Sample records for cost effective incentives

  1. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph


    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  2. Cost-Effectiveness of Rural Incentive Packages for Graduating Medical Students in Lao PDR. (United States)

    Keuffell, Eric; Jaskiewicz, Wanda; Theppanya, Khampasong; Tulenko, Kate


    The dearth of health workers in rural settings in Lao People's Democratic Republic (PDR) and other developing countries limits healthcare access and outcomes. In evaluating non-wage financial incentive packages as a potential policy option to attract health workers to rural settings, understanding the expected costs and effects of the various programs ex ante can assist policy-makers in selecting the optimal incentive package. We use discrete choice experiments (DCEs), costing analyses and recent empirical results linking health worker density and health outcomes to estimate the future location decisions of physicians and determine the cost-effectiveness of 15 voluntary incentives packages for new physicians in Lao PDR. Our data sources include a DCE survey completed by medical students (n = 329) in May 2011 and secondary cost, economic and health data. Mixed logit regressions provide the basis for estimating how each incentive package influences rural versus urban location choice over time. We estimate the expected rural density of physicians and the cost-effectiveness of 15 separate incentive packages from a societal perspective. In order to generate the cost-effectiveness ratios we relied on the rural uptake probabilities inferred from the DCEs, the costing data and prior World Health Organization (WHO) estimates that relate health outcomes to health worker density. Relative to no program, the optimal voluntary incentive package would increase rural physician density by 15% by 2016 and 65% by 2041. After incorporating anticipated health effects, seven (three) of the 15 incentive packages have anticipated average cost-effectiveness ratio less than the WHO threshold (three times gross domestic product [GDP] per capita) over a 5-year (30 year) period. The optimal package's incremental cost-effectiveness ratio is $1454/QALY (quality-adjusted life year) over 5 years and $2380/QALY over 30 years. Capital intensive components, such as housing or facility improvement

  3. Are financial incentives cost-effective to support smoking cessation during pregnancy? (United States)

    Boyd, Kathleen A; Briggs, Andrew H; Bauld, Linda; Sinclair, Lesley; Tappin, David


    To investigate the cost-effectiveness of up to £400 worth of financial incentives for smoking cessation in pregnancy as an adjunct to routine health care. Cost-effectiveness analysis based on a Phase II randomized controlled trial (RCT) and a cost-utility analysis using a life-time Markov model. The RCT was undertaken in Glasgow, Scotland. The economic analysis was undertaken from the UK National Health Service (NHS) perspective. A total of 612 pregnant women randomized to receive usual cessation support plus or minus financial incentives of up to £400 vouchers (US $609), contingent upon smoking cessation. Comparison of usual support and incentive interventions in terms of cotinine-validated quitters, quality-adjusted life years (QALYs) and direct costs to the NHS. The incremental cost per quitter at 34-38 weeks pregnant was £1127 ($1716).This is similar to the standard look-up value derived from Stapleton & West's published ICER tables, £1390 per quitter, by looking up the Cessation in Pregnancy Incentives Trial (CIPT) incremental cost (£157) and incremental 6-month quit outcome (0.14). The life-time model resulted in an incremental cost of £17 [95% confidence interval (CI) = -£93, £107] and a gain of 0.04 QALYs (95% CI = -0.058, 0.145), giving an ICER of £482/QALY ($734/QALY). Probabilistic sensitivity analysis indicates uncertainty in these results, particularly regarding relapse after birth. The expected value of perfect information was £30 million (at a willingness to pay of £30 000/QALY), so given current uncertainty, additional research is potentially worthwhile. Financial incentives for smoking cessation in pregnancy are highly cost-effective, with an incremental cost per quality-adjusted life years of £482, which is well below recommended decision thresholds. © 2015 Society for the Study of Addiction.

  4. The cost-effectiveness of using financial incentives to improve provider quality: a framework and application

    DEFF Research Database (Denmark)

    Meacock, R.; Kristensen, Søren Rud; Sutton, M.


    Despite growing adoption of pay-for-performance (P4P) programmes in health care, there is remarkably little evidence on the cost-effectiveness of such schemes. We review the limited number of previous studies and critique the frameworks adopted and the narrow range of costs and outcomes considered......, and whether performance improvement is a transitory or investment activity. Our application to the Advancing Quality initiative demonstrates that the incentive payments represented less than half of the 13m pound total programme costs. By generating approximately 5200 quality-adjusted life years and 4.4m...

  5. The cost-effectiveness of cash versus lottery incentives for a web-based, stated-preference community survey. (United States)

    Gajic, Aleksandra; Cameron, David; Hurley, Jeremiah


    We present the results of a randomized experiment to test the effectiveness and cost-effectiveness of response incentives for a stated-preference survey of a general community population. The survey was administered using a mixed-mode approach, in which community members were invited to participate using a traditional mailed letter using contact information for a representative sample of the community; but individuals completed the survey via the web, which exploited the advantages of electronic capture. Individuals were randomized to four incentive groups: (a) no incentive, (b) prepaid cash incentive ($2), (c) a low lottery (10 prizes of $25) and (d) a high lottery (2 prizes of $250). Letters of invitation were mailed to 3,000 individuals. In total, 405 individuals (14.4%) contacted the website and 277 (9.8%) provided complete responses. The prepaid cash incentive generated the highest contact and response rates (23.3 and 17.3%, respectively), and no incentive generated the lowest (9.1 and 5.7%, respectively). The high lottery, however, was the most cost-effective incentive for obtaining completed surveys: compared with no incentive, the incremental cost-effectiveness ratio (ICER) per completed survey for high lottery was $13.89; for prepaid cash, the ICER was $18.29. This finding suggests that the preferred response incentive for community-based, stated-preference surveys is a lottery with a small number of large prizes.

  6. An analysis of cost effective incentives for initial commercial deployment of advanced clean coal technologies

    Energy Technology Data Exchange (ETDEWEB)

    Spencer, D.F. [SIMTECHE, Half Moon Bay, CA (United States)


    This analysis evaluates the incentives necessary to introduce commercial scale Advanced Clean Coal Technologies, specifically Integrated Coal Gasification Combined Cycle (ICGCC) and Pressurized Fluidized Bed Combustion (PFBC) powerplants. The incentives required to support the initial introduction of these systems are based on competitive busbar electricity costs with natural gas fired combined cycle powerplants, in baseload service. A federal government price guarantee program for up to 10 Advanced Clean Coal Technology powerplants, 5 each ICGCC and PFBC systems is recommended in order to establish the commercial viability of these systems by 2010. By utilizing a decreasing incentives approach as the technologies mature (plants 1--5 of each type), and considering the additional federal government benefits of these plants versus natural gas fired combined cycle powerplants, federal government net financial exposure is minimized. Annual net incentive outlays of approximately 150 million annually over a 20 year period could be necessary. Based on increased demand for Advanced Clean Coal Technologies beyond 2010, the federal government would be revenue neutral within 10 years of the incentives program completion.

  7. Cost-effectiveness analysis of malaria rapid diagnostic test incentive schemes for informal private healthcare providers in Myanmar. (United States)

    Chen, Ingrid T; Aung, Tin; Thant, Hnin Nwe Nwe; Sudhinaraset, May; Kahn, James G


    The emergence of artemisinin-resistant Plasmodium falciparum parasites in Southeast Asia threatens global malaria control efforts. One strategy to counter this problem is a subsidy of malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapy (ACT) within the informal private sector, where the majority of malaria care in Myanmar is provided. A study in Myanmar evaluated the effectiveness of financial incentives vs information, education and counselling (IEC) in driving the proper use of subsidized malaria RDTs among informal private providers. This cost-effectiveness analysis compares intervention options. A decision tree was constructed in a spreadsheet to estimate the incremental cost-effectiveness ratios (ICERs) among four strategies: no intervention, simple subsidy, subsidy with financial incentives, and subsidy with IEC. Model inputs included programmatic costs (in dollars), malaria epidemiology and observed study outcomes. Data sources included expenditure records, study data and scientific literature. Model outcomes included the proportion of properly and improperly treated individuals with and without P. falciparum malaria, and associated disability-adjusted life years (DALYs). Results are reported as ICERs in US dollars per DALY averted. One-way sensitivity analysis assessed how outcomes depend on uncertainty in inputs. ICERs from the least to most expensive intervention are: $1,169/DALY averted for simple subsidy vs no intervention, $185/DALY averted for subsidy with financial incentives vs simple subsidy, and $200/DALY averted for a subsidy with IEC vs subsidy with financial incentives. Due to decreasing ICERs, each strategy was also compared to no intervention. The subsidy with IEC was the most favourable, costing $639/DALY averted compared with no intervention. One-way sensitivity analysis shows that ICERs are most affected by programme costs, RDT uptake, treatment-seeking behaviour, and the prevalence and virulence of non

  8. Improving the cost effectiveness of financial incentives in managing travel demand management (TDM). (United States)


    Providing financial incentives to commuters to use alternative modes is a common element of managing transportation demand. Although these incentives have become common during the past two decades as elements of transportation demand management (TDM)...

  9. Cost-effectiveness analysis of public education and incentive programs for controlling radon in the home. Final report

    International Nuclear Information System (INIS)

    Bierma, T.J.; Swartzman, D.


    The objective of this study was to evaluate the cost-effectiveness in Illinois of five radon public education and incentive program options. Programs evaluated included (1) no program, (2) a toll-free hotline and information packet, (3) free short-term monitors, (4) free confirmatory monitors, and (5) low-interest loans. Existing literature and expert opinion were used to estimate program costs and public responses under the various programs. Computer simulation, with Monte Carlo sampling, was used for uncertainty and sensitivity analysis. The cost-effectiveness model was analyzed based on assumed radon exposures to Illinois citizens. Results for standard conditions indicate that budget levels under approximately $30,000 do not warrant a radon education and incentive program. For budget levels of approximately $30,000 to $1 million, Program 2 was most effective, and Program 3 was most effective above this level. Sensitivity analyses indicate the results are relatively insensitive to input variable assumptions with the exception of public-response estimates. Study results suggest that all of the programs evaluated are likely to be relatively ineffective. Considerable improvement may be possible using more innovative approaches to public education

  10. Improving the cost effectiveness of financial incentives in managing travel demand management (TDM) : [technical summary]. (United States)


    During the last two decades, financial incentives : have become common in efforts to reduce : demand on roadways by motivating commuters to : use alternative modes of transportation. Despite : common use, limited effort has been made to : understand ...

  11. Price Endogeneity and Marginal Cost Effects on Incentive Compatible Stormwater Management Policies


    Huber, Matthew C.; Willis, David B.; Hayes, John C.; Privette, Charles V., III


    Incentive based stormwater management policies offer the prospect of reducing urban stormwater runoff while increasing developer profits. An incentive compatible Stormwater Banking Program (SBP) is presented that allows developers to build at higher residential densities in exchange for including low impact stormwater Best Management Practices (BMPs) in the development’s stormwater management infrastructure. Price endogeneity presents itself when the smaller residential lots created by buildi...

  12. Evaluating the effect of the new incentive system for high-risk pressure ulcer patients on wound healing and cost-effectiveness: a cohort study. (United States)

    Sanada, Hiromi; Nakagami, Gojiro; Mizokami, Yuko; Minami, Yukiko; Yamamoto, Aya; Oe, Makoto; Kaitani, Toshiko; Iizaka, Shinji


    To evaluate the effectiveness and cost-effectiveness of new incentive system for pressure ulcer management, which focused on skilled nurse staffing in terms of rate of healing and medical costs. A prospective cohort study included two types of groups: 39 institutions, which introduced the new incentive system, and 20 non-introduced groups (control). Sixty-seven patients suffering from severe pressure ulcers in the introduced group and 38 patients in the non-introduced group were included. Wound healing and medical costs were monitored weekly for three weeks by their skilled nurses in charge. Healing status and related medical costs. The introduced group showed significantly higher rate of healing compared with the control group at each weekly assessment. Multiple regression analysis revealed that the introduction of the new incentive system was independently associated with the faster healing rate (beta=3.44, Pcost of treating severe pressure ulcers by 1.776 billion yen per year. The new incentive system for the management of pressure ulcers, which focused on staffing with skilled nurses can improve healing rate with reduced medical cost. Copyright 2009 Elsevier Ltd. All rights reserved.

  13. The Effect of Incentives and Meta-incentives on the Evolution of Cooperation.

    Directory of Open Access Journals (Sweden)

    Isamu Okada


    Full Text Available Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards and negative incentives (punishments with second-order incentives, which are incentives for other players' incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer after playing donation games, is needed. The paper concludes that (1 second-order incentives for first-order reward are necessary for cooperative regimes, (2 a system without first-order rewards cannot maintain a cooperative regime, (3 a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4 a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives.

  14. The Effect of Incentives and Meta-incentives on the Evolution of Cooperation. (United States)

    Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya


    Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (rewards) and negative incentives (punishments) with second-order incentives, which are incentives for other players' incentives. The critical assumption of our model is that players who tend to provide incentives to other players for their cooperative or non-cooperative behavior also tend to provide incentives to their incentive behaviors. In this paper, we solve the replicator dynamics for a simple version of the game and analytically categorize the game types into four groups. We find that the second-order free-rider problem is completely resolved without any third-order or higher (meta) incentive under the assumption. To do so, a second-order costly incentive, which is given individually (peer-to-peer) after playing donation games, is needed. The paper concludes that (1) second-order incentives for first-order reward are necessary for cooperative regimes, (2) a system without first-order rewards cannot maintain a cooperative regime, (3) a system with first-order rewards and no incentives for rewards is the worst because it never reaches cooperation, and (4) a system with rewards for incentives is more likely to be a cooperative regime than a system with punishments for incentives when the cost-effect ratio of incentives is sufficiently large. This solution is general and strong in the sense that the game does not need any centralized institution or proactive system for incentives.

  15. Cost effectiveness of the Dutch incentive for the environmental quality of power generation (MEP)

    International Nuclear Information System (INIS)

    Melgerd, R.


    This article relates to research on the cost effectiveness of the MEP scheme ('Milieukwaliteit Elektriciteitsproductie' or Environmental Quality of Electricity Generation), carried out as a graduation project at the Vrije Universiteit, Amsterdam, Netherlands. MEP subsidies are intended to promote investment in sustainable energy sources in the Netherlands by offering investors more certainty and a simpler structure than previous energy subsidies. The MEP also helps prevent Dutch taxpayers' money 'leaking' abroad to purchase sustainable electricity produced cheaper elsewhere. This makes the MEP measurably more effective than its predecessors. The scheme is moreover a step towards the effective deployment of state funds for the reduction of CO2 emission [nl

  16. Using Effective Contractual Incentives to Obtain Superior Contractor Performance

    National Research Council Canada - National Science Library

    Venable, Timothy


    The purpose of this thesis is to provide the reader with the ability to analyze the effectiveness of incentives and to document innovative approaches to incentive contracting that can be applied to Cost-Plus-Award-Fee (CPAF) contracts...

  17. A Novel and Cost-Effective Monitoring Approach for Outcomes in an Australian Biodiversity Conservation Incentive Program (United States)

    Lindenmayer, David B.; Zammit, Charles; Attwood, Simon J.; Burns, Emma; Shepherd, Claire L.; Kay, Geoff; Wood, Jeff


    We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme – the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities). The ecological monitoring was explicitly aligned with the Program’s policy objective and desired outcomes and was applied to the Program’s initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program’s investment in the first four years and hence are in broad accord with the general rule of thumb that 5–10% of a program’s funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies. PMID:23236399

  18. A novel and cost-effective monitoring approach for outcomes in an Australian biodiversity conservation incentive program.

    Directory of Open Access Journals (Sweden)

    David B Lindenmayer

    Full Text Available We report on the design and implementation of ecological monitoring for an Australian biodiversity conservation incentive scheme - the Environmental Stewardship Program. The Program uses competitive auctions to contract individual land managers for up to 15 years to conserve matters of National Environmental Significance (with an initial priority on nationally threatened ecological communities. The ecological monitoring was explicitly aligned with the Program's policy objective and desired outcomes and was applied to the Program's initial Project which targeted the critically endangered White Box-Yellow Box-Blakely's Red Gum Grassy Woodland and Derived Native Grassland ecological community in south eastern Australia. These woodlands have been reduced to <3% of their original extent and persist mostly as small remnants of variable condition on private farmland. We established monitoring sites on 153 farms located over 172,232 sq km. On each farm we established a monitoring site within the woodland patch funded for management and, wherever possible, a matched control site. The monitoring has entailed gathering data on vegetation condition, reptiles and birds. We also gathered data on the costs of experimental design, site establishment, field survey, and data analysis. The costs of monitoring are approximately 8.5% of the Program's investment in the first four years and hence are in broad accord with the general rule of thumb that 5-10% of a program's funding should be invested in monitoring. Once initial monitoring and site benchmarking are completed we propose to implement a novel rotating sampling approach that will maintain scientific integrity while achieving an annual cost-efficiency of up to 23%. We discuss useful lessons relevant to other monitoring programs where there is a need to provide managers with reliable early evidence of program effectiveness and to demonstrate opportunities for cost-efficiencies.

  19. Costs and results of federal incentives for commercial nuclear energy

    International Nuclear Information System (INIS)

    Bezdek, R.H.; Wendling, R.M.


    This paper (1) estimates the total costs of federal expenditures in support of incentives for the development of commercial nuclear energy through 1988, and (2) analyzes the results and benefits to the nation of this federal investment. The federal incentives analyzed include research and development, regulation of commercial nuclear energy, tax incentives, waste management and disposal, enrichment plants, liability insurance, the uranium mining industry, and all other federal support activities. The authors estimate that net federal incentives totaled about $45-50 billion (1988 dollars). They estimate the results of the federal incentives, focusing on six categories, namely, electric energy produced, the total (direct plus indirect) economic benefits of the industry created, R and D program benefits, value of energy imports displaced, environmental effects, and health, safety, and risk effects. The results total $1.9 trillion, with approximately $250-300 billion identified as net benefits. The authors conclude that the high return on the investment justified federal incentives for nuclear energy development over the past four decades and that the federal government and the nation have received a significant return on the incentives investment

  20. Incentive Effects of Peer Pressure in Organizations


    Kohei Daido


    This paper studies the effects of peer pressure on incentives. We assume that, in addition to the material payoff, each agent's utility includes the psychological payoff from peer pressure generated by a comparison of effort costs. We show that the optimal incentive schemes depend mainly on the degree of peer pressure and of the heterogeneity of agents. Furthermore, we examine the optimal organizational forms in terms of the principal''s intention to make use of the effects of peer pressure.

  1. A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace. (United States)

    Dallat, Mary Anne T; Hunter, Ruth F; Tully, Mark A; Cairns, Karen J; Kee, Frank


    Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer's perspective. Employees used a 'loyalty card' to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer's perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable "business model" which

  2. The effect of fiscal incentives on market penetration of electric vehicles: A pairwise comparison of total cost of ownership

    International Nuclear Information System (INIS)

    Lévay, Petra Zsuzsa; Drossinos, Yannis; Thiel, Christian


    An important barrier to electric vehicle (EV) sales is their high purchase price compared to internal combustion engine (ICE) vehicles. We conducted total cost of ownership (TCO) calculations to study how costs and sales of EVs relate to each other and to examine the role of fiscal incentives in reducing TCO and increasing EV sales. We composed EV-ICE vehicle pairs that allowed cross-segment and cross-country comparison in eight European countries. Actual car prices were used to calculate the incentives for each model in each country. We found a negative TCO-sales relationship that differs across car segments. Compared to their ICE vehicle pair, big EVs have lower TCO, higher sales, and seem to be less price responsive than small EVs. Three country groups can be distinguished according to the level of fiscal incentives and their impact on TCO and EV sales. In Norway, incentives led to the lowest TCO for the EVs. In the Netherlands, France, and UK the TCO of EVs is close to the TCO of the ICE pairs. In the other countries the TCO of EVs exceeds that of the ICE vehicles. We found that exemptions from flat taxes favour big EVs, while lump-sum subsidies favour small EVs. - Highlights: • Pairwise comparison of EV and ICE vehicle TCO and sales in eight European countries. • In NO, EV TCO is lower than ICE TCO; in NL, FR, and UK, EV TCO is slightly higher. • Compared to ICE vehicles, big EVs have lower TCO and higher sales than small EVs. • Exemptions from flat taxes favour big EVs, lump-sum subsidies favour small EVs. • Most popular EV models: Tesla Model S, Nissan Leaf, Mitsubishi Outlander PHEV.

  3. 48 CFR 416.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 416.405 Section 416.405 Federal Acquisition Regulations System DEPARTMENT OF...-reimbursement incentive contracts. ...

  4. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study. (United States)

    Peirce, Jessica M; Petry, Nancy M; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C; Royer-Malvestuto, Charlotte; Roll, John M; Cohen, Allan; Copersino, Marc L; Kolodner, Ken; Li, Rui


    Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial. Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was 120 dollars per participant. An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

  5. Incentive and insurance effects of income taxation

    DEFF Research Database (Denmark)

    Andersen, Torben M.


    the sensitivity of labour supply to taxes, which tends to reduce tax distortions and lower the marginal costs of public funds. The relation between incentives and insurance and thus efficiency and equity is flattened by the insurance effect and it may even be non-monotone. However, the optimal utilitarian policy......Tax distortions cause a trade-off between efficiency and equity. However, taxes not only affect incentives; they also provide implicit insurance, and this may critically affect the efficiency–equity relationship. For a standard labour supply problem it is shown that the insurance effect mutes...

  6. The cost of policy simplification in conservation incentive programs

    DEFF Research Database (Denmark)

    Armsworth, Paul R.; Acs, Szvetlana; Dallimer, Martin


    of biodiversity. Common policy simplifications result in a 49100% loss in biodiversity benefits depending on the conservation target chosen. Failure to differentiate prices for conservation improvements in space is particularly problematic. Additional implementation costs that accompany more complicated policies......Incentive payments to private landowners provide a common strategy to conserve biodiversity and enhance the supply of goods and services from ecosystems. To deliver cost-effective improvements in biodiversity, payment schemes must trade-off inefficiencies that result from over-simplified policies...... with the administrative burden of implementing more complex incentive designs. We examine the effectiveness of different payment schemes using field parameterized, ecological economic models of extensive grazing farms. We focus on profit maximising farm management plans and use bird species as a policy-relevant indicator...

  7. 48 CFR 1316.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 1316.405 Section 1316.405 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 1316.405 Cost-reimbursement...

  8. 48 CFR 216.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 216.405 Section 216.405 Federal Acquisition Regulations System DEFENSE ACQUISITION... Contracts 216.405 Cost-reimbursement incentive contracts. ...

  9. 48 CFR 1816.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Cost-reimbursement incentive contracts. 1816.405 Section 1816.405 Federal Acquisition Regulations System NATIONAL AERONAUTICS... 1816.405 Cost-reimbursement incentive contracts. [62 FR 3478, Jan. 23, 1997. Redesignated at 62 FR...

  10. 48 CFR 916.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 916.405 Section 916.405 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 916.405 Cost-reimbursement...

  11. 48 CFR 16.405 - Cost-reimbursement incentive contracts. (United States)


    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-reimbursement incentive contracts. 16.405 Section 16.405 Federal Acquisition Regulations System FEDERAL ACQUISITION...-reimbursement incentive contracts. See 16.301 for requirements applicable to all cost-reimbursement contracts...

  12. Net costs of health worker rural incentive packages: an example from the Lao People's Democratic Republic. (United States)

    Keuffel, Eric; Jaskiewicz, Wanda; Paphassarang, Chanthakhath; Tulenko, Kate


    Many developing countries are examining whether to institute incentive packages that increase the share of health workers who opt to locate in rural settings; however, uncertainty exists with respect to the expected net cost (or benefit) from these packages. We utilize the findings from the discrete choice experiment surveys applied to students training to be health professionals and costing analyses in Lao People's Democratic Republic to model the anticipated effect of incentive packages on new worker location decisions and direct costs. Incorporating evidence on health worker density and health outcomes, we then estimate the expected 5-year net cost (or benefit) of each incentive packages for 3 health worker cadres--physicians, nurses/midwives, and medical assistants. Under base case assumptions, the optimal incentive package for each cadre produced a 5-year net benefit (maximum net benefit for physicians: US$ 44,000; nurses/midwives: US$ 5.6 million; medical assistants: US$ 485,000). After accounting for health effects, the expected net cost of select incentive packages would be substantially less than the original estimate of direct costs. In the case of Lao People's Democratic Republic, incentive packages that do not invest in capital-intensive components generally should produce larger net benefits. Combining discrete choice experiment surveys, costing surveys and cost-benefit analysis methods may be replicated by other developing countries to calculate whether health worker incentive packages are viable policy options.

  13. 48 CFR 16.304 - Cost-plus-incentive-fee contracts. (United States)


    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-plus-incentive-fee...-incentive-fee contracts. A cost-plus-incentive-fee contract is a cost-reimbursement contract that provides... allowable costs to total target costs. Cost-plus-incentive-fee contracts are covered in subpart 16.4...

  14. Variation in Incentive Effects across Neighbourhoods

    Directory of Open Access Journals (Sweden)

    Mark J Hanly


    Full Text Available Small monetary incentives increase survey cooperation rates, however evidence suggests that the appeal of incentives may vary across sample subgroups. Fieldwork budgets can be most effectively distributed by targeting those subgroups where incentives will have the strongest appeal. We examine data from a randomised experiment implemented in the pilot phase of the Irish Longitudinal Study of Ageing, which randomly assigned households to receive a higher (€25 or lower (€10 incentive amount. Using a random effects logistic regression model, we observe a variable effect of the higher incentive across geographic neighbourhoods. The higher incentive has the largest impact in neighbourhoods where baseline cooperation is low, as predicted by Leverage-Saliency theory. Auxiliary neighbourhood-level variables are linked to the sample frame to explore this variation further, however none of these moderate the incentive effect, suggesting that richer information is needed to identify sample subgroups where incentive budgets should be directed.

  15. 48 CFR 16.405-1 - Cost-plus-incentive-fee contracts. (United States)


    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost-plus-incentive-fee... CONTRACTING METHODS AND CONTRACT TYPES TYPES OF CONTRACTS Incentive Contracts 16.405-1 Cost-plus-incentive-fee contracts. (a) Description. The cost-plus-incentive-fee contract is a cost-reimbursement contract that...

  16. Incentive-Based Primary Care: Cost and Utilization Analysis. (United States)

    Hollander, Marcus J; Kadlec, Helena


    In its fee-for-service funding model for primary care, British Columbia, Canada, introduced incentive payments to general practitioners as pay for performance for providing enhanced, guidelines-based care to patients with chronic conditions. Evaluation of the program was conducted at the health care system level. To examine the impact of the incentive payments on annual health care costs and hospital utilization patterns in British Columbia. The study used Ministry of Health administrative data for Fiscal Year 2010-2011 for patients with diabetes, congestive heart failure, chronic obstructive pulmonary disease, and/or hypertension. In each disease group, cost and utilization were compared across patients who did, and did not, receive incentive-based care. Health care costs (eg, primary care, hospital) and utilization measures (eg, hospital days, readmissions). After controlling for patients' age, sex, service needs level, and continuity of care (defined as attachment to a general practice), the incentives reduced the net annual health care costs, in Canadian dollars, for patients with hypertension (by approximately Can$308 per patient), chronic obstructive pulmonary disease (by Can$496), and congestive heart failure (by Can$96), but not diabetes (incentives cost about Can$148 more per patient). The incentives were also associated with fewer hospital days, fewer admissions and readmissions, and shorter lengths of hospital stays for all 4 groups. Although the available literature on pay for performance shows mixed results, we showed that the funding model used in British Columbia using incentive payments for primary care might reduce health care costs and hospital utilization.

  17. The effective use of property tax incentives for economic development


    Daphne A. Kenyon; Adam H. Langley; Bethany P. Paquin


    To make property-tax incentives for business more effective, do not approve every incentive request, target use of incentives, avoid incentive wars, cooperate with surrounding localities, and conduct regular evaluations.

  18. Adaptive Incentive Controls for Stackelberg Games with Unknown Cost Functionals. (United States)



  19. Managing Threat, Cost, and Incentive to Kill: The Short- and Long-Term Effects of Intervention in Mass Killings (United States)

    Kathman, Jacob D.; Wood, Reed M.


    How do third-party interventions affect the severity of mass killings? The authors theorize that episodes of mass killing are the consequence of two factors: (1) the threat perceptions of the perpetrators and (2) the cost of implementing genocidal policies relative to other alternatives. To reduce genocidal hostilities, interveners must address…

  20. The Effect of Incentives and Meta-incentives on the Evolution of Cooperation


    Okada, Isamu; Yamamoto, Hitoshi; Toriumi, Fujio; Sasaki, Tatsuya


    Although positive incentives for cooperators and/or negative incentives for free-riders in social dilemmas play an important role in maintaining cooperation, there is still the outstanding issue of who should pay the cost of incentives. The second-order free-rider problem, in which players who do not provide the incentives dominate in a game, is a well-known academic challenge. In order to meet this challenge, we devise and analyze a meta-incentive game that integrates positive incentives (re...

  1. Shaping dental contract reform: a clinical and cost-effective analysis of incentive-driven commissioning for improved oral health in primary dental care (United States)

    Hulme, C; Robinson, P G; Saloniki, E C; Vinall-Collier, K; Baxter, P D; Douglas, G; Gibson, B; Godson, J H; Meads, D; Pavitt, S H


    Objective To evaluate the clinical and cost-effectiveness of a new blended dental contract incentivising improved oral health compared with a traditional dental contract based on units of dental activity (UDAs). Design Non-randomised controlled study. Setting Six UK primary care dental practices, three working under a new blended dental contract; three matched practices under a traditional contract. Participants 550 new adult patients. Interventions A new blended/incentive-driven primary care dentistry contract and service delivery model versus the traditional contract based on UDAs. Main outcome measures Primary outcome was as follows: percentage of sites with gingival bleeding on probing. Secondary outcomes were as follows: extracted and filled teeth (%), caries (International Caries Detection and Assessment System (ICDAS)), oral health-related quality of life (Oral Health Impact Profile-14 (OHIP-14)). Incremental cost-effective ratios used OHIP-14 and quality adjusted life years (QALYs) derived from the EQ-5D-3L. Results At 24 months, 291/550 (53%) patients returned for final assessment; those lost to follow-up attended 6.46 appointments on average (SD 4.80). The primary outcome favoured patients in the blended contract group. Extractions and fillings were more frequent in this group. Blended contracts were financially attractive for the dental provider but carried a higher cost for the service commissioner. Differences in generic health-related quality of life were negligible. Positive changes over time in oral health-related quality of life in both groups were statistically significant. Conclusions This is the first UK study to assess the clinical and cost-effectiveness of a blended contract in primary care dentistry. Although the primary outcome favoured the blended contract, the results are limited because 47% patients did not attend at 24 months. This is consistent with 39% of adults not being regular attenders and 27% only visiting their dentist when

  2. Nationwide expansion of a financial incentive program on fruit and vegetable purchases among Supplemental Nutrition Assistance Program participants: A cost-effectiveness analysis. (United States)

    An, Ruopeng


    High prices remain a formidable barrier for many people, especially those of low socioeconomic status, to adopt a healthier diet. The Food, Conservation, and Energy Act of 2008 mandated the U.S. Department of Agriculture (USDA) to conduct a pilot study to assess the impact of making fruits and vegetables more affordable for households in the Supplemental Nutrition Assistance Program (SNAP). Based on the USDA final report of the Healthy Incentives Pilot (HIP), a large-scale randomized trial in 2011-2012 that provided 30% rebate on targeted fruits and vegetables to 7500 study participants enrolled in the SNAP, we constructed a decision model to evaluate the cost-effectiveness of an expansion of the HIP to all SNAP households nationwide. The estimated life-time per capita costs of the HIP to the Federal government is $1323 in 2012 U.S. dollars, and the average gains in quality-adjusted life expectancy to a SNAP participant is 0.082 quality-adjusted life year (QALY), resulting in an incremental cost-effectiveness ratio (ICER) of $16,172 per QALY gained. Sensitivity analysis using Monte Carlo simulations indicates a 94.4% and 99.6% probability that the estimated ICER would be lower than the cost-effective threshold of $50,000 and $100,000 per QALY gained, respectively. Moreover, the estimated ICER of the HIP expansion tends to be competitive in comparison to other interventions that aimed at promoting fruit/vegetable intake among adult population. Findings from this study suggest that a nationwide expansion of the HIP is likely to nudge SNAP households towards purchasing and consuming more targeted fruits and vegetables. However, diet behavior modification is proportional to price change. When people's actual eating behaviors and what dietary guidelines recommend differ by several folds, even a 30% rebate closes just a small fraction of that gap and has limited beneficial impact on participants' weight management, disease prevention, and health-related quality of life

  3. 48 CFR 216.405-1 - Cost-plus-incentive-fee contracts. (United States)


    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Cost-plus-incentive-fee... Contracts 216.405-1 Cost-plus-incentive-fee contracts. See PGI 216.405-1 for guidance on the use of cost-plus-incentive-fee contracts. [71 FR 39007, July 11, 2006] ...

  4. IncentivesEffectiveness and efficiency

    Directory of Open Access Journals (Sweden)

    Björn Hinderlich


    Full Text Available This paper covers the question if and how incentive schemes work evaluated by their impact on company performance (market capitalization and profit before tax. Based on a unique data set for German executive directors of DAX companies it can be proved that neither short (STI nor long term incentives (LTI plans necessarily support the company success. It rather depends on the efficiency of each plan, i. e. on its design. Special attention has to be paid on target setting. Short term focused objectives often miss their targets, whereas long term oriented objectives significantly support the company success. To solve the prisoner’s dilemma between employers and employees by a quasi-endless game, additional measures may be helpful, such as share ownership guidelines.

  5. Analysing Incentive and Cost Sharing Issues in Livestock Disease Management

    DEFF Research Database (Denmark)

    Biira, Juliet

    This PhD thesis tackles two main issues in livestock health management: a) the incentives for animal disease prevention on Danish livestock farms and b) allocation of costs of animal disease outbreaks and animal disease preparedness, among stakeholders involved in the livestock sector. The main...... contributions of this thesis are firstly the investigation of incentives for Danish livestock farmers to prevent animal diseases at the farm level and recommendations on how they could be improved. Secondly, the exploration of a mutual fund as a possibility for risk pooling among farmers and how it can...... is used in paper 5. The thesis consists of two parts; first is the introduction section where I introduce the thesis in general and provide an overview of the objectives and main theories and the second part includes the 5 papers which address the thesis objectives. Paper 1 uses existing literature...

  6. Incentive pricing and cost recovery at the basin scale. (United States)

    Ward, Frank A; Pulido-Velazquez, Manuel


    Incentive pricing programs have potential to promote economically efficient water use patterns and provide a revenue source to compensate for environmental damages. However, incentive pricing may impose disproportionate costs and aggravate poverty where high prices are levied for basic human needs. This paper presents an analysis of a two-tiered water pricing system that sets a low price for subsistence needs, while charging a price equal to marginal cost, including environmental cost, for discretionary uses. This pricing arrangement can promote efficient and sustainable water use patterns, goals set by the European Water Framework Directive, while meeting subsistence needs of poor households. Using data from the Rio Grande Basin of North America, a dynamic nonlinear program, maximizes the basin's total net economic and environmental benefits subject to several hydrological and institutional constraints. Supply costs, environmental costs, and resource costs are integrated in a model of a river basin's hydrology, economics, and institutions. Three programs are compared: (1) Law of the River, in which water allocations and prices are determined by rules governing water transfers; (2) marginal cost pricing, in which households pay the full marginal cost of supplying treated water; (3) two-tiered pricing, in which households' subsistence water needs are priced cheaply, while discretionary uses are priced at efficient levels. Compared to the Law of the River and marginal cost pricing, two-tiered pricing performs well for efficiency and adequately for sustainability and equity. Findings provide a general framework for formulating water pricing programs that promote economically and environmentally efficient water use programs while also addressing other policy goals.

  7. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, Jason S. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Grace, Robert C. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Rickerson, Wilson H. [Meister Consultants Group, Inc., Boston, MA (United States)


    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  8. 48 CFR 1852.216-84 - Estimated cost and incentive fee. (United States)


    ... Provisions and Clauses 1852.216-84 Estimated cost and incentive fee. As prescribed in 1816.406-70(d), insert the following clause: Estimated Cost and Incentive Fee (OCT 1996) The target cost of this contract is $___. The target fee of this contract is $___. The total target cost and target fee as contemplated by the...

  9. On the Effectiveness of Incentive Pay

    DEFF Research Database (Denmark)

    Friis, Ivar; Hansen, Allan; Vámosi, Tamás S.


    research addressing the need to better understand how interdependencies arise among management control system elements and how they affect organisational effectiveness. Based on an in-depth case study on the implementation of a new incentive system in a manufacturing firm, we seek to provide more research...... and insight into how incentive pay features in complementary and substitutional relationships in an individual organisational setting. Greater insight can help illustrate how complementary and substitutional relationships unfold in even more complex ways than current research indicates, as well as how...

  10. Developmental Effects of Incentives on Response Inhibition (United States)

    Geier, Charles F.; Luna, Beatriz


    Inhibitory control and incentive processes underlie decision making, yet few studies have explicitly examined their interaction across development. Here, the effects of potential rewards and losses on inhibitory control in 64 adolescents (13- to 17-year-olds) and 42 young adults (18- to 29-year-olds) were examined using an incentivized antisaccade…

  11. The effect of policy incentives on electric vehicle adoption

    International Nuclear Information System (INIS)

    Langbroek, Joram H.M.; Franklin, Joel P.; Susilo, Yusak O.


    In order to increase the attractiveness of electric vehicles (EVs), packages of policy incentives are provided in many countries. However, it is still unclear how effective different policy incentives are. Also, it is questionable that they have the same impact on different groups of people. In this study, based on a stated-choice experiment, the effect of several potential policy incentives on EV-adoption, as well as the influence of socio-psychological determinants are investigated, using constructs of the Transtheoretical Model of Change (TTM) and the Protection Motivation Theory (PMT). The probability of stated EV-adoption increases if policy incentives are offered in the choice experiment, which is expected because of the decrease of the generalized cost of EV-use. The high stated valuation of free parking or access to bus lanes makes those incentives an efficient alternative to expensive subsidies. EV-adoption probability increases for people that are further in the process of behavioural change. However, the responsiveness to subsidies decreases for people in more advanced stages-of-change. People that believe EVs to be effective in decreasing the negative externalities of the current transport system and people whose travel patterns can cope with the use of EVs also have a higher probability to choose the EV. - Highlights: •Policy incentives have a positive influence on electric vehicle adoption. •Being in advanced stages-of-change to EV-adoption increases likelihood to adopt EVs. •People in more advanced stages-of-change to EV-adoption are less price-sensitive. •People with a high self-efficacy and response efficacy are more likely to adopt EVs.

  12. Mergers, managerial incentives, and efficiencies


    Jovanovic, Dragan


    We analyze the effects of synergies from horizontal mergers in a Cournot oligopoly where principals provide their agents with incentives to cut marginal costs prior to choosing output. We stress that synergies come at a cost which possibly leads to a countervailing incentive effect: The merged firm's principal may be induced to stifle managerial incentives in order to reduce her agency costs. Whenever this incentive effect dominates the well-known direct synergy effect, synergies actually red...

  13. Effort and Selection Effects of Incentive Contracts

    NARCIS (Netherlands)

    Bouwens, J.F.M.G.; van Lent, L.A.G.M.


    We show that the improved effort of employees associated with incentive contracts depends on the properties of the performance measures used in the contract.We also find that the power of incentives in the contract is only indirectly related to any improved employee effort.High powered incentive

  14. Exploring the comparative cost-effectiveness of economic incentive and command-and-control instruments, and of renewable energy technologies in PM10 emission control: A case study of Lima-Callao, Peru (United States)

    Kroeger, Timm

    Much economic literature expounds the superior cost-effectiveness of economic incentive (EI) policies over command-and-control (CAC) ones, based on appealing theoretical arguments. However, one of the assumptions underlying much of this literature is that monitoring and enforcement (M&E) of policies are not only feasible, but essentially costless. In reality, M&E are never costless and sometimes infeasible, and, crucially, M&E requirements vary across policy types. Furthermore, in technical economic terms, cost-effectiveness is defined with respect to variable costs only; however, in choosing among policies, the objective generally is to identify that with the lowest total (variable plus fixed) cost per unit abatement, which in its own right may be termed cost-effective. The neglect of M&E and of fixed costs throws up the question of the validity of much of the policy advice that draws on the environmental economics literature for developing countries, where the institutional capacity for effective M&E often is strongly limited, and where creating this capacity will require considerable infrastructure investments. The limited institutional capacity also has led to the suggestion that in developing countries, conventional environmental policies, such as input or output taxes, emission charges, or standards, may be less cost-effective than non-conventional environmental policies, such as direct public provision of electricity from renewable sources, because the M&E capacity required for the implementation of non-conventional policies is often less stringent. I test the hypotheses of superior cost-effectiveness of EI over CAC and of non-conventional over conventional environmental policy instruments. The samples of pollution control policies used to test the hypotheses are drawn from a list of frequently recommended urban air pollution abatement measures for developing countries, plus two renewable energy sources. Both sets of environmental policy types are compared

  15. Cost-benefit of tax incentives and performance indicators: a case study in the company GRENDENE S/A

    Directory of Open Access Journals (Sweden)

    Josiane Marostica


    Full Text Available This study aimed to analyze the cost/benefit of tax incentives and performance indicators of Grendene S/A footwear company in the period of 2010 to 2014. The research is justified by the importance of companies seeking techniques and methodologies that are more advantageous corporately to achieve better performance. In this sense, the accounting is shown as an important tool, acting as a source of information for decision-making and wealth measurement of their investors. The methodology will be through case study in a company in the footwear sector, listed on the BM & FBovespa, with data in the periods of 2010 to 2014 available at the base of Economatica and the Financial Statements. Having the data has been identified, the modalities of tax incentives that the company benefited during the study, as well as the traditional performance indicators. To analyze the cost/benefit of tax incentives was used data from DVA and tax subsidies provided in the notes to DFPs. The results show that the company needs a constant and effective monitoring of the costs and benefits of tax waiver. Also identifies that the value of tax incentives received does not equal proportion the generation of net wealth. The results of this study confirm the theoretical basis that the benefits brought by tax incentives outnumber the costs of tax waiver, but may represent a dangerous dependence as to jeopardize the continuity of the company if they were removed.

  16. Cost-competitive incentives for wind energy development in China: institutional dynamics and policy changes

    International Nuclear Information System (INIS)

    Wenqiang Liu; Xiliang Zhang; Lin Gan


    This paper presents an overview of the development of wind power in China. The factors that affect the directions of wind power development are analyzed. It examines the economics of wind farm development and compares it with conventional energy sources. The major constraints in wind technology development, and defects of the current policies, are discussed. It points out that wind power development should be subject to rational policy change and institutional adjustment. It discusses the incentive mechanisms and institutional frameworks for future development. Particular importance is attributed to market incentives for wind power to reach the objectives of industrialization and commercialization. A number of cost-competitive incentive measures and policies are recommended: (i) introducing market based mechanisms through standard power purchase agreement; (ii) establishing effective investment policies and regulations to attract private investment; (iii) promoting localization of wind turbine production; (iv) adjusting tax and subsidy policies; and (v) reforming governmental institutions to make clear rules and responsibilities for policymaking, and enhancing communication/coordination between relevant government agencies in order to formulate uniform and effective policies. (Author)

  17. Private versus Public Feedback - The Incentive Effects of Symbolic Awards

    DEFF Research Database (Denmark)

    Gerhards, Leonie; Siemer, Neele

    We experimentally compare the incentive effects of rewarding individuals for outstanding performance publicly versus privately. We implement two real-effort tasks, which differ in how prestigious subjects perceive working on them. In both tasks private and public feedback similarly enhances...... experiment at a secondary school we furthermore compare the incentive effects of different forms of public recognition....

  18. Renewable Energy Cost Modeling: A Toolkit for Establishing Cost-Based Incentives in the United States; March 2010 -- March 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, J. S.; Grace, R. C.; Rickerson, W. H.


    This report is intended to serve as a resource for policymakers who wish to learn more about establishing cost-based incentives. The report will identify key renewable energy cost modeling options, highlight the policy implications of choosing one approach over the other, and present recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, feed-in tariffs (FITs), or similar policies. These recommendations will be utilized in designing the Cost of Renewable Energy Spreadsheet Tool (CREST). Three CREST models will be publicly available and capable of analyzing the cost of energy associated with solar, wind, and geothermal electricity generators. The CREST models will be developed for use by state policymakers, regulators, utilities, developers, and other stakeholders to assist them in current and future rate-setting processes for both FIT and other renewable energy incentive payment structures and policy analyses.

  19. The effects of the Employment Tax Incentive on South African employment


    Ebrahim, Amina; Leibbrandt, Murray; Ranchhod, Vimal


    South Africa's Employment Tax Incentive, launched in 2014, aimed to address low youth employment by reducing the cost of hiring young workers. We make use of anonymized tax administrative data from the 2012-2015 tax years to examine the effect of the Incentive on youth employment. We match firms claiming the subsidy with similar firms not claiming the subsidy and observe their hiring behaviour before and after the implementation of the policy. We find no statistically significant impact on yo...

  20. Irregular incentives

    International Nuclear Information System (INIS)

    Cicchetti, M.A.


