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Sample records for care economic evaluation

  1. Payment and economic evaluation of integrated care

    Directory of Open Access Journals (Sweden)

    Apostolos Tsiachristas

    2015-04-01

    Full Text Available Chronic diseases have an increasingly negative impact on (1 population health by increasing morbidity and mortality, (2 society by increasing health inequalities and burden to informal caregivers, and (3 economy by requiring enormous financial resources and jeopardising macro-economic development (e.g. consumption, capital accumulation, labour productivity and labour supply. Integrated care is the most promising concept in redesigning care to tackle the increasing threat of chronic diseases. Several European countries have experimented with models for integrating care, most frequently in the form of disease management programmes. These models were often supported by payment schemes to provide financial incentives to health care providers for implementing integrated care. This thesis aimed to investigate these payment schemes and assess their impact, explore the variability in costs of disease management programmes, and determine the costs and effects of disease management programmes.

  2. Integrated care for diabetes: clinical, psychosocial, and economic evaluation. Diabetes Integrated Care Evaluation Team.

    OpenAIRE

    1994-01-01

    OBJECTIVES--To evaluate integrated care for diabetes in clinical, psychosocial, and economic terms. DESIGN--Pragmatic randomised trial. SETTING--Hospital diabetic clinic and three general practice groups in Grampian. PATIENTS--274 adult diabetic patients attending a hospital clinic and registered with one of three general practices. INTERVENTION--Random allocation to conventional hospital clinic care or integrated care. Integrated care patients seen in general practice every three or four mon...

  3. Decision analytic models, sensitivity analysis and value of information in economic evaluations in health care

    OpenAIRE

    Bischof, Matthias

    2010-01-01

    Economic evaluations of health care technologies are now commonly carried out to assess the economic value of new pharmaceuticals, medical devices and procedures. The aim of health economic evaluations is to measure, value and compare the costs and benefits of different health care interventions. To date, cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) are the two types of economic evaluations that are applied in the vast majority of economic evaluation studie...

  4. The Impact of Caregiving : The measurement and valuation of informal care for use in economic evaluations

    NARCIS (Netherlands)

    R.J. Hoefman (Renske)

    2015-01-01

    markdownabstractAbstract This thesis studied methods that facilitate the inclusion of informal care in economic evaluations of health care programmes. Economic evaluations that include informal care inform policy makers about the broader impact of interventions in society, and help them to alloca

  5. Economic evaluation in primary health care: the case of Western Kenya community based health care project.

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    Wang'ombe, J K

    1984-01-01

    This paper describes the methodology and presents preliminary results of an economic appraisal of a community based health care project in Kenya. Community health workers, trained for 12 weeks and deployed in two locations in Kenya's Western Province, act as first contact providers of basic health care and promoters of selected health, sanitation and nutrition practices. A Cost Benefit Analysis has been undertaken using the Willingness to Pay approach to compare the costs of the project and its benefits. The benefits are in the form of more easily accessible basic health care and are measured as consumer surplus accruing to the community. Gain in consumer surplus is consequent on the fall of average user costs and rise in utilisation of the project established points of first contact with primary health care. The argument for the economic viability of the project is validated by the large Net Present Value and Benefit Cost Ratio obtained for the whole of the project area and for the two locations separately. Although the evaluation technique used faces the problem of valuation of community time, aggregation of health care services at all points of first contact and the partial nature of cost benefit analysis evaluations, the results are strongly in favour of decentralisation of primary health care on similar lines in the rest of the country. PMID:6427933

  6. Economic Evaluation of Continuing Care Interventions in the Treatment of Substance Abuse: Recommendations for Future Research

    Science.gov (United States)

    Popovici, Ioana; French, Michael T.; McKay, James R.

    2008-01-01

    The chronic and relapsing nature of substance abuse points to the need for continuing care after a primary phase of treatment. This article reviews the economic studies of continuing care, discusses research gaps, highlights some of the challenges of conducting rigorous economic evaluations of continuing care, and offers research guidelines and…

  7. The state of the art of costing health care for economic evaluation.

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    Donaldson, C

    1990-01-01

    In this paper, the principles of costing health care for economic evaluation are outlined. Hypothetical and published examples are used to illustrate these principles. First, the economic concept of opportunity cost is defined. Secondly, the techniques of economic evaluation which follow from this definition are introduced: they are cost-benefit analysis, cost-effectiveness analysis and cost-utility analysis. Thirdly, a list of costs which should be considered for inclusion in either of these types of evaluation is provided, this listing being based on the concept of opportunity cost. Problems of measurement and valuation of costs are then outlined, focusing in particular on inflation, discounting, marginal costing, patient-based versus per diem costing, allocating overheads, costing capital and equipment and adjusting distorted market valuations. An example of sensitivity analysis is provided and also a checklist of questions to ask when setting up any costing exercise within an economic evaluation.

  8. An overview of methods and applications to value informal care in economic evaluations of healthcare.

    Science.gov (United States)

    Koopmanschap, Marc A; van Exel, Job N A; van den Berg, Bernard; Brouwer, Werner B F

    2008-01-01

    This paper compares several applied valuation methods for including informal care in economic evaluations of healthcare programmes: the proxy good method; the opportunity cost method; the contingent valuation method (CVM); conjoint measurement (CM); and valuation of health effects in terms of health-related quality of life (HR-QOL) and well-being. The comparison focuses on three questions: what outcome measures are available for including informal care in economic evaluations of healthcare programmes; whether these measures are compatible with the common types of economic evaluation; and, when applying these measures, whether all relevant aspects of informal care are incorporated. All types of economic evaluation can incorporate a monetary value of informal care (using the opportunity cost method, the proxy good method, CVM and CM) on the cost side of an analysis, but only when the relevant aspects of time costs have been valued. On the effect side of a cost-effectiveness or cost-utility analysis, the health effects (for the patient and/or caregiver) measured in natural units or QALYs can be combined with cost estimates based on the opportunity cost method or the proxy good method. One should be careful when incorporating CVM and CM in cost-minimization, cost-effectiveness and cost-utility analyses, as the health effects of patients receiving informal care and the carers themselves may also have been valued separately. One should determine whether the caregiver valuation exercise allows combination with other valuation techniques. In cost-benefit analyses, CVM and CM appear to be the best tools for the valuation of informal care. When researchers decide to use the well-being method, we recommend applying it in a cost-benefit analysis framework. This method values overall QOL (happiness); hence it is broader than just HR-QOL, which complicates inclusion in traditional health economic evaluations that normally define outcomes more narrowly. Using broader, non

  9. Effectiveness and economic evaluation of chiropractic care for the treatment of low back pain: a systematic review protocol

    OpenAIRE

    Blanchette, Marc-André; Bussières, André; Stochkendahl, Mette Jensen; Boruff, Jill; Harrison, Pamela

    2015-01-01

    Background Chiropractic care is a common treatment for low back pain (LBP). Previous studies have failed to clarify the relative cost-effectiveness of chiropractic care in comparison with other commonly used approaches because previous attempts to synthetize the economic literature has only included partial economic evaluations. The objective of this project is to estimate the clinical effectiveness and cost-effectiveness of chiropractic care compared to other commonly used care approaches am...

  10. Care in Feminist Economics

    OpenAIRE

    Hara, Nobuko; 原, 伸子

    2006-01-01

    This article reviews the literature in the field of care in terms of theconcept and methodology. This is an area that has been under theorisedin mainstream economics, but that has received considerable attentionover the last few decades by feminist economics. The provisioning ofcaring service is a social as well as an economic issue and it is increasinglydifficult even for conventional economics to consider caringactivities. The integration of caring situation into economic thinkingposes the ...

  11. A note on the depreciation of the societal perspective in economic evaluation of health care.

    Science.gov (United States)

    Johannesson, M

    1995-07-01

    It is common in cost-effectiveness analyses of health care to only include health care costs, with the argument that some fictive 'health care budget' should be used to maximize the health effects. This paper provides a criticism of the 'health care budget' approach to cost-effectiveness analysis of health care. It is argued that the approach is ad hoc and lacks theoretical foundation. The approach is also inconsistent with using a fixed budget as the decision rule for cost-effectiveness analysis. That is the case unless only costs that fall into a single annual actual budget are included in the analysis, which would mean that any cost paid by the patients should be excluded as well as any future cost changes and all costs that fall on other budgets. Furthermore the prices facing the budget holder should be used, rather than opportunity costs. It is concluded that the 'health care budget' perspective should be abandoned and the societal perspective reinstated in economic evaluation of health care.

  12. Effectiveness and Economic Evaluation of Chiropractic Care for the Treatment of Low Back Pain: A Systematic Review of Pragmatic Studies

    Science.gov (United States)

    Blanchette, Marc-André; Stochkendahl, Mette Jensen; Borges Da Silva, Roxane; Boruff, Jill; Harrison, Pamela; Bussières, André

    2016-01-01

    Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent

  13. Economic evaluation of care for the chronically ill: A literature review

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    R. Huijsman (Robbert)

    1995-01-01

    textabstractFinancial problems of governments and the consequent urge to set limits on health care growth have increased the importance of economic rationalization. A systematic review of the present body of knowledge might facilitate the need to set priorities in health care policies and research i

  14. Managed care and economic dynamics.

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    Riggs, J E

    1996-09-01

    Over the past several decades, health care delivery in the United States evolved in an environment lacking marketplace constraints. The unforeseen result was the current health care crisis--uncontrolled costs, shrinking access, and redundant technological capabilities. Managed care is a strategy to impose fiscal constraints on health care delivery. A diagrammatic analysis of the economic dynamics between consumers and producers in an open marketplace is compared with that of patients, providers, and payers under the health care scheme that produced the health care crisis and under managed care. Patient demands, expectations, and needs for health care are not subject to fiscal constraint under managed care since the dislinkage between consumer and payer still exits. Managed care does not impose true open marketplace fiscal constraints on health care delivery. Furthermore, any solution to the US health care crisis that used true marketplace fiscal constraints would necessitate fundamental changes in societal values concerning individual rights to health care.

  15. Differences in primary health care delivery to Australia’s Indigenous population: a template for use in economic evaluations

    Directory of Open Access Journals (Sweden)

    Ong Katherine S

    2012-09-01

    Full Text Available Abstract Background Health economics is increasingly used to inform resource allocation decision-making, however, there is comparatively little evidence relevant to minority groups. In part, this is due to lack of cost and effectiveness data specific to these groups upon which economic evaluations can be based. Consequently, resource allocation decisions often rely on mainstream evidence which may not be representative, resulting in inequitable funding decisions. This paper describes a method to overcome this deficiency for Australia’s Indigenous population. A template has been developed which can adapt mainstream health intervention data to the Indigenous setting. Methods The ‘Indigenous Health Service Delivery Template’ has been constructed using mixed methods, which include literature review, stakeholder discussions and key informant interviews. The template quantifies the differences in intervention delivery between best practice primary health care for the Indigenous population via Aboriginal Community Controlled Health Services (ACCHSs, and mainstream general practitioner (GP practices. Differences in costs and outcomes have been identified, measured and valued. This template can then be used to adapt mainstream health intervention data to allow its economic evaluation as if delivered from an ACCHS. Results The template indicates that more resources are required in the delivery of health interventions via ACCHSs, due to their comprehensive nature. As a result, the costs of such interventions are greater, however this is accompanied by greater benefits due to improved health service access. In the example case of the polypill intervention, 58% more costs were involved in delivery via ACCHSs, with 50% more benefits. Cost-effectiveness ratios were also altered accordingly. Conclusions The Indigenous Health Service Delivery Template reveals significant differences in the way health interventions are delivered from ACCHSs compared to

  16. Decision rules and uncertainty in the economic evaluation of health care technologies

    NARCIS (Netherlands)

    P.P. Sendi (Pedram)

    2005-01-01

    textabstractHealth is often regarded as the most precious good of all. This is frequently illustrated by the widespread opinion that no expense should be spared to maintain one's health. However, in most societies the awareness that health care expenditure should be controlled in one way or another

  17. Cost-effectiveness of a nurse-led case management intervention in general medical outpatients compared with usual care : An economic evaluation alongside a randomized controlled trial

    NARCIS (Netherlands)

    Latour, Corine H. M.; Bosmans, Judith E.; van Tulder, Maurits W.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

    2007-01-01

    Objective: The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care. Methods: Economic evaluation alongside a randomized controlled trial after being discharged home with 24 we

  18. Public health interventions: evaluating the economic evaluations

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    Martin Forster

    2013-10-01

    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  19. Economic Evaluation of Health IT.

    Science.gov (United States)

    Luzi, Daniela; Pecoraro, Fabrizio; Tamburis, Oscar

    2016-01-01

    Economic evaluation in health care supports decision makers in prioritizing interventions and maximizing the available limited resources for social benefits. Health Information Technology (health IT) constitutes a promising strategy to improve the quality and delivery of health care. However, to determine whether the appropriate health IT solution has been selected in a specific health context, its impact on the clinical and organizational process, on costs, on user satisfaction as well as on patient outcomes, a rigorous and multidimensional evaluation analysis is necessary. Starting from the principles of evaluation introduced since the mid-1980s within the Health Technology Assessment (HTA) guidelines, this contribution provides an overview of the main challenging issues related to the complex task of performing an economic evaluation of health IT. A set of necessary key principles to deliver a proper design and implementation of a multidimensional economic evaluation study is described, focusing in particular on the classification of costs and outcomes as well as on the type of economic analysis to be performed. A case study is eventually described to show how the key principles introduced are applied. PMID:27198101

  20. The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand

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    Russell Steve

    2008-09-01

    Full Text Available Abstract Background This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Methods Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Results Twenty six out of 36 (72% respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17% whose decisions were influenced by economic evaluation evidence. Conclusion This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

  1. Who can afford health care? Evaluating the socio-economic conditions and the ability to contribute to health care in a post-conflict area in DR Congo.

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    Sibylle Gerstl

    Full Text Available INTRODUCTION: The Democratic Republic of the Congo is today one of the poorest countries in the world; the health status of the population ranks among the worst in Sub-Saharan Africa. Public health services charge user fees and drug prices. Since 2008, north-eastern Congo is facing a guerrilla war. Malteser International is assisting with free health care for internally displaced persons as well as the general population. Before the incursion the health system was based on user fees. The aim of this study was to determine the socio-economic conditions of the population and to assess their ability to contribute to health care. METHODOLOGY: Heads of 552 randomly selected households in 23 clusters in two health zones were interviewed using a standardised questionnaire. FINDINGS: The demographic description and socio-economic conditions of the study population were homogenous. Major source of income was agriculture (57%; 47% of the households earned less than US$ 5.5/week. Ninety-two percent of the interviewed households estimated that they would be able to contribute to consultation fees (maximum amount of US$ 0.27 and 79% to the drug prices (maximum amount of US$ 1.10. Six percent opted for free consultations and 19% for free drugs. CONCLUSIONS: Living conditions were very basic; the estimated income of the study population was low. Almost half of the population perceived their current living situation as fairly good/good. More than 90% of the study population estimated to be able to contribute to consultation fees and 80% to drug prices. As a result Malteser International suggested introducing flat-rates for health care services. Once the project ends, the population will have to pay again for their health service. One solution would be the introduction of a health care financing system with the goal to reach universal coverage to health care.

  2. Evaluating economic impacts

    OpenAIRE

    2014-01-01

    Should a value be put on nature? On what basis can it be evaluated? Although disagreements persist as to the legitimacy of such evaluations, many economists think that economics can usefully be applied to the mechanisms leading to destruction of natural environments. Ecological and human systems are closely intertwined. The aim of an evaluation is to pro-vide tools on which to base environmental policy. But there has to be agreement as to the methods and criteria to apply. For the United Stat...

  3. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

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    Langer Astrid

    2009-07-01

    Full Text Available Abstract Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Methods On the basis of an extensive explorative search, an appropriate algorithm for a systematic database search was developed. The following databases were searched: BIOSIS Previews, CRD databases, Cochrane Library, EconLit, Embase, Medline, and Web of Science. Only completed and published trial- or model-based studies which contained a full economic evaluation of growth factors and bioengineered skin substitutes for the treatment of chronic wounds were included. Two reviewers independently undertook the assessment of study quality. The relevant studies were assessed by a modified version of the Consensus on Health Economic Criteria (CHEC list and a published checklist for evaluating model-based economic evaluations. Results Eleven health economic evaluations were included. Three biotechnology products were identified for which topical growth factors or bioengineered skin substitutes for the treatment of chronic leg ulceration were economically assessed: (1 Apligraf®, a bilayered living human skin equivalent indicated for the treatment of diabetic foot and venous leg ulcers (five studies; (2 Dermagraft®, a human fibroblast-derived dermal substitute, which is indicated only for use in the treatment of full-thickness diabetic foot ulcers (one study; (3 REGRANEX® Gel, a human platelet-derived growth factor for the treatment of deep neuropathic diabetic foot ulcers (five studies. The studies considered in this review were of varying and partly low

  4. Forecast model for the evaluation of economic resources employed in the health care of patients with HIV infection

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    Sacchi P

    2012-05-01

    Full Text Available Paolo Sacchi1, Savino FA Patruno1, Raffaele Bruno1, Serena Maria Benedetta Cima1, Pietro Previtali2, Alessia Franchini2, Luca Nicolini3, Carla Rognoni4, Lucia Sacchi5, Riccardo Bellazzi4, Gaetano Filice11Divisione di Malattie Infettive e Tropicali - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; 2Università degli Studi di Pavia – Facoltà di Economia, Pavia, Italy; 3Controllo di Gestione Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy; 4Dipartimento di Informatica e Sistemistica, Universita' degli Studi di Pavia, Pavia, Italy; 5Department of Information Systems and Computing, Brunel University, London, UKBackground and aims: The total health care cost for human immunodeficiency virus (HIV patients has constantly grown in recent years. To date, there is no information about how this trend will behave over the next few years. The aim of the present study is to define a pharmacoeconomic model for the forecast of the costs of a group of chronically treated patients followed over the period 2004–2009.Methods: A pharmacoeconomics model was built to describe the probability of transition among different health states and to modify the therapy over time. A Markov model was applied to evaluate the temporal evolution of the average cost. The health care resources exploited during hospitalization were analyzed by using an “activity-based costing” method.Results: The Markov model showed that the mean total cost, after an initial increase, tended to remain stable. A total of 20 clinical records were examined. The average daily cost for each patient was EUR 484.42, with a cost for admission of EUR 6781.88.Conclusion: The treatment of HIV infection in compliance with the guidelines is also effective from the payer perspective, as it allows a good health condition to be maintained and reduces the need and the costs of hospitalizations.Keywords: health care cost, HIV, Markov model, activity-based costing

  5. An economic evaluation alongside a randomized controlled trial evaluating an individually tailored lifestyle intervention compared with usual care in people with Familial Hypercholesterolemia.

    NARCIS (Netherlands)

    Broekhuizen, K.; Wier, M.F. van; Koppes, L.L.J.; Brug, J.; Mechelen, W. van; Bosmans, J.E.; Poppel, M.N.M. van

    2015-01-01

    Background: Cost-effectiveness analyses provide insight in the use of lifestyle interventions. To evaluate the cost-effectiveness of a lifestyle intervention compared to usual care in people with Familial Hypercholesterolemia, 340 people with FH were randomized to the intervention or control group.

  6. An economic evaluation alongside a randomized controlled trial evaluating an individually tailored lifestyle intervention compared with usual care in people with Familial Hypercholesterolemia

    NARCIS (Netherlands)

    Broekhuizen, K.; Wier, M.F. van; Koppes, L.L.J.; Brug, J.; Mechelen, W. van; Bosmans, J.E.; Poppel, M.N.

    2015-01-01

    Background: Cost-effectiveness analyses provide insight in the use of lifestyle interventions. To evaluate the cost-effectiveness of a lifestyle intervention compared to usual care in people with Familial Hypercholesterolemia, 340 people with FH were randomized to the intervention or control group.

  7. Informal care: an economic approach

    NARCIS (Netherlands)

    B. van den Berg (Bernard)

    2005-01-01

    textabstractIn the 1970s and 1980s health care expenditures increased excessively, both in absolute numbers and as a share of the gross domestic product (GDP). Table 1.1 shows the total expenditures on health care as percentage of the GDP in thirteen OECD countries.

  8. Productivity Costs in Economic Evaluations

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    H.M. Krol (Marieke)

    2012-01-01

    textabstractThe increase in health expenditures has raised important questions about the appropriate height of health care spending as well as the justification of these expenditures. One tool in the search of ensuring the optimal allocation of scarce societal and health care resources is economic e

  9. Unpaid work in health economic evaluations.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner

    2015-11-01

    Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. PMID:26421997

  10. Value for money: economic evaluation of two different caries prevention programmes compared with standard care in a randomized controlled trial

    NARCIS (Netherlands)

    J.H. Vermaire; C. van Loveren; W.B.F. Brouwer; M. Krol

    2014-01-01

    A cost-effectiveness analysis was conducted during a 3-year randomized controlled clinical trial in a general dental practice in the Netherlands in which 230 6-year-old children (± 3 months) were assigned to either regular dental care, an increased professional fluoride application (IPFA) programme

  11. Value for Money: Economic Evaluation of Two Different Caries Prevention Programmes Compared with standard Care in a Randomized Controlled Trial

    NARCIS (Netherlands)

    Vermaire, J.H.; Loveren, C. van; Brouwer, W.B.F.; Krol, M.

    2014-01-01

    A cost-effectiveness analysis was conducted during a 3-year randomized controlled clinical trial in a general dental practice in the Netherlands in which 230 6-year-old children (± 3 months) were assigned to either regular dental care, an increased professional fluoride application (IPFA) programme

  12. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    2006-01-01

    Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

  13. An Economic Evaluation of TENS in Addition to Usual Primary Care Management for the Treatment of Tennis Elbow: Results from the TATE Randomized Controlled Trial

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    Lewis, Martyn; Chesterton, Linda S.; Sim, Julius; Mallen, Christian D.; Hay, Elaine M.; van der Windt, Daniëlle A.

    2015-01-01

    Background The TATE trial was a multicentre pragmatic randomized controlled trial of supplementing primary care management (PCM)–consisting of a GP consultation followed by information and advice on exercises–with transcutaneous electrical nerve stimulation (TENS), to reduce pain intensity in patients with tennis elbow. This paper reports the health economic evaluation. Methods and Findings Adults with new diagnosis of tennis elbow were recruited from 38 general practices in the UK, and randomly allocated to PCM (n = 120) or PCM plus TENS (n = 121). Outcomes included reduction in pain intensity and quality-adjusted-life-years (QALYs) based on the EQ5D and SF6D. Two economic perspectives were evaluated: (i) healthcare–inclusive of NHS and private health costs for the tennis elbow; (ii) societal–healthcare costs plus productivity losses through work absenteeism. Mean outcome and cost differences between the groups were evaluated using a multiple imputed dataset as the base case evaluation, with uncertainty represented in cost-effectiveness planes and through probabilistic cost-effectiveness acceptability curves). Incremental healthcare cost was £33 (95%CI -40, 106) and societal cost £65 (95%CI -307, 176) for PCM plus TENS. Mean differences in outcome were: 0.11 (95%CI -0.13, 0.35) for change in pain (0–10 pain scale); -0.015 (95%CI -0.058, 0.029) for QALYEQ5D; 0.007 (95%CI -0.022, 0.035) for QALYSF6D (higher score differences denote greater benefit for PCM plus TENS). The ICER (incremental cost effectiveness ratio) for the main evaluation of mean difference in societal cost (£) relative to mean difference in pain outcome was -582 (95%CI -8666, 8113). However, incremental ICERs show differences in cost–effectiveness of additional TENS, according to the outcome being evaluated. Conclusion Our findings do not provide evidence for or against the cost-effectiveness of TENS as an adjunct to primary care management of tennis elbow. PMID:26317528

  14. An Economic Evaluation of TENS in Addition to Usual Primary Care Management for the Treatment of Tennis Elbow: Results from the TATE Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Martyn Lewis

    Full Text Available The TATE trial was a multicentre pragmatic randomized controlled trial of supplementing primary care management (PCM-consisting of a GP consultation followed by information and advice on exercises-with transcutaneous electrical nerve stimulation (TENS, to reduce pain intensity in patients with tennis elbow. This paper reports the health economic evaluation.Adults with new diagnosis of tennis elbow were recruited from 38 general practices in the UK, and randomly allocated to PCM (n = 120 or PCM plus TENS (n = 121. Outcomes included reduction in pain intensity and quality-adjusted-life-years (QALYs based on the EQ5D and SF6D. Two economic perspectives were evaluated: (i healthcare-inclusive of NHS and private health costs for the tennis elbow; (ii societal-healthcare costs plus productivity losses through work absenteeism. Mean outcome and cost differences between the groups were evaluated using a multiple imputed dataset as the base case evaluation, with uncertainty represented in cost-effectiveness planes and through probabilistic cost-effectiveness acceptability curves. Incremental healthcare cost was £33 (95%CI -40, 106 and societal cost £65 (95%CI -307, 176 for PCM plus TENS. Mean differences in outcome were: 0.11 (95%CI -0.13, 0.35 for change in pain (0-10 pain scale; -0.015 (95%CI -0.058, 0.029 for QALYEQ5D; 0.007 (95%CI -0.022, 0.035 for QALYSF6D (higher score differences denote greater benefit for PCM plus TENS. The ICER (incremental cost effectiveness ratio for the main evaluation of mean difference in societal cost (£ relative to mean difference in pain outcome was -582 (95%CI -8666, 8113. However, incremental ICERs show differences in cost-effectiveness of additional TENS, according to the outcome being evaluated.Our findings do not provide evidence for or against the cost-effectiveness of TENS as an adjunct to primary care management of tennis elbow.

  15. Economic evaluation of KALIMER

    International Nuclear Information System (INIS)

    The main results of this study are as follows. To estimate the economic feasibility of KALIMER, the cost estimate model has been developed by using MS Excel software. Two scenarios were considered in this study. Scenario-A is composed of KALIMER options, which have FC1B (first commercial plant with 1 block), FC3B (first commercial plant with 3 blocks), NOAK1B (Nth-of-a-kind plant with 1 block), NOAK3B(Nth-of-a-kind plant with 3 blocks). The size of each block is 333 MWe. Scenario-B is comprised of PWR options, which have existing PWRs and new concepts of advanced PWR (APWR) in order to compare with KALIMER options. According to the results, the specific capital cost ($/kWe) and the levelized busbar cost (mills/kWh) for the NOAK3B option are 11% and 12% lower than that of FC3B option, respectively. These results from learning effects, scaling factors and some reductions of material and labor requirements for the NOAK3B option. And the levelized capital cost of NOAK3B option is 17%, 6% lower than that of existing PWR and APWR option, respectively. These results form shorten of construction times and labor requirements, modularization and design simplications etc. Therefore, decision and policy maker related to KALIMER development must note through the results of this study that multi-blocks design concept for its commercial plant should be considered to get the economy of scale effects. KALIMER has high competitiveness comparing to the existing PWRs and APWR. Therefore, it should be considered as a power supply option in the future in Korea. (author). 7 refs., 17 tabs., 7 figs

  16. Organizational economics and health care markets.

    Science.gov (United States)

    Robinson, J C

    2001-04-01

    As health policy emphasizes the use of private sector mechanisms to pursue public sector goals, health services research needs to develop stronger conceptual frameworks for the interpretation of empirical studies of health care markets and organizations. Organizational relationships should not be interpreted exclusively in terms of competition among providers of similar services but also in terms of relationships among providers of substitute and complementary services and in terms of upstream suppliers and downstream distributors. This article illustrates the potential applicability of transactions cost economics, agency theory, and organizational economics more broadly to horizontal and vertical markets in health care. Examples are derived from organizational integration between physicians and hospitals and organizational conversions from nonprofit to for-profit ownership. PMID:11327173

  17. Economic Evaluation of Multiphase Meters

    OpenAIRE

    Samuel S. MOFUNLEWI; Joseph. A. AJIENKA

    2007-01-01

    When operators must decide between a traditional approach to the production facilities and one including multiphase flow meters (MPFM), they must compare the capital and operating expenditures (CAPEX and OPEX) of each solution. In order to achieve this, CAPEX and OPEX for the same brand of test separator and multiphase flow meter were obtained.A deterministic economic model was developed for evaluating the economics of MPFM and Test Separators. Two cases were considered. Case A considered whe...

  18. [Economics of health care in Mali].

    Science.gov (United States)

    Coulibaly, S O; Keita, M

    1996-01-01

    From the results obtained regarding the financing of health care in Mali, we emphasize two important points. First, there is a lack of criteria for the distribution of finding in the health care sector, resulting in a waste of resources. Secondly, there is an absence of adequate pharmaceutical policies. The field studies led in 1987 provided the following observations. The rate of occupation of the beds is very low. Also, the numerous new investments are not yet put into service because of the lack of necessary equipment of qualified personnel. In addition, this does not consider the excessive investments occurring in certain localities where neither the rate of frequentation nor the economic conditions will ever allow the use of the capacity created. Among the possible solutions for the crisis of health care funding in Mali, the following should be priority: first, to fight against the complete lack of organization of the activities at the health care centers; secondly, to fight against the waste and misappropriation of money resulting from the behavior of the medical and paramedical personnel: and thirdly, to clarify the management of the resources coming from the charges for each service. The pharmaceutical policies adopted and implemented in recent years Largely contributed to, first, the creation of competition between essential generic medications and nongeneric medications that can be replaced, and then, the destruction of the public network of drug distribution. These conditions considerably limited the distribution of essential medications; yet, this is the only manner of reducing the pharmaceutical expenses and accordingly, allowing more funding for other medical services. As the distribution network is disorganized, the only alternative for the population to obtain the medications at the lowest price was to create centers of purchasing and distribution and to multiply the number of retailers of essential medications. Extensive work has been conducted in

  19. An economic framework for preventive care advice.

    Science.gov (United States)

    Pauly, Mark V; Sloan, Frank A; Sullivan, Sean D

    2014-11-01

    Under the Affordable Care Act, preventive care measures, including vaccinations and screenings, recommended by the Advisory Committee on Immunization Practices and the US Preventive Services Task Force must be covered in full by insurance. These recommendations affect the cost of medical care. Yet neither organization explicitly incorporates measures of efficiency or cost-effectiveness in making its recommendations. To redress this shortcoming, we propose a decision-making framework for these two organizations based on the principles of economic efficiency. Our analysis suggests that routine use of a preventive service should be recommended for full insurance coverage if the service's cost-effectiveness exceeds a socially determined threshold. For less cost-effective services, we suggest that information about effectiveness and cost should be provided to consumers by physicians or government, but the choice of care and insurance coverage for care should be made by individuals. For the least cost-effective services, the two organizations should discourage public and private insurers from covering such services and report their unfavorable cost-effectiveness. PMID:25368000

  20. Approaches to economic evaluations of stroke rehabilitation.

    Science.gov (United States)

    Craig, Louise E; Wu, Olivia; Bernhardt, Julie; Langhorne, Peter

    2014-01-01

    Many stroke rehabilitation services and interventions are complex in that they involve a number of components, interactions, and outcomes. Much of the onus of stroke care lies with rehabilitation services and because stroke rehabilitation is highly resource intensive, it is important for policy makers to consider the potential trade-offs between all relevant costs and benefits. The primary aim of this systematic review was to assess the methods used to conduct economic evaluations of stroke rehabilitation. Studies that compared two or more alternative stroke rehabilitation interventions or services with the costs and outcomes being examined for each alternative were included. EMBASE, MEDLINE In-Process, and National Health Service's Economic Evaluation Database were searched using search strategies. The methodological quality of the included studies was appraised using a checklist for the conduct and reporting of economic evaluations. Twenty-one studies met the selection criteria. The economic evaluations in the majority of these studies were inadequate based on their ability to identify, measure, and value all resources and benefits pertinent to the complexity of stroke rehabilitation. This study highlights that complex interventions such as stroke rehabilitation have widespread effects, which may not be represented by the changes on a single outcome. This study recommends the adoption of a wider cost and benefit perspective in the economic evaluations of complex interventions. It supports a move away from conventional economic evaluation and decision making, based purely on cost-effectiveness, toward multicriteria decision analysis frameworks for complex interventions, where a broader range of criteria may be assessed by policy makers.

  1. Economic analysis in health care research.

    Science.gov (United States)

    Rizk, Diaa E E

    2008-04-01

    There is contemporary widespread acceptance in the medical community of the need to address economic perspective of healthcare, specifically whether the benefits of a proposed or existing medical intervention are sufficient to justify that particular use of scarce health resources. The use of any scarce resources whether manpower, buildings or equipment has an opportunity cost in terms of the benefits foregone by denying those resources to other competing claims. Health economics emphasizes the need to assess formally the implications of choices over the deployment of resources. A number of economic evaluation techniques such as cost-benefit analysis and cost-effectiveness analysis have thus been developed to aid this formal assessment and to help identify the most efficient allocation of resources. The methodological quality and principles of economic analyses studies recently published in the biomedical literature, however, can be further improved. The most common limitations are in the methodology or presentation of cost, incremental analyses, sensitivity analysis and discounting. The ten methodological principles that should be incorporated in studies addressing economic analyses are highlighted. Understanding the methodology of cost-benefit analysis and cost-effectiveness analysis is critical for biomedical researchers, editors, reviewers and readers from developing countries to accurately interpret the results of the growing body of these articles. PMID:19143119

  2. Ghana--medical care amid economic problems.

    Science.gov (United States)

    Bacon, L

    1980-07-01

    Describing the pattern of disease encountered in primary health care (PHC) in Ghana and the facilities available to treat it, this discussion provides an account of the rapidly deteriorating economic situation and its effects on the inhabitants and on medical practice. During the 1977-79 period Ghana suffered severe economic and political difficulties, affecting work at the University Hospital in Legon, Ghana. The workload differs from that in developed countries in several ways: tropical diseases are common; the diseases of proverty are rife; diseases due to poor public health and an absence of some diseases, e.g., myocardial infarct and multiple sclerosis. There is no equivalent of the British general practioner, but there are 4 main sources of care: 54 government hospitals with 137 health centrs and health posts distributed around the country; 57 private but relatively low cost hospitals and clinics; exclusive, high cost private clinics; and traditional healers and herbalists practicing their art. Between 1976-79 the economy of Ghana went into a steep decline. Exact figures for inflation are difficult to come by; 15% per year was popularly quoted. The cedi (the Ghanaian unit of currency) was officially devalued. Goods became very scarce as well as expensive. Basic food items, spare parts for vehicles and other machinery, petroleum products, soap, and all medical supplies were hard to obtain. There was public unrest during this period. Strikes became frequent. Notable from the health perspective was a strike of all professionals, including doctors, in June 1977, strikes of government employed nurses in April 1978 and May 1979. The main events were 3 changes of government. Although exact data are not easy to obtain, the diseases of poverty appeared to be on the increase. Lack of money tended to keep those not entitled to free treatment away from private hospitals, but the deteriorating situation at the clinics seemed to more than compensate for this. Shortages

  3. Evaluation of small reactor economics

    International Nuclear Information System (INIS)

    The EPRI small reactor design program requires a procedure to analyze the economic benefits of specific design improvements suggested by the participating contractors, and to evaluate the total impacts of a new plant design on nuclear power generation costs. To that purpose, an analysis procedure is now being developed by EPRI and its participating contractors. This procedure involves the use of two separate costing models: 1. A top-down total generation cost model that integrates, in a relatively simplified manner, capital operating and fuel expenses, to yield total unit costs on an annual as well as on a lifetime levelized basis. A bottoms-up model that enables the analysis of specific system changes on station capital costs. Using a detailed reference plant cost breakdown, proposed design improvements can be measured against the reference data for their economic benefits

  4. Understanding Economic Evaluation: A Policy Perspective for Clinicians

    Directory of Open Access Journals (Sweden)

    M Giacomini

    1997-01-01

    Full Text Available The rhetoric of ‘efficiency’ frames much current debate about how limited health care resources should be used. Clinicians increasingly turn to economic evaluation literature to discern evidence-based claims of ‘efficiency’ or ‘cost effectiveness’ from empty ones. Economic evaluation research is designed to compare health services on the basis of their efficiency (eg, how well they produce health benefits relative to resource costs. Although economic studies appear throughout the respirology literature, relatively few are complete economic evaluations. Economic evaluation studies serve various purposes, including critical evaluation and persuasive marketing, which produce studies that vary in research agendas and scientific rigour. This paper is intended to serve clinicians and consumers of economic evaluation studies by: introducing economic evaluation research information as a policy making tool; describing the three basic elements and three basic types of economic evaluation (cost-benefit, cost-effectiveness, and cost-utility analyses; and reviewing some limitations of economic evaluation information for policy decision making. The usefulness of economic evaluation research for policy making depends not only on the scientific merit of the analysis but also crucially on whose specific concerns the research questions address.

  5. [Telemedicine in acute stroke care--a health economics view].

    Science.gov (United States)

    Günzel, F; Theiss, S; Knüppel, P; Halberstadt, S; Rose, G; Raith, M

    2010-05-01

    Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market.

  6. Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario

    Directory of Open Access Journals (Sweden)

    van der Velde Gabrielle

    2011-07-01

    Full Text Available Abstract Background Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD. A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1 physician-based education and activation, 2 a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers, and 3 the legislated standard of care in the Canadian province of Ontario: the Pre-approved Framework Guideline for Whiplash developed by the Financial Services Commission of Ontario. Methods/Design The economic evaluation will use participant-level data from the University Health Network Whiplash Intervention Trial and will be conducted from the societal perspective over the trial's one-year follow-up. Resource use (costs will include all health care goods and services, and benefits provided during the trial's 1-year follow-up. The primary health effect will be the quality-adjusted life year. We will identify the most cost-effective intervention using the incremental cost-effectiveness ratio and incremental net-benefit. Confidence ellipses and cost-effectiveness acceptability curves will represent uncertainty around these statistics, respectively. A budget impact analysis will assess the total annual impact of replacing the current legislated standard of care with each of the other interventions. An expected value of perfect information will determine the maximum research expenditure Canadian society should be willing to pay for, and inform priority setting in, research of WAD management. Discussion Results will provide health care decision makers with much needed economic evidence on common interventions for acute whiplash management. Trial Registration http://ClinicalTrials.gov identifier NCT00546806 [Trial registry date: October 18, 2007; Date first patient was randomized: February

  7. A Framework for Including Family Health Spillovers in Economic Evaluation.

    Science.gov (United States)

    Al-Janabi, Hareth; van Exel, Job; Brouwer, Werner; Coast, Joanna

    2016-02-01

    Health care interventions may affect the health of patients' family networks. It has been suggested that these "health spillovers" should be included in economic evaluation, but there is not a systematic method for doing this. In this article, we develop a framework for including health spillovers in economic evaluation. We focus on extra-welfarist economic evaluations where the objective is to maximize health benefits from a health care budget (the "health care perspective"). Our framework involves adapting the conventional cost-effectiveness decision rule to include 2 multiplier effects to internalize the spillover effects. These multiplier effects express the ratio of total health effects (for patients and their family networks) to patient health effects. One multiplier effect is specified for health benefit generated from providing a new intervention, one for health benefit displaced by funding this intervention. We show that using multiplier effects to internalize health spillovers could change the optimal funding decisions and generate additional health benefits to society.

  8. Considerations for planning and evaluating economic analyses of telemental health.

    Science.gov (United States)

    Luxton, David D

    2013-08-01

    The economic evaluation of telemental health (TMH) is necessary to inform ways to decrease the cost of delivering care, to improve access to care, and to make decisions about the allocation of resources. Previous reviews of telehealth economic analysis studies have concluded that there are significant methodological deficiencies and inconsistencies that limit the ability to make generalized conclusions about the costs and benefits of telehealth programs. Published economic evaluations specific to TMH are also limited. There are unique factors that influence costs in TMH that are necessary for those who are planning and evaluating economic analyses to consider. The purpose of this review is to summarize the main problems and limitations of published economic analyses, to discuss considerations specific to TMH, and to inform and encourage the economic evaluation of TMH in both the public and private sectors. The topics presented here include perspective of costs, direct and indirect costs, and technology, as well as research methodology considerations. The integration of economic analyses into effectiveness trials, the standardization of outcome measurement, and the development of TMH economic evaluation guidelines are recommended.

  9. Estimating benefits for economic evaluation, CHERE Discussion Paper No 2

    OpenAIRE

    Jane Hall; Gavin Mooney

    1991-01-01

    This discussion paper provides an introduction to the estimation of benefits in economic evaluation. The concept of benefits, as something worth making a sacrifice to obtain, is explained. The issue of what the benefits of health care is discussed. Methods for the identification of benefits are described. Two approaches to valuing human life, human capital and willingness to pay are considered. A more recent development in health economics is the estimation of benefits using Quality Adjusted ...

  10. Evaluating Robert Franks Economic Naturalist Writing Assignment

    OpenAIRE

    Wayne Geerling

    2011-01-01

    This paper begins by asking a fundamental question: why do students who take Economics at an introductory level often leave the subject without understanding even the most basic economic principles? The superficial answer seems to be that courses try to cover too many concepts at the expense of mastering the important threshold concepts. Another issue is the way Economics is taught and assessed. I will evaluate an alternative pedagogical device pioneered by Robert Frank: The Economic Naturali...

  11. Economic evaluation of CISM : a pilot study

    DEFF Research Database (Denmark)

    Vogt, Joachim

    2004-01-01

    air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment......air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment...

  12. Economic analysis of health care interventions.

    Science.gov (United States)

    Konski, Andre

    2008-07-01

    According to US government statistics, health care expenditures approached $2 trillion in 2005 or $6,697/person, with spending expected to exceed $4.1 trillion by 2016 (http://www.cms.hhs.gov/NationalHealthExpendData/). Total Centers for Medicare and Medicaid Services spending (including Medicaid, State Children's Health Insurance Program (SCHIP), and Medicare) was $660.7 million in 2005. Despite the decline in the growth rate of health care spending growth over the past 4 years, health care spending increased 6.9% from 2004 to 2005 and was 16% of the gross domestic product (GDP) in 2005 and forecasted to be 19.6% of the GDP by 2016. Although the percentage of GDP may not concern providers of health care products or services, it has an affect on the rest of the economy. Spending on health care by employers or patients increases the cost of the products produced, making goods produced here in the United States less attractive to world markets in the age of globalization in addition to leaving less money for patients to spend on other goods and services or save.

  13. The Economics of Adoption of Children from Foster Care

    Science.gov (United States)

    Hansen, Mary Eschelbach; Hansen, Bradley A.

    2006-01-01

    Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care. For many waiting children, the path to adoption is long. The authors offer an economic analysis of adoption from foster care, with an emphasis on the reasons why achieving the goal of adoption for all waiting children may be so…

  14. ECONOMIC THEORY OF LOBBYING: EVALUATION OF ECONOMIC EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Tolstyh Pavel Aleksandrovich

    2013-01-01

    Full Text Available In this article the author continues to analyze lobbying with regards to economic paradigm. [The author has started discussing lobbying in terms of economic theory in the article Politico-economic theory of lobbying / / Historical, philosophical, political and legal sciences, culture and art. Theory and practice. Tambov: Gramota, 2013. No 1. Part 2. p. 177-189.] Researcher evaluates the cost effectiveness of the lobbying function. Lobbying is understood as activity of specifically authorized employees of corporations and lobbying firms representing their interests, trade associations. This activity is aimed at improving the profitability of integrated and sustainable business development by representing long-term, comfortable, predictable system of relationships with the relevant field-specific political stakeholders of the federal and regional levels. The article presents an in-depth analysis of economic concepts of lobbying function.

  15. ECONOMIC THEORY OF LOBBYING: EVALUATION OF ECONOMIC EFFICIENCY

    Directory of Open Access Journals (Sweden)

    Павел Александрович Толстых

    2013-04-01

    Full Text Available In this article the author continues to analyze lobbying with regards to economic paradigm. [The author has started discussing lobbying in terms of economic theory in the article Politico-economic theory of lobbying / / Historical, philosophical, political and legal sciences, culture and art. Theory and practice. Tambov: Gramota, 2013. No 1. Part 2. p. 177-189.] Researcher evaluates the cost effectiveness of the lobbying function. Lobbying is understood as activity of specifically authorized employees of corporations and lobbying firms representing their interests, trade associations. This activity is aimed at improving the profitability of integrated and sustainable business development by representing  long-term, comfortable, predictable system of relationships with the relevant field-specific political stakeholders of the federal and regional levels. The article presents an in-depth analysis of economic concepts of lobbying function.DOI: http://dx.doi.org/10.12731/2218-7405-2013-1-3

  16. [Empirical standard costs for health economic evaluation in Germany -- a proposal by the working group methods in health economic evaluation].

    Science.gov (United States)

    Krauth, C; Hessel, F; Hansmeier, T; Wasem, J; Seitz, R; Schweikert, B

    2005-10-01

    Measurement of health care costs is a crucial task in health economic evaluation. Various guidelines with different amount of details have been set up for costing methods in economic evaluation which, however, do not precisely stipulate how to value resource consumption. In this article we present a proposal for the standardisation of the monetary valuation of health care utilisation occurring in the follow up period after the actual intervention to be evaluated. From a societal perspective the primary direct and indirect cost components are considered, such as outpatient medical care, pharmaceuticals, non-physician health services, inpatient care, days of sick leave and early retirement due to sickness. The standard costs are based on administrative charges and rates or on official statistics. They are based on the most current data sources which are mainly from 2002 and 2003. This system of standard costs aims at an average valuation of resource consumption. This makes for the comparability of different health economic studies. Most standard costs are not based on market prices but on administratively specified charges and rates. This implies that institutional changes which are quite common in the health care system, may also affect the valuation rates, for example the introduction of DRGs. This should be taken into account when updating the system of standard costs.

  17. Economic evaluation and mental health: sparse past. fertile future?

    Science.gov (United States)

    Knapp, Martin

    1999-12-01

    BACKGROUND: Demands for economic inputs to mental health policy-making, practice decisions and research evaluations have grown considerably in recent years, but the overall supply response has been modest and uneven. AIMS: This paper examines the key historical phases in the development of mental health economics research, and what they imply for the way economics is received and employed. Focusing on the quest for cost-effectiveness, the paper considers challenges for mental health economics. METHODS: An informal review of the growing demand for mental health economics (and how that demand has been expressed), and how economists have responded. RESULTS: Five historical development phases characterize this growth. Initially, the dominant feature is innocence or neglect of scarcity. Cost measures are rarely calculated, cost-effectiveness is not part of the decision-making lexicon and the potential for inefficiency is huge. In the second phase, innocence turns to criticism of attempts to introduce resource rationality, and many clinicians actively reject economics. Health is seen as priceless, and not to be compromised by the pursuit of efficiency. After a period of reluctance there follows impetuosity as the need for economic insights is recognized, but the search for data is desperate and undiscriminating. Poor quality research is conducted, with the risk that decisions are misinformed and perhaps damaging. Once again, resources are inappropriately used. Next follows the constructive development phase: previous mistakes are appreciated and the standards of evaluation improve markedly. Studies are better designed, more likely to be integrated into clinical or policy evaluations, carefully conducted and sensibly interpreted. Inefficiency should be reduced, along with inequity. Finally, there is perhaps a nirvana-like fifth phase in which sophisticated economic studies are widely undertaken, where systematic reviews and meta-analyses help to reveal the wider picture

  18. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    OpenAIRE

    Langer Astrid; Rogowski Wolf

    2009-01-01

    Abstract Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Metho...

  19. Economic Evaluation of Active Implementation versus Guideline Dissemination for Evidence-Based Care of Acute Low-Back Pain in a General Practice Setting

    OpenAIRE

    Duncan Mortimer; French, Simon D.; McKenzie, Joanne E; Denise A O'Connor; Green, Sally E

    2013-01-01

    INTRODUCTION: The development and publication of clinical practice guidelines for acute low-back pain has resulted in evidence-based recommendations that have the potential to improve the quality and safety of care for acute low-back pain. Development and dissemination of guidelines may not, however, be sufficient to produce improvements in clinical practice; further investment in active implementation of guideline recommendations may be required. Further research is required to quantify the ...

  20. Prevention of fall incidents in patients with a high risk of falling: design of a randomised controlled trial with an economic evaluation of the effect of multidisciplinary transmural care

    Directory of Open Access Journals (Sweden)

    Bouter Lex M

    2007-07-01

    Full Text Available Abstract Background Annually, about 30% of the persons of 65 years and older falls at least once and 15% falls at least twice. Falls often result in serious injuries, such as fractures. Therefore, the prevention of accidental falls is necessary. The aim is to describe the design of a study that evaluates the efficacy and cost-effectiveness of a multidisciplinary assessment and treatment of multiple fall risk factors in independently living older persons with a high risk of falling. Methods/Design The study is designed as a randomised controlled trial (RCT with an economic evaluation. Independently living persons of 65 years and older who recently experienced a fall are interviewed in their homes and screened for risk of recurrent falling using a validated fall risk profile. Persons at low risk of recurrent falling are excluded from the RCT. Persons who have a high risk of recurrent falling are blindly randomised into an intervention (n = 100 or usual care (n = 100 group. The intervention consists of a multidisciplinary assessment and treatment of multifactorial fall risk factors. The transmural multidisciplinary appraoch entails close cooperation between geriatrician, primary care physician, physical therapist and occupational therapist and can be extended with other specialists if relevant. A fall calendar is used to record falls during one year of follow-up. Primary outcomes are time to first and second falls. Three, six and twelve months after the home visit, questionnaires for economic evaluation are completed. After one year, during a second home visit, the secondary outcome measures are reassessed and the adherence to the interventions is evaluated. Data will be analysed according to the intention-to-treat principle and also an on-treatment analysis will be performed. Discussion Strengths of this study are the selection of persons at high risk of recurrent falling followed by a multidisciplinary intervention, its transmural character and

  1. Realism and resources: Towards more explanatory economic evaluation

    Science.gov (United States)

    Anderson, Rob; Hardwick, Rebecca

    2016-01-01

    To be successfully and sustainably adopted, policy-makers, service managers and practitioners want public programmes to be affordable and cost-effective, as well as effective. While the realist evaluation question is often summarised as what works for whom, under what circumstances, we believe the approach can be as salient to answering questions about resource use, costs and cost-effectiveness – the traditional domain of economic evaluation methods. This paper first describes the key similarities and differences between economic evaluation and realist evaluation. It summarises what health economists see as the challenges of evaluating complex interventions, and their suggested solutions. We then use examples of programme theory from a recent realist review of shared care for chronic conditions to illustrate two ways in which realist evaluations might better capture the resource requirements and resource consequences of programmes, and thereby produce explanations of how they are linked to outcomes (i.e. explanations of cost-effectiveness).

  2. Dairy plants financial and economic security evaluation

    Directory of Open Access Journals (Sweden)

    Ganna Misko

    2015-06-01

    Full Text Available The essence of the concept “financial and economic security of the enterprise” is covered. Methodological approaches to the enterprise financial and economic security evaluation are considered, enabling the method of index numberrating score of the enterprise financial and economic security to be found. Dynamics of milk anddairy production in Ukraine has been studied. Ukrainian regions leading in liquid processed milk production have been identified. Dynamics of milk and dairy production per man has been analyzed which allowed to find out the annual increase in demand per man. Integrated index of the dairy enterprise financial and economic security has been evaluated. As a result, the ways to increase the managerial efficiency of financial and economic security of the following enterprises:PJSC "Dubnomoloko", PJSC "Kupyans'ki milk canning plant", PJSC the "Yagotyns'ki creamery", PJSC the "Pervomais'ki milk canning plant" are offered.

  3. SLIMMER: a randomised controlled trial of diabetes prevention in Dutch primary health care: design and methods for process, effect, and economic evaluation

    NARCIS (Netherlands)

    Duijzer, G.; Haveman-Nies, A.; Jansen, S.C.; Beek, ter J.; Hiddink, G.J.; Feskens, E.J.M.

