Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit

Richard Kim, Simon Chakko, Robert J Myerburg, Kenneth M. Kessler

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

The usefulness and cost of echocardiography was evaluated in 133 consecutive patients admitted to the Coronary Care Unit. A useful echocardiogram was one that provided new information, which influenced diagnosis, prognosis, or treatment. The cost of a useful echocardiogram was defined as the unit cost ($476 the Medicare global fee) x units (i.e., total echocardiograms / useful echocardiograms). Admission diagnoses were unstable angina (34%), arrhythmia (14%), congestive heart failure (8%), postprocedure monitoring (7%), acute myocardial infarction (6%), and miscellaneous (20%). The echocardiogram provided new information in 29% of patients. Patients without a recent echocardiogram (within 3 months) were twice as likely to have a useful echocardiogram (33 of 99, 33%) as those with a recent echocardiogram (5 of 34, 15%, p <0.05). A cardiologist predicted the overall usefulness of echocardiography with a positive predictive accuracy of 52% and a negative predictive accuracy of 94% (p <0.0001). The over-all cost of a useful echocardiogram of 3.5 units or $1,666 per useful study was decreased to $904 (1.9 units) if only studies predicted to be useful were considered. The usefulness of echocardiography varied significantly p <0.02) within the admitting diagnostic categories. The usefulness of an echocardiogram was underestimated in patients with congestive heart failure, where it was found to be most useful (64%; $762 or 1.6 units). Thus, usefulness relates to the admission diagnosis, the availability of a recent echocardiogram, and to clinical judgment.

Original languageEnglish
Pages (from-to)1273-1276
Number of pages4
JournalAmerican Journal of Cardiology
Volume80
Issue number10
DOIs
StatePublished - Nov 15 1997

Fingerprint

Coronary Care Units
Echocardiography
Costs and Cost Analysis
Heart Failure
Fees and Charges
Unstable Angina
Medicare
Cardiac Arrhythmias
Myocardial Infarction
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit. / Kim, Richard; Chakko, Simon; Myerburg, Robert J; Kessler, Kenneth M.

In: American Journal of Cardiology, Vol. 80, No. 10, 15.11.1997, p. 1273-1276.

Research output: Contribution to journalArticle

Kim, Richard ; Chakko, Simon ; Myerburg, Robert J ; Kessler, Kenneth M. / Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit. In: American Journal of Cardiology. 1997 ; Vol. 80, No. 10. pp. 1273-1276.
@article{5253cbcfd9934611aae184263d65ee70,
title = "Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit",
abstract = "The usefulness and cost of echocardiography was evaluated in 133 consecutive patients admitted to the Coronary Care Unit. A useful echocardiogram was one that provided new information, which influenced diagnosis, prognosis, or treatment. The cost of a useful echocardiogram was defined as the unit cost ($476 the Medicare global fee) x units (i.e., total echocardiograms / useful echocardiograms). Admission diagnoses were unstable angina (34{\%}), arrhythmia (14{\%}), congestive heart failure (8{\%}), postprocedure monitoring (7{\%}), acute myocardial infarction (6{\%}), and miscellaneous (20{\%}). The echocardiogram provided new information in 29{\%} of patients. Patients without a recent echocardiogram (within 3 months) were twice as likely to have a useful echocardiogram (33 of 99, 33{\%}) as those with a recent echocardiogram (5 of 34, 15{\%}, p <0.05). A cardiologist predicted the overall usefulness of echocardiography with a positive predictive accuracy of 52{\%} and a negative predictive accuracy of 94{\%} (p <0.0001). The over-all cost of a useful echocardiogram of 3.5 units or $1,666 per useful study was decreased to $904 (1.9 units) if only studies predicted to be useful were considered. The usefulness of echocardiography varied significantly p <0.02) within the admitting diagnostic categories. The usefulness of an echocardiogram was underestimated in patients with congestive heart failure, where it was found to be most useful (64{\%}; $762 or 1.6 units). Thus, usefulness relates to the admission diagnosis, the availability of a recent echocardiogram, and to clinical judgment.",
author = "Richard Kim and Simon Chakko and Myerburg, {Robert J} and Kessler, {Kenneth M.}",
year = "1997",
month = "11",
day = "15",
doi = "10.1016/S0002-9149(97)00664-4",
language = "English",
volume = "80",
pages = "1273--1276",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit

