Aj. White et al., THE EFFECTS OF NEW-YORK STATES BAN ON MULTIPLE LISTING FOR CADAVERIC KIDNEY-TRANSPLANTATION, Health services research, 33(2), 1998, pp. 205-222
Citations number
13
Categorie Soggetti
Heath Policy & Services","Health Care Sciences & Services
Objective. To study the effectiveness of a 1990 ban by New York state
on entry to more than one waiting list for a cadaver kidney transplant
, and the impact of the ban on equity in access to transplantation. Da
ta Sources. (1) Waiting list files from the Organ Procurement and Tran
splantation Network, (2) the Health Care Financing Administration's Me
dicare Program Management and Medical Information System, and (3) U.S.
Census Public Use Files. Study Design. Multivariate hazard models wer
e used to estimate the impact of the ban on the overall odds of multip
le listing and on the odds of multiple listing at instate and out-of-s
tate transplant centers. After estimating the relationship between mul
tiple listing and subsequent transplantation, we used simulation techn
iques to estimate the effects of a complete multiple listing ban on gr
oup waiting time differentials. Independent variables included demogra
phic/socioeconomic characteristics, measures of ESRD severity, general
transplantation suitability, measures that affect the likelihood of f
inding a good donor organ, and measures of the productivity of the tra
nsplant/dialysis center. Principal Findings. The ban was associated wi
th a 66 percent reduction in the rate of multiple listing for New York
patients, and multiple listing at in-state transplant centers decline
d by 87 percent. Simulation results suggested that even a completely e
ffective ban would produce only small, mixed equity effects. Conclusio
ns. While the ban was effective in reducing the proportion of patients
who registered at multiple transplant centers, taken together the res
ults suggest that banning multiple listing is not likely to result in
large improvements in equity in access to transplantation.