Cost-Benefit of Real-Time Multiplex PCR Testing of SARS-CoV-2 in German Hospitals
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Cost-Benefit of Real-Time Multiplex PCR Testing of SARS-CoV-2 in German Hospitals. / Diel, Roland; Nienhaus, Albert.
In: INT J ENV RES PUB HE, Vol. 20, No. 4, 3447, 15.02.2023.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Cost-Benefit of Real-Time Multiplex PCR Testing of SARS-CoV-2 in German Hospitals
AU - Diel, Roland
AU - Nienhaus, Albert
PY - 2023/2/15
Y1 - 2023/2/15
N2 - BACKGROUND: The current Omicron COVID-19 pandemic has significant morbidity worldwide.OBJECTIVE: Assess the cost-benefit relation of implementing PCR point-of-care (POCT) COVID-19 testing in the emergency rooms (ERs) of German hospitals and in the case of inpatient admission due to other acute illnesses.METHODS: A deterministic decision-analytic model simulated the incremental costs of using the Savanna® Multiplex RT-PCR test compared to using clinical judgement alone to confirm or exclude COVID-19 in adult patients in German ERs prior to hospitalization or just prior to discharge. Direct and indirect costs were evaluated from the hospital perspective. Nasal or nasopharyngeal swabs of patients suspected to have COVID-19 by clinical judgement, but without POCT, were sent to external labs for RT-PCR testing.RESULTS: In probabilistic sensitivity analysis, assuming a COVID-19 prevalence ranging between 15.6-41.2% and a hospitalization rate between 4.3-64.3%, implementing the Savanna® test saved, on average, €107 as compared to applying the clinical-judgement-only strategy. A revenue loss of €735 can be avoided when SARS-CoV-2 infection in patients coming unplanned to the hospital due to other acute illnesses are excluded immediately by POCT.CONCLUSIONS: Using highly sensitive and specific PCR-POCT in patients suspected of COVID-19 infection at German ERs may significantly reduce hospital expenditures.
AB - BACKGROUND: The current Omicron COVID-19 pandemic has significant morbidity worldwide.OBJECTIVE: Assess the cost-benefit relation of implementing PCR point-of-care (POCT) COVID-19 testing in the emergency rooms (ERs) of German hospitals and in the case of inpatient admission due to other acute illnesses.METHODS: A deterministic decision-analytic model simulated the incremental costs of using the Savanna® Multiplex RT-PCR test compared to using clinical judgement alone to confirm or exclude COVID-19 in adult patients in German ERs prior to hospitalization or just prior to discharge. Direct and indirect costs were evaluated from the hospital perspective. Nasal or nasopharyngeal swabs of patients suspected to have COVID-19 by clinical judgement, but without POCT, were sent to external labs for RT-PCR testing.RESULTS: In probabilistic sensitivity analysis, assuming a COVID-19 prevalence ranging between 15.6-41.2% and a hospitalization rate between 4.3-64.3%, implementing the Savanna® test saved, on average, €107 as compared to applying the clinical-judgement-only strategy. A revenue loss of €735 can be avoided when SARS-CoV-2 infection in patients coming unplanned to the hospital due to other acute illnesses are excluded immediately by POCT.CONCLUSIONS: Using highly sensitive and specific PCR-POCT in patients suspected of COVID-19 infection at German ERs may significantly reduce hospital expenditures.
KW - Adult
KW - Humans
KW - SARS-CoV-2
KW - COVID-19
KW - COVID-19 Testing
KW - Multiplex Polymerase Chain Reaction
KW - Pandemics
KW - Acute Disease
KW - Cost-Benefit Analysis
KW - Hospitals
KW - Sensitivity and Specificity
U2 - 10.3390/ijerph20043447
DO - 10.3390/ijerph20043447
M3 - SCORING: Journal article
C2 - 36834141
VL - 20
JO - INT J ENV RES PUB HE
JF - INT J ENV RES PUB HE
SN - 1660-4601
IS - 4
M1 - 3447
ER -
