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Economic Evaluation

A prospective cost evaluation related to allogeneic haemopoietic stem cell transplantation including pretransplant procedures, transplantation and 1 year follow-up procedures

Bone Marrow Transplantation volume 28, pages 1111–1116 (2001)Cite this article

Abstract

The Norwegian Ministry of Health and Social Affairs recently introduced activity-based financing for hospitals partly based on diagnosis-related groups (DRG). We soon observed that there seemed to be a considerable discrepancy between the reimbursement amount and the real cost of allogeneic haemopoietic stem cell transplantation. It was therefore decided to undertake a prospective micro-cost analysis to define a more realistic reimbursement. To identify real costs, we undertook a registration of pre-transplant procedures, transplantation and 1 year follow-up costs, including harvesting, personnel costs, clinical and laboratory procedures, together with blood products and drugs related to patients and donors. These data were compared to hospital DRG reimbursement. This information was registered for 17 consecutive patients, with a mean age 40 years (range 17–58 years). Ten patients had chronic myeloid leukaemia, three had acute lymphatic leukaemia, two had acute myeloid leukaemia and two had myelodysplastic syndrome. The data analysis showed a mean cost of US$ 106825 (NOK 901982), (range US$ 42376–362430). The average actual hospital revenue (50% DRG reimbursement + income related to length of stay + special procedure funding) was US$ 36404 (range US$ 26228–55998). Activity-based financing as applied in Norway, under-compensates hospital costs for allogeneic bone marrow transplantation. The government should make realistic estimates of real costs before introducing financial reforms in the health care system.

Bone Marrow Transplantation (2001) 28, 1111–1116.

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References

  1. DRG Diagnosis-related groups definitions manuals, version 12.0 3M 1998

  2. Kahn KI, Droper D, Keeler EB et al. The effects of the DRG-based prospective payment system on quality of care for hospitalised medicare patients JAMA 1990 264: 1953–1955

    Article  CAS  Google Scholar 

  3. Hanery MC, Thode Jr HC, Shrestha C et al. Inadequate hospital reimbursement for victims of motor vehicle crashes due to health reform legislation Ann Emerg Med 2000 35: 277–282

    Article  Google Scholar 

  4. Clancy T, Kitchen S, Churchill P et al. DRG reimbursement geriatric hip fractures in the community hospital trauma center South Med J 1998 91: 457–461

    Article  CAS  Google Scholar 

  5. Buhaug H, Nyland K, Solstad K . Method evaluation to make Norwegian DRGs from HCFA. SINTEF Unimed Health Services Research in Trondheim, Norway, No STF78, A99501, February 1999

    Google Scholar 

  6. Department of Health and Social Services, Norway. Price list, 2000

  7. Kristensen F, Jacobsen JE et al. Cost analysis of high cost medicine at the National hospital Tidsskr for Lœgeforening 1994 21: 2505–2509

    Google Scholar 

  8. Lee SJ, Anasetti C, Kuntz KM et al. The cost and cost-effectiveness of unrelated donor bone marrow transplantation for chronic phase chronic myelogenous leukaemia Blood 1998 92: 4047–4052

    CAS  PubMed  Google Scholar 

  9. Lee SJ, Klar N, Weeks JC et al. Predicting costs of stem cell transplantation J Clin Oncol 2000 18: 64–71

    Article  CAS  Google Scholar 

  10. Copeland S, Weston J . Financial Theory and Corporate Policy Addison Wesley 1999 498 pp

    Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the assistance of the nursing staff in the Haematology Section and Bone Marrow Transplant Unit. Special thanks to Dr Torstein Egeland at the Norwegian Bone Marrow Registry Department for assistance in providing cost data related to donor evaluation, harvesting procedure and marrow transport for unrelated donors.

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Authors and Affiliations

  1. Center for Epidemiology and Hospital Statistics, The National University Hospital, Oslo, Norway

    V Mishra & S Vaaler

  2. Medical Department, Section of Haematology, The National University Hospital, Oslo, Norway

    L Brinch

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  1. V Mishra
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  2. S Vaaler
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  3. L Brinch
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Mishra, V., Vaaler, S. & Brinch, L. A prospective cost evaluation related to allogeneic haemopoietic stem cell transplantation including pretransplant procedures, transplantation and 1 year follow-up procedures. Bone Marrow Transplant 28, 1111–1116 (2001). https://doi.org/10.1038/sj.bmt.1703310

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  • DOI: https://doi.org/10.1038/sj.bmt.1703310

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