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Rev Esp Quimioter 2019; January 9

Economic evaluation of the Alfred 60/AST device implantation for bacterial growth detection with automatic sewing machine

OSCAR HERRÁEZ CARRERA, MARÍA HUERTAS VAQUERO, MARÍA ÁNGELES ASENCIO EGEA, JORGE GAITÁN PITERA, RAFAEL CARRANZA GONZÁLEZ

Introduction. It is becoming increasingly necessary to automatize screening of urine samples to culture at Microbiology laboratories. Our objective was to estimate the budget threshold from which the Alfred 60/AST device would be profitable for our hospital.
Material and methods. Cost minimization study by decision trees, carried out in a General Hospital. The cost of traditional urine culture and urine processing using Alfred-60/AST were compared. Traditional processing involves the culture of all urine specimens received onto blood and MacConkey agar, and identification of every microorganism isolated by Vitek-2 system. The autoanalyzer would only inoculate the positive urines onto a chromogenic media, directly identifying the Escherichia coli isolates.
Results. The variables with the greatest economic impact in the model were the probability of obtaining a positive culture, the prevalence of E. coli in the urine cultures and the cost per sample using Alfred-60/AST. The multivariate sensitivity analysis showed that the model was solid. The bivariate sensitivity analysis showed that the model is suceptible to cost modification, mainly of the automatic device. At a threshold value of 1.40 euros/determination, the automatic processing would decrease the annual costs in 2,879 euros.
Conclusion. The introduction of the Alfred-60/AST device in our laboratory at 1.40 euros/determination would reduce urine processing workload, saving time and costs.

Rev Esp Quimioter 2019; January 9  [Texto completo PDF]