Canadian and Provincial Deceased Donation Data Update

Transcription

1 Canadian and Provincial Deceased Donation Data Update

2 Disclosures Chair of Deceased Donation Data Working Group (D3WG) Canadian Blood Services

3 Deceased Donation Why Data? Describe and explain variation Understand trends Performance measurement and comparisons Evaluate policy decisions Address supply-demand mismatch

4 Deceased Donation Why Data? Canadian organ donation Supply vs. demand Donors Persons transplanted Persons on waitlist 4

5 1:134 Canadian Death Ratio Deceased Donation in Canada 35,848,600 Canadian Population 5

6 651 Utilized Donors Deceased Donation in Canada ,236 Potential Donors* ~150,000 Hospital Deaths ~267,000 Deaths * CORR estats

7 High Performing Donation Systems 651 Utilized Donors Deceased Donation in Canada ,236 Potential Donors ~150,000 Hospital Deaths ~267,000 Deaths Donors 444 1,037 1,996 Transplants Performed 4, Withdrawals Waiting Deaths

8 Spain Croatia Belgium Portugal Malta* USA France Slovenia Czech Austria Finland Norway Italy UK Belarus Latvia Poland Australia Canada Hungary Ireland Switzerl Slovak Sweden Netherla Denmark Brazil Argentina Uruguay New Germany Iran South Israel Chile Turkey Bulgaria Hong Kong Romania Luxembu Russia Saudi Trinidad China Japan Georgia International Deceased Donation Rates 2015 (PMP per million population) 22.0 Call to action Source: International Data: Canadian Data: 2016 Canadian Blood Services survey of Canadian transplant centres and organ donation organizations 8

9 DECEASED DONATION DATA WORKING GROUP (D3WG) Organized by CBS Tasked with making recommendations for a Minimum Data Set using standard definitions Coordinates activities with other transplant data working groups

10 Canadian Data Capabilities

11 Canadian Challenges Deceased Donation Data Canadian Challenges Deceased Donation Data Multiple, incomplete data sources Different data definitions and datasets Different triggers (potential donors) Lack of data prior to consent Lack of timely reporting Difficulty comparing regions/ provinces Lack of performance data in relation to implementation of leading practices

12 POPULATION - 34,754,312 DEATHS 243,643 HOSPITAL DEATHS 117,156 National, aggregate, data Individual data VENTILATED DEATHS - 4,790* BRAIN-INJURED VENTILATED DEATHS POTENTIAL DONORS (PD) 3,711 REFERRED PD 3,000 ELIGIBLE DONORS (ED) APPROACHED ED CONSENTED DONORS ACTUAL DONORS data based on local standards data based on national standards 542 DRAFT DATA FOR 2012

13

14 D3WG Recommendations Minimum dataset for organ donation Use existing data sources (e.g. CIHI DAD) to provide common estimates of donation potential Improvements to CIHI coding Initiative to harmonize referral triggers Common definitions and similar data collection from potential donors

15 Deceased Donation in Canada

16 Deceased Donation in Canada Deceased donors in Canada by type, % Increase in total deceased donors ( ) DCD NDD Total % DCD 1% 5% 9% 9% 10% 13% 16% 12% 21% 21% 23% 2016 results reported are preliminary and may be subject to change pending validation.

17 Deceased Donation in Canada Deceased donors in Canada per million population by type, DCD NDD Total % DCD 1% 5% 9% 9% 10% 13% 16% 12% 21% 21% 23% 49% Increase in total deceased donor rate ( ) 2016 results reported are preliminary and may be subject to change pending validation

18 Deceased Donation in Canada Deceased organ donation rates PMP by province over time, % 33% 66% 122% 28% 35% 38% 9% -42% 11% 21.0 Canada B.C.* Alta.** Sask. Man. Ont. Que. N.B. N.L. N.S.*** 22.0 Call to Action Target 21.0 Current Rate as of 2016 *Rates for BC - population of Yukon is included **Rates for Alberta - populations of NWT & Nunavut are included. ***Rates for NS population of PEI is included results reported are preliminary and may be subject to change pending validation

19 Deceased Donation in Canada DCD donors per million population by province and year, B.C.* Alta.** Sask. Man. Ont. Que. N.B. N.S.*** N.L *Rates for BC - population of Yukon is included **Rates for Alberta - populations of NWT & Nunavut are included. ***Rates for NS population of PEI is included results reported are preliminary and may be subject to change pending validation

20 Deceased Donation in Canada DCD donors per million population by province and year, B.C.* Alta.** Sask. Man. Ont. Que. N.S. *Rates for BC - population of Yukon is included; **Rates for Alberta - populations of NWT & Nunavut are included 2016 results reported are preliminary and may be subject to change pending validation

21 Transplantation

22 Deceased Donation in Canada Organs transplanted by deceased donor type, % Increase in deceased donor transplants ( ) * DCD NDD Total * Missing Quebec data 2016 results reported are preliminary and may be subject to change pending validation

23 Deceased Donation in Canada Patients on Transplant Waitlist by Province, BC AB SK MB ON QC ATL B.C. Results include Yukon Alberta results include Nunavut and the Northwest Territories 2016 results reported are preliminary and may be subject to change pending validation

24 Deceased Donation in Canada Effect of DCD on organ transplants

25 Deceased Donation in Canada Effect of DCD on organ transplants

26 Deceased Donation in Canada Effect of DCD on organ transplants

27 Deceased Donation in Canada Effect of DCD on organ transplants

28 Deceased Donation in Canada Effect of DCD on organ transplants

29 Deceased Donation in Canada Time from admission to death NDD DCD Median 2.7d Median 6.0d

30 Provincial Practices

31 Deceased Donation in Canada Factors Contributing to Higher Donation Rates B.C ALTA. SASK. MAN. ONT. QUE. N.B. N.L. N.S. Mandatory referral * Donation physicians NDD leading practices DCD programs % DCD donors, Leading practices in donor management Deceased donors, 2016 (DPMP) 20.4** 16.3*** Number of deceased donors, % change in DPMP Implementation complete or near completion as of 2015 Implementation in progress as of 2015 * Mandatory consideration ** The population of Yukon is included in the calculation of this rate. *** The populations of Nunavut and the Northwest Territories are included in the calculation of this rate. The population of PEI is included in the calculation of this rate. Implementation not started as of results reported are preliminary and may be subject to change pending validation

32 International Comparisons

33 Deceased Donation in Canada International deceased donation rates, (DPMP) % 23% 53% 66% 112% Spain United States Canada United Kingdom Australia Increase in deceased donor rate, international rates based on IRODaT Preliminary Numbers, 2016 (published August 2017), with the exception of the United States rate, which is bases on SRTR reported count (consistent with UNOS publications) and population estimate from US Census Bureau results reported are preliminary and may be subject to change pending validation

34 Deceased Donation in Canada Deceased Donation: Summary National rate of deceased donation up 49% since 2006 Up 35% since 2012 Major driver in recent years DCD Improvements appear to be correlated with implementation of common leading practices Greatest improvements seen in provinces with multiple system changes Canada s rate now among top 20 in world Rsults reported are preliminary and may be subject to change pending validation

35