Cost Analysis of Cot-Side Screening Methods for Neonatal Hypoglycaemia.

Area of Science:

• Neonatal Medicine
• Clinical Diagnostics
• Health Economics

Background:

• Neonatal hypoglycemia screening often uses point-of-care glucometers.
• Non-enzymatic glucometers exhibit inaccuracies, leading to potential overtreatment or undertreatment.
• Enzymatic glucometers offer higher accuracy but are perceived as more expensive.

Purpose of the Study:

• To compare the cost-effectiveness of point-of-care enzymatic versus non-enzymatic glucometers for neonatal hypoglycemia screening.
• To evaluate the economic implications of different screening strategies.

Main Methods:

• A decision tree model was employed to calculate costs, including consumables and staff time.
• Sensitivity analyses explored variations in staff time, costs, laboratory confirmation rates, and glucometer accuracy.
• The impact of adjusting the blood glucose concentration threshold was also assessed.

Main Results:

• Enzymatic glucometer screening cost NZD 86.94 per baby, compared to NZD 97.08 for non-enzymatic.
• Enzymatic glucometers proved cost-saving across various scenarios, including different staff costs and false-positive rates.
• Lowering the screening threshold to 1.94 mmol/L significantly reduced hypoglycemia incidence and non-enzymatic glucometer costs.

Conclusions:

• Enzymatic glucometers are more cost-effective for neonatal hypoglycemia screening in most situations.
• The superior accuracy of enzymatic glucometers supports their routine use in point-of-care settings.
• Optimizing screening protocols, including threshold adjustments, can further enhance cost-efficiency and clinical outcomes.