Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
2009-5-8
pubmed:abstractText
Despite universal payer coverage with Medicare, sociodemographic disparities confound the care of patients with renal failure. We sought to determine whether adults who realize access to kidney transplantation suffer inequities in the utilization of live donor renal transplantation (LDRT). We identified adults undergoing primary renal transplantation in 2004-2006 from the United Network for Organ Sharing (UNOS). We modeled receipt of live versus deceased donor renal transplant on multilevel multivariate models that examined recipient, center and UNOS region-specific covariates. Among 41 090 adult recipients identified, 39% underwent LDRT. On multivariate analysis, older recipients (OR 0.62, 95% CI 0.56-0.68 for 50-59 year-olds vs. 18-39 year-old recipients), those of African American ethnicity (OR 0.54, 95% CI 0.50-0.59 vs. whites) and of lower socioeconomic status (OR 0.72, 95% CI 0.67-0.79 for high school-educated vs. college-educated recipients; OR 0.78, 95% CI 0.71-0.87 for lowest vs. highest income quartile) had lower odds of LDRT. These characteristics accounted for 14.2% of the variation in LDRT, more than recipient clinical variables, transplant center characteristics and UNOS region level variation. We identified significant racial and socioeconomic disparities in the utilization of LDRT. Educational initiatives and dissemination of processes that enable increased utilization of LDRT may address these disparities.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
1600-6143
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
9
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1124-33
pubmed:meshHeading
pubmed-meshheading:19422338-Adolescent, pubmed-meshheading:19422338-Adult, pubmed-meshheading:19422338-Aged, pubmed-meshheading:19422338-Comorbidity, pubmed-meshheading:19422338-Continental Population Groups, pubmed-meshheading:19422338-Educational Status, pubmed-meshheading:19422338-Ethnic Groups, pubmed-meshheading:19422338-Female, pubmed-meshheading:19422338-Humans, pubmed-meshheading:19422338-Income, pubmed-meshheading:19422338-Kidney Failure, Chronic, pubmed-meshheading:19422338-Kidney Transplantation, pubmed-meshheading:19422338-Living Donors, pubmed-meshheading:19422338-Male, pubmed-meshheading:19422338-Middle Aged, pubmed-meshheading:19422338-Patient Selection, pubmed-meshheading:19422338-Poverty, pubmed-meshheading:19422338-Socioeconomic Factors, pubmed-meshheading:19422338-Young Adult
pubmed:year
2009
pubmed:articleTitle
Disparities in the utilization of live donor renal transplantation.
pubmed:affiliation
VA Greater Los Angeles Healthcare System, Robert Wood Johnson Clinical Scholars Program, Department of Urology, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA. jgore@mednet.ucla.edu
pubmed:publicationType
Journal Article, Research Support, U.S. Gov't, P.H.S.