Data show higher hospitalization costs for delayed graft function
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Delayed graft function increased hospitalization costs significantly compared with patients who have a functioning graft post-transplant, according to new research.
“Delayed graft function (DGF) is associated with poor clinical outcomes after kidney transplantation (KT), including longer transplant hospitalization, increased risk of graft failure, and higher mortality,” Tracy Mayne, PhD, and colleagues wrote in an abstract for the virtual American Transplant Congress. “Uncomplicated KT is already complex, requiring management not only of graft patency but also multiple comorbid conditions.
“Most studies of the incremental health care resource use (HCRU) and cost of DGF have focused on the initial hospitalization, with little analysis of the long-term cost-consequences of DGF.”
Mayne, working with researchers from Genesis Research (Hoboken, NJ) and Columbia University Medical Center, New York, looked at the cost of care during a 1-year follow-up period for patients with commercial insurance who experienced delayed graft function (DGF) compared with patients who had immediate graft function. The retrospective analysis was conducted using administrative claims data from January 2014 to September 2018, and the dataset included patients with employer group health plans from over 60 large employers.
The researchers reviewed records of patients aged between 18 and 65 who had at least one inpatient KT procedure; patients who had pre-emptive transplants were excluded.
Mayne and colleagues set definitions for the review: non-DGF were kidney transplant patients who did not require dialysis on days 1 to 7 post-transplantation and DGF were kidney transplant patients who required dialysis on days 1 to 7 post-transplantation.
Medical costs for inpatient admissions during the first month and 1-year follow-up were reviewed for both groups. “Total medical costs were defined as the sum of all costs over the first year,” the researchers wrote.
For the study, 965 patients met the criteria and 187 (19.4%) had DGF.
“In the first month, including the initial transplant admission, patients with DGF had higher inpatient costs compared to non-DGF patients (difference = $28,240). Over the entire year post-transplantation total incremental health care costs for DGF were $52,589. Incremental inpatient costs for DGF were $42,265. Incremental outpatient costs for DGF were $10,324,” the researchers wrote.
“Results indicate that early hospitalization costs and total costs are significantly higher, and outpatient costs numerically higher, for commercially insured KT patients with DGF.
KT patients covered by commercial insurance developing DGF have significant incremental yearly cost of [more than] $52,000 per patient. Effective prevention and management of DGF in KT patients has the potential for substantial cost offset or savings.”
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Mayne et al. Abstract #C-214. Presented at: The American Transplant Congress, May 30-June 2, 2020 (virtual).
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