Candidates for kidney transplant face age, racial gaps in telehealth
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Key takeaways:
- Black candidates were less likely to complete all pre-transplant virtual evaluation visits.
- Older patients were more likely to complete all virtual pre-transplant evaluation.
PHILADELPHIA — Age and racial gaps exist when using telehealth for evaluating candidates for kidney transplant, according to data presented at the American Transplant Congress here.
Notably, researchers found Black patients are less likely to be referred for transplant and added to the waitlist than white patients. Older patients are also less likely to be put on the waitlist vs. younger patients, Jae Hyung Chang, MD, FASN, assistant professor of medicine at Columbia University Vagelos College of Physicians and Surgeons in New York, said in a presentation.
While telehealth offers real-time remote health care services and has the potential to improve access, “ ... The use of technology to maintain access to outpatient care raises important equity concerns,” Chang said. “The digital divide has been well-documented in multiple studies across medical specialties with lower rates of technology and broadband adoption among older patients, racial [and] ethnic minority groups and those of lower socioeconomic status.”
Researchers at Columbia University Medical Center conducted a study among candidates for and recipients of a kidney transplant to characterize use of telehealth post-COVID-19.
Between Jan. 1, 2022 and June 30, 2023, 3,277 patients were scheduled for at least one virtual visit for pre-transplant evaluation and post-transplant care. Of the patient group, 41.8% were women. Mean age was 54.5 years. One-third of patients (1,124) completed all scheduled virtual visits.
The primary outcome was completion of all scheduled telehealth visits during the study period and this was based on electronic medical records.
Chang and colleagues found patients aged 60 years or older were more likely to complete all virtual pre-transplant evaluation and/or post-transplant follow-up appointments.
Black candidates for a transplant were less likely to complete all virtual pre-transplant evaluation visits vs. white candidates, according to the findings. However, there was no difference in completion rates of appointments post-transplant based on age, race or insurance status.
Sex, ethnicity, language, employment and education did not to affect the completion of telehealth visits in patients with end-stage kidney disease pre- or post-transplant.
“At our center, age and racial disparities appear to exist ... among kidney transplant candidates,” Chang said. “The widespread adoption of telemedicine has benefited patients but risks unintended consequences of exacerbating age and racial disparities and access to kidney transplant in the absence of active monitoring. Strategies are needed to mitigate these disparities so that all patients can benefit from the advantages of telemedicine.”
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Chang JH, et al. Poster 344. Presented at: American Transplant Congress; June 1-5, 2024; Philadelphia.
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