Abstract：
BACKGROUND: The decision to become a living donor requires consideration of a complex, interactive array of factors that could be targeted for clinical, policy, and educational interventions. Our objective was to assess how financial barriers interact with motivators, other barriers, and facilitators during this process.
METHODS: Data were obtained from a public survey assessing motivators, barriers, and facilitators of living donation. We used multivariable logistic regression and consensus k-means clustering to assess interactions between financial concerns and other considerations in the decision-making process.
RESULTS: Among 1592 respondents, the average age was 43; 74% were female and 14% and 6% identified as Hispanic and Black, respectively. Among employed respondents (72%), 40% indicated that they would not be able to donate without lost wage reimbursement. Stronger agreement with worries about expenses and dependent care challenges was associated with not being able to donate without lost wage reimbursement (OR = 1.2, 95% CI = 1.0-1.3; OR = 1.2, 95% CI = 1.1-1.3, respectively). Four respondent clusters were identified. Cluster 1 had strong motivators and facilitators with minimal barriers. Cluster 2 had barriers related to health concerns, nervousness, and dependent care. Clusters 3 and 4 had financial barriers. Cluster 3 also had anxiety related to surgery and dependent care.
CONCLUSIONS: Financial barriers interact primarily with health and dependent care concerns when considering living organ donation. Targeted interventions to reduce financial barriers and improve provider communication regarding donation-related risks are needed.
METHODS: Data were obtained from a public survey assessing motivators, barriers, and facilitators of living donation. We used multivariable logistic regression and consensus k-means clustering to assess interactions between financial concerns and other considerations in the decision-making process.
RESULTS: Among 1592 respondents, the average age was 43; 74% were female and 14% and 6% identified as Hispanic and Black, respectively. Among employed respondents (72%), 40% indicated that they would not be able to donate without lost wage reimbursement. Stronger agreement with worries about expenses and dependent care challenges was associated with not being able to donate without lost wage reimbursement (OR = 1.2, 95% CI = 1.0-1.3; OR = 1.2, 95% CI = 1.1-1.3, respectively). Four respondent clusters were identified. Cluster 1 had strong motivators and facilitators with minimal barriers. Cluster 2 had barriers related to health concerns, nervousness, and dependent care. Clusters 3 and 4 had financial barriers. Cluster 3 also had anxiety related to surgery and dependent care.
CONCLUSIONS: Financial barriers interact primarily with health and dependent care concerns when considering living organ donation. Targeted interventions to reduce financial barriers and improve provider communication regarding donation-related risks are needed.
摘要：
背景：成为活体捐赠者的决定需要考虑复杂的因素，一系列可以作为临床目标的相互作用的因素，政策,和教育干预。我们的目标是评估财务障碍如何与动机相互作用，其他障碍,以及在此过程中的促进者。
方法：数据来自评估激励因素的公共调查，障碍,和生活捐赠的促进者。我们使用多变量逻辑回归和共识k均值聚类来评估财务问题与决策过程中其他考虑因素之间的相互作用。
结果：在1592名受访者中，平均年龄为43岁；74%为女性，14%和6%为西班牙裔和黑人，分别。在就业受访者中（72%），40%的人表示，如果没有工资报销，他们将无法捐赠。对费用和依赖护理挑战的担忧与无法在没有工资补偿的情况下进行捐赠有关（OR=1.2，95％CI=1.0-1.3；OR=1.2，95％CI=1.1-1.3，分别）。确定了四个受访者集群。第1组有强大的激励者和促进者，障碍很小。第2组有与健康问题有关的障碍，紧张,和依赖护理。集群3和集群4有财务障碍。第3组也有与手术和依赖护理相关的焦虑。
结论：考虑活体器官捐赠时，财务障碍主要与健康和依赖护理问题有关。需要采取有针对性的干预措施，以减少财务障碍并改善提供者关于捐赠相关风险的沟通。
方法：数据来自评估激励因素的公共调查，障碍,和生活捐赠的促进者。我们使用多变量逻辑回归和共识k均值聚类来评估财务问题与决策过程中其他考虑因素之间的相互作用。
结果：在1592名受访者中，平均年龄为43岁；74%为女性，14%和6%为西班牙裔和黑人，分别。在就业受访者中（72%），40%的人表示，如果没有工资报销，他们将无法捐赠。对费用和依赖护理挑战的担忧与无法在没有工资补偿的情况下进行捐赠有关（OR=1.2，95％CI=1.0-1.3；OR=1.2，95％CI=1.1-1.3，分别）。确定了四个受访者集群。第1组有强大的激励者和促进者，障碍很小。第2组有与健康问题有关的障碍，紧张,和依赖护理。集群3和集群4有财务障碍。第3组也有与手术和依赖护理相关的焦虑。
结论：考虑活体器官捐赠时，财务障碍主要与健康和依赖护理问题有关。需要采取有针对性的干预措施，以减少财务障碍并改善提供者关于捐赠相关风险的沟通。
