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The Wallet Biopsy: Medical Crowdfunding for Heart Transplantation
Ersilia M Defilippis1, Adhya Mehta2, Fatimah A Alkhunaizi1
1Division of Cardiology, Columbia University Irving Medical Center, New York, NY.
Insights
Crowdfunding is used by many heart transplant candidates facing significant financial toxicity. Many campaigns raise little money, highlighting disparities in access to care.
Area of Science:
- Cardiology
- Health Economics
- Transplantation Medicine
Background:
- Financial barriers significantly impede access to heart transplantation.
- Patients face numerous costs, including hospitalization, medications, and travel.
- Crowdfunding has emerged as a potential, albeit insufficient, support mechanism.
Purpose of the Study:
- To describe the landscape of crowdfunding for heart transplant candidates.
- To identify characteristics of campaigns and fundraising outcomes.
- To understand the financial toxicity associated with heart transplantation.
Main Methods:
- A review of 1000 GoFundMe campaigns using the search term "heart transplant".
- Inclusion criteria resulted in 634 campaigns for analysis.
- Campaign demographics, fundraising amounts, and patient admission status were analyzed.
Main Results:
- Most campaigns supported white, male, adult patients.
- 15% of campaigns raised no funds; others raised a median of $53.24/day.
- 44% of patients were hospitalized during fundraising; highest activity in non-Medicaid expansion states.
Conclusions:
- Crowdfunding reveals substantial financial burdens for heart transplant candidates.
- Significant disparities exist, particularly in non-Medicaid expansion states.
- Advocacy for improved governmental and payer coverage is crucial for equitable access.
Abstract:
Financial considerations continue to impact access to heart transplantation. Transplant recipients face various costs, including, but not limited to, the index hospitalization, immunosuppressive medications, and lodging and travel to appointments. In this study, we sought to describe the state of crowdfunding for individuals being evaluated for heart transplantation. Using the search term heart transplant, 1000 GoFundMe campaigns were reviewed. After exclusions, 634 (63.4%) campaigns were included. Most campaigns were in support of white individuals (57.8%), males (63.1%) and adults (76.7%). Approximately 15% of campaigns had not raised any funds. The remaining campaigns fundraised a median of $53.24 dollars per day. Of the patients, 44% were admitted at the time of the fundraising. Within the campaigns in the United States, the greatest proportions were in the Southeast United States in non-Medicaid expansion states. These findings highlight the significant financial toxicities associated with heart transplantation and the need for advocacy at the governmental and payer levels to improve equitable access and coverage for all.
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