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Ruling out IBD: Estimation of the possible economic effects of pre-endoscopic screening with F-calprotectin
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry. (Biokemisk struktur och funktion)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry. (Biokemisk struktur och funktion)
2012 (English)In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 45, no 7-8, 552-555 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To estimate the possible economic effects of a sequential testing strategy with F-calprotectin to minimize colonoscopies.

DESIGN AND METHODS: Retrospective study in a third party payer perspective. The costs were calculated from initial F-calprotectin test results of 3639 patients. Two cut-off levels were used: 50μg/g feces and 100μg/g feces, respectively. The cost-effectiveness of the testing strategy was estimated through the short-term cost avoidance and reduction in demand for colonoscopies.

RESULTS: The estimated demand for colonoscopies was reduced by 50% with the 50μg/g cut-off and 67% with the 100μg/g cut-off. This corresponded to a cost avoidance of approximately €1.57million and €2.13million, respectively.

CONCLUSIONS: The use of F-calprotectin as a screening test substantially could reduce the number of invasive measurements necessary in the diagnostic work-up of patients with suspected IBD, as well as the associated costs.

Place, publisher, year, edition, pages
2012. Vol. 45, no 7-8, 552-555 p.
Keyword [en]
cost-effectiveness, diagnostic tests, health care costs, inflammatory bowel disease, irritable bowel syndrome, calprotectin
National Category
Other Clinical Medicine
Research subject
Biomedical Laboratory Science
Identifiers
URN: urn:nbn:se:uu:diva-120552DOI: 10.1016/j.clinbiochem.2011.10.015ISI: 000303553300008OAI: oai:DiVA.org:uu-120552DiVA: diva2:303558
Note
Original title of the manuscript: Ruling out IBD: The cost-effectiveness of pre-endoscopic screening with F-calprotectinAvailable from: 2010-03-12 Created: 2010-03-12 Last updated: 2017-12-12Bibliographically approved
In thesis
1. The Use of Laboratory Analyses in Sweden: Quality and Cost-Effectiveness in Test Utilization
Open this publication in new window or tab >>The Use of Laboratory Analyses in Sweden: Quality and Cost-Effectiveness in Test Utilization
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Laboratory analyses, essential in screening, diagnosis, treatment, and monitoring of disease, are indispensable in health care, but appropriate utilization is intricate. The overall aim of this thesis was to study the use of laboratory tests in Sweden with the objective to evaluate and optimize test utilization.

Considerable inter-county variations in test utilization in primary health care in Sweden were found; variations likely influenced by local traditions and habits of test ordering leading to over- as well as underutilization. Optimized test utilization was demonstrated to convey improved quality and substantial cost savings.

It was further established that continuing medical education is a suitable means of optimizing test utilization, and consequently enhancing quality and cost-efficiency, as such education was demonstrated to achieve long-lasting improvements in the test ordering habits of primary health care physicians.

Laboratory tests are closely associated with other, greater, health care costs, but their indirect effects on other areas of medicine are rarely evaluated or measured in monetary terms. In an illustrative example of the effects that optimal test utilization may have on associated health care costs it was demonstrated that F-calprotectin, a fecal marker of intestinal inflammation, has the potential to substantially reduce the number of invasive investigations necessary in, and the costs associated with, the diagnosis of Inflammatory Bowel Disease.

Information on trends in test utilization is essential to optimal financial management of laboratories. A longitudinal evaluation revealed that test utilization had increased by 70% in 6 years, and even though the selection of tests more than doubled, a very small number of tests represented a stable, and disproportionally large, share of the total number of tests ordered. The study defines trends and thus has potential predictive values.

In summary, appropriate utilization of laboratory analyses has both clinical and economical benefits on all levels of health care.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 538
Keyword
continuing medical education, cost control, cost savings, physician practice patterns, diagnostic tests, clinical chemistry, primary health care, health care costs, laboratory management, test utilization, trends, cost-effectiveness, inflammatory bowel disease, irritable bowel syndrome, calprotectin, cost avoidance
National Category
Other Clinical Medicine
Research subject
Biomedical Laboratory Science
Identifiers
urn:nbn:se:uu:diva-120554 (URN)978-91-554-7751-6 (ISBN)
Public defence
2010-05-07, Enghoffsalen, Ing 50, bv, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-14 Created: 2010-03-12 Last updated: 2010-04-16

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Mindemark, MirjaLarsson, Anders

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