BACKGROUND/AIMS: Despite implications for long-term care, little is known about outpatient care for kidney transplant patients. METHODS: In this retrospective observational cohort study, outpatient claims were examined for 42,078 Medicare kidney transplant patients using United States Renal Data System data to ascertain location and timing of outpatient visits and type of physician seen. Logistic regression with generalized estimating equations was used to determine the odds and clinical correlates of visits in 4 post-transplant time periods. RESULTS: In months 1-3, 88% of patients visited their transplant centers, but this declined to 69% in months 25-36. In the adjusted analysis, Native Americans (odds ratio 0.56, 95% confidence interval 0.48-0.65) and Hispanics (OR 0.86, 95% CI 0.80-0.92) were less likely than whites to visit their transplant centers. Centers performing 18-34 (OR 1.44, 95% CI 1.30-1.59) and 35-61 transplants per year (OR 1.30, 95% CI 1.18-1.43) were more likely to see patients than centers performing <18 or >61. Almost 80% of patients saw nephrologists in months 1-3 after transplant. African-Americans (OR 0.85, 95% CI 0.80-0.90), Asians (OR 0.87, 95% CI 0.77-0.97), and Native Americans (OR 0.63, 95% CI 0.53-0.75) were less likely than whites to see nephrologists, as were Hispanics (OR 0.78, 95% CI 0.72-0.84) compared with non-Hispanics. CONCLUSION: Frequency of visits to transplant centers varied by center and region; most visits were to nephrologists. Patients from minority groups were less likely to visit transplant centers and nephrologists, with possibly significant public health implications. Copyright 2009 S. Karger AG, Basel.
BACKGROUND/AIMS: Despite implications for long-term care, little is known about outpatient care for kidney transplant patients. METHODS: In this retrospective observational cohort study, outpatient claims were examined for 42,078 Medicare kidney transplant patients using United States Renal Data System data to ascertain location and timing of outpatient visits and type of physician seen. Logistic regression with generalized estimating equations was used to determine the odds and clinical correlates of visits in 4 post-transplant time periods. RESULTS: In months 1-3, 88% of patients visited their transplant centers, but this declined to 69% in months 25-36. In the adjusted analysis, Native Americans (odds ratio 0.56, 95% confidence interval 0.48-0.65) and Hispanics (OR 0.86, 95% CI 0.80-0.92) were less likely than whites to visit their transplant centers. Centers performing 18-34 (OR 1.44, 95% CI 1.30-1.59) and 35-61 transplants per year (OR 1.30, 95% CI 1.18-1.43) were more likely to see patients than centers performing <18 or >61. Almost 80% of patients saw nephrologists in months 1-3 after transplant. African-Americans (OR 0.85, 95% CI 0.80-0.90), Asians (OR 0.87, 95% CI 0.77-0.97), and Native Americans (OR 0.63, 95% CI 0.53-0.75) were less likely than whites to see nephrologists, as were Hispanics (OR 0.78, 95% CI 0.72-0.84) compared with non-Hispanics. CONCLUSION: Frequency of visits to transplant centers varied by center and region; most visits were to nephrologists. Patients from minority groups were less likely to visit transplant centers and nephrologists, with possibly significant public health implications. Copyright 2009 S. Karger AG, Basel.
Authors: Jesse D Schold; Joshua J Augustine; Anne M Huml; John O'Toole; John R Sedor; Emilio D Poggio Journal: Am J Transplant Date: 2019-11-15 Impact factor: 8.086
Authors: Akinlolu O Ojo; José María Morales; Miguel González-Molina; Diane E Steffick; Fu L Luan; Robert M Merion; Tammy Ojo; Francesc Moreso; Manuel Arias; Josep María Campistol; Domingo Hernandez; Daniel Serón Journal: Nephrol Dial Transplant Date: 2012-07-02 Impact factor: 5.992
Authors: Ajay Israni; Carl E Dean; Nicholas Salkowski; Suying Li; Lloyd E Ratner; Hamid Rabb; Neil R Powe; S Joseph Kim Journal: Transplantation Date: 2014-09-15 Impact factor: 4.939
Authors: Anne Tsampalieros; Gregory A Knoll; Nicholas Fergusson; Alexandria Bennett; Monica Taljaard; Dean Fergusson Journal: Can J Kidney Health Dis Date: 2017-10-19