Journal article
Identifying and understanding variation in population-based access to liver transplantation in the United States
American journal of transplantation, Vol.23(9), pp.1401-1410
09/2023
DOI: 10.1016/j.ajt.2023.06.002
PMCID: PMC10529375
PMID: 37302576
Abstract
We aimed to identify variation in liver transplant access across transplant referral regions (TRRs), accounting for differences in population characteristics and practice environment. Adult end-stage liver disease (ESLD) deaths and liver waitlist additions from 2015 - 2019 were included. The primary outcome was listing to death ratio (LDR). We modeled the LDR as a continuous variable and obtained adjusted LDR estimates for each TRR accounting for clinical and demographic characteristics of ESLD decedents, socioeconomic and healthcare environment within the TRR, and characteristics of the transplant environment. The overall mean LDR was 0.24 (range: 0.10, 0.53). In the final model, proportion of patients living in poverty and concentrated poverty were negatively associated with LDR; organ donation rate was positively associated with LDR. The R2 was 0.60, indicating that 60% of the variability in LDR was explained by the model. Approximately 40% of this variation remained unexplained and may be due to transplant center behaviors amenable to intervention to improve access to care for ESLD patients.
Details
- Title: Subtitle
- Identifying and understanding variation in population-based access to liver transplantation in the United States
- Creators
- Katie Ross-Driscoll - Emory UniversityJonathan Gunasti - Emory UniversityArrey-Takor Ayuk-Arrey - Emory UniversityJoel T. Adler - The University of Texas at AustinDavid Axelrod - University of IowaLisa McElroy - Duke UniversityRachel E. Patzer - Emory UniversityRaymond Lynch - Emory University
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.23(9), pp.1401-1410
- DOI
- 10.1016/j.ajt.2023.06.002
- PMID
- 37302576
- PMCID
- PMC10529375
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: KL2TR002381, UL1TR002378
- Language
- English
- Electronic publication date
- 06/09/2023
- Date published
- 09/2023
- Academic Unit
- Surgery
- Record Identifier
- 9984433852302771
Metrics
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