Economics of Point of Care Testing

The point of care testing is an old exercise in the medical circles. It is always wise to take the patient through thorough and satisfactory testing before putting him or her under any medical treatment. This helps in that it reduces the chances of putting a patient under a mistaken spectrum of medication. This method (Point Of Care Testing) also known as near patient, bedside or extra-laboratory testing.

The utmost and prerequisite goal is to obtain the test results faster and administer treatment accordingly, resulting to high quality clinical outcomes.

(A) Cost aspect of the POCT devices

A point of care testing (POCT) dealing with glucose and cholesterol should have the following apparatus

1. Easy Touch GCU Blood Glucose Cholesterol Uric Acid Meter

2. ET301 Multi-function Blood Glucose Meter

3. Blood Hemoglobin, Cholesterol, Uric Acid and Glucose Meter & Test Strips

4. Multi-Function Monitoring Meter       

5. Multi check Glucose meter

6. Cholesterol Test Meter

7. Easy Mate GCU Blood Glucose Cholesterol Uric Acid Monitor

8. Blood Hemoglobin, Cholesterol, Uric Acid and Glucose Meter & Test Strips

9. Multi-Function Monitoring Meter

10. A 4 in 1 Glucose, Cholesterol, Uric Acid & Hemoglobin Monitor

11. Easy touch Glucose, Uric Acid and Cholesterol Meter GCU meter

12. Cholesterol, Uric Acid and Glucose Meter and Strips

13. A Blood Hemoglobin, Cholesterol, Uric Acid and Glucose Meter & Test Strips

14. Blood Meter (Cholesterol Tester)

15. Blood Meter (Single / Dual / Multi Function Meter)

The estimated cost schedule in US $ given in the following table:

Estimated cost in US $

Easy Touch GCU Blood Glucose Cholesterol Uric Acid Meter

ET301 Multi-function Blood Glucose Meter

Blood Hemoglobin, Cholesterol, Uric Acid and Glucose Meter & Test Strips

Multi-Function Monitoring Meter

 Multi check Glucose meter

Cholesterol Test Meter

Easy Mate GCU Blood Glucose Cholesterol Uric Acid Monitor

Blood Hemoglobin, Cholesterol, Uric Acid and Glucose Meter & Test Strips

Multi-Function Monitoring Meter

A 4 in 1 Glucose, Cholesterol, Uric Acid & Hemoglobin Monitor

Easy touch Glucose, Uric Acid and Cholesterol Meter GCU meter

Cholesterol, Uric Acid and Glucose Meter and Strips

Blood Meter (Single / Dual / Multi Function Meter)

The quoted costs in the table above have been estimated but in U.S Dollars. This is because their prices are not standard but vary from time to time and place and time to time.

(B)  THE RELEVANT "FIXED COSTS" AND "VARIABLE COSTS"

The costs involved can easily be classified as fixed or variable costs. Fixed costs are the ones that are not affected by the day to day operations of the Point Of Care Testing center. They are always incurred regardless of whether there was any patient who came for testing or not. From the foregoing, we notice that these costs will accrue the same way without considering the number of clients who visited.

The rate of amortization is taken to straight basis. The scenario above applies if all the costs in that table are capitalized. The rate of 33.3% amortizes the costs for 3 years.

Over and above the fixed costs, we also have the relevant variable costs. It is important to note the costs are not capitalized. They are incremental and they will be affected by the number of patients tested. Examples are like the cost of reagents. The reagents will be used more when more patients are treated. The table below shows the different variable costs available. Examples of the costs involved are: Reagent costs, Reagent costs, Cost of record keeping, Staff outsourcing costs, Document review costs, Documentation cost, Stationery costs, Packaging costs

(C)  THE INFLUENCE WHICH TESTING VOLUME MAY HAVE ON THE OVERALL COSTING

The testing volume will only affect the variable costs. This is because the fixed costs are not affected by the variations in the operations of the Point of care Testing. From the line thought so far, we notice that the overall cost will be made up of the fixed and the variable costs. We also know that only the variable costs are changing. With the change in the variable costs, the overall cost therefore also changes. To this end, we see that the overall cost increases with the increase in the testing volume.

COMPARATIVE COST ANALYSIS

(D) The comparison is based on an average study of other Points of Care Testing

The reason why my figures are below the existing market figures is for attracting patients then maintaining them by offering high quality services. The below shows a simplified summary of the comparative costs of the glucose and Cholesterol tests

(E)  COST EFFICIENCY WITH REGARD TO PATIENT TREATMENT AND THE ONGOING MANAGEMENT

The costs of the fixed and the variable items are effective in that the results of the tests in revenue terms are higher. This leaves a good margin even to pay the management and the existing staff. In our revenue statement, we shall have a surplus as a result of the increased sales of services. Since some costs are variable, we can control the cost so that we maintain a good profit level. When patients are treated, they pay on cash basis so there are no debt issues. This guarantees the point of Care Testing Centre continuity.

(F)   COST JUSTIFICATION FOR POCT

The cost is justified because it covers the capital costs, the cost of labor and other direct costs that affect the testing process, like the cost of reagents among other costs

(G) Suggestions for cost recovery, cross subsidisation, patient or Medicare billing Requirements

Cost recovery - The Point of Care Testing Centre should always aim to recover the full cost from the revenue obtained from the customer payments to avoid operating at losses

Cost Subsidization- the Point of Care Testing Centre should start by charging a subsidized cost to the patients since already there are already other centers in the market supplying similar services. The prices should be competitive

Medicare Billing - The patients should be billed as and when the services are delivered. This is to avoid having credit issues, so as to facilitate perpetuity of the Testing centre.