title: Financial implications of pancreas transplant complications: a business case for quality improvement.
abstract: We quantified the financial implications of surgical complications following pancreas transplantation. We reviewed medical and financial records of 49 pancreas transplant recipients at the University of Michigan Health System (UMHS) between 1/6/2002 and 11/22/2004. The association of donor, transplant recipient and financial variables was assessed. The median costs to UMHS of procedures and follow-up were $92,917 for recipients without surgical complications versus $108,431 when a surgical complication occurred, a difference of $15,514 (p = 0.03). Median reimbursement by the payer was $17,363 higher in patients with a surgical complication (p = 0.001). Similar trends (higher insurer costs) were noted when stratifying by payer (public and private) and specific procedure (SPK and PAK). All parties (patient, physician, payer and medical center) should benefit from quality improvement, with payers having a financial interest in pancreas transplant surgical quality initiatives.
authors.affiliation: Department of Surgery, Division of Transplantation, University of Michigan Health System, Ann Arbor, MI, USA. englesbe@med.umich.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Cohn
authors.forename: M J
authors.initials: MJ
authors.lastname: Englesbe
authors.forename: Y M
authors.initials: YM
authors.lastname: Ads
authors.forename: J L
authors.initials: JL
authors.lastname: Paruch
authors.forename: S J
authors.initials: SJ
authors.lastname: Pelletier
authors.forename: T H
authors.initials: TH
authors.lastname: Welling
authors.forename: C J
authors.initials: CJ
authors.lastname: Sonnenday
authors.forename: J C
authors.initials: JC
authors.lastname: Magee
authors.forename: J D
authors.initials: JD
authors.lastname: Punch
authors.forename: D A
authors.initials: DA
authors.lastname: Campbell
authors.forename: R S
authors.initials: RS
authors.lastname: Sung
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008824:Michigan; D016035:Pancreas Transplantation / Q000191:economics* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D014019:Tissue Donors / Q000706:statistics & numerical data