End Results, Cost and Productivity of Coronary-Care Units

Abstract The use of coronary-care units for the treatment of patients with myocardial infarction has increased explosively with little attention to efficacy, need, or cost. A study of 32 hospital units revealed that half the patients treated did not have myocardial infarctions and were a very low-risk group. Larger units in teaching hospitals with full-time directors showed lower mean case fatality rates from myocardial infarction, higher percentages of patients with infarction and greater productivity and efficiency. These important differences were often not statistically significant because of the great variation within hospital groups. Intensive care for patients after myocardial infarction should be planned by region, not by individual hospitals, to assure effectiveness and economy. Intensive care of such patients presents an ideal model for regional planning. Finally, proof of effectiveness of intensive care in these cases is lacking.