Ethnicity, medical insurance, and living kidney donation. (19th June 2013)

• Record Type: Journal Article
• Authors: Reeves‐Daniel, Amber Michelle; Farney, Alan C.; Fletcher, Alison J.; Assimos, Dean; Westcott, Carl; Rogers, Jeffrey; Stratta, Robert J.; Rocco, Michael V.; Freedman, Barry I.
• Is Part Of: Clinical transplantation. Volume 27:Number 4(2013:Jul./Aug.)
• Page Start: E498
• Page End: E503
• Publication Date: 2013-06-19
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.12168
• Languages: English
• ISSNs: 0902-0063

Abstract

<abstract abstract-type="main" id="ctr12168-abs-0001"> <title>Abstract</title> <sec id="ctr12168-sec-0001" sec-type="section"> <title>Background</title> <p>Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described.</p> </sec> <sec id="ctr12168-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ctr12168-sec-0003" sec-type="section"> <title>Results</title> <p>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).</p> </sec> <sec id="ctr12168-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>