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The Impact of the Boise Per Diem Model Implemented to Increase Organ Donations and Referrals in Western Idaho

1 August 2004


Context: It is estimated that over 80,000 American are currently waiting for organ transplants, 800 of which are located in western Idaho at any given time. However, very few of these individuals actually receive organ transplants due to misinformation, lack of options, and lack of counseling that could have been provided by OPOs in their area. Objective: The Boise per diem Model was implemented in February of 1999 as a way of increasing the number of organ donations in western Idaho by requiring OPOs to be present during all donations thereby providing services to the surviving families. The purpose of this study is to retrospectively determine if implementing the policy actually helped to increase the number of organ donations and referrals. Design: Data was gathered by PNTB using their internal electronic charting system called CCL and DARTS (Donor And Referral Tracking System). The data collected included the number of calls, referrals and donations made to the servicing OPO in western Idaho. The mean values between 1995-1998 and 1999-2002 were compared in all three categories to determine if statistically significant-increases were present after the policy was implemented in 1999. Subjects: Western Idaho individuals who have been declared brain dead by the nine hospitals located in this region beginning January 1, 1995 through December 31,2002. Results: Statistically significant increases in number of calls and number of referrals were found following the policy being implemented. There was not a statistically significant difference' found between the number of donations prior to the policy change compared to the years following the implementation, though a positive trend did exist in the three years following;, Conclusions: Both the federal policy and Boise per Diem model implemented in 1999 helped increase the number of calls and referrals in western Idaho as well as helped contribute to the positive trend in the number of organ donations. The decrease in organ donations in year 2002 can be attributed largely to the poor relationship found between the main hospital, hospital staff, and servicing OPO in the western Idaho region at that time. More research into year 2002 should be conducted to address specific issues regarding hospital and OPO relationships and how to better support organ donation in the future.


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