Abstract：
:It is no secret that the health care environment today is motivated by the underlying, largely economic impetus of managed care. This is particularly evident within the organ transplantation community, where third party payers hope to minimize their financial risk by relying more and more on "centers of excellence" networks to provide high-quality transplant services in an economically efficient manner. The burgeoning interest in the economics of liver transplantation raises a number of complex, yet important, issues to which transplant professionals should lend serious thought. This article addresses these issues by offering an elementary guide to contract negotiations with third party payers. Among other things, the article: (1) discusses several methods by which third party payers avert and shift risk to transplant programs; (2) emphasizes the importance and identifies the limitations of actuaries and other consulting; (3) demonstrates, with examples, how comparative analyses of existing data sources, both public and proprietary, can assist rational decision-making.
journal_name
Clin Liver Disjournal_title
Clinics in liver diseaseauthors
Evans RW,Kitzmann DJdoi
10.1016/s1089-3261(05)70272-5subject
Has Abstractpub_date
1997-08-01 00:00:00pages
287-303, viiiissue
2eissn
1089-3261issn
1557-8224pii
S1089-3261(05)70272-5journal_volume
1pub_type
杂志文章,评审abstract：:Pruritus is a common symptom with primary biliary cholangitis. Research has focused on refining understanding of the neurohumoral pathways involved in transduction of pruritus from peripheral cutaneous receptors to the central nervous system, and identifying modulating drugs. Current treatments have variable efficacy ...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2018.03.005
更新日期：2018-08-01 00:00:00
abstract：:Liver dysfunction is common in both the critically ill and postoperative patient. Metabolic derangements secondary to sepsis, poor hepatic perfusion, total parenteral nutrition, in addition to hemodynamic and anesthetic-induced changes that occur during surgery, can cause liver damage ranging from small self-limited a...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2010.09.004
更新日期：2011-02-01 00:00:00
abstract：:Good management of patients at risk for the development of hepatocellular carcinoma includes regular ultrasound surveillance, and aggressive management of lesions detected at ultrasound. Good radiology and good pathology are essential to the appropriate management of these small lesions. With good quality testing it i...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2007.08.011
更新日期：2007-11-01 00:00:00
abstract：:Chronic hepatitis C virus (HCV) infection is the most common indication for liver transplantation in the United States and Europe, and more than 20,000 patients worldwide have undergone transplantation for complications of chronic hepatitis C. In North America, HCV accounts for 15% to 50% of the liver transplants perf...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2005.05.004
更新日期：2005-08-01 00:00:00
abstract：:This article introduces one of the most diverse classes of direct-acting antivirals for hepatitis C, the nucleoside and non-nucleoside NS5B polymerase inhibitors. Through a systematic review of the published literature, we describe their structure, mechanism of action, issues with resistance, and clinical effectivenes...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2011.05.003
更新日期：2011-08-01 00:00:00
abstract：:The term "alcoholic liver disease" encompasses a spectrum of pathologic conditions ranging from isolated steatosis to established cirrhosis. Within this spectrum, varying degrees of inflammation, hepatocellular ballooning degeneration, hepatocyte necrosis, cholestasis, and fibrosis may be encountered. This article rev...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2016.02.006
更新日期：2016-08-01 00:00:00
abstract：:Liver biopsy is used to determine the pathogenesis of liver dysfunction after liver transplantation. One or more causative factors may be identified on biopsy. The pathologist must be familiar with the histopathology of acute rejection to differentiate it from other potential complications, including biliary obstructi...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(02)00003-x
更新日期：2002-05-01 00:00:00
abstract：:Epidemiologic studies suggest that 10% to 15% of patients infected with hepatitis C virus (HCV) are coinfected with hepatitis B virus (HBV) in the United States as a result of the shared modality of transmission, but the true prevalence is not known. The progression of liver disease to cirrhosis and hepatocellular car...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2019.04.003
