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Transplant trends in Mexico during the COVID-19 pandemic: Disparities within healthcare sectors
Authors:Maximiliano Servin-Rojas  Antonio Olivas-Martinez  Fernando Ramirez Del Val  Armando Torres-Gomez  Luis Navarro-Vargas  Ignacio García-Juárez
Affiliation:1. Faculty of Medicine, Universidad Autónoma del Estado de Morelos, Cuernavaca, Mexico;2. Department of Biostatistics, University of Washington, Seattle, Washington, USA;3. Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA;4. Department of Orthopaedic Surgery, Centro Médico ABC, Mexico City, Mexico;5. Department of Transplant Surgery, Centro Médico ABC, Mexico City, Mexico;6. Hepatology and Liver Transplant Unit, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico
Abstract:Healthcare systems worldwide were challenged during the COVID-19 pandemic. In Mexico, the public hospitals that perform most transplants were adapted to provide care for COVID-19 patients. Using a nationwide database, we describe the first report of the impact of COVID-19 and related transplantation healthcare policies in a middle-income country by comparing statistics before and during the pandemic (pre-COVID: March 2019–February 2020 vs. COVID era: March 2020–February 2021) and by type of institution (public vs. private). The global reduction in transplantation was higher in public institutions compared with private institutions, 89% versus 62%, respectively, p < .001. When analyzing by organ, kidney transplantation decreased by 89% at public versus 57% at private, p < .001; cornea by 88% at public versus 64% at private, p < .001; liver by 88% at public versus 35% at private, p < .001; and heart by 88% in public versus 67% at private institutions, p = .4. The COVID-19 pandemic along with the implemented health policies were associated with a decrease in donations, waiting list additions, and a decrease in transplantation, particularly at public institutions, which care for the most vulnerable.
Keywords:corneal transplantation / ophthalmology  disparities  ethics and public policy  health services and outcomes research  insurance - private  insurance - public  registry/registry analysis  kidney transplantation / nephrology  liver transplantation / hepatology
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