanitkit
Professor, Surin Rajabhat University, Thailand

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The critical care is a very important work in medicine. In each hospital, there must be an emergency or critical care unit to manage the critical case. However, an important fact is that the critical case is sometimes an acute problem and the patient has to seek for the prompt care from the nearest health service unit. Dean noted that “effectively utilizing current resources is a challenge for all emergency medical services systems for reasons of cost-effectiveness and safety” [1]. The big issue is the cost for caring. Equity and economics has to be balanced [2]. This is usually the issue in several settings, especially for the poor developing countries. Sometimes, critical patients might be poorly managed or receive no management due to unethical practice of the hospital that seeks for only money or profit [3]. The issue is serious in many developing countries. The private hospital is usually accused of this unethical problem.

Although there are some attempts and health policies in some countries to provide social welfare, universal coverage or accident victim fund to correspond to the critical case management it is usually problematic. Sometimes, the fund is misused by some unethical hospital. Some makes a business on the fund, giving poor management but ask for the expensive refunding. Some makes the collaboration with local rescue team to “get the severe patients” as a case predating. “Regulation to protect patients from financial abuse by private medical providers, pharmacies, and drug vendors” are usually the issue for improvement in developing countries [4]. How to manage these problematics issues is the big problem for us to think and manage.


  1. Dean SF (2008)Why the closest ambulance cannot be dispatched in an urbanemergencymedical services system. Prehosp Disaster Med23:161-165.
  2. Moreno-Millán E, Tejedor-Fernández M, Torres-Murillo JM, García-Torrecillas JM, Cid-Cumplido M, et al. (2010) Economics and equity in urgency andemergencycare. AnSistSanitNavar1:19-27.
  3. Josephson GW (1997) Private hospitalcare for profit? A reappraisal. Health Care Manage Rev22:64-73.
  4. Sepehri A, Chernomas R, Akram-Lodhi AH (2003)If they get sick, they are in trouble: health care restructuring, user charges, and equity in Vietnam. Int J Health Serv33:137-161.