IDEAS home Printed from https://ideas.repec.org/p/hit/cisdps/522.html
   My bibliography  Save this paper

Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System

Author

Listed:
  • Paarsch, Harry J.
  • Segre, Alberto M.
  • Roberts, John P.
  • Halldorson, Jeffrey B.

Abstract

Previous researchers have modelled the decision to accept a donor organ for transplantation as a Markov decision problem, the solution to which is often a control-limit optimal policy: accept any organ whose match quality exceeds some health-dependent threshold; otherwise, wait for another. When competing transplant centers vie for the same organs, the decision rule changes relative to no competition; the relative size of competing centers affects the decision rules as well. Using center-specific graft and patient survival-rate data for cadaveric adult livers in the United States, we have found empirical evidence supporting these predictions.

Suggested Citation

  • Paarsch, Harry J. & Segre, Alberto M. & Roberts, John P. & Halldorson, Jeffrey B., 2011. "Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System," CIS Discussion paper series 522, Center for Intergenerational Studies, Institute of Economic Research, Hitotsubashi University.
  • Handle: RePEc:hit:cisdps:522
    Note: First Draft: 15 September 2010; this Draft: 5 July 2011.
    as

    Download full text from publisher

    File URL: https://hermes-ir.lib.hit-u.ac.jp/hermes/ir/re/19287/pie_dp522.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Rust, John, 1987. "Optimal Replacement of GMC Bus Engines: An Empirical Model of Harold Zurcher," Econometrica, Econometric Society, vol. 55(5), pages 999-1033, September.
    2. Alvin E. Roth & Tayfun Sönmez, 2005. "A Kidney Exchange Clearinghouse in New England," American Economic Review, American Economic Association, vol. 95(2), pages 376-380, May.
    3. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2004. "Kidney Exchange," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(2), pages 457-488.
    4. Gaynor, Martin & Vogt, William B, 2003. "Competition among Hospitals," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 764-785, Winter.
    5. Oguzhan Alagoz & Lisa M. Maillart & Andrew J. Schaefer & Mark S. Roberts, 2004. "The Optimal Timing of Living-Donor Liver Transplantation," Management Science, INFORMS, vol. 50(10), pages 1420-1430, October.
    6. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    7. Zeileis, Achim, 2004. "Econometric Computing with HC and HAC Covariance Matrix Estimators," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 11(i10).
    8. Tayfun Sönmez & Alvin E. Roth & M. Utku Ünver, 2007. "Efficient Kidney Exchange: Coincidence of Wants in Markets with Compatibility-Based Preferences," American Economic Review, American Economic Association, vol. 97(3), pages 828-851, June.
    9. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
    10. Andrews, Donald W K, 1991. "Heteroskedasticity and Autocorrelation Consistent Covariance Matrix Estimation," Econometrica, Econometric Society, vol. 59(3), pages 817-858, May.
    11. Saidman, Susan L. & Roth, Alvin E. & Sonmez, Tayfun & Unver, M. Utku & Delmonico, Francis L., 2014. "Increasing the Opportunity of Live Kidney Donation by Matching for Two and Three Way Exchanges," MPRA Paper 58247, University Library of Munich, Germany.
    12. Andrews, Donald W K & Monahan, J Christopher, 1992. "An Improved Heteroskedasticity and Autocorrelation Consistent Covariance Matrix Estimator," Econometrica, Econometric Society, vol. 60(4), pages 953-966, July.
    13. Howard, David H., 2002. "Why do transplant surgeons turn down organs?: A model of the accept/reject decision," Journal of Health Economics, Elsevier, vol. 21(6), pages 957-969, November.
    14. Jason Snyder, 2010. "Gaming the Liver Transplant Market," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 26(3), pages 546-568.
    15. Martin Gaynor & Harald Seider & William B. Vogt, 2005. "The Volume–Outcome Effect, Scale Economies, and Learning-by-Doing," American Economic Review, American Economic Association, vol. 95(2), pages 243-247, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Murat Kurt & Mark S. Roberts & Andrew J. Schaefer & M. Utku Ünver, 2011. "Valuing Prearranged Paired Kidney Exchanges: A Stochastic Game Approach," Boston College Working Papers in Economics 785, Boston College Department of Economics, revised 14 Oct 2011.
