Abstract: TH-PO737
Impact of Advancing American Kidney Health on Access to Kidney Transplant
Session Information
- Diversity and Equity in Kidney Health - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 800 Diversity and Equity in Kidney Health
Authors
- Ng Sueng, Luis, Henry Ford Health System, Detroit, Michigan, United States
- Peracha, Nawal, Wayne State University School of Medicine, Detroit, Michigan, United States
- Wu, Andrew, Henry Ford Health System, Detroit, Michigan, United States
- Khoury, Nadeen J., Henry Ford Health System, Detroit, Michigan, United States
- Samaniego-Picota, Milagros D., Henry Ford Health System, Detroit, Michigan, United States
- Jesse, Michelle, Henry Ford Health System, Detroit, Michigan, United States
- Shrivastava, Pritika, Henry Ford Health System, Detroit, Michigan, United States
Background
In July 2019, the US Federal Government launched the executive order (EO) Advancing American Kidney Health (AAKH). The focus of this EO was to reduce kidney failure rates and increase rates of kidney transplant. Herein, we explore the impact of the EO on referral (REF), evaluation (EVAL), waitlist (WL), and kidney transplants (T) across racial groups before and after the signing of AAKH.
Methods
Retrospective chart review of all patients referred for kidney transplant evaluation at a large, urban healthcare system in Detroit, MI. To ensure equal pre-post timeframes, data collected from all patients referred within 30 months pre- (1/1/2017-6/30/2019) and post-EO (10/1/2019-3/31/2022). Patients referred in the three months immediate post-EO (7/1/2019-9/30/2019) were excluded to account for system-level adjustment to the EO. Data extracted via existing internal systems included patient race/ethnicity, gender, frequency and dates of events (i.e., REF, EVAL, WL, and T). An event was coded each time a patient was referred for possible evaluation and categorized as the furthest step achieved (i.e., REF, EVAL, WL, T).
Results
A total of 4949 unique patients were identified, though 673 patients had more than one event. Patients were predominantly male (60.4%) and Black (50.8%), followed by White (37.4%) and Other (11.7%). There were significantly greater increases in referrals and evaluations for Black patients compared to White and Other racial categories. Since local average wait time for kidney transplant is >30 months, EO impact on transplant may be too early to assess. WL and T was equitable across groups. Table 1 reports on frequency of events across racial groups pre- to post-EO.
Conclusion
Since the passage of EO, minority populations may have better access to kidney transplant, as noted by increase in referrals and evaluation.