Evaluation and selection of candidates for liver transplantation : an economic perspective
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/210714 |
Resumo: | Background – Over the next 20 years, the number of patients on the waiting list for liver transplantation (LTx) is expected to increase by 23%, while pre-LTx costs should raise by 83%. Objective – To evaluate direct medical costs of the pre-LTx period from the perspective of a tertiary care center. Methods – The study included 104 adult patients wait-listed for deceased donor LTx between October 2012 and May 2016 whose treatment was fully provided at the study transplant center. Clinical and economic data were obtained from electronic medical records and from a hospital management software. Outcomes of interest and costs of patients on the waiting list were compared through the Kruskal-Wallis test. A generalized linear model with logit link function was used for multivariate analysis. P-values <0.05 were considered statistically significant. Results – The costs of patients who underwent LTx ($8,879.83; 95% CI 6,735.24–11,707.27; P<0.001) or who died while waiting ($6,464.73; 95% CI 3,845.75–10,867.28; P=0.04) were higher than those of patients who were excluded from the list for any reason except death ($4,647.78; 95% CI 2,469.35–8,748.04; P=0.254) or those who remained on the waiting list at the end of follow-up. Conclusion – Although protocols of inclusion on the waiting list vary among transplant centers, similar approaches exist and common problems should be addressed. The results of this study may help centers with similar socioeconomic realities adjust their transplant policies. |
id |
UFRGS-2_a3a6bbd0c380f0de873d9d68da6e6561 |
---|---|
oai_identifier_str |
oai:www.lume.ufrgs.br:10183/210714 |
network_acronym_str |
UFRGS-2 |
network_name_str |
Repositório Institucional da UFRGS |
repository_id_str |
|
spelling |
Balbinotto Neto, GiacomoRodríguez, SantiagoMotta, Fabio daBrandao, Ajacio Bandeira de Mello2020-06-27T03:39:47Z20200004-2803http://hdl.handle.net/10183/210714001114395Background – Over the next 20 years, the number of patients on the waiting list for liver transplantation (LTx) is expected to increase by 23%, while pre-LTx costs should raise by 83%. Objective – To evaluate direct medical costs of the pre-LTx period from the perspective of a tertiary care center. Methods – The study included 104 adult patients wait-listed for deceased donor LTx between October 2012 and May 2016 whose treatment was fully provided at the study transplant center. Clinical and economic data were obtained from electronic medical records and from a hospital management software. Outcomes of interest and costs of patients on the waiting list were compared through the Kruskal-Wallis test. A generalized linear model with logit link function was used for multivariate analysis. P-values <0.05 were considered statistically significant. Results – The costs of patients who underwent LTx ($8,879.83; 95% CI 6,735.24–11,707.27; P<0.001) or who died while waiting ($6,464.73; 95% CI 3,845.75–10,867.28; P=0.04) were higher than those of patients who were excluded from the list for any reason except death ($4,647.78; 95% CI 2,469.35–8,748.04; P=0.254) or those who remained on the waiting list at the end of follow-up. Conclusion – Although protocols of inclusion on the waiting list vary among transplant centers, similar approaches exist and common problems should be addressed. The results of this study may help centers with similar socioeconomic realities adjust their transplant policies.application/pdfengArquivos de gastroenterologia. São Paulo. Vol. 57, n. 1 (jan./mar. 2020), p. 31-38Economia da saúdeEvaluation and selection of candidates for liver transplantation : an economic perspectiveinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/otherinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001114395.pdf.txt001114395.pdf.txtExtracted Texttext/plain40685http://www.lume.ufrgs.br/bitstream/10183/210714/2/001114395.pdf.txt694a312f4a7207d57b4ad0b9e280f144MD52ORIGINAL001114395.pdfTexto completo (inglês)application/pdf354783http://www.lume.ufrgs.br/bitstream/10183/210714/1/001114395.pdf6b91437febd20ba82b4c9782f214a56cMD5110183/2107142021-09-19 04:30:43.584754oai:www.lume.ufrgs.br:10183/210714Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2021-09-19T07:30:43Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
title |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
spellingShingle |
Evaluation and selection of candidates for liver transplantation : an economic perspective Balbinotto Neto, Giacomo Economia da saúde |
title_short |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
title_full |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
title_fullStr |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
title_full_unstemmed |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
title_sort |
Evaluation and selection of candidates for liver transplantation : an economic perspective |
author |
Balbinotto Neto, Giacomo |
author_facet |
Balbinotto Neto, Giacomo Rodríguez, Santiago Motta, Fabio da Brandao, Ajacio Bandeira de Mello |
author_role |
author |
author2 |
Rodríguez, Santiago Motta, Fabio da Brandao, Ajacio Bandeira de Mello |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Balbinotto Neto, Giacomo Rodríguez, Santiago Motta, Fabio da Brandao, Ajacio Bandeira de Mello |
dc.subject.por.fl_str_mv |
Economia da saúde |
topic |
Economia da saúde |
description |
Background – Over the next 20 years, the number of patients on the waiting list for liver transplantation (LTx) is expected to increase by 23%, while pre-LTx costs should raise by 83%. Objective – To evaluate direct medical costs of the pre-LTx period from the perspective of a tertiary care center. Methods – The study included 104 adult patients wait-listed for deceased donor LTx between October 2012 and May 2016 whose treatment was fully provided at the study transplant center. Clinical and economic data were obtained from electronic medical records and from a hospital management software. Outcomes of interest and costs of patients on the waiting list were compared through the Kruskal-Wallis test. A generalized linear model with logit link function was used for multivariate analysis. P-values <0.05 were considered statistically significant. Results – The costs of patients who underwent LTx ($8,879.83; 95% CI 6,735.24–11,707.27; P<0.001) or who died while waiting ($6,464.73; 95% CI 3,845.75–10,867.28; P=0.04) were higher than those of patients who were excluded from the list for any reason except death ($4,647.78; 95% CI 2,469.35–8,748.04; P=0.254) or those who remained on the waiting list at the end of follow-up. Conclusion – Although protocols of inclusion on the waiting list vary among transplant centers, similar approaches exist and common problems should be addressed. The results of this study may help centers with similar socioeconomic realities adjust their transplant policies. |
publishDate |
2020 |
dc.date.accessioned.fl_str_mv |
2020-06-27T03:39:47Z |
dc.date.issued.fl_str_mv |
2020 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/other |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/210714 |
dc.identifier.issn.pt_BR.fl_str_mv |
0004-2803 |
dc.identifier.nrb.pt_BR.fl_str_mv |
001114395 |
identifier_str_mv |
0004-2803 001114395 |
url |
http://hdl.handle.net/10183/210714 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
Arquivos de gastroenterologia. São Paulo. Vol. 57, n. 1 (jan./mar. 2020), p. 31-38 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFRGS instname:Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS |
instname_str |
Universidade Federal do Rio Grande do Sul (UFRGS) |
instacron_str |
UFRGS |
institution |
UFRGS |
reponame_str |
Repositório Institucional da UFRGS |
collection |
Repositório Institucional da UFRGS |
bitstream.url.fl_str_mv |
http://www.lume.ufrgs.br/bitstream/10183/210714/2/001114395.pdf.txt http://www.lume.ufrgs.br/bitstream/10183/210714/1/001114395.pdf |
bitstream.checksum.fl_str_mv |
694a312f4a7207d57b4ad0b9e280f144 6b91437febd20ba82b4c9782f214a56c |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS) |
repository.mail.fl_str_mv |
|
_version_ |
1801224993243136000 |