    Public utility regulation lacks a formal proxy for the economic profits that can be earned in an effectively competitive market if a firm is efficient or innovative. After all, public utility regulation operated on cost-plus basis. If a utility is efficient or innovative and lowers its costs, its typical reward is to have its rates reduced. This is a perverse incentive to motivate a utility to produce at the most efficient level. In addition, since regulation operates on this cost-plus basis, a utility can increase its net income, all other things being equal, by overinvesting in (or open-quotes gold-platingclose quotes) its system, another perverse incentive. Recognizing these flaws of regulation, academicians, utility executives, regulators, and legislators have tried over the last several years to implement incentive regulation plans that correct such perverse incentives. However, under many of the earnings-sharing or price-regulation incentive plans, the rewards for efficient production are not tied directly to measures under a company's control. In fact, such plans could prove highly detrimental to ratepayers and competitors of the regulated company and its affiliates. An incentive regulation plan that ties an appropriate reward for efficient production to specific efficiency gains is a better proxy of an effectively competitive environment. What's more, it is superior to an incentive plan that rewards circumstances beyond the company's control or self-serving manipulation. This is particularly true if no earnings cap is associated with the reward for efficiency. Rewards for efficient production should be tied to specific actions. A suitable incentive plan does not preclude appropriately derived flexible prices for certain products or services where warranted

  1. Multifaceted intervention including education, rounding checklist implementation, cost feedback, and financial incentives reduces inpatient laboratory costs. (United States)

    Yarbrough, Peter M; Kukhareva, Polina V; Horton, Devin; Edholm, Karli; Kawamoto, Kensaku


    Inappropriate laboratory testing is a contributor to waste in healthcare. To evaluate the impact of a multifaceted laboratory reduction intervention on laboratory costs. A retrospective, controlled, interrupted time series (ITS) study. University of Utah Health Care, a 500-bed academic medical center in Salt Lake City, Utah. All patients 18 years or older admitted to the hospital to a service other than obstetrics, rehabilitation, or psychiatry. Multifaceted quality-improvement initiative in a hospitalist service including education, process change, cost feedback, and financial incentive. Primary outcomes of lab cost per day and per visit. Secondary outcomes of number of basic metabolic panel (BMP), comprehensive metabolic panel (CMP), complete blood count (CBC), and prothrombin time/international normalized ratio tests per day; length of stay (LOS); and 30-day readmissions. A total of 6310 hospitalist patient visits (intervention group) were compared to 25,586 nonhospitalist visits (control group). Among the intervention group, the unadjusted mean cost per day was reduced from $138 before the intervention to $123 after the intervention (P analysis showed significant reductions in cost per day, cost per visit, and the number of BMP, CMP, and CBC tests per day (P = 0.034, 0.02, <0.001, 0.004, and <0.001). LOS was unchanged and 30-day readmissions decreased in the intervention group. A multifaceted approach to laboratory reduction demonstrated a significant reduction in laboratory cost per day and per visit, as well as common tests per day at a major academic medical center. Journal of Hospital Medicine 2016;11:348-354. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  2. Cost Conscious: Incentive and Discount Programs Help Students Meet the Rising Cost of a Community College Education (United States)

    Ullman, Ellen


    Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…

  3. The effect of explicit financial incentives on physician behavior. (United States)

    Armour, B S; Pitts, M M; Maclean, R; Cangialose, C; Kishel, M; Imai, H; Etchason, J


    Managed care organizations use explicit financial incentives to influence physicians' use of resources. This has contributed to concerns regarding conflicts of interest for physicians and adverse effects on the quality of patient care. In light of recent publicized legislative and legal battles about this issue, we reviewed the literature and analyzed studies that examine the effect of these explicit financial incentives on the behavior of physicians. The method used to undertake the literature review followed the approach set forth in the Cochrane Collaboration handbook. Our literature review revealed a paucity of data on the effect of explicit financial incentives. Based on this limited evidence, explicit incentives that place individual physicians at financial risk appear to be effective in reducing physician resource use. However, the empirical evidence regarding the effectiveness of bonus payments on physician resource use is mixed. Similarly, our review revealed mixed effects of the influence of explicit financial incentives on the quality of patient care. The effect of explicit financial incentives on physician behavior is complicated by a lack of understanding of the incentive structure by the managed care organization and the physician. The lack of a universally acceptable definition of quality renders it important that future researchers identify the term explicitly.

  4. Social cost-efficient service quality-Integrating customer valuation in incentive regulation: Evidence from the case of Norway

    International Nuclear Information System (INIS)

    Growitsch, Christian; Jamasb, Tooraj; Mueller, Christine; Wissner, Matthias


    In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities.

  5. Social cost-efficient service quality. Integrating customer valuation in incentive regulation. Evidence from the case of Norway

    Energy Technology Data Exchange (ETDEWEB)

    Growitsch, Christian; Mueller, Christine; Wissner, Matthias [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany); Jamasb, Tooraj [University of Cambridge, Faculty of Economics (United Kingdom)


    In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities. (author)

  6. Social cost-efficient service quality-Integrating customer valuation in incentive regulation: Evidence from the case of Norway

    Energy Technology Data Exchange (ETDEWEB)

    Growitsch, Christian, E-mail: c.growitsch@wik.or [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany); Jamasb, Tooraj [University of Cambridge, Faculty of Economics (United Kingdom); Mueller, Christine; Wissner, Matthias [WIK, Department Energy Markets and Energy Regulation, Rhoendorfer Str. 68, 53604 Bad Honnef (Germany)


    In order to overcome the perverse incentives of excessive maintenance reductions and insufficient network investments arising with incentive regulation of electricity distribution companies, regulators throughout Europe have started regulating service quality. In this paper, we explore the impact of incorporating customers' willingness-to-pay for service quality in benchmarking models on cost efficiency of distribution networks. Therefore, we examine the case of Norway, which features this approach to service quality regulation. We use the data envelopment analysis technique to analyse the effectiveness of such regulatory instruments. Moreover, we discuss the extent to which this indirect regulatory instrument motivates a socially desired service quality level. The results indicate that internalising external or social cost of service quality does not seem to have played an important role in improving cost efficiency in Norwegian distribution utilities.

  7. Win some, lose some: parental hypertension and heart rate change in an incentive versus response cost paradigm. (United States)

    Hastrup, J L; Johnson, C A; Hotchkiss, A P; Kraemer, D L


    Fowles (1983), citing evidence from separate studies, suggests that both incentive and response cost paradigms increase heart rate and should be subsumed under Gray's (1975) 'appetitive motivational system'. Shock avoidance and loss of reward (response cost) contingencies, while aversive, appear to evoke this motivational system; consequently both should elicit heart rate increases independent of anxiety. The present investigation compared magnitude of heart rate changes observed under conditions of winning and losing money. Results showed: no differences between incentive and response cost conditions; no effect of state anxiety on heart rate in these conditions, despite an elevation of state anxiety on the task day relative to a subsequent relaxation day assessment; and some evidence for the presence under both such appetitive conditions of cardiovascular hyperresponsivity among offspring of hypertensive parents. The results suggest a need for systematic parametric studies of experimental conditions.

  8. Effectiveness of UK provider financial incentives on quality of care: a systematic review. (United States)

    Mandavia, Rishi; Mehta, Nishchay; Schilder, Anne; Mossialos, Elias


    Provider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency. To review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care. Systematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. MEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as 'positive', those that were 'intermediate' showed improvement in some measures, and those classified as 'negative' showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist. Of the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points. The effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives - if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK. © British Journal of General Practice 2017.

  9. Risk, Incentives and Coordination Costs in Agro-Food Chains in the Presence of Futures Markets

    NARCIS (Netherlands)

    Kuwornu, J.K.M.


    This thesis focuses on developing conceptual models to examine the role of futures markets for risk-shifting, incentives and coordination costs in the context of commodity marketing channels. The empirical analysis is conducted for different marketing channel structures (two-stage and three-stage

  10. How effective are energy-efficiency incentive programs? Evidence from Italian homeowners

    International Nuclear Information System (INIS)

    Alberini, Anna; Bigano, Andrea


    We evaluate incentives for residential energy upgrades in Italy using data from an original survey of Italian homeowners. In this paper, attention is restricted to heating system replacements, and to the effect of monetary and non-monetary incentives on the propensity to replace the heating equipment with a more efficient one. To get around adverse selection and free riding issues, we ask stated preference questions to those who weren't planning energy efficiency upgrades any time soon. We argue that these persons are not affected by these behaviors. We use their responses to fit an energy-efficiency renovations curve that predicts the share of the population that will undertake these improvements for any given incentive level. This curve is used to estimate the CO_2 emissions saved and their cost-effectiveness. Respondents are more likely to agree to a replacement when the savings on the energy bills are larger and experienced over a longer horizon, and when rebates are offered to them. Reminding the respondents about possible CO_2 emissions reductions (our non-monetary incentive) had little effect. Even under optimistic assumptions, monetary incentives similar to those in the Italian tax credit program are generally not cost-effective.

  11. From Non-market Support to Cost-Competitive Incentives. Wind Energy Commercialization in China

    Energy Technology Data Exchange (ETDEWEB)

    Wenqiang, Liu; Xiliang, Zhang; Shuhua, Gu; Gan, Lin


    This paper presents an overview of the development of wind energy in China. By examining the economics of windfarm development, it compares the economics of wind technology with other conventional energy technologies and analyzes the role of alternative policy instruments. Meanwhile, it identifies the major constraints of wind technology development and the defects of current non-market support from the government. It shows that the development of wind power will be directly subject to rational policy change, incentive mechanisms and institutional framework building. Particular importance is paid to market incentives to reach the objectives of commercialization and industrialization of wind power. The paper recommends some cost-competitive incentive measure and policies to drive the wind power market. It concludes that promising market incentives to speed up the development of wind energy include: (i) establish market competition mechanisms through standard power purchase agreement; (ii) adjust tax policies and government subsidies; (iii) stimulate investment incentive policies and regulations; and (iv) change governmental institutions and management modes. (author)

  12. Pharmaceutical policies: effects of financial incentives for prescribers. (United States)

    Rashidian, Arash; Omidvari, Amir-Houshang; Vali, Yasaman; Sturm, Heidrun; Oxman, Andrew D


    The proportion of total healthcare expenditures spent on drugs has continued to grow in countries of all income categories. Policy-makers are under pressure to control pharmaceutical expenditures without adversely affecting quality of care. Financial incentives seeking to influence prescribers' behaviour include budgetary arrangements at primary care and hospital settings (pharmaceutical budget caps or targets), financial rewards for target behaviours or outcomes (pay for performance interventions) and reduced benefit margin for prescribers based on medicine sales and prescriptions (pharmaceutical reimbursement rate reduction policies). This is the first update of the original version of this review. To determine the effects of pharmaceutical policies using financial incentives to influence prescribers' practices on drug use, healthcare utilisation, health outcomes and costs (expenditures). We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (searched 29/01/2015); MEDLINE, Ovid SP (searched 29/01/2015); EMBASE, Ovid SP (searched 29/01/2015); International Network for Rational Use of Drugs (INRUD) Bibliography (searched 29/01/2015); National Health Service (NHS) Economic Evaluation Database (searched 29/01/2015); EconLit - ProQuest (searched 02/02/2015); and Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Knowledge (citation search for included studies searched 10/02/2015). We screened the reference lists of relevant reports and contacted study authors and organisations to identify additional studies. We included policies that intend to affect prescribing by means of financial incentives for prescribers. Included in this category are pharmaceutical budget caps or targets, pay for performance and drug reimbursement rate reductions and other financial policies, if they were specifically targeted at prescribing or drug utilisation. Policies in this review were defined as laws, rules

  13. Is Historical Cost Accounting a Panacea? Market Stress, Incentive Distortions, and Gains Trading


    Ellul, Andrew; Jotikasthira, Chotibhak; Lundblad, Christian T; Wang, Yihui


    This paper explores the trading incentives of financial institutions induced by the interaction between regulatory accounting rules and capital requirements by investigating insurance companies’ trading behavior during the recent financial crisis. According to insurance regulation, life insurers have a greater degree of flexibility to hold downgraded instruments at historical cost, whereas property and casualty insurers are forced to re-mark many of their downgraded securities to market price...

  14. Wage structure and the incentive effects of promotions

    NARCIS (Netherlands)

    van Herpen, M.; Cools, C.; van Praag, M.


    This paper studies wage structure characteristics and their incentive effects within one firm. Based on personnel records and an employee survey, we provide evidence that wages are attached to jobs and that promotions play a dominant role as a wage determinant. We furthermore show that a promotion

  15. Wage structure and the incentive effect of promotions

    NARCIS (Netherlands)

    van Herpen, M.; Cools, K.; van Praag, C.M.


    This paper studies wage structure characteristics and their consequent incentive effects empirically. Based on personnel records and an employee survey, we provide evidence that wages are attached to jobs and that promotions play a dominant role as a wage determinant. Our findings indicate

  16. The Effects of Incentives in Acquisition Competition on Program Outcomes (United States)


    organizational, management, and cultural issues (Madachy, EFFECTS OF INCENTIVES IN ACQUISITION COMPETITION 5 2008, Frangos , 1998). In the SEI’s direct...change from the task force on defense acquisition law and oversight Forrester, J. W. (1971). Principles of systems. Pegasus Communications. Frangos , S

  17. Dynamic Incentive Effects of Relative Performance Pay: A Field Experiment

    NARCIS (Netherlands)

    J. Delfgaauw (Josse); A.J. Dur (Robert); J.A. Non (Arjan); W.J.M.I. Verbeke (Willem)


    textabstractWe conduct a field experiment among 189 stores of a retail chain to study dynamic incentive effects of relative performance pay. Employees in the randomly selected treatment stores could win a bonus by outperforming three comparable stores from the control group over the course of four

  18. Using a Mnemonic to Develop Effective Incentive Systems (United States)

    Forbringer, Linda L.


    Special educators frequently provide consultation for parents and general education teachers who are struggling to manage student behavior. One intervention often discussed is the use of rewards to increase student motivation. While research has shown that well-designed incentive systems can provide an effective intervention, poorly designed…

  19. The Effects of Financial Incentives on Retirement Decisions:

    DEFF Research Database (Denmark)

    Søgaard, Jakob Egholt; Anton Schultz, Esben; Schaarup, Jonas Zielke


    We exploit a temporary tax rebate introduced in Denmark in 2008 to estimate the effect of financial incentives on retirement decisions. The scheme offered individuals in a limited number of cohorts a tax rebate of up to 100,000 DKK (approximately $20,000) if they stayed on the labor market until...

  20. Evaluation of fixed and variable hospital costs due to Clostridium difficile infection: institutional incentives and directions for future research. (United States)

    Ryan, P; Skally, M; Duffy, F; Farrelly, M; Gaughan, L; Flood, P; McFadden, E; Fitzpatrick, F


    Economic analysis of Clostridium difficile infection (CDI) should consider the incentives facing institutional decision-makers. To avoid overstating the financial benefits of infection prevention, fixed and variable costs should be distinguished. To quantify CDI fixed and variable costs in a tertiary referral hospital during August 2015. A micro-costing analysis estimated CDI costs per patient, including the additional costs of a CDI outbreak. Resource use was quantified after review of patient charts, pharmacy data, administrative resource input, and records of salary and cleaning/decontamination expenditure. The incremental cost of CDI was €75,680 (mean: €5,820 per patient) with key cost drivers being cleaning, pharmaceuticals, and length of stay (LOS). Additional LOS ranged from 1.75 to 22.55 days. For seven patients involved in a CDI outbreak, excluding the value of the 58 lost bed-days (€34,585); costs were 30% higher (€7,589 per patient). Therefore, total spending on CDI was €88,062 (mean: €6,773 across all patients). Potential savings from variable costs were €1,026 (17%) or €1,768 (26%) if outbreak costs were included. Investment in an antimicrobial pharmacist would require 47 CDI cases to be prevented annually. Prevention of 5%, 10% and 20% CDI would reduce attributable costs by €4,403, €8,806 and €17,612. Increasing the incremental LOS attributable to CDI to seven days per patient would have increased costs to €7,478 or €8,431 (if outbreak costs were included). As much CDI costs are fixed, potential savings from infection prevention are limited. Future analysis must consider more effectively this distinction and its impact on institutional decision-making. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Incentive motivation deficits in schizophrenia reflect effort computation impairments during cost-benefit decision-making. (United States)

    Fervaha, Gagan; Graff-Guerrero, Ariel; Zakzanis, Konstantine K; Foussias, George; Agid, Ofer; Remington, Gary


    Motivational impairments are a core feature of schizophrenia and although there are numerous reports studying this feature using clinical rating scales, objective behavioural assessments are lacking. Here, we use a translational paradigm to measure incentive motivation in individuals with schizophrenia. Sixteen stable outpatients with schizophrenia and sixteen matched healthy controls completed a modified version of the Effort Expenditure for Rewards Task that accounts for differences in motoric ability. Briefly, subjects were presented with a series of trials where they may choose to expend a greater amount of effort for a larger monetary reward versus less effort for a smaller reward. Additionally, the probability of receiving money for a given trial was varied at 12%, 50% and 88%. Clinical and other reward-related variables were also evaluated. Patients opted to expend greater effort significantly less than controls for trials of high, but uncertain (i.e. 50% and 88% probability) incentive value, which was related to amotivation and neurocognitive deficits. Other abnormalities were also noted but were related to different clinical variables such as impulsivity (low reward and 12% probability). These motivational deficits were not due to group differences in reward learning, reward valuation or hedonic capacity. Our findings offer novel support for incentive motivation deficits in schizophrenia. Clinical amotivation is associated with impairments in the computation of effort during cost-benefit decision-making. This objective translational paradigm may guide future investigations of the neural circuitry underlying these motivational impairments. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. The Lure of Authority: Motivation and Incentive Effects of Power


    Fehr, Ernst; Herz, Holger; Wilkening, Tom


    Authority and power permeate political, social, and economic life, but empirical knowledge about the motivational origins and consequences of authority is limited. We study the motivation and incentive effects of authority experimentally in an authority delegation game. Individuals often retain authority even when its delegation is in their material interest—suggesting that authority has nonpecuniary consequences for utility. Authority also leads to over provision of effort by the controlling...

  3. An analysis of the impacts of economic incentive programs on commercial nuclear power plant operations and maintenance costs

    International Nuclear Information System (INIS)

    Kavanaugh, D.C.; Monroe, W.H.; Wood, R.S.


    Operations and Maintenance (O and M) expenditures by nuclear power plant owner/operators possess a very logical and vital link in considerations relating to plant safety and reliability. Since the determinants of O and M outlays are considerable and varied, the potential linkages to plant safety, both directly and indirectly, can likewise be substantial. One significant issue before the US Nuclear Regulatory Commission is the impact, if any, on O and M spending from state programs that attempt to improve plant operating performance, and how and to what extent these programs may affect plant safety and pose public health risks. The purpose of this study is to examine the role and degree of impacts from state promulgated economic incentive programs (EIPs) on plant O and M spending. A multivariate regression framework is specified, and the model is estimated on industry data over a five-year period, 1986--1990. Explanatory variables for the O and M spending model include plant characteristics, regulatory effects, financial strength factors, replacement power costs, and the performance incentive programs. EIPs are found to have statistically significant effects on plant O and M outlays, albeit small in relation to other factors. Moreover, the results indicate that the relatively financially weaker firms are more sensitive in their O and M spending to the presence of such programs. Formulations for linking spending behavior and EIPs with plant safety performance remains for future analysis

  4. Social and cultural drivers of incentive effectiveness in infrastructure projects

    NARCIS (Netherlands)

    Rose, T.M.; Volker, L.


    Formal incentives systems aim to encourage improved performance by offering a reward for the achievement of project-specific goals. Despite argued benefits of incentive systems on project delivery outcomes, there remains debate over how incentive systems can be designed to encourage the formation of

  5. Effect of incentives on the financial attractiveness of solar industrial process heating in India★

    Directory of Open Access Journals (Sweden)

    Sharma Ashish K.


    Full Text Available India has a huge industrial demand for process heating at temperatures that can be provided with commercially available solar collectors. Government of India with support from multi-lateral agencies has initiated an ambitious programme for promoting large scale adoption of Solar Industrial Process Heating (SIPH in the industrial sector of the country. This paper presents the details of an attempt to study the effect of several existing and potential incentives on the financial attractiveness of SIPH systems in India. A case of solar process heating in dairy industry has been presented to demonstrate the relative efficacy of different incentives on the economics of SIPH systems in terms of their impact on levelized cost of useful thermal energy delivered. Finally, policy implications of the results obtained have been discussed.

  6. Design of effective interventions for smoking cessation through financial and non-financial incentives. (United States)

    Balderrama, Fanor; Longo, Christopher J


    Smoking has a tremendous negative impact on the Canadian economy and contributes to growing costs in the healthcare system. Efforts to reduce smoking rates may therefore reduce strain on the healthcare system and free up scarce resources. Academic literature on economic smoking cessation incentives presents a countless variety of interventions that have met with varying degrees of success. This study reviews six different variables used in the design of incentives in smoking cessation interventions: direction, form, magnitude, certainty, recipient grouping, and target demographic. The purpose of this study is to provide analysis and recommendations about the contribution of each variable into the overall effectiveness of smoking cessation programs and help health leaders design better interventions according to their specific needs.

  7. Influential Effects of Intrinsic-Extrinsic Incentive Factors on Management Performance in New Energy Enterprises. (United States)

    Wang, Ping; Lu, Zhengnan; Sun, Jihong


    Background : New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The increase in job performance relies on, to a certain extent, incentive mechanism. Based on the Two-factor Theory, differences in influences and effects of different incentives on management performance have been checked in this paper from an empirical perspective. Methods : This paper selects the middle and low level managers in new energy enterprises as research samples and classifies the managers' performance into task performance, contextual performance and innovation performance. It uses manager performance questionnaires and intrinsic-extrinsic incentive factor questionnaires to investigate and study the effects and then uses Amos software to analyze the inner link between the intrinsic-extrinsic incentives and job performance. Results : Extrinsic incentives affect task performance and innovation performance positively. Intrinsic incentives impose active significant effects on task performance, contextual performance, and innovation performance. The intrinsic incentive plays a more important role than the extrinsic incentive. Conclusions : Both the intrinsic-extrinsic incentives affect manager performance positively and the intrinsic incentive plays a more important role than the extrinsic incentive. Several suggestions to management should be given based on these results.

  8. Influential Effects of Intrinsic-Extrinsic Incentive Factors on Management Performance in New Energy Enterprises

    Directory of Open Access Journals (Sweden)

    Ping Wang


    Full Text Available Background: New energy has become a key trend for global energy industry development. Talent plays a very critical role in the enhancement of new energy enterprise competitiveness. As a key component of talent, managers have been attracting more and more attention. The increase in job performance relies on, to a certain extent, incentive mechanism. Based on the Two-factor Theory, differences in influences and effects of different incentives on management performance have been checked in this paper from an empirical perspective. Methods: This paper selects the middle and low level managers in new energy enterprises as research samples and classifies the managers’ performance into task performance, contextual performance and innovation performance. It uses manager performance questionnaires and intrinsic-extrinsic incentive factor questionnaires to investigate and study the effects and then uses Amos software to analyze the inner link between the intrinsic-extrinsic incentives and job performance. Results: Extrinsic incentives affect task performance and innovation performance positively. Intrinsic incentives impose active significant effects on task performance, contextual performance, and innovation performance. The intrinsic incentive plays a more important role than the extrinsic incentive. Conclusions: Both the intrinsic-extrinsic incentives affect manager performance positively and the intrinsic incentive plays a more important role than the extrinsic incentive. Several suggestions to management should be given based on these results.

  9. Incentive mechanism based on cooperative advertising for cost information sharing in a supply chain with competing retailers (United States)

    Setak, Mostafa; Kafshian Ahar, Hajar; Alaei, Saeed


    This paper proposes a new motivation for information sharing in a decentralized channel consisting of a single manufacturer and two competing retailers. The manufacturer provides a common product to the retailers at the same wholesale price. Both retailers add their own values to the product and distribute it to consumers. Factors such as retail prices, values added to the product, and local advertising of the retailers simultaneously have effect on market demand. Each retailer has full information about the own added value which is unknown to the manufacturer and other retailer. The manufacturer uses a cooperative advertising program for motivating the retailers to disclose their private information. A numerical study is presented to compare different scenarios of information sharing. Computational results show that there is a condition in which full information sharing is beneficial for all members of the supply chain through cooperative advertising program and, therefore, retailers have enough incentive to disclose their cost information to the manufacturer.

  10. The effect of financial incentives on the quality of health care provided by primary care physicians. (United States)

    Scott, Anthony; Sivey, Peter; Ait Ouakrim, Driss; Willenberg, Lisa; Naccarella, Lucio; Furler, John; Young, Doris


    The use of blended payment schemes in primary care, including the use of financial incentives to directly reward 'performance' and 'quality' is increasing in a number of countries. There are many examples in the US, and the Quality and Outcomes Framework (QoF) for general practitioners (GPs) in the UK is an example of a major system-wide reform. Despite the popularity of these schemes, there is currently little rigorous evidence of their success in improving the quality of primary health care, or of whether such an approach is cost-effective relative to other ways to improve the quality of care. The aim of this review is to examine the effect of changes in the method and level of payment on the quality of care provided by primary care physicians (PCPs) and to identify:i) the different types of financial incentives that have improved quality;ii) the characteristics of patient populations for whom quality of care has been improved by financial incentives; andiii) the characteristics of PCPs who have responded to financial incentives. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) and Cochrane Database of Systematic Reviews (CDSR) (The Cochrane Library), MEDLINE, HealthSTAR, EMBASE, CINAHL, PsychLIT, and ECONLIT. Searches of Internet-based economics and health economics working paper collections were also conducted. Finally, studies were identified through the reference lists of retrieved articles, websites of key organisations, and from direct contact with key authors in the field. Articles were included if they were published from 2000 to August 2009. Randomised controlled trials (RCT), controlled before and after studies (CBA), and interrupted time series analyses (ITS) evaluating the impact of different financial interventions on the quality of care delivered by primary healthcare physicians (PCPs). Quality of care was defined as patient reported outcome

  11. Designing effective incentives for energy conservation in the public sector (United States)

    Drezner, Jeffrey Alan

    Understanding why government officials behave in certain ways under particular circumstances is an important theme in political science. This research explores the design of policies and incentives targeted at public sector officials, in particular the use of market based policy tools in a non-market environment, and the influence of that organizational environment on the effectiveness of the policy. The research examines the case of Department of Defense (DoD) facility energy management. DoD energy policy includes a provision for the retention of savings generated by conservation activities: two-thirds of the savings is retained at the installation generating the savings, half to used for further investment in energy conservation, and half to be used for general morale, welfare, and recreation activities. This policy creates a financial incentive for installation energy managers to establish higher quality and more active conservation programs. A formal written survey of installation energy managers within DoD was conducted, providing data to test hypotheses regarding policy effectiveness and factors affecting policy implementation. Additionally, two detailed implementation case studies were conducted in order to gain further insights. Results suggest that policy design needs to account for the environment within which the policy will be implemented, particularly organizational culture and standard operating procedures. The retention of savings policy failed to achieve its intended outcome---retention of savings for re-investment in energy conservation---because the role required of the financial management community was outside its normal mode of operation and interests and the budget process for allocating resources did not include a mechanism for retention of savings. The policy design did not adequately address these start-up barriers to implementation. This analysis has shown that in order for retention of savings, or similar policies based on market

  12. Do managerial incentives drive cost behavior? Evidence about the role of the zero earnings benchmark for labor cost behavior in Belgian private firms

    NARCIS (Netherlands)

    Dierynck, B.; Landsman, W.R.; Renders, A.


    This study investigates the influence of managerial incentives to meet or beat the zero earnings benchmark on labor cost behavior of private Belgian firms. We posit that relative to managers of firms reporting healthy profits, managers meeting or beating the zero earnings benchmark will increase

  13. To mitigate or not to mitigate: Regulatory treatment of emissions trading and its effect on marketplace incentives

    International Nuclear Information System (INIS)

    McDermott, K.A.


    The Clean Air Act Amendments of 1990 (hereafter CAAA) have created a market-based mechanism that is designed to employ a profit-oriented incentive to enable electric utilities to reduce SO 2 emissions at the least cost. One of the most important challenges facing state regulatory utility commissions in the next decade is the integration of this marker-based profit-incentive process into the traditional rate-base, rate-of-return, profit-control approach to regulation. How the struggle to meld two potentially contradictory control and incentive programs will be resolved remains to be seen. As of now, it is an open question. The purpose of this paper is to help clarify some of the issues that need to be addressed and to offer some policy recommendations that will allow regulators to employ the effectiveness of market forces while they still retain overall control of the evolution of the regulated electric supply market

  14. Effects of Mental Fatigue on Physical Endurance Performance and Muscle Activation Are Attenuated by Monetary Incentives. (United States)

    Brown, Denver M Y; Bray, Steven R


    Physical performance is impaired following cognitive control exertion. Incentives can ameliorate adverse carryover effects of cognitive control exertion but have not been investigated for physical endurance. This study examined the effect of monetary incentives on physical performance and muscle activation following exposure to a mentally fatiguing, cognitive control task. Participants (N = 82) performed two isometric endurance handgrip trials separated by a 12-min cognitive control manipulation using a 2 (high cognitive control [HCC]/low cognitive control [LCC]) × 2 (incentive/no incentive) design. Mental fatigue was significantly higher in the HCC conditions. Performance decreased in the HCC/no incentive condition but was unaffected in the HCC/incentive condition, which did not differ from the low cognitive control conditions. Electromyography data revealed increased muscle activation in the HCC/no incentive condition, which was also attenuated in the HCC/incentive condition. Findings show that incentives counteract the negative effects of HCC on physical endurance and alter central drive to motor units.

  15. Competitive investments in cost reducing process improvement : The role of managerial incentives and spillover learning

    NARCIS (Netherlands)

    Veldman, Jasper; Gaalman, Gerard J.c.


    We study the rivalry between two firms and consider the effect of spillovers when the firms' operations and technology managers are given bonuses for cost reduction. We model a game in which the firm owners independently offer their manager a bonus to stimulate cost reducing process improvement

  16. Performance Incentives Within Firms: The Effect of Managerial Responsibility


    Rajesh K. Aggarwal; Andrew A. Samwick


    Empirical research on executive compensation has focused almost exclusively on the incentives provided to chief executive officers. However, firms are run by teams of managers, and a theory of the firm should also explain the distribution of incentives and responsibilities for other members of the top management team. An extension of the standard principal-agent model to allow for multiple signals of effort predicts that executives who have other, more precise signals of their effort than fir...

  17. Neural effects of positive and negative incentives during marijuana withdrawal.

    Directory of Open Access Journals (Sweden)

    Francesca M Filbey

    Full Text Available In spite of evidence suggesting two possible mechanisms related to drug-seeking behavior, namely reward-seeking and harm avoidance, much of the addiction literature has focused largely on positive incentivization mechanisms associated with addiction. In this study, we examined the contributing neural mechanisms of avoidance of an aversive state to drug-seeking behavior during marijuana withdrawal. To that end, marijuana users were scanned while performing the monetary incentive delay task in order to assess positive and negative incentive processes. The results showed a group x incentive interaction, such that marijuana users had greater response in areas that underlie reward processes during positive incentives while controls showed greater response in the same areas, but to negative incentives. Furthermore, a negative correlation between withdrawal symptoms and response in the amygdala during negative incentives was found in the marijuana users. These findings suggest that although marijuana users have greater reward sensitivity and less harm avoidance than controls, that attenuated amygdala response, an area that underlies fear and avoidance, was present in marijuana users with greater marijuana withdrawal symptoms. This is concordant with models of drug addiction that involve multiple sources of reinforcement in substance use disorders, and suggests the importance of strategies that focus on respective mechanisms.

  18. Rewarding Multitasking: Negative Effects of an Incentive on Problem Solving under Divided Attention (United States)

    Wieth, Mareike B.; Burns, Bruce D.


    Research has consistently shown negative effects of multitasking on tasks such as problem solving. This study was designed to investigate the impact of an incentive when solving problems in a multitasking situation. Incentives have generally been shown to increase problem solving (e.g., Wieth & Burns, 2006), however, it is unclear whether an…

  19. Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)

    Gouchoe, S.; Everette, V.; Haynes, R.


    The North Carolina Solar Center at NC State University, in collaboration with the National Renewable Energy Laboratory, examined 10 state financial-incentive programs in six states using a case-study approach in order to clarify the key factors-both internal and external to the program-that influence their effectiveness at stimulating deployment of renewable energy technologies. While existing information resources such as the National Database of State Incentives for Renewable Energy (DSIRE, have documented what incentive programs are available, the effectiveness of such programs is not well understood. Understanding the impact of current financial incentives on the deployment of renewables and the factors that influence their effectiveness is critical to a variety of stakeholders, particularly in states considering new incentives or interested in improving or discarding existing ones.

  20. The Effect of Family Size on Incentive Effects of Welfare Transfers in Two-Parent Families (United States)

    Lewin, Alisa C.; Maurin, Eric


    Family size is an important determinant of family well-being, and it is a good predictor of poverty. This study examines effects of waiving the 100-hour rule, by family size, and distinguishes between the "work-incentive effects" and the "eligibility effects" of the waiver. The 100-hour rule limits eligibility to aid to…

  1. Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness? (United States)

    Fleck, Leonard M


    Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

  2. Increasing Educator Effectiveness: Lessons Learned from Teacher Incentive Fund Sites (United States)

    Eckert, Jonathan


    Created by the U.S. Congress in 2006, the Teacher Incentive Fund (TIF) represents the first federal initiative targeted directly at state and district efforts to introduce performance measures into educator compensation. TIF responds to a growing body of evidence that existing pay structures do not respond to labor force realities or adequately…

  3. Effects of Social Incentives on Task Performance in the Elderly (United States)

    Levendusky, Philip G.


    The performance of 60 elderly volunteers on two cancellation tasks was examined under one of three experimental conditions: social praise, social reproof, or no comment. The clear implications from these data are that social incentives may well facilitate behavioral change in the aged. (Author)

  4. A systematic review of financial incentives for physical activity: The effects on physical activity and related outcomes


    Barte, J.C.M.; Wendel-Vos, G.C.W.


    The aim of this review is to give an overview of the available evidence on the effects of financial incentives to stimulate physical activity. Therefore, a systematic literature search was performed for randomized trials that investigate the effects of physical-activity-related financial incentives for individuals. Twelve studies with unconditional incentives (eg, free membership sport facility) and conditional incentives (ie, rewards for reaching physical-activity goals) related to physical ...

  5. Reading Incentives that Work: No-Cost Strategies to Motivate Kids to Read and Love It! (United States)

    Small, Ruth V.


    In education, it is possible to find dozens of examples of "forced" reading incentive programs that categorize student reading levels, provide limited reading lists coordinated with those reading levels, assess student reading through computer-based tests, and award tangible prizes when they pass the test. Those who perform best get the most…

  6. The effect of financial incentives on adherence to antipsychotic depot medication: does it change over time? (United States)

    Pavlickova, Hana; Bremner, Stephen A; Priebe, Stefan


    A recent cluster-randomized controlled trial found that offering financial incentives improves adherence to long-acting injectable antipsychotics (LAIs). The present study investigates whether the impact of incentives diminishes over time and whether the improvement in adherence is linked to the amount of incentives offered. Seventy-three teams with 141 patients with psychotic disorders (using ICD-10) were randomized to the intervention or control group. Over 1 year, patients in the intervention group received £15 (US $23) for each LAI, while control patients received treatment as usual. Adherence levels, ie, the percentage of prescribed LAIs that were received, were calculated for quarterly intervals. The amount of incentives offered was calculated from the treatment cycle at baseline. Multilevel models were used to examine the time course of the effect of incentives and the effect of the amount of incentives offered on adherence. Adherence increased in both the intervention and the control group over time by an average of 4.2% per quarterly interval (95% CI, 2.8%-5.6%; P time and treatment group. Further, a higher total amount of incentives was associated with poorer adherence (βbootstrapped = -0.11; 95% CIbootstrapped, -0.20 to -0.01; P = .023). A substantial effect of financial incentives on adherence to LAIs occurs within the first 3 months of the intervention and is sustained over 1 year. A higher total amount of incentives does not increase the effect. identifier: ISRCTN77769281 and identifier: 7033. © Copyright 2015 Physicians Postgraduate Press, Inc.

  7. Accounting Conservatism and Managerial Incentives


    Young K. Kwon


    There are two sources of agency costs under moral hazard: (1) distortions in incentive contracts and (2) implementation of suboptimal decisions. In the accounting literature, the relation between conservative accounting and agency costs of type (1) has received considerable attention (cf. Watts 2002). However, little appears to be known about the effects of accounting conservatism on agency costs of type (2) or trade-offs between agency costs of types (1) and (2). The purpose of this study is...

  8. Investment Incentives and Effective Tax Rates in the Philippines; A Comparison With Neighboring Countries


    Alexander D Klemm; Dennis P Botman; Reza Baqir


    We compare the general tax provisions and investment incentives in the Philippines to six other east-Asian economies-Malaysia, Indonesia, Lao, Vietnam, Cambodia, and Thailand. We calculate effective tax rates and find that general effective tax rates are relatively high in the Philippines, while investment incentives are comparable to those in neighboring countries. Tax holidays are most attractive for very profitable firms, creating redundancy, and for investment in short-lived assets. We al...

  9. Acquisition War-Gaming Technique for Acquiring Future Complex Systems: Modeling and Simulation Results for Cost Plus Incentive Fee Contract

    Directory of Open Access Journals (Sweden)

    Tien M. Nguyen


    Full Text Available This paper provides a high-level discussion and propositions of frameworks and models for acquisition strategy of complex systems. In particular, it presents an innovative system engineering approach to model the Department of Defense (DoD acquisition process and offers several optimization modules including simulation models using game theory and war-gaming concepts. Our frameworks employ Advanced Game-based Mathematical Framework (AGMF and Unified Game-based Acquisition Framework (UGAF, and related advanced simulation and mathematical models that include a set of War-Gaming Engines (WGEs implemented in MATLAB statistical optimization models. WGEs are defined as a set of algorithms, characterizing the Program and Technical Baseline (PTB, technology enablers, architectural solutions, contract type, contract parameters and associated incentives, and industry bidding position. As a proof of concept, Aerospace, in collaboration with the North Carolina State University (NCSU and University of Hawaii (UH, successfully applied and extended the proposed frameworks and decision models to determine the optimum contract parameters and incentives for a Cost Plus Incentive Fee (CPIF contract. As a result, we can suggest a set of acquisition strategies that ensure the optimization of the PTB.

  10. Research on the Effectively Building Patterns of Talent Incentive and Cultural Atmosphere for Modern Enterprise Management

    Institute of Scientific and Technical Information of China (English)

    Zhang Penghui[1


    In this paper, we conduct research on the effectively building patterns of talent incentive and cultural atmosphere for modern enterprise management. Targeted incentive direction refers to the motivation, namely, to what kind of content to implement incentive. It has signifi cant effect on incentive effect. According to American psychologist Maslow’s hierarchy of needs theory, people’s behavior motives originated in fi ve kinds of need, namely: the physiological needs, security needs, belonging needs, respect for the needs and the self-actualization needs. People need not set in stone, which is a developing process from low to high, but the process is not a cascade of discontinuous jumping, but a continuous, the evolution of wave. Under this general basis, we propose the cultural atmosphere for modern enterprise management that is novel and innovative.

  11. Performance-based financial incentives for diabetes care: an effective strategy? (United States)

    Latham, Lesley P; Marshall, Emily Gard


    The use of financial incentives provided to primary care physicians who achieve target management or clinical outcomes has been advocated to support the fulfillment of care recommendations for patients with diabetes. This article explores the characteristics of incentive models implemented in the context of universal healthcare systems in the United Kingdom, Australia, Taiwan and Canada; the extent to which these interventions have been successful in improving diabetes outcomes; and the key challenges and concerns around implementing incentive models. Research in the effect of incentives in the United Kingdom demonstrates some improvements in process outcomes and achievement of cholesterol, blood pressure and glycated hemoglobin (A1C) targets. Evidence of the efficacy of programs implemented outside of the United Kingdom is very limited but suggests that physicians participating in these enhanced billing incentive programs were already completing the guideline-recommended care prior to the introduction of the incentive. A shift to pay-for-performance programs may have important implications for professionalism and patient-centred care. In the absence of definitive evidence that financial incentives drive the quality of diabetes management at the level of primary care, policy makers should proceed with caution. It is important to look beyond simply modifying physicians' behaviours and address the factors and systemic barriers that make it challenging for patients and physicians to manage diabetes in partnership. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  12. The Incentive Effect of Scores: Randomized Evidence from Credit Committees


    Daniel Paravisini; Antoinette Schoar


    We design a randomized controlled trial to evaluate the adoption of credit scoring with a bank that uses soft information in small businesses lending. We find that credit scores improve the productivity of credit committees, reduce managerial involvement in the loan approval process, and increase the profitability of lending. Credit committee members' effort and output also increase when they anticipate the score becoming available, indicating that scores improve incentives to use existing in...

  13. A dynamic simulation model for assessing the overall impact of incentive policies on power system reliability, costs and environment

    International Nuclear Information System (INIS)

    Ibanez-Lopez, A.S.; Martinez-Val, J.M.; Moratilla-Soria, B.Y.


    The liberalization of power markets has entailed dramatic changes in power system planning worldwide. The inception of new alternative technologies, smart grids and distributed generation and storage is expected to make system planning even more challenging. Government policies still play a major role in the evolution of a country's power generation mix, even in those countries with liberalized markets. This paper presents a System Dynamics model aimed at assessing the overall technical, economic and environmental impact of renewable energy incentives and capacity payment policies. The model has been used to simulate Spain's power industry in order to assess the impact of electric power policies with the goal of getting insights regarding how to achieve an optimum power generation mix. The main conclusions of the present paper are (i) the necessity of specific regulatory actions in Spain in order to keep adequate reliability levels, avoid price spikes and boom and bust investment cycles as well as to deploy specific technologies, (ii) the fact that capacity payments are a better instrument for keeping adequate reserve margins and avoiding power price spikes than renewable energy incentives and (iii) the evidence that both instruments entail additional system costs over the base case scenario. - Highlights: • A System Dynamics model of Spain's power generation mix is proposed. • The overall policy impact on system costs, environment and reliability is assessed. • Current policies are not enough to keep adequate reliability levels. • Capacity payments are an adequate instrument for guaranteeing system reliability. • RES incentives do not solve reliability issues and entail greater system costs.

  14. Effects of compensation methods and physician group structure on physicians' perceived incentives to alter services to patients. (United States)

    Reschovsky, James D; Hadley, Jack; Landon, Bruce E


    To examine how health plan payment, group ownership, compensation methods, and other practice management tools affect physician perceptions of whether their overall financial incentives tilt toward increasing or decreasing services to patients. Nationally representative data on physicians are from the 2000-2001 Community Tracking Study Physician Survey (N=12,406). Ordered and multinomial logistic regression were used to explore how physician, group, and market characteristics are associated with physician reports of whether overall financial incentives are to increase services, decrease services, or neither. Seven percent of physicians report financial incentives are to reduce services to patients, whereas 23 percent report incentives to increase services. Reported incentives to reduce services were associated with reports of lower ability to provide quality care. Group revenue in the form of capitation was associated with incentives to reduce services whereas practice ownership and variable compensation and bonuses for employee physicians were mostly associated with incentives to increase services to patients. Full ownership of groups, productivity incentives, and perceived competitive markets for patients were associated with incentives to both increase and reduce services. Practice ownership and the ways physicians are compensated affect their perceived incentives to increase or decrease services to patients. In the latter case, this adversely affects perceived quality of care and satisfaction, although incentives to increase services may also have adverse implications for quality, cost, and insurance coverage.

  15. The Effect of Financial Incentives on Quality of Care: The Case of Diabetes


    Anthony Scott; Stefanie Schurer; Paul H. Jensen; Peter Sivey


    Australia introduced an incentive payment scheme for general practitioners to ensure systematic and high quality care in chronic disease management. There is little empirical evidence and ambiguous theoretical guidance on which effects to expect on the quality of care. This paper evaluates the impact of the payment incentives on quality of care in diabetes, as measured by the probability of ordering an HbA1c test. The empirical analysis is conducted with a unique data set and a multivariate p...

  16. The Effects of Financial Incentives on Quality of Care: The Case of Diabetes


    Scott, A; Schurer, S; Jensen, P H; Sivey, P


    Australia introduced an incentive payment scheme for general practitioners to ensure systematic and high quality care in chronic disease management. There is little empirical evidence and ambiguous theoretical guidance on which effects to expect on the quality of care. This paper evaluates the impact of the payment incentives on quality of care in diabetes, as measured by the probability of ordering an HbA1c test. The empirical analysis is conducted with a unique data set and a multivariate p...

  17. The Impact of Policy Incentives on Long-Term Care Insurance and Medicaid Costs: Does Underwriting Matter? (United States)

    Cornell, Portia Y; Grabowski, David C


    To test whether underwriting modifies the effect of state-based incentives on individuals' purchase of long-term care insurance. Health and Retirement Study (HRS), 1996-2012. We estimated difference-in-difference regression models with an interaction of state policy indicators with individuals' probabilities of being approved for long-term care insurance. We imputed probabilities of underwriting approval for respondents in the HRS using a model developed with underwriting decisions from two U.S. insurance firms. We measured the elasticity response to long-term care insurance price using changes in simulated after-tax price as an instrumental variable for premium price. Tax incentives and Partnership programs increased insurance purchase by 3.62 percentage points and 1.8 percentage points, respectively, among those with the lowest risk (highest approval probability). Neither had any statistically significant effects among the highest risk individuals. We show that ignoring the effects of underwriting may lead to biased estimates of the potential state budget savings of long-term care insurance tax incentives. If the private market is to play a role in financing long-term care, policies need to address the underlying adverse selection problems. © Health Research and Educational Trust.

