Evidence map›Paper›PMID 30051153›Full record

ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2019

Potential savings in the treatment pathway of liver transplantation: an inter-sectorial analysis of cost-rising factors.

Lena Harries, Jill Gwiasda, Zhi Qu, Harald Schrem, Christian Krauth, Volker Eric Amelung

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Adult Stem Cell Therapy as Regenerative Medicine for End-Stage Liver Disease.Advances in experimental medicine and biology · 2022
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lena HarriesDepartment of Health Economics and Health Policy, Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. harries.lena@mh-hannover.de.ORCID http://orcid.org/0000-0003-3044-7906
Jill GwiasdaCore Facility Quality Management Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Zhi QuDepartment of Health Economics and Health Policy, Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Harald SchremCore Facility Quality Management Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Christian KrauthDepartment of Health Economics and Health Policy, Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Volker Eric AmelungDepartment of Health Economics and Health Policy, Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIdentification of cost-driving factors in patients undergoing liver transplantation is essential to target reallocation of resources and potential savings.

aimThe aim of this study is to identify main cost-driving factors in liver transplantation from the perspective of the Statutory Health Insurance.

methodsVariables were analyzed with multivariable logistic regression to determine their influence on high cost cases (fourth quartile) in the outpatient, inpatient and rehabilitative healthcare sectors as well as for medications.

resultsSignificant cost-driving factors for the inpatient sector of care were a high labMELD-score (OR 1.042), subsequent re-transplantations (OR 7.159) and patient mortality (OR 3.555). Expenditures for rehabilitative care were significantly higher in patients with a lower adjusted Charlson comorbidity index (OR 0.601). The indication of viral cirrhosis and hepatocellular carcinoma resulted in significantly higher costs for medications (OR 21.618 and 7.429). For all sectors of care and medications each waiting day had a significant impact on high treatment costs (OR 1.001). Overall, cost-driving factors resulted in higher median treatment costs of 211,435 €.

conclusionsTreatment costs in liver transplantation were significantly influenced by identified factors. Long pre-transplant waiting times that increase overall treatment costs need to be alleviated by a substantial increase in donor organs to enable transplantation with lower labMELD-scores. Disease management programs, the implementation of a case management for vulnerable patients, medication plans and patient tracking in a transplant registry may enable cost savings, e.g., by the avoidance of otherwise necessary re-transplants or incorrect medication.

Indexed as

Cost of IllnessHealth Care CostsAdultCase ManagementCosts and Cost AnalysisDrug CostsFemaleGermanyHospitalizationHumansImmunosuppressive AgentsInsurance, HealthLiver DiseasesLiver TransplantationLogistic ModelsMaleImmunosuppressive AgentsCost analysis of liver transplantationCross-sectorial costsGerman healthcare costsHigh cost casesSectors of healthcare

Identifiers

PMID30051153

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.