Cost analysis of leukemia treatment: a problem-oriented approach

A Problem Oriented List of Charges (POLC) can be used to obtain information about the cost of treatment of a single medical problem in patients with several coexisting medical problems. To prepare a POLC, each charge item is associated with one of the patient's problems. POLCs were compiled from the Problem Oriented Medical Records (POMRs) of patients with Acute Non-Lymphocytic Leukemic (ANLL). From the POLCs at was apparent that the treatment of granulocytopenia and thrombocytopenia and their sequelae were the most costly problems associated with ANLL. The projected cost of treatment for all problems for 11.5 months (the median survival of patients with ANLL treated with a single chemotherapeutic agent at this institution) was $40,022. By extending the POMR into the area of Medical reimbursement with a POLC, charge incurring activities can be coupled to the results of patient care. Only by directly coupling, in the original medical record, the reasons for, the charges for, and the results of medical care, can cost data be appropriately interpreted.