    2. Alvin E. Roth, 2010. "Marketplace Institutions Related to the Timing of Transactions," NBER Working Papers 16556, National Bureau of Economic Research, Inc.
    3. Alvin E. Roth, 2012. "Marketplace Institutions Related to the Timing of Transactions: Reply to Priest," Journal of Labor Economics, University of Chicago Press, vol. 30(2), pages 479-494.
    4. Alvin E. Roth, 2009. "What Have We Learned from Market Design?," Innovation Policy and the Economy, University of Chicago Press, vol. 9(1), pages 79-112.
    5. Andersson, Tommy & Kratz, Jörgen, 2016. "Kidney Exchange over the Blood Group Barrier," Working Papers 2016:11, Lund University, Department of Economics, revised 29 Nov 2017.
    6. Roth, Alvin E. & Sonmez, Tayfun & Unver, Utku & Delmonico, Francis & Saidman, Susan L., 2014. "Utilizing List Exchange and Non-directed Donation through “Chain” Paired Kidney Donations," MPRA Paper 58246, University Library of Munich, Germany.
    7. Sönmez, Tayfun & Ünver, M. Utku, 2014. "Altruistically unbalanced kidney exchange," Journal of Economic Theory, Elsevier, vol. 152(C), pages 105-129.
    8. , & , E., 2014. "Free riding and participation in large scale, multi-hospital kidney exchange," Theoretical Economics, Econometric Society, vol. 9(3), September.
    9. Committee, Nobel Prize, 2012. "Alvin E. Roth and Lloyd S. Shapley: Stable allocations and the practice of market design," Nobel Prize in Economics documents 2012-1, Nobel Prize Committee.
    10. Kessler, Judd B. & Roth, Alvin E., 2014. "Loopholes undermine donation: An experiment motivated by an organ donation priority loophole in Israel," Journal of Public Economics, Elsevier, vol. 114(C), pages 19-28.
    11. Alvin E. Roth, 2007. "Repugnance as a Constraint on Markets," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 37-58, Summer.
    12. Tayfun Sönmez & M Utku Ünver, 2017. "Market design for living-donor organ exchanges: an economic policy perspective," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 33(4), pages 676-704.
    13. Ross Anderson & Itai Ashlagi & David Gamarnik & Michael Rees & Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2015. "Kidney Exchange and the Alliance for Paired Donation: Operations Research Changes the Way Kidneys Are Transplanted," Interfaces, INFORMS, vol. 45(1), pages 26-42, February.
    14. Itai Ashlagi & Alvin E. Roth, 2011. "Individual Rationality and Participation in Large Scale, Multi-Hospital Kidney Exchange," NBER Working Papers 16720, National Bureau of Economic Research, Inc.
    15. Constantino, Miguel & Klimentova, Xenia & Viana, Ana & Rais, Abdur, 2013. "New insights on integer-programming models for the kidney exchange problem," European Journal of Operational Research, Elsevier, vol. 231(1), pages 57-68.
    16. Scott Duke Kominers & Alexander Teytelboym & Vincent P Crawford, 2017. "An invitation to market design," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 33(4), pages 541-571.
    17. Alvin E Roth & Tayfun Sönmez & M. Utku Ünver, 2005. "Efficient Kidney Exchange: Coincidence of Wants in a Structured Market," Levine's Bibliography 784828000000000126, UCLA Department of Economics.
    18. Alvin Roth, 2008. "Deferred acceptance algorithms: history, theory, practice, and open questions," International Journal of Game Theory, Springer;Game Theory Society, vol. 36(3), pages 537-569, March.
    19. Zhu, Min, 2014. "College admissions in China: A mechanism design perspective," China Economic Review, Elsevier, vol. 30(C), pages 618-631.
    20. Tayfun Sönmez & Tobias B. Switzer, 2013. "Matching With (Branch‐of‐Choice) Contracts at the United States Military Academy," Econometrica, Econometric Society, vol. 81(2), pages 451-488, March.

    More about this item

    Keywords

    liver transplantation; competition; optimal stopping;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • L1 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hit:cisdps:522. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Digital Resources Section, Hitotsubashi University Library (email available below). General contact details of provider: https://edirc.repec.org/data/cihitjp.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.