Researchers find new way to measure transplant centers post-COVID-19
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Key takeaways:
- Researchers found discordance with a classification system for transplant centers post-COVID-19.
- Overall, 9% of kidney transplant programs were flagged by all methods.
Researchers developed a new method of measuring the performance of transplant centers given the ramifications of COVID-19, according to data presented at the American Transplant Congress.
“The devastating impact of the COVID-19 pandemic has presented significant challenges for measuring performance given COVID-related deaths may not have reflected quality of care,” Jesse Schold, PhD, professor at the University of Colorado Anschutz Medical Campus, said in a presentation.
To address this challenge, the Scientific Registry of Transplant Recipients (SRTR) adopted a policy that “carved out” transplants and outcomes that occurred during the first 3 months the COVID-19 pandemic. To evaluate the impact on measured performance for each U.S. program, researchers used national SRTR data to simulate 1-year graft and patient survival for kidney, liver, heart and lung adult programs using risk adjustment models for the January 2022 reporting period.
Researchers found significant discordance between centers flagged using OPTN Membership and Professional Standards Committee (MPSC) thresholds for low performance and reclassification of centers based on five-tier ratings. For kidney programs, 9% of programs were flagged by all methods, but 4% to 7% of programs changed flagging status. Another 14% to 27% of programs changed five-tier rating based on method.
Overall, 8% of liver programs were flagged by each method with 2% to 6% centers changing flagging status and 8% to 39% of programs changed five-tier rating. Overall, 11% of heart programs were flagged by each method, and 3% of programs changed flagging status. Additionally, 7% to 31% changed five-tier rating. For the lung programs, 12% to 13% of centers were flagged by each method. Additionally, 4% to 6% of the lung programs changed flagging status by method and 10% to 36% of centers changed five-tier rating.
“There was significant discordance between centers flagged using MPSC thresholds for low performance and re-classification of centers based on five-tier ratings,” Scold said.
While the COVID-19 pandemic has presented significant challenges for measuring the performance of transplant centers, the SRTR’s carve-out policy may “result in significantly different measured performance for prior and future SRTR PSRs that include these periods,” Scold said.
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Schold J, et al. Impact of different assumptions to address the impact of COVID-19 on transplant center measured performance. Presented at: American Transplant Congress; June 3-7, 2023; San Diego (hybrid).
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