Financial implications of surgical complications in pediatric liver transplantation

John B. Ammori, Shawn J. Pelletier, Amit Mathur, Joshua Cohn, Yasser Ads, Darrell A. Campbell, John C. Magee, Michael J. Englesbe

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Surgical complications following pediatric liver transplantation are common and expensive. We examined the incremental costs of surgical complications and determined who pays for these complications (center or payer). We reviewed the records of 36 pediatric liver transplant patients aged ≤12 yr transplanted between July 1, 2002 and December 31, 2005. The association of recipient and financial data points was assessed. On univariate analysis, total hospital costs were significantly increased in patients with ACR, PNF, HAT, biliary complications, and ARF. Reimbursement by the payer was significantly increased in patients with PNF, HAT, biliary complications, and ARF. Hospital profits were significantly decreased in recipients with ACR and pneumonia. Multiple linear regression models (controlling for recipient factors) revealed that ARF and HAT were independently associated with a significant increase in median hospital costs (incremental costs of $238 990 and $125 650, respectively). ARF and HAT were also independently associated with a significant increase in median reimbursements (incremental costs of $231 611 and $125 287, respectively). No complications were independently associated with hospital margins. All parties (patient and families, physician, payer, and medical center) should benefit from quality improvement efforts, with payers having the largest financial interest.

Original languageEnglish (US)
Pages (from-to)174-179
Number of pages6
JournalPediatric Transplantation
Volume12
Issue number2
DOIs
StatePublished - Mar 2008
Externally publishedYes

Fingerprint

Liver Transplantation
Pediatrics
Hospital Costs
Costs and Cost Analysis
Linear Models
Family Physicians
Quality Improvement
Pneumonia
Transplants
Liver

Keywords

  • Complications
  • Quality improvement
  • Transplant finances

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Cite this

Ammori, J. B., Pelletier, S. J., Mathur, A., Cohn, J., Ads, Y., Campbell, D. A., ... Englesbe, M. J. (2008). Financial implications of surgical complications in pediatric liver transplantation. Pediatric Transplantation, 12(2), 174-179. https://doi.org/10.1111/j.1399-3046.2007.00783.x

Financial implications of surgical complications in pediatric liver transplantation. / Ammori, John B.; Pelletier, Shawn J.; Mathur, Amit; Cohn, Joshua; Ads, Yasser; Campbell, Darrell A.; Magee, John C.; Englesbe, Michael J.

In: Pediatric Transplantation, Vol. 12, No. 2, 03.2008, p. 174-179.

Research output: Contribution to journalArticle

Ammori, JB, Pelletier, SJ, Mathur, A, Cohn, J, Ads, Y, Campbell, DA, Magee, JC & Englesbe, MJ 2008, 'Financial implications of surgical complications in pediatric liver transplantation', Pediatric Transplantation, vol. 12, no. 2, pp. 174-179. https://doi.org/10.1111/j.1399-3046.2007.00783.x
Ammori, John B. ; Pelletier, Shawn J. ; Mathur, Amit ; Cohn, Joshua ; Ads, Yasser ; Campbell, Darrell A. ; Magee, John C. ; Englesbe, Michael J. / Financial implications of surgical complications in pediatric liver transplantation. In: Pediatric Transplantation. 2008 ; Vol. 12, No. 2. pp. 174-179.
@article{8c1a79a8ad5d4539bab1a28299c4ab3d,
title = "Financial implications of surgical complications in pediatric liver transplantation",
abstract = "Surgical complications following pediatric liver transplantation are common and expensive. We examined the incremental costs of surgical complications and determined who pays for these complications (center or payer). We reviewed the records of 36 pediatric liver transplant patients aged ≤12 yr transplanted between July 1, 2002 and December 31, 2005. The association of recipient and financial data points was assessed. On univariate analysis, total hospital costs were significantly increased in patients with ACR, PNF, HAT, biliary complications, and ARF. Reimbursement by the payer was significantly increased in patients with PNF, HAT, biliary complications, and ARF. Hospital profits were significantly decreased in recipients with ACR and pneumonia. Multiple linear regression models (controlling for recipient factors) revealed that ARF and HAT were independently associated with a significant increase in median hospital costs (incremental costs of $238 990 and $125 650, respectively). ARF and HAT were also independently associated with a significant increase in median reimbursements (incremental costs of $231 611 and $125 287, respectively). No complications were independently associated with hospital margins. All parties (patient and families, physician, payer, and medical center) should benefit from quality improvement efforts, with payers having the largest financial interest.",
keywords = "Complications, Quality improvement, Transplant finances",
author = "Ammori, {John B.} and Pelletier, {Shawn J.} and Amit Mathur and Joshua Cohn and Yasser Ads and Campbell, {Darrell A.} and Magee, {John C.} and Englesbe, {Michael J.}",
year = "2008",
month = "3",
doi = "10.1111/j.1399-3046.2007.00783.x",
language = "English (US)",
volume = "12",
pages = "174--179",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Financial implications of surgical complications in pediatric liver transplantation

