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Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation.

Cho PS, Saidi RF, Cutie CJ, Ko DS - Int J Organ Transplant Med (2015)

Bottom Line: There are over 250 kidney transplant programs in the USA.Herfindahl-Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition.States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000-1800 considered moderate competition; and HHI>1800 considered highly concentrated).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

ABSTRACT

Background: There are over 250 kidney transplant programs in the USA.

Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide.

Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, organs transplanted, and ESRD prevalence. Herfindahl-Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition.

Results: States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000-1800 considered moderate competition; and HHI>1800 considered highly concentrated). The percentage of ESRD patients listed in competitive, moderate, and highly concentrated regions were 19.73%, 17.02%, and 13.75%, respectively. The ESRD listing difference between competitive versus highly concentrated was significant (p<0.05).

Conclusion: When there is strong competition without a dominant center as defined by the HHI, the entire state tends to list more patients for transplant to drive up their own center's market share. Our analysis of the available national data suggests a discrepancy in access for ESRD patient to transplantation due to transplant center competition.

No MeSH data available.


Related in: MedlinePlus

Competition by HHI within states
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Figure 1: Competition by HHI within states

Mentions: The HHI was applied to centers within a given state. All 50 states and one territory (Puerto Rico) could be grouped into non-concentrated competitive (HHI<1500), moderately concentrated (1500≤HHI≤2500), highly concentrated (HHI>2500), or single-center (HHI 10,000) markets for transplant centers (Fig 1). Eleven states and one territory (Puerto Rico) were single-center markets. Twenty-three states were categorized as highly concentrated markets. Eight states were found to be moderately competitive markets, while five states were non-concentrated competitive systems. These groups were utilized for purposes of subsequent comparison.


Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation.

Cho PS, Saidi RF, Cutie CJ, Ko DS - Int J Organ Transplant Med (2015)

Competition by HHI within states
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644566&req=5

Figure 1: Competition by HHI within states
Mentions: The HHI was applied to centers within a given state. All 50 states and one territory (Puerto Rico) could be grouped into non-concentrated competitive (HHI<1500), moderately concentrated (1500≤HHI≤2500), highly concentrated (HHI>2500), or single-center (HHI 10,000) markets for transplant centers (Fig 1). Eleven states and one territory (Puerto Rico) were single-center markets. Twenty-three states were categorized as highly concentrated markets. Eight states were found to be moderately competitive markets, while five states were non-concentrated competitive systems. These groups were utilized for purposes of subsequent comparison.

Bottom Line: There are over 250 kidney transplant programs in the USA.Herfindahl-Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition.States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000-1800 considered moderate competition; and HHI>1800 considered highly concentrated).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

ABSTRACT

Background: There are over 250 kidney transplant programs in the USA.

Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide.

Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, organs transplanted, and ESRD prevalence. Herfindahl-Hirschman Index (HHI) was used to measure the size of firms in relation to the industry to determine the amount of competition.

Results: States were separated into 3 groups (HHI<1000 considered competitive; HHI 1000-1800 considered moderate competition; and HHI>1800 considered highly concentrated). The percentage of ESRD patients listed in competitive, moderate, and highly concentrated regions were 19.73%, 17.02%, and 13.75%, respectively. The ESRD listing difference between competitive versus highly concentrated was significant (p<0.05).

Conclusion: When there is strong competition without a dominant center as defined by the HHI, the entire state tends to list more patients for transplant to drive up their own center's market share. Our analysis of the available national data suggests a discrepancy in access for ESRD patient to transplantation due to transplant center competition.

No MeSH data available.


Related in: MedlinePlus