New Managed Care Study Findings Have Been Reported by Investigators at Albert Einstein College of Medicine (Impact of Race and Health Coverage On Listing and Waitlist Mortality In Pediatric Cardiac Transplantation): Managed Care

2023 JUL 10 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Researchers detail new data in Managed Care. According to news reporting from Bronx, New York, by NewsRx journalists, research stated, “Social factors like race and insurance affect transplant outcomes. However, little is known in pediatric heart transplantation.”

The news correspondents obtained a quote from the research from the Albert Einstein College of Medicine, “We hypothesized that race and insurance coverage impact list-ing and waitlist outcomes across eras. Data from the Pediatric Heart Transplant Society multi-center registry prospectively col-lected between January 1, 2000-December 31, 2019 were analyzed. Patients were divided by race as Black, White and other and by insurance coverage at listing (US governmental, US private and non-US single payer systems (UK, Canada). Clinical condition at listing and waitlist outcomes were compared across races and insurance coverages. Categorical variables were compared using a chi-square test and continuous variables using the Wilcoxon rank sum test. Risk factors for waitlist mortality were exam-ined using multiphase parametric hazard modeling. A sensitivity analysis using parametric hazard explored the interaction between race and insurance.At listing, compared to Whites (n = 5391) and others (n = 1167), Black patients (n = 1428) were older, more likely on US governmental insurance and had cardiomyopathy as the predominant diagnosis (p < 0.0001). Black patients were more likely to be higher status at listing, in hospital, on inotropes or a ventricular assist device (p < 0.0001). Black patients had significantly shorter time on the waitlist compared to other races (p < 0.0001) but had higher waitlist mortality (p = 0.0091), driven by the earlier era (2000-2009) (p = 0.0005), most promi-nently within the US private insurance cohort (p = 0.015). Outcomes were not different in other insurance cohorts or in the recent era (2010-2019). Black children are older and sicker at the time of listing, deteriorate more often and face a higher wait list mortality, despite a shorter waitlist period and favorable clinical factors, with improvement in the recent era associated with the recent US healthcare reforms.”

According to the news reporters, the research concluded: “The social construct of race appears to dis-advantage Black children by limiting referral, consideration or access to pediatric cardiac transplantation.”

This research has been peer-reviewed.

For more information on this research see: Impact of Race and Health Coverage On Listing and Waitlist Mortality In Pediatric Cardiac Transplantation. The Journal of Heart and Lung Transplantation, 2023;42(6):754-764. The Journal of Heart and Lung Transplantation can be contacted at: Elsevier Science Inc, Ste 800, 230 Park Ave, New York, NY 10169, USA.

Our news journalists report that additional information may be obtained by contacting Neha Bansal, Children’s Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, United States. Additional authors for this research include Ashwin K. Lal, Antonio G. Cabrera, Devin Koehl, Ryan S. Cantor, James K. Kirklin, William J. Ravekes, Scott R. Auerbach, Carissa M. Baker-Smith, Shahnawaz Amdani and Simon Urschel.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.healun.2022.12.002. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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