Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre
Dublin Core
Title
Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre
African Journal of Emergency Medicine
The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre
Subject
Emergency department
Point-of-care systems
Point-of-care testing
Economic analysis
Point-of-care systems
Point-of-care testing
Economic analysis
Description
Introduction: Time and cost constraints abound in the Emergency Centre (EC). These resource-constraints are
further magnified in low- and middle-income countries (LMIC). Almost half of all patients presenting to the EC
require laboratory tests. Unfortunately, access to laboratory services in LMIC is commonly inadequate. Point-of-
Care (POC) tests may assist to avert this shortcoming. The aims of this study were to evaluate the cost effectiveness
of upfront POC blood tests performed prior to doctor assessment compared to the standard EC workflow.
Methods: A secondary analysis was performed on data from a prospective, randomised, controlled trial where
patients with abdominal/chest symptoms or generalised body pain/weakness followed either the normal EC
workflow pathway or one of two enhanced workflow pathways with POC tests (i-STAT with and without a
complete blood count (CBC)) prior to doctor evaluation. The incremental cost effectiveness ratio (ICER) was used
to perform the cost effectiveness analysis.
Results: There were 248 patients enrolled in the study. The use of the two upfront, POC test pathways significantly
exceeded the primary outcome measure of a 20% reduction in treatment time. In the i-STAT+CBC
group, the 31 min. time-saving translated into cost-saving of US$14.96 per patient (IECR 0.27) whereas the
21 min. time-saving in the i-STAT only group only had an additional net cost of US$3.11 per patient (IECR 0.90).
Conclusion: Upfront, POC blood tests can be utilised in the resource-constrained EC to manage patients more
efficiently by saving time. This time-saving can, in fact, be more cost effective than traditional EC workflow
making it an economically viable option for implementation in LMIC.
further magnified in low- and middle-income countries (LMIC). Almost half of all patients presenting to the EC
require laboratory tests. Unfortunately, access to laboratory services in LMIC is commonly inadequate. Point-of-
Care (POC) tests may assist to avert this shortcoming. The aims of this study were to evaluate the cost effectiveness
of upfront POC blood tests performed prior to doctor assessment compared to the standard EC workflow.
Methods: A secondary analysis was performed on data from a prospective, randomised, controlled trial where
patients with abdominal/chest symptoms or generalised body pain/weakness followed either the normal EC
workflow pathway or one of two enhanced workflow pathways with POC tests (i-STAT with and without a
complete blood count (CBC)) prior to doctor evaluation. The incremental cost effectiveness ratio (ICER) was used
to perform the cost effectiveness analysis.
Results: There were 248 patients enrolled in the study. The use of the two upfront, POC test pathways significantly
exceeded the primary outcome measure of a 20% reduction in treatment time. In the i-STAT+CBC
group, the 31 min. time-saving translated into cost-saving of US$14.96 per patient (IECR 0.27) whereas the
21 min. time-saving in the i-STAT only group only had an additional net cost of US$3.11 per patient (IECR 0.90).
Conclusion: Upfront, POC blood tests can be utilised in the resource-constrained EC to manage patients more
efficiently by saving time. This time-saving can, in fact, be more cost effective than traditional EC workflow
making it an economically viable option for implementation in LMIC.
Creator
Lara Nicole Goldstein, Mike Wells, Craig Vincent-Lambert
Source
www.elsevier.com/locate/afjem
Publisher
afem
Date
16 January 2019
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Lara Nicole Goldstein, Mike Wells, Craig Vincent-Lambert, “Jurnal Internasional Afrika vol. 9 issue 2 2019
African Journal of Emergency Medicine
The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2389.
African Journal of Emergency Medicine
The cost of time: A randomised, controlled trial to assess the economic impact of upfront, point-of-care blood tests in the Emergency Centre,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/2389.