Benchmarking performance in organ donation programs: dependence on demographics and mortality rates

Area of Science:

• Transplantation Science
• Public Health
• Biostatistics

Background:

• Neurologically determined deaths are the primary source for organ donation.
• Donors Per Million Population (DPMP) is the standard metric for organ donation program effectiveness.
• DPMP compares available donors to the potential donor population.

Purpose of the Study:

• To investigate if population demographics, specifically age and gender-specific mortality rates, explain variations in organ donation rates (DPMP).
• To assess the reliability of crude DPMP as a performance benchmark for organ donation programs.

Main Methods:

• Data on population distribution and deaths for the Calgary Health Region (CHR) and Spain in 2000 were obtained.
• Expected deaths were calculated by standardizing the sample using weighted averages of age, gender, and cause-specific mortality rates.

Main Results:

• Spain reported a crude organ donation rate of 33.9 DPMP in 2000.
• Standardizing Spain's observed deaths using CHR population distribution and CHR rates yielded an adjusted rate of 19.2 DPMP (P < 0.05).

Conclusions:

• The findings question the reliability of crude DPMP for evaluating organ and tissue donation program performance.
• Alternative benchmarking measures for organ donation programs should be explored.