The influence of clinical variables on hospital costs after orthotopic liver transplantation.
The burgeoning influence of managed care in transplantation, coupled with a shrinking health-care dollar, has placed most transplant programs under intense pressure to cut costs.
We undertook a retrospective cost-identification analysis to determine what clinical variables influenced financial outcomes after orthotopic cadaver liver transplants (OLTx).
Fifty patients receiving 53 transplants between April 1995 and November 1996 were reviewed.
Clinical data were obtained from our institution's transplant database, and total costs (not charges) for the transplant admission and the 6 months after transplant were obtained with use of an activity-based cost accounting system (HBOC Trendstar, Atlanta, Ga).
The average total cost of second transplants (n=5) was $97,262 greater than for first transplants (n=48, P<. 05).
Patients transplanted initially as United Network for Organ Sharing (UNOS) status 2 (n=20) incurred average costs that were $51,762 higher than for patients transplanted as UNOS status 3 (n=28, P=008).
Patients with a major bacterial or fungal infection (n=28) incurred average costs $46,282 higher than recipients who were infection free (n=22, P=02).
Multivariate analysis demonstrated that only length of stay, retransplantation, and postoperative dialysis were significantly and independently correlated with costs (r2=605). (...)
Mots-clés Pascal : Etats Unis, Amérique du Nord, Amérique, Homme, Homotransplantation, Foie, Economie santé, Analyse coût, Hospitalisation, Soin intégré, Transplantation, Chirurgie
Mots-clés Pascal anglais : United States, North America, America, Human, Homotransplantation, Liver, Health economy, Cost analysis, Hospitalization, Managed care, Transplantation, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0127385
Code Inist : 002B30A04B. Création : 16/11/1999.