Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: a randomized controlled trial

Article Abstract:

Using an accelerated diagnostic protocol (ADP) in the emergency department (ED) to detect heart attack in patients with chest pain may save time, money and unnecessary hospitalizations. Of 165 patients seen in an ED for chest pain, 83 were admitted to the hospital for monitoring and 82 received more intensive monitoring for 12 hours in the ED. All of the patients had low risk of a heart attack based on their history. Only 45% of the patients in the ADP were admitted to the hospital and the ADP reduced the average cost per patient from $2,095 to $1,528. Length of stay was reduced from 44.8 hours to 33.1 hours.

Evaluation

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Distribution of Variable vs Fixed Costs of Hospital Care

Article Abstract:

Efforts to control health care costs by denying services to patients may not be effective. Most hospitals and outpatient clinics have fixed expenses and variable expenses. Fixed expenses include the costs of buying, renting or leasing the building and its equipment, and the cost of salaries and benefits to its employees. Variable expenses include the cost of medications, supplies and diagnostic tests and reagents. Denying services to patients would only save variable expenses. In one large urban hospital, 84% of the 1993 budget was spent on fixed expenses and only 16% on variable expenses.

Analysis, Economic aspects, Hospitals, Medical care, Cost of, Health care costs

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Chest pain evaluation units: an idea whose time has come

Article Abstract:

Chest pain evaluation units (CPEUs) may be a safe and effective alternative to hospitalization for patients with chest pain who have a low risk of heart attack. The CPEU is usually located in the emergency department, where these patients can be intensively monitored and discharged without hospitalization. A 1997 study of one CPEU found that it resulted in lower costs per patient when compared to hospitalization. Other studies have confirmed the benefits of CPEUs. Advances in diagnostic technology will allow physicians to monitor these patients more effectively.

Editorial, Usage

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