Coppen Remco, Friele Roland D, Gevers Sjef K M, Blok Geke A, van der Zee Jouke
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands.
BMC Health Serv Res. 2008 Nov 13;8:235. doi: 10.1186/1472-6963-8-235.
Transplantable organs are scarce everywhere. Therefore, countries have developed policies to support the efficient use of potential donors. Nevertheless, the shortage of organs remains. Were these policies in vain? The aim of this study is to assess the impact of donor policies on donor procurement in 10 Western European countries from 1995 to 2005.
To assess the impact of the donor policies we studied the conversion of potential donors into effectuated donors. 80% of the donors died from CVAs or a (traffic) accident. We considered these mortality rates to be a good proxy for potential donors. Here we call the conversion of potential donors into actual donors 'the donor efficiency rate by proxy'.
The mortality rates for CVA and (traffic) accidents have decreased in the countries under study. At the same time, in most countries the donor efficiency rates have steadily increased. The variance in donor efficiency rates between countries has also increased from 1995 to 2005. Four countries introduced a new consent system or changed their existing system, without (visible) long-term effects.
The overall increase in donor efficiency means that the efforts to improve donor policies have paid off. However, substantial differences between countries were found. The success of donor policies in terms of the number of absolute donors is blurred by the success of policies on traffic safety and CVA treatment. It remains unclear which specific policy measures are responsible for the increase in donor efficiency rates. This increase is not related to having a presumed consent system. Furthermore, an analysis of countries that introduced a new consent system or changed their system showed no effect on donor efficiency.
可移植器官在各地都很稀缺。因此，各国制定了政策以支持有效利用潜在捐赠者。然而，器官短缺问题依然存在。这些政策是否徒劳无功？本研究的目的是评估1995年至2005年期间捐赠者政策对10个西欧国家捐赠者获取情况的影响。
为评估捐赠者政策的影响，我们研究了潜在捐赠者向实际捐赠者的转化情况。80%的捐赠者死于脑血管意外（CVA）或（交通）事故。我们认为这些死亡率是潜在捐赠者的一个良好替代指标。在此，我们将潜在捐赠者向实际捐赠者的转化称为“替代指标下的捐赠者效率率”。
在所研究的国家中，CVA和（交通）事故的死亡率有所下降。与此同时，在大多数国家，捐赠者效率率稳步上升。1995年至2005年期间，各国之间捐赠者效率率的差异也有所增加。四个国家引入了新的同意系统或改变了现有系统，但没有（明显的）长期影响。
捐赠者效率的总体提高意味着改善捐赠者政策的努力取得了成效。然而，发现各国之间存在显著差异。捐赠者政策在绝对捐赠者数量方面的成功因交通安全和CVA治疗政策的成功而变得模糊。目前尚不清楚哪些具体政策措施导致了捐赠者效率率的提高。这种提高与推定同意系统无关。此外，对引入新同意系统或改变其系统的国家进行的分析表明，对捐赠者效率没有影响。
