| LDO Home | General | Kidney | Liver | Marrow | Experiences | Buddies | Hall of Fame | Calendar | Contact Us |

Author Topic: Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney  (Read 3361 times)

0 Members and 1 Guest are viewing this topic.

Offline Clark

  • Administrator
  • Top 10 Poster!
  • *****
  • Posts: 3,021
  • Please give the gift of life!
    • Living Donors Online!
http://onlinelibrary.wiley.com/doi/10.1111/ajt.13286/abstract

Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney: Findings From the KDOC Study
J. R. Rodrigue1,2,*, J. D. Schold3, P. Morrissey4, J. Whiting5, J. Vella5, L. K. Kayler6, D. Katz7, J. Jones7, B. Kaplan8,9, A. Fleishman1,2, M. Pavlakis1,2, D. A. Mandelbrot1,10 andfor the KDOC Study Group
DOI: 10.1111/ajt.13286
American Journal of Transplantation

Abstract

Limited information exists on the predonation costs incurred by eventual living kidney donors (LKDs). Expenses related to completion of the donation evaluation were collected from 194 LKDs participating in the multi-center, prospective Kidney Donor Outcomes Cohort (KDOC) Study. Most LKDs (n = 187, 96%) reported one or more direct costs, including ground transportation (80%), healthcare (24%), lodging (17%) and air transportation (14%), totaling $101 484 (USD; mean = $523 ± 942). Excluding paid vacation or sick leave, donor and companion lost wages totaled $35 918 (mean = $187 ± 556) and $14 378 (mean = $76 ± 311), respectively. One-third of LKDs used paid vacation or sick leave to avoid incurring lost wages. Few LKDs reported receiving financial support from the transplant candidate (6%), transplant candidate's family (3%), a nonprofit organization (3%), the National Living Donor Assistance Center (7%), or transplant center (3%). Higher total costs were significantly associated with longer distance traveled to the transplant center (p < 0.001); however, total costs were not associated with age, sex, race/ethnicity, household income, marital status, insurance status, or transplant center. Moderate predonation direct and indirect costs are common for adults who complete the donation evaluation. Potential LKDs should be advised of these possible costs, and the transplant community should examine additional strategies to reimburse donors for them.
Unrelated directed kidney donor in 2003, recipient and I both well.
625 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

Offline Clark

  • Administrator
  • Top 10 Poster!
  • *****
  • Posts: 3,021
  • Please give the gift of life!
    • Living Donors Online!
How to Eliminate Some Living Donation Related Costs
« Reply #1 on: May 12, 2015, 01:28:19 PM »
http://livingdonorsarepeopletoo.com/how-to-eliminate-some-living-donation-related-costs/


How to Eliminate Some Living Donation Related Costs
by LDPeopleToo


Note: Typical with most recently published studies, I’m only able to see the abstract for this one. Authors collected info from 194 living kidney donors enrolled in the KDOC study.“Most LKDs (n=187, 96%) reported one or more direct costs, including ground transportation (80%), healthcare (24%), lodging (17%) and air transportation (14%)…..Higher total costs were significantly associated with longer distance traveled to the transplant center” As I’ve discussed at length, not only is it not medically necessary for a potential living kidney donor to have their procedure at the same transplant center as their recipient, it can also be detrimental for the kidney donor’s care, recovery and treatment. Transplant centers prefer both parties to be at the same hospital because –A. It’s convenient for them.B. Variations in how transplant centers evaluate potential living donors results in a quality control issue. Transplant center 1 might miss something that transplant center 2 deems exclusionary, etcC. Transplant centers are paid by the procedure, so having folks at different hospitals splits the revenue pie.[size=78%]D. If the kidney donor and transplant recipient live in different states, there can be insurance and billing conflicts and issues.[/size]How to fix the problem (for the living donor, at least):1. Put *all* treatment for ESRD and kidney failure under Medicare (this would delight private insurance companies btw), or at minimum, have Medicare assume all healthcare expenses if the prospective living donor and would-be recipient reside in different states to circumvent the state insurance regulation obstacles.2. Completely standardize the living donor evaluation and selection process.3. Require insurance companies or transplant centers to pay for the living donor’s travel and lodging expenses. (This, however, would still leave the LKD at risk. S/he must return home at some point and could need further treatment) “Few LKDs reported receiving financial support from the transplant candidate (6%), transplant candidate’s family (3%), a nonprofit organization (3%), the National Living Donor Assistance Center (7%), or transplant center (3%).”Donation is an act of generosity, which causes the prospective LKD to bear the burden (in this case financial) by themselves. Transplant candidates (aka would-be recipients) are taught, in a million subtle ways, to passively accept the sacrifice a donor is making on their behalf. Maybe we need to change the dialogue from one of recipient entitlement to one of recipient responsibility? Rather than expecting the government (NLDAC) or a nonprofit to help with living donation related expenses, transplant candidates should be prepared to assume these costs. If a would-be recipient is unable or unwilling to do, s/he could continue on dialysis and wait until a deceased donor organ becomes available.If this idea offends your sense of fairness (Poor people won’t get living donor kidneys!), I hear you, but it’s also the reality of how our healthcare system works in general. If someone can’t afford a treatment or medication, that person can’t have that treatment or medication. Is that unfair? Certainly. But then again, one could argue, so is asking another person to act as your medical supply.
Rodrigue, J., Schold, J., Morrissey, P., Whiting, J., Vella, J., Kayler, L., Katz, D., Jones, J., Kaplan, B., Fleishman, A., Pavlakis, M., Mandelbrot, D., & , . (2015). Predonation Direct and Indirect Costs Incurred by Adults Who Donated a Kidney: Findings From the KDOC Study American Journal of Transplantation DOI: 10.1111/ajt.13286
« Last Edit: May 13, 2015, 10:20:08 AM by Clark »
Unrelated directed kidney donor in 2003, recipient and I both well.
625 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

 

Copyright © International Association of Living Organ Donors, Inc. All Rights Reserved