J Med Virol. 2019 Apr 5. doi: 10.1002/jmv.25479. [Epub ahead of print]
Impact of molecular point-of-care testing on clinical management and in-hospital costs of patients suspected of influenza or RSV infection: a modeling study.

Rahamat-Langendoen J1, Groenewoud H2, Kuijpers J1, Melchers WJG1, van der Wilt GJ2.
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Abstract

BACKGROUND:

At hospital admission, patients suspected of infection with influenza or respiratory syncytial virus (RSV) are placed in isolation, pending the outcome of diagnostics. In a significant number, isolated care proves unnecessary. We investigated the potential impact of molecular point-of-care (POC) diagnostics on patient management and in-hospital costs.
METHOD:

Prospective collection of data on resource utilization within the hospital from consecutive patients18 years or older presenting at our university medical center with symptoms of respiratory tract infection from December 2016 to April 2017. A cost analysis was conducted using Markov modeling comparing the actual course of events (based on routine diagnostic tests) with two hypothetical scenarios: when POC would impact time to diagnosis only (scenario 1) or on discharge from hospital, too (scenario 2).
RESULTS:

283 Patients were included, of whom 217 (76,7%) were admitted. Influenza and RSV were detected in 31% and 7% of the patients, respectively. 54% of patients tested negative, of which 79% were kept in isolated care waiting for test results, with median duration of 24 hours. Median length of stay was 6.0 days. Mean total in-hospital costs per patient were ? 5,243. Introducing POC would lower mean costs per patient to ? 4,904 (scenario 1) and ? 4,206 (scenario 2). At hospital level, this would result in a total cost reduction of ? 95,937 to ? 293,471 in a single influenza season.
CONCLUSIONS:

Introducing POC testing for patients presenting with symptoms of viral respiratory tract infection can reduce time-to-diagnosis, hospital stay and, thereby, in-hospital costs. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


KEYWORDS:

cost benefit; influenza virus; rapid detection; respiratory syncytial virus

PMID: 30950066 DOI: 10.1002/jmv.25479