Conflict of interest: None.
Ethnicity, medical insurance, and living kidney donation
Article first published online: 19 JUN 2013
© 2013 John Wiley & Sons A/S.
Volume 27, Issue 4, pages E498–E503, July/August 2013
How to Cite
Ethnicity, medical insurance, and living kidney donation., , , , , , , , .
- Issue published online: 7 AUG 2013
- Article first published online: 19 JUN 2013
- Manuscript Accepted: 7 MAY 2013
- Wake Forest School of Medicine
- Section on Nephrology
- African American;
- living donor kidney transplantation;
- medical insurance
Relationships between race/ethnicity, recipient medical insurance, and living donor kidney transplantation (LKT) are incompletely described.
Associations between medical insurance and LKT were assessed in 447 recipients at a southeastern US transplant center. Primary and secondary payers were included in the analyses.
A total of 387 deceased donor transplantations and 60 LKTs were performed in 246 (55%) European American (EA), 175 (39.2%) African American (AA), 15 (3.4%) Asian, and 11 (2.5%) Hispanic recipients. Among recipients, 182 (40.8%) were privately insured, 125 (28%) had Medicaid, and the remainder had Medicare, Medicare supplements, or Medicare replacement policies. A higher proportion of patients with private insurance, relative to those without private insurance, received LKT (22% vs. 7.6%, p < 0.0001). Among ethnic groups, LKT with, vs. without, private insurance was 27.5% vs. 12.4% in EAs (p = 0.0028) and 14.3% vs. 0.9% in AAs (p = 0.0005). Medicaid recipients (n = 125) were less likely to receive LKT than those without Medicaid (4.8% vs. 16.8%, p = 0.0003). Among the 69 AA recipients with Medicaid, none received LKT (0 Medicaid vs. 9.5% without Medicaid, p = 0.0065).
Recipient insurance status is associated with LKT, positively with private insurance and negatively with Medicaid. AAs were impacted to a greater extent, potentially contributing to lower rates of LKT.