COVID-19 rapid molecular point-of-care testing is effective and cost-beneficial for the acute care of trauma patients

Abstract

Purpose To evaluate the accuracy and cost benefit of a rapid molecular point-of-care testing (POCT) device detecting COVID-19 within a traumatological emergency department. Background Despite continuous withdrawal of COVID-19 restrictions, hospitals will remain particularly vulnerable to local outbreaks which is reflected by a higher institution-specific basic reproduction rate. Patients admitted to the emergency department with unknown COVID-19 infection status due to a- or oligosymptomatic COVID-19 infection put other patients and health care workers at risk, while fast diagnosis and treatment is necessary. Delayed testing results in additional costs to the health care system. Methods From the 8th of April 2021 until 31st of December 2021, all patients admitted to the emergency department were tested with routine RT-PCR and rapid molecular POCT device (Abbott ID NOW™ COVID-19). COVID-19-related additional costs for patients admitted via shock room or emergency department were calculated based on internal cost allocations. Results 1133 rapid molecular tests resulted in a sensitivity of 83.3% (95% CI 35.9–99.6%), specificity of 99.8% (95% CI 99.4–100%), a positive predictive value of 71.4% (95% CI 29–96.3%) and a negative predictive value of 99.9% (95% CI 99.5–100%) as compared to RT-PCR. Without rapid COVID-19 testing, each emergency department and shock room admission with subsequent surgery showed additional direct costs of 2631.25€, without surgery of 729.01€. Conclusion Although rapid molecular COVID-19 testing can initially be more expensive than RT-PCR, subsequent cost savings, improved workflows and workforce protection outweigh this effect by far. The data of this study support the use of a rapid molecular POCT device in a traumatological emergency department.

Point-of-Care Testing for SARS-CoV-2: A Prospective Study in a Primary Health Centre

“…No data on cost, such as labor and facility costs to run the testing, nor indirect costs to the patient were available. Data on other respiratory tract infections, such as influenza virus infection, suggest major cost savings by POCT, and it will be interesting to obtain more information evaluating cost analyses of such strategy for COVID-19 [22].…”

Point-of-Care Tests for COVID-19 and Influenza in Canada

“…[54][55][56][57] However, commercial tests authorized in Canada vary in performance, time to results, and costs. 4,56,57,75,76 Additionally, laboratory tests, specifically NAATs, remain the standard of care for diagnosing COVID-19 and influenza. 9,79,80 Confirmatory laboratory tests are still needed to rule out inaccurate diagnosis from POCTs.…”

“…From the literature, we also identified 4 budget impact analyses for authorized POCTs in Canada. 56,57,75,76 The budget impact analyses reported the following findings:…”

“…• A traumatological ED in Germany saved a total of 2,631.25€ per person with surgery and 729.01€ per person without surgery using Abbott ID Now. 75 • A pediatric ED in France saved a total of 69,000€ per season using The BD Veritor System for Rapid Detection of Flu A and B. 56 • Another ED in France calculated cost savings of 2,770€ during 2013 to 2014 season and 3,420€…”

The Role and Value of Professional Rapid Testing of Acute Respiratory Infections (ARIs) in Europe: A Special Focus on the Czech Republic, Poland, and Romania

“…Studies conducted during the emergency phase of the COVID-19 pandemic in hospital settings revealed that systematic screening using RT-qPCR tests of patients with respiratory symptoms can be an effective but highly resource-intensive containment strategy, unlikely to be sustained in the long run [ 69 ]. Nevertheless, as new rapid molecular testing technologies have become available, studies from high-resource countries, such as Germany, have shown promising results on the cost-effectiveness of such methods in emergency rooms and hospital settings [ 70 , 71 ]. Similarly, studies in Germany and Italy have also found economic benefits when using rapid antigen tests [ 72 , 73 ].…”