Is There a Need for a Chest Pain Observation Unit and Will it be Cost Effective?

Studies from the USA suggest that using an A&E department based chest pain observation unit (CPOU) saves from $567 to $2030 per patient compared with hospital admission. In the UK cost effectiveness figures are lower at around 78 per patient. This study aims to review current practice for patients presenting with chest pain in St.Lukes Hospital (SLH), to determine the proportion of patients suitable for CPOU evaluation and consequently calculate any related cost effectiveness. Methods: 236 patients presenting with a primary complaint of chest pain to the A&E department at SLH between 1st June and 12th July 2003 were selected. The case histories of these patients were reviewed to ascertain how many of them would qualify for a CPOU management and specific data was collected. Results: Notes were retrieved for 217 patients. A total of 103 (47.5%) patients were suitable for a CPOU management. Mean length of in-hospital stay of these patients was 67.5 hours. Estimated mean cost saving per patient was LM220 and overall LM 19,800 per month. Conclusion: Potential exists for the setting up of CPOU care to reduce health service costs and improve health utility at St.Lukes Hospital. Cassar et al, 2004 Malta Medical Journal 17 (04): 26 - 29.