    2014-01-01

    Background - Implementation of interventions in real-life settings requires a comprehensive evaluation approach. The aim of this article is to describe the evaluation design of the SLIMMER diabetes prevention intervention in a Dutch real-life setting. Methods/Design - The SLIMMER study is a randomis

  4. Situating care in mainstream health economics: an ethical dilemma?

    OpenAIRE

    Davis, John B.; McMaster, Robert

    2015-01-01

    Standard health economics concentrates on the provision of care by medical professionals. Yet ‘care’ receives scant analysis; it is portrayed as a spillover effect or externality in the form of interdependent utility functions. In this context care can only be conceived as either acts of altruism or as social capital. Both conceptions are subject to considerable problems stemming from mainstream health economics’ reliance on a reductionist social model built around instrumental rationality an...

  5. Economic evaluation of active implementation versus guideline dissemination for evidence-based care of acute low-back pain in a general practice setting.

    Directory of Open Access Journals (Sweden)

    Duncan Mortimer

    Full Text Available INTRODUCTION: The development and publication of clinical practice guidelines for acute low-back pain has resulted in evidence-based recommendations that have the potential to improve the quality and safety of care for acute low-back pain. Development and dissemination of guidelines may not, however, be sufficient to produce improvements in clinical practice; further investment in active implementation of guideline recommendations may be required. Further research is required to quantify the trade-off between the additional upfront cost of active implementation of guideline recommendations for low-back pain and any resulting improvements in clinical practice. METHODS: Cost-effectiveness analysis alongside the IMPLEMENT trial from a health sector perspective to compare active implementation of guideline recommendations via the IMPLEMENT intervention (plus standard dissemination against standard dissemination alone. RESULTS: The base-case analysis suggests that delivery of the IMPLEMENT intervention dominates standard dissemination (less costly and more effective, yielding savings of $135 per x-ray referral avoided (-$462.93/3.43. However, confidence intervals around point estimates for the primary outcome suggest that--irrespective of willingness to pay (WTP--we cannot be at least 95% confident that the IMPLEMENT intervention differs in value from standard dissemination. CONCLUSIONS: Our findings demonstrate that moving beyond development and dissemination to active implementation entails a significant additional upfront investment that may not be offset by health gains and/or reductions in health service utilization of sufficient magnitude to render active implementation cost-effective.

  6. The Economics of Adoption of Children from Foster Care

    OpenAIRE

    Mary Eschelbach Hansen; Bradley A. Hansen

    2005-01-01

    Federal initiatives since 1996 have intensified the efforts of states to achieve adoption for children in foster care with the case goal of adoption. For many waiting children, the path to adoption is long. We offer an economic analysis of adoption from foster care, with an emphasis on the reasons why it may be so difficult to achieve the goal of adoption for all waiting children. We then estimate the determinants of adoptions from foster care across the states using data for fiscal years 199...

  7. Avaliação econômica em Saúde na esfera de atenção local à saúde Health economic evaluation in a local level government health care system

    Directory of Open Access Journals (Sweden)

    Leyla Gomes Sancho

    2009-10-01

    possibility to apply a health economic evaluation research and have the results used in a local level government health care system.

  8. Applying the AHP in health economic evaluations of new technology

    NARCIS (Netherlands)

    Hummel, Marjan; Steuten, Lotte; Groothuis-Oudshoorn, Karin; IJzerman, Maarten

    2011-01-01

    Much research in health care is devoted to health economical modelling. Even though the Analytic Hierarchy Process (AHP) is increasingly being applied in health care, its value to health economical modelling is still unrecognized. We explored the value of using AHP-derived results in a health econom

  9. Economic Evaluation of Townhouse Solar Energy System

    Science.gov (United States)

    1982-01-01

    Solar-energy site in Columbia, South Carolina, is comprised of four townhouse apartments. Report summarizes economic evaluation of solar--energy system and projected performance of similar systems in four other selected cities. System is designed to supply 65 percent of heating and 75 percent of hot water.

  10. Methodology for evaluating economic impacts of transportation

    OpenAIRE

    Huang, Guoxiong

    1990-01-01

    This research addresses two important issues facing transportation economists and planners: the relationship between transportation investment and economic development and the methodology for evaluating transportation projects and programs. Transportation is viewed as an important factor which enters the production functions of firms and the consumption functions of individuals. The demand for and the supply of transportation cannot be determined within the transportation syste...

  11. Economic Evaluation of Home Visiting Programs.

    Science.gov (United States)

    Barnett, W. Steven

    1993-01-01

    Reviews important factors relevant to measuring the costs and outcomes of home visiting programs and examines six cost-benefit studies of such programs. Concludes that these studies demonstrate the feasibility of economic evaluation of home visiting and the importance of the insights it can produce. (MDM)

  12. Economic analysis of the cost of Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mazetas D.

    2014-04-01

    Full Text Available The cost of Intensive Care Units has the greatest impact on overall medical costs and the overall cost for the health of a country and an increasing number of studies from around the world presenting the quantification of these costs. Aim: Review of the Economic Analysis of the Cost of Intensive Care Units. Method: Search was made in the SCOPUS, MEDLINE and CINAHL databases using the key-words “Intensive Care Units (ICU”, “Cost”, “Cost Analysis”, “Health Care Costs”, “Health Resources”, “ICU resources”. The study was based on articles published in English from 2000 to 2011 investigating the Economic Analysis of the Cost of Intensive Care Units. Results: The cost of ICU is a significant percentage of gross domestic product in developed countries. Most cost analysis studies that relate to plans that include the study of staff costs, duration of stay in the ICU, the clinical situations of hospitalized patients, engineering support, medications and diagnostic tests costing scales and in relation to the diagnostic criteria. Conclusions: most studies conclude that the remuneration of staff, particularly nurses, in the ICU is the largest cost of ICU, while for the duration of stay in the ICU results are conflicting. The analysis on the cost-effectiveness of ICU can help to better apply these findings to the therapeutic context of ICU.

  13. The economics of early childhood education and day-care

    Science.gov (United States)

    Psacharopoulos, George

    1982-03-01

    This article discusses the economic rationale of providing educational and day-care facilities to young children, using an expanded social cost-benefit frame-work. The benefits side, in particular, includes the direct lifetime productive gains by working mothers and the indirect earnings increments of the recipients of these social services via the boosting of early abilities and eventual higher scholastic achievement. Recently compiled statistics in OECD Member Countries are used to support the argument that we know very little about the socio-economic effects of providing kindergarten and nursery facilities. An interdisciplinary research agenda is proposed to increase our understanding in this elusive area of social policy.

  14. Economic Evaluation Guide for alternative transportation fuels

    Energy Technology Data Exchange (ETDEWEB)

    de Percin, D.; Werner, J.F. Jr.

    1992-12-31

    The production of this Economic Evaluation Guide is one activity of AVFCAP. The guide is intended for use by project managers and fleet operators in the public sector. Public fleets have been identified as one of the most likely areas where ATFs will first gain widespread use, because of existing and impending state and federal legislative mandates, as well as for practical reasons such as centralized servicing and refueling. The purpose of this guide is to provide balanced decision-support information to project managers who are considering conducting, or currently managing, ATF demonstration programs. Information for this guide was gathered as part of a related AVFCAP activity, the development of an Information Resource Database. Economic issues related to the development and implementation of ATF programs at the local government level are extremely complex, and require an analysis of federal policies and national and international economics that is generally beyond the scope of local government project managers. The intent of this guide is to examine the information available on the economic evaluation of ATFs, and identify key elements that will help local governments realistically assess the potential costs and savings of an ATF program. The guide also discusses how these various economic factors are related, and how local government priorities affect how different factors are weighed.

  15. Economic Evaluation Guide for alternative transportation fuels

    Energy Technology Data Exchange (ETDEWEB)

    de Percin, D.; Werner, J.F. Jr.

    1992-01-01

    The production of this Economic Evaluation Guide is one activity of AVFCAP. The guide is intended for use by project managers and fleet operators in the public sector. Public fleets have been identified as one of the most likely areas where ATFs will first gain widespread use, because of existing and impending state and federal legislative mandates, as well as for practical reasons such as centralized servicing and refueling. The purpose of this guide is to provide balanced decision-support information to project managers who are considering conducting, or currently managing, ATF demonstration programs. Information for this guide was gathered as part of a related AVFCAP activity, the development of an Information Resource Database. Economic issues related to the development and implementation of ATF programs at the local government level are extremely complex, and require an analysis of federal policies and national and international economics that is generally beyond the scope of local government project managers. The intent of this guide is to examine the information available on the economic evaluation of ATFs, and identify key elements that will help local governments realistically assess the potential costs and savings of an ATF program. The guide also discusses how these various economic factors are related, and how local government priorities affect how different factors are weighed.

  16. An economic evaluation of solar radiation management

    International Nuclear Information System (INIS)

    Economic evaluations of solar radiation management (SRM) usually assume that the temperature will be stabilized, with no economic impacts of climate change, but with possible side-effects. We know from experiments with climate models, however, that unlike emission control the spatial and temporal distributions of temperature, precipitation and wind conditions will change. Hence, SRM may have economic consequences under a stabilization of global mean temperature even if side-effects other than those related to the climatic responses are disregarded. This paper addresses the economic impacts of implementing two SRM technologies; stratospheric sulfur injection and marine cloud brightening. By the use of a computable general equilibrium model, we estimate the economic impacts of climatic responses based on the results from two earth system models, MPI-ESM and NorESM. We find that under a moderately increasing greenhouse-gas concentration path, RCP4.5, the economic benefits of implementing climate engineering are small, and may become negative. Global GDP increases in three of the four experiments and all experiments include regions where the benefits from climate engineering are negative

  17. An economic evaluation of solar radiation management

    Energy Technology Data Exchange (ETDEWEB)

    Aaheim, Asbjørn; Romstad, Bård; Wei, Taoyuan [CICERO — Center for International Climate and Environmental Research Oslo (Norway); Kristjánsson, Jón Egill; Muri, Helene [Department of Geosciences, University of Oslo (Norway); Niemeier, Ulrike; Schmidt, Hauke [Max Planck Institute for Meteorology, Hamburg (Germany)

    2015-11-01

    Economic evaluations of solar radiation management (SRM) usually assume that the temperature will be stabilized, with no economic impacts of climate change, but with possible side-effects. We know from experiments with climate models, however, that unlike emission control the spatial and temporal distributions of temperature, precipitation and wind conditions will change. Hence, SRM may have economic consequences under a stabilization of global mean temperature even if side-effects other than those related to the climatic responses are disregarded. This paper addresses the economic impacts of implementing two SRM technologies; stratospheric sulfur injection and marine cloud brightening. By the use of a computable general equilibrium model, we estimate the economic impacts of climatic responses based on the results from two earth system models, MPI-ESM and NorESM. We find that under a moderately increasing greenhouse-gas concentration path, RCP4.5, the economic benefits of implementing climate engineering are small, and may become negative. Global GDP increases in three of the four experiments and all experiments include regions where the benefits from climate engineering are negative.

  18. Microeconomic surplus in health care: Applied economic theory in health care in four European countries

    Directory of Open Access Journals (Sweden)

    Stefan eWalzer

    2013-02-01

    Full Text Available Introduction: In economic theory economic surplus refers to two related quantities: Consumer and producer surplus. Applying this theory to health care convenience could be one way how consumer benefits might manifest itself. Methods: Various areas of economic surplus were identified and subsequently screened and analysed in Germany, Spain, The Netherlands and the UK: Caesarean births, emergency room visits (nights or weekends, drug availability after test results, and response surplus. A targeted literature search was being conducted to identify the associated costs. Finally the economic surplus (convenience value was calculated.Results: The economic surplus for different health care areas was being calculated. The highest economic surplus was obtained for the example of response surplus IVF-treatments in The Netherlands.Conclusions: The analyzed examples in this article support the underlying hypothesis for this research: Value of convenience defined as the consumer surplus in health care can be shown in different health care settings. Again, this hypothesis should be accepted as a starting point in this research area and hence further primary research is strongly recommended in order to fully proof this concept.

  19. Conceptual and practical difficulties with the economic evaluation of health services developments.

    Science.gov (United States)

    Coast, J; Hensher, M; Mulligan, J A; Shepperd, S; Jones, J

    2000-01-01

    Five recent economic evaluations comparing hospital at home schemes with acute hospital care faced remarkably similar problems. This paper outlines these problems and considers what strategies can be derived from these experiences, which will be relevant to economic evaluations of other aspects of the organisation of care, particularly those crossing the interfaces between primary and secondary health care or the interface between health and social services. The difficulties experienced can be divided into conceptual and practical problems. Conceptual problems were primarily associated with issues of context and related to the choice of comparator, capacity constraints and size of schemes, and the choice between a short or a long run perspective. Practical problems were connected with the time at which schemes were evaluated, the type of clinical study alongside which studies were conducted and the types of data available for use in the analysis. Strategies which can be pursued in conducting economic evaluations of organisational change include giving greater attention to conceptual and hence contextual problems as well as reporting these contextual issues in detail, accepting the need for repeated economic evaluations as organisational changes become more widespread and considering carefully the clinical study design where economic evaluations of organisational change are conducted alongside. These strategies are of importance not just to those conducting economic evaluations but also to those funding appraisals of changes in the organisation of care. Use of different strategies such as those suggested here should be evaluated. PMID:10787587

  20. Evaluating ICT Applications in Health Care

    NARCIS (Netherlands)

    A.P. Stoop

    2005-01-01

    textabstractThis thesis is about evaluation of ICT applications in health care. How can information systems for patients and health care professionals best be evaluated? How to take into account that one - in practice - is often confronted with limited resources? The author describes the difficultie

  1. Economic evaluations of personalized medicine: existing challenges and current developments

    Directory of Open Access Journals (Sweden)

    Shabaruddin FH

    2015-06-01

    Full Text Available Fatiha H Shabaruddin,1 Nigel D Fleeman,2 Katherine Payne3 1Department of Pharmacy, University of Malaya, Kuala Lumpur, Malaysia; 2Liverpool Reviews and Implementation Group (LRiG, University of Liverpool, Liverpool, UK; 3Institute of Population Health, The University of Manchester, Manchester, UK Abstract: Personalized medicine, with the aim of safely, effectively, and cost-effectively targeting treatment to a prespecified patient population, has always been a long-time goal within health care. It is often argued that personalizing treatment will inevitably improve clinical outcomes for patients and help achieve more effective use of health care resources. Demand is increasing for demonstrable evidence of clinical and cost-effectiveness to support the use of personalized medicine in health care. This paper begins with an overview of the existing challenges in conducting economic evaluations of genetics- and genomics-targeted technologies, as an example of personalized medicine. Our paper illustrates the complexity of the challenges faced by these technologies by highlighting the variations in the issues faced by diagnostic tests for somatic variations, generally referring to genetic variation in a tumor, and germline variations, generally referring to inherited genetic variation in enzymes involved in drug metabolic pathways. These tests are typically aimed at stratifying patient populations into subgroups on the basis of clinical effectiveness (response or safety (avoidance of adverse events. The paper summarizes the data requirements for economic evaluations of genetics and genomics-based technologies while outlining that the main challenges relating to data requirements revolve around the availability and quality of existing data. We conclude by discussing current developments aimed to address the challenges of assessing the cost-effectiveness of genetics and genomics-based technologies, which revolve around two central issues that are

  2. Economic Evaluation Enhances Public Health Decision Making

    OpenAIRE

    Rabarison, Kristina M.; Connie L. Bish; Massoudi, Mehran S.; Giles, Wayne H.

    2015-01-01

    Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking “how do investments in public health strategies influence or offset the need for downstream spending on medical ...

  3. Eco Global Evaluation: Cross Benefits of Economic and Ecological Evaluation

    OpenAIRE

    PERRY, Nicolas; Bernard, Alain; Bosch-Mauchand, Magali; Le Duigou, Julien; Xu, Yang

    2011-01-01

    International audience This paper highlights the complementarities of cost and environmental evaluation in a sustainable approach. Starting with the needs and limits for whole product lifecycle evaluation, this paper begins with the modeling, data capture and performance indicator aspects. In a second step, the information issue, regarding the whole lifecycle of the product is addressed. In order to go further than the economical evaluations/assessment, the value concept (for a product or ...

  4. Economic evaluation of bids for nuclear power plants. 1999 edition

    International Nuclear Information System (INIS)

    dominant role and lead to long term impact on the bid projects. Furthermore, the licensing of the various concepts has to be checked carefully. In addition to the NPP itself, requirements for fuel fabrication facilities, intermediate storage facilities and final disposal of high level radioactive waste have to be planned carefully in a nuclear programme. Furthermore, access to a storage area for low and medium level radioactive waste must be provided. The respective licensing authorities have to be established and qualified, a process which is normally organized with foreign partners. The main objectives of the economic bid evaluation are to establish the plant costs and to rank the available bids with the help of an economic figure of merit. This requires consideration of the following points: Results of the technical bid evaluation; Capital investment costs; Nuclear fuel cycle costs; Operation and maintenance costs; Owner's costs, Commercial and contractual terms and conditions, Financing proposals, Economic parameters, Domestic participation and technology transfer, Fringe benefits and spin-off effects, Political and socioeconomic aspects. It should be clear to the user of this report that it is not possible to have a fully comprehensive manual for the treatment of all feasible types and combinations of contract approach. However, this report aims at providing the user with the following valuable information: General outline of the bid evaluation process; Detailed description of, and guidelines for, the economic bid evaluation process; Examples of different factors that should be taken into account in the economic bid evaluation; Description of methodologies and analytical tools applicable to the economic bid evaluation; Detailed description of the IAEA account system, which allows great flexibility in the technical and economic bid evaluation process; An economic bid evaluation computer program updated to the state of the art. The structure of the IAEA account system

  5. Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

    OpenAIRE

    Franken Willemien K; van Mechelen Willem; Barendse Johanna M; van Tulder Maurits W; van der Roer Nicole; Ooms Arjan C; de Vet Henrica CW

    2004-01-01

    Abstract Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or me...

  6. Economics of periodontal care: market trends, competitive forces and incentives.

    Science.gov (United States)

    Flemmig, Thomas F; Beikler, Thomas

    2013-06-01

    The adoption of new technologies for the treatment of periodontitis and the replacement of teeth has changed the delivery of periodontal care. The objective of this review was to conduct an economic analysis of a mature periodontal service market with a well-developed workforce, including general dentists, dental hygienists and periodontists. Publicly available information about the delivery of periodontal care in the USA was used. A strong trend toward increased utilization of nonsurgical therapy and decreased utilization of surgical periodontal therapy was observed. Although periodontal surgery remained the domain of periodontists, general dentists had taken over most of the nonsurgical periodontal care. The decline in surgical periodontal therapy was associated with an increased utilization of implant-supported prosthesis. Approximately equal numbers of implants were surgically placed by periodontists, oral and maxillofacial surgeons, and general dentists. Porter's framework of the forces driving industry competition was used to analyze the role of patients, dental insurances, general dentists, competitors, entrants, substitutes and suppliers in the periodontal service market. Estimates of out-of-pocket payments of self-pay and insured patients, reimbursement by dental insurances and providers' earnings for various periodontal procedures and alternative treatments were calculated. Economic incentives for providers may explain some of the observed shifts in the periodontal service market. Given the inherent uncertainty about treatment outcomes in dentistry, which makes clinical judgment critical, providers may yield to economic incentives without jeopardizing their ethical standards and professional norms. Although the economic analysis pertains to the USA, some considerations may also apply to other periodontal service markets.

  7. On the Economic Evaluation of Volatility Forecasts

    DEFF Research Database (Denmark)

    Voev, Valeri

    driven by the variability of the conditional mean and portfolio weights. Simulations and a small empirical study suggest that the bias can be empirically substantial and lead to distortions in forecast evaluation. An important implication is that forecasting superiority of models using high frequency......We analyze the applicability of economic criteria for volatility forecast evaluation based on unconditional measures of portfolio performance. The main theoretical finding is that such unconditional measures generally fail to rank conditional forecasts correctly due to the presence of a bias term...

  8. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

    Science.gov (United States)

    Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

    2016-01-19

    Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care. PMID:26595370

  9. Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care.

    Science.gov (United States)

    Emanuel, Ezekiel J; Ubel, Peter A; Kessler, Judd B; Meyer, Gregg; Muller, Ralph W; Navathe, Amol S; Patel, Pankaj; Pearl, Robert; Rosenthal, Meredith B; Sacks, Lee; Sen, Aditi P; Sherman, Paul; Volpp, Kevin G

    2016-01-19

    Behavioral economics provides insights about the development of effective incentives for physicians to deliver high-value care. It suggests that the structure and delivery of incentives can shape behavior, as can thoughtful design of the decision-making environment. This article discusses several principles of behavioral economics, including inertia, loss aversion, choice overload, and relative social ranking. Whereas these principles have been applied to motivate personal health decisions, retirement planning, and savings behavior, they have been largely ignored in the design of physician incentive programs. Applying these principles to physician incentives can improve their effectiveness through better alignment with performance goals. Anecdotal examples of successful incentive programs that apply behavioral economics principles are provided, even as the authors recognize that its application to the design of physician incentives is largely untested, and many outstanding questions exist. Application and rigorous evaluation of infrastructure changes and incentives are needed to design payment systems that incentivize high-quality, cost-conscious care.

  10. Economic Evidence and Point-of-Care Testing.

    Science.gov (United States)

    St John, Andrew; Price, Christopher P

    2013-08-01

    Health economics has been an established feature of the research, policymaking, practice and management in the delivery of healthcare. However its role is increasing as the cost of healthcare begins to drive changes in most healthcare systems. Thus the output from cost effectiveness studies is now being taken into account when making reimbursement decisions, e.g. in Australia and the United Kingdom. Against this background it is also recognised that the health economic tools employed in healthcare, and particularly the output from the use of these tools however, are not always employed in the routine delivery of services. One of the notable consequences of this situation is the poor record of innovation in healthcare with respect to the adoption of new technologies, and the realisation of their benefits. The evidence base for the effectiveness of diagnostic services is well known to be limited, and one consequence of this has been a very limited literature on cost effectiveness. One reason for this situation is undoubtedly the reimbursement strategies employed in laboratory medicine for many years, simplistically based on the complexity of the test procedure, and the delivery as a cost-per-test service. This has proved a disincentive to generate the required evidence, and little effort to generate an integrated investment and disinvestment business case, associated with care pathway changes. Point-of-care testing creates a particularly challenging scenario because, on the one hand, the unit cost-per-test is larger through the loss of the economy of scale offered by automation, whilst it offers the potential of substantial savings through enabling rapid delivery of results, and reduction of facility costs. This is important when many health systems are planning for complete system redesign. We review the literature on economic assessment of point-of-care testing in the context of these developments. PMID:24151342

  11. Mobile economics and pricing of health care services.

    Science.gov (United States)

    Huttin, Christine C

    2012-01-01

    This paper presents tools and concepts to analyze the business environment of the biopharmaceutical industry. It was presented at MEDETEL 2010. Emerging paradigms appear in that industry and new ways to value life science technologies are developed especially using mobile economics analysis. At a time, mobile computing technologies revolutionize the field of health care, this paper contributes to show how the value chain concept can be useful to analyze the value system in a mobile computing environment. It is also a milestone for the designs of future technology platforms and of health care infrastructure, in order to retain enough value between innovators, new and traditionnal players from life science, IT and other new comers, in a fragmented global competitive environment. PMID:23079949

  12. Romanian Health Care Reform in the Context of Economic Crisis

    Directory of Open Access Journals (Sweden)

    Victoria Gheonea

    2010-12-01

    Full Text Available The effects of financial crisis are strongly felt in Romania, which already face with asignificant slowdown in economic growth or even economic recession. The current and internationalsituation remains still difficult, and requires high budget constraints. Under these conditions, thehealth system in Romania has become one of the most inefficient in Europe, mainly characterized bylack of transparency in the allocation of funds and inefficiency in resource use. The lack of clear andcoherent criteria to evaluate the performance of health institutions results in a difficultimplementation of efficient managerial systems to reward the efficient manager.

  13. Economic analyses in health care: an introduction to the methodology with an emphasis on radiation therapy

    International Nuclear Information System (INIS)

    Payers are increasingly interested in knowing whether they are receiving value for the dollars they spend on health care. Because economic analyses will be used as a means of evaluating radiation therapy, it is important that radiation oncologists understand the basic methodology employed in such analyses. This review article describes the four basic types of economic analyses: cost minimization, cost effectiveness, cost utility, and cost benefit. Specification of alternative therapies, choice of perspective of the analysis, measurements of costs and benefits, and the role of discounting and sensitivity analyses are discussed. Published economic analyses that pertain directly to treatment with radiation therapy are reviewed. Finally, we close with a brief discussion of the potential areas for future economic outcomes research in radiation oncology

  14. Optimizing Drug Prescribing in Managed Care Populations: Improving Clinical and Economic Outcomes

    OpenAIRE

    Rachel Czubak; Jasmine Tucker; Zarowitz, Barbara J.

    2004-01-01

    Managed care presents interesting opportunities to optimize clinical and economic outcomes related to drug prescribing. There are very few randomized controlled trials that have evaluated methods to educate or incentivize physicians, implement formulary management or guideline tools, profile physicians, and implement pharmacist interventions to ensure optimal drug prescribing. Single methods of optimizing medication outcomes have not been shown to be as effective as multifaceted approaches. S...

  15. Inter ministerial commission clean and careful vehicles; commission interministerielle vehicules propres et economes. Rapport annuel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-10-15

    The first report of the CIVEPE in 2004 established an evaluation and proposed a first approach with five working groups implemented. This second report presents the activities and the main events in a technological, economical and political points of view. The six chapters of the report concerns the context and the challenges, the public float, the biofuels, the research and development, the definition of a clean and careful vehicle and the regulations. (A.L.B.)

  16. Desalination Economic Evaluation Program (DEEP). User's manual

    International Nuclear Information System (INIS)

    DEEP (formerly named ''Co-generation and Desalination Economic Evaluation'' Spreadsheet, CDEE) has been developed originally by General Atomics under contract, and has been used in the IAEA's feasibility studies. For further confidence in the software, it was validated in March 1998. After that, a user friendly version has been issued under the name of DEEP at the end of 1998. DEEP output includes the levelised cost of water and power, a breakdown of cost components, energy consumption and net saleable power for each selected option. Specific power plants can be modelled by adjustment of input data including design power, power cycle parameters and costs

  17. Economic valuation of informal care: the contingent valuation method applied to informal caregiving.

    Science.gov (United States)

    van den Berg, Bernard; Brouwer, Werner; van Exel, Job; Koopmanschap, Marc

    2005-02-01

    This paper reports the results of the application of the contingent valuation method (CVM) to determine a monetary value of informal care. We discuss the current practice in valuing informal care and a theoretical model of the costs and benefits related to the provision of informal care. In addition, we developed a survey in which informal caregivers' willingness to accept (WTA) to provide an additional hour of informal care was elicited. This method is better than normally recommended valuation methods able to capture the heterogeneity and dynamics of informal care. Data were obtained from postal surveys. A total of 153 informal caregivers and 149 care recipients with rheumatoid arthritis returned a completed survey. Informal caregivers reported a mean WTA to provide a hypothetical additional hour of informal care of 9.52 Euro (n=124). Many hypotheses derived from the theoretical model and the literature were supported by the data.CVM is a promising alternative for existing methods like the opportunity cost method and the proxy good method to determine a monetary value of informal care that can be incorporated in the numerator of any economic evaluation.

  18. Evaluation of Fragility of the Economic System in Poyang Lake Ecological Economic Zone

    OpenAIRE

    Cheng, Qiao-zhen; Chen, Xiao-ling; Zhu, Feng-feng; Zhu, Jing

    2012-01-01

    From two aspects, namely the sensitivity of regional economic system to internal and external interference, and its resilience, we establish the evaluation indicator system of fragility of the economic system in Poyang Lake Ecological Economic Zone, and evaluate the internal differences in fragility of the regional economic system, using set pair analysis method. The results show that there is a great difference in fragility of the economic system between different administrative units; the d...

  19. Economic Evaluation and Impact Analysis of SMART

    International Nuclear Information System (INIS)

    The objective of this study is to analyze the economic value and contribution to the national economy of the SMART project. This study tries to evaluate three kinds of values of the project separately; national economy contribution, the financial cost-benefit analysis and intangible social benefit of the project. The research methods are Net Present Valuation (NPT) for the first analysis, Input-Output (IO) model for the second analysis and Contingent Valuation Method(CVM) for the last analysis. This study tries to answer for the following questions: (1) how much does the project affect on Korean national economy in area of construction, electricity generation and export? (2) what is the financial cost - benefit assessment of the SMART project which is of the most interest to the private sector constructing the reactor? (3) how much is the project's intangible social gains in that it brings Korea's scientific development in area of nuclear generation and improves Korea's global standing? Main Results of Research are (1) Domestic Construction and Electricity Generation of the 1st Reactor A. Contribution to the National Economy Production inducing effect by the domestic construction and generation of the 1st reactor amounts to 1,801 ∼2,059 billion won, value added inducing effect amounts to 789∼919 billion won, and employment inducing effect amounts to 11,015∼12, 856 men. B. Financial Cost-Benefit Assessment Financial cost - benefit of the domestic construction and generation of the 1st reactor turns out to be economically non-profitable from the point of view of private companies participating the project, by having economic loss over all scenarios of construction costs. C. Combining Financial Cost-Benefit Assessment and Contribution to the National Economy's Value-Added Combining financial cost - benefit and value added inducing effect of the domestic construction and generation of the 1st reactor turns out to be economically valid from the point of view of

  20. Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

    Directory of Open Access Journals (Sweden)

    Franken Willemien K

    2004-11-01

    Full Text Available Abstract Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity" and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available.

  1. ECONOMIC EVALUATION OF CO2 SEQUESTRATION TECHNOLOGIES

    Energy Technology Data Exchange (ETDEWEB)

    Bert R. Bock; Richard G. Rhudy; David E. Nichols

    2001-07-01

    In order to plan for potential CO{sub 2} mitigation mandates, utilities need better information on CO{sub 2} mitigation options, especially carbon sequestration options that involve non-utility operations. One of the major difficulties in evaluating CO{sub 2} sequestration technologies and practices, both geologic storage of captured CO{sub 2} and storage in biological sinks, is obtaining consistent, transparent, accurate, and comparable economics. This project is comparing the economics of major technologies and practices under development for CO{sub 2} sequestration, including captured CO{sub 2} storage options such as active oil reservoirs, depleted oil and gas reservoirs, deep aquifers, coal beds, and oceans, as well as the enhancement of biological sinks such as forests and croplands. An international group of experts has been assembled to compare on a consistent basis the economics of this diverse array of CO{sub 2} sequestration options. Designs and data collection are nearly complete for each of the CO{sub 2} sequestration options being compared. Initial spreadsheet development has begun on concepts involving storage of captured CO{sub 2}. No significant problems have been encountered, but some additional outside expertise will be accessed to supplement the team's expertise in the areas of life cycle analysis, oil and gas exploration and production, and comparing CO{sub 2} sequestration options that differ in timing and permanence of CO{sub 2} sequestration. Plans for the next reporting period are to complete data collection and a first approximation of the spreadsheet. We expect to complete this project on time and on budget.

  2. Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?

    Science.gov (United States)

    Jit, Mark; Hutubessy, Raymond

    2016-06-01

    Economic evaluation of vaccination is a key tool to inform effective spending on vaccines. However, many evaluations have been criticised for failing to capture features of vaccines which are relevant to decision makers. These include broader societal benefits (such as improved educational achievement, economic growth and political stability), reduced health disparities, medical innovation, reduced hospital beds pressures, greater peace of mind and synergies in economic benefits with non-vaccine interventions. Also, the fiscal implications of vaccination programmes are not always made explicit. Alternative methodological frameworks have been proposed to better capture these benefits. However, any broadening of the methodology for economic evaluation must also involve evaluations of non-vaccine interventions, and hence may not always benefit vaccines given a fixed health-care budget. The scope of an economic evaluation must consider the budget from which vaccines are funded, and the decision-maker's stated aims for that spending to achieve.

  3. Methodological Challenges to Economic Evaluations of Vaccines: Is a Common Approach Still Possible?

    Science.gov (United States)

    Jit, Mark; Hutubessy, Raymond

    2016-06-01

    Economic evaluation of vaccination is a key tool to inform effective spending on vaccines. However, many evaluations have been criticised for failing to capture features of vaccines which are relevant to decision makers. These include broader societal benefits (such as improved educational achievement, economic growth and political stability), reduced health disparities, medical innovation, reduced hospital beds pressures, greater peace of mind and synergies in economic benefits with non-vaccine interventions. Also, the fiscal implications of vaccination programmes are not always made explicit. Alternative methodological frameworks have been proposed to better capture these benefits. However, any broadening of the methodology for economic evaluation must also involve evaluations of non-vaccine interventions, and hence may not always benefit vaccines given a fixed health-care budget. The scope of an economic evaluation must consider the budget from which vaccines are funded, and the decision-maker's stated aims for that spending to achieve. PMID:26832145

  4. The IAEA desalination economic evaluation programme (DEEP)

    International Nuclear Information System (INIS)

    DEEP is derived from desalination cost evaluation package developed in the eighties by General Atomics on behalf of the IAEA. The old version, named 'Co-generation and Desalination Economic Evaluation' Spreadsheet, CDEE) was used for feasibility studies related to nuclear desalination in the IAEA and other Member States. Subsequently, with its increasing popularity, a user-friendly version was issued by the Agency towards the end of 1998 under the name of DEEP. Through the next years the software was updated constantly within DEEP-1 family (versions 1.0, 1.1, 1.2 and working version 1.7). Both the user interface and model structure were further developed and in 2000 a new upgrade - first version from the DEEP-2 family was released. Its salient feature was the complete modularization of various cases. As the user group enlarged, new ideas as well as criticisms of the DEEP models appeared. Some of them were implemented gradually in different working versions (versions 2.0, 2.1, 2.2, 2.3, 2.4, 2.6). The four year period of continuous development culminated in the development of DEEP 3.0, released in August 2005. Following further development, the latest version of DEEP 3.1 is currently available for user to down load freely from the web site of the IAEA at no cost. This paper summarizes the salient features of DEEP software and echoes some of the information presented in the TECDOC draft prepared as a result of the CRP on 'Economic Research on, and Assessment of, Selected Nuclear Desalination Projects and Case Studies' which was closed at the end of 2006

  5. Economic evaluation of nuclear waste transportation casks

    International Nuclear Information System (INIS)

    A method is described which allows the systematic economic evaluation of transportation cask designs which meet the requirements of the Test and Evaluation Facility (TEF) program. The heart of the method described is the Waste Management Transportation Model. This model uses a set of computer-based algorithms to assemble specific case information input, combine this input with the data base of transportation information maintained within the model, and calculate the cask types and quantities necessary, the cask utilization factors, and the total costs for each transport line specified. The model is capable of handling a large variety of transportation problems given the specific input related to each type. Three combinations of waste packaging facilities were examined. The first assumes all consolidation and packaging occurs at an existing hot cell. The second assumes all consolidation and packaging is done at the TEF site. The third combination assumes that spent fuels are consolidated at an existing hot cell while waste packaging occurs at the TEF site. Some of the general findings are: (1) defense high-level waste (DHLW) is generally lower in cost than SF as the prime waste form because of the fewer number of shipments required prior to the waste consolidation activity; (2) when DHLW is the prime waste form, it is beneficial to locate the packaging facility (PF) close to the TEF site because the packaged waste form is heavier, more costly to transport; (3) when SF is the prime waste form, it is beneficial to locate the PF close to the waste source to reduce the length of the transport links containing unconsolidated spent fuel assemblies; and (4) truck casks, and legal weight truck casks in particular, are generally superior to the rail casks on an economic basis

  6. Solar energy system economic evaluation: Fern Tunkhannock, Tunkhannock, Pennsylvania

    Science.gov (United States)

    1980-01-01

    The economic performance of an Operational Test Site (OTS) is described. The long term economic performance of the system at its installation site and extrapolation to four additional selected locations to demonstrate the viability of the design over a broad range of environmental and economic conditions is reported. Topics discussed are: system description, study approach, economic analysis and system optimization, and technical and economical results of analysis. Data for the economic analysis are generated through evaluation of the OTS. The simulation is based on the technical results of the seasonal report simulation. In addition localized and standard economic parameters are used for economic analysis.

  7. Methodology for evaluation of economic security of industrial enterprises

    Directory of Open Access Journals (Sweden)

    Kopytko Marta Ivanovna

    2014-07-01

    Full Text Available This paper investigates the features of evaluation of ensuring economic security of industrial enterprises and the algorithm of complex evaluation of the economic security of industrial enterprises over time and the system of criteria and their limit values ​​and the dynamics of change to determine the level of economic security industrial enterprise in terms of its components.

  8. Methodology for evaluation of economic security of industrial enterprises

    OpenAIRE

    Kopytko Marta Ivanovna

    2014-01-01

    This paper investigates the features of evaluation of ensuring economic security of industrial enterprises and the algorithm of complex evaluation of the economic security of industrial enterprises over time and the system of criteria and their limit values ​​and the dynamics of change to determine the level of economic security industrial enterprise in terms of its components.

  9. Managing the physics of the economics of integrated health care.

    Science.gov (United States)

    Zismer, Daniel K; Werner, Mark J

    2012-01-01

    The physics metaphor, as applied to the economics (and financial performance) of the integrated health system, seems appropriate when considered together with the nine principles of management framework provided. The nature of the integrated design enhances leaders' management potential as they consider organizational operations and strategy in the markets ahead. One question begged by this argument for the integrated design is the durability, efficiency and ultimate long-term survivability of the more "traditional" community health care delivery models, which, by design, are fragmented, internally competitive and less capital efficient. They also cannot exploit the leverage of teams, optimal access management or the pursuit of revenues made available in many forms. For those who wish to move from the traditional to the more integrated community health system designs (especially those who have not yet started the journey), the path requires: * Sufficient balance sheet capacity to fund the integration process-especially as the model requires physician practice acquisitions and electronic health record implementations * A well-prepared board13, 14 * A functional, durable and sustainable physician services enterprise design * A redesigned organizational and governance structure * Favorable internal financial incentives alignment design * Effective accountable physician leadership * Awareness that the system is not solely a funding strategy for acquired physicians, rather a fully -.. committed clinical and business model, one in which patient-centered integrated care is the core service (and not acute care hospital-based services) A willingness to create and exploit the implied and inherent potential of an integrated design and unified brand Last, it's important to remember that an integrated health system is a tool that creates a "new potential" (a physics metaphor reference, one last time). The design doesn't operate itself. Application of the management principles

  10. Help or hindrance? The role of economics in rationing health care.

    Science.gov (United States)

    Maynard, A; Bloor, K

    1995-10-01

    The economic evaluation of alternative diagnostic and therapeutic interventions is not merely a help to the processes by which decision makers allocate scarce economic resources, it is an essential ingredient into those rationing processes. Clinicians and other decision makers who advocate the use of effectiveness data alone to determine who will be treated and who will be left in pain and discomfort may perpetuate the inefficient use of resources. Rationing, or resource allocation, in health care must be informed by knowledge of the costs and consequences (effects) or alternative interventions. To ignore the economic element in clinical choices, generates inefficiency, and therefore unethical practice. The great advantage of the economic approach to rationing is that it requires an explicit framework which identifies the costs and benefits of alternative actions in all domains of human action. The combination of explicitness and precision inherent in good economic evaluation can only help in the difficult task of producing further health benefits for patients from the limited resources of the NHS. PMID:8556294

  11. Economic evaluation of bids for nuclear power plants

    International Nuclear Information System (INIS)

    The purpose of the guidebook is to assist an organisation responsible for a nuclear power project in evaluating and establishing an economic order of merit among competing bids. An approximate overall time schedule for a first nuclear power plant project is provided. A schematic outline of technical bid evaluation is given. The basic procedure of economic bid evaluation is outlined, e.g. evaluation of the present worth of all cost items of plant capital investment, of the nuclear cycle, of O and M costs (operation and maintenance costs), and of economic corrections. All these cost items are evaluated for the economic life of the plant and corrected for escalation where applicable

  12. Evaluating the economics of complementary and integrative medicine.

    Science.gov (United States)

    Herman, Patricia M

    2013-03-01

    Healthcare in the United States is expensive and becoming more so every year. Policy and decision makers increasingly need information on costs, as well as effectiveness and safety, in order to formulate health-care strategies that are both clinically effective and financially responsible. Many people believe the benefits of complementary and integrative medicine (CIM) exceed its costs. Surveys have shown that a substantial portion of the US population uses CIM and pays directly for that use.(1) (-) (4) The most recent estimates show that total US out-of-pocket expenditures for CIM were $34 billion-11% of all US out-of-pocket healthcare expenditures.(1) However, if CIM is to be considered in broader healthcare strategies, its economic impact must be determined. Theoretically, CIM seems a good candidate for cost-effectiveness, and even cost savings, because it avoids high technology, offers inexpensive and noninvasive remedies, encourages healthy lifestyle change, and focuses on the whole person, all of which may improve health beyond the targeted disease or condition. However, to many in the conventional health-care system, CIM is seen only as an "add on" expense. What must be demonstrated via economic evaluation are the healthcare costs that can be avoided through the use of CIM. CIM offers the potential for several avenues of cost reduction. The first is as a direct replacement for the usual conventional therapy for a condition. The second is in terms of lower future healthcare utilization both in general (through treating the whole person) and for the targeted disease or condition. A third avenue to cost reduction is through reducing productivity loss for employers. A reduction in costs to employers does not directly reduce healthcare costs (unless the employer is itself a health-care facility); however, both are costs to society. Productivity losses can be reduced through improved employee health, and potentially through the improved employee well-being and

  13. An Evaluation of SMR Economic Attractiveness

    Directory of Open Access Journals (Sweden)

    Sara Boarin

    2014-01-01

    Full Text Available The nuclear “renaissance” that is taking place worldwide concerns the new build of GW size reactor plants, but smaller GenIII+ NPP (Small Modular Reactors, SMR are on the verge to be commercially available and are raising increasing public interest. These reactor concepts rely on the pressurized water technology, capitalizing on thousands of reactor-years operations and enhancing the passive safety features, thanks to the smaller plant and equipment size. On the other hand, smaller plant size pays a loss of economy of scale, which might have a relevant impact on the generation costs of electricity, given the capital-intensive nature of nuclear power technology. The paper explores the economic advantages/disadvantages of multiple SMR compared to alternative large plants of the same technology and equivalent total power installed. The metrics used in the evaluation is twofold, as appropriate for liberalized markets of capital and electricity: investment profitability and investment risk are assessed, from the point of view of the plant owner. Results show that multiple SMR deployed on the same site may prove competitive with investment returns of larger plants, while offering, in addition, unique features that mitigate the investment risk.

  14. Improving early cycle economic evaluation of diagnostic technologies

    NARCIS (Netherlands)

    Steuten, Lotte M.G.; Ramsey, Scott D.

    2014-01-01

    The rapidly increasing range and expense of new diagnostics, compels consideration of a different, more proactive approach to health economic evaluation of diagnostic technologies. Early cycle economic evaluation is a decision analytic approach to evaluate technologies in development so as to increa

  15. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement

    OpenAIRE

    Husereau, Don; DRUMMOND, MICHAEL; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H.; Mauskopf, Josephine; Loder, Elizabeth

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporti...

  16. Consolidated health economic evaluation reporting standards (CHEERS) statement

    OpenAIRE

    Husereau, D.; Drummond, M.; Petrou, S; Carswell, C; Moher, D; Greenberg, D.; Augustovski, F.; Briggs, A H; Mauskopf, J.; Loder, E

    2013-01-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporti...

  17. Generic antiretroviral drugs and HIV care: An economic review.

    Science.gov (United States)

    Yazdanpanah, Y; Schwarzinger, M

    2016-03-01

    The cost of HIV care in European countries is high. Direct medical costs, in France, have been estimated at 500,000 Euros per patient's lifetime (20,000 Euros/year/patient). Overall, 73% of these costs are related to antiretroviral treatments. In the current financial crisis context, some European countries are beginning to make economic decisions on the drugs to be used. These approaches are likely to become more frequent. It is obviously essential to prescribe the most effective, appropriate, best tolerated, and easy-to-use antiretroviral treatments to patients. However, while taking the above into consideration, and if various treatment options or combinations are available, cost should also be considered in the treatment choice. One may thus reflect on the use of generic antiretroviral agents as they have just been launched in France. We aimed to review the cost and cost-effectiveness of generic antiretroviral drugs and to review treatment strategies other than generic drugs that could help reduce HIV-related costs. HIV clinicians should consider treatment costs to avoid any future coercive measures.

  18. Generic antiretroviral drugs and HIV care: An economic review.

    Science.gov (United States)

    Yazdanpanah, Y; Schwarzinger, M

    2016-03-01

    The cost of HIV care in European countries is high. Direct medical costs, in France, have been estimated at 500,000 Euros per patient's lifetime (20,000 Euros/year/patient). Overall, 73% of these costs are related to antiretroviral treatments. In the current financial crisis context, some European countries are beginning to make economic decisions on the drugs to be used. These approaches are likely to become more frequent. It is obviously essential to prescribe the most effective, appropriate, best tolerated, and easy-to-use antiretroviral treatments to patients. However, while taking the above into consideration, and if various treatment options or combinations are available, cost should also be considered in the treatment choice. One may thus reflect on the use of generic antiretroviral agents as they have just been launched in France. We aimed to review the cost and cost-effectiveness of generic antiretroviral drugs and to review treatment strategies other than generic drugs that could help reduce HIV-related costs. HIV clinicians should consider treatment costs to avoid any future coercive measures. PMID:26905394

  19. Introduction course on the economical evaluation of energy projects

    International Nuclear Information System (INIS)

    A theoretical course on the financial and economical evaluation of energy projects is presented. The course was organized by the Banque Mondiale in Bujumbura, Burundi, from 11 to 16 November 1991. Subsequently attention is paid to the basics of economic analysis, the financial and the economical analysis of an investment project, and finally the prices of energy products. 4 figs., 13 refs

  20. Systematic critical review of previous economic evaluations of smoking cessation during pregnancy

    OpenAIRE

    Jones, Matthew; Lewis, Sarah; Parrott, Steve; Coleman, Tim

    2015-01-01

    Objective: To identify and critically assess previous economic evaluations of smoking cessation interventions delivered during pregnancy. Design: Qualitative review of studies with primary data collection or hypothetical modelling. Quality assessed using the Quality of Health Economic Studies checklist. Data sources: Electronic search of 13 databases including Medline, Econlit, Embase, and PubMed, and manual search of the UK's National Institute of Health and Care Excellence guideline...

  1. Economic evaluation of coalbed methane production in China

    International Nuclear Information System (INIS)

    Roaring natural gas demand, energy security and environment protection concerns coupled with stringent emission reduction requirement have made China's abundant coalbed methane (CBM) resource an increasingly valuable energy source. However, not all of China's CBM resource is economic to develop under current technological condition and economic situation. In order to locate the CBM resource with economic viability to develop in China, economic evaluation of CBM production is conducted by applying net present value (NPV) method. The results indicate that more than half of CBM resource in China is economic to develop. It shows that CBM price, production rate and operating costs are the three major factors with most impact on the economic viability of the CBM development in target areas in China. The result also demonstrates that the economic limit production is roughly 1200 cubic meters per day. These economic evaluation results provide important information for both CBM companies and China government.

  2. Evaluation of economic rent of hydropower projects

    International Nuclear Information System (INIS)

    Existing studies have mostly estimated the ex post economic rent of hydropower for the hydroelectric system of a province or a country as a whole and have ignored the site- or project-specific variations in the economic rent of hydropower plants. Further, most of the existing studies have used simplified methods to calculate the rent ex post. This paper presents a rigorous methodology for estimation of site-specific (i.e., project specific) economic rent of hydropower ex ante. It applies the methodology in the case of a hydropower project and analyzes the sensitivity of the rent to variations in some key parameters.

  3. The TOPSIS Evaluation on Carbon Emission Economic Efficiency

    Institute of Scientific and Technical Information of China (English)

    Sheng; XU; Chao; ZHANG; Juan; YANG

    2013-01-01

    Based on carbon emission data of 17 cities in Shandong Province in 2005-2009,this paper analyzes carbon emission economic efficiency. It conducts weight distribution by the Ordered Weighted Averaging ( OWA) method,and takes systematic evaluation on carbon emission economic efficiency using TOPSIS method. In eastern coastal regions,including Dongying,Yantai,Weihai and Qingdao,the carbon emission economic efficiency is generally higher than inland regions of Shandong Province. The conclusion reached after correction of time weight is basically consistent with traditional TOPSIS overall evaluation,further proves validity of the evaluation. Finally,it gives recommendations for improving carbon emission economic efficiency in Shandong Province.

  4. A systematic review of care delivery models and economic analyses in lymphedema: health policy impact (2004-2011).

    Science.gov (United States)

    Stout, N L; Weiss, R; Feldman, J L; Stewart, B R; Armer, J M; Cormier, J N; Shih, Y-C T

    2013-03-01

    A project of the American Lymphedema Framework Project (ALFP), this review seeks to examine the policy and economic impact of caring for patients with lymphedema, a common side effect of cancer treatment. This review is the first of its kind undertaken to investigate, coordinate, and streamline lymphedema policy initiatives in the United States with potential applicability worldwide. As part of a large scale literature review aiming to systematically evaluate the level of evidence of contemporary peer-reviewed lymphedema literature (2004 to 2011), publications on care delivery models, health policy, and economic impact were retrieved, summarized, and evaluated by a team of investigators and clinical experts. The review substantiates lymphedema education models and clinical models implemented at the community, health care provider, and individual level that improve delivery of care. The review exposes the lack of economic analysis related to lymphedema. Despite a dearth of evidence, efforts towards policy initiatives at the federal and state level are underway. These initiatives and the evidence to support them are examined and recommendations for translating these findings into clinical practice are made. Medical and community-based disease management interventions, taking on a public approach, are effective delivery models for lymphedema care and demonstrate great potential to improve cancer survivorship care. Efforts to create policy at the federal, state, and local level should target implementation of these models. More research is needed to identify costs associated with the treatment of lymphedema and to model the cost outlays and potential cost savings associated with comprehensive management of chronic lymphedema.

  5. A new method for evaluating worst- and best-case (WBC) economic consequences of technological development

    DEFF Research Database (Denmark)

    Schjær-Jacobsen, Hans

    1996-01-01

    This paper is addressing the problem of evaluating economic worst- and best-care (WBC) consequences of technological development in industrial companies faking into account uncertainties and lack of exact cost and market information. In the theoretical part of the paper, the mathematical concepts...

  6. Toward Development of a New Health Economic Evaluation Definition

    OpenAIRE

    Botchkarev, Alexei

    2016-01-01

    Economic evaluation is a dynamically advancing knowledge area of health economics. It has been conceived to provide evidence for allocating scarce resources to gain the best value for money. The problem of efficiency of investments becomes even more crucial with advances in modern medicine and public health which bring about both improved patient outcomes and higher costs. Despite the abundance of literature on the economic evaluation concepts, some key notions including the definition of the...

  7. Evaluation of Ambulatory Care Information Systems

    OpenAIRE

    Simborg, Donald W.; Whiting-O'Keefe, Quinn E.

    1980-01-01

    The central purpose of an ambulatory care information system is to communicate information to the practitioner to facilitate clinical decision making. The clinical decision can be considered the dependent output variable in a process having the information system, the patient, clinician characteristics, and the environment as the independent input variables. Evaluation approaches using patient outcomes are problematic because of the indirect relationship between the information system and pat...

