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Impact of Medicaid expansion on kidney transplantation in the State Oklahoma

World Journal of Transplantation 2024年第3期14卷 110-119页

作者： hyoshin kwon Zoya Sandhu Zoona Sarwar Oya M Andacoglu Department of Surgery Division of TransplantationOu College of MedicineOK 73104United States Department of Internal Medicine University of OklahomaTulsa School of Community MedicineTulsaOK 74135United States Department of Surgery University of Oklahoma College of MedicineOklahomaOK 73104United States Department of Transplantation and Advanced Hepatobiliary Surgery University of UtahSalt LakeUT 84112United States

BACKGROUND There is no data evaluating the impact of Medicaid expansion on kidney tran-splants(KT)in *** To investigate the impact of Medicaid expansion on KT patients in *** The UNOS database was utilized to evaluate data pertaining to adult KT reci-pients in Oklahoma in the pre-and post-Medicaid *** analysis,Kaplan Meier analysis was used to estimate,and cox proportional models were *** There were 2758 pre-and 141 recipients in the post-Medicaid expansion ***-expansion patients were more often non-United States citizens(2.3%vs 5.7%),American Indian,Alaskan,or Pacific Islander(7.8%vs 9.2%),Hispanic(7.4%vs 12.8%),or Asian(2.5%vs 8.5%)(P<0.0001).Waitlist time was shorter in the post-expansion era(410 vs 253 d)(P=0.0011).Living donor rates,pre-emptive transplants,re-do transplants,delayed graft function rates,kidney donor profile index values,panel reactive antibodies levels,and insurance types were *** with public insurance were more *** increased early(<6 months)rejection rates,1-year patient and graft survival were *** Cox proportional hazards model,male sex,American Indian,Alaskan or Pacific Islander race,public insurance,and frailty category were independent risk factors for death at 1 *** expansion was not associated with graft failure or patient survival(adjusted hazard ratio:1.07;95%CI:0.26-4.41).CONCLUSION Medicaid expansion in Oklahoma is associated with increased KT access for non-White/non-Black and non-United States citizen patients with shorter wait times.1-year graft and patient survival rates were similar before and after *** expansion itself was not independently associated with graft or patient survival *** research is necessary to determine the long-term effects of Medicaid expansion.

关键词： Medicaid expansion Oklahoma Kidney transplant

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