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  • Absence of economic barriers does not reduce disparities in the access to renal transplantation: A population based study in a region of central Italy

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Absence of economic barriers does not reduce disparities in the access to renal transplantation: A population based study in a region of central Italy
  1. M Miceli,
  2. D Di Lallo,
  3. C A Perucci for the Dialysis Register of Lazio Region
  1. Epidemiology Unit of Lazio Region Health Authority, Rome, Italy
  1. Dr D Di Lallo, Epidemiology Unit of Lazio Region Health Authority, Via di S Costanza 53, 00198 Rome, Italy

https://doi.org/10.1136/jech.54.2.157

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    Renal transplantation in people with end stage renal disease (ESRD) is the most successful treatment in terms of survival and quality of life. The rate of renal transplantation in the Lazio region of central Italy is much lower than that in other industrialised countries. In 1997, the new transplantation rate was 19.8 per million population (pmp), compared with rates of 44 and 42 pmp, respectively, for the USA and Spain.1 Recent studies carried out in the USA have found differences in the access to, and candidacy for, renal transplantation that are associated with non-clinical factors such as sex, race, and income.2-4 However, in countries such as Italy, where the National Health Service (NHS) provides renal transplants at no cost to the person, and where socioeconomic characteristics would thus not be expected to play a part in the level of access, this issue has been not deeply explored.

    The objective of this study was to evaluate the effect, on access to renal transplantation among patients undergoing dialysis in the Lazio Region, of level of education, as a component of socioeconomic status5 6 related to the capability to choose between different treatments, and the ability to find the best opportunities to benefit from the NHS.

    Methods

    The source of data was the Dialysis Register of the Lazio Region, which collects individual forms filled in by the personnel of the dialysis units, from all patients undergoing dialysis in this region.7 On the Register's data collection form, renal transplantation is listed among the possible reasons for discontinuing dialysis.

    All 1177 patients aged 18–64 years, who began dialysis in the period from 1 July 1994 to 30 June 1998 were enrolled in a cohort and follow up lasted …

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    Footnotes

    • Dialysis Register of Lazio Region (a list of the participants of the register is shown at the end of the article)

    • Conflicts of interest: none.