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Time is Money—the Economic Impact of Point of Care on the Emergency Department of a Tertiary Care University Hospital

Schilling, Ulf Martin MD, PhD

Point of Care: The Journal of Near-Patient Testing & Technology: March 2014 - Volume 13 - Issue 1 - p 21–23
doi: 10.1097/POC.0000000000000003
Original Articles

Background With Swedish emergency departments (EDs) becoming independent financial units, economic pressure is placed onto the EDs. The use of point-of-care (POC) systems allowing rapid analysis of blood samples is increasing in the ED. In this study, we analyzed the potential economic impact of the use of the iSTAT POC system in the ED of a university hospital.

Methods Prices for the test batteries Chem8 +, CG4 +, and TNI and for the analyzers were provided by the manufacturer and compared to analyses by the hospitals central laboratory. With staffing being the major cost in the ED, the cost for attending each minute a patient in the ED was calculated. Fixed costs were omitted in the analysis. The difference in turnaround time for the available results of analysis by POC and by the central laboratory was determined.

Results The use of POC resulted in direct savings for analysis of 111 US$/patient. The mean ± SD delay between POC results and central laboratory results was 48.5 ± 28.67 minutes. This is equivalent to 32,333 working hours per year. Emergency department staffing accounts for a cost of 1.5 US$ per patient per minute. The time saved by POC translates into potential savings of 72.75 US$ per patient. Based on 40,000 patient visits per year in our ED, 7,350,000 US$ could be saved by the stringent use of POC.

Conclusions The use of POC could produce a major economic impact for the ED if all potential savings are realized. Considering the potential savings on waiting times, POC might also increase patients' safety and satisfaction as well as help to alleviate overcrowding in the ED.

From the Department of Accidents and Emergencies, Department of Health Sciences, Institution for Clinical and Experimental Medicine, Linköping University, Sweden.

Reprints: Ulf Martin Schilling, MD, PhD, Department of Accidents and Emergencies, Department of Health Sciences, Institution for Clinical and Experimental Medicine, Linköping University, Sweden. E-mail: ulf.martin.schilling@gmail.com.

Funding: Abbott point of care™ provided all POC materials. No other funding was received for this work.

Potential conflicts of interest: The author is a member of the speakers' bureau of Abbot point of care™. The present study was performed before the author became part of this bureau, and Abbot point of care™ did not have any influence on the planning, conduction, or evaluation of the study and its results.

Ethical adherence: The author confirms that the trial was performed in accordance with ICJME guidelines and the declaration of Helsinki, as well as local ethical guidelines.

© 2014 by Lippincott Williams & Wilkins