{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:34:58Z","timestamp":1775576098922,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T00:00:00Z","timestamp":1531267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U54 MD008173"],"award-info":[{"award-number":["U54 MD008173"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K23 HL124287"],"award-info":[{"award-number":["K23 HL124287"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Medicaid insurance in Georgia provides limited reimbursement for heart transplant (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>) and left ventricular assist devices (<jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>). We examined whether insurance type affects eligibility for and survival after receipt of <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We retrospectively identified patients evaluated for <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content> from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and 1\u2010year survival. Of 569 patients evaluated, 282 (49.6%) had private, 222 (39.0%) had Medicare, and 65 (11.4%) had Medicaid insurance. Patients with Medicaid were younger, more likely to be Black, with fewer medical comorbidities. In adjusted models, Medicare and Medicaid insurance predicted lower odds of eligibility for <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, but did not affect survival after <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>. Among those ineligible for <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, Medicaid patients were less likely to receive destination therapy (<jats:styled-content style=\"fixed-case\">DT<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">LVAD<\/jats:styled-content> (adj <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.08, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.01\u20100.66; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>.02) and had increased risk of death (adj <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u00a0=\u00a02.03, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.13\u20103.63; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite younger age and fewer comorbidities, patients with Medicaid insurance are less likely to receive <jats:styled-content style=\"fixed-case\">DT LVAD<\/jats:styled-content> and have an increased risk of death once deemed ineligible for <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>. Medicaid patients in Georgia need improved access to <jats:styled-content style=\"fixed-case\">DT LVAD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.13328","type":"journal-article","created":{"date-parts":[[2018,6,15]],"date-time":"2018-06-15T18:06:23Z","timestamp":1529085983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Impact of insurance type on eligibility for advanced heart failure therapies and survival"],"prefix":"10.1111","volume":"32","author":[{"given":"Sarah Streeter","family":"Hutcheson","sequence":"first","affiliation":[{"name":"Division of Cardiology Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Phillips","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Management Emory Rollins School of Public Health  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Patzer","sequence":"additional","affiliation":[{"name":"Division of Surgery Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Cardiology Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. David","family":"Vega","sequence":"additional","affiliation":[{"name":"Division of Surgery Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8033-3707","authenticated-orcid":false,"given":"Alanna A.","family":"Morris","sequence":"additional","affiliation":[{"name":"Division of Cardiology Emory University School of Medicine  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012175"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.03.063"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000139862.48167.23"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.08.003"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14128"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2013.05.014"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2014.04.010"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2015.10.023"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.09.013"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.07.019"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.03.008"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.116.003067"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.07.004"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2012.05.074"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2190\/HS.38.4.d"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1999.10474144"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13151211"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.8897"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02737.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2017.04.001"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e318160135f"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001152"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.959031"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.06.012"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2014.05.004"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.2067"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.10.013"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.10.034"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03520.x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02177.x"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fctr.13328","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.13328","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T20:02:09Z","timestamp":1694808129000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.13328"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,11]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1111\/ctr.13328"],"URL":"https:\/\/doi.org\/10.1111\/ctr.13328","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,11]]},"assertion":[{"value":"2018-05-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13328"}}