黒人,女性,貧困層における死体性腎臓移植に対する障壁
1School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
JAMA
|October 20, 1998
まとめ
死体腎臓移植へのアクセスにおける社会人口学的格差は,複数の段階で存在します. 医学的適性,関心,検査,待機リストの進行における障壁を克服することは,公平な腎臓配分に不可欠です.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 移植手術 移植手術について
- 医療サービス 研究 医療サービス
背景:
- 死体性腎臓移植の割合は,人種,性別,所得によって著しい差異を示しています.
- 以前の介入は,移植待ちリストに焦点を当て,以前の段階を無視していました.
研究 の 目的:
- 移植プロセスの各ステップが,死体腎臓移植率における社会人口学的差異に与える相対的な貢献を調査する.
主な方法:
- 長期透析を開始した7125人の患者の前向きなコホート研究 (1993-1996).
- フォローアップは,4つの主要なステップの完了を評価します:医療的適性/関心,明確な関心,移植前の作業,および移植待合者リストの進行.
主要な成果:
- 黒人患者は,ステップB (明確な関心),C (ワークアップ),D (移植) を完了する可能性が低い.
- 女性は,男性と比較して,4つのステップすべてにおいて,より低い完了率に直面しました.
- 低所得層の個人は,ステップA (適性/利息),ステップB (確定利息),ステップC (ワークアップ) を完了する可能性が低いことを示した.
結論:
- 死体腎臓移植へのアクセスにおける社会人口学的差異は,複数の段階での障壁の影響を受けています.
- 公平な腎臓の配分には,初期適合から最終移植まで,移植連続体の各段階を対象とした介入が必要です.
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