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

    Article, Communication - En anglais

    Society for Academic Emergency Medicine annual meeting. Denver (USA), 1996/05/06.

    Context. - More than 3 million patients are hospitalized yearly in the United States for chest pain.

    The cost is over $3 billion just for those found to be free of acute disease.

    New rapid diagnostic tests for acute myocardial infarction (AMI) have resulted in the proliferation of accelerated diagnostic protocols (ADPs) and chest pain observation units.

    Objective

    - To determine whether use of an emergency department (ED) - based ADP can reduce hospital admission rate, total cost, and length of stay (LOS) for patients needing admission for evaluation of chest pain.

    Design

    - Prospective randomized controlled trial comparing admission rate, total cost, and LOS for patients treated using ADP vs inpatient controls.

    Total costs were determined using empirically measured resource utilization and microcosting techniques.

    Setting

    - A large urban public teaching hospital serving a predominantly African American and Hispanic population.

    Patients

    - A sample of 165 patients was randomly selected from a larger consecutive sample of 429 patients with chest pain concurrently enrolled in an ADP diagnostic cohort trial.

    Eligible patients presented to the ED with clinical findings suggestive of AMI or acute cardiac ischemia (ACI) but at low risk using a validated predictive algorithm.

    Main Outcome Measures

    - Primary outcomes measured for each subject were LOS and total cost of treatment.

    Results

    - The hospital admission rate for ADP vs control patients was 45.2% vs 100% (P<. 001). (...)

    Mots-clés Pascal : Infarctus, Myocarde, Aigu, Ischémie, Diagnostic, Urgence, Service hospitalier, Economie santé, Analyse coût, Douleur, Thorax, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie, Vaisseau sanguin pathologie

    Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Ischemia, Diagnosis, Emergency, Hospital ward, Health economy, Cost analysis, Pain, Thorax, Human, Cardiovascular disease, Coronary heart disease, Myocardial disease, Vascular disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0032595

    Code Inist : 002B12A03. Création : 17/04/1998.