C. Quantin et al., High cost factors for leukaemia and lymphoma patients: a new analysis of costs within these diagnosis related groups, J EPIDEM C, 53(1), 1999, pp. 24-31
Citations number
26
Categorie Soggetti
Envirnomentale Medicine & Public Health","Medical Research General Topics
Study objective-To determine high cost factors to help managers and clinici
ans to analyse the reasons of adverse costs and provide indications for fin
ancial negotiation.
Design-To locate high cost or long stay patients, the analysis was designed
on the basis of a mixture of Weibull distributions. In this new model, the
proportion of high cost patients was expressed according to the multinomia
l logistic regression, permitting the determination of high cost factors.
Setting-The 1993 French reference database, constituted in the framework of
the national study of DRG costs, conducted by the French Ministry of Healt
h. The database of discharge abstracts recorded in 1993 in the Dijon public
teaching hospital.
Participants-The analyses were based on 1352 abstracts from the French refe
rence database and 368 from the Dijon database concerning patients, aged 18
and over, suffering from leukaemia and lymphoma.
Main results-High cost and long stay factors were the same: number of stays
, death, transfer, acute leukaemia, neutropenia, septicaemia, high dose apl
astic chemotherapy, central venous catheterisation, parenteral nutrition, p
rotected or laminar airflow room, blood transfusion, and intravenous antibi
otherapy.
Conclusions-Taking into account high cost predictive factors, as shown in t
he case of leukaemia and lymphoma patients, would help to reduce the advers
e effects of a prospective payment system.