Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States.

Published

Journal Article

INTRODUCTION: Procedures such as liver transplantation, which entail large costs while benefiting only a small percentage of the population, are being increasingly scrutinized by third-party payors. The purpose of our study was to conduct a longitudinal analysis of the early clinical outcomes and health care resource utilization for liver transplantation in the United States. METHODS: The Nationwide Inpatient Sample database was used to conduct a longitudinal analysis of the clinical outcome and resource utilization data for liver transplantation procedures in adult recipients performed in the United States over three time periods (Period I: 1988-1993; Period II: 1994-1998: Period III: 1999-2003). RESULTS: Compared to Period I, adult liver transplant recipients were more likely to be male, older, and non-White in Period III. Recipients were more likely to have at least one major comorbidity preoperatively than in Period I. The in-hospital mortality rate after liver transplantation decreased significantly from Period I to Period III, but the major intraoperative and postoperative complication rates increased over the same time period. Mean length of hospital stay decreased over the 15-year period, but the percentage of patients with a non-routine discharge status increased. CONCLUSION: Our findings indicate that the rate of postoperative complications and non-routine discharges after liver transplantation is increasing. However, these negative changes in the cost-outcomes relationship for liver transplantation are balanced by improving postoperative survival rates and reductions in the length of hospital stay.

Full Text

Duke Authors

Cited Authors

  • Scarborough, JE; Pietrobon, R; Marroquin, CE; Tuttle-Newhall, JE; Kuo, PC; Collins, BH; Desai, DM; Pappas, TN

Published Date

  • January 1, 2007

Published In

Volume / Issue

  • 11 / 1

Start / End Page

  • 82 - 88

PubMed ID

  • 17390192

Pubmed Central ID

  • 17390192

International Standard Serial Number (ISSN)

  • 1091-255X

Digital Object Identifier (DOI)

  • 10.1007/s11605-007-0103-5

Language

  • eng

Conference Location

  • United States