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Economic Issues in Pancreas Transplantation

  • Angelika C. Gruessner
  • Cynthia R. Gross
  • Rainer W. G. Gruessner

Abstract

Worldwide, diabetes mellitus is one of the most common public health concerns. In the United States alone, it affects some 16 million people or 6% of the population. About 700,000 new cases are diagnosed each year.1 Diabetes mellitus is the seventh leading cause of death, but on death certificates, it is believed to be underreported, both as a condition and as a cause of death. In 1997, according to the American Diabetes Association, 159,719 deaths were attributed to diabetes, representing a loss of 2.0 million years of life.2

Keywords

Peritoneal Dialysis ESRD Patient Hospital Charge Pancreas Transplant United States Renal Data System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Harris MI. Summary: Diabetes in America. In: Diabetes in America. 2nd ed. NIH publication 1995; no. 95–1468. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 1995: 1–14.Google Scholar
  2. 2.
    American Diabetes Association. Economic consequences of diabetes mellitus in the U.S. in 1997. Diabetes Care 1998; 21: 296–309.CrossRefGoogle Scholar
  3. 3.
    Javitt JC, Chiang YP. Economic impact of diabetes. In: Diabetes in America. 2nd ed. NIH publication 1995; no. 95–1468. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 1995: 601–611.Google Scholar
  4. 4.
    Ray NF, Wills S, Thamer M, et al. Direct and Indirect Costs of Diabetes in the United States in 1992. Alexandria, VA: American Diabetes Association; 1993.Google Scholar
  5. 5.
    Ng YC, Jacobs P, Johnson JA. Productivity losses associated with diabetes in the U.S. Diabetes Care 2001; 24: 257–261.PubMedCrossRefGoogle Scholar
  6. 6.
    Klonoff DC, Schwartz DM. An economic analysis of interventions for diabetes. Diabetes Care 2000; 23: 390–404.PubMedCrossRefGoogle Scholar
  7. 7.
    Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.CrossRefGoogle Scholar
  8. 8.
    Diabetes Control and Complications Trial Research Group. Resource utilization and costs of care in the Diabetes Control and Complications Trial. Diabetes Care 1995; 18: 1468–1478.CrossRefGoogle Scholar
  9. 9.
    Diabetes Control and Complications Trial Research Group. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes Control and Complications Trial. JAMA 1996; 276: 1409–1415.CrossRefGoogle Scholar
  10. 10.
    US Renal Data System. USRDS 2001 Annual Data Report. Chapter 1: Incidence and Prevalence of ESRD. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 37–52.Google Scholar
  11. 11.
    US Renal Data System. USRDS 2000 Annual Data Report. Chapter 1: Incidence and Prevalence of ESRD. Am J Kidney Dis 2000; 36: 537 - S54.Google Scholar
  12. 12.
    US Renal Data System. USRDS 2001 Annual Data Report. Reference Tables, Section K (Economic Costs of ESRD). Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 521–552.Google Scholar
  13. 13.
    US Renal Data System. USRDS 2001. Chapter 12: Economic Costs of ESRD. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 181–194.Google Scholar
  14. 14.
    Port FK, Wolfe RA, Mauger EA, et al. Comparison of survival probabilities for dialysis patients vs. cadaveric renal transplant recipients. JAMA 1993; 270: 1339–1343.PubMedCrossRefGoogle Scholar
  15. 15.
    US Renal Data System. USRDS 2001. Reference Tables, Section I (Patient Survival). Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 477–508.Google Scholar
  16. 16.
    US Renal Data System. USRDS 2001. Reference Tables, Section H (Mortality and Causes of Death). Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 453–476.Google Scholar
  17. 17.
    United Network for Organ Sharing. Personal communication, November 2001.Google Scholar
  18. 18.
    Gruessner RWG. Should priority on the waiting list be given to patients with diabetes? Pro. Transplant Proc. 2002; 34: 1575–1576.PubMedCrossRefGoogle Scholar
  19. 19.
    US Renal Data System. USRDS 2001. A Summary of the U.S. ESRD program. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2001: 17–36.Google Scholar
