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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.
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    References listed on IDEAS

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    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

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