PURPOSE: Frequent monitoring of blood glucose is an essential component of care for many patients in the critical care setting. Although analyses of the cost-effectiveness of various glycemic management strategies have been completed, the direct and indirect costs attributable to point-of-care (POC) blood glucose measurements are unknown and often ignored. The purpose of this study was to estimate the overall costs to perform a POC blood glucose determination at an academic medical center.
METHODS: Estimates of the cost to determine a POC blood glucose value included the acquisition costs of the meter and attendant supplies in addition to the cost of time spent by the nurses obtaining the equipment and performing the blood glucose test. The costs of supplies and hardware were based upon current wholesale acquisition pricing. The nursing costs were based upon salary information from three metropolitan Omaha hospitals.
RESULTS: The average time spent in obtaining a POC glucose value was 5.19 ± 0.66 minutes, equivalent to an average of 2.53 ± 0.49 dollars for nursing salary cost. The total cost of disposable supplies was 57 cents per measurement: 19 cents for the cotton ball, bandage, alcohol swab, and lancet plus 38 cents per blood glucose test strip. The cost of the meter to run one POC blood glucose value was estimated at 17 cents based on the manufacturer’s projected performance data for the device. The total cost of a single POC blood glucose value was estimated at 3.27 ± 0.49 dollars, the sum of the costs for nursing salary, the disposable supplies, and the glucometer.
CONCLUSION: Multiple variables must be considered when estimating the cost for a POC blood glucose determination. A disproportionate amount of our cost was attributable to the nursing salary component.
CLINICAL IMPLICATIONS: Optimal glycemic control in the critical care setting is an area of intense controversy and active investigation. Reliable estimates of the cost-effectiveness of various glucose control strategies require consideration of the cost of POC blood glucose measurements.
DISCLOSURE: Mark Malesker, No Financial Disclosure Information; No Product/Research Disclosure Information