Readmission following liver transplantation: an unwanted occurrence but an opportunity to act

Patel, Madhukar S.; Mohebali, Jahan; Shah, Jigesh A.; Markmann, James F.; Vagefi, Parsia A.

doi:10.1016/j.hpb.2016.08.003

Cited by 22 publications

(23 citation statements)

References 15 publications

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“…In addition, patient quality of life can be greatly impacted by quality measures such as readmissions and hospital length of stay. Multiple single‐center studies have found post‐liver transplant 30‐day readmission rates as high as 45% . These unplanned hospital readmissions are associated with increased short‐ and long‐term mortality .…”

Section: Key Pointsmentioning

confidence: 99%

“…Multiple single‐center studies have found post‐liver transplant 30‐day readmission rates as high as 45% . These unplanned hospital readmissions are associated with increased short‐ and long‐term mortality . Liver transplantation places a large financial burden on payers and patients, with an average transplant length of stay of 14 days and mean cost of the transplant hospitalization of $114,000 .…”

Section: Key Pointsmentioning

confidence: 99%

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Con: Patient and graft survival outcome at 1 and 3 years posttransplant do not reflect the value of successful liver transplantation‡

George

Lominadze

Kallwitz

2018

Clinical Liver Disease

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Section: Key Pointsmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Con: Patient and graft survival outcome at 1 and 3 years posttransplant do not reflect the value of successful liver transplantation‡

George

Lominadze

Kallwitz

2018

Clinical Liver Disease

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“…(2) Readmissions account for a substantial portion of those costs with a reported 90-day readmission rate of 46%. (3) In an analysis of 11,937 LT recipients, 90-day readmissions accounted for $43,785 of added costs compared with patients who were not readmitted. (4) Factors associated with increased costs or resource utilization include pretransplant hospitalization and functional status.…”

Section: See Editorial On Page 1502mentioning

confidence: 99%

“…The estimated cost of the LT index admission and the first year’s expenses is $735,000 . Readmissions account for a substantial portion of those costs with a reported 90‐day readmission rate of 46% . In an analysis of 11,937 LT recipients, 90‐day readmissions accounted for $43,785 of added costs compared with patients who were not readmitted .…”

mentioning

confidence: 99%

Strategies That Reduce 90‐Day Readmissions and Inpatient Costs After Liver Transplantation

Zeidan

Levi²,

Pierce³

et al. 2018

Liver Transpl

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Liver transplantation (LT) is hospital-resource intensive and associated with high rates of readmission. We have previously shown a reduction in 30-day readmission rates by implementing a specifically designed protocol to increase access to outpatient care. The aim of this work is to determine if the strategies that reduce 30-day readmission after LT were effective in also reducing 90-day readmission rates and costs. A protocol was developed to reduce inpatient readmissions after LT that expanded outpatient services and provided alternatives to readmission. The 90-day readmission rates and costs were compared before and after implementing strategies outlined in the protocol. Multivariable analysis was used to control for potential confounding factors. Over the study period, 304 adult primary LTs were performed on patients with a median biological Model for End-Stage Liver Disease of 22. There were 112 (37%) patients who were readmitted within 90 days of transplant. The readmission rates before and after implementation of the protocol were 53% and 26%, respectively (P < 0.001). The most common reason for readmission was elevated liver tests/rejection (24%). In multivariable analysis, the protocol remained associated with avoiding readmission (odds ratio, 0.33; 95% confidence interval, 0.20-0.55; P < 0.001). The median length of stay after transplant before and after protocol implementation was 8 days and 7 days, respectively. A greater proportion of patients were discharged to hospital lodging after protocol implementation (10% versus 19%; P = 0.03). The 90-day readmission costs were reduced by 55%, but the total 90-day costs were reduced by only 2.7% because of higher outpatient costs and index admission costs. In conclusion, 90-day readmission rates and readmission costs can be reduced by improving access to outpatient services and hospital-local lodging. Total 90-day costs were similar between the 2 groups because of higher outpatient costs after the protocol was introduced.

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“…Furthermore, families are managing follow‐up care for laboratory and clinic appointments on average of three times per week. The complexity of transplant patients during ongoing recovery at home places them at risk for readmission in the first 30 days after hospital discharge (McAdams‐Demarco, Grams, Hall, Coresh, & Segev, 2012; Patel, Mohebali, Shah, Markmann, & Vagefi, 2016).…”

Section: Introductionmentioning

confidence: 99%

Pilot study protocol of a mHealth self‐management intervention for family members of pediatric transplant recipients

Lerret

White‐Traut

Medoff‐Cooper

et al. 2020

Research in Nursing & Health

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Solid‐organ transplantation is the treatment of choice for end‐stage organ failure. Parents of pediatric transplant recipients who reported a lack of readiness for discharge had more difficulty coping and managing their child's medically complex care at home. In this paper, we describe the protocol for the pilot study of a mHealth intervention (myFAMI). The myFAMI intervention is based on the Individual and Family Self‐Management Theory and focuses on family self‐management of pediatric transplant recipients at home. The purpose of the pilot study is to test the feasibility of the myFAMI intervention with family members of pediatric transplant recipients and to test the preliminary efficacy on postdischarge coping through a randomized controlled trial. The sample will include 40 family units, 20 in each arm of the study, from three pediatric transplant centers in the United States. Results from this study may advance nursing science by providing insight for the use of mHealth to facilitate patient/family–nurse communication and family self‐management behaviors for family members of pediatric transplant recipients.

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Readmission following liver transplantation: an unwanted occurrence but an opportunity to act

Abstract: Background: Liver transplant (LT) patients are at high risk for readmission. This study sought to identify

Cited by 22 publications

References 15 publications

Con: Patient and graft survival outcome at 1 and 3 years posttransplant do not reflect the value of successful liver transplantation‡

Con: Patient and graft survival outcome at 1 and 3 years posttransplant do not reflect the value of successful liver transplantation‡

Strategies That Reduce 90‐Day Readmissions and Inpatient Costs After Liver Transplantation

Pilot study protocol of a mHealth self‐management intervention for family members of pediatric transplant recipients

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