Kidney Procurement System in Colombia: A System Dynamics Approach

Objective: This paper presents an analysis of two regulatory proposals in response to the growing demand for kidney transplants in Colombia. The results can be useful in evaluating these possible policy interventions once they have been implemented. Methods: The proposed model uses System Dynamics a...

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Autores:: Cruz, Joan Paola
Guerrero Rueda, William J.
Pérez, Edna Rocío
Lizarazo Walteros, David Leonardo
Rico Ardila, Paula Carolina
Castillo, Ana María
Torres Tinjacá, Laura Natalia

Tipo de recurso:: Article of investigation

Fecha de publicación:: 2019

Institución:: Escuela Colombiana de Ingeniería Julio Garavito

Repositorio:: Repositorio Institucional ECI

Idioma:: eng

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dc.title.eng.fl_str_mv	Kidney Procurement System in Colombia: A System Dynamics Approach
dc.title.alternative.spa.fl_str_mv	Sistema de obtención de riñones en Colombia: un enfoque basado en la Dinámica de Sistemas
dc.title.alternative.por.fl_str_mv	Sistema de obtenção de rins na Colômbia: uma abordagem baseada na Dinâmica de Sistemas
title	Kidney Procurement System in Colombia: A System Dynamics Approach
spellingShingle	Kidney Procurement System in Colombia: A System Dynamics Approach Riñones - Trasplante (Colombia) Donación de órganos - Colombia Política de la salud - Colombia Health policy Kidney exchange program System Dynamics modeling Healthcare Kidney transplantation Organ procurement system Programa de intercambio de riñón Modelos de Dinámica de Sistemas Atención médica Trasplante de riñón Sistema de obtención de órganos Programa de troca de rins Atendimento médico Transplante renal Sistema de aquisição de órgãos
title_short	Kidney Procurement System in Colombia: A System Dynamics Approach
title_full	Kidney Procurement System in Colombia: A System Dynamics Approach
title_fullStr	Kidney Procurement System in Colombia: A System Dynamics Approach
title_full_unstemmed	Kidney Procurement System in Colombia: A System Dynamics Approach
title_sort	Kidney Procurement System in Colombia: A System Dynamics Approach
dc.creator.fl_str_mv	Cruz, Joan Paola Guerrero Rueda, William J. Pérez, Edna Rocío Lizarazo Walteros, David Leonardo Rico Ardila, Paula Carolina Castillo, Ana María Torres Tinjacá, Laura Natalia
dc.contributor.author.none.fl_str_mv	Cruz, Joan Paola Guerrero Rueda, William J. Pérez, Edna Rocío Lizarazo Walteros, David Leonardo Rico Ardila, Paula Carolina Castillo, Ana María Torres Tinjacá, Laura Natalia
dc.subject.armarc.spa.fl_str_mv	Riñones - Trasplante (Colombia) Donación de órganos - Colombia Política de la salud - Colombia
topic	Riñones - Trasplante (Colombia) Donación de órganos - Colombia Política de la salud - Colombia Health policy Kidney exchange program System Dynamics modeling Healthcare Kidney transplantation Organ procurement system Programa de intercambio de riñón Modelos de Dinámica de Sistemas Atención médica Trasplante de riñón Sistema de obtención de órganos Programa de troca de rins Atendimento médico Transplante renal Sistema de aquisição de órgãos
dc.subject.armarc.eng.fl_str_mv	Health policy
dc.subject.proposal.eng.fl_str_mv	Kidney exchange program System Dynamics modeling Healthcare Kidney transplantation Organ procurement system
dc.subject.proposal.spa.fl_str_mv	Programa de intercambio de riñón Modelos de Dinámica de Sistemas Atención médica Trasplante de riñón Sistema de obtención de órganos
dc.subject.proposal.por.fl_str_mv	Programa de troca de rins Atendimento médico Transplante renal Sistema de aquisição de órgãos
description	Objective: This paper presents an analysis of two regulatory proposals in response to the growing demand for kidney transplants in Colombia. The results can be useful in evaluating these possible policy interventions once they have been implemented. Methods: The proposed model uses System Dynamics as a tool to understand the behavior of this complex social system if two intervention projects are executed. The first is a bill of law seeking to expand the legal presumption of organ donation. The second one is to implement a Kidney Exchange Program. The analysis is made in two parts. Firstly, a causal loop diagram is proposed. Secondly, the simulation of the system using a stock and flow diagram is analyzed. Results: Results show that the projects can balance the system and encourage donations. Conclusion: The implementation of a KEP is recommended since it achieves stability of the system earlier than the amendment to the law, with a reduction in the waiting list size.