  8. The logic of transaction cost economics in health care organization theory.

    Science.gov (United States)

    Stiles, R A; Mick, S S; Wise, C G

    2001-01-01

    Health care is, at its core, comprised of complex sequences of transactions among patients, providers, and other stakeholders; these transactions occur in markets as well as within systems and organizations. Health care transactions serve one of two functions: the production of care (i.e., the laying on of hands) or the coordination of that care (i.e., scheduling, logistics). Because coordinating transactions is integral to care delivery, it is imperative that they are executed smoothly and efficiently. Transaction cost economics (TCE) is a conceptual framework for analyzing health care transactions and quantifying their impact on health care structures (organizational forms), processes, and outcomes. PMID:11293015

  9. Economic evaluation of preconcentration of uranium ores

    International Nuclear Information System (INIS)

    The economics of two options for the preconcentration of low-grade uranium ores prior to hydrochloric acid leaching were studied. The first option uses flotation followed by wet high-intensity magnetic separation. The second option omits the flotation step. In each case it was assumed that most of the pyrite in the ore would be recovered by froth flotation, dewatered, and roasted to produce sulphuric acid and a calcine suitable for acid leaching. Savings in operating costs from preconcentration are offset by the value of uranium losses. However, a capital saving of approximately 6 million dollars is indicated for each preconcentration option. As a result of the capital saving, preconcentration appears to be economically attractive when combined with hydrochloric acid leaching. There appears to be no economic advantage to preconcentration in combination with sulphuric acid leaching of the ore

  10. Evaluating replicability of laboratory experiments in economics.

    Science.gov (United States)

    Camerer, Colin F; Dreber, Anna; Forsell, Eskil; Ho, Teck-Hua; Huber, Jürgen; Johannesson, Magnus; Kirchler, Michael; Almenberg, Johan; Altmejd, Adam; Chan, Taizan; Heikensten, Emma; Holzmeister, Felix; Imai, Taisuke; Isaksson, Siri; Nave, Gideon; Pfeiffer, Thomas; Razen, Michael; Wu, Hang

    2016-03-25

    The replicability of some scientific findings has recently been called into question. To contribute data about replicability in economics, we replicated 18 studies published in the American Economic Review and the Quarterly Journal of Economics between 2011 and 2014. All of these replications followed predefined analysis plans that were made publicly available beforehand, and they all have a statistical power of at least 90% to detect the original effect size at the 5% significance level. We found a significant effect in the same direction as in the original study for 11 replications (61%); on average, the replicated effect size is 66% of the original. The replicability rate varies between 67% and 78% for four additional replicability indicators, including a prediction market measure of peer beliefs. PMID:26940865

  11. Economic evaluation of minimum flow at Rockton

    International Nuclear Information System (INIS)

    This paper reports that the Rockton Hydroelectric Project is a two-unit, 1,100 kW plant operated by South Beloit Water, Gas and Electric Company, a wholly owned subsidiary of Wisconsin Power and Light Company. The project's 1,000-foot spillway directs water from the main stem of the Rock River, down a 5,000-foot power canal to the project. During relicensing of the project, state and federal resource agencies directed the licensee to propose an operations scheme for providing a protected minimum flow in the main stem of the river. As the prime relicensing consultant to Wisconsin Power and Light, Mead and Hunt conducted field studies to assess the environmental impact of various minimum flows. Mead and Hunt then conducted economic analyses to determine the economic impact of various minimum flows. The economic and environmental analyses were combined to develop a recommended minimum flow, which will be provided in the Draft Application for Subsequent License

  12. Economic evaluation of tokamak power plants

    International Nuclear Information System (INIS)

    This study reports the impact of plasma operating characteristics, engineering options, and technology on the capital cost trends of tokamak power plants. Tokamak power systems are compared to other advanced energy systems and found to be economically competitive. A three-phase strategy for demonstrating commercial feasibility of fusion power, based on a common-site multiple-unit concept, is presented

  13. Economic evaluation of investment in electricity conservation

    International Nuclear Information System (INIS)

    The paper presents an economic study of the potential for energy conservation in Israel. We analyze energy conservation policies targeted at the household sector, focusing on the economic feasibility of scrapping old household electrical appliances, and considering the effect of such policies at both the household and the macro-economic level. The results of our analysis show that the appliance that provides the most potential conservation is the air conditioner (used for both heating and cooling). A scrapping program for old air conditioners passes a cost benefit analysis (CBA) even when external benefits are excluded from the calculation. When external benefits are included, scrapping programs for both washing machines and dishwashers pass the test as well. According to our findings, the annual economic benefit of a program involving the scrapping of 100,000 air conditioners, 45,000 washing machines and 15,000 dishwashers per annum over 10 years ranges from 246 million New Israeli Shekels (NIS) in the first year of implementation to 693 million in the tenth year. Most of the savings are derived from the scrapping of air conditioners

  14. Economic evaluation of prevention; further evidence

    NARCIS (Netherlands)

    Wit GA de; Verweij A; Baal PHM van; Vijgen SMC; Berg M van den; Busch MCM; Barnhoorn MJM; Schuit AJ; Wit GA de; Schuit AJ; Berg M van den; ZonMw; VTV; PZO

    2007-01-01

    This report is the third in a series of reports that aim to identify cost-effective preventive interventions that have not yet been diffused into the Dutch health care system or into a public health setting. In the first part of this report, five new interventions are presented and at the same time,

  15. Economic evaluation of home blood pressure telemonitoring

    DEFF Research Database (Denmark)

    Madsen, Line Bille; Christiansen, Terkel; Kirkegaard, Peder;

    2011-01-01

    Aims. The purpose of the present study was to compare the costs of home blood pressure (BP) telemonitoring (HBPM) with the costs of conventional office BP monitoring. In a randomized controlled trial, 105 hypertensive patients performed HBPM and 118 patients received usual care with conventional...

  16. Evaluation of UK Integrated Care Pilots: research protocol

    Directory of Open Access Journals (Sweden)

    Tom Ling

    2010-09-01

    Full Text Available Background: In response to concerns that the needs of the aging population for well-integrated care were increasing, the English National Health Service (NHS appointed 16 Integrated Care Pilots following a national competition. The pilots have a range of aims including development of new organisational structures to support integration, changes in staff roles, reducing unscheduled emergency hospital admissions, reduced length of hospital stay, increasing patient satisfaction, and reducing cost. This paper describes the evaluation of the initiative which has been commissioned. Study design and data collection methods: A mixed methods approach has been adopted including interviews with staff and patients, non-participant observation of meetings, structured written feedback from sites, questionnaires to patients and staff, and analysis of routinely collected hospital utilisation data for patients/service users. The qualitative analysis aims to identify the approaches taken to integration by the sites, the benefits which result, the context in which benefits have resulted, and the mechanisms by which they occur. Methods of analysis: The quantitative analysis adopts a 'difference in differences' approach comparing health care utilisation before and after the intervention with risk-matched controls. The qualitative data analysis adopts a 'theory of change' approach in which we triangulate data from the quantitative analysis with qualitative data in order to describe causal effects (what happens when an independent variable changes and causal mechanisms (what connects causes to their effects. An economic analysis will identify what incremental resources are required to make integration succeed and how they can be combined efficiently to produce better outcomes for patients. Conclusion: This evaluation will produce a portfolio of evidence aimed at strengthening the evidence base for integrated care, and in particular identifying the context in which

  17. Evaluation of UK Integrated Care Pilots: research protocol

    Directory of Open Access Journals (Sweden)

    Tom Ling

    2010-09-01

    Full Text Available Background: In response to concerns that the needs of the aging population for well-integrated care were increasing, the English National Health Service (NHS appointed 16 Integrated Care Pilots following a national competition. The pilots have a range of aims including development of new organisational structures to support integration, changes in staff roles, reducing unscheduled emergency hospital admissions, reduced length of hospital stay, increasing patient satisfaction, and reducing cost. This paper describes the evaluation of the initiative which has been commissioned.Study design and data collection methods: A mixed methods approach has been adopted including interviews with staff and patients, non-participant observation of meetings, structured written feedback from sites, questionnaires to patients and staff, and analysis of routinely collected hospital utilisation data for patients/service users. The qualitative analysis aims to identify the approaches taken to integration by the sites, the benefits which result, the context in which benefits have resulted, and the mechanisms by which they occur.Methods of analysis: The quantitative analysis adopts a 'difference in differences' approach comparing health care utilisation before and after the intervention with risk-matched controls. The qualitative data analysis adopts a 'theory of change' approach in which we triangulate data from the quantitative analysis with qualitative data in order to describe causal effects (what happens when an independent variable changes and causal mechanisms (what connects causes to their effects. An economic analysis will identify what incremental resources are required to make integration succeed and how they can be combined efficiently to produce better outcomes for patients.Conclusion: This evaluation will produce a portfolio of evidence aimed at strengthening the evidence base for integrated care, and in particular identifying the context in which

  18. HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

    Science.gov (United States)

    Tamba, B I; Azoicăi, Doina; Druguş, Daniela

    2016-01-01

    Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony. PMID:27125091

  19. HEALTH CARE ECONOMICS IN ROMANIA--DYNAMICS AND EVOLUTION.

    Science.gov (United States)

    Tamba, B I; Azoicăi, Doina; Druguş, Daniela

    2016-01-01

    Health economics refers to the analysis of medical institutions considering their economic and social efficacy, but also the regularity and the relationships that govern the phenomena and the processes from the field of health with the final purpose of achieving better results with the minimum of resources; it represents the study of health price in its complexity. The economics of the population's health needs and in particular the health needs in case of the poor groups of the population, consider health to be the main component of global human vulnerability. Health economics tries to change the simple interpretation of health price and disease cost into a wider consideration of a system administration similar to educational and social economics and the study of health in the context of the multiple specializations of the macro economy of the national group, as it is an instrument in the country's great economics symphony.

  20. The economic evidence for advance care planning: systematic review of evidence

    OpenAIRE

    Dixon, Josie; Matosevic, Tihana; Knapp, Martin

    2015-01-01

    Background: Advance care planning (ACP), a process of discussion and review concerning future care in the event of losing capacity. Aimed at improving the appropriateness and quality of care, it is also often considered a means of controlling health spending at the end of life. Aim: To review and summarise economic evidence on advance care planning. Design: A systematic review of academic literature. Data sources: We searched for English language peer-reviewed journal articles, 1990 to 201...

  1. Economic crisis and counter-reform of universal health care systems: Spanish case

    OpenAIRE

    Paulo Antônio de Carvalho Fortes; Regina Ribeiro Parizi Carvalho; Marília Cristina Prado Louvison

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, ...

  2. Techno-economical evaluation of lignocellulose hydrolysis

    OpenAIRE

    Mirsch, Mikaela

    2014-01-01

    The economic dependency on fossil fuels affects the climate and environment, which drives the fuel research on the largest known renewable carbohydrate source: fermentable sugars from lignocellulose. Several fermentable sugars exist in lignicellulosic materials, but are not accessible for efficient use without pretreatment and hydrolysis. Enzymatic hydrolysis is typically used. Enzymatic hydrolysis has a high selectivity and is performed in mild conditions, but the cost of...

  3. Economic Evaluation of Road Traffic Safety Measures

    OpenAIRE

    Gul, Ejaz

    2013-01-01

    The number of road traffic casualties is still very lofty and the trend shows a boost with each passing day. The road traffic accidents involve fatalities due to which economic resources are damaged and the productivity of the economy is correspondingly impaired. Costs resulting from traffic accidents represent the largest single part of the overall cost of traffic to the economy. Knowledge about the harm of these traffic accidents to the economy is essential if measures to reduce road traffi...

  4. Economic evaluation of subsidence damage mitigation techniques

    International Nuclear Information System (INIS)

    Coal mining in Illinois has resulted in many structures being exposed to subsidence damage. Damage mitigation techniques (DMT) applied in the foundation design/construction have proven successful in minimizing damage in several test cases. To determine the practicality of these techniques, the costs of their application are investigated. The DMT costs are compared to foundation and total house costs for various classes and sizes of houses. An economical and effective subsidence resistant foundation construction is proposed

  5. An Economic Evaluation of Plastic Bag Regulation

    OpenAIRE

    2010-01-01

    In recent years, several jurisdictions worldwide have implemented plastic bag regulations to curb environmentally deleterious effects of plastic bag production and consumption. The problems that each jurisdiction experience vary from place-to-place; as do the policy mechanisms set forth to combat these problems. Documentation of explicit economic rationality regarding these plastic bag regulations is scarce. This thesis sets out to fill some of that void. The thesis is organized as fol...

  6. Economic evaluation in the field of mental health: conceptual basis

    Directory of Open Access Journals (Sweden)

    Ana Flávia Barros da Silva Lima

    2013-06-01

    Full Text Available Objective: Technological advances in medicine have given rise to a dilemma concerning the use of new health technologies in a context of limited financial resources. In the field of psychiatry, health economic evaluation is a recent method that can assist in choosing interventions with different cost and/or effectiveness for specific populations or conditions. This article introduces clinicians to the fundamental concepts required for critical assessment of health economic evaluations. Methods: The authors conducted a review with systematic methods to assess the essential theoretical framework of health economic evaluation and mental health in Brazil through textbooks and studies indexed in the PubMed, Cochrane Central, LILACS, NHS CRD, and REBRATS databases. A total of 334 studies were found using the specified terms (MeSH - Mental Health AND Economic, Medical and filters (Brazil AND Humans; however, only five Brazilian economic evaluations were found. Results and conclusions: Economic evaluation studies are growing exponentially in the medical literature. Publications focusing on health economics as applied to psychiatry are increasingly common, but Brazilian data are still very incipient. In a country where financial resources are so scarce, economic analyses are necessary to ensure better use of public resources and wider population access to effective health technologies.

  7. Solar energy system economic evaluation: IBM System 2, Togus, Maine

    Science.gov (United States)

    1980-01-01

    The economic analysis of the solar energy system, is developed for Torgus and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f-chart design procedure with inputs taken on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over a projected twenty year life, life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Results demonstrate that the solar energy system is economically viable at all of the five sites for which the analysis was conducted.

  8. THE ECONOMIC EVALUATION OF FOREST ROAD BUILDING

    OpenAIRE

    Muška, Aina; Bičevskis, Matīss

    2010-01-01

    Forest road density in Latvia is insufficient, although the Joint Stock Company ‘‘Latvijas valsts meži” (“Latvian State Forestry”) performs active forest road building. The hypothesis of the research is that the resources invested in a forest road building pay off during its use. The goal of the research is to study the economic benefit from forest road building. The authors’ research showed that the total costs of forest road building and use could result in Ls 246,779 over 40 years or Ls 6,...

  9. Economical evaluation of electricity generation considering externalities

    Energy Technology Data Exchange (ETDEWEB)

    El-Kordy, M.N.; Badr, M.A.; Abed, K.A. [National Research Center, Mechanical Engineering Dept., Giza (Egypt); Ibrahim, Said M.A. [Al-Azhar Univ., Mechanical Engineering Dept., Cairo (Egypt)

    2002-02-01

    The economics of renewable energy are the largest barrier to renewable penetration. Nevertheless, the strong desire to reduce environmental emissions is considered a great support for renewable energy sources. In this paper, a full analysis for the cost of the kWh of electricity generated from different systems actually used in Egypt is presented. Also renewable energy systems are proposed and their costs are analyzed. The analysis considers the external cost of emissions from different generating systems. A proposed large scale PV plant of 3.3 MW, and a wind farm 11.25 MW grid connected at different sites are investigated. A life cycle cost analysis for each system was performed using the present value criterion. The comparison results showed that wind energy generation has the lowest cost, followed by a combined cycle-natural gas fired system. A photovoltaic system still uses comparatively expensive technology for electricity generation; even when external costs are considered the capital cost of photovoltaic needs to be reduced by about 60% in order to be economically competitive. (Author)

  10. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

    Science.gov (United States)

    Husereau, Don; Drummond, Michael; Petrou, Stavros; Carswell, Chris; Moher, David; Greenberg, Dan; Augustovski, Federico; Briggs, Andrew H; Mauskopf, Josephine; Loder, Elizabeth

    2013-06-01

    Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website ( www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23526140

  11. Can we do better? Economic analysis of human resource investment to improve home care service for the elderly in Serbia

    Directory of Open Access Journals (Sweden)

    Mihic MM

    2016-01-01

    Full Text Available Marko M Mihic, Marija Lj Todorovic, Vladimir Lj Obradovic, Zorica M Mitrovic Department for Management and Specialised Management Disciplines, Faculty of Organisational Sciences, University of Belgrade, Belgrade, Serbia Background: Social services aimed at the elderly are facing great challenges caused by progressive aging of the global population but also by the constant pressure to spend funds in a rational manner.Purpose: This paper focuses on analyzing the investments into human resources aimed at enhancing home care for the elderly since many countries have recorded progress in the area over the past years. The goal of this paper is to stress the significance of performing an economic analysis of the investment.Methods: This paper combines statistical analysis methods such as correlation and regression analysis, methods of economic analysis, and scenario method.Results: The economic analysis of investing in human resources for home care service in Serbia showed that the both scenarios of investing in either additional home care hours or more beneficiaries are cost-efficient. However, the optimal solution with the positive (and the highest value of economic net present value criterion is to invest in human resources to boost the number of home care hours from 6 to 8 hours per week and increase the number of the beneficiaries to 33%.Conclusion: This paper shows how the statistical and economic analysis results can be used to evaluate different scenarios and enable quality decision-making based on exact data in order to improve health and quality of life of the elderly and spend funds in a rational manner. Keywords: home care, social investment, human resources, economic analysis, elderly

  12. Social, Economic, and Political Issues Affecting End-of-Life Care.

    Science.gov (United States)

    Sopcheck, Janet

    2016-02-01

    For many decades, Americans showed a preference for delaying death through a technological imperative that often created challenges for nurses in caring for dying patients and their families. Because of their vast knowledge of health and healing, and their proximity to patients' bedsides, nurses are often well positioned to advocate for healthcare reform and legislation to improve end-of-life care. This article provides an overview of the social, economic, and political factors that are shaping end-of-life care in the United States. First, historical perspectives on end-of-life care are presented to enhance understanding of why some clinicians and patients seem to resist change to current practices. Second, end of care issues related to advanced technology utilization, societal expectations of care, clinical practices, financial incentives, palliative care services, and policy reforms are discussed. Finally, future recommendations are provided to encourage nurses and other healthcare providers to improve care for individuals facing end-of-life care decisions.

  13. Economic Evaluation of Computerized Structural Analysis

    Science.gov (United States)

    Fortin, P. E.

    1985-01-01

    This completed effort involved a technical and economic study of the capabilities of computer programs in the area of structural analysis. The applicability of the programs to NASA projects and to other users was studied. The applications in other industries was explored including both research and development and applied areas. The costs of several alternative analysis programs were compared. A literature search covered applicable technical literature including journals, trade publications and books. In addition to the literature search, several commercial companies that have developed computerized structural analysis programs were contacted and their technical brochures reviewed. These programs include SDRC I-DEAS, MSC/NASTRAN, SCADA, SUPERSAP, NISA/DISPLAY, STAAD-III, MICAS, GTSTRUDL, and STARS. These programs were briefly reviewed as applicable to NASA projects.

  14. The Economic Well-Being of Lesbian, Gay, and Bisexual Youth Transitioning Out of Foster Care.

    OpenAIRE

    Amy Dworsky

    2013-01-01

    The brief describes the characteristics and economic well-being of young people aging out of foster care who identify themselves as lesbian, gay, or bisexual (LGB). It also compares their economic self-sufficiency with that of their heterosexual peers also aging out of care. The analysis uses data from the Midwest Study of Adult Functioning of Former Foster Youth, a longitudinal study that followed a sample of young people from Illinois, Iowa, and Wisconsin as they transitioned out of foster ...

  15. The Economic WellBeing of Lesbian Gay and Bisexual Youth Transitioning Out of Foster Care

    OpenAIRE

    Amy Dworsky

    2013-01-01

    The brief describes the characteristics and economic well-being of young people aging out of foster care who identify themselves as lesbian, gay, or bisexual (LGB). It also compares their economic self-sufficiency with that of their heterosexual peers also aging out of care. The analysis uses data from the Midwest Study of Adult Functioning of Former Foster Youth, a longitudinal study that followed a sample of young people from Illinois, Iowa, and Wisconsin as they transitioned out of foster ...

  16. Economic evaluation in long-term clinical trials.

    Science.gov (United States)

    Hlatky, Mark A; Boothroyd, Derek B; Johnstone, Iain M

    2002-10-15

    Economic endpoints have been increasingly included in long-term clinical trials, but they pose several methodologic challenges, including how best to collect, describe, analyse and interpret medical cost data. Cost of care can be measured by converting billed charges, performing detailed micro-costing studies, or by measuring use of key resources and assigning cost weights to each resource. The latter method is most commonly used, with cost weights based either on empirical regression models or administratively determined reimbursement rates. In long-term studies, monetary units should be adjusted to reflect cost inflation and discounting. The temporal pattern of accumulating costs can be described using a modification of the Kaplan-Meier curve. Regression analyses to evaluate factors associated with cost are best performed on the log of costs due to their typically skewed distribution.Cost-effectiveness analysis attempts to measure the value of a new therapy by calculating the difference in cost between the new therapy and the standard therapy, divided by the difference in benefit between the new therapy and the standard therapy. The cost-effectiveness ratio based on the results of a randomized trial may change substantially with longer follow-up intervals, particularly for therapies that are initially expensive but eventually improve survival. A model that projects long-term patterns of cost and survival expected beyond the end of completed follow-up can provide an important perspective in the setting of limited trial duration.

  17. Integrating economic evaluation methods into clinical and translational science award consortium comparative effectiveness educational goals.

    Science.gov (United States)

    Iribarne, Alexander; Easterwood, Rachel; Russo, Mark J; Wang, Y Claire

    2011-06-01

    With the ongoing debate over health care reform in the United States, public health and policy makers have paid growing attention to the need for comparative effectiveness research (CER). Recent allocation of federal funds for CER represents a significant move toward increased evidence-based practice and better-informed allocation of constrained health care resources; however, there is also heated debate on how, or whether, CER may contribute to controlling national health care expenditures. Economic evaluation, in the form of cost-effectiveness or cost-benefit analysis, is often an aspect of CER studies, yet there are no recommendations or guidelines for providing clinical investigators with the necessary skills to collect, analyze, and interpret economic data from clinical trials or observational studies. With an emphasis on multidisciplinary research, the Clinical and Translational Science Award (CTSA) consortium and institutional CTSA sites serve as an important resource for training researchers to engage in CER. In this article, the authors discuss the potential role of CTSA sites in integrating economic evaluation methods into their comparative effectiveness education goals, using the Columbia University Medical Center CTSA as an example. By allowing current and future generations of clinical investigators to become fully engaged not only in CER but also in the economic evaluations that result from such analyses, CTSA sites can help develop the necessary foundation for advancing research to guide clinical decision making and efficient use of limited resources.

  18. Solar energy system economic evaluation: IBM System 4, Clinton, Mississippi

    Science.gov (United States)

    1980-01-01

    An economic analysis of the solar energy system was developed for five sites, typical of a wide range of environmental and economic conditions in the continental United States. The analysis was based on the technical and economic models in the F-chart design procedure, with inputs based on the characteristic of the installed system and local conditions. The results are of the economic parameters of present worth of system cost over a 20 year time span: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated.

  19. Solar energy system economic evaluation for Seeco Lincoln, Lincoln, Nebraska

    Science.gov (United States)

    1980-01-01

    The economic analysis of the solar energy system that was installed at Lincoln, Nebraska is developed for this and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over projected twenty year life: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated.

  20. Economic Evaluation of a Chosen Firm

    OpenAIRE

    POSPÍŠILOVÁ, Eva

    2011-01-01

    The aim of my diploma thesis is to evaluate a chosen firm. My evaluated firm is AUDITOR Praha s.r.o. which offers auditing services, audit of bookkeeping and tax, accounting and financial advices. The company has been registered in the official list of auditors of the Czech Republic since 1999. The affiliated company Auditor spol. s r. o. was founded as a 100 percent subsidiary company of an Austrian consulting firm in May 1991 in Prague. Firstly it was needed to elaborate the strategic and f...

  1. Economic evaluation of the Blanket Comparison and Selection Study

    International Nuclear Information System (INIS)

    The economic impact of employing the highly ranked blankets in the Blanket Comparison and Selection Study (BCSS) was evaluated in the context of both a tokamak and a tandem mirror power reactor (TMR). The economic evaluation criterion was determined to be the cost of electricity. The influencing factors that were considered are the direct cost of the blankets and related systems; the annual cost of blanket replacement; and the performance of the blanket, heat transfer, and energy conversion systems. The technical and cost bases for comparison were those of the STARFIRE and Mirror Advanced Reactor Study conceptual design power plants. The economic evaluation results indicated that the nitrate-salt-cooled blanket concept is an economically attractive concept for either reactor type. The water-cooled, solid breeder blanket is attractive for the tokamak and somewhat less attractive for the TMR. The helium-cooled, liquidlithium breeder blanket is the least economically desirable of higher ranked concepts. The remaining self-cooled liquid-metal and the helium-cooled blanket concepts represent moderately attractive concepts from an economic standpoint. These results are not in concert with those found in the other BCSS evaluation areas (engineering feasibility, safety, and research and development (R and D) requirements). The blankets faring well economically had generally lower cost components, lower pumping power requirements, and good power production capability. On the other hand, helium- and lithium-cooled systems were preferred from the standpoints of safety, engineering feasibility, and R and D requirements

  2. Comprehensive Child Care Program: Phase 1 - Evaluation Results.

    Science.gov (United States)

    Harachi, Tracy; Anthony, Emily; Bleisner, Siri

    Seattle's Comprehensive Child Care Program (CCCP) (Washington) is made up of a child care subsidy to offset child care costs for working and student families with low incomes, and quality assurance and technical assistance for 150 child care providers, including on-site evaluations, public health consulting, continuing education for providers, and…

  3. Can economic evaluation in telemedicine be trusted? A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Bergmo Trine S

    2009-10-01

    Full Text Available Abstract Background Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles published in peer-reviewed journals and written in English in the period from 1990 to 2007 were analysed. The literature search identified 33 economic evaluations where both costs (resource use and outcomes (non-resource consequences were measured. Results This review shows that economic evaluations in telemedicine are highly diverse in terms of both the study context and the methods applied. The articles covered several medical specialities ranging from cardiology and dermatology to psychiatry. The studies analysed telemedicine in home care, and in primary and secondary care settings using a variety of different technologies including videoconferencing, still-images and monitoring (store-and-forward telemedicine. Most studies used multiple outcome measures and analysed the effects using disaggregated cost-consequence frameworks. Objectives, study design, and choice of comparators were mostly well reported. The majority of the studies lacked information on perspective and costing method, few used general statistics and sensitivity analysis to assess validity, and even fewer used marginal analysis. Conclusion As this paper demonstrates, the majority of the economic evaluations reviewed were not in accordance with standard evaluation techniques. Further research is needed to explore the reasons for this and to address how economic evaluation in telemedicine best can take advantage of local constraints and at the same time produce valid and generalisable results.

  4. Evaluation of Ecological and Economic Index in Poyang Lake Ecological Economic Zone

    Institute of Scientific and Technical Information of China (English)

    Heping; HUANG; Xiaolin; PENG

    2015-01-01

    The society and related research fields were paying close attention to make great efforts to promote the construction level of ecological civilization in China. And measuring and evaluating the status of eco-economic development always was the focus and difficulty in current researches. Based on the methods of Analytic Hierarchy Process( AHP) and the concept of Eco-Factor of Economic Growth and Ecological Efficiency,combined with the fact of research area,the index system of Ecological Economy Index( EEI),which includes social development,economic growth,ecological building,resource use and environmental protection,was built up to measure and evaluate the eco-economic system’s development situation. The weights of all indicators in the EEI system were acquired from the method of expert consultation. All the methods were applied to assess the eco-economic development situation in Poyang Lake Ecological Economic Zone of Jiangxi Province. The results showed that:( i) The model of EEI could intuitively apply to reflect the eco-economic development situation and coordinate extent of the assessment units in the Poyang Lake Eco-economic Zone,which could provide some scientific guides on finding breakthrough point of evaluating eco-economic level for concerned management departments and policies making organizations.( ii) There were distinct differences of Ecological Economy Index value between the counties,cities or districts. Wannian county was on the best situation with the highest EEI value( EEI = 55.74),and Ruichang city was found to be on the worst eco-economic development situation with the lowest EEI value( EEI = 28. 65).( iii) The developed counties( cities or districts) with high EEI value should improve resource use’s efficiency,protect environment and strengthen ecological construction. The other areas should effectively combine the speed with the quality of economic growth in the process of eco-economic development.( iv) The counties( cities or districts

  5. 多药耐药菌医疗相关感染经济损失评价%Evaluation of economic losses induced by multidrug-resistant bacteria health care-associated infections

    Institute of Scientific and Technical Information of China (English)

    孙吉花; 邢敏; 姜雪锦; 王琳; 邱会芬; 赵爱荣; 李卫光

    2015-01-01

    OBJECTIVE To observe the effect of multidrug‐resistant bacteria health care‐associated infections (HAIs) on length of hospital stay and hospitalization expenses and evaluate the economical losses induced by the multidrug‐resistant bacteria HAIs .METHODS In 2012 and 2013 ,a retrospective survey was conducted to collect the related data of the patients with multidrug‐resistant bacteria HAIs and the patients without multidrug‐resistant bacteria HAIs ,and the occurrence tendency of HAIs ,length of hospital stay ,and hospitalization expenses were statistically analyzed by using SPSS17 .0 software .RESULTS The detection rate of the multidrug‐resistant bacteria HAIs was 44 .16% in 2012 and dropped to 23 .68% in 2013 .The average length of hospital stay of the patients with multidrug‐resistant bacteria HAIs was 51 .48 days in 2012 ,significantly longer than 20 .67 days of the pa‐tients without multidrug‐resistant bacteria HAIs ;it was 45 .16 days in 2013 ,significantly longer than 21 .19 days of the patients without multidrug‐resistant bacteria HAIs .The total hospitalization expense of the patients with multidrug‐resistant bacteria HAI was 130 749 .80 yuan in 2012 ,significantly more than 20 919 .86 yuan of the pa‐tients without multidrug‐resistant bacteria infections ;it was 127 473 .29 yuan in 2013 ,significantly more than 29 225 .12 yuan of the patients without multidrug‐resistant bacteria infections .CONCLUSIONS The multidrug‐resist‐ant bacteria HAIs may increase the length of hospital stay and the economic losses ,and it is urgent to take effec‐tive prevention measures .%目的:了解多药耐药菌(MDROs)医疗相关感染(HAIs)对住院日及住院费用的影响,评价其导致的经济损失。方法回顾性调查2012及2013年多药耐药菌 H A Is及非多药耐药菌 H A Is患者的相关资料,采用SPSS17.0软件对 HAIs发生趋势、两组患者的住院日及住院费用进行统计

  6. Socio-economic status influences blood pressure control despite equal access to care

    DEFF Research Database (Denmark)

    Paulsen, M S; Andersen, M; Munck, A P;

    2012-01-01

    OBJECTIVE: Denmark has a health care system with free and equal access to care irrespective of age and socio-economic status (SES). We conducted a cross-sectional study to investigate a possible association between SES and blood pressure (BP) control of hypertensive patients treated in general pr...

  7. The changing role of economic evaluation in valuing medical technologies.

    Science.gov (United States)

    Rotter, Jason S; Foerster, Douglas; Bridges, John Fp

    2012-12-01

    Economic evaluation is established within health-technology assessment but is challenged by those wanting to use economic evaluation to inform pricing and/or incorporate nontraditional sources of value and the views of diverse stakeholders. The changing role of economic evaluation in (formally or informally) assessing prices/values in four jurisdictions (UK, Australia, Germany and USA) is detailed and the authors propose a taxonomy of factors impacting the value of medical technology spanning clinical utility (effectiveness, safety/tolerability and quality of evidence), consumer demand (consumer preferences, process utility and unmet need), economic incentives (innovation, option value and market competition) and the societal perspective (social justice, social values and national interest). The authors suggest that multicriteria decision analysis methods grounded in hedonic-pricing theory can facilitate the valuing/pricing of medical technologies. The use of such an approach is hindered by a paucity of relevant educational opportunities, vested interests and aversion to placing prices/values on health.

  8. Professional Economic Ethics: Why Heterodox Economists Should Care

    OpenAIRE

    George DeMartino

    2013-01-01

    In presenting the case for professional economic ethics over the past two years, since the publication of The Economist's Oath, I've encountered more scepticism among heterodox economists on the left than from those on the right. Left-leaning economists argue inter aliathat the project to establish a field of professional economic ethics is naïve, since economists are hardly to be dissuaded from doing wrong by the existence of a code of conduct; off target, since professional ethics doesn't a...

  9. Socio-economic inequalities in the use of postnatal care in India.

    Directory of Open Access Journals (Sweden)

    Abhishek Singh

    Full Text Available OBJECTIVES: First, our objective was to estimate socio-economic inequalities in the use of postnatal care (PNC compared with those in the use of care at birth and antenatal care. Second, we wanted to compare inequalities in the use of PNC between facility births and home births and to determine inequalities in the use of PNC among mothers with high-risk births. METHODS AND FINDINGS: Rich-poor ratios and concentration indices for maternity care were estimated using the third round of the District Level Household Survey conducted in India in 2007-08. Binary logistic regression models were used to examine the socio-economic inequalities associated with use of PNC after adjusting for relevant socio-economic and demographic characteristics. PNC for both mothers and newborns was substantially lower than the care received during pregnancy and child birth. Only 44% of mothers in India at the time of survey received any care within 48 hours after birth. Likewise, only 45% of newborns received check-up within 24 hours of birth. Mothers who had home births were significantly less likely to have received PNC than those who had facility births, with significant differences across the socio-economic strata. Moreover, the rich-poor gap in PNC use was significantly wider for mothers with birth complications. CONCLUSIONS: PNC use has been unacceptably low in India given the risks of mortality for mothers and babies shortly after birth. However, there is evidence to suggest that effective use of pregnancy and childbirth care in health facilities led to better PNC. There are also significant socio-economic inequalities in access to PNC even for those accessing facility-based care. The coverage of essential PNC is inadequate, especially for mothers from economically disadvantaged households. The findings suggest the need for strengthening PNC services to keep pace with advances in coverage for care at birth and prenatal services in India through targeted policy

  10. ECONOMIC EVALUATION OF BEEKEEPING IN KARLOVACKA COUNTY

    Directory of Open Access Journals (Sweden)

    Janja Kezić

    2009-03-01

    Full Text Available Beekeeping in Croatia has a long tradition. There are favourable climate and vegetation conditions for development of beekeeping in Croatia. The number of registered beekeepers in Croatia is 3.404 with total of 313.978 beehives. Most of them are part–time beekeepers (53 %, hobby beekeepers comprise 37 % and professional beekeepers represent the smallest part with 11 % [3]. Beekeeping production is mainly organized on family farms [5]. Karlovačka county, in the cental part of Croatia, was chosen to analyse the economic attributes of beekeeping. The number of beekeepers in Karlovačka county in 2007. was 179 with total of 17.636 beehives [3]. Beekeepers were interviewed during the regular meeting of the Beekeepers Association. Forty–five beekeepers were interviewed which is a representative sample of beekeepers in Karlovacka county. Beekeepers were categorized as hobby beekeepers (<60, part–time (61–150 and professional beekeepers (>151 based on the number of beehives. There are 56 % of hobby beekeepers, 31 % of part–time beekeepers and 13 % are professional beekeepers. Fixed assets in beekeeping consist of equipment, beehives and vehicles used in beekeeping (trucks, trailers, personal car. Hobby beekeepers generate 5.031,55 € of total income per year with 52 average beehives per beekeeper. They achieve the highiest selling price an average of 3,20 € per kilo for their honey. Part–time beekeepers generate 9.875,74 € total income per year. The average number of beehives per part–time beekeeper is 110 and they achieve a selling price of 2,69 € per kilo. Professional beekeepers generate 26.681,36 € total income per year with an average number of 329 beehives per beekeeper. Their actual selling price, on average, is 2,07 €.

  11. [The effects of economic crises on health care].

    Science.gov (United States)

    Chang, Nai-Hsin; Huang, Chiu-Ling; Yang, Yu-O

    2010-08-01

    In September 2008, financial turmoil on Wall Street led to severe losses in that country's financial derivatives market and plunged the United States into the most severe financial crisis in over a decade. The backlash of this "financial tsunami" has affected countries around the world. The world economy, facing the most critical financial crisis since the 1930s, must deal with recession, severe unemployment and general fears of worse to come, which have, in turn, spawned a range of physical, psychological and spiritual problems. In this article we study the effects of the economic crisis on healthcare from several angles, including: decreasing incomes causing changing attitudes toward seeking healthcare; decreasing numbers of people covered by medical insurance; increasing impact on the job market of untreated illnesses; changing national healthcare policies in response to economic pressures; increasing physical, psychological and social problems resulting from economic problems; and the need for the nursing profession to respond to these and other rapid changes in the healthcare landscape. Nursing staff are sometimes unaware of social problems outside their profession. This article may, therefore, provide a general reference to medical and nursing staff on the effects of the economic crisis on healthcare. PMID:20661861

  12. Economic evaluation of the integrated SMART desalination plant

    International Nuclear Information System (INIS)

    In this study, an economic evaluation methodology of the integrated SMART desalination plant was established and the economic evaluation of SMART was performed. The plant economics was evaluated with electricity generation costs calculated using approximate estimates of SMART cost data and the result was compared with the result calculated using the SMART design data and estimated bulk materials. In addition, a series of sensitivity studies on the power generation cost was performed for the main economic parameters of SMART Power credit method was used for the economic analysis of the integrated SMART desalination plant. Power credit method is a widely used economic analysis method for the cogeneration plant when the major portion of the energy is used for the electricity generation. In the case of using SMART fot power generation only, the result shows that the electricity generation cost of SMART is higher than that of the alternative power options. However, it can be competitive with the other power options in the limited cases, especially with the gas fired combined plant. In addition, an economic analysis of the integrated SMART desalination plant coupled with MED was performed. The calculated water production cost is in the range of 0.56 approx. 0.88($/m3) for the plant availability of 80% or higher, which is close to the study results presented by the various other countries. This indicates that SMART can be considered as a competitive choice for desalination among various alternative energy sources

  13. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  14. Indonesia health care system and Asean economic community

    Directory of Open Access Journals (Sweden)

    Joko Gunawan

    2015-07-01

    However, AEC, by looking at this challenges, is expected to improve health care system and service in Indonesia, and close the gap by collaborating among ten ASEAN member countries through 4 modes of AEC consisting of cross border supply, consumption abroad, commercial presence, and movement of natural persons. [Int J Res Med Sci 2015; 3(7.000: 1571-1577

  15. A Primer on Health Economic Evaluations in Thoracic Oncology.

    Science.gov (United States)

    Whittington, Melanie D; Atherly, Adam J; Bocsi, Gregary T; Camidge, D Ross

    2016-08-01

    There is growing interest for economic evaluation in oncology to illustrate the value of multiple new diagnostic and therapeutic interventions. As these analyses have started to move from specialist publications into mainstream medical literature, the wider medical audience consuming this information may need additional education to evaluate it appropriately. Here we review standard practices in economic evaluation, illustrating the different methods with thoracic oncology examples where possible. When interpreting and conducting health economic studies, it is important to appraise the method, perspective, time horizon, modeling technique, discount rate, and sensitivity analysis. Guidance on how to do this is provided. To provide a method to evaluate this literature, a literature search was conducted in spring 2015 to identify economic evaluations published in the Journal of Thoracic Oncology. Articles were reviewed for their study design, and areas for improvement were noted. Suggested improvements include using more rigorous sensitivity analyses, adopting a standard approach to reporting results, and conducting complete economic evaluations. Researchers should design high-quality studies to ensure the validity of the results, and consumers of this research should interpret these studies critically on the basis of a full understanding of the methodologies used before considering any of the conclusions. As advancements occur on both the research and consumer sides, this literature can be further developed to promote the best use of resources for this field.

  16. Health economics evidence for medical nutrition: are these interventions value for money in integrated care?

    Directory of Open Access Journals (Sweden)

    Walzer S

    2014-05-01

    value for money of medical nutrition interventions. The evaluations were conducted by analyzing different medical nutrition according to their indications, the economic methodology or perspective adopted, the cost source and utility measures, selected efficiency measures, as well as the incremental cost-effectiveness ratio. Results: A total of 225 abstracts were identified for the detailed review, and the data were entered into a data extraction sheet. For the abstracts that finally met the predefined inclusion criteria (n=53, full-text publications were obtained via PubMed, subito, or directly via each journal's Webpage for further assessment. After a detailed review of the full text articles, 34 publications have been qualified for a thorough data extraction procedure. When differentiating the resulting articles in terms of their settings, 20 studies covered inpatients, whereas 14 articles covered outpatients, including patients in community centers. When reviewing the value-for-money evaluations, the indications showed that the different results were mostly impacted by the different perspectives adopted and the comparisons that were made. In order to draw comprehensive conclusions, the results were split according to the main indications and diseases. Discussion: The systematic literature search has shown that there is not only an interest in health economics and its application in medical nutrition, but that there is a lot of ongoing research in this area. Based on the underlying systematic analysis, it has been shown that medical nutrition interventions offer value for money in the different health care settings, particularly for the specific disease areas that have been pointed out. Conclusion: Based on the systematic literature search that was performed, it was shown that medical nutrition interventions offer value for money in the different health care settings. Although medical nutrition has been the topic of some health economic analyses, the usual willingness

  17. Economic evaluations of hepatitis B vaccination for developing countries

    NARCIS (Netherlands)

    H.A.T. Tu; H.J. Woerdenbag; S. Kane; A. Riewpaiboon; M. van Hulst; M.J. Postma

    2009-01-01

    Economic evaluations, in particular cost-effectiveness, are important determinants for policy makers and stakeholders involved in decision-making for health interventions. Up until now, most evaluations of cost-effectiveness of hepatitis B vaccination have been performed in developed countries. Appr

  18. Experiences of including costs of added life years in health economic evaluations in Sweden

    Directory of Open Access Journals (Sweden)

    Laura Pirhonen

    2014-06-01

    Full Text Available It is of importance to include the appropriate costs and outcomes when evaluating a health intervention. Sweden is the only country where the national guidelines of decisions on reimbursement explicitly state that costs of added life years should be accounted for when presenting health economic evaluations. The aim of this article is to, from a theoretical and empirical point of view, critically analyze the Swedish recommendations used by the Dental and Pharmaceutical Benefits Agency (TLV, when it comes to the use of costs of added life years in economic evaluations of health care. The aim is furthermore to analyze the numbers used in Sweden and discuss their impact on the incremental cost‑effectiveness ratios of assessed technologies. If following a societal perspective, based on welfare economics, there is strong support for the inclusion of costs of added life years in health economic evaluations. These costs have a large impact on the results. However this fact may be in conflict with ethical concerns of allocation of health care resources, such as favoring the younger part of the population over the older. It is important that the estimates of production and consumption reflect the true societal values, which is not the case with the values used in Sweden.http://dx.doi.org/10.7175/fe.v15i2.925

  19. Evaluation of Ecological and Economic Index in Poyang Lake Ecological Economic Zone

    OpenAIRE

    HUANG, Heping; Peng, Xiaolin

    2015-01-01

    The society and related research fields were paying close attention to make great efforts to promote the construction level of ecological civilization in China. And measuring and evaluating the status of eco-economic development always was the focus and difficulty in current researches. Based on the methods of Analytic Hierarchy Process (AHP) and the concept of Eco-Factor of Economic Growth and Ecological Efficiency, combined with the fact of research area, the index system of Ecological Econ...

  20. Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods.

    Science.gov (United States)

    van den Berg, Bernard; Brouwer, Werner; van Exel, Job; Koopmanschap, Marc; van den Bos, Geertrudis A M; Rutten, Frans

    2006-02-01

    This paper reports the results of the application of the opportunity costs and proxy good methods to determine a monetary value of informal care. We developed a survey in which we asked informal caregivers in The Netherlands to indicate the different types of time forgone (paid work, unpaid work and leisure) in order to be able to provide care. Moreover, we asked informal caregivers how much time they spent on a list of 16 informal care tasks during the week before the interview. Data were obtained from surveys in two different populations: informal caregivers and their care recipients with stroke and with rheumatoid arthritis (RA). A total of 218 care recipients with stroke and their primary informal caregivers completed a survey as well as 147 caregivers and their care recipients with RA. The measurement of care according to both methods is more problematic compared to the valuation. This is especially the case for the opportunity costs method and for the housework part in the proxy good method. More precise guidelines are necessary for the consistent application of both methods in order to ensure comparability of results and of economic evaluations of health care.

  1. Are economic evaluations an important tool in vaccine policy decisions?

    Science.gov (United States)

    Jacobs, Philip

    2011-10-01

    In the 1980s, drug prices began rising considerably worldwide, and in the 1990s, countries began incorporating health economics into the scientific review process. Rising prices in vaccines began around the year 2000 and national bodies began to use health economics to review vaccines in the next decade. Health economics is a discipline that evaluates alternative interventions, balancing costs and health outcomes. There are characteristics of infectious diseases that differ from other illnesses, most notably the herd effect. We reviewed the role of economics in conducting vaccine scientific reviews. We conclude that health economics can move some of the considerations in vaccine policy decision-making from the political to the scientific arena, but there are still many unresolved issues. Health economists will continue to address these issues in the coming years, but there will always be a need for a separate policy review.

  2. Solar energy system economic evaluation for Solaron Akron, Akron, Ohio

    Science.gov (United States)

    1980-01-01

    The economic analysis of the solar energy system that was installed at Akron, Ohio is developed for this and four other sites typical of a wide range of environmental and economic conditions. The analysis is accomplished based on the technical and economic models in the f chart design procedure with inputs based on the characteristics of the installed parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Results show that only in Albuquerque, New Mexico, where insolation is 1828 Btu/sq ft/day and the conventional energy cost is high, is this solar energy system marginally profitable.

  3. Evaluating the economic impact of casino liberalization in Macao.

    Science.gov (United States)

    Zheng, Victor; Hung, Eva P W

    2012-09-01

    This paper aims to evaluate the economic impact after Macao decided to liberalize its gaming industry. By analysing both objective data of official statistics and subjective data of the perceptions of quality of life, we painted a picture of mixed blessings. Although objective indicators showed strong economic growth in terms of a rise in per capita GDP and public revenue as well as a decline in unemployment rate, subjective indicators revealed that local residents were less than optimistic about their own employment outlook and did not perceive any improvement in their overall economic situation. While casino liberalization brought forth tremendous economic gain, the general population did not subjectively feel the benefits. An integrative analysis of both objective and subjective indicators would therefore allow us to look closer how residents' lives in the micro-level could have been adversely affected by the prosperous economic outlook at the macro-level.

  4. Feasibility Study on Nuclear Propulsion Ship according to Economic Evaluation

    International Nuclear Information System (INIS)

    The use of nuclear ships has been extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, the relevant regulations need to be considered. In this study, we reviewed the nuclear ship-related regulations. In addition, economic value is one of the most important factors which should be considered in the pre-design phase. To evaluate the economics of the nuclear ship, we calculated Capital Expenditure (abbreviated as CAPEX) and Operation Expenditure (abbreviated as OPEX) for various types of ships. We reviewed the nuclear ship-related regulations and evaluated the economics of the nuclear ship compared to the diesel ship. The calculation result shows that economic feasibility of the nuclear ship depends on the oil price as well as the cost of the nuclear reactor

  5. Feasibility Study on Nuclear Propulsion Ship according to Economic Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Gil, Youngmi; Yoo, Seongjin; Oh, June; Byun, Yoonchul; Woo, Ilguk [Daewoo Shipbuilding and Marine Engineering Co., Ltd, Seoul (Korea, Republic of); Kim, Jiho; Choi, Suhn [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2013-05-15

    The use of nuclear ships has been extending to the icebreaker, the deep-water exploration ship, and the floating nuclear power plant. Prior to developing the new ship, the relevant regulations need to be considered. In this study, we reviewed the nuclear ship-related regulations. In addition, economic value is one of the most important factors which should be considered in the pre-design phase. To evaluate the economics of the nuclear ship, we calculated Capital Expenditure (abbreviated as CAPEX) and Operation Expenditure (abbreviated as OPEX) for various types of ships. We reviewed the nuclear ship-related regulations and evaluated the economics of the nuclear ship compared to the diesel ship. The calculation result shows that economic feasibility of the nuclear ship depends on the oil price as well as the cost of the nuclear reactor.

  6. Virtual outreach: a randomised controlled trial and economic evaluation of joint teleconferenced medical consultations

    OpenAIRE

    Wallace, P.; Barber, J; Clayton, W.; Currell, R.; Fleming, K.; Garner, P.; Haines, A.; Harrison, R; Jacklin, P.; Jarrett, C.; Jayasuriya, R.; Lewis, L; Parker, S; Roberts, J.; Thompson, S

    2004-01-01

    Objectives: To test the hypotheses that virtual outreach would reduce offers of hospital follow-up appointments and reduce numbers of medical interventions and investigations, reduce numbers of contacts with the health care system, have a positive impact on patient satisfaction and enablement, and lead to improvements in patient health status. To perform an economic evaluation of virtual outreach.Design: A randomised controlled trial comparing joint teleconsultations between GPs, specialists ...

  7. Can economic evaluation in telemedicine be trusted? A systematic review of the literature

    OpenAIRE

    Bergmo Trine S

    2009-01-01

    Abstract Background Telemedicine has been advocated as an effective means to provide health care services over a distance. Systematic information on costs and consequences has been called for to support decision-making in this field. This paper provides a review of the quality, validity and generalisability of economic evaluations in telemedicine. Methods A systematic literature search in all relevant databases was conducted and forms the basis for addressing these issues. Only articles publi...

  8. Economic Evaluation of Brief Psychodynamic Interpersonal Therapy in Patients with Multisomatoform Disorder

    OpenAIRE

    Chernyak, Nadja; Sattel, Heribert; Scheer, Marsel; Baechle, Christina; Kruse, Johannes; Henningsen, Peter; Icks, Andrea

    2014-01-01

    Background A brief psychodynamic interpersonal therapy (PIT) in patients with multisomatoform disorder has been recently shown to improve health-related quality of life. Aims To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder. Method An economic evaluation alongside a randomised controlled trial (International Standard Randomised Controlled Trial Number ISRCTN23215121) conducted in 6 German academic outpatient centres was performed....

  9. Personalized Primary Care for Older People: An evaluation of a multicomponent nurse-led care program

    OpenAIRE

    Bleijenberg, N.

    2013-01-01

    Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high health care expenditures. In the Utrecht Proactive Frailty Intervention Trial (U-PROFIT, in Dutch:’ Om U’), we designed and evaluated a strategy for proactive patient-centred primary care of frail...

  10. Harsh choices: Chinese women's paid work and unpaid care responsibilities under economic reform.

    Science.gov (United States)

    Cook, Sarah; Dong, Xiao-yuan

    2011-01-01

    China's economic reforms over the past three decades have dramatically changed the mechanisms for allocating goods and labour in both market and non-market spheres. This article examines the social and economic trends that intensify the pressure on the care economy, and on women in particular in playing their dual roles as care givers and income earners in post-reform China. The analysis sheds light on three critical but neglected issues. How does the reform process reshape the institutional arrangements of care for children and elders? How does the changing care economy affect women's choices between paid work and unpaid care responsibilities? And what are the implications of women's work–family conflicts for the well-being of women and their families? The authors call for a gendered approach to both social and labour market policies, with investments in support of social reproduction services so as to ease the pressures on women. PMID:22164881

  11. Economic crisis and counter-reform of universal health care systems: Spanish case

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  12. Economic crisis and counter-reform of universal health care systems: Spanish case

    Directory of Open Access Journals (Sweden)

    Paulo Antônio de Carvalho Fortes

    2015-01-01

    Full Text Available The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities.

