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Vogl, M. ; Warnecke, G.* ; Haverich, A.* ; Gottlieb, J.* ; Welte, T.* ; Hatz, R.A.* ; Hunger, M. ; Leidl, R. ; Lingner, H.* ; Behr, J.* ; Winter, H.* ; Schramm, R.* ; Zwissler, B.* ; Hagl, C.* ; Strobl, N.* ; Jaeger, C.* ; Preissler, G.*

Lung transplantation in the spotlight: Reasons for high-cost procedures.

J. Heart Lung Transpl. 35, 1227-1236 (2016)
Open Access Green as soon as Postprint is submitted to ZB.
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.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Drg ; Costs ; Economic Evaluation ; Lung Transplantation ; Resource Utilization; Allocation Score Era; International Society; Resource Utilization; Adult Lung; Heart; Netherlands; Regression; Registry; English; Utility
ISSN (print) / ISBN 1053-2498
e-ISSN 1557-3117
Quellenangaben Volume: 35, Issue: 10, Pages: 1227-1236 Article Number: , Supplement: ,
Publisher Elsevier
Publishing Place New York
Reviewing status Peer reviewed