OBJECTIVES: This study aims to estimate the potential budget impact of introducing automated point-of-care testing (POCT) for cardiac markers among patients with heart disease-related chest pain in the emergency department (ED), considering the hospitals’ and patients' perspectives in China.

METHODS: A budget impact model was built to evaluate the differences in total hospital costs and per patient per year (PPPY) costs before and after adding automated POCT to test cardiac markers, specifically NT-pro BNP, Tnl, and D-dimer. The model incorporated costs associated with testing fees (automated and semi-automated POCT), hospitalization, complications due to delayed diagnosis, and labor costs for technicians and maintenance over a one-year period. Data from published sources and expert interviews were used to estimate the number of patients with heartache related to heart disease, the ED length of stay (LOS), complication costs, test reporting and handling time. All costs were estimated in 2023 Chinese Yuan. The base case assumed that automated POCT would capture 60% of market share.

RESULTS: In the hypothetical population of 500,000 patients, 23,500 patients had heart disease-related chest pain. Introducing automated POCT resulted in a decrease of ¥0.3 million in annual hospital costs and a reduction of ¥66 PPPY. Additionally, the introduction of automated POCT generated an additional 623 emergency bed days per year. The total hospital costs were found to be sensitive to test reporting and handling time. Furthermore, the PPPY costs were sensitive to test reporting and handling time, automated POCT fees, and ED LOS.

CONCLUSIONS: The inclusion of automated POCT to test cardiac markers provides a budget-saving and efficient option for patients with heart disease-related chest pain in ED from both hospitals’ and patients’ perspectives.