Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Kiel, Airway Research Center North (ARCN), 24015 Kiel, Germany.
Lung Clinic Grosshansdorf, Germany. Airway Disease Center North (ARCN), German Center for Lung Research (DZL), 22949 Großhansdorf, Germany.
Int J Environ Res Public Health. 2019 Jul 3;16(13):2368. doi: 10.3390/ijerph16132368.
Seasonal influenza causes significant morbidity worldwide and has a substantial economic impact on the healthcare system.
To assess the cost-benefit relation of implementing a real-time influenza test in emergency rooms (ER) of German hospitals.
A deterministic decision-analytic model was developed simulating the incremental costs of using the Solana Influenza A+B test, compared to those of using conventional clinical judgement alone to confirm or exclude influenza in adult ILI (influenza-like illness) patients, in German ER, prior to hospitalization. Direct costs were evaluated from the hospital perspective, considering resource use directly related to influenza testing and treatment, as well as indirect costs incurred by nosocomial influenza transmission.
Through base-case analysis and assuming an influenza prevalence of 42.6%, real-time testing with Solana reduced average costs of hospitalized ILI patients by €132.61, per tested patient. Moreover, the Solana saved €6.9 per tested patient in favor of the hospital. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Solana saved on average €144.13 as compared to applying the clinical-judgement-only strategy, thus, it was found to be constantly less expensive.
Using highly sensitive and specific real-time influenza tests in ILI patients at German ER might significantly reduce hospital expenditures.
季节性流感在全球范围内导致了大量发病，对医疗保健系统造成了巨大的经济影响。
评估在德国医院急诊室实施实时流感检测的成本效益关系。
开发了一个确定性决策分析模型，模拟了与仅使用传统临床判断来确诊或排除成年 ILI（流感样疾病）患者的流感相比，在住院前使用 Solana 流感 A+B 检测的增量成本，在德国急诊室。直接成本从医院角度进行评估，考虑与流感检测和治疗直接相关的资源利用，以及医院内流感传播造成的间接成本。
通过基本情况分析并假设流感流行率为 42.6%，使用 Solana 进行实时检测可使每个接受检测的住院 ILI 患者的平均成本降低 132.61 欧元。此外，Solana 为医院节省了每个检测患者 6.9 欧元。在概率敏感性分析中，在所有合理的假设下，与仅使用临床判断策略相比，使用 Solana 平均可节省 144.13 欧元，因此它始终更便宜。
在德国急诊室的 ILI 患者中使用高度敏感和特异的实时流感检测可能会显著降低医院支出。
