Anticoagulation services in Malta – an economic study comparing a central laboratory model vs. a point-of-care approach

Abstract

In Malta, warfarin is used as oral anticoagulation therapy, and INR testing is centralized at Mater Dei Hospital. Patient sampling for all anticoagulated patients takes place at one of eight health centres and at the Anticoagulation Clinic (ACC) within Mater Dei Hospital. Patients are allotted the sampling locality according to their hometown; however, part of the patients attending ACC are because of emergency or dental cases and INR variations because of drug treatment such as antibiotics. This study estimates the proportion of Maltese patients who require anticoagulation therapy with warfarin, and the direct cost of an INR test using a centralized laboratory system against a point-of-care (PoC) system.