Brian Wayda|Autumn Clemons|Raymond C. Givens|Koji Takeda|Hiroo Takayama|F. Latif|Susan Restaino|Yoshifumi Naka|Maryjane Farr|P.C. Colombo|V.K. Topkara
Socioeconomic Disparities in Adherence and Outcomes After Heart Transplant
Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University|Columbia University
background mixed evidence racial socioeconomic disparities heart transplant outcomes underlying causeand whether individual communitylevel traits influentialremains unclear current study aimed characterize socioeconomic disparities outcomes identify time trends mediators disparities methods results used united network organ sharing registry data included 33 893 adult heart transplant recipients 1994 2014 socioeconomic status ses indicators included insurance education neighborhood ses measured using composite index black race multiple indicators low ses associated primary outcome death retransplant independent baseline clinical characteristics blacks lower hla race matching adjustment graft characteristics slightly attenuated association black race hr 125 adjustment associations neighborhood ses hr 119 lowest versus highest decile medicare hr 117 medicaid hr 129 college education hr 090 remained significant full adjustment comparing early 19942000 late 20012014 cohorts disparities associated middle second third quartiles significantly decreased time associated lowest ses quartile black race persisted low neighborhood ses also associated higher risks noncompliance hr 176 rejection hr 128 hospitalization hr 113 infection hr 110 conclusions racial socioeconomic disparities exist heart transplant outcomes latter may narrowing time disparities explained differences clinical graft characteristics