Journal article
The Changing Financial Landscape of Renal Transplant Practice: A National Cohort Analysis
American journal of transplantation, Vol.17(2), pp.377-389
10/04/2016
DOI: 10.1111/ajt.14018
PMCID: PMC5524376
PMID: 27565133
Abstract
Kidney transplantation has become more resource intensive as recipient
complexity has increased and average donor quality has diminished over time. A
national retrospective cohort study was performed to assess the impact of kidney
donor and recipient characteristics on transplant center cost (exclusive of
organ acquisition) and Medicare reimbursement. Data from the national transplant
registry, University HealthSystem Consortium hospital costs, and Medicare
payments for deceased donor (N=53,862) and living donor (N=36,715) transplants
from 2002–2013 were linked and analyzed using multivariate linear
regression modeling. Deceased donor kidney transplant costs were correlated with
recipient (Expected Post Transplant Survival Score, degree of allosensitization,
obesity, cause of renal failure) donor (age, cause of death, donation after
cardiac death, terminal creatinine), and transplant (histocompatibility
matching) characteristics. Living donor costs rose sharply with higher degrees
of allosensitization, and were also associated with obesity, cause of renal
failure, recipient work ability, and 0-ABDR mismatching. Analysis of Medicare
payments for a subsample of 24,809 transplants demonstrated minimal correlation
with patient and donor characteristics. In conclusion, the complexity in the
landscape of kidney transplantation increases center costs, posing financial
disincentives that may reduce organ utilization and limit access for higher risk
populations.
Details
- Title: Subtitle
- The Changing Financial Landscape of Renal Transplant Practice: A National Cohort Analysis
- Creators
- David Axelrod - East Carolina UniversityMark A. Schnitzler - Saint Louis UniversityHuiling Xiao - Saint Louis UniversityAbhijit S. Naik - University of MichiganDorry L. Segev - Johns Hopkins UniversityVikas R. Dharnidharka - Washington University in St. LouisDaniel C. Brennan - Washington University in St. LouisKrista L. Lentine - University of Michigan
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.17(2), pp.377-389
- DOI
- 10.1111/ajt.14018
- PMID
- 27565133
- PMCID
- PMC5524376
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000062, name: National Institute of Diabetes and Digestive and Kidney Diseases, award: R01DK102981
- Language
- English
- Date published
- 10/04/2016
- Academic Unit
- Surgery
- Record Identifier
- 9984322950302771
Metrics
13 Record Views