Centre for Health Economics Research and Evaluation, University of Technology Sydney.
School of Nursing, University of Wollongong; Ingham Institute for Allied Health Research; St George Hospital, South Eastern Local Health District.
Transplant Cell Ther. 2024 May;30(5):542.e1-542.e29. doi: 10.1016/j.jtct.2024.01.084. Epub 2024 Feb 7.
This scoping review summarizes the evidence regarding healthcare resource utilization (HRU) and costs associated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study was conducted in accordance with the Joanne Briggs Institute methodology for scoping reviews. The PubMed, Embase, and Health Business Elite Electronic databases were searched, in addition to grey literature. The databases were searched from inception up to November 2022. Studies that reported HRU and/or costs associated with adult (≥18 years) allo-HSCT were eligible for inclusion. Two reviewers independently screened 20% of the sample at each of the 2 stages of screening (abstract and full text). Details of the HRU and costs extracted from the study data were summarized, based on the elements and timeframes reported. HRU measures and costs were combined across studies reporting results defined in a comparable manner. Monetary values were standardized to 2022 US Dollars (USD). We identified 43 studies that reported HRU, costs, or both for allo-HSCT. Of these studies, 93.0% reported on costs, 81.4% reported on HRU, and 74.4% reported on both. HRU measures and cost calculations, including the timeframe for which they were reported, were heterogeneous across the studies. Length of hospital stay was the most frequently reported HRU measure (76.7% of studies) and ranged from a median initial hospitalization of 10 days (reduced-intensity conditioning [RIC]) to 73 days (myeloablative conditioning). The total cost of an allo-HSCT ranged from $63,096 (RIC) to $782,190 (double umbilical cord blood transplantation) at 100 days and from $69,218 (RIC) to $637,193 at 1 year (not stratified). There is heterogeneity in the reporting of HRU and costs associated with allo-HSCT in the literature, making it difficult for clinicians, policymakers, and governments to draw definitive conclusions regarding the resources required for the delivery of these services. Nevertheless, to ensure that access to healthcare meets the necessary high cost and resource demands of allo-HSCT, it is imperative for clinicians, policymakers, and government officials to be aware of both the short- and long-term health resource requirements for this patient population. Further research is needed to understand the key determinants of HRU and costs associated with allo-HSCT to better inform the design and delivery of health care for HSCT recipients and ensure the quality, safety, and efficiency of care.
本范围综述总结了与异基因造血干细胞移植（allo-HSCT）相关的所有医疗资源利用（HRU）和成本的证据。本研究按照乔安妮·布里格斯研究所（Joanne Briggs Institute）的范围综述方法进行。检索了 PubMed、Embase 和 Health Business Elite 电子数据库以及灰色文献。数据库检索从建立到 2022 年 11 月。符合纳入标准的研究报告了与成人（≥18 岁）allo-HSCT 相关的 HRU 和/或成本。两名审查员在筛选的 2 个阶段（摘要和全文）中，独立筛选了 20%的样本。根据报告的要素和时间框架，从研究数据中提取 HRU 和成本的详细信息，并进行总结。报告结果以可比方式定义的研究中，对 HRU 测量值和成本进行了组合。货币价值已标准化为 2022 年美元（USD）。我们确定了 43 项报告 allo-HSCT 的 HRU、成本或两者的研究。其中，93.0%的研究报告了成本，81.4%的研究报告了 HRU，74.4%的研究报告了两者。研究之间的 HRU 测量值和成本计算方法，包括报告的时间框架，存在异质性。住院时间是最常报告的 HRU 测量值（76.7%的研究），范围从中位数初始住院 10 天（强化诱导[RIC]）到中位数 73 天（清髓性诱导）。allo-HSCT 的总费用在 100 天时范围从 63096 美元（RIC）到 782190 美元（双脐血移植），在 1 年时范围从 69218 美元（RIC）到 637193 美元（未分层）。文献中与 allo-HSCT 相关的 HRU 和成本报告存在异质性，这使得临床医生、政策制定者和政府难以就这些服务所需的资源得出明确结论。然而，为了确保获得医疗保健服务符合 allo-HSCT 所需的高成本和资源需求，临床医生、政策制定者和政府官员必须了解该患者群体的短期和长期卫生资源需求。需要进一步研究以了解与 allo-HSCT 相关的 HRU 和成本的关键决定因素，以便更好地为 HSCT 受者提供医疗保健服务，并确保护理的质量、安全性和效率。
