ArticleClinical transplantation2017
Impact of insurance status on heart transplant wait-list mortality for patients with left ventricular assist devices.
Article in Clinical transplantation, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review.Journal of the American Heart Association · 2023Pooled it
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Burden and predictors of mortality related to cardiogenic shock in the South Bronx Population.American journal of cardiovascular disease · 2024Article
- Increased disparities in waitlist and post-heart transplantation outcomes according to socioeconomic status with the new heart transplant allocation system.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2024Article
- Temporal trends in primary payers in pediatric heart transplant and association with long-term survival.Pediatric transplantation · 2023Article
- Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.Circulation · 2023Review
- A scoping review of inequities in access to organ transplant in the United States.International journal for equity in health · 2022Article
- Article
- Exception Status Listing in the New Adult Heart Allocation System: A New Solution to an Old Problem?Circulation. Heart failure · 2021Article
- Health Insurance and Left Ventricular Assist Device Outcomes: Focus on the Patient Journey, Not the Destination.Circulation. Heart failure · 2021Article
- Association of Health Insurance Payer Type and Outcomes After Durable Left Ventricular Assist Device Implantation: An Analysis of the STS-INTERMACS Registry.Circulation. Heart failure · 2021Article
- Racial Disparity in Liver Transplantation Listing.Journal of the American College of Surgeons · 2021Article
- Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.Circulation · 2021Article
- Effects of socioeconomic status on clinical outcomes with ventricular assist devices.Clinical cardiology · 2018Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesTo test the hypotheses that receipt of Medicaid or Medicare (versus private insurance or self-pay) and low socioeconomic status (SES) leads to increased mortality and lower chances of transplantation among heart transplant (HTx) candidates with bridge to transplant left ventricular assist devices (BTT LVADs).
backgroundSurvival while awaiting HTx has improved with the use of BTT LVADs. However, it is unknown whether benefits extend uniformly across patient groups based on insurance status.
methodsData from the United Network of Organ Sharing (UNOS) registry between 2006 and 2015 were examined for first-time HTx candidates ≥18 and <65 years who had LVAD support while wait-listed. Multivariable survival analysis was conducted on competing outcomes of mortality and time to transplant stratified by insurance source at the time of listing. Additional covariates included demographic information and SES.
resultsA total of 4626 patients met inclusion criteria, with 3353 being used for multivariable analysis. A majority of patients (68%) underwent HTx during the study period. BTT LVAD wait-list mortality was found to be greater among Medicaid beneficiaries vs. private insurance (SHR 1.57, P<.05) and did not diminish with the inclusion of neighborhood SES. Transplantation as an outcome demonstrated no difference by insurance status.
conclusionMedicaid insurance status is associated with worse survival on the HTx wait-list among patients with BTT LVADs, although access to transplant was not different among insurance groups. The disparity is not reflective of SES in general and therefore points to other barriers inherent to Medicaid beneficiaries.
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