Welcome to my homepage. I am an Assistant Research Fellow (Assistant Professor) at Institute of Economics at Academia Sinica. I received my PhD in Economics from Pennsylvania State University, State College in 2024.
My research interests are in applied microeconomics, health economics, and industrial organization. This is a version of my CV.
Working Papers:
[Performance Scores and Strategic Choices of Kidney Transplant Centers] New draft coming soon!
Kidney transplant centers are critical to patient survival, yet there is little oversight over their performance and behavior. This study examines the impact of a policy that terminates centers if risk-adjusted death rates exceed a limit. Using variation in policy exposure across centers and over time, combined with adjustments for statistical trends, I implement a difference-in-differences design to identify causal effects. The policy reduced post-transplant death rates by 19 percent, with the improvements coming from better detection of complications like acute kidney rejections during follow-up visits. While the policy did not cause discriminatory practices at the transplant or admission stages, nor did it increase waiting times or waiting-list deaths, it had unintended consequences. Notably, a 28 percent drop in risky kidney offerings by adjustments in the centralized allocation system led to an 18 percent rise in the discard rate. These findings challenge existing assumptions in the medical literature and demonstrate that regulatory oversight can enhance patient outcomes while maintaining equity and access. The study offers valuable lessons for regulators on balancing quality improvement initiatives with minimizing unintended consequences, such as kidney discards.
Do transplant centers change strategies after poor performance?
Medicare’s conditions of participation (CoP) is a policy that requires kidney transplant centers’ numbers of graft failure or patient death 1 year after transplant to fall below a cutoff. Centers that repeatedly exceed the cutoff are flagged for poor performance and risk losing Medicare funding or certification. I use a sharp regression discontinuity design to study centers’ response to being flagged for poor performance. Contrary to the existing literature, I find no evidence to suggest that flagged centers reduce (increase) the transplant of high (low) risk kidneys or waitlist younger, less obese or non-diabetic patients.
Publications:
Association of transplant center market concentration and local organ availability with deceased donor kidney utilization. Am J Transplant. 2022;22(6):1603-1613.
with Syed A. Husain, Kristen L. King, David C. Cron, Nikole A. Neidlinger, Sumit Mohan, Joel T. Adler