title: Kidney transplant access in the Southeastern United States: the need for a top-down transformation.
abstract: End-stage renal disease (ESRD) and poverty are highly prevalent conditions in the Southeastern United States. The American Southeast also has some of the lowest attainments of health status among its constituents. Transplantation rates are particularly low in the Southeast compared with other regions of the United States. These low kidney transplantation rates in the Southeast likely reflect poor access to medical care. This disproportionate lack of access to medical care among ESRD patients in the Southeast reflects the convergence and interaction of socioeconomic and biologic forces at the patient level interacting with the financial and organizational structure of the health-care system. Improving kidney transplant access in the Southeast will take disruptive political, financial and health system changes whose scope transcends transplant centers and dialysis units.
authors.affiliation: Transplant Nephrology Section, Division of Nephrology, Medical University of South Carolina, Charleston, SC.
authors.forename: T R
authors.initials: TR
authors.lastname: Srinivas
mesh_terms: D005006:Ethnicity; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D007676:Kidney Failure, Chronic / Q000517:prevention & control*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D015144:Southeastern United States / Q000453:epidemiology
keywords: Disparities; economics; kidney transplantation; nephrology; social sciences