Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis

Objective To compare National Health Service (NHS) organisations’ testing pathways for patients with suspected COVID-19 in the community versus standard hospital testing practices.Perspective NHS commissioners and services.Methods During the containment phase of the COVID-19 pandemic we developed a...

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Main Authors: Jonny Currie, Robin Howe, Brendan Healy, James Adamson, Bethan Bowden, Julie Woolls, David Heyburn
Format: Article
Language:English
Published: BMJ Publishing Group 2020-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/8/e038017.full
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author Jonny Currie
Robin Howe
Brendan Healy
James Adamson
Bethan Bowden
Julie Woolls
David Heyburn
author_facet Jonny Currie
Robin Howe
Brendan Healy
James Adamson
Bethan Bowden
Julie Woolls
David Heyburn
author_sort Jonny Currie
collection DOAJ
description Objective To compare National Health Service (NHS) organisations’ testing pathways for patients with suspected COVID-19 in the community versus standard hospital testing practices.Perspective NHS commissioners and services.Methods During the containment phase of the COVID-19 pandemic we developed a community model pathway for COVID-19 testing in Wales with testing teams undertaking swabbing for COVID-19 in individuals’ usual place of residence. We undertook a cost-minimisation analysis comparing the costs to the NHS in Wales of community testing for COVID-19 versus standard hospital testing practices and ambulance conveyancing. We analysed data from patients with suspected COVID-19 between January and February 2020 and applied assumptions of costs from national contractual and reference costs for ambulances, staffing and transportation with market costs at the time of publication.Results 177 patients with suspected COVID-19 underwent community testing via local NHS organisations between January and February 2020 with a mean age of 46.1 (IQR 27.5–56.3). This was 92% of total patients who were tested for COVID-19 during this period. We estimate, compared with standard hospital testing practices, cash savings in improved productivity for the NHS of £24,539 during this time period, in addition to further non-monetised benefits for hospital and ambulance flow.Conclusions Community testing for COVID-19 in Wales is now an established pathway and continues to bring benefits for patients, local healthcare organisations and the NHS. Further application of this model in other settings and to other infectious diseases may herald promising returns.
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spelling doaj-art-680fd66bb24a45cbbe071460f83f4baf2025-08-20T02:08:27ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2020-038017Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysisJonny Currie0Robin Howe1Brendan Healy2James Adamson3Bethan Bowden4Julie Woolls5David Heyburn61 Public Health Wales, Cardiff, UKMicrobiology, Public Health Wales, Cardiff, UKUniversity Hospital Wales Heath Park, Cardiff, UKPublic Health Wales, Cardiff, UKPublic Health Wales, Cardiff, UKUniversity Hospital of Wales Healthcare NHS Trust, Cardiff, UKPublic Health Wales, Cardiff, UKObjective To compare National Health Service (NHS) organisations’ testing pathways for patients with suspected COVID-19 in the community versus standard hospital testing practices.Perspective NHS commissioners and services.Methods During the containment phase of the COVID-19 pandemic we developed a community model pathway for COVID-19 testing in Wales with testing teams undertaking swabbing for COVID-19 in individuals’ usual place of residence. We undertook a cost-minimisation analysis comparing the costs to the NHS in Wales of community testing for COVID-19 versus standard hospital testing practices and ambulance conveyancing. We analysed data from patients with suspected COVID-19 between January and February 2020 and applied assumptions of costs from national contractual and reference costs for ambulances, staffing and transportation with market costs at the time of publication.Results 177 patients with suspected COVID-19 underwent community testing via local NHS organisations between January and February 2020 with a mean age of 46.1 (IQR 27.5–56.3). This was 92% of total patients who were tested for COVID-19 during this period. We estimate, compared with standard hospital testing practices, cash savings in improved productivity for the NHS of £24,539 during this time period, in addition to further non-monetised benefits for hospital and ambulance flow.Conclusions Community testing for COVID-19 in Wales is now an established pathway and continues to bring benefits for patients, local healthcare organisations and the NHS. Further application of this model in other settings and to other infectious diseases may herald promising returns.https://bmjopen.bmj.com/content/10/8/e038017.full
spellingShingle Jonny Currie
Robin Howe
Brendan Healy
James Adamson
Bethan Bowden
Julie Woolls
David Heyburn
Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
BMJ Open
title Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
title_full Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
title_fullStr Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
title_full_unstemmed Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
title_short Impact of a novel community testing pathway for people with suspected COVID-19 in Wales: a cost-minimisation analysis
title_sort impact of a novel community testing pathway for people with suspected covid 19 in wales a cost minimisation analysis
url https://bmjopen.bmj.com/content/10/8/e038017.full
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