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. 2023 Feb 15;20(4):3447. doi: 10.3390/ijerph20043447.
The current Omicron COVID-19 pandemic has significant morbidity worldwide.
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.
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.
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.
Using highly sensitive and specific PCR-POCT in patients suspected of COVID-19 infection at German ERs may significantly reduce hospital expenditures.
目前的奥密克戎 COVID-19 大流行在全球范围内造成了很高的发病率。
评估在德国医院急诊室（ER）和因其他急性疾病住院时实施 PCR 即时检测（POCT）COVID-19 检测的成本效益关系。
使用确定性决策分析模型模拟了与仅使用临床判断相比，在德国 ER 中对即将住院或即将出院的成年患者进行 COVID-19 确诊或排除时使用 Savanna 多重 RT-PCR 检测的增量成本。从医院角度评估了直接和间接成本。对临床判断怀疑患有 COVID-19 但未进行 POCT 的患者进行鼻拭子或鼻咽拭子采样，并送到外部实验室进行 RT-PCR 检测。
在概率敏感性分析中，假设 COVID-19 的患病率在 15.6-41.2%之间，住院率在 4.3-64.3%之间，与仅应用临床判断策略相比，实施 Savanna 测试平均可节省 107 欧元。当通过 POCT 立即排除因其他急性疾病而计划外到医院的患者的 SARS-CoV-2 感染时，可避免 735 欧元的收入损失。
在德国 ER 中对疑似 COVID-19 感染的患者使用高度敏感和特异的 PCR-POCT 可能会显著降低医院支出。
