Christiansen C L, Gortmaker S L, Williams J M, Beasley C L, Brigham L E, Capossela C, Matthiesen M E, Gunderson S
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA 02215, USA.
Am J Public Health. 1998 Nov;88(11):1645-50. doi: 10.2105/ajph.88.11.1645.
This study sought to develop a methodology for estimating potential solid organ donors and measuring donation performance in a geographic region based on readily available data on the hospitals in that region.
Medical records were reviewed in a stratified random sample of 89 hospitals from 3 regions to attain a baseline of donor potential. Data on a range of hospital characteristics were collected and tested as predictors of donor potential through the use of hierarchical Poisson regression modeling.
Five hospital characteristics predicted donor potential: hospital deaths, hospital Medicare case-mix index, total hospital staffed beds, medical school affiliation, and trauma center certification. Regional estimates were attained by aggregating individual hospital estimates. Confidence intervals for these regional estimates indicated that actual donations represented from 28% to 44% of the potential in the regions studied.
This methodology accurately estimates organ donor potential within 3 geographic regions and lays the foundation for evaluating organ donation effectiveness nationwide. Additional research is needed to test the validity of the model in other geographic regions and to further explore organ donor potential in hospitals with fewer than 50 beds.
本研究旨在开发一种方法，用于基于某一地理区域内医院的现有数据，估算潜在的实体器官捐赠者，并衡量该区域的捐赠表现。
对来自3个地区的89家医院进行分层随机抽样，审查医疗记录以获得捐赠者潜力的基线。收集了一系列医院特征的数据，并通过分层泊松回归模型将其作为捐赠者潜力的预测指标进行测试。
五个医院特征可预测捐赠者潜力：医院死亡人数、医院医疗保险病例组合指数、医院总床位、医学院附属关系以及创伤中心认证。通过汇总各医院的估算值得出区域估算值。这些区域估算值的置信区间表明，在所研究的区域中，实际捐赠量占潜在捐赠量的28%至44%。
该方法准确估算了3个地理区域内的器官捐赠者潜力，并为在全国范围内评估器官捐赠有效性奠定了基础。需要进一步开展研究，以检验该模型在其他地理区域的有效性，并进一步探索床位少于50张的医院的器官捐赠者潜力。