  18. Changing physician incentives for cancer care to reward better patient outcomes instead of use of more costly drugs. (United States)

    Newcomer, Lee N


    More-sophisticated chemotherapy regimens have improved the outlook for cancer patients since the 1970s, but the payment system for cancer chemotherapy has not changed during that time span. The "buy and bill" approach for reimbursement provides incentives for medical oncologists to use expensive medications when less costly alternatives that deliver similar results are available. Furthermore, the system does nothing to assess how much value society derives from high-price drugs. This paper reviews the historical context of "buy and bill" reimbursement and considers the use of clinical pathways and bundled payments, two alternative strategies that are being tried to reward physicians for improving outcomes and reducing the total cost of cancer care.

  19. Negativity bias and task motivation: testing the effectiveness of positively versus negatively framed incentives. (United States)

    Goldsmith, Kelly; Dhar, Ravi


    People are frequently challenged by goals that demand effort and persistence. As a consequence, philosophers, psychologists, economists, and others have studied the factors that enhance task motivation. Using a sample of undergraduate students and a sample of working adults, we demonstrate that the manner in which an incentive is framed has implications for individuals' task motivation. In both samples we find that individuals are less motivated when an incentive is framed as a means to accrue a gain (positive framing) as compared with when the same incentive is framed as a means to avoid a loss (negative framing). Further, we provide evidence for the role of the negativity bias in this effect, and highlight specific populations for whom positive framing may be least motivating. Interestingly, we find that people's intuitions about when they will be more motivated show the opposite pattern, with people predicting that positively framed incentives will be more motivating than negatively framed incentives. We identify a lay belief in the positive correlation between enjoyment and task motivation as one possible factor contributing to the disparity between predicted and actual motivation as a result of the framing of the incentive. We conclude with a discussion of the managerial implications for these findings. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  20. Cost-Effectiveness of Aflatoxin Control Methods: Economic Incentives (United States)

    Multiple sectors in U.S. crop industries – growers, elevators, handlers/shellers, processors, distributors, and consumers – are affected by aflatoxin contamination of commodities, and have the potential to control it. Aflatoxin control methods at both preharvest and postharvest levels have been dev...


    Directory of Open Access Journals (Sweden)

    Florian Marcel NUTǍ


    Full Text Available The economic integration trend has freed the capital movement and many new locations became available for investment. That is why the policy makers had to think for new and more efficient ways to lure the capital owners. One of the most used and dynamic method is the fiscal policy. The fiscal incentives were in many cases the main reason for choosing a country and stay away from another. The main reason for this situation is that the fiscal policy is one of the most flexible public tools to manipulate the market and the decisions on it. Public administrations can encourage or block different kinds of investment decisions according to its policy and long term plans.

  2. Effects of incentives on psychosocial performances in simulated space-dwelling groups (United States)

    Hienz, Robert D.; Brady, Joseph V.; Hursh, Steven R.; Gasior, Eric D.; Spence, Kevin R.; Emurian, Henry H.

    Prior research with individually isolated 3-person crews in a distributed, interactive, planetary exploration simulation examined the effects of communication constraints and crew configuration changes on crew performance and psychosocial self-report measures. The present report extends these findings to a model of performance maintenance that operationalizes conditions under which disruptive affective responses by crew participants might be anticipated to emerge. Experiments evaluated the effects of changes in incentive conditions on crew performance and self-report measures in simulated space-dwelling groups. Crews participated in a simulated planetary exploration mission that required identification, collection, and analysis of geologic samples. Results showed that crew performance effectiveness was unaffected by either positive or negative incentive conditions, while self-report measures were differentially affected—negative incentive conditions produced pronounced increases in negative self-report ratings and decreases in positive self-report ratings, while positive incentive conditions produced increased positive self-report ratings only. Thus, incentive conditions associated with simulated spaceflight missions can significantly affect psychosocial adaptation without compromising task performance effectiveness in trained and experienced crews.

  3. Game Theoretical Analysis on Cooperation Stability and Incentive Effectiveness in Community Networks. (United States)

    Song, Kaida; Wang, Rui; Liu, Yi; Qian, Depei; Zhang, Han; Cai, Jihong


    Community networks, the distinguishing feature of which is membership admittance, appear on P2P networks, social networks, and conventional Web networks. Joining the network costs money, time or network bandwidth, but the individuals get access to special resources owned by the community in return. The prosperity and stability of the community are determined by both the policy of admittance and the attraction of the privileges gained by joining. However, some misbehaving users can get the dedicated resources with some illicit and low-cost approaches, which introduce instability into the community, a phenomenon that will destroy the membership policy. In this paper, we analyze on the stability using game theory on such a phenomenon. We propose a game-theoretical model of stability analysis in community networks and provide conditions for a stable community. We then extend the model to analyze the effectiveness of different incentive policies, which could be used when the community cannot maintain its members in certain situations. Then we verify those models through a simulation. Finally, we discuss several ways to promote community network's stability by adjusting the network's properties and give some proposal on the designs of these types of networks from the points of game theory and stability.

  4. Game Theoretical Analysis on Cooperation Stability and Incentive Effectiveness in Community Networks.

    Directory of Open Access Journals (Sweden)

    Kaida Song

    Full Text Available Community networks, the distinguishing feature of which is membership admittance, appear on P2P networks, social networks, and conventional Web networks. Joining the network costs money, time or network bandwidth, but the individuals get access to special resources owned by the community in return. The prosperity and stability of the community are determined by both the policy of admittance and the attraction of the privileges gained by joining. However, some misbehaving users can get the dedicated resources with some illicit and low-cost approaches, which introduce instability into the community, a phenomenon that will destroy the membership policy. In this paper, we analyze on the stability using game theory on such a phenomenon. We propose a game-theoretical model of stability analysis in community networks and provide conditions for a stable community. We then extend the model to analyze the effectiveness of different incentive policies, which could be used when the community cannot maintain its members in certain situations. Then we verify those models through a simulation. Finally, we discuss several ways to promote community network's stability by adjusting the network's properties and give some proposal on the designs of these types of networks from the points of game theory and stability.

  5. Carrots and sticks: impact of an incentive/disincentive employee flexible credit benefit plan on health status and medical costs. (United States)

    Stein, A D; Karel, T; Zuidema, R


    Employee wellness programs aim to assist in controlling employer costs by improving the health status and fitness of employees, potentially increasing productivity, decreasing absenteeism, and reducing medical claims. Most such programs offer no disincentive for nonparticipation. We evaluated an incentive/disincentive program initiated by a large teaching hospital in western Michigan. The HealthPlus Health Quotient program is an incentive/disincentive approach to health promotion. The employer's contribution to the cafeteria plan benefit package is adjusted based on results of an annual appraisal of serum cholesterol, blood pressure, tobacco use, body fat, physical fitness, motor vehicle safety, nutrition, and alcohol consumption. The adjustment (health quotient [HQ]) can range from -$25 to +$25 per pay period. We examined whether appraised health improved between 1993 and 1996 and whether the HQ predicted medical claims. Mean HQ increased slightly (+$0.47 per pay period in 1993 to +$0.89 per pay period in 1996). Individuals with HQs of less than -$10 per pay period incurred approximately twice the medical claims of the other groups (test for linear trend, p = .003). After adjustment, medical claims of employees in the worst category (HQ benefits. Most employees are impacted minimally, but savings are accruing to the employer from reductions in medical claims paid and in days lost to illness and disability.

  6. The Promise of Tailoring Incentives for Healthy Behaviors. (United States)

    Kullgren, Jeffrey T; Williams, Geoffrey C; Resnicow, Kenneth; An, Lawrence C; Rothberg, Amy; Volpp, Kevin G; Heisler, Michele


    To describe how tailoring financial incentives for healthy behaviors to employees' goals, values, and aspirations might improve the efficacy of incentives. We integrate insights from self-determination theory (SDT) with principles from behavioral economics in the design of financial incentives by linking how incentives could help meet an employee's life goals, values, or aspirations. Tailored financial incentives could be more effective than standard incentives in promoting autonomous motivation necessary to initiate healthy behaviors and sustain them after incentives are removed. Previous efforts to improve the design of financial incentives have tested different incentive designs that vary the size, schedule, timing, and target of incentives. Our strategy for tailoring incentives builds on strong evidence that difficult behavior changes are more successful when integrated with important life goals and values. We outline necessary research to examine the effectiveness of this approach among at-risk employees. Instead of offering simple financial rewards for engaging in healthy behaviors, existing programs could leverage incentives to promote employees' autonomous motivation for sustained health improvements. Effective application of these concepts could lead to programs more effective at improving health, potentially at lower cost. Our approach for the first time integrates key insights from SDT, behavioral economics, and tailoring to turn an extrinsic reward for behavior change into an internalized, self-sustaining motivator for long-term engagement in risk-reducing behaviors.

  7. Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch. (United States)

    Pittman, D W; Parker, J S; Getz, B R; Jackson, C M; Le, T-A P; Riggs, S B; Shay, J M


    We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.

  8. Cost benefit analysis cost effectiveness analysis

    International Nuclear Information System (INIS)

    Lombard, J.


    The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

  9. Effects of incentive programs to stimulate safety belt use : a meta-analysis.

    NARCIS (Netherlands)

    Hagenzieker, M.P. Bijleveld, F.D. & Davidse, R.J.


    The effects of campaigns using tangible incentives (rewards) to promote safety belt usage have been evaluated by means of a meta-analytic approach. Two coders extracted a total number of 136 short-term and 114 long-term effect sizes and coded many other variables from 34 journal articles and

  10. The effect of framing incentives as either losses or gains with contingency management for smoking cessation. (United States)

    Romanowich, Paul; Lamb, R J


    Cumulative prospect theory predicts that losses motivate behavior more than equal gains. Contingency management procedures effectively reduce drug use by placing incentives in direct competition with the drug taking behavior. Therefore, framing incentives as losses, rather than gains should decrease drug use to a greater extent, given equivalent incentives. We examined whether contingent vouchers described as either losses or gains differentially affected smoking abstinence rates. Over 5 consecutive days, participants could either gain $75 per day for verified abstinence or lose $75 per day (initial endowment=$375) for continuing to smoke. As a result, loss-framed participants were more likely to achieve at least one day of abstinence. There was a trend towards loss-framed participants reducing the amount smoked more than gain-framed participants. However, participants in the gain-framed group were more likely to maintain abstinence, once initiated. The results partially support cumulative prospect theory and suggest additional ways to initiate behavior change using incentives, outside of using larger magnitude incentives in contingency management procedures. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Effectiveness and acceptability of parental financial incentives and quasi-mandatory schemes for increasing uptake of vaccinations in preschool children: systematic review, qualitative study and discrete choice experiment. (United States)

    Adams, Jean; Bateman, Belinda; Becker, Frauke; Cresswell, Tricia; Flynn, Darren; McNaughton, Rebekah; Oluboyede, Yemi; Robalino, Shannon; Ternent, Laura; Sood, Benjamin Gardner; Michie, Susan; Shucksmith, Janet; Sniehotta, Falko F; Wigham, Sarah


    Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK. To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations. Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire. Community, health and education settings in England. Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children. Qualitative study - focus groups and individual interviews. DCE - online questionnaire. The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted. Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted

  12. Cost-effectiveness analysis and innovation. (United States)

    Jena, Anupam B; Philipson, Tomas J


    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  13. Tax incentives and firm size : effects on private R&D investment in Spain

    NARCIS (Netherlands)

    Labeaga Azcona, J.; Martínez-Ros, E.; Mohnen, P.


    The use of fiscal policy instruments to stimulate private R&D is widespread and important in some countries like Spain. In this paper we explore the effectiveness of R&D tax incentives on knowledge capital accumulation in Spanish manufacturing firms using an unbalanced panel and compare the

  14. A business case for HIT adoption: effects of "meaningful use" EHR financial incentives on clinic revenue. (United States)

    Behkami, Nima A; Dorr, David A; Morrice, Stuart


    The goal of this study is to describe a framework that allows decision makers to efficiently evaluate factors that affect Electronic Health Record (EHR) adoption and test suitable interventions; specifically financial incentives. The United States healthcare delivery system is experiencing a transformation to improve population health. There is strong agreement that "meaningful use" of Health Information Technology (HIT) is a major enabler in this effort. However it's also understood that the high cost of implementing an EHR is an obstacle for adoption. To help understand these complexities we developed a simulation model designed to capture the dynamic nature of policy interventions that affect the adoption of EHR. We found that "Effective" use of HIT approaches break-even-point and larger clinic revenue many times faster that "average" or "poor" use of HIT. This study uses a systems perspective to the evaluate EHR adoption process through the "meaningful use" redesign as proposed in the American Reinvestment and Recovery Act 2009 in the United States healthcare industry by utilizing the System Dynamics methodology and Scenario Analysis.

  15. A systematic review of financial incentives for physical activity: The effects on physical activity and related outcomes

    NARCIS (Netherlands)

    Barte, J.C.M.; Wendel-Vos, G.C.W.


    The aim of this review is to give an overview of the available evidence on the effects of financial incentives to stimulate physical activity. Therefore, a systematic literature search was performed for randomized trials that investigate the effects of physical-activity-related financial incentives

  16. Group Incentives for Teachers and Their Effects on Student Learning: A Systematic Review of Theory and Evidence (United States)

    Tirivayi, Nyasha; Maasen van den Brink, Henriette; Groot, Wim


    The effects of teachers' group incentives on student achievement are examined by reviewing theoretical arguments and empirical studies published between 1990 and 2011. Studies from developing countries reported positive effects of group incentives on student test scores. However, experimental studies from developed countries reported insignificant…

  17. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes (United States)

    Flodgren, Gerd; Eccles, Martin P; Shepperd, Sasha; Scott, Anthony; Parmelli, Elena; Beyer, Fiona R


    reviews); generally ineffective in improving compliance with guidelines outcomes (improving 5/17 outcomes from five studies in two reviews); and generally effective in improving prescribing costs outcomes (improving 28/34 outcomes from 10 studies in one review). Authors’ conclusions Financial incentives may be effective in changing healthcare professional practice. The evidence has serious methodological limitations and is also very limited in its completeness and generalisability. We found no evidence from reviews that examined the effect of financial incentives on patient outcomes. PMID:21735443

  18. Options for Low Income Countries Effective and Efficient Use of Tax Incentives for Investment : A Report to the G-20 Development Working Group by the IMF, OECD, UN and World Bank


    International Monetary Fund; OECD; United Nations; World Bank


    Experience shows that there is often ample room for more effective and efficient use of investment tax incentives in low-income countries. Tax incentives generally rank low in investment climate surveys in low-income countries, and there are many examples in which they are reported to be redundant, that is, investment will have been undertaken even without them. And their fiscal cost can b...

  19. Design of economic incentive instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård


    • Economic incentives are instruments to improve diets and reduce the fraction of people exposed to diet-related health risks • Proper targeting and design of economic incentive instruments is important, if such instruments should be efficient and feasible policy measures in the improvement...... of dietary behaviour in industrialised countries • From a cost-effectiveness perspective, there are considerable potential for optimizing the targeting and design of economic incentive instruments in nutritional policy...

  20. Dopamine and incentive learning: a framework for considering antipsychotic medication effects. (United States)

    Beninger, Richard J


    Hyperfunction of brain dopamine (DA) systems is associated with psychosis in schizophrenia and the medications used to treat schizophrenia are DA receptor blockers. DA also plays a critical role in incentive learning produced by rewarding stimuli. Using DA as the link, these results suggest that psychosis in schizophrenia can be understood from the point of view of excessive incentive learning. Incentive learning is mediated through the non-declarative memory system and may rely on the striatum or medial prefrontal cortex depending on the task. Typical and atypical antipsychotics differentially affect expression of the immediate early gene c-fos, producing greater activity in the striatum and medial prefrontal cortex, respectively. This led to the hypothesis that performance of schizophrenic patients on tasks that depend on the striatum or medial prefrontal cortex will be differentially affected by their antipsychotic medication. Results from a number of published papers supported this dissociation. Furthermore, the effects of two atypical drugs, clozapine and olanzapine, on c-fos expression were different from another atypical, risperidone that resembles the typical antipsychotics. Similarly, in tests of incentive learning, risperidone acted like the typical antipsychotics. Thus, typical and atypical antipsychotic drugs differed in the types of cognitive performance they affected and, furthermore, members of the atypical class differed in their effects on cognition. It remains the task of researchers and clinicians to sort out the symptoms associated with the endogenous illness from possible iatrogenic symptoms resulting from the antipsychotic medications used to treat schizophrenia.

  1. Incentive effects of performance-vested stock options

    NARCIS (Netherlands)

    Kuang, Y.


    This dissertation investigates the effects of PVSOs in motivating managers to promote shareholder value. Undesired consequences associated with PVSOs are also examined. Chapter 2 studies the effectiveness of PVSOs in aligning interests between managers and shareholders. Chapter 3 explores managers’

  2. The false consensus effect disappears if representative information and monetary incentives are given


    Engelmann, Dirk; Strobel, Martin


    In this paper we present an experiment on the false consensus effect. Unlike previous experiments, we provide monetary incentives for revealing the actual estimation of others' behavior. In each session and round sixteen subjects make a choice between two options simultaneously. Then they estimate the choices of a randomly selected subgroup. For half of the rounds we provide information about other subjects' choices. There we find no false consensus effect. At an aggregate level, subjects sig...

  3. The effects of incentives on visual-spatial working memory in children with attention-deficit/hyperactivity disorder. (United States)

    Shiels, Keri; Hawk, Larry W; Lysczek, Cynthia L; Tannock, Rosemary; Pelham, William E; Spencer, Sarah V; Gangloff, Brian P; Waschbusch, Daniel A


    Working memory is one of several putative core neurocognitive processes in attention-deficit/hyperactivity disorder (ADHD). The present work seeks to determine whether visual-spatial working memory is sensitive to motivational incentives, a laboratory analogue of behavioral treatment. Participants were 21 children (ages 7-10) with a diagnosis of ADHD-combined type. Participants completed a computerized spatial span task designed to assess storage of visual-spatial information (forward span) and manipulation of the stored information (backward span). The spatial span task was completed twice on the same day, once with a performance-based incentive (trial-wise feedback and points redeemable for prizes) and once without incentives. Participants performed significantly better on the backward span when rewarded for correct responses, compared to the no incentive condition. However, incentives had no effect on performance during the forward span. These findings may suggest the use of motivational incentives improved manipulation, but not storage, of visual-spatial information among children with ADHD. Possible explanations for the differential incentive effects are discussed, including the possibility that incentives prevented a vigilance decrement as task difficulty and time on task increased.

  4. Economic Incentives or Communication: How Different Are their Effects on Trust

    Directory of Open Access Journals (Sweden)

    Tatiana Iwai


    Full Text Available This study investigates the effects of economic incentives and communication on the cognitive and behavioral responses after an alleged trust violation. We argue that these responses depend on the type of solution used to foster cooperation between agents. On the cognitive level, we compare the effects that structural (economic incentives and motivational (communication solutions exert on trusting beliefs and trusting intentions after an adverse event. On the behavioral level, we compare these effects on the willingness to bear risk. Our experiment shows that, after a negative event, relationships wherein communication is used to foster cooperation are associated to greater external causal attribution, greater perceived benevolence/integrity, and greater willingness to reconcile and to accept risks related to other's behavior. These findings suggest that relationships based on motivational solutions are more resilient to negative events than ones based on structural solutions.

  5. The incentive effects of missions - Evidence from experiments with NGO employees and students

    DEFF Research Database (Denmark)

    Gerhards, Leonie


    This paper studies the incentive effects of an organization׳s ‘mission’ on the effort provision of agents. Across treatments, I exogenously vary how much the agents׳ and their projects׳ missions match. In the first study, NGO employees are assigned the role of agents in an online, one-shot, princ......This paper studies the incentive effects of an organization׳s ‘mission’ on the effort provision of agents. Across treatments, I exogenously vary how much the agents׳ and their projects׳ missions match. In the first study, NGO employees are assigned the role of agents in an online, one......-agent game with random matching, I do not find a motivational effect of missions, unlike in my first two studies....

  6. The Effect of Performance-Contingent Incentives when Task Complexity is Manipulated through Instruction

    Directory of Open Access Journals (Sweden)

    Monte Wynder


    Full Text Available When, and how, performance-contingent incentives improve performance is an important question fororganisations. Empirical results have been mixed – performance-contingent incentives sometimes increaseperformance, sometimes decrease performance, and sometimes have no effect. Theorists have called forfurther research to identify the effect of various moderating variables, including knowledge and taskcomplexity. This study responds by considering the role of instruction in providing the necessary knowledgeto reduce task complexity. The results suggest that a performance-contingent penalty can be a particularlyeffective means of directing effort for a simple task. For a complex task, performance can be improvedthrough instruction. The type of instruction is important – with rule-based instruction effectively directingeffort – however principle-based instruction is necessary to facilitate problem investigation and problemsolving.

  7. Effects of government incentives on wind innovation in the United States (United States)

    Horner, Nathaniel; Azevedo, Inês; Hounshell, David


    In the United States, as elsewhere, state and federal governments have considered or implemented a range of policies to create more sustainable energy generation systems in response to concerns over climate change, security of fuel supply, and environmental impacts. These policies include both regulatory instruments such as renewable portfolio standards (RPSs) and market incentives such as tax credits. While these policies are primarily geared towards increasing renewable generation capacity, they can indirectly affect innovation in associated technologies through a ‘demand-pull’ dynamic. Other policies, such as public research and development (R&D) funding, directly incentivize innovation through ‘technology-push’ means. In this letter, we examine these effects on innovation in the United States wind energy industry. We estimate a set of econometric models relating a set of US federal and state policies to patenting activity in wind technologies over the period 1974-2009. We find that RPS policies have had significant positive effects on wind innovation, whereas tax-based incentives have not been particularly effective. We also find evidence that the effects of RPS incentives differ between states. Finally, we find that public R&D funding can be a significant driver of wind innovation, though its effect in the US has been modest.

  8. Effects of government incentives on wind innovation in the United States

    International Nuclear Information System (INIS)

    Horner, Nathaniel; Azevedo, Inês; Hounshell, David


    In the United States, as elsewhere, state and federal governments have considered or implemented a range of policies to create more sustainable energy generation systems in response to concerns over climate change, security of fuel supply, and environmental impacts. These policies include both regulatory instruments such as renewable portfolio standards (RPSs) and market incentives such as tax credits. While these policies are primarily geared towards increasing renewable generation capacity, they can indirectly affect innovation in associated technologies through a ‘demand-pull’ dynamic. Other policies, such as public research and development (R and D) funding, directly incentivize innovation through ‘technology-push’ means. In this letter, we examine these effects on innovation in the United States wind energy industry. We estimate a set of econometric models relating a set of US federal and state policies to patenting activity in wind technologies over the period 1974–2009. We find that RPS policies have had significant positive effects on wind innovation, whereas tax-based incentives have not been particularly effective. We also find evidence that the effects of RPS incentives differ between states. Finally, we find that public R and D funding can be a significant driver of wind innovation, though its effect in the US has been modest. (letter)

  9. Why are financial incentives not effective at influencing some smokers to quit? Results of a process evaluation of a worksite trial assessing the efficacy of financial incentives for smoking cessation. (United States)

    Kim, Annice; Kamyab, Kian; Zhu, Jingsan; Volpp, Kevin


    Process evaluation of a worksite intervention in which employees were offered $750 to complete a cessation program and to quit smoking. Awareness and attitudes about financial incentives were assessed following a randomized controlled trial of 878 smokers at a US-based company. Cessation program attendance was higher in incentive group versus control (20.2% vs 7.1%, P motivated to quit and reported that they would have quit for less money, said incentives were "not at all" or only "somewhat" important. Most nonquitters in the incentive group reported that even $1500 would not have motivated them to quit. Financial incentives are ineffective at motivating some smokers to quit. Internal motivation and readiness to quit need to be sufficiently high for relatively modest incentives to be effective.

  10. Incentive Compatibility


    Ledyard, John O.


    Incentive compatibility is described and discussed. A summary of the current state of understanding is provided. Key words are: incentive compatibility, game theory, implementation, mechanism, Bayes, Nash, and revelation.

  11. The different effect of consumer learning on incentives to differentiate in Cournot and Bertrand competition


    Conze, Maximilian; Kramm, Michael


    We combine two extensions of the differentiated duopoly model of Dixit (1979), namely Caminal and Vives (1996) and Brander and Spencer (2015a,b), to analyze the effect of consumer learning on firms' incentives to differentiate their products in models of Cournot and Bertrand competition. Products are of different quality, consumers buy sequentially and are imperfectly informed about the quality of the goods. Before simultaneously competing in quantities, firms simultaneously choose their inve...

  12. DSM shareholder incentives: Current designs and economic theory

    International Nuclear Information System (INIS)

    Stoft, S.; Eto, J.; Kito, S.


    This report reviews recent DSM shareholder incentive designs and performance at 10 US utilities identifies opportunities for regulators to improve the design of DSM shareholder incentive mechanisms to increase the procurement of cost-effective DSM resources. We develop six recommendations: (1) apply shared-savings incentives to DSM resource programs; (2) use markup incentives for individual programs only when net benefits are difficult to measure, but are known to be positive; (3) set expected incentive payments based on covering a utility's open-quotes hidden costs,close quotes which include some transitional management and risk-adjusted opportunity costs; (4) use higher marginal incentives rates than are currently found in practice, but limit total incentive payments by adding a fixed charge; (5) mitigate risks to regulators and utilities by lowering marginal incentive rates at high and low performance levels; and (6) use an aggregate incentive mechanism for all DSM resource programs, with limited exceptions (e.g., information programs where markups are more appropriate)

  13. Cost effectiveness analysis in radiopharmacy

    International Nuclear Information System (INIS)

    Carpentier, N.; Verbeke, S.; Ducloux, T.


    Objective: to evaluate the cost effectiveness of radiopharmaceuticals and their quality control. Materials and methods: this retrospective study was made in the Nuclear Medicine Department of the University Hospital of Limoges. Radiopharmaceutical costs were obtained with adding the price of the radiotracer, the materials, the equipments, the labour, the running expenses and the radioisotope. The costs of quality control were obtained with adding the price of labour, materials, equipments, running expenses and the cost of the quality control of 99m Tc eluate. Results: during 1998, 2106 radiopharmaceuticals were prepared in the Nuclear Medicine Department. The mean cost effectiveness of radiopharmaceutical was 1430 francs (846 to 4260). The mean cost effectiveness of quality control was 163 francs (84 to 343). The rise of the radiopharmaceutical cost induced by quality control was 11%. Conclusion: the technical methodology of quality control must be mastered to optimize the cost of this operation. (author)

  14. Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation. (United States)

    Halpern, Scott D; French, Benjamin; Small, Dylan S; Saulsgiver, Kathryn; Harhay, Michael O; Audrain-McGovern, Janet; Loewenstein, George; Asch, David A; Volpp, Kevin G


    Targeting different smoking cessation programs to smokers most likely to quit when using them could reduce the burden of lung disease. To identify smokers most likely to quit using pure reward-based financial incentives or incentive programs requiring refundable deposits to become eligible for rewards. We conducted prespecified secondary analyses of a randomized trial in which 2,538 smokers were assigned to an $800 reward contingent on sustained abstinence from smoking, a refundable $150 deposit plus a $650 reward, or usual care. Using logistic regression, we identified characteristics of smokers that were most strongly associated with accepting their assigned intervention and ceasing smoking for 6 months. We assessed modification of the acceptance, efficacy, and effectiveness of reward and deposit programs by 11 prospectively selected demographic, smoking-related, and psychological factors. Predictors of sustained smoking abstinence differed among participants assigned to reward- versus deposit-based incentives. However, greater readiness to quit and less steep discounting of future rewards were consistently among the most important predictors. Deposit-based programs were uniquely effective relative to usual care among men, higher-income participants, and participants who more commonly failed to pay their bills (all interaction P values rewards, deposits were more effective among black persons (P = 0.022) and those who more commonly failed to pay their bills (P = 0.082). Relative to rewards, deposits were more commonly accepted by higher-income participants, men, white persons, and those who less commonly failed to pay their bills (all P incentives suggests potential benefits of targeting behavior-change interventions based on patient characteristics. Clinical trial registered with (NCT 01526265).

  15. The effect of incentive spirometry on postoperative pulmonary function following laparotomy: a randomized clinical trial. (United States)

    Tyson, Anna F; Kendig, Claire E; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G


    Changes in pulmonary dynamics following laparotomy are well documented. Deep breathing exercises, with or without incentive spirometry, may help counteract postoperative decreased vital capacity; however, the evidence for the role of incentive spirometry in the prevention of postoperative atelectasis is inconclusive. Furthermore, data are scarce regarding the prevention of postoperative atelectasis in sub-Saharan Africa. To determine the effect of the use of incentive spirometry on pulmonary function following exploratory laparotomy as measured by forced vital capacity (FVC). This was a single-center, randomized clinical trial performed at Kamuzu Central Hospital, Lilongwe, Malawi. Study participants were adult patients who underwent exploratory laparotomy and were randomized into the intervention or control groups (standard of care) from February 1 to November 30, 2013. All patients received routine postoperative care, including instructions for deep breathing and early ambulation. We used bivariate analysis to compare outcomes between the intervention and control groups. Adult patients who underwent exploratory laparotomy participated in postoperative deep breathing exercises. Patients in the intervention group received incentive spirometers. We assessed pulmonary function using a peak flow meter to measure FVC in both groups of patients. Secondary outcomes, such as hospital length of stay and mortality, were obtained from the medical records. A total of 150 patients were randomized (75 in each arm). The median age in the intervention and control groups was 35 years (interquartile range, 28-53 years) and 33 years (interquartile range, 23-46 years), respectively. Men predominated in both groups, and most patients underwent emergency procedures (78.7% in the intervention group and 84.0% in the control group). Mean initial FVC did not differ significantly between the intervention and control groups (0.92 and 0.90 L, respectively; P=.82 [95% CI, 0.52-2.29]). Although

  16. Renewable energy rebound effect?: Estimating the impact of state renewable energy financial incentives on residential electricity consumption (United States)

    Stephenson, Beth A.

    Climate change is a well-documented phenomenon. If left unchecked greenhouse gas emissions will continue global surface warming, likely leading to severe and irreversible impacts. Generating renewable energy has become an increasingly salient topic in energy policy as it may mitigate the impact of climate change. State renewable energy financial incentives have been in place since the mid-1970s in some states and over 40 states have adopted one or more incentives at some point since then. Using multivariate linear and fixed effects regression for the years 2002 through 2012, I estimate the relationship between state renewable energy financial incentives and residential electricity consumption, along with the associated policy implications. My hypothesis is that a renewable energy rebound effect is present; therefore, states with renewable energy financial incentives have a higher rate of residential electricity consumption. I find a renewable energy rebound effect is present in varying degrees for each model, but the results do not definitively indicate how particular incentives influence consumer behavior. States should use caution when adopting and keeping renewable energy financial incentives as this may increase consumption in the short-term. The long-term impact is unclear, making it worthwhile for policymakers to continue studying the potential for renewable energy financial incentives to alter consumer behavior.

  17. Cost-effectiveness of hepatitis B vaccination of prison inmates. (United States)

    Pisu, Maria; Meltzer, Martin Isaac; Lyerla, Rob


    The purpose of this paper is to determine the cost-effectiveness of vaccinating inmates against hepatitis B. From the prison perspective, vaccinating inmates at intake is not cost-saving. It could be economically beneficial when the cost of a vaccine dose is US dollars 30 per dose, or there is no prevalence of infection upon intake, or the costs of treating acute or chronic disease are about 70% higher than baseline costs, or the incidence of infection during and after custody were >1.6 and 50%, respectively. The health care system realizes net savings even when there is no incidence in prison, or there is no cost of chronic liver disease, or when only one dose of vaccine is administered. Thus, while prisons might not have economic incentives to implement hepatitis B vaccination programs, the health care system would benefit from allocating resources to them.

  18. Heterogeneity in the Effects of Reward- and Deposit-based Financial Incentives on Smoking Cessation (United States)

    French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Asch, David A.; Volpp, Kevin G.


    Rationale: Targeting different smoking cessation programs to smokers most likely to quit when using them could reduce the burden of lung disease. Objectives: To identify smokers most likely to quit using pure reward-based financial incentives or incentive programs requiring refundable deposits to become eligible for rewards. Methods: We conducted prespecified secondary analyses of a randomized trial in which 2,538 smokers were assigned to an $800 reward contingent on sustained abstinence from smoking, a refundable $150 deposit plus a $650 reward, or usual care. Measurements and Main Results: Using logistic regression, we identified characteristics of smokers that were most strongly associated with accepting their assigned intervention and ceasing smoking for 6 months. We assessed modification of the acceptance, efficacy, and effectiveness of reward and deposit programs by 11 prospectively selected demographic, smoking-related, and psychological factors. Predictors of sustained smoking abstinence differed among participants assigned to reward- versus deposit-based incentives. However, greater readiness to quit and less steep discounting of future rewards were consistently among the most important predictors. Deposit-based programs were uniquely effective relative to usual care among men, higher-income participants, and participants who more commonly failed to pay their bills (all interaction P values patient characteristics. Clinical trial registered with (NCT 01526265). PMID:27064456

  19. The effect of a monetary incentive for administrative assistants on the survey response rate: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Arnav Agarwal


    Full Text Available Abstract Background There is sufficient evidence that monetary incentives are effective in increasing survey response rates in the general population as well as with physicians. The objective of this study was to assess the impact of a monetary incentive intended for administrative assistants on the survey response rate of physicians in leadership positions. Methods This was an ancillary study to a national survey of chairs of academic Departments of Medicine in the United States about measuring faculty productivity. We randomized survey participants to receive or not receive a $5 gift card enclosed in the survey package. The cover letter explained that the gift card was intended for the administrative assistants as a “thank you for their time.” We compared the response rates between the 2 study arms using the Chi-square test. Results Out of 152 participants to whom survey packages were mailed to, a total of 78 responses were received (51 % response rate. The response rates were 59 % in the incentive arm and 46 % in the no incentive arm. The relative effect of the incentive compared to no monetary incentive was borderline statistically significant (relative risk (RR = 1.36, 95 % confidence interval (CI 0.99 to 1.87; p = 0.055. Conclusion Monetary incentives intended for administrative assistants likely increase the response rate of physicians in leadership positions.

  20. The effectiveness of a monetary incentive offer on survey response rates and response completeness in a longitudinal study. (United States)

    Yu, Shengchao; Alper, Howard E; Nguyen, Angela-Maithy; Brackbill, Robert M; Turner, Lennon; Walker, Deborah J; Maslow, Carey B; Zweig, Kimberly C


    Achieving adequate response rates is an ongoing challenge for longitudinal studies. The World Trade Center Health Registry is a longitudinal health study that periodically surveys a cohort of ~71,000 people exposed to the 9/11 terrorist attacks in New York City. Since Wave 1, the Registry has conducted three follow-up surveys (Waves 2-4) every 3-4 years and utilized various strategies to increase survey participation. A promised monetary incentive was offered for the first time to survey non-respondents in the recent Wave 4 survey, conducted 13-14 years after 9/11. We evaluated the effectiveness of a monetary incentive in improving the response rate five months after survey launch, and assessed whether or not response completeness was compromised due to incentive use. The study compared the likelihood of returning a survey for those who received an incentive offer to those who did not, using logistic regression models. Among those who returned surveys, we also examined whether those receiving an incentive notification had higher rate of response completeness than those who did not, using negative binomial regression models and logistic regression models. We found that a $10 monetary incentive offer was effective in increasing Wave 4 response rates. Specifically, the $10 incentive offer was useful in encouraging initially reluctant participants to respond to the survey. The likelihood of returning a survey increased by 30% for those who received an incentive offer (AOR = 1.3, 95% CI: 1.1, 1.4), and the incentive increased the number of returned surveys by 18%. Moreover, our results did not reveal any significant differences on response completeness between those who received an incentive offer and those who did not. In the face of the growing challenge of maintaining a high response rate for the World Trade Center Health Registry follow-up surveys, this study showed the value of offering a monetary incentive as an additional refusal conversion strategy. Our

  1. The effect of financial incentives on top of behavioral support on quit rates in tobacco smoking employees: study protocol of a cluster-randomized trial. (United States)

    van den Brand, F A; Nagelhout, G E; Winkens, B; Evers, S M A A; Kotz, D; Chavannes, N H; van Schayck, C P


    Stimulating successful tobacco cessation among employees has multiple benefits. Employees who quit tobacco are healthier, more productive, less absent from work, and longer employable than employees who continue to use tobacco. Despite the evidence for these benefits of tobacco cessation, a successful method to stimulate employees to quit tobacco is lacking. The aim of this study is to evaluate whether adding a financial incentive to behavioral support (compared with no additional incentive) is effective and cost-effective in increasing abstinence rates in tobacco smoking employees participating in a smoking cessation group training. In this cluster-randomized trial employees in the intervention and control group both participate in a smoking cessation group training consisting of seven weekly counseling sessions of ninety minutes each. In addition to the training, employees in the intervention group receive a voucher as an incentive for being abstinent from smoking at the end of the training (€50), after three months (€50), after six months (€50), and after one year (€200). The control group does not receive any incentive. The primary outcome is carbon monoxide validated 12-month continuous abstinence from smoking (Russel's standard). Additionally, an economic evaluation is performed from a societal and an employer perspective. The present paper describes the methods and design of this cluster-randomized trial in detail. We hypothesize that the financial incentive for abstinence in the form of vouchers increases abstinence rates over and above the group training. The results of this study can provide important recommendations for enhancement of employee tobacco cessation. Dutch Trial Register: NTR5657 . First received 27-01-2016.

  2. The effective obove local development of the spanish regional policy applied through economic incentives during the period 1988-2003


    Pedro Benito, Moyano Pesquera; Aleixandre Mendizábal, Guillermo; Ogando Canabal, Olga


    The objective of this paper is to assess the effectiveness of regional incentive policy applied in Spain during the period 1988-2001 at a municipal scale. Specifically, the relation between economic growth and the amount of incentives received by each Spanish municipality is analysed, taking into consideration the characteristics of the subsidised projects and the municipalities concerned. One of the main problems faced was the lack of economic information at a local scale. Therefore, it was ...

  3. Ensuring Efficient Incentive and Disincentive Values for Highway Construction Projects: A Systematic Approach Balancing Road User, Agency and Contractor Acceleration Costs and Savings

    Directory of Open Access Journals (Sweden)

    Eul-Bum Lee


    Full Text Available United States State Highway Agencies (SHAs use Incentive/Disincentives (I/D to minimize negative impacts of construction on the traveling public through construction acceleration. Current I/D practices have the following short-comings: not standardized, over- or under-compensate contractors, lack of auditability result in disincentives that leave SHAs vulnerable to contractor claims and litigation and are based on agency costs/savings rather than contractor acceleration. Presented within this paper is an eleven-step I/D valuation process. The processes incorporate a US-nationwide RUC and agency cost calculation program, CA4PRS and a time-cost tradeoff I/D process. The incentive calculation used is the summation of the contractor acceleration and a reasonable contractor bonus (based on shared agency savings with an optional reduction of contractor’s own saving from schedule compression (acceleration. The process has a capability to be used both within the US and internationally with minor modifications, relies on historical costs, is simple and is auditable and repeatable. As such, it is a practical tool for optimizing I/D amounts and bridges the gap in existing literature both by its industry applicability, integrating the solution into existing SHA practices and its foundation of contractor acceleration costs.

  4. Cost-effectiveness of health research study participant recruitment strategies: a systematic review. (United States)

    Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A


    A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

  5. Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy

    Energy Technology Data Exchange (ETDEWEB)



    September 2002 · NREL/SR-620-32819 Case Studies on the Effectiveness of State Financial Incentives for Renewable Energy S. Gouchoe, V. Everette, and R. Haynes North Carolina State University Raleigh, North Carolina National Renewable Energy Laboratory 1617 Cole Boulevard Golden, Colorado 80401-3393 NREL is a U.S. Department of Energy Laboratory Operated by Midwest Research Institute · Battelle · Bechtel Contract No. DE-AC36-99-GO10337 September 2002 · NREL/SR-620-32819Case Studies on the Effecti

  6. Effects of Mentioning the Incentive Prize in the Email Subject Line on Survey Response

    Directory of Open Access Journals (Sweden)

    Robert Janke


    Full Text Available Objective – This study examined the effects that mentioning the survey incentive prize in the subject line of a reminder email had on the response rate and data quality. To date, manipulation of the subject line, specifically in terms of mentioning the incentive prize, has received limited attention in the survey design literature. Methods – The delivery of the survey invitation is discussed in terms of the timing of the launch and reminder emails. Particular emphasis is given to the design of the email subject line and justification of the format. Weekly response rates from four LibQUAL+TM surveys were compared. In addition, weekly responses for one year were analyzed using SPSS to investigate if there were any between means differences in terms of three elements of data quality. The three elements were: length of time it took to complete the survey, the number of core questions with an N/A response, and the number of illogical responses where minimum scores were higher than desired. Results – The response rates for the second week were grouped together based on the presence or absence of the subject line manipulation. There was a significant difference between these means (4.75%, p 0.033. There was no statistical difference in regards to the measures of data quality as determined by a one-way ANOVA test. Conclusions – Reminding survey participants with an email that mentions the incentive prize in the subject line appears to increase response rates with no deleterious effects on data quality. The results of this investigation are encouraging, and those running the LibQUAL+TM survey in their universities should consider implementing this method to increase response rates. Further research to replicate these findings in other contexts and using an experimental design would be beneficial.

  7. Tax Incentives : Using Tax Incentives to Attract Foreign Direct Investment


    Morisset, Jacques


    The increasing mobility of international firms and the gradual elimination of barriers to global capital flows have stimulated competition among governments to attract foreign direct investment, often through tax incentives. This note reviews the debate about the effectiveness of tax incentives, examining two much-contested questions: can tax incentives attract foreign investment? And what...

  8. Energy Efficiency Under Alternative Carbon Policies. Incentives, Measurement, and Interregional Effects

    Energy Technology Data Exchange (ETDEWEB)

    Steinberg, Daniel C. [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Boyd, Erin [National Renewable Energy Laboratory (NREL), Golden, CO (United States)


    In this report, we examine and compare how tradable mass-based polices and tradable rate-based policies create different incentives for energy efficiency investments. Through a generalized demonstration and set of examples, we show that as a result of the output subsidy they create, traditional rate-based policies, those that do not credit energy savings from efficiency measures, reduce the incentive for investment in energy efficiency measures relative to an optimally designed mass-based policy or equivalent carbon tax. We then show that this reduced incentive can be partially addressed by modifying the rate-based policy such that electricity savings from energy efficiency measures are treated as a source of zero-carbon generation within the framework of the standard, or equivalently, by assigning avoided emissions credit to the electricity savings at the rate of the intensity target. These approaches result in an extension of the output subsidy to efficiency measures and eliminate the distortion between supply-side and demand-side options for GHG emissions reduction. However, these approaches do not address electricity price distortions resulting from the output subsidy that also impact the value of efficiency measures. Next, we assess alternative approaches for crediting energy efficiency savings within the framework of a rate-based policy. Finally, we identify a number of challenges that arise in implementing a rate-based policy with efficiency crediting, including the requirement to develop robust estimates of electricity savings in order to assess compliance, and the requirement to track the regionality of the generation impacts of efficiency measures to account for their interstate effects.

  9. The meetings, incentives, conferences, and exhibitions (MICE industry: Determinants of Thai organizational effectiveness

    Directory of Open Access Journals (Sweden)

    Songsiri Bandhuseve


    Full Text Available Studies have shown that there is more money in business tourism than leisure travel, and on average, business travellers spend more money. To understand this phenomenon, this study aimed to investigate the effect of relationships between capacity management, customer relationship management, information computer technology (ICT, service quality, supplier relationship management, and supply chain management on Thailand’s meetings, incentives, conferences, and exhibitions (MICE industry organizational effectiveness. The researchers embraced a descriptive survey methodology designed to assess how the 500 managers surveyed viewed their organization’s effectiveness. The design employed the self-administration of questionnaires to a sample of individuals which was aimed at finding each individual’s attitudes and opinion about how the 21 observed variables impacted their operations. Of the 10 hypotheses and 21 observed variables, nine hypotheses were proven, with the findings confirming that service quality and information computer technology having a significant effect on MICE organizational effectiveness.

  10. Costs and cost-effectiveness of periviable care. (United States)

    Caughey, Aaron B; Burchfield, David J


    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Neural substrates of social facilitation effects on incentive-based performance (United States)

    Chib, Vikram S; Adachi, Ryo; O’Doherty, John P


    Abstract Throughout our lives we must perform tasks while being observed by others. Previous studies have shown that the presence of an audience can cause increases in an individual’s performance as compared to when they are not being observed—a phenomenon called ‘social facilitation’. However, the neural mechanisms underlying this effect, in the context of skilled-task performance for monetary incentives, are not well understood. We used functional magnetic resonance imaging to monitor brain activity while healthy human participants performed a skilled-task during conditions in which they were paid based on their performance and observed and not observed by an audience. We found that during social facilitation, social signals represented in the dorsomedial prefrontal cortex (dmPFC) enhanced reward value computations in ventromedial prefrontal cortex (vmPFC). We also found that functional connectivity between dmPFC and ventral striatum was enhanced when participants exhibited social facilitation effects, indicative of a means by which social signals serve to modulate brain regions involved in regulating behavioral motivation. These findings illustrate how neural processing of social judgments gives rise to the enhanced motivational state that results in social facilitation of incentive-based performance. PMID:29648653

  12. Cost effective campaigning in social networks (United States)

    Kotnis, Bhushan; Kuri, Joy


    Campaigners are increasingly using online social networking platforms for promoting products, ideas and information. A popular method of promoting a product or even an idea is incentivizing individuals to evangelize the idea vigorously by providing them with referral rewards in the form of discounts, cash backs, or social recognition. Due to budget constraints on scarce resources such as money and manpower, it may not be possible to provide incentives for the entire population, and hence incentives need to be allocated judiciously to appropriate individuals for ensuring the highest possible outreach size. We aim to do the same by formulating and solving an optimization problem using percolation theory. In particular, we compute the set of individuals that are provided incentives for minimizing the expected cost while ensuring a given outreach size. We also solve the problem of computing the set of individuals to be incentivized for maximizing the outreach size for given cost budget. The optimization problem turns out to be non trivial; it involves quantities that need to be computed by numerically solving a fixed point equation. Our primary contribution is, that for a fairly general cost structure, we show that the optimization problems can be solved by solving a simple linear program. We believe that our approach of using percolation theory to formulate an optimization problem is the first of its kind.

