Background: An Early Result Acceptance Program (ERAP) has been proposed for obstetrics and gynecology (OB/GYN) to address challenges in the transition to residency. However, there are no available data-driven analyses on the effects of ERAP on the residency transition.
Objective: We used National Resident Matching Program (NRMP) data to simulate the outcomes of ERAP and compare those to what occurred in the Match historically.
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.
View Article and Find Full Text PDFLow adherence to prescribed medications causes substantial health and economic burden. We analyzed primary data from electronic medical records of 250,000 random patients from Israel's Maccabi Healthcare services from 2007 to 2017 to predict whether a patient will purchase a prescribed antibiotic. We developed a decision model to evaluate whether an intervention to improve purchasing adherence is warranted for the patient, considering the cost of the intervention and the cost of non-adherence.
View Article and Find Full Text PDFWe examined what happened during a 6-year period to 1121 end-stage renal disease patients who registered with their willing/incompatible living donors for kidney exchanges with the Alliance for Paired Donation (APD). Of all patients, 65% were transplanted: 37% in kidney paired donation (APD-KPD, APD-other-KPD); 10% with compatible live donors (APD-LD); and 18% with deceased donors (APD-DD). The remaining patients were withdrawn (sick/died/others; 15%), or were still waiting (20%).
View Article and Find Full Text PDFNumerous kidney exchange (kidney paired donation [KPD]) registries in the United States have gradually shifted to high-frequency match-runs, raising the question of whether this harms the number of transplants. We conducted simulations using clinical data from 2 KPD registries-the Alliance for Paired Donation, which runs multihospital exchanges, and Methodist San Antonio, which runs single-center exchanges-to study how the frequency of match-runs impacts the number of transplants and the average waiting times. We simulate the options facing each of the 2 registries by repeated resampling from their historical pools of patient-donor pairs and nondirected donors, with arrival and departure rates corresponding to the historical data.
View Article and Find Full Text PDFProc Natl Acad Sci U S A
January 2015
As of May 2014 there were more than 100,000 patients on the waiting list for a kidney transplant from a deceased donor. Although the preferred treatment is a kidney transplant, every year there are fewer donors than new patients, so the wait for a transplant continues to grow. To address this shortage, kidney paired donation (KPD) programs allow patients with living but biologically incompatible donors to exchange donors through cycles or chains initiated by altruistic (nondirected) donors, thereby increasing the supply of kidneys in the system.
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