David O Hamilton1,2, Tosin Lambe3, Alexander Howard4, Patricia Crossey1, Jennifer Hughes1, Rui Duarte3, Ingeborg D Welters1,2. 1. Critical Care Department, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, United Kingdom. 2. Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L69 8TX, United Kingdom. 3. Liverpool Reviews and Implementation Group, Department of Health Data Science, University of Liverpool, Liverpool L69 3GB, United Kingdom. 4. Microbiology Department, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, United Kingdom.
Abstract
We performed a cost comparison of the current diagnostic and treatment pathway for invasive fungal infection (IFI) versus a proposed pathway that incorporates Beta-D-Glucan (BDG) testing from the NHS perspective. A fungal pathogen was identified in 58/107 (54.2%) patients treated with systemic anti-fungals in the Critical Care Department. Mean therapy duration was 23 days (standard deviation [SD] = 22 days), and cost was £5590 (SD = £7410) per patient. Implementation of BDG tests in the diagnostic and treatment pathway of patients with suspected IFI could result in a mean saving of £1643 per patient should a result be returned within 2 days. LAY SUMMARY: Invasive fungal infection increases the risk of death in very sick people. So, treatment is started before test results are known. Beta-D-Glucan (BDG) test is faster than standard blood culture tests. We estimate that using BDG tests in how patients are diagnosed could save about £1643 per patient.
We performed a cost comparison of the current diagnostic and treatment pathway for invasive fungal infection (IFI) versus a proposed pathway that incorporates Beta-D-Glucan (BDG) testing from the NHS perspective. A fungal pathogen was identified in 58/107 (54.2%) patients treated with systemic anti-fungals in the Critical Care Department. Mean therapy duration was 23 days (standard deviation [SD] = 22 days), and cost was £5590 (SD = £7410) per patient. Implementation of BDG tests in the diagnostic and treatment pathway of patients with suspected IFI could result in a mean saving of £1643 per patient should a result be returned within 2 days. LAY SUMMARY: Invasive fungal infection increases the risk of death in very sick people. So, treatment is started before test results are known. Beta-D-Glucan (BDG) test is faster than standard blood culture tests. We estimate that using BDG tests in how patients are diagnosed could save about £1643 per patient.
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