For people presenting with acute chest pain, how effective and cost-effective is care in a chest pain observation unit compared with routine care?
Cluster randomised controlled trial.
Hospital admissions were significantly less likely with the chest pain observation unit (CPOU) compared with routine care (36.7% CPOU vs 53.8% routine care; adjusted OR 0.49, 95% CI 0.36 to 0.65). There was no significant difference between groups in the incidence of major coronary events at 6 months (3.8% with CPOU vs 3.4% with routine care; difference 0.4%, 95% CI –2.0% to +2.7%). The mean cost of chest pain related care per participant was lower for the CPOU than for routine care, but the difference was not significant (£478 for CPOU vs £556 for routine care; adjusted difference £53, 95% CI −£88 to +£194).
Care in a chest pain observation unit reduces hospital admissions and may be more cost effective than routine care.Le texte complet de cet article est disponible en PDF.
Keywords : Chest pain, Pain clinics, Cost–benefit analysis, Hospital costs, Randomised controlled trial
| Abstracted from: Goodacre S, Nicholl J, Dixon S et al. Randomised controlled trial and economic evaluation of a chest pain observation unit compared with routine care. BMJ 2004; 328: 254–257.