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Free riding and participation in large scale, multi-hospital kidney exchange

Author

Listed:
  • Ashlagi, Itai

    () (Sloan School of Management, MIT)

  • Roth, Alvin E.

    () (Department of Economics, Stanford University)

Abstract

As multi-hospital kidney exchange has grown, the set of players has grown from patients and surgeons to include hospitals. Hospitals can choose to enroll only their hard-to-match patient-donor pairs, while conducting easily-arranged exchanges internally. This behavior has already been observed. We show that as the population of hospitals and patients grows the cost of making it individually rational for hospitals to participate fully becomes low in almost every large exchange pool (although the worst-case cost is very high), while the cost of failing to guarantee individual rationality is high, in lost transplants. We identify a mechanism that gives hospitals incentives to reveal all patient-donor pairs. We observe that if such a mechanism were to be implemented and hospitals enrolled all their pairs, the resulting patient pools would allow efficient matchings that could be implemented with two and three way exchanges.

Suggested Citation

  • Ashlagi, Itai & Roth, Alvin E., 2014. "Free riding and participation in large scale, multi-hospital kidney exchange," Theoretical Economics, Econometric Society, vol. 9(3), September.
  • Handle: RePEc:the:publsh:1357
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    References listed on IDEAS

    as
    1. Sönmez, Tayfun & Ünver, M. Utku, 2014. "Altruistically unbalanced kidney exchange," Journal of Economic Theory, Elsevier, vol. 152(C), pages 105-129.
    2. Tayfun Sönmez & Alvin E. Roth & M. Utku Ünver, 2007. "Efficient Kidney Exchange: Coincidence of Wants in Markets with Compatibility-Based Preferences," American Economic Review, American Economic Association, vol. 97(3), pages 828-851, June.
    3. Roth, Alvin E. & Sonmez, Tayfun & Utku Unver, M., 2005. "Pairwise kidney exchange," Journal of Economic Theory, Elsevier, vol. 125(2), pages 151-188, December.
    4. Alvin E. Roth, 2009. "What Have We Learned from Market Design?," Innovation Policy and the Economy, University of Chicago Press, vol. 9(1), pages 79-112.
    5. Roth, Alvin E. & Leider, Stephen, 2010. "Kidneys For Sale: Who Disapproves, and Why?," Scholarly Articles 5128483, Harvard University Department of Economics.
    6. Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2004. "Kidney Exchange," The Quarterly Journal of Economics, Oxford University Press, vol. 119(2), pages 457-488.
    7. Muriel Niederle & Alvin E. Roth, 2003. "Unraveling Reduces Mobility in a Labor Market: Gastroenterology with and without a Centralized Match," Journal of Political Economy, University of Chicago Press, vol. 111(6), pages 1342-1352, December.
    8. Parag A. Pathak & Alvin E. Roth, 2013. "Matching with Couples: Stability and Incentives in Large Markets," The Quarterly Journal of Economics, Oxford University Press, vol. 128(4), pages 1585-1632.
    9. Muriel Niederle & Alvin E. Roth, 2001. "Unraveling Reduces the Scope of an Entry Level Labor Market: Gastroenterology With and Without a Centralized Match," NBER Working Papers 8616, National Bureau of Economic Research, Inc.
    10. Shapley, Lloyd & Scarf, Herbert, 1974. "On cores and indivisibility," Journal of Mathematical Economics, Elsevier, vol. 1(1), pages 23-37, March.
    11. repec:hrv:faseco:30831454 is not listed on IDEAS
    12. Guillaume R. Fréchette & Alvin E. Roth & M. Utku Ünver, 2007. "Unraveling yields inefficient matchings: evidence from post-season college football bowls," RAND Journal of Economics, RAND Corporation, vol. 38(4), pages 967-982, December.
    13. Saidman, Susan L. & Roth, Alvin E. & Sonmez, Tayfun & Unver, M. Utku & Delmonico, Francis L., 2014. "Increasing the Opportunity of Live Kidney Donation by Matching for Two and Three Way Exchanges," MPRA Paper 58247, University Library of Munich, Germany.
    14. Alvin E. Roth & Tayfun Sönmez, 2005. "A Kidney Exchange Clearinghouse in New England," American Economic Review, American Economic Association, vol. 95(2), pages 376-380, May.
    15. Alvin E. Roth, 2007. "Repugnance as a Constraint on Markets," Journal of Economic Perspectives, American Economic Association, vol. 21(3), pages 37-58, Summer.
