1. Moving past "think local, act global": A perspective on geographic disparity.
- Author
-
Lynch RJ, Magliocca JF, Hundley JC, and Karp SJ
- Subjects
- Geography, Humans, Regional Health Planning, United States, Health Services Needs and Demand organization & administration, Healthcare Disparities, Liver Transplantation statistics & numerical data, Tissue Donors supply & distribution, Tissue and Organ Procurement organization & administration, Waiting Lists
- Abstract
The transplant community has debated the necessity and merits of broader organ distribution for several years, but the debate has been fundamentally shaped by inaccurate assessments of donor supply and demand. The possible legal requirements of distribution must be balanced with (a) the moral and statutory imperatives to reduce inequities resulting from socioeconomic disparity, and (b) the shortcomings of MELD in predicting mortality risk in rural areas. In this viewpoint, we use the example of liver transplantation to discuss the drivers of geographic disparity as a direct consequence of donation rates, local organ use, wealth, and poverty. Seen in this light, strategies seeking to equalize MELD at transplant across the United States risk severely exacerbating existing inequalities in access to health care., (© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2019
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