Hematopoietic cell transplantation (HCT) using the patient’s own (autologous) or a donor’s (allogeneic) HCT progenitor cells is a highly effective but costly therapy for life-threatening blood disorders and cancers. Despite the small number of annual procedures (20 000 a year in the United States), HCT hospitalization spending increased from $684 million to $1.3 billion between 2004 and 2007, placing it among the procedures with the most rapid spending increases.1 Those increases reflect rising procedure volume and rising hospitalization costs.1 Prior research2 on HCT costs has been limited to single-institution analyses. To quantify variation in costs of HCT across hospitals, we analyzed data from the Nationwide Inpatient Sample (NIS),3 the largest hospital database with charge information on all patients admitted to the sampled hospitals regardless of payer.
Hospital geometric means are shown for autologous (n = 32) (A) and allogeneic (n = 22) (B) HCTs. The size of the plotting character is proportional to the hospital’s total volume of HCT cases. Hospitals in the highest and lowest quintile are indicated with squares. The lines across the graphs indicate the overall adjusted mean. Limit lines indicate 95% CI.
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