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Crenshaw R, Woods C, Koizumi N, Dave HS, Gentili M, Saleem JJ. Understanding Barriers and Facilitators to Living Kidney Donation Within a Sociotechnical Systems Framework. QUALITATIVE HEALTH RESEARCH 2024; 34:691-702. [PMID: 38229412 DOI: 10.1177/10497323231224706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
The objective of this study was to investigate factors influencing one's decision to become a live kidney donor under the framework of sociotechnical systems, by expanding the focus to include larger organizational influences and technological considerations. Semi-structured interviews were conducted with live kidney donors who donated through University of Louisville Health, Trager Transplant Center, a mid-scale transplant program, in the years 2017 through 2019. The interview transcripts were analyzed for barriers and facilitators to live kidney donation within a sociotechnical system. The most salient facilitators included: having an informative, caring, and available care team; the absence of any negative external pressure toward donating; donating to a family or friend; and the ability to take extra time off work for recovery. The most recurrent barriers included: short/medium-term (<1 year) negative health impacts because of donation; the need to make minor lifestyle changes (e.g., less alcohol consumption) after donation; and mental health deterioration stemming from the donation process. The sociotechnical systems framework promotes a balanced system comprised of social, technical, and environmental subsystems. Assessing the facilitators and barriers from the sociotechnical system perspective revealed the importance of and opportunities for developing strategies to promote integration of technical subsystem, such as social media apps and interactive AI platforms, with social and environmental subsystems to enable facilitators and reduce barriers effectively.
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Affiliation(s)
- Rachel Crenshaw
- Department of Industrial Engineering, University of Louisville, Louisville, KY, USA
- Analytics, Planning, Strategy and Improvement, Brigham and Women's Hospital, Boston, MA, USA
| | - Cary Woods
- Department of Industrial Engineering, University of Louisville, Louisville, KY, USA
| | - Naoru Koizumi
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Hitarth S Dave
- Division of Nephrology & Hypertension, School of Medicine, University of Louisville, Louisville, KY, USA
| | - Monica Gentili
- Department of Industrial Engineering, University of Louisville, Louisville, KY, USA
| | - Jason J Saleem
- Department of Industrial Engineering, University of Louisville, Louisville, KY, USA
- Center for Human Systems Engineering, University of Louisville, Louisville, KY, USA
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Reed RD, Locke JE. Mitigating Health Disparities in Transplantation Requires Equity, Not Equality. Transplantation 2024; 108:100-114. [PMID: 38098158 PMCID: PMC10796154 DOI: 10.1097/tp.0000000000004630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Despite decades of research and evidence-based mitigation strategies, disparities in access to transplantation persist for all organ types and in all stages of the transplant process. Although some strategies have shown promise for alleviating disparities, others have fallen short of the equity goal by providing the same tools and resources to all rather than tailoring the tools and resources to one's circumstances. Innovative solutions that engage all stakeholders are needed to achieve equity regardless of race, sex, age, socioeconomic status, or geography. Mitigation of disparities is paramount to ensure fair and equitable access for those with end-stage disease and to preserve the trust of the public, upon whom we rely for their willingness to donate organs. In this overview, we present a summary of recent literature demonstrating persistent disparities by stage in the transplant process, along with policies and interventions that have been implemented to combat these disparities and hypotheses for why some strategies have been more effective than others. We conclude with future directions that have been proposed by experts in the field and how these suggested strategies may help us finally arrive at equity in transplantation.
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Affiliation(s)
- Rhiannon D. Reed
- Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL
| | - Jayme E. Locke
- Comprehensive Transplant Institute, University of Alabama at Birmingham, Birmingham, AL
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Shenoy A, Shenoy GN, Shenoy GG. Living kidney and liver donations and transplantations: an interrupted time series analysis spanning years, 1988–2020. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2051127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Amrita Shenoy
- College of Public Affairs, University of Baltimore, Baltimore, MD, USA
| | | | - Gayatri G. Shenoy
- Diplomate of National Board (DNB) Faculty of Anesthesiology, K. J. Somaiya Medical College and Hospital, Mumbai, India
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Siddique AB, Apte V, Fry-Revere S, Jin Y, Koizumi N. The impact of country reimbursement programmes on living kidney donations. BMJ Glob Health 2020; 5:bmjgh-2020-002596. [PMID: 32792408 PMCID: PMC7430320 DOI: 10.1136/bmjgh-2020-002596] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Living-donor kidney transplantation is the gold standard treatment for patients with end-stage kidney disease. However, potential donors ubiquitously face financial as well as logistical barriers. To remove these disincentives from living kidney donations, the governments of 23 countries have implemented reimbursement programmes that shift the burdens of non-medical costs from donors to the governments or private entities. However, scientific evidence for the effectiveness of these programmes is scarce. The present study investigates whether these reimbursement programmes designed to ease the financial and logistical barriers succeeded in increasing the number of living kidney donations at the country level. The study examined within-country variations in the timing of such reimbursement programmes. METHOD The study applied the difference-in-difference (two-way panel fixed-effect) technique on the Poisson distribution to estimate the effects of these reimbursement programmes on a 17 year long (2000-2016) dataset covering 109 countries where living donor kidney transplants were performed. RESULTS The results indicated that reimbursement programmes have a statistically significant positive effect. Overall, the model predicted that reimbursement programmes increased country-level donation numbers by a factor of 1.12-1.16. CONCLUSION Reimbursement programmes may be an effective approach to alleviate the kidney shortage worldwide. Further analysis is warranted on the type of reimbursement programmes and the ethical dimension of each type of such programmes.