  13. Economic crisis and counter-reform of universal health care systems: Spanish case.

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Carvalho, Regina Ribeiro Parizi; Louvison, Marília Cristina Prado

    2015-01-01

    The economic crisis that has been affecting Europe in the 21st century has modified social protection systems in the countries that adopted, in the 20th century, universal health care system models, such as Spain. This communication presents some recent transformations, which were caused by changes in Spanish law. Those changes relate to the access to health care services, mainly in regards to the provision of care to foreigners, to financial contribution from users for health care services, and to pharmaceutical assistance. In crisis situations, reforms are observed to follow a trend which restricts rights and deepens social inequalities. PMID:26083942

  14. Evaluation of the economic burden of Herpes Zoster (HZ) infection.

    Science.gov (United States)

    Panatto, Donatella; Bragazzi, Nicola Luigi; Rizzitelli, Emanuela; Bonanni, Paolo; Boccalini, Sara; Icardi, Giancarlo; Gasparini, Roberto; Amicizia, Daniela

    2015-01-01

    The main objective of this systematic review was to evaluate the economic burden of Herpes Zoster (HZ) infection.   The review was conducted in accordance with the standards of the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines. The following databases were accessed: ISI/Web of Knowledge (WoS), MEDLINE/PubMed, Scopus, ProQuest, the Cochrane Library and EconLit. Specific literature on health economics was also manually inspected. Thirty-three studies were included. The quality of the studies assessed in accordance with the Consolidated Health Economic Evaluation Reporting Standards checklist was good. All studies evaluated direct costs, apart from one which dealt only with indirect costs. Indirect costs were evaluated by 12 studies. The economic burden of HZ has increased over time. HZ management and drug prescriptions generate the highest direct costs. While increasing age, co-morbidities and drug treatment were found to predict higher direct costs, being employed was correlated with higher indirect costs, and thus with the onset age of the disease. Despite some differences among the selected studies, particularly with regard to indirect costs, all concur that HZ is a widespread disease which has a heavy social and economic burden.

  15. Evaluation of Fragility of the Economic System in Poyang Lake Ecological Economic Zone

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    From two aspects,namely the sensitivity of regional economic system to internal and external interference,and its resilience,we establish the evaluation indicator system of fragility of the economic system in Poyang Lake Ecological Economic Zone,and evaluate the internal differences in fragility of the regional economic system,using set pair analysis method. The results show that there is a great difference in fragility of the economic system between different administrative units; the difference in resilience is the major factor responsible for difference in fragility of the economic system in various cities and counties within the region; according to the difference in fragility characteristics,we conduct classification as follows: Nanchang City is a low-sensitivity and high-resilience type; Jiujiang City is a high-sensitivity and high-resilience type; Jiujiang County,Xingzi County,Yongxiu County,Hukou County,Duchang County,Ruichang County,De’an Xian,Wuning County,Pengze County,Leping City, Dongxiang County,Fengcheng City and Gao’an City are a high-sensitivity and low-resilience type; other cities and counties are a low-sensitivity and low-resilience type.

  16. Economic Evaluation of Mental Health Interventions: A Guide to Costing Approaches.

    Science.gov (United States)

    Shearer, James; McCrone, Paul; Romeo, Renee

    2016-07-01

    Costing approaches in the economic evaluation of mental health interventions are complicated by the broad societal impacts of mental health, and the multidisciplinary nature of mental health interventions. This paper aims to provide a practical guide to costing approaches across a wide range of care inputs and illness consequences relevant to the treatment of mental health. The resources needed to deliver mental health interventions are highly variable and depend on treatment settings (institutional, community), treatment providers (medical, non-medical) and formats (individual, group, electronic). Establishing the most appropriate perspective is crucial when assessing the costs associated with a particular mental health problem or when evaluating interventions to treat them. We identify five key cost categories (social care, informal care, production losses, crime and education) impacted by mental health and discuss contemporary issues in resource use measurement and valuation, including data sources and resource use instruments. PMID:26922076

  17. Productivity costs in economic evaluations: past, present, future.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner; Rutten, Frans

    2013-07-01

    Productivity costs occur when the productivity of individuals is affected by illness, treatment, disability or premature death. The objective of this paper was to review past and current developments related to the inclusion, identification, measurement and valuation of productivity costs in economic evaluations. The main debates in the theory and practice of economic evaluations of health technologies described in this review have centred on the questions of whether and how to include productivity costs, especially productivity costs related to paid work. The past few decades have seen important progress in this area. There are important sources of productivity costs other than absenteeism (e.g. presenteeism and multiplier effects in co-workers), but their exact influence on costs remains unclear. Different measurement instruments have been developed over the years, but which instrument provides the most accurate estimates has not been established. Several valuation approaches have been proposed. While empirical research suggests that productivity costs are best included in the cost side of the cost-effectiveness ratio, the jury is still out regarding whether the human capital approach or the friction cost approach is the most appropriate valuation method to do so. Despite the progress and the substantial amount of scientific research, a consensus has not been reached on either the inclusion of productivity costs in economic evaluations or the methods used to produce productivity cost estimates. Such a lack of consensus has likely contributed to ignoring productivity costs in actual economic evaluations and is reflected in variations in national health economic guidelines. Further research is needed to lessen the controversy regarding the estimation of health-related productivity costs. More standardization would increase the comparability and credibility of economic evaluations taking a societal perspective.

  18. Conceptual framework for standard economic evaluation of physical activity programs in primary prevention.

    Science.gov (United States)

    Wolfenstetter, Silke B

    2011-12-01

    Economic evaluations of primary prevention physical activity programs have gained importance because of scarce resources in health-care-systems. A concept for economic evaluation should be based on the efficacy of physical activity, the standard methods of economic evaluation and the aims of public health. Previous publications have examined only parts of these components and have not developed a comprehensive conceptual framework; it is the objective of this article to develop such a framework. The derived method should aid decision makers and staff members of intervention programs in reviewing and conducting an economic evaluation. A literature search of articles was done using six electronic databases. Referenced works for standard methods and more comprehensive approaches for evaluation of preventive programs were studied. The newly developed conceptual framework for economic evaluation includes: (1) the type of physical activity program; (2) features of a selected study population; (3) the outcome dimension comprising exercise efficacy, reach, recruitment, response rate, maintenance, compliance and adverse health effects plus the social impact; and (4) the cost dimension consisting of program development costs, program implementation costs including the implementation, recruitment, program, participants' time costs and savings resulting from the health effects of the intervention. Cost-effectiveness also depends on the methodology, such as the chosen perspective, data collection, valuation methods and discounting. If an intervention is not considered cost-effective, it is necessary to check each dimension to find possible failures in order to learn for future interventions. A more detailed economic evaluation is of utmost importance for improved comparability and transferability. PMID:21773728

  19. Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care

    OpenAIRE

    Sheppard, Lauren; Dewey, Helen; Bernhardt, Julie; Collier, Janice M; Ellery, Fiona; Churilov, Leonid; Tay-Teo, Kiu; Wu, Olivia; Moodie, Marj

    2016-01-01

    Rationale: A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. Aim and hypothesis To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other in...

  20. Building bridges between health economics research and public policy evaluation.

    Science.gov (United States)

    Debrand, Thierry; Dourgnon, Paul

    2010-12-01

    The Institut de Recherche et Documentation en Economie de la Santé (IRDES) Workshop on Applied Health Economics and Policy Evaluation aims at disseminating health economic research's newest findings and enhancing the community's capacity to address issues that are relevant to public policy. The 2010 program consisted of 16 articles covering a vast range of topics, such as health insurance, social health inequalities and health services research. While most of the articles embedded theoretical material, all had to include empirical material in order to favor more applied and practical discussions and results. The 2010 workshop is to be the first of a series of annual workshops in Paris gathering together researchers on health economics and policy evaluation. The next workshop is to be held at IRDES in June 2011.

  1. Sustainability and economic evaluation of microalgae grown in brewery wastewater.

    Science.gov (United States)

    Mata, Teresa M; Mendes, Adélio M; Caetano, Nídia S; Martins, António A

    2014-09-01

    This article evaluates the sustainability and economic potential of microalgae grown in brewery wastewater for biodiesel and biomass production. Three sustainability and two economic indicators were considered in the evaluation within a life cycle perspective. For the production system the most efficient process units were selected. Results show that harvesting and oil separation are the main process bottlenecks. Microalgae with higher lipid content and productivity are desirable for biodiesel production, although comparable to other biofuel's feedstock concerning sustainability. However, improvements are still needed to reach the performance level of fossil diesel. Profitability reaches a limit for larger cultivation areas, being higher when extracted biomass is sold together with microalgae oil, in which case the influence of lipid content and areal productivity is smaller. The values of oil and/or biomass prices calculated to ensure that the process is economically sound are still very high compared with other fuel options, especially biodiesel.

  2. Decision making in Germany: is health economic evaluation as a supporting tool a sleeping beauty?

    Science.gov (United States)

    Gerber-Grote, Andreas; Sandmann, Frank Gerd; Zhou, Min; Ten Thoren, Corinna; Schwalm, Anja; Weigel, Carolin; Balg, Christiane; Mensch, Alexander; Mostardt, Sarah; Seidl, Astrid; Lhachimi, Stefan K

    2014-01-01

    For many years, the legal situation within the statutory health insurance (SHI) system in Germany has allowed for health economic evaluations. There are various reasons why health economic evaluations have played virtually no role in decision making until now: to begin with, a method for the evaluation of the relation between benefits and costs which needed to be in accordance with the legal requirements had to be developed, the outcome of which was the efficiency frontier approach. Subsequent health care reforms have led to changing objectives and strategies. Currently, price negotiations of newly launched drugs are based on an early benefit assessment of dossiers submitted by pharmaceutical manufacturers. Other reasons might be the presently very comfortable financial situation of the statutory health insurance system as well as a historically grown societal fear and discomfort towards what is perceived to be a rationing of medicinal products. For the time being, it remains open how long the German health care system can afford to continue neglecting the benefits of health economic evaluations for drug and non-drug interventions, and when it will be time to wake this sleeping beauty. PMID:25444297

  3. Economic evaluation in stratified medicine: methodological issues and challenges

    Directory of Open Access Journals (Sweden)

    Hans-Joerg eFugel

    2016-05-01

    Full Text Available Background: Stratified Medicine (SM is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for health technology assessments (HTAs in many countries. However, these guidelines have initially been developed for traditional pharmaceuticals and not for complex interventions with multiple components. This raises the issue as to whether these guidelines are adequate to SM interventions or whether new specific guidance and methodology is needed to avoid inconsistencies and contradictory findings when assessing economic value in SM.Objective: This article describes specific methodological challenges when conducting health economic (HE evaluations for SM interventions and outlines potential modifications necessary to existing evaluation guidelines /principles that would promote consistent economic evaluations for SM.Results/Conclusions: Specific methodological aspects for SM comprise considerations on the choice of comparator, measuring effectiveness and outcomes, appropriate modelling structure and the scope of sensitivity analyses. Although current HE methodology can be applied for SM, greater complexity requires further methodology development and modifications in the guidelines.

  4. Discounting in economic evaluations : Stepping forward towards optimal decision rules

    NARCIS (Netherlands)

    Gravelle, Hugh; Brouwer, Werner; Niessen, Louis; Postma, Maarten; Rutten, Frans

    2007-01-01

    The National Institute for Clinical Excellence has recently changed its guidelines on discounting costs and effects in economic evaluations. In common with most other regulatory bodies it now requires that health effects should be discounted at the same rate as costs. We show that the guideline lead

  5. Evaluating economic costs and benefits of climate resilient livelihood strategies

    Directory of Open Access Journals (Sweden)

    S. Liu

    2016-01-01

    Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.

  6. Disease specific methods for economic evaluations of breast cancer therapies

    NARCIS (Netherlands)

    Frederix, G.W.J.

    2013-01-01

    Cost-effectiveness analyses (CEAs) are widely considered to be helpful tools for making informative decisions in a resource constrained environment. Since the introduction of economic evaluations in reimbursement submissions in Australia as a formal requirement in 1993, CEAs have become widespread w

  7. Stakeholders' Perspectives About and Priorities for Economic Evaluation of Health and Safety Programs in Healthcare.

    Science.gov (United States)

    Tompa, Emile; de Boer, Henriette; Macdonald, Sara; Alamgir, Hasanat; Koehoorn, Mieke; Guzman, Jaime

    2016-04-01

    This study identified and prioritized resources and outcomes that should be considered in more comprehensive and scientifically rigorous health and safety economic evaluations according to healthcare sector stakeholders. A literature review and stakeholder interviews identified candidate resources and outcomes and then a Delphi panel ranked them. According to the panel, the top five resources were (a) health and safety staff time; (b) training workers; (c) program planning, promotion, and evaluation costs; (d) equipment purchases and upgrades; and (e) administration costs. The top five outcomes were (a) number of injuries, illnesses, and general sickness absences; (b) safety climate; (c) days lost due to injuries, illnesses, and general sickness absences; (d) job satisfaction and engagement; and (e) quality of care and patient safety. These findings emphasize stakeholders' stated priorities and are useful as a benchmark for assessing the quality of health and safety economic evaluations and the comprehensiveness of these findings. PMID:27056937

  8. Theoretical and methodological basis for the formation and evaluation of the level of the economic system's strategic economic potential

    Directory of Open Access Journals (Sweden)

    Kljushin Vladislav Vladimirovich

    2014-12-01

    Full Text Available The current level of business activity of socio-economic systems of different scale and insufficient to increase their overall potential. To solve this problem, the first priority is the effective management of their strategic and economic potential. Managerial decision-making about the use of economic resources strategic socio-economic systems requires the development of a methodology to identify and evaluate strategic and economic potential.

  9. Economic Evaluation of Environmental Health Interventions to Support Decision Making

    Directory of Open Access Journals (Sweden)

    Guy Hutton

    2008-01-01

    Full Text Available Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost- effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH, vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution. Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds.

  10. Socio-Economic Determinants of the Need for Dental Care in Adults.

    Directory of Open Access Journals (Sweden)

    Gilda Trohel

    Full Text Available Oral health has improved in France. However, there are still inequalities related to the socio-economic status.The aim of this study was to measure the prevalence of dental care needs in an adult population and to identify the demographic, socio-economic and behavioral variables that may explain variations in this parameter.A cross-sectional analysis of the French SIRS cohort (n = 2,997 adults from the Paris region; 2010 data was carried out to determine the prevalence of self-reported dental care needs relative to demographic, socio-economic and behavioral variables. A logistic regression model was used to identify the variables that were most strongly associated with the level of need.In 2010, the prevalence of the need for dental care in the SIRS cohort was 35.0% (95% CI [32.3-37.8]. It was lower in people with higher education levels (31.3% [27.9-34.6], without immigrant background (31.3% [28.0-34.6] and with comprehensive health insurance (social security + complementary health cover; 32.8% [30.2-35.4]. It decreased as the socio-economic status increased, but without following a strict linear change. It was also lower among individuals who had a dental check-up visit in the previous two years. In multivariate analyses, the socioeconomic variables most strongly associated with the need for dental care were: educational attainment (OR = 1.21 [1.02-1.44], income level (OR = 1.66 [1.92-2.12] and national origin (OR = 1.53 [1.26-1.86].These results confirm that the prevalence of dental care needs is higher among adults with low socio-economic status. Education level, income level and also national origin were more strongly associated with the need for dental care than insurance cover level.

  11. Prevention of fall incidents in patients with a high risk of falling: Design of a randomised controlled trial with an economic evaluation of the effect of multidisciplinary transmural care

    OpenAIRE

    Bouter Lex M; Pluijm Saskia MF; Elders Petra JM; de Vries Oscar J; Peeters Geeske MEE; Lips Paul

    2007-01-01

    Abstract Background Annually, about 30% of the persons of 65 years and older falls at least once and 15% falls at least twice. Falls often result in serious injuries, such as fractures. Therefore, the prevention of accidental falls is necessary. The aim is to describe the design of a study that evaluates the efficacy and cost-effectiveness of a multidisciplinary assessment and treatment of multiple fall risk factors in independently living older persons with a high risk of falling. Methods/De...

  12. Angra 3 - economic and financial evaluation of the enterprise

    International Nuclear Information System (INIS)

    This paper presents an updated economic-financial evaluation of Angra 3 Nuclear Power Plant project and estimates the lowest power tariff value at which power potentially made available may be commercialized and yet ensures the project a profitability level agreeable to the interests of economic agents and shareholders. According to the project evaluation practice, Angra 3 power generation was considered separately from ELETRONUCLEAR operating plants (Angra 1 and Angra 2), thus preventing result distortions bound to occur if the economic-financial variables of the new project were analyzed associated with financial commitments and commercialization conditions resulting from the project implementation process and the generated power commercialization conditions, respectively. For this evaluation different technical and economic scenarios were devised, and the theory of Capital Asset Pricing Model (CAPM) for Own Capital cost and that of Weighted Average Cost of Capital (WACC) were used in addition to the forecast of the Statement of Results and Free Cash flow of Shareholders throughout the power plant life, which is the estimate basis for the lowest power tariff value and the Internal Return Rate (IRR) of the project. (author)

  13. Economic Evaluation of Intensive Growing of Selected Crops

    Directory of Open Access Journals (Sweden)

    J. Homolka

    2013-06-01

    Full Text Available The submitted paper on the topic: “Economic Evaluation of Intensive Growing of Selected Crops” deals with an economic evaluation of growing of selected crops – winter oilseed rape, winter wheat, and sugar beet in Agro Žlunice a.s. where intensive growing technologies are used. Reached results are compared with results in the framework of the Czech Republic which represent average values for the mentioned crops. Agro Žlutice a.s. is situated in sugar beet production area in district Jičín and it farms on 1902 ha of agricultural land of which 1742 ha is arable land. A decisive subject of business here is plant production, animal production, and fruit growing. In the paper, an intensity and economics of growing of winter oilseed rape, winter wheat, and sugar beet in 2010, 2011 and 2012 is evaluated. Winter oilseed rape from a market view-point is an important crop for the chosen enterprise and Czech agriculture. In suitable growing it significantly contributes to a positive economic result. In winter wheat growing, from a view-point of competitiveness, it is important to reduce technological inputs which does not lead to decrease in yield and has provable economic benefit in evaluation of costs per a production unit. A favourable economics of growing of this crop is reached both in the intensive growing technology in the given enterprise, and within average growing conditions. A basic presumption whether to grow sugar beet is a possibility of the enterprise to supply this raw-material for processing either for sugar or bio-ethanol production. This crop in the mentioned enterprise and in the nationwide framework shows a favourable profitability. The reached growing and economic results of the enterprise Agro Žlunice a.s. in use of intensive growing technologies are more favourable in comparison with average results over the whole sector of agriculture.Pieces of knowledge introduced in this paper resulted from solution of an

  14. Economic evaluations of childhood influenza vaccination: a critical review.

    Science.gov (United States)

    Newall, Anthony T; Jit, Mark; Beutels, Philippe

    2012-08-01

    The potential benefits of influenza vaccination programmes targeted at children have gained increasing attention in recent years. We conducted a literature search of economic evaluations of influenza vaccination in those aged ≤18 years. The search revealed 20 relevant articles, which were reviewed. The studies differed widely in terms of the costs and benefits that were included. The conclusions were generally favourable for vaccination, but often applied a wider perspective (i.e. including productivity losses) than the reference case for economic evaluations used in many countries. Several evaluations estimated outcomes from a single-year epidemiological study, which may limit their validity given the year-to-year variation in influenza transmissibility, virulence, vaccine match and prior immunity. Only one study used a dynamic transmission model able to fully incorporate the indirect herd protection to the wider community. The use of dynamic models offers great scope to capture the population-wide implications of seasonal vaccination efforts, particularly those targeted at children.

  15. Economic evaluation of a problem solving intervention to prevent recurrent sickness absence in workers with common mental disorders.

    Directory of Open Access Journals (Sweden)

    Iris Arends

    Full Text Available OBJECTIVES: Workers with common mental disorders (CMDs frequently experience recurrent sickness absence but scientifically evaluated interventions to prevent recurrences are lacking. The objectives of this study are to evaluate the cost-effectiveness and cost-benefit of a problem solving intervention aimed at preventing recurrent sickness absence in workers with CMDs compared to care as usual. METHODS: An economic evaluation was conducted alongside a cluster-randomised controlled trial with 12 months follow-up. Treatment providers were randomised to either a 2-day training in the SHARP-at work intervention, i.e. a problem solving intervention, or care as usual. Effect outcomes were the incidence of recurrent sickness absence and time to recurrent sickness absence. Self-reported health care utilisation was measured by questionnaires. A cost-effectiveness analysis (CEA from the societal perspective and a cost-benefit analysis (CBA from the employer's perspective were conducted. RESULTS: The CEA showed that the SHARP-at work intervention was more effective but also more expensive than care as usual. The CBA revealed that employer's occupational health care costs were significantly higher in the intervention group compared to care as usual. Overall, the SHARP-at work intervention showed no economic benefit compared to care as usual. CONCLUSIONS: As implementation of the SHARP-at work intervention might require additional investments, health care policy makers need to decide if these investments are worthwhile considering the results that can be accomplished in reducing recurrent sickness absence.

  16. The Economic Evaluation for Kori-1 Steam Generator Replacement

    International Nuclear Information System (INIS)

    The economic evaluation was performed for Kori-1 steam generator(SG) replacement, in which the six senarios were evaluated for a 30, 40 and 50 year plant operating period : Scenario 1-Current Maintenance Approach : Scenario 2-SG Replacement as Early as Possible(1998) : Scenario 3-Scenario 2 + 4.8% Rerate :Scenario 4-18% Plugging Limit : Scenario 5-SG Replacement when Plugging Rate exceeds 15% : Scenario 6-Scenario 5 + 4.8% Rerate. The results of the evaluation indicate that immediate replacement of existing SGs was the most profitable alternative, especially in combination with a 4.8% rerate

  17. Comprehensive Evaluation of the Economic Development Level of Guanzhong-Tianshui Economic Zone Using Principal Component Cluster Analysis

    Institute of Scientific and Technical Information of China (English)

    Chunxiang; ZHAO; Xinrong; YAN; Xu; GUO

    2014-01-01

    Based on 10 years of statistics concerning economic development in Xi’an as the main part of Guanzhong- Tianshui Economic Zone, this article builds the main indicator system to reflect economic development. Using two mathematical methods( principal component analysis and cluster analysis),we carry out comprehensive evaluation analysis of the main economic indicators,point out the distribution differences in the economic development level in this region,and make classification,in order to provide a scientific basis for the decision- making body to lay down the relevant economic development strategies in accordance with the economic development level and geographical location.

  18. Integration of economic appraisal and health care policy in a health insurance system; The Dutch case

    NARCIS (Netherlands)

    F.F.H. Rutten (Frans); J.-W. van der Linden (J.)

    1994-01-01

    textabstractThis article discusses the role of economic appraisal in insurance based health care systems, taking the case of the Netherlands as an example. The public health insurance system in this country is governed by the Health Insurance Executive Board, which policies are firmly based on the r

  19. Solar energy system economic evaluation: Contemporary Newman, Georgia

    Science.gov (United States)

    1980-01-01

    An economic evaluation of performance of the solar energy system (based on life cycle costs versus energy savings) for five cities considered to be representative of a broad range of environmental and economic conditions in the United States is discussed. The considered life cycle costs are: hardware, installation, maintenance, and operating costs for the solar unique components of the total system. The total system takes into consideration long term average environmental conditions, loads, fuel costs, and other economic factors applicable in each of five cities. Selection criteria are based on availability of long term weather data, heating degree days, cold water supply temperature, solar insolation, utility rates, market potential, and type of solar system.

  20. The Emotional and Economic Costs of Bereavement in Health Care Settings

    Directory of Open Access Journals (Sweden)

    Janice L Genevro

    2010-09-01

    Full Text Available Research to date on grief and bereavement in health care providers has focused on those experiences from the perspective of the individual. We propose, however, that the emotional costs of bereavement in the health care setting are also health care systems issues. This paper focuses on the emotional costs of grief and bereavement in health care providers, and on the economic costs of bereavement and bereavement care in health care settings. Evidence regarding the costs and cost-effectiveness of bereavement interventions is limited. We summarise existing relevant research and offer an overview of the types of costs and cost information that would optimally be collected in research on bereavement in health care settings. We also propose an analytic framework that could be used to systematically consider the larger picture of bereavement in health care settings, how available evidence fits into this picture, and what evidence is needed to improve care. This approach is derived from health services research. It is hoped that the proposed framework will prove useful in stimulating new research questions, and in guiding research that not only advance

  1. Economic evaluation studies in nuclear medicine: the need for standardization

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Department of Nuclear Medicine, University of Cologne (Germany); Knapp, W.H. [Department of Nuclear Medicine, University of Hanover (Germany); Lauterbach, K.W. [Institute of Public Health, University of Cologne (Germany)

    1999-06-01

    The guidelines for publishing economic evaluations require a statement of the economic importance of the analysis and the viewpoint from which it has been carried out, as well as specification of at least two alternative programmes or interventions, the form of economic evaluation, the outcome measure, the method of costing, the time horizon and adjustment for timing of costs and benefits (e.g. by a discount factor), and the allowance for uncertainties (e.g. by implementation of a sensitivity analysis). The decision analysis can be based on clinical trial data, on retrospective or administrative databases, or on modelling. The choice of outcome measures is the key issue in an economic evaluation. In cost-effectiveness analysis, benefits are usually measured in natural units. This is the form of economic evaluation most frequently used in nuclear medicine. Endpoints of effectiveness applied in studies in this field have been procedures avoided, procedures initiated, cardiac events, survival probability, morbidity, quality of life and protracted or failed surgical procedures. In other instances, surrogate endpoints have been used such as metastases detected, staging, viability or tumour response. This, however, limits comparability of cost-effectiveness considerably, as proof of a change in the health outcome cannot be obtained. Measures of utility such as QALYs (quality-adjusted life years) have so far only been applied for decision tree analysis. Useful examples of economic evaluation studies in nuclear medicine are presented here for fluorodeoxyglucose positron emission tomography (FDG-PET) in the preoperative staging of non-small cell lung cancer, for FDG-PET in differentiating indeterminate solitary pulmonary nodules, for somatostatin receptor scintigraphy in detecting metastases of carcinoid tumours, for routine preoperative scintigraphy with sestamibi in patients with parathyroid adenoma, for periodic measurement of thyroid-stimulating hormone in detecting

  2. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  3. Who cares? Who doesn’t? An exploration of perceptions of care based on the experiences of secondary school students from different economic groups

    OpenAIRE

    McDowell, Kelly Ross

    2011-01-01

    This qualitative study analyzes the perspectives of secondary students from different economic backgrounds and how they do or do not experience care in their schools. A secondary finding determines that the economic status of these same students is often a contributing factor to how they perceive care. The theoretical framework for this study is anchored in the work of Nel Noddings and others who have contributed to the ever-growing body of knowledge regarding ethics of care in an educational...

  4. Care or custody? An evaluation of palliative care in prisons in North West England.

    Science.gov (United States)

    Turner, Mary; Payne, Sheila; Barbarachild, Zephyrine

    2011-06-01

    This study aimed to evaluate health professionals' views about palliative care provision in prisons in the counties of Cumbria and Lancashire in the North West of England. Seventeen prison healthcare staff and nine specialist palliative care staff participated in semi-structured interviews and 16 prison healthcare staff completed a questionnaire designed to measure knowledge, skills and confidence in relation to palliative care. The findings highlighted tensions between the philosophies of care and custody, and the many challenges in providing palliative care in a custodial setting. This paper presents two illustrative case study examples, and suggests ways in which some of these challenges can be overcome in practice.

  5. ECONOMIC EVALUATION OF Eucalyptus grandis PLANTATION FOR CELLULOSE PRODUCTION

    Directory of Open Access Journals (Sweden)

    Antonio Donizette de Oliveira

    2008-03-01

    Full Text Available The aims of this research were: to analyze the economic feasibility of planting eucalyptus for producing wood pulp,considering various site index and two spacings; to analyze the economic effects regarding the profitability of the forest activity indifferent distances from the industry and changes on discount rate, wood price, transportation costs, minimum profitable diameter oflogs and the length of the logs. A biometric model for making wood volume prognosis was developed, using data of a trial ofEucalyptus grandis stands 19 and 103 months old. The prognosis started at the age zero, considering logs of 2.5 and 6.0 m of lenghtand the minimum diameter varying from 4 to 10 cm, in intervals of 2 cm. Net Present Worth (NPW was used as the economic decisioncriterium, considering an infinite horizon. The main conclusions were: reducing the minimum profitable diameter and the length ofthe logs are good strategies to increase wood utilization and profit; plantations located in less productive lands are economicallyunfeasible; the cost of transportation has significant effect on the profitability of the forest activity and must be analyzed carefully atthe moment of defining the location of new plantations; small variations on wood sales price may cause big alterations on theprofitability of the forest activity, suggesting that the improvement of the wood quality together with other decisions that may increasewood price are alternatives that may render the plantations in less productive areas profitable.

  6. Economic evaluation of closure cap barrier materials study

    International Nuclear Information System (INIS)

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

  7. Economic evaluation of closure cap barrier materials study

    Energy Technology Data Exchange (ETDEWEB)

    Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

    1993-09-01

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

  8. New approaches to the economic evaluation of fusion research

    International Nuclear Information System (INIS)

    The economic evaluation of fusion research to date has focussed on the benefits of essentially unlimited energy for future generations. In this paper it is shown that energy research in general, and fusion research in particular, also provides benefits in the short term, benefitting us today as well as future generations. Short-term benefits are the result of two distinct aspects of fusion research. First, fusion research provides information for decision making on both the continuing fusion research efforts and on other energy research programs. Second, fusion research provides an expectation of a future energy source thereby promoting accelerated consumption of existing fossil fuels today. Both short-term benefits can be quantitatively evaluated and both are quite substantial. Together, these short-term benefits form the primary economic rationale for fusion research

  9. Community health workers and health care delivery: evaluation of a women's reproductive health care project in a developing country.

    Directory of Open Access Journals (Sweden)

    Abdul Wajid

    Full Text Available BACKGROUND: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH services in two areas with different levels of service in Punjab, Pakistan. METHODS: A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA. Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility. RESULTS: The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention. CONCLUSIONS: Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an

  10. Economic evaluation in stratified medicine: methodological issues and challenges

    OpenAIRE

    Hans-Joerg eFugel; Mark eNuijten; Maarten Jacobus Postma; Ken eRedekop

    2016-01-01

    Background: Stratified Medicine (SM) is becoming a practical reality with the targeting of medicines by using a biomarker or genetic-based diagnostic to identify the eligible patient sub-population. Like any healthcare intervention, SM interventions have costs and consequences that must be considered by reimbursement authorities with limited resources. Methodological standards and guidelines exist for economic evaluations in clinical pharmacology and are an important component for health tech...

  11. Evaluating Health Care Financing Reforms in Africa

    NARCIS (Netherlands)

    I.E.J. Bonfrer (Igna)

    2015-01-01

    markdownabstract__Abstract__ Africa is on a steady economic growth path. Over the last decade, most Sub-Saharan African (SSA) countries outperformed European and North-American countries’ growth rates, as shown in Figure 1. A number of SSA countries are among the fastest growing economies in the wo

  12. Exergy-Economic Criteria for Evaluating Heat Exchanger Performance

    Institute of Scientific and Technical Information of China (English)

    Wu Shuangying; Li Yourong

    2001-01-01

    Based on the exergy-economic analysis of heat exchanger heat transfer and flow process, two new exergyeconomic criteria which are defined as the total costs per unit heat transfer rate ηt t for heat transfer exchanger and the net profit per unit heat recovery rate ηr for heat recovery exchanger respectively are put forward.Furthermore, the application of criteria is illustrated by the evaluation of down-flow, counter-flow and cross-flow heat exchangers performance. The methods employed and results presented in this paper can serve as a guide for the performance evaluation of heat exchangers.

  13. Evaluation of undrilled prospects. Sensitivity to economic and geological factors

    International Nuclear Information System (INIS)

    Economic prospect evaluation at an early stage involves personnel with different skills, such as geoscientists, reservoir engineers, construction engineers and economists. Data are transferred between these groups of people who often have only a vague understanding of the accuracy of the data they receive. This lack of communication naturally limits the correctness of the results. To improve this communication, the complete process of prospect evaluation (including both geological and economical aspects) has been followed here in order to show the different data sets that are transferred and to comment upon their accuracy. Although this paper is based entirely on Statoil's methodology, it is nevertheless believed to be of general relevance. In Statoil's methodology, prospect volumes calculated by geoscientists are given as likelihood distributions. Post-drilling examination of such volume distributions show that historically they have been too optimistic. However, historical prospect risking has correctly identified the most important risk factors and has been able to separate low-risk from high-risk prospects in a satisfactory manner. The number of appraisal wells that are needed before the development of a field can be decided upon is often crucial to the economic evaluations. This number, however, is usually underestimated during the early stages of exploration, probably because data limitations mask reservoir heterogeneities. Reservoir performance is of utmost importance to early economic calculations as it influences both the drilling costs and the production of hydrocarbons vs. time. Of course, reservoir productivity is highly uncertain when judged prior to drilling the first well. Historical data show that reserve estimates of producing fields tend to be upgraded as reservoir depletion proceeds, although several fields have had their reserve estimates downgraded shortly after production start-up. The operational and investment costs are not generally

  14. Evaluation and economic value of winter weather forecasts

    Science.gov (United States)

    Snyder, Derrick W.

    State and local highway agencies spend millions of dollars each year to deploy winter operation teams to plow snow and de-ice roadways. Accurate and timely weather forecast information is critical for effective decision making. Students from Purdue University partnered with the Indiana Department of Transportation to create an experimental winter weather forecast service for the 2012-2013 winter season in Indiana to assist in achieving these goals. One forecast product, an hourly timeline of winter weather hazards produced daily, was evaluated for quality and economic value. Verification of the forecasts was performed with data from the Rapid Refresh numerical weather model. Two objective verification criteria were developed to evaluate the performance of the timeline forecasts. Using both criteria, the timeline forecasts had issues with reliability and discrimination, systematically over-forecasting the amount of winter weather that was observed while also missing significant winter weather events. Despite these quality issues, the forecasts still showed significant, but varied, economic value compared to climatology. Economic value of the forecasts was estimated to be 29.5 million or 4.1 million, depending on the verification criteria used. Limitations of this valuation system are discussed and a framework is developed for more thorough studies in the future.

  15. Economic evaluation of radiation processing in urban solid wastes treatment

    Science.gov (United States)

    Carassiti, F.; Lacquaniti, L.; Liuzzo, G.

    During the last few years, quite a number of studies have been done, or are still in course, on disinfection of urban liquid wastes by means of ionizing radiations. The experience gained by SANDIA pilot plant of irradiation on dried sewage sludge, together with the recently presented conceptual design of another plant handling granular solids, characterized by high efficiency and simple running, have shown the possibility of extending this process to the treatment of urban solid wastes. As a matter of fact, the problems connected to the pathogenic aspects of sludge handling are often similar to those met during the disposal of urban solid wastes. This is even more so in the case of their reuse in agriculture and zootechny. The present paper introduces the results of an analysis carried out in order to evaluate the economical advantage of inserting irradiation treatment in some process scheme for management of urban solid wastes. Taking as an example a comprehensive pattern of urban solid wastes management which has been analysed and estimated economically in previous works, we first evaluated the extra capital and operational costs due to the irradiation and then analysed economical justification, taking into account the increasing commercial value of the by-products.

  16. Economic evaluation of seawater desalination in Cuba using DEEP

    International Nuclear Information System (INIS)

    Full text: DEEP is a Desalination Economic Evaluation Programme developed by the International Atomic Energy Agency (IAEA). The version 3 of DEEP (DEEP-3.0) was acquired and implemented in the country as a result of the cooperation between the IAEA and Cuba. The above-mentioned programme has been used in the national project 'Feasibility of seawater desalination in Cuba', which will be implemented in the 2005 - 2007 triennium. This project is aimed at analyzing different technologies of seawater desalination so as to determine the most feasible technology for Cuba from the technical and economic viewpoints. DEEP was used in the economic evaluation of different desalination plants with reverse osmosis (RO) technology. Real data obtained from the RO plant performance such as required capacity, modular unit size, seawater pump efficiency, feed salinity, and design flux as well as data of the RO plant costs was used. The selected energy source was grid electricity (stand-alone RO). The results obtained from the modeling of the desalination plant located at the Cayo Largo Island (at the Southern portion of Cuba) are shown. The RO plant, which uses Italian technology, has a capacity of 1000 m3/day. The paper presents the results of the sensitivity analyses by changing the interest rate, total capacity of the desalination plant, feed salinity, feed temperature and purchased electricity cost. (author)

  17. Economic evaluation of multilateral nuclear fuel cycle approach

    International Nuclear Information System (INIS)

    Recently previous works have shown that multilateral nuclear fuel cycle approach has benefits not only of non-proliferation but also of cost effectiveness. This is because for most facilities in nuclear fuel cycle, there exist economies of scale, which has a significant impact on the costs of nuclear fuel cycle. Therefore, the evaluation of economic rationality is required as one of the evaluation factors for the multilateral nuclear fuel cycle approach. In this study, we consider some options with respect to multilateral approaches to nuclear fuel cycle in Asian-Pacific region countries that are proposed by the University of Tokyo. In particular, the following factors are embedded into each type: A) no involvement of assurance of services, B) provision of assurance of services including construction of new facility, without transfer of ownership, and C) provision of assurance of service including construction of new joint facilities with ownership transfer of facilities to multilateral nuclear fuel cycle approach. We show the overnight costs taking into account install and operation of nuclear fuel cycle facilities for each option. The economic parameter values such as uranium price, scale factor, and market output expansion influences the total cost for each option. Thus, we show how these parameter values and economic risks affect the total overnight costs for each option. Additionally, the international facilities could increase the risk of transportation for nuclear material compared to national facilities. We discuss the potential effects of this transportation risk on the costs for each option. (author)

  18. Economic Cost and Health Care Workforce Effects of School Closures in the U.S.

    OpenAIRE

    Lempel, Howard; Epstein, Joshua M.; Hammond, Ross A

    2009-01-01

    School closure is an important component of U.S. pandemic flu mitigation strategy, but has important costs. We give estimates of both the direct economic and health care impacts for school closure durations of 2, 4, 6, and 12 weeks under a range of assumptions. We find that closing all schools in the U.S. for four weeks could cost between $10 and $47 billion dollars (0.1-0.3% of GDP) and lead to a reduction of 6% to 19% in key health care personnel.

  19. Health and Socio-Economic Status: Factors impacting care and treatment in ovarian cancer patients

    DEFF Research Database (Denmark)

    Seibæk, L.; Petersen, L. K.; Blaakaer, J.;

    2011-01-01

    To provide knowledge about health status, socio-economic status and use of public health care in women undergoing ovarian cancer surgery, in order to improve their care during the perioperative period. Method: An epidemiological methodology was applied. The material consisted of data from...... and a tendency to be overweight. Many had a low educational level, were retired, and lived alone with few financial resources. The quality of the surgical treatment had improved in terms of centralisation and staging procedures. Conclusions: As a group the women proved to be in a vulnerable position in terms...

  20. Economic Evaluation of Childhood Obesity Interventions: Reflections and Suggestions.

    Science.gov (United States)

    Frew, Emma

    2016-08-01

    Rising levels of childhood obesity present a serious global public health problem amounting to 7 % of GDP in developed countries and affecting 14 % of children. As such, many countries are investing increasingly large quantities of resource towards treatment and prevention. Whilst it is important to demonstrate the clinical effectiveness of any intervention, it is equally as important to demonstrate cost effectiveness as policy makers strive to get the best value for money from increasingly limited public resources. Economic evaluation assists with making these investment decisions and whilst it can offer considerable support in many healthcare contexts, applying it to a childhood obesity context is not straightforward. Childhood obesity is a complex disease with interventions being multi-component in nature. Furthermore, the interventions are implemented in a variety of settings such as schools, the community, and the home, and have costs and benefits that fall outside the health sector. This paper provides a reflection from a UK perspective on the application of the conventional approach to economic evaluation to childhood obesity. It offers suggestions for how evaluations should be designed to fit better within this context, and to meet the needs of local decision makers. An excellent example is the need to report costs using a micro-costing format and for benefit measurement to go beyond a health focus. This is critical as the organisation and commissioning of childhood obesity services is done from a Local Authority setting and this presents further challenges for what is the most appropriate economic evaluation approach to use. Given that adult obesity is now of epidemic proportions, the accurate assessment of childhood obesity interventions to support public health decision making is critical. PMID:26968705

  1. Economical evaluation of damaged vacuum insulation panels in buildings

    Science.gov (United States)

    Kim, Y. M.; Lee, H. Y.; Choi, G. S.; Kang, J. S.

    2015-12-01

    In Korea, thermal insulation standard of buildings have been tightened annually to satisfy the passive house standard from the year 2009. The current domestic policies about disseminating green buildings are progressively conducted. All buildings should be the zero energy building in the year 2025, obligatorily. The method is applied to one of the key technologies for high-performance insulation for zero energy building. The vacuum insulation panel is an excellent high performance insulation. But thermal performance of damaged vacuum insulation panels is reduced significantly. In this paper, the thermal performance of damaged vacuum insulation panels was compared and analyzed. The measurement result of thermal performance depends on the core material type. The insulation of building envelope is usually selected by economic feasibility. To evaluate the economic feasibility of VIPs, the operation cost was analyzed by simulation according to the types and damaged ratio of VIPs

  2. Reported barriers to evaluation in chronic care

    DEFF Research Database (Denmark)

    Knai, Cécile; Nolte, Ellen; Brunn, Matthias;

    2013-01-01

    The growing movement of innovative approaches to chronic disease management in Europe has not been matched by a corresponding effort to evaluate them. This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries....

  3. Economic evaluation of agricultural pollution control options for China

    Institute of Scientific and Technical Information of China (English)

    David Abler

    2015-01-01

    Environmental sustainability has become a policy priority in China. In agriculture, China has had major success in reha-bilitating desertiifed lands through programs to convert steeply-sloped cropland to forest and limit grazing on sensitive grasslands. However, little has been done in terms of policies for agricultural nutrient management. Runoff and leaching of nutrients in chemical fertilizers and livestock manure are widely acknowledged as signiifcant problems in China. This paper presents an evaluation of agricultural nonpoint pol ution control options for China. Options analyzed include design standards (command&control), performance standards, and design and performance incentives. Evaluation criteria include economic efifciency and effectiveness, environmental impact and risk, and social criteria such as equity and food security. The evaluation indicates that the best options for China involve subsidies to farmers for changing production practices in order to reduce nonpoint emissions, combined with appropriate farmer education and technical assistance.

  4. Economic Valuation of Health Care Services in Public Health Systems: A Study about Willingness to Pay (WTP) for Nursing Consultations

    Science.gov (United States)

    Martín-Fernández, Jesús; del Cura-González, Mª Isabel; Rodríguez-Martínez, Gemma; Ariza-Cardiel, Gloria; Zamora, Javier; Gómez-Gascón, Tomás; Polentinos-Castro, Elena; Pérez-Rivas, Francisco Javier; Domínguez-Bidagor, Julia; Beamud-Lagos, Milagros; Tello-Bernabé, Mª Eugenia; Conde-López, Juan Francisco; Aguado-Arroyo, Óscar; Bayona, Mª Teresa Sanz-; Gil-Lacruz, Ana Isabel

    2013-01-01

    Background Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC) by its users. Methods and Results Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP) of €14.4 (CI 95%: €13.2–15.5; median €10) and an average Willingness to Accept [Compensation] (WTA) of €20.9 (CI 95%: €19.6–22.2; median €20). Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4–6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively). Conclusions The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception of value of

  5. Economic valuation of health care services in public health systems: a study about Willingness to Pay (WTP for nursing consultations.

    Directory of Open Access Journals (Sweden)

    Jesús Martín-Fernández

    Full Text Available BACKGROUND: Identifying the economic value assigned by users to a particular health service is of principal interest in planning the service. The aim of this study was to evaluate the perception of economic value of nursing consultation in primary care (PC by its users. METHODS AND RESULTS: Economic study using contingent valuation methodology. A total of 662 users of nursing consultation from 23 health centers were included. Data on demographic and socioeconomic characteristics, health needs, pattern of usage, and satisfaction with provided service were compiled. The validity of the response was evaluated by an explanatory mixed-effects multilevel model in order to assess the factors associated with the response according to the welfare theory. Response reliability was also evaluated. Subjects included in the study indicated an average Willingness to Pay (WTP of €14.4 (CI 95%: €13.2-15.5; median €10 and an average Willingness to Accept [Compensation] (WTA of €20.9 (CI 95%: €19.6-22.2; median €20. Average area income, personal income, consultation duration, home visit, and education level correlated with greater WTP. Women and older subjects showed lower WTP. Fixed parameters explained 8.41% of the residual variability, and response clustering in different health centers explained 4-6% of the total variability. The influence of income on WTP was different in each center. The responses for WTP and WTA in a subgroup of subjects were consistent when reassessed after 2 weeks (intraclass correlation coefficients 0.952 and 0.893, respectively. CONCLUSIONS: The economic value of nursing services provided within PC in a public health system is clearly perceived by its user. The perception of this value is influenced by socioeconomic and demographic characteristics of the subjects and their environment, and by the unique characteristics of the evaluated service. The method of contingent valuation is useful for making explicit this perception

  6. The roles of Medicaid and economic factors in the demand for nursing home care.

    OpenAIRE

    Reschovsky, J D

    1998-01-01

    OBJECTIVE: To examine nursing home demand, focusing on how Medicaid affects demand, the role of economic variables, and on important interactions between explanatory factors. DATA SOURCES: From the 1989 National Long Term Care Survey, a nationally representative sample of community-based and institutionalized elderly persons with disabilities (N = 3,837). Survey data are merged with state- and county-level data on Medicaid policy and local market conditions. STUDY DESIGN: Sample members are c...

  7. Demographic and socio-economic influences on community-based care and caregivers of people with dementia in China

    Directory of Open Access Journals (Sweden)

    Ruoling Chen

    2016-06-01

    Full Text Available Background Dementia is a major public health challenge and China has the largest population with dementia in the world. However, dementia care and caregivers for Chinese are less investigated. Objectives and design To evaluate demographic and socio-economic influences on dementia care, management patterns and caregiver burden in a household community-dwelling-based survey, using participants’ care receipts and Zarit scale. Setting and participants Rural and urban communities across six provinces of China comprising 4837 residents aged ≥60 years, in whom 398 had dementia and 1312 non-dementia diseases. Results People with dementia were less likely to receive care if they were living in rural compared to urban areas (Odd ratio (OR = 0.20; 95%CI: 0.10–0.41, having education level below compared to above secondary school (OR = 0.24; 95%CI: 0.08–0.70, manual labourer compared to non-manual workers (OR = 0.27; 95%CI: 0.13–0.55, having personal annual income below RMB 10,000 yuan (£1000 compared to above (OR = 0.37; 95%CI: 0.13–0.74 or having four or more than compared to less four children (OR = 0.52; 95%CI: 0.27–1.00. Caregivers for dementia compared with those for non-dementia diseases were younger and more likely to be patients’ children or children in-law, had lower education and spent more caring time. Caregiver burden increased with low education, cutback on work and caring for patients who were younger or living in rural areas, and this caregiver burden was three-fold greater than that for non-dementia diseases. Conclusions There are a number of inequalities in dementia care and caregiver burden in China. Reducing the socio-economic gap and increasing education may improve community care for people with dementia and preserve caregivers’ well-being.

  8. Economic Inequality in Eye Care Utilization and its Determinants: A Blinder–Oaxaca Decomposition

    Directory of Open Access Journals (Sweden)

    Mohammad Hassan Emamian

    2014-11-01

    Full Text Available Background The current study aimed to determine eye care utilization, to assess the role of economic inequality in the utilization of eye care services, and to identify its determinants in Shahroud, North of Iran. Methods Of the 6,311 invited people, 5,190 (82.24% individuals aged 40 to 64 years old participated in the study. A history of a visit by an ophthalmologist or optometrist was considered as eye care utilization. The gap between low- and high-economic groups was decomposed into its determinants using the Oaxaca decomposition method. Results Among the participants, 16.32% [95% Confidence Intervals (CI= 15.31–17.33%] had never been examined by an ophthalmologist or optometrist, and 30.94% (95% CI= 29.69–32.20% had not undergone an eye examination in the past 5 years. This negative history was significantly higher among female subjects [Odds Ratio (OR= 1.79, 95% CI= 1.51–2.14], the low-economic group (OR= 2.33, 95% CI= 1.90–2.87, the visually impaired (OR= 1.41, 95% CI= 1.05–1.90, and the uninsured (OR= 1.93, 95% CI= 1.45–2.58. The negative history of eye examination decreased with increasing in age (OR= 0.94, 95% CI= 0.93–0.96 and education (OR= 0.94, 95% CI= 0.92–0.96. In this study, 24.72% (95% CI= 22.30–27.14 of the low-economic group and 9.94% (95% CI= 8.75–11.14 of the high-economic group had no history of eye examination. Decomposition of the gap between the two economic groups showed that education and gender were the most important determinants of inequality. Conclusion A considerable percentage of adults, even those with visual impairment, do not receive appropriate eye care. There is a definite economic inequality in the community for which poverty per se could be the major cause

  9. Evaluation the potential economic impacts of Taiwanese biomass energy production

    International Nuclear Information System (INIS)

    The Taiwanese rice paddy land set-aside program diverts a substantial land area. Given today's high energy prices and interests in energy security, that set-aside area could be converted to produce bioenergy feedstocks. This study evaluates the economic and environmental impacts of such a policy change using a Taiwanese agricultural sector model. The results show that such a strategy provides increased farm revenue, increased rural employment, increased energy sufficiency and reduced greenhouse gas emissions but also increased government expenditures. These outcomes indicate that the agricultural sector could play a positive role by producing renewable energy. -- Highlights: → This paper evaluates the economic and environmental impacts of converting set-aside area to produce bioenergy feedstocks. → Taiwanese agricultural sector model is built and applied to evaluate such impacts. → The empirical results show that producing bioenergy using set-aside area could provide increased farm revenue, increased rural employment, increased energy sufficiency and reduced greenhouse gas emissions but also increased government expenditures. → Agricultural sector in Taiwan could play a positive role by producing renewable energy.

  10. HIV treatment as prevention: issues in economic evaluation.

    Directory of Open Access Journals (Sweden)

    Till Bärnighausen

    Full Text Available Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, "Investigating the Impact of Treatment on New HIV Infections", that economic evaluations of antiretroviral therapy (ART in currently existing programs and in HIV treatment as prevention (TasP programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope of delivery, health states, ART regimens, health workers' experience, patients' time on treatment, and the distribution of delivery across public and private sectors. We argue that for particular evaluation purposes (e.g., to establish the social value of TasP and from particular perspectives (e.g., national health policy makers less detailed cost functions may be sufficient. We then extend the discussion of economic evaluation of TasP, describing why ART outcomes and costs assessed in currently existing programs are unlikely to be generalizable to TasP programs for several fundamental reasons. First, to achieve frequent, widespread HIV testing and high uptake of ART immediately following an HIV diagnosis, TasP programs will require components that are not present in current ART programs and whose costs are not included in current estimates. Second, the early initiation of ART under TasP will change not only patients' disease courses and treatment experiences--which can affect behaviors that determine clinical treatment success, such as ART adherence and retention--but also quality of life and economic outcomes for HIV-infected individuals. Third, the preventive effects of TasP are likely to alter the composition of the HIV-infected population over time, changing its biological and behavioral characteristics and leading to different costs and outcomes for ART.

