The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation
Abstract Aims Adequate health insurance coverage is necessary for heart transplantation (HT) candidates. Prior studies have suggested inferior outcomes post HT with public health insurance. We sought to evaluate the effects of insurance type on transplantation rates, listing status and mortality pri...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-06-01
|
| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.12655 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832544433713709056 |
|---|---|
| author | Alexandros Briasoulis Emmanuel Akintoye Chakradhari Inampudi Aziz Hammoud Paulino Alvarez |
| author_facet | Alexandros Briasoulis Emmanuel Akintoye Chakradhari Inampudi Aziz Hammoud Paulino Alvarez |
| author_sort | Alexandros Briasoulis |
| collection | DOAJ |
| description | Abstract Aims Adequate health insurance coverage is necessary for heart transplantation (HT) candidates. Prior studies have suggested inferior outcomes post HT with public health insurance. We sought to evaluate the effects of insurance type on transplantation rates, listing status and mortality prior to HT. Methods and results Patients ≥18 years old with a left ventricular assist device implanted and listed with 1A status were identified in the United Network for Organ Sharing registry between January 2010 and December 2017, with follow‐up through March 2018. Patients were grouped based on the type of insurance private/self‐pay (PV), Medicare (MC), and Medicaid (MA) at the time of listing. We conducted multivariable competing risks regression analysis on listing status and mortality on the waiting list, stratified by insurance type at the time of listing. We identified 2604 patients listed in status 1A (PV: 51.4%, MC: 32.1%, and MA: 16.5%). MA patients were younger (43.5 vs. 56.4 for MC vs. 51.5 for PV, P < 0.001) and less frequently White (P < 0.001). The cumulative incidence of HT did not differ among the three insurance types (PV: 74.8%, MC 76.3%, and MA 71.1%, P = 0.14). The cumulative mortality on the waiting list prior to HT was not different among groups (PV: 29.3%, MC 26.3%, and MA 21.8%, P = 0.94). Μore patients with MA were removed from the list because of improvement of their condition (MA 40.3% vs. MC 28.3% and PV 32.8%). Conclusions We did not detect any disparities in listing status and mortality among different insurance types. |
| format | Article |
| id | doaj-art-c61a628da7314e61a8b04d99d7d6c178 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-c61a628da7314e61a8b04d99d7d6c1782025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017380481010.1002/ehf2.12655The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantationAlexandros Briasoulis0Emmanuel Akintoye1Chakradhari Inampudi2Aziz Hammoud3Paulino Alvarez4Division of Cardiovascular Diseases, Section of Heart Failure and Transplant University of Iowa Hospitals and Clinics Iowa City IA USADivision of Cardiovascular Diseases, Section of Heart Failure and Transplant University of Iowa Hospitals and Clinics Iowa City IA USADivision of Cardiovascular Diseases, Section of Heart Failure and Transplant University of Iowa Hospitals and Clinics Iowa City IA USADivision of Cardiovascular Diseases, Section of Heart Failure and Transplant University of Iowa Hospitals and Clinics Iowa City IA USADivision of Cardiovascular Diseases, Section of Heart Failure and Transplant University of Iowa Hospitals and Clinics Iowa City IA USAAbstract Aims Adequate health insurance coverage is necessary for heart transplantation (HT) candidates. Prior studies have suggested inferior outcomes post HT with public health insurance. We sought to evaluate the effects of insurance type on transplantation rates, listing status and mortality prior to HT. Methods and results Patients ≥18 years old with a left ventricular assist device implanted and listed with 1A status were identified in the United Network for Organ Sharing registry between January 2010 and December 2017, with follow‐up through March 2018. Patients were grouped based on the type of insurance private/self‐pay (PV), Medicare (MC), and Medicaid (MA) at the time of listing. We conducted multivariable competing risks regression analysis on listing status and mortality on the waiting list, stratified by insurance type at the time of listing. We identified 2604 patients listed in status 1A (PV: 51.4%, MC: 32.1%, and MA: 16.5%). MA patients were younger (43.5 vs. 56.4 for MC vs. 51.5 for PV, P < 0.001) and less frequently White (P < 0.001). The cumulative incidence of HT did not differ among the three insurance types (PV: 74.8%, MC 76.3%, and MA 71.1%, P = 0.14). The cumulative mortality on the waiting list prior to HT was not different among groups (PV: 29.3%, MC 26.3%, and MA 21.8%, P = 0.94). Μore patients with MA were removed from the list because of improvement of their condition (MA 40.3% vs. MC 28.3% and PV 32.8%). Conclusions We did not detect any disparities in listing status and mortality among different insurance types.https://doi.org/10.1002/ehf2.12655LVADInsuranceHeart transplantation |
| spellingShingle | Alexandros Briasoulis Emmanuel Akintoye Chakradhari Inampudi Aziz Hammoud Paulino Alvarez The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation ESC Heart Failure LVAD Insurance Heart transplantation |
| title | The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation |
| title_full | The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation |
| title_fullStr | The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation |
| title_full_unstemmed | The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation |
| title_short | The impact of insurance type on listing status and wait‐list mortality of patients with left ventricular assist devices as bridge to transplantation |
| title_sort | impact of insurance type on listing status and wait list mortality of patients with left ventricular assist devices as bridge to transplantation |
| topic | LVAD Insurance Heart transplantation |
| url | https://doi.org/10.1002/ehf2.12655 |
| work_keys_str_mv | AT alexandrosbriasoulis theimpactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT emmanuelakintoye theimpactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT chakradhariinampudi theimpactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT azizhammoud theimpactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT paulinoalvarez theimpactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT alexandrosbriasoulis impactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT emmanuelakintoye impactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT chakradhariinampudi impactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT azizhammoud impactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation AT paulinoalvarez impactofinsurancetypeonlistingstatusandwaitlistmortalityofpatientswithleftventricularassistdevicesasbridgetotransplantation |