[The evaluation of the lung transplantation program at Groningen: survival rate, quality of life, and cost-effectiveness].
OBJECTIVE
Assessment of the effectiveness and cost-effectiveness of lung transplantation, and the supply and need of donor lungs in the Netherlands.


METHODS
Prospective and comparative.


METHODS
University Hospital Groningen, the Netherlands.


METHODS
Costs and effects were compared of the situations with and without a lung transplantation programme. Costs and effects were registered during all phases of this programme (November 1990 to February 1996; 76 patients reached the transplantation phase), and the situation without a programme was judged on pre-transplant evidence. The effect of lung transplantation on survival was assessed by means of a Cox regression model, and in the quality of life study of a longitudinal analysis was applied. The supply and the need of donor lungs were based on several registrations.


RESULTS
Lung transplantation led to a significant improvement in survival and quality of life. The average gain in life years and quality adjusted life years (Qalys) were estimated at 4.4 and 5.2, respectively. The average costs per transplanted patient were estimated at Hfl. 670,000 (Hfl. 1 is about 0.5 dollar). The average costs per life year and Qaly gained were estimated at Hfl 153,000 and Hfl. 120,000 (both discounted), respectively. The annual need of donor lungs was estimated at 50-75, the annual supply at 17-27.


CONCLUSIONS
Lung transplantation leads to improvement of survival and quality of life. However, it involves considerable costs and the cost-effectiveness is unfavourable compared with other Dutch transplant programmes. Moreover, there is a great discrepancy between the need and supply of donor lungs in the Netherlands.
TenVergert
E M
EM
Academisch Ziekenhuis, Groningen.
van Enckevort
P J
PJ
Geertsma
A
A
Koopmanschap
M A
MA
van der Bij
W
W
de Boer
W J
WJ
D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D006291:Health Policy; D006301:Health Services Needs and Demand; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D016014:Linear Models; D016040:Lung Transplantation / Q000191:economics* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D015397:Program Evaluation; D011788:Quality of Life; D012189:Retrospective Studies; D015996:Survival Rate; D014019:Tissue Donors / Q000600:supply & distribution; D026712:Value of Life
Evaluatie van het groningse longtransplantatieprogramma: overleving, kwaliteit van leven en kosteneffectiviteit.