2021/02/25 by Philip J. Held, Jennifer L. Bragg-Gresham, Thomas G. Peters +4 · 3 citations
Medicine · #Asset (computer security) #OPOS #Organ Donation and Transplantation #Organ procurement #Procurement #Renal Transplantation Outcomes and Treatments #Request for proposal #Transplantation: Methods and Outcomes
paper · doi:10.1097/tp.0000000000003667
openalex publication_date 2021/02/25 · openalex created_date 2021/03/15 · openalex updated_date 2026/07/26
BACKGROUND: The goal is to provide a national analysis of organ procurement organization (OPO) costs. METHODS: Five years of data, for 51 of the 58 OPOs (2013-2017, a near census) were obtained under a FOIA. OPOs are not-for-profit federal contractors with a geographic monopoly. A generalized 15-factor cost regression model was estimated with adjustments to precision of estimates (P) for repeated observations. Selected measures were validated by comparison to IRS forms. RESULTS: Decease donor organ procurement is a 1B/y operation with over 26 000 transplants/y. Over 60% of the cost of an organ is overhead. Profits are 2.3M/OPO/y. Total assets are 45M/OPO and growing at 9%/y. "Tissue" (skin, bones) generates 2-3M profit/OPO/y. A comparison of the highest with the lower costing OPOs showed our model explained 75% of the cost difference. Comparing costs across OPOs showed that highest-cost OPOs are smaller, import 44% more kidneys, face 6% higher labor costs, report 98% higher compensation for support personnel, spend 46% more on professional education, have 44% fewer assets, compensate their Executive Director 36% less, and have a lower procurement performance (SDRR) score. CONCLUSIONS: Profits and assets suggest that OPOs are fiscally secure and OPO finances are not a source of the organ shortage. Asset accumulation (45M/OPO) of incumbents suggests establishing a competitive market with new entrants is unlikely. Kidney-cost allocations support tissue procurements. Professional education spending does not reduce procurement costs. OPO importing of organs from other OPOs is a complex issue possibly increasing cost (6K/kidney).