publishDate	2019
dc.date.issued.none.fl_str_mv	2019
dc.date.accessioned.none.fl_str_mv	2021-06-25T20:20:04Z 2021-06-25T20:20:10Z 2021-10-01T17:37:35Z
dc.date.available.none.fl_str_mv	2021-06-25 2021-10-01T17:37:35Z
dc.type.spa.fl_str_mv	Artículo de revista
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dc.identifier.doi.none.fl_str_mv	10.11144/Javeriana.rgps18-36.kpsc
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identifier_str_mv	1657-7027 10.11144/Javeriana.rgps18-36.kpsc
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dc.language.iso.spa.fl_str_mv	eng
language	eng
dc.relation.citationedition.spa.fl_str_mv	Rev. Gerenc. Polit. Salud, Bogotá, Colombia, 18(36): enero-junio de 2019.
dc.relation.citationendpage.spa.fl_str_mv	27
dc.relation.citationissue.spa.fl_str_mv	36
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dc.relation.citationvolume.spa.fl_str_mv	18
dc.relation.indexed.spa.fl_str_mv	N/A
dc.relation.ispartofjournal.spa.fl_str_mv	Gerencia y Políticas de Salud
dc.relation.references.spa.fl_str_mv	Torres Zamudio C. Insuficiencia renal crónica. Revista Médica Herediana [Internet]. 2003; 14(1):1-4. Available from: http://www.upch.edu.pe/vrinve/dugic/revistas/index.php/RMH/article/view/764/730 Instituto Nacional de Salud. Informe ejecutivo red de donación y trasplantes [Internet].Bogotá, D.C.; 2015. Available from: https://www.ins.gov.co/Direcciones/RedesSaludPublica/DonacionOrganosYTejidos/Estadisticas/Informe%20Ejecutivo%20Donaci%C3%B3n%20y%20Trasplantes%202016.pdf Acuña-Merchán L, Sánchez-Quintero P, Soler LA. Situación de la enfermedad renal crónica [Internet]. Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, D.C., 2014. Available from: https://cuentadealtocosto.org/site/images/Publicaciones/Situacion%20de%20la%20ERC%20Colombia%202014.pdf Huang S-K, Lin MT, Chen HC, Huang SC, Wu SH. Epidemiology of Kawasaki disease: Prevalence from national database and future trends projection by system dynamics modeling. J Pediatr. 2013; 163(1):126-131. Available from: https://doi.org/10.1016/j.jpeds.2012.12.011 Shin N, Kwag T, Park S, Kim SY. Effects of operational } on the diffusion of epidemic disease: A system dynamics modeling of the merscov outbreak in South Korea. J Theor Biol. 2017; 421 (Supplement C), 39-50. Available from https://doi.org/10.1016/j.jtbi.2017.03.020 Kwak JY, Kwon OJ, Lee KS, Kang CM, Park HY, Kim JH. Exchange-donor program in renal transplantation: a single-center experience. Transplant Proc. 1999; 31(1):344-345. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10083136 Thiel G, Vogelbach P, Gurke L, Gasser T, Lehmann K, Voegele T, Kiss A, Kirste G. Crossover renal transplantation: hurdles to be cleared! Transplant Proc. 2001; 33(1):811-816. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11267078 Abraham DJ, Blum A, Sandholm T. Clearing algorithms for barter exchange markets: Enabling nationwide kidney exchanges. In Proceedings of the 8th ACM conference on Electronic commerce. 2007 Jun 11-15; San Diego, California. 2007 p. 295-304. Available from: https://www.cs.cmu.edu/~sandholm/kidneyExchange.EC07.withGrantInfo.pdf Saidman SL, Roth AE, Sonmez T, Utku M, Ünver, Delmonico FL. Increasing the opportunity of live kidney donation by matching for two-and three-way exchanges. Transplantation. 2006; 81(5):773-782. Available from: https://doi.org/10.1097/01.tp.0000195775.77081.25 Veale J, Hil G. National kidney registry: 213 transplants in three years. Clin Transpl. 2010; 333-344. Gurkan A, Kacar SH, Varilsuha C, Tilif S, Coker I, Karaca C, Karaoglan M. Exchange kidney transplantation: a good solution in living kidney transplantation. Transplant Proc. 2004. 36(10): 2952-2953. Available from http://hdl.handle.net/10822/986410 Lucan M. Five years of single-center experience with paired kidney exchange transplantation. Transplant Proc. 2007 39(5):1371-1375. Available from: https://doi.org/10.1016/j.transproceed.2007.02.081 Klerk MD, Keizer KM, Claas FHJ, Witvliet M, Haase-Kromwijk BJJM, Weimar W. The Dutch national living donor kidney exchange program. American Journal of Transplantation. 