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Equilibrium Allocations under Alternative Waitlist Designs: Evidence from Deceased Donor Kidneys

Author

Listed:
  • Nikhil Agarwal
  • Itai Ashlagi
  • Michael A. Rees
  • Paulo J. Somaini
  • Daniel C. Waldinger
Abstract
Waitlists are often used to ration scarce resources, but the trade-offs in designing these mechanisms depend on agents preferences. We study equilibrium allocations under alternative designs for the deceased donor kidney waitlist. We model the decision to accept an organ or wait for a preferable one as an optimal stopping problem and estimate preferences using administrative data from the New York City area. Our estimates show that while some kidney types are desirable for all patients, there is substantial match-specific heterogeneity in values. We then develop methods to evaluate alternative mechanisms, comparing their effects on patient welfare to an equivalent change in donor supply. Past reforms to the kidney waitlist primarily resulted in redistribution, with similar welfare and organ discard rates to the benchmark first come first served mechanism. These mechanisms and other commonly studied theoretical benchmarks remain far from optimal. We design a mechanism that increases patient welfare by the equivalent of an 18.2 percent increase in donor supply.

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  • Nikhil Agarwal & Itai Ashlagi & Michael A. Rees & Paulo J. Somaini & Daniel C. Waldinger, 2019. "Equilibrium Allocations under Alternative Waitlist Designs: Evidence from Deceased Donor Kidneys," NBER Working Papers 25607, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:25607
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    6. Genie, Mesfin G. & Nicoló, Antonio & Pasini, Giacomo, 2020. "The role of heterogeneity of patients’ preferences in kidney transplantation," Journal of Health Economics, Elsevier, vol. 72(C).
    7. Sears, Louis S. & Lin Lawell, C.-Y. Cynthia & Walter, M. Todd, 2020. "Groundwater Under Open Access: A Structural Model of the Dynamic Common Pool Extraction Game," 2020 Annual Meeting, July 26-28, Kansas City, Missouri 304276, Agricultural and Applied Economics Association.
    8. Nikhil Agarwal & Itai Ashlagi & Michael A. Rees & Paulo Somaini & Daniel Waldinger, 2021. "Equilibrium Allocations Under Alternative Waitlist Designs: Evidence From Deceased Donor Kidneys," Econometrica, Econometric Society, vol. 89(1), pages 37-76, January.
    9. Kheiravar, Khaled H, 2019. "Economic and Econometric Analyses of the World Petroleum Industry, Energy Subsidies, and Air Pollution," Institute of Transportation Studies, Working Paper Series qt3gj151w9, Institute of Transportation Studies, UC Davis.

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    JEL classification:

    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation
    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design
    • I10 - Health, Education, and Welfare - - Health - - - General

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