Economics of Early Warning Scores for identifying clinical deterioration-a systematic review

Ir J Med Sci. 2018 Feb;187(1):193-205. doi: 10.1007/s11845-017-1631-y. Epub 2017 Jun 3.

Abstract

Aim: In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration.

Methods: A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings.

Results: The search yielded one health technology assessment, two budget impact analyses and two cost descriptions. Three of the studies were Irish, and considered the national EWS system. A Dutch study reported financial consequences of a single parameter EWS, as part of a rapid response system, in a surgical ward. The fifth study examined an advanced triage system in a medical emergency admission unit in Wales.

Conclusions: The economic evidence on the use of EWS amongst adult patients in acute health care settings for the timely detection of physiological deterioration is limited. Further research is required to investigate the cost effectiveness of EWS, and the appropriateness of using standard methods to do so. The recent implementation of a national EWS in Ireland offers a unique opportunity to bridge this gap in the literature to examine the costs and cost effectiveness of a nationally implemented EWS system.

Keywords: Early Warning Scores; Economics; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Clinical Deterioration*
  • Early Diagnosis
  • Economics, Medical / trends*
  • Hospitalization
  • Humans
  • Treatment Outcome*