ESTIMATING THE CLINICAL IMPACT AND COSTS OF IMPLEMENTING A POINT OF CARE TEST FOR INFLUENZA A/B AND RESPIRATORY SYNCYTIAL VIRUS ON AN ACUTE PAEDIATRIC HOSPITAL INPATIENT WARD

Purpose:

We aimed to explore the impact of introducing a high performance point of care test (POCT) for influenza and respiratory syncytial virus (RSV) (Enigma® MiniLab™ FluAB-RSV) on an acute paediatric ward of a large London hospital during influenza season compared to standard care of using a laboratory-based test. 

Method(s):

We estimated the reimbursement charges, length of stay, and utilisation and total costs of laboratory tests and drugs before and after implementing the Enigma® MiniLab™ FluAB-RSV test for paediatric patients admitted to an acute respiratory ward in the 2013/14 and 2014/15 respiratory seasons.

Result(s):

We found a significant reduction in reimbursement charges for influenza- and RSV-negative patients, for the full hospital stay and the period on the acute paediatric ward (£165 and £148 respectively, p=0.05) after implementing the POCT.  However, these differences disappeared when controlling for top-up service charges.  There was no change for patients who were influenza or RSV positive. More appropriate treatment of patients with influenza occurred after implementing the POCT (40% versus 13% received oseltamivir, p=0.02). There was no difference in length of stay between the two periods.

Conclusion(s):

We observed clinical improvements in prescribing treatment for influenza after implementing a POCT for influenza A/B and RSV infections in paediatric patients, accompanied by a reduction in reimbursement and laboratory costs. This could mean savings for commissioners and hospitals, even without a reduction in the length of stay.