The effectiveness of organ donor policies in 10 European countries: a widening gap?

Coppen, R., Friele, R.D., Blok, G.A., Smit, M.C., Gevers. J.K.M. The effectiveness of organ donor policies in 10 European countries: a widening gap? European Journal of Public Health: 2007, 17(suppl. 2), p. 108. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
Background: Each country has a shortage of organ donors. Therefore, countries develop policies to support the efficient use of potential donors. Nonetheless, there is a large variety in the numbers of organ donors amongst different European countries. This presumes there are differences between countries regarding the effectiveness of their policies. However, whether an organ donor policy is effective or not does not only depend on the difference of donation rates per million people (pmp.) in a certain year, but also depends on the differences in numbers of potential donors and whether the policy causes a structural increase of the donation rates over a long period of time, taking into account the number of potential donors. For that reason this study uses the crude donor efficiency rate to give insight in the effectiveness of donation policies of 10 European countries in the period 1995–2005. Methods: We studied the effects of donation policies on the efficient use of potential donors in 10 European countries from 1995 to 2000. Most of the organ donors have died from a cerebral vascular accident (CVA) or (traffic) accident. That is why these categories were considered relevant for organ donation and were considered as a good proxy for potential donors in this international comparison. The mortality rates ( < 65 years) for CVA and (traffic) accident were retrieved from the WHO Health For All Database. The national transplant centres provided the donation rates. On the basis of the mortality rates pmp and the donation rates pmp the crude donor efficiency rate was calculated. This rate represents the number of donations taking into account the limited number of people dying in a relevant mortality category. As this rate corrects for differences in relevant mortality between countries it is considered as the best measure for international comparison of the effectiveness of donor policies. Results: The donor efficiency rate shows a steady increasing trend over the period 1995–2005 for some countries (e.g. Spain, Italy, France, Austria, Germany), while other countries (e.g. Switzerland, the Netherlands, Sweden, The United Kingdom) show a more fluctuating trend. Because of this difference between countries over a period of time the variance of the donor efficiency in 1995 and 2000 between countries is smaller than in 2005. Conclusions: This suggests that in some countries the organ donation policy was more effective during 1995–2005 than in others and that the gap between efficient and less efficient countries is widening.(aut. ref.)