The cost-effectiveness of point of care testing in a general practice setting: results from a randomised controlled trial

Laurence, Caroline O; Moss, John R; Briggs, Nancy E; Beilby, Justin J

doi:10.1186/1472-6963-10-165

Table 2 Resource use items and unit costs for all tests

From: The cost-effectiveness of point of care testing in a general practice setting: results from a randomised controlled trial

Category of resource	Description	Source	Volume	Unit Cost
Establishment Program	PoCT equipment	Industry sources	Equivalent annual cost over clinically useful life (3 years)
	Device Training initial and refresher	Trial	Twice - at commencement of Trial and 12 months later
	Accreditation	Trial	Annual
Pathology testing	Pathology tests - PoCT and laboratory testing*	Medicare Australia data	No. of tests claimed	100% of MBS fee for PoCT. 85% of schedule fee for laboratory test**
	Consultations - including where PoCT test ordered	Medicare Australia data	No. of consultations	Actual charge
	Copayments***	Medicare Australia data	No. of consultations	Actual charge minus MBS fee rebate
	Device Operator time (test, notes etc)	Time and motion study of sample of practices	No. of tests claimed	SA Nurses Award - Registered Nurse 3^rd year + oncosts
	Patient follow-up of test results (GP and nurse)	Time and motion study	No. of tests claimed	SA Nurses Award - Registered Nurse 3^rd year + oncosts SADI Division GP claims policy 2005-2007
	Patient Episode Initiation	Medicare Australia data	No.r of episodes claimed	85% of schedule fee**
Quality management	Quality Assurance Program	Industry source	Annual
	Quality control	Device Group	No. of QC tests (monthly)
	Quality assurance	RCPA QAP Pty Ltd	No. of QA tests (monthly
	Device Operator time for QA and QC	Time and motion study	Number of QA and QC tests	SA Nurses Award - Registered Nurse 3^rd year + oncosts
Consumables and maintenance	Consumables - per test items and periodically used items****	Industry sources		Per test cost
	Annual maintenance fee			Nil. Manufacturers replaced defective devices at no cost.
Downstream costs	Hospital admissions (related only to disease group in study)	Case note audit on sample of patients	No. of visits	National Hospital Data Collection - Public Section Estimated Round 9 (2004-05) - AR-DRG 5.0*****
	Emergency department visits	Patient satisfaction survey	No. of visits	National Hospital Data Collection - Public Section Estimated Round 9 (2004-05) - AR-DRG 5.0
	Specialist referrals	Medicare Australia data	No. of referrals	MBS fee
	Allied health visits	Medicare Australia data	No. of referrals	MBS fee when referred by a GP
	Pharmaceutical costs	Medicare Australia data	No. of prescriptions for conditions associated with the test	PBS dispensed price and copayment
Patient costs	Motor vehicle travel	Patient satisfaction survey	Distance (Km)	Australian Taxation Office
	Other travel costs (eg bus, taxi)	Patient satisfaction survey	Mean cost
	Time seeking healthcare (travel time, waiting time)	Patient satisfaction survey Time and motion study	Mean travel and waiting time	ABS seasonally adjusted average weekly earnings - applied whether were employed, unemployed or retired

* The effect of coning out of pathology was accounted for. Pathology providers can charge through the Medicare Benefits Schedule (MBS) fee only for the three most expensive tests ordered on the one occasion even when more tests are actually done. This is known as 'coning' and means that the tests recorded in the MBS data include only those charged for and not all that were done.
**87% of GP requested pathology is bulk-billed.
*** The high percentage of patients in the Trial who held health care cards or were pensioners (91%) and the location of practices in lower socio-economic status areas meant that most Medicare care items used in the Trial were bulked-billed so that patients did not make a copayment.
****Combined costs of items required to undertake each test. This included the testing strip/cassette, lancet, capillary tubes, plungers, urine pots, dipsticks and gloves. Periodically used items such as dust filters and cleaning kits were costed on an annual basis.
*****Hospitalisation rates were applied to a sample of patients obtained through the case note audit and weighted estimates generated for the Trial population to determine estimates for the whole sample. This approach was taken due to poor reporting of hospitalisations by practices. The hospitalisations were then assigned an AR-DRG code by a researcher blinded to the patient identification and their allocation to intervention or control under guidance from an expert AR-DRG coder. AR-DRG costs were adjusted by the CPI.

Back to article page

ISSN: 1472-6963

Contact us

General enquiries: journalsubmissions@springernature.com

BMC Health Services Research

Contact us