A detailed analysis of charges for hematopoietic stem cell transplantation at a children's hospital.
We analyzed hospital charges for pediatric hematopoietic stem cell transplantation (HSCT) to understand better the medical origin of these charges.
Forty-nine patients undergoing HSCT at Kosair Children's Hospital between January 1992 and August 1995 had hospital charges analyzed by cost center, donor type and clinical outcome.
Thirty-three autologous, two syngeneic and 14 allogeneic transplants were performed.
Twenty-four transplants were performed for hematological malignancies, 22 for solid tumors, and three for non-malignant diseases.
Pharmaceutical charges comprised the largest single component of total hospital charges (THC), accounting for 38.9%. Room charges were the next largest group at 33.7% of THC.
Other cost centers, in order of magnitude, were central supply (7.9%), transfusion services (7.5%), laboratory (5.8%), microbiology (3.6%), miscellaneous (1.9%), and radiology (1.4%). Within the pharmaceutical cost center, colony-stimulating factors comprised the largest single item, making up 18% of total pharmacy charges and 7% of THC.
Antibiotics were the second largest component, at 16% of pharmacy charges and 6% of THC.
Patients transferred to the intensive care unit (ICU) had charges 68% greater than non-ICU patients.
Allogeneic transplant patients had THC 35% greater than autologous transplant patients, but also a four-fold greater chance of becoming an ICU patient. (...)
Mots-clés Pascal : Economie santé, Etats Unis, Amérique du Nord, Amérique, Greffe, Cellule hématopoïétique, Cellule souche, Moelle osseuse, Cancérologie, Pédiatrie, Hôpital, Enfant, Homme, Analyse coût
Mots-clés Pascal anglais : Health economy, United States, North America, America, Graft, Hematopoietic cell, Stem cell, Bone marrow, Cancerology, Pediatrics, Hospital, Child, Human, Cost analysis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0124766
Code Inist : 002B27D02. Création : 22/06/1998.