| n an era of decreasing financial resources and increasing shortage of donor organs, maximizing cost-effective outcomes is imperative. This investigation was undertaken to determine the cost effectiveness of liver transplantation. Clinical and financial data were obtained from the charts of 102 adult patients who underwent liver transplantation since January, 1990, at The University of Tennessee William F. Bowld Hospital. Financial charges were adjusted by departmental cost-to-charge ratios and consumer price indices to obtain 1995 dollar equivalents for comparison. Costs for patients who had not survived to an evaluation point were equally distributed among survivors within strata to result in a summary measurement of cost per survival. Analysis of variance (ANOVA) was utilized to determine differences in cost per survival among classes of patients according to the UNOS (graded 1, 2, or 3 representing highest, moderate, and lowest acuity) and Child-Pugh (graded C or B representing highest and moderate acuity) pre-operative severity of illness classification systems.;By demonstrating differences in cost and mortality among differing pre-operative acuities, this study supports the proposition for changing organ allocation priority from those of highest acuity to a lower acuity. Additionally, this study validates the ability of the UNOS score to predict cost per survival.;Significant differences were noted in total cost of transplantation per survival between UNOS classes 1 and 2 and between classes 2 and 3 (p... |
