Abstract
We use biliary complication following liver transplantation to quantify the financial implications of surgical complications and make a case for surgical improvement initiatives as a sound financial investment. We reviewed the medical and financial records of all liver transplant patients at the UMHS between July 1, 2002 and June 30, 2005 (N = 256). The association of donor, transplant, recipient and financial data points was assessed using both univariable (Student's t-test, a chi-square and logistic regression) and multivariable (logistic regression) methods. UMHS made a profit of $6822 ± 39 087 on patients without a biliary complication while taking a loss of $5742 ± 58 242 on patients with a biliary complication (p = 0.04). Reimbursement by the payer was $55 362 higher in patients with a biliary complication compared to patients without a biliary complication (p = 0.001). Using multivariable logistic regression analysis, the two independent risk factors for a negative margin included private insurance (compared to public) (OR 1.88, CI 1.10-3.24, p = 0.022) and biliary leak (OR = 2.09, CI 1.06-4.13, p = 0.034). These findings underscore the important impact of surgical complications on transplant finances. Medical centers have a financial interest in transplant surgical quality improvement, but payers have the most to gain with improved surgical outcomes.
Original language | English (US) |
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Pages (from-to) | 2978-2982 |
Number of pages | 5 |
Journal | American Journal of Transplantation |
Volume | 6 |
Issue number | 12 |
DOIs | |
State | Published - Dec 2006 |
Keywords
- Biliary complication
- Liver transplant
- Quality improvement
- Surgical complications
- Transplant finances
ASJC Scopus subject areas
- Immunology and Allergy
- Transplantation
- Pharmacology (medical)