Michael J. McCue

A comprehensive strategy for the evaluation and triage of the chest pain patient: a cost comparison study ☆

BackgroundOur objective was to determine the cost-effectiveness of a comprehensive, risk-based triage system, composed of multiple critical pathways, with the use of early myocardial perfusion imaging (MPI) in low-risk patients. We found previously that a chest pain evaluation system that uses MPI in low-risk patients was safe and effective, but the costeffectiveness of this approach was not studied.Methods and ResultsWe compared two groups. The Acute Cardiac Team (ACT) group (n = 874) was assigned prospectively to 1 of 4 risk levels by emergency department (ED) physicians. Level 1, 2, and 3 patients were admitted; level 4 patients were evaluated in the ED. Level 3 and 4 patients underwent ED MPI. The control group (n = 713) represented consecutive patients evaluated in the prior year according to standard care and assigned retrospectively to an ACT level based on the presenting electrocardiographic and clinical data. Record and hospital administrative data were assessed for clinical variables, outcomes, lengths of stay, and all expenses incurred within 30 days of the index visit. The baseline characteristics of the two groups were similar, including age, sex, myocardial infarction prevalence, and 30-day revascularization rates within each level or between the two groups. Mean costs per encounter were reduced for the ACT patients for each level, which was significant when all patients were compared (

Measuring the technical efficiency of psychiatric hospitals

5,030 ±

STRATEGIC HOSPITAL ALLIANCES: DO THE TYPE AND MARKET STRUCTURE OF STRATEGIC HOSPITAL ALLIANCES MATTER?

7,081 vs

Small Hospitals with Positive Cash Flow: Why are they Winners?

6,044 ±

The Rural Cancer Outreach Program: clinical and financial analysis of palliative and curative care for an underserved population

10,432, P ± .02). Use of MPI in the low-risk patients was associated with reduced costs (level 3,

Assessing the performance of freestanding hospitals.

4,958 ±

The relationship of financial and mission factors to the level of uncompensated care provided in California hospitals.

4,948 vs

A profile of hospital acquisitions.

5,051 ±

ASSESSING THE CHARACTERISTICS OF HOSPITAL BOND DEFAULTS

7,036; level 4,

The Effects of For-Profit Multihospital System Ownership on Hospital Financial and Operating Performance

1,529 ±