title: Pediatric liver transplantation in Georgia: a paradigm for the health care crisis in the United States?
abstract: The United States health care system, felt by many to be the most technologically advanced program in the world, has many critics. Two indisputable facts that drive such criticism are 1) inequitable access and 2) rising costs out of proportion to other countries. Although Georgia is a poor state and ranks nationally near the bottom in most measures of child and adolescent care, we decided to start a pediatric liver transplant program at Egleston Children's Hospital at Emory, Atlanta. Over the past 2 1/2 years, 18 transplants have been performed in 14 patients; 10 children are presently surviving. Looking carefully at the expenses of the first 10 patients, the average cost of orthotopic liver transplantation for the eight survivors was $206,375. The hospital costs for providing care to these 10 children were over $2 million. In a state that ranks 49th out of 50 states in infant mortality and with nearly one-third of its pre-school children not immunized against preventable diseases, is this a fair and equitable distribution of our resources?
authors.affiliation: Egleston Children's Hospital at Emory, Atlanta, Georgia.
authors.forename: T F
authors.initials: TF
authors.lastname: Dodson
authors.forename: J E
authors.initials: JE
authors.lastname: Ingraham
authors.forename: W J
authors.initials: WJ
authors.lastname: Millikan
authors.forename: J M
authors.initials: JM
authors.lastname: Henderson
authors.forename: R R
authors.initials: RR
authors.lastname: Ricketts
authors.forename: J R
authors.initials: JR
authors.lastname: Galloway
authors.forename: R A
authors.initials: RA
authors.lastname: Olson
authors.forename: D B
authors.initials: DB
authors.lastname: Caplan
authors.forename: B T
authors.initials: BT
authors.lastname: Schoen
authors.forename: C A
authors.initials: CA
authors.lastname: Perlino
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics / Q000592:standards; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005845:Georgia; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007349:Insurance, Health, Reimbursement; D016031:Liver Transplantation / Q000191:economics*; D008484:Medicaid; D014481:United States