2005; 5(9):2302-2305. Available from: https://doi.org/10.1111/j.1600-6143.2005.01024.x Klerk M, Witvliet MD, Haase-Kromwijk BJJM, Claas FHJ, Weimar W. A highly efficient living donor kidney exchange program for both blood type and crossmatch incompatible donor-recipient combinations. Transplantation. 2006; 82(12):1616-1620. Available from: https://doi.org/10.1097/01.tp.0000250906.66728.8d Kranenburg L, Zuidema W, Weimar W, Hilhorst M, Ijzermans J, Passchier J, Busschbach J. Strategies to advance living kidney donation: a single center's experience. Progress in Transplantation. 2009;19(1):71-75. Available from: https://doi.org/10.1177/152692480901900110 Biro P, Manlove DF, Rizzi R. Maximum weight cycle packing in directed graphs, with application to kidney exchange programs. Discrete Mathematics, Algorithms and Applications. 2009;1(04):499-517. Available from: http://eprints.gla.ac.uk/25732/ Johnson RJ, Allen JE, Fuggle SV, Bradley JA, Rudge C, et al. Early experience of paired living kidney donation in the United Kingdom. Transplantation. 2008;86(12):1672-1677. Available from: https://doi.org/10.1097/TP.0b013e3181901a3d. Manlove DF, Omalley G. Paired and altruistic kidney donation in the UK: Algorithms and experimentation. J of Experimental Algorithmics. 2015; 19:2-6. Available from 10.1145/2670129 Ellison B. A systematic review of kidney paired donation: Applying lessons from historic and contemporary case studies to improve the U.S. model. Wharton Research Scholars. 2014. Available from: https://repository.upenn.edu/wharton_research_scholars/107/ Fakkert S, Schwarz P, Pruyt E. Kidney transplantations in the United States: A system dynamics approach to reduce the waiting list and illegal tracking. In Proceedings of the 33rd International Conference of the System Dynamics Society. 2015; 1-13. Roth AE. What have we learned from market design? The Economic Journal. 2008; 118(527):285-310. Available from: https://doi.org/10.1111/j.1468-0297.2007.02121.x Paricio I, Figal J. A system dynamics model of the kidney transplants in the U.S. In Proceedings of the 33rd International Conference of the System Dynamics Society. 2015;1-23. Available from: https://www.systemdynamics.org/assets/conferences/2015/proceed/papers/P1171.pdf Bruni ME, Conforti D, Sicilia N, Trotta S. A new organ transplantation location-allocation policy: a case study of Italy. Health Care Management Science. 2006; 9(2):125-142. Fajardo-Vallejo E. Emparejamiento voluntario de riñón: Una propuesta para incrementar el número de trasplantes en Colombia. Bachelor thesis, Universidad de los Andes, 2013. Villa S, Patrone F. Incentive compatibility in kidney exchange problems. Health Care Management Science. 2008; 12(4):351-362. Available from: https://doi.org/10.1007/s10729-008-9089-0 Ahmadvand S, Pishvaee MS. An efficient method for kidney allocation problem: a credibility-based fuzzy common weights data envelopment analysis approach. Health Care Manag Sci. 2017; 1-17. https://doi.org/10.1007/s10729-017-9414-6 Ünver MU. Dynamic kidney exchange. The Review of Economic Studies. 2010; 77(1): 372-414. https://doi.org/10.1111/j.1467-937X.2009.00575.x Zenios SA. Optimal control of a paired-kidney exchange program. Management Science. 2002; 48(3):328-342. Available from: https://www.jstor.org/stable/822569 Thompson D, Waisanen L, Wolfe R, Merion RM, McCullough K, Rodgers A. Simulating the allocation of organs for transplantation. Health Care Manag Sci. 2004; 7(4):331-338. Available from: https://doi.org/10.1016/j.socscimed.2017.09.005 Sterman JD. Business dynamics: systems thinking and modeling for a complex world. Number HD30. 