This page is designed to give donors a standardized method for evaluating the impact of their charitable donations. Donors will find this process to be helpful when evaluating programs that are meant to deliver one or more of the following outcomes:
In order to standardize the evaluation process for various charities we use a variation of a calculation called Quality Adjusted Life Years (QALYs). In the information below we offer a detailed explanation of the evaluation process, provide a 'do-it-yourself' calculator, and point out the strengths and limitations of using this process to compare orgranizations.
- Increase the quality of life for beneficiaries
- Extend the length of life for beneficiaries
In order to standardize the evaluation process for various charities we use a variation of a calculation called Quality Adjusted Life Years (QALYs). In the information below we offer a detailed explanation of the evaluation process, provide a 'do-it-yourself' calculator, and point out the strengths and limitations of using this process to compare orgranizations.
If you are a donor seeking a turn-key solution we encourage you to donate to one of our vetted programs - Save A Life, Fight Poverty, Save A Soul - as these programs where selected using similar measurements; the results for which are detailed on each program page.
Use the table of contents below to navigate this page more effectively.
Use the table of contents below to navigate this page more effectively.
WHAT IS A QALY?
Quality Adjusted Life Years, or QALYs are used to measure both the quality and quantity of life added due to an intervention. This measurement has been used as an economic evaluation to assess the value of money for medical interventions since roughly 1976. We use similar QALY calculation methods to determine the effectiveness of charitable programs, which allows us to level the playing field between two or more programs that may have completely different interventions.
Our goal when using these calculations is to find the lowest possible cost per Quality Adjusted Life Year ($/QALY) as a way to measure effectiveness between different charitable interventions.
Our goal when using these calculations is to find the lowest possible cost per Quality Adjusted Life Year ($/QALY) as a way to measure effectiveness between different charitable interventions.
WHY ARE QALY CALCULATIONS SOMETIME UNIQUE TO EACH DONOR?
As you will see, part of the QALY calculation requires us to measure the quality of life. Depending on which calculation method is used, this measurement is sometimes subjective and may vary from one donor to the next. For donors that want final metrics to closely match their personal moral position, we use tool called a Visual Analog Scale to determine the quality of life metric.
For donors that prefer to rely on aggregate data from others, we provide a reverse disability weight table created using data from World Health Organization*. However, this data is limited to a select number of disease burdens and may not be helpful for evaluating charities that fall outside the data provided in the table.
*Calculations for the reverse disability weight table use the inverse disability weights provided by the World Health Organization which they use to calculate disability adjusted life years (DALYs). We use the inverse of this data because DALYs are the inverse measurement to QALYs.
For donors that prefer to rely on aggregate data from others, we provide a reverse disability weight table created using data from World Health Organization*. However, this data is limited to a select number of disease burdens and may not be helpful for evaluating charities that fall outside the data provided in the table.
*Calculations for the reverse disability weight table use the inverse disability weights provided by the World Health Organization which they use to calculate disability adjusted life years (DALYs). We use the inverse of this data because DALYs are the inverse measurement to QALYs.
HOW TO CALCULATE A QALY
QALY = (YEARS OF LIFE ADDED x QUALITY OF LIFE ADDED)+(REMAINING LIFE EXPECTANCY X QUALITY OF LIFE ADDED)
Click Here to download the PIF Foundation QALY calculator. Detailed instructions for using this calculator can be found below.
Click Here to download the PIF Foundation QALY calculator. Detailed instructions for using this calculator can be found below.
QALY CALCULATOR INPUT INSTRUCTIONS
Intervention Specific Inputs
Length of Life Inputs
Length of Life Inputs
- Average age of the target population. What is the average age of the population that will benefit from this intervention?
- Average life expectancy of target population without intervention. How long is the target population expected to live without exposure to the intervention? This number is important because it acts as our baseline to determine how effectively an intervention can add to the length of life for its beneficiaries.
- Click Here for a map of life expectancy by country.
- Average life expectancy of target population after intervention. How long is the target population expected to live after exposure to the intervention? This number is important because it helps to measure the potential benefit of the intervention in terms of additional life years.
QUALITY OF LIFE CALCULATION METHODS
There are two ways to calculate the quality of life for an intervention. Both are listed below:
Using the QALY Inverse Disability Weight Table Method
Using the QALY Inverse Disability Weight Table Method
- Within the calculator spreadsheet we include a table of Inverse Disability Weights for a large number of common disease burdens, provided by the World Health Organization. This table can be used as an example of the severity of various diseases and to assess the QALY Inverse Disability Weight for specific burdens that you may be looking to positively impact (malaria, HIV, schistosomiasis, etc.).
- Use the scale below to approximate what you believe to be the quality of life for a person before they receive the intervention that you are evaluating - assuming that the intervention (if successful) would result in a VAS score of 1 (Ideal Quality of Life).
SOCIAL PROGRESS SCORE
Find the score of the country where the program that you are evaluating primarily focuses on. If the program operates in multiple countries, use the average (weighted by population) of the countries. If the map does not load, please click here.
CHARITY SPECIFIC INPUTS
- Total organization expenses (during review period). This is an important measurement because it is used to calculated the true cost a specific intervention from a specific charity.
- Donors can obtain this information using this link to the Foundation Center where they can search for the organizations 990 - a public tax document that each charity must file.
