No survival benefit to gaining private health insurance coverage for post-lung transplant care in adults with cystic fibrosis

Clinical Transplantation
Dmitry TuminDon Hayes

Abstract

The use of public insurance is associated with diminished survival in patients with cystic fibrosis (CF) following lung transplantation. No data exist on benefits of gaining private health insurance for post-transplant care among such patients previously using public insurance. The United Network for Organ Sharing database was used to identify first-time lung transplant recipients participating in Medicare or Medicaid, diagnosed with CF, and transplanted between 2005 and 2015. Survival outcomes were compared between recipients gaining private insurance after transplantation and those maintaining public coverage throughout follow-up. Since implementation of the lung allocation score, 575 adults with CF received lung transplantation funded by Medicare or Medicaid and contributed data on insurance status post-transplant. There were 128 (22%) patients who gained private insurance. Multivariable analysis of time-varying insurance status found no survival benefit of gaining private insurance (HR = 0.822; 95% CI = 0.525, 1.286; p = 0.390). Further analysis demonstrated that resuming public insurance coverage was detrimental, relative to gaining and keeping private insurance (HR = 2.315; 95% CI = 1.020, 5.258; p = 0.045). Survival disa...Continue Reading

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Citations

Jul 30, 2016·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Randi E ForakerDon Hayes
Sep 11, 2018·Expert Review of Respiratory Medicine·Susan S LiDon Hayes
Sep 15, 2016·Circulation. Cardiovascular Quality and Outcomes·Francis D Pagani
Sep 15, 2016·Circulation. Cardiovascular Quality and Outcomes·Dmitry TuminDon Hayes
Nov 30, 2018·Journal of Cystic Fibrosis : Official Journal of the European Cystic Fibrosis Society·Angela KoutsokeraAnne L Stephenson

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