2 S7835 2000. McGraw-Hill, 2000. Chang AY, Ogbuoji O, Atun R, and Verguet S. Dynamic modeling approaches to characterize the functioning of health systems: A systematic review of the literature. Soc Sci Med.. 2017; 194(1) 160-167. https://doi.org/10.1016/j.socscimed.2017.09.005 Acuña-Merchán L, Sánchez-Quintero P, Soler LA, Piñeros L. Situación de la enfermedad renal crónica, hipertensión arterial y diabetes mellitus en Colombia. Technical report, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, D.C., 2015. Available from: https://cuentadealtocosto.org/site/images/Publicaciones/Situacion_ERC_HA_DM_Colombia_2016.pdf Ojo AO, Hanson JA, Meier-Kriesche H-U, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol. 2001; 12(3):589-597. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11181808 Acosta Roldán Y, Arias-Murillo YR, García S, Salinas Nova MA, Torres Aunta, E et al. Informe Anual Red De Donación Y Trasplantes Colombia Año 2015. Technical Report. Instituto Nacional De Salud Coordinación Nacional Red Donación Y Trasplantes. Bogotá, D.C., Colombia, 2015. Online edition: ISSN 2256-408X. Available from: https://www.ins.gov.co/Direcciones/RedesSaludPublica/DonacionOrganosYTejidos/Estadisticas/Informe%20Red%20de%20Donaci%C3%B3n%20y%20Trasplante%202015.pdf Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, et al. Prevalence of chronic kidney disease in the United States. Jama. 2007; 298(17):2038-2047.
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dc.publisher.spa.fl_str_mv	Pontificia Universidad Javeriana
dc.publisher.place.spa.fl_str_mv	Bogotá, Colombia.
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institution	Escuela Colombiana de Ingeniería Julio Garavito
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spelling	Cruz, Joan Paola243871432682ebc04dbbe5b4de703eb5600Guerrero Rueda, William J.cbeae8cf9f84f9d7858cf33daff93439600Pérez, Edna Rocíob8aa29ed1d7be1d32e24427f68bfa3ea600Lizarazo Walteros, David Leonardo5f6915f1567a1c981d75e659316ba3ba600Rico Ardila, Paula Carolinab1c79976a508fcd7b13b185fa0fa49eb600Castillo, Ana María3fa462f27c62a8ba35e7eab4e8af7eaf600Torres Tinjacá, Laura Natalia9e60ed36d9f1b2076c341b303f8eb19e6002021-06-25T20:20:04Z2021-06-25T20:20:10Z2021-10-01T17:37:35Z2021-06-252021-10-01T17:37:35Z20191657-7027https://repositorio.escuelaing.edu.co/handle/001/160410.11144/Javeriana.rgps18-36.kpschttps://doi.org/10.11144/Javeriana.rgps18-36.kpscObjective: This paper presents an analysis of two regulatory proposals in response to the growing demand for kidney transplants in Colombia. The results can be useful in evaluating these possible policy interventions once they have been implemented. Methods: The proposed model uses System Dynamics as a tool to understand the behavior of this complex social system if two intervention projects are executed. The first is a bill of law seeking to expand the legal presumption of organ donation. The second one is to implement a Kidney Exchange Program. The analysis is made in two parts. Firstly, a causal loop diagram is proposed. Secondly, the simulation of the system using a stock and flow diagram is analyzed. Results: Results show that the projects can balance the system and encourage donations. Conclusion: The implementation of a KEP is recommended since it achieves stability of the system earlier than the amendment to the law, with a reduction in the waiting list size.Objetivo: Este artículo presenta un análisis de dos propuestas de regulación en respuesta a la creciente demanda de trasplantes de riñón en Colombia. Los resultados pueden ser útiles al evaluar esas posibles intervenciones en las políticas una vez han sido implementadas. Métodos: El modelo propuesto emplea la Dinámica de Sistemas como herramienta para entender el comportamiento de este complejo sistema social cuando se ejecutan dos proyectos de intervención. El primero es un proyecto de ley que buscan expandir la presunción legal