Day zero of autologous cryopreserved hematopoietic stem cell transplantation: microcosting of care provided by senior nurses

Abstract

Objective: To measure the average direct cost of care provided by senior nurses to patients on day zero of autologous, cryopreserved hematopoietic stem cell transplantation in a public transplant hospital in the state of São Paulo. Method: Quantitative, exploratory-descriptive, single-case study based on bottom-up micro-costing, conducted from February to April 2025. Results: Twenty-eight procedures performed by senior nurses on 16 patients on day zero of the transplant were observed, covering the pre-infusion (n = 718), intra-infusion (n = 375), and post-infusion (n = 463) phases of hematopoietic stem cell transplantation. In the pre-infusion phase of hematopoietic stem cell transplantation, the total average direct cost was US$59.52; in the intra-infusion phase, US$663.45; and in the post-infusion phase, US$16.84. The average direct cost of nursing labor predominated in all three phases. However, in the intra-infusion phase, the cost of supplies was the largest contributor to the total average direct cost. Conclusion: Considering the three phases (n = 1556 observations), the total average direct cost was US$739.81 (100.00%), with 8.04% related to the pre-infusion phase, 89.68% to the intra-infusion phase, and 2.28% to the post-infusion phase.