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http://hdl.handle.net/2445/180666
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DC Field | Value | Language |
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dc.contributor.author | Gratwohl, Alois | - |
dc.contributor.author | Sureda, Anna | - |
dc.contributor.author | Baldomero, Helen | - |
dc.contributor.author | Gratwohl, Michael | - |
dc.contributor.author | Dreger, Peter | - |
dc.contributor.author | Kröger, Nicolaus | - |
dc.contributor.author | Ljungman, Per | - |
dc.contributor.author | McGrath, Eoin | - |
dc.contributor.author | Mohty, Mohamad | - |
dc.contributor.author | Nagler, Arnon | - |
dc.contributor.author | Rambaldi, Alessandro | - |
dc.date.accessioned | 2021-10-19T13:54:02Z | - |
dc.date.available | 2021-10-19T13:54:02Z | - |
dc.date.issued | 2015-11-19 | - |
dc.identifier.issn | 2352-3964 | - |
dc.identifier.uri | http://hdl.handle.net/2445/180666 | - |
dc.description.abstract | Hematopoietic stem cell transplantation (HSCT) is a lifesaving expensive medical procedure. Hence, more transplants are performed in more affluent countries. The impact of economic factors on patient outcome is less defined. We analyzed retrospectively a defined cohort of 102,549 patients treated with an allogeneic (N = 37,542; 37%) or autologous (N = 65,007; 63%) HSCT. They were transplanted by one of 404 HSCT centers in 25 European countries between 1999 and 2006. We searched for associations between center-specific microeconomic or country-specific macroeconomic factors and outcome. Center patient-volume and center program-duration were significantly and systematically associated with improved survival after allogeneic HSCT (HR 0·87; 0·84-0·91 per 10 patients; p < 0·0001; HR 0·90;0·85-0·90 per 10 years; p < 0·001) and autologous HSCT (HR 0·91;0·87-0·96 per 10 patients; p < 0·001; HR 0·93;0·87-0·99 per 10 years; p = 0·02). The product of Health Care Expenditures by Gross National Income/capita was significantly associated in multivariate analysis with all endpoints (R2 = 18%; for relapse free survival) after allogeneic HSCT. Data indicate that country- and center-specific economic factors are associated with distinct, significant, systematic, and clinically relevant effects on survival after HSCT. They impact on center expertise in long-term disease and complication management. It is likely that these findings apply to other forms of complex treatments. | - |
dc.format.extent | 9 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Elsevier | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1016/j.ebiom.2015.11.021 | - |
dc.relation.ispartof | EBioMedicine, 2015, vol. 2, num. 12, p. 2101-2109 | - |
dc.relation.uri | https://doi.org/10.1016/j.ebiom.2015.11.021 | - |
dc.rights | cc-by-nc-nd (c) Gratwohl, Alois et al., 2015 | - |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Cèl·lules mare | - |
dc.subject.classification | Avaluació de resultats (Assistència mèdica) | - |
dc.subject.classification | Dret a la salut | - |
dc.subject.classification | Salut pública | - |
dc.subject.other | Stem cells | - |
dc.subject.other | Outcome assessment (Medical care) | - |
dc.subject.other | Right to health care | - |
dc.subject.other | Public health | - |
dc.title | Economics and outcome after hematopoietic stem cell transplantation: a retrospective cohort study | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 696090 | - |
dc.date.updated | 2021-10-19T13:54:02Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 26844291 | - |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) |
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