ESRD & Dialysis: The Transportation Adherence Gap
26% of in-center hemodialysis patients miss sessions, most often over transportation. The KDQOL-36 captures it. Most centers collect the data and act on none of it.
Matthew Sexton, LCSWRead article
SDOH
Still neon
8 articles, newest publications first. Browse this subject or search the full archive.
4 articles in the wider archive have updated wording and source notes. The other 164 have not been fact-checked as part of this review. Older topics and links are retained to keep existing articles findable.
SDOH Referral Gap: Your Doctor Asked, Then Nothing Happened
1 in 4 positive SDOH screens never lead to a completed referral, 2024 data shows. Your doctor asked about housing or food — here's why nothing happened next.
Matthew Sexton, LCSWRead article
SDOH Inpatient Rollback: CMS's Outpatient Mandate Gap
Fewer than 20% of ESRD patients ever reach transplant evaluation (UNOS) — CMS's SDOH rollback just widened the inpatient-outpatient gap they fall through.
Matthew Sexton, LCSWRead article
IOTA Model: Dialysis Centers Are Missing Transplant Patients
80% of dialysis patients never get evaluated for a kidney transplant. CMS's new IOTA Model fixes transplant centers, but misses the referral gap upstream.
Matthew Sexton, LCSWRead article
Urban Hospital Closures and the Hidden Equity Crisis
More than 200 U.S. hospitals closed 2005-2022, clustered in low-income neighborhoods — turning ERs into primary care and compounding social determinants of health.
Matthew Sexton, LCSWRead article
Healthcare Access Gap: Why Urban and Rural Patients Both Lose
Adding providers fixes supply, not access. Urban patients face six-week waits despite nearby specialists; rural patients face long drives to burned-out clinicians.
Matthew Sexton, LCSWRead article
Implantable Artificial Kidney Gets FDA Breakthrough Status
90,000 people are waiting for a kidney right now. Nephrodite's implantable Holly system is still 5-10 years away. Here's what transplant patients need to know today.
Matthew Sexton, LCSWRead article
SDOH Screening Without Referral Facilitation Is Performative
Kaiser's Thrive Local raised closed-loop referral completion from 15% to over 60%. SDOH screening without referral facilitation is just documentation theater.
Matthew Sexton, LCSWRead article