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 £95 000 and £120 000 in one year.

Introduction of an early pregnancy assessment unit: audit on the first 6 months of service

“…The benefits of an outpatient EPAU service were described by Bigrigg and Read in 1991 [6]. EPAU is an established concept in the UK, but it is relatively new in Ireland.…”

“…It helps in streamlining the service for the patient, general practitioner (GP) and the hospital. It also works as a daycare facility and is cost effective [6]. The EPAU in the Rotunda Hospital is one of the first such units in Ireland.…”

Analyse de l’évolution des temps d’attente et durées de passage aux urgences gynécologiques et obstétricales du CHU de Nantes entre 2005 et 2012

“…Ces publications orientées sur les modèles anglo-saxons des early pregnancy units du Royaume-Uni ou les acute gynaecological and early pregnancy units d'Australie montrent cependant qu'une prise en charge spécialisée directe en gynécologie permet de diminuer les temps d'attente et les durées de passage aux urgences [10,11]. L'organisation est le facteur primordial influant sur les temps d'attente et durées de passage qui permet d'accroître la réponse à la demande croissante à capacité constante ou équivalente [5,6,12].…”

Cost-effectiveness of ultrasound use by on-call registrars in an acute gynaecology setting

“…Th e one-stop ultrasound-based model of care in early pregnancy units (EPUs) has been shown to improve the quality of care and produce signifi cant savings through the reduction of hospital admissions by 40% with a further 20% of those admitted requiring a shorter hospital stay (Bigrigg and Read 1991;Bradley and Hamilton-Fairley 1998;Wren and Craven 1999). Th is model of care in EPUs has been mirrored in acute gynaecology units (AGUs), which are gradually spreading.…”