Utilization and Cost Analysis of Lung Transplantation and Survival After 10 years of Adopting the Lung Allocation Score (LAS)

Background Lungs are allocated in the United States using the Lung Allocation Score (LAS). We investigated the effect of LAS trends on lung transplant-related costs, health care utilization, and mortality. Methods Utilization data from Mayo Clinic (FL and MN) from 2005-2015 were obtained from the electronic health records (N=465). Costs were categorized as 1-year post or transplant episode and standardized using 2015 Medicare reimbursement and cost-to-charge ratios. Regression analysis was used to assess the relationship of LAS to length of stay (LOS), mortality, and cost of transplant. Results The mean LAS at transplant increased from 45.7 to 58.3 during the study period, while the 1-year survival improved from 88.1% to 92.5%, (p60) at transplant is associated with increased mortality. Corresponding Author: Cesar Keller, MD, Mayo Clinic Transplant Center, 3600 San Pablo Road, Jacksonville, FL 32224, keller.cesar@mayo.edu ©2018 Mayo Foundation for Medical Education and Research Mayo Clinic does not endorse specific products or services included in this article. Authorship Participated in research design: CAK, TAG, LJW, MER, SLV, JMN Participated in writing of the paper: CAK, TAG, LJW, CCK, RCD, JMN Participated in the performance of the research: CAK, TAG, LJW, SLV, JMN Contributed new reagents or analytic tools: LJW, MER, SLV, JMN Participated in data analysis: CAK, TAG, LJW, SLV, CCK, JMN Conflicts of Interest: The authors declare no conflicts of interest. Funding: This work was supported in part by the Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, an unrestricted grant by United Therapeutics and by NHLBI of the NIH under award number K23 HL 128859 (CCK principal investigator). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Descriptor Number: 16.2 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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