Abstract
Point of care (POC) testing in dialysis clinics can improve the quality of care provided to end-stage renal disease (ESRD) patients. The objective of this study was to estimate the budgetary impact of transitioning from weekly lab-based analysis of hemoglobin at each dialysis session to POC. A budget impact model with a 1-year time horizon was developed. Our model included costs of POC testing in real-time in dialysis clinics compared to requiring the shipment of 3 blood samples per month to a lab for analysis. A non-invasive monitoring technology, the Crit-Line monitor ® (CLM) measures hematocrit. Hemoglobin levels can be calculated from the measured hematocrit value. CLM is already used for fluid management in dialysis clinics and can also be used for POC testing. The model took the perspective of a healthcare organization responsible for providing dialysis treatments. The 2020 Medicare reimbursement value for a hematocrit test was used as a proxy value for lab testing costs. Our model also included costs associated with shipping, blood collection tubes, and erythropoiesis-stimulating agent (ESA) which is indicated for the treatment of anemia. Labor costs were excluded as they were considered fixed costs and would not change if POC testing was implemented. By replacing three blood draws per month, the use of a Crit-Line monitor® to assess hemoglobin levels could save $16.82 USD per patient per month. The use of Crit-Line monitor® technology for point of care assessment of hemoglobin levels can result in decreased resource use and costs savings of $16.82 USD per patient per month compared to lab-based testing. Point of care testing may also have environmental benefits by reducing emissions associated with shipping samples and decreasing packaging needed to ship samples to a lab for analysis.
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