  20. 20.
    US Department of Health and Human Services, Health Resources and Services Administration, Office of Special Programs, Division of Transplantation. 2000 Annual Report of the U.S. Scientific Registry for Transplant Recipients and the Organ Procurement and Transplantation Network. Richmond, VA: United Network for Organ Sharing; 2000: 42–74.Google Scholar
  21. 21.
    Evans RW, Manninen DL, Dong FB. An economic analysis of pancreas transplantation: Costs, insurance coverage, and reimbursement. Clin Transplant 1993; 7: 166–174.PubMedGoogle Scholar
  22. 22.
    Stratta R. The economics of pancreas transplantation. Graft 2000; 3: 19–24.Google Scholar
  23. 23.
    Evans RW. Economic, actuarial, and contracting perspectives on liver transplantation. In: Maddrey WC, Schiff ER, Sorrell MF, eds. Transplantation of the Liver. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2001: 479–490.Google Scholar
  24. 24.
    Holohan TV. Cost-effectiveness modeling of simultaneous pancreas-kidney transplantation. Int J Tech Assess Health Care 1996; 12: 416–424.Google Scholar
  25. 25.
    Douzdjian V, Ferrara D, Silvestri G. Treatment strategies for insulin-dependent diabetics with ESRD: A cost-effectiveness decision analysis model. Am J Kidney Dis 1998; 31: 794–802.PubMedCrossRefGoogle Scholar
  26. 26.
    Lenisa L, Castoldi R, Socci C, et al. Cost-effective treatment for diabetic end-stage renal disease: Dialysis, kidney, or kidney-pancreas transplantation? Transplant Proc 1995; 27: 3108–3113.PubMedGoogle Scholar
  27. 27.
    Stratta RJ, Cushing KA, Frisbie K, et al. Analysis of hospital charges after simultaneous pancreas-kidney transplantation in the era of managed care. Transplantation 1997; 64: 287–292.PubMedCrossRefGoogle Scholar
  28. 28.
    Douzdjian V, Escobar F, Kupin WL, et al. Cost-utility analysis of living-donor kidney transplantation followed by pancreas transplantation versus simultaneous pancreas-kidney transplantation. Clin Transplant 1999; 13: 51–58.PubMedCrossRefGoogle Scholar
  29. 29.
    Kiberd BA, Larson T. Estimating the benefits of solitary pancreas transplantation in nonuremic patients with type 1 diabetes mellitus: A theoretical analysis. Transplantation 2000; 70: 1121 1127.Google Scholar
  30. 30.
    Gruessner AC, Troppmann C, Sutherland DER, et al. Donor and recipient risk factors significantly affect cost of pancreas transplants. Transplant Proc 1997; 29: 656–657.PubMedCrossRefGoogle Scholar
  31. 31.
    Troppmann C, Gruessner AC, Dunn DL. Surgical complications requiring early relaparotomy after pancreas transplantation. Ann Surg 1998; 227: 255–268.PubMedCrossRefGoogle Scholar
  32. 32.
    Reddy KS, Johnston TD, Karounas D, et al. Hospital charges following simultaneous kidney-pancreas transplantation: enteric drainage versus bladder drainage. Clin Transplant 2000; 14: 375379.Google Scholar
  33. 33.
    Stratta R. Outcome analysis of hospital charges after simultaneous kidney-pancreas transplantation: Influence of outliers on resource utilization. Transplant Proc 1998; 30: 261.CrossRefGoogle Scholar
  34. 34.
    Douzdjian V, Lanza KT, Uber L, et al. The effectiveness of a transplant out-patient unit as a cost-reducing strategy following pancreas transplantation. Transplant Proc 1998; 30: 272.PubMedCrossRefGoogle Scholar
  35. 35.
    Stuart FP, Abecassis MM, Kaufman DB. Regulatory and fiscal relationships between transplant centers and transplant surgeons/physicians. Graft 2001; 4: 398–402.CrossRefGoogle Scholar
  36. 36.
    Medicare Program, Changes to the Hospital Inpatient Prospective Payment System and Fiscal Year 2003 Rates; Final Rule. Federal Register 2002; 67: 49982–50289.Google Scholar
  37. 37.
    Orlowski JP, Jaynes CL, Spees EK. Practical reduction of transplantation costs. Arch Surg 1993; 128: 1111–1114.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2004

Authors and Affiliations

  • Angelika C. Gruessner
  • Cynthia R. Gross
  • Rainer W. G. Gruessner

There are no affiliations available

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