Does point-of-care testing offer a positive economic impact on primary healthcare? A systematic review

Point-of-Care Testing (POCT) offers rapid diagnostics, yet its economic efficiency in primary healthcare is not fully established.

To evaluate the impact of POCT on primary healthcare expenditures and cost-effectiveness compared to standard laboratory testing.

We searched Web of Science, Scopus, and PubMed (January 2000-January 2024) for original economic evaluations (e.g., Cost-Effectiveness, Cost-Minimization) of POCT in primary care settings. English-language studies evaluating human health outcomes were included. We assessed methodological quality using the Consensus on Health Economic Criteria (CHEC) list. Due to significant heterogeneity in study designs and perspectives, a narrative synthesis was conducted.

Sixteen studies were included. While POCT devices often introduced higher upfront unit costs, they frequently yielded cost savings by preventing expensive secondary care referrals (e.g., ruling out Deep Vein Thrombosis (DVT), managing early pregnancy bleeding) and reducing unnecessary antibiotic prescribing. However, economic outcomes varied significantly based on the healthcare setting (societal vs. payer perspective), disease prevalence, and clinician adherence to test results.

POCT demonstrates potential for economic benefits by optimizing clinical pathways and reducing downstream resource use. However, decision-makers must account for local system capacities, as cost-effectiveness is context-dependent and not universal.