The Cost Savings of Preemptive Kidney Transplantation
1Division of Transplantation Surgery, Mayo Clinic, Rochester, MN
2Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MD.
Meeting: 2018 American Transplant Congress
Abstract number: 577
Keywords: Economics, Kidney transplantation
Session Information
Date: Tuesday, June 5, 2018
Session Name: Concurrent Session: Non-Organ Specific: Economics, Public Policy, Allocation, Ethics - 3
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Room 4C-4
Introduction: Preemptive kidney transplantation (PreKTx) is associated with improved patient survival and quality of life. The goal of this study was to compare the costs of PreKTx and non-PreKTx.
Materials & Methods: We identified recipients of first kidney transplants from 2008-2015 utilizing the OptumLabs Data Warehouse, a database including administrative claims data on privately insured and Medicare Advantage enrollees in the United States. All patients had insurance coverage for 2 years prior to transplant. Health care costs were consumer price index adjusted to 2016.
Results: Of 1544 KTx recipients, 725 (47%) received PreKTx [565 living donor (LD) + 160 deceased donor (DD)] and 819 (54%) received non-PreKTx (464 LD + 355 DD). Recipients of Pre-KTx were more likely to be white and have commercial insurance. PreKTx was associated fewer pre-tx ED visits and hospitalizations, lower pre-transplant hospital and medical costs, and shorter transplant length of stay (Table).
| Preemptive (n=725) | Non-Preemptive (n=819) | ||
| Number (% or Std. Dev.) | Number (% or Std. Dev.) | P Value | |
| Commercial Insurance | 688 (94.9%) | 625 (75.9%) | <0.0001 |
| Medicare Advantage (MA) | 37 (5.1%) | 197 (24.1%) | <0.0001 |
| Pre-Tx ED Visit | 80 (11.0%) | 277 (33.8%) | <0.0001 |
| Pre-Tx Hospital Days | 1.1 (6.2) | 3.9 (7.2%) | <0.0001 |
| Pre-Tx Medical Costs (Commercial) | $25,508 (24,247) | $153,972 (149,645) | <0.0001 |
| Pre-Tx Hospital Costs(Commercial) | $4,822 (23,048) | $23,171 (50,787) | <0.0001 |
| Tx Hospital Stay Costs (Commercial) | $116,964 (49,177) | $119,146 (57,310) | 0.5033 |
| Pre-Tx Medical Costs (MA) | $14,393 (8,870) | $65,863 (27,193) | <0.0001 |
| Pre-Tx Hospital Costs (MA) | $4,988 (11,927) | $11,897 (22,566) | 0.0495 |
| Tx Hospital Stay Costs (MA) | $104,121 (37,572) | $112334 (38,118) | 0.0522 |
| Transplant Length of Stay (days) | 5.5 (4.2) | 6.7 (6.0) | <0.0001 |
Conclusions: PreKTx results in lower utilization of healthcare resources and lower costs (~$146,000 per patient with commercial insurance). These data suggest that "Transplant First" should be a priority rather than current guidelines for "Fistula First".
CITATION INFORMATION: Dean P., Heien H., Swanson K., Borah B., Sangaralingham L., Naessens J., Stegall M. The Cost Savings of Preemptive Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Dean P, Heien H, Swanson K, Borah B, Sangaralingham L, Naessens J, Stegall M. The Cost Savings of Preemptive Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/the-cost-savings-of-preemptive-kidney-transplantation/. Accessed March 8, 2021.« Back to 2018 American Transplant Congress