Heart failure & cardiomyopathiesCohort study
Insurance Churn and Survival After Heart Transplantation, 2018–2024: A United States National Cohort Study
- national cohort study
Authors' conclusion
Public insurance and insurance instability are associated with worse heart transplantation outcomes, while gaining private insurance was associated with improved outcomes, highlighting disparities in posttransplant care.
Study context
- Population
- Adults aged 18 to 64 years undergoing first-time heart transplantation between October 2018 and March 2024, United Network for Organ Sharing registry, surviving ≥1 year
- Participants
- 15,864 recipients
- Exposure
- Insurance trajectory groups with continuous private insurance as the referent
Main finding
As reported in the abstract
Insurance trajectory distribution
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | |
|---|---|---|---|
| Mortality · 5 years — continuous public vs continuous private · multivariable Cox model | continuous public 15.1% · multiple transitions 14.6% · continuous private 11.9% | 1.27 (1.15–1.40) | |
| Mortality · 5 years — multiple transitions vs continuous private · multivariable Cox model | 1.19 (1.12–1.43) | ||
| Graft failure · 5 years — continuous public vs continuous private | continuous public 4.3% · multiple transitions 3.6% · continuous private 3.2% | 1.29 (1.06–1.56) | |
| Graft failure · 5 years — private-to-public transition vs continuous private | 1.32 (1.03–1.71) | ||
| Graft failure · 5 years — multiple transitions vs continuous private | 1.09 (1.07–1.55) | ||
| Graft failure · 5 years — public-to-private transition vs continuous private · lowered risk | 0.73 (0.45–0.92) | ||
| 0.512Hazard ratio (log scale) |
Residence in distressed communities: mortality and graft failure
- mortality HR [95% CI]
- 1.21 [95% CI, 1.12-1.57]
- graft failure HR [95% CI]
- 1.31 [95% CI, 1.20-1.41]
- comparator not stated
Original publication
Insurance Churn and Survival After Heart Transplantation, 2018–2024: A United States National Cohort Study. Circ Popul Health Outcomes. Published 11 June 2026. doi:10.1161/circoutcomes.125.012943
Summarised from the published abstract; every number is checked against it