1 / 43

What is Our Current National Multicultural Reality?

What is Our Current National Multicultural Reality?. Bob Carrico, PhD Senior Biostatistician UNOS. Number of Donors 2009 - 2012. Introduction / Outline. Can we find standout OPOs using current national DSA level data? Metric: Authorization Rate

niran
Download Presentation

What is Our Current National Multicultural Reality?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. What is Our Current National Multicultural Reality? Bob Carrico, PhD Senior Biostatistician UNOS

  2. Number of Donors 2009 - 2012

  3. Introduction / Outline • Can we find standout OPOs using current national DSA level data? • Metric: Authorization Rate • Authorization of Eligible Deaths – Percent by OPO. • By ethnicities: White, Black, Hispanic, Asian • Can we find statistical significance? • Where does this leave us?

  4. Implications • Speakers at this conference are invited based on this analysis • Data indicated that they are top performers • Want to find factors that influence this • Data • Geography and Population • Philosophies, Procedures, Techniques • How can this influence practice

  5. Authorization Rate 2009 - 2012

  6. Authorization Distribution: White

  7. Authorization Distribution: Black

  8. Authorization Distribution: Hispanic

  9. Authorization Distribution: Asian

  10. Authorization Distribution: All

  11. Analysis Technique • Odds Ratio: • Odds of Authorization for Candidate OPOs • Compare to adjusted average of other candidate OPOs and non-candidate OPOs • How to select OPOs to test when there are many • Which OPOs can be candidates? • Logistic Regression Models • Compute adjusted odds ratios • Are candidate OPOs more likely to authorize individuals of a given ethnicity? • Adjust for: • Age; Gender; Cause, Mechanism, and Circumstance of Death.

  12. Authorization Rates - White

  13. Authorization Rates - White OPO Mean Authorization Rate: 82.8%

  14. Authorization Rates - White Median Number of Eligible Deaths: 324 OPO Mean Authorization Rate: 82.8%

  15. Authorization Rates - White

  16. Authorization Rates - White

  17. Authorization Rates - White

  18. Top Performers: White • ILIP-OP1 – Gift of Hope • Crude Authorization Rate 90.8% • Adjusted Odds Ratio: 1.72 (p-value<0.01) • CORS-OP1 – Donor Alliance • Crude Authorization Rate 91.2% • Adjusted Odds Ratio: 1.60 (p-value=0.01) • PADV-OP1 – Gift of Life Donor Program • Crude Authorization Rate 88.0% • Adjusted Odds Ratio: 1.31 (p-value<0.01)

  19. Authorization Rates - Black

  20. Authorization Rates - Black OPO Mean Authorization Rate: 59.3%

  21. Authorization Rates - Black Median Number of Eligible Deaths: 91 OPO Mean Authorization Rate: 59.3%

  22. Authorization Rates - Black

  23. Authorization Rates - Black

  24. Authorization Rates - Black

  25. Top Performers: Black • TNMS-OP1 – Mid-South Transplant Foundation • Crude Authorization Rate 75.0% • Adjusted Odds Ratio: 1.51 (p-value=0.02) • MWOB-OP1 – Midwest Transplant Network • Crude Authorization Rate 70.7% • Adjusted Odds Ratio: 1.50 (p-value=0.04) • SCOP-OP1 – LifePoint, Inc. • Crude Authorization Rate 74.5% • Adjusted Odds Ratio: 1.47 (p-value<0.01) • ILIP-OP1 – Gift of Hope • Crude Authorization Rate 69.9% • Adjusted Odds Ratio: 1.33 (p-value=0.01)

  26. Authorization Rates - Hispanic

  27. Authorization Rates - Hispanic OPO Mean Authorization Rate: 66.2%

  28. Authorization Rates - Hispanic 75th Percentile Number of Eligible Deaths: 105 OPO Mean Authorization Rate: 66.2%

  29. Authorization Rates - Hispanic

  30. Authorization Rates - Hispanic

  31. Authorization Rates - Hispanic

  32. Top Performers: Hispanic • ILIP-OP1 – Gift of Hope • Crude Authorization Rate 83.7% • Adjusted Odds Ratio: 1.84 (p-value<0.01) • PRLL-OP1– LifeLink of Puerto Rico • Crude Authorization Rate 81.1% • Adjusted Odds Ratio: 1.59 (p-value<0.01)

  33. Authorization Rates - Asian

  34. Authorization Rates - Asian OPO Mean Authorization Rate: 54.5%

  35. Authorization Rates - Asian 75th Percentile Number of Eligible Deaths: 25 OPO Mean Authorization Rate: 54.5%

  36. Authorization Rates - Asian

  37. Authorization Rates - Asian

  38. Top Performers: Asian • Data does not suggest that there exist any statistically significant top performing OPOs in authorization of Asian eligible deaths.

  39. Authorization Rates 2009-2012: National Significance

  40. Analytical Limitations • Multivariable Analysis • Can only adjust models for data we have • Fit models separately for ethnicities • Missing significant factors • Identify other top performers

  41. Unavailable Data • Socio-Economic Status (SES) • Zip code on DNR form is missing for many non-donors. • Missingness keeps zip code from being used for national analyses • Zip Code • Relates donor to their socio-economic lifestyles and circumstances • Current analysis does not separate ethnicities by their lifestyles or circumstances. • These are likely indicative of donation potential and hence authorization rate.

  42. Where is the data? • OPOs house more data than we can aggregate nationally • Locally, OPOs are able to use their data and knowledge of their demographics to look at the same trends in their population

  43. Questions? Bob.Carrico@UNOS.org

More Related