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Azienda Ospedaliera Nazionale“SS. Antonio e Biagio e Cesare Arrigo”Working Paper of Public Healthnr. 3/2012donation, especially about the concept of brain death, which had caused fear in some ofthe population that organs would be removed before they were clinically dead; ii)hesitation of surgeons to remove organs without family authorization; iii) as most poorBrazilians do not have personal identification (ID or driver license), it meant they had noway of objecting to donation while alive.Table 1: Descriptive statistics - average values (1998-2002).Country [1] [2] [3] [4] [5] [6] [7] [8] [9]Argentina 6.94 1 62.43 9.80 12163.80 1080.80 6.55 1 0Australia 9.88 0 64.35 9.20 26375.60 2411.80 35.91 0 1Austria 22.92 1 108.30 10.52 27394.80 2112.60 30.57 1 0Brazil 4.16 0 49.71 16.90 7394.40 568.60 3.88 1 0Canada 13.94 0 50.85 8.92 27961.40 2581.20 39.67 0 1Chile 8.66 0 50.19 11.74 10456.60 612.60 13.28 1 0Costa Rica 10.40 1 26.18 15.64 7623.60 647.80 8.15 1 0Croatia 5.78 1 190.90 6.78 7819.20 639.20 8.88 1 0Czech Rep. 16.56 1 163.75 6.03 14910.00 1005.20 12.15 0 0Denmark 12.66 0 93.98 9.05 27819.00 2378.80 37.34 0 0Finland 18.06 1 95.15 7.56 25070.60 1745.80 37.78 0 0France 17.64 1 40.19 8.04 26063.00 2455.40 17.53 1 0Germany 12.84 0 101.44 7.54 24720.60 2645.00 28.41 0 0Greece 4.50 1 173.91 20.56 16878.80 1609.20 8.39 0 0Hungary 13.36 1 185.10 13.36 12109.80 896.20 9.53 1 0Ireland 19.23 0 69.03 12.81 28018.60 1862.20 17.66 1 1Israel 10.96 1 40.78 5.60 20656.80 1827.00 20.24 0 1Italy 15.30 1 117.83 13.43 24515.40 1985.40 20.80 1 0Latvia 19.57 1 274.20 26.38 7750.20 429.40 6.86 0 0Netherlands 12.06 0 76.19 6.26 26966.00 2206.60 40.95 0 0New Zealand 10.60 0 69.35 12.88 20332.80 1629.20 36.36 0 1Norway 15.36 1 103.24 7.25 33048.00 2857.60 35.87 0 0Panama 2.08 1 39.80 16.58 6335.60 546.60 3.57 1 0Poland 10.10 1 107.80 14.69 10166.80 602.00 9.92 1 1Portugal 19.44 1 204.90 17.71 16992.20 1529.60 19.47 1 0Romania 0.68 0 241.46 10.19 6671.00 390.80 4.61 0 0Slovak Rep. 10.08 1 89.77 15.18 10823.40 627.40 9.21 1 0Slovenia 13.48 1 103.71 14.41 17217.00 1382.40 21.07 1 0Spain 33.04 1 93.61 15.10 20070.20 1508.00 12.54 1 0Sweden 12.14 1 115.29 5.68 25863.00 2239.40 45.87 0 0Switzerland 13.48 0 65.98 8.50 29597.60 3159.40 25.71 1 0UK 12.96 0 109.23 5.62 25475.80 1868.60 27.25 1 1USA 22.36 0 59.60 15.33 34085.00 4616.00 43.38 0 1Venezuela 1.72 0 33.32 17.30 5946.80 324.00 3.47 1 0Average 12.73 0.59 102.10 11.84 18979.22 1617.11 20.67 0.56 0.249
Azienda Ospedaliera Nazionale“SS. Antonio e Biagio e Cesare Arrigo”Working Paper of Public Healthnr. 3/2012Note: [1] number of cadaveric organ donations per million population; [2] country has presumedconsent law; [3] number of deaths by brain vascular disease per 100,000 population; [4] numberof deaths by traffic accident per 100,000 population; [5] GDP per capita (US$); [6] Total healthexpenditure per capita (US$); [7] percentage of population that access the Internet; [8] Catholiccountry (>50% population); and [9] Common law as legal system.Unfortunately, the Brazilian organization responsible for collecting data on issues relatedto transplantation (Sistema Nacional de Transplantes) began only in 1997, which meansthere is no official data on cadaveric organ donation before that. However, there is acommon belief in the Brazilian medical community that presumed consent had a negativeimpact on organ donation in Brazil. In 1998, Brazil had the lowest cadaveric organdonation rate (2.6 pmp). As a result, in the same year, the Brazilian government added anew paragraph to the presumed consent law, stating that physicians should get permissionfrom the deceased’s family to remove organs (Gsillag, 1998). The following year, thecadaveric organ donation had an expressive increase, which was 4.1 pmp. A smallincrease was verified in the later years analyzed in this paper and in 2002 the cadavericorgan donation was 5.4 pmp.Table 1 gives us an overview of the sample descriptive statistics. Approximately 60% ofcountries have presumed consent for organ donation. Of presumed consent countries,65% are catholic and only 10% have common law as legal system. For the same group,40% have GDP per capita above the sample average (US$ 1879.22). Only three countieshad spent more than 10% of their GDP in the health sector: USA (13.54%), Germany(10.70%) and Switzerland (10.67%); the lowest rates were observed in Venezuela(5.45%), Latvia (5.54%), Slovak Republic (5.80%), Chile (5.86%) and Poland (5.92%).All of these data are related to average values from 1998 to 2002.The number of deaths by brain failure is larger in OECD countries, with females the mostaffected. However, Latin American countries have more deaths by traffic accident whencompared to other countries, males being responsible for most of them. These twovariables are important for organ donation, because a representative part of cadavericdonations come from them.Internet access has increased in all countries between 1998 and 2002, except in Norway.Almost half of the Swedish population had access to the Internet for the period 1998-2002. The USA was the second in terms of access to the Internet and the lowest rates10
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