Kidney Transplant Access in the Southeast: View From the Bottom

摘要: The Southeastern region of the United States has highest burden end-stage renal disease (ESRD) but lowest rates kidney transplantation in nation. There are many patient-, dialysis facility–, ESRD Network– and health system–level barriers that contribute to this regional disparity. Compared rest nation, Southeast a larger population African-Americans higher poverty, as well more prevalent risk factors including hypertension, obesity diabetes. Dialysis facilities—where patients receive majority their healthcare—play an important role transplant access. Identifying characteristics individual units with low transplantation, such understaffing or for-profit status, can help identify targets for quality improvement initiatives. Geographic differences across country opportunities increase funding healthcare resources proportion patient burden. Focusing interventions among facilities within Southeast, provider education, potential referrals leading transplants region. Referral should be measured on national level monitor disparities early access transplantation. Transplant centers have obligation assist under-served populations ensuring equity services. Policies improve care patients, Affordable Care Act Medicaid expansion, particularly Southern states may alleviate geographic disparities.