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New policy stops transplant heart gaming put potential still exists

Researchers have found evidence of gaming -- exaggerating the severity of a heart patient's condition -- at heart transplant centers prior to 1999 to increase the likelihood of obtaining a transplant organ, but not after that year when new policies governing the patient waiting list went into effect.

Dr. Dennis Scanlon, assistant professor of health policy and administration at Penn State, says, "Although we did not find evidence of gaming after 1999, suggesting that the new policy regulates the system competently, the competition driving gaming still exists. We need to remain vigilant because the continued competition for scarce transplantable organs could encourage new kinds of gaming."

The findings are published in the paper, "Does Competition for Transplantable Hearts Encourage 'Gaming' of the Waiting List," in the March/April issue of Health Affairs. The authors are Scanlon; Dr. Christopher S. Hollenbeak, assistant professor of surgery and health evaluation sciences, Penn State College of Medicine; Woolton Lee, doctoral candidate in health policy and administration, Penn State College of Health and Human Development; Dr. Evan Loh, assistant vice president of cardiovascular/infectious disease, Wyeth Corp.; and Dr. Peter A. Ubel, associate professor of internal medicine and psychology, University of Michigan, and director of the U-M Health System's Program for Improving Health Care Decisions.

Currently, demand exceeds the supply of transplantable hearts in the United States. In 2003, 3,517 people were on the waiting list, compared with 1,174 heart transplants performed, according to the United Network for Organ Sharing (UNOS), which develops allocation procedures and maintains lists that give priority to the sickest patients.

Organ Procurement Organizations (OPO) obtain and disperse the transplantable hearts within a specific geographical region. Since long transport could damage cadaver hearts, organs obtained in an OPO are used primar
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Contact: Barbara Hale
bah@psu.edu
814-865-9481
Penn State
9-Mar-2004


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