Healthcare cost burden of acute chest pain presentations.
Emerg Med J
; 40(6): 437-443, 2023 Jun.
Article
in En
| MEDLINE
| ID: mdl-36918268
ABSTRACT
BACKGROUND:
This study aimed to estimate the direct healthcare cost burden of acute chest pain attendances presenting to ambulance in Victoria, Australia, and to identify key cost drivers especially among low-risk patients.METHODS:
State-wide population-based cohort study of consecutive adult patients attended by ambulance for acute chest pain with individual linkage to emergency and hospital admission data in Victoria, Australia (1 January 2015-30 June 2019). Direct healthcare costs, adjusted for inflation to 2020-2021 ($A), were estimated for each component of care using a casemix funding method.RESULTS:
From 241 627 ambulance attendances for chest pain during the study period, mean chest pain episode cost was $6284, and total annual costs were estimated at $337.4 million ($68 per capita per annum). Total annual costs increased across the period ($310.5 million in 2015 vs $384.5 million in 2019), while mean episode costs remained stable. Cardiovascular conditions (25% of presentations) were the most expensive (mean $11 523, total annual $148.7 million), while a non-specific pain diagnosis (49% of presentations) was the least expensive (mean $3836, total annual $93.4 million). Patients classified as being at low risk of myocardial infarction, mortality or hospital admission (Early Chest pain Admission, Myocardial infarction, and Mortality (ECAMM) score) represented 31%-57% of the cohort, with total annual costs estimated at $60.6 million-$135.4 million, depending on the score cut-off used.CONCLUSIONS:
Total annual costs for acute chest pain presentations are increasing, and a significant proportion of the cost burden relates to low-risk patients and non-specific pain. These data highlight the need to improve the cost-efficiency of chest pain care pathways.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Emergency Service, Hospital
/
Myocardial Infarction
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Humans
Country/Region as subject:
Oceania
Language:
En
Journal:
Emerg Med J
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2023
Type:
Article
Affiliation country:
Australia