Procurement characteristics of high‐ and low‐performing OPOs as seen in OPTN/SRTR data. Issue 2 (29th September 2021)

• Record Type: Journal Article
• Authors: Lynch, Raymond J.; Doby, Brianna L.; Goldberg, David S.; Lee, Kevin J.; Cimeno, Arielle; Karp, Seth J.
• Is Part Of: American journal of transplantation. Volume 22:Issue 2(2022)
• Page Start: 455
• Page End: 463
• Publication Date: 2021-09-29
• Subjects: deceased -- donors and donation -- health services and outcomes research -- organ procurement -- organ procurement and allocation -- Organ Procurement and Transplantation Network -- organ procurement organization -- Scientific Registry for Transplant Recipients; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.16832
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : To meet new Centers for Medicare and Medicaid Services (CMS) metrics, organ procurement organizations (OPOs) will benefit from understanding performance across decedent and hospital types. We sought to determine the utility of existing data‐reporting structures for this purpose by reviewing Scientific Registry of Transplant Recipient (SRTR) OPO‐Specific Reports (OSRs) from 2013 to 2019. OSRs contain both the Standardized donation rate ratio (SDRR) metric and OPO‐reported numbers of "eligible deaths" and donors by hospital. Donor hospitals were characterized using information from Homeland Infrastructure Foundation‐Level Data, Dartmouth Atlas Hospital Service Area data, and the US Census Bureau. Hospital data reported by OPOs showed 51% higher eligible death donors and 140% higher noneligible death donors per 100 inpatient beds in CMS ranked top versus bottom‐quartile OPOs. Top‐quartile OPOs by the CMS metric recovered 78% more donors than those in the bottom quartile, but were indistinguishable by SDRR rankings. These differences persisted across hospital sizes, trauma case mix, and area demographics. OPOs with divergent performance were indistinguishable over time by SDRR, but showed changes to hospital‐level recovery patterns in SRTR data. Contemporaneous recognition of underperformance across hospitals may provide important and actionable data for regulators and OPOs for focused quality improvement projects. Abstract : Variability in organ procurement organization performance is evident in data already reported to federal contractors but is not apparent in previous metrics for deceased donation. Mathur comments on page 339 .