Transplantability In Burdened Populations: A Regional Analysis of the Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors

<p><strong>Introduction/Background</strong></p> <p>The social contract of health (SCOH) in America that governs healthcare interactions has listed toward provider organizations and away from the patient. End stage renal disease treatment provides an explicatory case to examine an unbalanced SCOH. The study evaluates whether the robot-assisted kidney transplantation (RAKT) technique allows for patients with higher body mass indices and of burdened socioeconomic and sociodemographic status improved access to transplant compared to traditional open kidney transplant (OKT).</p> <p><strong>Methods</strong></p> <p>The study set combined extant data for patients transplanted at Chicago from two data sets. Investigators used independent t-tests, chi-squared tests, survival analysis, analysis of frequencies, and bivariate correlation to ascertain differences in the RAKT and OKT cohorts from January 1, 2009, to December 31, 2018.</p> <p><strong>Results</strong></p> <p>The RAKT group was objectively sicker, demonstrated higher proportions of recipients with Black ethnicity, without a college degree, and lower median household income. The RAKT cohort had a markedly lower wait time for kidney transplant (499.5 days vs 822.7 days in OKT). Patients with BMI over 40 in the two groups had no statistically significant difference in length of stay, graft function, or post-transplant outcomes.</p> <p><strong>Conclusions/Implications</strong></p> <p>Despite the myriad of disadvantages, the RAKT cohort clinical outcomes were equivalent to OKT in most respects and superior in wait list duration. As rates of obesity and kidney disease increase, wider proliferation of tools with demonstrated efficacy in treating this population support the social contract of health. Community psychology praxis can support communities in advocating for change in the American healthcare system.</p>

Name thesis:degree_name

Ph.D. Doctor of Philosophy

Level thesis:degree_level

Dissertation - Public Access

Discipline thesis:degree_discipline

Community Psychology

Year dc:date.available

2022

Author dc:creator

• Davis, Earnest James, Jr.

Contributors dc:contributor

• Suzette Fromm Reed, PhD
• Judah Viola, PhD
• David San Filippo, PhD

• Health
• Healthcare
• Social Contract
• Transplant
• ESRD (End Stage Renal Disease)
• Chicago
• Bioethics and Medical Ethics
• Health Policy
• Nephrology
• Quality Improvement
• Surgery
• Surgical Procedures, Operative

Repository record dc:identifier

https://digitalcommons.nl.edu/diss/717

OAI identifier oai:identifier

oai:digitalcommons.nl.edu:diss-1769