Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Colorado Center for Transplant Care, Research and Education (CCTCARE), Aurora, CO, USA.
BMC Nephrol. 2022 Jul 15;23(1):251. doi: 10.1186/s12882-022-02879-4.
Hispanic Americans receive disproportionately fewer organ transplants than non-Hispanic whites. In 2018, the Hispanic Kidney Transplant Program (HKTP) was established as at the University of Colorado Hospital (UCH). The purpose of this quality improvement study was to examine the effect of this culturally sensitive program in reducing disparities in kidney transplantation.
We performed a mixed-methods analysis of data from 436 Spanish-speaking patients referred for transplant to UCH between 2015 and 2020. We compared outcomes for patients referred between 2015-2017 (n = 156) to those referred between 2018-2020 (n = 280). Semi-structured phone interviews were conducted with 6 patients per time period and with 6 nephrology providers in the Denver Metro Area. Patients and providers were asked to evaluate communication, transplant education, and overall experience.
When comparing the two time periods, there was a significant increase in the percentage of patients being referred (79.5% increase, p-0.008) and evaluated for transplant (82.4% increase, p = 0.02) during 2018-2020. While the number of committee reviews and number waitlisted increased during 2018-2020, it did not reach statistical significance (82.9% increase, p = 0.37 and 79.5% increase, p = 0.75, respectively. During patient and provider interviews, we identified 4 themes reflecting participation in the HKTP: improved communication, enhanced patient education, improved experience and areas for advancement. Overall, patients and providers reported a positive experience with the HKTP and noted improved patient understanding of the transplantation process.
The establishment of the HKTP is associated with a significant increase in Spanish-speaking Hispanic patients being referred and evaluated for kidney transplantation.
西班牙裔美国人接受器官移植的比例明显低于非西班牙裔白人。2018 年，科罗拉多大学医院（UCH）成立了西班牙裔肾脏移植计划（HKTP）。本质量改进研究的目的是检验该具有文化敏感性的项目在减少肾脏移植差异方面的效果。
我们对 2015 年至 2020 年期间向 UCH 转诊的 436 名讲西班牙语的患者的数据进行了混合方法分析。我们比较了 2015-2017 年（n=156）和 2018-2020 年（n=280）转诊患者的结果。对丹佛都会区的 6 名患者和 6 名肾病学提供者进行了半结构化电话访谈。要求患者和提供者评估沟通、移植教育和整体体验。
在比较两个时间段时，2018-2020 年转诊（79.5%的增长，p-0.008）和接受移植评估（82.4%的增长，p=0.02）的患者比例显著增加。虽然 2018-2020 年委员会审查次数和等待名单人数增加，但没有达到统计学意义（82.9%的增长，p=0.37 和 79.5%的增长，p=0.75）。在患者和提供者访谈中，我们确定了反映参与 HKTP 的 4 个主题：改善沟通、增强患者教育、改善体验和进步领域。总体而言，患者和提供者报告了 HKTP 的积极体验，并指出患者对移植过程的理解有所提高。
HKTP 的建立与西班牙语裔西班牙裔患者转诊和接受肾脏移植的比例显著增加有关。
