Machado Sara, Perez Beatrice, Papanicolas Irene
Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI 02903, United States.
Department of Health Policy, London School of Economics, London WC2A 2AE, United Kingdom.
Health Aff Sch. 2024 Feb 28;2(3):qxae027. doi: 10.1093/haschl/qxae027. eCollection 2024 Mar.
Medical crowdfunding is a key source of financing for individuals facing high out-of-pocket costs, including organ-transplant candidates. However, little is known about racial disparities in campaigning activity and outcomes, or how these relate to access to care. In this exploratory, nationwide, cross-sectional study, we examined racial disparities in campaigning activity across states and the association between US campaigners' race and ethnicity and crowdfunding outcomes using a novel database of organ-transplant-related campaigns, and an algorithm to identify race and ethnicity based on name and geographic location. This analysis suggests that there are racial disparities in individuals' ability to successfully raise requested funds, with Black and Hispanic campaigners fundraising lower amounts and less likely to achieve their monetary goals. We also found that crowdfunding among White, Black, and Hispanic populations exhibits different patterns of activity at the state level, and in relation to race-specific uninsurance and waitlist additions, highlighting potential differences in fundraising need across the 3 groups. Policy efforts should consider not only how inequalities in fundraising ability for associated costs influence accessibility to care but also how to identify clinical need among minorities.
医疗众筹是面临高额自付费用的个人(包括器官移植候选人)的关键融资来源。然而,对于竞选活动和结果中的种族差异,或者这些差异与医疗服务可及性之间的关系,我们知之甚少。在这项探索性的全国横断面研究中,我们使用一个与器官移植相关的竞选活动的新数据库,以及一种基于姓名和地理位置识别种族和民族的算法,研究了各州竞选活动中的种族差异,以及美国竞选者的种族和民族与众筹结果之间的关联。该分析表明,个人成功筹集所需资金的能力存在种族差异,黑人和西班牙裔竞选者筹集的资金较少,实现货币目标的可能性也较小。我们还发现,白人、黑人和西班牙裔人群中的众筹在州层面以及与特定种族的未参保率和加入等待名单情况相关的方面呈现出不同的活动模式,凸显了这三个群体在筹资需求上的潜在差异。政策措施不仅应考虑相关费用的筹资能力不平等如何影响医疗服务可及性,还应考虑如何识别少数群体中的临床需求。