  11. HIV treatment as prevention: issues in economic evaluation.

    Science.gov (United States)

    Bärnighausen, Till; Salomon, Joshua A; Sangrujee, Nalinee

    2012-01-01

    Meyer-Rath and Over assert in another article in the July 2012 PLoS Medicine Collection, "Investigating the Impact of Treatment on New HIV Infections", that economic evaluations of antiretroviral therapy (ART) in currently existing programs and in HIV treatment as prevention (TasP) programs should use cost functions that capture cost dependence on a number of factors, such as scale and scope of delivery, health states, ART regimens, health workers' experience, patients' time on treatment, and the distribution of delivery across public and private sectors. We argue that for particular evaluation purposes (e.g., to establish the social value of TasP) and from particular perspectives (e.g., national health policy makers) less detailed cost functions may be sufficient. We then extend the discussion of economic evaluation of TasP, describing why ART outcomes and costs assessed in currently existing programs are unlikely to be generalizable to TasP programs for several fundamental reasons. First, to achieve frequent, widespread HIV testing and high uptake of ART immediately following an HIV diagnosis, TasP programs will require components that are not present in current ART programs and whose costs are not included in current estimates. Second, the early initiation of ART under TasP will change not only patients' disease courses and treatment experiences--which can affect behaviors that determine clinical treatment success, such as ART adherence and retention--but also quality of life and economic outcomes for HIV-infected individuals. Third, the preventive effects of TasP are likely to alter the composition of the HIV-infected population over time, changing its biological and behavioral characteristics and leading to different costs and outcomes for ART.

  12. The economic cost of pathways to care in first episode psychosis.

    LENUS (Irish Health Repository)

    Heslin, Margaret

    2011-01-01

    Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.

  13. Technical and economic evaluation of nuclear seawater desalination systems

    International Nuclear Information System (INIS)

    The IAEA Cogeneration/Desalination Cost Model spreadsheets were used for the economic evaluation of sea water desalination plants coupled with small and medium size nuclear reactors developed in RDIPE. The results of calculations have shown that the cost of potable water is equal to or even below 1$/m3. This is very close to similar indices of the best fossil driven desalination plants. For remote and difficult-to-access regions, where the transportation share contributes significantly to the product water cost at fossil plants, the nuclear power sources of these reactor types are cost-efficient and can successfully compete with fossil power sources. (author)

  14. Pharmaceutical treatments to prevent recurrence of endometriosis following surgery: a model-based economic evaluation

    Science.gov (United States)

    Sanghera, Sabina; Barton, Pelham; Bhattacharya, Siladitya; Horne, Andrew W; Roberts, Tracy Elizabeth

    2016-01-01

    Objective Conduct an economic evaluation based on best currently available evidence comparing alternative treatments levonorgestrel-releasing intrauterine system, depot-medroxyprogesterone acetate, combined oral contraceptive pill (COCP) and ‘no treatment’ to prevent recurrence of endometriosis after conservative surgery in primary care, and to inform the design of a planned trial-based economic evaluation. Methods We developed a state transition (Markov) model with a 36-month follow-up. The model structure was informed by a pragmatic review and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per quality-adjusted life year (QALY). As available data were limited, intentionally wide distributions were assigned around model inputs, and the average costs and outcome of the probabilistic sensitivity analyses were reported. Results On average, all strategies were more expensive and generated fewer QALYs compared to no treatment. However, uncertainty attributing to the transition probabilities affected the results. Inputs relating to effectiveness, changes in treatment and the time at which the change is made were the main causes of uncertainty, illustrating areas where robust and specific data collection is required. Conclusions There is currently no evidence to support any treatment being recommended to prevent the recurrence of endometriosis following conservative surgery. The study highlights the importance of developing decision models at the outset of a trial to identify data requirements to conduct a robust post-trial analysis. PMID:27084280

  15. Evaluation of wound care options in patients with recessive dystrophic epidermolysis bullosa: a costly necessity.

    Science.gov (United States)

    Kirkorian, Anna Yasmine; Weitz, Nicole A; Tlougan, Brook; Morel, Kimberly D

    2014-01-01

    Recessive dystrophic epidermolysis bullosa (RDEB) is a genetic disorder in which mutations in collagen VII, the main component of the anchoring fibril, lead to skin fragility and to the development of acute and chronic wounds. Wound care and dressing changes are an important part of the daily lives of individuals with RDEB. Ideal wound care should improve wound healing, minimize pain, and improve quality of life. The objective of the current study was to review wound care options that might be used in a patient with RDEB and calculate the cost of these various options based on publicly available pricing of wound care products. There is a wide range of costs for wound care options in patients with RDEB. For example, a 1-day supply of dressing for a neonate boy with RDEB ranges from $10.64 for the least expensive option to $127.54 for the most expensive option. Wound care in patients with severe, generalized RDEB has not only a significant economic effect, but also directly affects quality of life in this patient population. Although randomized controlled trials evaluating different wound care products in patients with RDEB are lacking, small studies and expert opinion support the use of specialized nonadherent dressings that minimize skin trauma and promote wound healing. Until there is a cure, prospective studies are needed to assess pain, quality of life, and wound healing associated with the use of specialized wound care products for this life-altering condition.

  16. Evaluation of the Economical and Intensive Use of Industrial Land in Chizhou Economic and Technological Development Zone

    Institute of Scientific and Technical Information of China (English)

    Rui; LIU

    2014-01-01

    Based on the subdivision of industrial land in Chizhou Economic and Technological Development Zone,this paper builds the evaluation indicator system for the economical and intensive use of industrial land in the development zone,to analyze the current situation of economical and intensive use of industrial land. The results show that the levels of economical and intensive use of industrial land vary in the development zone; the factors affecting the intensive degree of various industries also vary; the industry in Chizhou Economic and Technological Development Zone is still in the transition phase from inefficient use to low level of use to intensive use.

  17. Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

    Science.gov (United States)

    Ceci, Christine

    2006-03-01

    Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

  18. Evaluation on Indicator System of Food Economic Project Evaluation based on Combination Weight and TOPSIS

    OpenAIRE

    Aiying Shang; Weihua Li; Huijuan Sun; Xiumin Zhao; Zhigang Zheng

    2015-01-01

    This study takes the drawback that the project performance has great influence on food enterprise performance into consideration, through the introduction of financial indicators, indicators of internal processes, learning and development indicators, to build a new comprehensive performance evaluation index system for food economic projects. Based on this, performance indicators data of food economic project is collected and then further processed, which lays the foundation for determining in...

  19. Evaluating Health Care Externality Costs Generated by Risky Consumption Goods

    OpenAIRE

    Cohen, Michael A.; Marina-Selini Katsaiti

    2009-01-01

    We present an overlapping-generations (OLG) macroeconomic model that applies a behavioral interpretation of preferences for goods that generate health risks. In this paper proneness to poor health is viewed as a cognitive miscalculation by economic agents between their expected health state over various consumption bundles and the actual health care they require for their health outcome. To model this the paper borrows insight from prospect theory and applies the reference-dependent preferenc...

  20. Evaluating Health Care Externality Costs Generated by Risky Consuption Goods

    OpenAIRE

    Michael Cohen; Marina-Selini Katsaiti

    2009-01-01

    We present an overlapping-generations (OLG) macroeconomic model that applies a behavioral interpretation of preferences for goods that generate health risks. In this paper proneness to poor health is viewed as a cognitive miscalculation by economic agents between their expected health state over various consumption bundles and the actual health care they require for their health outcome. To model this the paper borrows insight from prospect theory and applies the reference-dependent preferenc...

  1. Spirituality and spiritual evaluation, their role in providing spiritual care

    Directory of Open Access Journals (Sweden)

    Tzounis E.

    2013-01-01

    Full Text Available Introduction: Spiritual evaluation is the procedure in which health professionals are able to recognize the spiritual needs of the patients with the use of the right “tools”. The specific models of spirituality and their correlation to health and sickness are more and more attached and applied to medical-nursing care. This is why spiritual care is recognized by the bibliography as a significant factor which affects the biological and psycho – emotional needs of the people. Aim: This specific review is conducted in order to define the influence of spirituality and spiritual evaluation in providing spiritual care by the healthcare professionals. Μaterial and method: A bibliographic search on the data bases Pubmed using the terms: spirituality, spiritual care, spiritual evaluation, spiritual needs, spiritual pain, teaching on spirituality. Results: The last few years, more and more healing interventions include the patients’ thoughts and those of the health care professional in relation to spirituality and spiritual care. The patients desire discussions of spiritual content with the health professionals considering spiritual health as important as physical health. In order to evaluate and diagnose, both doctors and nurses should evaluate whether spirituality is important for a patient and whether the spiritual factors can actually help or prevent healing procedure. Moreover, health professionals who actually recognize their own spiritual needs, formulate the most important healing relationships.Conclusion: The spiritual area of the clinical care is important. The health care professionals have access to emotionally loaded moments of their patients. This is the reason why, any possible tendency for intervention in their patients’ belief system needs attention and should be limited. Because awareness of spiritual needs is best achieved through education, should at least be provided in the curriculum of medical and nursing schools in Greece.

  2. Endline report – Ethiopia, CARE Ethiopia MFS II country evaluations

    OpenAIRE

    Ingen, van, T.; Kusters, C.S.L.; Zerfu, E.; Kefyalew, D.; Peters, B; Buizer, N.N.

    2015-01-01

    This report presents the findings of the endline of the evaluation of the organisational capacity component of the MFS II country evaluations. The focus of this report is Ethiopia, CARE Ethiopia. The format is based on the requirements by the synthesis team and NWO/WOTRO. The endline was carried out in 2014. The baseline was carried out in 2012.

  3. OMERACT 6 Economics Working Group report: a proposal for a reference case for economic evaluation in rheumatoid arthritis.

    Science.gov (United States)

    Gabriel, Sherine; Drummond, Michael; Maetzel, Andreas; Boers, Maarten; Coyle, Doug; Welch, Vivian; Tugwell, Peter

    2003-04-01

    Standardization of methods for economic evaluation is essential for defining the methodological research agenda that will advance the discipline. Standardization also greatly facilitates the interpretation and comparison of the results of economic analyses. For these reasons, several jurisdictions now require economic evaluation, conducted according to standardized methodological guidelines, as a key ingredient in decision making for reimbursement of health treatments and technologies. The application of these general guidelines, however, can be difficult in the absence of disease-specific information. In the case of rheumatoid arthritis (RA), the recent emergence of innovative, highly effective, but also expensive treatments has created an immediate need to more fully understand the economic implications of RA treatments. With this background, the OMERACT Economics Working Group set out in 1994 to develop an RA-specific reference case for economic evaluation. This report summarizes the OMERACT process leading to specific recommendations on the 12 key elements of a proposed "reference case" for economic evaluation in RA. These elements include: study horizon, duration of therapy, extrapolation beyond trial duration, modeling beyond therapy, synthesis of comparisons where head-to-head trials do not exist, clinical outcome measures, mortality, valuation of health states, resource utilization, discontinuation of therapy, therapeutic sequence, and population risk stratification. Through these efforts, the OMERACT Economics Working Group aims to expedite and enhance the conduct and dissemination of methodological research in economic analyses in the rheumatic diseases. PMID:12672223

  4. Standard cost lists for health economic evaluation in Thailand.

    Science.gov (United States)

    Riewpaiboon, Arthorn

    2014-05-01

    This analysis was undertaken to generate a set of standard costs for medical services and those incurred by patient receiving treatment, for use in health economic evaluations. Medical service unit cost data were derived from a survey of 3,091 hospital medical services in five hospitals, disaggregated by type of hospital (district or provincial/regional) and analyzed using the relative value unit method. Patient-borne ambulatory cost values were derived from data gathered through 905 patient interviews that took place in six health centers, three district hospitals, and three provincial/regional hospitals. The survey gathered data on costs a rising from the distance travelled to access the medical service, the time spent in the healthcare facility, as well as travel and meal costs. The analysis generated a set of standard cost data for Thailand that will make conducting economic evaluations more accurate, faster and more convenient, as well as allowing better comparability between studies. This is the first standard cost menu that has been developed specifically for Thailand, and as such should be revised and refined in the future. Some areas that would benefit from revision are suggested. PMID:24964710

  5. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    Directory of Open Access Journals (Sweden)

    Srijana Pandey, PhD

    2014-09-01

    Full Text Available Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.

  6. Economic Evaluation of Coronary Heart Disease (CHD: Expectations and Challenges in UK and Iran

    Directory of Open Access Journals (Sweden)

    AD Parsa

    2005-10-01

    Full Text Available Introduction: Hearth disease is a major worldwide health problem with high incidence and prevalence in developed countries and rising incidence in developing countries. During last ten years, almost 20% of all acute hospital admissions are cardiac-related. More than 25,000 bypass procedures, about 40,000 angioplasty, and other coronary intervention procedures are carried out annually in the UK. CHD burdens the UK economy by £7.06 billion. Methods: Economic evaluation involves three basic steps of cost identification, cost valuation and cost measurement. The most accepted perspective is societal. Patient data are extracted from the patient file record or patients’ questionnaire or interview. Both quantitative and qualitative analyses are used. Discussion: Management is important clinically and from the economics viewpoint (e.g.; individuals and society must be considered. CHD management is becoming increasingly costly. Direct and indirect costs divert scarce resources (patient’s or family and society to medical care. Economic evaluation assesses the value of heart management in terms of their expected costs and expected benefits, if it includes an analysis of all direct and indirect cost and also all benefits forgone. Increasingly technical solutions are deployed and consideration must be given to which would better meet health sector objectives. Health care expectations: The basic principle is simple- comprehensive, high quality medical care should be available to all without financial barriers to access. However, in the face of increasing costs and ever more patients, this is under threat. In addition, sometimes, populations in greatest need are those least likely to receive it. It is expected economic evaluation aid to define choices on how best to use resources. The current distribution of resources leaves some high- priority demands unmet. The challenge of meeting the demand free public services is increasing. Demand for CHD treatment

  7. The economics of dementia-care mapping in nursing homes: a cluster-randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Geertje van de Ven

    Full Text Available BACKGROUND: Dementia-care mapping (DCM is a cyclic intervention aiming at reducing neuropsychiatric symptoms in people with dementia in nursing homes. Alongside an 18-month cluster-randomized controlled trial in which we studied the effectiveness of DCM on residents and staff outcomes, we investigated differences in costs of care between DCM and usual care in nursing homes. METHODS: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training, a DCM organizational briefing day and conducted the 4-months DCM-intervention twice during the study. A single DCM cycle consists of observation, feedback to the staff, and action plans for the residents. We measured costs related to health care consumption, falls and psychotropic drug use at the resident level and absenteeism at the staff level. Data were extracted from resident files and the nursing home records. Prizes were determined using the Dutch manual of health care cost and the cost prices delivered by a pharmacy and a nursing home. Total costs were evaluated by means of linear mixed-effect models for longitudinal data, with the unit as a random effect to correct for dependencies within units. RESULTS: 34 units from 11 nursing homes, including 318 residents and 376 nursing staff members participated in the cost analyses. Analyses showed no difference in total costs. However certain changes within costs could be noticed. The intervention group showed lower costs associated with outpatient hospital appointments over time (p = 0.05 than the control group. In both groups, the number of falls, costs associated with the elderly-care physician and nurse practitioner increased equally during the study (p<0.02. CONCLUSIONS: DCM is a cost-neutral intervention. It effectively reduces outpatient hospital appointments compared to usual care. Other considerations than costs, such as nursing homes' preferences, may determine whether they

  8. Evaluation of the Efficiency of Economic and Medical Activities in Romanian Hospitals

    OpenAIRE

    Tudor C. DRUGAN; Andrada URDA-CÎMPEAN; Mihaela IANCU; Andrei ACHIMAȘ; Petrică ŞUŞCA

    2012-01-01

    Medical work in public hospitals in Romania has a double subordination: strictly speaking the Health Care Directives is coordinated by the Ministry of Health and in terms of economics the activity is funded by the National Health Insurance through its county subsidiaries. This separation of the two fields, medical and economical, has generated problems in many cases of hospital activity in our country.Economic and financial parameters of 39 hospitals were extracted from their economic balance...

  9. Terminal care: evaluation of effects on surviving family of care before and after bereavement.

    OpenAIRE

    Cameron, J; Parkes, C. M.

    1983-01-01

    To evaluate the effects on the family of a comprehensive programme of terminal cancer care, 20 close relatives of patients who had died in a Palliative Care Unit (PCU) were compared with a matched group of 20 relatives of patients who had died of cancer in other wards of the same teaching hospital. Interviewed by telephone 1 year and 2 weeks after bereavement, relatives of PCU patients report significantly fewer psychological symptoms and less lasting grief and anger than relatives of patient...

  10. Economic Evaluation of Observatory Solar-Energy System

    Science.gov (United States)

    1982-01-01

    Long-term economic performance of a commercial solar-energy system was analyzed and used to predict economic performance at four additional sites. Analysis described in report was done to demonstrate viability of design over a broad range of environmental/economic conditions. Topics covered are system description, study approach, economic analysis and system optimization.

  11. Future demand for dental care in Norway; a macro-economic perspective.

    Science.gov (United States)

    Grytten, J; Lund, E

    1999-10-01

    The future demand for dental care in Norway is discussed on the basis of economic theory. During the next 30 years gross national income will increase substantially due to a marked increase in national income from the sale of oil and gas. On the basis of the model we predict that this increase in income will lead to an increase in demand for dental services in the short run, say for the next 10-15 years. To a large extent this increase in demand is supported by evidence from dental epidemiology. In particular, an increasing proportion of elderly dentate people will demand more services. This picture is different in the long run, say from the year 2010-15 and onwards. Evidence from dental epidemiology indicates that at that stage there will be a fairly high proportion of disease-free individuals in the population who will demand less dental care. Such a trend is also supported by economic theory as long as disease-free individuals consume less dental care irrespective of their income.

  12. Networks for integrated care provision: an economic approach based on opportunism and trust.

    Science.gov (United States)

    Meijboom, Bert; de Haan, Job; Verheyen, Piet

    2004-07-01

    In this paper, we provide the economic rationale for an important issue in the health care sector, namely the network formation, e.g., in The Netherlands. The presence of such cooperation structures is hard to explain using the basic concept of the economic organization (EO) theory, i.e., the dichotomy of hierarchy versus market. However, acknowledging the aspect of trust renders the clan concept to be a powerful tool in understanding the viability of intra- and inter-organizational cooperation in the health sector. The main reason for this is the manner in which the professionals involved perform, as well as the importance of the tacit knowledge of the actors employed in the various health institutions. First, we address the conversion from supply towards demand orientation and the resulting pressure on multi-professional cooperation between health care providers. Then, relevant EO concepts will be reviewed, while introducing theory on knowledge, learning, and trust. Moreover, we offer conclusions for the health care sector on a concept-by-concept basis. Finally, we propose the notion of interclan, a clan-inspired notion for inter-organizational cooperation, and analyse the observed network formation.

  13. Ecological and economic evaluation of biogas from intercrops

    Energy Technology Data Exchange (ETDEWEB)

    Niemetz, Nora; Kettl, Karl-Heinz [Graz Univ. of Technology (Austria). Inst. for Process and Particle Engineering

    2012-12-01

    Biogas made from main crops (e.g., corn) is commonly used for producing electricity and heat. Nevertheless, the production of energy from monocultures is highly unsustainable and not truly renewable. Since neither monocultures nor food competition are desirable, intercrops can be used to increase the yield per hectare instead of leaving agricultural fields unplanted for soil regeneration. The extra biomass can be used for biogas production. In a case study, the economic as well as the ecological feasibility of biogas production using intercrops, cattle manure, grass and corn silage as feedstocks for fermenters was analyzed. The set-up for the case study included different feedstock combinations as well as spatial distributions of substrate supply and heat demand for modeling and optimization. Using the process network synthesis, an optimum structure was generated representing the most economical technology constellation which included transport of substrates, heat and biogas (when applicable). The ecological evaluation was carried out by using the sustainable process index method. The application of both methodologies to different scenarios allowed a constellation to be found which is economically feasible while entailing low ecological pressure. It is demonstrated that the production of intercrops for producing biogas has so far not been regarded as a viable option by the farmers due to a variety of barriers. Sensitization is needed to emphasize that planting intercrops holds many advantages like positive effects on soil regeneration and raised nitrogen fixation, as well as increased biomass output per hectare and, last but not least, it allows the production of energy without conflicts between food and energy production. (orig.)

  14. The environment of coal mining areas and the economic evaluation of the land reclamation

    Institute of Scientific and Technical Information of China (English)

    王志宏; 肖兴田; 何志强

    2001-01-01

    The environment impact of the coal resources mining was analyzed. The method of economic evaluation for the coal mining was established to analyze land destruction. The opportunity cost method was used to quantitatively analyze and estimate the economic loss of the land destruction by coal mining. At the same time, the dump land reclamation of the Yuanbaoshan. Open Pit was taken as an example to evaluate environmental and economical benefit with the method of economic evaluation for the coal mining areas land reclamation.

  15. Health state values for use in the economic evaluation of treatments for Alzheimer's disease.

    Science.gov (United States)

    Shearer, James; Green, Colin; Ritchie, Craig W; Zajicek, John P

    2012-01-01

    Alzheimer's disease (AD) is a chronic, progressive, neurodegenerative disease that places a heavy burden on people with the condition, their families and carers, health care systems and society in general. Health-related quality of life (HR-QOL) in patients deteriorates as the cognitive, behavioural and functional symptoms of AD develop. The human and financial cost of AD is forecast to grow rapidly as populations age, and those responsible for planning and financing health care face the challenge of allocating increasingly scarce resources against current and future interventions targeted towards AD. These include calls for early detection and diagnosis, preventative strategies, new medications, residential care, supportive care, and meeting the needs of carers as well as patients. Health care funders in many health systems now require a demonstration of the value of new interventions through a comparison of benefits in terms of improvements in HR-QOL and costs relative to those of competing or existing practices. Changes in HR-QOL provide the basis for the calculation of the quality-adjusted life-year (QALY), a key outcome used in economic evaluations to compare treatments within and between different disease conditions. The objective of this systematic review was to provide a summary of the published health state values (utilities) for AD patients and their carers that are currently available to estimate QALYs for use in health economic evaluations of interventions in AD. The health care literature was searched for articles published in English between 2000 and 2011, using keywords and variants including 'quality-adjusted life years', 'health state indicators', 'health utilities' and the specific names of generic measures of HR-QOL and health state valuation techniques. Databases searched included MEDLINE, EMBASE, NHS EED, PsycINFO and ISI Web of Science. This review identified 12 studies that reported utility values associated with health states in AD. Values

  16. Methods for Health Economic Evaluation of Vaccines and Immunization Decision Frameworks : A Consensus Framework from a European Vaccine Economics Community

    NARCIS (Netherlands)

    Ultsch, Bernhard; Damm, Oliver; Beutels, Philippe; Bilcke, Joke; Brueggenjuergen, Bernd; Gerber-Grote, Andreas; Greiner, Wolfgang; Hanquet, Germaine; Hutubessy, Raymond; Jit, Mark; Knol, Mirjam; von Kries, Ruediger; Kuhlmann, Alexander; Levy-Bruhl, Daniel; Perleth, Matthias; Postma, Maarten; Salo, Heini; Siebert, Uwe; Wasem, Jurgen; Wichmann, Ole

    2016-01-01

    Incremental cost-effectiveness and cost-utility analyses [health economic evaluations (HEEs)] of vaccines are routinely considered in decision making on immunization in various industrialized countries. While guidelines advocating more standardization of such HEEs (mainly for curative drugs) exist,

  17. A Review of Economic Evaluations of Tobacco Control Programs

    Directory of Open Access Journals (Sweden)

    Jennifer W. Kahende

    2008-12-01

    Full Text Available Each year, an estimated 443,000 people die of smoking-related diseases in the United States. Cigarette smoking results in more than $193 billion in medical costs and productivity losses annually.In an effort to reduce this burden, many states, the federal government, and several national organizations fund tobacco control programs and policies. For this report we reviewed existing literature on economic evaluations of tobacco control interventions. We found that smoking cessation therapies, including nicotine replacement therapy (NRT and self-help are most commonly studied. There are far fewer studies on other important interventions, such as price and tax increases, media campaigns, smoke free air laws and workplace smoking interventions, quitlines, youth access enforcement, school-based programs, and community-based programs. Although there are obvious gaps in the literature, the existing studies show in almost every case that tobacco control programs and policies are either cost-saving or highly cost-effective.

  18. Systematic literature review to evaluate and characterize the health economics and outcomes research studies in India

    Directory of Open Access Journals (Sweden)

    Divya Mishra

    2015-01-01

    Full Text Available Aim: This systematic literature review was conducted to identify, evaluate, and characterize the variety, quality, and intent of the health economics and outcomes research studies being conducted in India. Materials and Methods: Studies published in English language between 1999 and 2012 were retrieved from Embase and PubMed databases using relevant search strategies. Two researchers independently reviewed the studies as per Cochrane methodology; information on the type of research and the outcomes were extracted. Quality of reporting was assessed for model-based health economic studies using a published 100-point Quality of Health Economic Studies (QHES instrument. Results: Of 546 studies screened, 132 were included in the review. The broad study categories were cost-effectiveness analyses [(CEA 54 studies], cost analyses (19 studies, and burden of illness [(BOI 18 studies]. The outcomes evaluated were direct and indirect costs, and incremental cost-effectiveness ratio (ICER, quality-adjusted life years (QALYs, and disability-adjusted life years (DALYs. Direct medical costs assessed cost of medicines, monitoring costs, consultation and hospital charges, along with direct non-medical costs (travel and food for patients and care givers. Loss of productivity and loss of income of patients and care givers were identified as the components of indirect cost. Overall, 33 studies assessed the quality of life (QoL, and the WHO Quality of Life-BREF (WHOQOL-BREF was the most commonly used instrument. Quality assessment for modeling studies showed that most studies were of high quality [mean (range QHES score to be 75.5 (34-93]. Conclusions: This review identified various patterns of pharmacoeconomic studies and good-quality CEA studies. However, there is a need for better assessment of utilization of healthcare resources in India.

  19. Barriers and incentives to orphan care in a time of AIDS and economic crisis: a cross-sectional survey of caregivers in rural Zimbabwe

    Directory of Open Access Journals (Sweden)

    Goodman Karen J

    2006-02-01

    Full Text Available Abstract Background Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment, emotional underdevelopment, illiteracy, poverty, sexual exploitation, and HIV infection, endangering the future health of the society they are expected to sustain. Methods To explore barriers and possible incentives to orphan care, a quantitative cross-sectional survey in rural eastern Zimbabwe asked 371 adults caring for children, including 212 caring for double orphans, about their well-being, needs, resources, and perceptions and experiences of orphan care. Results Survey responses indicate that: 1 foster caregivers are disproportionately female, older, poor, and without a spouse; 2 98% of non-foster caregivers are willing to foster orphans, many from outside their kinship network; 3 poverty is the primary barrier to fostering; 4 financial, physical, and emotional stress levels are high among current and potential fosterers; 5 financial need may be greatest in single-orphan AIDS-impoverished households; and 6 struggling families lack external support. Conclusion Incentives for sustainable orphan care should focus on financial assistance, starting with free schooling, and development of community mechanisms to identify and support children in need, to evaluate and strengthen families' capacity to provide orphan care, and to initiate and support placement outside the family when necessary.

  20. The Diffusion of Health Economics Knowledge in Europe: The EURONHEED (European Network of Health Economics Evaluation Database) Project

    OpenAIRE

    Gerard de Pouvourville; Philippe Ulmann; John Nixon; Stephanie Boulenger; Julie Glanville; Michael Drummond

    2005-01-01

    This paper overviews the EURONHEED (EUROpean Network of Health Economics Evaluation Databases) project. Launched in 2003, this project is funded by the EU. Its aim is to create a network of national and international databases dedicated to health economic evaluation of health services and innovations. Seven centres (France, Germany, Italy, The Netherlands, Spain, Sweden and the UK) are involved covering 17 countries. The network is based on two existing databases, the French CODECS (COnnaissa...

  1. Economic evaluation of CO2 pipeline transport in China

    International Nuclear Information System (INIS)

    Highlights: ► We build a static hydrodynamic model of CO2 pipeline for CCS application. ► We study the impact on pressure drop of pipeline by viscosity, density and elevation. ► We point out that density has a bigger impact on pressure drop than viscosity. ► We suggest dense phase transport is preferred than supercritical state. ► We present cost-optimal pipeline diameters for different flowrates and distances. - Abstract: Carbon capture and sequestration (CCS) is an important option for CO2 mitigation and an optimized CO2 pipeline transport system is necessary for large scale CCS implementation. In the present work, a hydrodynamic model for CO2 pipeline transport was built up and the hydrodynamic performances of CO2 pipeline as well as the impacts of multiple factors on pressure drop behavior along the pipeline were studied. Based on the model, an economic model was established to optimize the CO2 pipeline transport system economically and to evaluate the unit transport cost of CO2 pipeline in China. The hydrodynamic model results show that pipe diameter, soil temperature, and pipeline elevation change have significant influence on the pressure drop behavior of CO2 in the pipeline. The design of pipeline system, including pipeline diameter and number of boosters etc., was optimized to achieve a lowest unit CO2 transport cost. In regarding to the unit cost, when the transport flow rate and distance are between 1–5 MtCO2/year and 100–500 km, respectively, the unit CO2 transport cost mainly lies between 0.1–0.6 RMB/(tCO2 km) and electricity consumption cost of the pipeline inlet compressor was found to take more than 60% of the total cost. The present work provides reference for CO2 transport pipeline design and for feasibility evaluation of potential CCS projects in China.

  2. Impact of the east Asian economic crisis on health and health care: Malaysia's response.

    Science.gov (United States)

    Suleiman, A B; Lye, M S; Yon, R; Teoh, S C; Alias, M

    1998-01-01

    In the wake of the east Asian economic crisis, the health budget for the public sector in Malaysia was cut by 12%. The Ministry of Health responded swiftly with a series of broad-based and specific strategies. There was a careful examination of the operating expenditure and where possible measures were taken to minimise the effects of the budget constraints at the service interface. The MOH reprioritised the development of health projects. Important projects such as rural health projects and training facilities, and committed projects, were continued. In public health, population-based preventive and promotive activities were expected to experience some form of curtailment. There is a need to refocus priorities, maximise the utilisation of resources, and increase productivity at all levels and in all sectors, both public and private, in order to minimise the impact of the economic downturn on health.

  3. Biosignal-based relaxation evaluation of head-care robot.

    Science.gov (United States)

    Ando, Takeshi; Takeda, Maki; Maruyama, Tomomi; Susuki, Yuto; Hirose, Toshinori; Fujioka, Soichiro; Mizuno, Osamu; Yamada, Kenji; Ohno, Yuko; Yukio, Honda

    2013-01-01

    Such popular head care procedures as shampooing and scalp massages provide physical and mental relaxation. However, they place a big burden such as chapped hands on beauticians and other practitioners. Based on our robot hand technology, we have been developing a head care robot. In this paper, we quantitatively evaluated its relaxation effect using the following biosignals: accelerated plethymography (SDNN, HF/TP, LF/HF), heart rate (HR), blood pressure, salivary amylase (sAA) and peripheral skin temperature (PST). We compared the relaxation of our developed head care robot with the head care provided by nurses. In our experimental result with 54 subjects, the activity of the autonomic nerve system changed before and after head care procedures performed by both a human nurse and our proposed robot. Especially, in the proposed robot, we confirmed significant differences with the procedure performed by our proposed head care robot in five indexes: HF/TP, LF/HF, HR, sAA, and PST. The activity of the sympathetic nerve system decreased, because the values of its indexes significantly decreased: LF/HF, HR, and sAA. On the other hand, the activity of the parasympathetic nerve system increased, because of the increase of its indexes value: HF/TP and PST. Our developed head care robot provided satisfactory relaxation in just five minutes of use. PMID:24111288

  4. Economic burden of Clostridium difficile in five hospitals of the Florence health care system in Italy

    Directory of Open Access Journals (Sweden)

    Poli A

    2015-11-01

    Full Text Available Anna Poli,1 Sergio Di Matteo,2 Giacomo M Bruno,2 Enrica Fornai,1 Maria Chiara Valentino,2 Giorgio L Colombo2,31Vigilanza e Controllo Infezioni Correlate all'Assistenza, Ospedale Piero Palagi, Azienda Sanitaria di Firenze, Firenze, Italy; 2SAVE Studi – Health Economics and Outcomes Research, Milan, Italy; 3Department of Drug Sciences, University of Pavia, Pavia, ItalyIntroduction: Despite the awareness about the increasing rates of Clostridium difficile infection (CDI and the economic burden arising from its management (prolonged hospitalization, laboratory tests, visits, surgical treatment, environmental sanitation, few studies are available in Italy on the economic costs directly attributable to the CDI. The Florence health care system has designed a study with the aim of describing the costs attributable to the CDI and defines the incremental economic burden associated with the management of this complication.Methods: We conducted a retrospective study in five hospitals of the Florence health care system. The enrolled population included all patients who were hospitalized during the year 2013 with a diagnosis of CDI. Of the 187 total cases reported in 2013, 69 patients were enrolled, for whom the main cause of hospitalization was directly attributable to CDI.Results: We enrolled 69 patients (19 males and 50 females, with a mean age of 82.16 years (minimum 46 to maximum 98. The total number of hospitalization days observed was 886 (12.8 per patient on average. The data from this study show that the mean total incremental cost for a patient with CDI was €3,270.52 per year. The hospital stay length is the most significant cost parameter, having the largest influence on the overall costs, with an impact of 87% on the total cost. The results confirm the costs for the management of CDI in five hospitals of the Florence health care system are in line with data from the international literature.Conclusion: The economic impact of CDI is most

  5. Economic analysis of delivering primary health care services through community health workers in 3 North Indian states.

    Directory of Open Access Journals (Sweden)

    Shankar Prinja

    Full Text Available We assessed overall annual and unit cost of delivering package of services and specific services at sub-centre level by CHWs and cost effectiveness of Government of India's policy of introducing a second auxiliary nurse midwife (ANM at the sub-centre compared to scenario of single ANM sub-centre.We undertook an economic costing of health services delivered by CHWs, from a health system perspective. Bottom-up costing method was used to collect data on resources spent in 50 randomly selected sub-centres selected from 4 districts. Mean unit cost along with its 95% confidence intervals were estimated using bootstrap method. Multiple linear regression model was used to standardize cost and assess its determinants.Annually it costs INR 1.03 million (USD 19,381, or INR 187 (USD 3.5 per capita per year, to provide a package of preventive, curative and promotive services through community health workers. Unit costs for antenatal care, postnatal care, DOTS treatment and immunization were INR 525 (USD 10 per full ANC care, INR 767 (USD 14 per PNC case registered, INR 974 (USD 18 per DOTS treatment completed and INR 97 (USD 1.8 per child immunized in routine immunization respectively. A 10% increase in human resource costs results in 6% rise in per capita cost. Similarly, 10% increment in the ANC case registered per provider through-put results in a decline in unit cost ranging from 2% in the event of current capacity utilization to 3% reduction in case of full capacity utilization. Incremental cost of introducing 2nd ANM at sub-centre level per unit percent increase ANC coverage was INR 23,058 (USD 432.Our estimates would be useful in undertaking full economic evaluations or equity analysis of CHW programs. Government of India's policy of hiring 2nd ANM at sub-centre level is very cost effective from Indian health system perspective.

  6. [Assessing and evaluating physical activity during counseling in health care].

    Science.gov (United States)

    Hagströmer, Maria; Wisén, Anita; Hassmén, Peter

    2015-01-01

    To make individualized counseling possible, valid and reliable measures of physical activity are necessary. In health care, quality must be continuously secured and developed. Follow-up of life-style habits such as physical activity does not differ from monitoring of other treatment in the health care setting.  After counseling and appropriate period of time, evaluation should be done to assess if there has been any change in the physical activity level. For assessment and evaluation of physical activity in routine clinical practice the National Board for Health and Social Welfare indicator questions regarding physical activity are recommended. For a more detailed assessment and evaluation of physical activity and sedentary behavior comprehensive validated instruments/diaries should be used. For precise and objective assessment and evaluation of both physical activity and sedentary behavior, movement sensors are recommended.

  7. Evaluation of Healthy Lifestyle Behaviors in Health Care Workers

    Directory of Open Access Journals (Sweden)

    Meltem Yalcinkaya

    2007-12-01

    Full Text Available This research was conducted as a descriptive study for the purpose of determining the healthy lifestyle behaviors of health care workers employed at university and state hospitals in Afyon and Denizli. There were 1779 health care personnel in the sample who were employed at university and state hospitals in Afyon and Denizli. It was planned conducted the research on the entire population however some health care workers did not want to participate a total of 316 health care workers were included in the study sample. Data were collected between 15 June-15 Agust 2006 using a demografik questionnaire form and the Healthy Lifestyle Behaviors Scale. In the evaluation data gained, Number-percentage calculations, t-test, One Way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. This study was determined that 84.5% of the health care workers were nurses, 55.7% were in the 20-30 year old age group, 75.0% were married, 39.2% worked on surgical units, 69.6% ate regular meals, only 22.8% were interested in sports, 61.1% did not smoke cigarettes. A statistically significant difference was found health care workers between for age group, gender, educational level, years of employment, hospital unit where they worked, status of eating regular meals, status of being interested in sports, use of alcohol, hospital where employed and the health care workers' healthy lifestyle behaviors (p<0.05. For development health care behaviors lifestyle the main factor which is avoid risk behavior life. Healt care workers must play an important role on the issue. [TAF Prev Med Bull 2007; 6(6.000: 409-420

  8. Evaluation of Healthy Lifestyle Behaviors in Health Care Workers

    Directory of Open Access Journals (Sweden)

    Meltem Yalcinkaya

    2007-12-01

    Full Text Available This research was conducted as a descriptive study for the purpose of determining the healthy lifestyle behaviors of health care workers employed at university and state hospitals in Afyon and Denizli. There were 1779 health care personnel in the sample who were employed at university and state hospitals in Afyon and Denizli. It was planned conducted the research on the entire population however some health care workers did not want to participate a total of 316 health care workers were included in the study sample. Data were collected between 15 June-15 Agust 2006 using a demografik questionnaire form and the Healthy Lifestyle Behaviors Scale. In the evaluation data gained, Number-percentage calculations, t-test, One Way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. This study was determined that 84.5% of the health care workers were nurses, 55.7% were in the 20-30 year old age group, 75.0% were married, 39.2% worked on surgical units, 69.6% ate regular meals, only 22.8% were interested in sports, 61.1% did not smoke cigarettes. A statistically significant difference was found health care workers between for age group, gender, educational level, years of employment, hospital unit where they worked, status of eating regular meals, status of being interested in sports, use of alcohol, hospital where employed and the health care workers' healthy lifestyle behaviors (p<0.05. For development health care behaviors lifestyle the main factor which is avoid risk behavior life. Healt care workers must play an important role on the issue. [TAF Prev Med Bull. 2007; 6(6: 409-420

  9. Solar energy system economic evaluation for Wormser Columbia, South Carolina

    Science.gov (United States)

    1980-01-01

    The Solar Energy System is not economically beneficial under the assumed economic conditions at the sites considered. Economic benefits from this system depend on decreasing the initial investment and the continued increase in the cost of conventional energy. Decreasing the cost depends on favorable tax treatment and continuing development of solar energy technology. Fuel cost would have to increase drastically while the cost of the system would have to remain constant or decrease for the system to become economically feasible.

  10. Specialized Pediatric Palliative Home Care: A Prospective Evaluation

    OpenAIRE

    Groh, Gesa; Borasio, Gian Domenico; Nickolay, Carla; Bender, Hans-Ulrich; von Lüttichau, Irene; Führer, Monika

    2013-01-01

    Objectives: In Germany since 2007 children with advanced life-limiting diseases are eligible for Pediatric Palliative Home Care (PPHC), which is provided by newly established specialized PPHC teams. The objective of this study was to evaluate the acceptance and effectiveness of PPHC as perceived by the parents.

  11. Evaluating the Quality of the Child Care in Finland

    Science.gov (United States)

    Hujala, Eeva; Fonsen, Elina; Elo, Janniina

    2012-01-01

    In this study we examine parents' and teachers' perceptions of the early childhood education and care (ECEC) quality in Finland. The study is based on the paradigm of inclusionary quality and the assessment is based on the quality evaluation model. The parents and teachers assess the quality to be good. The strength of the quality was the effect…

  12. Optimization Model for Economic Evaluation of Wind Farms - How to Optimize a Wind Energy Project Economically and Technically

    Directory of Open Access Journals (Sweden)

    Wagner Sousa de Oliveira

    2012-01-01

    Full Text Available This paper makes a review and systematize methods and techniques of economic evaluation applied to renewable energy projects, specific to wind energy projects. Both project and cost methodologies of economic evaluation are reviewed for a model optimization construction for a proposed optimization model with its objective function most appropriated. It is necessary to engage in different approaches, but complementary, microeconomic project evaluation methods and optimization methods applied to engineering solutions in wind energy converter systems. Optimization model for economic evaluation of wind farms can be as an efficient planning and resource management, which is the key to the success of an energy project. Wind energy is one of the most potent alternative energy resources; however the economics of wind energy is not yet universally favorable to place wind at a competitive platform with coal and natural gas (fossil fuels. Economic evaluation models of wind projects developed would allow investors to better plan their projects, as well as provide valuable insight into the areas that require further development to improve the overall economics of wind energy projects.

  13. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care.

    NARCIS (Netherlands)

    Salchev, P.; Schäfer, W.; Boerma, W.; Groenewegen, P.

    2011-01-01

    Today, strengthening primary care is worldwide probably higher than ever on the agenda of scientist and policy makers (1). Primary care is expected to be an effective response to effects of the current economic crisis on health and health care. The policy strategy towards primary care reinforcement

  14. Economic evaluation of IGCC plants with hot gas cleaning

    International Nuclear Information System (INIS)

    Highlights: ► Techno-economic evaluation of hot gas cleaning IGCC power plants in Germany. ► Scenario analysis in light of nuclear phase-out and outdated coal-fired power plants. ► Consideration of Enhanced Oil Recovery (EOR) and combined heat and power (CHP). ► Economic viability is sensitive to heat-to-power ratio, CHP subsidy, and CO2 price. ► Least-cost investment is not necessarily the one with the lowest GHG emissions. -- Abstract: This paper investigates whether coal-fired Integrated Gasification Combined-Cycle (IGCC) power plants can be an economically viable future technology for providing less carbon-intensive electricity and heat energy in Germany than today. In the context of CO2 emission mitigation in power generation, energy conversion technologies enabling the implementation of Carbon Capture and Storage (CCS) need to be considered. IGCC is such a technology, as it utilizes coal but does not necessarily emit CO2. In our study we investigate, from an economic perspective, whether IGCC plants can be an alternative to nuclear and/or conventional coal-fired power plants. The research is based on scenario analysis. The starting point is the expected shut-down of nuclear power stations and outdated coal-fired power plants, as well as the projected evolution of the CO2 price. The hot gas cleaning option in IGCC plants is of particular interest, as it allows a significant enhancement of the efficiency of the IGCC technology and the use of combined heat and power production (CHP). Corresponding supplementary earnings (incl. subsidies) are compared with an increase in specific investment costs. Besides hot gas cleaning, we also investigate the economic impact of injecting pure CO2 (separated from the IGCC process) into oilfields, as Enhanced Oil Recovery (EOR) can help to reduce the costs of CO2 transport and storage. Based on the results from our analysis we find that the replacement of currently operating power plants by IGCC facilities is only

  15. Implementation and evaluation of Stanford Health Care direct-care teledermatology program

    Directory of Open Access Journals (Sweden)

    Akhilesh S Pathipati

    2016-07-01

    Full Text Available Introduction: Teledermatology has proven to be an effective means of providing dermatologic care. The existing research has primarily evaluated its usefulness in a consultative model. Few academic centers have evaluated a patient-initiated model, and direct-to-consumer services remain the subject of controversy. Stanford Health Care recently launched a direct-care, patient-initiated teledermatology pilot program. This article evaluates the viability and patient satisfaction with this service. Materials and Methods: During the pilot period, patients were able to seek remote dermatologic care using an eVisit tool in their MyHealth account. Patients initiated the consultation, answered questions regarding their complaint, and uploaded a picture if relevant. A Stanford dermatologist reviewed each eVisit and responded with an assessment and plan. The dermatologist noted whether they were able to make a diagnosis and their level of confidence in it. After the study, 10 patients participated in a focus group to provide feedback on the service. Results: In all, 38 patients sought care during the pilot period. A dermatologist was able to make a diagnosis in 36 of 38 (95% cases, with an average confidence level of 7.9 of 10. The average time to consultation was 0.8 days. Patients indicated high levels of satisfaction with the service although they had suggestions for improvement. Discussion: Patients provided clinically useful images and information in a direct-care teledermatology model. Such services allow dermatology providers to increase access while maintaining high-quality care in an academic medical center. Further research is needed on standalone services that cannot integrate encounters with the patient’s existing medical record.

  16. [Clinical effectiveness and economical evaluation of preventive vaccination].

    Science.gov (United States)

    Vaz Carneiro, António; Belo, Ana Isabel; Gouveia, Miguel; Costa, João; Borges, Margarida

    2011-01-01

    The value of mass vaccination as a preventive measure for infectious diseases is one of the most important advances of modern Medicine. The impact on incidence of several infectious diseases, until recently responsible for significant morbidity and mortality at world level, is well proved in a series of high quality epidemiological studies. In this scientific review we aimed firstly to briefly resume the history of mass vaccination and its scientists, responsible for synthesis and marketing of these drugs. In second place we present a group of a few disease preventable by vaccines as well as the Portuguese National Vaccination Plan and its benefits. In third place we identified groups of subjects in which a well structured vaccination plan is particularly important, as well as the correspondent diseases to be covered by vaccination. Fourthly, we discussed the ethical considerations of vaccination, and its tensions between subject autonomy and society advantages in com pulsive programs. Fifthly, we analyzed clinical effectiveness of vaccines through the concept of herd immunity, clinical evaluation of immune response to vaccines and some examples of systematic reviews on three relevant diseases (influenza, meningococcal and pneumococcal infections). In sixth place we discussed vaccine safety presenting monitoring methods of vaccination risks, as well as discussing the public myths concerning vaccines. Finally we present a economic analysis of preventive vaccination with a review of some published literature on specific diseases. We conclude that mass vaccination is a efficacious preventive measure, as well as a economic rational choice, and that this public health intervention should be a pillar of a modern preventive system.

  17. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  18. Evaluation of water resource economics within the Pasco Basin, Washington

    Energy Technology Data Exchange (ETDEWEB)

    Leaming, G F

    1981-09-30

    The Columbia River basalt beneath the Hanford Site in south-central Washington is being considered for possible use as a terminal repository medium for high-level nuclear waste. Such underground storage would require that the facility be contiguous to at least a portion of the ambient groundwater system of the Pasco Basin. This report attempts to evaluate the economic factors and conditions related to the water resources of the Pasco Basin and the probable economic effects associated with selected hypothetical changes in local water demand and supply as a basis for eventual selection of credible water supply alternatives and more detailed analyses of the consequences of such alternative selection. It is most likely that total demand for water for consumptive uses in the Pasco Basin will increase from nearly 2.0 million acre-feet per year in 1980 to almost 2.8 million acre-feet in 2010, with total demand slightly more than 3.6 million acre-feet per year in 2080. The Columbia River and other surface streams constitute the source of more than 99 percent of the water available each year for all uses, both consumptive and non-consumptive, in the Pasco Basin. It is estimated that pumped groundwater accounted for 3 percent of the value of all water supplied to consumers of water in the Pasco Basin in 1980. Groundwater's share of the total cost is proportionately higher than groundwater's share of total use because it is generally more costly to acquire than is surface water and the value of water is considered equivalent to its cost of acquisition. Because groundwater represents such a small part of the total water supply and demand within the Pasco Basin, it is concluded that if the development of a nuclear waste repository on the Hanford Site were to result in changes in the groundwater supply during the next 100 years, the economic impact on the overall water supply picture for the entire basin would be insignificant.

  19. Evaluation of water resource economics within the Pasco Basin, Washington

    International Nuclear Information System (INIS)

    The Columbia River basalt beneath the Hanford Site in south-central Washington is being considered for possible use as a terminal repository medium for high-level nuclear waste. Such underground storage would require that the facility be contiguous to at least a portion of the ambient groundwater system of the Pasco Basin. This report attempts to evaluate the economic factors and conditions related to the water resources of the Pasco Basin and the probable economic effects associated with selected hypothetical changes in local water demand and supply as a basis for eventual selection of credible water supply alternatives and more detailed analyses of the consequences of such alternative selection. It is most likely that total demand for water for consumptive uses in the Pasco Basin will increase from nearly 2.0 million acre-feet per year in 1980 to almost 2.8 million acre-feet in 2010, with total demand slightly more than 3.6 million acre-feet per year in 2080. The Columbia River and other surface streams constitute the source of more than 99 percent of the water available each year for all uses, both consumptive and non-consumptive, in the Pasco Basin. It is estimated that pumped groundwater accounted for 3 percent of the value of all water supplied to consumers of water in the Pasco Basin in 1980. Groundwater's share of the total cost is proportionately higher than groundwater's share of total use because it is generally more costly to acquire than is surface water and the value of water is considered equivalent to its cost of acquisition. Because groundwater represents such a small part of the total water supply and demand within the Pasco Basin, it is concluded that if the development of a nuclear waste repository on the Hanford Site were to result in changes in the groundwater supply during the next 100 years, the economic impact on the overall water supply picture for the entire basin would be insignificant

  20. Cancer care coordination: building a platform for the development of care coordinator roles and ongoing evaluation.

    Science.gov (United States)

    Freijser, Louise; Naccarella, Lucio; McKenzie, Rosemary; Krishnasamy, Meinir

    2015-01-01

    Continuity of care is integral to the quality and safety of care provided to people with cancer and their carers. Further evidence is required to examine the contribution Nurse Cancer Care Coordinator (NCCC) roles make in improving the continuity. The aim of the present study was to clarify the assumptions underpinning the NCCC roles and provide a basis for ongoing evaluation. The project comprised a literature review and a qualitative study to develop program logic. The participants who were purposively sampled included policy makers, practitioners, patient advocates, and researchers. Both the literature and participant reports found that NCCC roles are diverse and responsive to contextual influences to coordinate care at the individual (patient), organisational, and systems levels. The application of the program logic for the development of NCCC roles was explored. The conceptualisation of NCCC roles was also examined in relation to Boundary Spanning and Relational Coordination theory. Further research is required to examine how NCCCs contribute to improving equity, safety, quality and coordination of care. The project has implications for research, policy and practice, and makes explicit existing assumptions to provide a platform for further development and evaluation of these roles. PMID:26509202

  1. Economic evaluation of noncontact normothermic wound therapy for treatment of pressure ulcers.

    Science.gov (United States)

    Macario, Alex

    2002-06-01

    New adjunctive treatments for pressure ulcers have become available to complement standard care. The economic benefits of new advanced wound care treatments like noncontact normothermic wound therapy are related to: the costs of adequately providing standard care treatment, the baseline probability of healing a pressure ulcer to closure with standard care, the relative improvement in healing rates with the advanced wound care treatment and the acquisition cost of the advanced treatment. Healing data from preliminary clinical trials suggest that pressure ulcer healing in long-term care patients is accelerated two-fold with noncontact normothermic wound therapy. At this healing rate, noncontact normothermic wound therapy for stage III and IV pressure ulcer is an economically attractive intervention. Additional well-controlled clinical trials are necessary.

  2. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country. PMID:24688306

  3. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country.

  4. A data-driven agent based simulation platform for early health economics device evaluation

    OpenAIRE

    Bell, D; Kashefi, A; Saleh, N.; Turchi, T

    2016-01-01

    Health economics is a relatively new but growing field within the discipline of economics and is concerned with making the best use of scarce resources. Early health economic estimates of new medical devices, in particular, can assist producers of health technology in making appropriate product design and investment decisions. It allows companies to understand their likely market and possible reimbursement more thoroughly. Despite the many advantages of point-of-care testing the key problem f...

