A Five-Tier System for Improving the Categorization of Transplant Program Performance

Objective: To better inform health care consumers by better identifying differences in transplant program performance. Data Source: Adult kidney transplants performed in the United States, January 1, 2012–June 30, 2014. Study Design: In December 2016, the Scientific Registry of Transplant Recipients instituted a five-tier system for reporting transplant program performance. We compare the differentiation of program performance and the simulated misclassification rate of the five-tier system with the previous three-tier system based on the 95 percent credible interval. Data Collection: Scientific Registry of Transplant Recipients database. Principal Findings: The five-tier system improved differentiation and maintained a low misclassification rate of less than 22 percent for programs differing by two tiers. Conclusion: The five-tier system will better inform health care consumers of transplant program performance.