It is unclear whether patients and grafts survival (PS and GS) rates alone are indices of Quality. Programs who cherry pick could have outstanding PS/GS while fair quality organs get wasted and higher risk patients die on the wait list. We have developed a Quality Index (QI), which includes transplant rates (TR) and compared randomly selected liver transplant programs using their SRTR data. The QI was calculated using the following formula (Observed OPS/ Expected EPS) x (0.7 if below expected, 1 if as expected or 1.3 if above expected)x (OGS/ EGS)x (0.7, 1 or 1.3)x (OTR/ETR). High volume centers (HVC) were defined has centers doing >85 yearly liver transplants. The QI value ranged from 0.35 to 3.19 with a median of 0.60. The QI was higher in center who perfom living donor liver transplants than in centers who do not (1.17 vs 1.00). High volume centers also had a QI higher than lower volume centers (0.95 vs 1.40). The percentage of organ sharing was higher in program with a QI <1 (22%) vs programs with a QI> than 1. There was no difference in the usage of older donors related to QI. Interestingly, centers with QI >1 had a significantly shorter length of stay (median 7.3 days) vs QI<1 (median 13.75 days). Adding transplant rate to outcomes markers of quality like graft and patients survival may prove useful in enhancing and assessing quality in liver transplantation.
To cite this abstract in AMA style:Rochon C, Lally A, Brown M, Sheiner P. Liver Transplant Program Quality Index Which Accounts for Transplant Rate; the Power of Numbers!, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/liver-transplant-program-quality-index-which-accounts-for-transplant-rate-the-power-of-numbers-a/. Accessed September 23, 2017.
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