The Impact of Funding and Program Structure on the Performance of Organ Donation Organizations in Canada

Canada’s performance in deceased organ donation lags behind that of high performing countries and the demand of waitlisted transplant candidates is not being met. We performed a scan of the literature to determine key funding-related components of deceased donation to determine high priority areas for investment. We also surveyed literature on the economic and financial benefits of transplant compared to non-transplant medical care. This literature scan informed the development of a survey and interview conducted of organ donation organizations and donation programs in Canada. The purpose was to gain understanding of the practices of the most successful jurisdictions in Canada, to investigate which financial factors contributed to success in those jurisdictions, to investigate financial barriers that hinder improvement, and to determine if a correlation exists between performance within a province and donation program funding within that province. Five areas were identified that were key components to the success of high performing jurisdictions and critical areas of improvement for those that are underperforming. These were: structure and processes of donation programs, prioritization of new funding, optimization of existing funding and consideration of new approaches, performance and accountability measures, and supporting and guiding these changes with robust research. This study supports the conclusion that a minimum level of funding is required to sustain a functioning deceased donation system and that provinces that invest more seem to outperform others. This report serves to provide an increased understanding of how organ donation is currently funded in Canada, identify key differences that exist between jurisdictions, and provides an overview of current challenges. 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