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 journalArticle

12 Citations (Scopus)

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

Fingerprint

Patient Acceptance of Health Care
Health Resources
Liver Transplantation
Length of Stay
Health Insurance Reimbursement
Costs and Cost Analysis
Intraoperative Complications
Hospital Mortality
Comorbidity
Inpatients
Survival Rate
Databases
Mortality
Liver
Population

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Scarborough, J. E., Pietrobon, R., Marroquin, C. E., Tuttle-Newhall, J. E., Kuo, P. C., Collins, B. H., ... Pappas, T. N. (2007). Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States. Journal of Gastrointestinal Surgery, 11(1), 82-88. https://doi.org/10.1007/s11605-007-0103-5

Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States. / Scarborough, John E.; Pietrobon, Ricardo; Marroquin, Carlos E.; Tuttle-Newhall, Janet E.; Kuo, Paul C.; Collins, Bradley H.; Desai, Dev M.; Pappas, Theodore N.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 1, 01.2007, p. 82-88.

Research output: Contribution to journalArticle

Scarborough, John E. ; Pietrobon, Ricardo ; Marroquin, Carlos E. ; Tuttle-Newhall, Janet E. ; Kuo, Paul C. ; Collins, Bradley H. ; Desai, Dev M. ; Pappas, Theodore N. / Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States. In: Journal of Gastrointestinal Surgery. 2007 ; Vol. 11, No. 1. pp. 82-88.
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