| Titre : | Resource utilization in liver transplantation : Effects of patient characteristics and clinical practice. (1999) |
| Auteurs : | J. SHOWSTACK ; S. BELLE ; Rsjr BROWN ; R.A. DUDLEY ; J. EVERHART ; P.P. KATZ ; J.R. LAKE ; R.H. WIESNER ; R.K. ZETTERMAN ; Department of Medicine. University of California. San Francisco. USA ; Liver Transplant Program. University of California. San Francisco. USA ; Niddk Liver Transplantation Database Group. INC |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 281, n° 15, 1999) |
| Pagination : | 1381-1386 |
| Langues: | Anglais |
| Mots-clés : | Foie ; Etude comparée ; Age ; Foie [pathologie] ; Alcoolisme ; Structure hospitalière ; Etats Unis ; Amérique ; Homme ; Chirurgie ; Chirurgie digestive ; Appareil digestif [pathologie] ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST RR0xKyhW. Diffusion soumise à autorisation]. Context Liver transplantation is among the most costly of medical services, yet few studies have addressed the relationship between the resources utilized for this procedure and specific patient characteristics and clinical practices. Objective To assess the association of pretransplant patient characteristics and clinical practices with hospital resource utilization. Design Prospective cohort of patients who received liver transplants between January 1991 and July 1994. Setting University of California, San Francisco ; Mayo Clinic, Rochester, Minn ; and the University of Nebraska, Omaha. Patients Seven hundred eleven patients who received single-organ liver transplants, were at least 16 years old, and had nonfulminant liver disease. Main Outcome Measure Standardized resource utilization derived from a database created by matching all services to a single price list. Results Higher adjusted resource utilization was associated with donor age of 60 years or older (28% [$53 813] greater mean resource utilization ; P=005) ; recipient age of 60 years or older (17% [$32 795] ; P=01) ; alcoholic liver disease (26% [$49 596] ; P=002) ; Child-Pugh class C (41% [$67 658] ; P<. 001) ; care from the intensive care unit at time of transplant (42% [$77 833] ; P<. 001) ; death in the hospital (35% [$67 076] ; P<. 001) ; and having multiple liver transplants during the index hospitalization (154% increase [$474 740 vs $186726 for 1 transplant] ; P<. 001). (...) |
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