Financial Feasibility Analysis of a Culturally and Linguistically Competent Hispanic Kidney Transplant Program.
Financial Feasibility Analysis of a Culturally and Linguistically Competent Hispanic Kidney Transplant Program.
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DOI：
10.1097/tp.0000000000003269
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发表时间：
2021-03-01
期刊：
影响因子：
6.2
通讯作者：
Gordon, Elisa J.
中科院分区：
文献类型：
--
作者：
Wang, Andrew;Caicedo, Juan Carlos;McNatt, Gwen;Abecassis, Michael;Gordon, Elisa J.
2006年，西北医学实施了一项具有文化针对性和语言一致性的西语裔肾脏移植计划(HKTP)。HKTP与减少活体肾移植中西班牙裔/拉丁裔差异有关。这篇文章评估了在另外两个移植中心实施HKTP干预的财务可行性。我们使用每月对参与移植计划的移植工作人员进行的时间研究的数据，研究了移植计划对员工成本和移植中心总成本的影响。时间研究是在HKTP实施前(2016)和实施(2017)阶段进行的。劳动力成本是使用时代研究的数据和劳工部的平均工资来估计的。我们使用医疗保险成本报告中的数据，回顾了2016年和2017年两个中心的肾脏获取和移植成本。在实施前，中心A的员工(n=21)投入了764小时(44 607美元)，中心B的工作人员(n=15)投入了800小时(45 193美元)来建立HKTP。在推行过程中，A中心员工(n=19)投入了1125小时(55594美元)，B中心员工(n=24)投入了1396小时(170美元)来交付香港主题公园。总体而言，HKTP涉及的员工时间的总成本包括每个中心每年(2016年和2017年)总成本的1.0%。我们的研究结果显示实施HKTP在财政上是可行的，并为HKTP在其他移植中心实施以减少活体供肾移植的健康差距提供了一个潜在的商业案例。
In 2006, Northwestern Medicine implemented a culturally targeted and linguistically congruent Hispanic Kidney Transplant Program (HKTP). The HKTP has been associated with a reduction in Hispanic/Latino disparities in live donor kidney transplantation. This article assessed the financial feasibility of implementing the HKTP intervention at 2 other transplant centers. We examined the impact of the HKTP on staffing costs compared with the total transplant center costs using data from monthly time studies conducted among transplant staff involved in the HKTP. Time studies were conducted during the HKTP preimplementation (2016) and implementation (2017) phases. Labor costs were estimated using data from the time studies and mean salaries from the Department of Labor. We retrospectively examined kidney acquisition and transplant costs at both centers in 2016 and 2017 using data from the Medicare cost reports. During preimplementation, center A staff (n = 21) committed 764 hours ($44 607), and center B staff (n = 15) committed 800 hours ($45 193) to establish the HKTP. During implementation, center A staff (n = 19) committed 1125 hours ($55 594), and center B staff (n = 24) committed 1396 hours ($64 170), in delivering the HKTP. Overall, the total costs from the staffing time involved in the HKTP encompassed <1.0% per year (2016 and 2017) of each center’s annual total costs. Our findings suggest the financial feasibility of implementing the HKTP and present a potential business case for the HKTP’s implementation at other transplant centers to reduce health disparities in live donor kidney transplantation.