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El. knyga: Realizing the Promise of Equity in the Organ Transplantation System

  • Formatas: 278 pages
  • Išleidimo metai: 29-Apr-2022
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309270779
Kitos knygos pagal šią temą:
  • Formatas: 278 pages
  • Išleidimo metai: 29-Apr-2022
  • Leidėjas: National Academies Press
  • Kalba: eng
  • ISBN-13: 9780309270779
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Each year, the individuals and organizations in the U.S. organ donation, procurement, allocation, and distribution system work together to provide transplants to many thousands of people, but thousands more die before getting a transplant due to the ongoing shortage of deceased donor organs and inequitable access to transplant waiting lists.



Realizing the Promise of Equity in the Organ Transplantation System, a new consensus study report from the National Academies of Sciences, Engineering, and Medicine's Committee on A Fairer and More Equitable, Cost-Effective, and Transparent System of Donor Organ Procurement, Allocation, and Distribution, provides expert recommendations to improve fairness, equity, transparency, and cost-effectiveness in the donor organ system.

Table of Contents



Front Matter Summary 1 Introduction and Study Context 2 The U.S. Organ Transplantation System and Opportunities for Improvement 3 Foundations for a Trustworthy Deceased Donor Organ Transplantation System 4 Confronting and Eliminating Inequities in the Organ Transplantation System 5 Saving More Lives and Enhancing Equity with Deceased Donor Organ Allocation Policies 6 Improving Procurement, Acceptance, and Use of Deceased Donor Organs 7 Measuring and Improving System Performance Appendix A: Public Meeting Agendas Appendix B: IOM and National Academies Solid Organ Transplantation Reports Appendix C: Biographical Sketches of Committee Members and Staff
Acronyms and Abbreviations xxiii
SUMMARY
1(224)
Abstract
1(3)
Challenges and Opportunities
4(2)
Recommendations
6(11)
References
17(2)
1 Introduction and Study Context
19(16)
Movement Toward a National System
19(1)
Complexity, Scarcity, and Public Concerns
20(4)
Study Charge
24(2)
The National Academies Study Process
26(1)
Committee Approach and Interpretation of the Statement of Task
27(4)
Why Is This Study Needed?
31(1)
Overview of Challenges
31(2)
References
33(2)
2 The U.S. Organ Transplantation System And Opportunities For Improvement
35(26)
Evolution of National Organ Transplantation Systems, Policies, and Oversight
35(4)
Complexity of the Current Organ Transplantation System
39(2)
National Coals to Drive Systematic Improvement
41(7)
Deceased Donor Organ Use and Economics Today
48(7)
Innovation Challenges and Opportunities
55(1)
References
56(5)
3 Foundations For A Trustworthy Deceased Donor Organ Transplantation System
61(24)
Why Is Trustworthiness Important?
61(2)
Ethical Principles and Theories for a Trustworthy System
63(9)
The Relevance of Ethical Principles for the Organ Transplantation System
72(6)
Transparency: An Instrumental Value For a Trustworthy System
78(3)
References
81(4)
4 Confronting And Eliminating Inequities In The Organ Transplantation System
85(32)
Prioritizing Health Equity in the Transplantation System---Why Is This Important?
86(2)
Striving for Health Equity and Fairness in Organ Transplantation
88(9)
Data Challenges Related to Assessing and Assuring Equity
97(3)
Structural Barriers to Equity in the Pathway to an Organ Transplant
100(3)
Improving Quality and Health Equity Across the Entire Organ Transplantation System
103(2)
Evidence-Based Interventions for Improving Health Equity in the Organ Transplantation System
105(4)
References
109(8)
5 Saving More Lives And Enhancing Equity With Deceased Donor Organ Allocation Policies
117(36)
Disparities Exacerbated by Allocation Scoring Systems
120(1)
Current Allocation Policies and Scoring Systems
121(16)
Survival Benefit of Transplantation
137(5)
Modeling Allocation Policy Changes
142(2)
Information Technology Infrastructure Opportunities
144(3)
References
147(6)
6 Improving Procurement, Acceptance, And Use Of Deceased Donor Organs
153(46)
Increasing Deceased Organ Donation and Procurement
154(1)
OPO Regulatory Framework and Performance Metrics
155(3)
Key Area for Improvement for OPOs: Donation After Circulatory Determination of Death
158(8)
Transplant Center Regulatory Framework and Performance Metrics
166(3)
Key Area for Improvement for Transplant Centers: Organ Use
169(7)
Key Area for Improvement for Transplant Centers: Organ Offer Acceptance
176(11)
Donor Care Units
187(5)
References
192(7)
7 Measuring And Improving System Performance
199(26)
OPTN Measurement Challenges
200(1)
Dashboard of Standardized, Consensus-Based Performance Measures
201(5)
Quality Improvement in Organ Donation and Transplantation
206(5)
Aligning Incentives to Maximize Organ Use
211(9)
References
220(5)
APPENDIXES
A Public Meeting Agendas
225(14)
B Iom And National Academies Solid Organ Transplantation Reports
239(4)
C Biographical Sketches Of Committee Members And Staff
243