Individual rationality and participation in large scale, multi-hospital kidney exchange

As multi-hospital kidney exchange clearinghouses have grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals have the option of enrolling only their hard-to-match patient-donor pairs, while conducting easily arranged exchanges internally. This behavior has alr...

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Bibliographic Details
Main Authors: Ashlagi, Itai, Roth, Alvin
Other Authors: Sloan School of Management
Format: Article
Language:en_US
Published: Association for Computing Machinery 2014
Online Access:http://hdl.handle.net/1721.1/87607
https://orcid.org/0000-0003-2124-738X
Description
Summary:As multi-hospital kidney exchange clearinghouses have grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals have the option of enrolling only their hard-to-match patient-donor pairs, while conducting easily arranged exchanges internally. This behavior has already started to be observed. We show that the cost of making it individually rational for hospitals to participate fully is low in almost every large exchange pool (although the worst-case cost is very high), while the cost of failing to guarantee individually rational allocations could be large, in terms of lost transplants. We also identify an incentive compatible mechanism.