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Cost–Benefit Analysis of Real-Time Influenza Testing for Patients in German Emergency Rooms

1,2,3,* and 3,4
Institute for Epidemiology, University Medical Hospital Schleswig-Holstein, Kiel, Airway Research Center North (ARCN), 24015 Kiel, Germany
Lung Clinic Grosshansdorf, Germany. Airway Disease Center North (ARCN), German Center for Lung Research (DZL), 22949 Großhansdorf, Germany
Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
Institute for Health Service Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(13), 2368;
Received: 31 May 2019 / Revised: 30 June 2019 / Accepted: 2 July 2019 / Published: 3 July 2019
(This article belongs to the Section Health Economics)
PDF [963 KB, uploaded 4 July 2019]


Background: Seasonal influenza causes significant morbidity worldwide and has a substantial economic impact on the healthcare system. Objective: To assess the cost–benefit relation of implementing a real-time influenza test in emergency rooms (ER) of German hospitals. Methods: A deterministic decision-analytic model was developed simulating the incremental costs of using the Solana® Influenza A+B test, compared to those of using conventional clinical judgement alone to confirm or exclude influenza in adult ILI (influenza-like illness) patients, in German ER, prior to hospitalization. Direct costs were evaluated from the hospital perspective, considering resource use directly related to influenza testing and treatment, as well as indirect costs incurred by nosocomial influenza transmission. Results: Through base-case analysis and assuming an influenza prevalence of 42.6%, real-time testing with Solana® reduced average costs of hospitalized ILI patients by €132.61, per tested patient. Moreover, the Solana® saved €6.9 per tested patient in favor of the hospital. In probabilistic sensitivity analysis, under all reasonable assumptions, implementing the Solana® saved on average €144.13 as compared to applying the clinical-judgement-only strategy, thus, it was found to be constantly less expensive. Conclusions: Using highly sensitive and specific real-time influenza tests in ILI patients at German ER might significantly reduce hospital expenditures View Full-Text
Keywords: cost–benefit analysis; sensitivity analysis; PCR; real-time testing; influenza cost–benefit analysis; sensitivity analysis; PCR; real-time testing; influenza

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Diel, R.; Nienhaus, A. Cost–Benefit Analysis of Real-Time Influenza Testing for Patients in German Emergency Rooms. Int. J. Environ. Res. Public Health 2019, 16, 2368.

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