Payer status, but not race, affects the cost of liver transplantation

M. W. Russo, R. S. Sandler, L. Mandelkehr, Jeffrey Fair, M. W. Johnson, Jr Brown R.S.

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Prior studies evaluating the impact of race and payer on cost of liver transplantation did not adjust for clinical factors known to increase cost. We analyzed the impact of race and payer on the cost of liver transplantation after controlling for clinical factors. We analyzed data obtained on patient and graft survival, cost, race, age, sex, payer, and United Network for Organ Sharing (UNOS) status from 153 consecutive liver transplants in 130 patients performed at University of North Carolina Hospitals from September 1991 through December 1996. Race was classified as white or nonwhite, and payer status was classified as commercial or Medicare/Medicaid. Multivariate linear regression was used to compare costs, adjusting for age, sex, race, payer, and UNOS status. For the 130 patients, 1-year patient and graft survival rates were 88% and 82%, respectively. There were no significant differences in patient and graft survival or in the unadjusted average cost of liver transplantation by race or payer. After adjusting for demographic and clinical factors, the cost of transplantation was $28,494 more for Medicare/Medicaid recipients compared with the commercial insurance recipients (P = .02). The Medicare/Medicaid group had higher intensive care unit costs compared with the commercial insurance group ($17,807 and $9,359, respectively; P = .03), and a longer length of stay (41 and 31 days, respectively; P = .04). There was no significant difference in cost between whites and nonwhites adjusting for these factors. Medicare or Medicaid patients had a higher cost of transplantation compared with those with commercial insurance. The cost of liver transplantation was similar for whites and nonwhites.

Original languageEnglish (US)
Pages (from-to)370-377
Number of pages8
JournalLiver Transplantation and Surgery
Volume4
Issue number5
StatePublished - 1998
Externally publishedYes

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Liver Transplantation
Costs and Cost Analysis
Medicaid
Medicare
Graft Survival
Insurance
Transplantation
Intensive Care Units
Linear Models
Length of Stay
Survival Rate
Demography
Transplants
Liver

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Russo, M. W., Sandler, R. S., Mandelkehr, L., Fair, J., Johnson, M. W., & Brown R.S., J. (1998). Payer status, but not race, affects the cost of liver transplantation. Liver Transplantation and Surgery, 4(5), 370-377.

Payer status, but not race, affects the cost of liver transplantation. / Russo, M. W.; Sandler, R. S.; Mandelkehr, L.; Fair, Jeffrey; Johnson, M. W.; Brown R.S., Jr.

In: Liver Transplantation and Surgery, Vol. 4, No. 5, 1998, p. 370-377.

Research output: Contribution to journalArticle

Russo, MW, Sandler, RS, Mandelkehr, L, Fair, J, Johnson, MW & Brown R.S., J 1998, 'Payer status, but not race, affects the cost of liver transplantation', Liver Transplantation and Surgery, vol. 4, no. 5, pp. 370-377.
Russo MW, Sandler RS, Mandelkehr L, Fair J, Johnson MW, Brown R.S. J. Payer status, but not race, affects the cost of liver transplantation. Liver Transplantation and Surgery. 1998;4(5):370-377.
Russo, M. W. ; Sandler, R. S. ; Mandelkehr, L. ; Fair, Jeffrey ; Johnson, M. W. ; Brown R.S., Jr. / Payer status, but not race, affects the cost of liver transplantation. In: Liver Transplantation and Surgery. 1998 ; Vol. 4, No. 5. pp. 370-377.
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