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Race, insurance status affect access to transplantation and kidney disease treatment
Date:2/27/2008

a mandatory waiting period before being eligible for kidney transplantation. However, the disparities for racial and ethnic minorities and for less-educated patients persisted after age 65.

"The most important issue for timely access to the waiting list is insurance or the lack of it," Dr. Keith comments. "Our study suggests that a universal system of insurance coverage would improve access for those most disadvantaged by the current insurance system." The study is limited in that it includes only patients who actually made it to the waiting list.

In the second study, Dr. Sam W. Gao of Naval Medical Center Portsmouth (Virginia) and colleagues analyzed the quality of care for more than 8,000 patients with moderate to advanced chronic kidney disease (CKD) treated in the Department of Defense (DOD) medical system. Their goal was to determine whether universal access to health services in the DOD system avoids racial disparities in CKD care.

The results suggested that the care provided to black patients with CKD in the DOD system was very similar to that provided to white patients. In some cases, measures of kidney care were higher for black patients. The one significant difference was lower monitoring of cholesterol levels among black patients.

"We were able to show that blacks and whites received similar care, unlike some other aspects of medicine in the United States where blacks receive less care than whites," Dr. Gao comments. "This may be due to universal access to care provided to all DOD beneficiaries." The study is limited in its ability to show a cause-and-affect relationship, and by the fact that it included only DOD beneficiaries.

In their editorial, Drs. Norris and Nissenson call on the nephrology community to "take the opportunity as health leaders to ensure uniform health care to all citizens and move closer to eliminating the tragedy of health inequities, and the unacceptable morbidity and mortality
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Contact: Shari Leventhal
sleventhal@asn-online.org
202-416-0658
American Society of Nephrology
Source:Eurekalert

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