Cost Differential - Chest Pain Workup vs. Admission

The economic impact of the emergency chest pain workup is significant. It is estimated that the economic impact of a negative workup is approximately $5 billion in the USA every year. There is a positive correlation between length of stay in the hospital and cost.

A study of patients with low risk chest pain was performed in a randomized control fashion. 200 patients received either immediate Coronary CTA or conventional workup (serial cardiac enzymes, ECG, nuclear stress test). Median length of stay and median cost in the immediate Coronary CTA patients was 12.5 hours and $1586 and the median length of stay and median cost for the conventional work up was 22.1 hours and $1900. The potential cost avoidance was $300. ( William Beaumont Hospital, Royal Oaks, Michigan. Presented at the Annual Meeting of the American College of Cardiology 2006).