更新日期：2019-08-01 00:00:00
abstract：:Primary biliary cirrhosis (PBC) is characterized by the presence of high-titer disease specific autoantibodies directed against mitochondrial antigens (AMA) of the inner mitochondrial membrane, that are members of the 2-oxo acid complex. Among numerous other autoantibodies found in PBC the focus of ongoing studies is ...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(03)00104-1
更新日期：2003-11-01 00:00:00
abstract：:The metabolic syndrome and the hepatitis C virus (HCV) infection are 2 global health care challenges with a complex interaction. Insulin resistance, a central component of the metabolic syndrome, is epidemiologically and pathophysiologically intrinsically linked to HCV infection. Insulin resistance and diabetes affect...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2013.09.007
更新日期：2014-02-01 00:00:00
abstract：:Primary biliary cirrhosis and primary sclerosing cholangitis share some clinical features with autoimmune hepatitis, but when features of autoimmune hepatitis are present, prognosis can be affected and immunosuppressive treatment warranted. The presence of severe interface hepatitis in primary biliary cirrhosis porten...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2012.12.006
更新日期：2013-05-01 00:00:00
abstract：:In summary, re-OLT accounts for 10% of all OLTs performed and is associated with significantly increased resource use, and decreased survival compared with primary OLT. After transplantation into an HCV-infected recipient, infection of the allograft by HCV is invariable. As patients survive longer after liver transpla...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(03)00053-9
更新日期：2003-08-01 00:00:00
abstract：:HCV infection becomes persistent in many patients who are otherwise immune competent. There is increasing support for potential contribution of innate immune response and viral interference with its components to the subsequent outcome. As for the adaptive immune response, humoral immunity may be largely ineffective d...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(02)00068-5
更新日期：2003-02-01 00:00:00
abstract：:The incidence of nonalcoholic fatty liver disease is increasing at an astonishing rate in the US population. Although only a small proportion of these patients develop steatohepatitis (NASH), those who do have a greater likelihood of developing end-stage liver disease and complications. Research on liver fibrosis and ...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2012.05.002
更新日期：2012-08-01 00:00:00
abstract：:In the past two decades, pediatric liver transplantation has become the state-of-the-art operation with anticipated success and limited mortality. The future success of pediatric liver transplantation will require thoughtful solutions to the delicate balance of risk to donors and recipients, the complex needs of the a...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2005.10.004
更新日期：2006-02-01 00:00:00
abstract：:Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are examples of complex diseases accompanied by changes in the expression of thousands of genes and a plethora of proteins encoded by these genes. Before the era of high-throughput analysis, typical translational research initiatives, a...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2007.02.003
更新日期：2007-02-01 00:00:00
abstract：:Recurrent autoimmune hepatitis (AIH) and de novo AIH are 2 important causes of late graft failure after liver transplantation (LT). Recurrent AIH occurs in patients who undergo LT for AIH. De novo AIH occurs in patients who are transplanted for etiologies other than AIH. Although typically treated with standard treatm...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2016.12.010
更新日期：2017-05-01 00:00:00
abstract：:Obesity has become increasingly prevalent, and the number of obese patients in need of liver transplant is expected to continue to increase. In addition, liver disease due to nonalcoholic fatty liver disease is expected to become the leading cause of liver transplantation in the near future. However, obesity remains a...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2016.12.001
更新日期：2017-05-01 00:00:00
abstract：:Hepatic granulomas are a common finding in systemic sarcoidosis, but most patients remain asymptomatic. Elevated alkaline phosphatase is the most common sign of hepatic sarcoidosis (HS). Lacking a specific diagnostic test, the diagnosis of HS is one of exclusion. Therapy may be indicated in a minority of patients to c...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2018.12.012
更新日期：2019-05-01 00:00:00
