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Health Serv Res. 1998 June; 33(2 Pt 1): 205–222.
PMCID: PMC1070261

The effects of New York state's ban on multiple listing for cadaveric kidney transplantation.


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. DATA SOURCES: (1) Waiting list files from the Organ Procurement and Transplantation Network, (2) the Health Care Financing Administration's Medicare Program Management and Medical Information System, and (3) U.S. Census Public Use Files. STUDY DESIGN: Multivariate hazard models were used to estimate the impact of the ban of the overall odds of multiple listing and on the odds of multiple listing at in-state and out-of-state transplant centers. After estimating the relationship between multiple listing and subsequent transplantation, we used simulation techniques to estimate the effects of a complete multiple listing ban on group waiting time differentials. Independent variables included demographic/socioeconomic characteristics, measures of ESRD severity, general transplantation suitability, measures that affect the likelihood of finding a good donor organ, and measures of the productivity of the transplant/dialysis center. PRINCIPAL FINDINGS: The ban was associated with a 66 percent reduction in the rate of multiple listing for New York patients, and multiple listing at in-state transplant centers declined by 87 percent. Simulation results suggested that even a completely effective ban would produce only small, mixed equity effects. CONCLUSIONS: While the ban was effective in reducing the proportion of patients who registered at multiple transplant centers, taken together the results suggest that banning multiple listing is not likely to result in large improvements in equity in access to transplantation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Eggers PW. Racial differences in access to kidney transplantation. Health Care Financ Rev. 1995 Winter;17(2):89–103. [PubMed]
  • Gaylin DS, Held PJ, Port FK, Hunsicker LG, Wolfe RA, Kahan BD, Jones CA, Agodoa LY. The impact of comorbid and sociodemographic factors on access to renal transplantation. JAMA. 1993 Feb 3;269(5):603–608. [PubMed]
  • Held PJ, Pauly MV, Bovbjerg RR, Newmann J, Salvatierra O., Jr Access to kidney transplantation. Has the United States eliminated income and racial differences? Arch Intern Med. 1988 Dec;148(12):2594–2600. [PubMed]
  • Leffell MS, Steinberg AG, Bias WB, Machan CH, Zachary AA. The distribution of HLA antigens and phenotypes among donors and patients in the UNOS registry. Transplantation. 1994 Nov 27;58(10):1119–1130. [PubMed]
  • Ozminkowski RJ, Friedman B, Taylor Z. Access to heart and liver transplantation in the late 1980s. Med Care. 1993 Nov;31(11):1027–1042. [PubMed]
  • Sanfilippo FP, Vaughn WK, Peters TG, Shield CF, 3rd, Adams PL, Lorber MI, Williams GM. Factors affecting the waiting time of cadaveric kidney transplant candidates in the United States. JAMA. 1992 Jan 8;267(2):247–252. [PubMed]

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