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Affiliation(s)
- Abu Bakkar Siddique
- Schar School of Policy and Government, George Mason University-Arlington Campus, Arlington, Virginia, USA
| | - Vandana Apte
- Department of Agricultural, Food and Resource Economics, Rutgers University, New Brunswick, New Jersey, USA
| | - Sigrid Fry-Revere
- Independent Bioethics Scholar, Washington, District of Columbia, USA
| | - Yanhong Jin
- Department of Agricultural, Food and Resource Economics, Rutgers University, New Brunswick, New Jersey, USA
| | - Naoru Koizumi
- Schar School of Policy and Government, George Mason University-Arlington Campus, Arlington, Virginia, USA
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Platz TT, Siersbæk N, Østerdal LP. Ethically Acceptable Compensation for Living Donations of Organs, Tissues, and Cells: An Unexploited Potential? APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:1-14. [PMID: 30143995 DOI: 10.1007/s40258-018-0421-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The number of living donations of human organs, tissues, and cells falls far short of the need. Market-like arrangements to increase donation rates have been proposed, but they are broadly considered unacceptable due to ethical concerns and are therefore not policy relevant in most countries. The purpose of this paper is to explore a different approach to increasing living donations, namely through the use of ethically acceptable compensation of donors. We review the compensation practices in Europe and find a lack of reimbursement of incurred costs and lack of compensation for non-monetary losses, which create disincentives for donation. We draw on a well-known philosophical theory to explain why donors are rarely fully compensated and why many existing proposals to raise donation rates are seen as controversial or even unethical. We present and discuss three categories of compensation with the potential to increase donation rates in an ethically acceptable way.
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Affiliation(s)
- Trine Tornøe Platz
- Department of Economics, Copenhagen Business School, Porcelænshaven 16A, 2000, Frederiksberg, Denmark.
| | - Nikolaj Siersbæk
- Department of Business and Economics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
| | - Lars Peter Østerdal
- Department of Economics, Copenhagen Business School, Porcelænshaven 16A, 2000, Frederiksberg, Denmark
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Querido S, Weigert A, Adragão T, Machado D, Pais D. Rewards to increase living kidney donation: The state of the art. Nefrologia 2018; 39:11-14. [PMID: 30391020 DOI: 10.1016/j.nefro.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/25/2018] [Indexed: 10/28/2022] Open
Affiliation(s)
- Sara Querido
- Department of Nephrology, Centro Hospitalar de Lisboa Ocidental - Hospital Santa Cruz, Carnaxide, Portugal.
