This page contains exclusive content for the member of the following sections: TTS, ISODP. Log in to view.
Presenter: Kirsten, Howard, Sydney, Australia
Authors: Kirsten Howard, Stephen Jan, John M. Rose, Michelle Irving, Germaine Wong, Allison Tong, Jonathan C. Craig, Steven Chadban, Richard D. Allen, Alan Cass
“I’d register, but I’ve never been asked…†Key factors influencing decisions about whether to register as an organ donor
Kirsten Howard1, Stephen Jan2, John M. Rose3, Michelle Irving1,4, Germaine Wong1,4, Allison Tong1,4, Jonathan C. Craig1,4, Steven Chadban5,6, Richard D. Allen6, Alan Cass2,7
1School of Public Health, University of Sydney, Sydney, Australia, 2The George Institute for International Health, Sydney, Australia, 3Institute for Transport and Logistics Studies, University of Sydney, Sydney, Australia, 4Centre for Kidney Research, The Children's Hospital Westmead, Westmead, Australia, 5Central Clinical School, Bosch Institute, University of Sydney, Sydney, Australia, 6Department of Renal Medicine, Royal Prince Alfred Hopspital, Sydney, Australia, 7Menzies School of Health Research, Casuarina, Australia
Background: Despite broad public support for organ donation, there is a chronic shortage of deceased donor organs. We aimed to identify the key factors that would influence the decision about whether to register as an organ donor
Methods: A best-worst-scaling method was used where policies/services are described by factors presented with varying levels. Community respondents were recruited from an existing internet panel; quota sampling ensured they were broadly representative of the adult Australian age distribution. Participants answered 30 online scenarios presenting 9 factors (Table1), and chose, in each, the factor that made them most likely, and least likely, to register to be a donor. Using MNL regression we calculated: the importance of each factor, and the contribution each factor made to overall utility of a policy
Results: There were 2041 respondents with a mean age of 45.4 (range18-87); 51.8% were female. The importance ranking of attributes is shown below (Table1), with the type of consent system ranking highest. The largest gains in overall utility of a policy could be achieved from: reimbursement of funeral expenses, family priority in the future, how death is defined and direct payment mechanisms. There were some differences in the valuation of attribute levels with respondent age, for example respondents <50yrs valuing financial mechanisms more highly than older people
Conclusions: How donation intent is registered (ie the consent system in place) and the extent of family overrule were valued highly, as was ease of registration. Interestingly, less important attributes such as possible incentive mechanisms (funeral expense reimbursement, direct payment and family priority) all significantly contributed positively to overall policy utility, suggesting the Australian public is open to donation policies that include incentives, including financial mechanisms
Factors presented |
Factor importance score |
Rank importance of factor |
Overall impact of factor levels on utility of policy |
Rank of utility impact |
How donation is registered (consent system) |
1.308 |
1 |
0.484 |
9 |
Whether family are able to overrule decision |
1.021 |
2 |
0.743 |
5 |
How often you need to register/ confirm |
0.545 |
3 |
0.720 |
7 |
How easy it is to register donation intent |
0.484 |
4 |
0.516 |
8 |
Whether a direct payment is made to your family |
0.449 |
5 |
1.554 |
4 |
How death is defined |
0.227 |
6 |
1.597 |
3 |
Whether family receive priority in future |
0.164 |
7 |
1.723 |
2 |
Whether reimbursement of funeral expenses is provided |
0.073 |
8 |
1.817 |
1 |
Whether there is any formal recognition of donation |
0 |
9 |
0.724 |
6 |
By viewing the material on this site you understand and accept that:
The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada