title: Predictors of cost of liver transplantation in children: a single center study.
abstract: OBJECTIVE
  Efforts to decrease the cost of orthotopic liver transplantation (OLT) must address the impact of specific interventions on clinical outcome. We hypothesized that an intervention designed to decrease the length of hospitalization would reduce costs without jeopardizing clinical outcome. We further sought to identify predictors of length of stay and cost for hospitalization after liver transplantation.
  
  
  METHODS
  The study group included 47 children who underwent OLT from September 1996 to April 1999, and the control group included 36 children who underwent OLT from March 1994 to August 1996. The intervention was a transition to home program in which patients were discharged to a family living center when they met established clinical criteria and their families met predefined educational goals. We analyzed patients who survived 3 months after OLT.
  
  
  RESULTS
  For the intervention group, the mean length of stay, total costs, and surgical costs were 29%, 36%, and 34% lower, respectively. Organ type, height z score, race, hepatic artery thrombosis, early allograft rejection, and participation in the transition to home program predicted length of stay and total costs.
  
  
  CONCLUSIONS
  An early discharge program based on defined criteria can be used to decrease length of stay and cost after OLT without jeopardizing clinical outcome.
authors.affiliation: Division of Gastroenterology and Nutrition, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
authors.forename: J C
authors.initials: JC
authors.lastname: Bucuvalas
authors.forename: F C
authors.initials: FC
authors.lastname: Ryckman
authors.forename: H
authors.initials: H
authors.lastname: Atherton
authors.forename: M P
authors.initials: MP
authors.lastname: Alonso
authors.forename: W F
authors.initials: WF
authors.lastname: Balistreri
authors.forename: U
authors.initials: U
authors.lastname: Kotagal
mesh_terms: D002675:Child, Preschool; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000191:economics*; D008297:Male; D015999:Multivariate Analysis; D009820:Ohio; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D012107:Research Design