| | - André Weigert
- Department of Nephrology, Centro Hospitalar de Lisboa Ocidental - Hospital Santa Cruz, Carnaxide, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Teresa Adragão
- Department of Nephrology, Centro Hospitalar de Lisboa Ocidental - Hospital Santa Cruz, Carnaxide, Portugal
| | - Domingos Machado
- Department of Nephrology, Centro Hospitalar de Lisboa Ocidental - Hospital Santa Cruz, Carnaxide, Portugal
| | - Diogo Pais
- Nova Medical School, Faculdade de Ciências Médicas - Universidade Nova de Lisboa, Lisbon, Portugal
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8
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Yang XW, Xiong TW, Hua XF, Xu Q, Tang YE, Chen WJ, Sun QQ. Anxiety and Depression among Families of Deceased Donors in China. Chin Med J (Engl) 2018; 131:99-102. [PMID: 29271388 PMCID: PMC5754966 DOI: 10.4103/0366-6999.221278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Xiang-Wei Yang
- Division of Renal Transplantation, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Tian-Wei Xiong
- Organ Donation Administrative Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Xue-Feng Hua
- Division of Renal Transplantation, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Qian Xu
- Organ Donation Administrative Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Yue-E Tang
- Organ Donation Administrative Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Wei-Jian Chen
- Organ Donation Administrative Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
| | - Qi-Quan Sun
- Division of Renal Transplantation, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510530, China
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Barnieh L, Collister D, Manns B, Lam NN, Shojai S, Lorenzetti D, Gill JS, Klarenbach S. A Scoping Review for Strategies to Increase Living Kidney Donation. Clin J Am Soc Nephrol 2017; 12:1518-1527. [PMID: 28818845 PMCID: PMC5586566 DOI: 10.2215/cjn.01470217] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/12/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The literature on strategies to increase the number of potential living kidney donors is extensive and has yet to be characterized. Scoping reviews are a novel methodology for systematically assessing a wide breadth of a given body of literature and may be done before conducting a more targeted systematic review. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a scoping review and summarized the evidence for existing strategies to increase living kidney donation. RESULTS Our review identified seven studies that tested interventions using rigorous methods (i.e., randomized, controlled trials) and outcome measures, all of which focused on using education targeted at potential recipients to increase living donation. Of these, two studies that targeted the potential recipients' close social network reported statistically significant results. Other interventions were identified, but their effect was assessed through quasiexperimental or observational study designs. CONCLUSIONS We identified an important gap in the literature for evidence-based strategies to increase living kidney donation. From the limited data available, strategies directed at potential recipients and their social networks are the most promising. These results can inform transplant programs that are considering strategies to increase living kidney donation and highlight the need for conduct of high-quality study to increase living donation.
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Affiliation(s)
- Lianne Barnieh
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - David Collister
- Division of Nephrology, Department of Medicine, McMaster University, St. Joseph’s Hospital, Hamilton, Ontario, Canada
| | - Braden Manns
- Department of Community Health Sciences and
- Department of Medicine, Institute of Public Health and Libin Cardiovascular Institute, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada; and
| | - Ngan N. Lam
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - Soroush Shojai
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
| | - Diane Lorenzetti
- Department of Medicine, Institute of Public Health and Libin Cardiovascular Institute, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada; and
| | - John S. Gill
- Division of Nephrology, Centre for Health Evaluation and Outcomes Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Klarenbach
- Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada
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Callison K, Levin A. Donor registries, first-person consent legislation, and the supply of deceased organ donors. JOURNAL OF HEALTH ECONOMICS 2016; 49:70-75. [PMID: 27388535 DOI: 10.1016/j.jhealeco.2016.06.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 06/06/2023]
Abstract
In this paper, we exploit the varied timing in state adoption of organ donor registries and first-person consent (FPC) legislation to examine corresponding changes in the supply of deceased organ donors. Results indicate that the establishment of a state organ donor registry leads to an increase in donation rates of approximately 8%, while the adoption of FPC legislation has no effect on the supply of organ donors. These results reinforce the need to encourage individuals to communicate their donation preferences, either explicitly via a registry or by discussing them with family.
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Affiliation(s)
- Kevin Callison
- Grand Valley State University, 50 Front Ave SW, Grand Rapids, MI 49504, United States.
| | - Adelin Levin
- Grand Valley State University, 50 Front Ave SW, Grand Rapids, MI 49504, United States
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Tushla L, Rudow DL, Milton J, Rodrigue JR, Schold JD, Hays R. Living-Donor Kidney Transplantation: Reducing Financial Barriers to Live Kidney Donation--Recommendations from a Consensus Conference. Clin J Am Soc Nephrol 2015; 10:1696-702. [PMID: 26002904 DOI: 10.2215/cjn.01000115] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Live-donor kidney transplantation (LDKT) is the best treatment for eligible people with late-stage kidney disease. Despite this, living kidney donation rates have declined in the United States in recent years. A potential source of this decline is the financial impact on potential and actual living kidney donors (LKDs). Recent evidence indicates that the economic climate may be associated with the decline in LDKT and that there are nontrivial financial ramifications for some LKDs. In June 2014, the American Society of Transplantation's Live Donor Community of Practice convened a Consensus Conference on Best Practices in Live Kidney Donation. The conference included transplant professionals, patients, and other key stakeholders (with the financial support of 10 other organizations) and sought to identify best practices, knowledge gaps, and opportunities pertaining to living kidney donation. This workgroup was tasked with exploring systemic and financial barriers to living kidney donation. The workgroup reviewed literature that assessed the financial effect of living kidney donation, analyzed employment and insurance factors, discussed international models for addressing direct and indirect costs faced by LKDs, and summarized current available resources. The workgroup developed the following series of recommendations to reduce financial and systemic barriers and achieve financial neutrality for LKDs: (1) allocate resources for standardized reimbursement of LKDs' lost wages and incidental costs; (2) pass legislation to offer employment and insurability protections to LKDs; (3) create an LKD financial toolkit to provide standardized, vetted education to donors and providers about options to maximize donor coverage and minimize financial effect within the current climate; and (4) promote further research to identify systemic barriers to living donation and LDKT to ensure the creation of mitigation strategies.