  13. Analysis of the results of Federal incentives used to stimulate energy production

    Energy Technology Data Exchange (ETDEWEB)

    Cone, B.W.; Emery, J.C.; Fassbender, A.G.


    The research program analyzed the Federal incentives used to stimulate nuclear, hydro, coal, gas, oil, and electricity production in order to supply what was learned to the selection of an incentives strategy to induce new energy production from renewable resources. Following the introductory chapter, Chapter 2 examines the problem of estimating effects from a theoretical perspective. Methods of quantifying and identifying the many interactive effects of government actions are discussed. Chapter 3 presents a generic analysis of the result of Federal incentives. Chapters 4 through 9 deal with incentives to energy forms - nuclear, hydro, coal, oil, gas, and electricity. Chapter 10 summarizes the estimated results of the incentives, which are presented in terms of their quantity and price impacts. The incentive costs per million Btu of induced energy production is also discussed. Chapter 11 discusses the parity issue, that is an equivalence between Federal incentives to renewable resources and to traditional energy resources. Any analysis of incentives for solar needs will profit from an analysis of the costs of solar incentives per million Btu compared with those for traditional energy forms. Chapter 12 concludes the analysis, discussing the history of traditional energy incentives as a guide to solar-energy incentives. 216 references, 38 figures, 91 tables.

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


    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.

  15. Study on Effects of Incentive Factors on supply chain Performance in E-commerce Environment

    Directory of Open Access Journals (Sweden)

    Mu Huiping


    Full Text Available The past studies aimed at the effects which related incentive factors of supply chain mad-e on supply chain performance are mostly concentrated on the manufacturing sector,Few literature regards the e-commerce system leading enterprise as the core enterprise of supply chain. In the e-commerce environment, supply contract, trust, relationship commitment is regarded as a motivating factor in Inter-enterprise supply chain and the operating conditions with suppliers, financial situation of enterprises in two dimensions are used to measure the performance of the supply chain, and then construct the theoretical model assumptions .Using structural equation modeling empirical analysis,the results show that the supply contract, trust, relationship commitment have significant positive effects on suppliers operating performance and supply contracts have a significant positive impact on corporate financial performance; Effects of trust, relationship commitment and supplier operational performance on corporate financial performance are not significant.

  16. Effect of Financial Incentives on Breastfeeding: A Cluster Randomized Clinical Trial. (United States)

    Relton, Clare; Strong, Mark; Thomas, Kate J; Whelan, Barbara; Walters, Stephen J; Burrows, Julia; Scott, Elaine; Viksveen, Petter; Johnson, Maxine; Baston, Helen; Fox-Rushby, Julia; Anokye, Nana; Umney, Darren; Renfrew, Mary J


    Although breastfeeding has a positive effect on an infant's health and development, the prevalence is low in many communities. The effect of financial incentives to improve breastfeeding prevalence is unknown. To assess the effect of an area-level financial incentive for breastfeeding on breastfeeding prevalence at 6 to 8 weeks post partum. The Nourishing Start for Health (NOSH) trial, a cluster randomized trial with 6 to 8 weeks follow-up, was conducted between April 1, 2015, and March 31, 2016, in 92 electoral ward areas in England with baseline breastfeeding prevalence at 6 to 8 weeks post partum less than 40%. A total of 10 010 mother-infant dyads resident in the 92 study electoral ward areas where the infant's estimated or actual birth date fell between February 18, 2015, and February 17, 2016, were included. Areas were randomized to the incentive plus usual care (n = 46) (5398 mother-infant dyads) or to usual care alone (n = 46) (4612 mother-infant dyads). Usual care was delivered by clinicians (mainly midwives, health visitors) in a variety of maternity, neonatal, and infant feeding services, all of which were implementing the UNICEF UK Baby Friendly Initiative standards. Shopping vouchers worth £40 (US$50) were offered to mothers 5 times based on infant age (2 days, 10 days, 6-8 weeks, 3 months, 6 months), conditional on the infant receiving any breast milk. The primary outcome was electoral ward area-level 6- to 8-week breastfeeding period prevalence, as assessed by clinicians at the routine 6- to 8-week postnatal check visit. Secondary outcomes were area-level period prevalence for breastfeeding initiation and for exclusive breastfeeding at 6 to 8 weeks. In the intervention (5398 mother-infant dyads) and control (4612 mother-infant dyads) group, the median (interquartile range) percentage of women aged 16 to 44 years was 36.2% (3.0%) and 37.4% (3.6%) years, respectively. After adjusting for baseline breastfeeding prevalence and local government

  17. Using financial incentives to improve value in orthopaedics. (United States)

    Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J


    A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

  18. Rewards and Performance Incentives. (United States)

    Zigon, Jack


    Discusses rewards and performance incentives for employees, including types of rewards; how rewards help in managing; dysfunctional awards; selecting the right reward; how to find rewards that fit; and delivering rewards effectively. Examples are included. (three references) (LRW)

  19. Effect of non-monetary incentives on uptake of couples' counselling and testing among clients attending mobile HIV services in rural Zimbabwe: a cluster-randomised trial. (United States)

    Sibanda, Euphemia L; Tumushime, Mary; Mufuka, Juliet; Mavedzenge, Sue Napierala; Gudukeya, Stephano; Bautista-Arredondo, Sergio; Hatzold, Karin; Thirumurthy, Harsha; McCoy, Sandra I; Padian, Nancy; Copas, Andrew; Cowan, Frances M


    Couples' HIV testing and counselling (CHTC) is associated with greater engagement with HIV prevention and care than individual testing and is cost-effective, but uptake remains suboptimal. Initiating discussion of CHTC might result in distrust between partners. Offering incentives for CHTC could change the focus of the pre-test discussion. We aimed to determine the impact of incentives for CHTC on uptake of couples testing and HIV case diagnosis in rural Zimbabwe. In this cluster-randomised trial, 68 rural communities (the clusters) in four districts receiving mobile HIV testing services were randomly assigned (1:1) to incentives for CHTC or not. Allocation was not masked to participants and researchers. Randomisation was stratified by district and proximity to a health facility. Within each stratum random permutation was done to allocate clusters to the study groups. In intervention communities, residents were informed that couples who tested together could select one of three grocery items worth US$1·50. Standard mobilisation for testing was done in comparison communities. The primary outcome was the proportion of individuals testing with a partner. Analysis was by intention to treat. 3 months after CHTC, couple-testers from four communities per group individually completed a telephone survey to evaluate any social harms resulting from incentives or CHTC. The effect of incentives on CHTC was estimated using logistic regression with random effects adjusting for clustering. The trial was registered with the Pan African Clinical Trial Registry, number PACTR201606001630356. From May 26, 2015, to Jan 29, 2016, of 24 679 participants counselled with data recorded, 14 099 (57·1%) were in the intervention group and 10 580 (42·9%) in the comparison group. 7852 (55·7%) testers in the intervention group versus 1062 (10·0%) in the comparison group tested with a partner (adjusted odds ratio 13·5 [95% CI 10·5-17·4]). Among 427 (83·7%) of 510 eligible

  20. Effect of incentive payments on chronic disease management and health services use in British Columbia, Canada: Interrupted time series analysis. (United States)

    Lavergne, M Ruth; Law, Michael R; Peterson, Sandra; Garrison, Scott; Hurley, Jeremiah; Cheng, Lucy; McGrail, Kimberlyn


    We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods. We observed no increases in primary care visits or continuity of care after incentives were introduced. Rates of ACR testing and antihypertensive dispensing increased among patients with hypertension, but none of the other modest increases in laboratory testing or prescriptions dispensed reached statistical significance. Rates of hospitalizations for stroke and heart failure among patients with hypertension fell relative to pre-intervention patterns, while hospitalizations for COPD increased. Total hospitalizations and hospitalizations via the emergency department did not change. Health care spending increased for patients with hypertension. This large-scale incentive scheme for primary care physicians showed some positive effects for patients with hypertension, but we observe no similar changes in patient management, reductions in hospitalizations, or changes in spending for patients with diabetes and COPD. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis. (United States)

    McConnachie, Alex; Haig, Caroline; Sinclair, Lesley; Bauld, Linda; Tappin, David M


    The Cessation in Pregnancy Incentives Trial (CPIT), which offered financial incentives for smoking cessation during pregnancy showed a clinically and statistically significant improvement in cessation. However, infant birth weight was not seen to be affected. This study re-examines birth weight using an intuitive and a complier average causal effects (CACE) method to uncover important information missed by intention-to-treat analysis. CPIT offered financial incentives up to £400 to pregnant smokers to quit. With incentives, 68 women (23.1%) were confirmed non-smokers at primary outcome, compared to 25 (8.7%) without incentives, a difference of 14.3% (Fisher test, p financial incentives to quit. Viewed in this way, the overall birth weight gain with incentives is attributable only to potential quitters. We compared an intuitive approach to a CACE analysis. Mean birth weight of potential quitters in the incentives intervention group (who therefore quit) was 3338 g compared with potential quitters in the control group (who did not quit) 3193 g. The difference attributable to incentives, was 3338 - 3193 = 145 g (95% CI -617, +803). The mean difference in birth weight between the intervention and control groups was 21 g, and the difference in the proportion who managed to quit was 14.3%. Since the intervention consisted of the offer of incentives to quit smoking, the intervention was received by all women in the intervention group. However, "compliance" was successfully quitting with incentives, and the CACE analysis yielded an identical result, causal birth weight increase 21 g ÷ 0.143 = 145 g. Policy makers have great difficulty giving pregnant women money to stop smoking. This study indicates that a small clinically insignificant improvement in average birth weight is likely to hide an important clinically significant increase in infants born to pregnant smokers who want to stop but cannot achieve smoking cessation without the addition of financial

  2. Good research practices for measuring drug costs in cost-effectiveness analyses: a societal perspective: the ISPOR Drug Cost Task Force report--Part II. (United States)

    Garrison, Louis P; Mansley, Edward C; Abbott, Thomas A; Bresnahan, Brian W; Hay, Joel W; Smeeding, James


    Major guidelines regarding the application of cost-effectiveness analysis (CEA) have recommended the common and widespread use of the "societal perspective" for purposes of consistency and comparability. The objective of this Task Force subgroup report (one of six reports from the International Society for Pharmacoeconomics and Outcomes Research [ISPOR] Task Force on Good Research Practices-Use of Drug Costs for Cost Effectiveness Analysis [Drug Cost Task Force (DCTF)]) was to review the definition of this perspective, assess its specific application in measuring drug costs, identify any limitations in theory or practice, and make recommendations regarding potential improvements. Key articles, books, and reports in the methodological literature were reviewed, summarized, and integrated into a draft review and report. This draft report was posted for review and comment by ISPOR membership. Numerous comments and suggestions were received, and the report was revised in response to them. The societal perspective can be defined by three conditions: 1) the inclusion of time costs, 2) the use of opportunity costs, and 3) the use of community preferences. In practice, very few, if any, published CEAs have met all of these conditions, though many claim to have taken a societal perspective. Branded drug costs have typically used actual acquisition cost rather than the much lower social opportunity costs that would reflect only short-run manufacturing and distribution costs. This practice is understandable, pragmatic, and useful to current decision-makers. Nevertheless, this use of CEA focuses on static rather than dynamic efficacy and overlooks the related incentives for innovation. Our key recommendation is that current CEA practice acknowledge and embrace this limitation by adopting a new standard for the reference case as one of a "limited societal" or "health systems" perspective, using acquisition drug prices while including indirect costs and community preferences. The

  3. Effect of Non Financial Incentives on Job Satisfaction of Teachers in Public Secondary Schools--Survey of Kisii Sub County (United States)

    Sabina, Asiago Lenah; Okibo, Walter; Nyang'au, Andrew; Ondima, Cleophas


    Job satisfaction is a major challenge among employees in many organizations. The purpose of this research project is to assess the effect of non-financial incentives on job satisfaction of teachers in public secondary schools of Kisii Sub County in the Republic of Kenya. The specific objectives for the study include: to assess the effect of…

  4. Speed regulating Effects of Incentive-based Intelligent Speed Adaptation in the short and medium term

    DEFF Research Database (Denmark)

    Agerholm, Niels

    Speed regulating Effects of Incentive-based Intelligent Speed Adaptation in the short and medium term Despite massive improvements in vehicles’ safety equipment, more information and safer road network, inappropriate road safety is still causing that more than 250 people are killed and several...... thousands injured each year in Denmark. Until a few years ago the number of fatalities in most countries had decreased while the amount of traffic increased. However, this trend has been replaced by a more uncertain development towards a constant or even somewhat increasing risk. Inappropriate speeding...... is a central cause for the high number of fatalities on the roads. Despite speed limits, speed limit violating driving behaviour is still widespread in Denmark. Traditional solutions to prevent speed violation have been enforcement, information, and enhanced road design. It seems, however, hard to achieve...

  5. Cost-effective conservation planning: lessons from economics. (United States)

    Duke, Joshua M; Dundas, Steven J; Messer, Kent D


    Economists advocate that the billions of public dollars spent on conservation be allocated to achieve the largest possible social benefit. This is "cost-effective conservation"-a process that incorporates both monetized benefits and costs. Though controversial, cost-effective conservation is poorly understood and rarely implemented by planners. Drawing from the largest publicly financed conservation programs in the United States, this paper seeks to improve the communication from economists to planners and to overcome resistance to cost-effective conservation. Fifteen practical lessons are distilled, including the negative implications of limiting selection with political constraints, using nonmonetized benefit measures or benefit indices, ignoring development risk, using incomplete cost measures, employing cost measures sequentially, and using benefit indices to capture costs. The paper highlights interrelationships between benefits and complications such as capitalization and intertemporal planning. The paper concludes by identifying the challenges at the research frontier, including incentive problems associated with adverse selection, additionality, and slippage. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. The Relative Effectiveness of Various Incentives and Deterrents as Judged by Pupils and Teachers. (United States)

    Burns, Robert B.


    Compares opinions of British teachers and students toward educational incentives and deterrents. Little change has occurred in the responses of teachers and students over the 24 years. Differences of opinion are evident between pupils and teachers, especially with regard to corporal punishment as a deterrent and adult approval as an incentive.…

  7. Effects of Monetary Incentives on Engagement in the PACE Parenting Program (United States)

    Dumas, Jean E.; Begle, Angela Moreland; French, Brian; Pearl, Amanda


    This study evaluated parental engagement in an 8-week parenting program offered through daycare centers that were randomly assigned to a monetary incentive or nonincentive condition. Of an initial sample of 1,050 parents who rated their intent to enroll in the program, 610 went on to enroll--319 in the incentive and 291 in the nonincentive…

  8. Exploring the effect of monetary incentives on user behavior in Online Sharing Platforms

    NARCIS (Netherlands)

    Lu, Yixin; Ou, Carol; Angelopoulos, Spyros


    We examine the impact of monetary incentives on user onboarding in online sharing platforms. Specifically, drawing upon the literature of monetary incentives, privacy, and consumer behavior, we conduct a randomized field experiment to explore users’ initial engagement and interaction with an online

  9. The effectiveness of financial incentives for smoking cessation during pregnancy: is it from being paid or from the extra aid?

    Directory of Open Access Journals (Sweden)

    Mantzari Eleni


    Full Text Available Abstract Background Financial incentives appear to be effective in promoting smoking cessation in pregnancy. The mechanisms by which they might operate however, are poorly understood. The present study examines how financial incentives for smoking cessation during pregnancy may work, by exploring pregnant women's experiences of trying to stop smoking, within and outside of a financial incentives scheme. Methods Thirty-six (n = 36 UK-based pregnant smokers (n = 36, offered standard NHS Stop-Smoking Services, of whom twenty (n = 20 were enrolled in a financial incentives scheme for smoking cessation (n = 20 and sixteen (n = 16 were not, were interviewed about (i their motivation to stop smoking, and (ii the factors they perceived as influencing their quitting efforts. Framework Analysis was used to analyse the data. Results Women in the two groups reported similar reasons for wanting to stop smoking during pregnancy. However, they described dissimilar experiences of the Stop-Smoking Services, which they perceived to have differentially influenced their quit attempts. Women who were incentivised reported using the services more than women who were not incentivised. In addition, they described the motivating experience of being monitored and receiving feedback on their progress. Non-incentivised women reported problems receiving the appropriate Nicotine Replacement Therapy, which they described as having a detrimental effect on their quitting efforts. Conclusion Women participating in a financial incentives scheme to stop smoking reported greater engagement with the Stop-Smoking Services, from which they described receiving more help in quitting than women who were not part of the scheme. These results highlight the complexity of financial incentives schemes and the intricacies surrounding the ways in which they operate to affect smoking cessation. These might involve influencing individuals' motivation and self-regulation, changing engagement with

  10. Analyses of Blood Bank Efficiency, Cost-Effectiveness and Quality (United States)

    Lam, Hwai-Tai Chen

    In view of the increasing costs of hospital care, it is essential to investigate methods to improve the labor efficiency and the cost-effectiveness of the hospital technical core in order to control costs while maintaining the quality of care. This study was conducted to develop indices to measure efficiency, cost-effectiveness, and the quality of blood banks; to identify factors associated with efficiency, cost-effectiveness, and quality; and to generate strategies to improve blood bank labor efficiency and cost-effectiveness. Indices developed in this study for labor efficiency and cost-effectiveness were not affected by patient case mix and illness severity. Factors that were associated with labor efficiency were identified as managerial styles, and organizational designs that balance workload and labor resources. Medical directors' managerial involvement was not associated with labor efficiency, but their continuing education and specialty in blood bank were found to reduce the performance of unnecessary tests. Surprisingly, performing unnecessary tests had no association with labor efficiency. This suggested the existence of labor slack in blood banks. Cost -effectiveness was associated with workers' benefits, wages, and the production of high-end transfusion products by hospital-based donor rooms. Quality indices used in this study included autologous transfusion rates, platelet transfusion rates, and the check points available in an error-control system. Because the autologous transfusion rate was related to patient case mix, severity of illness, and possible inappropriate transfusion, it was not recommended to be used for quality index. Platelet-pheresis transfusion rates were associated with the transfusion preferences of the blood bank medical directors. The total number of check points in an error -control system was negatively associated with government ownership and workers' experience. Recommendations for improving labor efficiency and cost-effectiveness

  11. Can a Costly Intervention Be Cost-effective? (United States)

    Foster, E. Michael; Jones, Damon


    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  12. Producer incentives and plant investments for Salmonella control in pork supply chains

    NARCIS (Netherlands)

    Backus, G.B.C.; King, R.P.


    This paper presents a unified analysis of dynamic producer incentive systems for Salmonella control in primary production and slaughter plant investments in Salmonella control measures. We identify optimal incentive system parameters and cost-effective control strategies for achieving various levels

  13. Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs

    Directory of Open Access Journals (Sweden)

    Elizabeth Jacob-Files


    Full Text Available Incentives can promote adult wellness. We sought to examine whether incentives might help overcome barriers to engagement in child weight management programs and the ideal value, type and recipient of incentives. In 2017, we conducted semi-structured phone interviews with parents of children ≤17 years old, formerly or currently affected by obesity, who had (n = 11 or had never (n = 12 participated in family-based behavioral treatment (FBT for obesity. Interviews explored the range and type of incentives families would be willing to accept. Interview transcripts were coded and data were analyzed using a thematic analysis. We found that some parents were skeptical about receiving cash incentives. However, once treatment-related costs were identified, some became more interested in reimbursement for out of pocket expenditures. Most parents felt up to $100/month would be adequate and that incentives should be tied to changing behaviors, not BMI. Some interviewees expressed preferences for non-cash incentives (e.g. a gift card over cash incentives. Parents were willing to share incentives with adolescents, up to $50/month, but there was concern about incentives affecting a child's intrinsic motivation for behavior change. All parents acknowledged that moderate incentives alone couldn't overcome the realities of structural and familial barriers to engaging in weight management programs. In summary, we identified aspects of an incentive program to promote engagement in FBT that would be desirable and feasible to implement. Future quantitative work can reveal the value and structure of incentives that are effective for improving obesogenic health behaviors and outcomes. Keywords: Behavioral economics, Family-based treatment, Financial incentives, Health incentives, Childhood obesity

  14. A Departmental Cost-Effectiveness Model. (United States)

    Holleman, Thomas, Jr.

    In establishing a departmental cost-effectiveness model, the traditional cost-effectiveness model was discussed and equipped with a distant and deflation equation for both benefits and costs. Next, the economics of costing was examined and program costing procedures developed. Then, the model construct was described as it was structured around the…

  15. Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial. (United States)

    Finkelstein, Eric A; Haaland, Benjamin A; Bilger, Marcel; Sahasranaman, Aarti; Sloan, Robert A; Nang, Ei Ei Khaing; Evenson, Kelly R


    additional 37 MVPA bout min per week (19-56; p=0·0001) and the charity group an additional 32 MVPA bout min per week (12-51; p=0·0013) compared with control; the difference between cash and control was not significant (15 MVPA bout min per week [-5 to 34; p=0·1363]). A decrease in physical activity of -23 MVPA bout min per week (95% CI -42 to -4; p=0·0184) was seen when comparing the cash group with the Fitbit group. There were no improvements in any health outcomes (weight, blood pressure, etc) at either assessment. The cash incentive was most effective at increasing MVPA bout min per week at 6 months, but this effect was not sustained 6 months after the incentives were discontinued. At 12 months, the activity tracker with or without charity incentives were effective at stemming the reduction in MVPA bout min per week seen in the control group, but we identified no evidence of improvements in health outcomes, either with or without incentives, calling into question the value of these devices for health promotion. Although other incentive strategies might generate greater increases in step activity and improvements in health outcomes, incentives would probably need to be in place long term to avoid any potential decrease in physical activity resulting from discontinuation. Ministry of Health, Singapore. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Inspections - a cost effective approach

    International Nuclear Information System (INIS)

    Joseph, C.


    This paper describes a cost effective approach for inspections of Computerized Nuclear Materials Control and Accounting Systems (CNMCAS). Highlighted is the capability to conduct an inspection program via portable telephone terminals from off-site locations. The program can be applied to various materials management functions including materials control, quality assurance, and materials accounting. The system is designed to facilitate inspections by both external and internal groups

  17. Do rewards reinforce the growth mindset?: Joint effects of the growth mindset and incentive schemes in a field intervention. (United States)

    Chao, Melody Manchi; Visaria, Sujata; Mukhopadhyay, Anirban; Dehejia, Rajeev


    The current study draws on the motivational model of achievement which has been guiding research on the growth mindset intervention (Dweck & Leggett, 1988) and examines how this intervention interacts with incentive systems to differentially influence performance for high- and low-achieving students in Indian schools that serve low-SES communities. Although, as expected, the growth mindset intervention did interact with incentive systems and prior achievement to influence subsequent academic performance, the existing growth mindset framework cannot fully account for the observed effects. Specifically, we found that the growth mindset intervention did facilitate performance through persistence, but only when the incentive system imparted individuals with a sense of autonomy. Such a facilitation effect was only found among those students who had high prior achievement, but not among those who had underperformed. When the incentive did not impart a sense of autonomy, the growth mindset intervention undermined the performance of those who had high initial achievement. To reconcile these discrepancies and to advance understanding of the impacts of psychological interventions on achievement outcomes, we discuss how the existing theory can be extended and integrated with an identity-based motivation framework (Oyserman & Destin, 2010). We also discuss the implications of our work for future research and practice. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Peace Incentives

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.


    How does economic assistance influence the success or failure of peace processes in Africa? Can economic assistance act as an incentive to facilitate an end to conflict? The literature largely ignores aid as a factor supporting peace processes. In addressing this topic, the current study tries...

  19. Costs and Cost-Effectiveness of Plasmodium vivax Control. (United States)

    White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard


    The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

  20. Effect of prospective reimbursement on nursing home costs. (United States)

    Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P


    This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and facility case-mix information from random, stratified samples of homes and residents. Data were obtained for six years (1979-1985) covering the three-year period before and after implementation of the prospective payment system. This study used a pre-post, longitudinal analytical design in which interrupted, time-series regression models were estimated to test the effects of prospective payment and other factors, e.g., facility characteristics, nursing home market factors, facility case mix, and quality of care, on nursing home costs. Prospective payment contributed to an estimated $3.03 decrease in total variable costs in the third year from what would have been expected under the previous retrospective cost-based payment system. Responsiveness to payment system efficiency incentives declined over the study period, however, indicating a growing problem in achieving further cost reductions. Some evidence suggested that cost reductions might have reduced access for public patients. Study findings are consistent with the results of other studies that have demonstrated the effectiveness of prospective payment systems in restraining nursing home costs. Potential policy trade-offs among cost containment, access, and quality assurance deserve further consideration, particularly by researchers and policymakers designing the new generation of case mix-based and other nursing home payment systems.

  1. Effects of Performance-Based Financial Incentives on Work Performance: A Study of Technical-Level Employees in the Private Sector in Sri Lanka (United States)

    Wickramasinghe, Vathsala; Dabere, Sampath


    The objective of the study is to investigate the effect of performance-based financial incentives on work performance. The study hypothesized that the design features of performance-based financial incentive schemes themselves may influence individuals' work performance. For the study, survey methodology was used and 93 technical-level employees…

  2. Federal Financial Incentives to Induce Early Experience Producing Unconventional Liquid Fuels

    National Research Council Canada - National Science Library

    Camm, Frank; Bartis, James T; Bushman, Charles J


    This technical report explains an analytic way to design and assess packages of financial incentives that the government can use to cost effectively promote early experience with coal-to-liquids (CTL...

  3. Pursuing Photovoltaic Cost-Effectiveness

    DEFF Research Database (Denmark)

    Yang, Yongheng; Koutroulis, Eftichios; Sangwongwanich, Ariya


    loading of the power devices. However, its feasibility is challenged by the associated energy losses. An increase of the inverter lifetime and a reduction of the energy yield can alter the cost of energy, demanding an optimization of the power limitation. Therefore, aiming at minimizing the Levelized Cost...... be flexibly performed. As an advanced control strategy, the Absolute Active Power Control (AAPC) can effectively solve the overloading issues by limiting the maximum possible PV power to a certain level (i.e., the power limitation), and also benefit the inverter reliability due to the reduction in the thermal...... performance in terms of LCOE and energy production can be obtained by enabling the AAPC strategy, compared to the conventional PV inverter operating only in the maximum power point tracking mode. In the presented case study, the minimum of the LCOE is achieved for the PV system when the power limit...

  4. Incentives for solar energy in industry (United States)

    Bergeron, K. D.


    Several issues are analyzed on the effects that government subsidies and other incentives have on the use of solar energy in industry, as well as on other capital-intensive alternative energy supplies. Discounted cash flow analysis is used to compare tax deductions for fuel expenses with tax credits for capital investments for energy. The result is a simple expression for tax equity. The effects that market penetration of solar energy has on conventional energy prices are analyzed with a free market model. It is shown that net costs of a subsidy program to the society can be significantly reduced by price. Several government loan guarantee concepts are evaluated as incentives that may not require direct outlays of government funds; their relative effectiveness in achieving loan leverage through project financing, and their cost and practicality, are discussed.

  5. What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?

    Directory of Open Access Journals (Sweden)

    Emma Swann


    Full Text Available Financial incentives are used by natural resource management organisations to encourage landholders to adopt sustainable practices where the outcomes on a farm scale may be negative or marginal. There is a growing body of research aimed at understanding why landholders do or do not agree to participate in financial incentive programs, however research that considers when and how financial incentives work to bring about long-term behaviour change is relatively immature. The purpose of this review is to answer the question ‘What factors influence the effectiveness of financial incentives on long-term natural resource management practice change?’ In synthesising the evidence, it was found that there are numerous characteristics of the practice change itself, along with the program design and implementation, which are important to understand long-term behaviour change. These include whether inexpensive maintenance or long-term funding is available; whether the changes are relatively simple to sustain; whether the program involves structural changes; whether there is land use rigidity; and whether the changes have resulting environmental benefits that are highly observable. Additionally, it is advisable for programs that use financial incentives to include the following program features: ongoing extension support and a focus on building relationship and trust; flexibility in how the practice change is applied; active landholder involvement from planning to evaluation; and contract length that is appropriate for the complexity of the NRM practice. These characteristics can be used to guide policy makers in their natural resource management investment decisions. There is a clear need for greatly increased monitoring and evaluation of existing programs, both during the program and after its conclusion, in order to more fully understand its long-term impacts and ultimate effectiveness. Finally, landholders undertaking a practice change generally

  6. Effects of Individual Physician-Level and Practice-Level Financial Incentives on Hypertension Care: A Cluster Randomized Trial (United States)

    Petersen, Laura A.; Simpson, Kate; Pietz, Kenneth; Urech, Tracy H.; Hysong, Sylvia J.; Profit, Jochen; Conrad, Douglas A.; Dudley, R. Adams; Woodard, LeChauncy D.


    Importance Pay for performance is intended to align incentives to promote high quality care, but results have been contradictory. Objective To test the effect of explicit financial incentives to reward guideline-recommended hypertension care. Design, Setting, and Participants Cluster randomized controlled trial of 12 Veterans Affairs hospital-based outpatient clinics with five performance periods and a 12-month washout. We enrolled 83 primary care physicians and 42 non-physician personnel (e.g., nurses, pharmacists) working with physicians to deliver hypertension care. Interventions Clinics randomized to one of four groups: physician-level (individual) incentives; practice-level incentives; individual- plus practice-level incentives (combined); or none. Intervention participants received up to five payments every four months; all participants could access feedback reports. Main outcome measures For each four-month period, the number of hypertensive patients among a random sample who achieved guideline-recommended blood pressure thresholds or received an appropriate response to uncontrolled blood pressure; and/or been prescribed guideline-recommended medications and the number who developed hypotension. Results Mean (standard deviation) total payments over the study were $4,270 ($459), $2,672 ($153), and $1,648 ($248) for the combined, individual, and practice-level interventions, respectively. The adjusted change over the study in patients meeting the combined blood pressure/appropriate response measure was 8.84 percentage points (95% confidence interval [CI], 4.20–11.80) for the individual-level, 3.70 (95% CI, 0.24–7.68) for the practice-level, 5.54 (95% CI, 1.92–9.52) for the combined, and 0.47 (95% CI, −3.12–4.04) for the control groups. For medications, the change was 9.07 (95% CI, 4.52–13.44), 4.98 (95% CI, 0.64–10.08), 7.26 (95% CI, 2.92–12.48), and 4.35 (95% CI, −0.28–9.28) percentage points, respectively. The adjusted estimated

  7. Motivating safety belt use at a community hospital: an effective integration of incentive and commitment strategies. (United States)

    Nimmer, J G; Geller, E S


    An effective hospital-based safety-belt program incorporated several advantages over prior attempts to increase safety belt use, including (a) the use of indigenous staff as program sponsors, coordinators, and delivery agents; (b) a yearlong program evaluation; and (c) a combination of extrinsic incentives and intrinsic commitment. To be eligible for a weekly $5, employees met the following contingencies: (a) signed a pledge card; (b) displayed the signed pledge card in their vehicle; and (c) wore a safety belt. Overall, belt use increased from a 2-week baseline mean of 15.6% to 34.7% during the 6-month intervention, and decreased to 25.6% at withdrawal. For the pledge card signers (n = 188) and the nonsigners (n = 533), belt use increased from baseline means of 29.4% and 11.8% to intervention use rates of 75.1 and 17.7%, respectively. Withdrawal and 4-month follow-up use rates were 56.0% and 44.9% for the Pledge group, and 17.2% and 22.1% for the Nonpledge group.

  8. Long-lasting effects of perinatal asphyxia on exploration, memory and incentive downshift. (United States)

    Galeano, Pablo; Blanco Calvo, Eduardo; Madureira de Oliveira, Diêgo; Cuenya, Lucas; Kamenetzky, Giselle Vanesa; Mustaca, Alba Elisabeth; Barreto, George Emilio; Giraldez-Alvarez, Lisandro Diego; Milei, José; Capani, Francisco


    Perinatal asphyxia remains as one of the most important causes of death and disability in children, without an effective treatment. Moreover, little is known about the long-lasting behavioral consequences of asphyxia at birth. Therefore, the main aim of the present study was to investigate the motor, emotional and cognitive functions of adult asphyctic rats. Experimental subjects consisted of rats born vaginally (CTL), by cesarean section (C+), or by cesarean section following 19 min of asphyxia (PA). At three months of age, animals were examined in a behavioral test battery including elevated plus maze, open field, Morris water maze, and an incentive downshift procedure. Results indicated that groups did not differ in anxiety-related behaviors, although a large variability was observed in the asphyctic group and therefore, the results are not completely conclusive. In addition, PA and C+ rats showed a deficit in exploration of new environments, but to a much lesser extent in the latter group. Spatial reference and working memory impairments were also found in PA rats. Finally, when animals were downshifted from a 32% to a 4% sucrose solution, an attenuated suppression of consummatory behavior was observed in PA rats. These results confirmed and extended those reported previously about the behavioral alterations associated with acute asphyxia around birth. Copyright © 2011 ISDN. Published by Elsevier Ltd. All rights reserved.

  9. Effectiveness of Motivational Incentives for Adolescent Marijuana Users in a School-Based Intervention. (United States)

    Stewart, David G; Felleman, Benjamin I; Arger, Christopher A


    This study examined whether adolescents receiving Motivational Interviewing (MI) intervention have different outcomes compared to those receiving Motivational Incentives (Motivational Interviewing combined with Contingency Management; MI+CM). A total of 136 adolescents (from a parent study of 220 adolescents) with problematic substance use were recruited from 8 high schools in Washington State, where they completed either 8-weeks of MI or MI+CM. Frequency of marijuana use was assessed at baseline, at the end-of-treatment, and at 16-week follow-up. A balanced and matched sample was created using propensity scores, then analyzed using Hierarchical Linear Modeling (HLM). Multilevel regression analyses revealed that adolescents who received MI+CM exhibited a greater reduction in use across time (pmotivation and school attendance were not found. Use of coping strategies at the end-of-treatment had a significant indirect effect on the relationship between the intervention condition and marijuana use at the end-of-treatment (F3, 121=10.20, R2=.20, p<.01). These results suggest that the inclusion of contingencies into adolescent marijuana treatment decreases the end-of-treatment frequency of marijuana use and related consequences while increasing the use of coping strategies and the pursuit of additional treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. How much do incentives affect car purchase? Agent-based microsimulation of consumer choice of new cars. Part 2. Forecasting effects of feebates based on energy-efficiency

    International Nuclear Information System (INIS)

    Haan, Peter de; Mueller, Michel G.; Scholz, Roland W.


    In this paper, we simulate the car market in order to forecast the effects of feebate systems based on an energy-labeling scheme using categories A to G. Very fuel-efficient (A) cars receive a cash incentive, highly inefficient (G) cars pay additional fees. Consumers have different price elasticities and behavioral options to react to feebates. They can switch to a smaller sized car, but as energy-efficiency varies widely within size segments, they can also stick to the preferred size class and choose a more efficient (smaller) engine. In addition, previously owned cars influence the next car to be chosen. We use an agent-based microsimulation approach particularly suited to predict environmental and market effects of feebates. Heteorogeneous agents choose from a choice set drawn from a detailed fleet of new cars. Incentives of EUR2000 for A-labeled cars induce an additional rated CO 2 emission decrease of new car registrations between 3.4% and 4.3%, with CO 2 abatement costs between EUR6 and EUR13 per ton, and otherwise little undesired market disturbance. The risk of rebound effects is estimated to be low. After adopting the frequencies of consumer segments to a given country, the model presented is applicable to all European car markets. (author)

  11. The Impact of Lottery Incentives on Student Survey Response Rates. (United States)

    Porter, Stephen R.; Whitcomb, Michael E.


    A controlled experiment tested the effects of lottery incentives using a prospective college applicant Web survey, with emails sent to more than 9,000 high school students. Found minimal effect of postpaid incentives for increasing levels of incentive. (EV)

  12. Evaluation of the effects of an offer of a monetary incentive on the rate of questionnaire return during follow-up of a clinical trial: a randomised study within a trial. (United States)

    Hardy, Pollyanna; Bell, Jennifer L; Brocklehurst, Peter


    A systematic review on the use of incentives to promote questionnaire return in clinical trials suggest they are effective, but not all studies have sufficient funds to use them. Promising an incentive once data are returned can reduce the cost-burden of this approach, with possible further cost-savings if the offer were restricted to reminder letters only. This study aimed to evaluate the effect of promising a monetary incentive at first mailout versus a promise on reminder letters only. This was a randomised Study Within A Trial (SWAT) nested within BUMPES, a multicentre randomised controlled trial of maternal position in the late stage of labour in women with an epidural. The follow-up questionnaire asked for information on the women's health, wellbeing and health service use one year following the birth of their baby. Women who consented to be contacted were randomised to a promise of a monetary incentive at first mailout or a promise on reminder letters only. Women were given an option of completing the questionnaire on paper or on online. The incentive was posted out on receipt of a completed questionnaire. The primary outcome was the overall return rate, and secondary outcomes were the return rate without any chasing from the study office, and the total cost of the vouchers. A total of 1,029 women were randomised, 508 to the first mailout group and 518 to the reminder group. There was no evidence to suggest a difference between groups in the overall return rate (adjusted RR 1.03 (95 % CI 0.96 to 1.11), however the proportion returned without chasing was higher in the first mailout group (adjusted RR 1.22, 95 % CI 1.07 to 1.39). The total cost of the vouchers per participant was higher in the first mailout group (mean difference £4.56, 95 % CI £4.02 to £5.11). Offering a monetary incentive when a reminder is required could be cost-effective depending on the sample size of the study and the resources available to administer the reminder letters. The

  13. The incentive amplifying effects of nicotine are reduced by selective and non-selective dopamine antagonists in rats. (United States)

    Palmatier, Matthew I; Kellicut, Marissa R; Brianna Sheppard, A; Brown, Russell W; Robinson, Donita L


    Nicotine is a psychomotor stimulant with 'reinforcement enhancing' effects--the actions of nicotine in the brain increase responding for non-nicotine rewards. We hypothesized that this latter effect of nicotine depends on increased incentive properties of anticipatory cues; consistent with this hypothesis, multiple laboratories have reported that nicotine increases sign tracking, i.e. approach to a conditioned stimulus (CS), in Pavlovian conditioned-approach tasks. Incentive motivation and sign tracking are mediated by mesolimbic dopamine (DA) transmission and nicotine facilitates mesolimbic DA release. Therefore, we hypothesized that the incentive-promoting effects of nicotine would be impaired by DA antagonists. To test this hypothesis, separate groups of rats were injected with nicotine (0.4mg/kg base) or saline prior to Pavlovian conditioning sessions in which a CS (30s illumination of a light or presentation of a lever) was immediately followed by a sweet reward delivered in an adjacent location. Both saline and nicotine pretreated rats exhibited similar levels of conditioned approach to the reward location (goal tracking), but nicotine pretreatment significantly increased approach to the CS (sign tracking), regardless of type (lever or light). The DAD1 antagonist SCH-23390 and the DAD2/3 antagonist eticlopride reduced conditioned approach in all rats, but specifically reduced goal tracking in the saline pretreated rats and sign tracking in the nicotine pretreated rats. The non-selective DA antagonist flupenthixol reduced sign-tracking in nicotine rats at all doses tested; however, only the highest dose of flupenthixol reduced goal tracking in both nicotine and saline groups. The reductions in conditioned approach behavior, especially those by SCH-23390, were dissociated from simple motor suppressant effects of the antagonists. These experiments are the first to investigate the effects of dopaminergic drugs on the facilitation of sign-tracking engendered by

  14. Does a monetary incentive improve the response to a postal questionnaire in a randomised controlled trial? The MINT incentive study

    Directory of Open Access Journals (Sweden)

    Mt-Isa Shahrul


    Full Text Available Abstract Background Sending a monetary incentive with postal questionnaires has been found to improve the proportion of responders, in research in non-healthcare settings. However, there is little research on use of incentives to improve follow-up rates in clinical trials, and existing studies are inconclusive. We conducted a randomised trial among participants in the Managing Injuries of the Neck Trial (MINT to investigate the effects on the proportion of questionnaires returned and overall non-response of sending a £5 gift voucher with a follow-up questionnaire. Methods Participants in MINT were randomised to receive either: (a a £5 gift voucher (incentive group or (b no gift voucher (no incentive group, with their 4 month or 8 month follow-up questionnaire. We recorded, for each group, the number of questionnaires returned, the number returned without any chasing from the study office, the overall number of non-responders (after all chasing efforts by the study office, and the costs of following up each group. Results 2144 participants were randomised, 1070 to the incentive group and 1074 to the no incentive group. The proportion of questionnaires returned (RR 1.10 (95% CI 1.05, 1.16 and the proportion returned without chasing (RR 1.14 (95% CI 1.05, 1.24 were higher in the incentive group, and the overall non-response rate was lower (RR 0.68 (95% CI 0.53, 0.87. Adjustment for injury severity and hospital of recruitment to MINT made no difference to these results, and there were no differences in results between the 4-month and 8-month follow up questionnaires. Analysis of costs suggested a cost of £67.29 per additional questionnaire returned. Conclusion Monetary incentives may be an effective way to increase the proportion of postal questionnaires returned and minimise loss to follow-up in clinical trials. Trial registration number ISRCTN61305297

  15. Paying people to lose weight: the effectiveness of financial incentives provided by health insurers for the prevention and management of overweight and obesity - a systematic review. (United States)

    Ananthapavan, J; Peterson, A; Sacks, G


    Curbing the obesity epidemic is likely to require a suite of interventions targeting the obesogenic environment as well as individual behaviour. Evidence suggests that the effectiveness of behaviour modification programmes can be enhanced by financial incentives that immediately reward weight loss behaviour. This systematic review investigated the effectiveness of incentives with a focus on assessing the relative effectiveness of incentives that target different behaviours as well as factors of importance when implementing these programmes in real-world settings (health insurer settings). A narrative review of the academic and grey literature including a variety of study designs was undertaken. Twenty studies met inclusion criteria and were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results suggest that incentivizing weight loss is effective in the short term while the incentives are in place. There are various incentive designs, and although the relative effectiveness of each of these on weight loss is not clear, it appears that positive incentives increase the uptake into programmes and may reduce dropouts. As with other weight loss initiatives, there is a need to explore ways to maintain weight loss in the longer term - incentives for weight maintenance could play a role. © 2017 World Obesity Federation.

  16. Costs and effects in lumbar spinal fusion

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn Bjarke; Christiansen, Terkel


    of the Dallas Pain Questionnaire and the Low Back Pain Rating Scale at baseline and 2 years postoperatively. Regression models were used to reveal determinants for costs and effects. Costs and effects were analyzed as a net-benefit measure to reveal determinants for cost-effectiveness, and finally, adjusted...... areas. Multi-level fusion and surgical technique significantly affected the net-benefit as well. Surprisingly, no correlation was found between treatment costs and treatment effects. Incremental analysis suggested that the probability of posterior instrumentation being cost-effective was limited......Although cost-effectiveness is becoming the foremost evaluative criterion within health service management of spine surgery, scientific knowledge about cost-patterns and cost-effectiveness is limited. The aims of this study were (1) to establish an activity-based method for costing at the patient...

  17. Incentives, equity and the Able Chooser Problem. (United States)

    Grill, Kalle


    Health incentive schemes aim to produce healthier behaviours in target populations. They may do so both by making incentivised options more salient and by making them less costly. Changes in costs only result in healthier behaviour if the individual rationally assesses the cost change and acts accordingly. Not all people do this well. Those who fail to respond rationally to incentives will typically include those who are least able to make prudent choices more generally. This group will typically include the least advantaged more generally, since disadvantage inhibits one's effective ability to choose well and since poor choices tend to cause or aggravate disadvantage. Therefore, within the target population, health benefits to the better off may come at the cost of aggravated inequity. This is one instance of a problem I name the Able Chooser Problem, previously emphasised by Richard Arneson in relation to coercive paternalism. I describe and discuss this problem by distinguishing between policy options and their effects on the choice situation of individuals. Both positive and negative incentives, as well as mandates that are less than perfectly effective, require some sort of rational deliberation and action and so face the Able Chooser Problem. In contrast, effective restriction of what options are physically available, as well as choice context design that makes some options more salient or appealing, does not demand rational agency. These considerations provide an equity-based argument for preferring smart design of our choice and living environment to incentives and mandates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  18. The effect of reimbursement on medical decision making: do physicians alter treatment in response to a managed care incentive? (United States)

    Melichar, Lori


    The empirical literature that explores whether physicians respond to financial incentives has not definitively answered the question of whether physicians alter their treatment behavior at the margin. Previous research has not been able to distinguish that part of a physician response that uniformly alters treatment of all patients under a physician's care from that which affects some, but not all of a physician's patients. To explore physicians' marginal responses to financial incentives while accounting for the selection of physicians into different financial arrangements where others could not, I use data from a survey of physician visits to isolate the effect that capitation, a form of reimbursement wherein physicians receive zero marginal revenue for a range of physician provided services, has on the care provided by a physician. Fixed effects regression results reveal that physicians spend less time with their capitated patients than with their non-capitated patients.

