Intra-hospital organ and tissue donation coordination project: cost-effectiveness and social benefits.
OBJECTIVE To evaluate the viability of a professional specialist in intra-hospital committees of organ and tissue donation for transplantation.METHODS Epidemiological, retrospective and cross-sectional study (2003-2011 and 2008-2012), which was performed using organ donation for transplants data in the state of Sao Paulo, Southeastern Brazil. Nine hospitals were evaluated (hospitals 1 to 9). Logistic regression was used to evaluate the differences in the number of brain death referrals and actual donors (dependent variables) after the professional specialist started work (independent variable) at the intra-hospital committee of organ and tissue donation for transplantation. To evaluate the hospital invoicing, the hourly wage of the doctor and registered nurse, according to the legislation of the Consolidation of Labor Laws, were calculated, as were the investment return and the time elapsed to do so.RESULTS Following the nursing specialist commencement on the committee, brain death referrals and the number of actual donors increased at hospital 2 (4.17 and 1.52, respectively). At hospital 7, the number of actual donors also increased from 0.005 to 1.54. In addition, after the nurse started working, hospital revenues increased by 190.0% (ranging 40.0% to 1.955%). The monthly cost for the nurse working 20 hours was US$397.97 while the doctor would cost US$3,526.67. The return on investment was 275% over the short term (0.36 years).CONCLUSIONS This paper showed that including a professional specialist in intra-hospital committees for organ and tissue donation for transplantation proved to be cost-effective. Further economic research in the area could contribute to the efficient public policy implementation of this organ and tissue harvesting model.
Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Vanessa Silva e
VS
Silva
Instituto Israelita de Responsabilidade Social, Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.
Luciana Carvalho
LC
Moura
Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Renata Fabiana
RF
Leite
Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Priscilla Caroliny de
PC
Oliveira
Departamento de Enfermagem na Saúde da Mulher, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Janine
J
Schirmer
Departamento de Enfermagem Clínica e Cirúrgica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Bartira De' Aguiar
BD
Roza
D001926:Brain Death; D001938:Brazil; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D006801:Humans; D012189:Retrospective Studies; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000191:economics* / Q000706:statistics & numerical data