Outcomes related to hospital characteristics of heart transplant centers: A National Readmission Database analysis

Abstract

Background: This study showcases an analysis performed using the National Readmission Database (NRD) from 2016 to 2019 to analyze the impact of ownership, location, size, and teaching status of transplant centers on cardiac transplant outcomes. Methods: Demographic variables and hospital characteristics were identified using NRD data and International Classification of Diseases,10th revision codes. Comorbidities were assessed using the Elixhauser comorbidity index. Multivariable linear and logistic regression analyses were used to assess in-hospital mortality, 30-day and 180-day readmission rates, length of stay, days from admission to procedure, transfer to a rehab center, graft rejection, graft failure, and index admission total cost. Results: Most cardiac transplants occurred in privately owned, large metropolitan areas, large bed size, and teaching centers. No significant difference was seen in in-hospital mortality, graft rejection, or graft failure by hospital ownership, location, size, or teaching status. Patients in private hospitals were more likely to be readmitted at 180 days and less likely to be transferred to rehab center compared to government-owned hospitals. Patients in private, small bed size, and teaching centers were more likely to have shorter length of stay. Additionally, days of admission to procedure were shorter in small bed size and teaching centers. Furthermore, the cost of index-hospital stay was higher in privately owned, large metropolitan areas, large bed size, and teaching centers. Conclusions: While in-hospital mortality was not significantly different, various other outcomes related to cost and efficiency seem to be impacted by hospital characteristics.

Keywords

• heart transplant
• outcomes
• center characteristics
• mortality
• care efficiency