Compensation and Incentives for Living Kidney Donors
This multinational study was undertaken to elicit the perspectives of transplant nephrologists and surgeons on the uncertainties, challenges, and controversies in living kidney donation. This article focuses on the attitudes and opinions of clinicians on financial reimbursement, compensation, and incentivization in the context of a regulated system. The working definitions are provided in Box 1.
Transplant nephrologists or surgeons involved in living kidney donor transplantation in the United States, Canada, Europe, Australia, and New Zealand were eligible to participate. Participants were purposively selected to capture a range of years of clinical experience, age, sex, practice locations, and transplantation unit size. After each interview, participants could nominate others who could add a different or important perspective. Interviews were conducted in clinic offices and meeting rooms or at conference venues. The University of Sydney Ethics Committee provided approval.
The interview guide was based on a literature review of clinical guidelines and consensus statements on living kidney donation and discussion among the research team. Questions focused on reimbursement, compensation, and incentivization are provided in Table S1 http://www.ajkd.org/cms/attachment/2018422149/2038596165/mmc1.pdf (provided as online supplementary material). A.T. conducted a face-to-face semistructured interview with each participant from May to October 2012. Participant recruitment ceased when theoretical saturation was reached. All interviews were digitally audiorecorded and transcribed.
Transcripts were entered into HyperRESEARCH software (version 3.0; ResearchWare Inc). Based on grounded theory and thematic analysis, A.T. coded transcripts and recorded concepts relevant to perspectives on financial reimbursement, compensation, and incentivization. Similar concepts were grouped into themes. The coding structure was revised until all concepts relating to donor reimbursement, compensation, and incentivization were captured. The preliminary findings were discussed among the research team and then e-mailed to all participants, who were given 2 weeks to include additional points (ie, member checking). Their feedback was coded and incorporated into subsequent revisions of the analytical framework.
Methods
Study Overview
This multinational study was undertaken to elicit the perspectives of transplant nephrologists and surgeons on the uncertainties, challenges, and controversies in living kidney donation. This article focuses on the attitudes and opinions of clinicians on financial reimbursement, compensation, and incentivization in the context of a regulated system. The working definitions are provided in Box 1.
Participant Selection and Practice Setting
Transplant nephrologists or surgeons involved in living kidney donor transplantation in the United States, Canada, Europe, Australia, and New Zealand were eligible to participate. Participants were purposively selected to capture a range of years of clinical experience, age, sex, practice locations, and transplantation unit size. After each interview, participants could nominate others who could add a different or important perspective. Interviews were conducted in clinic offices and meeting rooms or at conference venues. The University of Sydney Ethics Committee provided approval.
Data Collection
The interview guide was based on a literature review of clinical guidelines and consensus statements on living kidney donation and discussion among the research team. Questions focused on reimbursement, compensation, and incentivization are provided in Table S1 http://www.ajkd.org/cms/attachment/2018422149/2038596165/mmc1.pdf (provided as online supplementary material). A.T. conducted a face-to-face semistructured interview with each participant from May to October 2012. Participant recruitment ceased when theoretical saturation was reached. All interviews were digitally audiorecorded and transcribed.
Analysis
Transcripts were entered into HyperRESEARCH software (version 3.0; ResearchWare Inc). Based on grounded theory and thematic analysis, A.T. coded transcripts and recorded concepts relevant to perspectives on financial reimbursement, compensation, and incentivization. Similar concepts were grouped into themes. The coding structure was revised until all concepts relating to donor reimbursement, compensation, and incentivization were captured. The preliminary findings were discussed among the research team and then e-mailed to all participants, who were given 2 weeks to include additional points (ie, member checking). Their feedback was coded and incorporated into subsequent revisions of the analytical framework.
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