Use and Cost Analysis of Comprehensive Respiratory Panel Testing in a Pediatric Emergency Department

Area of Science:

• Pediatric Emergency Medicine
• Clinical Diagnostics
• Health Economics

Background:

• Fever and respiratory infections are common reasons for pediatric emergency department visits.
• Diagnostic tests are often used to identify microbial causes, but comprehensive panels can be costly.
• The financial impact and clinical utility of these panels require analysis.

Purpose of the Study:

• To analyze the financial impact of comprehensive respiratory viral panel (RVP) use.
• To evaluate the association between RVP testing and clinical outcomes in pediatric patients.
• To determine if RVP use affects healthcare charges, length of stay, or antimicrobial utilization.

Main Methods:

• Retrospective chart review of pediatric emergency department patients diagnosed with upper respiratory infection, fever, or bronchiolitis.
• Analysis of 5766 patient visits between October 2016 and April 2018.
• Primary outcome: total healthcare charge; Secondary outcomes: emergency department length of stay and antimicrobial use.

Main Results:

• 229 (4%) of patients underwent RVP testing, with 163 (71%) having positive results.
• Total healthcare charges were significantly higher for patients tested with RVPs ($643.39) compared to those not tested ($295.15).
• RVP testing did not decrease emergency department length of stay or significantly alter antimicrobial use.

Conclusions:

• Comprehensive RVPs in pediatric emergency settings for common respiratory illnesses increase patient costs.
• RVP utilization did not lead to reduced length of stay or antimicrobial prescribing.
• Further research is needed to establish appropriate, targeted indications for RVP testing in pediatric patients.