Non-medical barriers in access to early steps of kidney transplantation in the United States – A scoping review
In the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented. Barriers in access to earlier steps (i.e. referral and evaluation) are less well described due to the lack of national surveillance data. In this review, w...
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Published in | Transplantation reviews (Philadelphia, Pa.) Vol. 35; no. 4; p. 100654 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Elsevier Inc
01.12.2021
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Subjects | |
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Abstract | In the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented. Barriers in access to earlier steps (i.e. referral and evaluation) are less well described due to the lack of national surveillance data. In this review, we summarize the available literature on non-medical barriers in access to kidney transplant referral and evaluation.
Following PRISMA guidelines, we conducted a scoping review of the literature through June 3, 2021. We included all studies (quantitative and qualitative) reporting on barriers to kidney transplant referral and evaluation in the US published from 1990 onwards in English and among adult end-stage kidney disease (ESKD) patients (PROSPERO registration number: CRD42014015027). We narratively synthesized results across studies.
We retrieved information from 33 studies published from 1990 to 2021 (reporting data between 1990 and 2018). Most studies (n = 28, 85%) described barriers among patient populations, three (9%) among provider populations, and two (6%) included both patients and providers. Key barriers were identified across multiple levels and included patient- (e.g. demographic, socioeconomic, sociocultural, and knowledge), provider- (e.g. miscommunication, staff availability, provider perceptions and attitudes), and system- (e.g. geography, distance to care, healthcare logistics) level factors.
A multi-pronged approach (e.g. targeted and systemwide interventions, and policy change) implemented at multiple levels of the healthcare system will be necessary to reduce identified barriers in access to early kidney transplant steps. Collection of national surveillance data on these early kidney transplant steps is also needed to enhance our understanding of barriers to referral and evaluation.
•Non-medical barriers to kidney transplant exist at referral and evaluation steps.•Barriers are multi-level, operating at individual, provider, and system-levels.•A multi-pronged approach is needed to improve equitable access to early transplant steps. |
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AbstractList | BACKGROUNDIn the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented. Barriers in access to earlier steps (i.e. referral and evaluation) are less well described due to the lack of national surveillance data. In this review, we summarize the available literature on non-medical barriers in access to kidney transplant referral and evaluation. METHODSFollowing PRISMA guidelines, we conducted a scoping review of the literature through June 3, 2021. We included all studies (quantitative and qualitative) reporting on barriers to kidney transplant referral and evaluation in the US published from 1990 onwards in English and among adult end-stage kidney disease (ESKD) patients (PROSPERO registration number: CRD42014015027). We narratively synthesized results across studies. RESULTSWe retrieved information from 33 studies published from 1990 to 2021 (reporting data between 1990 and 2018). Most studies (n = 28, 85%) described barriers among patient populations, three (9%) among provider populations, and two (6%) included both patients and providers. Key barriers were identified across multiple levels and included patient- (e.g. demographic, socioeconomic, sociocultural, and knowledge), provider- (e.g. miscommunication, staff availability, provider perceptions and attitudes), and system- (e.g. geography, distance to care, healthcare logistics) level factors. CONCLUSIONSA multi-pronged approach (e.g. targeted and systemwide interventions, and policy change) implemented at multiple levels of the healthcare system will be necessary to reduce identified barriers in access to early kidney transplant steps. Collection of national surveillance data on these early kidney transplant steps is also needed to enhance our understanding of barriers to referral and evaluation. In the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented. Barriers in access to earlier steps (i.e. referral and evaluation) are less well described due to the lack of national surveillance data. In this review, we summarize the available literature on non-medical barriers in access to kidney transplant referral and evaluation. Following PRISMA guidelines, we conducted a scoping review of the literature through June 3, 2021. We included all studies (quantitative and qualitative) reporting on barriers to kidney transplant referral and evaluation in the US published from 1990 onwards in English and among adult end-stage kidney disease (ESKD) patients (PROSPERO registration number: CRD42014015027). We narratively synthesized results across studies. We retrieved information from 33 studies published from 1990 to 2021 (reporting data between 1990 and 2018). Most studies (n = 28, 85%) described barriers among patient populations, three (9%) among provider populations, and two (6%) included both patients and providers. Key barriers were identified across multiple levels and included patient- (e.g. demographic, socioeconomic, sociocultural, and knowledge), provider- (e.g. miscommunication, staff availability, provider perceptions and attitudes), and system- (e.g. geography, distance to care, healthcare logistics) level factors. A multi-pronged approach (e.g. targeted and systemwide interventions, and policy change) implemented at multiple levels of the healthcare system will be necessary to reduce identified barriers in access to early kidney transplant steps. Collection of national surveillance data on these early kidney transplant steps is also needed to enhance our understanding of barriers to referral and evaluation. •Non-medical barriers to kidney transplant exist at referral and evaluation steps.•Barriers are multi-level, operating at individual, provider, and system-levels.•A multi-pronged approach is needed to improve equitable access to early transplant steps. |
ArticleNumber | 100654 |
Author | Snow, Kylie Urbanski, Megan Patzer, Rachel E. Perez, Aubriana Retzloff, Samantha White, Mia S. Harding, Jessica L. |
Author_xml | – sequence: 1 givenname: Jessica L. surname: Harding fullname: Harding, Jessica L. email: Jessica.harding@emory.edu organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America – sequence: 2 givenname: Aubriana surname: Perez fullname: Perez, Aubriana organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America – sequence: 3 givenname: Kylie surname: Snow fullname: Snow, Kylie organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America – sequence: 4 givenname: Samantha surname: Retzloff fullname: Retzloff, Samantha organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America – sequence: 5 givenname: Megan surname: Urbanski fullname: Urbanski, Megan organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America – sequence: 6 givenname: Mia S. surname: White fullname: White, Mia S. organization: Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, United States of America – sequence: 7 givenname: Rachel E. surname: Patzer fullname: Patzer, Rachel E. organization: Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States of America |
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Snippet | In the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented. Barriers in... BACKGROUNDIn the United States (US), barriers in access to later steps in the kidney transplantation process (i.e. waitlisting) have been well documented.... |
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Title | Non-medical barriers in access to early steps of kidney transplantation in the United States – A scoping review |
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