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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/180666
Economics and outcome after hematopoietic stem cell transplantation: a retrospective cohort study
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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.
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GRATWOHL, Alois, SUREDA, Anna, BALDOMERO, Helen, GRATWOHL, Michael, DREGER, Peter, KRÖGER, Nicolaus, LJUNGMAN, Per, MCGRATH, Eoin, MOHTY, Mohamad, NAGLER, Arnon, RAMBALDI, Alessandro. Economics and outcome after hematopoietic stem cell transplantation: a retrospective cohort study. _EBioMedicine_. 2015. Vol. 2, núm. 12, pàgs. 2101-2109. [consulta: 29 de gener de 2026]. ISSN: 2352-3964. [Disponible a: https://hdl.handle.net/2445/180666]