Session 3: Characterizing Rational Transplant Program Response to Outcome-Based Regulation
Presentation Type
Invited
Student
No
Track
Other
Abstract
Transplant programs in the United States are subject to federal regulations that aim to improve the efficient utilization of the scarce organ supply. Under these regulations, transplant programs are evaluated based on their patients' post-transplant survival outcomes. However, there is concern that such regulations may drive transplant programs towards risk-averse patient selection, even as the rationality of such a response is debated.
In this work, we present an optimization models that considers the perspective of an individual self-interested transplant program that seeks to maximize its transplant volume, while controlling the risk of violating the regulatory criteria. Using historical transplant data to calibrate the model, we demonstrate that under realistic conditions, it may be rational for a transplant program to curtail its transplant volume to limit its risk of getting penalized. This finding confirms empirical results observed in the clinical literature. We also highlight other structural shortcomings of the regulations which have not been observed previously in the literature.
Start Date
2-6-2024 9:50 AM
End Date
2-6-2024 10:50 AM
Session 3: Characterizing Rational Transplant Program Response to Outcome-Based Regulation
Pasque 255
Transplant programs in the United States are subject to federal regulations that aim to improve the efficient utilization of the scarce organ supply. Under these regulations, transplant programs are evaluated based on their patients' post-transplant survival outcomes. However, there is concern that such regulations may drive transplant programs towards risk-averse patient selection, even as the rationality of such a response is debated.
In this work, we present an optimization models that considers the perspective of an individual self-interested transplant program that seeks to maximize its transplant volume, while controlling the risk of violating the regulatory criteria. Using historical transplant data to calibrate the model, we demonstrate that under realistic conditions, it may be rational for a transplant program to curtail its transplant volume to limit its risk of getting penalized. This finding confirms empirical results observed in the clinical literature. We also highlight other structural shortcomings of the regulations which have not been observed previously in the literature.