The cost of operating a national renal/pancreas transplant unit, CHERE Discussion Paper No 13

In June 1990 the Australian Health Ministers endorsed a policy, known as the Nationally Funded Centres (NFC) programme, aimed at providing new and developing technologies in a coordinated and planned way on a national basis. The principal objective was to ensure that such technologies were available to the Australian population on an equitable and cost effective basis. A reference group of the NFC was established, charged with appraising the annual budgets for each NFC. For this a detailed independent costing was necessary, which comprehensively detailed all resources used in a manner allowing funds to be allocated between cost centres. The objective of this study was to prepare estimates of the cost of renal/pancreas transplant services at Westmead hospital under the auspices of the NFC programme. The Pancreas Transplant Research Group at Westmead has, throughout the 1980s, been involved in developing pancreas transplantation in the laboratory and bringing it into clinical practice. The Renal Unit performed its first renal/pancreas combined transplant in July 1987 and has, to date, performed approximately 32 such transplants. The costing was based on a predicted patient throughput of 14 for 1993; although only 10 patients actually proceed to transplantation. The results were an average direct cost to the hospital of $70,595 per patient, ranging from $2,660, for patients who progress no further than assessment, to $79,806 for patients who receive a transplant but who experience significant complications. External costs per patient, covering patient and escort travel, were $9,948. Overheads averaged $16,965, and capital costs averaged $887, per patient. Thus, the predicted total cost of running the Unit for 1993 was $983,973. The average cost per patient transplanted (10) therefore works out at $98,397.