Health Care Reimbursement, Service Utilization, and Outcomes among Medicare Beneficiaries with Multiple Myeloma Receiving Autologous Hematopoietic Cell Transplantation in Inpatient and Outpatient Settings

Dunavin, Neil; Mau, Lih Wen; Meyer, Christa; Divine, Clint; Abdallah, Al Ola; Leppke, Susan; D’Souza, Anita; Denzen, Ellen M.; Saber, Wael; Burns, Linda J.; Ganguly, Siddhartha

doi:10.1016/j.bbmt.2019.12.772

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…If we considered that in Calabria Region (south of Italy), the DRG reimbursement for a transplant is €60,000, the estimated cost saving per patient is €31,190.85 for the inpatient approach and €43,306.57 for the outpatient model. Dunavin et al using a merged dataset of the Center for International Blood and Marrow Transplant Research (CIBMTR) observational database and Centers for Medicare & Medicaid Services Medicare administrative claims data to analyse reimbursement, service utilisation and patient financial responsibility amongst Medicare beneficiaries in 1640 patients with MM who underwent ASCT in inpatient and outpatient settings (62). Total reimbursement and patient responsibility were analysed for patient and disease characteristics.…”

Section: Cost Datamentioning

confidence: 99%

Multiple Myeloma Outpatient Transplant Program in the Era of Novel Agents: State-of-the-Art

et al. 2020

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Multiple myeloma (MM) is the most common indication for autologous stem cell transplantation (ASCT), and outpatient models have been widely developed in this setting. Although numerous studies have demonstrated the safety and feasibility of outpatient ASCT, it is not a routine procedure. Stringent guidelines for patient selection and clinical management, including functional status, caregiver support, and psychological aspects, are essential to identify eligible patients. However, there is still no general agreement on these criteria. Quality of life data are limited and contradictory. There is considerable variability in outpatient transplant models, and there are no randomised studies supporting the use of one over the other. Studies evaluating results in terms of long-term survival, transplant toxicity in comparison with a standard approach are lacking. The procedure is cost-effective within the context of a hospital budget, but an in-depth analysis of the real cost of these programmes has yet to be performed.

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Section: Cost Datamentioning

confidence: 99%

Multiple Myeloma Outpatient Transplant Program in the Era of Novel Agents: State-of-the-Art

et al. 2020

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“…Moreover, factors such as hospitalization [ 25 , 26 ] and geographical distance from home [ 21 , 25 , 27 , 28 , 29 ] should be carefully considered, given their potential impact on quality of life [ 30 ]. As such, there is a compelling need to broaden the scope of research on this subject, exploring the multifaceted dimensions of the HSCT experience and its implications for patients and their support networks.…”

Section: Introductionmentioning

confidence: 99%

Hematopoietic Stem Cell Transplantation Impact on Patients’ Perceived Quality of Life: A Longitudinal Study

Ortolá-Alonso,

Santacatalina-Roig,

Chover-Sierra

et al. 2024

Nursing Reports

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Objective: The aim of this paper was to evaluate the quality of life of adult patients with onco-hematological disease treated with hematopoietic stem cell transplantation up to two years post-transplantation. Method: A quantitative, observational, longitudinal, and analytical study was conducted with 121 participants diagnosed with onco-hematological cancer who underwent hematopoietic stem cell transplantation between October 2017 and September 2019, with a 2-year post-transplantation follow-up, of whom only 39 completed the study. The Functional Assessment of Cancer Therapy—Bone Marrow Transplantation (FACT-BMT) questionnaire and its subscales, Functional Assessment of Cancer Therapy—General (FACT-BMT) and Functional Assessment of Cancer Therapy Trial Outcome Index (FACT-TOI), developed by the Functional Assessment of Chronic Illness Therapy (FACIT) and validated for Spain, were used to assess quality of life. Result: The average age for hematopoietic stem cell transplantation was 54 years, with a majority of male participants. The evaluation of quality of life showed a decrease at the time of hospital discharge, followed by a progressive improvement up to one year after the transplantation. There was a significant difference in the quality of life questionnaire scores between both sexes during all stages of the research, with higher scores in male participants. The length of hospital stay significantly affected patients’ physical and functional well-being, and marital status was related to differences in the perception of quality of life. Conclusions: Despite the initial decrease in quality of life for patients undergoing hematopoietic stem cell transplantation, levels of quality of life similar to baseline are regained one year after the transplantation. Sociodemographic variables are related to how these patients perceive their quality of life. However, further studies with a larger sample size are needed for more precise results.

