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Published on: October 19, 2014
Economic evaluation of chronic lymphocytic leukemia from a hospital management perspective
Florian Kron1, Nadine Kutsch1, Anna Kostenko1
1Department I of Internal Medicine, Center for Integrated Oncology Cologne, University Hospital of Cologne, Cologne, Germany.
Insights
Inpatient treatment for chronic lymphocytic leukemia (CLL) is not cost-covering, leading to significant economic risks for hospitals. New reimbursement strategies are essential for sustainable CLL care management.
Area of Science:
- Oncology
- Health Economics
- Hospital Management
Background:
- Chronic lymphocytic leukemia (CLL) treatment is evolving.
- Hospitalized patients with CLL face economic challenges.
- Management perspective on economic risks is crucial.
Purpose of the Study:
- Analyze economic risks in hospitalized CLL patients.
- Evaluate the cost-effectiveness of CLL inpatient treatment.
- Identify financial implications from a hospital management viewpoint.
Main Methods:
- Retrospective analysis of 112 CLL patients hospitalized in 2013-2014.
- Merged diagnosis-related group (DRG) reimbursement data with internal cost accounting.
- Assessed profit margins (PMs) per case using age, prognostic factors, and DRG KPIs.
Main Results:
- Overall negative PM of €137,147 across 284 cases and 19 DRGs.
- DRG R61H (174 cases) showed a deficit of €814 per case.
- Excessive length of stay and staff costs contributed to non-cost-covering payments.
Conclusions:
- Inpatient CLL treatment is not cost-covering in a tertiary care setting.
- Novel care and reimbursement structures are needed for CLL.
- Cost-revenue controlling is vital for mitigating economic risks in CLL management.
Objectives:
Treatment of chronic lymphocytic leukemia (CLL) is currently undergoing dramatic changes. We analyzed economic risks in hospitalized patients with CLL from a management perspective.
Methods:
One hundred and twelve patients with CLL hospitalized in 2013 and 2014 at the University Hospital of Cologne were analyzed. To assess profit margins (PMs) per case, diagnosis-related group (DRG) reimbursement data were merged with an internal cost accounting scheme depending on age, prognostic factors, and DRG key performance indicators.
Results:
In 112 patients, 284 cases coded by 19 different DRG with strongly fluctuating cost revenue ratios were found with an overall negative PM of €137 147. The DRG R61H was identified as the one most commonly coded (174 cases, 61.3%) with a deficit per case of €814. Subanalysis demonstrated that the payments were not cost covering due to excessive length of stay and staff costs. Significant differences in PM per case concerning age, length of stay and number of operation and procedure key (OPS) codes (P < 0.05) were found.
Conclusion:
In our research-driven tertiary care hospital, inpatient treatment of patients with CLL is not cost covering. This analysis demonstrates the need for novel care/reimbursement structures in CLL. From a hospital management perspective, cost revenue controlling is crucial to avoid major economic risks.
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