1 Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA. 2 Department of Medicine & Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Transplantation. 2016 Jun;100(6):1332-8. doi: 10.1097/TP.0000000000000957.
Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alleviates organ shortage, this belief continues to drive investments into registry promotion. In this study, return on investment in donor registry promotion was examined using cost-outcomes analysis.
Cost of promoting the donor registry was estimated in US dollars whereas the outcome was measured as the number of individuals who join the registry (registrants) and their value in terms of organ donors. The study was conducted from the perspective of a regional Organ Procurement Organization (OPO). Costs were directly obtained from the OPO. The number of new registrants was obtained from the OPO and the departments of motor vehicles that maintain the donor registry. The value of registrants in terms of organ donors was computed based on a registrant's age-dependent risk of dying and age-dependent probability of becoming an organ donor.
Six thousand seven hundred eight individuals joined the organ donor registry (95% confidence interval [95% CI], 5429-7956) at a cost of $455 per registrant (95% CI, US $383-US $562). These individuals result in 4.2 present-day donors (95% CI, 2.5-6.6) at a cost of US $726 000 (95% CI, US $462000-US $1.2 million).
Because the cost per registrant and cost per donor is less than society's willingness to pay, donor registry promotion offers positive return on investment. Investment in registry promotion should at the minimum be maintained at current levels.
移植医学对美国公共卫生的影响受到可移植器官严重短缺的严重限制。因此，美国已经对促进器官捐献者登记处进行了大量投资。尽管没有证据表明促进器官捐献者登记处可以缓解器官短缺问题，但这种信念仍然促使人们继续投资于登记处的推广。在这项研究中，使用成本效益分析来检查器官捐献者登记处推广的投资回报。
用成本效益分析来衡量器官捐献者登记处推广的成本效益。推广成本以美元计，而结果则以加入登记处的人数（登记人数）及其作为器官捐献者的价值来衡量。该研究从区域器官采购组织（OPO）的角度进行。成本直接从 OPO 获得。新登记人数从 OPO 和维护登记处的机动车部门获得。根据登记者的死亡风险和成为器官捐献者的概率随年龄的变化，计算出登记者作为器官捐献者的价值。
6708 人加入了器官捐献者登记处（95%置信区间[95%CI]，5429-7956），每位登记者的费用为 455 美元（95%CI，383 美元至 562 美元）。这些人产生了 4.2 名目前的捐赠者（95%CI，2.5-6.6），费用为 726000 美元（95%CI，462000 美元至 1200 万美元）。
由于每位登记者和每位捐赠者的成本都低于社会的支付意愿，因此器官捐献者登记处的推广带来了积极的投资回报。登记处推广的投资至少应保持在目前水平。
