Program-specific reports: Implications and impact on program behavior

Lisa B. Vanwagner, Anton I. Skaro

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


PURPOSE OF REVIEW: Measuring and monitoring transplant center performance is vital to ongoing quality assessment and performance improvement initiatives geared toward ensuring optimal care for patients with end-stage organ failure. The impact of regulatory oversight on transplant center behavior and programmatic decision-making is complex. RECENT FINDINGS: Program-specific reports (PSRs) are published by the Scientific Registry for Transplant Recipients (SRTR) and are publically available for use by a variety of stakeholders, including patients, regulators, insurers, and care providers. PSRs have been both groundbreaking and controversial. The principal areas of concern relate to potential unintended consequences of PSRs, limitations in both the data collected by the registry and the currently used statistical methodology employed by the SRTR for risk adjustment, and the subsequent impact on transplant program behavior. SUMMARY: PSRs, which serve the purposes of fueling ongoing performance improvement initiatives and informing consumers and payers by fostering transparency in the communication of risk, also involve trade-offs because of their unintended use for regulatory oversight and subsequent impact on transplant center behavior. Future research is necessary to improve data integrity and risk-adjustment methodologies which will enhance regulation and preserve access to transplantation among vulnerable patient populations.

Original languageEnglish (US)
Pages (from-to)210-215
Number of pages6
JournalCurrent opinion in organ transplantation
Issue number2
StatePublished - Apr 2013
Externally publishedYes


  • OPTN
  • Organ transplantation
  • Quality improvement
  • Risk assessment
  • SRTR

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation


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