  5. Recommendations for evaluation of health care improvement initiatives.

    Science.gov (United States)

    Parry, Gareth J; Carson-Stevens, Andrew; Luff, Donna F; McPherson, Marianne E; Goldmann, Donald A

    2013-01-01

    Intensive efforts are underway across the world to improve the quality of health care. It is important to use evaluation methods to identify improvement efforts that work well before they are replicated across a broad range of contexts. Evaluation methods need to provide an understanding of why an improvement initiative has or has not worked and how it can be improved in the future. However, improvement initiatives are complex, and evaluation is not always well aligned with the intent and maturity of the intervention, thus limiting the applicability of the results. We describe how initiatives can be grouped into 1 of 3 improvement phases-innovation, testing, and scale-up and spread-depending on the degree of belief in the associated interventions. We describe how many evaluation approaches often lead to a finding of no effect, consistent with what has been termed Rossi's Iron Law of Evaluation. Alternatively, we recommend that the guiding question of evaluation in health care improvement be, "How and in what contexts does a new model work or can be amended to work?" To answer this, we argue for the adoption of formative, theory-driven evaluation. Specifically, evaluations start by identifying a program theory that comprises execution and content theories. These theories should be revised as the initiative develops by applying a rapid-cycle evaluation approach, in which evaluation findings are fed back to the initiative leaders on a regular basis. We describe such evaluation strategies, accounting for the phase of improvement as well as the context and setting in which the improvement concept is being deployed. Finally, we challenge the improvement and evaluation communities to come together to refine the specific methods required so as to avoid the trap of Rossi's Iron Law. PMID:24268081

  6. Economic evaluation of nuclear reactor operation utilizing power effect

    International Nuclear Information System (INIS)

    The operation of a reactor at the so-called power effect may substantially increase the burnup of fuel to be removed. The aim of the evaluation of such reactor operation is the optimal determination of the time over which the yield of the higher use of fuel exceeds economic losses resulting from the increased share of constant expenditure of the price of generated kWh of electric power which ensues from such operation. A mathematical model is presented for such evaluation of reactor operation with regard to benefits for the national economy which is the basis of the ESTER 2 computer program. The calculations show that the prices of generated and delivered kWh are minimally 2% less than the prices of generated power without the power effect use. The minimum ranges in the interval of 30 to 50 days. The dependence of the price of generated and delivered kWh from the point of view of the operator of the power plant as well as the component of fuel price of generated kWh will not reach the minimum even after 50 days of operation. From the operating and physical points of view the duration of power effect is not expected to exceed 20 to 30 days which means that from the point of view of the national economy the price of generated and delivered kWh will be 1.6 to 2% less and the fuel component of the price of the generated kWh will be 3 to 4.5% lower. (Z.M.). 5 figs., 3 refs

  7. The impact of health economic evaluations in Sweden.

    Science.gov (United States)

    Heintz, Emelie; Arnberg, Karl; Levin, Lars-Åke; Liliemark, Jan; Davidson, Thomas

    2014-01-01

    The responsibility for healthcare in Sweden is shared by the central government, county councils and municipalities. The counties and municipalities are free to make their own prioritizations within the framework of the state healthcare laws. To guide prioritization of healthcare resources in Sweden, there is consensus that cost-effectiveness constitutes one of the three principles. The objective of this paper is to describe how cost-effectiveness, and hence health economic evaluations (HEE), have a role in pricing decisions, reimbursement of pharmaceuticals as well as the overall prioritization and allocation of resources in the Swedish healthcare system. There are various organizations involved in the processes of implementing health technologies in the Swedish healthcare system, several of which consider or produce HEEs when assessing different technologies: the Dental and Pharmaceutical Benefits Agency (TLV), the county councils' group on new drug therapies (NLT), the National Board of Health and Welfare, the Swedish Council on Health Technology Assessment (SBU), regional HTA agencies and the Public Health Agency of Sweden. The only governmental agency that has official and mandatory guidelines for how to perform HEE is TLV (LFNAR 2003:2). Even though HEEs may seem to have a clear and explicit role in the decision-making processes in the Swedish healthcare system, there are various obstacles and challenges in the use and dissemination of the results.

  8. BUSINESS SURVEYS-EVALUATION INSTRUMENT OF THE EUROPEAN ECONOMIC CLIMATE

    OpenAIRE

    SECAREANU CONSTANTIN

    2010-01-01

    Business surveys or conjuncture surveys are specific statiostical researches, but complementary to traditional, official statistics.While official statistics provide quantitive information regardin the level,structure and evolution of varied economic process and phenomena, business surveys offer quality information, essential to the short term evolutional analysis of economic indicators: the diagnosis of the current situation, the timely detection of inflexion points within the economic cycle...

  9. Methodological Approach to Comprehensive Economic Evaluation of Water Resources

    OpenAIRE

    Valeriy Mandzyk

    2014-01-01

    As a result of this research, the methodical approaches to comprehensive economic assessment of water resources are worked out. In particular, it is offered to conduct the comprehensive economic assessment in three stages. In the first stage, the economic assessment of water resources as the basis of human life is carried out. The result of this assessment is the monetary value of social and environmental significance of water resource of water body for human and the environment. The main met...

  10. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2013-10-01

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  11. Guidelines for pharmaco-economic research in relation to published health-economics evaluations

    NARCIS (Netherlands)

    Postma, MJ; Kwik, JJ; Rutten, WJMJ; de Jong-van den Berg, LTW; Brouwers, JRBJ

    2002-01-01

    Objective. To investigate whether the health-economics research published in Dutch journals is in agreement with the guidelines for pharmaco-economic research as published in 1999 by the Dutch 'College voor zorgverzekeringen' [Healthcare Insurance Board]. Design. Descriptive. Method. A literature se

  12. Solar energy system economic evaluation for Colt Pueblo, Pueblo, Colorado

    Science.gov (United States)

    1980-01-01

    The Solar Energy System is not economically beneficial under the assumed economic conditions at Pueblo, Colorado; Yosemite, California; Albuquerque, New Mexico; Fort Worth, Texas; and Washington, D.C. Economic benefits from this system depend on decreasing the initial investment and the continued increase in the cost of conventional energy. Decreasing the cost depends on favorable tax treatment and continuing development of solar energy technology. Fuel cost would have to increase drastically while the cost of the system would have to remain constant or decrease for the system to become economically feasible.

  13. Economic gains stimulate negative evaluations of corporate sustainability initiatives

    Science.gov (United States)

    Makov, Tamar; Newman, George E.

    2016-09-01

    In recent years, many organizations have sought to align their financial goals with environmental ones by identifying strategies that maximize profits while minimizing environmental impacts. Examples of this `win-win' approach can be found across a wide range of industries, from encouraging the reuse of hotel towels, to the construction of energy efficient buildings, to the large-scale initiatives of multi-national corporations. Although win-win strategies are generally thought to reflect positively on the organizations that employ them, here we find that people tend to respond negatively to the notion of profiting from environmental initiatives. In fact, observers may evaluate environmental win-wins less favourably than profit-seeking strategies that have no environmental benefits. The present studies suggest that how those initiatives are communicated to the general public may be of central importance. Therefore, organizations would benefit from carefully crafting the discourse around their win-win initiatives to ensure that they avoid this type of backlash.

  14. Economic Evaluation in Medical Information Technology: Why the Numbers Don’t Add Up

    OpenAIRE

    Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R; Lobach, David F.

    2006-01-01

    Standards for the economic evaluation of medical technologies were instituted in the mid-1990s, yet little is known about their application in medical information technology studies. In a review of evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased. However, investigators routinely omitted key cost or effectiveness elements in their designs, resulting in publications with incomplete, and potentially biased, economic f...

  15. Geographical, Ethnic and Socio-Economic Differences in Utilization of Obstetric Care in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Anke G Posthumus

    Full Text Available All women in the Netherlands should have equal access to obstetric care. However, utilization of care is shaped by demand and supply factors. Demand is increased in high risk groups (non-Western women, low socio-economic status (SES, and supply is influenced by availability of hospital facilities (hospital density. To explore the dynamics of obstetric care utilization we investigated the joint association of hospital density and individual characteristics with prototype obstetric interventions.A logistic multi-level model was fitted on retrospective data from the Netherlands Perinatal Registry (years 2000-2008, 1.532.441 singleton pregnancies. In this analysis, the first level comprised individual maternal characteristics, the second of neighbourhood SES and hospital density. The four outcome variables were: referral during pregnancy, elective caesarean section (term and post-term breech pregnancies, induction of labour (term and post-term pregnancies, and birth setting in assumed low-risk pregnancies.Higher hospital density is not associated with more obstetric interventions. Adjusted for maternal characteristics and hospital density, living in low SES neighbourhoods, and non-Western ethnicity were generally associated with a lower probability of interventions. For example, non-Western women had considerably lower odds for induction of labour in all geographical areas, with strongest effects in the more rural areas (non-Western women: OR 0.78, 95% CI 0.77-0.80, p<0.001.Our results suggest inequalities in obstetric care utilization in the Netherlands, and more specifically a relative underservice to the deprived, independent of level of supply.

  16. Increasing the Supply of Quality, Accessible, Affordable Child Care: An Economic Development Strategy for the North Central Region. NCRCRD Policy Briefs

    Science.gov (United States)

    Traill, Saskia; Brown, Brentt

    2005-01-01

    The child care industry has not been fully integrated into economic development activities despite its growing importance in the economy. This is, in large part, because child care is not usually thought of as an element of economic development. As a result, states in the North Central region are not maximizing the economic benefits from quality,…

  17. Economic Evaluation of Office Solar-Heating System

    Science.gov (United States)

    1982-01-01

    Solar-energy system at U.S. Department of Transportation Test Center at Pueblo, Colorado and five similar installations around the country is the subject of 109-page report. Objective of economic analysis is to report long-term economic performance of system at installation site and to extrapolate results to four other locations and an alternate site.

  18. Economic evaluation of safety measures for transport companies

    NARCIS (Netherlands)

    Rietveld, Piet; Rienstra, Sytze A.

    1998-01-01

    Measures to reduce material damage within companies may both increase the business economic performance of the company and traffic safety in general. In this paper the notion of whether such measures are economically feasible is investigated. Results are presented of a series of interviews amongtran

  19. Models of economic geography : dynamics, estimation and policy evaluation

    NARCIS (Netherlands)

    Knaap, Thijs

    2004-01-01

    In this thesis we look at economic geography models from a number of angles. We started by placing the theory in a context of preceding theories, both earlier work on spatial economics and other children of the monopolistic competition ‘revolution.’ Next, we looked at the theoretical properties of t

  20. A study of the user's perception of economic value in nursing visits to primary care by the method of contingent valuation

    Directory of Open Access Journals (Sweden)

    Conde-López Juan

    2011-10-01

    Full Text Available Abstract Background The identification of the attribution of economic value that users of a health system assign to a health service could be useful in planning these services. The method of contingent valuation can provide information about the user's perception of value in monetary terms, and therefore comparable between services of a very different nature. This study attempts to extract the economic value that the subject, user of primary care nursing services in a public health system, attributes to this service by the method of contingent valuation, based on the perspectives of Willingness to Pay (WTP and Willingness to Accept [Compensation] (WTA. Methods/Design This is an economic study with a transversal design. The contingent valuation method will be used to estimate the user's willingness to pay (WTP for the care received from the primary care nurse and the willingness to accept [compensation] (WTA, were this service eliminated. A survey that meets the requisites of the contingent valuation method will be constructed and pilot-tested. Subsequently, 600 interviews will be performed with subjects chosen by systematic randomized sampling from among those who visit nursing at twenty health centers with different socioeconomic characteristics in the Community of Madrid. The characteristics of the subject and of the care received that can explain the variations in WTP, WTA and in the WTP/WTA ratio expressed will be studied. A theoretical validation of contingent valuation will be performed constructing two explanatory multivariate mixed models in which the dependent variable will be WTP, and the WTP/WTA relationship, respectively. Discussion The identification of the attribution of economic value to a health service that does not have a direct price at the time of use, such as a visit to primary care nursing, and the definition of a profile of "loss aversion" in reference to the service evaluated, can be relevant elements in planning

  1. Socio-economic evaluation of selected biogas technologies

    Energy Technology Data Exchange (ETDEWEB)

    Moeller, F.; Martinsen, L.

    2013-05-15

    Financial and welfare economic analyses are conducted of 15 different biogas production scenarios that vary in terms of plant size and type of input. All considered scenarios lead to welfare economic losses. Overall welfare economic GHG reduction costs seem to increase with increasing crop/crop material share of input, and although the costs vary significantly across scenarios they are quite high for all scenarios. The financial analyses suggest that biogas production generally will be financially profitable for the agricultural sector and local CHP facilities but unprofitable for the biogas plants and the State. Seen from a policy perspective the results highlights the importance of designing regulatory instruments in a way that create incentives for private actors to engage in welfare economically desirable biogas production activities while discouraging the expansion of welfare economically undesirable activities. (Author)

  2. Introducing Economic Evaluation as a Policy Tool in Korea: Will Decision Makers get Quality Information?: A Critical Review of Published Korean Economic Evaluations

    OpenAIRE

    Kun-Sei Lee; Brouwer, Werner B.F.; Sang-Il Lee; Hye-Won Koo

    2005-01-01

    Interest in the use of economic evaluations in Korea as an aid for healthcare decision makers has been growing rapidly since the financial crisis of the Korean National Health Insurance fund and the separation in 2000 of the roles of prescribing and dispensing drugs. The Korean Health Insurance Review Agency (HIRA) is considering making it mandatory for pharmaceutical companies to submit the results of an economic evaluation when demanding reimbursement of new pharmaceuticals. The usefulness ...

  3. To Design and Evaluate a 12th Grade Course in the Principles of Economics; Final Report.

    Science.gov (United States)

    Wiggins, Suzanne E.; Sperling, John G.

    Reported is the design, development, and evaluation of a one-semester course on the principles of economics for twelfth grade students. The course is intended to develop students' capacity for economic reasoning through economic theory and empirical research. To do this, teaching materials and innovative techniques for teacher training were…

  4. Economic Evaluation of Single-Family-Residence Solar-Energy Installation

    Science.gov (United States)

    1982-01-01

    Long-term economic performance of a commercial solar-energy system was analyzed and used to predict economic performance at four additional sites. Analysis described in report was done to demonstrate viability of design over a broad range of environmental/economic conditions. Report contains graphs and tables that present evaluation procedure and results. Also contains appendixes that aid in understanding methods used.

  5. Introduction to some fundamental concepts in the economic analysis of dental care delivery.

    Science.gov (United States)

    van der Wal, C J; Smithwick, C L

    1997-01-01

    This paper discusses some basic economic principles and concepts and how they relate to the analysis of dental care delivery. The fundamental theories of consumer behavior, profit maximization, information and transaction costs, and agency are considered. It is asserted that the information gap existing between patients and providers gives rise to a principal-agent problem, the operative element of this paper. The authors conclude that while under managed fee-for-service (MFFS) delivery systems, third-party administrators use financial, administrative, and utilization management tools to guide consumer and provider behavior, to reduce the size of the information gap, and achieve a more efficient allocation of resources, this does not occur under direct reimbursement (DR). PMID:9420386

  6. Economic evaluation of neutral streams and of river construction methods

    International Nuclear Information System (INIS)

    There are no current markets for the management and restoration of natural streams. However, economic elements tend to play an increasingly important role when it comes to decisions about river management activities. Although preference structures of market consumers can be analyzed using prices, there are several short-comings in using this technique for goods with no or an insufficient market. This is especially true for 'natural streams'. The non-existence of market prices for goods or their parts does not mean that they do not have a value or that there is no preference structure for them. After an introductory discussion of ethical and value issues, specific methods for evaluating and analyzing the willingness-to-pay for natural streams and theirs restoration are developed further. Using direct interview techniques, locals in three different watersheds in Upper Austria are ask for their preferences and social pricing of natural streams and river management options. The areas the interviews were conducted in, represent a watershed dominated by intensive agricultural and residential uses, another watershed typical for a rural community and a third representing a watershed of a relatively pristine river of the Northern Alpine limestone range mainly used by forestry and tourism. Demographic data, eco-morphological stream characteristics and preferences of the interviewed about elements of a natural stream, user and non-user values were linked and analyzed. The results of a personal interviewing technique conducted in these watersheds showed to be capable to capture the preference structure in small watersheds and may offer some help for decision-making concerning river management issues. (author)

  7. Economic evaluations of implantable cardioverter defibrillators: a systematic review.

    Science.gov (United States)

    García-Pérez, Lidia; Pinilla-Domínguez, Pilar; García-Quintana, Antonio; Caballero-Dorta, Eduardo; García-García, F Javier; Linertová, Renata; Imaz-Iglesia, Iñaki

    2015-11-01

    The aim of this paper was to review the cost-effectiveness studies of implantable cardioverter defibrillators (ICD) for primary or secondary prevention of sudden cardiac death (SCD). A systematic review of the literature published in English or Spanish was performed by electronically searching MEDLINE and MEDLINE in process, EMBASE, NHS-EED, and EconLit. Some keywords were implantable cardioverter defibrillator, heart failure, heart arrest, myocardial infarction, arrhythmias, syncope, sudden death. Selection criteria were the following: (1) full economic evaluations published after 1995, model-based studies or alongside clinical trials (2) that explored the cost-effectiveness of ICD with or without associated treatment compared with placebo or best medical treatment, (3) in adult patients for primary or secondary prevention of SCD because of ventricular arrhythmias. Studies that fulfilled these criteria were reviewed and data were extracted by two reviewers. The methodological quality of the studies was assessed and a narrative synthesis was prepared. In total, 24 studies were included: seven studies on secondary prevention and 18 studies on primary prevention. Seven studies were performed in Europe. For secondary prevention, the results showed that the ICD is considered cost-effective in patients with more risk. For primary prevention, the cost-effectiveness of ICD has been widely studied, but uncertainty about its cost-effectiveness remains. The cost-effectiveness ratios vary between studies depending on the patient characteristics, methodology, perspective, and national settings. Among the European studies, the conclusions are varied, where the ICD is considered cost-effective or not dependent on the study. PMID:25323413

  8. Economics.

    Science.gov (United States)

    Palley, Paul D; Parcero, Miriam E

    2016-10-01

    A review of literature in the calendar year 2015 dedicated to environmental policies and sustainable development, and economic policies. This review is divided into these sections: sustainable development, irrigation, ecosystems and water management, climate change and disaster risk management, economic growth, water supply policies, water consumption, water price regulation, and water price valuation.

  9. BUSINESS SURVEYS-EVALUATION INSTRUMENT OF THE EUROPEAN ECONOMIC CLIMATE

    Directory of Open Access Journals (Sweden)

    SECAREANU CONSTANTIN

    2010-07-01

    Full Text Available Business surveys or conjuncture surveys are specific statiostical researches, but complementary to traditional, official statistics.While official statistics provide quantitive information regardin the level,structure and evolution of varied economic process and phenomena, business surveys offer quality information, essential to the short term evolutional analysis of economic indicators: the diagnosis of the current situation, the timely detection of inflexion points within the economic cycle and the rapid estimation of short term tendencies of the main macroeconomic indicators (the dynamics of the gross domestic product, the index of industrial production, etc.

  10. African Primary Care Research: Performing a programme evaluation

    Directory of Open Access Journals (Sweden)

    Lilian Dudley

    2014-01-01

    Full Text Available This article is part of a series on Primary Care Research in the African context and focuses on programme evaluation. Different types of programme evaluation are outlined: developmental, process, outcome and impact. Eight steps to follow in designing your programme evaluation are then described in some detail: engage stakeholders; establish what is known; describe the programme; define the evaluation and select a study design; define the indicators; planand manage data collection and analysis; make judgements and recommendations; and disseminate the findings. Other articles in the series cover related topics such as writing your research proposal, performing a literature review, conducting surveys with questionnaires, qualitative interviewing and approaches to quantitative and qualitative data analysis.

  11. Evaluating Robert Frank’s ‘Economic Naturalist’ Writing Assignment

    OpenAIRE

    Wayne Geerling

    2011-01-01

    This paper begins by asking a fundamental question: why do students who take Economics at an introductory level often leave the subject without understanding even the most basic economic principles? The superficial answer seems to be that courses try to cover too many concepts at the expense of mastering the important threshold concepts. Another issue is the way Economics is taught and assessed. I will evaluate an alternative pedagogical device pioneered by Robert Frank: ‘The Economic Natural...

  12. CARES - CERAMICS ANALYSIS AND RELIABILITY EVALUATION OF STRUCTURES

    Science.gov (United States)

    Nemeth, N. N.

    1994-01-01

    The beneficial properties of structural ceramics include their high-temperature strength, light weight, hardness, and corrosion and oxidation resistance. For advanced heat engines, ceramics have demonstrated functional abilities at temperatures well beyond the operational limits of metals. This is offset by the fact that ceramic materials tend to be brittle. When a load is applied, their lack of significant plastic deformation causes the material to crack at microscopic flaws, destroying the component. CARES calculates the fast-fracture reliability or failure probability of macroscopically isotropic ceramic components. These components may be subjected to complex thermomechanical loadings. The program uses results from a commercial structural analysis program (MSC/NASTRAN or ANSYS) to evaluate component reliability due to inherent surface and/or volume type flaws. A multiple material capability allows the finite element model reliability to be a function of many different ceramic material statistical characterizations. The reliability analysis uses element stress, temperature, area, and volume output, which are obtained from two dimensional shell and three dimensional solid isoparametric or axisymmetric finite elements. CARES utilizes the Batdorf model and the two-parameter Weibull cumulative distribution function to describe the effects of multi-axial stress states on material strength. The shear-sensitive Batdorf model requires a user-selected flaw geometry and a mixed-mode fracture criterion. Flaws intersecting the surface and imperfections embedded in the volume can be modeled. The total strain energy release rate theory is used as a mixed mode fracture criterion for co-planar crack extension. Out-of-plane crack extension criteria are approximated by a simple equation with a semi-empirical constant that can model the maximum tangential stress theory, the minimum strain energy density criterion, the maximum strain energy release rate theory, or experimental

  13. Economic Evaluation of Longevity in Organic Dairy Farming

    OpenAIRE

    Horn, Marco; Knaus, Wilhelm; Kirner, Leopold; Steinwidder, Andreas

    2012-01-01

    The aim of this study was to highlight the economic importance of longevity in organic dairy cattle husbandry. Performance and reproductive data of 44,976 Austrian organic Simmental dairy cows were analysed by applying a bio-economic model. A farm scenario as well as different market situations were modelled. Overall costs declined with increasing longevity, due to dropping replacement costs. Annual profit was influenced considerably by milk yield and longevity. Short-lived animals needed sub...

  14. New anticoagulant drugs versus warfarin in atrial fibrillation: economic evaluation and cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Mauro Silingardi

    2013-12-01

    Full Text Available Health care resources available for medical procedures, including pharmaceuticals, are limited worldwide. Health economic evidence is now accepted as an essential component of health technology appraisal, realizing the importance of value for money considerations for a more efficient (cost-effective prescribing. Regulatory agencies in more and more countries perform economic evaluation and cost-effectiveness analysis in order to decide about reimbursement of a new and almost always more expensive drug. Pharmacoeconomy is now acknowledged as a science. Cost-effective analysis is just one of its approaches, measuring cost in money and benefit in terms of Quality Adjusted Life Year, a new outcome measure which combines quantity/quality of additional life-years gained with the new drug/technology. A growing body of pharmacoeconomic evidence about new anticoagulant drugs (dabigatran, rivaroxaban, apixaban for stroke prevention in atrial fibrillation is now available. Most of this evidence comes from the National Institute of Health and Clinical Excellence (NICE in the United Kingdom, the most referenced regulatory agency in the world. Compared to current standard therapies (warfarin, dabigatran, rivaroxaban and apixaban are cost-effective treatments for the whole population of patients with atrial fibrillation, independently of poor/good international normalized ratio control (time in therapeutic range and risk stratification for stroke (CHADS2 score. Significant innovation and the lower rate of intracranial hemorrhage/hemorrhagic stroke coupled with the new drugs are the key drivers of these results.

  15. EVALUATION OF TOTAL ECONOMIC VALUE OF AYURVEDA MEDICINE WITH REFERENCE TO ENVIRONMENTAL VALUATION TECHNIQUES

    Directory of Open Access Journals (Sweden)

    De Silva R.H.S.K.

    2011-08-01

    Full Text Available Ayurveda is one of the oldest medical systems in the world. Health is a state of equilibrium of Physical, Psychological and Spiritual components. This equilibrium is maintained between internal and external environment which is known as Loka Purusa Samya. Ayurvedic therapeutics uses herbs and minerals extracted from environment to maintain the well being of human being. Universally this unique feature ensured sustainable utilization of both environmental and Ayurvedic principles in providing health care. Recently, mankind’s attitude towards the environment has changed with new concepts such as Sustainable Development, Cleaner Production Technology and Environmental Valuation Techniques etc; Increased knowledge and awareness of environmental goods & services, global attention is oriented towards Ayurvedic Medicine.Due to this resurgence, economic value of Ayurvedic Medicine in the global market is at a peak level. Our focus is on the evaluation of Total Economic Value (TEV of Ayurvedic Medicine with reference to Environmental Valuation Techniques (EVT. Revealed Preference (RP and Stated Preference (SP EVT are clearly described. Some critical points of Hedonic Pricing, Travel Cost and Benefit Transfer Methods of RP and Contingent Valuation and Choice modeling Methods of SP were outlined with demonstrative examples related to Ayurveda according to their markets. This paper will be helpful to identify the TEV of Ayurvedic Medicine. Moreover, it explores a new area of study for further research and development to overcome the issues relating to globalization of Ayurveda.

  16. ENVIRONMENTAL, ECONOMIC AND ENERGY IMPACTS OF MATERIAL RECOVERY FACILITIES - A MITE PROGRAM EVALUATION

    Science.gov (United States)

    This report documents an evaluation of the environmental, economic, and energy impacts of material recovery facilities (MRFS) conducted under the Municipal Solid Waste Innovative Technology Evaluation (MITE) Program. he MITE Program is sponsored by the U.S. Environmental Protecti...

  17. Improving end of life care in care homes; an evaluation of the six steps to success programme

    OpenAIRE

    O’Brien, Mary; Kirton, Jennifer; Knighting, Katherine; Roe, Brenda; Jack, Barbara

    2016-01-01

    Background There are approximately 426,000 people residing within care homes in the UK. Residents often have complex trajectories of dying, which make it difficult for staff to manage their end-of-life care. There is growing recognition for the need to support care homes staff in the care of these residents with increased educational initiatives. One educational initiative is The Six Steps to Success programme. Method In order to evaluate the implementation of Six Steps with the first cohort ...

  18. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

    Directory of Open Access Journals (Sweden)

    Fayers Peter

    2010-09-01

    Full Text Available Abstract Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1 To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2 To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1 To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1 in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2 To conduct patient focus group discussions at each of these (Phase 1 to determine care received. 3 To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2. 4 To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2. 5 To undertake document

  19. The plan for the economic evaluation of the Public Service Communication Satellite system

    Science.gov (United States)

    1977-01-01

    A total plan for the economic evaluation of the PSCS public service communication satellite program within domestic markets is presented. It extends from the present through the planning, performance and evaluation of economic experiments following the launch of the PSCS, and includes the consideration of how the results of these experiments impact the transfer from demonstration to operations. The implementation of this plan will provide NASA with information needed to understand and manage the economic and social impacts of the PSCS program.

  20. Economic Evaluation of Dual-Level-Residence Solar-Energy System

    Science.gov (United States)

    1982-01-01

    105-page report is one in a series of economic evaluations of different solar-energy installations. Using study results, an optimal collector area is chosen that minimizes life-cycle costs. From this optimal size thermal and economic performance is evaluated.

  1. Methodological issues and new developments in the economic evaluation of vaccines

    NARCIS (Netherlands)

    P. Beutels (Philippe); E.K.A. van Doorslaer (Eddy); P. van Damme (Damme); J. Hall (Jane)

    2003-01-01

    textabstractThe application of economic evaluation in healthcare, including vaccination programs, has increased exponentially since the 1980s. There are a number of aspects of economic evaluation of vaccine programs that present particular challenges to the analyst. These include the development of

  2. Economism

    Directory of Open Access Journals (Sweden)

    P. Simons

    2010-07-01

    Full Text Available Modern society is characterised not only by a fascination with scientific technology as a means of solving all problems, especially those that stand in the way of material progress (technicism, but also by an obsessive interest in everything that has to do with money (economism or mammonism. The article discusses the relationship between technicism and economism, on the basis of their relationship to utilitarian thinking: the quest for the greatest happiness for the greatest number of people. Recent major studies of neo-liberalism (seen as an intensification of utilitarianism by Laval and Dardot are used as reference to the development of utilitarianism. It is suggested that the western view of the world, as expressed in economism and technicism, with a utilitarian ethics, features three absolutisations: those of theoretical thinking, technology and economics. In a second part, the article draws on the framework of reformational philosophy to suggest an approach that, in principle, is not marred by such absolutisations.

  3. Health economics and orthopaedics.

    Science.gov (United States)

    Maniadakis, N; Gray, A

    2000-01-01

    It is becoming widely accepted that research which considers only the outcome and not the costs associated with new technologies in health care, is of limited value in making decisions about the use of scarce resources. Economic evaluation is becoming a standard feature of clinical research but many published economic evaluations fall short of best practice in their methodology. We have described the essential features of economic evaluation, using published studies in orthopaedics, in order to try to improve the ability of orthopaedic surgeons to read, understand and appraise such studies critically, and to encourage them to consider including economic evaluation in future investigations. PMID:10697306

  4. Evaluation of the integrated community based home care model

    Directory of Open Access Journals (Sweden)

    LR Uys

    2001-09-01

    Full Text Available In 1999-2000 the Integrated Community-Based Home Care model for the care of people with AIDS in communities were implemented in seven sites across the country. The post-implementation evaluation showed that most respondents felt that the model could be replicated if a functioning and informed network including all partners, and a strong management team were in place. The effects of the project were mainly positive for all stakeholders (hospice, clinic, hospital, PWA and their carers, professionals and other community members. Hospitals and community- based services became more aware of and involved in the needs of PWA and felt that the model enabled them to address these needs. PWA and their carers felt supported and respected.

  5. Appointment standardization evaluation in a primary care facility.

    Science.gov (United States)

    Huang, Yu-Li

    2016-07-11

    Purpose - The purpose of this paper is to evaluate the performance on standardizing appointment slot length in a primary care clinic to understand the impact of providers' preferences and practice differences. Design/methodology/approach - The treatment time data were collected for each provider. There were six patient types: emergency/urgent care (ER/UC), follow-up patient (FU), new patient, office visit (OV), physical exam, and well-child care. Simulation model was developed to capture patient flow and measure patient wait time, provider idle time, cost, overtime, finish time, and the number of patients scheduled. Four scheduling scenarios were compared: scheduled all patients at 20 minutes; scheduled ER/UC, FU, OV at 20 minutes and others at 40 minutes; scheduled patient types on individual provider preference; and scheduled patient types on combined provider preference. Findings - Standardized scheduling among providers increase cost by 57 per cent, patient wait time by 83 per cent, provider idle time by five minutes per patient, overtime by 22 minutes, finish time by 30 minutes, and decrease patient access to care by approximately 11 per cent. An individualized scheduling approach could save as much as 14 per cent on cost and schedule 1.5 more patients. The combined preference method could save about 8 per cent while the number of patients scheduled remained the same. Research limitations/implications - The challenge is to actually disseminate the findings to medical providers and adjust scheduling systems accordingly. Originality/value - This paper concluded standardization of providers' clinic preference and practice negatively impact clinic service quality and access to care. PMID:27298064

  6. Enviro-Economic Evaluation of Natural Water Resources: A Retrospect

    Directory of Open Access Journals (Sweden)

    Er.S.S.Kopekar

    2013-10-01

    Full Text Available Today, the threat to the environment is high on industrial agenda in many countries and there is every reason to believe that it will stay there for a long time to come, although local issues may still temporarily overshadow the long term impact on the environment as a result of human activity. The World Commission on Environment and Development (WECD foresaw the possibility for new areas of economic growth, based on policies that sustain the environmental resource base. A central finding of all country studies confirm that economic policies and environmental trends are closely linked but often in the ways that have not been widely recognized. Since economic policies must be designed increasingly in terms of their sustainability.

  7. Creation of minimum standard tool for palliative care in India and self-evaluation of palliative care programs using it

    Directory of Open Access Journals (Sweden)

    M R Rajagopal

    2014-01-01

    Full Text Available Background: It is important to ensure that minimum standards for palliative care based on available resources are clearly defined and achieved. Aims: (1 Creation of minimum National Standards for Palliative Care for India. (2 Development of a tool for self-evaluation of palliative care organizations. (3 Evaluation of the tool in India. In 2006, Pallium India assembled a working group at the national level to develop minimum standards. The standards were to be evaluated by palliative care services in the country. Materials and Methods: The working group prepared a "standards" document, which had two parts - the first composed of eight "essential" components and the second, 22 "desirable" components. The working group sent the document to 86 hospice and palliative care providers nationwide, requesting them to self-evaluate their palliative care services based on the standards document, on a modified Likert scale. Results: Forty-nine (57% palliative care organizations responded, and their self-evaluation of services based on the standards tool was analyzed. The majority of the palliative care providers met most of the standards identified as essential by the working group. A variable percentage of organizations had satisfied the desirable components of the standards. Conclusions: We demonstrated that the "standards tool" could be applied effectively in practice for self-evaluation of quality of palliative care services.

  8. Care for the Caregiver: Evaluation of Mind-Body Self-Care for Accelerated Nursing Students.

    Science.gov (United States)

    Drew, Barbara L; Motter, Tracey; Ross, Ratchneewan; Goliat, Laura M; Sharpnack, Patricia A; Govoni, Amy L; Bozeman, Michelle C; Rababah, Jehad

    2016-01-01

    Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress.

  9. Care for the Caregiver: Evaluation of Mind-Body Self-Care for Accelerated Nursing Students.

    Science.gov (United States)

    Drew, Barbara L; Motter, Tracey; Ross, Ratchneewan; Goliat, Laura M; Sharpnack, Patricia A; Govoni, Amy L; Bozeman, Michelle C; Rababah, Jehad

    2016-01-01

    Stress affects the well-being of both nursing students and the individuals with whom they work. With the theory of cognitive appraisal as a framework for this study, it is proposed that mind-body self-care strategies promote stress management by stabilization of emotions. Outcomes will be a perception of less stress and more mindful engagement with the environment. Objective of the study was to describe an evaluation of student perceived stress and mindfulness to 1-hour per week of class time dedicated to mind-body self-care (yoga, mindful breathing, Reiki, and essential oil therapy). It was a quasi-experimental study; data collection took place at 4 time points. Participants were entry-level accelerated nursing students from 3 US universities: 50 in the treatment group, 64 in the comparison group. Data included health-promoting practices using Health-Promoting Promotion Lifestyle Profile II as a control variable, stress and mindfulness (Perceived Stress Scale [PSS] and Mindful Attention Awareness Scale [MAAS]), and demographic information; analysis using mixed-design repeated-measures analysis of variances. There was a statistically significant interaction between intervention and time on PSS scores, F(3, 264) = 3.95, P = .009, partial η(2) = 0.043, with PSS scores of the intervention group decreasing from baseline to T3 when intervention ended whereas PSS scores of the comparison group increased from baseline. The average scores on the MAAS did not differ significantly. Evaluation of an embedded mind-body self-care module in the first nursing course demonstrated promising improvements in stress management. The findings support the appropriateness of integrating mind-body self-care content into nursing curricula to enhance students' ability to regulate stress. PMID:27078809

  10. Scale interactions in economics: application to the evaluation of the economic damages of climatic change and of extreme events

    International Nuclear Information System (INIS)

    Growth models, which neglect economic disequilibria, considered as temporary, are in general used to evaluate the damaging effects generated by climatic change. This work shows, through a series of modeling experiences, the importance of disequilibria and of endogenous variability of economy in the evaluation of damages due to extreme events and climatic change. It demonstrates the impossibility to separate the evaluation of damages from the representation of growth and of economic dynamics: the comfort losses will depend on both the nature and intensity of impacts and on the dynamics and situation of the economy to which they will apply. Thus, the uncertainties about the damaging effects of future climatic changes come from both scientific uncertainties and from uncertainties about the future organization of our economies. (J.S.)

  11. How do patients with a Turkish background evaluate their medical care in Germany? An observational study in primary care

    Directory of Open Access Journals (Sweden)

    Goetz K

    2015-11-01

    Full Text Available Katja Goetz,1 Jessica Bungartz,2 Joachim Szecsenyi,1 Jost Steinhaeuser3 1Department of General Practice and Health Services Research, University of Heidelberg, Heidelberg, Germany; 2Praxis Medizin im Zentrum, München, Germany; 3Institute of Family Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany Background: Patients’ evaluation of medical care is an essential dimension of quality of care and an important aspect of the feedback cycle for health care providers. The aim of this study was to document how patients with a Turkish background evaluate primary care in Germany and determine which aspects of care are associated with language abilities.Methods: The study was based on an observational design. Patients with a Turkish background from German primary care practices completed the EUROPEP (European Project on Patient Evaluation of General Practice Care questionnaire consisting of 23 items. Seventeen primary care practices were involved with either German (n=8 or Turkish (n=9 general practitioners (GPs.Results: A convenience sample of 472 patients with a Turkish background from 17 practices participated in the study (response rate 39.9%. Practices with a German GP had a lower response rate (19.6% than those with a Turkish GP (57.5%. Items evaluated the highest were “keeping data confidential” (73.4% and “quick services for urgent health problems” (69.9%. Subgroup analysis showed lower evaluation scores from patients with good or excellent German language abilities. Patients who consulted a Turkish GP had higher evaluation scores.Conclusion: The evaluation from patients with a Turkish background living in Germany with either Turkish or German GPs showed lower scores than patients in other studies in Europe using EUROPEP. However, our results had higher evaluation scores than those of Turkish patients evaluating GPs in Turkey. Therefore, different explanation models for these findings should be explored in future studies

  12. Cancer survival in the elderly: Effects of socio-economic factors and health care system features (ELDCARE project)

    NARCIS (Netherlands)

    M. Vercelli (Marina); R. Lillini (Roberto); R. Capocaccia (Riccardo); A. Micheli; J.W.W. Coebergh (Jan Willem); M.J. Quinn (M.); C. Martinez-Garcia (Carmen); A. Quaglia (Alberto); W. Oberaigner; J. Ajmová (J.); T. Aareleid (T.); J. Palo (Jukka); T. Hakulinen (Timo); P. Grosclaude (P.); H. Ziegler (H.); L. Tryggvadottir (Laufey); F. Langmark (F.); A. Andersen; M. Bielska-Lasota (Magdalena); M.A. Pinheiro (Magda Avelar); I. Pleško (I.); V. Pompe-Kirn (V.); P. Ecimovic (P.); T. Möller (Thomas); J.-M. Lutz (J.)

    2006-01-01

    textabstractThe purpose of the ELDCARE project is to study differences in cancer survival for elderly patients by country, taking into account the socio-economic conditions and the characteristics of health care systems at the ecological level. Fifty-three European cancer registries, from 19 countri

  13. Subsidizing Early Childhood Education and Care for Parents on Low Income: Moving beyond the Individualized Economic Rationale of Neoliberalism

    Science.gov (United States)

    Simpson, Donald; Envy, Rose

    2015-01-01

    Neoliberalism and an associated "new politics of parenting" adopts a predominantly economic rationale which discursively positions early childhood education and care (ECEC) as essential to tackling several social ills by allowing individual parents (particularly young mothers) to improve their labour force participation, thus boosting…

  14. Evaluation of Computer-Assisted Instruction in Principles of Economics.

    Science.gov (United States)

    Coates, Dennis; Humphreys, Brad R.

    2001-01-01

    Assesses the effectiveness of supplementary Web-based materials and activities in traditional introductory college economics courses. Results suggest that faculty should focus more on developing self-test quizzes and effective bulletin board discussion projects as opposed to generating online content related to text or lecture notes. (Author/LRW)

  15. Ecological and economic evaluation of Dutch egg production systems.

    NARCIS (Netherlands)

    Dekker, S.E.M.; Boer, de I.J.M.; Vermeij, I.; Aarnink, A.J.A.; Groot Koerkamp, P.W.G.

    2011-01-01

    The upcoming ban on battery cages in the European Union is expected to cause a shift in husbandry systems from predominantly battery cages to enriched cages and loose housing systems, such as barn, free range and organic systems. To gain insight into ecological and economic consequences of such a ba

  16. An Economic Evaluation Comparing Stroke Telemedicine to Conventional Stroke Medicine

    Science.gov (United States)

    Budhram, Stanley Chandra

    2011-01-01

    Stroke is not only a serious medical problem, but it also poses an enormous economic burden on society. Stroke ranks the third as the leading cause of death in the United States behind heart disease and cancer. The survivors of stroke suffer from various degrees of long-term disability which create a severe financial burden on society. University…

  17. Economic evaluation of the efficiency of use of circulating assets

    Directory of Open Access Journals (Sweden)

    Svetlana Mullinova

    2015-06-01

    Full Text Available The article reviewed the status of inventory in the organization. The results of an economic study of current assets and their effect on the financial condition of the organization. The analysis of indicators of working capital and their efficiency. The recommendations to speed up inventory turnover may find practical application in the accounting and analytical activity of the agricultural organizations.

  18. Evaluating transfer capability of economic-driven power markets

    DEFF Research Database (Denmark)

    Xu, Zhao

    2007-01-01

    in the present economic-driven electricity markets. A mathematical model of a multi-objective optimization (MOOP) technique has been adopted and presented here for transfer capability studies; which can be helpful for power system planning and operation procedures. The newly-developed algorithm is being tested...

  19. Ex-ante environmental and economic evaluation of polymer photovoltaics

    NARCIS (Netherlands)

    Roes, A.L.; Alsema, E.A.; Blok, K.; Patel, M.K.

    2009-01-01

    The use of polymer materials for photovoltaic applications is expected to have several advantages over current crystalline silicon technology. In this paper, we perform an environmental and economic assessment of polymer-based thin film modules with a glass substrate and modules with a flexible subs

  20. Methodological Approaches To Economic Evaluation Of Forest Resources

    OpenAIRE

    Igor Lytsur

    2012-01-01

    The article formed the complex process of economic assessment of forest resources and given it's definition. A new approach to determining costs for locking the main types of forest. Allocated forestry (in Keywords: forest) and forest harvesting (in forest exploitation) rents.

  1. The Economics of Dementia-Care Mapping in Nursing Homes: A Cluster-Randomised Controlled Trial

    OpenAIRE

    Geertje van de Ven; Irena Draskovic; Elke van Herpen; Koopmans, Raymond T C M; Rogier Donders; Zuidema, Sytse U.; Eddy M M Adang; Vernooij-Dassen, Myrra J. F. J.

    2014-01-01

    BACKGROUND: Dementia-care mapping (DCM) is a cyclic intervention aiming at reducing neuropsychiatric symptoms in people with dementia in nursing homes. Alongside an 18-month cluster-randomized controlled trial in which we studied the effectiveness of DCM on residents and staff outcomes, we investigated differences in costs of care between DCM and usual care in nursing homes. METHODS: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care hom...

  2. LSE centre for economic performance: evaluating education policies: the evidence from economic research

    OpenAIRE

    McNally, Sandra

    2010-01-01

    A new series of Election Analyses is now available from the LSE’s Centre for Economic Performance (CEP). The series will discuss the research evidence on some of the key policy battlegrounds of the 2010 General Election, including macroeconomic policy, immigration, health, education, crime, poverty and inequality, labour market policy, regional policy, energy and the environment, financial regulation and bankers’ bonuses, and foreign aid.The latest CEP Election Analysis gives an overview of t...

  3. Economic Regions Based on the Agglomeration Economics: an Evaluation for the Spanish Case.

    OpenAIRE

    Morollon, Fernando Rubiera; Viñuela, Ana

    2011-01-01

    What is region? From an economic point of view, a region is a unit in which capital and labour move freely and goods and services are totally open to trade with other regions without any frontiers or limitations. The openness of the regions and their interaction with other regions are their main characteristics. From a statistical point of view internal homogeneity and also heterogeneity between the regions are both desirable properties of a set of regions. The objective of this chapter is re...

  4. Teaching and evaluating critical thinking in respiratory care.

    Science.gov (United States)

    Mishoe, Shelley C; Hernlen, Kitty

    2005-09-01

    The capacity to perform critical thinking in respiratory care may be enhanced through awareness and education to improve skills, abilities, and opportunities. The essential skills for critical thinking in respiratory care include prioritizing, anticipating, troubleshooting, communicating, negotiating, decision making, and reflecting. In addition to these skills, critical thinkers exhibit certain characteristics such as critical evaluation, judgment,insight, motivation, and lifelong learning. The teaching of critical thinking may be accomplished though problem-based learning using an evidenced-based approach to solve clinical problems similar to those encountered in professional practice. Other traditional strategies such as discussion, debate, case study, and case presentations can be used. Web-based curriculum and technologic advances have created opportunities such as bulletin boards, real-time chats, and interactive media tools that can incorporate critical thinking. Many concerns and controversies surround the assessment of critical thinking, and individuals who administer critical thinking tests must be aware of the strengths and limitations of these assessment tools, as well as their relevance to the workplace. The foundational works reported in this article summarize the current status of assessment of critical thinking and can stimulate further investigation and application of the skills, characteristics, educational strategies, and measurement of critical thinking in respiratory care. PMID:16168915

  5. Assessing the Quality of Medical Information Technology Economic Evaluations: Room for Improvement

    OpenAIRE

    Eisenstein, Eric L.; Ortiz, Maqui; Anstrom, Kevin J.; Crosslin, David R; Lobach, David F.

    2006-01-01

    Medical information systems are being recognized for their ability to improve patient outcomes. While standards for the economic evaluation of medical technologies were instituted in the mid-1990s, little is known about their application in medical information technology studies. In a review of medical information technology evaluation studies published between 1982 and 2002, we found that the volume and variety of economic evaluations had increased; however, investigators routinely omitted k...

  6. Summary of the SWOT panel's evaluation of the organisation and financing of the Danish health care system.

    Science.gov (United States)

    Christiansen, Terkel

    2002-02-01

    The organisation and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. This paper systematically summarises the panel's assessments, within the framework of the triangular model of health care. The members of the panel are in agreement on a number of aspects, while their views on other aspects differ. In general they find many strength in the way the system is organised and financed more so in the primary sector than in the hospital sector.

  7. Health: A Key Factor in the Evaluation of Day Care.

    Science.gov (United States)

    Bollin, Gail G.

    Research has inadequately examined why health has become a problem in the day care setting. Health regulations for day care have not been researched in the day care setting per se but have been imposed on day care by the medical community working from a hospital model. Day care research has presumed that having antecedent health regulations in…

  8. Economic valuation of informal care in Asia: a case study of care for disabled stroke survivors in Thailand.

    Science.gov (United States)

    Riewpaiboon, Arthorn; Riewpaiboon, Wachara; Ponsoongnern, Kanyarat; Van den Berg, Bernard

    2009-08-01

    This study values informal care for disabled stroke survivors in Thailand. It applies the conventional recommended opportunity cost method to value informal care in monetary terms. Data were collected by means of face-to-face interviews conducted during 2006. The sample consisted of 101 disabled persons who had suffered a stroke at least six months prior to the interview, and who had a functional status score of less than 95 as measured by the Barthel Index. Average monthly time spent on informal care was 94.6 hours, and the major source of opportunity cost was forgone unpaid work (43.5%). The average monthly monetary value of informal care was 4642.6 baht, based on 2006 prices. This study shows that providing informal care involves a substantial opportunity cost, implying a hidden value to Thai society.

  9. Diagnostic evaluation of dementia in the secondary health care sector

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Andersen, Birgitte Bo; Kessing, Lars Vedel;

    2009-01-01

    BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia...... diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable...... completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence...

  10. Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

    Directory of Open Access Journals (Sweden)

    Nora Döring

    2016-09-01

    Full Text Available Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention.

  11. Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations

    Science.gov (United States)

    Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

    2016-01-01

    Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

  12. Economic Evaluation of Obesity Prevention in Early Childhood: Methods, Limitations and Recommendations.

    Science.gov (United States)

    Döring, Nora; Mayer, Susanne; Rasmussen, Finn; Sonntag, Diana

    2016-01-01

    Despite methodological advances in the field of economic evaluations of interventions, economic evaluations of obesity prevention programmes in early childhood are seldom conducted. The aim of the present study was to explore existing methods and applications of economic evaluations, examining their limitations and making recommendations for future cost-effectiveness assessments. A systematic literature search was conducted using PubMed, Cochrane Library, the British National Health Service Economic Evaluation Databases and EconLit. Eligible studies included trial-based or simulation-based cost-effectiveness analyses of obesity prevention programmes targeting preschool children and/or their parents. The quality of included studies was assessed. Of the six studies included, five were intervention studies and one was based on a simulation approach conducted on secondary data. We identified three main conceptual and methodological limitations of their economic evaluations: Insufficient conceptual approach considering the complexity of childhood obesity, inadequate measurement of effects of interventions, and lack of valid instruments to measure child-related quality of life and costs. Despite the need for economic evaluations of obesity prevention programmes in early childhood, only a few studies of varying quality have been conducted. Moreover, due to methodological and conceptual weaknesses, they offer only limited information for policy makers and intervention providers. We elaborate reasons for the limitations of these studies and offer guidance for designing better economic evaluations of early obesity prevention. PMID:27649218

  13. THE ORGANIZATION WORKS TO IMPROVE THE CLINICAL AND ECONOMIC OUTCOMES OF CARE FOR PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    O. I. Apolikhin

    2015-01-01

    Programme on the territory of theVoronezh region they deployed 7 Interdistrict (ITC and 1 regional centre. The most difficult clinical cases were sent to the Federal urology center - research Institute of urology. They humiliated 140 experts from the region, with 80 of them they studied using remote sensing technology. For the realisation of the Program it was established an Advisory portal NetHealth.ru, which considered 498 clinical cases of prostate cancer, with 28 of specialists in various stages of the region took an active part in distance counseling.      From 2009 to 2013 an improvement of a number of indicators was marked: increase in the absolute number of patients with newly diagnosed prostate cancer from 451 to 603 cases, a localized increase in the share stages with 60.3% to 71.2 %, a decrease of deaths within one year from the date of diagnosis for prostate cancer from 14.6% to 6.5% and deaths among all registered patients with prostate cancer from 10.4% to 5.5%, reducing the proportion of clinically insignificant PCA from 36.4 to 14.1%.Conclusions. "PC module" of integrated phased standardized program "Urology" is a universal tool for solving the problems of improving the organization of medical care for prostate cancer, as well as the principles of operation can be used in other diseases of urology and other medical fields. Clinical and economic efficiency and the versatility of the basis for its recommendations as a priority in the organization of medical care at a cancer on the entire territory of the Russian Federation.

  14. An economic evaluation of tick line deregulation in Queensland

    OpenAIRE

    Chudleigh, Fred; Franco-Dixon, Mary Ann

    2010-01-01

    Rhipicephalus microplus, the cattle tick, is widely distributed across many tropical and subtropical regions of the world and has been identified as the most economically important species of tick across a number of countries. Quarantine boundaries currently limit the spread of the cattle tick into northern New South Wales, parts of South East Queensland, the central parts of the Northern Territory and northern parts of Western Australia. The Queensland tick line (or quarantine boundary) larg...

  15. Evaluation of health policies : an economic analysis applied to Cameroon

    OpenAIRE

    Nkwenkeu, Sylvain F.

    2014-01-01

    In Cameroon, the sequence of reforms in the health sector has reinforced an ideological wavering between two opposing currents: a socio-universal that promotes equity, and a neoliberal, which militates for greater economic efficiency of existing systems. Articulating two concerns which are, the worsening of health inequalities as consequence of policy choices made on the efficacy of services without taking into account factors that support the demand, and the form of organization of the healt...

