Central laboratory versus point of care testing in intraoperative monitoring of parathyroid hormone levels: cost comparison

J Otolaryngol Head Neck Surg. 2008 Feb;37(1):91-7.

Abstract

Objectives: To examine the cost of central laboratory-based intraoperative parathyroid hormone (PTH) during parathyroid surgery compared with a point of care-based PTH testing system.

Methods: Based on a retrospective analysis of intraoperative PTH testing in 50 parathyroid surgeries, a cost comparison between the current testing system at a university-affiliated tertiary care facility (Elecsys 1010, Roche Diagnostics, Basel, Switzerland) and a theoretical model using the QuiCK-intraoperative intact PTH system (Nichols Institute Diagnostics, San Juan Capistrano, CA) was generated.

Results: The cost per surgery of central laboratory-based PTH testing was $129.15 compared with $550.98 for the point of care-based system. Costs were calculated accounting for the purchase price of equipment, cost of reagents and processing, and laboratory technician time.

Conclusions: This is the first cost comparison study using a Canadian-based health care model for point of care versus central laboratory PTH testing and adds to a very limited number of cost comparison studies on this topic. This study provides evidence that in the setting of a tertiary care facility that has on-site laboratory facilities with dedicated staff, central laboratory-based PTH assays provide an efficient and cost-effective way of monitoring PTH levels during parathyroidectomy surgery.

Publication types

  • Comparative Study

MeSH terms

  • Humans
  • Hyperparathyroidism, Primary / blood*
  • Hyperparathyroidism, Primary / economics
  • Hyperparathyroidism, Primary / surgery
  • Intraoperative Period
  • Laboratories, Hospital / economics*
  • Models, Biological
  • Parathyroid Hormone / blood*
  • Parathyroidectomy / economics*
  • Point-of-Care Systems / economics*
  • Retrospective Studies

Substances

  • Parathyroid Hormone