Skip to main content

Table 2 POC tests employed and cost comparisons between the control pathway tests and their POC equivalents

From: The cost-effectiveness of upfront point-of-care testing in the emergency department: a secondary analysis of a randomised, controlled trial

Abbott Point-of-Care i-STAT® System
The i-STAT System utilises single-use i-STAT test cartridges (i-STAT, Abbott Point of Care, Princeton, NJ, USA) with a handheld POC blood analyser. The CHEM8+ (sodium, potassium, chloride, total carbon dioxide, ionised calcium, glucose, urea, creatinine, haematocrit, haemoglobin and anion gap) and CG4+ (Lactate; pH; partial pressure carbon dioxide (PCO2); partial pressure of oxygen (PO2); total carbon dioxide; bicarbonate; base excess and oxygen saturation) were performed on venous blood specimens.
Abbott CEL-DYN Emerald 22 benchtop haematology system
The CEL-DYN Emerald 22 benchtop haematology system was used. It is capable of providing a POC Complete/Full Blood Count as well as a white blood cell differential count.
Philips Pagewriter TC30 ECG machines were utilised to obtain the ECGs. All patients randomised to receive an ECG received a standard 12-lead ECG as well as a right-sided (V1R-V6R) and posterior (V7-V9) ECG. The cost of the ECG was the same in both the control and the intervention groups.
A Lodox Xmplar-dr was used by a radiographer to perform the LODOX® (LOw-DOse X-ray) radiographs (chest and abdomen, antero-posterior and lateral). The radiation exposure was approximately 339uGy per patient versus a standard chest and abdomen radiograph of approximately 5200uGy [11]. LODOX® is the radiological equivalent of a POC test as it can provide a full body X-ray within 19 s without the patient leaving the ED. Its utility in trauma patients is reasonably well-known but its use as a diagnostic tool for non-trauma patients in the ED has not been evaluated previously [12].
Diagnostic testsCostPoint-of-Care equivalentCost
Complete Blood Count4.57CBC (CEL-DYN Emerald 22)2.33
Urea, Creatinine, Electrolytes
Blood Gas
17.89i-STAT Chem8 CG4+27.61
TOTAL$ 144.04aTOTAL$ 134.11a
  1. $ Costs shown in US dollars for each individual test
  2. CBC Complete Blood Count, ECG electrocardiogram, i-STAT i-STAT POC tests, LODOX® Low-dose x-ray
  3. aThe direct comparison of net costs for testing between the groups if the costs of the tests alone are shown in isolation at face value i.e. what the cost would be for a patient who received all the standard diagnostic tests compared to a patient who received all the POC tests. It would cost $9.93 less to have all the POC tests. This does not include the costs of other tests that might be ordered (e.g. serum amylase or lipase tests)