Relationship between Diagnostic Method and Pathogen Detection, Healthcare Resource Use, and Cost in U.S. Adult...

Area of Science:

• Infectious Diseases
• Clinical Diagnostics
• Health Economics

Background:

• Acute infectious gastroenteritis (AGE) is a common outpatient diagnosis.
• Diagnostic methods for AGE include traditional work-up (TW), multiplex PCR panels with <12 targets (PCR<12), and multiplex PCR panels with ≥12 targets (PCR12).
• Assessing the impact of diagnostic method on yield, healthcare resource use, and cost is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate the relationship between diagnostic method (TW, PCR<12, PCR12) and diagnostic yield, healthcare resource use (HRU), and cost in adult outpatients with AGE.
• To compare the effectiveness and economic impact of different diagnostic approaches for AGE.

Main Methods:

• Retrospective observational study using the PINC AI Healthcare Database (January 2016 - June 2021).
• Analysis of adult outpatients with an AGE diagnosis and stool testing.
• Comparison of pathogen detection rates, HRU, and costs across TW, PCR<12, and PCR12 groups.

Main Results:

• PCR12 was associated with a higher diagnostic yield (73.1% pathogen detection) compared to PCR<12 (63.6%) and TW (45.4%).
• PCR12 demonstrated lower 30-day AGE-related follow-up costs (by $117) and hospitalization risk (1.7% vs 2.7%) than TW.
• PCR12 resulted in fewer stool tests per patient, faster turnaround times, and reduced likelihood of in-hospital antibiotic use compared to TW.

Conclusions:

• Large multiplex PCR panels (PCR12) offer superior diagnostic yield for AGE compared to traditional work-up.
• PCR12 is associated with reduced healthcare resource utilization and lower overall costs, including decreased 30-day follow-up expenses and hospitalization risk.
• Multiplex PCR panels represent a more efficient and cost-effective diagnostic strategy for managing adult outpatients with acute infectious gastroenteritis.