According to the study registry data showing that there is indeed a correlation between treatment resulting and the frequency of the service provided stem cell transplantation. This applies in particular to the survival chances of patients; The more frequently the transplantation team performs the procedure, the higher the chances of survival.
In contrast, no studies could be found investigating the healthcare consequences of setting a specific minimum number of cases. The G-BA set minimum volumes for certain plannable inpatient services for the first time; Since then, hospitals may only provide and invoice these services if they reach the set annual minimum volumes.
In accordance with the G-BA’s commission; studies that would either allow robust conclusions to be drawing as to how the volume; and quality of services providing for (autologous or allogeneic) stem cell transplantation were relating; or could answer the question as to how a binding number of cases per hospital and year affected treatment success. Since 2016, for setting minimum volumes only evidence is required indicating a probable correlation.
Stem cell transplantation
In 2017, the G-BA adjusted its Minimum Volume Regulation accordingly and has now commissioned IQWiG to examine the evidence in 8 indications. in the assessment, each of which had analyzed patient data from international clinical registries on stem cell transplantation for malignant hematological diseases. No evidence was available for the second question, which therefore currently remains unanswered.
Regarding mortality, the high-quality Loberiza study showed that patients survived longer after stem cell transplantation if doctors had already performed this procedure more frequently. Two studies also supported this result in terms of the volume of services provided by the hospital. However, from a methodological point of view, both of these studies were less informative.
Terms of mortality
For other outcomes, the correlations in these overall poorly informative studies were considerably weaker or even non-existent. It was not possible to statistically pool the data of all studies, partly because the characteristics of the participants (e.g. age, sex, underlying disease) were too different or unknown.
In terms of mortality, we see a positive correlation between the volume of stem cell transplantations and treatment success. However, due to a lack of usable data; it is not possible to assess the effects of setting specific minimum volumes; for example, on patient mortality after stem cell transplantation. It therefore remaining to be seeing whether a case number of 25 cases per hospital location; and year guarantees an optimal chance of survival for patients.