Estimation and characterization of the potential renal organ donor pool in Pennsylvania. Report of the Pennsylvania Statewide Donor Study.

The Pennsylvania Statewide Donor Study evaluated deaths under the age of 66 occurring in 149 participating hospitals in 1987. After elimination of 6146 patients from 11,983 based upon ICD-9 code criteria, an on-site medical record review was performed on 5603 patients. Each patient was assessed for organ donor suitability based upon brain death and medical suitability criteria--and, after a series of eliminations, 453 patients were found to have a moderate or higher potential as acceptable organ donors. An estimation of the organ donor rate was placed between 38.3 and 55.2 donors per million population per year, depending upon the stringency of organ donor criteria. Educational efforts targeted at physicians, patient's families and transplant surgeons will be necessary, however, to attain this maximal rate.

Data initiatives: building a managed care network utilizing clinical performance data.

Responding to the rising health care costs of its traditional indemnity health care plan, Hershey Foods Corporation developed its own managed care plan as part of the company strategy to better control its health care costs. In developing a provider network for its managed care plan, Hershey Foods utilized data from the Pennsylvania Health Care Cost Containment Council and the expertise of many different groups, health care data consultants (Healthcare Research Affiliates), the insurance provider (Capital Blue Cross/Pennsylvania Blue Shield), health care providers, as well as the employees and their union representatives. Selection of providers for the network necessitated a data initiative that analyzed indicators of quality and cost efficiency. This article explores the roles of these different groups in building the managed care network for Hershey and examines the organizational changes within these different groups to accommodate the Hershey Foods project.