title: The role of disparities and socioeconomic factors in access to kidney transplantation and its outcome.
abstract: BACKGROUND
  Research focused on identifying vulnerable populations and revealing specific risk factors for barriers along the pathway from ESRD to kidney transplantation has been mostly descriptive and the causes of existing disparities remain unclear. However, several socio-economic factors that are associated with the access to and the outcome of the kidney transplantation have been identified.
  
  
  CONCLUSIONS
  While the presence of racial, gender, and geographic disparities is noted, we were interested mostly to describe potential socio-economic factors associated with and possibly responsible for the presence of such disparities. In this review we focused on five factors: education level, employment status, income, presence of substance addiction or abuse, and marital status. We describe the new method to quantify patients' socio-economic status and identify the group of high risk in terms of the transplant outcome, easily calculated social adaptability index, previously associated with clinical outcome in several patient populations including those with kidney transplant. At the end, based on literature analyzed we offer potential interventions that potentially can be used in order to reduce the degree of disparities.
  
  
  CONCLUSIONS
  Based on review of literature socio-economic factors are associated with and possibly responsible for healthcare disparities. Social adaptability index allows quantifying the degree of socio-economic status and identifying the group of high risk for inferior transplant outcome.
authors.affiliation: Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston , MA .
authors.forename: Tammy
authors.initials: T
authors.lastname: Hod
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Goldfarb-Rumyantzev
mesh_terms: D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D012959:Socioeconomic Factors; D016896:Treatment Outcome
keywords: Disparities; access to transplantation; education; employment; outcome; renal transplantation; social adaptability index; socio-economic factors