Department of Medicine, Division of Nephrology, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA.
The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.
Am J Transplant. 2018 Nov;18(11):2781-2790. doi: 10.1111/ajt.14985. Epub 2018 Jul 30.
Factors that patients value when choosing a transplant center have not been well studied. In order to guide the improvement of patient-facing materials, we conducted an anonymous electronic survey of patients that assessed the relative importance of patient experience, practical considerations, transplant center reputation, center experience, and waitlist when selecting a transplant center. A total of 409 respondents completed the survey, of whom 68% were kidney transplant recipients and 32% had chronic kidney disease or were on dialysis. Participants had mean age 56 ± 12 years and were predominantly female (61%), white (79%), and had an associate's degree or higher (68%). Participants most often prioritized waitlist when evaluating transplant centers (transplanted 26%, chronic kidney disease 40%), and waitlist was almost twice as likely as outcomes to be ranked most important (30% vs 17%). Education level and transplant status were significantly associated with factors used for center prioritization. Waitlisted respondents most commonly (48%) relied on physicians for information when selecting a center, while a minority cited transplant-specific organizations. In order to improve shared decision-making, materials outlining center-specific waitlist features should be prioritized. Novel patient-oriented metrics for measuring transplant center quality that align with patient priorities must be explored.
患者在选择移植中心时看重的因素尚未得到充分研究。为了指导面向患者材料的改进，我们对患者进行了一项匿名的电子调查，评估患者在选择移植中心时对患者体验、实际考虑因素、移植中心声誉、中心经验和等待名单的相对重要性。共有 409 名受访者完成了调查，其中 68%是肾移植受者，32%患有慢性肾脏病或正在接受透析。参与者的平均年龄为 56 ± 12 岁，主要为女性（61%）、白人（79%），且具有大专或以上学历（68%）。参与者在评估移植中心时最常优先考虑等待名单（移植患者中 26%，慢性肾脏病患者中 40%），且等待名单被列为最重要因素的可能性几乎是结果的两倍（30%比 17%）。教育程度和移植状况与中心优先排序因素显著相关。等待名单上的受访者在选择中心时最常（48%）依赖医生的信息，而少数人引用了移植特定的组织。为了改善共同决策，应优先考虑概述中心特定等待名单特征的材料。必须探索与患者优先事项一致的、以患者为导向的新的衡量移植中心质量的指标。
