Journal article
Impact of Public Reporting of Center-Specific Survival Analysis Scores on Patient Volumes at Hematopoietic Cell Transplant Centers
Transplantation and cellular therapy, Vol.29(8), pp.523-528
08/2023
DOI: 10.1016/j.jtct.2023.05.013
PMID: 37220838
Abstract
•A transplant center classified as underperforming (Center-Specific Survival Analysis score of −1) is associated with a decrease in hematopoietic cell transplantation volume at the index center while transplant centers neighboring the underperforming center experience an increase in their hematopoietic cell transplantation volume.•Public reporting of hematopoietic cell transplantation center performance affects patient volumes and may have additional unintended consequences.
The Center for International Blood and Marrow Transplant Research (CIBMTR) reports the outcomes of allogeneic hematopoietic cell transplantation (alloHCT) at United States transplant centers (TC) annually through its Center-Specific Survival Analysis (CSA). The CSA compares the actual 1-year overall survival (OS) and predicted 1-year OS rate after alloHCT at each TC, which is then reported as 0 (OS as expected), −1 (OS worse than expected), or +1 (OS better than expected).
We evaluated the impact of public reporting of TC performance on their alloHCT patient volumes.
Ninety-one TCs that serve adult or combined adult and pediatric populations and had CSA scores reported for 2012–2018 were included. We analyzed prior-calendar year TC volume, prior-calendar year CSA score, whether the CSA score had changed in the prior year from two years earlier, calendar year, TC type (adult only vs. combined adult and pediatric), and years of alloHCT experience for their impact on patient volumes.
A CSA score of −1, as compared with 0 or +1, was associated with an 8%–9% reduction in the mean TC volume (P < 0.001) in the subsequent year, adjusting for the prior year center volume. Additionally, being a TC neighboring an index TC with a −1 CSA score, was associated with a 3.5% increase in mean TC volume (P = 0.04).
Our data show that public reporting of CSA scores is associated with changes in alloHCT volumes at TCs. Additional investigation into the causes of this shift in patient volume and the impact on outcomes is ongoing.
Details
- Title: Subtitle
- Impact of Public Reporting of Center-Specific Survival Analysis Scores on Patient Volumes at Hematopoietic Cell Transplant Centers
- Creators
- Akshay Sharma - St. Jude Children's Research HospitalBrent Logan - Medical College of WisconsinNoel Estrada-Merly - Medical College of WisconsinLeslie E. Lehmann - Dana-Farber Cancer InstituteHemalatha G. Rangarajan - Nationwide Children's HospitalJaime M. Preussler - National Marrow Donor ProgramJesse D. Troy - Duke UniversityLuke P. Akard - Franciscan Health IndianapolisNeel S. Bhatt - University of WashingtonTony H. Truong - Alberta Children's HospitalWilliam A. Wood - University of North Carolina at Chapel HillChristopher Strouse - University of IowaMark Juckett - University of MinnesotaNandita Khera - Mayo Clinic in FloridaDouglas Rizzo - Medical College of WisconsinWael Saber - Medical College of Wisconsin
- Resource Type
- Journal article
- Publication Details
- Transplantation and cellular therapy, Vol.29(8), pp.523-528
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jtct.2023.05.013
- PMID
- 37220838
- ISSN
- 2666-6367
- eISSN
- 2666-6367
- Language
- English
- Electronic publication date
- 05/21/2023
- Date published
- 08/2023
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984419355202771
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