Hod Tammy, Goldfarb-Rumyantzev Alexander S
Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston , MA .
Ren Fail. 2014 Sep;36(8):1193-9. doi: 10.3109/0886022X.2014.934179. Epub 2014 Jul 2.
Research focused on identifying vulnerable populations and revealing specific risk factors for barriers along the pathway from ESRD to kidney transplantation has been mostly descriptive and the causes of existing disparities remain unclear. However, several socio-economic factors that are associated with the access to and the outcome of the kidney transplantation have been identified.
While the presence of racial, gender, and geographic disparities is noted, we were interested mostly to describe potential socio-economic factors associated with and possibly responsible for the presence of such disparities. In this review we focused on five factors: education level, employment status, income, presence of substance addiction or abuse, and marital status. We describe the new method to quantify patients' socio-economic status and identify the group of high risk in terms of the transplant outcome, easily calculated social adaptability index, previously associated with clinical outcome in several patient populations including those with kidney transplant. At the end, based on literature analyzed we offer potential interventions that potentially can be used in order to reduce the degree of disparities.
Based on review of literature socio-economic factors are associated with and possibly responsible for healthcare disparities. Social adaptability index allows quantifying the degree of socio-economic status and identifying the group of high risk for inferior transplant outcome.
针对识别弱势群体以及揭示从终末期肾病到肾移植过程中存在障碍的特定风险因素的研究大多是描述性的，现有差异的原因仍不明确。然而，已经确定了一些与肾移植的可及性和结果相关的社会经济因素。
虽然注意到存在种族、性别和地理差异，但我们主要感兴趣的是描述与这些差异的存在相关并可能导致这些差异的潜在社会经济因素。在本综述中，我们关注五个因素：教育水平、就业状况、收入、药物成瘾或滥用情况以及婚姻状况。我们描述了一种量化患者社会经济状况的新方法，并根据移植结果确定高风险组，即易于计算的社会适应指数，该指数先前与包括肾移植患者在内的多个患者群体的临床结果相关。最后，基于所分析的文献，我们提供了可能用于减少差异程度的潜在干预措施。
基于文献综述，社会经济因素与医疗保健差异相关并可能导致这些差异。社会适应指数能够量化社会经济状况的程度，并识别移植结果较差的高风险组。
