Josep Ferrer
Estela Giménez
Diego Carretero
Javier Buesa
Francisco Morillas
Rafael Granell
Amadeo Fuenmayor
David Navarro
Eliseo Albert
Abstract
Economic evaluation is needed to gauge the value of implementing syndromic PCR platforms in the microbiology laboratory for the diagnosis of communicable diseases. PCR in the microbiology laboratory for the diagnosis of community-acquired acute gastroenteritis (CAGE) in paediatric and adult inpatients and outpatients. A cost-benefit analysis from a health system perspective was performed using the BD MAX Enteric Bacterial, Bacterial Plus and Virus panels. Two 6-month periods were selected, using either conventional procedures (in 2017) or BD MAX multiplex PCR panels (in 2018). The medical records of all patients with positive results and a representative sample of negatives were retrospectively reviewed. A Markov model was used to represent the transition probabilities between the different states of care from the time of stool microbiological examination to the completion of care associated with the SGA episode. A total of 1,336 medical records were reviewed (829 in 2018 and 507 in 2017), showing overall a significantly higher positivity rate in 2018 than in 2017 (26% vs. 6%, P < 0.001). The total cost per individual associated with healthcare per AGE was €314 in 2018 and €341 in 2017; when only considering the paediatric cohort, the figures were €271 and €456, respectively. Using Tornado sensitivity analysis, we found that the three variables that most influenced the model in descending order of weight were the probability of longer hospital stays, the probability of returning to the emergency room (ER) and the probability of hospitalisation from the ER. The use of BD MAX enteric PCR platforms for the diagnosis of community-acquired AGE rather than a conventional non-PCR-based approach results in an incremental benefit from a healthcare perspective in the general population, especially in children.
Reference
Ferrer, J; Giménez, E; Carretero, D; Buesa, J; Morillas, F; Granell, R; Fuenmayor, A; Navarro, D; Albert, E. (2022): BD MAX Enteric Bacterial, Bacterial Plus, and Virus Panels for Diagnosis of Acute Infectious Gastroenteritis: a Cost-Benefit Analysis, Microbiology Spectrum Journal, 10, 5. DOI: https://doi.org/10.1128/spectrum.00880-22