Perception of social inequities in the access to the kidney transplant waiting list by nephrology trainees: a national survey

Lucile Paris; Eve Calvar; Rémy Morello; Angélique Lecouf; Mathilde Beaumier; Thierry Lobbedez; Valérie Châtelet

doi:10.1186/s12882-022-03017-w

Perception of social inequities in the access to the kidney transplant waiting list by nephrology trainees: a national survey

BMC Nephrol. 2022 Dec 8;23(1):394. doi: 10.1186/s12882-022-03017-w.

Authors

Lucile Paris^{1

2}, Eve Calvar^{1

2

3}, Rémy Morello⁴, Angélique Lecouf¹, Mathilde Beaumier^{1

2

3}, Thierry Lobbedez^{1

2

3}, Valérie Châtelet^{5

6

7}

Affiliations

¹ Centre Universitaire des Maladies Rénales, CHU de Caen, Avenue de la Côte de Nacre, 14 033, Caen Cedex 9, France.
² Normandie Université, Unicaen, UFR de Médecine, 2 rue des Rochambelles, 14032, Caen Cedex, France.
³ U1086 INSERM - ANTICIPE - Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, France.
⁴ Plateforme de Méthodologie, CHU de Caen, Avenue de la Côte de Nacre, Niveau 3, CS 30001, 14033, Caen Cedex 9, France.
⁵ Centre Universitaire des Maladies Rénales, CHU de Caen, Avenue de la Côte de Nacre, 14 033, Caen Cedex 9, France. chatelet-v@chu-caen.fr.
⁶ Normandie Université, Unicaen, UFR de Médecine, 2 rue des Rochambelles, 14032, Caen Cedex, France. chatelet-v@chu-caen.fr.
⁷ U1086 INSERM - ANTICIPE - Centre Régional de Lutte Contre le Cancer, François Baclesse, Caen, France. chatelet-v@chu-caen.fr.

Abstract

Background: Social inequalities in health are responsible for disparities in access to the kidney transplant waiting list (KTWL). The perception of disparities by nephrologists has consequences for the registration on the KTWL. The purposes of our study were to assess the perception of the factors implicated in the disparities in access to the KTWL by nephrology trainees and to assess the quality of the questionnaire.

Methods: A questionnaire was developed to assess the perception of the determinants of the inequities in access to waitlisting. Continuous variables were described by median, 1st and 3rd quartiles. Categorical variables were described by frequencies and percentages. A principal component analysis and a hierarchical cluster analysis were performed to approach the correlation between the variables. A scree plot and a factor analysis were performed to determine the dimensions of the questionnaire. The internal consistency was estimated by Cronbach's coefficient.

Results: The response rate was 98/110 (89%). The determinants of inequities in the access to KTWL not perceived by the nephrology trainees were "female sex", "income level" and "the centre provision to adapt the information to all of the patients" (18,3%, 36,7, 47% respectively). "Age", "being born abroad", "place of living", "education level", "transplant centre", "the health care provider" were determinants of disparities perceived by most of the trainees (85,7%, 75,5%, 82,6%, 78,6%, 73,5% et 78,5% respectively). Items related to the transplant centre were positively correlated, as well as "being born abroad", "education level" and "income level". The Cronbach's coefficient was 0,60.

Conclusion: Social inequalities in health are partially perceived by nephrology trainees. A teaching session could raise nephrologists' awareness of this issue and could help reduce the impact of these disparities on the course of ESKD (end-stage kidney disease) patients.

Keywords: Access to kidney transplant waitlisting; Nephrology trainees; Perception; Social inequalities in health.

MeSH terms

Female
Humans
Kidney Transplantation*
Perception