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Economic burden of not recognizing panic disorder in the emergency department

Kim C Coley1, Melissa I Saul, Amy L Seybert

  • 1University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania 15261, USA.

The Journal of Emergency Medicine
|October 16, 2007
PubMed

Insights

Patients with chest pain of unknown origin, potentially panic attacks, incur significant healthcare costs. Unspecified chest pain diagnoses lead to high emergency department and hospital utilization, especially for those on Medicare or Medicaid.

Area of Science:

  • Emergency Medicine
  • Health Economics
  • Psychosomatic Medicine

Background:

  • Chest pain is a common Emergency Department (ED) presentation.
  • Patients with non-cardiac chest pain, including suspected panic attacks, represent a substantial patient group.
  • Understanding diagnostic patterns and resource use is crucial for healthcare management.

Purpose of the Study:

  • To investigate diagnostic patterns for patients with chest pain of unknown origin in the ED.
  • To assess resource utilization and healthcare charges associated with these patients.
  • To identify factors influencing repeat hospital visits.

Main Methods:

  • Cohort study design.
  • Inclusion of 155 patients presenting to the ED with chest pain, excluding coronary artery disease.
  • Analysis of diagnostic codes, hospitalization charges, and 1-year follow-up data.

Main Results:

  • Unspecified chest pain was the most frequent diagnosis (78%).
  • Index hospitalization charges totaled over $1.2 million (median $7340/visit).
  • 41% of patients had repeat visits within a year, generating $1.6 million in charges; Medicare/Medicaid patients had higher odds of repeat visits (OR=11.7).

Conclusions:

  • ED patients with non-cardiac chest pain contribute significantly to hospital resource consumption.
  • High rates of repeat visits and associated costs highlight the need for effective management strategies.
  • Insurance status (Medicare/Medicaid) is associated with increased healthcare utilization in this population.

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