  19. Controlled trial of the effect of length, incentives, and follow-up techniques on response to a mailed questionnaire. (United States)

    Hoffman, S C; Burke, A E; Helzlsouer, K J; Comstock, G W


    Mailed questionnaires are an economical method of data collection for epidemiologic studies, but response tends to be lower than for telephone or personal interviews. As part of a follow-up study of volunteers who provided a brief health history and blood sample for a blood specimen bank in 1989, the authors conducted a controlled trial of the effect of length, incentives, and follow-up techniques on response to a mailed questionnaire. Interventions tested included variations on length of the questionnaire, effect of a monetary incentive, and effect of a postcard reminder versus a letter accompanied by a second questionnaire. Response was similar for the short (16-item, 4-page) and long (76-item, 16-page) questionnaire groups. The non-monetary [corrected] incentive did not improve the frequency of response. The second mailing of a questionnaire was significantly better than a postcard reminder in improving responses (23% vs. 10%). It is important to systematically test marketing principles to determine which techniques are effective in increasing response to mailed questionnaires for epidemiologic studies.

  20. Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia.

    NARCIS (Netherlands)

    Lai, T.; Habicht, J.; Reinap, M.; Chisholm, D.; Baltussen, R.M.P.M.


    OBJECTIVE: To assess the population-level costs, effects and cost-effectiveness of different alcohol and tobacco control strategies in Estonia. DESIGN: A WHO cost-effectiveness modelling framework was used to estimate the total costs and effects of interventions. Costs were assessed in Estonian


    Directory of Open Access Journals (Sweden)

    Natalia KRAUS


    Full Text Available The incentives and obstacles of effective functioning of the innovations are investigated in the article. It is determined that on the formation of the market and establishment of its equilibrium directly affects a number of system characteristics that established in the institutional environment, including such as: differing vectors of actions of economic (market and political (political and legal institutes and state factors of the development of national economy; formation of a “double standard” and various rules of the market game for different classes of participants; negative mutual influence of key institutes, which indicates that the state has no interest in establishing of transparent rules and eliminates the possibility of effective regulation in individual segments. It is offered an author’s understanding of the market of innovations through the prism of institutionalism, the market of innovations is a complete range of social and economic institutions-organizations and joint structures and aims the economic exchange, that includes a common understanding of mutual benefit, the transfer of ownership, “transparent” and fair agreements on proportional sharing. It is proved that institutional factor in some situations that arise in the market is a natural limiter, controller of his freedom. Institute of the market of innovations is under the powerful influence of a number of informal and not always visible institutional the market of innovations. They include intuition of manufacturers, perception the innovations by individuals, feelings, motives of internal motivations of consumer behavior. It is presented institutional structure of the market of innovations according to different levels of economic aggregation in order to obtain an overall vision of institutional design of the market of innovations. This structuring enables better determine with possible mutual influences and relationships between the “players” in the

  2. The productivity effects of profit sharing, employee ownership, stock option and team incentive plans: Evidence from korean panel data


    Kato, Takao; Lee, Ju Ho; Ryu, Jang-soo


    We report the first results for Korean firms on the incidence, diffusion, scope and effects of diverse employee financial participation schemes, such as Profit Sharing Plans (PSPs), Employee Stock Ownership Plans (ESOPs), Stock Option Plans (SOPs) and Team Incentive Plans (TIPs). In do doing, we assemble important new panel data by merging data from a survey of all Korean firms listed on Korean Stock Exchange which enjoys an unusually high response rate of 60 percent with accounting data from...

  3. Applying Psychology to Economic Policy Design: Using Incentive Preserving Rebates to Increase Acceptance of Critical Peak Electricity Pricing


    Letzler, Robert


    This project extends the idea that policy makers should address problems by improving economic incentives. This project adds that presenting incentives in a way that reflects how people make decisions can sometimes improve consumers’ responses to the incentives and policy outcomes. This paper uses behavioral economics to propose ways to increase electricity policy effectiveness. The cost of generating power fluctuates enormously from hour to hour but most customers pay time-invariant prices f...

  4. An Analysis of a Biometric Screening and Premium Incentive-Based Employee Wellness Program: Enrollment Patterns, Cost, and Outcome. (United States)

    Maeng, Daniel D; Geng, Zhi; Marshall, Wendy M; Hess, Allison L; Tomcavage, Janet F


    Since 2012, a large health care system has offered an employee wellness program providing premium discounts for those who voluntarily undergo biometric screenings and meet goals. This study evaluates the program impact on care utilization and total cost of care, taking into account employee self-selection into the program. A retrospective claims data analysis of 6453 employees between 2011 and 2015 was conducted, categorizing the sample into 3 mutually exclusive subgroups: Subgroup 1 enrolled and met goals in all years, Subgroup 2 enrolled or met goals in some years but not all, and Subgroup 3 never enrolled. Each subgroup was compared to a cohort of employees in other employer groups (N = 24,061). Using a difference-in-difference method, significant reductions in total medical cost (14.2%; P = 0.014) and emergency department (ED) visits (11.2%; P = 0.058) were observed only among Subgroup 2 in 2015. No significant impact was detected among those in Subgroup 1. Those in Subgroup 1 were less likely to have chronic conditions at baseline. The results indicate that the wellness program enrollment was characterized by self-selection of healthier employees, among whom the program appeared to have no significant impact. Yet, cost savings and reductions in ED visits were observed among the subset of employees who enrolled or met goal in some years but not all, suggesting a potential link between the wellness program and positive behavior changes among certain subsets of the employee population.

  5. Do Monetary Incentives Matter in Classroom Experiments? Effects on Course Performance (United States)

    Rousu, Matthew C.; Corrigan, Jay R.; Harris, David; Hayter, Jill K.; Houser, Scott; Lafrancois, Becky A.; Onafowora, Olugbenga; Colson, Gregory; Hoffer, Adam


    Using 641 principles of economics students across four universities, the authors examine whether providing monetary incentives in a prisoner's dilemma game enhances student learning as measured by a set of common exam questions. Subjects either play a two-player prisoner's dilemma game for real money, play the same game with no money at stake…

  6. Effects of Decreasing External Incentives on Higher Education--Reflections from the Case of Taiwan (United States)

    Lin, Yung-feng


    Widened participation in post-compulsory and higher education is generally regarded as a result of the growing recognition of the internal and external benefits of higher education, which are categorised either as a private or public good. However, a question can be raised: once these incentives become less promising or less evident, will a strong…

  7. A Meta-Analysis of Experiments on the Effectiveness of Incentives in Organizational Surveys

    NARCIS (Netherlands)

    Torres van Grinsven, Vanessa; Hox, Joop


    The use of monetary and non-monetary incentives for increasing response is considered a proven and widely used method in surveys of individuals or households. This applies not only to mail, but also to face-to-face and telephone surveys. Experimental research shows that the technique is also

  8. Monetary incentive moderates the effect of implicit fear on effort-related cardiovascular response. (United States)

    Chatelain, Mathieu; Gendolla, Guido H E


    Integrating the implicit-affect-primes-effort model (Gendolla, 2012, 2015) with the principles of motivational intensity theory (Brehm & Self, 1989) we investigated if the effort mobilization deficit observed in people exposed to fear primes (vs. anger primes) in a difficult short-term memory task could be compensated by high monetary incentive. Effort was operationalized as cardiac response. We expected that fear primes should lead to the strongest cardiac pre-ejection period (PEP) reactivity when incentive was high (high subjective demand and high justified effort) and to the weakest response when incentive was low (high subjective demand but only low justified effort). PEP reactivity in the anger-prime conditions should fall in between (high but feasible demand). We obtained the predicted pattern on responses of PEP and systolic blood pressure. The present findings show for the first time that the effort mobilization deficit of participants exposed to fear primes in a difficult cognitive task could be compensated by a high incentive. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. The effect of task demand and incentive on neurophysiological and cardiovascular markers of effort. (United States)

    Fairclough, Stephen H; Ewing, Kate


    According to motivational intensity theory, effort is proportional to the level of task demand provided that success is possible and successful performance is deemed worthwhile. The current study represents a simultaneous manipulation of demand (working memory load) and success importance (financial incentive) to investigate neurophysiological (EEG) and cardiovascular measures of effort. A 2×2 repeated-measures study was conducted where 18 participants performed a n-back task under three conditions of demand: easy (1-back), hard (4-back) and very hard (7-back). In addition, participants performed these tasks in the presence of performance-contingent financial incentive or in a no-incentive (pilot trial) condition. Three bands of EEG activity were quantified: theta (4-7Hz), lower-alpha (7.5-10Hz) and upper-alpha (10.5-13Hz). Fronto-medial activity in the theta band and activity in the upper-alpha band at frontal, central and parietal sites were sensitive to demand and indicated greatest effort when the task was challenging and success was possible. Mean systolic blood pressure and activity in the lower-alpha band at parietal sites were also sensitive to demand but also increased in the incentive condition across all levels of task demand. The results of the study largely support the predictions of motivational intensity using neurophysiological markers of effort. Copyright © 2017. Published by Elsevier B.V.

  10. Incentives and Earnings Growth

    DEFF Research Database (Denmark)

    Frederiksen, Anders


    The career prospects of newly recruited employees differ substantially within an organization. The stars experience considerable growth in earnings; others can hardly maintain their entry salaries. This article sheds light on the mechanisms generating the observed heterogeneity in earnings growth...... by investigating the effects that explicit short-run incentives and implicit incentives have on earnings growth. The model’s predictions are tested using personnel records from a large bank and are found to be consistent with the observed earnings growth during the first half of the employees’ careers....

  11. Monetary Incentive Effects on Event-Based Prospective Memory Three Months after Traumatic Brain Injury in Children (United States)

    Pedroza, Claudia; Chapman, Sandra B.; Cook, Lori G.; Vásquez, Ana C.; Levin, Harvey S.


    Information regarding the remediation of event-based prospective memory (EB-PM) impairments following pediatric traumatic brain injury (TBI) is scarce. Addressing this, two levels of monetary incentives were used to improve EB-PM in children ages 7 to 16 years with orthopedic injuries (OI, n = 51), or moderate (n = 25), and severe (n = 39) TBI at approximately three months postinjury. The EB-PM task consisted of the child giving a specific verbal response to a verbal cue from the examiner while performing a battery of neuropsychological measures (ongoing task). Significant effects were found for Age-at-Test, Motivation Condition, Period, and Group. Within-group analyses indicated OI and moderate TBI groups performed significantly better under the high-versus low-incentive condition, but the severe TBI group demonstrated no significant improvement. These results indicate EB-PM can be significantly improved at three months postinjury in children with moderate, but not severe, TBI. PMID:21347945

  12. An Analysis of the Costs, Benefits, and Implications of Different Approaches to Capturing the Value of Renewable Energy Tax Incentives

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark


    This report compares the relative costs, benefits, and implications of capturing the value of renewable energy tax benefits in these three different ways – applying them against outside income , carrying them forward in time until they can be fully absorbed internally, or monetizing them through third-party tax equity investors – to see which method is most competitive under various scenarios. It finds that under current law and late-2013 market conditions, monetization makes sense for all but the most tax-efficient project sponsors. In other words, for most project sponsors, bringing in third-party tax equity currently provides net benefits to a project.

  13. Geothermal power, policy, and design: Using levelized cost of energy and sensitivity analysis to target improved policy incentives for the U.S. geothermal market (United States)

    Richard, Christopher L.

    At the core of the geothermal industry is a need to identify how policy incentives can better be applied for optimal return. Literature from Bloomquist (1999), Doris et al. (2009), and McIlveen (2011) suggest that a more tailored approach to crafting geothermal policy is warranted. In this research the guiding theory is based on those suggestions and is structured to represent a policy analysis approach using analytical methods. The methods being used are focus on qualitative and quantitative results. To address the qualitative sections of this research an extensive review of contemporary literature is used to identify the frequency of use for specific barriers, and is followed upon with an industry survey to determine existing gaps. As a result there is support for certain barriers and justification for expanding those barriers found within the literature. This method of inquiry is an initial point for structuring modeling tools to further quantify the research results as part of the theoretical framework. Analytical modeling utilizes the levelized cost of energy as a foundation for comparative assessment of policy incentives. Model parameters use assumptions to draw conclusions from literature and survey results to reflect unique attributes held by geothermal power technologies. Further testing by policy option provides an opportunity to assess the sensitivity of each variable with respect to applied policy. Master limited partnerships, feed in tariffs, RD&D, and categorical exclusions all result as viable options for mitigating specific barriers associated to developing geothermal power. The results show reductions of levelized cost based upon the model's exclusive parameters. These results are also compared to contemporary policy options highlighting the need for tailored policy, as discussed by Bloomquist (1999), Doris et al. (2009), and McIlveen (2011). It is the intent of this research to provide the reader with a descriptive understanding of the role of

  14. Incentives for vertical integration in healthcare: the effect of reimbursement systems. (United States)

    Byrne, M M; Ashton, C M


    In the United States, many healthcare organizations are being transformed into large integrated delivery systems, even though currently available empirical evidence does not provide strong or unequivocal support for or against vertical integration. Unfortunately, the manager cannot delay organizational changes until further research has been completed, especially when further research is not likely to reveal a single, correct solution for the diverse healthcare systems in existence. Managers must therefore carefully evaluate the expected effects of integration on their individual organizations. Vertical integration may be appropriate if conditions facing the healthcare organization provide opportunities for efficiency gains through reorganization strategies. Managers must consider (1) how changes in the healthcare market have affected the dynamics of production efficiency and transaction costs; (2) the likelihood that integration strategies will achieve increases in efficiency or reductions in transaction costs; and (3) how vertical integration will affect other costs, and whether the benefits gained will outweigh additional costs and efficiency losses. This article presents reimbursement systems as an example of how recent changes in the industry may have changed the dynamics and efficiency of production. Evaluation of the effects of vertical integration should allow for reasonable adjustment time, but obviously unsuccessful strategies should not be followed or maintained.

  15. Investigation of existing financial incentive policies for solar photovoltaic systems in U.S. regions

    Directory of Open Access Journals (Sweden)

    Jian Zhang


    Full Text Available This paper analyzes some of the existing incentives for solar photovoltaic (PV energy generation in the U.S. Four types of buildings (e.g., hospitals, large offices, large hotels, and secondary schools located in five different U.S. states, each having their own incentives, are selected and analyzed for the PV incentive policies. The payback period of the PV system is chosen as an indicator to analyze and critique the effectiveness of each incentive by comparing the payback periods before and after taking the incentive into consideration. Then a parametric analysis is conducted to determine the influence of the variation in key parameters, such as PV system capacity, capital cost of PV, sell back ratio and the performance-based incentive rate, on the performance of the PV system. The results show how the existing incentives can be effectively used to promote the PV systems in the U.S. and how variations of the parameters can impact the payback period of the PV systems. Through the evaluation of the existing incentive policies and the parametric study, this paper demonstrates that the type and level of incentives should be carefully determined in policy-making processes to effectively promote the PV systems.

  16. Acceptability of financial incentives and penalties for encouraging uptake of healthy behaviours: focus groups. (United States)

    Giles, Emma L; Sniehotta, Falko F; McColl, Elaine; Adams, Jean


    There is evidence that financial incentive interventions, which include both financial rewards and also penalties, are effective in encouraging healthy behaviours. However, concerns about the acceptability of such interventions remain. We report on focus groups with a cross-section of adults from North East England exploring their acceptance of financial incentive interventions for encouraging healthy behaviours amongst adults. Such information should help guide the design and development of acceptable, and effective, financial incentive interventions. Eight focus groups with a total of 74 adults were conducted between November 2013 and January 2014 in Newcastle upon Tyne, UK. Focus groups lasted approximately 60 minutes and explored factors that made financial incentives acceptable and unacceptable to participants, together with discussions on preferred formats for financial incentives. Verbatim transcripts were thematically coded and analysed in Nvivo 10. Participants largely distrusted health promoting financial incentives, with a concern that individuals may abuse such schemes. There was, however, evidence that health promoting financial incentives may be more acceptable if they are fair to all recipients and members of the public; if they are closely monitored and evaluated; if they are shown to be effective and cost-effective; and if clear health education is provided alongside health promoting financial incentives. There was also a preference for positive rewards rather than negative penalties, and for shopping vouchers rather than cash incentives. This qualitative empirical research has highlighted clear suggestions on how to design health promoting financial incentives to maximise acceptability to the general public. It will also be important to determine the acceptability of health promoting financial incentives in a range of stakeholders, and in particular, those who fund such schemes, and policy-makers who are likely to be involved with the design

  17. The effects of information, social and financial incentives on voluntary undirected blood donations: evidence from a field experiment in Argentina. (United States)

    Iajya, Victor; Lacetera, Nicola; Macis, Mario; Slonim, Robert


    In many low- and middle-income countries blood donations per capita are substantially lower than in advanced economies. In these countries blood supply is mostly collected through directed donations from relatives and friends to individuals needing transfusions or to replace blood used in emergencies. The World Health Organization considers this method of blood supply inefficient compared to undirected voluntary donations. To examine methods to motivate undirected voluntary donations, we ran a large-scale, natural field experiment in Argentina, testing the effectiveness of information, social and financial incentives. We find that only higher-valued financial incentives generated more donations, increasing with the value of the reward. These incentives did not create adverse selection in the safety or usability of the donated blood. We discuss the implications of our findings for researchers interested in understanding motivations for pro-social behavior and for health agencies and policymakers concerned with the current and growing shortages in blood supply in low- and middle-income countries. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Tax Incentives for Retirement Savings: Macro and Welfare Effects in an OLG-GE Model with Liquidity Constraints and Heterogeneous Consumers.


    Rodrigo Cifuentes


    This paper uses an Overlapping Generations-General Equilibrium model to study the impact of the introduction of tax incentives to voluntary savings for retirement in Chile. The paper analyzes the macro impact of the reform, driven mainly by its effect on savings and capital accumulation, and its effect on welfare. A setting with heterogeneous consumers is considered where agents differ in their income levels, and therefore on the relevance that tax-incentives have for them. Both the transitio...

  19. Streamlining: Reducing costs and increasing STS operations effectiveness (United States)

    Petersburg, R. K.


    The development of streamlining as a concept, its inclusion in the space transportation system engineering and operations support (STSEOS) contract, and how it serves as an incentive to management and technical support personnel is discussed. The mechanics of encouraging and processing streamlining suggestions, reviews, feedback to submitters, recognition, and how individual employee performance evaluations are used to motivation are discussed. Several items that were implemented are mentioned. Information reported and the methodology of determining estimated dollar savings are outlined. The overall effect of this activity on the ability of the McDonnell Douglas flight preparation and mission operations team to support a rapidly increasing flight rate without a proportional increase in cost is illustrated.

  20. The goose is (half) cooked: a consideration of the mechanisms and interpersonal context is needed to elucidate the effects of personal financial incentives on health behaviour. (United States)

    Hagger, Martin S; Keatley, David A; Chan, Derwin C K; Chatzisarantis, Nikos L D; Dimmock, James A; Jackson, Ben; Ntoumanis, Nikos


    While we agree that personal financial incentives (PFIs) may have some utility in public health interventions to motivate people in the uptake and persistence of health behaviour, we disagree with some of the sentiments outlined by Lynagh et al. (Int J Behav Med 20:114-120, 2012). Specifically, we feel that the article gives a much stronger impression that PFIs will likely lead to long-term behaviour change once the incentive has been removed than is warranted by current research. This claim has not received strong empirical support nor is it grounded in psychological theory on the role of incentives and motivation. We also feel that the presentation of some of the tenets of self-determination theory by the authors is misleading. Based on self-determination theory, we propose that PFIs, without sufficient consideration of the mechanisms by which external incentives affect motivation and the interpersonal context in which they are presented, are unlikely to lead to persistence in health behaviour once the incentive is removed. We argue that interventions that adopt PFIs as a strategy to promote health-behaviour change should incorporate strategies in the interpersonal context to minimise the undermining effect of the incentives on intrinsic motivation. Interventions should present incentives as informational regarding individuals' competence rather than as purely contingent on behavioural engagement and emphasise self-determined reasons for pursuing the behaviour.

  1. The Effect of Incentive Structure on Heuristic Decision Making: The Proportion Heuristic


    Robert Oxoby


    When making judgments, individuals often utilize heuristics to interpret information. We report on a series of experiments designed to test the ways in which incentive mechanisms influence the use of a particular heuristic in decision-making. Specifically, we demonstrate how information regarding the number of available practice problems influences the behaviors of individuals preparing for an exam (the proportion heuristic). More importantly the extent to which this information influences be...

  2. Unintended consequences of incentive provision for behaviour change and maintenance around childbirth. (United States)

    Thomson, Gill; Morgan, Heather; Crossland, Nicola; Bauld, Linda; Dykes, Fiona; Hoddinott, Pat; Dombrowski, Stephan; MacLennan, Graeme; Rothnie, Kieran; Stewart, Fiona; Farrar, Shelley; Yi, Deokhee; Hislop, Jenni; Ludbrook, Anne; Campbell, Marion; Moran, Victoria Hall; Sniehotta, Falko; Tappin, David


    , but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation.

  3. Unintended consequences of incentive provision for behaviour change and maintenance around childbirth.

    Directory of Open Access Journals (Sweden)

    Gill Thomson

    service delivery, but may be detrimental to other health care areas. Financial incentives are controversial and generated emotive and oppositional responses. The planning, design and delivery of future incentive interventions should evaluate unexpected consequences to inform the evidence for effectiveness, cost-effectiveness and future implementation.

  4. Health Workers' Incentives in South Sudan (IMCHA) | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The findings from this project will address gaps in knowledge for cost-effective measures, such as non-financial incentives, to improve access to health care for mothers and children in high conflict contexts. The results will directly inform, strengthen, and scale community health-worker program efforts implemented by BRAC ...

  5. Earnings progression, human capital and incentives

    DEFF Research Database (Denmark)

    Frederiksen, Anders

    progression by investigating the effects of on-the-job human capital acquisition, explicit short-run incentives and career concern incentives on earnings progression. The model leads to predictions about the incentive structure and the progression in both cross-sectional and individual earnings which...

  6. Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services. (United States)

    Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R


    To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

  7. Beyond Widgets -- Systems Incentive Programs for Utilities

    Energy Technology Data Exchange (ETDEWEB)

    Regnier, Cindy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mathew, Paul [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Robinson, Alastair [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Walter, Travis [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    Utility incentive programs remain one of the most significant means of deploying commercialized, but underutilized building technologies to scale. However, these programs have been largely limited to component-based products (e.g., lamps, RTUs). While some utilities do provide ‘custom’ incentive programs with whole building and system level technical assistance, these programs require deeper levels of analysis, resulting in higher program costs. This results in custom programs being restricted to utilities with greater resources, and are typically applied mainly to large or energy-intensive facilities, leaving much of the market without cost effective access and incentives for these solutions. In addition, with increasingly stringent energy codes, cost effective component-based solutions that achieve significant savings are dwindling. Building systems (e.g., integrated façade, HVAC and/or lighting solutions) can deliver higher savings that translate into large sector-wide savings if deployed at the scale of these programs. However, systems application poses a number of challenges – baseline energy use must be defined and measured; the metrics for energy and performance must be defined and tested against; in addition, system savings must be validated under well understood conditions. This paper presents a sample of findings of a project to develop validated utility incentive program packages for three specific integrated building systems, in collaboration with Xcel Energy (CO, MN), ComEd, and a consortium of California Public Owned Utilities (CA POUs) (Northern California Power Agency(NCPA) and the Southern California Public Power Authority(SCPPA)). Furthermore, these program packages consist of system specifications, system performance, M&V protocols, streamlined assessment methods, market assessment and implementation guidance.

  8. Assessing the Battery Cost at Which Plug-In Hybrid Medium-Duty Parcel Delivery Vehicles Become Cost-Effective

    Energy Technology Data Exchange (ETDEWEB)

    Ramroth, L. A.; Gonder, J. D.; Brooker, A. D.


    The National Renewable Energy Laboratory (NREL) validated diesel-conventional and diesel-hybrid medium-duty parcel delivery vehicle models to evaluate petroleum reductions and cost implications of hybrid and plug-in hybrid diesel variants. The hybrid and plug-in hybrid variants are run on a field data-derived design matrix to analyze the effect of drive cycle, distance, engine downsizing, battery replacements, and battery energy on fuel consumption and lifetime cost. For an array of diesel fuel costs, the battery cost per kilowatt-hour at which the hybridized configuration becomes cost-effective is calculated. This builds on a previous analysis that found the fuel savings from medium duty plug-in hybrids more than offset the vehicles' incremental price under future battery and fuel cost projections, but that they seldom did so under present day cost assumptions in the absence of purchase incentives. The results also highlight the importance of understanding the application's drive cycle specific daily distance and kinetic intensity.

  9. Incentives for partitioning, revisited

    International Nuclear Information System (INIS)

    Cloninger, M.O.


    The incentives for separating and eliminating various elements from radioactive waste prior to final geologic disposal were investigated. Exposure pathways to humans were defined, and potential radiation doses to an individual living within the region of influence of the underground storage site were calculated. The assumed radionuclide source was 1/5 of the accumulated high-level waste from the US nuclear power economy through the year 2000. The repository containing the waste was assumed to be located in a reference salt site geology. The study required numerous assumptions concerning the transport of radioactivity from the geologic storage site to man. The assumptions used maximized the estimated potential radiation doses, particularly in the case of the intrusion water well scenario, where hydrologic flow field dispersion effects were ignored. Thus, incentives for removing elements from the waste tended to be maximized. Incentives were also maximized by assuming that elements removed from the waste could be eliminated from the earth without risk. The results of the study indicate that for reasonable disposal conditions, incentives for partitioning any elements from the waste in order to minimize the risk to humans are marginal at best

  10. CT colonography and cost-effectiveness

    Energy Technology Data Exchange (ETDEWEB)

    Mavranezouli, Ifigeneia [University College London, National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness, Sub-department of Clinical Health Psychology, London (United Kingdom); East, James E. [St Marks Hospital, Imperial College London, Wolfson Unit for Endoscopy, London (United Kingdom); Taylor, Stuart A. [University College Hospital, Specialist X-Ray, London (United Kingdom); University College Hospital, Department of Imaging, London (United Kingdom)


    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  11. CT colonography and cost-effectiveness

    International Nuclear Information System (INIS)

    Mavranezouli, Ifigeneia; East, James E.; Taylor, Stuart A.


    CT colonography (CTC) is increasingly advocated as an effective initial screening tool for colorectal cancer. Nowadays, policy-makers are increasingly interested in cost-effectiveness issues. A number of studies assessing the cost-effectiveness of CTC have been published to date. The majority of findings indicate that CTC is probably not cost-effective when colonoscopy is available, but this conclusion is sensitive to a number of key parameters. This review discusses the findings of these studies, and considers those factors which most influence final conclusions, notably intervention costs, compliance rates, effectiveness of colonoscopy, and the assumed prevalence and natural history of diminutive advanced polyps. (orig.)

  12. Cost-effectiveness of monitoring free flaps. (United States)

    Subramaniam, Shiva; Sharp, David; Jardim, Christopher; Batstone, Martin D


    Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  13. Incentive contracts and time use


    Tor Viking Eriksson; Jaime Ortega


    Empirical studies on incentive contracts have primarily been concerned with the effects on employees’ productivity and earnings. The productivity increases associated with such contracts may, however, come at the expense of quality of life at or outside work. In this paper we study the effect on the employees’ non-work activities, testing whether incentive contracts lead to a change in the allocation of time across work and non-work activities. In doing so, we distinguish between two effects,...


    NARCIS (Netherlands)



    Associated with effects of scale, scope, experience and learning there are effects of firm size on transaction costs; in the stages of contact, contract and control. These effects are due to ''threshold costs'' in setting up contacts, contracts and governance schemes, and to differences with respect

  15. Biosimilar medicines and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Steven Simoens


    Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost-effectiveness

  16. Cost-effectiveness thresholds: pros and cons. (United States)

    Bertram, Melanie Y; Lauer, Jeremy A; De Joncheere, Kees; Edejer, Tessa; Hutubessy, Raymond; Kieny, Marie-Paule; Hill, Suzanne R


    Cost-effectiveness analysis is used to compare the costs and outcomes of alternative policy options. Each resulting cost-effectiveness ratio represents the magnitude of additional health gained per additional unit of resources spent. Cost-effectiveness thresholds allow cost-effectiveness ratios that represent good or very good value for money to be identified. In 2001, the World Health Organization's Commission on Macroeconomics in Health suggested cost-effectiveness thresholds based on multiples of a country's per-capita gross domestic product (GDP). In some contexts, in choosing which health interventions to fund and which not to fund, these thresholds have been used as decision rules. However, experience with the use of such GDP-based thresholds in decision-making processes at country level shows them to lack country specificity and this - in addition to uncertainty in the modelled cost-effectiveness ratios - can lead to the wrong decision on how to spend health-care resources. Cost-effectiveness information should be used alongside other considerations - e.g. budget impact and feasibility considerations - in a transparent decision-making process, rather than in isolation based on a single threshold value. Although cost-effectiveness ratios are undoubtedly informative in assessing value for money, countries should be encouraged to develop a context-specific process for decision-making that is supported by legislation, has stakeholder buy-in, for example the involvement of civil society organizations and patient groups, and is transparent, consistent and fair.

  17. [Cost-effectiveness of addiction care]. (United States)

    Suijkerbuijk, A W M; van Gils, P F; Greeven, P G J; de Wit, G A


    A large number of interventions are available for the treatment of addiction. Professionals need to know about the effectiveness and cost-effectiveness of interventions so they can prioritise appropriate interventions for the treatment of addiction. To provide an overview of the scientific literature on the cost-effectiveness of addiction treatment for alcohol- and drug-abusers. We searched the databases Medline and Centre for Reviews and Dissemination. To be relevant for our study, articles had to focus on interventions in the health-care setting, have a Western context and have a health-related outcome measure such as quality adjusted life years (QALY). Twenty-nine studies met our inclusion criteria: 15 for alcohol and 14 for drugs. The studies on alcohol addiction related mainly to brief interventions. They proved to be cost-saving or had a favourable incremental cost-effectiveness ratio (ICER), remaining below the threshold of € 20,000 per QALY. The studies on drug addiction all involved pharmacotherapeutic interventions. In the case of 10 out of 14 interventions, the ICER was less than € 20,000 per QALY. Almost all of the interventions studied were cost-saving or cost-effective. Many studies consider only health-care costs. Additional research, for instance using a social cost-benefit analysis, could provide more details about the costs of addiction and about the impact that an intervention could have in these/the costs.

  18. The Effects of Financial Incentives on Women’s Performance: The Tournament Theory Applied to Female Tennis Players

    Directory of Open Access Journals (Sweden)

    Matthieu LLORCA


    Full Text Available The purpose of this paper is to analyze the management model of women’s professional tennis by using the theoretical framework of the tournament theory. Indeed, this sport is particularly appropriate to study the effects of financial incentives on women’s performance in the context of competitive elimination tournament. Moreover, we take into account the direct opposition between players by building two relative performance indicators. Empirical tests are conducted, by using Ordinary Least Squares method, on the whole tournaments played by the 30 best women’s tennis players, over the 2011 season. Interesting implication found is that one tournament theory principle, the incentive effect, is confirmed. In other words, an undistributed prize structure between tournament rounds increases the player performance. However, the other consequence of the tournament theory, the participative effect, is rejected because the monetary gains distributed by the tournament’s organizer (either the premium earned or the total dollar endowment do not induce better player performance.

  19. Cost-effectiveness Analysis for Technology Acquisition. (United States)

    Chakravarty, A; Naware, S S


    In a developing country with limited resources, it is important to utilize the total cost visibility approach over the entire life-cycle of the technology and then analyse alternative options for acquiring technology. The present study analysed cost-effectiveness of an "In-house" magnetic resonance imaging (MRI) scan facility of a large service hospital against outsourcing possibilities. Cost per unit scan was calculated by operating costing method and break-even volume was calculated. Then life-cycle cost analysis was performed to enable total cost visibility of the MRI scan in both "In-house" and "outsourcing of facility" configuration. Finally, cost-effectiveness analysis was performed to identify the more acceptable decision option. Total cost for performing unit MRI scan was found to be Rs 3,875 for scans without contrast and Rs 4,129 with contrast. On life-cycle cost analysis, net present value (NPV) of the "In-house" configuration was found to be Rs-(4,09,06,265) while that of "outsourcing of facility" configuration was Rs-(5,70,23,315). Subsequently, cost-effectiveness analysis across eight Figures of Merit showed the "In-house" facility to be the more acceptable option for the system. Every decision for acquiring high-end technology must be subjected to life-cycle cost analysis.

  20. Effect of GABRA2 Genotype on Development of Incentive-Motivation Circuitry in a Sample Enriched for Alcoholism Risk (United States)

    Heitzeg, Mary M; Villafuerte, Sandra; Weiland, Barbara J; Enoch, Mary-Anne; Burmeister, Margit; Zubieta, Jon-Kar; Zucker, Robert A


    Heightened reactivity of the incentive-motivation system has been proposed to underlie adolescent-typical risky behaviors, including problem alcohol involvement. However, even in adolescence considerable individual variation in these behaviors exists, which may have genetic underpinnings and be related to variations in risk for later alcohol use disorder (AUD). Variants in GABRA2 have been associated with adult alcohol dependence as well as phenotypic precursors, including impulsiveness and externalizing behaviors. We investigated the impact of GABRA2 on the developmental trajectory of nucleus accumbens (NAcc) activation during anticipation of monetary reward from childhood to young adulthood. Functional MRI during a monetary incentive delay task was collected in 175 participants, with the majority (n=151) undergoing repeated scanning at 1- to 2-year intervals. One group entered the study at age 8–13 years (n=76) and another entered at age 18–23 years (n=99). Most participants were children of alcoholics (79%) and thus at heightened risk for AUD. A total of 473 sessions were completed, covering ages 8–27 years. NAcc activation was heightened during adolescence compared with childhood and young adulthood. GABRA2 genotype (SNP rs279858) was associated with individual differences in NAcc activation specifically during adolescence, with the minor allele (G) associated with greater activation. Furthermore, NAcc activation mediated an effect of genotype on alcohol problems (n=104). This work demonstrates an impact of GABRA2 genotype on incentive-motivation neurocircuitry in adolescence, with implications for vulnerability to alcoholism. These findings represent an important step toward understanding the genetic and neural basis of individual differences in how risk for addiction unfolds across development. PMID:24975023

  1. Decisions to Attend and Drink at Party Events: The Effects of Incentives and Disincentives and Lifetime Alcohol and Antisocial Problems. (United States)

    Finn, Peter R; Gerst, Kyle; Lake, Allison; Bogg, Tim


    Alcohol use disorders are associated with patterns of impulsive/risky decision making on behavioral economic decision tasks, but little is known about the factors affecting drinking-related decisions. The effects of incentives and disincentives to attend and drink at hypothetical alcohol-related party events as a function of lifetime (LT) alcohol and antisocial problems were examined in a sample of 434 young adults who varied widely in LT alcohol and antisocial problems. Moderate and high disincentives substantially discouraged decisions to attend the party events and were associated with decisions to drink less at the party events. High versus low party incentives were associated with more attendance decisions. LT antisocial problems were associated with being less deterred from attending by moderate and high disincentives. LT alcohol problems were associated with greater attendance at high party incentive contexts. LT alcohol problems were associated with drinking more at the majority of events; however, the results indicate that young adults with high levels of alcohol problems moderate their drinking in response to moderate and high disincentives. Finally, attendance and drinking decisions on this hypothetical task were significantly related to actual drinking practices. The results suggest that antisocial symptoms are associated with a reduced sensitivity to the potential negative consequences of drinking, while alcohol problems are associated with a greater sensitivity to the rewarding aspects of partying. The results also underline the value of directly assessing drinking-related decisions in different hypothetical contexts as well as assessing decisions about attendance at risky drinking events in addition to drinking amount decisions. Copyright © 2017 by the Research Society on Alcoholism.

  2. Aligning ambition and incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc


    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact, and derive implications for the design of incentive contracts and organizational choice...

  3. Aligning Ambition and Incentives

    DEFF Research Database (Denmark)

    Koch, Alexander; Peyrache, Eloïc

    Labor turnover creates longer term career concerns incentives that motivate employees in addition to the short term monetary incentives provided by the current employer. We analyze how these incentives interact and derive implications for the design of incentive contracts and organizational choice...

  4. Gedanken Experiments in Educational Cost Effectiveness (United States)

    Brudner, Harvey J.


    Discusses the effectiveness of cost determining techniques in education. The areas discussed are: education and management; cost-effectiveness models; figures of merit determination; and the implications as they relate to the areas of audio-visual and computer educational technology. (Author/GA)

  5. Tuition fees and sunk-cost effects

    NARCIS (Netherlands)

    Ketel, N.; Linde, J.; Oosterbeek, H.; van der Klaauw, B.


    This article reports on a field experiment testing for sunk-cost effects in an education setting. Students signing up for extra-curricular tutorial sessions randomly received a discount on the tuition fee. The sunk-cost effect predicts that students who pay more will attend more tutorial sessions,

  6. Decision-making in general practice: the effect of financial incentives on the use of laboratory analyses. (United States)

    Munkerud, Siri Fauli


    This paper examines the reaction of general practitioners (GPs) to a reform in 2004 in the remuneration system for using laboratory services in general practice. The purpose of this paper is to study whether income motivation exists regarding the use of laboratory services in general practice, and if so, the degree of income motivation among general practitioners (GPs) in Norway. We argue that the degree of income motivation is stronger when the physicians are uncertain about the utility of the laboratory service in question. We have panel data from actual physician-patient encounters in general practices in the years 2001-2004 and use discrete choice analysis and random effects models. Estimation results show that an increase in the fees will lead to a small but significant increase in use. The reform led to minor changes in the use of laboratory analyses in GPs' offices, and we argue that financial incentives were diluted because they were in conflict with medical recommendations and existing medical practice. The patient's age has the most influence and the results support the hypothesis that the impact of income increases with increasing uncertainty about diagnosis and treatment. The policy implication of our results is that financial incentives alone are not an effective tool for influencing the use of laboratory services in GPs' offices.

  7. Incentives and Prosocial Behavior


    Roland Bénabou; Jean Tirole


    We develop a theory of prosocial behavior that combines heterogeneity in individual altruism and greed with concerns for social reputation or self-respect. Rewards or punishments (whether material or image-related) create doubt about the true motive for which good deeds are performed, and this ?overjustification effect? can induce a partial or even net crowding out of prosocial behavior by extrinsic incentives. We also identify the settings that are conducive to multiple social norms and, mor...

  8. Audit of Cost-Plus-Award-Fee Contracts

    National Research Council Canada - National Science Library

    Granetto, Paul


    The audit objectives were to determine whether award fees contain adequate incentive amounts for contractors to reduce costs and whether the DoD contracting officers were effectively using cost-plus-award-fee contracts...

  9. Incentives for mitigation investment and more effective risk management: the need for public-private partnerships. (United States)

    Kunreuther, H


    A key question facing both well-developed industrial countries and emerging economies is how to reduce future disaster losses while still providing financial protection to victims from these events. This paper proposes a strategy for the use of cost-effective risk mitigation measures coupled with insurance and/or new capital market instruments to achieve these objectives. The mix of these measures will depend on the governance structure and the institutional arrangements in the particular country. There will always be a need for a combination of policy tools and the interaction among key interested parties from both the private and public sectors in developing a disaster management strategy. Two examples, one from US and the other from Honduras, illustrate differences between strategies that countries can adopt.

  10. Modeling regulated water utility investment incentives (United States)

    Padula, S.; Harou, J. J.


    This work attempts to model the infrastructure investment choices of privatized water utilities subject to rate of return and price cap regulation. The goal is to understand how regulation influences water companies' investment decisions such as their desire to engage in transfers with neighbouring companies. We formulate a profit maximization capacity expansion model that finds the schedule of new supply, demand management and transfer schemes that maintain the annual supply-demand balance and maximize a companies' profit under the 2010-15 price control process in England. Regulatory incentives for costs savings are also represented in the model. These include: the CIS scheme for the capital expenditure (capex) and incentive allowance schemes for the operating expenditure (opex) . The profit-maximizing investment program (what to build, when and what size) is compared with the least cost program (social optimum). We apply this formulation to several water companies in South East England to model performance and sensitivity to water network particulars. Results show that if companies' are able to outperform the regulatory assumption on the cost of capital, a capital bias can be generated, due to the fact that the capital expenditure, contrarily to opex, can be remunerated through the companies' regulatory capital value (RCV). The occurrence of the 'capital bias' or its entity depends on the extent to which a company can finance its investments at a rate below the allowed cost of capital. The bias can be reduced by the regulatory penalties for underperformances on the capital expenditure (CIS scheme); Sensitivity analysis can be applied by varying the CIS penalty to see how and to which extent this impacts the capital bias effect. We show how regulatory changes could potentially be devised to partially remove the 'capital bias' effect. Solutions potentially include allowing for incentives on total expenditure rather than separately for capex and opex and allowing

  11. Cost effectiveness of radon mitigation in Canada

    International Nuclear Information System (INIS)

    Letourneau, E.G.; Krewski, D.; Zielinski, J.M.; McGregor, R.G.


    This paper examines the cost effectiveness of comprehensive strategies for reducing exposure to radon gas in indoor air in Canadian homes. The analysis is conducted within the context of a general framework for risk management programme evaluation which includes well-known evaluation techniques such as cost effectiveness and cost-benefit analyses as special cases. Based on this analysis, it is clear that any comprehensive programme to reduce exposure to environmental radon will be extremely expensive, and may not be justifiable in terms of health impact, particularly when considered in relation to other public health programmes. Testing of homes at the point of sale and installing sub-slab suction equipment to reduce exposure to indoor radon where necessary appears to be a relatively cost-effective radon mitigation strategy. In general, radon mitigation was found to be most cost effective in cities with relatively high levels of radon. (author)

  12. Effects of demand-side incentives in improving the utilisation of delivery services in Oyam District in northern Uganda: a quasi-experimental study. (United States)

    Massavon, William; Wilunda, Calistus; Nannini, Maria; Majwala, Robert Kaos; Agaro, Caroline; De Vivo, Emanuela; Lochoro, Peter; Putoto, Giovanni; Criel, Bart


    effectively increased utilisation of maternal health services whereas the baby-kit scheme was only effective in increasing institutional deliveries. The transport vouchers were less costly than the baby kits in the promotion of institutional deliveries. Such incentives can be sustainable if the Ministry of Health integrates them in the health system.

  13. Beslissingsprocessen van verkeersdeelnemers : covernota bij de rapporten van W.H. Janssen: "Risk compensation and the effect of an incentive : a laboratory study" (IFZ 1988 C-26), "An experimental evaluation of safety incentive schemes" (IZF 1989 C-19), en "Seat belt wearing and driving behaviour : an empirical investigation" (IZF 1991 C-15).

    NARCIS (Netherlands)

    Levelt, P.B.M.


    This cover note comments on the following three TNO Institute for Perception (IZF) Reports: (1) "Risk compensation and the effect of an incentive: a laboratory study"; (2) "An experimental evaluation of safety incentive schemes"; and (3) "Seat belt wearing and driving behaviour: an empirical

  14. Managing risk selection incentives in health sector reforms. (United States)

    Puig-Junoy, J


    The object of the paper is to review theoretical and empirical contributions to the optimal management of risk selection incentives ('cream skimming') in health sector reforms. The trade-off between efficiency and risk selection is fostered in health sector reforms by the introduction of competitive mechanisms such as price competition or prospective payment systems. The effects of two main forms of competition in health sector reforms are observed when health insurance is mandatory: competition in the market for health insurance, and in the market for health services. Market and government failures contribute to the assessment of the different forms of risk selection employed by insurers and providers, as the effects of selection incentives on efficiency and their proposed remedies to reduce the impact of these perverse incentives. Two European (Netherlands and Spain) and two Latin American (Chile and Colombia) case studies of health sector reforms are examined in order to observe selection incentives, their effects on efficiency and costs in the health system, and regulation policies implemented in each country to mitigate incentives to 'cream skim' good risks.

  15. Economic Incentives and Policies to Improve Quality in a Binational Coastal Watershed


    Fernandez, Linda M


    This research compares economic incentives for sediment and wastewater management of upstream and downstream countries in a shared waterway under cooperative and noncooperative strategies. Asymmetry between the countries in terms of costs, damages and emissions influence the incentives to abate pollution. Along the 2000 mile U.S. Mexico border, water flow runs in many directions, with asymmetric flow and stock effects. The Tijuana River watershed shared by the U.S. and Mexico is one example w...

  16. Effect of extrinsic incentives on use of test anxiety as an anticipatory attributional defense: playing it cool when the stakes are high. (United States)

    Greenberg, J; Pyszczynski, T; Paisley, C


    We conducted an experiment to assess the effect of extrinsic incentives on the use of test anxiety as a self-handicapping strategy. We hypothesized that although reports of anxiety may be greater when such symptoms can serve a defensive function, this effect occurs only when extrinsic incentives are low and not under conditions of high extrinsic incentive. Eighty-four male undergraduates anticipated taking a test of intellectual abilities and either were led to believe that test anxiety has no effect on test performance or were given no particular information about the relation between test anxiety and performance. Subjects were offered either +5 or +25 for obtaining the highest score on the test. Consistent with predictions, no-information subjects reported greater test anxiety before the test than did those who believed that test anxiety was unrelated to performance, but only when the extrinsic incentive for performance was low. However, these subjects did not report greater cognitive interference or exhibit lower test scores than did subjects in other conditions. It is tentatively suggested that the defensive strategy used by these subjects consisted of altering perceptions of anxiety, rather than anxiety itself. The implications of the absence of self-handicapping under high incentive conditions are discussed.

  17. Incentives of Health Care Expenditure

    Directory of Open Access Journals (Sweden)

    Eero Siljander


    Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of

  18. Do Tax Incentives Affect Business Location? Evidence from State Film Incentives


    Patrick Button


    I provide the first estimates of the impacts of recently-popular U.S. state film incentives on filming location, establishment location, and employment in the film industry. Filming in this industry is relatively insensitive to locational characteristics, and these incentives are numerous and strong, so this is a good case study to bound the effects of tax incentives on business location. I compile a detailed database of incentives across U.S. states, matching this with TV series and feature ...

