Point-of-care COVID-19 antigen testing in German emergency rooms - a cost-benefit analysis
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Point-of-care COVID-19 antigen testing in German emergency rooms - a cost-benefit analysis. / Diel, R; Nienhaus, A.
In: PULMONOLOGY, Vol. 28, No. 3, 2022, p. 164-172.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Point-of-care COVID-19 antigen testing in German emergency rooms - a cost-benefit analysis
AU - Diel, R
AU - Nienhaus, A
N1 - Copyright © 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The current COVID-19 pandemic is causing significant morbidity and death worldwide and produces significant socio-economic losses.OBJECTIVE: To assess the cost-benefit relation of implementing point-of-care COVID-19 antigen testing (POCT) in emergency rooms (ER) of German hospitals.METHODS: A deterministic decision-analytic model simulated the incremental costs of using the Sofia® SARS Antigen FIA test compared to those of using clinical judgement alone to confirm or exclude COVID-19 in adult patients in German ER, prior to hospitalization. Direct and indirect costs, with and without subsequent RT-PCR confirmation, were evaluated from the hospital perspective.RESULTS: With respect to ER patients, in base-case analysis, considering a COVID-19 prevalence of 15.6% and a hospitalization rate among COVID-19 suspects of 10.1%, POCT testing reduces average costs of hospitalized patients by €213 per tested patient if nasopharyngeal swabs of patients suspected to have COVID-19 are also sent to external labs for RT-PCR testing. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Sofia® SARS Antigen FIA saves on average about €210 as compared to applying the clinical-judgement-only strategy. The major part of cost savings, €159 or 75.9%, is due to the POC test´s high specificity resulting in a 21-fold lower proportion of unnecessary bed blocking at the first day of hospitalization.CONCLUSIONS: Using highly specific rapid COVID-19 tests in COVID-19 suspects at German ER, despite of their sub-optimal sensitivity, may significantly reduce hospital expenditure.
AB - BACKGROUND: The current COVID-19 pandemic is causing significant morbidity and death worldwide and produces significant socio-economic losses.OBJECTIVE: To assess the cost-benefit relation of implementing point-of-care COVID-19 antigen testing (POCT) in emergency rooms (ER) of German hospitals.METHODS: A deterministic decision-analytic model simulated the incremental costs of using the Sofia® SARS Antigen FIA test compared to those of using clinical judgement alone to confirm or exclude COVID-19 in adult patients in German ER, prior to hospitalization. Direct and indirect costs, with and without subsequent RT-PCR confirmation, were evaluated from the hospital perspective.RESULTS: With respect to ER patients, in base-case analysis, considering a COVID-19 prevalence of 15.6% and a hospitalization rate among COVID-19 suspects of 10.1%, POCT testing reduces average costs of hospitalized patients by €213 per tested patient if nasopharyngeal swabs of patients suspected to have COVID-19 are also sent to external labs for RT-PCR testing. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Sofia® SARS Antigen FIA saves on average about €210 as compared to applying the clinical-judgement-only strategy. The major part of cost savings, €159 or 75.9%, is due to the POC test´s high specificity resulting in a 21-fold lower proportion of unnecessary bed blocking at the first day of hospitalization.CONCLUSIONS: Using highly specific rapid COVID-19 tests in COVID-19 suspects at German ER, despite of their sub-optimal sensitivity, may significantly reduce hospital expenditure.
U2 - 10.1016/j.pulmoe.2021.06.009
DO - 10.1016/j.pulmoe.2021.06.009
M3 - SCORING: Journal article
C2 - 34315687
VL - 28
SP - 164
EP - 172
JO - PULMONOLOGY
JF - PULMONOLOGY
SN - 2531-0437
IS - 3
ER -