SPC365

Utility and cost of routine blood test profiles in acute coronary syndrome: a multicenter survey study

Session: Posters - N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Speaker: Inês Fialho

Congress: CPC 2021
Topic: N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
Theme: 34. Public Health and Health Economics
Subtheme: 34.3 Health Economics
Session Type: Posters
FP Number: ---
Authors: Inês Fialho; Miguel Borges Santos; João Bicho Augusto; Daniel Faria; João Baltazar Ferreira; Marco Beringuilho; Hilaryano Ferreira; Mariana Passos; Joana Lima Lopes; Sérgio Baptista; Luis Brízida; Carlos Morais

<div style="text-align:justify"><span style="font-size:14px"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Introduction:</strong> Blood test (BT) profiles are widely available in medical institutions and contribute to improve the efficiency of medical care. However, its easy access can lead to overuse and a consequent increase in health costs.</span></span></span></span></span></div>

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<div style="text-align:justify"><span style="font-size:14px"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Objectives:</strong> For 2 different clinical scenarios, hospital admission for ACS and post-ACS follow-up appointments, we aimed to (i) evaluate which BTs are considered useful by Portuguese cardiologists and (ii) how much can be saved if only useful BTs are prescribed.</span></span></span></span></span></div>

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<div style="text-align:justify"><span style="font-size:14px"><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#2f5496"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Methods:</strong> Consultant Cardiologist and Cardiology residents from nine Portuguese hospitals were invited via e-mail to participate in an online anonymous survey. The survey included questions about the local availability of BT profiles and which BTs are considered routinely useful in the aforementioned scenarios. Some BTs are absolutely necessary and were excluded from the survey (full blood count, serum creatinine, sodium and potassium, total cholesterol, LDL cholesterol and high-sensitivity troponin). For the cost analysis, a BT was considered useful whenever <u>&gt;</u>65% of answers indicated so. The reference cost for each test was obtained from the Clinical Pathology Department. The potential savings from adopting a &ldquo;useful BT profile&rdquo;-only strategy was estimated at our institution from the yearly average number of individual patients submitted to coronary angiography due to ACS and the predicted number of four routine Cardiology appointments per patient in the first year post-ACS.</span></span></span></span></span></div>

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<div style="text-align:justify"><span style="font-size:14px"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Results:</strong> A total of</span></span> <span style="font-family:Calibri,sans-serif"><span style="color:black">65 answers were analyzed, 37% from Cardiology residents (n=24) and 63% (n=41) from consultant Cardiologists. Two incomplete answers were excluded. BT profiles were available across all centers, and 75% (n=49) of the participants use them routinely. The results considering &lsquo;routinely useful&rsquo; or &lsquo;routinely not useful&rsquo; are presented in Table 1. At our institution, the BT profile at hospital admission costs &euro;126.36; if only useful BTs were prescribed, it would save &euro;61.89 per admission &ndash; an estimated yearly saving of &euro;21,661.50 for an average of 350 ACS admissions.&nbsp;For post-ACS routine appointments, the BT profile costs &euro;48,07. The total cost of useful BTs in this setting is &euro;22.90 - an estimated yearly saving of &euro;35,238.00 assuming an average of 1,400 outpatient appointments per year for these 350 ACS patients.</span></span></span></span></span></div>

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<div style="text-align:justify"><span style="font-size:14px"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:#000000"><span style="font-family:Calibri,sans-serif"><span style="color:black"><strong>Conclusions:</strong> BT profiles routinely used in our institution for ACS patients include several tests deemed as &ldquo;not routinely useful&rdquo; by a large proportion of cardiologists from nine different Portuguese hospitals. In these patients, routine prescription limited to the &ldquo;routinely useful BTs&rdquo; at hospital admission and outpatient appointments may lead to yearly savings up to &euro;21,661.50 and &euro;35,238.00, respectively. Confirmatory studies using an updated &ldquo;useful&rdquo; BT profile are in order to confirm these predicted savings.</span></span></span></span></span></div>