Cardiothoracic Surgery |

Lung Allocation Score Increases Health Care Resource Utilization After Lung Transplantation FREE TO VIEW

Peter Lee, MD; Bryan Maxwell, MD; Joseph Levitt, MD; Vincent Valentine, MD; Ahmad Sheikh, MD; David Weill, MD; Gundeep Dhillon, MD
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Stanford University, Stanford, CA

Chest. 2013;144(4_MeetingAbstracts):110A. doi:10.1378/chest.1704705
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SESSION TITLE: Cardiac and Thoracic Surgery Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: A shift toward older and sicker patients undergoing lung transplantation has occurred since the implementation of the lung allocation score (LAS) in 2005. The effect of this change on health care resources utilization is unknown.

METHODS: Between 2000 - 2009, 2241 admissions for the initial lung transplantation procedure were identified from the Nationwide Inpatient Sample. The trends in average hospital charges (adjusted for inflation in inpatient hospital services component of Consumer Price Index), length of stay (LOS) and percentage of patients discharged to other facilities before and after instituting LAS were compared.

RESULTS: The average hospital charges increased from $ 225,000 in 2000 to $ 484, 000 in 2009 (p < 0.01). Over the same period, LOS increased from 22 days to 26 days; and the percentage of patients discharged to other facilities increased from 6% to 26%. The most striking changes were observed between 2005 and 2007.

CONCLUSIONS: Over the last decade, hospital charges associated with lung transplantation have more than doubled with a concomitant increase in health care resource utilization. The most marked increase in both resource utilization and expenditure is observed following the implementation of the LAS in 2005.

CLINICAL IMPLICATIONS: Although one-year survival remains unaltered in a sicker population undergoing lung transplantation since the implementation of LAS, there has been a significant increase in resource utilization suggesting an increase in morbidity after lung transplantation.

DISCLOSURE: The following authors have nothing to disclose: Peter Lee, Bryan Maxwell, Joseph Levitt, Vincent Valentine, Ahmad Sheikh, David Weill, Gundeep Dhillon

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