Understanding Disparities in the Liver Transplant Evaluation, Referral Process скачать в хорошем качестве

Understanding Disparities in the Liver Transplant Evaluation, Referral Process

New research is calling attention to disparities in the referral and evaluation processes preceding liver transplant waitlisting in patients diagnosed with hepatocellular carcinoma, highlighting lower referral rates among older patients with non-private insurance and lower transplant evaluation rates among Black patients as well as those living in higher poverty neighborhoods. Leveraging population-based cancer registry data from 2 liver transplant centers in Georgia, the study builds upon previous research showing disparities in liver transplant waitlisting by looking at potential inequities earlier in the transplant process to better inform potential interventions. “If we know that patients aren't being listed, but we don't know anything about where in the process they dropped out, we can't really design interventions in order to help people complete the process and gets transplanted,” lead investigator Katie Ross-Driscoll, PhD, MPH, assistant professor of surgery at Indiana University School of Medicine and research scientist at the Regenstrief Institute, explained to HCPLive. “That's why we thought it was important to look at referral and evaluation as opposed to listing.” Among the 1379 patients included in the study, 26% were referred to liver transplant, with private insurance and younger age associated with increased likelihood of referral. Further analysis revealed patients living in census tracts with ≥20% of residents in poverty were less likely to initiate evaluation among those referred (cause-specific hazard ratio [csHR], 0.62; 95% Confidence interval [CI], 0.42–0.94), and Medicaid patients were less likely to complete the evaluation once initiated (csHR, 0.53; 95% CI, 0.32–0.89). #Liver #Hepatology #Cancer #Transplant