Competition linked to poor hospital transplant outcomes

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Although more hospital competition is associated with improved access to care, it also can be linked to poorer outcomes, according to a new study in the journal Liver Transplantation.

Researchers from the University of California, San Diego, found that low, mid and high levels of competition significantly increased the risk of graft failure and patient death. With increased competition among medical centers that perform liver transplants, higher-risk patients received lower-quality donor organs, Reuters reported.

Transplantation for sicker patients and the use of higher-risk organs also meant higher costs, according to the study that looked at more than 38,00 transplants at 112 transplant centers in 47 donation service areas.

The findings question whether competition for the same organs decreased the ability to match donor and recipient characteristics. That's because competition incentivizes medical centers to perform enough transplants to meet fixed costs, boost profits and maintain market share, which can inhibit them from best matching organs with recipients, the authors noted.

"Competition has been advocated as important for bettering market performance, but these findings suggest that there may be limits to the value of competition in the healthcare setting," they wrote.

As competition among hospital transplant programs heats up, they also must adhere to new patient-tracking and reporting requirements.

In November 2012, the United Network for Organ Sharing created uniform minimum standards, which include hospitals to report clinical information on at least 80 percent of living kidney donors and kidney function lab results on at least 70 percent of donations after Dec. 31, 2014, FierceHealthcare previously reported.

For more:
- here's the study
- read the Reuters article

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