abstract：:Drug-induced liver injury (DILI) can be predictable or idiosyncratic and has an estimated incidence of approximately 20 cases per 100,000 persons per year. DILI is a common cause of acute liver failure in the United States. No accurate tests for diagnosing DILI exist, and its diagnosis is based on exclusion of other c...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2016.08.012
更新日期：2017-02-01 00:00:00
abstract：:Nonsteroidal anti-inflammatory drugs are among the most common drugs associated with drug-induced liver injury, with an estimated incidence of between 3 and 23 per 100,000 patient years. Nimesulide, sulindac, and diclofenac seem to be associated with the highest risk and the only risk factor consistently identified is...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2007.06.004
更新日期：2007-08-01 00:00:00
abstract：:Hepatobiliary dysfunction associated with the use of total parenteral nutrition is a commonly recognized phenomenon occurring in up to 90% of patients on long-term therapy. Reasons for these abnormalities, both supported by research as well as theoretical possibilities are explored. Practical guidelines considered use...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(05)70368-8
更新日期：1998-02-01 00:00:00
abstract：:Hepatitis C virus (HCV) infection is a systemic disease with hepatic and extrahepatic manifestations, including neuropsychiatric conditions. Depression is a frequent disorder, which has been reported in one-third of patients with HCV infection and has an estimated prevalence of 1.5 to 4.0 times higher than that observ...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2017.03.007
更新日期：2017-08-01 00:00:00
abstract：:Osteopenia, in the form of osteoporosis, is a common complication of chronic cholestatic liver diseases and, although its cause is poorly understood, it appears to be intimately related to the cholestasis itself. With more patients surviving longer with successful liver transplantation, the clinical significance of su...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/s1089-3261(05)70015-5
更新日期：1998-05-01 00:00:00
abstract：:Because of shared routes of transmission, hepatitis C virus (HCV) coinfection is common among HIV-infected persons. Because of the effectiveness of antiretroviral therapy, chronic HCV has now emerged as a major cause of morbidity and mortality in this population. Because chronic HCV is highly prevalent among HIV-infec...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2008.03.009
更新日期：2008-08-01 00:00:00
abstract：:Understanding of the pathogenesis of hepatic fibrosis on a molecular level has led to the identification of several putative serum markers of hepatic fibrosis. Either individually or in combination, these serum markers appear capable of determining early and advanced hepatic fibrosis. Radiological determination of hep...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2005.08.002
更新日期：2005-11-01 00:00:00
abstract：:Acetaminophen (APAP) is the leading worldwide cause of drug overdose and acute liver failure (ALF). Single overdose ingestion and therapeutic misadventure may cause hepatotoxicity. Several factors, such as concomitant alcohol use or abuse, concurrent medications, genetic factors, and nutritional status, can influence ...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2013.07.005
更新日期：2013-11-01 00:00:00
abstract：:Liver transplant (LT) is now an established indication for patients with chronic hepatitis B, mainly because of the development and use of hepatitis B immunoglobulin (HBIG) and oral antivirals for prophylaxis. The combination of low-dose HBIG and antivirals has been considered the standard prophylaxis regimen to preve...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2016.06.004
更新日期：2016-11-01 00:00:00
abstract：:Development of ethanol-induced fatty liver, alcoholic hepatitis, and cirrhosis has been attributed in part to nutritional deficiencies for many years. Special attention must be focused on treating alcohol-induced liver disease while providing replacement of deficient amino acids, vitamins, minerals, and other nutrient...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2004.11.003
更新日期：2005-02-01 00:00:00
abstract：:Nonalcoholic fatty liver disease is emerging as the most common cause of chronic liver disease worldwide. This trend is, in part, secondary, to the growing incidence of obesity, type 2 diabetes, and metabolic syndrome. Other risk factors include age, gender, race/ethnicity, genetic predisposition, and polycystic ovari...
journal_title：Clinics in liver disease
pub_type： 杂志文章,评审
doi：10.1016/j.cld.2017.08.008
更新日期：2018-02-01 00:00:00
