The Impact of Mobile Coronary Care Units: Final Report

摘要

Comparisons were made between users of mobile coronary care units (MCCU) and a matched sample of persons with cardiovascular emergencies who entered the hospital by other routes. Of 551 MCCU users, 290 were confirmed as acute myocardial infarctions (AMI), and of 551 controls, 270 were confirmed AMI. Users and nonusers were found to be the same with respect to social and demographic variables and general health history. The major determining factor in MCCU use was the severity of acute illness. MCCU users sought help in a shorter period of time and were less likely to have pre-hospital physician evaluation. Fatality rates prior to hospital discharge were much greater among the AMI-MCCU users (21.7%) than among the AMI controls (1.5%). The very low rate among the controls indicated that the community of Columbus, Ohio had been 'saturated' with MCCU use. However, the rate of serious complications was much greater among MCCU users. It was estimated that approximately one out of ten MCCU users who were discharged alive from the hospital, there was little difference in 6 months survival between MCCU users and nonusers. The data indicated clearly that MCCU saves lives at a reasonable cost. The study methods and outcome/cost estimation procedures are generalizable, with some adaptation, to other communities.