Impact of the heart transplant allocation policy change on inpatient cost of index hospitalization.
UNOS allocation policy
health care cost
heart transplant
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
revised:
01
04
2022
received:
22
02
2022
accepted:
25
04
2022
pubmed:
3
5
2022
medline:
14
7
2022
entrez:
2
5
2022
Statut:
ppublish
Résumé
We sought to determine the financial impact of the United Network for Organ Sharing heart transplant (HT) allocation policy change of October 2018. Using the Nationwide Inpatient Sample we retrospectively analyzed hospital discharge data between January 1, 2016 and December 31, 2019. ICD-10-CM procedure codes were used to identify hospitalizations of patients undergoing HT as well as the use of temporary mechanical circulatory support (MCS) during the HT hospitalization. Patients < 18 years old and those with missing data on costs were excluded. The primary outcome was inflation-adjusted costs. Total costs were inflated to 2019 US dollars. During the course of the study, temporary MCS increased significantly among 11 380 weighted patients transplanted while mean length of stay (LOS) did not. Mean inflation-adjusted costs rose about $40k per HT. On univariate analysis, transplantation year, use of temporary MCS and LOS were all significantly associated with increased cost while on multivariate analysis only temporary MCS and LOS were. The 2018 allocation change has resulted in more expensive inpatient costs for HT correlating with an increase in temporary MCS.
Sections du résumé
BACKGROUND
We sought to determine the financial impact of the United Network for Organ Sharing heart transplant (HT) allocation policy change of October 2018.
METHODS
Using the Nationwide Inpatient Sample we retrospectively analyzed hospital discharge data between January 1, 2016 and December 31, 2019. ICD-10-CM procedure codes were used to identify hospitalizations of patients undergoing HT as well as the use of temporary mechanical circulatory support (MCS) during the HT hospitalization. Patients < 18 years old and those with missing data on costs were excluded. The primary outcome was inflation-adjusted costs. Total costs were inflated to 2019 US dollars.
RESULTS
During the course of the study, temporary MCS increased significantly among 11 380 weighted patients transplanted while mean length of stay (LOS) did not. Mean inflation-adjusted costs rose about $40k per HT. On univariate analysis, transplantation year, use of temporary MCS and LOS were all significantly associated with increased cost while on multivariate analysis only temporary MCS and LOS were.
CONCLUSIONS
The 2018 allocation change has resulted in more expensive inpatient costs for HT correlating with an increase in temporary MCS.
Identifiants
pubmed: 35499219
doi: 10.1111/ctr.14692
pmc: PMC9541533
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14692Informations de copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Int J Cardiol. 2021 Apr 15;329:115-122
pubmed: 33321128
JACC Heart Fail. 2018 May;6(5):424-432
pubmed: 29724365
ASAIO J. 2020 Feb;66(2):125-127
pubmed: 31977354
J Thorac Cardiovasc Surg. 2020 Sep 16;:
pubmed: 34756380
JACC Heart Fail. 2020 Jul;8(7):548-556
pubmed: 32417413
Clin Transplant. 2021 Jul;35(7):e14345
pubmed: 33977552
Clin Transplant. 2022 Jul;36(7):e14692
pubmed: 35499219