  19. Low-cost carriers fare competition effect

    NARCIS (Netherlands)

    Carmona Benitez, R.B.; Lodewijks, G.


    This paper examines the effects that low-cost carriers (LCC’s) produce when entering new routes operated only by full-service carriers (FSC’s) and routes operated by low-cost carriers in competition with full-service carriers. A mathematical model has been developed to determine what routes should

  20. A Stackelberg Game Theoretic Analysis of Incentive Effects under Perceived Risk for China’s Straw-Based Power Plant Supply Chain

    Directory of Open Access Journals (Sweden)

    Lingling Wang


    Full Text Available The rapid expansion of the biomass power generation industry has resulted in the conversion of substantial agricultural waste (crop straw into energy feedstock, thereby increasing the income of farmers and promoting the development of rural areas. However, the promising industry faces financial deficits because of difficulties in collecting straw from farmers. To determine strategies for overcoming the biomass supply problem, we apply Stackelberg game theory in modeling the Chinese biomass supply chain and design incentive scenarios under stakeholder risk perception. We illustrate the proposed methodology through an empirical case study on China and demonstrate the effects of incentives on farmers and middlemen. Results show that with incentives, straw quantity and stakeholder profit are expected to increase. Incentives exert a particularly remarkable effect on farmers, with such inducements producing the highest social welfare. Moreover, perceived risk dramatically affects stakeholder profit. Mitigating the risk perception of farmers is expected to significantly advance the development of the biomass power generation industry, increase stakeholder profit, and decrease the amount of incentives needed.

  1. Federal tax incentives affecting coal and nuclear power economics

    International Nuclear Information System (INIS)

    Chapman, D.


    This paper analyzes the effect of federal corporate income tax incentives on coal and nuclear power developments. It estimates (1) the magnitudes of tax incentives in relationship to utility costs, (2) the relative magnitude of benefits going to coal and nuclear facilities, and (3) the influence which the time paths of tax payments and after-tax net income have upon possible incentives for premature construction and excess capacity. Utility planners currently believe that nuclear power enjoys an after-tax competitive advantage over coal plants. Investigation of investment-related credits, deductions, and exclusions in the Internal Revenue Code shows that nuclear power enjoys a more favorable tax subsidy because of its greater capital intensity. In the absence of tax subsidies, no utility would prefer nuclear power to coal generation. Tax changes now under consideration could increase the tax benefits to both without disturbing the differential advantage held by nuclear power. 43 references, 2 figures, 4 tables

  2. Incentives and provider payment methods. (United States)

    Barnum, H; Kutzin, J; Saxenian, H


    The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

  3. The Interpersonal Sunk-Cost Effect. (United States)

    Olivola, Christopher Y


    The sunk-cost fallacy-pursuing an inferior alternative merely because we have previously invested significant, but nonrecoverable, resources in it-represents a striking violation of rational decision making. Whereas theoretical accounts and empirical examinations of the sunk-cost effect have generally been based on the assumption that it is a purely intrapersonal phenomenon (i.e., solely driven by one's own past investments), the present research demonstrates that it is also an interpersonal effect (i.e., people will alter their choices in response to other people's past investments). Across eight experiments ( N = 6,076) covering diverse scenarios, I documented sunk-cost effects when the costs are borne by someone other than the decision maker. Moreover, the interpersonal sunk-cost effect is not moderated by social closeness or whether other people observe their sunk costs being "honored." These findings uncover a previously undocumented bias, reveal that the sunk-cost effect is a much broader phenomenon than previously thought, and pose interesting challenges for existing accounts of this fascinating human tendency.

  4. Navy Shipbuilding: Need to Document Rationale for the Use of Fixed-Price Incentive Contracts and Study Effectiveness of Added Incentives (United States)


    share line and 120 percent ceiling price should be the norm , or starting point.8 The Director of Defense Pricing stated that he believes DOD’s...constructing nuclear submarines. We previously reported that this is in contrast to commercial ship buyers, who have an array of yards and suppliers to...overrun up until costs reached a specified point, with the government’s maximum liability capped at the ceiling price. Cost increases above target

  5. Using EnviroAtlas Data to Identify Cost-Effective Locations for Manure Management Incentives (United States)

    This is a use case that walks through an example application of how EnviroAtlas data, in conjunction with other available data or resources, may be used to address real-world questions. The use case is available on the EnviroAtlas at

  6. Beyond case studies: Quantitative effects of recycling, incentive, and diversion program choices

    Energy Technology Data Exchange (ETDEWEB)

    Skumatz, L.A. [Skumatz Economic Research Associates, Seattle, WA (United States)


    Communities, facing tight budgets, volatile markets, and the recycling backlash are turning their attention to making their programs more efficient and effective. Unfortunately, communities have very little quantitative information available to help them improve their programs. This is despite the fact that the majority of recycling programs have been running for over 6 years. Further, the author found that there are many thousands of curbside and dropoff recycling programs across the nation, as well as thousands of yard waste and variable rate programs. Still, with all these years of operating experience across the nation, at conferences, when planners ask about the likely impacts of possible program improvements, the answers usually begin, ``well, the City of [fill in the blank] made that change and found...``. Answers like this are seldom transferable to other communities. Similarly, most published information also relies on one or a few (less than ten) case studies, and published case studies usually describe programs that are outstanding in some way, making the information even less transferable. This type of information is wholly inadequate to derive information that is transferable to any other community. Can one really expect information from the City of San Jose, California, to transfer directly to the Village of Hartland, Wisconsin? That is the level of information that has been available thus far to planners. This study uses specially collected data from over 500 communities across North America as the basis for a statistical analysis of those programmatic and socio-demographic factors that contribute most to higher levels of recycling diversion. The work is unique in that it provides the first reliable quantitative information for use by community program planners in analyzing impacts of alternative programs and their cost-effectiveness to design sustainable, appropriate programs to improve diversion.

  7. Electromyographic activity of hand muscles in a motor coordination game: effect of incentive scheme and its relation with social capital.

    Directory of Open Access Journals (Sweden)

    Roberto Censolo

    Full Text Available BACKGROUND: A vast body of social and cognitive psychology studies in humans reports evidence that external rewards, typically monetary ones, undermine intrinsic motivation. These findings challenge the standard selfish-rationality assumption at the core of economic reasoning. In the present work we aimed at investigating whether the different modulation of a given monetary reward automatically and unconsciously affects effort and performance of participants involved in a game devoid of visual and verbal interaction and without any perspective-taking activity. METHODOLOGY/PRINCIPAL FINDINGS: Twelve pairs of participants were submitted to a simple motor coordination game while recording the electromyographic activity of First Dorsal Interosseus (FDI, the muscle mainly involved in the task. EMG data show a clear effect of alternative rewards strategies on subjects' motor behavior. Moreover, participants' stock of relevant past social experiences, measured by a specifically designed questionnaire, was significantly correlated with EMG activity, showing that only low social capital subjects responded to monetary incentives consistently with a standard rationality prediction. CONCLUSIONS/SIGNIFICANCE: Our findings show that the effect of extrinsic motivations on performance may arise outside social contexts involving complex cognitive processes due to conscious perspective-taking activity. More importantly, the peculiar performance of low social capital individuals, in agreement with standard economic reasoning, adds to the knowledge of the circumstances that makes the crowding out/in of intrinsic motivation likely to occur. This may help in improving the prediction and accuracy of economic models and reconcile this puzzling effect of external incentives with economic theory.

  8. Green Infrastructure Siting and Cost Effectiveness Analysis (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  9. The effect of financial incentives on patients' motivation for treatment: results of "Money for Medication," a randomised controlled trial. (United States)

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony F T; Mulder, Cornelis L


    Offering financial incentives is an effective intervention for improving adherence in patients taking antipsychotic depot medication. We assessed whether patients' motivation for treatment might be reduced after receiving financial rewards. This study was part of Money for Medication, a multicentre, open-label, randomised controlled trial, which demonstrated the positive effects of financial incentives on antipsychotic depot compliance. Three mental healthcare institutions in Dutch secondary psychiatric care services participated. Eligible patients were aged 18-65 years, had been diagnosed with schizophrenia or another psychotic disorder, had been prescribed antipsychotic depot medication or had an indication to start using depot medication, and were participating in outpatient treatment. For 12 months, patients were randomly assigned either to treatment as usual (control group) or to treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group). They were followed up for 6 months, during which time no monetary rewards were offered for taking antipsychotic medication. To assess treatment motivation after 0, 12 and 18 months, interviews were conducted using a supplement to the Health of the Nation Outcome Scales (HoNOS) and the Treatment Entry Questionnaire (TEQ). Patients were randomly assigned to the intervention (n = 84) or the control group (n = 85). After 12 months, HoNOS motivation scores were available for 131 patients (78%). Ninety-one percent of the patients had no or mild motivational problems for overall treatment; over time, there were no significant differences between the intervention and control groups. TEQ data was available for a subgroup of patients (n = 61), and showed no significant differences over time between the intervention and control groups for external motivation (β = 0.37 95% CI: -2.49 - 3.23, p = 0.799); introjected motivation (

  10. Incentive mechanism design for the residential building energy efficiency improvement of heating zones in North China

    International Nuclear Information System (INIS)

    Zhong, Y.; Cai, W.G.; Wu, Y.; Ren, H.


    Starting with analyzing the investigation results by Ministry of Housing and Urban-Rural Development of China in 2005, more than half of the 10,236 participants are willing to improve the residential building energy efficiency and accept an additional cost of less than 10% of the total cost, the authors illustrate that incenting actions are necessary to improve building energy efficiency and build a central government-local government-market model. As a result of the model analysis, to pursue good execution effects brought by the incentive policies, the executors are required to distinguish the differences of incentive objects' economic activities and strongly respect the incenting on the energy conservation performance. A case study on the incentive policies of existing residential building energy efficiency improvement in heating zones in North China is given as well. Finally, it is strongly recommended to give the first priority to performance-based incentives so that to reduce the lazy behaviors of the incented objects and ensure the targets to be achieved.

  11. [Incremental cost effectiveness of multifocal cataract surgery]. (United States)

    Pagel, N; Dick, H B; Krummenauer, F


    Supplementation of cataract patients with multifocal intraocular lenses involves an additional financial investment when compared to the corresponding monofocal supplementation, which usually is not funded by German health care insurers. In the context of recent resource allocation discussions, however, the cost effectiveness of multifocal cataract surgery could become an important rationale. Therefore an evidence-based estimation of its cost effectiveness was carried out. Three independent meta-analyses were implemented to estimate the gain in uncorrected near visual acuity and best corrected visual acuity (vision lines) as well as the predictability (fraction of patients without need for reading aids) of multifocal supplementation. Study reports published between 1995 and 2004 (English or German language) were screened for appropriate key words. Meta effects in visual gain and predictability were estimated by means and standard deviations of the reported effect measures. Cost data were estimated by German DRG rates and individual lens costs; the cost effectiveness of multifocal cataract surgery was then computed in terms of its marginal cost effectiveness ratio (MCER) for each clinical benefit endpoint; the incremental costs of multifocal versus monofocal cataract surgery were further estimated by means of their respective incremental cost effectiveness ratio (ICER). An independent meta-analysis estimated the complication profiles to be expected after monofocal and multifocal cataract surgery in order to evaluate expectable complication-associated additional costs of both procedures; the marginal and incremental cost effectiveness estimates were adjusted accordingly. A sensitivity analysis comprised cost variations of +/- 10 % and utility variations alongside the meta effect estimate's 95 % confidence intervals. Total direct costs from the health care insurer's perspective were estimated 3363 euro, associated with a visual meta benefit in best corrected visual

  12. Effect of Leadership Style, Motivation, and Giving Incentives on the Performance of Employees--PT. Kurnia Wijaya Various Industries (United States)

    Elqadri, Zaenal Mustafa; Priyono; Suci, Rahayu Puji; Chandra, Teddy


    This study aims to identify and examine the importance of leadership style, motivation, and incentives to improve employee performance. Variables examined as factors that affect performance of employees were style of leadership (X1), motivation (X2), and the provision of incentives (X3). The population of this study was all employees in the Sales…

  13. Cost-effectiveness Analysis with Influence Diagrams. (United States)

    Arias, M; Díez, F J


    Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

  14. Comparison of energy efficiency incentive programs: Rebates and white certificates

    Energy Technology Data Exchange (ETDEWEB)

    Transue, Morghan; Felder, Frank A. [Center for Energy, Economic, and Environmental Policy, Rutgers the State University of New Jersey, Bloustein School of Planning and Public Policy, 33 Livingston Avenue, New Brunswick, NJ 08901 (United States)


    With increased interest in energy efficiency in recent years, energy efficiency portfolio standards (EEPS) have gained popularity in state policymaking. This analysis employed New Jersey specific data to compare two incentive based approaches to EEPS implementation: rebates and white certificates. Quantitative modeling suggests that white certificate approaches that depend on market-clearing prices generate much larger upfront incentive outlays than rebate programs. They do not however increase societal burden. Both programs overcome high upfront efficiency measure costs and both recoup the expenses over the long run. Administration costs and participation rates can affect this dynamic however and require additional research to determine which approaches are most cost effective for various energy efficiency measures. (author)

  15. Cost and effectiveness of radon barrier systems

    International Nuclear Information System (INIS)

    Baker, E.G.; Freeman, H.D.; Hartley, J.N.; Gee, G.W.


    Earthen, asphalt, and multilayer radon barrier systems can all provide reduction in the amount of radon gas released from uranium mill tailings. Pacific Northwest Laboratory field tested all three types of covers at Grand Junction, Colorado during the summer of 1981. All nine individual radon barrier systems tested currently meet the EPA standard for radon flux of 20 pCi m - 2 s - 1 . The cost of the asphalt and 3m earthen covers were about the same at the field test. Multilayer covers were significantly more costly. Cost estimates for three high priority western sites indicate 3m of earthen cover is the least costly radon barrier when earthen material is available at or near the disposal site. If earthen material must be imported more than 8 to 10 km asphalt and possibly multilayer radon barriers can be cost effective

  16. Cost effectiveness of recycling: A systems model

    Energy Technology Data Exchange (ETDEWEB)

    Tonjes, David J., E-mail: [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States); Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000 (United States); Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044 (United States); Mallikarjun, Sreekanth, E-mail: [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States)


    Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.

  17. Determinants of investment under incentive regulation: The case of the Norwegian electricity distribution networks

    International Nuclear Information System (INIS)

    Poudineh, Rahmatallah; Jamasb, Tooraj


    Investment in electricity networks, as regulated natural monopolies, is among the highest regulatory and energy policy priorities. The electricity sector regulators adopt different incentive mechanisms to ensure that the firms undertake sufficient investment to maintain and modernise the grid. Thus, an effective regulatory treatment of investment requires understanding the response of companies to the regulatory incentives. This study analyses the determinants of investment in electricity distribution networks using a panel dataset of 129 Norwegian companies observed from 2004 to 2010. A Bayesian Model Averaging approach is used to provide a robust statistical inference by taking into account the uncertainties around model selection and estimation. The results show that three factors drive nearly all network investments: investment rate in previous period, socio-economic costs of energy not supplied and finally useful life of assets. The results indicate that Norwegian companies have, to some degree, responded to the investment incentives provided by the regulatory framework. However, some of the incentives do not appear to be effective in driving the investments. - Highlights: • This paper investigates determinants of investment under incentive regulation. • We apply a Bayesian model averaging technique to deal with model uncertainty. • Dataset comprises 129 Norwegian electricity network companies from 2004 to 2010. • The results show that firms have generally responded to investment incentives. • However, some of the incentives do not appear to have been effective.

  18. Deregulation and Nuclear Training: Cost Effective Alternatives

    International Nuclear Information System (INIS)

    Richard P. Coe; Patricia A. Lake


    Training is crucial to the success of any organization. It is also expensive, with some estimates exceeding $50 billion annually spent on training by U.S. corporations. Nuclear training, like that of many other highly technical organizations, is both crucial and costly. It is unlikely that the amount of training can be significantly reduced. If anything, current trends indicate that training needs will probably increase as the industry and workforce ages and changes. With the advent of energy deregulation in the United States, greater pressures will surface to make the costs of energy more cost-competitive. This in turn will drive businesses to more closely examine existing costs and find ways to do things in a more cost-effective way. The commercial nuclear industry will be no exception, and nuclear training will be equally affected. It is time for nuclear training and indeed the entire nuclear industry to begin using more aggressive techniques to reduce costs. This includes the need for nuclear training to find alternatives to traditional methods for the delivery of cost-effective high-quality training that meets regulatory requirements and produces well-qualified personnel capable of working in an efficient and safe manner. Computer-based and/or Web-based training are leading emerging technologies

  19. Incentive delegation and collusion

    NARCIS (Netherlands)

    Mukherjee, A.


    In an infinitely repeated duopoly the implications of strategic incentive delegation are shown. Whether incentive delegation makes consumers or producers better-off depends on the nature of competition. WeThe presence or absence of incentive delegation may affect the interests of the consumers and

  20. Universal health insurance through incentives reform. (United States)

    Enthoven, A C; Kronick, R


    Roughly 35 million Americans have no health care coverage. Health care expenditures are out of control. The problems of access and cost are inextricably related. Important correctable causes include cost-unconscious demand, a system not organized for quality and economy, market failure, and public funds not distributed equitably or effectively to motivate widespread coverage. We propose Public Sponsor agencies to offer subsidized coverage to those otherwise uninsured, mandated employer-provided health insurance, premium contributions from all employers and employees, a limit on tax-free employer contributions to employee health insurance, and "managed competition". Our proposed new government revenues equal proposed new outlays. We believe our proposal will work because efficient managed care does exist and can provide satisfactory care for a cost far below that of the traditional fee-for-service third-party payment system. Presented with an opportunity to make an economically responsible choice, people choose value for money; the dynamic created by these individual choices will give providers strong incentives to render high-quality, economical care. We believe that providers will respond to these incentives.

  1. Assessing the cost-effectiveness of electric vehicles in European countries using integrated modeling

    International Nuclear Information System (INIS)

    Seixas, J.; Simões, S.; Dias, L.; Kanudia, A.; Fortes, P.; Gargiulo, M.


    Electric vehicles (EVs) are considered alternatives to internal combustion engines due to their energy efficiency and contribution to CO 2 mitigation. The adoption of EVs depends on consumer preferences, including cost, social status and driving habits, although it is agreed that current and expected costs play a major role. We use a partial equilibrium model that minimizes total energy system costs to assess whether EVs can be a cost-effective option for the consumers of each EU27 member state up to 2050, focusing on the impact of different vehicle investment costs and CO 2 mitigation targets. We found that for an EU-wide greenhouse gas emission reduction cap of 40% and 70% by 2050 vis-à-vis 1990 emissions, battery electric vehicles (BEVs) are cost-effective in the EU only by 2030 and only if their costs are 30% lower than currently expected. At the EU level, vehicle costs and the capability to deliver both short- and long-distance mobility are the main drivers of BEV deployment. Other drivers include each state’s national mobility patterns and the cost-effectiveness of alternative mitigation options, both in the transport sector, such as plug-in hybrid electric vehicles (PHEVs) or biofuels, and in other sectors, such as renewable electricity. - Highlights: • Electric vehicles were assessed through the minimization of the total energy systems costs. • EU climate policy targets could act as a major driver for PHEV adoption. • Battery EV is an option before 2030 if costs will drop by 30% from expected costs. • EV deployment varies per country depending on each energy system configuration. • Incentives at the country level should consider specific cost-effectiveness factors

  2. Effectiveness of a Program Using a Vehicle Tracking System, Incentives, and Disincentives to Reduce the Speeding Behavior of Drivers with ADHD (United States)

    Markham, Paula T.; Porter, Bryan E.; Ball, J. D.


    Objective: In this article, the authors investigated the effectiveness of a behavior modification program using global positioning system (GPS) vehicle tracking devices with contingency incentives and disincentives to reduce the speeding behavior of drivers with ADHD. Method: Using an AB multiple-baseline design, six participants drove a 5-mile…

  3. Is expanding Medicare coverage cost-effective?

    Directory of Open Access Journals (Sweden)

    Muennig Peter


    Full Text Available Abstract Background Proposals to expand Medicare coverage tend to be expensive, but the value of services purchased is not known. This study evaluates the efficiency of the average private supplemental insurance plan for Medicare recipients. Methods Data from the National Health Interview Survey, the National Death Index, and the Medical Expenditure Panel Survey were analyzed to estimate the costs, changes in life expectancy, and health-related quality of life gains associated with providing private supplemental insurance coverage for Medicare beneficiaries. Model inputs included socio-demographic, health, and health behavior characteristics. Parameter estimates from regression models were used to predict quality-adjusted life years (QALYs and costs associated with private supplemental insurance relative to Medicare only. Markov decision analysis modeling was then employed to calculate incremental cost-effectiveness ratios. Results Medicare supplemental insurance is associated with increased health care utilization, but the additional costs associated with this utilization are offset by gains in quality-adjusted life expectancy. The incremental cost-effectiveness of private supplemental insurance is approximately $24,000 per QALY gained relative to Medicare alone. Conclusion Supplemental insurance for Medicare beneficiaries is a good value, with an incremental cost-effectiveness ratio comparable to medical interventions commonly deemed worthwhile.

  4. Cost-effectiveness of colorectal cancer screening

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); A.B. Knudsen (Amy); H. Brenner (Hermann)


    textabstractColorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to

  5. Provider and Patient Directed Financial Incentives to Improve Care and Outcomes for Patients with Diabetes (United States)

    Lorincz, Ilona S.; Lawson, Brittany C. T.


    Incentive programs directed at both providers and patients have become increasingly widespread. Pay-for-performance (P4P) where providers receive financial incentives to carry out specific care or improve clinical outcomes has been widely implemented. The existing literature indicates they probably spur initial gains which then level off or partially revert if incentives are withdrawn. The literature also indicates that process measures are easier to influence through P4P programs but that intermediate outcomes such as glucose, blood pressure, and cholesterol control are harder to influence, and the long term impact of P4P programs on health is largely unknown. Programs directed at patients show greater promise as a means to influence patient behavior and intermediate outcomes such as weight loss; however, the evidence for long term effects are lacking. In combination, both patient and provider incentives are potentially powerful tools but whether they are cost-effective has yet to be determined. PMID:23225214

  6. Cost-Effective Fuel Treatment Planning (United States)

    Kreitler, J.; Thompson, M.; Vaillant, N.


    The cost of fighting large wildland fires in the western United States has grown dramatically over the past decade. This trend will likely continue with growth of the WUI into fire prone ecosystems, dangerous fuel conditions from decades of fire suppression, and a potentially increasing effect from prolonged drought and climate change. Fuel treatments are often considered the primary pre-fire mechanism to reduce the exposure of values at risk to wildland fire, and a growing suite of fire models and tools are employed to prioritize where treatments could mitigate wildland fire damages. Assessments using the likelihood and consequence of fire are critical because funds are insufficient to reduce risk on all lands needing treatment, therefore prioritization is required to maximize the effectiveness of fuel treatment budgets. Cost-effectiveness, doing the most good per dollar, would seem to be an important fuel treatment metric, yet studies or plans that prioritize fuel treatments using costs or cost-effectiveness measures are absent from the literature. Therefore, to explore the effect of using costs in fuel treatment planning we test four prioritization algorithms designed to reduce risk in a case study examining fuel treatments on the Sisters Ranger District of central Oregon. For benefits we model sediment retention and standing biomass, and measure the effectiveness of each algorithm by comparing the differences among treatment and no treat alternative scenarios. Our objective is to maximize the averted loss of net benefits subject to a representative fuel treatment budget. We model costs across the study landscape using the My Fuel Treatment Planner software, tree list data, local mill prices, and GIS-measured site characteristics. We use fire simulations to generate burn probabilities, and estimate fire intensity as conditional flame length at each pixel. Two prioritization algorithms target treatments based on cost-effectiveness and show improvements over those

  7. Examination of incentive mechanisms for innovative technologies applicable to utility and nonutility power generators

    Energy Technology Data Exchange (ETDEWEB)

    McDermott, K.A. [Illinois Commerce Commission, Springfield, IL (United States); Bailey, K.A.; South, D.W. [Argonne National Lab., IL (United States). Environmental Assessment and Information Sciences Div.


    Innovative technologies, built by either utility or nonutility power generators, have the potential to lower costs with less environmental emissions than conventional technologies. However, the public-good nature of information, along with uncertain costs, performance, and reliability, discourages rapid adoption of these technologies. The effect of regulation of electricity production may also have an adverse impact on motivation to innovate. Slower penetration of cleaner, more efficient technologies could result in greater levels of pollution, higher electricity prices, and a reduction in international competitiveness. Regulatory incentives could encourage adoption and deployment of innovative technologies of all kinds, inducting clean coal technologies. Such incentives must be designed to offset risks inherent in innovative technology and encourage cost-effective behavior. To evaluate innovative and conventional technologies equally, the incremental cost of risk (ICR) of adopting the innovative technology must be determined. Through the ICR, the magnitude of incentive required to make a utility (or nonutility) power generator equally motivated to use either conventional or innovative technologies can be derived. Two technology risks are examined: A construction risk, represented by a 15% cost overrun, and an operating risk, represented by a increased forced outage rate (decreased capacity factor). Different incentive mechanisms and measurement criteria are used to assess the effects of these risks on ratepayers and shareholders. In most cases, a regulatory incentive could offset the perceived risks while encouraging cost-effective behavior by both utility and nonutility power generators. Not only would the required incentive be recouped, but the revenue requirements would be less for the innovative technology; also, less environmental pollution would be generated. In the long term, ratepayers and society would benefit from innovative technologies.

  8. Some Observations on Cost-Effectiveness Analysis in Education. (United States)

    Geske, Terry G.


    The general nature of cost-effectiveness analysis is discussed, analytical frameworks for conducting cost-effectiveness studies are described, and some of the problems inherent in measuring educational costs and in assessing program effectiveness are addressed. (Author/IRT)

  9. An Incentive Theory of Matching


    Brown, Alessio J. G.; Merkl, Christian; Snower, Dennis J.


    This paper examines the labour market matching process by distinguishing its two component stages: the contact stage, in which job searchers make contact with employers and the selection stage, in which they decide whether to match. We construct a theoretical model explaining two-sided selection through microeconomic incentives. Firms face adjustment costs in responding to heterogeneous variations in the characteristics of workers and jobs. Matches and separations are described through firms'...

  10. Cost-effectiveness of tubal patency tests. (United States)

    Verhoeve, H R; Moolenaar, L M; Hompes, P; van der Veen, F; Mol, B W J


    Guidelines are not in agreement on the most effective diagnostic scenario for tubal patency testing; therefore, we evaluated the cost-effectiveness of invasive tubal testing in subfertile couples compared with no testing and treatment. Cost-effectiveness analysis. Decision analytic framework. Computer-simulated cohort of subfertile women. We evaluated six scenarios: (1) no tests and no treatment; (2) immediate treatment without tubal testing; (3) delayed treatment without tubal testing; (4) hysterosalpingogram (HSG), followed by immediate or delayed treatment, according to diagnosis (tailored treatment); (5) HSG and a diagnostic laparoscopy (DL) in case HSG does not prove tubal patency, followed by tailored treatment; and (6) DL followed by tailored treatment. Expected cumulative live births after 3 years. Secondary outcomes were cost per couple and the incremental cost-effectiveness ratio. For a 30-year-old woman with otherwise unexplained subfertility for 12 months, 3-year cumulative live birth rates were 51.8, 78.1, 78.4, 78.4, 78.6 and 78.4%, and costs per couple were €0, €6968, €5063, €5410, €5405 and €6163 for scenarios 1, 2, 3, 4, 5 and 6, respectively. The incremental cost-effectiveness ratios compared with scenario 1 (reference strategy), were €26,541, €19,046, €20,372, €20,150 and €23,184 for scenarios 2, 3, 4, 5 and 6, respectively. Sensitivity analysis showed the model to be robust over a wide range of values for the variables. The most cost-effective scenario is to perform no diagnostic tubal tests and to delay in vitro fertilisation (IVF) treatment for at least 12 months for women younger than 38 years old, and to perform no tubal tests and start immediate IVF treatment from the age of 39 years. If an invasive diagnostic test is planned, HSG followed by tailored treatment, or a DL if HSG shows no tubal patency, is more cost-effective than DL. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013

  11. Incentives for early adoption of carbon capture technology

    International Nuclear Information System (INIS)

    Comello, Stephen; Reichelstein, Stefan


    We analyze a policy proposal for regulating the next generation of baseload electricity generation facilities in the United States. The cornerstone of this regulation is a (hypothetical) EPA mandate for an emission standard of 80 kg of CO 2 per MWh of electricity generated. The mandate would go into effect at the end of 2027 for all power generating facilities that come into operation after 2017. Fossil-fuel power plants could meet the standard by capturing between 80 and 90% of their current CO 2 emissions. While the initial cost of complying with this standard is relatively high for first-of-a-kind facilities, learning effects are projected to reduce this cost substantially by the end of 2027, provided new facilities consistently adopt carbon capture technology in the intervening years. We identify a combination of investment- and production tax credits that provide the required incentives for new facilities to be willing to comply with the standard ahead of the mandate. Due to the anticipated learning effects, the incremental cost associated with the stricter emission limit is projected to about 1.2¢ per kWh of electricity in the long run. - Highlights: • Study the cost effects of a CO 2 emission standard for natural gas power plants. • The standard requires the deployment of carbon capture technology. • Future compliance costs are reduced through learning effects. • Identify tax incentives that induce early technology adoption. • Early adoption results in relatively modest electricity cost increases

  12. Incentives to promote family planning. (United States)

    Heil, Sarah H; Gaalema, Diann E; Herrmann, Evan S


    Over the past 60 years, population control has become an increasingly urgent issue worldwide as a growing population strains already limited resources. The use of financial incentives to promote family planning is an innovative approach that has potential to make a contribution to efforts to better manage population growth. This report reviews eight studies that examined the effect of incentives on family planning. Published studies that tested the impact of incentives to promote some aspect of family planning and included an appropriate control or comparison condition were reviewed. Incentives have been used to promote attendance at contraceptive education sessions, adoption and continuation of contraceptive methods, sterilization, and to limit family size. All but one of the eight studies reviewed reported positive outcomes, but weaknesses in study design and execution limit the strength of the conclusions that can be drawn. Review of this literature suggests that family planning behaviors, like other behaviors, are sensitive to incentives. Given the tremendous need for efficacious interventions in global efforts to manage population growth, further research on this topic using more rigorous experimental methods is warranted. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Insuring against earthquakes: simulating the cost-effectiveness of disaster preparedness. (United States)

    de Hoop, Thomas; Ruben, Ruerd


    Ex-ante measures to improve risk preparedness for natural disasters are generally considered to be more effective than ex-post measures. Nevertheless, most resources are allocated after an event in geographical areas that are vulnerable to natural disasters. This paper analyses the cost-effectiveness of ex-ante adaptation measures in the wake of earthquakes and provides an assessment of the future role of private and public agencies in disaster risk management. The study uses a simulation model approach to evaluate consumption losses after earthquakes under different scenarios of intervention. Particular attention is given to the role of activity diversification measures in enhancing disaster preparedness and the contributions of (targeted) microcredit and education programmes for reconstruction following a disaster. Whereas the former measures are far more cost-effective, missing markets and perverse incentives tend to make ex-post measures a preferred option, thus occasioning underinvestment in ex-ante adaptation initiatives.

  14. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa


    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  15. Effectiveness of Loan Guarantees versus Tax Incentives for Space Launch Ventures (United States)

    Scottoline, S.; Coleman, R.


    Over the course of the past few years, several new and innovative fully or partiailly reusable launch vehicle designs have been initiated with the objective of reducing the cost of space transportation. These new designs are in various stages hardware development for technology and system demonstrators. The larger vehicles include the Lockheed Martin X-33 technology demonstrator for VentureStar and the Space Access launcher. The smaller launcher ventures include Kelly Space and Technology and Rotary Rocket Company. A common denominator between the new large and small commercial launch systems is the ability to obtain project financing and at an affordable cost. Both are having or will have great difficulty in obtaining financing in the capital markets because of the dollar amounts and the risk involved. The large established companies are pursuing multi-billion dollar developments which are a major challenge to finance because of the size and risk of the projects. The smaller start-up companies require less capital for their smaller systems, however, their lack of corporate financial muscle and launch vehicle track record results in a major challenge to obtain financing also because of high risk. On Wall Street, new launch system financing is a question of market, technical, organizational, legal/regulatory and financial risk. The current limit of acceptable financial risk for Space businesses on Wall Street are the telecommunications and broadcast satellite projects, of which many in number are projected for the future. Tbc recent problems with Iridium market and financial performance are casting a long shadow over new satellite project financing, making it increasingly difficult for the new satellite projects to obtain needed financing.

  16. 10 CFR 436.18 - Measuring cost-effectiveness. (United States)


    ... 10 Energy 3 2010-01-01 2010-01-01 false Measuring cost-effectiveness. 436.18 Section 436.18 Energy... Procedures for Life Cycle Cost Analyses § 436.18 Measuring cost-effectiveness. (a) In accordance with this section, each Federal agency shall measure cost-effectiveness by combining cost data established under...

  17. 42 CFR 457.1015 - Cost-effectiveness. (United States)


    ... 42 Public Health 4 2010-10-01 2010-10-01 false Cost-effectiveness. 457.1015 Section 457.1015... Waivers: General Provisions § 457.1015 Cost-effectiveness. (a) Definition. For purposes of this subpart... may demonstrate cost-effectiveness by comparing the cost of coverage for the family to the cost of...

  18. Layoffs as part of an optimal incentive mix:

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Takáts, Elöd

    Firms offer highly complex contracts to their employees. These contracts contain a mix of incentives, such as fixed wages, bonus payments, promotion options, and layoff threats. In general, economists understand how incentives motivate employees but not why a particular mix should be used....... In this paper we present a model in which the observed incentive mix is an optimal contract. In particular, we show that it can be optimal for firms to combine cost-efficient incentives such as promotions and bonuses with layoffs. The intuition is that layoffs play a dual role. First, they create incentives...

  19. Acute effects of volume-oriented incentive spirometry on chest wall volumes in patients after a stroke. (United States)

    Lima, Illia Ndf; Fregonezi, Guilherme Af; Melo, Rodrigo; Cabral, Elis Ea; Aliverti, Andrea; Campos, Tânia F; Ferreira, Gardênia Mh


    The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P = .001) and under 3 conditions (P spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to VT was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P = .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P = .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P = .14). Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation. Copyright © 2014 by Daedalus Enterprises.

  20. A cost effective CO2 strategy

    DEFF Research Database (Denmark)

    , a scenario-part and a cost-benefit part. Air and sea modes are not analyzed. The model adopts a bottom-up approach to allow a detailed assessment of transport policy measures. Four generic areas of intervention were identified and the likely effect on CO2 emissions, socioeconomic efficiency and other...... are evaluated according to CO2 reduction potential and according to the ‘shadow price’ on a reduction of one ton CO2. The shadow price reflects the costs (and benefits) of the different measures. Comparing the measures it is possible to identify cost effective measures, but these measures are not necessarily...... by the Ministry of Transport, with the Technical University of Denmark as one of the main contributors. The CO2-strategy was to be based on the principle of cost-effectiveness. A model was set up to assist in the assessment. The model consists of a projection of CO2-emissions from road and rail modes from 2020...

  1. Incentives for Ex Ante wildfire risk mitigation in the wildland-urban interface: The relationship between contingent wildfire insurance and fuel management subsidies


    Lankoande, Mariam D.; Yoder, Jonathan K.; Wandschneider, Philip R.


    Contingent wildfire insurance and fuel management cost-sharing programs are becoming more prevalent in western states. This paper develops a model to examine the incentive effects of these two mechanisms for private investment in wildfire risk mitigation. The model shows that contingent insurance contracts strengthen incentives for risk mitigation relative to pooled contracts and subsidies induce more risk mitigation effort by reducing margin private costs of mitigation. With pooled insurance...

  2. Cost effectiveness of transportation fuels from biomass

    International Nuclear Information System (INIS)

    De Jager, D.; Faaij, A.P.C.; Troelstra, W.P.


    The aim of the study on the title subject was to investigate whether stimulation of the production and use of biofuels for transportation is worthwhile compared to the production of electricity from biomass. Several options are compared to each other and with reference technologies on the basis of the consumption or the avoided input of fossil fuels, emissions of greenhouse gases, specific costs and cost effectiveness. For each phase in the biomass conversion process (cultivation, pretreatment, transportation, conversion, distribution and final consumption) indicators were collected from the literature. Next to costs of the bioconversion routes attention is paid to other relevant aspects that are important for the introduction of the technological options in the Netherlands. 41 refs

  3. Cost-effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD. (United States)

    Huber, Manuel B; Präger, Maximilian; Coyle, Kathryn; Coyle, Doug; Lester-George, Adam; Trapero-Bertran, Marta; Nemeth, Bertalan; Cheung, Kei Long; Stark, Renee; Vogl, Matthias; Pokhrel, Subhash; Leidl, Reiner


    To evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany. A Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates. Germany. Cohort of current smoking population (18+ years) in Germany. Interventions included group-based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group-based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England. EQUIPTMOD considered reach, intervention cost, number of quitters, quality-of-life years (QALYs) gained, cost-effectiveness and return on investment. The highest returns through reduction in smoking-related health-care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group-based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost-savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return-on-investment estimates. At a hypothetical willingness-to-pay threshold of only €5000, the probability of being cost-effective is approximately 75% for prospective scenario 1. Increasing the reach of group-based behavioural support, financial incentives and varenicline for smoking cessation by

  4. Effects of the Strategic Prevention Framework State Incentives Grant (SPF SIG) on state prevention infrastructure in 26 states. (United States)

    Orwin, Robert G; Stein-Seroussi, Alan; Edwards, Jessica M; Landy, Ann L; Flewelling, Robert L


    The Strategic Prevention Framework State Incentive Grant (SPF SIG) program is a national public health initiative sponsored by the U.S. Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Prevention to prevent substance abuse and its consequences. State grantees used a data-driven planning model to allocate resources to 450 communities, which in turn launched over 2,200 intervention strategies to target prevention priorities in their respective populations. An additional goal was to build prevention capacity and infrastructure at the state and community levels. This paper addresses whether the state infrastructure goal was achieved, and what contextual and implementation factors were associated with success. The findings are consistent with claims that, overall, the SPF SIG program met its goal of increasing prevention capacity and infrastructure across multiple infrastructure domains, though the mediating effects of implementation were evident only in the evaluation/monitoring domain. The results also show that an initiative like the SPF SIG, which could easily have been compartmentalized within the states, has the potential to permeate more broadly throughout state prevention systems.

  5. Marine Corps Pay Incentives (United States)

    Marines from 2000 to 2017. The thesis includes a literature review on economic theory related to pay incentives in the Department of Defense, a...The purpose of this thesis to provide the Marine Corps with a comprehensive report on pay incentive programs and special pay that were available to...summarization of pay incentive categories, a data analysis on take-up rates and average annual amounts at the end of each fiscal year, and a program review

  6. Nucleus accumbens corticotropin-releasing factor increases cue-triggered motivation for sucrose reward: paradoxical positive incentive effects in stress?

    Directory of Open Access Journals (Sweden)

    Schulkin Jay


    Full Text Available Abstract Background Corticotropin-releasing factor (CRF is typically considered to mediate aversive aspects of stress, fear and anxiety. However, CRF release in the brain is also elicited by natural rewards and incentive cues, raising the possibility that some CRF systems in the brain mediate an independent function of positive incentive motivation, such as amplifying incentive salience. Here we asked whether activation of a limbic CRF subsystem magnifies the increase in positive motivation for reward elicited by incentive cues previously associated with that reward, in a way that might exacerbate cue-triggered binge pursuit of food or other incentives? We assessed the impact of CRF microinjections into the medial shell of nucleus accumbens using a pure incentive version of Pavlovian-Instrumental transfer, a measure specifically sensitive to the incentive salience of reward cues (which it separates from influences of aversive stress, stress reduction, frustration and other traditional explanations for stress-increased behavior. Rats were first trained to press one of two levers to obtain sucrose pellets, and then separately conditioned to associate a Pavlovian cue with free sucrose pellets. On test days, rats received microinjections of vehicle, CRF (250 or 500 ng/0.2 μl or amphetamine (20 μg/0.2 μl. Lever pressing was assessed in the presence or absence of the Pavlovian cues during a half-hour test. Results Microinjections of the highest dose of CRF (500 ng or amphetamine (20 μg selectively enhanced the ability of Pavlovian reward cues to trigger phasic peaks of increased instrumental performance for a sucrose reward, each peak lasting a minute or so before decaying after the cue. Lever pressing was not enhanced by CRF microinjections in the baseline absence of the Pavlovian cue or during the presentation without a cue, showing that the CRF enhancement could not be explained as a result of generalized motor arousal, frustration or stress

  7. Nucleus accumbens corticotropin-releasing factor increases cue-triggered motivation for sucrose reward: paradoxical positive incentive effects in stress? (United States)

    Peciña, Susana; Schulkin, Jay; Berridge, Kent C


    Corticotropin-releasing factor (CRF) is typically considered to mediate aversive aspects of stress, fear and anxiety. However, CRF release in the brain is also elicited by natural rewards and incentive cues, raising the possibility that some CRF systems in the brain mediate an independent function of positive incentive motivation, such as amplifying incentive salience. Here we asked whether activation of a limbic CRF subsystem magnifies the increase in positive motivation for reward elicited by incentive cues previously associated with that reward, in a way that might exacerbate cue-triggered binge pursuit of food or other incentives? We assessed the impact of CRF microinjections into the medial shell of nucleus accumbens using a pure incentive version of Pavlovian-Instrumental transfer, a measure specifically sensitive to the incentive salience of reward cues (which it separates from influences of aversive stress, stress reduction, frustration and other traditional explanations for stress-increased behavior). Rats were first trained to press one of two levers to obtain sucrose pellets, and then separately conditioned to associate a Pavlovian cue with free sucrose pellets. On test days, rats received microinjections of vehicle, CRF (250 or 500 ng/0.2 microl) or amphetamine (20 microg/0.2 microl). Lever pressing was assessed in the presence or absence of the Pavlovian cues during a half-hour test. Microinjections of the highest dose of CRF (500 ng) or amphetamine (20 microg) selectively enhanced the ability of Pavlovian reward cues to trigger phasic peaks of increased instrumental performance for a sucrose reward, each peak lasting a minute or so before decaying after the cue. Lever pressing was not enhanced by CRF microinjections in the baseline absence of the Pavlovian cue or during the presentation without a cue, showing that the CRF enhancement could not be explained as a result of generalized motor arousal, frustration or stress, or by persistent attempts to

  8. Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly. (United States)

    Lunardi, Adriana C; Porras, Desiderio C; Barbosa, Renata Cc; Paisani, Denise M; Marques da Silva, Cibele C B; Tanaka, Clarice; Carvalho, Celso R F


    Aging causes physiological and functional changes that impair pulmonary function. Incentive spirometry is widely used for lung expansion, but the effects of volume-oriented incentive spirometry (VIS) versus flow-oriented incentive spirometry (FIS) on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly are poorly understood. We compared VIS and FIS in elderly subjects and healthy adult subjects. Sixteen elderly subjects (9 women, mean ± SD age 70.6 ± 3.9 y, mean ± SD body mass index 23.8 ± 2.5 kg/m(2)) and 16 healthy adults (8 women, mean ± age 25.9 ± 4.3 y, mean ± body mass index 23.6 ± 2.4 kg/m(2)) performed quiet breathing, VIS, and FIS in randomized sequence. Chest wall kinematics (via optoelectronic plethysmography) and inspiratory muscle activity (via surface electromyography) were assessed simultaneously. Synchrony between the superior thorax and abdominal motion was calculated (phase angle). In the elderly subjects both types of incentive spirometry increased chest wall volumes similarly, whereas in the healthy adult subjects VIS increased the chest wall volume more than did FIS. FIS and VIS triggered similar lower thoracoabdominal synchrony in the elderly subjects, whereas in the healthy adults FIS induced lower synchrony than did VIS. FIS required more muscle activity in the elderly subjects to create an increase in chest wall volume. Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.

  9. The Identification of Incentive Effects of Benefit Exhaustion in Unemployment Insurance Systems

    DEFF Research Database (Denmark)

    Pico Geerdsen, Lars

    The paper examines the different assumptions which have been applied in the literature in order to identify the motivation effect of benefits exhaustion. The different assumptions are tested on a common data set.......The paper examines the different assumptions which have been applied in the literature in order to identify the motivation effect of benefits exhaustion. The different assumptions are tested on a common data set....