de la donación del órgano. El segundo es la implementación de un Programa de intercambio de riñones (KEP). El análisis se realiza en dos partes: primero se propone un diagrama causal; en segundo lugar, se analiza la simulación del sistema usando un diagrama de existencias y flujos. Resultados: Los resultados muestran que los proyectos pueden equilibrar el sistema y motivar las donaciones. Conclusión: Se recomienda la implementación de un programa KEP dado que logra la estabilidad del sistema antes que la enmienda de las leyes, con una reducción en el tamaño de la lista de esperaObjetivo: Este artigo apresenta análise de duas propostas regulatórias em resposta à crescente demanda por transplantes renais na Colômbia. Os resultados podem ser úteis na avaliação das possíveis intervenções nas políticas, uma vez implementadas. Métodos: O modelo proposto usa a Dinâmica de Sistemas como uma ferramenta para compreender o comportamento desse complexo sistema social quando executados dois projetos de intervenção. O primeiro é um projeto de lei visando expandir a presunção legal da doação de órgãos. O segundo é a implementação de um Programa de troca de rins (KEP). A análise é realizada em duas partes: primeiro propõe-se diagrama causal; segundo, analisa-se a simulação do sistema usando um diagrama de estoque e fluxo. Resultados: Os resultados mostram que os projetos podem equilibrar o sistema e motivar as doações. Conclusão: Recomenda-se a implementação de um programa KEP uma vez que alcança a estabilidade do sistema antes da alteração das leis, com uma redução no tamanho da lista de espera.Corresponding author. E-mail: william.guerrero1@unisabana.edu.co27 páginasapplication/pdfengPontificia Universidad JaverianaBogotá, Colombia.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessAtribución 4.0 Internacional (CC BY 4.0)http://purl.org/coar/access_right/c_abf2https://revistas.javeriana.edu.co/index.php/gerepolsal/article/view/26143Kidney Procurement System in Colombia: A System Dynamics ApproachSistema de obtención de riñones en Colombia: un enfoque basado en la Dinámica de SistemasSistema de obtenção de rins na Colômbia: uma abordagem baseada na Dinâmica de SistemasArtículo de revistainfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85Rev. Gerenc. Polit. Salud, Bogotá, Colombia, 18(36): enero-junio de 2019.2736118N/AGerencia y Políticas de SaludTorres Zamudio C. Insuficiencia renal crónica. Revista Médica Herediana [Internet]. 2003; 14(1):1-4. Available from: http://www.upch.edu.pe/vrinve/dugic/revistas/index.php/RMH/article/view/764/730Instituto Nacional de Salud. Informe ejecutivo red de donación y trasplantes [Internet].Bogotá, D.C.; 2015. Available from: https://www.ins.gov.co/Direcciones/RedesSaludPublica/DonacionOrganosYTejidos/Estadisticas/Informe%20Ejecutivo%20Donaci%C3%B3n%20y%20Trasplantes%202016.pdfAcuña-Merchán L, Sánchez-Quintero P, Soler LA. Situación de la enfermedad renal crónica [Internet]. Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, D.C., 2014. Available from: https://cuentadealtocosto.org/site/images/Publicaciones/Situacion%20de%20la%20ERC%20Colombia%202014.pdfHuang S-K, Lin MT, Chen HC, Huang SC, Wu SH. Epidemiology of Kawasaki disease: Prevalence from national database and future trends projection by system dynamics modeling. J Pediatr. 2013; 163(1):126-131. Available from: https://doi.org/10.1016/j.jpeds.2012.12.011Shin N, Kwag T, Park S, Kim SY. Effects of operational } on the diffusion of epidemic disease: A system dynamics modeling of the merscov outbreak in South Korea. J Theor Biol. 2017; 421 (Supplement C), 39-50. Available from https://doi.org/10.1016/j.jtbi.2017.03.020Kwak JY, Kwon OJ, Lee KS, Kang CM, Park HY, Kim JH. Exchange-donor program in renal transplantation: a single-center experience. Transplant Proc. 1999; 31(1):344-345. Available from: https://www.ncbi.nlm.nih.gov/pubmed/10083136Thiel G, Vogelbach P, Gurke L, Gasser T, Lehmann K, Voegele T, Kiss A, Kirste G. Crossover renal transplantation: hurdles to be cleared! Transplant Proc. 2001; 33(1):811-816. Available from: https://www.ncbi.nlm.nih.gov/pubmed/11267078Abraham DJ, Blum A, Sandholm T. Clearing algorithms for barter exchange markets: Enabling nationwide kidney exchanges. In Proceedings of the 8th ACM conference on Electronic commerce. 