AU - Ammori, John B.

AU - Pelletier, Shawn J.

AU - Mathur, Amit

AU - Cohn, Joshua

AU - Ads, Yasser

AU - Campbell, Darrell A.

AU - Magee, John C.

AU - Englesbe, Michael J.

PY - 2008/3

Y1 - 2008/3

N2 - Surgical complications following pediatric liver transplantation are common and expensive. We examined the incremental costs of surgical complications and determined who pays for these complications (center or payer). We reviewed the records of 36 pediatric liver transplant patients aged ≤12 yr transplanted between July 1, 2002 and December 31, 2005. The association of recipient and financial data points was assessed. On univariate analysis, total hospital costs were significantly increased in patients with ACR, PNF, HAT, biliary complications, and ARF. Reimbursement by the payer was significantly increased in patients with PNF, HAT, biliary complications, and ARF. Hospital profits were significantly decreased in recipients with ACR and pneumonia. Multiple linear regression models (controlling for recipient factors) revealed that ARF and HAT were independently associated with a significant increase in median hospital costs (incremental costs of $238 990 and $125 650, respectively). ARF and HAT were also independently associated with a significant increase in median reimbursements (incremental costs of $231 611 and $125 287, respectively). No complications were independently associated with hospital margins. All parties (patient and families, physician, payer, and medical center) should benefit from quality improvement efforts, with payers having the largest financial interest.

AB - Surgical complications following pediatric liver transplantation are common and expensive. We examined the incremental costs of surgical complications and determined who pays for these complications (center or payer). We reviewed the records of 36 pediatric liver transplant patients aged ≤12 yr transplanted between July 1, 2002 and December 31, 2005. The association of recipient and financial data points was assessed. On univariate analysis, total hospital costs were significantly increased in patients with ACR, PNF, HAT, biliary complications, and ARF. Reimbursement by the payer was significantly increased in patients with PNF, HAT, biliary complications, and ARF. Hospital profits were significantly decreased in recipients with ACR and pneumonia. Multiple linear regression models (controlling for recipient factors) revealed that ARF and HAT were independently associated with a significant increase in median hospital costs (incremental costs of $238 990 and $125 650, respectively). ARF and HAT were also independently associated with a significant increase in median reimbursements (incremental costs of $231 611 and $125 287, respectively). No complications were independently associated with hospital margins. All parties (patient and families, physician, payer, and medical center) should benefit from quality improvement efforts, with payers having the largest financial interest.

KW - Complications

KW - Quality improvement

KW - Transplant finances

UR - http://www.scopus.com/inward/record.url?scp=40149108620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=40149108620&partnerID=8YFLogxK

U2 - 10.1111/j.1399-3046.2007.00783.x

DO - 10.1111/j.1399-3046.2007.00783.x

M3 - Article

C2 - 18307665

AN - SCOPUS:40149108620

VL - 12

SP - 174

EP - 179

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 2

ER -