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Limiting access to allogeneic bone marrow transplantation in five European countries: what can we learn about
1Department of Public Health and Primary Health Care, University of Bergen, Uriksdal 8c, 5009, Bergen, Norway. ole.norheim@isf.uib.no
Background:
Allogeneic bone marrow transplantation is a complex procedure exemplifying a class of new and emerging treatment modalities involving advanced medical technologies with high costs.
Objectives:
To collect available data on volume of allogeneic bone marrow transplantation in five European countries for the period 1990-1994. To assess the opinion of selected physicians on whether they felt that patients that would have benefited from a transplant actually received a transplant in the same period. To assess their opinion on possible reasons for limited access.
Method:
Literature review and mailed self-administered questionnaire to the responsible physician at 76 transplant centres in Denmark, Germany, The Netherlands, Norway, and the UK.
Results:
Substantial geographical differences in transplantation rates between the five countries studied. For adult patients 62.5% of the respondents felt that there was limited access to allogeneic bone marrow transplantation in the period. For children, the corresponding figure was 37.5%. The reasons for limited access cited most frequently were scarcity of facilities or transplant beds, scarcity of donors, and inadequate referral practices.