Financial impact of delayed graft function in kidney transplantation.
Financial impact of delayed graft function in kidney transplantation.
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DOI：
10.1111/ctr.14022
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发表时间：
2020-10
影响因子：
2.1
通讯作者：
Mohan S
中科院分区：
文献类型：
--
作者：
Kim DW;Tsapepas D;King KL;Husain SA;Corvino FA;Dillon A;Wang W;Mayne TJ;Mohan S
由于器官短缺，次优器官的利用率增加，导致移植后移植物功能延迟恢复（DGF）的发生率增加。虽然假定与发展支助小组有关的费用增加是对利用这些机构的一种威慑，但发展支助小组的财政负担尚未确定。我们使用Premier Healthcare数据库对2014年1月1日至2018年12月31日期间肾移植患者（n = 12 097）的医疗资源利用和成本进行了回顾性分析。我们比较了高容量（n = 8715）与低容量医院（n = 3382）、DGF（n = 3087）与非DGF（n = 9010）以及接受1次透析（n = 1485）与多次透析（n = 1602）的受者的移植成本和医院资源利用。高容量医院的成本低于低容量医院（103 946美元对123 571美元，P < .0001）。DGF与平均费用增加约18000美元（10%）（130492美元vs 112598美元，P < .0001），住院时间增加6天（14.7 vs 8.7，P < .0001），ICU天数增加2天（4.3 vs 2.1，P < .0001）相关。与仅接受1次透析的患者相比，多次透析治疗额外增加了10000美元。总之，DGF与指数肾移植住院治疗的费用和住院时间增加有关，考虑到这一点的支付计划可能会减少临床医生不愿意使用不太理想的肾脏。
Increased utilization of suboptimal organs in response to organ shortage has resulted in increased incidence of delayed graft function (DGF) after transplantation. Although presumed increased costs associated with DGF are a deterrent to the utilization of these organs, the financial burden of DGF has not been established. We used the Premier Healthcare Database to conduct a retrospective analysis of healthcare resource utilization and costs in kidney transplant patients (n = 12 097) between 1/1/2014 and 12/31/2018. We compared cost and hospital resource utilization for transplants in high-volume (n = 8715) vs low-volume hospitals (n = 3382), DGF (n = 3087) vs non-DGF (n = 9010), and recipients receiving 1 dialysis (n = 1485) vs multiple dialysis (n = 1602). High-volume hospitals costs were lower than low-volume hospitals ($103 946 vs $123 571, P < .0001). DGF was associated with approximately $18 000 (10%) increase in mean costs ($130 492 vs $112 598, P < .0001), 6 additional days of hospitalization (14.7 vs 8.7, P < .0001), and 2 additional ICU days (4.3 vs 2.1, P < .0001). Multiple dialysis sessions were associated with an additional $10 000 compared to those with only 1. In conclusion, DGF is associated with increased costs and length of stay for index kidney transplant hospitalizations and payment schemes taking this into account may reduce clinicians’ reluctance to utilize less-than-ideal kidneys.
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DOI：
10.1177/1526924819874699
发表时间：
2019-12
期刊：
Progress in transplantation (Aliso Viejo, Calif.)
影响因子：
--
作者：
Husain SA;King KL;Dube GK;Tsapepas D;Cohen DJ;Ratner LE;Mohan S
通讯作者：
Mohan S
影响因子：
6.2
作者：
Hall IE;Reese PP;Doshi MD;Weng FL;Schröppel B;Asch WS;Ficek J;Thiessen-Philbrook H;Parikh CR
通讯作者：
Parikh CR
影响因子：
8.8
作者：
Chandraker, Anil;Andreoni, Kenneth A.;Pruett, Timothy L.
通讯作者：
Pruett, Timothy L.
影响因子：
120.7
作者：
Merion, RM;Ashby, VB;Port, FK
通讯作者：
Port, FK
影响因子：
19.6
作者：
Mohan, Sumit;Chiles, Mariana C.;Cohen, David J.
通讯作者：
Cohen, David J.