Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.
Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Transpl Int. 2023 May 25;36:11006. doi: 10.3389/ti.2023.11006. eCollection 2023.
Conceptual frameworks are valuable resources that can be used to guide the planning, evaluation, and development of healthcare services. However, there are currently no comprehensive frameworks focused on organ donation and transplantation that identify the critical factors underlying a successful national program. To address this knowledge gap, we developed a conceptual framework that takes into account all major domains of influence, including political and societal aspects as well as clinical implementation. The framework was initially constructed based on a targeted review of the relevant medical literature. Feedback provided by a panel of international experts was incorporated into the framework an iterative process. The final framework features 16 essential domains that are critical for initiating and maintaining a successful program and improving the health of patients with organ failure. Of particular note, these domains are subject to three overarching health system principles: responsiveness, efficiency, and equity. This framework represents a first attempt to develop a whole-system view of the various factors that contribute to the success of a national program. These findings provide a useful tool that can be adapted to any jurisdiction and used to plan, evaluate, and improve organ donation and transplantation programs.
概念框架是有价值的资源，可用于指导医疗服务的规划、评估和发展。然而，目前没有专门针对器官捐献和移植的全面框架，无法确定成功的国家项目所必需的关键因素。为了弥补这一知识空白，我们开发了一个概念框架，该框架考虑了所有主要的影响领域，包括政治和社会方面以及临床实施。该框架最初是基于对相关医学文献的有针对性的审查构建的。国际专家小组提供的反馈意见被纳入框架的迭代过程中。最终的框架包含 16 个对启动和维持成功项目以及改善器官衰竭患者健康至关重要的基本领域。值得注意的是，这些领域受到三个总体卫生系统原则的制约：响应性、效率和公平性。该框架代表了首次尝试从整体系统的角度来理解促成国家项目成功的各种因素。这些发现提供了一个有用的工具，可适用于任何司法管辖区，并用于规划、评估和改进器官捐献和移植项目。
