The impact of waiting time on liver transplant outcomes.
OBJECTIVE
To measure the impact of patient waiting time on the probability of graft failure following liver transplantation.


METHODS
Observations on all patients receiving transplants between 1995 and 1997 collected by the United Network for Organ Sharing.


METHODS
This study uses a two-stage probit algorithm. The first stage is an ordinary least squares regression of controls and indicators of patient blood type (the instrument set) on waiting time. The second uses the predicted value from the first regression in a probit analysis where the dependent variable is graft failure.


RESULTS
Waiting time has a statistically and clinically significant effect on the probability of graft failure following transplantation. Waiting 50 additional days for a transplant increases the probability of graft failure at one year by between one and two percentage points.


CONCLUSIONS
Policies to reduce waiting times will yield clinical benefits beyond decreasing the length of time patients spend in poor health.
Howard
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Department of Health Policy and Management, Emory University, Atlanta, GA 30322, USA.
D000465:Algorithms; D001789:Blood Group Antigens; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology / Q000209:etiology*; D006085:Graft Survival; D015276:Health Care Rationing / Q000458:organization & administration; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D016018:Least-Squares Analysis; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists
D001789:Blood Group Antigens