1. Financial burden following adult liver transplantation is common and associated with adverse recipient outcomes
- Author
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Ufere, Nneka N, Serper, Marina, Kaplan, Alyson, Horick, Nora, Indriolo, Teresa, Li, Lucinda, Satapathy, Nishant, Donlan, John, Jimenez, Janeth C Castano, Lago-Hernandez, Carlos, Lieber, Sarah, Gonzalez, Carolina, Keegan, Eileen, Schoener, Kimberly, Bethea, Emily, Dageforde, Leigh-Anne, Yeh, Heidi, El-Jawahri, Areej, Park, Elyse R, Vodkin, Irine, Schonfeld, Emily, Nipp, Ryan, Desai, Archita, and Lai, Jennifer C
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Organ Transplantation ,Transplantation ,Digestive Diseases ,Clinical Research ,Behavioral and Social Science ,Liver Disease ,Oral and gastrointestinal ,Good Health and Well Being ,Humans ,Liver Transplantation ,Female ,Male ,Middle Aged ,Quality of Life ,Cost of Illness ,Adult ,Health Expenditures ,United States ,Surveys and Questionnaires ,Financial Stress ,Aged ,Adaptation ,Psychological ,End Stage Liver Disease ,Efficiency ,Surgery ,Clinical sciences - Abstract
The financial impact of liver transplantation has been underexplored. We aimed to identify associations between high financial burden (≥10% annual income spent on out-of-pocket medical costs) and work productivity, financial distress (coping behaviors in response to the financial burden), and financial toxicity (health-related quality of life, HRQOL) among adult recipients of liver transplant. Between June 2021 and May 2022, we surveyed 207 adult recipients of liver transplant across 5 US transplant centers. Financial burden and distress were measured by 25 items adapted from national surveys of cancer survivors. Participants also completed the Work Productivity and Activity Impairment and EQ-5D-5L HRQOL questionnaires. In total, 23% of recipients reported high financial burden which was significantly associated with higher daily activity impairment (32.9% vs. 23.3%, p =0.048). In adjusted analyses, the high financial burden was significantly and independently associated with delayed or foregone medical care (adjusted odds ratio, 3.95; 95% CI, 1.85-8.42) and being unable to afford basic necessities (adjusted odds ratio, 5.12; 95% CI: 1.61-16.37). Recipients experiencing high financial burden had significantly lower self-reported HRQOL as measured by the EQ-5D-5L compared to recipients with low financial burden (67.8 vs. 76.1, p =0.008) and an age-matched and sex-matched US general population (67.8 vs. 79.1, p
- Published
- 2024