Hospital Buyer

A study published in the current issue of Academic Emergency Medicine highlights the value of 64-slice multi-detector CT (MDCT) to assess patients with chest pain who present to the emergency room. One of the key benefits of this approach is that it is more cost effective than the current standard of care.

The study was completed by a group at Northwestern Memorial Hospital in Chicago. The group sought to determine which approach to evaluating these patients was most cost-effective. The lead researcher noted that determining the most cost-effective approach has been challenging.

The team created a computer model with a single patient avatar, a 54-year old male. This patient was considered the average patient seen with this complaint in the chest pain observation unit. The model calculated costs for three different treatment approaches. The first was care in the observation unit and stress testing, the second was observation and stress echocardiography, and the final approach was MDCT with no observation.

The model was programmed to consider three different patient scenarios: those who were moderate-risk for coronary artery disease, those who were low risk, and the very low risk patients. The effect of each approach was also considered with respect to quality adjusted life years (QALYs).

All of the patient risk groups benefited from assessment with MDCT imaging. In addition, the cost to assess patients with this approach was less expensive. An additional benefit of this evaluation means was improvement in QALYs; patient’s overall life expectancy increased. Improvements are a function, in part, of the diagnostic superiority of MDCT.The current standard of care to assess these patients is to admit them for overnight observation and completion of cardiac stress testing. This study is one of just a few trials published to evaluate the cost-effectiveness of MDCT for diagnostic evaluation of patients with chest pain.

July 22, 2008 Related topics: Diagnostic, Emergency