Economic evaluation of the specialized donor care facility for thoracic organ donor management.
Economic evaluation of the specialized donor care facility for thoracic organ donor management.
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DOI：
10.21037/jtd-20-1575
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发表时间：
2020-10
影响因子：
2.5
通讯作者：
Puri V
中科院分区：
文献类型：
--
作者：
Gauthier JM;Doyle MBM;Chapman WC;Marklin G;Witt CA;Trulock EP;Byers DE;Hachem RR;Pasque MK;Meyers BF;Patterson GA;Nava RG;Kozower BD;Kreisel D;Chang SH;Puri V
在过去的十年里，美国出现了两种不同的捐赠者护理模式：传统模式，捐赠者在发生脑死亡的医院进行管理，以及专门的捐赠者护理设施(SDCF)，在这种模式下，脑死亡的捐赠者被转移到SDCF进行医疗优化和器官采购。尽管特别提款权模式的使用越来越多，但与传统模式相比，其成本效益仍不得而知。我们从美国移植中心的角度对SDCF和传统的供者护理模式进行了为期两年的经济评估。在这项分析中，我们利用了来自移植受者科学登记处的全国数据，并控制了捐赠者的特征和全国器官采购组织(OPO)之间的器官共享模式。亚组分析以确定SDCF模型对胸部器官移植的影响。在研究期间，美国共有13,539名捐赠者进行了38,944例器官移植，观察到的器官总成本为13.6亿美元。如果每个OPO都假设SDCF模型的成本和有效性，预计将进行39,155个器官移植(+211)，预计总器官成本为12.6亿美元(−为1亿美元)。对胸部器官的亚组分析显示，SDCF模型将导致预计额外的156例移植，节省成本2460万美元。与传统的以医院为基础的模式相比，美国的SDCF模式可能是一种成本更低、更有效的多器官捐赠者管理手段，特别是对胸部器官捐赠者。
Over the last decade two alternative models of donor care have emerged in the United States: the conventional model, whereby donors are managed at the hospital where brain death occurs, and the specialized donor care facility (SDCF), in which brain dead donors are transferred to a SDCF for medical optimization and organ procurement. Despite increasing use of the SDCF model, its cost-effectiveness in comparison to the conventional model remains unknown. We performed an economic evaluation of the SDCF and conventional model of donor care from the perspective of U.S. transplant centers over a 2-year study period. In this analysis, we utilized nationwide data from the Scientific Registry of Transplant Recipients and controlled for donor characteristics and patterns of organ sharing across the nation’s organ procurement organizations (OPOs). Subgroup analysis was performed to determine the impact of the SDCF model on thoracic organ transplants. A total of 38,944 organ transplants were performed in the U.S. during the study period from 13,539 donors with an observed total organ cost of $1.36 billion. If every OPO assumed the cost and effectiveness of the SDCF model, a predicted 39,155 organ transplants (+211) would have been performed with a predicted total organ cost of $1.26 billion (−$100 million). Subgroup analysis of thoracic organs revealed that the SDCF model would lead to a predicted 156 additional transplants with a cost saving of $24.6 million. The U.S. SDCF model may be a less costly and more effective means of multi-organ donor management, particularly for thoracic organ donors, compared to the conventional hospital-based model.
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影响因子：
8.8
作者：
Doyle, M. B. M.;Vachharajani, N.;Chapman, W. C.
通讯作者：
Chapman, W. C.
影响因子：
8.8
作者：
Englesbe, M. J.;Merion, R. M.
通讯作者：
Merion, R. M.
影响因子：
4.6
作者：
Chang, Stephanie H.;Kreisel, Daniel;Puri, Varun
通讯作者：
Puri, Varun
DOI：
10.1111/j.1600-6143.2009.02784.x
发表时间：
2009-10
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Lynch RJ;Mathur AK;Hundley JC;Kubus J;Pietroski RE;Mattice BJ;Punch JD;Englesbe MJ
通讯作者：
Englesbe MJ
DOI：
10.1016/j.jamcollsurg.2015.12.032
发表时间：
2016-04-01
影响因子：
5.2
作者：
Doyle, Majella;Subramanian, Vijay;Chapman, William C.
通讯作者：
Chapman, William C.