Table 2

Cost effectiveness studies of assessment/admission wards in A&E medicine

First author (year)	Country	Patient group studied	Main conclusions
De Leon, 1989⁶⁸	US	Chest pain	Use of the chest pain evaluation unit resulted in an 80% reduction in cost of ruling out acute myocardial infarction for patients not admitted to a coronary care unit.
Zwicke, 1982⁶⁹	US	Asthma	Use of an ED observation unit is less expensive than admission with the mean observation unit stay being 34% of the cost incurred for a hospital admission.
Brillman, 1994⁴³	US		The use of an observation unit in the ED does not produce cost savings. Patients that would have been discharged home from the ED were sent to the unit therefore not reducing overall costs.
Henneman, 1989⁶⁵	US	Abdominal trauma	Evaluation of the use of 12 hrs monitoring in an ED observation unit in the management of 230 patients. Selected patients can be managed cost effectively with a potential saving of more than $51000.
Gaspoz, 1994⁶⁴	US	Myocardial infarction	Examined the cost benefits of a new short stay unit for low risk patients who may be admitted to a hospital to rule out myocardial infarction. Concluded that a coronary observation unit may be a cost effective alternative to current triage strategies for patients with a low risk of acute myocardial infarction admitted from the emergency department.