  10. Long-lasting effects of performance-contingent unconscious and conscious reward incentives during cued task-switching. (United States)

    Capa, Rémi L; Bouquet, Cédric A; Dreher, Jean-Claude; Dufour, André


    Motivation is often thought to interact consciously with executive control, although recent studies have indicated that motivation can also be unconscious. To date, however, the effects of unconscious motivation on high-order executive control functions have not been explored. Only a few studies using subliminal stimuli (i.e., those not related to motivation, such as an arrow to prime a response) have reported short-lived effects on high-order executive control functions. Here, building on research on unconscious motivation, in which a behavior of perseverance is induced to attain a goal, we hypothesized that subliminal motivation can have long-lasting effects on executive control processes. We investigated the impact of unconscious/conscious monetary reward incentives on evoked potentials and neural activity dynamics during cued task-switching performance. Participants performed long runs of task-switching. At the beginning of each run, a reward (50 cents or 1 cent) was displayed, either subliminally or supraliminally. Participants earned the reward contingent upon their correct responses to each trial of the run. A higher percentage of runs was achieved with higher (conscious and unconscious) than lower rewards, indicating that unconscious high rewards have long-lasting behavioral effects. Event-related potential (ERP) results indicated that unconscious and conscious rewards influenced preparatory effort in task preparation, as suggested by a greater fronto-central contingent negative variation (CNV) starting at cue-onset. However, a greater parietal P3 associated with better reaction times (RTs) was observed only under conditions of conscious high reward, suggesting a larger amount of working memory invested during task performance. Together, these results indicate that unconscious and conscious motivations are similar at early stages of task-switching preparation but differ during task performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Clinical evaluation based on cost-effectiveness

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko


    We carried out two Phase III clinical trials using high dose rate (HDR) remote afterloading brachytherapy unit. We evaluated the clinical results based not only on the medical but also the economical standpoint. The first trial is the Phase III trial for cervical cancer treated with HDR or medium dose rate (MDR) intracavitary radiotherapy. The second one is the Phase III trial for tongue cancer treated with HDR or low dose rate (LDR) interstitial radiation. For cervical cancer, the survival rate of patients treated with HDR brachytherapy is the some as for LDR brachytherapy. The average total cost of treatment for the HDR group was 1.47 million yen, while that for the MDR group was 1.58 million yen. The average total admission days was 63. For tongue cancer, the local control rate of the HDR group is almost the same as that of the LDR groups. The average total cost for the HDR group was 780 thousand yen, and that for the LDR group was 830 thousand yen. The average total admission days was 34. According to the cost-effectiveness, HDR brachytherapy for cervical cancer has the same result as MDR, and HDR brachytherapy for tongue cancer has the same result as LDR. However, HDR can be treated without admission for patients who live near the hospital. HDR can be applied for these patients with less expense. We must be aware of not only the medical results but also the cost-effectiveness. (author)

  12. SSP Plus at 36 Months: Effects of Adding Employment Services to Financial Work Incentives. (United States)

    Lei, Ying; Michalopoulos, Charles

    A study examined effects of the Self-Sufficiency Project (SSP) Plus program. A small group of long-term income assistance (IA) recipients in New Brunswick was offered an earnings supplement and employment services (SSP Plus); a second group was offered the regular SSP earnings supplement only; and a third group was offered neither supplement nor…

  13. Cost effectiveness of surveillance for GI cancers. (United States)

    Omidvari, Amir-Houshang; Meester, Reinier G S; Lansdorp-Vogelaar, Iris


    Gastrointestinal (GI) diseases are among the leading causes of death in the world. To reduce the burden of GI diseases, surveillance is recommended for some diseases, including for patients with inflammatory bowel diseases, Barrett's oesophagus, precancerous gastric lesions, colorectal adenoma, and pancreatic neoplasms. This review aims to provide an overview of the evidence on cost-effectiveness of surveillance of individuals with GI conditions predisposing them to cancer, specifically focussing on the aforementioned conditions. We searched the literature and reviewed 21 studies. Despite heterogeneity of studies in terms of settings, study populations, surveillance strategies and outcomes, most reviewed studies suggested at least some surveillance of patients with these GI conditions to be cost-effective. For some high-risk conditions frequent surveillance with 3-month intervals was warranted, while for other conditions, surveillance may only be cost-effective every 10 years. Further studies based on more robust effectiveness evidence are needed to inform and optimise surveillance programmes for GI cancers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Differential Effects of Systemic Cholinergic Receptor Blockade on Pavlovian Incentive Motivation and Goal-Directed Action Selection (United States)

    Ostlund, Sean B; Kosheleff, Alisa R; Maidment, Nigel T


    Reward-seeking actions can be guided by external cues that signal reward availability. For instance, when confronted with a stimulus that signals sugar, rats will prefer an action that produces sugar over a second action that produces grain pellets. Action selection is also sensitive to changes in the incentive value of potential rewards. Thus, rats that have been prefed a large meal of sucrose will prefer a grain-seeking action to a sucrose-seeking action. The current study investigated the dependence of these different aspects of action selection on cholinergic transmission. Hungry rats were given differential training with two unique stimulus-outcome (S1-O1 and S2-O2) and action-outcome (A1-O1 and A2-O2) contingencies during separate training phases. Rats were then given a series of Pavlovian-to-instrumental transfer tests, an assay of cue-triggered responding. Before each test, rats were injected with scopolamine (0, 0.03, or 0.1 mg/kg, intraperitoneally), a muscarinic receptor antagonist, or mecamylamine (0, 0.75, or 2.25 mg/kg, intraperitoneally), a nicotinic receptor antagonist. Although the reward-paired cues were capable of biasing action selection when rats were tested off-drug, both anticholinergic treatments were effective in disrupting this effect. During a subsequent round of outcome devaluation testing—used to assess the sensitivity of action selection to a change in reward value—we found no effect of either scopolamine or mecamylamine. These results reveal that cholinergic signaling at both muscarinic and nicotinic receptors mediates action selection based on Pavlovian reward expectations, but is not critical for flexibly selecting actions using current reward values. PMID:24370780

  15. Effects of incentives, age, and behavior on brain activation during inhibitory control: A longitudinal fMRI study

    Directory of Open Access Journals (Sweden)

    David J. Paulsen


    Full Text Available We investigated changes in brain function supporting inhibitory control under age-controlled incentivized conditions, separating age- and performance-related activation in an accelerated longitudinal design including 10- to 22-year-olds. Better inhibitory control correlated with striatal activation during neutral trials, while Age X Behavior interactions in the striatum indicated that in the absence of extrinsic incentives, younger subjects with greater reward circuitry activation successfully engage in greater inhibitory control. Age was negatively correlated with ventral amygdala activation during Loss trials, suggesting that amygdala function more strongly mediates bottom-up processing earlier in development when controlling the negative aspects of incentives to support inhibitory control. Together, these results indicate that with development, reward-modulated cognitive control may be supported by incentive processing transitions in the amygdala, and from facilitative to obstructive striatal function during inhibitory control.

  16. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa


    ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 6. Uncertainty in cost-effectiveness analysis . . . . . . . . . . . . . . . . . . 73 7. 8. Policy uses of Generalized CEA...

  17. Cost-effectiveness of the fenceline cow

    Energy Technology Data Exchange (ETDEWEB)

    Eichholz, G G; Lando, A V [Georgia Inst. of Tech., Atlanta (USA). School of Nuclear Engineering


    The grass-cow-milk pathway for /sup 131/I is one of the main contributers to estimated population dose from BWR's and PWR's. Such estimates assume a cow at the fenceline grazing for 12 months of the year. Reductions in the population dose would require a trade-off, based on cost-effectiveness criteria, between additions to the effluent treatment system, expanding the exclusion area, or raising the stack height. It is suggested that a more practical and more cost-effective means may be provided by redistribution of nearby dairy cattle (or goats), and that the plant operator buy these animals and/or contract with the land owner(s) to use the land for alternative crops. Even a subsidy to compensate the farmer for any financial losses entailed in these changes might be less expensive than alternative technical installations to lower iodine effluent levels. Figures are provided to illustrate these points.

  18. Structuring economic incentives to reduce emissions from deforestation within Indonesia. (United States)

    Busch, Jonah; Lubowski, Ruben N; Godoy, Fabiano; Steininger, Marc; Yusuf, Arief A; Austin, Kemen; Hewson, Jenny; Juhn, Daniel; Farid, Muhammad; Boltz, Frederick


    We estimate and map the impacts that alternative national and subnational economic incentive structures for reducing emissions from deforestation (REDD+) in Indonesia would have had on greenhouse gas emissions and national and local revenue if they had been in place from 2000 to 2005. The impact of carbon payments on deforestation is calibrated econometrically from the pattern of observed deforestation and spatial variation in the benefits and costs of converting land to agriculture over that time period. We estimate that at an international carbon price of $10/tCO(2)e, a "mandatory incentive structure," such as a cap-and-trade or symmetric tax-and-subsidy program, would have reduced emissions by 163-247 MtCO(2)e/y (20-31% below the without-REDD+ reference scenario), while generating a programmatic budget surplus. In contrast, a "basic voluntary incentive structure" modeled after a standard payment-for-environmental-services program would have reduced emissions nationally by only 45-76 MtCO(2)e/y (6-9%), while generating a programmatic budget shortfall. By making four policy improvements--paying for net emission reductions at the scale of an entire district rather than site-by-site; paying for reductions relative to reference levels that match business-as-usual levels; sharing a portion of district-level revenues with the national government; and sharing a portion of the national government's responsibility for costs with districts--an "improved voluntary incentive structure" would have been nearly as effective as a mandatory incentive structure, reducing emissions by 136-207 MtCO(2)e/y (17-26%) and generating a programmatic budget surplus.

  19. Structuring economic incentives to reduce emissions from deforestation within Indonesia (United States)

    Busch, Jonah; Lubowski, Ruben N.; Godoy, Fabiano; Steininger, Marc; Yusuf, Arief A.; Austin, Kemen; Hewson, Jenny; Juhn, Daniel; Farid, Muhammad; Boltz, Frederick


    We estimate and map the impacts that alternative national and subnational economic incentive structures for reducing emissions from deforestation (REDD+) in Indonesia would have had on greenhouse gas emissions and national and local revenue if they had been in place from 2000 to 2005. The impact of carbon payments on deforestation is calibrated econometrically from the pattern of observed deforestation and spatial variation in the benefits and costs of converting land to agriculture over that time period. We estimate that at an international carbon price of $10/tCO2e, a “mandatory incentive structure,” such as a cap-and-trade or symmetric tax-and-subsidy program, would have reduced emissions by 163–247 MtCO2e/y (20–31% below the without-REDD+ reference scenario), while generating a programmatic budget surplus. In contrast, a “basic voluntary incentive structure” modeled after a standard payment-for-environmental-services program would have reduced emissions nationally by only 45–76 MtCO2e/y (6–9%), while generating a programmatic budget shortfall. By making four policy improvements—paying for net emission reductions at the scale of an entire district rather than site-by-site; paying for reductions relative to reference levels that match business-as-usual levels; sharing a portion of district-level revenues with the national government; and sharing a portion of the national government's responsibility for costs with districts—an “improved voluntary incentive structure” would have been nearly as effective as a mandatory incentive structure, reducing emissions by 136–207 MtCO2e/y (17–26%) and generating a programmatic budget surplus. PMID:22232665

  20. Cost-Effectiveness of a Community Exercise and Nutrition Program for Older Adults: Texercise Select. (United States)

    Akanni, Olufolake Odufuwa; Smith, Matthew Lee; Ory, Marcia G


    The wide-spread dissemination of evidence-based programs that can improve health outcomes among older populations often requires an understanding of factors influencing community adoption of such programs. One such program is Texercise Select , a community-based health promotion program previously shown to improve functional health, physical activity, nutritional habits and quality of the life among older adults. This paper assesses the cost-effectiveness of Texercise Select in the context of supportive environments to facilitate its delivery and statewide sustainability. Participants were surveyed using self-reported instruments distributed at program baseline and conclusion. Program costs were based on actual direct costs of program implementation and included costs of recruitment and outreach, personnel costs and participant incentives. Program effectiveness was measured using quality-adjusted life year (QALY) gained, as well as health outcomes, such as healthy days, weekly physical activity and Timed Up-and-Go (TUG) test scores. Preference-based EuroQol (EQ-5D) scores were estimated from the number of healthy days reported by participants and converted into QALYs. There was a significant increase in the number of healthy days ( p nutrition-related outcomes among participants, this study supports the use of Texercise Select as an intervention with substantial health and cost benefits.

  1. Cost effects of hospital mergers in Portugal. (United States)

    Azevedo, Helda; Mateus, Céu


    The Portuguese hospital sector has been restructured by wide-ranging hospital mergers, following a conviction among policy makers that bigger hospitals lead to lower average costs. Since the effects of mergers have not been systematically evaluated, the purpose of this article is to contribute to this area of knowledge by assessing potential economies of scale to explore and compare these results with realized cost savings after mergers. Considering the period 2003-2009, we estimate the translog cost function to examine economies of scale in the years preceding restructuring. Additionally, we use the difference-in-differences approach to evaluate hospital centres (HC) that occurred between 2004 and 2007, comparing the years after and before mergers. Our findings suggest that economies of scale are present in the pre-merger configuration with an optimum hospital size of around 230 beds. However, the mergers between two or more hospitals led to statistically significant post-merger cost increases, of about 8 %. This result indicates that some HC become too large to explore economies of scale and suggests the difficulty of achieving efficiencies through combining operations and service specialization.

  2. Incentive Regulation and Utility Benchmarking for Electricity Network Security


    Zhang, Y.; Nepal, R.


    The incentive regulation of costs related to physical and cyber security in electricity networks is an important but relatively unexplored and ambiguous issue. These costs can be part of cost efficiency benchmarking or, alternatively, dealt with separately. This paper discusses the issues and proposes options for incorporating network security costs within incentive regulation in a benchmarking framework. The relevant concerns and limitations associated with the accounting and classification ...

  3. The effects of economic and policy incentives on carbon mitigation technologies

    International Nuclear Information System (INIS)

    Newell, Richard G.; Jaffe, Adam B.; Stavins, Robert N.


    The ability to estimate the likely effects of potential climate change policies on energy use and greenhouse gas (GHG) emissions requires an improved understanding of the relationship between different policy alternatives and energy-saving and GHG-reducing changes in technology. A particularly important and understudied aspect of this set of issues is the conceptual and empirical modeling of how the various stages of technological change are interrelated, how they unfold over time in response to market forces, and the differential impact of various policies (for example, R and D subsidies, environmental taxes, information programs). We summarize several contributions to this literature and suggest promising areas for continued research on empirical analysis and modeling of induced technological change

  4. Acceptability of Parental Financial Incentives and Quasi-Mandatory Interventions for Preschool Vaccinations: Triangulation of Findings from Three Linked Studies.

    Directory of Open Access Journals (Sweden)

    Jean Adams

    Full Text Available Childhood vaccinations are a core component of public health programmes globally. Recent measles outbreaks in the UK and USA have prompted debates about new ways to increase uptake of childhood vaccinations. Parental financial incentives and quasi-mandatory interventions (e.g. restricting entry to educational settings to fully vaccinated children have been successfully used to increase uptake of childhood vaccinations in developing countries, but there is limited evidence of effectiveness in developed countries. Even if confirmed to be effective, widespread implementation of these interventions is dependent on acceptability to parents, professionals and other stakeholders.We conducted a systematic review (n = 11 studies included, a qualitative study with parents (n = 91 and relevant professionals (n = 24, and an on-line survey with embedded discrete choice experiment with parents (n = 521 exploring acceptability of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Here we use Triangulation Protocol to synthesise findings from the three studies.There was a consistent recognition that incentives and quasi-mandatory interventions could be effective, particularly in more disadvantaged groups. Universal incentives were consistently preferred to targeted ones, but relative preferences for quasi-mandatory interventions and universal incentives varied between studies. The qualitative work revealed a consistent belief that financial incentives were not considered an appropriate motivation for vaccinating children. The costs of financial incentive interventions appeared particularly salient and there were consistent concerns in the qualitative work that incentives did not represent the best use of resources for promoting preschool vaccinations. Various suggestions for improving delivery of the current UK vaccination programme as an alternative to incentives and quasi-mandates were made.Parental financial

  5. Photovoltaic Incentive Design Handbook

    Energy Technology Data Exchange (ETDEWEB)

    Hoff, T. E.


    Investments in customer-owned grid-connected photovoltaic (PV) energy systems are growing at a steady pace. This is due, in part, to the availability of attractive economic incentives offered by public state agencies and utilities. In the United States, these incentives have largely been upfront lump payments tied to the system capacity rating. While capacity-based ''buydowns'' have stimulated the domestic PV market, they have been criticized for subsidizing systems with potentially poor energy performance. As a result, the industry has been forced to consider alternative incentive structures, particularly ones that pay based on long-term measured performance. The industry, however, lacks consensus in the debate over the tradeoffs between upfront incentive payments versus longer-term payments for energy delivery. This handbook is designed for agencies and utilities that offer or intend to offer incentive programs for customer-owned PV systems. Its purpose is to help select, design, and implement incentive programs that best meet programmatic goals. The handbook begins with a discussion of the various available incentive structures and then provides qualitative and quantitative tools necessary to design the most appropriate incentive structure. It concludes with program administration considerations.

  6. Cost-Effectiveness Analysis of Three Leprosy Case Detection Methods in Northern Nigeria (United States)

    Ezenduka, Charles; Post, Erik; John, Steven; Suraj, Abdulkarim; Namadi, Abdulahi; Onwujekwe, Obinna


    Background Despite several leprosy control measures in Nigeria, child proportion and disability grade 2 cases remain high while new cases have not significantly reduced, suggesting continuous spread of the disease. Hence, there is the need to review detection methods to enhance identification of early cases for effective control and prevention of permanent disability. This study evaluated the cost-effectiveness of three leprosy case detection methods in Northern Nigeria to identify the most cost-effective approach for detection of leprosy. Methods A cross-sectional study was carried out to evaluate the additional benefits of using several case detection methods in addition to routine practice in two north-eastern states of Nigeria. Primary and secondary data were collected from routine practice records and the Nigerian Tuberculosis and Leprosy Control Programme of 2009. The methods evaluated were Rapid Village Survey (RVS), Household Contact Examination (HCE) and Traditional Healers incentive method (TH). Effectiveness was measured as number of new leprosy cases detected and cost-effectiveness was expressed as cost per case detected. Costs were measured from both providers' and patients' perspectives. Additional costs and effects of each method were estimated by comparing each method against routine practise and expressed as incremental cost-effectiveness ratio (ICER). All costs were converted to the U.S. dollar at the 2010 exchange rate. Univariate sensitivity analysis was used to evaluate uncertainties around the ICER. Results The ICER for HCE was $142 per additional case detected at all contact levels and it was the most cost-effective method. At ICER of $194 per additional case detected, THs method detected more cases at a lower cost than the RVS, which was not cost-effective at $313 per additional case detected. Sensitivity analysis showed that varying the proportion of shared costs and subsistent wage for valuing unpaid time did not significantly change the

  7. Incentive contracts for development projects (United States)

    Finley, David T.; Smith, Byron; DeGroff, B.


    Finding a contract vehicle that balances the concerns of the customer and the contractor in a development project can be difficult. The customer wants a low price and an early delivery, with as few surprises as possible as the project progresses. The contractor wants sufficient cost and schedule to cover risk. Both want to clearly define what each party will provide. Many program offices do not want to award cost plus contracts because their funding sources will not allow it, their boards do not want an open ended commitment, and they feel like they lose financial control of the project. A fixed price incentive contract, with a mutually agreed upon target cost, provides the owner with visibility into the project and input into the execution of the project, encourages both parties to save costs, and stimulates a collaborative atmosphere by aligning the respective interests of customers and contractors.

  8. On cost-effective communication network designing (United States)

    Zhang, Guo-Qiang


    How to efficiently design a communication network is a paramount task for network designing and engineering. It is, however, not a single objective optimization process as perceived by most previous researches, i.e., to maximize its transmission capacity, but a multi-objective optimization process, with lowering its cost to be another important objective. These two objectives are often contradictive in that optimizing one objective may deteriorate the other. After a deep investigation of the impact that network topology, node capability scheme and routing algorithm as well as their interplays have on the two objectives, this letter presents a systematic approach to achieve a cost-effective design by carefully choosing the three designing aspects. Only when routing algorithm and node capability scheme are elegantly chosen can BA-like scale-free networks have the potential of achieving good tradeoff between the two objectives. Random networks, on the other hand, have the built-in character for a cost-effective design, especially when other aspects cannot be determined beforehand.

  9. The Effects of Incentives on Visual-Spatial Working Memory in Children with Attention-Deficit/Hyperactivity Disorder (United States)

    Shiels, Keri; Hawk, Larry W., Jr.; Lysczek, Cynthia L.; Tannock, Rosemary; Pelham, William E., Jr.; Spencer, Sarah V.; Gangloff, Brian P.; Waschbusch, Daniel A.


    Working memory is one of several putative core neurocognitive processes in attention-deficit/hyperactivity disorder (ADHD). The present work seeks to determine whether visual-spatial working memory is sensitive to motivational incentives, a laboratory analogue of behavioral treatment. Participants were 21 children (ages 7-10) with a diagnosis of…

  10. 49 CFR 639.21 - Determination of cost-effectiveness. (United States)


    ... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...

  11. Custom LSI plus hybrid equals cost effectiveness (United States)

    Friedman, S. N.

    The possibility to combine various technologies, such as Bi-Polar linear and CMOS/Digital makes it feasible to create systems with a tailored performance not available on a single monolithic circuit. The custom LSI 'BLOCK', especially if it is universal in nature, is proving to be a cost effective way for the developer to improve his product. The custom LSI represents a low price part in contrast to the discrete components it will replace. In addition, the hybrid assembly can realize a savings in labor as a result of the reduced parts handling and associated wire bonds. The possibility of the use of automated system manufacturing techniques leads to greater reliability as the human factor is partly eliminated. Attention is given to reliability predictions, cost considerations, and a product comparison study.

  12. Coupons for Success: A Marketing Incentive in Academic Support (United States)

    Potacco, Donna R.; Chen, Peter; Desroches, Danielle; Chisholm, Daniel R.; De Young, Sandra


    How does a Coupon Incentive Program motivate students to seek academic support in high-risk courses? Results from this study demonstrated that the Coupon Incentive Program was effective in motivating voluntary student attendance and improving student outcomes. Recommendations related to implementation of the Coupon Incentive Program are discussed.…

  13. Final Technical Report Power through Policy: "Best Practices" for Cost-Effective Distributed Wind

    Energy Technology Data Exchange (ETDEWEB)

    Rhoads-Weaver, Heather; Gagne, Matthew; Sahl, Kurt; Orrell, Alice; Banks, Jennifer


    Power through Policy: 'Best Practices' for Cost-Effective Distributed Wind is a U.S. Department of Energy (DOE)-funded project to identify distributed wind technology policy best practices and to help policymakers, utilities, advocates, and consumers examine their effectiveness using a pro forma model. Incorporating a customized feed from the Database of State Incentives for Renewables and Efficiency (DSIRE), the Web-based Distributed Wind Policy Comparison Tool (Policy Tool) is designed to assist state, local, and utility officials in understanding the financial impacts of different policy options to help reduce the cost of distributed wind technologies. The project's final products include the Distributed Wind Policy Comparison Tool, found at, and its accompanying documentation: Distributed Wind Policy Comparison Tool Guidebook: User Instructions, Assumptions, and Case Studies. With only two initial user inputs required, the Policy Tool allows users to adjust and test a wide range of policy-related variables through a user-friendly dashboard interface with slider bars. The Policy Tool is populated with a variety of financial variables, including turbine costs, electricity rates, policies, and financial incentives; economic variables including discount and escalation rates; as well as technical variables that impact electricity production, such as turbine power curves and wind speed. The Policy Tool allows users to change many of the variables, including the policies, to gauge the expected impacts that various policy combinations could have on the cost of energy (COE), net present value (NPV), internal rate of return (IRR), and the simple payback of distributed wind projects ranging in size from 2.4 kilowatts (kW) to 100 kW. The project conducted case studies to demonstrate how the Policy Tool can provide insights into 'what if' scenarios and also allow the current status of incentives to be examined or defended when

  14. Sustainable Groundwater Management Using Economic Incentive Approach (United States)

    Yan, T.; Shih, J.; Sanchirico, J. N.


    with development rights and development in the high intensity area is contingent on the purchase of the rights, which are transferred via a market. By comparing these two policy regimes, which are often analyzed separately, we can gain a better sense of the relative costs involved and the potential trade-offs and/or benefits from a hybrid policy. Furthermore, we will also investigate the potential barriers of adopting economic incentive approach specifically for the groundwater management context. These research results will assist policymakers at all levels to better understand how to design effective trading programs and realize the potential costs savings associated with these approaches for sustainable groundwater management.

  15. Regulatory Incentives and Disincentives for Utility Investments in Grid Modernization

    Energy Technology Data Exchange (ETDEWEB)

    Kihm, Steve [Seventhware, Madison, WI (United States); Beecher, Janice [Michigan State Univ., East Lansing, MI (United States). Inst. of Public Utilities; Lehr, Ronald L.


    Electric power is America's most capital-intensive industry, with more than $100 billion invested each year in energy infrastructure. Investment needs are likely to grow as electric utilities make power systems more reliable and resilient, deploy advanced digital technologies, and facilitate new services to meet some consumers' expectations for greater choice and control. But do current regulatory approaches provide the appropriate incentives for grid modernization investments? This report presents three perspectives: -Financial analyst Steve Kihm begins by explaining that any major investor-owned electric utility that wants to raise capital today can do so at a reasonable cost. The question is whether utility managers want to raise capital for grid modernization. Specifically, they look for investments that create the most value for their existing shareholders. In cases where grid modernization investments are not the best choice in terms of shareholder value, Kihm describes shareholder incentive mechanisms that regulators could consider to encourage such investments when they are in the public interest. -From an institutional perspective, Dr. Janice Beecher finds that the traditional rate-base/rate of return regulatory model provides powerful incentives for utilities to pursue investments, cost control, efficiency and even innovation, and it is well suited to the policy objectives of grid modernization. Prudence of grid modernization investments (fair returns) depends on careful evaluation of the specific asset, and any special incentives (bonus returns) should be used only if they promote economic efficiency consistent with the core goals of economic regulation. According to Beecher, realizing the promises of grid modernization depends on effective implementation of the traditional regulatory model and ratemaking tools to serve the public interest. -Conversely, former commissioner and clean energy consultant Ron Lehr says that rapid electric industry

  16. Wind and solar energy incentives in Iran

    International Nuclear Information System (INIS)

    Taleghani, G.; Kazemi Karegar, H.


    Incentive have yet been viewed as a means of supporting technological developments until a new technology becomes cost competitive wind based electricity is not jet generally competitive with alternate sources of electricity such as fossil fuels. This paper presents the potential for wind and solar in Iran and shows how much electric energy is now produced by renewable power plants compared to steam and gas. The importance of renewable energy effects on Iran environment and economy is also discussed and the issue of the contribution of renewable energy for producing electricity in the future will be shown. Also this paper highlights the ability of Iran to manufacture the components of the wind turbine and solar system locally, and its effect on the price of wind turbine and solar energy

  17. Cost effects of Cu powder and bentonite on the disposal costs of an HLW repository in

    International Nuclear Information System (INIS)

    Kim, Sung Ki; Lee, Min Soo; Lee, Jong Youl; Choi, Heui Joo; Choi, Jong Won


    This paper provides the cost effect results of Cu powder and bentonite on the disposal cost for an HLW repository in Korea. In the cost analysis for both of these cost drivers, the price of Cu powder and the bentonite can affect the canister cost and the bentonite cost of the disposal holes as well as backfilling cost of the tunnels, respectively. Finally, we found that the unit cost of Cu and bentonite was the dominant cost drivers for the surface and underground facilities of an HLW repository. Therefore, an optimization of a canister and the layout of a disposal hole and disposal tunnels are essential to decrease the direct disposal cost of spent fuels. The disposal costs can be largely divided into two parts such as a surface facilities' cost and an underground facilities' cost. According to the KRS' cost analysis, the encapsulation material as well as the buffering and backfilling cost were the significant costs. Especially, a canister's cost was approximately estimated to be more than one fourth of the overall disposal costs. So it can be estimated that the unit cost of Cu powder is an important cost diver. Because the outer shell of the canister was made of Cu powder by a cold spray coating method. In addition, the unit cost of bentonite can also affect the buffering and the backfilling costs of the disposal holes and the disposal tunnels. But, these material costs will be highly expensive and unstable due to the modernization of the developing countries. So the studies for a material cost should be continued to identify the actual cost of an HLW repository

  18. Aid Effectiveness, Transaction Costs and Conditionality in the Education Sector (United States)

    Ashford, Richard; Biswas, Shampa


    The reduction of transaction costs is a commonly mentioned yet rarely elaborated goal for aid effectiveness in educational development. The casual use of the concept of transaction costs conceals which costs may be reduced, which costs are required and, indeed, what transaction costs actually are. Examining issues related to harmonizing the…

  19. Impact of government incentives in the profitability of green energy production using fuel cells in Colombia.

    Directory of Open Access Journals (Sweden)

    Bernardo A. Potosí-Guerrero


    Full Text Available Fuel cells are a technological alternative to produce green energy, however, high costs make fuel cell a non-profitable option. This paper analyses the impact of the Colombian government incentives in the profitability of fuel cells. The analysis is based on the total operation cost of the fuel cell in three representative applications: residential, office and building elevator. The economic viability of fuel cell generation in those cases is contrasted with classical solutions like diesel generators and standard grid to provide a reference framework. Such results enable to evaluate the effectiveness of the Colombian government incentives in promoting the use of fuel cells over other less environmental-friendly options such as diesel generators. Finally, new incentives are proposed by subsidies offered by other countries with higher fuel cell penetration into their electric market. All the analyses are supported in simulations performed with a mathematical model parameterized using the characteristics of commercial devices.

  20. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

  1. Global technology learning and national policy-An incentive scheme for governments to assume the high cost of early deployment exemplified by Norway

    International Nuclear Information System (INIS)

    Martinsen, Thomas


    In this paper it is argued that technology learning may be both a barrier and an incentive for technology change in the national energy system. The possibility to realize an ambitious global emission reduction scenario is enhanced by coordinated action between countries in national policy implementation. An indicator for coordinated action is suggested. Targeted measures to increase deployment of nascent energy technologies and increasing energy efficiency in a small open economy like Norway are examined. The measures are evaluated against a set of baselines with different levels of spillover of technology learning from the global market. It is found that implementation of technology subsidies increase the national contribution to early deployment independent of the level of spillover. In a special case with no spillover for offshore floating wind power and endogenous technology learning substantial subsidy or a learning rate of 20% is required. Combining the high learning rate and a national subsidy increases the contribution to early deployment. Enhanced building code on the other hand may reduce Norway's contribution to early deployment, and thus the realization of a global emission reduction scenario, unless sufficient electricity export capacity is assured.

  2. How rebates, copayments, and administration costs affect the cost-effectiveness of osteoporosis therapies. (United States)

    Ferko, Nicole C; Borisova, Natalie; Airia, Parisa; Grima, Daniel T; Thompson, Melissa F


    Because of rising drug expenditures, cost considerations have become essential, necessitating the requirement for cost-effectiveness analyses for managed care organizations (MCOs). The study objective is to examine the impact of various drug-cost components, in addition to wholesale acquisition cost (WAC), on the cost-effectiveness of osteoporosis therapies. A Markov model of osteoporosis was used to exemplify different drug cost scenarios. We examined the effect of varying rebates for oral bisphosphonates--risedronate and ibandronate--as well as considering the impact of varying copayments and administration costs for intravenous zoledronate. The population modeled was 1,000 American women, > or = 50 years with osteoporosis. Patients were followed for 1 year to reflect an annual budget review of formularies by MCOs. The cost of therapy was based on an adjusted WAC, and is referred to as net drug cost. The total annual cost incurred by an MCO for each drug regimen was calculated using the net drug cost and fracture cost. We estimated cost on a quality adjusted life year (QALY) basis. When considering different rebates, results for risedronate versus ibandronate vary from cost-savings (i.e., costs less and more effective) to approximately $70,000 per QALY. With no risedronate rebate, an ibandronate rebate of approximately 65% is required before cost per QALY surpasses $50,000. With rebates greater than 25% for risedronate, irrespective of ibandronate rebates, results become cost-saving. Results also showed the magnitude of cost savings to the MCO varied by as much as 65% when considering no administration cost and the highest coinsurance rate for zoledronate. Our study showed that cost-effectiveness varies considerably when factors in addition to the WAC are considered. This paper provides recommendations for pharmaceutical manufacturers and MCOs when developing and interpreting such analyses.

  3. Adoption of residential solar power under uncertainty: Implications for renewable energy incentives

    International Nuclear Information System (INIS)

    Bauner, Christoph; Crago, Christine L.


    Many incentives at the state and federal level exist for household adoption of renewable energy like solar photovoltaic (PV) panels. Despite generous financial incentives the adoption rate is low. We use the option value framework, which takes into account the benefit of delaying investment in response to uncertainty, to examine the decision by households to invest in solar PV. Using a simulation model, we determine optimal adoption times, critical values of discounted benefits, and adoption rates over time for solar PV investments using data from Massachusetts. We find that the option value multiplier is 1.6, which implies that the discounted value of benefits from solar PV needs to exceed installation cost by 60% for investment to occur. Without any policies, median adoption time is eight years longer under the option value decision rule compared to the net present value decision rule where households equate discounted benefits to installation cost. Rebates and other financial incentives decrease adoption time, but their effect is attenuated if households apply the option value decision rule to solar PV investments. Results suggest that policies that reduce the uncertainty in returns from solar PV investments would be most effective at incentivizing adoption. - Highlights: • We examine household adoption of solar PV using the option value framework. • Uncertainty in benefits and costs leads to delay in investment timing. • Discounted benefits from solar PV have to exceed investment cost by 60% to trigger investment. • Policy incentives that reduce uncertainty in returns from solar PV are most effective.

  4. The use of financial incentives in Australian general practice. (United States)

    Kecmanovic, Milica; Hall, Jane P


    To examine the uptake of financial incentive payments in general practice, and identify what types of practitioners are more likely to participate in these schemes. Analysis of data on general practitioners and GP registrars from the Medicine in Australia - Balancing Employment and Life (MABEL) longitudinal panel survey of medical practitioners in Australia, from 2008 to 2011. Income received by GPs from government incentive schemes and grants and factors associated with the likelihood of claiming such incentives. Around half of GPs reported receiving income from financial incentives in 2008, and there was a small fall in this proportion by 2011. There was considerable movement into and out of the incentives schemes, with more GPs exiting than taking up grants and payments. GPs working in larger practices with greater administrative support, GPs practising in rural areas and those who were principals or partners in practices were more likely to use grants and incentive payments. Administrative support available to GPs appears to be an increasingly important predictor of incentive use, suggesting that the administrative burden of claiming incentives is large and not always worth the effort. It is, therefore, crucial to consider such costs (especially relative to the size of the payment) when designing incentive payments. As market conditions are also likely to influence participation in incentive schemes, the impact of incentives can change over time and these schemes should be reviewed regularly.

  5. Economic incentive in community nursing: attraction, rejection or indifference?

    Directory of Open Access Journals (Sweden)

    Kingma Mireille


    Full Text Available Abstract Background It is hard to imagine any period in time when economic issues were more visible in health sector decision-making. The search for measures that maximize available resources has never been greater than within the present decade. A staff payroll represents 60%-70% of budgeted health service funds. The cost-effective use of human resources is thus an objective of paramount importance. Using incentives and disincentives to direct individuals' energies and behaviour is common practice in all work settings, of which the health care system is no exception. The range and influence of economic incentives/disincentives affecting community nurses are the subject of this discussion paper. The tendency by nurses to disregard, and in many cases, deny a direct impact of economic incentives/disincentives on their motivation and professional conduct is of particular interest. The goal of recent research was to determine if economic incentives/disincentives in community nursing exist, whether they have a perceivable impact and in what areas. Conclusion Understanding the value system of community nurses and how they respond to economic incentives/disincentives facilitates the development of reward systems more likely to be relevant and strategic. If nurse rewards are to become more effective organizational tools, the data suggest that future initiatives should: • Improve nurses' salary/income relativities (e.g. comparable pay/rates; • Provide just compensation for job-related expenses (e.g. petrol, clothing; • Introduce promotional opportunities within the clinical area, rewarding skill and competence development; • Make available a range of financed rewards. - Direct (e.g. subsidized education, additional leave, insurance benefits; - Indirect (e.g. better working conditions, access to professional support network, greater participation in decision-making bodies.

  6. Training effectiveness vs. cost effectiveness: The next millennium challenge

    International Nuclear Information System (INIS)

    Coe, Richard P.


    With the advent of the new millennium and energy deregulation, organizations will be challenged to be cost competitive and profitable. Deregulation in the US energy industry will force utilities and, more specifically, commercial nuclear power production to unprecedented cost control measures. It will also renew the fires of debate about costs vs. safety. With personnel costs being the single largest expenditure for most organizations management will be faced with constant dilemmas of competition for scarce resources. Salaries, benefits and training costs will be under greater scrutiny. Training resources and programs will face increased pressure to be job related, based on conservative requirements and more cost effective than in the past. For nearly two decades the US National Academy for Nuclear Training (NANT) has developed and used industry-wide accreditation and evaluation standards based on the Systematic Approach to Training (SAT). This process assures that existing and emerging technical training is constantly reviewed and evaluated against standardized criteria to assure job relatedness and enhanced job performance. The process also requires management to approve, actively participate in and support the training of NPP personnel. Instructors must be highly skilled and well trained in the SAT process and various instructional strategies. The SAT process is grounded in five interlocking keystone steps; Analysis - Design - Development - Implementation - Evaluation (ADDIE). Evaluation of training is often said to be the most crucial and most difficult step. Here is where an organization determines if the training is effective and meeting the legitimate needs of all of the stakeholders. This QA/QC aspect of training must be an ongoing process involving management, instructors and the students. It is only through the discipline of an SAT based evaluation process that an organization can truly determine if the training is efficient, effective, cost effective and

  7. Cost effective material control and accountability training

    International Nuclear Information System (INIS)

    Robichaux, J.J.; Shull, L.M.; Salizzoni, L.M.


    DOE Order 5630.15, ''Safeguards and Security Training Program'' is being implemented at the Savannah River Site within the Westinghouse Savannah River Company's material control and accountability program. This paper reviews the development of a material control and accountability task analysis, the development of specific material control and accountability courses, and the cost effective and innovative strategies employed to implement the training program. The paper also discusses how the site material control and accountability policies and procedures are incorporated into the Westinghouse Savannah River Company training program to ensure that personnel receive the most current information

  8. 10 CFR 436.13 - Presuming cost-effectiveness results. (United States)


    ... 10 Energy 3 2010-01-01 2010-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

  9. Traditional Birth Attendant reorientation and Motherpacks incentive's effect on health facility delivery uptake in Narok County, Kenya: An impact analysis. (United States)

    Kitui, John Emmanuel; Dutton, Vaughan; Bester, Dirk; Ndirangu, Rachel; Wangai, Susan; Ngugi, Stephen


    A community health programme in Narok County in Kenya aimed to improve skilled birth assistance during childbirth through two demand side interventions. First, traditional birth attendants (TBAs) were co-opted into using their influence to promote use of skilled birth attendants (SBAs) at health facilities during delivery, and to accompany pregnant women to health facilities in return for a Ksh500 (Approximately USD5 as of August 2016) cash incentive for each pregnant mother they accompanied. Secondly, a free Motherpack consisting of a range of baby care items was given to each mother after delivering at a health facility. This paper estimates the impact of these two interventions on trends of facility deliveries over a 36-month period here. Dependency or inferred causality was estimated between reorientation of TBAs and provision of Motherpacks with changes in facility delivery numbers. The outcome variable consists of monthly facility delivery data from 28 health facilities starting from January 2013 to December 2015 obtained from the District Health Information Systems 2 (DHIS2). Data were collected on the 13th, 14th or 15th of each month, resulting in a total of 35 collections, over 35 months. The intervention data consisted of the starting month for each of the two interventions at each of the 28 facilities. A negative binomial generalized linear model framework is applied to model the relationship as all variables were measured as count data and were overdispersed. All analyses were conducted using R software. During the 35 months considered, a total of 9095 health facility deliveries took place, a total of 408 TBAs were reached, and 2181 Motherpacks were distributed. The reorientation of TBAs was significant (p = 0.009), as was the provision of Motherpacks (p = .0001). The number of months that passed since the start of the intervention was also found to be significant (p = 0.033). The introduction of Motherpacks had the greatest effect on the

  10. Incentives for improvement of CANDU

    International Nuclear Information System (INIS)

    Hart, R.S.; Dunn, J.T.; Finlay, R.B.


    CANDU is a relatively young technology which has demonstrated many achievements as an electrical power generation system. These achievements include an unsurpassed safety record, high annual and lifetime capacity factors, low electricity cost and a broad range of other performance strengths which together indicate that the CANDU technology is fundamentally sound. Known capabilities not yet fully exploited, such as advanced fuel cycle options, indicate that CANDU technology will continue to pay strong dividends on research, development and design investment. This provides a strong incentive for the improvement of CANDU on a continuing basis

  11. Cost-effective analysis of PET application in NSCLC

    International Nuclear Information System (INIS)

    Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang


    Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

  12. Designing Incentives for Public School Teachers: Evidence from a Texas Incentive Pay Program (United States)

    Springer, Matthew G.; Taylor, Lori L.


    Pay-for-performance is a popular public education reform, but there is little evidence about the characteristics of a well-designed incentive pay plan for teachers. Some of the literature suggests that effective incentive plans must offer relatively large awards to induce behavioral changes. On the other hand, the experimental economics literature…

  13. Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan. (United States)

    Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D


    We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

  14. Economic barriers and incentives for biodiversity restoration

    International Nuclear Information System (INIS)

    Garcia Frapolli, Eduardo; Lindigcisneros, Roberto


    Costs related with restoration efforts, as well as the economic incentives, are fundamental issues that have not been fully considered from a formal standpoint. Through the analysis of restoration trials in collaboration with an indigenous community in western Mexico, we analyzed economic issues related with the restoration trials themselves, and with the economic context that gives incentives for ecological restoration. We reach to the conclusion that the cost-benefit relationship of the restoration process by itself can be straightforward calculated in some cases, calculating economic benefits accrued from the diversity restored to ecosystem is more difficult. In terms of the incentives for biodiversity restoration, we concluded that in many cases, economic variables out of the control of those involved in restoration are determinant.

  15. Support mechanisms for renewables: How risk exposure influences investment incentives

    Directory of Open Access Journals (Sweden)

    Lena Kitzing


    Full Text Available We analyse quantitatively how risk exposure from different support mechanisms, such as feed-in tariffs and premiums, can influence the investment incentives for private investors. We develop a net cash flow approach that takes systematic and unsystematic risks into account through cost of capital and the Capital Asset Pricing Model as well as through active liquidity management. Applying the model to a specific case, a German offshore wind park, we find that the support levels required to give adequate investment incentives are for a feed-in tariff scheme approximately 4-10% lower than for a feed-in premium scheme. The effect of differences in risk exposure from the support schemes is significant and cannot be neglected in policy making, especially when deciding between support instruments or when determining adequate support levels.

  16. The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives. (United States)

    Bertone, Maria Paola; Witter, Sophie


    Human resources for health represent an essential component of health systems and play a key role to accelerate progress towards universal health coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution and performance of health workers, which could be in part addressed by providing effective financial incentives. Based on an overview of the existing literature, the paper highlights the gaps in the existing research in low-income countries exploring the different components of health workers' incomes. It then proposes a novel approach to the analysis of financial incentives and delineates a research agenda, which could contribute to shed light on this topic. The article finds that, while there is ample research that investigates separately each of the incomes health workers may earn (for example, salary, fee-for-service payments, informal incomes, "top-ups" and per diems, dual practice and non-health activities), there is a dearth of studies which look at the health workers' "complex remuneration", that is, the whole of the financial incentives available. Little research exists which analyses simultaneously all revenues of health workers, quantifies the overall remuneration and explores its complexity, its multiple components and their features, as well as the possible interaction between income components. However, such a comprehensive approach is essential to fully comprehend health workers' incentives, by investigating the causes (at individual and system level) of the fragmentation in the income structure and the variability in income levels, as well as the consequences of the "complex remuneration" on motivation and performance. This proposition has important policy implications in terms of devising effective incentive packages as it calls for an active consideration of the role that "complex remuneration" plays in determining recruitment, retention and motivation patterns, as well as, more broadly, the

  17. Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses. (United States)

    Angevine, Peter D; Berven, Sigurd


    Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

  18. An improved set of standards for finding cost for cost-effectiveness analysis. (United States)

    Barnett, Paul G


    Guidelines have helped standardize methods of cost-effectiveness analysis, allowing different interventions to be compared and enhancing the generalizability of study findings. There is agreement that all relevant services be valued from the societal perspective using a long-term time horizon and that more exact methods be used to cost services most affected by the study intervention. Guidelines are not specific enough with respect to costing methods, however. The literature was reviewed to identify the problems associated with the 4 principal methods of cost determination. Microcosting requires direct measurement and is ordinarily reserved to cost novel interventions. Analysts should include nonwage labor cost, person-level and institutional overhead, and the cost of development, set-up activities, supplies, space, and screening. Activity-based cost systems have promise of finding accurate costs of all services provided, but are not widely adopted. Quality must be evaluated and the generalizability of cost estimates to other settings must be considered. Administrative cost estimates, chiefly cost-adjusted charges, are widely used, but the analyst must consider items excluded from the available system. Gross costing methods determine quantity of services used and employ a unit cost. If the intervention will affect the characteristics of a service, the method should not assume that the service is homogeneous. Questions are posed for future reviews of the quality of costing methods. The analyst must avoid inappropriate assumptions, especially those that bias the analysis by exclusion of costs that are affected by the intervention under study.

  19. Effects of waste content of glass waste forms on Savannah River high-level waste disposal costs

    International Nuclear Information System (INIS)

    McDonell, W.R.; Jantzen, C.M.


    Effects of the waste content of glass waste forms of Savannah River high-level waste disposal costs are evaluated by their impact on the number of waste canisters produced. Changes in waste content affect onsite Defense Waste Processing Facility (DWPF) costs as well as offsite shipping and repository emplacement charges. A nominal 1% increase over the 28 wt % waste loading of DWPF glass would reduce disposal costs by about $50 million for Savannah River wastes generated to the year 2000. Waste form modifications under current study include adjustments of glass frit content to compensate for added salt decontamination residues and increased sludge loadings in the DWPF glass. Projected cost reductions demonstrate significant incentives for continued optimization of the glass waste loadings. 13 refs., 3 figs., 3 tabs

  20. CREST Cost of Renewable Energy Spreadsheet Tool: A Model for Developing Cost-Based Incentives in the United States; User Manual Version 4, August 2009 - March 2011 (Updated July 2013)

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, J. S.; Grace, R. C.


