Funding Opportunity Number: CMS-1W1-22-001
Applicant Name: The University of Illinois at Chicago
Descriptive Title of Applicant Project: Addressing Disparities in Access to Transplant: The ESRD Patient Evaluation Clearinghouse (EPEC)
Project Abstract (2762 of 4000 characters)
The prevailing literature of the field asserts that end stage renal disease (ESRD), like it’s precursors hypertension and diabetes, is disproportionately borne by persons of burdened socioeconomic and demographic status. Renal transplant is the optimal therapy for ESRD yet minorities face disparities in transplant referral, evaluation, listing, and outcomes. Printed materials, online resources, and face-to-face interventions have attempted to address disparities in transplantation and living donation along racial and socioeconomic lines. However, they often fail to address the gatekeeping of nephrology and dialysis providers or the general lack of inter-program standards impeding the patient’s ability to access transplantation.
Researchers at the University of Illinois at Chicago (UIC) developed the ESRD Patient Evaluation Clearinghouse (EPEC) research project to take aim at those barriers to a successful, efficient transplant experience. The research pilots personalized assessments of dialysis patients by unaffiliated transplant professionals. The study will intentionally engage patients at dialysis centers in Cook County’s low-resourced neighborhoods to ensure oversampling of burdened populations demonstrated to suffer from disparities in access to renal transplant. The goals of the project are to inform patients of their individualized characteristics impacting transplantability and educate them regarding Cook County transplant tendencies which provide the most utility to them and do so in a manner respectful of their culture and transplant knowledgeability. The intended outcome of the research is the efficient matching of participant characteristics to transplant program functionality as to lessen the socioeconomic and demographic disparities in access to renal transplantation. Long-term researchers expect additional Medicare beneficiaries will seek and attain transplants with each beneficiary conversion saving CMS $54,666 per patient per year.
The requested budget for this project is $332,067 during the two-year grant period. The budget supports the manpower needed to create a de novo method of comparing geographically collocated transplant programs and providing individualized support from a transplant professional. A majority of the budget is dedicated to the UIC staff and consultants who will collect and analyze transplant center information, create and administer surveys of ESRD patients, and perform assessment and education sessions for study participants. Evidence to support the hypothesis that individualized intervention improves patient willingness and ability to be transplanted could be impetus for a national transplant patient clearinghouse in an agency of the Department of Health and Human Services.