ArticleAmerican heart journal2017
County socioeconomic characteristics and heart transplant outcomes in the United States.
Article in American heart journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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Who cites it
8 citing papers in PubMed.
- Individual- and Community-Level Socioeconomic Status and Deceased Donor Renal Transplant Outcomes.Journal of racial and ethnic health disparities · 2025Article
- Heart transplantation in patients from socioeconomically distressed communities.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 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
- Disparities in heart and lung transplantation.Current opinion in organ transplantation · 2021Review
- Designing a patient-specific search of transplant program performance and outcomes: Feedback from heart transplant candidates and recipients.Clinical transplantation · 2021Article
- County Rankings Have Limited Utility When Predicting Liver Transplant Outcomes.Digestive diseases and sciences · 2020Article
- Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review.JMIR public health and surveillance · 2019Review
- County socioeconomic characteristics and pediatric renal transplantation outcomes.Pediatric nephrology (Berlin, Germany) · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundGeographic disparities in survival after heart transplantation have received mixed support in prior studies, and specific geographic characteristics that might be responsible for these differences are unclear. We tested for differences in heart transplant outcomes across United States (US) counties after adjustment for individual-level covariates. Our secondary aim was to evaluate whether specific county-level socioeconomic characteristics explained geographic disparities in survival.
methodsData on patients aged ≥18 years undergoing a first-time heart transplant between July 2006 and December 2014 were obtained from the United Network for Organ Sharing. Residents of counties represented by <5 patients were excluded. Patient survival (censored in March 2016) was analyzed using multivariable Cox regression. Shared frailty models were used to test for residual differences in overall all-cause mortality across counties after adjusting for recipient and donor characteristics. Measures of county economic disadvantage, inequality, and racial segregation were obtained from US Census data and coded into quintiles. A likelihood ratio test determined whether adjusting for each county measure improved the fit of the Cox model.
resultsMultivariable analysis of 10,879 heart transplant recipients found that, adjusting for individual-level characteristics, there remained statistically significant variation in mortality hazard across US counties (P=.004). Adjusting for quintiles of community disadvantage, economic inequality, or racial segregation did not significantly improve model fit (likelihood ratio test P=.092, P=.273, and P=.107, respectively) and did not explain residual differences in patient survival across counties.
conclusionsHeart transplantation outcomes vary by county, but this difference is not attributable to county-level socioeconomic disadvantage.
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