In this study, we have shown that liver transplant candidates covered by Medicare or Medicaid have poorer wait-list and transplant outcomes, including higher on-the-list and posttransplant mortality, even after adjustment for clinicodemographic confounders.The outcomes of liver transplantation may vary according to socioeconomic factors such as insurance coverage.05).Ĭonclusions: Liver transplant candidates covered by Medicare or Medicaid have poorer wait-list outcomes and higher posttransplant mortality. Having Medicare (adjusted hazard ratio, 1.24 95% CI, 1.17-1.31) or Medicaid (aHR, 1.14 95% CI, 1.06-1.21) was independently associated with higher posttransplant mortality ( P. Posttransplant mortality was 11.6% at 1 year, 20.1% at 3 years, 26.8% at 5 years, and 41.6% at 10 years. In multivariate analysis, adjusted for demographic and clinical factors, being covered by Medicare (odds ratio, 0.81 95% CI, 0.78-0.84) or Medicaid (OR, 0.76 95% CI, 0.73-0.79) was independently associated with a lower chance of receiving a transplant (reference: private insurance). After listing, 56% eventually received transplants (mean wait time of 229 days) and 22% dropped off the list. Fifty-nine percent were primarily covered by private insurance, 21% by Medicare, and 16% by Medicaid. Results: There were 177,862 liver transplant candidates with payer and outcomes data: The mean (SD) age was 54.1 (10.4) years, 64% were male, 39% had chronic hepatitis C with or without alcoholic liver disease (ALD), 19% had ALD alone, 17% had nonalcoholic steatohepatitis, and 16% had hepatocellular carcinoma. Methods: The US Scientific Registry of Transplant Recipients was used to select adults (≥18 years) wait-listed for liver transplantation in the United States (2001-2017) patients were followed until March 2018. Study Design: This was a retrospective cohort study of a national database. The aim of this study was to assess the association between the type of insurance payer and outcomes of liver transplant candidates and recipients in the United States. Objectives: The outcomes of liver transplantation may vary according to socioeconomic factors such as insurance coverage.
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