title: Preferences for Policy Options for Deceased Organ Donation for Transplantation: A Discrete Choice Experiment.
abstract: Despite broad public support for organ donation, there is a chronic shortage of deceased donor organs. We sought to identify community preferences for features of organ donation policies.
  
  
  
  A discrete choice study was conducted using an online panel of Australian community respondents older than 18 years. Respondents were presented with scenarios comparing a "new" policy to the current policy. Tradeoffs between 8 policy aspects were quantified using mixed logit and latent class models: registration system, extent of donor family involvement, ease of registration, frequency of confirmation of intent, direct payment, and funeral expense reimbursement, priority for donor's family, and formal recognition of donation.
  
  
  
  There were 2005 respondents (mean, 44.6 years). We found a strong preference for a new policy. Overall, respondents favored a policy that included: some involvement of the donor's family in the final decision, simple registration processes, less frequent reconfirmation of donation intent, direct payment or funeral expense reimbursement, and formal recognition of donation. However, there was significant preference heterogeneity across respondents, with various respondent groups valuing policy mechanisms differently. Respondents who viewed policy change negatively were also those who would be unlikely to be organ donors anyway, because they tended to hold negative views toward organ donation.
  
  
  
  Our results suggest that the Australian community are open to alternative organ donation policies including changes to: registration systems, family involvement, and financial and nonfinancial mechanisms. Future policy discussions should not be limited by preconceived notions of what is acceptable to the community, rather informed by actual community values and preferences.
authors.affiliation: 1 Institute for Choice, University of South Australia, North Sydney, NSW, Australia. 2 Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. 3 The George Institute for Global Health, Sydney, NSW, Australia. 4 Centre for Kidney Research, The Children's Hospital Westmead, Sydney, NSW, Australia. 5 Central Clinical School, Bosch Institute, The University of Sydney, Sydney, NSW, Australia. 6 Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, Australia. 7 Menzies School of Health Research, Casuarina, NT, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.forename: Stephen
authors.initials: S
authors.lastname: Jan
authors.forename: John M
authors.initials: JM
authors.lastname: Rose
authors.forename: Germaine
authors.initials: G
authors.lastname: Wong
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.forename: Michelle
authors.initials: M
authors.lastname: Irving
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.forename: Steven
authors.initials: S
authors.lastname: Chadban
authors.forename: Richard D
authors.initials: RD
authors.lastname: Allen
authors.forename: Alan
authors.initials: A
authors.lastname: Cass
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001315:Australia; D002755:Choice Behavior; D003643:Death; D005260:Female; D006291:Health Policy; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009102:Multiple Organ Failure; D016377:Organ Transplantation / Q000191:economics / Q000331:legislation & jurisprudence*; D057240:Patient Preference; D011795:Surveys and Questionnaires; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000191:economics / Q000331:legislation & jurisprudence*; D055815:Young Adult