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，我们进行了器官移植，特别是心脏移植的成本分析和成本效益分析（CBA）问题。首先，设计如下计算方法作为成本分析：(1)计算移植手术和术后管理费用作为移植的直接成本；(2)计算供体心脏运输费用和信息系统等器官移植网络系统的工作费用以及人员费用作为移植的间接成本。心脏移植费用为直接费用和间接费用之和。接下来，将下面的方法设计为CBA。(1)以移植延长生命的时间作为移植有效性的指标。(2)采用质量调整年（QALY）作为衡量移植效用的指标。(3)根据QALY计算移植效益，采用交通事故赔偿常用的Hoffman方法。实际效益是指心脏移植手术的效益与费用的差额。利用上述方法，在几种条件下进行了成本效益的初步计算。(1)移植成本(正常情况下):(1)直接成本:2300000年捐赠心脏\提取,操作移植\ 2940000年,进入医院(2个月)\ 3644000,术后管理(移植后3个月- 1年)\ 4060000 /年(和两年之后),(2)间接成本:1300000年捐赠心脏\运输,器官移植网络系统的工作成本\ 1200000/1移植,(3)心脏移植的成本\ 15375000。(2) CBA:(1)福利：88,827,200（以男性和50岁受薪男性为例，工作能力系数为0.8），(2)实际福利：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