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Background: Use of improved early risk stratification protocols and chest pain observation units has reduced inpatient admissions for evaluation of chest pain. We sought to examine the trend in inpatient admissions for evaluation of chest pain and impact on healthcare cost in the US.
Methods: We reviewed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample (NEDS) databases from 2006-2013 for ER visits with a primary complaint of chest pain (ICD-9-CM codes 786.50, 786.51 and 786.59). We analyzed the annual number of inpatient admissions. Costs were estimated based on 2009 Medicare data for hospital reimbursement and physician services.
Results: From 2006 to 2013, a total of 50.6 million patients presented to the ER with a primary complaint of chest pain. In 2006, out of 5.4 million patients evaluated for chest pain, 1.1 million (21.01%) were admitted for further evaluation. In 2013, out of 7.1 million patients evaluated for chest pain, 0.8 million (11.83%) were admitted for further evaluation. This represents a 43.7 % relative reduction in admissions for evaluation of chest pain. With an estimated mean inflation adjusted cost of $ 12, 421 per admission in 2013 US dollars, this represents a saving of around $ 8 billion in 2013.
Conclusions: Although the number of patients presenting with chest pain has increased from 2006 to 2013, the overall rate of inpatient admissions for chest pain evaluation has reduced significantly. However, there is still room for further cost savings.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-332
- 2017 American College of Cardiology Foundation