NEW YORK, Jan 14 (Reuters) -- Patients with chest pain who are treated in special emergency department (ED) units dedicated to chest pain are happier with their care than those who are admitted for observation, say researchers.
Patients who attended Chicago's Cook County Hospital with chest pain were referred to a special unit called the Chest Pain Observation Unit (CPOU). "Patients were more satisfied with rapid diagnosis in the CPOU than with inpatient stays for acute chest pain," conclude researchers at the University of Illinois.
The CPOU gives emergency room physicians an alternative to either admitting those suffering unexplained chest pain, or sending them home. Patients are instead hooked up to monitors, and remain in the CPOU for 12 hours in an effort to determine whether or not their chest pain is due to a heart attack.
Traditional inpatient admittance for acute chest pain usually lasts for days while staff determine the causes and risks implicated in the attack.
Researchers questioned over 100 such patients as to their satisfaction with the care they received, either in CPOUs, or as admitted patients. They were asked to evaluate such factors as physical comfort, emotional support, pain management, communication, and patient education.
Inpatient services had almost double the complaints of 'total problems' when compared to emergency departments, study authors say.
"It is remarkable that a busy ED could outperform the hospital inpatient service... in these problem domains," they conclude. EDs outperformed the competition on points like staff-patient communication, education, pain management, and physical comfort, among others.
Researchers say that "it seems ED-based diagnostic units can provide care that is equivalent, if not more satisfactory or satisfying, to patients" (than inpatient care).
They note the current "proliferation of... chest pain centers in the United States." Over 22% of all EDs now have such centers, they say, with more planned every year.
Besides increasing patient satisfaction, these units may lower costs as well. "It is unlikely that a 12-hour ED-based chest pain center would cost more than an inpatient hospital stay of one to three days," researchers conclude.
SOURCE: Annals of Emergency Medicine (1997;29(1):109-115)
