BACKGROUND: Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described. METHODS: Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were included in the analyses. RESULTS: A total of 387 deceased donor transplantations and 60 LKTs were performed in 246 (55%) European American (EA), 175 (39.2%) African American (AA), 15 (3.4%) Asian, and 11 (2.5%) Hispanic recipients. Among recipients, 182 (40.8%) were privately insured, 125 (28%) had Medicaid, and the remainder had Medicare, Medicare supplements, or Medicare replacement policies. A higher proportion of patients with private insurance, relative to those without private insurance, received LKT (22% vs. 7.6%, p < 0.0001). Among ethnic groups, LKT with, vs. without, private insurance was 27.5% vs. 12.4% in EAs (p = 0.0028) and 14.3% vs. 0.9% in AAs (p = 0.0005). Medicaid recipients (n = 125) were less likely to receive LKT than those without Medicaid (4.8% vs. 16.8%, p = 0.0003). Among the 69 AA recipients with Medicaid, none received LKT (0 Medicaid vs. 9.5% without Medicaid, p = 0.0065). CONCLUSIONS: Recipient insurance status is associated with LKT, positively with private insurance and negatively with Medicaid. AAs were impacted to a greater extent, potentially contributing to lower rates of LKT.
BACKGROUND: Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described. METHODS: Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were included in the analyses. RESULTS: A total of 387 deceased donor transplantations and 60 LKTs were performed in 246 (55%) European American (EA), 175 (39.2%) African American (AA), 15 (3.4%) Asian, and 11 (2.5%) Hispanic recipients. Among recipients, 182 (40.8%) were privately insured, 125 (28%) had Medicaid, and the remainder had Medicare, Medicare supplements, or Medicare replacement policies. A higher proportion of patients with private insurance, relative to those without private insurance, received LKT (22% vs. 7.6%, p < 0.0001). Among ethnic groups, LKT with, vs. without, private insurance was 27.5% vs. 12.4% in EAs (p = 0.0028) and 14.3% vs. 0.9% in AAs (p = 0.0005). Medicaid recipients (n = 125) were less likely to receive LKT than those without Medicaid (4.8% vs. 16.8%, p = 0.0003). Among the 69 AA recipients with Medicaid, none received LKT (0 Medicaid vs. 9.5% without Medicaid, p = 0.0065). CONCLUSIONS: Recipient insurance status is associated with LKT, positively with private insurance and negatively with Medicaid. AAs were impacted to a greater extent, potentially contributing to lower rates of LKT.
Authors: Donal J Sexton; Scott Reule; Craig A Solid; Shu-Cheng Chen; Allan J Collins; Robert N Foley Journal: Hemodial Int Date: 2015-02-17 Impact factor: 1.812
Authors: Elisa J Gordon; Jefferson J Uriarte; Jungwha Lee; Raymong Kang; Michelle Shumate; Richard Ruiz; Amit K Mathur; Daniela P Ladner; Juan Carlos Caicedo Journal: Am J Transplant Date: 2021-10-17 Impact factor: 8.086
Authors: James R Rodrigue; Matthew J Paek; Ogo Egbuna; Amy D Waterman; Jesse D Schold; Martha Pavlakis; Didier A Mandelbrot Journal: Prog Transplant Date: 2014-12 Impact factor: 1.187