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对器官采购组织绩效指标的种族调整
Jonathan M Miller1, David Zaun2, Nicholas L Wood1
1Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, USA; Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, Minnesota, USA.
概括
将器官采购组织 (OPO) 的绩效指标调整为种族显著影响层级排名. 这项分析强调了种族如何影响捐赠和移植率,表明需要更公平的绩效评估.
科学领域:
- 移植研究 移植研究
- 公共卫生政策 公共卫生政策
- 器官捐献和移植器官的使用
背景情况:
- 美国医疗保险和医疗补助服务中心 (CMS) 使用器官采购组织 (OPO) 的绩效指标 (捐赠率,移植率).
- 目前,CMS在OPO绩效指标中没有针对大多数人口统计学变量进行调整,包括种族,理由是缺乏生物学理由.
- 器官捐赠受到社会因素的影响,如信任和利他主义,而不仅仅是生物决定因素.
研究的目的:
- 更新对2020年OPO绩效指标人口调整的分析.
- 具体地检查种族调整对OPO级别排名的影响.
- 评估OPO绩效报告中分层和风险调整指标的潜力.
主要方法:
- 2020年器官采购组织 (OPO) 绩效数据的分析.
- 将种族作为人口统计学变量纳入绩效指标调整中.
- 与CMS等级排名的比较,有或没有比赛调整.
主要成果:
- 将OPO绩效指标调整为种族将改变8个OPO的CMS级别排名.
- 在非白人捐助者中,两家在全国范围内表现超标的OPO将从三级排名提升到二级排名.
- 种族调整揭示了OPO表现的差异和潜在的错误分类.
结论:
- 人口因素,特别是种族,显著影响器官捐赠和利用.
- 由于缺乏人口调整,当前的CMS绩效指标可能不准确地反映OPO绩效.
- 纳入分层和风险调整指标可以改善OPO绩效问题的识别,并促进公平的评估.
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