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,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 US7,000 per year, or near US million per year considering the effect on the quality of life.

Introduction: Chile has a low cadaveric organ donation rate; at the same time, living donor transplantation activity is also low. The purpose of this study was to analyze the impact on the number and quality of transplants using various mechanisms for kidney exchange from living donors to patients on Chile's waiting list. Methods: A computerized model was developed to simulate five options for living kidney donation: (1) direct donation; (2) direct donation plus pairwise and three-way exchanges; (3) pairwise exchange; (4) three-way exchange; and (5) allocation of donors based on the top trading cycles (TTC) mechanism. We calculated the projected number of transplantations, adjusting for the risk of a positive crossmatch, as well as the average quality in terms of the human leukocyte antigen (HLA) match. Results: If all patients on the waiting list have a willing direct donor, 47.7% of patients will receive a transplant. Allowing for incompatible pairs or pairs with a positive crossmatch an exchange of kidneys, can increase the number to 51.8%. This figure rises to 60% or 61% for pairwise or three-way exchanges, respectively. Although TTC ensures that 55% of the patients could be transplanted, the graft quality is better with an average HLA match of 3.5 versus 1.25. Conclusions: These results showed that kidney exchange mechanisms can increase the number of living donor transplantations by 4% and 13%.

Why does schooling attainment vary widely across countries? Why are differences in schooling attainment highly persistent? I show that cross-country differences in schooling are related to political institutions, such as democracy and local democracy (political decentralization), which are affected by colonial factors. By using the number of native cultures before colonization as an instrument for political decentralization, I show that after controlling for the causal effect of income on schooling, the degree of democratization positively affects the development of primary education, whereas political decentralization has a positive and significant impact on more advanced levels of schooling.

When a firm is forced to pay abnormally high wages, hiring transfers rents. This effectively endows the employer with the ability to grant favors, and he may wish to do so even at some cost to efficient production. We refer to this as the brother-in-law effect. This article analyzes its consequences. When the brother-in-law effect is due to unionization, decisions regarding both the number and type of workers employed could be inefficient; overemployment could obtain even relative to the workforce that would be employed without unionization.We also identify cases in which nepotism improves efficiency.

This paper examines a reputation-based mechanism that sustains the provision of high quality in the presence of competition among providers, where the incentive for high-quality production comes from a reputation premium: firms with higher reputations charge higher prices. The way we model the market highlights the fact that prices are not solely determined from consumers' willingness to pay as in the monopolistic setting studied in the previous literature. In effect, equilibrium prices are determined endogenously, from the interaction of the distribution of consumers' valuations for high quality and the distribution of firms' reputations—the demand and the supply sides of the market, respectively. This paper shows that: (i) there is a steady-state distribution of reputations, a result that allows the study of a stationary equilibrium; (ii) there are parameter configurations for which the existence of a high-quality equilibrium is guaranteed, and where the incentives for high quality production in the repeated game depend on the shape of the price function; and (iii) the Walrasian-equilibrium price function depends on the shape of the steady-state distribution of reputations, and the assignment of consumers to firms with different reputation levels in such an equilibrium is positively assortative if quality is a normal good.

Este trabajo presenta una metodología para valorizar reducciones de tasas de mortalidad. El valor de la vida se mide a partir de un modelo en que las agentes eligen sus patrones de consumo y ocio óptimos enfrentando probabilidades exógenas de supervivencia. Las condiciones de primer orden, así como algunos supuestos simplificadores relacionados a la función de utilidad, nos permiten calibrar el modelo utilizando datos de la economía Chilena durante los años 90s. Finalmente, se cuantifican las ganancias económicas de reducir tasas de mortalidad.