Public Release: 

VA patients face disparities in kidney transplantation

American Society of Nephrology

Highlights

  • From 2004 to 2016, VA patients had lower rates of transplantation compared with patients with Medicare or private insurance.
  • VA patients also had a higher rate of mortality on the waiting list compared with privately insured patients.
  • Results from the study will be presented at ASN Kidney Week 2017 October 31-November 5 at the Ernest N. Morial Convention Center in New Orleans, LA.

New Orleans, LA (Nov. 4, 2017) -- Military veterans with VA insurance experience low rates of transplantation and high rates of death while on the transplant waiting list, according to a study that will be presented at ASN Kidney Week 2017 October 31-November 5 at the Ernest N. Morial Convention Center in New Orleans, LA.

Recent reports have shown a lower-than-expected rate of kidney transplantations performed in VA centers. Because VA centers are affiliated with non-VA academic centers within the same donor service area, Joshua Augustine, MD (Cleveland Clinic) and his colleagues sought to compare transplantation rates nationally and also between VA centers and their non-VA affiliates.

In the researchers' analysis of all US adult patients listed for a primary kidney transplant from 2004 through 2016, a total of 3663 patients with VA insurance were compared with 141,523 with private insurance, 25,245 with Medicaid, and 132,026 with Medicare.

VA patients were 28% less likely to undergo transplantation than patients with private insurance nationally, and 22% less likely than those with private insurance at their non-VA affiliates. VA patients were also 14% less likely to undergo transplantation compared with those with Medicare nationally, but rates were similar compared with patients with Medicare in the non-VA centers. Transplantation rates were similar in patients with VA insurance and those with Medicaid.

VA patients also had a higher rate of death while on the waiting list compared with privately insured patients both nationally and in competing centers. The researchers

noted that VA patients lived an average of 282 miles from the transplant centers, compared with an average of 23 miles for non-VA patients.

"VA patients appear to have greater barriers to transplantation leading to lower rates of transplant and greater waitlist mortality compared with privately insured patients listed in local competing centers," said Dr. Augustine. "The much greater distance from transplant centers may contribute to lower transplant rates in Veterans, and other factors related to organ acceptance or center practices may also contribute to differences." He noted that additional analyses are required to determine the primary factors leading to discrepancies in transplant rates between VA and non-VA patients. "Ultimately, greater acceptance/coverage of VA insurance in local non-VA transplant centers may improve transplant rates for Veterans in the United States."

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Study: "Significantly Lower Rates of Transplantation and Increased Wait List Mortality among Kidney Transplant ***" (Abstract 2769210)

ASN Kidney Week 2017, the largest nephrology meeting of its kind, will provide a forum for more than 13,000 professionals to discuss the latest findings in kidney health research and engage in educational sessions related to advances in the care of patients with kidney and related disorders. Kidney Week 2017 will take place October 31-November 5, 2017 in New Orleans, LA.

Since 1966, the American Society of Nephrology (ASN) has been leading the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients. ASN has nearly 17,000 members representing 112 countries. For more information, please visit http://www.asn-online.org or contact us at 202-640-4660.

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