Sehgal N K R, Sullivan C, Figueroa M, Pencak J A, Einstadter D, Thornton J D
University School, Hunting Valley, Ohio, USA.
Center for Reducing Health Disparities, MetroHealth Campus of Case Western Reserve University, Cleveland, Ohio, USA.
Transplant Proc. 2017 Jul-Aug;49(6):1211-1214. doi: 10.1016/j.transproceed.2017.01.078.
Evaluating Department of Motor Vehicles (DMV) locations based on the percent of patrons who register as donors does not account for individual characteristics that may influence willingness to donate. We reviewed the driver's licenses of 2997 randomly selected patients at an urban medical system to obtain donor designation, age, gender, and DMV location and linked patient addresses with census tract data on race, ethnicity, income, and education. We then developed a Standardized Donor Designation Ratio (SDDR) (ie, the observed number of donors at each DMV divided by the expected number of donors based on patient demographic characteristics). Overall, 1355 (45%) patients were designated as donors. Donor designation was independently associated with younger age, female gender, nonblack race, and higher income. Across 18 DMVs, the proportion of patients who were donors ranged from 30% to 68% and SDDRs ranged from 0.82 to 1.17. Among the 6 facilities in the lowest tertile by SDDR, 3 were in the lowest tertile by percent donation. In conclusion, there is a great deal of variation across DMVs in rates of organ donor designation. SDDRs that adjust for DMV patron characteristics are distinct measures that may more accurately describe the performance of DMVs in promoting organ donation.
根据登记成为捐赠者的顾客比例来评估机动车管理部门（DMV）的地点，并不能考虑到可能影响捐赠意愿的个体特征。我们查阅了一家城市医疗系统中随机选取的2997名患者的驾照，以获取捐赠者指定情况、年龄、性别和DMV地点，并将患者地址与关于种族、族裔、收入和教育的普查区数据相联系。然后，我们制定了一个标准化捐赠者指定比率（SDDR）（即每个DMV观察到的捐赠者数量除以基于患者人口统计学特征的预期捐赠者数量）。总体而言，1355名（45%）患者被指定为捐赠者。捐赠者指定与较年轻的年龄、女性性别、非黑人种族和较高收入独立相关。在18个DMV中，捐赠患者的比例从30%到68%不等，SDDR范围从0.82到1.17。在SDDR处于最低三分位数的6个机构中，有3个在捐赠百分比方面也处于最低三分位数。总之，不同DMV在器官捐赠者指定率方面存在很大差异。针对DMV顾客特征进行调整的SDDR是不同的指标，可能更准确地描述DMV在促进器官捐赠方面的表现。
