Costs of autologous and allogeneic hematopoietic cell transplantation in the United States: a study using a large national private claims database.
Costs of autologous and allogeneic hematopoietic cell transplantation in the United States: a study using a large national private claims database.
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DOI：
10.1038/bmt.2012.133
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发表时间：
2013-02
影响因子：
4.8
通讯作者：
Arneson TJ
中科院分区：
文献类型：
--
作者：
Majhail NS;Mau LW;Denzen EM;Arneson TJ
造血细胞移植(HCT)缺乏多中心成本识别研究。我们使用一个代表全国商业保险人群的单一纵向行政索赔数据库来评估确定HCT接受者的可行性，并建立自体和异基因HCT接受者队列，以研究从移植住院到移植后前100天的住院和门诊直接医疗费用。使用ICD-9程序和诊断代码，我们确定了2007至2009年间在美国接受首次移植的3,365名患者(自体移植-1,678例，异体移植-1,320例，移植物来源未指明-367例)。自体HCT的100天总成本中值为99,899美元(四分位数范围[IQR]，73,914-140,555美元)，异基因HCT的100天总成本中位数为203,026美元(IQR，141,742-316,426美元)。大部分费用(>；75%)发生在自体和异基因HCT受者最初的移植住院期间。与成人(>；20年)受者相比，儿童受者(≤20年)的费用更高，这种差异在异基因血细胞移植中更为明显。使用代表全国血细胞移植人群的索赔数据库，我们强调了与自体和异体血细胞移植相关的高成本。我们的研究为今后利用索赔数据对医疗保险的经济方面进行研究奠定了基础。
There is a lack of multi-center cost-identification studies for hematopoietic cell transplantation (HCT). We used a single longitudinal administrative claims database representing a national, commercially insured population to evaluate the feasibility of identifying HCT recipients and to establish a cohort of autologous and allogeneic HCT recipients to study inpatient and outpatient direct medical costs from transplant hospitalization through first 100 days post-transplantation. Using ICD-9 procedure and diagnosis codes, we identified 3,365 patients who had received their first transplant in the United States between 2007 and 2009 (autologous-1,678, allogeneic-1,320, graft source not specified-367). The median 100-day total costs for autologous HCT were $99,899 (interquartile range [IQR], $73,914–140,555) and for allogeneic HCT were $203,026 (IQR, $141,742–316,426). The majority of costs (>75%) occurred during the initial transplant hospitalization for both autologous and allogeneic HCT recipients. Costs were greater among pediatric (≤ 20 years) compared to adult (>20 years) recipients and this difference was more pronounced with allogeneic HCT. Using a claims database representing a national HCT population, we highlight the high costs associated with autologous and allogeneic HCT. Our study lays the foundation for using claims data for future research on economic aspects of HCT.
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