Abstract
BackgroundThis study aims to examine the impact of home-to-transplantation center travel time as a potential barrier to healthcare accessibility. MethodsObservational study examined adult heart transplant recipients who received a graft between 2012 and 2022 in the United States. Travel time was calculated using the Google Distance Matrix API between the recipient's residence and transplantation center. A multivariable parametric survival model was fitted to minimize confounding bias. ResultsAmong the 25,923 recipients that met the selection criteria, the median travel time was 51 min and 95 % of recipients lived within a 5-h radius of their center. White recipients experienced longer median travel times (62 min, p < 0.001) compared to Black (36 min) or Hispanic (40 min) recipients. A travel time of 1–2 h (survival time ratio [STR] 0.867, p = 0.035) or >2 h (STR 0.873, p = 0.026) away from the transplantation center was independently associated with lower long-term survival rates. ConclusionExtended travel times to transplantation centers may negatively impact long-term survival outcomes for heart transplant recipients, suggesting the need to address this potential barrier to healthcare accessibility.
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