A cost-savings analysis of the use of a predictive instrument for coronary-care-unit admission decisions.

The predictive instrument for acute ischemic heart disease is one of several clinical decision aids developed to reduce unnecessary coronary-care-unit (CCU) admissions. Previous cost analyses of such decision aids have been based on hospital charges; however, estimates based on hospital charges significantly overstate true cost savings to hospitals. The actual savings for a hospital that wants to implement the predictive instrument depend on the hospital's cost structure, the competitiveness of its medical care, and its payor mix.