Journal Article

Health Care Utilization and Cost of Diagnostic Testing for Respiratory Infections

Goldberg, Steven E, Doshi, Riddhi, Yeaw, Jason, Coyle, Katharine, Wang, Elizabeth J, Evans, Azia, Fragala, Maren S, Reddy, Jairus

2025

Overview

This study compared all-cause health care resource use (HCRU) and costs between patients with acute oropharyngeal infections and respiratory tract infections (RTIs) receiving targeted syndromic real-time polymerase chain reaction (RT-PCR) tests with next-day results vs matched patients receiving other/no diagnostic tests. Propensity-matched, retrospective study. Two cohorts with International Classification of Diseases, Tenth Revision, Clinical Modification codes for diagnosis or symptom(s) of oropharyngeal infection or RTI (first diagnosis = index) on an outpatient claim were identified in the IQVIA PharMetrics Plus database (July 2020-October 2023). HCRU and costs were examined over 6 months post index across 5 subcohorts: patients receiving syndromic RT-PCR and 4 matched subcohorts (other PCR, point-of-care [POC] only, culture, or no test). The mean (SD) costs for postindex total outpatient services ($2598 [$7564] vs $2970 [$8417]; P < .0001), physician office visit ($624 [$1150] vs $689 [$1082]; P = .0002), emergency department (ED) ($290 [$1145] vs $397 [$1630]; P = .0192), and other medical services ($1684 [$6799] vs $1883 [$7568]; P < .0001) were significantly lower for the oropharyngeal RT-PCR subcohort than the matched culture subcohort. The mean (SD) postindex costs for any outpatient medical services ($2796 [$11,453] vs $3221 [$7873]; P < .0001), physician office visits ($525 [$974] vs $703 [$2635]; P = .0057), ED visits ($253 [$1036] vs $355 [$1300]; P = .0011), and other medical services ($2018 [$10,986] vs $2163 [$6458]; P < .0001) were significantly lower for the RTI RT-PCR subcohort than the matched culture subcohort. Patients in both RT-PCR subcohorts had lower utilization of other medical services and any outpatient services compared with all matched comparator subcohorts. This propensity-matched study provides evidence on the economic impact of syndromic RT-PCR tests for respiratory infections, highlighting their advantages over traditional diagnostic methods.

• Publisher: Intellisphere, LLC
• Subject: Adult / Aged / Diagnostic Tests, Routine - economics / Economic aspects / Female / Health aspects / Health Care Costs - statistics & numerical data / Humans / Infection / Male / Medical care / Medical care, Cost of / Middle Aged / Patient Acceptance of Health Care - statistics & numerical data / Propensity Score / Real-Time Polymerase Chain Reaction - economics / Respiratory tract diseases / Respiratory Tract Infections - diagnosis / Respiratory Tract Infections - economics / Retrospective Studies / Utilization