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Essays on the Economics of Organ Transplantation
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| 자료유형 | 학위논문 |
|---|---|
| 서명/저자사항 | Essays on the Economics of Organ Transplantation. |
| 개인저자 | Lemont, Bethany I. |
| 단체저자명 | Michigan State University. Economics - Doctor of Philosophy. |
| 발행사항 | [S.l.]: Michigan State University., 2019. |
| 발행사항 | Ann Arbor: ProQuest Dissertations & Theses, 2019. |
| 형태사항 | 145 p. |
| 기본자료 저록 | Dissertations Abstracts International 81-03A. Dissertation Abstract International |
| ISBN | 9781085723374 |
| 학위논문주기 | Thesis (Ph.D.)--Michigan State University, 2019. |
| 일반주기 |
Source: Dissertations Abstracts International, Volume: 81-03, Section: A.
Advisor: Dickert-Conlin, Stacy. |
| 이용제한사항 | This item must not be sold to any third party vendors.This item must not be added to any third party search indexes. |
| 요약 | Chapter 1: The Effect of Share 35 for Kidneys on Pediatric Transplant Candidates: Due to the shortage of donated kidneys in the United States, allocation policy is used to balance equity and efficiency in distribution of these scarce resources. I analyze the effect of a change in the allocation system for deceased donor kidneys called "Share 35" that gave priority to pediatric kidney transplant candidates over adult candidates for young deceased donor kidneys. Using data from the Scientific Registry of Transplant Recipients on all kidney transplant candidates in the US, I show that providing priority for pediatric candidates increased the average kidney quality by 30% and increased the likelihood of being transplanted within a year by 20 percentage points for pediatric candidates who are predicted to receive a deceased donor kidney in absence of Share 35. However, this policy also created an incentive for pediatric candidates with a living donor available to them to forgo using that donor to use a deceased donor instead. These candidates, who I estimate switch donor types, experience worse average kidney quality but no change in wait time. Additionally using the limited long run follow-up data available, the policy does not appear to have the unintended consequence of candidates with available living donors strategically "saving" their living donor for their second transplants when they would no longer have pediatric priority.Chapter 2: The Effects of the Affordable Care Act on the Demand for Organ Transplants: Many potential transplant candidates are unable to be registered on the wait list to receive an organ for transplant due to their lack of insurance. With the introduction of the Affordable Care Act, some of these potential candidates obtained insurance coverage through state Medicaid expansions or through the introduction of the private insurance marketplace. In this paper, I estimate the effect of this increase in availability of insurance coverage on these potential transplant candidates' wait list decisions and transplant outcomes using a difference in differences model. I find that the state expansions of Medicaid increased monthly wait list registrations by candidates insured through Medicaid by about 50 percent on average for all organs, but I find no effect of the marketplace on registrations. Additionally, I find that for candidates insured through Medicaid, the Medicaid expansion led to an increase in monthly deceased donor transplants for all organs, and a doubling of monthly living donor liver transplants.Chapter 3: Opioids and Organs: How Overdoses Affect the Supply of Donors,Waiting Lists, and Transplant Outcomes (with Stacy Dickert-Conlin, Todd Elder, and Keith Teltser): As the number of fatal drug overdoses has rapidly grown in recent years, patients awaiting organ transplants may be the unintended beneficiaries. In 2017, 70,237 people died due to a drug overdose, 5,795 transplant candidates died while waiting for an organ, and an additional 6,363 candidates were removed from waiting lists because they were too sick to accept a transplant. In this paper, we use mortality data from the National Vital Statistics System, merged with restricted-use data on transplant candidates and recipients from the Scientific Registry of Transplant Recipients, to study the extent to which the recent growth in fatal drug overdoses impacts the supply of deceased organ donations and transplants. We find that each opioid overdose death generates 0.019 additional organ donors, resulting in 0.053 additional organ transplants. Nearly all of this association is concentrated among donors aged 18-49, who account for the majority of opioid overdose victims. Somewhat surprisingly, opioid-driven supply shocks induce limited demand-side responses. |
| 일반주제명 | Economics. |
| 언어 | 영어 |
| 바로가기 | 
: 이 자료의 원문은 한국교육학술정보원에서 제공합니다. |
