Chapter 1. The Effect of Broader Liver Sharing on Patient Outcomes and Offer Acceptance: This paper evaluates a liver allocation policy known as Share 35, which provides transplant candidates facing high mortality risks with priority for livers obtained from relatively distant geographic areas. Exploiting the variation in the access to liver transplants across transplant candidates, I show that increasing access to liver transplants is an effective way to reduce mortality rates. Although the policy is well-targeted, I find that the policy causes unintended effects on the quality of transplanted livers and transplant candidates' liver offer-acceptance incentives. Because the policy promotes liver sharing across areas, targeted candidates receive a lower quality of livers due to longer liver transportation times. However, those candidates receive a compensation on liver quality by receiving livers with better donor characteristics. To further understand the mechanism of the compensation, I develop a strategic liver search model and estimate the model with match-run data that contain offer-acceptance decision histories for all donated livers. I find that the policy enables targeted candidates to be more selective of liver and transfer some of their quality loss to others.Chapter 2. The Role of Kidney Allocation Policy in Addressing Kidney Shortages: I examine whether prioritizing certain types of transplant candidates in deceased-donor kidney allocation can increase the total number of kidney transplants. Transplant candidates strategically choose one of the two kidney sources, namely, deceased-donor and living-donor kidneys. While deceased-donor kidneys are available for all transplant candidates (similar to public goods), living-donor kidneys are only available for the designated recipients by the donors (similar to private goods). Using a regression discontinuity design, I show that transplant candidates are less likely to choose living-donor kidneys when they have better access to deceased-donor kidneys, which can be interpreted as a crowd-out effect. Furthermore, I find that the size of the effect varies substantially across race, blood type, and dialysis status of transplant candidates. The result implies that prioritizing transplant candidates, who are less prone to crowd-out, in deceased-donor kidney allocation could make policies designed to increase the number of deceased donors more effective.Chapter 3. The Strategic Location Choice of For-profit Hemodialysis Facilities in the U.S.: In the last chapter, I identify key factors related to the location choice of for-profit hemodialysis facilities using a dataset from the United States Renal Data System (USRDS) and structural methods. All patients with kidney failure need to receive hemodialysis treatment regularly and permanently. Because dialysis treatments are homogeneous across facilities, patients are likely to choose a treatment facility based on the distance from their homes. The strategic model introduced by Seim (2006) involves a static and incomplete information game among dialysis facilities for entry and positioning in a market. The estimation results show that in choosing an optimal location, a tradeoff occurs between local demand and competition with potential entrants.
Read
