Empirical Analysis of Resource Allocation Problems

National Bureau Of Economic Research Inc, Cambridge MA

Investigators

Abstract

Approximately 100,000 patients are waiting for a life-saving kidney transplant, but only about 12,000 patients receive a transplant through the deceased donor waiting list in a typical year. Another 6,000 patients receive a live-donor kidney transplant. Given the scarcity of donors, it is important to find the best ways to organize organ allocation systems in the US. The investigator aims to use data driven methods to find better designs, promising savings on the costs of dialysis while simultaneously improving health outcomes. More broadly, this research is of interest to a growing body of empirical work studying how non-market mechanisms can be used to allocate scarce resources. This research studies both deceased and living donor kidney allocation systems. Priorities on the deceased donor list are determined by a variety of factors. Remarkably, most donor offers are turned down by several patients before their organs are ultimately transplanted because many patients prefer waiting for a better organ. The first project thus studies how to design the priorities and the allocation system to better align the system with objectives such as allocating organs to those that will get the most life-years from it. The second project on living donor kidney allocations studies the effects of hospital decisions to select which patients and donors are registered on nationwide kidney exchanges. This project uses data driven techniques and designs a well-tailored priority system that can align hospital incentives for participating in these platforms with social objectives. These projects complement and build on a recent body of theoretical work in economics that has studied how to allocate these scarce resources. Specifically, the investigator develops empirical approaches to study and evaluate dynamic allocation problems and barter exchanges. These techniques are likely to be useful in the study of a variety of other resource allocation problems including the allocation of public housing, child-care and child adoption in addition to organs of all types. The methods developed in this research present new approaches to topics studied by researchers in Operations Research, Health Economics, and Medical Transplantation.