Characterizing Rational Transplant Program Response to Outcome-Based Regulation
通过机会约束优化模型，证明移植项目为应对基于患者生存结果的监管而更严格筛选患者是理性的，并揭示监管可能不公平地惩罚中型项目，量化了哪些患者最可能被排斥。
U.S. health agencies periodically evaluate transplant programs based on their patients’ posttransplant survival outcomes, and a program is flagged for review if the number of unsuccessful transplants far exceeds what would be expected based on national averages. Some researchers have expressed concerns that these regulations might cause programs to reject high-risk patients, whereas others have questioned if such a response would be rational. In “Characterizing Rational Transplant Program Response to Outcome-Based Regulation,” Mildebrath et al. use chance-constrained optimization to demonstrate that it may, in fact, be rational for a transplant program to become more selective when evaluating transplant candidates for admittance to the waitlist. They also demonstrate that the regulations may unfairly penalize medium-sized programs. Moreover, their model quantifies which patients may be most at risk for adverse selection by programs. Their results provide insights to policymakers by quantitatively characterizing the response of rational programs to outcome-based regulations.