Navigation Links
Unemployment restricts access to kidney transplants, UNH research finds

DURHAM, N.H. People in end-stage kidney failure in need of a kidney transplant are much less likely to be placed on a waiting list for a new kidney or to actually receive a new kidney once on the list if they are unemployed or work part time, according to new collaborative research from the University of New Hampshire.

"There is a strong negative association between a patient's unemployment and the likelihood of being placed on a waiting list for a kidney transplant, and once on the waiting list, the likelihood of receiving a transplant," says Robert Woodward, the Forrest D. McKerley Endowed Chair in Health Economics at the University of New Hampshire.

The researchers found that patients who are retired and/or disabled, working part time, or working full time are much more likely to be placed on a transplant waiting list than unemployed patients. They also are more likely to receive a transplant once placed on the list than unemployed patients. Finally, those who work full time are most likely to be both added to the transplant list and receive a kidney transplant.

The research was conducted by Woodward and researchers at the University of Pittsburgh Medical Center, University of Massachusetts Memorial Medical Center, and the Transplant Institute at Beth Israel Deaconess Medical Center. The new research is presented in the journal Clinical Transplantation in the article "Recipient's unemployment restricts access to renal transplantation."

Researchers evaluated transplant waiting list information for nearly 430,000 patients in end-stage renal disease from the U.S. Renal Data System and the United Network for Organ Sharing. Researchers investigated the employment status of these patients in relation to the amount of time between being diagnosed with end-stage renal disease and being listed on the transplant list, and the amount of time from when the patient was listed to when s/he received a transplant.

Of the nearly 430,000 patients evaluated for a kidney transplant, about 54,000 were added to the list for a kidney transplant. And of those listed for a kidney transplant, nearly 22,000 actually received a kidney transplant.

Although this analysis did not identify why those who are unemployed experience faced restricted access to kidney transplantation, the authors suspect there may be many factors that contribute to the unwillingness of transplant centers to list and transplant poorly employed patients.

The researchers explain that a number of factors are considered when deciding to add someone to a transplant list and move forward with the transplant procedure, including whether the patient can afford the post-transplant medical care and immunosuppressive medications. This post-transplant medical care plays an important part in the success of the transplant and survival of the patient.

"A lack of employment can lead to limited financial resources for the patient and subsequent inadequate medical care following the transplant. Transplant centers have found that patients with limited financial resources have higher rates of noncompliance with post-transplant medical care. Because noncompliance with post-transplant care is a leading cause of rejection, infection, and death, transplant centers may be more hesitant about providing access to transplants to those with limited financial resources," Woodward says.

Insurance status also may play a key role in whether access to kidney transplants is restricted to patients who are unemployed or employed part time, many of whom who may not have insurance due to their employment status. Woodward says there is significant evidence to suggest that lack of health insurance can significantly contribute to noncompliance with post-transplant medical care requirements, which might be responsible for up to 35 percent of unsuccessful kidney transplants.

Those who rely only on Medicare also may experience restricted access to transplant services. According to the researchers, even though Medicare pays for a large portion of the cost of the required immunosuppressant medications, it does not cover non-immunosuppressant prescription drugs that transplant patients are more likely to require. As a result, many transplant centers require secondary, private insurance before a patient is considered for listing on the transplant list.

Finally, Woodward and his fellow researchers say that transplant centers could view employment status as a marker of mental and physical health status, education level, and perceived compliance by the patient with post-transplant care.

Woodward and his co-authors suggest that patients who are more likely to experience barriers to transplants based on employment status could benefit from increased interaction between patients, social workers, and other medical personnel, including case managers and financial specialists. The focus should be on continued employment and vocational rehabilitation, they said.


Contact: Robert Woodward
University of New Hampshire

Related medicine news :

1. Rheumatoid arthritis takes high toll in unemployment, early death, Mayo Clinic finds
2. Unemployment causes more mental health problems among Somalis in London than in Minneapolis
3. Parents addiction, unemployment and divorce are risk factors for childhood abuse
4. Unemployments Toll Can Be Heartbreaking
5. Unemployment Rate for People with Disabilities Climbs in First Quarter, Allsup Reports
6. Launches Major Offensive in War Against Unemployment
7. Image share project gives patients and physicians anytime, anywhere access to medical images
8. Equal access to care helps close survival gap for young African-American cancer patients
9. Premier issue of BioResearch Open Access launched by Mary Ann Liebert Inc. publishers
10. World Health Assembly endorses new plan to increase global access to vaccines
11. FDA Approves SonixGPS Needle Guidance Technology for Vascular Access Procedures
Post Your Comments:
(Date:11/25/2015)... ... , ... Many people know of the common symptoms of low thyroid hormone ... But many people who find their cholesterol levels and weight are creeping up are ... if they don’t have any of the other symptoms. , Thyroid hormone plays a ...
(Date:11/25/2015)... ... November 25, 2015 , ... Students and parents have something to be thankful ... Create Real Impact awards. California Casualty is proud to support the contest ... distracted and reckless driving, the number one killer of young drivers. , Almost ...
(Date:11/24/2015)... ... November 24, 2015 , ... Eric C. Seidel, DMD and ... of the revolutionary BIOLASE WaterLase iPlus 2.0™ system. This advanced laser technology uses ... a dentist in Gettysburg, PA . From routine visits to cosmetic treatments, ...
(Date:11/24/2015)... Tucson, AZ (PRWEB) , ... November 24, 2015 , ... ... iPlus 2.0™ treatments from Dr. Angela Wolfman and Dr. Kedar S. Lele, who are ... used for frenectomies, cavities and fillings, the WaterLase iPlus 2.0™ system causes minimal discomfort ...
(Date:11/24/2015)... ... 2015 , ... In an article published November 12th by Obesity ... are or are not eligible for bariatric surgery. The article explains that candidates for ... than 100 pounds overweight, or have a BMI of 35 and over with at ...
Breaking Medicine News(10 mins):
(Date:11/25/2015)... Developmental, commercial, and regulatory/legal strategies ... of pharmaceutical products, says GBI Research ... strategies all play a key role in boosting the ... . --> Developmental, commercial, ... boosting the profitability of pharmaceutical products, says GBI ...
(Date:11/25/2015)... 2015 ... the  "Global Drug Device Combination Products ... offering.  --> ) ... "Global Drug Device Combination Products Market ... --> Research and Markets ( ...
(Date:11/24/2015)... , Nov. 24, 2015  Natera, ... in non-invasive genetic testing and the analysis ... it will present at the 27 th ... December 2, 2015 at 1:00 p.m. ET.  Matthew Rabinowitz, Ph.D., ... financial results, business activities and financial outlook. ...
Breaking Medicine Technology: