Improving Societal Outcomes in the Organ Donation Value Chain

Many governing bodies have launched efforts to shape the operations of manufacturers, administration of civic entities and behavior of individuals to limit waste generation. Typically, such efforts commence with the enactment of targeted legislations that create operational changes (e.g., recycling fees, collection centers) to the waste collection and disposal processes. For example, over 25 states in the USA have enacted legislations that aim to properly dispose used electronic and electrical goods (i.e., e-waste) and divert such waste away from landfills. We argue that such legislations can have an impact that extends beyond just reducing e-waste. This is because such laws may not only motivate individuals to restrict e-waste but also induce broader behavioral spillovers that can prompt individuals to reduce waste in general. To explore this idea, we exploit a quasiexperimental setup that arises from California's enactment of the Electronic Waste Recycling Act (EWRA). Specifically, a difference-in-differences analysis reveals that the introduction and implementation of the EWRA resulted in at least 4.93% reduction of municipal solid waste (MSW). A plausibility analysis illustrates that these MSW reductions are much larger than what can be attributed purely to the decline of e-waste. Furthermore, we show that the effect of e-waste laws is stronger when consumers have increased market access through (i) online connectivity and (ii) offline proximity. Our study informs policy makers on the effects of e-waste legislation and the critical role of market access in enhancing the impact of such legislation.

Section: Literature Reviewmentioning

confidence: 99%

Do E‐Waste Laws Create Behavioral Spillovers? Quasi‐Experimental Evidence from California

Dhanorkar

Muthulingam

2020

“…Using a counterfactual study, the authors show sharing the bottom 15% quality kidneys increases the intent to procure organs. Arora and Subramanian ( 2019 ) develop a game‐theoretic model to analyze how the decisions of the organ procurement organization (OPO) and the hospital affect their respective payoffs and societal outcomes. The authors identify possible misalignments in the objectives of the social planner, the OPO, and the hospital, especially when the quality of recovered organs is heterogeneous.…”

Section: Literature Reviewmentioning

confidence: 99%

Pausing transplants in the face of a global pandemic: Patient survival implications

Zhang

Wang

et al. 2023

The coronavirus disease 2019 (COVID‐19) pandemic has disrupted normal operating procedures at transplant centers. With the possibility that COVID‐19 infection carries an overall 4% mortality rate and potentially a 24% mortality rate among the immunocompromised transplant recipients, many transplant centers considered the possibility of slowing down and even potentially pausing all transplants. Many proposals regarding the need for pausing organ transplants exist; however, much remains unknown. Whereas the impact of the COVID‐19 pandemic on the overall healthcare system is unknown, the potential impact of pausing organ transplants over a period can be estimated. This study presents a model for evaluating the impact of pausing liver transplants over a spectrum of model for end‐stage liver disease‐sodium (MELD‐Na) scores. Our model accounts for two potential risks of a pause: (1) the waitlist mortality of all patients who do not receive liver transplants during the pause period, and (2) the impact of a longer waiting list due to the pause of liver transplants and the continuous accrual of new patients. Using over 12 years of liver transplant data from the United Network for Organ Sharing and a system of differential equations, we estimate the threshold probability above which a decision maker should pause liver transplants to reduce the loss of patient life months. We also compare different pause policies to illustrate the value of patient‐specific and center‐specific approaches. Finally, we analyze how capacity constraints affect the loss of patient life months and the length of the waiting list. The results of this study are useful to decision makers in deciding whether and how to pause organ transplants during a pandemic. The results are also useful to patients (and their care providers) who are waiting for organ transplants.

“…Most NPOs depend on altruistic donations for their supplies of products or services, which leads to several limitations and challenges for NPOs when attempting to enhance their levels of supply (e.g., as studied in Arora and Subramanian 2019, Mehrotra and Natarajan 2020, Solak et al. 2018).…”

Section: Literature Reviewmentioning

confidence: 99%

Improving Outcomes in Child Care Subsidy Voucher Programs under Regional Asymmetries

Arora

Wei

Solak

2021

Self Cite

Related to several efforts by governments to attain United Nations Sustainable Development Goals, subsidy vouchers are used to provide monetary support to income‐eligible (IE) families who cannot afford child care. However, IE families are often unable to accept an offered voucher due to an inadequate supply of voucher‐accepting child care providers that best suit their needs. Child Care Resource and Referral agencies (CCR&Rs), which administer these programs, can influence the family's propensity to accept a voucher by investing funds both in outreach to increase the number of voucher‐accepting providers in each region, and in provider services to improve the service delivery to families. This study analyzes how a CCR&R should allocate its limited funds between these two types of activities to ensure equitable access to child care across the different regions of its service area. We show that it might be optimal for the CCR&R to invest more funds in outreach in the region with a lower proportion of IE families. This is especially true when: the external considerations (e.g., public transportation and infrastructure) in that region have a greater impact on a family's acceptance propensity; the marginal return of investment in outreach in that region is higher and abundant funds are available; the socioeconomic distress experienced by families in that region is significantly higher; or a large amount of funds is earmarked for outreach in that region. We contextualize our study for a CCR&R in Massachusetts and conclude that the proposed investment decisions can improve equity outcomes by 7.0%.