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Affiliation(s)
- Lara Tushla
- University Transplant Program, Rush University Medical Center, Chicago, Illinois;
| | - Dianne LaPointe Rudow
- Recanati Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York
| | - Jennifer Milton
- University of Texas Health Science Center of San Antonio, San Antonio, Texas
| | - James R Rodrigue
- Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Jesse D Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio; and
| | - Rebecca Hays
- Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
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Rodrigue JR, Kazley AS, Mandelbrot DA, Hays R, LaPointe Rudow D, Baliga P. Living Donor Kidney Transplantation: Overcoming Disparities in Live Kidney Donation in the US--Recommendations from a Consensus Conference. Clin J Am Soc Nephrol 2015; 10:1687-95. [PMID: 25883072 DOI: 10.2215/cjn.00700115] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities.
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Affiliation(s)
- James R Rodrigue
- Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Abby Swanson Kazley
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Didier A Mandelbrot
- Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and
| | - Rebecca Hays
- Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and
| | - Dianne LaPointe Rudow
- Recanati Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York
| | - Prabhakar Baliga
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina;
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Caulfield T, Nelson E, Goldfeldt B, Klarenbach S. Incentives and organ donation: what's (really) legal in Canada? Can J Kidney Health Dis 2014; 1:7. [PMID: 25780602 PMCID: PMC4349723 DOI: 10.1186/2054-3581-1-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/09/2014] [Indexed: 11/12/2022] Open
Abstract
Purpose of review To date, there has been little analysis of the degree to which emerging incentive initiatives are permissible under Canadian law. The purpose of this review is to examine the relevant law – including legislation and case law – in order to clarify the legality of existing proposed incentive schemes. Sources of information Legislation and case law. Findings Organ donation is governed by provincial legislation that, in general, bans the exchange of any “benefit” or any form of “valuable consideration” in return for an organ. As such, these laws are tremendously restrictive and could have significant implications for emerging and proposed procurement policy. Implications Given the need for innovative, ethically appropriate policies to increase donation rates, we suggest that the time is right to rethink the potentially restrictive nature of Canada’s organ donation laws.
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Affiliation(s)
- Timothy Caulfield
- Faculty of Law and School of Public Health, Health Law Institute, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada ; School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Avenue, Edmonton, AB T6G 1C9 Canada
| | - Erin Nelson
- Faculty of Law and School of Public Health, Health Law Institute, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada
| | - Brice Goldfeldt
- Faculty of Law and School of Public Health, Health Law Institute, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada
| | - Scott Klarenbach
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 116 St and 85 Avenue, Edmonton, AB T6G 2R3 Canada
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Lacetera N, Macis M, Stith SS. Removing financial barriers to organ and bone marrow donation: the effect of leave and tax legislation in the U.S. JOURNAL OF HEALTH ECONOMICS 2014; 33:43-56. [PMID: 24240145 DOI: 10.1016/j.jhealeco.2013.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 06/02/2023]
Abstract
Many U.S. states have passed legislation providing leave to organ and bone marrow donors and/or tax benefits for live and deceased organ and bone marrow donations and to employers of donors. We exploit cross-state variation in the timing of such legislation to analyze its impact on organ donations by living and deceased persons, on measures of the quality of the transplants, and on the number of bone marrow donations. We find that these provisions do not have a significant impact on the quantity of organs donated. The leave laws, however, do have a positive impact on bone marrow donations, and the effect increases with the size of the population of beneficiaries and with the generosity of the legislative provisions. Our results suggest that this legislation works for moderately invasive procedures such as bone marrow donation, but these incentives may be too low for organ donation, which is riskier and more burdensome.
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15
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Allen MB, Reese PP. Financial incentives for living kidney donation: ethics and evidence. Clin J Am Soc Nephrol 2013; 8:2031-3. [PMID: 24158795 DOI: 10.2215/cjn.09820913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Matthew B Allen
- Perelman School of Medicine,, †Renal Division, Department of Medicine, Perelman School of Medicine, and, ‡Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania
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