Rural Patients Less Likely To Receive Organ Transplants

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Rural Patients Less Likely To Receive Organ Transplants

ScienceDaily (Jan. 9, 2008) — Patients in small towns and isolated rural areas

have lower organ transplant rates and are less likely to be wait-listed than

patients in urban areas, according to a new study.

Organ transplantation offers the best, and often only hope for long-term

survival for patients with end-stage heart, liver, and kidney disease. However,

despite federal regulation and national efforts to ensure equal access to the

limited pool of donated organs, previous research has demonstrated the presence

of significant barriers to access to transplantation services for racial

minorities, women, and patients with low socioeconomic status or poor insurance,

according to background information in the article. Rural residents represent

another group that may have impaired access to transplant services. Nearly 14

percent of the U.S. population lives outside major urban areas.

A. Axelrod, M.D., M.B.A., of Dartmouth Medical School, Lebanon, N.H., and

colleagues assessed the impact of rural residence on waiting list registration

for heart, liver, and kidney transplant and rates of transplantation among

wait-listed candidates. A total of 174,630 patients who were wait-listed and who

underwent heart, liver, or kidney transplantation between 1999 and 2004 were

included in the study.

The researchers found significant disparities in access to organ transplantation

between rural and urban populations.

" This study demonstrates that patients living in small towns and isolated rural

regions were eight percent to 15 percent less likely to be wait-listed and ten

percent to 20 percent less likely to undergo heart, liver, and kidney

transplantation than patients in urban environments, " the authors write.

They suggest these discrepancies may be related to differences in the burden of

disease in rural environments or reduced access to entering the waiting list.

And they warn that the increasing concentration of transplant services in

high-volume urban centers may lead to increased access barriers for rural

patients.

" Further assessment of the disease burden facing rural residents and the

barriers in access to specialty care services is needed to ensure equitable

access to life-saving organ transplants, " the researchers conclude.

Journal reference: JAMA. 2008;299(2):202-208.

Adapted from materials provided by JAMA and Archives Journals.

http://www.sciencedaily.com/releases/2008/01/080108183106.htm

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