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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 3rd year + oncosts
  Patient follow-up of test results (GP and nurse) Time and motion study No. of tests claimed SA Nurses Award - Registered Nurse 3rd 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 3rd 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
  1. * 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.
  2. **87% of GP requested pathology is bulk-billed.
  3. *** 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.
  4. ****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.
  5. *****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.