Mossialos Elias, Costa-Font Joan, Rudisill Caroline
LSE Health, London School of Economics, London, UK.
BMC Health Serv Res. 2008 Feb 27;8:48. doi: 10.1186/1472-6963-8-48.
Maintaining adequately high organ donation rates proves essential to offering patients all appropriate and available treatment options. However, the act of donation is in itself an individual decision that requires a depth of understanding that interacts with the social setting and the institutional framework into which an individual is embedded. This study contributes to understanding factors driving organ donation rates by examining how country regulation, individuals' awareness of regulatory setting, social interactions and socio-demographic determinants influence individuals' willingness to donate their own organs or those of a relative.
We draw representative data from the Eurobarometer survey 58.2 undertaken in 2002 with respondents throughout the European Union to capture heterogeneity in institutional setting. We use logistic regression techniques to estimate the determinants of willingness to donate one's own organs and those of a deceased relative. We employ interaction terms to examine the relationship between institutional setting and respondent's awareness of organ donation legislation in their country.
Our findings indicate that individuals are more likely to donate their organs than to consent to the donation of a relative's organs. Both decisions are affected by regulation (presumed consent), awareness of regulation and social interactions such as the ability to count on others in case of a serious problem (reciprocity). Furthermore, education (more educated), age (younger), expressing some sort of political affiliation determine willingness to donate one's own organs and consent to the donation of those of a relative.
This study confirms and develops further previous research findings that presumed consent organ donation policy positively affects the willingness of individuals to donate their own organs and those of relative by highlighting the importance of awareness of this regulation and an individual's level of social interactions in making choices about donation. Results found using interaction terms underline the importance of population awareness of organ donation legislation as well as the legislation type itself. Findings also point to the role of social interactions in influencing individuals' willingness to donate their organs or those of a relative.
维持足够高的器官捐赠率对于为患者提供所有合适且可行的治疗选择至关重要。然而，捐赠行为本身是一个个人决定，需要深入理解，这种理解与个人所处的社会环境和制度框架相互作用。本研究通过考察国家监管、个人对监管环境的认知、社会互动以及社会人口统计学决定因素如何影响个人捐赠自己器官或亲属器官的意愿，有助于理解推动器官捐赠率的因素。
我们从2002年在欧盟各地开展的欧洲晴雨表调查58.2中提取代表性数据，以捕捉制度环境的异质性。我们使用逻辑回归技术来估计捐赠自己器官和已故亲属器官意愿的决定因素。我们采用交互项来考察制度环境与受访者对其所在国家器官捐赠立法的认知之间的关系。
我们的研究结果表明，个人捐赠自己器官的可能性高于同意捐赠亲属器官的可能性。这两个决定都受到监管（推定同意）、对监管的认知以及社会互动（如在遇到严重问题时能否依靠他人（互惠））的影响。此外，教育程度（受教育程度更高）、年龄（更年轻）、表达某种政治归属决定了捐赠自己器官以及同意捐赠亲属器官的意愿。
本研究通过强调对该监管的认知以及个人社会互动水平在做出捐赠选择中的重要性，证实并进一步发展了先前的研究结果，即推定同意器官捐赠政策对个人捐赠自己器官和亲属器官的意愿有积极影响。使用交互项得出的结果强调了公众对器官捐赠立法的认知以及立法类型本身的重要性。研究结果还指出了社会互动在影响个人捐赠自己器官或亲属器官意愿方面的作用。
