4.3 Article

Modeling patients as decision making units: evaluating the efficiency of kidney transplantation through data envelopment analysis

Journal

HEALTH CARE MANAGEMENT SCIENCE
Volume 24, Issue 1, Pages 55-71

Publisher

SPRINGER
DOI: 10.1007/s10729-020-09516-2

Keywords

Kidney transplantation; Data envelopment analysis; Living donors; Efficiency; Operations research; Dialysis

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The study applies Data Envelopment Analysis (DEA) to evaluate the efficiency of 485 patients undergoing kidney transplantation, classifying patients based on specific and interrelated variables and identifying potential improvements on a per patient basis.
The main applications of Data Envelopment Analysis (DEA) to medicine focus on evaluating the efficiency of different health structures, hospitals and departments within them. The evolution of patients after undergoing a medical procedure or their response to a given treatment are not generally studied through this programming technique. In addition to the difficulty inherent to the collection of this type of data, the use of a technique that is mainly applied to evaluate the efficiency of decision making units representing industrial and production structures to analyze the evolution of human patients may seem inappropriate. In the current paper, we illustrate how this is not actually the case and implement a decision engineering approach to model kidney transplantation patients as decision making units. As such, patients undergo three different phases, each composed by specific as well as interrelated variables, determining the potential success of the transplantation process. DEA is applied to a set of 12 input and 6 output variables - retrieved over a 10-year period - describing the evolution of 485 patients undergoing kidney transplantation from living donors. The resulting analysis allows us to classify the set of patients in terms of the efficiency of the transplantation process and identify the specific characteristics across which potential improvements could be defined on a per patient basis.

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