Resource Utilization in Allogeneic Bone Marrow Harvest Procedures: A Multi-Hospital Perspective

Abstract

Allogeneic Bone Marrow Transplant (alloBMT) is widely recognized as a resource intensive procedure. However, few studies have examined the resource utilization of allogeneic bone marrow extractions from a multi-hospital perspective. This study aims to provide a baseline for hospitals to benchmark themselves to determine resource efficiency in bone marrow extraction through depicting exiting trends among hospitals found in the Vizient Clinical Data Base/Resource Manager (CDBRM) tool. Using the Vizient CDBRM tool, hospitals were included in the analysis based on their participation in the resource management function and if they completed bone marrow harvest procedures in 2017. A total of 430 allogeneic bone marrow harvest procedures were identified in the outpatient setting during 2017. The total cost to hospitals of the bone marrow extraction encounter was examined. In the outpatient setting, the top drivers of cost for bone marrow extraction encounters were found to be operating room costs (32% of total costs), organ procurement –related activities (26% of total costs), and recovery room services (14% of total costs.) In the inpatient setting, 5,146 allogeneic bone marrow harvest encounters were conducted in 143 hospitals. The top three total cost drivers for hospitals in the inpatient setting were identified as medical/surgical supplies (41% of total costs for all hospitals), operating room costs (16% of total costs), and general routine care (12% of total costs). Implications from this study include a need for similar research in other stem cell extraction strategies such as autologous bone marrow harvest, and allogeneic peripheral blood stem cell transplantation collection. Resource utilization benchmarks, along with clinical outcomes, can be utilized to inform provider decision making in stem cell transplant.