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“…One aspect that affects the patients' quality of life is the lengthy hospitalization process that implies a change in the living conditions of the person and family and modifications to their routines and habitual patterns of behavior [24][25][26][27][28][29]. On the other hand, there has been a trend in recent years, not only for economic reasons but also for the effectiveness of the treatments, to transfer complex medical treatments to the home when possible, which triggered different initiatives to develop home transplants worldwide [30,31].…”

Section: Introductionmentioning

confidence: 99%

“…In our country, a pilot experience of home autologous hematopoietic cell transplantation (HCT) started in 2015 [34], following the lines of similar programs developed in Europe [35]. The results of this project indicated the presence of shorter periods of febrile neutropenia, fewer episodes of fever, and a lower rate of readmissions, as well as a reduction in costs and hospital care pressure [25].…”

Section: Introductionmentioning

confidence: 99%

Post-Transplant Complications in Patients Undergoing Autologous Hematopoietic Cell Transplantation (HCT)—A Comparative Analysis of Home Care versus Hospitalized Patients

Garcés-Carrasco,

Santacatalina-Roig,

Carretero-Márquez

et al. 2023

Medicina

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Background and Objectives: The increase in indications for hematopoietic cell transplants (HCTs) has led to the development of new care options after said transplant, such as home care after transplantation, which improves the patients’ quality of life. The main purpose of this research is to analyze the differences in the appearance of post-transplant complications between patients having underwent autologous HCT with at-home post-transplant modalities and those under in-hospital post-transplant care. Materials and Methods: An observational, analytical, longitudinal, and retrospective study of cases and controls. All transplanted people in the domiciliary model since 2020 are included as cases (20 subjects). For each case, two controls (40 subjects) are proposed among patients who received an autologous transplant in a hospital in the last five years with a similar demographic and pathological base profile in each case. Results: No significant differences were found between cases and controls, except for the Karnofsky value, which was higher in people receiving home treatment (91.7% vs. 87.74%; p = 0.05). The average number of days of the process post-transplantation was more significant at home (processing days 22.4 ± 2.6; post-transplantation days of 16.4 ± 2.08 versus 21.21 ± 4.18, with a mean of 15.51 ± 3.96 days post-transplant (days of the process p = 0.022; days post-transplant p = 0.002)). There is a more significant presence of neutropenic fever, mucositis, and positive blood cultures in the post-transplant patients who remain in the hospital. In contrast, the patients receiving home care post-transplantation undergo significantly more weight loss. Regarding the odds ratio of the appearance of adverse events, in the hospital setting, it is up to 8.5 times more likely to encounter neutropenic fever, 4.63 times more likely for mucositis, and 6.65 times more likely for the presence of pathogens in blood cultures. Conclusions: The home care modality in the post-transplant phase does not show an inferiority in conditions in the management and safety of the patient concerning the appearance of adverse events. However, more significant weight loss is detected in patients at home, and an increased risk of episodes of neutropenic fever, mucositis, and positive blood cultures for patients in hospital settings.

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Health Care Reimbursement, Service Utilization, and Outcomes among Medicare Beneficiaries with Multiple Myeloma Receiving Autologous Hematopoietic Cell Transplantation in Inpatient and Outpatient Settings

Cited by 8 publications

References 21 publications

Multiple Myeloma Outpatient Transplant Program in the Era of Novel Agents: State-of-the-Art

Multiple Myeloma Outpatient Transplant Program in the Era of Novel Agents: State-of-the-Art

Hematopoietic Stem Cell Transplantation Impact on Patients’ Perceived Quality of Life: A Longitudinal Study

Post-Transplant Complications in Patients Undergoing Autologous Hematopoietic Cell Transplantation (HCT)—A Comparative Analysis of Home Care versus Hospitalized Patients

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