FRIDAY, Nov. 28 (HealthDay News) -- Americans without health insurance are about 20 times more likely to donate a liver or kidney for transplant than to receive one, a new study says.

The national study by Harvard University researchers found that almost 17 percent of organ donors in 2003 lacked health insurance at the time of hospitalization.

In contrast, less than one percent of organ recipients were similarly uninsured.

The findings about donors, published in the current issue of the International Journal of Health Services, were described as both "new and poignant" by the researchers.

"The U.S. health care system denies adequate care to many of the uninsured during life. Yet, in death, the uninsured often give strangers the ultimate gift," the authors wrote.

Equal numbers (44.2 percent) of the transplant recipients were covered by either private insurance or Medicare. Medicaid covered another 9 percent, while about 2 percent were covered under other programs.

Among organ donors, however, insurance coverage was much less extensive. While almost 45 percent had private insurance, just 14.6 percent had Medicare, and 2.6 percent had Medicaid. A fifth of the donors listed their insurance status as "other," a designation that may have indicated that their bills were paid by organ procurement organizations.

Lack of insurance was a stronger predictor for donation than any other hospital characteristic or demographic factor, outside of age. The organs of older people are more likely to be diseased and less appropriate for transplantation.

"If you lack the financial resources to afford a transplant, either through insurance or otherwise, few centers will consider you as a candidate," study lead author Andrew Herring, an emergency medicine resident at Highland Hospital in Oakland, Calif., noted in a news release issued by the journal's publisher.

This holds true despite special protocols, including guidelines adopted by Congress, meant to improve equity in the transplantation of organs, Herring said.

"The fact that many organ donors were uninsured dramatically highlights the lack of fairness in the U.S. health care system as a whole," study co-author Steffie Woolhandler, an associate professor of medicine at Harvard, said in a news release issued by the journal's publisher. "The only way to surmount this problem is to adopt a single-payer national health insurance program, which would guarantee comprehensive and affordable care to everyone without exception."

More information

Donate Life America has more about organ donation.