- Number of intervention attempts. How many times during the review period did the charity that you are evaluating successfully acheive its intended outcome? Once you are clear on the intervention that you are looking to support as a donor, you can generally rely on organizations that you are evaluating to provide you with this information.
- Case Rate (%). What percentage of the target population that will receive the intervention would otherwise likely be impacted by the issue.
- Intervention Efficacy Rate (%). How effective is the intervention at achieving its intended outcome once implemented?
- Example: x% of people that receive a vaccine are cured.
BENCHMARK COMPARISONS
- Determine your Home or Away Multiple. This number helps to account for preferences that you may have towards "staying local". Click the link to learn how to calculate this number.
WHAT IS A GOOD QALY BENCHMARK FOR DONATIONS?
We set the baseline cost per QALY ($/QALY) benchmark at $500/QALY. It is our position that donors should seek to support programs that fall below the $500/QALY level if they are seeking a high-impact charitable investment.
LIMITATIONS OF THE QALY CALCULATOR
Quality of Information
In order to complete the calculator you will need to rely on third party information for some of the inputs. The results from your calculations will only be as a good as the data that you use in your inputs. Please make sure that the resources that you are relying on are reputable and obtain multiple data sources when possible.
QALY and DALY Disability Weight Tables
The QALY (Inverse Disability Weights) and the DALY (Disability Weights) provided are taken from the World Health Organization Global Burden of Disease 2004 Update. Some experts have criticized the scores in this study for reasons that are covered in this article. While we agree with some of these criticisms, we feel that using this data for the purpose of comparing disease burden provides a better starting point than other readily available alternatives. However, because of the shortcomings in this data we also provide donors with detailed instructions for calculating quality of life (the inverse of disease burden) on their own using the Visual Analog Scale (VAS) method. It is important to mention that the VAS method to determine quality of life also has limitations worth noting.
Visual Analog Scale
The Visual Analog Scale (VAS) allows donors to use their own judgment to determine the quality of life added to beneficiaries as a result of a specific intervention. This method of measuring quality of life is extremely subjective as it accounts for only a singular opinion with regards to disease burden or benefits of an intervention. However, because the score is a direct reflection of an individuals personal beliefs and/or moral compass, the results tend to skew towards personal preference - which some donors may prefer. Our official stance is that using this method is less desirable because of the high risk that results can be dramatically skewed from empirical evidence.
Diluting Results
It is important for donors seeking results subject with the lowest potential error rates to dilute certain inputs of each calculation which help account for natural flaws in any process. Examples of this can be found in the dilution factors of our case study for AMF. We use these numbers to approximate the actual impact that an intervention is likely to make, versus just accounting for the number of attempts that a proven intervention is implemented. In summary, we want the outcome to reflect the actual or statistical approximation of desired outcome for any intervention. If donors fail to appropriate dilute there inputs, the end results could be too aggressive.
Charity Specific Inputs
Data collected directly from charities has the probability to be skewed (many times unintentionally) because of bias factors. Our calculator attempts to limit the amount of data required directly from charities, but some data must be collected directly which means that the inputs have the potential to be subject to bias. Evaluating charities that incorporate a third party audit process on their results and financial information is encouraged.
In order to complete the calculator you will need to rely on third party information for some of the inputs. The results from your calculations will only be as a good as the data that you use in your inputs. Please make sure that the resources that you are relying on are reputable and obtain multiple data sources when possible.
QALY and DALY Disability Weight Tables
The QALY (Inverse Disability Weights) and the DALY (Disability Weights) provided are taken from the World Health Organization Global Burden of Disease 2004 Update. Some experts have criticized the scores in this study for reasons that are covered in this article. While we agree with some of these criticisms, we feel that using this data for the purpose of comparing disease burden provides a better starting point than other readily available alternatives. However, because of the shortcomings in this data we also provide donors with detailed instructions for calculating quality of life (the inverse of disease burden) on their own using the Visual Analog Scale (VAS) method. It is important to mention that the VAS method to determine quality of life also has limitations worth noting.
Visual Analog Scale
The Visual Analog Scale (VAS) allows donors to use their own judgment to determine the quality of life added to beneficiaries as a result of a specific intervention. This method of measuring quality of life is extremely subjective as it accounts for only a singular opinion with regards to disease burden or benefits of an intervention. However, because the score is a direct reflection of an individuals personal beliefs and/or moral compass, the results tend to skew towards personal preference - which some donors may prefer. Our official stance is that using this method is less desirable because of the high risk that results can be dramatically skewed from empirical evidence.
Diluting Results
It is important for donors seeking results subject with the lowest potential error rates to dilute certain inputs of each calculation which help account for natural flaws in any process. Examples of this can be found in the dilution factors of our case study for AMF. We use these numbers to approximate the actual impact that an intervention is likely to make, versus just accounting for the number of attempts that a proven intervention is implemented. In summary, we want the outcome to reflect the actual or statistical approximation of desired outcome for any intervention. If donors fail to appropriate dilute there inputs, the end results could be too aggressive.
Charity Specific Inputs
Data collected directly from charities has the probability to be skewed (many times unintentionally) because of bias factors. Our calculator attempts to limit the amount of data required directly from charities, but some data must be collected directly which means that the inputs have the potential to be subject to bias. Evaluating charities that incorporate a third party audit process on their results and financial information is encouraged.