Presumed Consent and other Predictors of Cadaveric Organ Donation in Europe

Gimbel, Ronald W.; Strosberg, Martin A.; Lehrman, Susan; Gefenas, Eugenijus; Taft, Frank

doi:10.1177/152692480301300104

Cited by 59 publications

(54 citation statements)

References 22 publications

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“…In order to correctly identify the impact of presumed consent on deceased donations, we included family consent and donor registry variables in columns (4) and (5) as well as all the relevant interactions of presumed consent, family consent and donor registry variables in column (6). 12 Based on the estimation results displayed in the last column of PC and IC denote ''presumed consent'' and ''informed consent'', respectively. FC and NFC denote ''family consent is always sought'' and ''family consent is not always sought'', respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Recently in the US, a first-person-informed consent system has been implemented by which organ procurement is solely based on the documented intent of the donor and the organs of a registered deceased donor are removed even if the family objects. 1 Most of the European countries have adopted presumed consent legislation, and it is suggested that presumed consent can play an important role in increasing donation rates [1,12,17,21]. However, disunity continues within the medical community and experts have expressed their skepticism whether any change in legislation per se could increase donations [19].…”

Section: Introductionmentioning

confidence: 99%

“…The author would like to thank an anonymous referee for pointing this out 12. In the specification analysis, a family veto dummy variable compiled from various sources has been considered as a potential explanatory factor.…”

mentioning

confidence: 99%

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The impact of presumed consent laws and institutions on deceased organ donation

Bilgel

2010

Eur J Health Econ

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This article purports to advance the literature on the impact of presumed consent laws on deceased donation rates by examining the interactions between a presumed consent legal regime and other customs and institutions, using data on health expenditure, death rates caused by cerebro vascular diseases, motor vehicle accidents and homicides, legislation, legal systems, family consent, civil rights and liberties and donor registry systems, for 24 countries over a 14-year period. Countries in which presumed consent is enacted exhibit significantly higher donation rates only if family consent is routinely sought and a combined registry is maintained or neither practice is administered. Otherwise, presumed consent legislation does not have a sizeable impact on deceased donation rates.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of presumed consent laws and institutions on deceased organ donation

Bilgel

2010

Eur J Health Econ

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“…In theory, there seem to be considerable differences in the efficiency of donor procurement between consent systems. But, there is a lot of debate as to whether in practice the efficiency of a presumed consent system prevails over the efficiency of an explicit consent system [21,[43][44][45][46][47][48][49][50][51]. Gevers et al report that because next of kin play an important role in obtaining consent for organ donation in each country, in reality consent systems are more similar than suggested by the explicit/presumed consent distinction [41,49,52].…”

Section: Discussionmentioning

confidence: 98%

“…Changing to another consent system will not incur legal objections, since it still leaves room for people to express their wishes and provides a guarantee for their right to physical integrity. The international literature provides diverging views regarding the impact of introducing a presumed consent system on increasing the supply of donor organs [21,43,[46][47][48][49][50][51]. However, international comparative research linking procurement rates to consent systems, while controlling for differences in mortality rates, suggests the impact of such a change to be limited [41,44,45,48,52].…”

Section: Discussionmentioning

confidence: 98%

The potential of legislation on organ donation to increase the supply of donor organs

Coppen¹,

Friele²,

Zee³

et al. 2010

Health Policy

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Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

Siqueira

Araújo

2018

Health Planning & Management

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an innovative context of application and may be useful for the community of relevant policymakers, academics, and health professionals. KEYWORDS Brazilian health system, data envelopment analysis, efficiency assessment, kidney transplant 1 | INTRODUCTION End-stage renal disease is a serious public health issue in which patient survival depends on renal transplantation or renal replacement therapy, such as dialysis. 1 In the long term, however, kidney transplantation is generally more effective than dialysis in public health system costs and patient quality of life. [2][3][4][5] In Brazil, dialysis is the predominant therapy for the increasing number of cases of end-stage renal disease. 6,7 From 2010 to 2014, the number of patients on dialysis increased from 92 000 to 112 000, with the Brazilian Public Health System (SUS) financing approximately 85% of treatments. 8 Brazil is also 1 of the most active countries in absolute numbers of transplanted organs, with an increasing number of transplants. Its health sector requires substantial public investment, because SUS fully funds more than 90% of transplants performed nationwide. 9Kidney transplantation from deceased donors is the most common mode of solid organ transplantation and requires confirmation of brain death diagnosis and family consent. In 2016, the estimated population needing kidney transplants exceeded the number performed by 45%. 9 Other challenges include the poor infrastructure of public hospitals, crowded intensive care units (ICUs), broken equipment, insufficient health care professionals, and delays in laboratory tests. [9][10][11] In addition, the sector faces an increased demand for SUS services 12-14 and a tight federal health budget. 15 Lastly, the size of Brazil's territory amplifies managerial complexity, with demographic and socioeconomic disparities across states reflected in contrasting availabilities of health resources. 2,16,17 Such a context highlights the importance of assessing how scarce public resources are allocated.In this context, the present study uses data envelopment analysis (DEA) to estimate the technical and scale efficiency (SE) of Brazilian states for kidney transplants performed by SUS from 2013 to 2015. Its general objective is to rank Brazilian states by their technical efficiency scores and identify those operating at an optimal, oversized or undersized scale. Two secondary objectives are to identify states with input idle capacity and to report productivity changes during the period of analysis.Data envelopment analysis is a mathematical method that compares decision making units (DMUs) with similar production processes-units using the same type of inputs to generate analogous outputs, albeit in different amounts. 18,19 The method uses a benchmarking approach that specifies for each inefficient unit an efficient peer as a managerial reference.In contrast to the numerous efficiency studies in other health care fields-mainly using nonparametric methods such as DEA 20-23 -the literature for organ donation and transplant...

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Presumed Consent and other Predictors of Cadaveric Organ Donation in Europe

Abstract: Findings may be useful to academics and professionals responsible for organ procurement. Additional research is necessary for practical application of findings. Generalizing these findings beyond Europe may be problematic because of external validity constraints.

Cited by 59 publications

References 22 publications

The impact of presumed consent laws and institutions on deceased organ donation

The impact of presumed consent laws and institutions on deceased organ donation

The potential of legislation on organ donation to increase the supply of donor organs

Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis

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