Point-of-care testing has a limited effect on time to clinical decision in primary health care.
OBJECTIVE
To investigate the clinical logistics of laboratory routines at primary health care centres (PHCs).


METHODS
Prospective registration was carried out for each PHC using questionnaires during 2-week intervals between the end of November 2001 and mid-January 2002. The study included 9 PHCs in the county of Ostergötland and 4 in the county of Jönköping, Sweden, with different numbers of blood tests analysed using point-of-care testing (POCT). Data for B-glucose, HbA1c, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), thyroid-stimulating hormone (TSH), T4, cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were collected. Main outcome measures were median time from sampling to available test result (TATa) and median time from sampling to clinical decision (TATd), and the proportion of patients informed of the outcome of the blood test in question during the sampling occasion.


RESULTS
A total of 3542 samples were collected. The median TATa showed that B-glucose, ESR and CRP were immediately analysed at all 13 PHCs. For the other tests, TATa varied from immediately to about two days. The median TATd varied from immediately to about a week. When POCT was used, 30% of the patients were informed about the outcome of the test during the sampling occasion.


CONCLUSIONS
POCT has a limited effect on the clinical logistics in PHCs.
Grodzinsky
E
E
Unit of Research and Development in Primary Health Care, County of Ostergötland, Linköping, Sweden. Ewa.Grodzinsky@lio.se
Wirehn
A-B
AB
Fremner
E
E
Haglund
S
S
Larsson
L
L
Persson
L-G
LG
Borgquist
L
L
D020000:Decision Support Systems, Clinical; D003933:Diagnosis; D006801:Humans; D019095:Point-of-Care Systems; D011320:Primary Health Care / Q000191:economics / Q000379:methods*; D013997:Time Factors