This table lists the chronology of events- with two already filled in-.docx
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This table lists the chronology of events, with two already filled in, beginning with the oldest event. comnlete the tahle bv selectine the missing events and placing them in correct sequential order. Match each event description to its correct numeric sequence to fill in the missing events. For example, find the description you believe represents Event 2 and select its corresponding letter from the description drop-down list. Repeat this for each missing event. Deposition of Toroweap Formation 1st period of Uplift and erosion Subsidence and deposition of Tonto Group forming an ungular uncomformity Deposition of Hermit Shale Magma intrudes and cools underground to form Zoraster Granite 4th period of Uplift and erosion Deposition of Kaibab Formation Subsidence and deposition of Unkar Group forming a nonconformity 3rd period of Uplift and erosion 5 th period of Uplift and erosion Tilting of rock layers 2nd period of Uplift and erosion Deposition of Coconino Sandstone Subsidence and deposition of Supai Group forming a disconformity .
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Objectives : Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. Whether music intervention reduces ICU costs is not known. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care.
Design : A cost-effectiveness analysis from the hospital perspective was conducted to determine if patient-directed music intervention was cost-effective in improving patient-reported anxiety. Cost savings were also evaluated. One-way and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness.
Setting : Midwestern ICUs.
Patients : Adult ICU patients from a parent clinical trial receiving mechanical ventilatory support.
Interventions : Patients receiving the experimental patient-directed music intervention received a MP3 player, noise-canceling headphones, and music tailored to individual preferences by a music therapist.
Measurements and Main Results : The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of $2,322/patient compared with usual ICU care, resulting in patient-directed music dominance (Table 1). The probabilistic cost-effectiveness analysis found that average patient-directed music intervention costs were $2,155 less than usual ICU care and projected that cost saving is achieved in 70% of 1,000 iterations. Based on break-even analyses, cost saving is achieved if the per-patient cost of patient-directed music intervention remains below $2,651, a value eight times the base case of $329.
Conclusions : Patient-directed music intervention is cost-effective for reducing anxiety in mechanically ventilated ICU patients.
TABLE 1. Incremental Cost-Effectiveness Ratio of Patient-Directed Music Versus Usual ICU Care
Cost-Effectiveness Components
PDM
UC
Incremental Value
Costs
Patient-directed music intervention, $
329
Not applicable
ICU cost, $
127,343
129,803
Physician cost, $
3,728
3,898
Sedative medication savings during PDM intervention period, a $
-22
Total cost, $
131,379
133,701
- 2,322
Effectiveness
Anxiety score (100-mm Visual Analogue Scale for Anxiety)
33
52
- 19
Study Outcomes
Incremental cost-effective ratio, b incremental cost per unit change in anxiety score
PDM dominates UC in 70% of probabilistic sensitivity analysis iterations
PDM = patient-directed music, UC = usual ICU care.
a Sedative medications are included in ICU costs, and therefore, no adjustment in sedative medication costs were made for UC.
b Incremental cost-effective ratio assumes a $0 willingness-to-pay to reduce the Visual Analogue Scale for Anxiety score by one unit.
Reference:
Chlan LL, Heiderscheit A, Skaar DJ, Neidecker M.
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Title: Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support
Objectives : Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. Whether music intervention reduces ICU costs is not known. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care.
Design : A cost-effectiveness analysis from the hospital perspective was conducted to determine if patient-directed music intervention was cost-effective in improving patient-reported anxiety. Cost savings were also evaluated. One-way and probabilistic sensitivity analyses determined the influence of input variation on the cost-effectiveness.
Setting : Midwestern ICUs.
Patients : Adult ICU patients from a parent clinical trial receiving mechanical ventilatory support.
Interventions : Patients receiving the experimental patient-directed music intervention received a MP3 player, noise-canceling headphones, and music tailored to individual preferences by a music therapist.
Measurements and Main Results : The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of $2,322/patient compared with usual ICU care, resulting in patient-directed music dominance (Table 1). The probabilistic cost-effectiveness analysis found that average patient-directed music intervention costs were $2,155 less than usual ICU care and projected that cost saving is achieved in 70% of 1,000 iterations. Based on break-even analyses, cost saving is achieved if the per-patient cost of patient-directed music intervention remains below $2,651, a value eight times the base case of $329.
Conclusions : Patient-directed music intervention is cost-effective for reducing anxiety in mechanically ventilated ICU patients.
TABLE 1. Incremental Cost-Effectiveness Ratio of Patient-Directed Music Versus Usual ICU Care
Cost-Effectiveness Components
PDM
UC
Incremental Value
Costs
Patient-directed music intervention, $
329
Not applicable
ICU cost, $
127,343
129,803
Physician cost, $
3,728
3,898
Sedative medication savings during PDM intervention period, a $
-22
Total cost, $
131,379
133,701
- 2,322
Effectiveness
Anxiety score (100-mm Visual Analogue Scale for Anxiety)
33
52
- 19
Study Outcomes
Incremental cost-effective ratio, b incremental cost per unit change in anxiety score
PDM dominates UC in 70% of probabilistic sensitivity analysis iterations
PDM = patient-directed music, UC = usual ICU care.
a Sedative medications are included in ICU costs, and therefore, no adjustment in sedative medication costs were made for UC.
b Incremental cost-effective ratio assumes a $0 willingness-to-pay to reduce the Visual Analogue Scale for Anxiety score by one unit.
Reference:
Chlan LL, Heiderscheit A, Skaar DJ, Neidecker M.
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