Heart transplant recipients who live in poorer neighborhoods face a higher risk of mortality and graft failure, according to new registry data. The study found that treatment at high-volume centers does not mitigate these disparities. Lead investigator Sara Sakowitz emphasized that while receiving care at higher-quality hospitals is important, it does not address the underlying causes of unequal outcomes. Factors such as access to follow-up care, immunosuppressive medications, and ongoing support after discharge are crucial in improving outcomes.
The study aimed to examine disparities in heart transplantation outcomes that go beyond individual factors and delve into community-level disparities and structural barriers. The findings revealed a significant association between area socioeconomic distress and survival rates. Patients living in more deprived neighborhoods had lower survival rates at both one and five years post-transplant compared to those in less-deprived areas. The analysis also highlighted that graft failure was more likely to cause death among patients from the most-deprived areas.
Notably, even when the analysis focused solely on high-volume centers, there was still a discrepancy in survival rates and allograft survival between patients from deprived and less-deprived areas. This suggests that the impact of socioeconomic disadvantage on outcomes cannot be entirely mitigated by receiving care at high-volume centers.
Experts note that addressing these disparities in heart transplantation outcomes requires tackling systemic issues and increasing engagement with longitudinal follow-up care. Efforts should focus on improving access to clinicians, medications, and regular checkups for patients from any neighborhood or socioeconomic status. Education materials should be tailored to match patients’ health literacy levels, ensuring that vital information is effectively communicated. Additionally, telehealth can play a significant role in improving follow-up care, especially for patients with transportation or economic barriers.
Advocacy is also essential in effecting change. The Immuno Bill, which guarantees immunosuppression medications to kidney transplant patients, serves as an example of what can be achieved through collective efforts. Experts emphasize the need for heart transplant programs to fight for similar legislation to alleviate the financial burden faced by heart transplant patients.
While the challenges ahead may seem daunting, experts encourage healthcare professionals and policymakers to focus on identifying small changes that can be made to address these systemic barriers. By starting somewhere and making incremental progress, it is possible to improve outcomes and create a more equitable transplantation system.
In conclusion, the study’s findings shed light on the impact of socioeconomic disparities on heart transplant outcomes. Despite the importance of receiving care at high-volume centers, the study highlights the need to address systemic issues and ensure access to long-term follow-up care and support. By advocating for change, tailoring education materials, and utilizing telehealth, stakeholders can work towards mitigating these disparities and improving outcomes for heart transplant recipients.
