Lung transplantation in the spotlight: Reasons for high-cost procedures
| Autor: | Rudolf Hatz, Juergen Behr, Matthias Vogl, Matthias Hunger, Tobias Welte, René Schramm, Reiner Leidl, Axel Haverich, Bernhard Zwissler, Heidrun Lingner, Hauke Winter, Gregor Warnecke, Cornelius Jaeger, Gerhard Preissler, N Strobl, Jens Gottlieb, Christian Hagl |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty medicine.medical_treatment 030230 surgery law.invention 03 medical and health sciences 0302 clinical medicine law medicine Humans Lung transplantation Prolonged ventilation 030212 general & internal medicine Intensive care medicine Diagnosis-Related Groups health care economics and organizations Reimbursement Transplantation business.industry Length of Stay Hospital treatment Cost driver Economic evaluation Ventilation (architecture) Costs and Cost Analysis Surgery Transplant patient Cardiology and Cardiovascular Medicine business Lung Transplantation |
| Zdroj: | The Journal of Heart and Lung Transplantation. 35:1227-1236 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2016.05.024 |
| Popis: | Background Hospital treatment costs of lung transplantation are insufficiently analyzed. Accordingly, it remains unknown, whether current Diagnosis Related Groups, merely accounting for 3 ventilation time intervals and length of hospital stay, reproduce costs properly, even when an increasing number of complex recipients are treated. Therefore, in this cost determination study, actual costs were calculated and cost drivers identified. Methods A standardized microcosting approach allowed for individual cost calculations in 780 lung transplant patients taken care of at Hannover Medical School and University of Munich from 2009 to 2013. A generalized linear model facilitated the determination of characteristics predictive for inpatient costs. Results Lung transplantation costs varied substantially by major diagnosis, with a mean of €85,946 (median €52,938 ± 3,081). Length of stay and ventilation time properly reproduced costs in many cases. However, complications requiring prolonged ventilation or reinterventions were identified as additional significant cost drivers, responsible for high costs. Conclusions Diagnosis Related Groups properly reproduce actual lung transplantation costs in straightforward cases, but costs in complex cases may remain underestimated. Improved grouping should consider major diagnosis, a higher gradation of ventilation time, and the number of reinterventions to allow for more reasonable reimbursement. |
| Databáze: | OpenAIRE |
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