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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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    File URL: http://econtheory.org/ojs/index.php/te/article/viewFile/20140817/11619/357
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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.
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    Citations

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    Cited by:

    1. Pycia, Marek & Ünver, M. Utku, 2017. "Incentive compatible allocation and exchange of discrete resources," Theoretical Economics, Econometric Society, vol. 12(1), January.
    2. repec:oup:oxford:v:33:y:2017:i:4:p:676-704. is not listed on IDEAS
    3. 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.
    4. 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.
    5. repec:eee:jetheo:v:176:y:2018:i:c:p:193-231 is not listed on IDEAS

    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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