Dehlholm-Lambertsen Emilie, Hall Bianca K, Jørgensen Simon M D, Jørgensen Christine W, Jensen Mia E, Larsen Sara, Jensen Josephine S, Ehlers Lars, Dahlerup Jens F, Hvas Christian L
School of Medicine and Health (SMH), Aalborg University, Denmark.
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark.
Therap Adv Gastroenterol. 2019 Apr 10;12:1756284819843002. doi: 10.1177/1756284819843002. eCollection 2019.
Recurrent infection (rCDI) is becoming increasingly common. Faecal microbiota transplantation (FMT) is effective for rCDI, but the costs of an FMT and hospital cost savings related to FMT are unknown. The aim of this study was to calculate the cost of an FMT and the total hospital costs before and after FMT.
This was an observational single-centre study, carried out in a public teaching hospital. We included all patients referred for rCDI from January 2014 through December 2015 and documented costs related to donor screening, laboratory processing, and clinical FMT application. We calculated patient-related hospital costs 1 year before FMT (pre-FMT) and 1 year after FMT (post-FMT). Sensitivity analyses were applied to assess the robustness of the results.
We included 50 consecutive adult patients who had a verified diagnosis of rCDI and were referred for FMT. The average cost of an outpatient FMT procedure if donor faeces were applied by colonoscopy was €3,326 per patient and €2,864 if donor faeces were applied using a nasojejunal tube. The total annual pre-FMT hospital costs per patient were €56,415 (95% confidence interval (CI) 41,133-71,697), and these costs dropped by 42% to €32,816 (22,618-42,014) post-FMT ( = 0.004). The main cost driver was hospital admissions. Sensitivity analyses demonstrated cost reductions in all scenarios.
In a public hospital with an implemented FMT service, the average cost of FMT applied by either colonoscopy or nasojejunal tube was €3,095. Total hospital costs dropped by 42% the first year after FMT. The reduction was mainly caused by reductions in the number of hospital admissions and in length of stay.
复发性艰难梭菌感染（rCDI）正变得越来越常见。粪便微生物群移植（FMT）对rCDI有效，但FMT的成本以及与FMT相关的医院成本节省情况尚不清楚。本研究的目的是计算FMT的成本以及FMT前后的医院总成本。
这是一项在一家公立教学医院进行的单中心观察性研究。我们纳入了2014年1月至2015年12月期间因rCDI转诊的所有患者，并记录了与供体筛查、实验室处理和临床FMT应用相关的成本。我们计算了FMT前1年（FMT前）和FMT后1年（FMT后）与患者相关的医院成本。应用敏感性分析来评估结果的稳健性。
我们纳入了50例经确诊的rCDI成年患者并转诊接受FMT。如果通过结肠镜应用供体粪便，门诊FMT手术的平均成本为每位患者3326欧元；如果使用鼻空肠管应用供体粪便，则为2864欧元。每位患者FMT前的年度医院总成本为56415欧元（95%置信区间（CI）41133 - 71697），FMT后这些成本下降了42%，降至32816欧元（22618 - 42014）（P = 0.004）。主要成本驱动因素是住院。敏感性分析表明在所有情况下成本均降低。
在一家开展FMT服务的公立医院，通过结肠镜或鼻空肠管进行FMT的平均成本为3095欧元。FMT后的第一年医院总成本下降了42%。成本降低主要是由于住院次数和住院时间的减少。
