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Economics of Early Warning Scores for identifying clinical deterioration—a systematic review

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Aim

In 2013, a National Early Warning System (EWS) was implemented in Ireland. Whilst evidence exists to support the clinical effectiveness of EWS in the acute health care setting, there is a paucity of information on their cost and cost effectiveness. The objective of this systematic literature review was to critically evaluate the economic literature on the use of EWS in adult patients in acute health care settings for the timely detection of physiological deterioration.

Methods

A systematic literature review was conducted to accumulate the economic evidence on the use of EWS in adult patients in acute health care settings.

Results

The search yielded one health technology assessment, two budget impact analyses and two cost descriptions. Three of the studies were Irish, and considered the national EWS system. A Dutch study reported financial consequences of a single parameter EWS, as part of a rapid response system, in a surgical ward. The fifth study examined an advanced triage system in a medical emergency admission unit in Wales.

Conclusions

The economic evidence on the use of EWS amongst adult patients in acute health care settings for the timely detection of physiological deterioration is limited. Further research is required to investigate the cost effectiveness of EWS, and the appropriateness of using standard methods to do so. The recent implementation of a national EWS in Ireland offers a unique opportunity to bridge this gap in the literature to examine the costs and cost effectiveness of a nationally implemented EWS system.

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Acknowledgements

Funding for the systematic review was from Department of Health, Ireland.

Support from rest of the research team which conducted the systematic review to inform the update of NCEC 1 for the Irish health system was recognized. Including: Dr Tom Andrews, Ms. Nuala Walshe, Dr Bridie McCarthy, Mr. Mohamad Saab, Ms. Mary Forde, Dr Dorothy Breen, Dr Pat Henn, Prof. Jonathan Drennan.

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Authors and Affiliations

  1. Department of Economics, Cork University Business School, University College Cork, Cork, Ireland

    A. Murphy & R. Whelan

  2. Centre for Policy Studies, Cork University Business School, University College Cork, Cork, Ireland

    J. Cronin

  3. School of Nursing and Midwifery and Department of Epidemiology and Public Health, University College Cork, Cork, Ireland

    F. J. Drummond

  4. School of Nursing and Midwifery, University College Cork, Cork, Ireland

    E. Savage & J. Hegarty

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  1. A. Murphy
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  2. J. Cronin
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  3. R. Whelan
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  4. F. J. Drummond
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  5. E. Savage
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  6. J. Hegarty
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Corresponding author

Correspondence to A. Murphy.

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Funding

This study was funded by the Department of Health, Ireland.

Conflict of interest

The authors declare that they have no conflict of interests.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Murphy, A., Cronin, J., Whelan, R. et al. Economics of Early Warning Scores for identifying clinical deterioration—a systematic review. Ir J Med Sci 187, 193–205 (2018). https://doi.org/10.1007/s11845-017-1631-y

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  • DOI: https://doi.org/10.1007/s11845-017-1631-y

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