AU - Kim, Richard

AU - Chakko, Simon

AU - Myerburg, Robert J

AU - Kessler, Kenneth M.

PY - 1997/11/15

Y1 - 1997/11/15

N2 - The usefulness and cost of echocardiography was evaluated in 133 consecutive patients admitted to the Coronary Care Unit. A useful echocardiogram was one that provided new information, which influenced diagnosis, prognosis, or treatment. The cost of a useful echocardiogram was defined as the unit cost ($476 the Medicare global fee) x units (i.e., total echocardiograms / useful echocardiograms). Admission diagnoses were unstable angina (34%), arrhythmia (14%), congestive heart failure (8%), postprocedure monitoring (7%), acute myocardial infarction (6%), and miscellaneous (20%). The echocardiogram provided new information in 29% of patients. Patients without a recent echocardiogram (within 3 months) were twice as likely to have a useful echocardiogram (33 of 99, 33%) as those with a recent echocardiogram (5 of 34, 15%, p <0.05). A cardiologist predicted the overall usefulness of echocardiography with a positive predictive accuracy of 52% and a negative predictive accuracy of 94% (p <0.0001). The over-all cost of a useful echocardiogram of 3.5 units or $1,666 per useful study was decreased to $904 (1.9 units) if only studies predicted to be useful were considered. The usefulness of echocardiography varied significantly p <0.02) within the admitting diagnostic categories. The usefulness of an echocardiogram was underestimated in patients with congestive heart failure, where it was found to be most useful (64%; $762 or 1.6 units). Thus, usefulness relates to the admission diagnosis, the availability of a recent echocardiogram, and to clinical judgment.

AB - The usefulness and cost of echocardiography was evaluated in 133 consecutive patients admitted to the Coronary Care Unit. A useful echocardiogram was one that provided new information, which influenced diagnosis, prognosis, or treatment. The cost of a useful echocardiogram was defined as the unit cost ($476 the Medicare global fee) x units (i.e., total echocardiograms / useful echocardiograms). Admission diagnoses were unstable angina (34%), arrhythmia (14%), congestive heart failure (8%), postprocedure monitoring (7%), acute myocardial infarction (6%), and miscellaneous (20%). The echocardiogram provided new information in 29% of patients. Patients without a recent echocardiogram (within 3 months) were twice as likely to have a useful echocardiogram (33 of 99, 33%) as those with a recent echocardiogram (5 of 34, 15%, p <0.05). A cardiologist predicted the overall usefulness of echocardiography with a positive predictive accuracy of 52% and a negative predictive accuracy of 94% (p <0.0001). The over-all cost of a useful echocardiogram of 3.5 units or $1,666 per useful study was decreased to $904 (1.9 units) if only studies predicted to be useful were considered. The usefulness of echocardiography varied significantly p <0.02) within the admitting diagnostic categories. The usefulness of an echocardiogram was underestimated in patients with congestive heart failure, where it was found to be most useful (64%; $762 or 1.6 units). Thus, usefulness relates to the admission diagnosis, the availability of a recent echocardiogram, and to clinical judgment.

UR - http://www.scopus.com/inward/record.url?scp=0030862328&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030862328&partnerID=8YFLogxK

U2 - 10.1016/S0002-9149(97)00664-4

DO - 10.1016/S0002-9149(97)00664-4

M3 - Article

VL - 80

SP - 1273

EP - 1276

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 10

ER -