Hospital Profiling and Hospital Stratification System as a First Step for Assessment the Potential of Organ Donation from Deceased Donors

Abstract

Background To be able to calculate the potential of deceased organ donation; in single hospital, in the region or totally in the country it was necessary to develop a useful stratification system for all hospitals taking into account their characteristic especially in the subject of having or not having departments crucial for donor identification and recruitment (ICU, Neurology, Neurosurgery), number of beds, patient profile (pediatric vs adult). We constructed such model in Poland. Materials Out of a total number of 1032 hospitals in Poland, 406 have structural possibilities (ICU as min) and stuff to confirm death according to neurological criteria. We excluded 19 hospitals where brain death determination is possible but deceased do not meet criteria for donation as a rule (oncological or infectious profile) or hospitals were not equipped in operating theatre. Then hospitals were divided into groups accordingly to characteristic mentioned above. Results The largest group of hospitals with potential organ donation were 1st degree referral hospitals having ICU only for adults - 161. Another group of hospitals have in their structure units: and in the remaining 19 cases, the hospitals were unique in the country range hospital department. The total amount of hospitals with potential donors in Poland is 387. Results The results of this study we treat as a basic and fundamental for next steps leading to calculation of potential donation in the country. Our thesis is, that characterized in details hospitals from the same group should have the same potential and should be active in donation process on the same level. Formal comparative analysis of historical data on donors referral from active and not active hospitals will allow us to estimate of possible donations and will focus efforts of transplantation system to find areas for improvement