    16. Fuhito Kojima & Parag A. Pathak, 2009. "Incentives and Stability in Large Two-Sided Matching Markets," American Economic Review, American Economic Association, vol. 99(3), pages 608-627, June.
    17. C. Nicholas McKinney & Muriel Niederle & Alvin E. Roth, 2005. "The Collapse of a Medical Labor Clearinghouse (and Why Such Failures Are Rare)," American Economic Review, American Economic Association, vol. 95(3), pages 878-889, June.
    18. Roth, Alvin E., 1982. "Incentive compatibility in a market with indivisible goods," Economics Letters, Elsevier, vol. 9(2), pages 127-132.
    19. M. Utku Ünver, 2010. "Dynamic Kidney Exchange," Review of Economic Studies, Oxford University Press, vol. 77(1), pages 372-414.
    20. Roth, Alvin E. & Postlewaite, Andrew, 1977. "Weak versus strong domination in a market with indivisible goods," Journal of Mathematical Economics, Elsevier, vol. 4(2), pages 131-137, August.
    21. Roth, Alvin E & Xing, Xiaolin, 1994. "Jumping the Gun: Imperfections and Institutions Related to the Timing of Market Transactions," American Economic Review, American Economic Association, vol. 84(4), pages 992-1044, September.
    22. Tayfun Sönmez & M. Utku Ünver, 2009. "Matching, Allocation, and Exchange of Discrete Resources," Boston College Working Papers in Economics 717, Boston College Department of Economics.
    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. Ortega, Josué, 2018. "Social integration in two-sided matching markets," Journal of Mathematical Economics, Elsevier, vol. 78(C), pages 119-126.
    2. Ross Anderson & Itai Ashlagi & David Gamarnik & Yash Kanoria, 2017. "Efficient Dynamic Barter Exchange," Operations Research, INFORMS, vol. 65(6), pages 1446-1459, December.
    3. Itai Ashlagi & Maximilien Burq & Patrick Jaillet & Vahideh Manshadi, 2019. "On Matching and Thickness in Heterogeneous Dynamic Markets," Operations Research, INFORMS, vol. 67(4), pages 927-949, July.
    4. Pycia, Marek & Ünver, M. Utku, 2017. "Incentive compatible allocation and exchange of discrete resources," Theoretical Economics, Econometric Society, vol. 12(1), January.
    5. Avraham Stoler & Judd B. Kessler & Tamar Ashkenazi & Alvin E. Roth & Jacob Lavee, 2017. "Incentivizing Organ Donor Registrations with Organ Allocation Priority," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 500-510, April.
    6. Balbuzanov, Ivan, 2020. "Short trading cycles: Paired kidney exchange with strict ordinal preferences," Mathematical Social Sciences, Elsevier, vol. 104(C), pages 78-87.
    7. Ghanbariamin, Roksana & Chung, Bobby W., 2020. "The effect of the National Kidney Registry on the kidney-exchange market," Journal of Health Economics, Elsevier, vol. 70(C).
    8. Ortega, Josué, 2019. "The losses from integration in matching markets can be large," Economics Letters, Elsevier, vol. 174(C), pages 48-51.
    9. Rajnish Kunar & Kriti Manocha & Josue Ortega, 2020. "On the integration of Shapley-Scarf housing markets," Papers 2004.09075, arXiv.org, revised Oct 2020.
    10. Tayfun Sönmez & M Utku Ünver, 2017. "Market design for living-donor organ exchanges: an economic policy perspective," Oxford Review of Economic Policy, Oxford University Press, vol. 33(4), pages 676-704.
    11. Sönmez, Tayfun & Ünver, M. Utku & Yılmaz, Özgür, 2018. "How (not) to integrate blood subtyping technology to kidney exchange," Journal of Economic Theory, Elsevier, vol. 176(C), pages 193-231.
    12. John P. Dickerson & Ariel D. Procaccia & Tuomas Sandholm, 2019. "Failure-Aware Kidney Exchange," Management Science, INFORMS, vol. 65(4), pages 1768-1791, April.
    13. Toulis, Panos & Parkes, David C., 2015. "Design and analysis of multi-hospital kidney exchange mechanisms using random graphs," Games and Economic Behavior, Elsevier, vol. 91(C), pages 360-382.
    14. Ross Anderson & Itai Ashlagi & David Gamarnik & Michael Rees & Alvin E. Roth & Tayfun Sönmez & M. Utku Ünver, 2015. "Kidney Exchange and the Alliance for Paired Donation: Operations Research Changes the Way Kidneys Are Transplanted," Interfaces, INFORMS, vol. 45(1), pages 26-42, February.

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    More about this item

    Keywords

    Market design; kidney exchange;

    JEL classification:

    • D47 - Microeconomics - - Market Structure, Pricing, and Design - - - Market Design
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design

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