Lack of health insurance in living kidney donors

Living donors are recommended to receive lifelong routine health maintenance after donation. There has been little examination of health insurance status among living donors, despite the fact that lack of health insurance is likely to impede donors' ability to obtain long-term healthcare post-donation. We performed a retrospective chart review for all living kidney donors at our institution between 2004 and 2008 to determine insurance status, demographic, socioeconomic, and basic health characteristics. Twenty-three percent of donors were uninsured at the time of donation. Odds of being uninsured were significantly lower in donors who were older than 40 yr of age or who had at least a college education, and significantly higher in donors who were non-white, non-English-speaking, or non-US citizens. Odds of being uninsured did not differ according to whether donors were obese, hypertensive, or smokers. On multivariate analysis, only non-white race, non-US citizenship, and education level less than a college degree were associated with lack of insurance. Lack of health insurance is more prevalent in living kidney donors than in the general US population. Its disproportionate impact on minorities, non-citizens, and the less well educated is greater than that in the general population.