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Organ donation in Hawaii: impact of the final rule
Kevin H Higashigawa1, Chris Carroll, Linda L Wong
1John A. Burns School of Medicine, University of Hawaii, Hawaii, USA.
Insights
The 1998 Final Rule slightly increased organ donor referral rates in Hawaii. Hospitals must enhance donor identification and referral to meet the growing demand for organ transplantation.
Area of Science:
- Public Health Policy
- Organ Donation and Transplantation
- Healthcare Administration
Background:
- The Department of Health and Human Services implemented the Final Rule in 1998 to boost organ donation rates.
- Hospitals were mandated by the Health Care Financing Administration (HCFA) to report all deaths and imminent deaths to organ procurement organizations (OPO) to maintain Medicare/Medicaid eligibility.
Purpose of the Study:
- To evaluate the impact of the Final Rule on organ donation practices in Hawaii.
Main Methods:
- A review of medical records for all deaths between January 1999 and December 2000 was conducted across 17 acute-care hospitals.
- The study identified the number of medically suitable potential organ donors.
Main Results:
- Out of 9427 deaths, 144 were identified as potential organ donors.
- In 1999 (pre-Final Rule), 80% of potential donors were identified, with a 53% referral rate to the OPO.
- In 2000 (post-Final Rule), the identification rate increased to 83%, and the referral rate rose to 70%.
Conclusions:
- The Final Rule demonstrated a modest increase in organ donor referral rates.
- Continued improvement in identifying potential donors and ensuring prompt referral is crucial for hospitals.
- Enhancing these processes is essential for compliance and for increasing organ availability to meet patient needs.
Background:
In an effort to increase organ donation, the Department of Health and Human Services issued the Final Rule in 1998. The Health Care Financing Administration (HCFA) later required hospitals to notify organ procurement organizations (OPO) of all deaths and imminent deaths in order to remain eligible for Medicare and Medicaid reimbursement. We set out to determine the impact of the Final Rule on organ donation in Hawaii.
Methods:
Medical records of all deaths between January 1999 and December 2000 at 17 acute-care hospitals were reviewed to determine the number of medically suitable, potential organ donors.
Results:
Of 9427 deaths, 144 were potential organ donors. In 1999, before the Final Rule, 60 of 75 (80%) potential donors were identified and 40 (53%) were referred to the OPO. In 2000, after the Final Rule, the identification rate was 83% and the referral rate was 70%.
Conclusions:
Although, the Final Rule increased the referral rate slightly, medical centres must continue to improve their identification of potential donors and prompt referral. This is not only to comply with the Final Rule, but ultimately to increase organ donation to meet the needs of the ever-expanding list of patients waiting for organs.