Liver transplantation is a resource-intensive medical procedure, and is under particular scrutiny in the current era of cost containment.
There have been significant changes in treatment protocols over the past decade. However, information is limited on how these changes have affected the economics of liver transplantation.
To tackle this problem, researchers examined the trends in expenditure for Medicare liver transplant recipients, from 1993 to 1999.
The findings of the study were reported in the October issue of Liver Transplantation.
Total first- and second-year expenditures, as well as expenditures 90 days pretransplantation were estimated.
|Average first-year expenditures:|
| Liver Transplantation |
The expenditures included inpatient, outpatient, physician, home health, and hospice care; immunosuppression expenditures were not estimated.
Average first-year expenditures for liver transplantation, excluding immunosuppressives, decreased from $201,677 in 1993 to $143,363 in 1998.
Inpatient costs accounted for the majority of total expenditures, decreasing from $179,306 in 1993 to $120,445 in 1998.
The team found that total days of hospitalization decreased from 57 days in 1993 to 42 days in 1998.
The majority of hospitalization occurred during the first 90 days post-transplantation, but decreased from 44 days in 1993 to 29 days in 1999.
Investigator Jennie H. Best, of Roche Global Health Economic Research, Palo Alto, California, concluded on behalf of her group, "Substantial cost reductions over this period were a result of reduced hospitalization and occurred while survival rates gradually improved."