Two Essays on the Economics of Organ Transplantation.

My dissertation analyzes two important factors in organ transplantation, transplant center performance and organ donation. The two chapters contribute to the economics literature on organizational learning-by-doing and on the effect of legal interventions on pro-social behavior, respectively. In the first chapter, I analyze organizational learning-by-doing. Organizational learning-by-doing implies that production outcomes improve with increases in cumulative volume produced. Empirical research documents the existence of organizational learning-by-doing, primarily in manufacturing, but provides little insight into why some firms learn while others do not. Using patient-level data on 120 new liver transplant centers, I first establish that organizational learning-by-doing exists, but only shortly after entry. Second, I show that significant variation in organizational learning-by-doing exists across centers. Third, I test whether the timing of entry and pre-entry experience transplanting other organs affect the existence and magnitude of organizational learning-by-doing. I find that organizational learning-by-doing only exists early in the sample period when liver transplantation was a relatively experimental procedure. Pre-entry experience also influences the relationship between survival outcomes and cumulative volume. My results indicate that current policies discouraging entry into liver transplantation may reduce access without improving outcomes. The second chapter of my dissertation tests whether laws intended to increase organ and bone marrow donation increase donation, which may determine whether a patient receives a life-saving transplant or dies waiting. Many U.S. states passed legislation providing leave to organ and bone marrow donors and/or tax benefits for organ and bone marrow donations and to employers of donors. We exploit cross-state variation in the timing and passage of such legislation to analyze its impact on organ donations by living and deceased persons, on measures of the quality of the organs transplanted, and on the number of bone marrow donations. We find that these provisions did not affect the quantity of organs donated. The leave legislation, however, did increase bone marrow donations. Our results suggest that this legislation works for moderately invasive procedures such as bone marrow donation, but may be too low for organ donation, which is riskier and more burdensome to the donor.PHDBusiness AdministrationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/100074/1/ssstith_1.pd