  16. Health Care Workers’ Knowledge, Attitudes and Practices on Tobacco Use in Economically Disadvantaged Dominican Republic Communities

    Directory of Open Access Journals (Sweden)

    Michael G. Prucha

    2015-04-01

    Full Text Available Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR where data have been lacking. Health care worker (HCW interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153 in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107 completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39% strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%. Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.

  17. Convergent innovation for sustainable economic growth and affordable universal health care: innovating the way we innovate.

    Science.gov (United States)

    Dubé, Laurette; Jha, Srivardhini; Faber, Aida; Struben, Jeroen; London, Ted; Mohapatra, Archisman; Drager, Nick; Lannon, Chris; Joshi, P K; McDermott, John

    2014-12-01

    This paper introduces convergent innovation (CI) as a form of meta-innovation-an innovation in the way we innovate. CI integrates human and economic development outcomes, through behavioral and ecosystem transformation at scale, for sustainable prosperity and affordable universal health care within a whole-of-society paradigm. To this end, CI combines technological and social innovation (including organizational, social process, financial, and institutional), with a special focus on the most underserved populations. CI takes a modular approach that convenes around roadmaps for real world change-a portfolio of loosely coupled complementary partners from the business community, civil society, and the public sector. Roadmaps serve as collaborative platforms for focused, achievable, and time-bound projects to provide scalable, sustainable, and resilient solutions to complex challenges, with benefits both to participating partners and to society. In this paper, we first briefly review the literature on technological innovation that sets the foundations of CI and motivates its feasibility. We then describe CI, its building blocks, and enabling conditions for deployment and scaling up, illustrating its operational forms through examples of existing CI-sensitive innovation.

  18. Economic evaluation of an industrial high temperature lift heat transformer

    International Nuclear Information System (INIS)

    Heat transformers are closed cycle thermodynamic systems which allow waste heat energy to be recycled by increasing its temperature. TAHTs (Triple stage heat transformers) are capable of increasing the temperature of supplied heat by up to ∼140 °C. This paper attempts to analyse the industrial attractiveness of such cycles by conducting a case study on the potential installation of a TAHT in a small Irish oil refinery, examining various different natural gas price scenarios. The choice of waste heat energy being recycled is shown to be pivotal to the success or failure of the installation. TAHTs are demonstrated to show most benefits when applied to waste heat streams with large quantities of latent heat. The usage of more efficient and cost effective equipment instead of conventional shell and tube heat exchangers within the system dramatically increases the potential economic return from the heat transformer. At the present gas price, the capital cost of (conventional) equipment is too high to make this investment financially attractive for the current industrial example, with excessive payback periods predicted. However a return to natural gas price levels observed in 2008 and 2009 would make the unit economically viable. - Highlights: • Economic viability of a triple stage heat transformer in an oil refinery is examined. • Energy Price, waste heat stream type and heat transfer equipment have largest effect. • Waste heat quantity and form are important in determining acceptable payback periods. • Rise of natural gas prices to 2008 levels makes investment feasible in most scenarios

  19. Economic evaluation alongside pragmatic randomised trials: developing a standard operating procedure for clinical trials units

    Directory of Open Access Journals (Sweden)

    Russell Ian T

    2008-11-01

    Full Text Available Abstract Background There is wide recognition that pragmatic randomised trials are the best vehicle for economic evaluation. This is because trials provide the best chance of ensuring internal validity, not least through the rigorous prospective collection of patient-specific data. Furthermore the marginal cost of collecting economic data alongside clinical data is typically modest. UK Clinical Research Collaboration (UKCRC does not require a standard operating procedure (SOP for economic evaluation as a prerequisite for trial unit registration. We judge that such a SOP facilitates the integration of health economics into trials. Methods A collaboration between health economists and trialists at Bangor University led to the development of a SOP for economic evaluation alongside pragmatic trials, in addition to the twenty SOPs required by UKCRC for registration, which include randomisation, data management and statistical analysis. Results Our recent telephone survey suggests that no other UKCRC-registered trials unit currently has an economic SOP. Conclusion We argue that UKCRC should require, from all Trials Units undertaking economic evaluation and seeking registration or re-registration, a SOP for economic evaluation as one of their portfolio of supporting SOPs.

  20. An Economic Evaluation of Rizatriptan in the Treatment of Migraine

    OpenAIRE

    Melissa Thompson; Marek Gawel; Brigitte Desjardins; Nicole Ferko; Daniel Grima

    2005-01-01

    Background: Migraine is a common, chronic, neurovascular disorder, generally characterised by attacks of severe headache and autonomic nervous system dysfunction. Triptans are selective serotonin 5-HT1B/1D receptor agonists that represent effective therapeutic options for moderate-to-severe migraine attacks but with higher acquisition costs relative to usual care therapies. Objective: The objective of this study was to examine the cost effectiveness of rizatriptan treatment compared with `Usu...

  1. Economic evaluation of urban track systems: integration of Life Cycle Costs and Socio-Economic Assessment

    OpenAIRE

    DE JONG, Marjolein; Declercq, Katrien

    2012-01-01

    Urban Track is an EU funded research project (2006-2010) aiming at the development and construction of modular track systems for tram, metro and light rail with a low life cycle cost and a high performance. Systems should be safe, and produce a minimum of noise and vibrations. In total, 28 different partners have worked on the development, implementation and assessment of the innovative rail technologies. To assess the Life Cycle Costs (LCC) and Socio-Economic Costs (SEC) of the newly develop...

  2. Bio-economic evaluation of implementing trawl fishing gear with different selectivity

    DEFF Research Database (Denmark)

    Kronbak, Lone Grønbæk; Nielsen, J. Rasmus; Jørgensen, Ole A.;

    2009-01-01

    The paper develops a biological-economic evaluation tool to analyse the consequences for trawl fishers of implementing more selective fishing technologies. This is done by merging a dynamic biological population model and an economic cost-benefit evaluation framework to describe the consequences...... for the fish stocks, fishermen and society. The bio-economic evaluation is applied to the case of the Danish trawl fishery in Kattegat and Skagerrak, which experiences a high level of discards and bycatches of several species. Four different kinds of selectivity scenarios are evaluated in comparison...... with a baseline. The results from the evaluation are indicators for the consequences on ecological and economic levels. The results show that implementation of different selective fishing gear in the Kattegat and Skagerrak mixed trawl fisheries generally implies a trade off over time between rebuilding the stocks...

  3. The environment of coal mining areas and the economic evaluation of the land reclamation

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-hong; XIAO Xing-tian; HE Zhi-qiang

    2001-01-01

    The environment impact of the coal resources mining was analyzed. The method of economic evaluation for the coal mining was established to analyze lan d destruction. The opportunity cost method was used to quantitatively analyze an d estimate the economic loss of the land destruction by coal mining. At the same time, the dump land reclamation of the Yuanbaoshan Open Pit was taken as an exa mple to evaluate environmental and economical benefit with the method of economi c evaluation for the coal mining areas land reclamation.

  4. Irrigation Cost Estimation Procedures Used in the Irrigation Economics Evaluation System (lEES)

    OpenAIRE

    Williams, Jeffery R.; Llewelyn, Richard V.; DeLano, Dan; Thangavelu, Ilango

    1996-01-01

    Establishment of efficient farm irrigation practices is influenced by the knowledge the irrigator has concerning both the economic and technological aspects of irrigation. The eventual goal of water conservation research is to have water users establish conservation techniques as parts of their continuing operating procedures. However, this will happen only when economic incentives exist. The farm manager requires a basic understanding of the economics of water use in order to evaluate adjust...

  5. The political conditioning of subjective economic evaluations: the role of party discourse

    OpenAIRE

    Pardos-Prado, Sergi; Sagarzazu, Inaki

    2015-01-01

    Classic and revisionist perspectives on economic voting have thoroughly analyzed the role of macroeconomic indicators and individual partisanship as determinants of subjective evaluations of the national economy. Surprisingly, however, top-down analysis of parties’ capacity to cue and persuade voters about national economic conditions is absent in the debate. This study uses a novel dataset containing monthly economic salience in party parliamentary speeches, macroeconomic indicators and indi...

  6. Economic evaluation and optimization of solar systems for space and domestic water heating

    Energy Technology Data Exchange (ETDEWEB)

    Abou-Zied, M.R.; Hawas, M.M.

    1983-01-01

    Solar energy will be utilized only if it proves to be economical. The economic feasibility of the use of solar energy for space and domestic water heating systems for a house in Benghazi, Libya. A comprehensive evaluation considerering 324 cases representing the proper ranges of economic and load factors and based on the annual equivalent cost approach is given. The optimum collector area for each case is determined. The results obtained and relationships developed permit generalizations that can be applicable in other locations.

  7. Solar energy system economic evaluation for IBM System 3, Glendo, Wyoming

    Science.gov (United States)

    1980-01-01

    This analysis was based on the technical and economic models in f-chart design procedures with inputs based on the characteristics of the parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings, and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables was also investigated.

  8. Economic evaluation alongside pragmatic randomised trials: developing a standard operating procedure for clinical trials units

    OpenAIRE

    Russell Ian T; Linck Pat; Hounsome Barry; Edwards Rhiannon T

    2008-01-01

    Abstract Background There is wide recognition that pragmatic randomised trials are the best vehicle for economic evaluation. This is because trials provide the best chance of ensuring internal validity, not least through the rigorous prospective collection of patient-specific data. Furthermore the marginal cost of collecting economic data alongside clinical data is typically modest. UK Clinical Research Collaboration (UKCRC) does not require a standard operating procedure (SOP) for economic e...

  9. Peer support in type 2 diabetes: a randomised controlled trial in primary care with parallel economic and qualitative analyses: pilot study and protocol

    Directory of Open Access Journals (Sweden)

    O'Kelly Fergus

    2007-07-01

    Full Text Available Abstract Background Diabetes is a chronic illness, which requires the individual to assume responsibility for their own care with the aim of maintaining glucose and blood pressure levels as close to normal as possible. Traditionally self-management training for diabetes has been delivered in a didactic manner. In recent times alternatives to the traditional delivery of diabetes care have been investigated, for example, the concept of peer support which emphasises patient rather than professional domination. This paper describes the pilot study and protocol for a study that aims to evaluate the effectiveness of a peer support intervention for people with type 2 diabetes in a primary care setting. Methods/Design A pilot study was conducted to access the feasibility of a randomized controlled trial of a peer support intervention. We used the MRC Framework for the evaluation of complex interventions. Elements of the intervention were defined and the study protocol was finalized. In this cluster randomised controlled trial twenty general practices are assigned to control and intervention groups. Each practice compiles a diabetes register and randomly selects 21 patients. All practices implement a standardised diabetes care system. In the intervention group all practices recruit three peer supporters. The peer supporters are trained to conduct nine group meetings in their general practice over a period of two years. Each meeting has a structured component. The primary outcomes are blood pressure, total cholesterol, HBA1c and the Diabetes Well-being score. In addition to biophysical, psychosocial, economic and health service utilization data peer supporter activity and qualitative data are collected. Discussion Peer support is a complex intervention and evaluating such an intervention presents challenges to researchers. This study will evaluate whether a peer support programme for patients with type 2 diabetes improves biophysical and psychosocial

  10. Economic evaluation of five curing processes for wood coatings

    International Nuclear Information System (INIS)

    In this work we study the economic feasibility of five methods for curing coatings over sheet wood products. Each year, Mexico is producing more than 40 millions of square meters of wood panels, but the demand is of the range of 58 millions of square meters of this product. Two millions are expended after they are coated, and 38 millions without coating, they are coated artisanilly when they are used to make pieces of furniture. The technical characteristics and the costs involved in each one of five methods of curing, are described. Investments involved with each method are processed to establish: fixed costs, variable costs, equilibrium point, and others. Initial investment, coasts and revenues are processed to determine the income statement pro-form, the projected statement of change in financial position, the projected working capital, the projected balance sheet, the cash-flow, and some economical and financial indicators for each one of the five curing methods. With this information, the internal rate of return (IRR) is determined, and used to compare the economic worth of each of the five methods. The five methods are profitable, because all they have a IRR greater than the opportunity cost of capital (15%) of projects with similar characteristics. Despite, with each one of the five methods, the capital invested is recoverable, and profits can be obtained; curing by ultraviolet light or by electron beam, let recover the investment in less than two years, require fewer dollars for investment, and have a IRR of 135% and 111% respectively. Besides ultraviolet light or electron beam curing processes, pollute less with volatile solvents, use the energy efficiently, have greater production rate, and the coating obtained have better quality than with the other three methods. (Author)

  11. The role (or not) of economic evaluation at the micro level: can Bourdieu's theory provide a way forward for clinical decision-making?

    Science.gov (United States)

    Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

    2010-06-01

    Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making.

  12. Economics in social care – an introductory presentation on aspects of the economic work for the NCCSC team

    OpenAIRE

    Bauer, Annette; Francis, Jennifer

    2013-01-01

    A wide range of perspectives• Multiple outcomes, some long-term ones and those difficult to quantify or express in monetary form• Difficulty to define routine care• Most studies in this area cannot establish causalities• Resource implications for other parts in the system, often savings for other public services such as health, education or criminal justice• Knock-on effects are typical for social care interventions but difficult to capture• Methods still underdeveloped• I...

  13. An Optimization Study on Syngas Production and Economic Evaluation

    Directory of Open Access Journals (Sweden)

    Qasim Faraz

    2016-01-01

    Full Text Available Syngas production in Gas-to-liquid (GTL process is focused in past by several researchers to increase the production with minimal capital and operating costs. In this study, syngas production process is simulated and optimized to increase its production and the economic analysis is studied for the proposed optimized process. Aspen HYSYS v8.4 is used for all process simulation work in this article. A new configuration is rigorously simulated while using auto-thermal reforming. Results exhibit a tremendous rise in production of syngas.

  14. The development of the Hydrogen Economic Evaluation Program (HEEP)

    International Nuclear Information System (INIS)

    The International Atomic Energy Agency (IAEA) is developing software to perform economic analysis related to hydrogen production. The software is expected to analyse the economics of the four most promising processes for hydrogen production. These processes are: high and low temperature electrolysis, thermochemical processes including the S-I process, conventional electrolysis and steam reforming. The IAEA HEEP software is expected to be used for comparative studies between nuclear and fossil energy sources. Therefore, typical conventional methods are also to be included in HEEP to enable comparison with nuclear hydrogen production. The HEEP models will be based on some economic and technical data, and on cost modelling. Modelling will include various aspects of hydrogen economy including storage, transport and distribution with options to eliminate or include specific details as required by the users. Development of HEEP is based on the IAEA's successful programme during the development of DEEP. This IAEA DEEP software has been distributed free of charge to more than 500 scientists/engineers and researchers from 50 countries interested in cost estimation of desalination plants using nuclear/fossil energy sources. DEEP is not a design code. A number of member states engaged in nuclear desalination activities in their countries have used DEEP for conducting feasibility studies for establishing large nuclear desalination projects based on different nuclear reactors types and desalination processes. HEEP is expected to be similar to the IAEA software DEEP which is being used to perform economic analysis and feasibility studies related to nuclear desalination in the IAEA and other member states. It is expected that HEEP will have similar architecture to DEEP but with the possibility of easy update and future expansion. Various major processes and technologies are to be incorporated in the HEEP programme as the basis for modelling the performance and cost

  15. Economic Evaluation of Peach Cultivation in North Indian Plains

    OpenAIRE

    Gangwar, L.S.; Singh, Dinesh; Mandal, Goutam

    2008-01-01

    The production constraints and economics of peach (Prunus persica (L) Batsch.) cultivation in Punjab and Uttarakhand have been presented. The investment in peach orchards has been found a profitable business. The internal rate of return (IRR) has been found to vary from 20.98 per cent to 23.80 per cent, depending on the size of peach orchards. The net present value, benefit-cost ratio and IRR at 12 per cent discount rate have been reported as Rs 44,807, 1.681 and 22.20, respectively for the o...

  16. Health economic evaluations of visceral leishmaniasis treatments: a systematic review.

    OpenAIRE

    Marinho, Daniel S.; Casas, Carmen N. P. R.; Pereira, Claudia C. A.; Iuri C. Leite

    2015-01-01

    Visceral leishmaniasis (VL) is a severe form of the leishmaniasis-disease complex. Its importance to public health relies on its high fatality rate in non-treated cases, the socio-economic impact related to its morbidity, and its endemicity on different continents. The estimated burden of disease of VL varies from 1,969,000 to 2,357,000 Disability Adjusted Life Years (DALYs). VL is classified as a Neglected Tropical Disease (NTD), and is strongly related to poverty and its consequences. Visce...

  17. Economic evaluations of hepatitis A vaccination in middle-income countries

    NARCIS (Netherlands)

    Suwantika, Auliya A; Yegenoglu, Selen; Riewpaiboon, Arthorn; Tu, Hong-Anh T; Postma, Maarten J

    2013-01-01

    Economic evaluations of hepatitis A vaccination are important to assist national and international policy makers in different jurisdictions on making effective decisions. Up to now, a comprehensive review of the potential health and economic benefits on hepatitis A vaccination in middle-income count

  18. A decision chart for assessing and improving the transferability of economic evaluation results between countries

    NARCIS (Netherlands)

    Welte, Robert; Feenstra, Talitha; Jager, Hans; Leidl, Reiner

    2004-01-01

    OBJECTIVE: To develop a user-friendly tool for managing the transfer of economic evaluation results. METHODS: Factors that may influence the transfer of health economic study results were systematically identified and the way they impact on transferability was investigated. A transferability decisio

  19. Using Multiple-Choice Questions to Evaluate In-Depth Learning of Economics

    Science.gov (United States)

    Buckles, Stephen; Siegfried, John J.

    2006-01-01

    Multiple-choice questions are the basis of a significant portion of assessment in introductory economics courses. However, these questions, as found in course assessments, test banks, and textbooks, often fail to evaluate students' abilities to use and apply economic analysis. The authors conclude that multiple-choice questions can be used to…

  20. Societal and Economic Engagement of Universities in Finland: An Evaluation Model

    Science.gov (United States)

    Ritsila, Jari; Nieminen, Mika; Sotarauta, Markku; Lahtonen, Jukka

    2008-01-01

    This paper is based on the work of an expert team invited by the Ministry of Education of Finland to develop criteria and an evaluation framework for societal and economic engagement for use in university performance management. The paper maps out possible indicators for the societal and economic engagement of universities in the light of national…

  1. Helping families improve: an evaluation of two primary care approaches to parenting support in the Netherlands

    NARCIS (Netherlands)

    Graaf, I.M. de; Onrust, S.A.; Haverman, M.C.C.; Janssens, J.M.A.M.

    2009-01-01

    The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary car

  2. Evaluating patient care communication in integrated care settings: application of a mixed method approach in cerebral palsy programs

    NARCIS (Netherlands)

    Gulmans, J.; Vollenbroek-Hutten, M.M.R.; Gemert-Pijnen, van J.E.W.C.; Harten, van W.H.

    2008-01-01

    Objective. In this study, we evaluated patient care communication in the integrated care setting of children with cerebral palsy in three Dutch regions in order to identify relevant communication gaps experienced by both parents and involved professionals. - Design. A three-step mixed method approac

  3. Evaluation of the Efficiency of Economic and Medical Activities in Romanian Hospitals

    Directory of Open Access Journals (Sweden)

    Tudor C. DRUGAN

    2012-03-01

    Full Text Available Medical work in public hospitals in Romania has a double subordination: strictly speaking the Health Care Directives is coordinated by the Ministry of Health and in terms of economics the activity is funded by the National Health Insurance through its county subsidiaries. This separation of the two fields, medical and economical, has generated problems in many cases of hospital activity in our country.Economic and financial parameters of 39 hospitals were extracted from their economic balance sheets for 2009-2010 and were entered into a multi-criteria analysis to generate an overall score. Then this was checked for possible relationships with the hospitals’ competence (established by the Ministry of Health with the help of a national program.The aim of this study was to assess the relationship between hospital medical competency and economical parameters in the Romanian Health Care System. The lack of correlation of the economic and financial parameters with the health parameters observed by our study reflects the current problems in the Romanian health system, where the impossibility of generating practical management solutions is the consequence of multiple subordination of hospital units, separate assessment of competence and administrative skills.

  4. Introducing economic evaluation as a policy tool in Korea: Will decision makers get quality information? A critical review of published Korean economic evaluations

    NARCIS (Netherlands)

    K.-S. Lee (Kun-Sei); W.B.F. Brouwer (Werner); S.-I. Lee (Sang-Il); H.-W. Koo (Hye-Won)

    2005-01-01

    textabstractInterest in the use of economic evaluations in Korea as an aid for healthcare decision makers has been growing rapidly since the financial crisis of the Korean National Health Insurance fund and the separation in 2000 of the roles of prescribing and dispensing drugs. The Korean Health In

  5. Economic evaluations of occupational health interventions from a corporate perspective - A systematic review of methodological quality

    NARCIS (Netherlands)

    Uegaki, K.; Bruijne, M.C. de; Lambeek, L.; Anema, J.R.; Beek, A.J. van der; Mechelen, W. van; Tulder, M.W. van

    2010-01-01

    Objective: Using a standardized quality criteria list, we appraised the methodological quality of economic evaluations of occupational safety and health (OSH) interventions conducted from a corporate perspective. Methods: The primary literature search was conducted in Medline and Embase. Supplementa

  6. Methods for health economic evaluations of vaccines-results from an international expert-workshop

    NARCIS (Netherlands)

    Ultsch, B.; Damm, O.; Beutels, P.; Bilcke, J.; Brüggenjürgen, B.; Gerber-Grote, A.U.; Greiner, W.; Hanquet, G.; Harder, T.; Hutubessy, R.; Jit, M.; Knol, M.; Kuhlmann, A.; Von Kries, R.; Levy-Bruhl, D.; Perleth, M.; Postma, M.J.; Salo, H.; Siebert, U.; Wasem, J.; Weidemann, F.; Wichmann, O.; Postma, Maarten

    2014-01-01

    Objectives: Health economic evaluations (HEEs) of vaccines are commonly considered during immunization introduction decision-making processes in most industrialized countries. Despite the availability of guidelines advocating more standardization for such HEEs, there are still several infection/immu

  7. Evaluation of the feasibility, economic impact, and effectiveness of underground nuclear power plants. Final technical report

    International Nuclear Information System (INIS)

    Information on underground nuclear power plants is presented concerning underground nuclear power plant concepts; public health impacts; technical feasibility of underground concepts; economic impacts of underground construction; and evaluation of related issues

  8. Evaluation of the feasibility, economic impact, and effectiveness of underground nuclear power plants. Final technical report

    Energy Technology Data Exchange (ETDEWEB)

    1978-05-01

    Information on underground nuclear power plants is presented concerning underground nuclear power plant concepts; public health impacts; technical feasibility of underground concepts; economic impacts of underground construction; and evaluation of related issues.

  9. EVALUATION OF UNSAFE BIRTHS AND POSTPARTUM HOME CARE SERVICES

    Directory of Open Access Journals (Sweden)

    Filiz ERGIN

    2005-12-01

    Full Text Available Introduction: It is known that mother/child deaths can be prevented by having safe births and taking routine postnatal home care. The aim of this study is to evaluate safety of births and postnatal home care visits of mothers having 0-11 month babies in the Center of Aydin. Methods: A cross-sectional design was used to study a group of 806 mothers. Multistage sampling method was used. Health stations was taken as cluster units. One rural-one urban health station from ten health-centers was selected by random sampling method. Safety of births, type of births, complications after births, home visits by health personel at postpartum period were asked. Results: Unsafe births was 6,0% in Aydin. It was found that family income, mother?s age/occupation/educational level, social security, number of children, father?s occupation/educational level and household size, effects the safety of births. 59,9% of women were visited by widwives at the postpartum period and mean number of visits were 2,0 ±1,7. At this period 9,4% of women had complications, and these complications were two times greater at unsafe births. Conclusion: Although Aydin is in the west part of Turkey, unsafe births and inadequate postpartum home visits are seen. In order to prevent these problems, health centers must take more active role. [TAF Prev Med Bull 2005; 4(6.000: 321-329

  10. Economic evaluation of mental health interventions: an introduction to cost-utility analysis.

    Science.gov (United States)

    Luyten, Jeroen; Naci, Huseyin; Knapp, Martin

    2016-05-01

    Finite resources need to be allocated over an ever-increasing range of competing health policies and interventions. Economic evaluation has been developed as a methodology to inform decision makers on the efficiency of particular resource allocations. In this paper we summarize cost-utility analysis, one of the most widely-used forms of economic evaluation in healthcare. We discuss its main elements, interpretation, limitations and relevance to the domain of mental health. PMID:27075444

  11. Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies

    OpenAIRE

    Koffi Alouki; Hélène Delisle; Clara Bermúdez-Tamayo; Mira Johri

    2016-01-01

    Objective. To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of type 2 diabetes (T2D) in high-risk subjects. Methods. We conducted a systematic review of peer-reviewed original studies published since January 2009 in English, French, and Spanish. Eligible studies were identified through relevant databases including PubMed, Medline, National Health Services Economic Evaluation, CINHAL, EconLit, Web of sciences, EMBASE, and the Latin America...

  12. An Evaluation of the Economic Theoretical Potential of the Rural Environment Mismanged During 1956-2010

    OpenAIRE

    Florentin Gabriel Niculescu

    2015-01-01

    Under the context of the essential role and growing importance of the rural environment in the development of a country, we focus on evaluating the economic theoretical potential of the rural environment that we consider to have been mismanaged during 1956-2010. For this purpose, in this paper we define, describe and explain the main concepts, as to be able to evaluate the economic potential of the rural development and further contribute to its improvement. The study focuses on the correlati...

  13. Informing road traffic intervention choices in South Africa: the role of economic evaluations

    OpenAIRE

    Wesson, Hadley K.H.; Boikhutso, Nkuli; Hyder, Adnan A; Bertram, Melanie; Hofman, Karen J.

    2016-01-01

    Introduction: Given the burden of road traffic injuries (RTIs) in South Africa, economic evaluations of prevention interventions are necessary for informing and prioritising public health planning and policy with regard to road safety.Methods: In view of the dearth of RTI cost analysis, and in order to understand the extent to which RTI-related costs in South Africa compare with those in other low- and middle-income countries (LMICs), we reviewed published economic evaluations of RTI-related ...

  14. Economic evaluation of herb extraction using supercritical fluid

    Directory of Open Access Journals (Sweden)

    M. Shariaty-Niassar

    2009-09-01

    Full Text Available Due to the climate diversity in different parts of Iran, a variety of plants grow across the country, many of them having pharmaceutical applications. At present, only a few companies are producing herbal essence, all of them are technically based on conventional methods of extraction such as steam distillation and others. Because of the current serious concern with respect to the environmental conservation law the use of green technology seems imperative. The supercritical fluid extraction is considered as a practical and procedural method which has become under serious consideration in recent years. For this, an economical analysis is made of herb extractions using a supercritical fluid. The results of such a survey can clarify the new methods to be of great concern. The aim of this paper is to present the feasibility studies of supercritical fluid extraction units used for producing a different plant extract and especially that of rosemary.

  15. An economic model for evaluating high-speed aircraft designs

    Science.gov (United States)

    Vandervelden, Alexander J. M.

    1989-01-01

    A Class 1 method for determining whether further development of a new aircraft design is desirable from all viewpoints is presented. For the manufacturer the model gives an estimate of the total cost of research and development from the preliminary design to the first production aircraft. Using Wright's law of production, one can derive the average cost per aircraft produced for a given break-even number. The model will also provide the airline with a good estimate of the direct and indirect operating costs. From the viewpoint of the passenger, the model proposes a tradeoff between ticket price and cruise speed. Finally all of these viewpoints are combined in a Comparative Aircraft Seat-kilometer Economic Index.

  16. Testing and economical evaluation of U(IV) in Purex

    International Nuclear Information System (INIS)

    The use of uranous nitrate, U(IV), as a plutonium reductant in the Purex solvent extraction process could significantly reduce the waste generation at the Savannah River Plant. The current reductant is a ferrous sulfamate (FS)/hydroxylamine nitrate (HAN) mixture. The iron and sulfate in the FS are major contributors to waste generation. The U(IV) reductant oxidizes to U(VI) producing no waste. The Savannah River Laboratory has developed an efficient electrochemical cell for U(IV) production and has demonstrated the effectiveness of U(IV) as a plutonium reductant. Plant tests and economic analyses are currently being conducted to determine the cost effectiveness of U(IV) implementation. The results of recent studies are presented

  17. ECOGEN - Soil ecological and economic evaluation of genetically modified crops

    DEFF Research Database (Denmark)

    Krogh, P. H

    2007-01-01

    , nematodes, springtails, mites and earthworms; Green-house model ecosystem or mesocosm studies to analyse ecological interactions; Field studies in three climatic zones of Northern and Southern Europe where Bt-maize management was compared with conventional management (that included insecticides...... and conventional non-GM maize. These results are in line with other research findings obtained over the past ten years since first commercialization. The few differences observed were inconsistent and within the natural variation expected for maize crops. Soil type, plant growth stage and the use of pesticides...... have a higher impact on soil organism diversity and function than the type of maize crop grown (GM or conventional). Furthermore, the adoption of reduced tillage technologies, facilitated in certain types of GM crops, may contribute to preserving the quality of agricultural soil. The economic analyses...

  18. Experience and economic evaluation of backwashable hollow fiber filter

    International Nuclear Information System (INIS)

    In the initial applications of filtration systems to nuclear power plants, filtration has been provided by precoat and cartridge type filters as required. These filters provide good effluent but generate a great amount of burial volume. This makes the cost of diatomaceous earth or other precoat media and spent cartridge filter burial costs not as significant. Today, however, and in particular in the future with present burial sites being restricted and the compact surcharge being imposed, volume reduction is a first priority in all considerations of waste handling. This paper discusses the hollow fiber filter process development, test data, results and economics of the 5 gpm hollow fiber filter system as tested on low TDS and high TDS solids from a secondary PWR. With this incineratible hollow fiber filter, the volume of drummed material is limited to the captured crud only. The effluent quality from these tests exceeded the NPDES discharge permit requirements

  19. Advancing the use of performance evaluation in health care

    DEFF Research Database (Denmark)

    Traberg, Andreas; Jacobsen, Peter

    2014-01-01

    acknowledge that there may be more suitable approaches in organizations with different settings. Practical implications – The strength of the framework lies in the identification of performance problems prior to decision making. The quality of decisions is directly related to the individual decision maker......Purpose – The purpose of this paper is to develop a framework for health care performance evaluation that enables decision makers to identify areas indicative of corrective actions. The framework should provide information on strategic pro-/regress in an operational context that justifies the need...... and five external databases are used for a quantitative data collection. Findings – By aggregating performance outcomes, collective measures of performance are achieved. This enables easy and intuitive identification of areas not strategically aligned. In general, the framework has proven helpful in an MRI...

  20. Techno-economical evaluation of protein extraction for microalgae biorefinery

    Science.gov (United States)

    Sari, Y. W.; Sanders, J. P. M.; Bruins, M. E.

    2016-01-01

    Due to scarcity of fossil feedstocks, there is an increasing demand for biobased fuels. Microalgae are considered as promising biobased feedstocks. However, microalgae based fuels are not yet produced at large scale at present. Applying biorefinery, not only for oil, but also for other components, such as carbohydrates and protein, may lead to the sustainable and economical microalgae-based fuels. This paper discusses two relatively mild conditions for microalgal protein extraction, based on alkali and enzymes. Green microalgae (Chlorella fusca) with and without prior lipid removal were used as feedstocks. Under mild conditions, more protein could be extracted using proteases, with the highest yields for microalgae meal (without lipids). The data on protein extraction yields were used to calculate the costs for producing 1 ton of microalgal protein. The processing cost for the alkaline method was € 2448 /ton protein. Enzymatic method performed better from an economic point of view with € 1367 /ton protein on processing costs. However, this is still far from industrially feasible. For both extraction methods, biomass cost per ton of produced product were high. A higher protein extraction yield can partially solve this problem, lowering processing cost to €620 and 1180 /ton protein product, using alkali and enzyme, respectively. Although alkaline method has lower processing cost, optimization appears to be better achievable using enzymes. If the enzymatic method can be optimized by lowering the amount of alkali added, leading to processing cost of € 633/ton protein product. Higher revenue can be generated when the residue after protein extraction can be sold as fuel, or better as a highly digestible feed for cattle.

  1. Integrated complex care coordination for children with medical complexity: A mixed-methods evaluation of tertiary care-community collaboration

    Directory of Open Access Journals (Sweden)

    Cohen Eyal

    2012-10-01

    Full Text Available Abstract Background Primary care medical homes may improve health outcomes for children with special healthcare needs (CSHCN, by improving care coordination. However, community-based primary care practices may be challenged to deliver comprehensive care coordination to complex subsets of CSHCN such as children with medical complexity (CMC. Linking a tertiary care center with the community may achieve cost effective and high quality care for CMC. The objective of this study was to evaluate the outcomes of community-based complex care clinics integrated with a tertiary care center. Methods A before- and after-intervention study design with mixed (quantitative/qualitative methods was utilized. Clinics at two community hospitals distant from tertiary care were staffed by local community pediatricians with the tertiary care center nurse practitioner and linked with primary care providers. Eighty-one children with underlying chronic conditions, fragility, requirement for high intensity care and/or technology assistance, and involvement of multiple providers participated. Main outcome measures included health care utilization and expenditures, parent reports of parent- and child-quality of life [QOL (SF-36®, CPCHILD©, PedsQL™], and family-centered care (MPOC-20®. Comparisons were made in equal (up to 1 year pre- and post-periods supplemented by qualitative perspectives of families and pediatricians. Results Total health care system costs decreased from median (IQR $244 (981 per patient per month (PPPM pre-enrolment to $131 (355 PPPM post-enrolment (p=.007, driven primarily by fewer inpatient days in the tertiary care center (p=.006. Parents reported decreased out of pocket expenses (p© domains [Health Standardization Section (p=.04; Comfort and Emotions (p=.03], while total CPCHILD© score decreased between baseline and 1 year (p=.003. Parents and providers reported the ability to receive care close to home as a key benefit. Conclusions Complex

  2. Barriers and Incentives to Orphan Care in a Time of AIDS and Economic Crisis: A Cross-Sectional Survey of Caregivers in Rural Zimbabwe

    Science.gov (United States)

    Howard, Brian H.; Phillips, Carl V.; Matinhure, Nelia; Goodman, Karen J.; McCurdy, Sheryl A; Johnson, Cary A.

    2007-01-01

    Background: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment,…

  3. Impact of national health care systems on patient evaluations of general practice in Europe.

    NARCIS (Netherlands)

    Wensing, M.J.P.; Baker, R.; Szecsenyi, J.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To examine associations between patient evaluations of general practice and characteristics of national health care systems. METHODS: International comparative study in 17 countries, using international patient survey data (n= 25052) and data-bases for health care system characteristics.

  4. Economic evaluation of brief psychodynamic interpersonal therapy in patients with multisomatoform disorder.

    Directory of Open Access Journals (Sweden)

    Nadja Chernyak

    Full Text Available BACKGROUND: A brief psychodynamic interpersonal therapy (PIT in patients with multisomatoform disorder has been recently shown to improve health-related quality of life. AIMS: To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder. METHOD: An economic evaluation alongside a randomised controlled trial (International Standard Randomised Controlled Trial Number ISRCTN23215121 conducted in 6 German academic outpatient centres was performed. Incremental cost-effectiveness ratio (ICER was calculated from the statutory health insurance perspective on the basis of quality adjusted life years (QALYs gained at 12 months. Uncertainty surrounding the cost-effectiveness of PIT was presented by means of a cost-effectiveness acceptability curve. RESULTS: Based on the complete-case analysis ICER was 41840 Euro per QALY. The results did not change greatly with the use of multiple imputation (ICER = 44222 and last observation carried forward (LOCF approach to missing data (ICER = 46663. The probability of PIT being cost-effective exceeded 50% for thresholds of willingness to pay over 35 thousand Euros per QALY. CONCLUSIONS: Cost-effectiveness of PIT is highly uncertain for thresholds of willingness to pay under 35 thousand Euros per QALY.

  5. Economic Evaluation of Brief Psychodynamic Interpersonal Therapy in Patients with Multisomatoform Disorder

    Science.gov (United States)

    Chernyak, Nadja; Sattel, Heribert; Scheer, Marsel; Baechle, Christina; Kruse, Johannes; Henningsen, Peter; Icks, Andrea

    2014-01-01

    Background A brief psychodynamic interpersonal therapy (PIT) in patients with multisomatoform disorder has been recently shown to improve health-related quality of life. Aims To assess cost-effectiveness of PIT compared to enhanced medical care in patients with multisomatoform disorder. Method An economic evaluation alongside a randomised controlled trial (International Standard Randomised Controlled Trial Number ISRCTN23215121) conducted in 6 German academic outpatient centres was performed. Incremental cost-effectiveness ratio (ICER) was calculated from the statutory health insurance perspective on the basis of quality adjusted life years (QALYs) gained at 12 months. Uncertainty surrounding the cost-effectiveness of PIT was presented by means of a cost-effectiveness acceptability curve. Results Based on the complete-case analysis ICER was 41840 Euro per QALY. The results did not change greatly with the use of multiple imputation (ICER = 44222) and last observation carried forward (LOCF) approach to missing data (ICER = 46663). The probability of PIT being cost-effective exceeded 50% for thresholds of willingness to pay over 35 thousand Euros per QALY. Conclusions Cost-effectiveness of PIT is highly uncertain for thresholds of willingness to pay under 35 thousand Euros per QALY. PMID:24465387

  6. Protocol for economic evaluation alongside the IMPLEMENT cluster randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McKenzie Joanne E

    2008-02-01

    Full Text Available Abstract Background The recent development and publication of evidence-based clinical practice guidelines (CPGs for acute low back pain (LBP has resulted in evidence-based recommendations that, if implemented, have the potential to improve the quality and safety of care for acute LBP. While a strategy has been specified for dissemination of the CPG for acute LBP in Australia, there is no accompanying plan for active implementation. Evidence regarding the cost-effectiveness of active implementation of CPGs for acute LBP is sparse. The IMPLEMENT study will consider the incremental benefits and costs of progressing beyond development and dissemination to implementation. Methods/design Cost-effectiveness and cost-utility analyses alongside the IMPLEMENT cluster randomised controlled trial (CRCT from a societal perspective to quantify the additional costs (savings and health gains associated with a targeted implementation strategy as compared with access to the CPG via dissemination only. Discussion The protocol provided here registers our intent to conduct an economic evaluation alongside the IMPLEMENT study, facilitates peer-review of proposed methods and provides a transparent statement of planned analyses. Trial registration Australian New Zealand Clinical Trials Registry ACTRN012606000098538

  7. The Economic Impact of Child Care Subsidies for Kentucky. Policy Insights. Occasional Policy Brief #3

    Science.gov (United States)

    Hardy, Bradley; Hokayem, Charles; Ziliak, James P.

    2011-01-01

    For parents of young children the decision to work strongly depends on the availability of affordable child care. Child care costs can take up a large portion of a family budget and may serve as an obstacle to work. In 2008 the National Association of Child Care Resource and Referral Agencies (NACCRRA) estimated that Kentucky families recently…

  8. Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries

    Directory of Open Access Journals (Sweden)

    Deogaonkar Rohan

    2012-10-01

    with other health economic evaluations. In addition, more country level evidence is needed from low and middle income countries to justify future investments in vaccines and immunization programs. Finally, the proposed broader economic impact framework may contribute towards better communication of the economic arguments surrounding vaccine uptake, leading to investments in immunization by stakeholders outside of the traditional health care sector such as ministries of finance and national treasuries.

  9. Economic evaluation of eribulin as second-line treatment for metastatic breast cancer in South Korea

    Science.gov (United States)

    Tremblay, Gabriel; Majethia, Unnati; Breeze, Janis L; Kontoudis, Ilias; Park, Jeongae

    2016-01-01

    Background Metastatic breast cancer (MBC) is associated with poor prognosis, particularly for those patients with human epidermal growth factor receptor (HER2)-negative tumor. Similar to the rest of the world, treatment options are limited in South Korea following first-line chemotherapy with anthracyclines and/or taxanes. This study examined the cost-effectiveness and cost-utility of eribulin in South Korean patients with HER2-negative MBC who have progressed after usage of at least one chemotherapeutic regimen for advanced disease (second-line therapy). Methods A partition survival model was developed from the perspective of the South Korean health care system. The economic impact of introducing eribulin as second-line therapy for HER2-negative MBC was compared to that of capecitabine and vinorelbine. The analysis estimated incremental cost per life-year (LY), that is, cost-effectiveness, and cost per quality-adjusted life-year (QALY), that is, cost-utility, of eribulin for management of HER2-negative MBC in South Korea. The model accounted for overall survival, progression-free survival, drug costs, grade 3/4 adverse events, and health care utilization. Deterministic and probabilistic sensitivity analyses were performed to identify uncertainty in the results of the economic evaluation. Results Second-line eribulin was associated with greater benefits in terms of LY and QALY, compared to capecitabine and vinorelbine. The incremental cost-effectiveness ratio was ₩10.5M (approximately USD 9,200) per LY, and the incremental cost-utility ratio was ₩17M (approximately USD 14,800) per QALY in the basecase analysis. The incremental cost-utility ratio ranged from ₩12M (USD 10,461) to ₩27M (USD 23,538) per QALY in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, >99% of the simulations were below ₩50M (USD 42,300), and the lower and upper 95% confidence intervals were ₩3M (USD 2,600) and ₩24M (USD 20,900) per QALY

  10. Economic evaluation of eribulin as second-line treatment for metastatic breast cancer in South Korea

    Science.gov (United States)

    Tremblay, Gabriel; Majethia, Unnati; Breeze, Janis L; Kontoudis, Ilias; Park, Jeongae

    2016-01-01

    Background Metastatic breast cancer (MBC) is associated with poor prognosis, particularly for those patients with human epidermal growth factor receptor (HER2)-negative tumor. Similar to the rest of the world, treatment options are limited in South Korea following first-line chemotherapy with anthracyclines and/or taxanes. This study examined the cost-effectiveness and cost-utility of eribulin in South Korean patients with HER2-negative MBC who have progressed after usage of at least one chemotherapeutic regimen for advanced disease (second-line therapy). Methods A partition survival model was developed from the perspective of the South Korean health care system. The economic impact of introducing eribulin as second-line therapy for HER2-negative MBC was compared to that of capecitabine and vinorelbine. The analysis estimated incremental cost per life-year (LY), that is, cost-effectiveness, and cost per quality-adjusted life-year (QALY), that is, cost-utility, of eribulin for management of HER2-negative MBC in South Korea. The model accounted for overall survival, progression-free survival, drug costs, grade 3/4 adverse events, and health care utilization. Deterministic and probabilistic sensitivity analyses were performed to identify uncertainty in the results of the economic evaluation. Results Second-line eribulin was associated with greater benefits in terms of LY and QALY, compared to capecitabine and vinorelbine. The incremental cost-effectiveness ratio was ₩10.5M (approximately USD 9,200) per LY, and the incremental cost-utility ratio was ₩17M (approximately USD 14,800) per QALY in the basecase analysis. The incremental cost-utility ratio ranged from ₩12M (USD 10,461) to ₩27M (USD 23,538) per QALY in the deterministic sensitivity analysis. In the probabilistic sensitivity analysis, >99% of the simulations were below ₩50M (USD 42,300), and the lower and upper 95% confidence intervals were ₩3M (USD 2,600) and ₩24M (USD 20,900) per QALY

  11. An Evaluation of the Economic Theoretical Potential of the Rural Environment Mismanged During 1956-2010

    Directory of Open Access Journals (Sweden)

    Florentin Gabriel Niculescu

    2015-09-01

    Full Text Available Under the context of the essential role and growing importance of the rural environment in the development of a country, we focus on evaluating the economic theoretical potential of the rural environment that we consider to have been mismanaged during 1956-2010. For this purpose, in this paper we define, describe and explain the main concepts, as to be able to evaluate the economic potential of the rural development and further contribute to its improvement. The study focuses on the correlations between the population of working age, occupancy, unemployment and the wasted economic potential, putting forward a new concept, statistically valid, demographic named the absolute able overpopulation.

  12. Technical and economic evaluation of advanced air cargo system concepts

    Science.gov (United States)

    Whitehead, A. H., Jr.

    1977-01-01

    The paper reviews NASA air cargo market studies, reports on NASA and NASA-sponsored studies of advanced freighter concepts, and identifies the opportunities for the application of advanced technology. The air cargo market is studied to evaluate the timing for, and the potential market response to, advanced technology aircraft. The degree of elasticity in future air freight markets is also being investigated, since the demand for a new aircraft is most favorable in a price-sensitive environment. Aircraft design studies are considered with attention to mission and design requirements, incorporation of advanced technologies in transport aircraft, new cargo aircraft concepts, advanced freighter evaluation, and civil-military design commonality.

  13. The economic benefits of negative pressure wound therapy in community-based wound care in the NHS.

    Science.gov (United States)

    Dowsett, Caroline; Davis, Lynn; Henderson, Valerie; Searle, Richard

    2012-10-01

    The human and economic costs of wounds are of major concern within today's National Health Service. Advances in wound care technology have been shown to be beneficial both in healing and in relation to patient quality of life. Negative pressure has often been associated with high-cost care and restricted to use in the secondary care setting. There is growing use of negative pressure within the community, and this has the potential to benefit the patient and the service by providing quality care in the patient's home setting. Three community sites were chosen to monitor their use of negative pressure wound therapy (NPWT) over a period of 2 years, and this paper presents some of the key findings of this work. The data generated has been used to help target resources and prevent misuse of therapy. Cost per patient episode has been calculated, and this can be compared to similar costs in secondary care, showing significant savings if patients are discharged earlier from secondary care. There is also an increased demand for more patients with complex wounds to be cared for in the community, and in the future, it is likely that community initiated NPWT may become more common. Early analysis of the data showed that the average cost of dressing complex wounds would be significantly less than using traditional dressings, where increased nursing visits could increase costs. There is a compelling argument for more negative pressure to be used and initiated in the community, based not only on improved quality of life for patients but also on the economic benefits of the therapy.

  14. Economic evaluation of environmental impacts of open cast mining project - an approach

    International Nuclear Information System (INIS)

    Economic valuation of environmental attributes are pragmatic approach to evaluating the impacts and it helps decision makers to arrive at objective decisions on the basis of cost benefit ratio. For determining the physical impact and its quantification, four evaluation methods, namely-market price method, surrogate market price, survey based and cost based approaches are generally used. The present paper reviews the importance of environmental evaluation of impacts of mining and also reviews a few suitable methodologies that could be effectively used for economic evaluation of environmental impacts in open cast mining projects. (author)

  15. Evaluation of economic loss from energy-related environmental pollution: a case study of Beijing

    Science.gov (United States)

    Chen, Chen; Su, Meirong; Liu, Gengyuan; Yang, Zhifeng

    2013-09-01

    With the growth of energy consumption, energy-related environmental pollution has become increasingly serious, which in turn causes enormous economic loss because of public health damage, corrosion of materials, crop yield reduction, and other factors. Evaluating economic loss caused by energy-related environmental pollution can contribute to decision making in energy management. A framework for evaluating economic loss from environmental pollution produced during energy production, transportation, and consumption is proposed in this paper. Regarding SO2, PM10, and solid waste as the main pollutants, economic losses from health damage, materials corrosion, crop yield reduction, and solid waste pollution are estimated based on multiple concentration-response relationships and dose-response functions. The proposed framework and evaluation methods are applied to Beijing, China. It is evident that total economic loss attributable to energy-related environmental pollution fluctuated during 2000-2011 but had a general growth trend, with the highest value reaching 2.3 × 108 CNY (China Yuan) in 2006. Economic loss caused by health damage contributes most to the total loss among the four measured damage types. The total economic loss strongly correlates with the amount of energy consumption, especially for oil and electricity. Our evaluation framework and methods can be used widely to measure the potential impact of environmental pollution in the energy lifecycle.

  16. Economic evaluation of stall stocking density of lactating dairy cows.

    Science.gov (United States)

    De Vries, Albert; Dechassa, Hailegziabher; Hogeveen, Henk

    2016-05-01

    conclusion, overstocking was profitable under plausible economic conditions in the United States. The 3 metamodels accurately captured the results for a wide range of values of the input variables. A tradeoff will occur between economically optimal SSD and animal welfare in some situations. PMID:26923039

  17. Economic evaluation of stall stocking density of lactating dairy cows.

    Science.gov (United States)

    De Vries, Albert; Dechassa, Hailegziabher; Hogeveen, Henk

    2016-05-01

    conclusion, overstocking was profitable under plausible economic conditions in the United States. The 3 metamodels accurately captured the results for a wide range of values of the input variables. A tradeoff will occur between economically optimal SSD and animal welfare in some situations.

  18. Techno-economic evaluation of broadband access technologies

    DEFF Research Database (Denmark)

    Sigurdsson, Halldór Matthias; Skouby, Knud Erik

    2005-01-01

    Broadband for all is an essential element in the EU policy concerning the future of ICT-based society. The overall purpose of this paper is to present a model for evaluation of different broadband access technologies and to present some preliminary results based on the model that has been carried...

  19. Economic Evaluation of a General Hospital Unit for Older People with Delirium and Dementia (TEAM Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Lukasz Tanajewski

    Full Text Available One in three hospital acute medical admissions is of an older person with cognitive impairment. Their outcomes are poor and the quality of their care in hospital has been criticised. A specialist unit to care for older people with delirium and dementia (the Medical and Mental Health Unit, MMHU was developed and then tested in a randomised controlled trial where it delivered significantly higher quality of, and satisfaction with, care, but no significant benefits in terms of health status outcomes at three months.To examine the cost-effectiveness of the MMHU for older people with delirium and dementia in general hospitals, compared with standard care.Six hundred participants aged over 65 admitted for acute medical care, identified on admission as cognitively impaired, were randomised to the MMHU or to standard care on acute geriatric or general medical wards. Cost per quality adjusted life year (QALY gained, at 3-month follow-up, was assessed in trial-based economic evaluation (599/600 participants, intervention: 309. Multiple imputation and complete-case sample analyses were employed to deal with missing QALY data (55%.The total adjusted health and social care costs, including direct costs of the intervention, at 3 months was £7714 and £7862 for MMHU and standard care groups, respectively (difference -£149 (95% confidence interval [CI]: -298, 4. The difference in QALYs gained was 0.001 (95% CI: -0.006, 0.008. The probability that the intervention was dominant was 58%, and the probability that it was cost-saving with QALY loss was 39%. At £20,000/QALY threshold, the probability of cost-effectiveness was 94%, falling to 59% when cost-saving QALY loss cases were excluded.The MMHU was strongly cost-effective using usual criteria, although considerably less so when the less acceptable situation with QALY loss and cost savings were excluded. Nevertheless, this model of care is worthy of further evaluation.ClinicalTrials.gov NCT01136148.

  20. Technical and economical evaluation of predictive methods applicable to equipment; Evaluacion tecnico-economica de metodos predictivos aplicados a equipos

    Energy Technology Data Exchange (ETDEWEB)

    Pagola, Guillermo Alejandro [TRANSENER S.A. - Companhia de Transporte de Energia Eletrica em Alta Tensao, Buenos Aires (Argentina)]. E-mail: pagolgui@transx.com.ar

    2001-07-01

    This document presents the accomplished evaluation analysis in relation to new real time predictive method applicable to circuit breakers through both economical evaluations and reliability calculations.

