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. 2016 Dec;16(12):3504-3511.
doi: 10.1111/ajt.13827. Epub 2016 May 23.

Health Insurance Trends in United States Living Kidney Donors (2004 to 2015)

J R Rodrigue  1   2 , A Fleishman  1
Affiliations

Health Insurance Trends in United States Living Kidney Donors (2004 to 2015)

J R Rodrigue et al. Am J Transplant. 2016 Dec.

Abstract

Some transplant programs consider the lack of health insurance as a contraindication to living kidney donation. Still, prior studies have shown that many adults are uninsured at time of donation. We extend the study of donor health insurance status over a longer time period and examine associations between insurance status and relevant sociodemographic and health characteristics. We queried the United Network for Organ Sharing/Organ Procurement and Transplantation Network registry for all living kidney donors (LKDs) between July 2004 and July 2015. Of the 53 724 LKDs with known health insurance status, 8306 (16%) were uninsured at the time of donation. Younger (18 to 34 years old), male, minority, unemployed, less educated, unmarried LKDs and those who were smokers and normotensive were more likely to not have health insurance at the time of donation. Compared to those with no health risk factors (i.e. obesity, smoking, hypertension, estimated glomerular filtration rate <60, proteinuria) (14%), LKDs with 1 (18%) or ≥2 (21%) health risk factors at the time of donation were more likely to be uninsured (p < 0.0001). Among those with ≥2 health risk factors, blacks (28%) and Hispanics (27%) had higher likelihood of being uninsured compared to whites (19%; p < 0.001). Study findings underscore the importance of providing health insurance benefits to all previous and future LKDs.

Keywords: donors and donation; donors and donation: living, insurance; ethics and public policy; health services and outcomes research; kidney transplantation/nephrology.

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Conflict of interest statement

DISCLOSURE

The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Figures

Figure 1
Figure 1
Percentage of uninsured living kidney donors (LKDs) and U.S. adult population from 2004 to 2015.
Figure 2
Figure 2
Percentage of uninsured living kidney donors (LKDs) by race/ethnicity and number of health risk factors at time of donation. Health risk factors include obesity, hypertension, smoking, eGFR<60, and proteinuria.
Figure 3
Figure 3
Percentage of uninsured living kidney donors (LKDs) and U.S. adult population by UNOS/OPTN region.
See this image and copyright information in PMC

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References

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