A Study on Medico-economical Analysis of Organ Transplant

为了建立移植医学，必须考虑器官移植的经济问题，在本研究中，我们对器官移植，特别是心脏移植的成本分析和成本效益分析(CBA)进行了研究。首先，设计了如下成本分析方法：(1)计算移植手术费用和术后管理费用作为移植的直接费用；(2)计算供心运输费用和器官移植网络系统的工作费用，如信息系统和人员费用作为移植的间接费用。心脏移植的费用是直接费用和间接费用的总和。接下来，设计了以下方法作为CBA。(1)以移植延长生命的时间作为移植效果的指标。(2)质量调整年(QALY)作为…更多移植实用程序的索引。(3)移植效益的计算依赖于QALY，采用交通事故赔偿中常用的霍夫曼方法。真正的收益是心脏移植的收益和成本的差额。(1)移植成本(正常情况)：(1)直接成本：供心取出2,300,000，移植手术2,940,000，住院(2个月)3,644,000，术后管理(3个月-移植后1年)，4,060,000/年(移植时和2年后)，(2)间接成本：供心运输\1,300,000，器官移植网络系统的工作成本\1,200,000/1移植，(3)心脏移植费用\15,375,000。(2)CBA：(1)受益：\88,827,200(如果男性和50岁的受薪男子在工作能力系数：0.8的情况下)，(2)实际受益：\6,462,200少

It is important to consider economic problems of organ transplant in order to establish transplantation medicine, In the present study, we conducted the problems in which a cost-analysis and a cost-benefit analysis (CBA) of organ transplant, especially heart transplant were included. In the first place, the following calculation method was contrived as the cost-analysis (1) Calculation of costs of operations for transplantation and post-operative management as the direct cost of the transplant, (2) Calculation of costs of donor heart transportation and working costs of a organ transplant network system such as informaton system and personnel expenses as the indirect cost of the transplant. The cost of heart transplant is obtained as the sum of the direct and indirect costs. Next, the following method was contrived as the CBA.(1) The time of prolongation of life by the transplant is adopted as an index of the transplant effectiveness. (2) The quality adjusted years (QALY) is used as an … More index of the transplant utility. (3) The transplant benefit is calculated depending upon QALY by using the Hoffman method which is usually used for compensation of traffic accident. Real benefit is obtained as the difference of the benefit and the cost of the heart transplant. By using the before-mentioned methods, the following trial calculation of the cost and benefit was conducted under several conditions.(1) Transplant cost (normal cases) : (1) Direct costs : extraction of donor heart \ 2,300,000, operations for transplantation \ 2,940,000, admission to a hospital (2 months) \ 3,644,000, post-operative management (3 months - one year after transplantation), \ 4,060,000/year (on and after two years), (2) Indirect costs : transportation of donor heart \ 1,300,000, working costs of the organ transplant network system \ 1,200,000/1 transplant, (3) Cost of heart transplant \ 15,375,000.(2) CBA : (1) Benefit : \ 88,827,200 (in case of a male and 50 years old salaried man under the condition of work ability coefficient : 0.8), (2) Real benefit : \ 6,462,200 Less