School of Industrial Engineering, Iran University of Science & Technology, Tehran, Iran.
Health Care Manag Sci. 2018 Dec;21(4):587-603. doi: 10.1007/s10729-017-9414-6. Epub 2017 Aug 9.
Given the perennial imbalance and chronic scarcity between the demand for and supply of available organs, organ allocation is one of the most critical decisions in the management of organ transplantation networks. Organ allocation systems undergo rapid revisions for the sake of improved outcomes in terms of both equity and medical efficiency. This paper presents a Data Envelopment Analysis (DEA)-based model to evaluate the efficiency of possible patient-organ pairs for kidney allocation in order to enhance the fitness of organ allocation under inherent uncertainty in such problem. Eligible patient-kidney pairs are regarded as decision making units (DMUs) in a Credibility-based Fuzzy Common Weights DEA (CFCWDEA) approach and are ranked based on efficiency scores. Using a common set of weights for all DMUs ensures a high degree of fairness in the assessment and ranking of DMUs. The proposed model is also the first allocation method capable of coping with the vague and intervallic medical and nonmedical allocation factors by the aid of fuzzy programming. Verification and validation of the proposed approach are performed in two steps using a real case study from the Iranian kidney allocation system. First, the superiority of the proposed deterministic model in enhancing allocation outcomes is demonstrated and analyzed. Second, the applicability of the proposed fuzzy DEA method is demonstrated using a series of data realizations for different credibility levels.
鉴于可用器官的需求与供应之间长期存在的不平衡和慢性短缺,器官分配是器官移植网络管理中最关键的决策之一。为了提高公平性和医疗效率方面的结果,器官分配系统正在进行快速修订。本文提出了一种基于数据包络分析(DEA)的模型,用于评估肾脏分配中可能的患者-器官对的效率,以增强在该问题固有不确定性下的器官分配的适应性。合格的患者-肾脏对被视为信誉度为基础的模糊共同权重数据包络分析(CFCWDEA)方法中的决策单元(DMU),并根据效率得分进行排名。为所有 DMU 使用共同的权重集确保了 DMU 的评估和排名具有高度的公平性。所提出的模型也是第一个能够通过模糊编程来处理模糊和区间医疗和非医疗分配因素的分配方法。使用来自伊朗肾脏分配系统的实际案例研究分两步验证和验证所提出的方法。首先,证明和分析了所提出的确定性模型在增强分配结果方面的优越性。其次,使用不同可信度水平的一系列数据实现证明了所提出的模糊 DEA 方法的适用性。