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活体和已故供者肾移植的差异支付意愿:终末期肾病 (ESKD) 患者的实证研究。

Differential Willingness to Pay for Kidney Transplantation From Living and Deceased Donors: Empirical Study Among End-Stage Kidney Disease (ESKD) Patients.

机构信息

Department of Economics and Business Administration, Ariel University, Ariel, Israel.

Department of behavioral sciences, Academic College of Israel, Ramat-Gan, Israel.

出版信息

Inquiry. 2022 Jan-Dec;59:469580221139368. doi: 10.1177/00469580221139368.

Abstract

Kidney transplantation has developed to the stage where it is currently the most cost-effective treatment for patients suffering from end-stage kidney disease (ESKD) and, when available, offers them the highest quality of life. Yet, kidney transplantation is challenged by cultural and traditional beliefs; thus, this study sought to evaluate the willingness to pay for a kidney transplant in a culturally sensitive population. A self-administered survey was completed by 734 end-stage kidney disease (ESKD) patients. A quantitative method and survey design were chosen and employed descriptive, correlational, nonparametric, and multivariate statistical tests. Participants were willing to pay a mean amount of $40 751.36 for a living donor kidney transplant, whereas the mean is considerably lower, $18 350.51, for a deceased donor kidney. Significant predictors of the willingness to pay (WTP) for a kidney transplant from a living donor and a deceased donor were found, among them: religiosity and ethnicity. The participants' willingness to pay for a kidney transplant could attest to significant benefits in enhancing patient well-being. The willingness to pay differentially for a donation from a deceased or a living donor stems from the higher chances of success with a living-donor organ as well as from moral and religious motives. In Israel kidney transplantation is not tradable in the free market and is fully funded by the state. The average cost of kidney transplantation in Israel is $61 714.50. Since the cost exceeds the utility and since the economic literature suggests that the funding of healthcare interventions should be provided up to the point where the costs of that funding equal the benefits that society derives from it, crucial revisions in public health policy should be made. Education may have a significant impact on the approach to kidney donation and organ donation in general.

摘要

肾移植已经发展到目前阶段,它是治疗终末期肾病(ESKD)患者最具成本效益的治疗方法,而且在有条件的情况下,能为患者提供最高质量的生活。然而,肾移植受到文化和传统观念的挑战;因此,本研究旨在评估在具有文化敏感性的人群中,对肾移植的支付意愿。通过自我管理的问卷调查了 734 名终末期肾病(ESKD)患者。选择并采用了定量方法和调查设计,进行了描述性、相关性、非参数和多变量统计检验。参与者愿意为活体供肾移植支付平均 40751.36 美元,而对于已故供体肾,平均支付金额则低得多,为 18350.51 美元。研究发现,愿意支付(WTP)活体供肾和已故供体肾移植的显著预测因素包括宗教信仰和种族。参与者对肾移植的支付意愿可以证明在提高患者福祉方面具有重要意义。对已故供体或活体供体捐赠的支付意愿存在差异,这源于活体供体器官成功的几率更高,以及道德和宗教动机。在以色列,肾移植在自由市场上不可交易,完全由国家出资。以色列肾移植的平均成本为 61714.50 美元。由于成本超过了效用,而且经济文献表明,医疗保健干预措施的资金应提供到该资金的成本等于社会从中获得的收益的程度,因此应做出重大的公共卫生政策修订。教育可能对肾脏捐赠和一般器官捐赠的方法产生重大影响。

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本文引用的文献

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