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Adoption of C-reactive protein rapid tests for the management of acute childhood infections in hospitals in the Netherlands and England: a comparative health systems analysis.
Dewez, Juan Emmanuel; Nijman, Ruud G; Fitchett, Elizabeth J A; Li, Edmond C; Luu, Queena F; Lynch, Rebecca; Emonts, Marieke; de Groot, Ronald; van der Flier, Michiel; Philipsen, Ria; Ettelt, Stefanie; Yeung, Shunmay.
Afiliación
  • Dewez JE; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Nijman RG; Section of Paediatric Infectious Diseases, Department of Infectious Diseases, Imperial College London, London, UK.
  • Fitchett EJA; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Li EC; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Luu QF; Institute of Global Health Innovation, Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, UK.
  • Lynch R; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
  • Emonts M; Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, UK.
  • de Groot R; Paediatric Immunology, Infectious Diseases & Allergy, Great North Children's Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
  • van der Flier M; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK.
  • Philipsen R; Section of Paediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Centre for Infectious Diseases, Radboud Institute for Molecular Life Sciences, Radboud UMC, Nijmegen, the Netherlands.
  • Ettelt S; Paediatric Infectious Diseases and Immunology, Amalia Children's Hospital, Radboud UMC, Nijmegen, the Netherlands.
  • Yeung S; Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
BMC Health Serv Res ; 24(1): 351, 2024 Mar 19.
Article en En | MEDLINE | ID: mdl-38504318
ABSTRACT

BACKGROUND:

The adoption of C-reactive protein point-of-care tests (CRP POCTs) in hospitals varies across Europe. We aimed to understand the factors that contribute to different levels of adoption of CRP POCTs for the management of acute childhood infections in two countries.

METHODS:

Comparative qualitative analysis of the implementation of CRP POCTs in the Netherlands and England. The study was informed by the non-adoption, abandonment, spread, scale-up, and sustainability (NASSS) framework. Data were collected through document analysis and qualitative interviews with stakeholders. Documents were identified by a scoping literature review, search of websites, and through the stakeholders. Stakeholders were sampled purposively initially, and then by snowballing. Data were analysed thematically.

RESULTS:

Forty-one documents resulted from the search and 46 interviews were conducted. Most hospital healthcare workers in the Netherlands were familiar with CRP POCTs as the tests were widely used and trusted in primary care. Moreover, although diagnostics were funded through similar Diagnosis Related Group reimbursement mechanisms in both countries, the actual funding for each hospital was more constrained in England. Compared to primary care, laboratory-based CRP tests were usually available in hospitals and their use was encouraged in both countries because they were cheaper. However, CRP POCTs were perceived as useful in some hospitals of the two countries in which the laboratory could not provide CRP measures 24/7 or within a short timeframe, and/or in emergency departments where expediting patient care was important.

CONCLUSIONS:

CRP POCTs are more available in hospitals in the Netherlands because of the greater familiarity of Dutch healthcare workers with the tests which are widely used in primary care in their country and because there are more funding constraints in England. However, most hospitals in the Netherlands and England have not adopted CRP POCTs because the alternative CRP measurements from the hospital laboratory are available in a few hours and at a lower cost.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Proteína C-Reactiva / Pruebas en el Punto de Atención Límite: Child / Humans País/Región como asunto: Europa Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Proteína C-Reactiva / Pruebas en el Punto de Atención Límite: Child / Humans País/Región como asunto: Europa Idioma: En Revista: BMC Health Serv Res Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido