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

51 Pages Posted: 8 Mar 2019

See all articles by Nikhil Agarwal

Nikhil Agarwal

Massachusetts Institute of Technology (MIT) - Department of Economics; Yale University - Cowles Foundation

Itai Ashlagi

Stanford University - Department of Management Science & Engineering

Michael Rees

University of Toledo Medical Center

Paulo Somaini

Stanford University - Department of Economics

Daniel C. Waldinger

New York University (NYU) - Furman Center for Real Estate and Urban Policy

Date Written: February 2019

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.

Suggested Citation

Agarwal, Nikhil and Ashlagi, Itai and Rees, Michael and Somaini, Paulo and Waldinger, Daniel C., Equilibrium Allocations Under Alternative Waitlist Designs: Evidence from Deceased Donor Kidneys (February 2019). Available at SSRN: https://ssrn.com/abstract=3346254

Nikhil Agarwal (Contact Author)

Massachusetts Institute of Technology (MIT) - Department of Economics ( email )

50 Memorial Drive
E52-391
Cambridge, MA 02142
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Yale University - Cowles Foundation ( email )

Box 208281
New Haven, CT 06520-8281
United States

Itai Ashlagi

Stanford University - Department of Management Science & Engineering ( email )

473 Via Ortega
Stanford, CA 94305-9025
United States

Michael Rees

University of Toledo Medical Center ( email )

Mail Stop 119, HH 3000
Toledo, OH 43606
United States

Paulo Somaini

Stanford University - Department of Economics ( email )

Landau Economics Building
579 Serra Mall
Stanford, CA 94305-6072
United States

Daniel C. Waldinger

New York University (NYU) - Furman Center for Real Estate and Urban Policy ( email )

New York, NY 10012
United States

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