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A cost analysis of early biliary strictures following orthotopic liver transplantation in the United States
Author(s) -
Bhutiani Neal,
Jones Jordan M.,
Wei David,
Goldstein Laura J.,
Martin Robert C. G.,
Jones Christopher M.,
Can Robert M.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13396
Subject(s) - medicine , liver transplantation , perioperative , odds ratio , transplantation , orthotopic liver transplantation , surgery , emergency medicine
Abstract Introduction To date, the financial burden of biliary strictures ( BS ) after orthotopic liver transplantation ( OLT ) has remained largely unassessed. This study sought to approximate perioperative costs associated with early BS and delineate where in the hospital these costs are incurred. Methods The Premier Healthcare Database was queried for patients undergoing OLT between 2010 and 2016. Patients who did and did not develop early BS were compared with respect to perioperative costs and outcome variables. Multivariable regression models were used to estimate differences between groups. Results Patients who developed early BS had a longer length of stay ( LOS ) (35.3 days vs 17.8 days, P < 0.001) and were less likely to be discharged home (odds ratio = 0.45, P = 0.003). Development of early BS was associated with an incremental cost increase of $81 881 (45.8%, P < 0.001). The greatest relative cost increases were in radiology (+163.5%) and respiratory therapy (+157.1%), while the greatest absolute increase was in room and board (+$27 589). Conclusions Early BS after OLT result in higher costs stemming from longer LOS and increased need for various diagnostic studies and therapies. In addition to incentivizing measures that may prevent early BS , hospitals should account for these factors when developing payment schemes for OLT with payors.