Gerrymandering for Justice: Redistricting U.S. Liver Allocation

Sommer Gentry (), Eric Chow (), Allan Massie () and Dorry Segev ()
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Sommer Gentry: Mathematics Department, United States Naval Academy, Annapolis, Maryland 21402; and Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
Eric Chow: Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
Allan Massie: Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Johns Hopkins University School of Public Health, Baltimore, Maryland 21287
Dorry Segev: Johns Hopkins University School of Medicine, Baltimore, Maryland 21287; and Johns Hopkins University School of Public Health, Baltimore, Maryland 21287

Interfaces, 2015, vol. 45, issue 5, 462-480

Abstract: U.S. organ allocation policy sequesters livers from deceased donors within arbitrary geographic boundaries, frustrating the intent of those who wish to offer the livers to transplant candidates based on medical urgency. We used a zero-one integer program to partition 58 donor service areas into between four and eight sharing districts that minimize the disparity in liver availability among districts. Because the integer program necessarily suppressed clinically significant differences among patients and organs, we tested the optimized district maps with a discrete-event simulation tool that represents liver allocation at a per-person, per-organ level of detail. In April 2014, the liver committee of the Organ Procurement and Transplantation Network (OPTN) decided in a unanimous vote of 22-0-0 to write a policy proposal based on our eight-district and four-district maps. The OPTN board of directors could implement the policy after the proposal and public-comment period.Redistricting liver allocation would save hundreds of lives over the next five years and would attenuate the serious geographic inequity in liver transplant offers.

Keywords: redistricting; set partitioning; location allocation; zero-one integer programming; healthcare; transplantation; liver (search for similar items in EconPapers)
Date: 2015
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Citations: View citations in EconPapers (8)

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