| Social barriers to adult liver transplantation listing: Prevalence and association with program characteristics. | |
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MedLine Citation:
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PMID: 21656658 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Social barriers to effective medical care are mandated to be routinely assessed as part of evaluation for liver transplantation. This study explores how frequently liver transplant programs encounter such barriers in patients undergoing evaluation, and whether programs with higher proportions of Medicaid patients, historically disadvantaged minority patients, and rural-dwelling patients have higher perceived frequency of social barriers. A survey to assess patient demographic characteristics and experience with social barriers was electronically completed by representatives of 61 programs out of 104 eligible U.S. adult liver transplant programs (59%). Characteristics of the 58 self-identified responding programs were similar to those of all 104 U.S. programs, based on publicly available data from the Organ Procurement and Transplantation Network. Social barriers were reported as encountered "sometimes (10-30%)" or "frequently (>30%)" by programs as follows: inadequate or unstable health insurance 68.9%, chaotic social environment 63.9%, lack of a care partner 60.7%, inability to obtain transportation 49.2%, low educational level 36.1%, inadequate housing 23.0%, language barrier 19.7%, no reliable way to contact patient 16.4%, difficulty obtaining child care 11.5%, food insecurity 8.2%. The frequency of perceived social barriers did not differ significantly between programs reporting higher or lower proportions of Medicaid, minority, or rural populations. Our analysis suggests that program-level operational planning to address social barriers to transplant listing should be considered regardless of the proportion of Medicaid-insured, racial or ethnic minority, or rural-dwelling patients in the population. Liver Transpl, 2011. © 2011 AASLD. |
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Authors:
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Anna Flattau; Manhal Olaywi; Paul J Gaglio; Paula Marcus; Paul Meissner; Emily B L Dorfman; John F Reinus |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-7 |
Journal Detail:
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Title: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society Volume: - ISSN: 1527-6473 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100909185 Medline TA: Liver Transpl Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Association for the Study of Liver Diseases. |
Affiliation:
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Department of Family and Social Medicine; Montefiore-Einstein Liver Center. aflattau@montefiore.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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