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Objectives: Estimate the effects of non-pharmacological interventions used to prevent the spread of COVID-19 on the quality of life, measured by Quality Adjusted Life Years (QALYs)., Methods: A survey on 1,506 heads of households from Chile in May of 2022. Respondents were asked basic socioeconomic questions and a version of the EQ-5D-5L questionnaire that was used to calculate the evolution of HRQoLs. Comparisons of means in HRQoLs measures before the pandemic, at the peak of restrictions, and at the moment of the survey were performed., Results: The average HRQoL of the population before the pandemic was similar to other countries in the region (0.96). At the peak of restrictions (June 2020-August 2021), the average HRQoL decreased to 0.87 (-9%). At the time of survey (May 2022), the average HQRoL was 0.91 (4%). Assuming the recovery trend continued, pre-pandemic HRQoLs would be reached by January 2024. Altogether, the pandemic would have reduced QALYs by 0.2 in average. The effect is larger and the recovery slower among women. Our estimates imply that the restrictions to manage the pandemic came at a cost of 2.4 months of life years for the average (surviving) person, 1.8 months for men and 3.4 for women., Conclusions: Our results suggest that COVID-19 had worse effects on life quality than previously thought. These effects are more significant among women than among men. Efforts to improve life quality and speed up its recovery could have large positive consequences for the population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Atal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Kidney allocation should reach a balance between equity and efficiency. In Chile kidneys are allocated based on ABO matching, first to medical priorities and then according to a point scheme considering human leukocyte antigen (HLA) match (60%), waiting list time (20%), and panel-reactive antibodies (PRA; 20%); pediatric recipients receive extra points. A new policy maintains ABO matching and medical priorities as the first step, but incorporates other successive steps: previous living donors donors, 0 mismatch, pediatric recipients, and finally all other recipients according to a point scheme incorporating recipient age, HLA match, PRA, and time on waiting list with similar proportions. We compared the resulting transplantations using the new versus the older allocation policy., Methods: We analyzed computer-generated simulations using actual patients (N = 1176) on the Chilean waiting list in 2011 with the 300 donors over the previous 3 years., Results: The new policy a significantly decreased recipient age from 43 ± 0.3 years to 41 ± 0.3 and increased the number of 0-mismatched transplantations from 3% to 4%. The mean HLA mismatch increased from 2.8 ± 0.1 to 3.6 ± 0.1. Waiting time increased from a mean of 38 ± 1 months to 40 ± 1 months, but patients remaining on the waiting list had less waiting time with the new rule., Conclusions: With the proposed changes younger patients are being privileged and the importance of compatibility is diminished (except for 0-mismatched transplantations). The chance of a good match is directly related to the size of the recipient pool, thus an allocation policy that privileges HLA matching in a restricted recipient pool is especially unfavorable for younger patients. Including age of the recipient as a continuum can help to compensate for this lack of equity. Computer-generated simulations can help discern which policies are best suited for each country based on their local characteristics., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: In this article we present an economic evaluation of policies aimed at increasing deceased organ donation in Chile, a developing country that has low donation rates; it had 5.4 donors per million people (pmp) in 2010., Methods: Expert opinions of leading participants in donation and transplantation were analyzed, resulting in a set of local policies aimed at increasing donation rates. Using previous results of reported cost savings of increasing kidney transplantation in Chile, we estimated the net benefits of these policies, as a function of additional donors., Results: The main problem of the Chilean system seems to be the low capability to identify potential donors and a deficit in intensive care unit (ICU) beds. Among considered policies central to increase donation are the following: increasing human and capital resources dedicated to identifying potential donors, providing ICU beds from private centers, and developing an online information system that facilitates procurement coordination and the evaluation of performance at each hospital. Our results show that there is a linear relationship between cost savings and incremental donors pmp. For example, if these policies are capable of elevating donation rates in Chile by 6 donors pmp net estimated cost savings are approximately US $1.9 million. Likewise, considering the effect on patients' quality of life, savings would amount to around $15.0 million dollars per year., Conclusions: Our estimates suggest that these policies have a large cost-saving potential. In fact, considering implementation costs, cost reduction is positive after 4 additional donors pmp, and increasing afterward., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: In this paper we have estimated the cost savings for the health care system and quality-of-life improvement for patients from an increased number of kidney transplants in Chile. We compared the present value of dialysis and transplantation costs and quality of life over a 20-year horizon., Methods: We used Markov models and introduced some degree of uncertainty in the value of some of the parameters that built the model. Using Monte Carlo simulations, we estimated the confidence intervals for our results., Results: Our estimates suggested that a kidney transplant showed an expected savings value of US$28,000 for the health care system. If the quality-of-life improvement was also considered, the expected savings rise to US$ 102,000. These results imply that increasing donation rate by 1 donor per million population would achieve an estimated cost saving of US$827,000 per year, or near US$3 million per year considering the effect on the quality of life., Conclusion: These results demonstrated that kidney transplantation along with a better quality of life for patients are a cost-saving decision for developing countries., (Copyright © 2011 Elsevier Inc. All rights reserved.)