Analysis of hospital charges after simultaneous pancreas-kidney transplantation in the era of managed care.
Annual Meeting of the American Society of Transplant Physicians. Dallas, Texas (USA), 1996/05/27.
The purpose of this study was to analyze and compare hospital charges in simultaneous pancreas-kidney transplant (SPKT) recipients before and after implementation of managed care principles.
Two groups were compared : 14 consecutive SPKT patients transplanted in 1991 vs. 15 consecutive SPKT patients transplanted in 1995.
All patients underwent whole organ pancreas transplantation with bladder drainage and received quadruple immunosuppression with OKT3 induction.
The two groups were well-matched ; outliers were excluded (four in 1991 and five in 1995), and no attempt was made to convert 1991 to 1995 dollars.
Patient and graft survival rates were 100%, and no major early complications occurred.
All SPKTs were performed in a single hospital setting, and all inpatient charges for the initial hospitalization were analyzed retrospectively and itemized by service.
Pharmacy, organ acquisition, and clinical laboratory services accounted for nearly 80% of charges in each group.
For the initial transplant hospitalization, the 1995 group experienced significant reductions in :
(1) length of stay (16.3±1.4-13.5±3.5 days P=0.03) ;
(2) total number of laboratory tests (392±15-224±60, P<10-3) ;
(3) clinical laboratory charges ($23,623±$1,780-$11,165±$3,091, P<10-6) ;
and (4) total inpatient charges with organ acquisition charges excluded ($87,815±$8,678-$75,152±$16,871, P=0.049). (...)
Mots-clés Pascal : Transplantation, Pancréas, Rein, Simultané, Evaluation, Dépense, Evolution, Relation, Soin intégré, Economie, Etude statistique, Homme, Chirurgie, Appareil digestif pathologie, Pancréas pathologie, Appareil urinaire pathologie, Rein pathologie, Economie santé
Mots-clés Pascal anglais : Transplantation, Pancreas, Kidney, Concurrent, Evaluation, Expenditure, Evolution, Relation, Managed care, Economy, Statistical study, Human, Surgery, Digestive diseases, Pancreatic disease, Urinary system disease, Kidney disease, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0437024
Code Inist : 002B30A04B. Création : 19/12/1997.