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Posted: comet.paws on  Oct 29 08:43:24 PM
Title: Jumping the Line, Charitably: Analysis and Remedy of Donor-Priority Rule  
Tinglong Dai
Johns Hopkins Univ. Carey Business School
Sponsor: Carnegie Mellon University  >  Tepper School of Business
Series: Operations Management Seminar
Date: Nov 03, 2017 10:30 AM - 12:00 PM
Location: Tepper/GSIA Faculty Conference Room 322
Detail: Abstract of Jumping the Line, Charitably: Analysis and Remedy of Donor-Priority Rule


The ongoing shortage of organs for transplantation has inspired an expanding literature on efficient and equitable allocation of the donated cadaveric organs. By contrast, organ donation has been little explored. In this paper, we model and analyze the donor-priority rule, a policy initiative aimed to expand the organ-donor registry. Under the donor-priority rule, registered organ donors enjoy queueing priority over non-donors, should they need organ transplants in the future. The inner workings of the donor-priority rule present a compelling venue for queueing theoretic analysis, because in the steady state, more registered organ donors not only imply an increased supply of organs, but also translate to more organ-transplant candidates with priority status. This situation presents a three-way trade-off between abundance of supply, exclusivity of priority, and cost of donating. We adopt a strategic queueing approach and a quality-adjusted life expectancy (QALE) criterion to model an individual's decision to become a registered organ donor. To the best of our knowledge, the queueing literature has not examined this type of problems before.

One might expect society to be better off under the donor-priority rule due to a larger donor pool. Yet the welfare consequences are not immediately clear, because social welfare also crucially depends on the ?cost of donating? (e.g., psychological burden) associated with an average registered organ donor?when such a cost is excessively high, it indicates the rule may be perceived by the public as overly ?oppressive.? Our model helps elucidate the social-welfare consequences of the donor-priority rule. We show society would indeed be better off when individuals differ only in terms of their costs of donating. Furthermore, our analysis of the heterogeneous-population case reveals an unbalanced incentive structure induced by the donor-priority rule?high-risk individuals are better motivated than low-risk ones to become registered organ donors. As a result, social welfare is likely to decrease due to introduction of the donor-priority rule.

To address such an unbalanced incentive structure, we propose an operational remedy that entails enforcing a freeze period, that is, a specified delay in granting individuals priority on waiting lists for organ transplants. We show that, echoing the theory of the second best (Lipsey and Lancaster 1956), this additional market friction helps rebalance the incentive structure, and in conjunction with the donor-priority rule, can guarantee an increase in social welfare by boosting organ supply without compromising organ quality or inducing excessively high costs of donating.


Tinglong Dai is an Assistant Professor of Operations Management and Business Analytics at the Johns Hopkins University, Carey Business School. His research areas include Healthcare Operations and Marketing/Operations Interfaces. He received his PhD (2013) and MSIA (2009) in Operations Management/Robotics from Carnegie Mellon University, jointly offered by Tepper School of Business and Robotics Institute. He also received an MPhil (2006) in Industrial Engineering from Hong Kong University of Science and Technology.

Tinglong?s research has been published in leading journals such as Management Science, Operations Research, Manufacturing & Service Operations Management, and INFORMS Journal on Computing. He is on the Editorial Review Board of Production and Operations Management Journal. He is the founder of Johns Hopkins Symposium on Healthcare Operations, and is the co-editor of the Handbook of Healthcare Analytics, to be published by John Wiley & Sons in 2018.

Tinglong is the recipient of the inaugural Johns Hopkins Discovery Award (2015), Dean?s Award for Faculty Excellence (2016, 2017), INFORMS Public Sector Operations Research Best Paper Award (2017), M&SOM Meritorious Service Award (2016), POMS Best Healthcare Paper Award, 1st Place (2012), INFORMS Pierskalla Award for the Best Paper in Healthcare, Runner-up (2012), and POMS Best Healthcare Paper Award, 2nd Place (2016). He is a finalist for the Elwood S. Buffa Doctoral Dissertation Award (2014) and the POMS College of Supply Chain Management Best Student Paper Award (2013).
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