306.5: Do reimbursement programs increase the number of living organ donations?

Abstract

Background: Living-donor kidney transplantation is the gold standard treatment for end-stage renal disease. However, living donors worldwide face significant financial and logistic barriers. To remove these disincentives to living donations, the governments of many countries have implemented reimbursement programs which shifts the burdens of non-medical financial and other costs from the donors to the governments or to the private entities as par by policies permit to encourage the donors to donate their living organs. This study investigates whether these reimbursement programs designed to ease the financial and logistic barriers are effective to increase the number of living donations worldwide. The study examined cross-country and within-country variation in the timing of such reimbursement programs to analyze their impacts on the number of living organ donations. Methods: The study used negative binomial regressions to estimate the effects of these reimbursement programs on panel data from 2000 to 2016 for 116 countries where living organ donations are practiced. Both bivariate and multivariate analyses were performed to investigate the effectiveness of the policy with and without adjusting for possible covariates. Results: Overall, the result demonstrated the significant positive effect of these reimbursement programs on the number of donations. However, further analysis indicated that the impact was significant only in high and medium income economy. For the low-income economy, the effect was insignificant presumably due to the small number of countries in this category having any reimbursement program. Conclusions: The result in this paper can be a supportive evidence for the policy-makers whether to expand the reimbursement program to minimize the organ shortage.