The case for value-based care in kidney transplantation: insights into geography, growth, and financial models.

IF 1.8 4区 医学 Q3 TRANSPLANTATION
Amber B Paulus, Dhiren Kumar, Vasco M Pontinha
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引用次数: 0

Abstract

Purpose of review: Kidney transplantation (KT) is the preferred treatment for end-stage renal disease (ESRD), yet systemic challenges, including geographic disparities, impede equitable access. This review evaluates transplant center activity and regional disparities using recent trends and discusses the potential of value-based care (VBC) models like the proposed Increasing Organ Transplant Access (IOTA) model to address these challenges.

Recent findings: Analysis of Organ Procurement and Transplantation Network (OPTN) data from 2021 to 2023 identified 185 of 322 transplant centers as potentially eligible for VBC inclusion. High ESRD prevalence states like Texas, California, and New York have the largest number of centers, while states like Wyoming and Vermont lack operational centers, creating access barriers. Growth in KT rates following the 2014 Kidney Allocation System (KAS) reforms has stabilized at 3-5% since 2023. Geographic disparities persist, with regions like the South Atlantic and Pacific showing high transplant activity but unmet demand relative to ESRD prevalence.

Summary: The proposed IOTA model could mitigate disparities by incentivizing infrastructure investment and prioritizing equitable access. Tailored VBC strategies are essential to addressing regional needs and improving KT equity and outcomes nationwide.

基于价值的肾移植护理案例:对地理、增长和金融模型的见解。
综述目的:肾移植(KT)是终末期肾病(ESRD)的首选治疗方法,但包括地理差异在内的系统性挑战阻碍了公平获取。本文利用最近的趋势评估了移植中心的活动和地区差异,并讨论了基于价值的护理(VBC)模型的潜力,如拟议的增加器官移植获取(IOTA)模型来解决这些挑战。最近的发现:器官获取和移植网络(OPTN)从2021年到2023年的数据分析确定了322个移植中心中的185个可能符合VBC纳入条件。ESRD高患病率的州,如德克萨斯州、加利福尼亚州和纽约州,拥有最多的中心,而怀俄明州和佛蒙特州等州缺乏运营中心,造成了准入障碍。自2023年以来,2014年肾脏分配制度(KAS)改革后的KT增长率稳定在3-5%。地域差异仍然存在,南大西洋和太平洋等地区显示出较高的移植活动,但相对于ESRD的患病率,需求未得到满足。摘要:提出的IOTA模型可以通过激励基础设施投资和优先考虑公平接入来缓解差距。量身定制的VBC战略对于解决区域需求和改善全国的KT公平性和成果至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
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