  1. Evaluation of Computer-Assisted Instruction in Principles of Economics

    Directory of Open Access Journals (Sweden)

    Dennis Coates

    2001-04-01

    Full Text Available Despite increasing use, little is known about the effectiveness of web-based instructional material. This study assesses the effectiveness of supplementary web-based materials and activities in introductory economics courses. We have collected data on 66 students from three principles sections that describe demographic characteristics, use of web-based instructional resources, and performance on graded quizzes and examinations. We use this data to statistically assess the effectiveness of the web-based material. Student utilization of web-based material was extensive. Students frequently used on-line practice quizzes and accessed the web-based material often. A sizable fraction of the students actively posted and read threaded discussions on the course bulletin board. The statistical analysis shows that both on-line computer graded practice quizzes and posting to the class bulletin board are positively correlated with student performance on the quizzes and exams, but use of web-based content and passive reading of bulletin board posts ("lurking" is not. These results suggest that faculty should focus more on developing self-test quizzes and effective bulletin board discussion projects and less on generating on-line content.

  2. Economic evaluation of snake antivenom production in the public system

    Directory of Open Access Journals (Sweden)

    V. Morais

    2006-01-01

    Full Text Available Snake antivenom, an expensive animal product, is presently the only effective treatment for the consequences of snakebite. In Latin America, antivenoms are mainly produced by public institutions with frequent shortages of the necessary supply. Here, we present an economical analysis of the factors affecting production cost, assuming a basic processing batch of 100 L hyperimmune plasma. Three annual production volumes were considered for two typical production technologies. The components of cost were classified as fixed, variable and semi-variable. We found that in all stages of production, fixed cost represents the major contribution to total cost, and is given essentially by manpower cost, particularly for low production volumes. Our estimation shows that antivenom cost can vary from US$ 2.4 to US$ 25 per 10 mL vial, depending on the production volume, the plasma processing technology used and the titer achieved during the immunization stage. We conclude that interested laboratories and authorities of countries with population at risk should consider the possibility of a joint production to improve the process efficiency, lower the product unitary cost and obtain the necessary supply for their own demand or that of other countries in need.

  3. Performance Evaluation of Rural Cooperative Economic Organizations in Hunan Province Based on Structural Equation

    Institute of Scientific and Technical Information of China (English)

    Naman; YANG

    2015-01-01

    Using the method of structural equation and balanced scorecard,this paper establishes the evaluation indicators and evaluation model for the performance of 21 rural cooperative economic organizations in X City of Hunan Province,and analyzes the relationship between indicators and dimensions of performance evaluation indicators,in order to find the influencing factors,obstacles and successful experience concerning the development of rural cooperative economic organizations. According to model analysis and conclusions,this paper sets forth the recommendations for promoting the development of rural cooperative economic organizations in Hunan Province,in order to provide a scientific basis for the institutional design and mechanism innovation of rural cooperative economic organizations in Hunan Province.

  4. THE ECONOMIC EVALUATION METHOD OF LAND RESOURCES OF AGRARIAN NOMINATION WITH THEIR REGIONAL REPRODUCTION PECULIARITIES

    Directory of Open Access Journals (Sweden)

    R.Sh. Shafeyev

    2009-03-01

    Full Text Available Peculiarities of land market formation and peculiarities of its function in modern (up-to-date environment are covered in this article. The objective necessity of governmental regulation is shown. In authors opinion the economic regulation of land market is the most important part of the system. Economic regulation mechanism is realized in correlation with economic land evaluation. Cadastre evaluation that is applied today does not reflect the true land value, but it is used as a basis for the land rent rat estimation and the initial selling price. The alternative way of land resource evaluation that is offered in the article reflects the change of country economic situation more real and is able to influence objectively on the land relations regulation decision making process.

  5. Health economic evaluation in lumbar spinal fusion: a systematic literature review anno 2005

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B

    2006-01-01

    clinical practice are present, economic evaluation is needed in order to facilitate the decision-makers' budget allocations. NHS Economic Evaluation Database, MEDLINE, EMBASE and Cochrane Library were searched. Two independent reviewers (one clinical content expert and one economic content expert) applied...... fact that the clinical effects are statistically synonymous, it does not support the use of high-cost techniques. There is a great potential for improvement of methodological quality in economic evaluations of lumbar spinal fusion and further research is imperative.......The goal of this systematic literature review was to assess the evidence for cost-effectiveness of various surgical techniques in lumbar spinal fusion in conformity with the guidelines provided by the Cochrane Back Review Group. As new technology continuously emerges and divergent directions in...

  6. Vouchers for Day Care of Children: Evaluating a Program Model.

    Science.gov (United States)

    Parker, Michael D.

    1989-01-01

    Examined effects of a pilot voucher program on the price, supply, and quality of day care. Findings offered no conclusive evidence concerning expected benefits. Discusses vouchers' potential for easing the day care crisis. (RJC)

  7. A review of typhoid fever transmission dynamic models and economic evaluations of vaccination.

    Science.gov (United States)

    Watson, Conall H; Edmunds, W John

    2015-06-19

    Despite a recommendation by the World Health Organization (WHO) that typhoid vaccines be considered for the control of endemic disease and outbreaks, programmatic use remains limited. Transmission models and economic evaluation may be informative in decision making about vaccine programme introductions and their role alongside other control measures. A literature search found few typhoid transmission models or economic evaluations relative to analyses of other infectious diseases of similar or lower health burden. Modelling suggests vaccines alone are unlikely to eliminate endemic disease in the short to medium term without measures to reduce transmission from asymptomatic carriage. The single identified data-fitted transmission model of typhoid vaccination suggests vaccines can reduce disease burden substantially when introduced programmatically but that indirect protection depends on the relative contribution of carriage to transmission in a given setting. This is an important source of epidemiological uncertainty, alongside the extent and nature of natural immunity. Economic evaluations suggest that typhoid vaccination can be cost-saving to health services if incidence is extremely high and cost-effective in other high-incidence situations, when compared to WHO norms. Targeting vaccination to the highest incidence age-groups is likely to improve cost-effectiveness substantially. Economic perspective and vaccine costs substantially affect estimates, with disease incidence, case-fatality rates, and vaccine efficacy over time also important determinants of cost-effectiveness and sources of uncertainty. Static economic models may under-estimate benefits of typhoid vaccination by omitting indirect protection. Typhoid fever transmission models currently require per-setting epidemiological parameterisation to inform their use in economic evaluation, which may limit their generalisability. We found no economic evaluation based on transmission dynamic modelling, and no

  8. Statistical Evaluation of the EU Countries using Economic Indicators

    Directory of Open Access Journals (Sweden)

    Opris (Stanila, M.

    2014-06-01

    Full Text Available The purpose of this paper is to evaluate the EU development area for the year 2012, using main statistical indicators. The cluster analysis and the Principal Component Analysis are the methods used to compare the 28 EU countries, the EU members, with each other and to determine the resemblances and the differences between them. The results show that the optimal solution is to create three clusters, allowing a suitable differentiation between the countries, while keeping the homogeneity among the countries it comprises.

  9. ECONOMIC EVALUATION OF CO2 STORAGE AND SINK ENHANCEMENT OPTIONS

    Energy Technology Data Exchange (ETDEWEB)

    Bert Bock; Richard Rhudy; Howard Herzog; Michael Klett; John Davison; Danial G. De La Torre Ugarte; Dale Simbeck

    2003-02-01

    This project developed life-cycle costs for the major technologies and practices under development for CO{sub 2} storage and sink enhancement. The technologies evaluated included options for storing captured CO{sub 2} in active oil reservoirs, depleted oil and gas reservoirs, deep aquifers, coal beds, and oceans, as well as the enhancement of carbon sequestration in forests and croplands. The capture costs for a nominal 500 MW{sub e} integrated gasification combined cycle plant from an earlier study were combined with the storage costs from this study to allow comparison among capture and storage approaches as well as sink enhancements.

  10. A Systematic Review of the Economic Evaluation of Telemedicine in Japan

    Science.gov (United States)

    2016-01-01

    Objectives: There is no systematic review on economic evaluations of telemedicine in Japan, despite over 1000 trials implemented. Our systematic review aims to examine whether Japan’s telemedicine is cost-saving or cost-effective, examine the methodological rigorousness of the economic evaluations, and discuss future studies needed to improve telemedicine’s financial sustainability. Methods: We searched five databases, including two Japanese databases, to find peer-reviewed articles published between January 1, 2000 and December 31, 2014 in English and Japanese that performed economic evaluations of Japan’s telemedicine programs. The methodological rigorousness of the economic analyses was assessed with a well-established checklist. We calculated the benefit-to-cost ratio (BCR) when a reviewed study reported related data but did not report the BCR. All cost values were adjusted to 2014 US dollars. Results: Among the 17 articles identified, six studies reported on settings connecting physicians for specialist consultations, and eleven studies on settings connecting healthcare providers and patients at home. There are three cost-benefit analyses and three cost-minimization analyses. The remaining studies measured the benefit of telemedicine only, using medical expenditure saved or users’ willingness-to-pay. There was substantial diversity in the methodological rigorousness. Studies on teledermatology and teleradiology indicated a favorable level of economic efficiency. Studies on telehomecare gave mixed results. One cost-benefit analysis on telehomecare indicated a low economic efficiency, partly due to public subsidy rules, e.g., a too short budget period. Conclusions: Overall, telemedicine programs in Japan were indicated to have a favorable level of economic efficiency. However, the scarcity of the economic literature indicates the need for further rigorous economic evaluation studies. PMID:27499161

  11. International care models for chronic kidney disease: methods and economics--United States.

    Science.gov (United States)

    Crooks, Peter

    2004-01-01

    In the United States, there is a major chronic kidney disease (CKD) problem with over 8 million adults having stage 3 or 4 CKD. There is good medical evidence that many of these patients can benefit from focused interventions. And while there are strong theoretical reasons to believe these interventions are cost-effective, there are little published data to back up this assertion. However, despite the lack of financial data proving cost-effectiveness and against the background of a disorganized health care system in the US, some models of CKD care are being employed. At the present time, the most comprehensive models of care in the US are emerging in vertically integrated health care programs. Other models of care are developing in the setting of managed care health plans that employ CKD disease management programs, either developed internally or in partnership with renal disease management companies.

  12. For profit versus non-profit: does economic sector make a difference in child-care?

    Science.gov (United States)

    Gelles, E

    1999-01-01

    The child-care industry in a large, southeastern community serves as this study's vehicle for comparing non-profit with for profit dependent care in areas not easily observable to clients. The cross-sectional analysis compares child-care centers on marketed and actual staff-to-child ratio; staff salary; consistency in the child's group environment; staff stability; and extent of parental involvement. Findings are based on self-reports of directors and support hypotheses derived from the theory that for profit day care centers will use their discretionary authority to vary the care environment to achieve profit goals despite the potential effect on the quality of the child's environment. Further, despite potential cost economies and enhanced quality of care achievable as a non-profit entity, few for profit center directors consider becoming non-profit centers.

  13. The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review.

    Science.gov (United States)

    Vijgen, Sylvia M C; Opmeer, Brent C; Mol, Ben Willem J

    2013-04-01

    We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic evaluation studies concerning tests or interventions in the field of obstetrics or gynecology. Each included study was evaluated by two reviewers using a quality checklist that was based on international guidelines for medical economic evaluation studies and a checklist used in a previous review. The mean number of quality criteria adhered to was 23 of 30 items, whereas five articles (3%) met all 30 criteria. Compliance was low for the description of the perspective (40%), the completeness of costs looking at the perspective (48%) or time horizon (48%), and reporting of quantities of resources (47%). Furthermore, if no discounting was applied, an explanation was infrequently given (14%). A comparison of study quality to that reported by Smith and Blackmore showed a considerable improvement in the following criteria: presentation perspective (from 19 to 40%), statement of primary outcome measure (from 72 to 81%), completeness costs looking at the time horizon (from 14 to 48%), the presentation of discount rates (from 10 to 54%), details of sensitivity analyses (from 21 to 61%), reporting incremental results (from 17 to 70%), and reporting a summary measure (from 57 to 74%). The quality of economic studies in obstetrics and gynecology has considerably improved in the last decade, but room for further improvement is present.

  14. Micro economic evaluations of transferal tariffs and income framework

    International Nuclear Information System (INIS)

    The report discusses conditions of transferral tariffs as micro economic measures in the income-regulating frameworks of today. The process from aim to implementation of the tariff measures is described and the conditions as the tariff goal, segmenting of the customers and their price sensitivity are discussed. The report deals specifically with construction grants and connection fees. Connection fees are proposed as measures in order to influence dimensioning, while construction grants may be suitable in certain conditions for influencing the localisation. These measures would have different effects on the network companies' incomes and costs also due to the accounting regulations. A selection of tariff measures is proposed that illuminate the problems of the network companies. ''How shall the present income frames be distributed among the customers in order to stimulate the reduction of the costs and an increase of the income framework.'' The tariff measures are illustrated by specific numeric examples and the influence on incomes and costs are discussed. Examples of tariff measures are: Do not use the connection fee but rather the construction grant or increase the firm power part, only use the energy part, effect part or the firm power part. Solely altering of the tariff parts may result in the following: 1) Altering the firm power part: An increase would give a more stable yearly profit. 2) Altering of the energy part: An increase would promote a reduced consumption and thereby negatively influence a possible increase in the income frames. An increase may on the other hand reduce the costs of loss and delay investments. 3) Altering of the effect part: An increase would promote reduced maximal effects, lower the costs of loss and delay investments. 4) Reducing the connection fee would increase the maximum construction grant that could be applied for. This would result in a larger part of the construction costs could be covered within the income frames and would

  15. Association of socio-economic status with diabetes prevalence and utilization of diabetes care services

    OpenAIRE

    Svenson Lawrence W; Southern Danielle A; Edwards Alun L; Rabi Doreen M; Sargious Peter M; Norton Peter; Larsen Eric T; Ghali William A

    2006-01-01

    Abstract Background Low income appears to be associated with a higher prevalence of diabetes and diabetes related complications, however, little is known about how income influences access to diabetes care. The objective of the present study was to determine whether income is associated with referral to a diabetes centre within a universal health care system. Methods Data on referral for diabetes care, diabetes prevalence and median household income were obtained from a regional Diabetes Educ...

  16. A political economic history of medical and dental care in Nunavut, Canada

    OpenAIRE

    Quiñonez, Carlos R.

    2012-01-01

    Objectives. To describe the historical development of medical and dental care in the territory of Nunavut, Canada. Study design. Ethnographic case study using political economy as a mode of explanation. Methods. Participant observations, document reviews and stakeholder interviews, conducted over a four-year period. Results. There is a clear and now long-term movement from state and professionally controlled health care delivery to Indigenous control over care. Conclusions. Indigenous groups ...

  17. Implementing collaborative care for depression treatment in primary care: A cluster randomized evaluation of a quality improvement practice redesign

    Directory of Open Access Journals (Sweden)

    Lee Martin

    2011-10-01

    Full Text Available Abstract Background Meta-analyses show collaborative care models (CCMs with nurse care management are effective for improving primary care for depression. This study aimed to develop CCM approaches that could be sustained and spread within Veterans Affairs (VA. Evidence-based quality improvement (EBQI uses QI approaches within a research/clinical partnership to redesign care. The study used EBQI methods for CCM redesign, tested the effectiveness of the locally adapted model as implemented, and assessed the contextual factors shaping intervention effectiveness. Methods The study intervention is EBQI as applied to CCM implementation. The study uses a cluster randomized design as a formative evaluation tool to test and improve the effectiveness of the redesign process, with seven intervention and three non-intervention VA primary care practices in five different states. The primary study outcome is patient antidepressant use. The context evaluation is descriptive and uses subgroup analysis. The primary context evaluation measure is naturalistic primary care clinician (PCC predilection to adopt CCM. For the randomized evaluation, trained telephone research interviewers enrolled consecutive primary care patients with major depression in the evaluation, referred enrolled patients in intervention practices to the implemented CCM, and re-surveyed at seven months. Results Interviewers enrolled 288 CCM site and 258 non-CCM site patients. Enrolled intervention site patients were more likely to receive appropriate antidepressant care (66% versus 43%, p = 0.01, but showed no significant difference in symptom improvement compared to usual care. In terms of context, only 40% of enrolled patients received complete care management per protocol. PCC predilection to adopt CCM had substantial effects on patient participation, with patients belonging to early adopter clinicians completing adequate care manager follow-up significantly more often than patients of

  18. Personalized Primary Care for Older People: An evaluation of a multicomponent nurse-led care program

    NARCIS (Netherlands)

    Bleijenberg, N.

    2013-01-01

    Providing optimal care for the increasing number of frail older people with complex care needs is a major challenge in primary care. The current approach is reactive and does not meet the needs of older patients, resulting in unnecessary loss of daily functioning, suboptimal quality of life and high

  19. Exergo-economic criteria for performance evaluation of enhanced heat transfer duct with constant wall temperature

    International Nuclear Information System (INIS)

    Combining the first and second laws of thermodynamics with the exergo-economic theory, the exergy-economic performance of enhanced duct in comparison with reference smooth duct subjected to constant wall temperature have been examined comprehensively under three design constraints. Extended exergo-economic performance evaluation criteria formulas, i.e., the net profit per unit transferred heat load (ηp) and the total cost per unit transferred heat load (ηc) have been obtained from the perspectives of exergy recovery and exergy destruction respectively, accounting for all potential factors such as heat transfer, flow and investment costs. The application of exergo-economic performance evaluation based on ηp and ηc is illustrated by selecting a spirally corrugated duct as an example. The results for different design constraints show that the exergo-economic performance of enhanced duct is largely determined by Reynolds number (Rea) and dimensionless inlet temperature difference (θ). There exist critical values of Rea and θ exceeding which ηp of enhanced and smooth ducts would be less than zero, showing no engineering significance; however, ηc of enhanced and smooth ducts is unconditionally greater than zero due to their specific physical meaning. For all the three design constraints, better exergo-economic performance for enhanced duct can be achieved provided that Rea and θ are in the desirable ranges. - Highlights: ► Extended exergo-economic performance evaluation criteria for enhanced duct with constant wall temperature are put forward. ► The performance evaluation from the perspectives of exergy recovery and exergy destruction respectively has been conducted. ► The effects of Reynolds number and dimensionless inlet temperature difference on exergo-economic performance are studied. ► The performance evaluation difference for various design constraints is given.

  20. Economic, Environmental, and Social Evaluation of Africa's Small-Scale Fisheries

    OpenAIRE

    World Bank

    2015-01-01

    This report is the culmination of a cross-African countries analytical and empirical study commissioned by the World Bank, which set out to improve the understanding of the characteristics and environmental, economic, and social performances of small-scale fisheries in Africa. It applies a common evaluation tool, called Fishery Performance Indicators (FPIs), which evaluates the ecological,...

  1. Integrated Emergy and Economic Evaluation of Tea Production Chains in Anxi, China

    Science.gov (United States)

    Emergy and economic methods were used to evaluate and compare tea production systems in Anxi, China. Tea production was classified into three phases, i.e., the nursery, the plantation and tea processing, and each phase was evaluated. The results showed that the nursery subsystems...

  2. Evaluation of economic impact of climatic change on agro-forestry systems

    Directory of Open Access Journals (Sweden)

    Vittorio Gallerani

    Full Text Available Climate change has a strong influence on agro-forestry systems. Present estimations evisage that changes in climate patterns and extreme events connected to climate change will have greater impacts in the future. This paper seeks to illustrate the articulation of the problems concerning the economic evaluation of climate change, with particularly attention to open problems and future lines of research. Research on this topic, though using methods and approaches consolidated in the disciplines of resource economics and evaluation, still have several open problems, particularly in the field of multidisciplinary studies of the man-environmental relations, policy evaluation and development of decision support systems for decision makers.

  3. Long-term socio-economic consequences and health care costs of poliomyelitis: a historical cohort study involving 3606 polio patients.

    Science.gov (United States)

    Nielsen, Nete Munk; Kay, Lise; Wanscher, Benedikte; Ibsen, Rikke; Kjellberg, Jakob; Jennum, Poul

    2016-06-01

    Worldwide 10-20 million individuals are living with disabilities after acute poliomyelitis. However, very little is known about the socio-economic consequences and health care costs of poliomyelitis. We carried out a historical register-based study including 3606 individuals hospitalised for poliomyelitis in Copenhagen, Denmark 1940-1954, and 13,795 age and gender-matched Danes. Participants were followed from 1980 until 2012, and family, socio-economic conditions and health care costs were evaluated in different age groups using chi-squared tests, boot-strapped t tests or hazard ratios (HR) calculated in Cox-regression models. The analyses were performed separately for paralytic and non-paralytic polio survivors and their controls, respectively. Compared with controls a higher percentage of paralytic polio survivors remained childless, whereas no difference was observed for non-paralytic polio survivors. The educational level among paralytic as well as non-paralytic polio survivors was higher than that among their controls, employment rate at the ages of 40, 50 and 60 years was slightly lower, whereas total income in the age intervals of 31-40, 41-50 and 51-60 years were similar to controls. Paralytic and non-paralytic polio survivors had a 2.5 [HR = 2.52 (95 % confidence interval (CI); 2.29-2.77)] and 1.4 [HR = 1.35 (95 % CI; 1.23-1.49)]-fold higher risk, respectively, of receiving disability pension compared with controls. Personal health care costs were considerably higher in all age groups in both groups of polio survivors. Individuals with a history of poliomyelitis are well educated, have a slightly lower employment rate, an income similar to controls, but a considerably higher cost in the health care system. PMID:27083562

  4. A systematic review of economic evaluations of treatments for borderline personality disorder.

    Directory of Open Access Journals (Sweden)

    Christian Brettschneider

    Full Text Available PURPOSE: The borderline personality disorder is a common mental disorder. It is frequently associated with various mental co-morbidities and a fundamental loss of functioning. The borderline personality disorder causes high costs to society. The aim of this study was to perform a systematic literature review of existing economic evaluations of treatments for borderline personality disorder. MATERIALS AND METHODS: We performed a systematic literature search in MEDLINE, EMBASE, PsycINFO and NHSEED for partial and full economic evaluations regarding borderline personality disorder. Reported cost data were inflated to the year 2012 and converted into US-$ using purchasing power parities to allow for comparability. Quality assessment of the studies was performed by means of the Consensus on Health Economic Criteria checklist, a checklist developed by a Delphi method in cooperation with 23 international experts. RESULTS: We identified 6 partial and 9 full economic evaluations. The methodical quality was moderate (fulfilled quality criteria: 79.2% [SD: 15.4%] in partial economic evaluations, 77.3% [SD: 8.5%] in full economic evaluations. Most evaluations analysed psychotherapeutic interventions. Although ambiguous, most evidence exists on dialectical-behavioural therapy. Cognitive behavioural therapy and schema-focused therapy are cost-saving. Evidence on other interventions is scarce. CONCLUSION: The economic evidence is not sufficient to draw robust conclusions for all treatments. It is possible that some treatments are cost-effective. Most evidence exists on dialectical-behavioural therapy. Yet, it is ambiguous. Further research concerning the cost-effectiveness of treatments is necessary as well as the identification of relevant cost categories and the validation of effect measures.

  5. The Economic Impact of the Child Care Industry in Southeast Wisconsin

    Science.gov (United States)

    Kovach, Melissa; Lam, Eva; Dickman, Anneliese

    2009-01-01

    Discussions of early childhood care and education usually focus on its social and educational value, and how it helps children and families. More recently, the focus in many states, including Wisconsin, has been on potential investments in child care quality improvements as strategies for improving long-term educational outcomes for disadvantaged…

  6. Grip on challenging behavior: process evaluation of the implementation of a care program

    NARCIS (Netherlands)

    Zwijsen, S.A.; Smalbrugge, M.; Eefsting, J.A.; Gerritsen, D.L.; Hertogh, C.M.P.M.; Pot, A.M.

    2014-01-01

    BACKGROUND: The Grip on Challenging Behavior care program for managing challenging behavior was implemented in the dementia special care units of 17 Dutch nursing homes. A process evaluation of the implementation of the care program was performed to determine the quality of the implementation and th

  7. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care

    NARCIS (Netherlands)

    Schafer, W.L.; Boerma, W.G.; Kringos, D.S.; Maeseneer, J. De; Gress, S.; Heinemann, S.; Rotar-Pavlic, D.; Seghieri, C.; Svab, I.; Berg, M.J. van den; Vainieri, M.; Westert, G.P.; Willems, S.; Groenewegen, P.P.

    2011-01-01

    ABSTRACT: BACKGROUND: The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects

  8. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care.

    NARCIS (Netherlands)

    Schäfer, W.L.A.; Boerma, W.G.W.; Kringos, D.S.; Maeseneer, J. de; Gress, S.; Heinemann, S.; Rotar-Pavlic, D.; Seghieri, C.; Svab, I.; Berg, M.J. van den; Vainieri, M.; Westert, G.P.; Willems, S.; Groenewegen, P.P.

    2011-01-01

    Background: The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary c

  9. Economic Evaluation of Pollination Services Comparing Coffee Landscapes in Ecuador and Indonesia

    OpenAIRE

    Stefan Schwarze; Pablo C. Benítez; Teja Tscharntke; Roland Olschewski; Alexandra-Maria Klein

    2006-01-01

    Biodiversity conservation through land-use systems on private land is becoming a pressing environmental policy issue. Agroforestry, such as shade-coffee production, contributes to biodiversity conservation. However, falling coffee prices force many coffee growers to convert their sites into economically more attractive land uses. We performed an economic evaluation of coffee pollination by bees in two distinct tropical regions: an area of low human impact with forests neighboring agroforestry...

  10. Evaluating Regional Development Agencies (RDAs) assistance on Spanish regional economic growth

    OpenAIRE

    Urueña, Baudelio

    2005-01-01

    In the process of decentralisation of regional policy, the European Union is delegating greater responsibility to Regional Governments in the promotion of regional economic growth and development. Regional Development Agencies (RDAs) would play a significant role as public agencies coordinating economic growth, promotion and development strategies in their respective territorial areas. In recent years, regional policy evaluation has been a theme under much debate internationally much of which...

  11. Evaluation of Exhaust Gas Condensing Economizer Installation at Riga CHP Plants

    OpenAIRE

    Zigurs, Aris; Kunickis, Maris; Balodis, Maris; Linkevics, Olegs; Stuklis, Ilmars; Ivanova, Polina

    2015-01-01

    In this study, passive exhaust gas condensing economizer installation is evaluated at Riga CHP plants No. 1 and No. 2 to increase efficiency of heat only boilers (HOBs). Five options are investigated: two options for Riga CHP plant No. 1 and three options for Riga CHP plant No. 2. The study provides the analysis of HOBs operation statistics, determination of HOBs operation trends, development of production programmes, as well as economic and sensitivity analysis of the considered options. Bas...

  12. Evaluating investment costs and economic performance criteria for nuclear power in Romania

    International Nuclear Information System (INIS)

    The transition from an overcentralized economy to a rational and efficient one asks for the implementation of a judicious economic policy which should cope with the specific conditions of Romania. The present work aims at a thorough analysis of several major aspects related to the evaluation and setting up of the economic efficiency in the power field, and to the implication possibilities into the market economy. (author). 1 fig

  13. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    OpenAIRE

    Tariq Luqman; van den Berg Matthijs; Hamberg-van Reenen Heleen H; van Gils Paul F; de Wit G Ardine

    2010-01-01

    Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic e...

  14. An evaluation of preventive sensor technology for dementia care.

    Science.gov (United States)

    Nijhof, Nienke; van Gemert-Pijnen, Lisette J E W C; Woolrych, Ryan; Sixsmith, Andrew

    2013-02-01

    We evaluated a commercially-available monitoring system for older people with dementia living at home. The system was designed to detect problems before they require crisis intervention. Fourteen clients from two healthcare organisations in the Netherlands used the system over a 9-month period. The formal and informal caregivers were interviewed, project group meetings were observed, nurse diaries were analysed and a cost analysis performed. Clients and informal caregivers reported enhanced feelings of safety and security as a result of having the system installed in the home. The system appeared to reduce the burden of care on the informal caregiver and had the potential to allow people to live at home for longer. There were financial savings for clients staying at home with the technology compared with the costs of staying in a nursing home: for 10 clients living at home for 2 months, the savings were 23,665 euro. The study showed that the monitoring system represents a potentially useful early warning system to detect a situation before it requires emergency intervention. PMID:23434539

  15. [Cancer and health economics].

    Science.gov (United States)

    Koinuma, N

    1996-01-01

    Health economics on cancer medicine is a supportive tool of cancer care and is becoming one of the essential weapons against cancer. Its principal roles are to enhance the quality and efficacy and to secure the finance necessary to the cancer care. The economic aspects of cancer medicine and the methods of economic evaluation are overviewed with emphasis on cost-benefit, cost-effectiveness and cost-utility analysis. The operational and interpretational checkpoints are introduced, and the problems and prospects of the practical use of the methods on clinical settings such as cancer chemotherapy are discussed. PMID:8546457

  16. Economic Evaluation for Energy Business Using Real Options Pricing Method

    Energy Technology Data Exchange (ETDEWEB)

    Yun, W.C. [Korea Energy Economics Institute, Euiwang (Korea)

    2001-11-01

    Recently, facing the new era of restructuring, privatization, and liberalization the energy industry in the world is changing rapidly, and thus the uncertain factors tend to increase. This would imply that energy-related business is now confronted with new market risks as well as the simple price risks. The traditional investment valuation method using the concept of net present value (NPV) or internal rate of revenue (IRR) might not incorporate the managerial alternatives which enable managers to respond flexibly to the changes in business environment. This study pointed out the problems of the traditional discounted cash flow (DCF) method when evaluating a certain capital investment in energy industry. As an alternative, the real option pricing method (ROPM) was proposed, which is widely adopted in the field of profit projection for the venture business. In addition, when applying to energy sector the feasibility of ROPM was discussed, and the frameworks and major results of previous related studies were described. For those using the ROPM in real business, I explained the detailed procedures and solutions of ROPM, and introduced the log-transformed binomial model which provides a more efficient solution. In order to verify the usefulness of the ROPM, this study performed an empirical analysis for a virtual construction and operation project of power plant. And, the results from the ROPM was compared to those from the traditional DCF method. Based on the empirical results, the values of various investment opportunities were shown to be high. Therefore, the project not justified in terms of traditional DCF would turn into the project with a positive gross project value, properly reflecting managerial flexibilities inherent in the original project. (author). 58 refs., 32 figs., 33 tabs.

  17. An economic evaluation of antihypertensive therapies based on clinical trials

    Directory of Open Access Journals (Sweden)

    Rosana Lima Garcia Tsuji

    2012-01-01

    Full Text Available OBJECTIVE: Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol and the current treatment (losartan and amlodipine were evaluated in patients with grade 1 or 2 hypertension (HT1-2. For patients with grade 3 hypertension (HT3, a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment. METHODS: Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg at the end of a 12-month study period. RESULTS: When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used. CONCLUSIONS: We conclude that the traditional treatment is more cost-effective (US$/mm Hg than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.

  18. An Economic Analysis of Obesity in Europe: Health, Medical Care and Absenteeism Costs

    OpenAIRE

    Anna Sanz De Galdeano

    2007-01-01

    Obesity is not only a health but also an economic phenomenon with potentially important direct and indirect economic costs that are unlikely to be fully internalized by the obese. In the US, obesity prevalence is the highest among OECD countries and the issue has long been the focus of policy debate and academic research. However, European obesity rates are rising and there is still a lack of economic analysis of the obesity phenomenon in Europe. This paper attempts to fill in this gap by usi...

  19. Economic evaluation of pneumococcal conjugate vaccination in The Gambia

    Directory of Open Access Journals (Sweden)

    Kim Sun-Young

    2010-09-01

    pneumococcal diseases caused by S. pneumoniae in The Gambia. Assuming a cost-effectiveness threshold of three times GDP per capita, all PCVs examined would be cost-effective at the tentative Advance Market Commitment (AMC price of $3.5 per dose. Because the cost-effectiveness of a PCV program could be affected by potential serotype replacement or herd immunity effects that may not be known until after a large scale introduction, type-specific surveillance and iterative evaluation will be critical.

  20. The feasibility of a train-the-trainer approach to end of life care training in care homes: an evaluation

    OpenAIRE

    Mayrhofer, Andrea; Goodman, Claire; Smeeton, Nigel; Handley, Melanie; Amador, Sarah; Davies, Sue

    2016-01-01

    Background The ABC End of Life Education Programme trained approximately 3000 care home staff in End of Life (EoL) care. An evaluation that compared this programme with the Gold Standards Framework found that it achieved equivalent outcomes at a lower cost with higher levels of staff satisfaction. To consolidate this learning, a facilitated peer education model that used the ABC materials was piloted. The goal was to create a critical mass of trained staff, mitigate the impact of staff turnov...

  1. Women's evaluation of abuse and violence care in general practice: a cluster randomised controlled trial (weave

    Directory of Open Access Journals (Sweden)

    Feder Gene

    2010-01-01

    Full Text Available Abstract Background Intimate partner abuse (IPA is a major public health problem with serious implications for the physical and psychosocial wellbeing of women, particularly women of child-bearing age. It is a common, hidden problem in general practice and has been under-researched in this setting. Opportunities for early intervention and support in primary care need to be investigated given the frequency of contact women have with general practice. Despite the high prevalence and health consequences of abuse, there is insufficient evidence for screening in primary care settings. Furthermore, there is little rigorous evidence to guide general practitioners (GPs in responding to women identified as experiencing partner abuse. This paper describes the design of a trial of a general practice-based intervention consisting of screening for fear of partner with feedback to GPs, training for GPs, brief counselling for women and minimal practice organisational change. It examines the effect on women's quality of life, mental health and safety behaviours. Methods/Design weave is a cluster randomised controlled trial involving 40 general practices in Victoria, Australia. Approximately 500 women (16-50 years seen by the GP in the previous year are mailed a short lifestyle survey containing an item to screen for IPA. Women who indicate that they were afraid of a partner/ex-partner in the last year and provide contact details are invited to participate. Once baseline data are collected, GPs are randomly assigned to either a group involving healthy relationship and responding to IPA training plus inviting women for up to 6 sessions of counselling or to a group involving basic education and usual care for women. Outcomes will be evaluated by postal survey at 6 and 12 months following delivery of the intervention. There will be an economic evaluation, and process evaluation involving interviews with women and GPs, to inform understanding about implementation

  2. Act In case of Depression: The evaluation of a care program to improve the detection and treatment of depression in nursing homes. Study Protocol

    Directory of Open Access Journals (Sweden)

    Vernooij-Dassen Myrra JFJ

    2011-05-01

    Full Text Available Abstract Background The aim of this study is evaluating the (cost- effectiveness of a multidisciplinary, evidence based care program to improve the management of depression in nursing home residents of somatic and dementia special care units. The care program is an evidence based standardization of the management of depression, including standardized use of measurement instruments and diagnostical methods, and protocolized psychosocial, psychological and pharmacological treatment. Methods/Design In a 19-month longitudinal controlled study using a stepped wedge design, 14 somatic and 14 dementia special care units will implement the care program. All residents who give informed consent on the participating units will be included. Primary outcomes are the frequency of depression on the units and quality of life of residents on the units. The effect of the care program will be estimated using multilevel regression analysis. Secondary outcomes include accuracy of depression-detection in usual care, prevalence of depression-diagnosis in the intervention group, and response to treatment of depressed residents. An economic evaluation from a health care perspective will also be carried out. Discussion The care program is expected to be effective in reducing the frequency of depression and in increasing the quality of life of residents. The study will further provide insight in the cost-effectiveness of the care program. Trial registration Netherlands Trial Register (NTR: NTR1477

  3. Central heating plant economic evaluation program. Volume 4. Coalfield properties information data management program. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Lin, M.C.; Moshage, R.; Schanche, G.; Blazek, C.; Biederman, R.

    1995-01-01

    Public law has directed the Department of Defense (DoD) to rehabilitate and convert its existing domestic power plants to burn more coal. Other Federal legislation requires DoD to use the most economic fuel for any new heating system. This five-volume report discusses the Central Heating Plant Economic Evaluation Program (CHPECON), a computer program for screening potential new and retrofit steam/power generation facilities. Volume 4 is the Coalfield Properties Information Data Management Program. CHPECON provides screening criteria to evaluate competing combustion technologies using coal, gas, or oil; detailed conceptual facility design information; budgetary facility costs; and economic measures of project acceptability including total life cycle costs and levelized cost of service. The program provides sufficient flexibility to vary critical design and operating parameters to determine project sensitivity and parametric evaluation.

  4. Evaluating the economic impacts of pipeline useage on the Texas oil & gas supply chain

    Science.gov (United States)

    Singh, Jashandeep

    The objective of this dissertation is to find the minimum supply chain cost for the Texas oil and gas industry, when pipeline is used as the major mode of transporting oil. The problem is solved, by introducing a mixed -- integer linear programming model which will help in taking the necessary decisions based on the cost estimates for various scenarios. In order to meet the objective, specific objectives were put down to evaluate their impacts. First was to evaluate the economic impact of mode of transport and the infrastructure second was to evaluate the economic impact of refinery flow. Finally this dissertation aims at the mixed -- integer programming model to demonstrate the economic impacts of pipeline usage on the supply chain.

  5. Economic evaluation in the context of rare diseases: is it possible?

    Directory of Open Access Journals (Sweden)

    Everton Nunes da Silva

    2015-03-01

    Full Text Available This study analyzes the available evidence on the adequacy of economic evaluation for decision-making on the incorporation or exclusion of technologies for rare diseases. The authors conducted a structured literature review in MEDLINE via PubMed, CRD, LILACS, SciELO, and Google Scholar (gray literature. Economic evaluation studies had their origins in Welfare Economics, in which individuals maximize their utilities based on allocative efficiency. There is no widely accepted criterion in the literature to weigh the expected utilities, in the sense of assigning more weight to individuals with greater health needs. Thus, economic evaluation studies do not usually weigh utilities asymmetrically (that is, everyone is treated equally, which in Brazil is also a Constitutional principle. Healthcare systems have ratified the use of economic evaluation as the main tool to assist decision-making. However, this approach does not rule out the use of other methodologies to complement cost-effectiveness studies, such as Person Trade-Off and Rule of Rescue.

  6. Economics and the evaluation of publicly funded energy R and D

    Energy Technology Data Exchange (ETDEWEB)

    Jones, D.W.; Paik, I.K.

    1998-10-19

    There are three major areas in which economics can contribute to the evaluation of federal R and D: assessment of net benefits, ex ante expected as well as ex post realized; tailoring of R and D portfolios to policy goals; and guiding the contractual organization of R and D production. Additionally, evaluation of R and D and scientific activity tend to be distinctly retrospective, principally because of the long lags between the initial production activity and the observability of consequences. Extending the purview of economic evaluation of R and D, they find ample opportunity for evaluation that can inform current R and D management practice. The conduct of R and D is organized through a series of explicit and implicit contracts designed to elicit long-term commitments by some agents while attempting to limit the commitment by others. It is natural to consider the efficiency with which R and D is conducted as a subject for economic inquiry, although in practice such inquiries generally are restricted to accounting exercises. In evaluating the efficiency with which R and D is done, the current ordinary practice is to look at labor rates and equipment and materials prices while considering quantities of those items as the principal instrument variables in an optimization problem (the authors conceptualization, not that of the typical review of an R and D project). The authors recommend the contractual structure and other elements of the incentive structure (pay and promotion) of R and D production as prime focal points for managerially useful economic evaluation. Non-economic motivations for funding public R and D, including energy R and D, are well known. The US will consider spending several billion dollars on an international space station, partly if not largely, to fund the peaceful employment of scientists from the Former Soviet Union. Nonetheless, it will be useful to understand the economics of the R and D programs even if other considerations play important

  7. Primary Medical Care Provider Accreditation (PMCPA): pilot evaluation.

    NARCIS (Netherlands)

    Campbell, S.M.; Chauhan, U.; Lester, H.

    2010-01-01

    BACKGROUND: While practice-level or team accreditation is not new to primary care in the UK and there are organisational indicators in the Quality and Outcomes Framework (QOF) organisational domain, there is no universal system of accreditation of the quality of organisational aspects of care in the

  8. Efficiency evaluation for pooling resources in health care

    NARCIS (Netherlands)

    Vanberkel, Peter T.; Boucherie, Richard J.; Hans, Erwin W.; Hurink, Johann L.; Litvak, Nelly

    2012-01-01

    Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centers, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and efficiency in service delivery can

  9. Physical, Psychosocial, Relationship, and Economic Burden of Caring for People With Cancer: A Review

    OpenAIRE

    Girgis, Afaf; Lambert, Sylvie; Johnson, Claire; Waller, Amy; Currow, David

    2012-01-01

    Having an understanding of the roles that caregivers play in the oncology setting may assist health care professionals in supporting caregivers with these tasks, and targeting services toward those most in need.

  10. Process Evaluation of a Workplace Integrated Care Intervention for Workers with Rheumatoid Arthritis

    OpenAIRE

    Vlisteren, M. van; Boot, C.R.; Voskuyl, A E; Steenbeek, R.; van Schaardenburg, D.; Anema, J. R.

    2016-01-01

    Purpose To perform a process evaluation of the implementation of a workplace integrated care intervention for workers with rheumatoid arthritis to maintain and improve work productivity. The intervention consisted of integrated care and a participatory workplace intervention with the aim to make adaptations at the workplace. Methods The implementation of the workplace integrated care intervention was evaluated with the framework of Linnan and Steckler. We used the concepts recruitment, reach,...

  11. A Laboratory-Based Evaluation of Four Rapid Point-of-Care Tests for Syphilis

    OpenAIRE

    Causer, Louise M.; Kaldor, John M.; Christopher K Fairley; Basil Donovan; Theo Karapanagiotidis; Leslie, David E.; Robertson, Peter W.; McNulty, Anna M.; David Anderson; Handan Wand; Damian P Conway; Ian Denham; Claire Ryan; Guy, Rebecca J.

    2014-01-01

    BACKGROUND: Syphilis point-of-care tests may reduce morbidity and ongoing transmission by increasing the proportion of people rapidly treated. Syphilis stage and co-infection with HIV may influence test performance. We evaluated four commercially available syphilis point-of-care devices in a head-to-head comparison using sera from laboratories in Australia. METHODS: Point-of-care tests were evaluated using sera stored at Sydney and Melbourne laboratories. Sensitivity and specificity were calc...

  12. Sensitivity analysis of technological, economic and sustainability evaluation of power plants using the analytic hierarchy process

    International Nuclear Information System (INIS)

    Technological, economic and sustainability evaluation of power plants by use of the analytic hierarchy process and nine end node criteria for a reference scenario based on subjective criteria weighting has been presented in a previous paper by authors. However, criteria weight variations may substantially modify overall evaluations and rankings of power plants. The current paper presents a sensitivity analysis with four alternative scenarios (sets of criteria weights) compared with the reference scenario. The results show that priority to 'technology and sustainability' favors renewable energy power plants, while priority to 'economic' criteria favors mainly nuclear power plants and less the four types of fossil fuel power plant

  13. Sensitivity analysis of technological, economic and sustainability evaluation of power plants using the analytic hierarchy process

    International Nuclear Information System (INIS)

    Technological, economic and sustainability evaluation of power plants by use of the analytic hierarchy process and nine end node criteria for a reference scenario based on subjective criteria weighting has been presented in a previous paper by authors. However, criteria weight variations may substantially modify overall evaluations and rankings of power plants. The current paper presents a sensitivity analysis with four alternative scenarios (sets of criteria weights) compared with the reference scenario. The results show that priority to 'technology and sustainability' favors renewable energy power plants, while priority to 'economic' criteria favors mainly nuclear power plants and less the four types of fossil fuel power plant. (author)

  14. State of health economic evaluation research in Saudi Arabia: a review

    Directory of Open Access Journals (Sweden)

    Al-Aqeel SA

    2012-07-01

    Full Text Available Sinaa A Al-AqeelClinical Pharmacy Department, King Saud University, Riyadh, Saudi ArabiaBackground: If evaluation of economic evidence is to be used increasingly in Saudi Arabia, a review of the published literature would be useful to inform policy decision-makers of the current state of research and plan future research agendas. The purpose of this paper is to provide a critical review of the state of health economic evaluation research within the Saudi context with regard to the number, characteristics, and quality of published articles.Methods: A literature search was conducted on May 8, 2011 to identify health economic articles pertaining to Saudi Arabia in the PubMed, Embase, and EconLit databases, using the following terms alone or in combination: “cost*”, “economics”, “health economics”, “cost-effectiveness”, “cost-benefit”, “cost minimization”, “cost utility analysis”, and “Saudi”. Reference lists of the articles identified were also searched for further articles. The tables of contents of the Saudi Pharmaceutical Journal and the Saudi Medical Journal were reviewed for the previous 5 years.Results: The search identified 535 citations. Based on a reading of abstracts and titles, 477 papers were excluded. Upon reviewing the full text of the remaining 58 papers, 43 were excluded. Fifteen papers were included. Ten were categorized as full economic evaluations and five as partial economic evaluations. These articles were published between 1997 and 2010. The majority of the studies identified did not clearly state the perspective of their evaluation. There are many concerns about the methods used to collect outcome and costs data. Only one study used some sort of sensitivity analysis to assess the effects of uncertainty on the robustness of its conclusions.Conclusion: This review highlights major flaws in the design, analysis, and reporting of the identified economic analyses. Such deficiencies mean that the

  15. Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care

    Science.gov (United States)

    2010-01-01

    Background Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated team consisting of an endocrinologist, diabetes nurse educators, General Practitioner Clinical Fellows (general practitioners who have undertaken focussed post-graduate training in complex diabetes care), and allied health personnel (a dietitian, podiatrist and psychologist). Methods/Design Using a geographical control, this evaluation study tests the impact of this model of diabetes care provided by the service on patient outcomes compared to usual care provided at the specialist diabetes outpatient clinic. Data collection at baseline, 6 and 12-months will compare the primary outcome (glycaemic control) and secondary outcomes (serum lipid profile, blood pressure, physical activity, smoking status, quality of life, diabetes self-efficacy and cost-effectiveness). Discussion This model of diabetes care combines the patient focus and holistic care valued by the primary care sector with the specialised knowledge and skills of hospital diabetes care. Our study will provide empirical evidence about the clinical effectiveness of this model of care. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12608000010392. PMID:20492731

  16. Protocol and baseline data from The Inala Chronic Disease Management Service evaluation study: a health services intervention study for diabetes care

    Directory of Open Access Journals (Sweden)

    Ware Robert S

    2010-05-01

    Full Text Available Abstract Background Type 2 Diabetes Mellitus is one of the most disabling chronic conditions worldwide, resulting in significant human, social and economic costs and placing huge demands on health care systems. The Inala Chronic Disease Management Service aims to improve the efficiency and effectiveness of care for patients with type 2 diabetes who have been referred by their general practitioner to a specialist diabetes outpatient clinic. Care is provided by a multidisciplinary, integrated team consisting of an endocrinologist, diabetes nurse educators, General Practitioner Clinical Fellows (general practitioners who have undertaken focussed post-graduate training in complex diabetes care, and allied health personnel (a dietitian, podiatrist and psychologist. Methods/Design Using a geographical control, this evaluation study tests the impact of this model of diabetes care provided by the service on patient outcomes compared to usual care provided at the specialist diabetes outpatient clinic. Data collection at baseline, 6 and 12-months will compare the primary outcome (glycaemic control and secondary outcomes (serum lipid profile, blood pressure, physical activity, smoking status, quality of life, diabetes self-efficacy and cost-effectiveness. Discussion This model of diabetes care combines the patient focus and holistic care valued by the primary care sector with the specialised knowledge and skills of hospital diabetes care. Our study will provide empirical evidence about the clinical effectiveness of this model of care. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12608000010392.

  17. Use of antidepressants in the treatment of major depressive disorder in primary care during a period of economic crisis

    Directory of Open Access Journals (Sweden)

    Sicras-Mainar A

    2015-12-01

    Full Text Available Antoni Sicras-Mainar,1 Ruth Navarro-Artieda2 1Research Unit, Badalona Serveis Assistencials SA, 2Medical Documentation Unit, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain Objective: To describe antidepressant (AD use in the treatment of major depressive disorder during a period of economic crisis.Patients and methods: This was a retrospective, observational study using population-based databases. Two periods were considered: 1 2008–2009, precrisis, and 2 2012–2013, economic crisis. Certain inclusion/exclusion criteria were taken into account for the study (initiation of AD treatment. Patients were followed up for 12 months. The main measures were use (defined daily doses, epidemiologic measures, strategies used and treatment persistence, referrals, and use of resources. Statistical significance was set at P<0.05.Results: In the precrisis period, 3,662 patients were enrolled, and 5,722 were enrolled in the period of economic crisis. Average age was 58.8 years and 65.4% were women. Comparing the two periods, major depressive disorder prevalence was 5.4% vs 8.1%, P<0.001. During the period of economic crisis, AD use rose by 35.2% and drug expenditures decreased by 38.7%. Defined daily dose per patient per day was 10.0 mg vs 13.5 mg, respectively, P<0.001. At 12-month follow-up, the majority of patients (60.8% discontinued the treatment or continued on the same medication as before, and in 23.3% a change of AD was made.Conclusion: Primary health care professionals are highly involved in the management of the illness; in addition, during the period of economic crisis, patients with major depressive disorder showed higher rates of prevalence of the illness, with increased use of AD drugs. Keywords: consumption, antidepressants, economic crisis

  18. Levonorgestrel-releasing intrauterine system vs. usual medical treatment for menorrhagia: an economic evaluation alongside a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Sabina Sanghera

    Full Text Available OBJECTIVE: To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device ('LNG-IUS' and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. METHODS: 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY estimated using both EQ-5D and SF-6D. RESULTS: Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100 and generated 0.002 more QALYs. CONCLUSION: Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most cost-effective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial.

  19. Structured pro-active care for chronic depression by practice nurses in primary care: a qualitative evaluation.

    Directory of Open Access Journals (Sweden)

    Madeleine Bennett

    Full Text Available PURPOSE: This qualitative study explored the impact and appropriateness of structured pro-active care reviews by practice nurses for patients with chronic or recurrent depression and dysthymia within the ProCEED trial. ProCEED (Pro-active Care and its Evaluation for Enduring Depression was a United Kingdom wide randomised controlled trial, comparing usual general practitioner care with structured 'pro-active care' which involved 3 monthly review appointments with practice nurses over 2 years for patients with chronic or recurrent depression. METHOD: In-depth interviews were completed with 41 participants: 26 patients receiving pro-active care and 15 practice nurses providing this care. Interview transcripts were analysed thematically using a 'framework' approach. RESULTS: Patients perceived the practice nurses to be appropriate professionals to engage with regarding their depression and most nurses felt confident in a case management role. The development of a therapeutic alliance between the patient and nurse was central to this model and, where it appeared lacking, dissatisfaction was felt by both patients and nurses with a likely negative impact on outcomes. Patient and nurse factors impacting on the therapeutic alliance were identified and nurse typologies explored. DISCUSSION: Pro-active care reviews utilising practice nurses as case managers were found acceptable by the majority of patients and practice nurses and may be a suitable way to provide care for patients with long-term depression in primary care. Motivated and interested practice nurses could be an appropriate and valuable resource for this patient group. This has implications for resource decisions by clinicians and commissioners within primary care.

  20. PROALCOOL: economic evaluation and adjustments on demand; PROALCOOL: Reavaliacao economica e ajustes de demanda

    Energy Technology Data Exchange (ETDEWEB)

    Motta, R.S. da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia; Rocha Ferreira, L. da [Universidade do Estado, Rio de Janeiro, RJ (Brazil). Faculdade de Ciencias Economicas

    1987-12-31

    The economic impact on the Brazilian National Alcohol Programme caused by changes in the energy scenery, in view of recent oil price fall in the international market, is discussed. The necessary adjustments of the Programme according to the new Brazilian economic reality are evaluated. The economic analysis concludes that the alcohol production, considering current production capacity and its investments could be economically feasible at international oil prices near US$ 30,00. Excluding investments, its feasibility would be between US$ 18,00 and US$ 20,00 per equivalent oil barrel. Based on these conclusions, proposals for adjusting the PROALCOOL are discussed, including alternative pricing, fiscal and credit policies to control the alcohol-fuel demand. 8 refs., 4 tabs.