Journal
MEDICAL DECISION MAKING
Volume 25, Issue 2, Pages 199-209Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0272989X04268956
Keywords
liver transplantation; discrete-event simulation; simulation modeling; Monte Carlo simulation; organ allocation; patient survival; graft survival; policy analysis
Funding
- AHRQ HHS [R01HS09694] Funding Source: Medline
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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 far 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.
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