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Your chance of getting a kidney transplant in Ontario varies greatly, depending on where you live, according to research led by The Ottawa Hospital’s Dr. Greg Knoll.
Transplant rates across the province ranged from 7.4 per cent of patients in one regional kidney care program, to 31.4 per cent of patients in another one, findings that surprised Knoll, who is a senior scientist and head of the division of nephrology at The Ottawa Hospital as well as chair in clinical transplantation at the University of Ottawa.
“The degree of variability did surprise me,” he said.
The research was conducted after a study in the United States, conducted earlier, found wide variability in transplant rates there.
Although the U.S. and Canada health-care systems are very different, Knoll noted that similar variation was seen across Ontario. Research in the U.K., which has universal health care, found similar variability to the Canadian study, which could be explained, researchers said, by potentially different referral rates across regions, amount of education provided to potential recipients or staffing ratios. Similar issues should be looked into in Ontario, said Knoll, to better understand what is behind different transplant rates.
Ontario is divided into 27 regional renal programs. Researchers looked at transplant rates for patients across those programs. They have not released the regions connected with the data, but Knoll said easy access to a transplant centre doesn’t seem to be a major factor in how many kidney patients get transplants in a given region.
“Distance to transplant centre didn’t have an impact.”
There are adult kidney transplant centres in Ottawa, Kingston, London, Hamilton and two in Toronto.
The difference in transplant rates across Ontario persisted when researchers looked only at patients who were most eligible to receive transplants, those between 18 and 50, who didn’t have a history of cancer, diabetes or heart disease. For those patients, the transplant rate ranged from 32.5 per cent to 82.7 per cent across the province.
The study tracked 23,022 chronic dialysis patients, 46.1 per cent of whom died and 11.8 per cent of whom received a transplant. They were followed for up to 11 years. Compared to undergoing regular dialysis, kidney transplants are associated with improved survival, better quality of life and lower health-care costs, but the demand for deceased donor kidneys outpaces supply. There are currently more than 1,000 people on Ontario’s kidney transplant list.
In Ontario, kidney patients die every year while awaiting a transplant, and long waiting lists persist, all of which can make equal access to transplants a potentially life-or-death issue for some patients.
Although kidney transplant rates vary among Canadian provinces, according to previous research, this is the first time that variability has also been seen within one province.
According to the analysis, 15 of the 27 regional kidney care programs performed kidney transplants at the expected Ontario rate. Six programs had transplant rates that were higher and six had lower than expected rates.
“If we can find out why these disparities exist, then we can help make the kidney transplant system more equitable for all patients,” said Knoll.
The study was published in the American Journal of Transplantation on Monday.
epayne@postmedia.com
查看原文...
Transplant rates across the province ranged from 7.4 per cent of patients in one regional kidney care program, to 31.4 per cent of patients in another one, findings that surprised Knoll, who is a senior scientist and head of the division of nephrology at The Ottawa Hospital as well as chair in clinical transplantation at the University of Ottawa.
“The degree of variability did surprise me,” he said.
The research was conducted after a study in the United States, conducted earlier, found wide variability in transplant rates there.
Although the U.S. and Canada health-care systems are very different, Knoll noted that similar variation was seen across Ontario. Research in the U.K., which has universal health care, found similar variability to the Canadian study, which could be explained, researchers said, by potentially different referral rates across regions, amount of education provided to potential recipients or staffing ratios. Similar issues should be looked into in Ontario, said Knoll, to better understand what is behind different transplant rates.
Ontario is divided into 27 regional renal programs. Researchers looked at transplant rates for patients across those programs. They have not released the regions connected with the data, but Knoll said easy access to a transplant centre doesn’t seem to be a major factor in how many kidney patients get transplants in a given region.
“Distance to transplant centre didn’t have an impact.”
There are adult kidney transplant centres in Ottawa, Kingston, London, Hamilton and two in Toronto.
The difference in transplant rates across Ontario persisted when researchers looked only at patients who were most eligible to receive transplants, those between 18 and 50, who didn’t have a history of cancer, diabetes or heart disease. For those patients, the transplant rate ranged from 32.5 per cent to 82.7 per cent across the province.
The study tracked 23,022 chronic dialysis patients, 46.1 per cent of whom died and 11.8 per cent of whom received a transplant. They were followed for up to 11 years. Compared to undergoing regular dialysis, kidney transplants are associated with improved survival, better quality of life and lower health-care costs, but the demand for deceased donor kidneys outpaces supply. There are currently more than 1,000 people on Ontario’s kidney transplant list.
In Ontario, kidney patients die every year while awaiting a transplant, and long waiting lists persist, all of which can make equal access to transplants a potentially life-or-death issue for some patients.
Although kidney transplant rates vary among Canadian provinces, according to previous research, this is the first time that variability has also been seen within one province.
According to the analysis, 15 of the 27 regional kidney care programs performed kidney transplants at the expected Ontario rate. Six programs had transplant rates that were higher and six had lower than expected rates.
“If we can find out why these disparities exist, then we can help make the kidney transplant system more equitable for all patients,” said Knoll.
The study was published in the American Journal of Transplantation on Monday.
epayne@postmedia.com
查看原文...
