Comparison of the approval process between private and public payers in hematopoietic stem cell transplantation

Abstract

Objectives: The increased use of hematopoietic stem cell transplant (HSCT) for its potentially curative properties has led to studies examining the quality of care that is currently received. More specifically, research examining the timeliness aspect of quality of care is being addressed. This study was therefore designed to examine timeliness of obtaining HSCT on two levels, the approval time period, and the time it takes to receive the transplant, based off of payer type. Methods: University of Nebraska Medical Center (UNMC) patients recommended for a HSCT were analyzed according to payer type (private vs. Medicare/Medicare) between the years of 2007 and 2011. Within this time period, 1389 patients were recommended for a HSCT. This sample size was divided into two cohorts of patients: not-transplanted and transplanted. Of these patients, 559 received the transplant. For statistical analysis purposes of this study, we used data from the patients that had the procedure and had it funded by either a public payer (Medicare/Medicaid) or private payer. It was found that 421 of these patients that were transplanted were covered by private insurance while 97 were on Medicare/Medicaid. We compared the patient-, disease-, and transplant-related characteristics according to payer. Univariate analyses were completed using Wilcoxon and Chi-square tests, while multivariate analyses were performed using multiple linear regression analysis. [TRUNCATED]