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Factors influencing third party payer costs for allogeneic BMT
R I Griffiths1, E B Bass, N R Powe
1Johns Hopkins Program for Medical Technology and Practice Assessment, Johns Hopkins Medical Institutions, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Bone Marrow Transplantation
|July 1, 1993
Summary
Allogeneic bone marrow transplant (BMT) costs are significantly increased by cytomegalovirus (CMV) infection and acute graft-versus-host disease (GVHD). Reducing these complications can lower overall BMT expenses for payers.
Area of Science:
- Hematology
- Transplant Immunology
- Health Economics
Background:
- Allogeneic bone marrow transplantation (BMT) is a complex procedure with significant associated healthcare costs.
- Understanding the drivers of payer costs is crucial for healthcare management and resource allocation.
Purpose of the Study:
- To analyze the relationship between patient characteristics, clinical complications, and payer costs for allogeneic BMT.
- To identify factors influencing inpatient costs within 180 days post-transplant.
Main Methods:
- Retrospective cohort study of 402 patients undergoing allogeneic BMT (1980-1987).
- Analysis of total inpatient payer costs (hospital and physician) and hospitalization days.
- Multivariate analysis to assess associations between costs, patient factors, and complications.
Main Results:
- Average inpatient payer cost was $208,410 (1990 dollars) within 180 days post-BMT.
- Costs were significantly increased by cytomegalovirus (CMV) infection (+$53,517) and acute graft-versus-host disease (GVHD) (+$46,500).
- Malignant disease was associated with lower costs (-$36,633) compared to non-malignant disease.
Conclusions:
- CMV infection and acute GVHD are major cost drivers in allogeneic BMT.
- Patient age, sex, and race did not significantly impact payer costs.
- Reducing BMT costs may necessitate improved prevention strategies for CMV infection and GVHD.