Resource Utilization for Initial Hospitalization in Pediatric Heart Transplantation in the United States

Boucek, Dana; Lal, Ashwin K.; Eckhauser, Aaron; Weng, Hsin‐Yi; Sheng, Xiaoming; Wilkes, Jacob; Pinto, Nelangi M.; Menon, Shaji C.

doi:10.1016/j.amjcard.2018.01.007

Cited by 3 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are comparable to the current analysis, accounting for inflation. A more recent study, which also utilized the PHIS database, highlighted the potential for variation in resource utilization across pediatric heart transplant centers dependent on center volume [23]. Our analysis provides contemporary high-quality cost data from the largest cohort of pediatric heart transplant recipients to date.…”

Section: Discussionmentioning

confidence: 99%

Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes

et al. 2018

View full text Add to dashboard Cite

There are limited published data addressing the costs associated with pediatric heart transplantation and no studies evaluating the variation in costs across centers. We aimed to describe center variation in pediatric heart transplant costs and assess the association of transplant hospitalization costs with patient outcomes. Using a linkage between the Pediatric Health Information System and Scientific Registry of Transplant Recipients databases, hospital costs were assessed for patients (<18 years) undergoing heart transplantation (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). Severity-adjusted patient costs were calculated using generalized linear mixed-effects models with a random hospital intercept. Center variation in hospital cost was described after adjusting for the predicted risk of in-hospital mortality. Post-transplant survival was compared between low and high-cost centers using Cox proportional hazard models. A total of 2156 patients were included from 24 centers. There was 3.7-fold variation in transplant hospitalization costs across centers, ranging from $329,477-$1,226,507. Patients transplanted at high-cost centers have a higher predicted risk of inhospital mortality (8.1% vs. 6.1%, p<0.001). Both early (p=0.008) and long-term (p=0.003) posttransplant survival was better in patients transplanted at low-cost centers. Transplant at low-cost

show abstract

Section: Discussionmentioning

confidence: 99%

Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes

et al. 2018

View full text Add to dashboard Cite

show abstract

“…2,3 Furthermore, the cost of HFrelated admissions and initial transplantation admission in pediatric patients has increased over time. [3][4][5] An important part of assessing resource utilization in HT is understanding the sources of reimbursement for this lifesaving care, which in the US comes from a mixture of public and private sources depending on the patient's insurance status. Trends in reimbursement for adult HT are changing, with a recent study demonstrating a shift to public sources (i.e., Medicaid, Medicare) as the primary payer for HT in adult patients.…”

Section: Introductionmentioning

confidence: 99%

“…For instance, compared with adult HF and HT patients, the care of pediatric patients with HF and HT is associated with higher costs, patient length of stay, and higher mortality 2,3 . Furthermore, the cost of HF‐related admissions and initial transplantation admission in pediatric patients has increased over time 3–5 …”

Section: Introductionmentioning

confidence: 99%

Temporal trends in primary payers in pediatric heart transplant and association with long‐term survival

Restaino

Zhang

Faerber

et al. 2023

Pediatric Transplantation

View full text Add to dashboard Cite

Background Pediatric heart transplantation (HT) is resource intensive. In adults, there has been an increase in the proportion of HTs funded by public insurance, with post‐HT outcomes inferior to those funded by private sources. Trends in the funding of pediatric HT and outcomes in children have not been described. Methods We queried the United Network for Organ Sharing (UNOS) database for children (<18 years) listed for and undergoing HT between 2004 and 2021. We identified the primary payer at listing, HT, 1 year, and 1–5 years following HT. Trends were analyzed using generalized logit models. Multivariable‐extended Cox regression models were used to test the relationship between insurance type at the time of transplant and time to death or re‐transplant. Results There were 6382 pediatric patients who underwent transplants and had either public or private insurance at the time of transplant. The percentage of patients with public insurance at the time of HT increased over time. Public insurance at the time of HT was associated with an increased risk of death or re‐transplant beyond 2 months after HT (adjusted HR at 6 months = 1.43, 95% CI: 1.13–1.81, p = .003; adjusted HR at 9 months = 1.67, 95% CI: 1.17–2.37, p = .004). Conclusion There has been a statistically significant trend toward increasing public insurance for children awaiting, at the time of, and after HT. Black patients and those with public insurance at HT have worse long‐term outcomes. This study highlights ongoing disparities in pediatric HT and the need to focus efforts on achieving equitable outcomes.

show abstract

Paediatric HT: increased cost despite reduced LOS

2018

PharmacoEcon Outcomes News

View full text Add to dashboard Cite

Resource Utilization for Initial Hospitalization in Pediatric Heart Transplantation in the United States

Cited by 3 publications

References 12 publications

Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes

Center Variation in Hospital Costs for Pediatric Heart Transplantation: The Relationship Between Cost and Outcomes

Temporal trends in primary payers in pediatric heart transplant and association with long‐term survival

Paediatric HT: increased cost despite reduced LOS

Contact Info

Product

Resources

About