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The effectiveness of transplant legislation, procedures and management: Cross-country evidence

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  • Bilgel, Fırat

Abstract

This article investigates the impact of legal determinants of cadaveric and living donor organ transplantation rates using panel data on legislative, procedural and managerial aspects of organ transplantation and procurement, government health expenditures, enrollment rates, religious beliefs, legal systems and civil rights and liberties for 62 countries over a 2-year period. Under living donor organ transplantation, we found that guaranteeing traceability of organs by law or performing psychiatric evaluation to living donors has a sizeable, negative impact on living transplant rates once the remaining determinants of living transplantation have been controlled for. Under cadaveric transplantation, our findings do not suggest an unequivocal and positive association between presumed consent, donor registries and cadaveric transplant rates. However, legally requiring family consent or maintaining written procurement standards for deceased donors has a sizeable, negative impact on cadaveric transplant rates. The latter finding suggests that informing families rather than asking for consent may be an effective strategy to raise procurement rates while respecting patient autonomy. Finally, we confirm that predominantly non-Christian countries have significantly higher living but lower cadaveric transplant rates.

Suggested Citation

  • Bilgel, Fırat, 2013. "The effectiveness of transplant legislation, procedures and management: Cross-country evidence," Health Policy, Elsevier, vol. 110(2), pages 229-242.
  • Handle: RePEc:eee:hepoli:v:110:y:2013:i:2:p:229-242
    DOI: 10.1016/j.healthpol.2012.12.014
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    References listed on IDEAS

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    1. Abadie, Alberto & Gay, Sebastien, 2006. "The impact of presumed consent legislation on cadaveric organ donation: A cross-country study," Journal of Health Economics, Elsevier, vol. 25(4), pages 599-620, July.
    2. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
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    4. Fırat Bilgel, 2012. "The impact of presumed consent laws and institutions on deceased organ donation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 29-38, February.
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    7. Plümper, Thomas & Troeger, Vera E., 2007. "Efficient Estimation of Time-Invariant and Rarely Changing Variables in Finite Sample Panel Analyses with Unit Fixed Effects," Political Analysis, Cambridge University Press, vol. 15(02), pages 124-139, March.
    8. Plümper, Thomas & Troeger, Vera E., 2011. "Fixed-Effects Vector Decomposition: Properties, Reliability, and Instruments," Political Analysis, Cambridge University Press, vol. 19(02), pages 147-164, March.
    9. Byrne, Margaret M. & Thompson, Peter, 2001. "A positive analysis of financial incentives for cadaveric organ donation," Journal of Health Economics, Elsevier, vol. 20(1), pages 69-83, January.
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    More about this item

    Keywords

    Cadaveric transplantation; Living donor organ transplantation; Transplant legislation; Medical standards; Regression analysis;

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law

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