Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation
Background: There are over 250 kidney transplant programs in the USA. Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent inc...
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Shiraz University of Medical Sciences
2015-10-01
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doaj-dfb96162544241e1bd6716c85e7a1bb72020-11-24T20:53:12ZengShiraz University of Medical SciencesInternational Journal of Organ Transplantation Medicine2008-64822008-64902015-10-0164196Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney TransplantationPS Cho0RF Saidi1CJ Cutie2DSC Ko3Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USADivision of Organ Transplantation, Department of Surgery, Alpert Medical School of Brown University, Providence, RI, USADepartment of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USADepartment of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USABackground: There are over 250 kidney transplant programs in the USA. Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide. Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, organs transplanted, and ESRD prevalence. Herfindahl- Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition. Results: States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000–1800 considered moderate competition; and HHI>1800 considered highly concentrated). The percentage of ESRD patients listed in competitive, moderate, and highly concentrated regions were 19.73%, 17.02%, and 13.75%, respectively. The ESRD listing difference between competitive versus highly concentrated was significant (p<0.05). Conclusion: When there is strong competition without a dominant center as defined by the HHI, the entire state tends to list more patients for transplant to drive up their own center’s market share. Our analysis of the available national data suggests a discrepancy in access for ESRD patient to transplantation due to transplant center competition.http://www.ijotm.com/ojs/index.php/IJOTM/article/view/314Kidney transplantationCompetitionAllocationWait-listMarket analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
PS Cho RF Saidi CJ Cutie DSC Ko |
spellingShingle |
PS Cho RF Saidi CJ Cutie DSC Ko Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation International Journal of Organ Transplantation Medicine Kidney transplantation Competition Allocation Wait-list Market analysis |
author_facet |
PS Cho RF Saidi CJ Cutie DSC Ko |
author_sort |
PS Cho |
title |
Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation |
title_short |
Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation |
title_full |
Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation |
title_fullStr |
Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation |
title_full_unstemmed |
Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation |
title_sort |
competitive market analysis of transplant centers and discrepancy of wait-listing of recipients for kidney transplantation |
publisher |
Shiraz University of Medical Sciences |
series |
International Journal of Organ Transplantation Medicine |
issn |
2008-6482 2008-6490 |
publishDate |
2015-10-01 |
description |
Background: There are over 250 kidney transplant programs in the USA.
Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide.
Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, organs transplanted, and ESRD prevalence. Herfindahl- Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition.
Results: States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000–1800 considered moderate competition; and HHI>1800 considered highly concentrated). The percentage of ESRD patients listed in competitive, moderate, and highly concentrated regions were 19.73%, 17.02%, and 13.75%, respectively. The ESRD listing difference between competitive versus highly concentrated was significant (p<0.05).
Conclusion: When there is strong competition without a dominant center as defined by the HHI, the entire state tends to list more patients for transplant to drive up their own center’s market share. Our analysis of the available national data suggests a discrepancy in access for ESRD patient to transplantation due to transplant center competition. |
topic |
Kidney transplantation Competition Allocation Wait-list Market analysis |
url |
http://www.ijotm.com/ojs/index.php/IJOTM/article/view/314 |
work_keys_str_mv |
AT pscho competitivemarketanalysisoftransplantcentersanddiscrepancyofwaitlistingofrecipientsforkidneytransplantation AT rfsaidi competitivemarketanalysisoftransplantcentersanddiscrepancyofwaitlistingofrecipientsforkidneytransplantation AT cjcutie competitivemarketanalysisoftransplantcentersanddiscrepancyofwaitlistingofrecipientsforkidneytransplantation AT dscko competitivemarketanalysisoftransplantcentersanddiscrepancyofwaitlistingofrecipientsforkidneytransplantation |
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