Comparing the Role of Post-Transplant Readmissions and Bed Days on Total One Year Cost of Care.
1Complex Medical Conditions, Optum, UnitedHealth Group, Eden Prairie, MN
2Surgery, St. Louis University, St. Louis, MO
Meeting: 2017 American Transplant Congress
Abstract number: 333
Keywords: Economics, Heart transplant patients, Kidney transplantation, Liver transplantation
Session Information
Session Name: Concurrent Session: Health Services and Policy in Organ Transplanation
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 4:30pm-6:00pm
Presentation Time: 4:54pm-5:06pm
Location: E271a
This study examines the marginal impact of readmissions and total bed days during the 90-day period following transplant in order to better understand drivers of the total cost of care during the year following kidney, liver, and heart transplantation.
Methods: Data was drawn from a large, multi-state private health insurance database. Using multivariate generalized linear models controlling for recipient, donor and transplant characteristics, we separately estimated the effect size of readmissions and total inpatient bed days during the 90 days post-transplant on the total one-year cost of care for patients transplanted between January 2010 and September 2015.
Results: A total of 1,590 kidney recipients, 985 liver recipients, and 314 heart recipients were included in the study. Mean bed days ranged from 6.3 days for kidney recipients to 16.6 days for heart recipients, while readmission rates ranged from 20.3% for kidney recipients to 29.6% for liver recipients. The impact of total bed days during the 90 days following transplant was significantly (p<.001) associated with increased one year total cost of care among all three transplant types. However, the impact of readmissions in the 90 days following transplant was not statistically significant (p > 0.05) for any of the transplant types.
| Organ | Metric | Mean bed days/Readmit rate | Estimate | Standard error | Pr > |t| |
| Kidney | Bed days | 6.3 | $4,099 | 290 | <.0001 |
| Readmission | 20.3% | $7,696 | 4,038 | 0.0568 | |
| Liver | Bed Days | 15.3 | $5,021 | 438 | <.0001 |
| Readmission | 29.6% | -$7,830 | 10,208 | 0.4433 | |
| Heart | Bed Days | 16.6 | $5,542 | 942 | <.0001 |
| Readmission | 23.9% | -$31,686 | 20,119 | 0.1166 |
Conclusions: Readmissions themselves do not seem to play a significant role in determining the total one year cost of care for transplantation, while the total bed days has been shown to have a significant impact. This suggests that efforts to reduce post-transplant readmissions in order to control costs may be misguided, and that a focus on total bed days including both the transplant admission as well as subsequent readmissions may provide better insights.
CITATION INFORMATION: Bannister W, Schnitzler M, Tao J, Bonagura A, Laihinen B, Irwin F, Horstman C. Comparing the Role of Post-Transplant Readmissions and Bed Days on Total One Year Cost of Care. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Bannister W, Schnitzler M, Tao J, Bonagura A, Laihinen B, Irwin F, Horstman C. Comparing the Role of Post-Transplant Readmissions and Bed Days on Total One Year Cost of Care. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/comparing-the-role-of-post-transplant-readmissions-and-bed-days-on-total-one-year-cost-of-care/. Accessed November 25, 2024.« Back to 2017 American Transplant Congress