طراحی سازوکار برای تبادل کلیه در ایران

نوع مقاله: علمی - پژوهشی

نویسندگان

1 دانشیار گروه اقتصاد دانشگاه تهران

2 دانشیار گروه اقتصاد دانشگاه مفید قم

3 استاد گروه ارولوژی دانشگاه علوم پزشکی همدان

4 دکتری اقتصاد

چکیده

ضرورت طراحی مکانیسم‏ تبادل از این جهت است که برخی از بازارها به‌دلیل پراکنده ‌بودن عرضه‌کنندگان و تقاضاکنندگان شکل نمی‌گیرند. به‌عبارت‌دیگر، بازار در این حالت از یک ویژگی نحیف بودن و یا لاغری رنج می‌بَرد که برای برطرف کردن این ضعف در این نوع بازارها باید مکانیسم‌هایی ابداع شود که بر مشکل اشاره شده فائق آید. بازار کلیه یا به‌عبارت دیگر سازوکار تبادل کلیه یک نمونه واقعی از این نوع بازارها است. به همین منظور پیشنهاد می‌شود برای ایجاد بازار و یا مکانیسم تبادل، اطلاعات اهداکنندگان کلیه و بیماران در اتاق تسویه‌ای ثبت شوند و بعد از پردازش این اطلاعات و مشخص کردن ترجیحات بیماران، از طریق الگوریتم بهم‌رسانی، زوج‌های سازگار را به هم تطبیق داد و مبادله کلیه را تسهیل نمود. این پژوهش در سال 1395 برای استان همدان با بهره‌گیری از تئوری تطبیق که خود زیرشاخه‌ای از طراحی بازار و طراحی سازوکار است با استفاده از اطلاعات 40 نفر که 20 نفر آن‌ها بیمار دیالیزی و 20 نفر دیگر اهداکنندگان کلیه بودند، انجام گرفت. اطلاعات اولیه بیماران در اتاق تسویه‌ای ثبت شد و بعد از انجام آزمایش‏های خونی و بافتی و مشخص کردن ترجیحات بیماران، مشخص شد که از طریق الگوریتم بهم‌رسانی به تعداد 17 زوج از 20 زوج انتخابی، می‌توانند پیوند کلیه دریافت کنند. نتایج حاصله نشان می‌دهد نه تنها با به‌کارگیری مکانیسم تطبیق تعداد پیوند‌ها نسبت به حالت قبل نزدیک به دو برابر افزایش داشته بلکه با به‌کارگیری این مکانیسم، حداقل به اندازه 163817796 ریال برای هر بیمار، صرفه‌جویی اقتصادی برای کشور در پی خواهد داشت. 

کلیدواژه‌ها


عنوان مقاله [English]

Designing a Mechanism for Kidney Exchange in Iran

نویسندگان [English]

  • jafar ebadi 1
  • Naser Elahi 2
  • Mohammad ali Amirzargar 3
  • jalal molabeigi 4
1 University faculty
2 University faculty
3 Dean of the Faculty of Medicine
چکیده [English]

One of the most critical market duties is to ensure coordination between the supplier and demander. When the market fails to fulfill this duty efficiently, it either does not form or fail and disintegrate. This is because the number of market participants is either too large or too small, and/or the market experiences conditions where the participants scarcely give voice to their priorities with ease and confidence. Economists contend that the fundamental challenge in market design is that we sufficiently understand complex markets and develop our abilities to the point where we can reconstruct or redesign them upon their failure and/or use market-like mechanisms. When the process of price adjustment is slowly at work, economic factors tend to select what they want in the price they observe. Still, many markets are by far beyond this simple economic rule. In such markets, we may not readily obtain what we need even when we can afford it. In other words, while to want to and to be able to (to want a product and to be able to pay for it) generate demand in common markets, these two factors do not necessarily present us as customers in the complex markets since commodities are offered with variable qualities so that it is impossible to form a market for them. Some markets are so complex that people cannot select what they need despite their willingness and ability to pay for it. That is, price mechanism and automatic adjustment do not provide the market with balance although this does not imply the impossibility of market formation. . Market design theory and matching theory seek to provide a stage where suppliers and demanders can meet without using the traditional market mechanism (price mechanism). In this theory, price mechanism does not offer solution to the problem of resource allocation. Rather, allocation is based on suppliers and demanders’ conditions. Based on the proposed algorithm, ranked preferences replace and act as price system. One of the most important applications of market design in the past decade has been to the kidney and body parts market. for the purposes of market design, one should employ an algorithm that can overcome the causes of market failure such as returns to scale, externalities, uncertainty, thinness, congestion and insecurity to demonstrate preferences.These factors affect both market failure and lack of market formation.
The present study aimed to address the problem of kidney market and provide a solution to the problem. Dispersed market participants, limited number of suppliers and demanders, and poor supplier-demander relationshipmay lead to market (kidney exchange mechanism) failure or impede market formation.
In order  to resolve this deficiencies we should design a mechanism for overcoming the market failures in order to reach to  an efficient and stable allocation. Kidney market is a true example of this type of markets. Therefore, it is  suggested to create a clearing room in which the information of kidney donors and patients be recorded and after processing  this information and determine patient preferences, the matching algorithm could match the compatible couples(donors and patients)‏ and kidney exchange can be facilitated. The present study was carried out in Hamedan Province in 2016 using matching theory which is a subset of market design and mechanism design. To this end, the information for forty‏ people , twenty of them patients and twenty others Kidney donator were recorded in the clearing room. Then, after blood and tissues tests and determining patient preferences and forming matching algorithms, seventeen of twenty patients could receive kidney transplant. However, without using this mechanisms only nine patient could have received transplan, Also using this mechanism will result at least 163817796 Rials per patient.

کلیدواژه‌ها [English]

  • mechanism design
  • market desin
  • matching theory
  • kidney exchange
  • Assignment‏ Algorithm

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