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Undocumented immigrants and advanced heart failure therapies
Matthew Kogan1, Sarah L Kimball1,2, Katherine Purrington3
1Section of General Internal Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine and Boston Medical Center.
JHLT Open
|March 27, 2025
Summary
Undocumented immigrants face barriers to advanced heart failure therapies due to provider misconceptions about immigration status, despite their contributions to organ donation. Improving access requires enhanced provider education and legal support.
Area of Science:
- Cardiology
- Health Equity
- Transplantation Medicine
Background:
- Undocumented immigrants contribute to the organ donor pool but face significant barriers to advanced heart failure therapies.
- Access to life-saving treatments is often hindered by systemic issues and provider perceptions.
Purpose of the Study:
- To investigate the challenges undocumented immigrants encounter when seeking advanced heart failure therapies.
- To identify key barriers, including provider awareness and perceptions of immigration status, affecting treatment access.
Main Methods:
- A survey was conducted among cardiologists at Massachusetts teaching hospitals.
- The survey assessed referral practices and perceived barriers related to patient immigration status for advanced therapies.
Main Results:
- 82.5% of providers refer patients with undocumented status for advanced therapies.
- However, 87.5% perceive immigration status as a barrier to transplantation, indicating a significant misconception.
- Key barriers identified include lack of provider awareness, social support issues, and timing constraints.
Conclusions:
- Despite referral rates, a majority of providers perceive immigration status as a barrier to advanced heart failure therapies.
- Addressing provider misconceptions through education and legal partnerships is essential to improve access for undocumented patients.
- Enhancing equity in advanced heart failure treatment is critical for this vulnerable population.
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