| Abstract |
Objectives Emergency Department (ED) crowding is a quality of care and financial problem. Among its causes are long length of stay in the ED (ED LoS). One of identified causes is prolonged Turnaround Time (TAT) for complementary tests, including laboratory tests. The main aim of this study is to design and validate a cost-effective model for improving resolution of hospital emergencies at the Virgen Macarena University Hospital (VMUH) based on application of point-of-care testing (POCT) on patients classified as priority 3 (P3), according to VMUH\'s triage system.Methods P3 patients who met inclusion criteria were randomly assigned into: POCT group (laboratory tests in ED using POCT) or LAB group (laboratory tests in central laboratory). Previously, a correlation study of analytical parameters was done between both groups. Gender, age, reason for consultation, pre-intervention TAT, disposition-decision time (DDT) and ED LoS with or without imaging tests were analysed. A cost study and an extrapolation of strategy at national level were performed.Results The correlation study proved favourable. POCT achieved a median reduction of DDT and ED LoS of 107.00 and 118.50 min respectively. This trend was maintained for non-pain related consultations and irrespective of imaging tests. Use of POCT resulted in a saving of 119.85/episode and a favourable Incremental Cost-Effectiveness Ratio (ICER) of 60.68 saved/ED LoS hour. Applying POCT to 50 % of national P3 EDs, potential savings of 284,206,701.19 were estimated.Conclusions In conclusion, our strategy was shown to reduce DDT and, consequently, ED LoS in a cost-effective way. |
