Factors influencing deceased organ donation rates in OECD countries: a panel data analysis

Objectives This study aims to investigate factors with a significant influence on deceased organ donation rates in Organisation for Economic Co-operation and Development (OECD) countries and determine their relative importance. It seeks to provide the necessary data to facilitate the development of more efficient strategies for improving deceased organ donation rates. Design Retrospective study. Setting Publicly available secondary annual data. Participants The study includes 36 OECD countries as panel members for data analysis. Outcome measures Multivariable panel data regression analysis was employed, encompassing data from 2010 to 2018 for all investigated variables in the included countries. Results The following variables had a significant influence on deceased organ donation rates: 'opt-in' system (beta=-4.734, p<0.001, ref: 'opt-out' system), only donation after brain death (DBD) donors allowed (beta=-4.049, p=0.002, ref: both DBD and donation after circulatory death (DCD) donors allowed), number of hospital beds per million population (pmp) (beta=0.002, p<0.001), total healthcare employment pmp (beta=-0.00012, p=0.012), World Giving Index (beta=0.124, p=0.008), total tax revenue as a percentage of gross domestic product (beta=0.312, p=0.009) and percentage of population aged >= 65 years (beta=0.801, p<0.001) as well as high education population in percentage (beta=0.118, p=0.017). Conclusions Compared with the promotion of socioeconomic factors with a positive significant impact on deceased organ donation rates, the following policies have been shown to significantly increase rates of deceased organ donation, which could be further actively promoted: the adoption of an 'opt-out' system with presumed consent for deceased organ donation and the legal authorisation of both DBD and DCD for transplantation.