Institutional Factors Affecting Organ Donation Rates

影响器官捐献率的制度因素

• 批准号: 6845825
• 负责人: Pamela C Spain
• 金额: $ 3.23万
• 依托单位: VIRGINIA COMMONWEALTH UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2005-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6845825
• 关键词: environment; health care model; health care policy; health services research tag; hospital organization /administration; human data; information systems; longitudinal human study; mathematical model; statistics /biometry; tissue donors

DESCRIPTION (provided by the applicant): This study will examine the degree to which environmental and organizational factors influence the change in the number of potential organ donors and the actual-to-potential donor conversion rate in hospitals over time. This study seeks to identify the reasons that hospitals differ in their organ donor potential and their donor conversion rate. Institutional theory is the organizational theory that will guide the research. The conceptual model proposes that a hospital's number of potential donors as well as its donor conversion rate is a function of 3 institutional forces within the hospital's environment: coercive, mimetic, and normative forces. The model proposes that each of these forces can be operationalized using hospital-level, organ procurement organization level, and donor service area-level variables. The study will be a 4-year longitudinal panel design and will be conducted using five large secondary databases: The Health Care Cost and Utilization Project's Statewide Inpatient Discharge database; the United Network for Organ Sharing database; the American Hospital Association database; the Area Resource File; and the Joint Commission on Accreditation of Healthcare Organizations. The analysis will be conducted using a structural equation modeling approach. Confirmatory factor analysis will be applied to measure the suitability of each of the variables chosen as indicators for the three theoretical constructs of institutional theory. Latent growth curve analysis will be employed to determine how growth rates of potential donors and donor conversion rates over time differ for different types of hospitals as well as how institutional factors influence these growth rates. This study will contribute to a very limited body of empirical research examining factors affecting organ donation at the hospital level. It will inform policy makers of the most important influences on hospitals' potential donor pools and donor conversion rates so that future legislative initiatives designed to increase the number of U.S. organ donors could target hospitals that are most capable of responding to them.

描述（由申请人提供）：本研究将考察环境和组织因素对潜在器官捐献者数量变化的影响程度以及医院中实际到潜在捐献者的转化率随时间的变化。本研究旨在找出医院的器官捐献潜力和捐献者转化率存在差异的原因。制度理论是指导研究的组织理论。该概念模型提出，医院的潜在捐赠者数量及其捐赠者转化率是医院环境中三种制度力量的函数：强制力、模仿力和规范力。该模型提出，这些力量中的每一个都可以使用医院级别、器官采购组织级别和捐赠服务区级别的变量来运作。该研究将是一项为期 4 年的纵向小组设计，并将使用五个大型二级数据库进行：医疗保健成本和利用项目的全州住院患者出院数据库；器官共享联合网络数据库；美国医院协会数据库；区域资源文件；和医疗保健组织认证联合委员会。将使用结构方程建模方法进行分析。将应用验证性因素分析来衡量被选为制度理论三个理论结构指标的每个变量的适用性。将采用潜在增长曲线分析来确定不同类型医院的潜在捐赠者增长率和捐赠者转化率随时间的变化以及制度因素如何影响这些增长率。这项研究将有助于进行非常有限的实证研究，检查影响医院层面器官捐赠的因素。它将告知政策制定者对医院潜在捐赠者库和捐赠者转化率最重要的影响，以便未来旨在增加美国器官捐赠者数量的立法举措可以针对最有能力应对这些捐赠的医院。