Waiting for organ transplantation: results of an analysis by an Institute of Medicine Committee.
One of the most visible and contentious issues regarding the fairness of the original system of organ procurement and allocation is the argument that it resulted in great disparities in the total amount of time a patient waited for an organ (i.e. the time from registration at a transplantation center to transplant), depending on where he or she lived. In an attempt to resolve this debate, Congress charged the National Academy of Sciences, Institute of Medicine to perform an independent study of the original system and proposed rule changes. In an analysis of approximately 68,000 transplant waiting list records, the committee developed several conclusions and recommendations largely specific to liver transplantation policies. The purpose of this paper is to describe both the results of the study and the statistical foundations of the mixed-effects multinomial logistic regression model that led to the committee's conclusions.
Gibbons
Robert D
RD
Center for Health Statistics, University of Illinois at Chicago, 1601 W. Taylor, Chicago, IL 60612, USA.
Duan
Naihua
N
Meltzer
David
D
Pope
Andrew
A
Penhoet
Edward D
ED
Dubler
Nancy N
NN
Francis
Charles
C
Gill
Barbara
B
Guinan
Eva
E
Henderson
Maureen
M
Ildstad
Suzanne T
ST
King
Patricia A
PA
Martinez-Maldonado
Manuel
M
McLain
George E
GE
Murray
Joseph
J
Nelkin
Dorothy
D
Spellman
Mitchell W
MW
Pitluck
Sarah
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D015276:Health Care Rationing; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D016377:Organ Transplantation; D018579:Patient Selection; D012737:Sex Factors; D013223:Statistics as Topic / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D014850:Waiting Lists