Livia A Goldraich1, Jeruza L Neyeloff2, Ana Paula Beck da Silva Etges3, Lais G Zeilmann4, Laura T Hastenteufel1, Eduarda C Ghisleni1, Nadine Clausell5. 1. Heart Transplant Program, Division of Cardiology, Hospital de Clínicas de Porto Alegre, Brazil. 2. Medical and Administrative Divisions, Hospital de Clínicas de Porto Alegre, Brazil; National Health Technology Assessment Institute, National Council for Scientific and Technological Development (CNPq), Brazil. 3. School of Technology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; National Health Technology Assessment Institute, National Council for Scientific and Technological Development (CNPq), Brazil; Department of Industrial Engineering, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. 4. Medical and Administrative Divisions, Hospital de Clínicas de Porto Alegre, Brazil. 5. Heart Transplant Program, Division of Cardiology, Hospital de Clínicas de Porto Alegre, Brazil; National Health Technology Assessment Institute, National Council for Scientific and Technological Development (CNPq), Brazil. Electronic address: nclausell@hcpa.edu.br.
Abstract
BACKGROUND: Advanced heart failure (HF) therapies, such as heart transplantation, are resource intensive and costly. In Brazil, only one-fifth of the estimated population need is fulfilled. We examined cost expenditures of heart transplants in a public institution in Brazil. METHODS AND RESULTS: We used microcosting analysis (time-driven activity-based costing) to examine total costs and individual cost components related to the index transplant hospital admission of all consecutive heart transplant recipients at a single center from July 2015 to June 2017. Average total cost for the 27 patients included was US$ 74,341 which exceeds the reimbursement value per patient by 60%. Major cost drivers were hospital structure and personnel, similarly to what is observed in the United States (US) and other developed countries. Total costs for index transplant admission were ∼50% lower than in the US, but approximate to values reported in some European countries. Costs of heart transplantation in Brazil were lower than those reported for developed countries, and higher than national reimbursement values. CONCLUSIONS: Advanced microcosting methodologies represent an important quality contribution to economic studies in health care and may provide insights for transplant-related health care policies in developing countries.
BACKGROUND: Advanced heart failure (HF) therapies, such as heart transplantation, are resource intensive and costly. In Brazil, only one-fifth of the estimated population need is fulfilled. We examined cost expenditures of heart transplants in a public institution in Brazil. METHODS AND RESULTS: We used microcosting analysis (time-driven activity-based costing) to examine total costs and individual cost components related to the index transplant hospital admission of all consecutive heart transplant recipients at a single center from July 2015 to June 2017. Average total cost for the 27 patients included was US$ 74,341 which exceeds the reimbursement value per patient by 60%. Major cost drivers were hospital structure and personnel, similarly to what is observed in the United States (US) and other developed countries. Total costs for index transplant admission were ∼50% lower than in the US, but approximate to values reported in some European countries. Costs of heart transplantation in Brazil were lower than those reported for developed countries, and higher than national reimbursement values. CONCLUSIONS: Advanced microcosting methodologies represent an important quality contribution to economic studies in health care and may provide insights for transplant-related health care policies in developing countries.
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Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Andreia Biolo; Bruno Ramos Nascimento; Deborah Carvalho Malta; Maria de Fatima Marinho de Souza; Gabriel Porto Soares; Gesner Francisco Xavier Junior; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Odilson Marcos Silvestre; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2020-09 Impact factor: 2.667
Authors: Fernando Luis Scolari; Laura Caroline Tavares Hastenteufel; Lídia Einsfeld; Julia Bueno; Letícia Orlandin; Nadine Clausell; Lívia Adams Goldraich Journal: Front Med (Lausanne) Date: 2022-02-09