Cost analysis of point-of-care laboratory testing in a community hospital

Point-of-care testing (POCT) is a means of providing patient services more rapidly. Most evaluations of bedside laboratory testing devices have emphasized analytical performance in tertiary care settings. In contrast, the authors compare the operating cost of POCT for glucose and an electrolyte/glucose/blood urea nitrogen chemistry panel with the cost of central laboratory stat testing in a 204-bed community hospital. In scenarios studied, POCT costs exceed central laboratory stat costs from 1.1 to 4.6 times. The more POCT is used, the greater the excess costs compared to the central laboratory. Cost analysis demonstrates that the investment in acquiring automated transport and data management systems for the authors' hospital was far less expensive than POCT for both an individual stat test and on an annual cost basis. The authors urge fiscal caution before indiscriminately implementing POCT.