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

John E. Scarborough, Ricardo Pietrobon, Carlos E. Marroquin, Janet E. Tuttle-Newhall, Paul C. Kuo, Bradley H. Collins, Dev M. Desai, Theodore N. Pappas

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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. 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). 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. 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.

Original languageEnglish (US)
Pages (from-to)82-88
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number1
DOIs
StatePublished - Jan 2007

Keywords

  • Health care resource utilization
  • Liver transplantation
  • Longitudinal analysis
  • Outcome assessment

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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