title: Cost burden of non-specific chest pain admissions.
abstract: BACKGROUND
  Non-cardiac aetiologies are common among patients presenting with chest pain.
  
  
  OBJECTIVE
  To determine the cost of non-specific chest pain admissions to a tertiary referral, teaching hospital.
  
  
  METHODS
  Thrombolysis in myocardial infarction risk (TIMI) risk score, lengths of stay (LOS), investigations and diagnoses were recorded for patients admitted with chest pain. Non-specific chest pain was defined as chest pain where cardiac, pulmonary and gastroesophageal aetiologies were excluded. Costs of admissions were calculated.
  
  
  RESULTS
  Of 80 patients, 34 (4%) and 22 (28%) were diagnosed with non-specific chest pain and acute coronary syndrome, respectively. Non-specific chest pain admissions had a mean age of 54 (11; 35-74) years, LOS of 3.8 (2.6; 1-11) days and TIMI risk score of 1.4 (1.5; 0-5). Acute coronary syndrome admissions had a mean age of 67 (14; 43-94) years, LOS of 7.7 (4.3; 2-16) days and TIMI risk score of 3.1 (1.2; 0-5). The mean cost per non-specific chest pain admission was €3,729 (2,378; 1,034-10,468), or 48% of the mean cost per acute coronary syndrome admission of €7,667 (4,279; 1,963-16,071). Bed day costs account for >90% of overall costs. Only 7% of patients were weekend discharges. The mean interval to exercise stress test was 2.7(1.5; 1-7) days.
  
  
  CONCLUSIONS
  The mean costs of admission and LOS for patients with non-specific chest pain are significant. Extrapolating findings, annual national cost is estimated at approximately €71 million for this cohort, with 73,000 bed days consumed nationally. Delays from admission to tests and low percentage of weekend discharges prolong LOS.
authors.affiliation: Department of Cardiology, Waterford Regional Hospital, Waterford, Ireland. johngroarke1@eircom.net
authors.forename: J
authors.initials: J
authors.lastname: Groarke
authors.forename: J
authors.initials: J
authors.lastname: O'Brien
authors.forename: G
authors.initials: G
authors.lastname: Go
authors.forename: M
authors.initials: M
authors.lastname: Susanto
authors.forename: P
authors.initials: P
authors.lastname: Owens
authors.forename: A O
authors.initials: AO
authors.lastname: Maree
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000175:diagnosis / Q000191:economics* / Q000209:etiology; D004636:Emergency Service, Hospital / Q000191:economics; D005080:Exercise Test / Q000009:adverse effects / Q000191:economics; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000191:economics; D011446:Prospective Studies