2007 Jun 11-15; San Diego, California. 2007 p. 295-304. Available from: https://www.cs.cmu.edu/~sandholm/kidneyExchange.EC07.withGrantInfo.pdfSaidman SL, Roth AE, Sonmez T, Utku M, Ünver, Delmonico FL. Increasing the opportunity of live kidney donation by matching for two-and three-way exchanges. Transplantation. 2006; 81(5):773-782. Available from: https://doi.org/10.1097/01.tp.0000195775.77081.25Veale J, Hil G. National kidney registry: 213 transplants in three years. Clin Transpl. 2010; 333-344.Gurkan A, Kacar SH, Varilsuha C, Tilif S, Coker I, Karaca C, Karaoglan M. Exchange kidney transplantation: a good solution in living kidney transplantation. Transplant Proc. 2004. 36(10): 2952-2953. Available from http://hdl.handle.net/10822/986410Lucan M. Five years of single-center experience with paired kidney exchange transplantation. Transplant Proc. 2007 39(5):1371-1375. 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Jama. 2007; 298(17):2038-2047.Riñones - Trasplante (Colombia)Donación de órganos - ColombiaPolítica de la salud - ColombiaHealth policyKidney exchange programSystem Dynamics modelingHealthcareKidney transplantationOrgan procurement systemPrograma de intercambio de riñónModelos de Dinámica de SistemasAtención médicaTrasplante de riñónSistema de obtención de órganosPrograma de troca de rinsAtendimento médicoTransplante renalSistema de aquisição de órgãosTEXT10.11144/Javeriana.rgps18-36.kpsc.pdf.txt10.11144/Javeriana.rgps18-36.kpsc.pdf.txtExtracted texttext/plain59429https://repositorio.escuelaing.edu.co/bitstream/001/1604/3/10.11144/Javeriana.rgps18-36.kpsc.pdf.txt43d9bc6eb444228230c1043dfba79493MD53open accessKidney Procurement System in Colombia: A System Dynamics Approach.pdf.txtKidney Procurement System in Colombia: A System Dynamics Approach.pdf.txtExtracted texttext/plain59429https://repositorio.escuelaing.edu.co/bitstream/001/1604/5/Kidney%20Procurement%20System%20in%20Colombia%3a%20A%20System%20Dynamics%20Approach.pdf.txt43d9bc6eb444228230c1043dfba79493MD55open accessTHUMBNAIL10.11144/Javeriana.rgps18-36.kpsc.pdf.jpg10.11144/Javeriana.rgps18-36.kpsc.pdf.jpgGenerated Thumbnailimage/jpeg10684https://repositorio.escuelaing.edu.co/bitstream/001/1604/4/10.11144/Javeriana.rgps18-36.kpsc.pdf.jpgf3ed4c5b11bef04e41eeb71ce2815f5fMD54open accessKidney Procurement System in Colombia: A System Dynamics Approach.pdf.jpgKidney Procurement System in Colombia: A System Dynamics Approach.pdf.jpgGenerated Thumbnailimage/jpeg10684https://repositorio.escuelaing.edu.co/bitstream/001/1604/6/Kidney%20Procurement%20System%20in%20Colombia%3a%20A%20System%20Dynamics%20Approach.pdf.jpgf3ed4c5b11bef04e41eeb71ce2815f5fMD56open accessLICENSElicense.txttext/plain1881https://repositorio.escuelaing.edu.co/bitstream/001/1604/1/license.txt5a7ca94c2e5326ee169f979d71d0f06eMD51open accessORIGINALKidney Procurement System in Colombia: A System Dynamics Approach.pdfapplication/pdf1905325https://repositorio.escuelaing.edu.co/bitstream/001/1604/2/Kidney%20Procurement%20System%20in%20Colombia%3a%20A%20System%20Dynamics%20Approach.pdf28a60a1734218fec57b76169f45e5317MD52open access001/1604oai:repositorio.escuelaing.edu.co:001/16042022-09-09 03:00:34.701open accessRepositorio Escuela Colombiana de Ingeniería Julio Garavitorepositorio.eci@escuelaing.edu.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

Kidney Procurement System in Colombia: A System Dynamics Approach

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