Does competition for transplantable hearts encourage 'gaming' of the waiting list?

Journal Article (Journal Article)

Transplant centers may "game" the severity of listed patients to increase their patients' likelihood of receiving transplantable organs. Recent lawsuits allege gaming at some centers, and listing policies were modified in 1999 to clarify listing criteria. We tested for gaming and its relationship to heart transplant center competition. We found that increased competition resulted in more patients listed in the most severe illness category (p < .01), consistent with the gaming hypothesis. Gaming was mitigated after the 1999 policy change (p > .05), which suggests that the new rules were effective. Continued monitoring is warranted, given prior gaming and recent accusations.

Full Text

Duke Authors

Cited Authors

  • Scanlon, DP; Hollenbeak, CS; Lee, W; Loh, E; Ubel, PA

Published Date

  • March 2004

Published In

Volume / Issue

  • 23 / 2

Start / End Page

  • 191 - 198

PubMed ID

  • 15046143

Electronic International Standard Serial Number (EISSN)

  • 1544-5208

International Standard Serial Number (ISSN)

  • 0278-2715

Digital Object Identifier (DOI)

  • 10.1377/hlthaff.23.2.191


  • eng