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Benchmarking performance in organ donation programs: dependence on demographics and mortality rates

[La performance comparative des programmes de don d’organes en fonction des données démographiques et des taux de mortalité]

Lianne Barnieh, MSc, David Baxter, Paul Boiteau, MD, Braden Manns, MD MSc^*, and Christopher Doig, MD MSc^*,,

^* From the Departments of Medicine,
Community Health Sciences; and
Critical Care Medicine, Faculty of Medicine, The University of Calgary, Calgary, Alberta; and the
Urban Futures Institute, Vancouver, British Columbia, Canada.

Address correspondence to: Dr. Christopher James Doig, Rm EG23G, Foothills Medical Centre, 1403-29th Street NW, Calgary, Alberta T2N 2T9, Canada. Phone: 403-944-1691; Fax: 403-283-9994; E-mail: cdoig{at}ucalgary.ca

Purpose: Donors whose diagnosis of death is based upon neurologic criteria are the primary source of organs for human transplantation. The current measure of effectiveness of organ donation programs is the crude statistic, donors per million population (DPMP). This statistic represents the number of available donors, divided by the potential donor population. Comparisons between transplantation programs are done using the DPMP statistic. We sought to determine if variance in organ donation rates, reported as DPMP could be accounted for by differences in population demographics, specifically age and gender-specific mortality rates.

Methods: We obtained the population distribution and deaths for the year 2000 for the Calgary Health Region (CHR) and the country of Spain. Expected deaths were then calculated by standardizing the sample, based upon weighted averages of age, gender and cause-specific mortality rates.

Results: In 2000, Spain reported a crude organ donation rate of 33.9 DPMP. Standardizing the observed deaths in Spain using the CHR population distribution and calculating expected deaths based on the CHR rates, resulted in an adjusted rate of 19.2 DPMP (P < 0.05).

Conclusions: These results bring into question the reliability of using crude DPMP as a measure of organ and tissue donation program performance. Alternative measures of benchmarking performance in organ donation programs should be considered.

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