Development and evaluation of a cost-effectiveness analysis model for sepsis diagnosis

Sepsis is a life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Sepsis is a substantial health care and economic burden worldwide and is one of the most common reasons for admission to the hospital and intensive care unit. Early diagnosis and targeted treatment of sepsis are the bases to reduce the mortality and morbidity. Conventional blood culturing is the gold standard method for sepsis diagnostics. However, blood culturing is a time consuming method, requiring at least 48 to 72 hours to get the first results with very low sensitivity and specificity. The aim of this study was to determine and assess the direct sepsis-related costs for PCR-based diagnostic strategies (SeptiFast and POC/LAB). A mathematical model was constructed to compare PCR-based diagnostic strategies with the conventional blood culturing. Three case scenarios were investigated based on data from the United Kingdom, Spain and the Czech Republic. It was found that, POC/LAB was the most cost effective strategy in all countries if it could reduce the hospitalization length of stay with at least 3 days in the normal hospital ward and 1 day in the intensive care unit. Reducing the hospitalization length of stay had the greatest impact on the economic outcomes. While, reducing the costs of the diagnostic strategies did not show a remarkable effect on the economic results. In conclusion, the findings suggest that PCR-rapid diagnostic methods could be cost-effective for the diagnosis of patients with sepsis if they could reduce the hospitalization length of stay