(Press-News.org) Policies passed by states to encourage organ donation have had virtually no effect on rates of organ donation and transplantation in the United States, according to an article published online by JAMA Internal Medicine.
The shortage of solid organs for transplant is a critical public health challenge in the United States. Since the late 1980s, states have enacted numerous policies to increase the organ supply.
Researcher Erika G. Martin, Ph.D., M.P.H., of the Nelson A. Rockefeller Institute of Government and Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York, and coauthors examined a variety of state policies on organ donation and transplantation. The authors used data from the United Network for Organ Sharing and Organ Procurement and Transplantation Network databases, state-specific legislative codes and a comprehensive database of federal and state laws. The authors examined six major types of state policies:
Dedicated revenue pools of individual voluntary contributions and protected state funds for donor recruitment activities
Education programs on organ donation through class in public schools or driver's education programs
Leaves of absence for donors in the public and private sectors
First-person consent laws registering individual consent for donation without family consent at time of donation
Donor registries to document consent for donation
Tax benefits for donors equal to the costs associated with the act of donation
The authors found that from 1988 to 2010, the number of states passing at last one donation-related policy increased from seven to 50. However, first-person consent laws, donor registries, public education, paid leave and tax incentives were not associated with either donation rates or numbers of transplants.
Only revenue policies, where individuals can contribute to a protected state fund for donation promotion activities, were associated with a 5.3 percent increase in the number of transplants, which was equivalent to, on average, 15 additional transplants per state per year, according to the results. Revenue policies also were associated with a 4.9 percent increase in the number of deceased donors per capita and an 8 percent increase in the number of transplants of organs from deceased donors. This increase represents an additional 6.5 deceased donors and eight transplants from deceased donors per state per year.
"However, state-by-state variation in how these funds are used is large, limiting the generalizability of this finding. These findings suggest that new policy designs may be needed to increase donation rates," the study concludes.
(JAMA Intern Med. Published online June 1, 2015. doi:10.1001/jamainternmed.2015.2194. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Commentary: Time to Test Incentives to Increase Organ Donation
In a related commentary, Sally Satel, M.D., of the Yale University School of Medicine, New Haven, Conn., and coauthors write: "We believe it is time for disruptive innovation. By this concept, we mean compensating donors, not simply seeking to soften the financial ramification of donation. It is time to test incentives, to reward people who are willing to save the life of a stranger through donation. ... The study by Chatterjee and colleagues is yet another reason to get serious about meaningful reform. Our current transplant system is inadequate for the task of boosting the volume of organs needed for life-saving transplantation. Altruism is not enough. Pilot trials of incentives are needed."
(JAMA Intern Med. Published online June 1, 2015. doi:10.1001/jamainternmed.2015.2200. Available pre-embargo to the media at http://media.jamanetwork.com.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
INFORMATION:
Media Advisory: To contact corresponding author Erika G. Martin, Ph.D., M.P.H., call Robert Bullock at 518-443-5837 or email robert.bullock@rockinst.suny.edu . To contact corresponding commentary author Sally Satel, M.D., call William Hathaway at 203-432-1322 or email william.hathaway@yale.edu.
To place an electronic embedded link in your story: Links will be live at the embargo time: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2015.2194 and http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2015.2200
Related material: A Special Communication entitled "Crisis Awaiting Heart Transplantation, Sinking the Lifeboat" http://archinte.jamanetwork.com/article.aspx?doi=10.1001/jamainternmed.2015.2203 and its related author audio interview. The author audio interview will be available when the embargo lifts on the JAMA Internal Medicine website: http://bit.ly/IZGqPC
A three-year study of a 'medical home' intervention that paid bonuses to physician practices based on financial savings has shown significant improvements in quality and use of some medical services relative to comparison practices, according to a new RAND Corporation study.
The study is the first published evaluation of a multipayer medical home intervention that featured shared savings for primary care practices. The results appear in the June 1 edition of JAMA Internal Medicine.
By paying bonuses to participating practices based on reaching quality and spending benchmarks, ...
