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.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      C-Reactive Protein*/analysis ; Point-of-Care Testing*; Child ; Humans ; Netherlands ; Hospitals ; Systems Analysis
    • 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.
      (© 2024. The Author(s).)
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    • Grant Information:
      No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; No. 668303 and No. 848196. Horizon 2020 Framework Programme; CF- 2015-21-016 and CL-2018-21-007 NIHR Imperial Biomedical Research Centre
    • Contributed Indexing:
      Keywords: Acute childhood infections; C-reactive protein; Comparative health systems analysis; England; Hospital care; NASSS framework; Point-of-care tests; The Netherlands
    • Accession Number:
      9007-41-4 (C-Reactive Protein)
    • Publication Date:
      Date Created: 20240320 Date Completed: 20240321 Latest Revision: 20240323
    • Publication Date:
      20240323
    • Accession Number:
      PMC10949747
    • Accession Number:
      10.1186/s12913-024-10698-6
    • Accession Number:
      38504318