Willingness to Donate Organs: Report on a Biethnic Medicare Population.

Abstract: Information on the willingness of the elderly and specifically the Hispanic elderly to donate organs is limited. We analyzed survey data from a community-based, cross-sectional survey of randomly selected elderly Medicare recipients regarding their willingness to donate organs after death. The study was designed to examine health and health-related issues of elderly (65 years and older) Hispanics and non-Hispanic whites in Bernalillo County, New Mexico (Albuquerque area). A total of 883 subjects--414 Hispanics and 469 non-Hispanic whites--participated.

Results showed that many elderly would be willing to donate organs, although Hispanics were less likely to be willing. Hispanics were less willing to donate organs if they did not understand English well (OR 0.45; CI 0.19-1.01; P [less than] 0.05). Subjects who completed high school (OR 1.89; CI 1.21-2.96; P [less than] 0.005) and who scored higher on the Iowa Self Assessment Instrument (ISAI) trusting others scale (OR 2.8; CI 1.5-5.0; P [less than] 0.008) were more likely to be willing to donate. Factors that did not influence willingness to donate organs included age, gender, income level, ISAI social support score, ISAI emotional balance score, number of doctor visits in the last 6 months, impaired cognition, three or more current major illnesses, depression, or number of persons living in the household.

These factors should be taken into consideration when attempting to recruit organ donors.

Introduction

In order to increase organ donation, the Health Care Financing Administration published its final rule on conditions for participation of Medicare and Medicaid programs which became effective August 21, 1998. Briefly, this regulation requires hospitals to have an agreement with an organ procurement organization to inform the family of every potential organ donor of the option to donate organs or tissues, and to educate staff on donation issues. [1]

Little information is available on the willingness to donate organs in minority or elderly populations although accepting older donors has surfaced as an option to increase the donor pool. [2,3] Regarding minorities, some studies have reported that they may be less willing to donate organs, [4-6] while others have no reported no difference. [7]

The New Mexico Elder Health Survey was a community-based, cross-sectional survey of randomly selected Medicare recipients living in Bernalillo County (Albuquerque area) that was conducted from May 1993 to September 1995. The survey's objective was to examine the health and health-related issues of Hispanic and non-Hispanic white elderly ([greater than] 65 years of age). As part of the survey, participants were asked about their willingness to donate organs after they die. This report discusses their answers.

Methods

Survey procedure

From the Medicare list of 50,700 recipients residing in Bernalillo County at that time, a randomized sample of 2,200 potential subjects, age 65 and older, consisting of Hispanic and non-Hispanic whites equally stratified by ethnicity and gender was selected. The Generally Useful Ethnic Search System Computer Program was used to designate ethnicity by surname pattern. [8,9] Ethnicity was further verified by self report during the home interview. To be eligible, potential participants had to self-identify as Hispanic or non-Hispanic white and to identify three of four grandparents as Hispanic or non-Hispanic white, respectively. The survey was conducted in two phases, an initial home visit followed by a 4-hour session in a senior health clinic. Data collected included socio-demographic and health information; physical, nutritional and cognitive assessments; body composition measurements; and laboratory tests. Of the 2,200 subjects originally selected, 1,666 remained in the eligible pool. Of these, 1,130 comple ted the home interview and 883 completed the 4-hour session. The participation rate was 67.8% for the home interview and 54% for the 4-hour session. A detailed description of the participants and the survey methods is reported elsewhere. [10] …