Department of Surgery, Division of Transplantation, University of Louisville, Louisville, KY 40292, USA.
Clin Transplant. 2012 Mar-Apr;26(2):242-6. doi: 10.1111/j.1399-0012.2011.01441.x. Epub 2011 Apr 5.
Data on employment outcomes after successful renal transplantation are few. We conducted this study to identify favorable factors for employment after transplantation.
Adult patients <65 yr of age who underwent renal transplantation between January 1, 2002 and December 31, 2007 were surveyed. Patients with graft survival <1 yr were excluded. We also tested their knowledge of Medicare coverage after transplantation. Data were analyzed using chi-squared and Fisher's exact tests. p-Value <0.05 was considered statistically significant.
A 55% response rate was obtained where 56% of respondents were employed after transplantation. Race, marital status, previous transplant, and complicated post-operative course did not influence employment. Favorable factors include male gender (p=0.04), younger age (<40 [p=0.0003] or <50 yr [p<0.0001]), having ≥1 dependent (p=0.04), higher education (minimum high school degree [p=0.003] or some college [p=0.002]), live donor recipient (p=0.004), wait time <2 yr (p=0.03), dialysis <2 yr (p<0.0001) or pre-dialysis (p=0.04), and pre-transplantation employment (p<0.0001). Mean time for employment was 4.9±6.3 months (median three months). Common reasons for unemployment were disability (59%) and retirement (27%). Finally, 7% correctly responded that Medicare benefits end 36 months following transplantation.
Potentially modifiable factors to improve employment are earlier referral and better education regarding Medicare eligibility.
成功肾移植后就业结果的数据很少。我们进行这项研究是为了确定移植后就业的有利因素。
对 2002 年 1 月 1 日至 2007 年 12 月 31 日期间接受肾移植的年龄<65 岁的成年患者进行调查。排除移植后 1 年内移植物存活的患者。我们还测试了他们对移植后医疗保险覆盖范围的了解。使用卡方和 Fisher 精确检验分析数据。p 值<0.05 被认为具有统计学意义。
我们获得了 55%的应答率，其中 56%的患者在移植后就业。种族、婚姻状况、既往移植和复杂的术后病程并未影响就业。有利因素包括男性（p=0.04）、较年轻（<40 岁 [p=0.0003] 或 <50 岁 [p<0.0001]）、有≥1 个受抚养人（p=0.04）、更高的教育程度（至少高中文凭 [p=0.003] 或一些大学 [p=0.002]）、活体供者受者（p=0.004）、等待时间<2 年（p=0.03）、透析<2 年（p<0.0001）或透析前（p=0.04）以及移植前就业（p<0.0001）。就业的平均时间为 4.9±6.3 个月（中位数为三个月）。失业的常见原因是残疾（59%）和退休（27%）。最后，7%的人正确回答说，医疗保险福利在移植后 36 个月结束。
可改善就业的潜在可改变因素是更早转诊和更好地了解医疗保险资格。
