Agnieszka Szymańska, Leszek Pączek, Krzysztof Mucha, Monika Krajewska, Michał Florczak, Michał Ciszek, Joanna Sańko-Resmer, Andrzej Chmura, Sławomir Nazarewski, Andrzej Górski, Magdalena Durlik, Marek Krawczyk, Bartosz Foroncewicz
(Department of Immunology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland)
Ann Transplant 2016; 21:194-199
The number of transplant surgeries across the globe has markedly increased in recent decades and is associated with improvement in outcomes. Factors that could improve the organization of post-transplant care are sought. The aim of our study was to evaluate the changes in post-transplant care in the largest Polish transplant center from 2010 to 2014.
MATERIAL AND METHODS: Analysis was performed in all transplant recipients followed up at our center. The following factors were evaluated: changes in patient inflow and outflow, changes in the number of ambulatory visits, causes of loss to follow-up of the patients, and changes in National Health Fund financing. All factors were measured in 5-year period from 2010 to 2014.
RESULTS: Stable year-to-year patient inflow increased by 31% in the total number of patients under follow-up within 5 years. In the same time, the total NHF spending increased by 32%, but spending per patient increased by only 11%. As a consequence, after the initial growth in the years 2010–2012, the number of ambulatory visits per patient per year tended to decline.
CONCLUSIONS: Our study revealed that the real challenge in long-term post-transplant care is the increasing number of patients and the increasing length of their follow-up. Potential risks related to financial expenditure discrepancy between short-term and long-term transplantation procedures were also found.
Keywords: Ambulatory Care, Bias (Epidemiology), Demography, Financing, Organized, Organ Transplantation