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American Economic Review Vol. 116 No. 8 2026

Designing Dynamic Reassignment Mechanisms: Evidence from GP Allocation

Ingrid Huitfeldt1; Victoria Marone2; Daniel Waldinger3

1 Department of Economics, BI Norwegian Business School (email: ) · 2 Department of Economics, Yale University (email: ) · 3 Department of Economics, New York University (email: )

Abstract

We study the problem of designing a dynamic reassignment mechanism when agents' preferences over objects change over time. In the context of Norway's system for (re)assigning patients to general practitioners (GPs), we provide direct evidence of misallocation under the current mechanism—patients waiting for each others' GPs, but who cannot trade—and estimate a structural model of GP-switching behavior to evaluate alternatives. Introducing top trading cycles (TTC) would, on average, reduce waiting times and increase patient welfare. However, patients endowed with less desirable GPs would be harmed. Prioritizing these patients can avoid these harms while preserving most of the gains from TTC.

DOI
10.1257/aer.20240617
Volume
116
Issue
8
Pages
3036-3075
Language
en
Sources
crossref

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