The incidence of end-stage renal disease is increasing at a very troubling rate worldwide. Renal transplantation generally is the preferred modality of renal replacement therapy resulting in a longer survival time compared with maintenance dialysis; however, in the United States, it is known that minority groups experience decreased access to renal transplantation. No one however has reported on the role of insurance status as a predictor of access to renal transplantation. Our research examined persons enrolled in the Medicare ESRD program and those - for various administrative reasons - were disqualified from enrolling and instead were enrolled in the California Medicaid program only. Important differences in access to kidney transplantation were found in our study suggesting the complexity of this issue.
Thamer M, Henderson SC, Ray NF, Rinehart CS, Greer JW, Danovitch GM. Unequal access to cadaveric kidney transplantation in California based on insurance status. Health Services Research 1999;34:879-900.