Cleveland: Cleveland Clinic researchers have discovered for the first time that a metabolite of an FDA-approved drug for metastatic prostate cancer, abiraterone (Abi), has more anti-cancer properties than its precursor. The research will be published online June 1st in Nature.
Cleveland Clinic researcher Nima Sharifi, M.D., found that abiraterone, a steroid inhibitor, is converted into the more physiologically active D4A (Δ4-abiraterone) in both patients and animal models with prostate cancer who take the drug. Furthermore, they found that D4A is more effective ...
For more than a decade, scientists have had a working map of the human genome, a complete picture of the DNA sequence that encodes human life. But new pages are still being added to that atlas: maps of chemical markers called methyl groups that stud strands of DNA and influence which genes are repressed and when.
Now, Salk scientists have constructed the most comprehensive maps yet of these chemical patterns--collectively called the epigenome--in more than a dozen different human organs from individual donors (including a woman, man and child). While the methylation ...
CHAMPAIGN, Ill. -- New compounds that specifically attack fungal infections without attacking human cells could transform treatment for such infections and point the way to targeted medicines that evade antibiotic resistance.
Led by University of Illinois chemistry professor Martin D. Burke, a team of chemists, microbiologists and immunologists developed and tested several derivatives of the antifungal drug amphotericin B (pronounced am-foe-TARE-uh-sin B). They published their findings in the journal Nature Chemical Biology.
Amphotericin B is doctors' last, best defense ...
WASHINGTON, DC, June 1, 2015 -- Non-heterosexual women who feel a disconnect between who they are attracted to and how they identify themselves may have a higher risk of alcohol abuse, according to a new study led by Amelia E. Talley, an assistant professor in Texas Tech University's Department of Psychological Sciences.
The study, titled "Longitudinal Associations among Discordant Sexual Orientation Dimensions and Hazardous Drinking in a Cohort of Sexual Minority Women," appears in the June issue of the Journal of Health and Social Behavior. It delves into the reasons ...
A new study links a commonly used household pesticide with attention deficit hyperactivity disorder (ADHD) in children and young teens.
The study found an association between pyrethroid pesticide exposure and ADHD, particularly in terms of hyperactivity and impulsivity, rather than inattentiveness. The association was stronger in boys than in girls.
The study, led by researchers at Cincinnati Children's Hospital Medical Center, is published online in the journal Environmental Health.
"Given the growing use of pyrethroid pesticides and the perception that they may ...
WASHINGTON, D.C. - In northwestern Greenland, glaciers flow from the main ice sheet to the ocean in see-sawing seasonal patterns. The ice generally flows faster in the summer than in winter, and the ends of glaciers, jutting out into the ocean, also advance and retreat with the seasons.
Now, a new analysis shows some important connections between these seasonal patterns, sea ice cover and longer-term trends. Glaciologists hope the findings, accepted for publication in the June issue of the American Geophysical Union's Journal of Geophysical Research-Earth Surface and ...
Washington, DC, June 1, 2015 - Tweets regarding the Ebola outbreak in West Africa last summer reached more than 60 million people in the three days prior to official outbreak announcements, according to a study published in the June issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
Researchers from the Columbia University School of Nursing in New York analyzed over 42,000 Ebola-related tweets posted to the social networking site Twitter, from July 24 - August ...
In the last 40 years, fructose, a simple carbohydrate derived from fruit and vegetables, has been on the increase in American diets. Because of the addition of high-fructose corn syrup to many soft drinks and processed baked goods, fructose currently accounts for 10 percent of caloric intake for U.S. citizens. Male adolescents are the top fructose consumers, deriving between 15 to 23 percent of their calories from fructose--three to four times more than the maximum levels recommended by the American Heart Association.
A recent study at the Beckman Institute for Advanced ...
Biology isn't the only reason women eat less as they near ovulation, a time when they are at their peak fertility.
Three new independent studies found that another part of the equation is a woman's desire to maintain her body's attractiveness, says social psychologist and assistant professor Andrea L. Meltzer, Southern Methodist University, Dallas.
Women nearing ovulation who also reported an increase in their motivation to manage their body attractiveness reported eating fewer calories out of a desire to lose weight, said Meltzer, lead researcher on the study.
When ...
