Another Inadequate Paper Published on Triage ECGs, whose Conclusions Need Scrutiny.

Conclusion: "Given the extremely low yield and high associated charges, current guidelines for triage ECG for identifying a possible STEMI should be reviewed. "Fair enough.  I will briefly review the guidelines here and now: One should never use charges to calculate cost.  Charges and cost have no relation to each other in hospital billing.  In our ED, a health care assistant (HCA) records all ECGs, in triage and elsewhere.  It takes at most 10 minutes (this is an exaggeration).  At total compensation of $50,000 per year, working 1800 hours, an HCA could record over 10,000 ECGs if that is all they did.  That is $5.00 per ECG in cost.  Let ' s double it to be certain, to $10.00.  Then it takes a staff physician all of 10 seconds to read it (at most!).  Is that $125.00 of cost?  No, again, charges and cost have no relation to each other in hospital billing.  One must add in the cost of paper, and the system, and the ECG machine, all of which are negligible per ECG.  Let ' s say, then, that the truecost of an ECG is $20.00 (this is an exaggeration -- it would cost even less).  We at HCMC have 30 walk-in STEMIs per year; the rest come by ambulance.  We also detect at least 5 OMI patients who do not meet STEMI criteria. We record ECGs in triage on every patient with chest pain, and some other indications, and this amounts to 8000 ECGs in triage each year, costingat most $200,000 (80...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs