Assessing health care disparities in US organ procurement organizations

Abstract There is extensive system-wide evidence of disparities in access to organ transplantation in the US based on race, ethnicity, and socioeconomic status. However, little information is available regarding care disparities among US organ procurement organizations (OPOs). Commissioned by the US...

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Main Authors: Wenbo Wu, Joseph M. Messana, Nicholas Hartman, Lonnie Barnes, Randall S. Sung, Tempie Shearon, Abhijit Naik, John C. Magee, Jonathan Segal, Claudia Dahlerus, Robin Padilla, Ashley Eckard, Yang Casher, Jennifer Sardone, Kevin He
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Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-01808-3
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author Wenbo Wu
Joseph M. Messana
Nicholas Hartman
Lonnie Barnes
Randall S. Sung
Tempie Shearon
Abhijit Naik
John C. Magee
Jonathan Segal
Claudia Dahlerus
Robin Padilla
Ashley Eckard
Yang Casher
Jennifer Sardone
Kevin He
author_facet Wenbo Wu
Joseph M. Messana
Nicholas Hartman
Lonnie Barnes
Randall S. Sung
Tempie Shearon
Abhijit Naik
John C. Magee
Jonathan Segal
Claudia Dahlerus
Robin Padilla
Ashley Eckard
Yang Casher
Jennifer Sardone
Kevin He
author_sort Wenbo Wu
collection DOAJ
description Abstract There is extensive system-wide evidence of disparities in access to organ transplantation in the US based on race, ethnicity, and socioeconomic status. However, little information is available regarding care disparities among US organ procurement organizations (OPOs). Commissioned by the US Centers for Medicare and Medicaid Services (CMS), we studied racial/ethnic disparities in organ donation and transplantation across and within OPOs. Based on the 2020 CMS final rule, we calculated OPO donation and organ transplantation rates with 95% confidence intervals for racial (Black, White, and Asian American and Pacific Islander, AAPI) and ethnic (Hispanic and non-Hispanic) groups. OPOs were ranked with national rates as references and classified according to the CMS 3-tier system. Of the 58 OPOs, 8 and 4 had donation rates lower for Black and AAPI donors than for White donors; 21 and 18 had organ transplantation rates lower for Black and AAPI donors than for White donors; 1 and 1 had a donation rate or organ transplantation rate lower for Hispanic donors than for non-Hispanic donors. Significant racial/ethnic disparities in organ donation and transplantation exist among many OPOs, whereas the overall OPO performance is dominated by White and non-Hispanic donors. These disparities may be influenced by variations and structural barriers in resource access, donor identification, transplantation referral, and waitlisting processes–some of which lie partially outside the direct control of OPOs and disproportionately affect disadvantaged populations. Results support equitable organ donation and allocation through enhanced awareness of health care disparities, increased accountability of OPOs, and informed policies and interventions.
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spelling doaj-art-6dbc25732fe844e6b09e9e36bd8da6102025-08-20T03:48:18ZengNature PortfolioScientific Reports2045-23222025-05-0115111110.1038/s41598-025-01808-3Assessing health care disparities in US organ procurement organizationsWenbo Wu0Joseph M. Messana1Nicholas Hartman2Lonnie Barnes3Randall S. Sung4Tempie Shearon5Abhijit Naik6John C. Magee7Jonathan Segal8Claudia Dahlerus9Robin Padilla10Ashley Eckard11Yang Casher12Jennifer Sardone13Kevin He14Division of Biostatistics, Department of Population Health, New York University Grossman School of MedicineKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganKidney Epidemiology and Cost Center, University of MichiganAbstract There is extensive system-wide evidence of disparities in access to organ transplantation in the US based on race, ethnicity, and socioeconomic status. However, little information is available regarding care disparities among US organ procurement organizations (OPOs). Commissioned by the US Centers for Medicare and Medicaid Services (CMS), we studied racial/ethnic disparities in organ donation and transplantation across and within OPOs. Based on the 2020 CMS final rule, we calculated OPO donation and organ transplantation rates with 95% confidence intervals for racial (Black, White, and Asian American and Pacific Islander, AAPI) and ethnic (Hispanic and non-Hispanic) groups. OPOs were ranked with national rates as references and classified according to the CMS 3-tier system. Of the 58 OPOs, 8 and 4 had donation rates lower for Black and AAPI donors than for White donors; 21 and 18 had organ transplantation rates lower for Black and AAPI donors than for White donors; 1 and 1 had a donation rate or organ transplantation rate lower for Hispanic donors than for non-Hispanic donors. Significant racial/ethnic disparities in organ donation and transplantation exist among many OPOs, whereas the overall OPO performance is dominated by White and non-Hispanic donors. These disparities may be influenced by variations and structural barriers in resource access, donor identification, transplantation referral, and waitlisting processes–some of which lie partially outside the direct control of OPOs and disproportionately affect disadvantaged populations. Results support equitable organ donation and allocation through enhanced awareness of health care disparities, increased accountability of OPOs, and informed policies and interventions.https://doi.org/10.1038/s41598-025-01808-3Caterpillar plotProvider profilingOrgan donation and transplantationRacial and ethnic disparities
spellingShingle Wenbo Wu
Joseph M. Messana
Nicholas Hartman
Lonnie Barnes
Randall S. Sung
Tempie Shearon
Abhijit Naik
John C. Magee
Jonathan Segal
Claudia Dahlerus
Robin Padilla
Ashley Eckard
Yang Casher
Jennifer Sardone
Kevin He
Assessing health care disparities in US organ procurement organizations
Scientific Reports
Caterpillar plot
Provider profiling
Organ donation and transplantation
Racial and ethnic disparities
title Assessing health care disparities in US organ procurement organizations
title_full Assessing health care disparities in US organ procurement organizations
title_fullStr Assessing health care disparities in US organ procurement organizations
title_full_unstemmed Assessing health care disparities in US organ procurement organizations
title_short Assessing health care disparities in US organ procurement organizations
title_sort assessing health care disparities in us organ procurement organizations
topic Caterpillar plot
Provider profiling
Organ donation and transplantation
Racial and ethnic disparities
url https://doi.org/10.1038/s41598-025-01808-3
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