Estimating the Patient's Price of Privacy in Liver Transplantation

作     者：Sandikci, Burhaneddin Maillart, Lisa M. Schaefer, Andrew J. Alagoz, Oguzhan Roberts, Mark S. 

作者机构：Univ Chicago Booth Sch Business Chicago IL 60637 USA Univ Pittsburgh Dept Ind Engn Pittsburgh PA 15260 USA Univ Wisconsin Dept Ind & Syst Engn Madison WI 53706 USA Univ Pittsburgh Dept Gen Internal Med Pittsburgh PA 15213 USA 

出 版 物：《OPERATIONS RESEARCH》 (运筹学)

年 卷 期：2008年第56卷第6期

页      面：1393-1410页

核心收录：

学科分类：1201[管理学-管理科学与工程(可授管理学、工学学位)] 07[理学] 070104[理学-应用数学] 0701[理学-数学] 

基　　金：National Science Foundation [CMMI-0546960, CMMI-0700094] National Library of Medicine [R21-LM008273] 

主　　题：dynamic programming/optimal control: applications Markov health care: treatment 

摘      要：In the United States, patients with end-stage liver disease must join a waiting list to be eligible for cadaveric liver transplantation. Due to privacy concerns, the details of the composition of this waiting list are not publicly available. This paper considers the benefits associated with creating a more transparent waiting list. We study these benefits by modeling the organ accept/reject decision faced by these patients as a Markov decision process in which the state of the process is described by patient health, quality of the offered liver, and a measure of the rank of the patient in the waiting list. We prove conditions under which there exist structured optimal solutions, such as monotone value functions and control-limit optimal policies. We de. ne the concept of the patient s price of privacy, namely, the number of expected life days lost due to the lack of complete waiting list information. We conduct extensive numerical studies based on clinical data, which indicate that this price of privacy is typically on the order of 5% of the optimal solution value.