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Rationing scarce organs for transplantation: healthcare provider perspectives on wait-listing and organ allocation

Tong, Allison, Jan, Stephen, Wong, Germaine, Craig, Jonathan C., Irving, Michelle, Chadban, Steve, Cass, Alan and Howard, Kirsten (2013). Rationing scarce organs for transplantation: healthcare provider perspectives on wait-listing and organ allocation. Clinical Transplantation,27(1):60-71.

Document type: Journal Article

IRMA ID 11035xPUB69
Title Rationing scarce organs for transplantation: healthcare provider perspectives on wait-listing and organ allocation
Author Tong, Allison
Jan, Stephen
Wong, Germaine
Craig, Jonathan C.
Irving, Michelle
Chadban, Steve
Cass, Alan
Howard, Kirsten
Journal Name Clinical Transplantation
Publication Date 2013
Volume Number 27
Issue Number 1
ISSN 0902-0063   (check CDU catalogue  open catalogue search in new window)
Start Page 60
End Page 71
Total Pages 12
Place of Publication United States
Publisher Wiley-Blackwell Publishing, Inc
HERDC Category C1 - Journal Article (DIISR)
Abstract Ongoing debate about how to maximize the benefit of scarce organs while maintaining equity of access to transplantation exists. This study aims to synthesize healthcare provider perspectives on wait-listing and organ allocation. MEDLINE, Embase, and PsycINFO were searched till February 21, 2011. Quantitative data were extracted, and a qualitative synthesis of the studies was conducted. Twenty studies involving 4254 respondents were included. We identified two goals underpinning healthcare provider preferences for organ allocation: (i) maximize clinical benefit (quality of life gains, patient survival, treatment adherence, and graft survival) and social outcomes (social support, productivity, and valuation); (ii) achieve equity (waiting time, patient preferences, access to live donation, and medical urgency). Maximizing clinical or social outcomes meant organs would be preferentially given to patients expected to achieve good transplant outcomes or wider social gain. Achieving equity meant all patients should have an equal chance of transplant, or patients deemed more urgent receive higher priority. A tension between equity and efficiency is apparent. Balanced against dimensions of efficiency were considerations to instill a degree of perceived fairness in organ allocation. Ongoing engagement with stakeholders is needed to enhance transparency, a reasonable balance between efficiency and equity, and avoid discrimination against specific populations.
DOI http://dx.doi.org/10.1111/ctr.12004   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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