Abstract
Background. The optimal allocation of scarce donor livers is a contentious health care issue requiring careful analysis. The objective of this article was to design a biologically based discrete-event simulation to test proposed changes in allocation policies. Methods. The authors used data from multiple sources to simulate end-stage liver disease and the complex allocation system. To validate the model, they compared simulation output with historical data. Results. Simulation outcomes were within 1% to 2% of actual results for measures such as new candidates, donated livers, and transplants by year. The model overestimated the yearly size of the waiting list by 5% in the last year of the simulation and the total number of pretransplant deaths by 10%. Conclusion. The authors created a discrete-event simulation model that represents the biology of end-stage liver disease and the health care organization of transplantation in the United States.
Original language | English (US) |
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Pages (from-to) | 199-209 |
Number of pages | 11 |
Journal | Medical Decision Making |
Volume | 25 |
Issue number | 2 |
DOIs | |
State | Published - Mar 2005 |
Externally published | Yes |
Keywords
- Discrete-event simulation
- Graft survival
- Liver transplantation
- Monte Carlo simulation
- Organ allocation
- Patient survival
- Policy analysis
- Simulation modeling
ASJC Scopus subject areas
- Health Policy