NDT Advance Access originally published online on November 19, 2007
Nephrology Dialysis Transplantation 2008 23(3):1039-1042; doi:10.1093/ndt/gfm643
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Public survey of financial incentives for kidney donation
1 Department of Medical Psychology & Psychotherapy, Erasmus University Medical Centre, Rotterdam, The Netherlands 2 Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands 3 Department of Medical Ethics and Philosophy, Erasmus University Medical Centre, Rotterdam, The Netherlands 4 TNS NIPO, Dutch Institute for Public Opinion and Market Research, Amsterdam, The Netherlands
Leonieke Kranenburg, Department of Medical Psychology & Psychotherapy, Erasmus University Medical Centre, 3000 CA Rotterdam, PO Box 2040, The Netherlands. Tel: +31–10-4087807; Fax: +31–10-4089420; E-mail: L.Kranenburg{at}erasmusmc.nl
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Abstract |
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Background. One of the most fiercely debated strategies to increase the number of kidneys for transplantation is the introduction of financial incentives. As the success of such strategy largely depends on public support, we performed a public survey on this topic.
Methods. We developed a questionnaire on financial incentives for living kidney donation. We investigated the public opinion on two different fixed compensations: either life-long health insurance compensation or 
25 000. Furthermore, we investigated public preferences on the practical implementation: either the patient seeks a donor or the donor registers for donation at an independent institute. For all examples, health insurance companies would cover costs of treatment. TNS NIPO, a professional organization for market research, sent the survey to a response panel that is made representative for the general population.
Results. Five hundred fifty respondents (M/F: 60/40; median age: 46) filled out the questionnaire. Forty-six percent considered the situation wherein health insurance companies would introduce financial incentives to increase the number of living kidney donors undesirable (26% undesirable; 20% very undesirable), compared to 25% who perceived this as desirable (20% desirable; 5% very desirable). The option wherein the donor registers at an independent institute to donate to a patient on the list and in turn receives life-long health insurance compensation was chosen as most favourable. Of all respondents, 5.5% stated that there was a (very) great chance that they would donate a kidney in order to get compensation if such system were to be reality.
Conclusion. Although almost half of the respondents (46%) were reluctant towards introducing a system with fixed compensation to increase the number of living kidney donors, still 25% of the general public reacted positively.
Keywords: economics; ethics; financial incentives; living kidney donation; paid donation; transplantation
Received for publication: 7. 4.07
Accepted in revised form: 23. 8.07