Access to Liver Transplantation: Gender, Race and Geographic Disparities...Policy Implications

2.50
Hdl Handle:
http://hdl.handle.net/10755/304411
Category:
Full-text
Type:
Presentation
Title:
Access to Liver Transplantation: Gender, Race and Geographic Disparities...Policy Implications
Author(s):
Brennan, Patricia A.
Lead Author STTI Affiliation:
Nu Xi
Author Details:
Patricia A. Brennan, PhD, RN, MS, pbrennan@samuelmerritt.edu
Abstract:

Session presented on: Monday, July 22, 2013

Purpose:

To'increase the understanding and the effect of specific predisposing, enabling and need variables on access to liver transplantation.

Methods:

Kaplan Meir survival and Cox Proportional Hazard regression analyses were conducted using secondary data from the US Scientific Research Transplant Registry (SRTR),'managed by the Organ Procurement Transplant Network and the United Network of Organ Sharing that included 32,566 patients.'

Database

United States Scientific Research Transplant Registry (SRTR), with input from the'US federally designated Organ Procurement Transplant Network (OPTN).'

Population

Individuals wait-listed for a cadaveric liver transplant in the US'from February 27, 2002 through November 30, 2007 excluding patients younger than 18 years of age, in acute liver failure or who had previously received a liver transplant.

Data Analysis

Descriptive statistics regarding those liver transplant recipients and candidates who continue to wait during the time-frame studied.''The population'is described in relation to those predisposing, enabling and need variables described by Anderson (1995) to explain or predict access to liver transplantation. Multivariate Cox Regression Models were used to investigate the effects of the defined variables on hazard of transplant during the time frame (2002-2007). Two Cox Regression Models were run to evaluate the effect of the MELD 15 Share Rule on hazard of transplantation at higher acuities within the US'national system and separately by designated region.

Results:

Despite the implementation of an acuity based model of liver allocation, disparities in gender, race and geographical region exist.

Conclusion:

There are differences in gender, race and geographical region in the current era of liver allocation in the United States.' Despite increased transplantation rates for those of greater acuity, disparities still exist nationally overall and within the 11 UNOS regions. These disparities suggest the need for an evaluation of the US federally mandated system of cadaveric liver'allocation.

Keywords:
health policy; liver transplantation; disparities
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013 ; 22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleAccess to Liver Transplantation: Gender, Race and Geographic Disparities...Policy Implicationsen
dc.contributor.authorBrennan, Patricia A.en
dc.contributor.departmentNu Xien
dc.author.detailsPatricia A. Brennan, PhD, RN, MS, pbrennan@samuelmerritt.eduen
dc.identifier.urihttp://hdl.handle.net/10755/304411-
dc.description.abstract<p>Session presented on: Monday, July 22, 2013</p><b>Purpose: </b> <p>To'increase the understanding and the effect of specific predisposing, enabling and need variables on access to liver transplantation. <p><b>Methods: </b> <p>Kaplan Meir survival and Cox Proportional Hazard regression analyses were conducted using secondary data from the US Scientific Research Transplant Registry (SRTR),'managed by the Organ Procurement Transplant Network and the United Network of Organ Sharing that included 32,566 patients.' <p><i>Database </i><p>United States Scientific Research Transplant Registry (SRTR), with input from the'US federally designated Organ Procurement Transplant Network (OPTN).' <p><i>Population</i><p>Individuals wait-listed for a cadaveric liver transplant in the US'from February 27, 2002 through November 30, 2007 excluding patients younger than 18 years of age, in acute liver failure or who had previously received a liver transplant. <p><i>Data Analysis</i><p>Descriptive statistics regarding those liver transplant recipients and candidates who continue to wait during the time-frame studied.''The population'is described in relation to those predisposing, enabling and need variables described by Anderson (1995) to explain or predict access to liver transplantation. Multivariate Cox Regression Models were used to investigate the effects of the defined variables on hazard of transplant during the time frame (2002-2007). Two Cox Regression Models were run to evaluate the effect of the MELD 15 Share Rule on hazard of transplantation at higher acuities within the US'national system and separately by designated region. <p><b>Results: </b> <p>Despite the implementation of an acuity based model of liver allocation, disparities in gender, race and geographical region exist. <p><b>Conclusion: </b> <p>There are differences in gender, race and geographical region in the current era of liver allocation in the United States.' Despite increased transplantation rates for those of greater acuity, disparities still exist nationally overall and within the 11 UNOS regions. These disparities suggest the need for an evaluation of the US federally mandated system of cadaveric liver'allocation.en
dc.subjecthealth policyen
dc.subjectliver transplantationen
dc.subjectdisparitiesen
dc.date.available2013-10-22T20:35:19Z-
dc.date.issued2013-10-22-
dc.date.issued2013-10-22en
dc.date.accessioned2013-10-22T20:35:19Z-
dc.conference.date2013en
dc.conference.name24th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationPrague, Czech Republicen
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en
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