Abstract: TH-PO737
Primary Care Utilization by Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Qian, Long, Yale University, New Haven, Connecticut, United States
- Faulkner, Sophia, Yale University, New Haven, Connecticut, United States
- Yamamoto, Yu, Yale University, New Haven, Connecticut, United States
- Virmani, Sarthak, University of Virginia, Charlottesville, Virginia, United States
- Wilson, Francis Perry, Yale University, New Haven, Connecticut, United States
- Mansour, Sherry, Yale University, New Haven, Connecticut, United States
Background
While most kidney transplant recipients (KTRs) receive consistent outpatient care from nephrologists, the extent to which they access primary care providers (PCPs) is unknown, as is whether receiving primary care affects clinical outcomes.
Methods
We used the electronic medical record data of Yale New Haven Hospital from 2016 to 2020 to investigate patterns of PCP exposure among KTRs and factors associated with PCP exposure. We used a multivariable cox regression analysis adjusting for demographics and clinical factors to assess the association between seeing a PCP and all-cause mortality.
Results
A total of 844 KTRs were included with a median follow-up time of 3.16 (IQR:1.55, 4.84) years. Median age was 54 (IQR: 42, 63) years; 311 (37%) were female; 244 (29%) identified as Black and 125 (15%) identified as Hispanic. 33% of KTRs had at least one PCP visit after transplantation during our study period but within 1 year after transplantation, only 15% saw a PCP. Those seen by a PCP were slightly older [56 (47, 64) vs. 53 (42, 63) years, p=0.08], and more likely to be female (61 (47%) vs. 250 (35%), p=0.01] and diabetic [75 (57%) vs. 56(43%), p=0.01]. Additionally, being female and diabetic were independently associated with, respectively, a 66% and 69% higher odds of seeing a PCP (aOR: 1.66 (95%CI:1.13-2.42 and aOR:1.69 (95%CI: 1.15-2.49)]. During our study follow up, 98 (12%) of KTRs died. Seeing a PCP within the first year was not significantly associated with all-cause mortality (aHR 0.74 (95%CI: 0.17-3.19).
Conclusion
Only a small proportion of KTRs are seen by a PCP post-transplant. There were certain factors associated with higher odds of PCP exposure, but overall PCP exposure was not associated with all-cause mortality. Further investigations are needed to evaluate if PCP exposure may improve outcomes in KTRs.