SummaryBackground: Although inroads have been made in the outpatient evaluation of chest pain, the majority of hospitals in the United States do not have chest pain centers and the direct costs associated with hospital admissions in lqw-risk patients is unknown.Hypothesis: The study was undertaken to evaluate the cost and outcomes of admission to the hospital for patients with acute chest pain and essentially normal electrocardiograms (ECGs).Methods: For that purpose, we reviewed 1,670 patients presenting to our emergency department with chest pain over a 5-month period in 1994. Of these, 567 [34.0%, confidence interval (CI) 95%, 3 I .7-36.3%] patients were considered to be low risk by ECG criteria alone.Results: Complete clinical and financial data were avail-