Organ donation in Hawaii: impact of the final rule.
BACKGROUND
In an effort to increase organ donation, the Department of Health and Human Services issued the Final Rule in 1998. The Health Care Financing Administration (HCFA) later required hospitals to notify organ procurement organizations (OPO) of all deaths and imminent deaths in order to remain eligible for Medicare and Medicaid reimbursement. We set out to determine the impact of the Final Rule on organ donation in Hawaii.


METHODS
Medical records of all deaths between January 1999 and December 2000 at 17 acute-care hospitals were reviewed to determine the number of medically suitable, potential organ donors.


RESULTS
Of 9427 deaths, 144 were potential organ donors. In 1999, before the Final Rule, 60 of 75 (80%) potential donors were identified and 40 (53%) were referred to the OPO. In 2000, after the Final Rule, the identification rate was 83% and the referral rate was 70%.


CONCLUSIONS
Although, the Final Rule increased the referral rate slightly, medical centres must continue to improve their identification of potential donors and prompt referral. This is not only to comply with the Final Rule, but ultimately to increase organ donation to meet the needs of the ever-expanding list of patients waiting for organs.
Higashigawa
Kevin H
KH
John A. Burns School of Medicine, University of Hawaii, Hawaii, USA.
Carroll
Chris
C
Wong
Linda L
LL
Wong
Livingston M
LM
D006254:Hawaii; D006801:Humans; D012017:Referral and Consultation; D014019:Tissue Donors / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence*