背景:蒙古在10年前引入了肝移植,成为全球第46个成功执行此程序的国家。然而,在蒙古,肝移植治疗的费用仍然昂贵,中低收入国家。因此,需要计算肝移植的费用,一种非常有价值的治疗方法,构成本研究的基础。
方法:本研究采用回顾性研究设计和次要资料。主要数据集包括2011年至2021年在蒙古第一中心医院进行的143例肝移植病例。
结果:在蒙古进行肝移植的平均费用为39,589±10,308美元,其中79.6%为直接成本,而20.4%为间接成本。在直接成本中,71%归因于毒品,医疗设备,和用品,而工资占8.6%。就终末期肝病(MELD)评分模型而言,MELD≤14分的患者的治疗费用为39,205±10,786美元,MELD15-20分的患者$40,296±1,517,MELD21-27分的患者$39,352±8,718,MELD≤28分的患者为39,812±9,954美元,差异无统计学意义(P=0.953)。然而,当根据Child-Turcotte-Pugh(CTP)评分分类计算时,CTP-A患者的治疗费用为$35,970±6,879,CTP-B患者的治疗费用为$41,951±12,195,CTP-C患者的治疗费用为$37,396±6,701,这具有统计学意义(WT=0.015).
结论:蒙古肝移植治疗的平均费用为39,589美元。尽管医疗设施每年有能力治疗多达50名患者,等待名单超过300人,强调重大未满足的医疗保健需求。
BACKGROUND: Mongolia introduced liver transplantation 10 years ago, becoming the 46th country globally to successfully perform this procedure. However, the cost of liver transplantation treatment remains expensive in
Mongolia, a lower-middle-income country. Thus, the need to calculate the cost of liver transplants, a highly-valued treatment, forms the basis for this study.
METHODS: This study employed a retrospective research design with secondary data. The primary dataset comprised 143 cases of liver transplantation performed at the First Central Hospital of
Mongolia between 2011 and 2021.
RESULTS: The average cost of a liver transplant in
Mongolia is $39,589 ± 10,308, with 79.6% being direct costs and 20.4% indirect costs. Of the direct costs, 71% were attributed to drugs, medical equipment, and supplies, while 8.6% accounted for salaries. In terms of the Model of End-Stage Liver Disease (MELD) scores, treatment costs were $39,205 ± 10,786 for patients with MELD ≤ 14 points, $40,296 ± 1,517 for patients with MELD 15-20 points, $39,352 ± 8,718 for patients with MELD 21-27 points, and $39,812 ± 9,954 for patients with MELD ≤ 28 points, with no statistically significant difference (P = 0.953). However, when calculated according to the Child-Turcotte-Pugh (CTP) score classification, treatment cost for CTP-A patients was $35,970 ± 6,879, for CTP-B patients $41,951 ± 12,195, and for CTP-C patients $37,396 ± 6,701, which was statistically significant (Р=0.015).
CONCLUSIONS: The average cost of liver transplantation treatment in
Mongolia was $39,589. Despite medical facilities\' capacity to treat up to 50 patients annually, the waiting list exceeds 300 individuals, highlighting significant unmet healthcare needs.