Yau Amy A, Nguyendo Long T, Lockett LaKeesha L, Michaud Edward
From the Department of Internal Medicine, San Antonio Military Medical Center, San Antonio, TX.
Crit Pathw Cardiol. 2017 Dec;16(4):126-128. doi: 10.1097/HPC.0000000000000124.
Chest pain is a common complaint in emergency departments. Several guidelines and tools exist to help the clinician determine need for hospitalization. For low-risk patients, clinical judgment can underestimate a patient's risk of major adverse cardiac event. Implementation of an advanced diagnostic protocol with the HEART Pathway can reduce hospital cost. For our academic institution, we saw an approximate $1 million in total savings during the initial implementation year along with increased outpatient visits. In addition, an increase in outpatient visits confirmed previous estimates that implementation of the HEART Pathway results in >20% reduction of hospital costs. We also identify challenges and considerations for facilities looking to repeat our successes.
胸痛是急诊科常见的主诉。有多项指南和工具可帮助临床医生确定住院需求。对于低风险患者，临床判断可能会低估患者发生重大不良心脏事件的风险。采用HEART路径实施先进的诊断方案可降低医院成本。对于我们的学术机构而言，在最初实施该方案的年份，我们总共节省了约100万美元，同时门诊就诊量有所增加。此外，门诊就诊量的增加证实了之前的估计，即实施HEART路径可使医院成本降低20%以上。我们还为希望复制我们成功经验的机构确定了挑战和注意事项。
