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Improving Fairness and Efficiency in Matching with Distributional Constraints: An Alternative Solution for the Japanese Medical Residency Match

机译:提高与分配约束匹配的公平与效率:日本医疗住院匹配的另一种解决方案

摘要

Regional imbalance of doctors is a serious issue in many countries. In an attempt to average the geographical distribution of doctors, the Japanese government introduced ``regional caps'' recently, restricting the total number of medical residents matched within each region.Motivated by this policy change, Kamada and Kojima (2013) proposed a mechanism called the flexible deferred acceptance mechanism (FDA) that makes every doctor weakly better off than the current system.In this paper, we further study this problem and develop an alternative mechanism that we call the priority-list based deferred acceptance mechanism (PLDA).Both mechanisms enable hospitals in the same region to fill their capacities flexibly until the regional cap is filled. FDA lets hospitals take turns to (tentatively) choose the best remaining doctor, while PLDA lets each region directly decide which doctor is (tentatively) matched with which hospital based on its priority list. We show that PLDA performs better than FDA in terms of efficiency and fairness through theoretical and computational analyses.
机译:在许多国家,医生的地区失衡是一个严重的问题。为了平均化医生的地域分布,日本政府最近引入了``区域上限'',以限制每个区域内匹配的医疗居民的数量.Kamada和Kojima(2013)提出了一种机制,以期改变政策。这种称为灵活的递延接受机制(FDA)的功能使每个医生的状况都比当前系统弱一些。本文中,我们进一步研究了这个问题,并开发了一种替代机制,称为基于优先级列表的递延接受机制(PLDA)。两种机制都可以使同一地区的医院灵活地发挥其能力,直到填补区域上限为止。 FDA允许医院轮流(暂定)选择剩余的最佳医生,而PLDA则允许每个地区根据其优先级列表直接(暂定)确定哪位医生与哪家医院匹配。通过理论和计算分析,我们显示PLDA在效率和公平性方面比FDA更好。

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