Featured Research

from universities, journals, and other organizations

Race, Insurance Status Affect Access To Transplantation And Kidney Disease Treatment

Date:
March 3, 2008
Source:
American Society of Nephrology
Summary:
Universal access to health care might help to overcome racial and ethnic barriers to treatment for kidney disease, suggest two new studies. During the four-year study period, there was a significant increase in the rate of "pre-emptive listing"--that is, being placed on the transplant waiting list before starting dialysis. However, the median time spent on dialysis before wait-listing was essentially unchanged.

Universal access to health care might help to overcome racial and ethnic barriers to treatment for kidney disease, suggest two studies in the March 2008 issue of Clinical Journal of the American Society of Nephrology.

Related Articles


The results should be seen as "yet another wake-up call as to how we as a medical community need to lead the health agenda for the nation, including the reduction and/or elimination of health disparities," according to an editorial by Dr. Keith Norris of Charles Drew University and Dr. Allen Nissenson of the David Geffen School of Medicine at UCLA.

In one of the two new studies, Dr. Douglas Keith of McGill University, Montreal, and colleagues analyzed data on nearly 76,000 U.S. patients wait-listed for kidney transplantation between 2001 and 2004. The goal was to identify factors affecting time on dialysis before being placed on the waiting list--the less time a patient spends on dialysis, the better the results of transplantation.

During the four-year study period, there was a significant increase in the rate of "pre-emptive listing"--that is, being placed on the transplant waiting list before starting dialysis. However, the median time spent on dialysis before wait-listing was essentially unchanged.

The rate of pre-emptive listing was lower, and time spent on dialysis was longer, for minority patients and for patients on Medicare (compared to those on private insurance).

Less-educated patients and those whose kidney disease was caused by high blood pressure also had a reduced rate of pre-emptive wait-listing and a longer time on dialysis. On average, a minority patient who was on Medicare and had less than a high school education spent 20 times longer on dialysis before being wait-listed, compared to a white patient with private insurance and at least a high school education.

The impact of insurance was greatly reduced after age 65. At that age, Medicare patients no longer have to go through a mandatory waiting period before being eligible for kidney transplantation. However, the disparities for racial and ethnic minorities and for less-educated patients persisted after age 65.

"The most important issue for timely access to the waiting list is insurance or the lack of it," Dr. Keith comments. "Our study suggests that a universal system of insurance coverage would improve access for those most disadvantaged by the current insurance system." The study is limited in that it includes only patients who actually made it to the waiting list.

In the second study, Dr. Sam W. Gao of Naval Medical Center Portsmouth (Virginia) and colleagues analyzed the quality of care for more than 8,000 patients with moderate to advanced chronic kidney disease (CKD) treated in the Department of Defense (DOD) medical system. Their goal was to determine whether universal access to health services in the DOD system avoids racial disparities in CKD care.

The results suggested that the care provided to black patients with CKD in the DOD system was very similar to that provided to white patients. In some cases, measures of kidney care were higher for black patients. The one significant difference was lower monitoring of cholesterol levels among black patients.

"We were able to show that blacks and whites received similar care, unlike some other aspects of medicine in the United States where blacks receive less care than whites," Dr. Gao comments. "This may be due to universal access to care provided to all DOD beneficiaries." The study is limited in its ability to show a cause-and-affect relationship, and by the fact that it included only DOD beneficiaries.

In their editorial, Drs. Norris and Nissenson call on the nephrology community to "take the opportunity as health leaders to ensure uniform health care to all citizens and move closer to eliminating the tragedy of health inequities, and the unacceptable morbidity and mortality associated with CKD." They note that the American Society of Nephrology (ASN), National Kidney Foundation (NKF), Renal Physicians Association (RPA), and American Society of Pediatric Nephrology (ASPN) are collaborating on a legislative agenda to improve care for patients with kidney disease, focusing on appropriate funding for CKD care. In conjunction with World Kidney Day on March 13, 2008, members from ASN and NKF will visit with congressional leaders on Capitol Hill to discuss the importance of improving care for patients with kidney disease through greater access, more research, and increased education.


Story Source:

The above story is based on materials provided by American Society of Nephrology. Note: Materials may be edited for content and length.


Cite This Page:

American Society of Nephrology. "Race, Insurance Status Affect Access To Transplantation And Kidney Disease Treatment." ScienceDaily. ScienceDaily, 3 March 2008. <www.sciencedaily.com/releases/2008/02/080227121844.htm>.
American Society of Nephrology. (2008, March 3). Race, Insurance Status Affect Access To Transplantation And Kidney Disease Treatment. ScienceDaily. Retrieved November 24, 2014 from www.sciencedaily.com/releases/2008/02/080227121844.htm
American Society of Nephrology. "Race, Insurance Status Affect Access To Transplantation And Kidney Disease Treatment." ScienceDaily. www.sciencedaily.com/releases/2008/02/080227121844.htm (accessed November 24, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, November 24, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Winter Can Cause Depression — Here's How To Combat It

Winter Can Cause Depression — Here's How To Combat It

Newsy (Nov. 23, 2014) Millions of American suffer from seasonal depression every year. It can lead to adverse health effects, but there are ways to ease symptoms. Video provided by Newsy
Powered by NewsLook.com
Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

Ebola-Hit Sierra Leone's Late Cocoa Leaves Bitter Taste

AFP (Nov. 23, 2014) The arable district of Kenema in Sierra Leone -- at the centre of the Ebola outbreak in May -- has been under quarantine for three months as the cocoa harvest comes in. Duration: 01:32 Video provided by AFP
Powered by NewsLook.com
Don't Fall For Flu Shot Myths

Don't Fall For Flu Shot Myths

Newsy (Nov. 23, 2014) Misconceptions abound when it comes to your annual flu shot. Medical experts say most people older than 6 months should get the shot. Video provided by Newsy
Powered by NewsLook.com
WFP: Ebola Risks Heightened Among Women Throughout Africa

WFP: Ebola Risks Heightened Among Women Throughout Africa

AFP (Nov. 21, 2014) Having children has always been a frightening prospect in Sierra Leone, the world's most dangerous place to give birth, but Ebola has presented an alarming new threat for expectant mothers. Duration: 00:37 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins