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Impact of Case Scheduling on Hospital Cost and Length of Stay in Living Donor Kidney Recipients

J. Yu1, L. A. Dageforde2, M. B. Doyle1, A. S. Khan1, W. C. Chapman1, Y. Lin1, S. Shenoy1, T. Alhamad3, T. A. Horwedel4, J. R. Wellen1

1Surgery, Washington University School of Medicine, St. Louis, MO, 2Surgery, Massachusetts General Hospital, Boston, MA, 3Medicine, Washington University School of Medicine, St. Louis, MO, 4Barnes-Jewish Hospital, St. Louis, MO

Meeting: 2019 American Transplant Congress

Abstract number: D30

Keywords: Economics, Kidney transplantation, Length of stay, Resource utilization

Session Information

Session Name: Poster Session D: Quality Assurance Process Improvement & Regulatory Issues

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

 Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: In an effort to optimize patient care and cost efficiency, we investigated if living donor kidney transplant (LDKT) recipients incurred any difference in hospital cost or length of stay (LOS) depending upon case scheduling.

*Methods: Using a prospectively collected institutional database, we identified all adult patients who underwent LDKT from January 2014 to July 2017. Patient demographics, operative characteristics, and hospital cost data were extracted from the electronic medical record. Descriptive statistics were used in data analysis.

*Results: Of the 202 patients who underwent LDKT, the majority (184/202, 91.1%) were scheduled for Tuesdays (108, 58.7%) and Thursdays (76, 41.3%), and data analysis was limited to these two days. Operative cost averaged $847 per case, and total hospital cost averaged $95,981 per patient. No significant differences were found between Tuesday and Thursday cases regarding patient age, sex, BMI, comorbidities, operative time, or intra-operative cost (p>0.05). Patients scheduled on Tuesdays had a significantly shorter LOS than those on Thursdays (4.2±3.2 vs. 4.4±1.5 days, p=0.01) as well as a lower overall hospital cost ($96,300 vs. $98,085, p=0.5) that did not reach statistical significance.

*Conclusions: At our institution, LDKT are most commonly scheduled on Tuesday or Thursday mornings. Current case scheduling for LDKT demonstrates a significant difference in LOS for patients undergoing their procedures on Tuesday vs. Thursday, though no statistically significant differences were found in operative or overall hospital costs. In an era of exploring opportunities to maximize profitability, modification of weekday case scheduling may help streamline postoperative patient care and decrease LOS.

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To cite this abstract in AMA style:

Yu J, Dageforde LA, Doyle MB, Khan AS, Chapman WC, Lin Y, Shenoy S, Alhamad T, Horwedel TA, Wellen JR. Impact of Case Scheduling on Hospital Cost and Length of Stay in Living Donor Kidney Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-case-scheduling-on-hospital-cost-and-length-of-stay-in-living-donor-kidney-recipients/. Accessed May 8, 2025.

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