Management of women referred to early pregnancy assessment unit: care and cost effectiveness.

Abstract

OBJECTIVE--To assess the efficiency of an early pregnancy assessment unit in the care of women with bleeding or pain in early pregnancy. DESIGN--Analysis of women attending in the first year of the unit's operation and in the six months immediately before its introduction. SETTING--Early pregnancy assessment unit in a district general hospital serving a population of 310,000. PATIENTS--1141 women referred with bleeding or pain in early pregnancy. MAIN OUTCOME MEASURES--Length of stay in hospital required for diagnosis and treatment. RESULTS--Before the unit was established the mean admission time was one and a half (range half to three) days for women who required no treatment and three (one and a half to five) days in women requiring evacuation of uterus. These times were reduced to two hours as an outpatient and one day respectively for most women after the unit was established. Between 318 and 505 women were estimated to have been saved from unnecessary admission, and 233 had their stay reduced; the associated saving was between pounds 95,000 and pounds 120,000 in one year. CONCLUSIONS--The early pregnancy assessment unit improved the quality of care and also produced considerable savings in financial and staff resources.