    The objective of this document is to help model users understand how to use the CREST model to support renewable energy incentives, FITs, and other renewable energy rate-setting processes. This user manual will walk the reader through the spreadsheet tool, including its layout and conventions, offering context on how and why it was created. This user manual will also provide instructions on how to populate the model with inputs that are appropriate for a specific jurisdiction's policymaking objectives and context. Finally, the user manual will describe the results and outline how these results may inform decisions about long-term renewable energy support programs.

  1. It helps me live, sends my children to school, and feeds me: a qualitative study of how food and cash incentives may improve adherence to treatment and care among adults living with HIV in Tanzania. (United States)

    Czaicki, Nancy L; Mnyippembe, Agatha; Blodgett, Madeline; Njau, Prosper; McCoy, Sandra I


    Financial and in-kind incentives have been shown to improve outcomes along the HIV care cascade, however the potential mechanismsthrough which they work remain unclear. To identify the pathways through which incentives improve retention in care and adherence to antiretroviral therapy (ART), we conducted a qualitative study with participants in a trial evaluating conditional food and cash incentives for HIV-positive food insecure adults in Shinyanga, Tanzania. We found that the incentives acted through three pathways to potentially increase retention in care and adherence to ART: (1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, (2) alleviating stress associated with attending clinic and meeting basic needs, and (3) by potentially increasing motivation. Participants did not report any harmful events associated with the incentives, but reported myriad beneficial effects on household welfare. Understanding how incentives are used and how they impact outcomes can improve the design of future interventions.

  2. Estimating the short run effects of South Africa's Employment Tax Incentive on youth employment probabilities using a difference-in-differences approach


    Vimal Ranchhod; Arden Finn


    What effect did the introduction of the Employment Tax Incentive (ETI) have on youth employment probabilities in South Africa in the short run? The ETI came into effect on the 1st of January 2014. Its purpose is to stimulate youth employment levels and ease the challenges that many youth experience in finding their first jobs. Under the ETI, firms that employ youth are eligible to claim a deduction from their taxes due, for the portion of their wage bill that is paid to certain groups of yout...

  3. 48 CFR 48.105 - Relationship to other incentives. (United States)


    ... incentives. 48.105 Section 48.105 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT VALUE ENGINEERING Policies and Procedures 48.105 Relationship to other incentives... should not be rewarded both as value engineering shares and under performance, design-to-cost, or similar...

  4. OPCAB surgery is cost-effective for elderly patients

    DEFF Research Database (Denmark)

    Houlind, Kim Christian; Kjeldsen, Bo Juul; Madsen, Susanne Nørgaard


    To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years.......To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years....

  5. Understanding Cost-Effectiveness of Energy Efficiency Programs (United States)

    Discusses the five standard tests used to assess the cost-effectiveness of energy efficiency, how states are using these tests, and how the tests can be used to determine the cost-effectiveness of energy efficiency measures.

  6. Incentives for preventing smoking in children and adolescents. (United States)

    Hefler, Marita; Liberato, Selma C; Thomas, David P


    Adult smoking usually has its roots in adolescence. If individuals do not take up smoking during this period it is unlikely that they ever will. Further, once smoking becomes established, cessation is challenging; the probability of subsequently quitting is inversely proportional to the age of initiation. One novel approach to reducing the prevalence of youth smoking is the use of incentives. To assess the effect of incentives on preventing children and adolescents (aged 5 to 18 years) from starting to smoke. It was also our intention to assess, where possible, the dose-response of incentives, the costs of incentive programmes, whether incentives are more or less effective in combination with other interventions to prevent smoking initiation, and any unintended consequences arising from the use of incentives. For the original review (published 2012) we searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, Embase, CINAHL, CSA databases and PsycINFO for terms relating to incentives, in combination with terms for smoking and tobacco use, and children and adolescents. The most recent searches were of the Cochrane Tobacco Addiction Group Specialized Register, and were carried out in December 2016. We considered randomized controlled trials (RCTs) allocating children and adolescents (aged 5 to 18 years) as individuals, groups or communities to intervention or control conditions, where the intervention included an incentive aimed at preventing smoking uptake. We also considered controlled trials (CTs) with baseline measures and post-intervention outcomes. Two review authors extracted and independently assessed the data. The primary outcome was the smoking status of children or adolescents at follow-up who reported no smoking at baseline. We required a minimum follow-up of six months from baseline and assessed each included study for risks of bias. We used the most rigorous definition of abstinence in each trial; we did

  7. Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use (United States)

    Metsch, Lisa R.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Stitzer, Maxine; Das, Moupali; Jain, Mamta K.; Rodriguez, Allan E.; Armstrong, Wendy S.; Lucas, Gregory M.; Nijhawan, Ank E.; Drainoni, Mari-Lynn; Herrera, Patricia; Vergara-Rodriguez, Pamela; Jacobson, Jeffrey M.; Mugavero, Michael J.; Sullivan, Meg; Daar, Eric S.; McMahon, Deborah K.; Ferris, David C.; Lindblad, Robert; VanVeldhuisen, Paul; Oden, Neal; Castellón, Pedro C.; Tross, Susan; Haynes, Louise F.; Douaihy, Antoine; Sorensen, James L.; Metzger, David S.; Mandler, Raul N.; Colfax, Grant N.; del Rio, Carlos


    IMPORTANCE Substance use is a major driver of the HIV epidemic and is associated with poor HIV care outcomes. Patient navigation (care coordination with case management) and the use of financial incentives for achieving predetermined outcomes are interventions increasingly promoted to engage patients in substance use disorders treatment and HIV care, but there is little evidence for their efficacy in improving HIV-1 viral suppression rates. OBJECTIVE To assess the effect of a structured patient navigation intervention with or without financial incentives to improve HIV-1 viral suppression rates among patients with elevated HIV-1 viral loads and substance use recruited as hospital inpatients. DESIGN, SETTING, AND PARTICIPANTS From July 2012 through January 2014, 801 patients with HIV infection and substance use from 11 hospitals across the United States were randomly assigned to receive patient navigation alone (n = 266), patient navigation plus financial incentives (n = 271), or treatment as usual (n = 264). HIV-1 plasma viral load was measured at baseline and at 6 and 12 months. INTERVENTIONS Patient navigation included up to 11 sessions of care coordination with case management and motivational interviewing techniques over 6 months. Financial incentives (up to $1160) were provided for achieving targeted behaviors aimed at reducing substance use, increasing engagement in HIV care, and improving HIV outcomes. Treatment as usual was the standard practice at each hospital for linking hospitalized patients to outpatient HIV care and substance use disorders treatment. MAIN OUTCOMES AND MEASURES The primary outcome was HIV viral suppression (≤200 copies/mL) relative to viral nonsuppression or death at the 12-month follow-up. RESULTS Of 801 patients randomized, 261 (32.6%) were women (mean [SD] age, 44.6 years [10.0 years]). There were no differences in rates of HIV viral suppression versus nonsuppression or death among the 3 groups at 12 months. Eighty-five of 249

  8. Extrinsic incentives and tax compliance


    Sour, Laura; Gutiérrez Andrade, Miguel Ángel


    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  9. Wellness Programs With Financial Incentives Through Disparities Lens. (United States)

    Cuellar, Alison; LoSasso, Anthony T; Shah, Mona; Atwood, Alicia; Lewis-Walls, Tanya R


    To examine wellness programs with financial incentives and their effect on disparities in preventive care. Financial incentives were introduced by 15 large employers, from 2010 to 2013. Fifteen private employers. A total of 299 436 employees and adult dependents. Preventive services and participation in financial incentives. Multivariate linear regression. Disparities in preventive services widened after introduction of financial incentives. Asians were 3% more likely and African Americans were 3% less likely to receive wellness rewards than whites and non-Hispanics, controlling for other factors. Federal law limits targeting of wellness financial incentives by subgroups; thus, employers should consider outreach and culturally appropriate messaging.

  10. Effectiveness of employer financial incentives in reducing time to report worker injury: an interrupted time series study of two Australian workers' compensation jurisdictions. (United States)

    Lane, Tyler J; Gray, Shannon; Hassani-Mahmooei, Behrooz; Collie, Alex


    Early intervention following occupational injury can improve health outcomes and reduce the duration and cost of workers' compensation claims. Financial early reporting incentives (ERIs) for employers may shorten the time between injury and access to compensation benefits and services. We examined ERI effect on time spent in the claim lodgement process in two Australian states: South Australia (SA), which introduced them in January 2009, and Tasmania (TAS), which introduced them in July 2010. Using administrative records of 1.47 million claims lodged between July 2006 and June 2012, we conducted an interrupted time series study of ERI impact on monthly median days in the claim lodgement process. Time periods included claim reporting, insurer decision, and total time. The 18-month gap in implementation between the states allowed for a multiple baseline design. In SA, we analysed periods within claim reporting: worker and employer reporting times (similar data were not available in TAS). To account for external threats to validity, we examined impact in reference to a comparator of other Australian workers' compensation jurisdictions. Total time in the process did not immediately change, though trend significantly decreased in both jurisdictions (SA: -0.36 days per month, 95% CI -0.63 to -0.09; TAS: 0.35, -0.50 to -0.20). Claim reporting time also decreased in both (SA: -1.6 days, -2.4 to -0.8; TAS: -5.4, -7.4 to -3.3). In TAS, there was a significant increase in insurer decision time (4.6, 3.9 to 5.4) and a similar but non-significant pattern in SA. In SA, worker reporting time significantly decreased (-4.7, -5.8 to -3.5), but employer reporting time did not (-0.3, -0.8 to 0.2). The results suggest that ERIs reduced claim lodgement time and, in the long-term, reduced total time in the claim lodgement process. However, only worker reporting time significantly decreased in SA, indicating that ERIs may not have shortened the process through the intended target of

  11. The economic effect of electricity net-metering with solar PV: Consequences for network cost recovery, cross subsidies and policy objectives

    International Nuclear Information System (INIS)

    Eid, Cherrelle; Reneses Guillén, Javier; Frías Marín, Pablo; Hakvoort, Rudi


    Net-metering is commonly known as a practice by which owners of distributed generation (DG) units may offset their electricity consumption from the grid with local generation. The increasing number of prosumers (consumers that both produce and consume electricity) with solar photovoltaic (PV) generation combined with net-metering results in reduced incomes for many network utilities worldwide. Consequently, this pushes utilities to increase charges per kW h in order to recover costs. For non-PV owners, this could result into inequality issues due to the fact that also non-PV owners have to pay higher chargers for their electricity consumed to make up for netted costs of PV-owners. In order to provide insight in those inequality issues caused by net-metering, this study presents the effects on cross-subsidies, cost recovery and policy objectives evolving from different applied netmetering and tariff designs for a residential consumer. Eventually this paper provides recommendations regarding tariffs and metering that will result in more explicit incentives for PV, instead of the current implicit incentives which are present to PV owners due to net-metering. - Highlights: • Network users are frequently charged by energy charging and fixed charging. • Net-metering with energy charging causes potential problems for DSO cost recovery. • Increasing rolling credit timeframes amplify net-metering impacts on cost recovery. • Observed capacity charging can incentivize local storage and self-consumption. • PV owners should receive direct incentives in order to avoid cross subsidization

  12. Recruiting phobic research subjects: effectiveness and cost. (United States)

    Kaakko, T; Murtomaa, H; Milgrom, P; Getz, T; Ramsay, D S; Coldwell, S E


    Efficiently enrolling subjects is one of the most important and difficult aspects of a clinical trial. This prospective study evaluated strategies used in the recruitment of 144 dental injection phobics for a clinical trial evaluating the effectiveness of combining alprazolam with exposure therapy. Three types of recruitment strategies were evaluated: paid advertising, free publicity, and professional referral. Sixty-three percent of subjects were enrolled using paid advertising (the majority of them from bus advertisements [27.0%], posters on the University of Washington campus [20.1%], and newspaper advertisements [13.2%]). Free publicity (eg, television coverage, word of mouth) yielded 18.8% of enrolled subjects and professionaL referrals 14.6% of subjects. The average cost (1996 dollars) of enrolling 1 subject was $79. Bus and poster advertising attracted more initial contacts and yielded the greatest enrollment.

  13. Design And Implementation Of Cost Effective Inverter

    Directory of Open Access Journals (Sweden)

    Niaz Morshedul Haque


    Full Text Available This paper deals with the design and construct of a 100 Watt 220 Volt and 50 Hz Inverter. The system is designed without any microcontroller and it has a cost-effective design architecture. The elementary purpose of this device is to transmute 12 V DC to 220 V AC. Snubber technology is used to diminish the reverse potential transients and excessive heat of transformer winding and transistor switches. Switching pulse generated by NE 555 timer circuit and comparator circuit was used to take signal strength input from its rear as well as from both sides for triggering the MOSFET switches. Another switch is used to invert pulse between two switching circuitries. A 5 volts regulator IC 7805 was used to supply fixed 5V for biasing the switching and amplifying circuitry.

  14. Cost-effective implementation of intelligent systems (United States)

    Lum, Henry, Jr.; Heer, Ewald


    Significant advances have occurred during the last decade in knowledge-based engineering research and knowledge-based system (KBS) demonstrations and evaluations using integrated intelligent system technologies. Performance and simulation data obtained to date in real-time operational environments suggest that cost-effective utilization of intelligent system technologies can be realized. In this paper the rationale and potential benefits for typical examples of application projects that demonstrate an increase in productivity through the use of intelligent system technologies are discussed. These demonstration projects have provided an insight into additional technology needs and cultural barriers which are currently impeding the transition of the technology into operational environments. Proposed methods which addresses technology evolution and implementation are also discussed.

  15. 10 CFR 455.63 - Cost-effectiveness testing. (United States)


    ... 10 Energy 3 2010-01-01 2010-01-01 false Cost-effectiveness testing. 455.63 Section 455.63 Energy..., Hospitals, Units of Local Government, and Public Care Institutions § 455.63 Cost-effectiveness testing. (a... paragraph (a) of this section, if the State plan requires the cost effectiveness of an energy conservation...

  16. Cost Effectiveness of Premium Versus Regular Gasoline in MCPS Buses. (United States)

    Baacke, Clifford M.; Frankel, Steven M.

    The primary question posed in this study is whether premium or regular gasoline is more cost effective for the Montgomery County Public School (MCPS) bus fleet, as a whole, when miles-per-gallon, cost-per-gallon, and repair costs associated with mileage are considered. On average, both miles-per-gallon, and repair costs-per-mile favor premium…

  17. Controlling Campylobacter in the chicken meat chain - Cost-effectiveness and cost-utility analysis

    NARCIS (Netherlands)

    Mangen MJJ; Havelaar AH; Nauta MJ; Koeijer AA de; Wit GA de; LEI; Animal Sciences Group; PZO; MGB


    The aim of this study was the estimation of cost-effectiveness and cost-utility of various interventions to control Campylobacter contamination of broiler meat. The relative risk, the intervention costs, the disease burden (expressed in Disability Adjusted Live Years (DALYs)) and the

  18. Incentive schemes in development of socio-economic systems (United States)

    Grachev, V. V.; Ivushkin, K. A.; Myshlyaev, L. P.


    The paper is devoted to the study of incentive schemes when developing socio-economic systems. The article analyzes the existing incentive schemes. It is established that the traditional incentive mechanisms do not fully take into account the specifics of the creation of each socio-economic system and, as a rule, are difficult to implement. The incentive schemes based on the full-scale simulation approach, which allow the most complete information from the existing projects of creation of socio-economic systems to be extracted, are proposed. The statement of the problem is given, the method and algorithm of the full-scale simulation study of the efficiency of incentive functions is developed. The results of the study are presented. It is shown that the use of quadratic and piecewise linear functions of incentive allows the time and costs for creating social and economic systems to be reduced by 10%-15%.

  19. Creating New Economic Incentives for Repurposing Generic Drugs for Unsolved Diseases Using Social Finance. (United States)

    Bloom, Bruce E


    Repurposing research improves patient lives by taking drugs approved for one disease and clinically testing them to create a treatment for a different disease. Repurposing drugs that are generic, inexpensive, and widely available and that can be taken in their current dosage and formulation in the new indication provide a quick, affordable, and effective way to create "new" treatments. However, generic drug repurposing often provides no profit potential, and so there is no economic incentive for industry to pursue this, and philanthropy and government funds are often insufficient. One way to create new economic incentive for the repurposing of generic drugs is through social finance. This perspective describes how social finance can create a new economic incentive by using a social impact bond, or similar financial structure, to repay for-profit investors who fund the repurposing research from the proceeds of healthcare cost reductions generated when these affordable, effective, and widely available repurposed therapies improve healthcare outcomes.

  20. Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

    Directory of Open Access Journals (Sweden)

    Jukes Matthew CH


    Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

  1. FORECAST: Regulatory effects cost analysis software annual

    International Nuclear Information System (INIS)

    Lopez, B.; Sciacca, F.W.


    Over the past several years the NRC has developed a generic cost methodology for the quantification of cost/economic impacts associated with a wide range of new or revised regulatory requirements. This methodology has been developed to aid the NRC in preparing Regulatory Impact Analyses (RIAs). These generic costing methods can be useful in quantifying impacts both to industry and to the NRC. The FORECAST program was developed to facilitate the use of the generic costing methodology. This PC program integrates the major cost considerations that may be required because of a regulatory change. FORECAST automates much of the calculations typically needed in an RIA and thus reduces the time and labor required to perform these analysis. More importantly, its integrated and consistent treatment of the different cost elements should help assure comprehensiveness, uniformity, and accuracy in the preparation of needed cost estimates

  2. Chapter 4. Economic Considerations: Cost-Effective and Efficient Climate Policies

    Directory of Open Access Journals (Sweden)

    Maximilian Auffhammer


    Full Text Available In this chapter we discuss the economics of climate change. We begin with a discussion of economic considerations that are important to take into account when designing and evaluating climate policy, including cost effectiveness and efficiency. We then discuss specific policies at the state, national, and international level in light of these economic considerations.  We have several recommendations for the path forward for climate policy. First, the goal of climate policy should be to reduce the damages caused by greenhouse gases. In addition to mitigation policy to reduce greenhouse gas concentrations in the atmosphere, one can also reduce the damages causes by greenhouse gases by adaptation measures that reduce our vulnerability to climate change impacts.  Second, policy-makers should use incentive- (or market- based instruments as opposed to command and control policies (including quantity-based mandates whenever possible. Whenever unpriced emissions are the sole market failure, incentive-based instruments such as a carbon tax or cap and trade program are more likely to achieve the social optimum and maximize social net benefits [1, 2]. Lin and Prince [3] calculate that the optimal gasoline tax for the state of California is $1.37 per gallon.  Our third recommendation is to address the risk of emissions leakage, which arises when only one jurisdiction (e.g., California imposes climate policy, but not the entire world. One way to reduce emissions leakage is to use the strategic distribution of emissions allowances to local producers. This method, known as “output-based allocation” or benchmarking, effectively subsidizes local producers and at least partially offsets the increase in their costs caused by an emissions cap [4]. Importantly, only local production is eligible for an allocation of valuable allowances, providing a counterweight to the incentive for emission leakage. Our fourth recommendation is that if they are used instead

  3. Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India.


    Floyd, Katherine; Arora, V. K.; Murthy, K. J. R.; Lonnroth, Knut; Singla, Neeta; Akbar, Y.; Zignol, Matteo; Uplekar, Mukund


    OBJECTIVE: To assess the cost and cost-effectiveness of the Public-Private Mix DOTS (PPM-DOTS) strategy for tuberculosis (TB) control in India. METHODS: We collected data on the costs and effects of pilot PPM-DOTS projects in Delhi and Hyderabad using documentary data and interviews. The cost of PPM-DOTS was compared with public sector DOTS (i.e. DOTS delivered through public sector facilities only) and non-DOTS treatment in the private sector. Costs for 2002 in US$ were assessed for the publ...

  4. Consumer-Operated Service Programs: monetary and donated costs and cost-effectiveness. (United States)

    Yates, Brian T; Mannix, Danyelle; Freed, Michael C; Campbell, Jean; Johnsen, Matthew; Jones, Kristine; Blyler, Crystal R


    Examine cost differences between Consumer Operated Service Programs (COSPs) as possibly determined by a) size of program, b) use of volunteers and other donated resources, c) cost-of-living differences between program locales, d) COSP model applied, and e) delivery system used to implement the COSP model. As part of a larger evaluation of COSP, data on operating costs, enrollments, and mobilization of donated resources were collected for eight programs representing three COSP models (drop-in centers, mutual support, and education/advocacy training). Because the 8 programs were operated in geographically diverse areas of the US, costs were examined with and without adjustment for differences in local cost of living. Because some COSPs use volunteers and other donated resources, costs were measured with and without these resources being monetized. Scale of operation also was considered as a mediating variable for differences in program costs. Cost per visit, cost per consumer per quarter, and total program cost were calculated separately for funds spent and for resources donated for each COSP. Differences between COSPs in cost per consumer and cost per visit seem better explained by economies of scale and delivery system used than by cost-of-living differences between program locations or COSP model. Given others' findings that different COSP models produce little variation in service effectiveness, minimize service costs by maximizing scale of operation while using a delivery system that allows staff and facilities resources to be increased or decreased quickly to match number of consumers seeking services.

  5. Incentives for reporting disease outbreaks.

    Directory of Open Access Journals (Sweden)

    Ramanan Laxminarayan

    Full Text Available BACKGROUND: Countries face conflicting incentives to report infectious disease outbreaks. Reports of outbreaks can prompt other countries to impose trade and travel restrictions, which has the potential to discourage reporting. However, reports can also bring medical assistance to contain the outbreak, including access to vaccines. METHODS: We compiled data on reports of meningococcal meningitis to the World Health Organization (WHO from 54 African countries between 1966 and 2002, a period is marked by two events: first, a large outbreak reported from many countries in 1987 associated with the Hajj that resulted in more stringent requirements for meningitis vaccination among pilgrims; and second, another large outbreak in Sub-Saharan Africa in 1996 that led to a new international mechanism to supply vaccines to countries reporting a meningitis outbreak. We used fixed-effects regression modeling to statistically estimate the effect of external forcing events on the number of countries reporting cases of meningitis to WHO. FINDINGS: We find that the Hajj vaccination requirements started in 1988 were associated with reduced reporting, especially among countries with relatively fewer cases reported between 1966 and 1979. After the vaccine provision mechanism was in place in 1996, reporting among countries that had previously not reported meningitis outbreaks increased. INTERPRETATION: These results indicate that countries may respond to changing incentives to report outbreaks when they can do so. In the long term, these incentives are likely to be more important than surveillance assistance in prompt reporting of outbreaks.

  6. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies. (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H


    Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

  7. [Cost effectiveness of workplace smoking policies]. (United States)

    Raaijmakers, Tamara; van den Borne, Inge


    This study reviews the motivations of companies to set out a policy for controlling smoking, the economic benefits for the company resulting from such a policy and the costs, broken down by European Union countries. The literature on the costs of implementing a policy related to smoking at the workplace is reviewed. The main objective of policies related to smoking at the workplace is that of safeguarding employees from environmental tobacco smoke. Other reasons are cutting costs, improving the company image, and reducing absenteeism, occupational accidents, internal quarrels and extra costs due to cigarette smoking, protection against environmental tobacco smoke does not entail any higher costs for companies, and economic advantages are visible. The benefits are by far greater than the costs involved, particularly on a long-range basis, and seem to be greater when smoking at the workplace is completely prohibited and no smoking areas are set.

  8. Infrastructure investment and incentives with supranational funding


    Socorro, M. Pilar; De Rus, Ginés


    Public infrastructure investment is usually co-financed by supranational organizations. The selection of projects is supposed to be decided using the information provided by conventional cost-benefit analysis. Nevertheless, we show that the type of institutional design regarding the financing mechanism affects the incentives of national governments to reduce costs and increase revenues, affecting project selection, the infrastructure capacity, the choice of technology, and the type of contrac...

  9. Perceived financial incentives, HMO market penetration, and physicians' practice styles and satisfaction. (United States)

    Hadley, J; Mitchell, J M; Sulmasy, D P; Bloche, M G


    to make referrals. These effects were generally reinforced by practicing in an area with a high level of HMO penetration and were offset to some extent by having had exposure to HMOs and the practice of cost-effective medicine while in medical training. Although financial incentives to reduce services are not widespread, there is a legitimate reason to be concerned about possible adverse affects on the quality of care. More research is needed to investigate directly whether changes in patients' health are affected by their physicians' financial incentives.

  10. Future Costs, Fixed Healthcare Budgets, and the Decision Rules of Cost-Effectiveness Analysis. (United States)

    van Baal, Pieter; Meltzer, David; Brouwer, Werner


    Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs that may result from this additional demand in health care and include only future costs of related illnesses. Although there has been much debate regarding the question to which extent future costs should be included from a societal perspective, the appropriate role of future medical costs in the widely adopted but more narrow healthcare perspective has been neglected. Using a theoretical model, we demonstrate that optimal decision rules for cost-effectiveness analyses assuming fixed healthcare budgets dictate that future costs of both related and unrelated medical care should be included. Practical relevance of including the costs of future unrelated medical care is illustrated using the example of transcatheter aortic valve implantation. Our findings suggest that guidelines should prescribe inclusion of these costs. Copyright © 2014 John Wiley & Sons, Ltd.

  11. The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan. (United States)

    Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe


    Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

  12. Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach. (United States)

    Gandjour, Afschin; Müller, Dirk


    One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

  13. Cost effectiveness of Tuberculosis Treatment from the Patients ...

    African Journals Online (AJOL)

    ... Directly Observed Treatment Short course is more cost effective from the patients' point of view. DOTS needs to be re-focused out of the hospitals and clinics and made community based in view of the increasing TB caseload occasioned by HI V/AIDS. Key Words: Cost effectiveness, Tuberculosis treatment, personal cost, ...

  14. Analysis of how changed federal regulations and economic incentives affect financing of geothermal projects

    Energy Technology Data Exchange (ETDEWEB)

    Meyers, D.; Wiseman, E.; Bennett, V.


    The effects of various financial incentives on potential developers of geothermal electric energy are studied and the impact of timing of plant construction costs on geothermal electricity costs is assessed. The effect of the geothermal loan guarantee program on decisions by investor-owned utilities to build geothermal electric power plants was examined. The usefulness of additional investment tax credits was studied as a method for encouraging utilities to invest in geothermal energy. The independent firms which specialize in geothermal resource development are described. The role of municipal and cooperative utilities in geothermal resource development was assessed in detail. Busbar capital costs were calculated for geothermal energy under a variety of ownerships with several assumptions about financial incentives. (MHR)

  15. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial. (United States)

    Wong, Charlene A; Miller, Victoria A; Murphy, Kathryn; Small, Dylan; Ford, Carol A; Willi, Steven M; Feingold, Jordyn; Morris, Alexander; Ha, Yoonhee P; Zhu, Jingsan; Wang, Wenli; Patel, Mitesh S


    Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes (BE IN CONTROL) study was an investigator-blinded, 6-month, 2-arm randomized clinical trial conducted between January 22 and November 2, 2016, with 3-month intervention and follow-up periods. Ninety participants (aged 14-20) with suboptimally controlled type 1 diabetes (hemoglobin A1c [HbA1c] >8.0%) were recruited from the Diabetes Center for Children at the Children's Hospital of Philadelphia. All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of nonadherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued. The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat. Of the 181 participants screened, 90 (52 [57.8%] girls) were randomized to the intervention (n = 45) or control (n = 45) arms. The mean (SD) age was 16.3 (1.9) years. The intervention group had significantly greater adherence to glucose monitoring goals in the incentive period (50.0% vs 18.9%; adjusted difference, 27.2%; 95% CI, 9.5% to 45.0%; P = .003) but not in the follow-up period (15

  16. Drilling contracts and incentives

    International Nuclear Information System (INIS)

    Osmundsen, Petter; Sorenes, Terje; Toft, Anders


    Shortages of rigs and personnel have encouraged discussion of designing incentive contracts in the drilling sector. However, for the drilling contracts, there are not a large variety of contract types in use. This article describes and analyses incentives for drilling contractors. These are directly represented by the compensation formats utilised in the present and in the consecutive drilling contracts. Indirectly, incentives are also provided by the evaluation criteria that oil companies use for awarding drilling assignments. Changes in contract format pose a number of relevant questions relating to resource management, and the article takes an in-depth look at some of these. Do evaluation criteria for awarding drilling assignments encourage the development of new technology and solutions? How will a stronger focus on drilling efficiency influence reservoir utilisation?

  17. Differential dependence of Pavlovian incentive motivation and instrumental incentive learning processes on dopamine signaling (United States)

    Wassum, Kate M.; Ostlund, Sean B.; Balleine, Bernard W.; Maidment, Nigel T.


    Here we attempted to clarify the role of dopamine signaling in reward seeking. In Experiment 1, we assessed the effects of the dopamine D1/D2 receptor antagonist flupenthixol (0.5 mg/kg i.p.) on Pavlovian incentive motivation and found that flupenthixol blocked the ability of a conditioned stimulus to enhance both goal approach and instrumental performance (Pavlovian-to-instrumental transfer). In Experiment 2 we assessed the effects of flupenthixol on reward palatability during post-training noncontingent re-exposure to the sucrose reward in either a control 3-h or novel 23-h food-deprived state. Flupenthixol, although effective in blocking the Pavlovian goal approach, was without effect on palatability or the increase in reward palatability induced by the upshift in motivational state. This noncontingent re-exposure provided an opportunity for instrumental incentive learning, the process by which rats encode the value of a reward for use in updating reward-seeking actions. Flupenthixol administered prior to the instrumental incentive learning opportunity did not affect the increase in subsequent off-drug reward-seeking actions induced by that experience. These data suggest that although dopamine signaling is necessary for Pavlovian incentive motivation, it is not necessary for changes in reward experience, or for the instrumental incentive learning process that translates this experience into the incentive value used to drive reward-seeking actions, and provide further evidence that Pavlovian and instrumental incentive learning processes are dissociable. PMID:21693635

  18. 41 CFR 302-14.100 - How should we administer our home marketing incentive payment program? (United States)


    ... reduce your overall relocation costs. You must not make a home marketing incentive payment that exceeds... our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and... 14-HOME MARKETING INCENTIVE PAYMENTS Agency Responsibilities § 302-14.100 How should we administer...

  19. Financial incentives for smoking cessation among depression-prone pregnant and newly postpartum women: effects on smoking abstinence and depression ratings. (United States)

    Lopez, Alexa A; Skelly, Joan M; Higgins, Stephen T


    We examined whether pregnant and newly postpartum smokers at risk for postpartum depression respond to an incentive-based smoking-cessation treatment and how the intervention impacts depression ratings. This study is a secondary data analysis. Participants (N = 289; data collected 2001-2013) were smokers at the start of prenatal care who participated in 4 controlled clinical trials on the efficacy of financial incentives for smoking cessation. Women were assigned either to an intervention wherein they earned vouchers exchangeable for retail items contingent on abstaining from smoking or to a control condition wherein they received vouchers of comparable value independent of smoking status. Treatments were provided antepartum through 12-weeks postpartum. Depression ratings (Beck Depression Inventory [BDI]-1A) were examined across 7 antepartum/postpartum assessments. Women who reported a history of prior depression or who had BDI scores ≥ 17 at the start of prenatal care were categorized as depression-prone (Dep+), while those meeting neither criterion were categorized as depression-negative (Dep-). The intervention increased smoking abstinence independent of depression status (p postpartum BDI ratings as well as the proportion of women scoring in the clinical range (≥17 and >21) compared with the control treatment (ps ≤ .05). Treatment effects on depression ratings were attributable to changes in Dep+ women. These results demonstrate that depression-prone pregnant and newly postpartum women respond well to this incentive-based smoking-cessation intervention in terms of achieving abstinence, and the intervention also reduces the severity of postpartum depression ratings in this at-risk population. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail:

  20. Sunk costs equal sunk boats? The effect of entry costs in a transboundary sequential fishery

    DEFF Research Database (Denmark)

    Punt, M. J.


    that for other fisheries substantial sunk investments are needed. In this paper I investigate the effect of such sunk entry costs in a sequential fisheries. I model the uncertainty as a shock to the stock dependent fishing costs, in a two player game, where one of the players faces sunk entry costs. I find that......, depending on parameters, sunk costs can i) increase the competitive pressure on the fish stock compared to a game where entry is free ii) act as a deterrence mechanism and iii) act as a commitment device. I conclude that entry costs can play a crucial role because they can change the outcome of the game...

  1. Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions (United States)

    Clayton, Byron C.


    Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives. PMID:25610406

  2. Shared vision and autonomous motivation vs. financial incentives driving success in corporate acquisitions. (United States)

    Clayton, Byron C


    Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A) management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.

  3. Shared Vision and Autonomous Motivation versus Financial Incentives Driving Success in Corporate Acquisitions

    Directory of Open Access Journals (Sweden)

    Byron C Clayton


    Full Text Available Successful corporate acquisitions require its managers to achieve substantial performance improvements in order to sufficiently cover acquisition premiums, the expected return of debt and equity investors, and the additional resources needed to capture synergies and accelerate growth. Acquirers understand that achieving the performance improvements necessary to cover these costs and create value for investors will most likely require a significant effort from mergers and acquisitions (M&A management teams. This understanding drives the common and longstanding practice of offering hefty performance incentive packages to key managers, assuming that financial incentives will induce in-role and extra-role behaviors that drive organizational change and growth. The present study debunks the assumptions of this common M&A practice, providing quantitative evidence that shared vision and autonomous motivation are far more effective drivers of managerial performance than financial incentives.

  4. Clinical effectiveness and cost savings in diabetes care, supported by pharmacist counselling. (United States)

    Rodriguez de Bittner, Magaly; Chirikov, Viktor V; Breunig, Ian M; Zaghab, Roxanne W; Shaya, Fadia Tohme

    To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. The Patients, Pharmacists Partnerships (P 3 Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2.5 years per patient. Of these patients, 162 had health plan cost and utilization data. A network of 50 trained pharmacists provided chronic disease management to patients with diabetes using a common process of care. Communications were provided to patients and physicians. Employers provided incentives for patients who opted in, including waived medication copayments and free diabetes self-monitoring supplies. The service was provided at no cost to the patient. A Web-based, electronic medical record that complied with the Health Insurance Portability and Accountability Act helped to standardize care. Quality assurance was conducted to ensure the standard of care. Glycosylated hemoglobin (A1c), blood pressure, and total health care costs (before and after enrollment). Statistically significant improvements were shown by mean decreases in A1c (-0.41%, P care costs to employers declined by $1031 per beneficiary after the cost of the program was deducted. This 66-month real-world study confirms earlier findings. Employers netted savings through improved clinical outcomes and reduced emergency and hospital utilization when comparing costs 12 months before and after enrollment. The P 3 program had positive clinical outcomes and economic outcomes. Pharmacist-provided comprehensive medication therapy management services should be included as a required element of insurance offered by employers and health insurance

  5. Bayesian models for cost-effectiveness analysis in the presence of structural zero costs. (United States)

    Baio, Gianluca


    Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  6. Generic host state incentive report. Draft

    International Nuclear Information System (INIS)


    Even the most carefully designed and operated low-level radioactive waste management facility will present potential risks and costs to nearby residents. Individuals who live near these facilities may receive some benefits, but they also bear the brunt of any adverse impacts. It is with this in mind that various siting techniques have been developed. Before any ''extra'' compensation or incentive can be discussed, however, it must first be clearly demonstrated that these facilities protect public health and the environment. This report addresses five distinct areas as follows: mitigation measure to prevent or reduce the impact of the facility; incentives and compensation techniques that might make a facility more acceptable; the use of agreement building in order to develop an arrangement between the host community and a facility proponent; the importance of economics resulting from a typical regional low-level radioactive waste facility; and the role of state government in promoting and legitimizing the use of incentives. 6 tabs

  7. The costs and cost-effectiveness of an integrated sepsis treatment protocol. (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan


    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

  8. Costs and cost-effectiveness of malaria control interventions - a systematic review

    Directory of Open Access Journals (Sweden)

    White Michael T


    Full Text Available Abstract Background The control and elimination of malaria requires expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs, indoor residual spraying (IRS, intermittent preventive treatment (IPT, diagnostic testing and appropriate treatment. Decisions on how to scale up the coverage of these interventions need to be based on evidence of programme effectiveness, equity and cost-effectiveness. Methods A systematic review of the published literature on the costs and cost-effectiveness of malaria interventions was undertaken. All costs and cost-effectiveness ratios were inflated to 2009 USD to allow comparison of the costs and benefits of several different interventions through various delivery channels, across different geographical regions and from varying costing perspectives. Results Fifty-five studies of the costs and forty three studies of the cost-effectiveness of malaria interventions were identified, 78% of which were undertaken in sub-Saharan Africa, 18% in Asia and 4% in South America. The median financial cost of protecting one person for one year was $2.20 (range $0.88-$9.54 for ITNs, $6.70 (range $2.22-$12.85 for IRS, $0.60 (range $0.48-$1.08 for IPT in infants, $4.03 (range $1.25-$11.80 for IPT in children, and $2.06 (range $0.47-$3.36 for IPT in pregnant women. The median financial cost of diagnosing a case of malaria was $4.32 (range $0.34-$9.34. The median financial cost of treating an episode of uncomplicated malaria was $5.84 (range $2.36-$23.65 and the median financial cost of treating an episode of severe malaria was $30.26 (range $15.64-$137.87. Economies of scale were observed in the implementation of ITNs, IRS and IPT, with lower unit costs reported in studies with larger numbers of beneficiaries. From a provider perspective, the median incremental cost effectiveness ratio per disability adjusted life year averted was $27 (range $8.15-$110 for ITNs, $143 (range $135

  9. Cost and cost-effectiveness of conventional and liquid-based ...

    African Journals Online (AJOL)

    Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

  10. At What Cost? Examining the Cost Effectiveness of a Universal Social-Emotional Learning Program (United States)

    Hunter, Leah J.; DiPerna, James C.; Hart, Susan Crandall; Crowley, Max


    Although implementation of universal social-emotional learning programs is becoming more common in schools, few studies have examined the cost-effectiveness of such programs. As such, the purpose of this article is two fold. First, we provide an overview of cost-effectiveness methods for school-based programs, and second, we share results of a…

  11. The effect of fossil energy and other environmental taxes on profit incentives for change in an open economy: Evidence from the UK

    International Nuclear Information System (INIS)

    Webster, Allan; Ayatakshi, Sukanya


    This paper argues that the underlying supply and demand analysis of fossil energy and other environmental taxes needs further elaboration when a country (a) introduces national fossil energy or environmental taxes and (b) is open to international trade at given world prices. We provide evidence that such conditions are plausible for many sectors in the UK. A key implication is that the short run effects of such taxes should not be felt in final good prices, since these are determined in world markets, but in terms of underlying profitability. These changes in underlying profits provide two key incentives for producers—to change to more environmentally friendly production techniques and to switch resources to production of less environmentally harmful goods. Using input—output techniques we provide evidence for the UK to show how existing fossil energy and other “green” taxes have affected underlying profitability. The evidence shows quite strong profit incentives to shift resources from a small number of energy intensive industries to others. - Highlights: • Energy taxes affect profits more than prices for sectors trading at world prices. • This study suggests that many sectors in the UK satisfy these conditions. • Our evidence suggests that few sectors are strongly affected by energy taxes. • Energy taxes have a strong effect relative to other possible environmental taxes

  12. Incentive, sustainable and fair pricing, a trilogy out of reach?


    Maria Salvetti


    The Water Framework Directive requires Member-States to implement by 2010 an incentive tariffication policy in order to ensure efficient use of water resources and compliance with environmental goals (good ecological status). But working out an incentive pricing system, that is both sustainable and fair, is not an easy task. 1) Can an incentive pricing be a sustainable pricing? a) Water & wastewater services are very capitalistic: fixed costs can represent up to 2/3 or 3/4 of the service cost...

  13. A Study of the Importance of Education and Cost Incentives on Individual Food Choices at the Harvard School of Public Health Cafeteria (United States)

    Michels, Karin B.; Bloom, Barry R.; Riccardi, Paul; Rosner, Bernard A.; Willett, Walter C.


    Objectives To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria. Design A non-randomized intervention study. Setting A medium size cafeteria in the Harvard School of Public Health. Participants Customers of the cafeteria mainly consisting of public health students, faculty, and school staff and workers from the medical campus. Intervention The purchase of healthy foods and dishes was subsidized and their prices reduced by 20%. This promotion was accompanied by the distribution of educational material. Main Outcome Measures Change in consumption of healthy and less healthy foods. Analysis The geometric mean was used to calculate the change in consumption. Results During the intervention, we observed a 6% increase in the consumption of healthy foods (95% confidence interval [CI]; 5% to 8%), and a 2% decline in the consumption of less-healthy foods (95% CI; −1% to −4%). After the prices returned to their original levels, the consumption of healthy foods increased further to 17% (95% CI; 13% to 20%) and a 2% decline in the consumption of less-healthy foods (95% CI; % 1 to −5%) persisted. Conclusions Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion. PMID:18460476

  14. A study of the importance of education and cost incentives on individual food choices at the Harvard School of Public Health cafeteria. (United States)

    Michels, Karin B; Bloom, Barry R; Riccardi, Paul; Rosner, Bernard A; Willett, Walter C


    To investigate the importance of cost and awareness of health- or disease-promoting properties of foods and meals for choices by customers of a cafeteria. A non-randomized intervention study. A medium size cafeteria in the Harvard School of Public Health. Customers of the cafeteria mainly consisting of public health students, faculty, and school staff and workers from the medical campus. The purchase of healthy foods and dishes was subsidized and their prices reduced by 20%. This promotion was accompanied by the distribution of educational material. Change in consumption of healthy and less healthy foods. The geometric mean was used to calculate the change in consumption. During the intervention, we observed a 6% increase in the consumption of healthy foods (95% confidence interval [CI]; 5% to 8%), and a 2% decline in the consumption of less-healthy foods (95% CI; -1% to -4%). After the prices returned to their original levels, the consumption of healthy foods increased further to 17% (95% CI; 13% to 20%) and a 2% decline in the consumption of less-healthy foods (95% CI; % 1 to -5%) persisted. Subsidizing healthful meals and educating consumers about the importance of a healthy diet can result in a modest increase in the selection of healthy foods and meals that can be maintained beyond the periods of subsidy and promotion.

  15. Statin cost effectiveness in primary prevention: A systematic review of the recent cost-effectiveness literature in the United States

    Directory of Open Access Journals (Sweden)

    Mitchell Aaron P


    Full Text Available Abstract Background The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. Findings We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study’s assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive. Conclusions Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.

  16. Cost effectiveness methodology for evaluating Korean international communication system alternatives.


    Hwang, Tae Kyun.


    Approved for public release; distribution in unlimited. Cost and Effectiveness models are developed by using of cost-effectiveness technique for fiber optic cable and satellite communication media. The models are applied to the Korean international communication problem. Alternative selection is required since the two medias different in cost and effectiveness. The major difficulties encountered were data gathering and measuring the effectiveness of the Korean international ...

  17. Assessment of the economic effects of financial incentives benefitting certain plants for renewable energy utilisation in Germany. Final report

    International Nuclear Information System (INIS)


    On account of their low sales figures, technologies for renewable energy utilisation are still rather expensive. A more decided support for their introduction to the market could boost the development in this field. The offer submitted by Fichtner Development Engineering on 21.04.1992 served as a basis for the commission by the Federal Minister for Economic Affairs. It comprised the following individual tasks; drawing up of a list of plants to be promoted; elaboration, assessment, and selection of suitable promotion mechanisms; elaboration of cause-and-effect relationships for estimating stimulus strength; principal executive questions; increase in number of plants sold and cost of promotion. The present report deals with these points. (orig./UA) [de

  18. Global cost-effectiveness of GDM screening and management

    DEFF Research Database (Denmark)

    Weile, Louise K K; Kahn, James G; Marseille, Elliot


    a systematic search and abstraction of cost-effectiveness and cost-utility studies from 2002 to 2014. We standardized all findings to 2014 US dollars. We found that cost-effectiveness ratios varied widely. Most variation was found to be due to differences in geographic setting, diagnostic criteria...... and intervention approaches, and outcomes (e.g., inclusion or exclusion of long-term type 2 diabetes risk and associated costs). We concluded that incorporation of long-term benefits of GDM screening and treatment has huge impact on cost-effectiveness estimates. Based on the large methodological heterogeneity...

  19. Consumer responses towards home energy financial incentives: A survey-based study

    International Nuclear Information System (INIS)

    Zhao Tingting; Bell, Lindsey; Horner, Mark W.; Sulik, John; Zhang Jinfeng


    Residential energy-efficient and renewable energy (EERE) products play an important role in energy conservation and carbon emissions reduction. Various financial incentive programs have been developed to promote the adoption of these products. However, their effectiveness in attracting consumers is not very well understood. In this study, we investigated impacts of financial incentives on homeowner's decision making towards six EERE products. Two forms of incentives, tax credits and interest-free loans, were examined through a household mailing survey in Florida, the United States. Results showed that, although half of the respondents were interested in EERE products, the high investment cost was a major concern that hindered their purchase activities. Homeowners were attracted to financial incentives and valued tax credits much higher than interest-free loans. The current federal home energy tax credit levels were found to attract only 2–12 percent of homeowners to buy EERE products. The willingness of participation was especially low for the costly products (such as solar panels). The participation rate was also very low for lower income (i.e., annual household income below $50,000) families living in older residences. This study contributes to the understanding of economic and social aspects of consumer decision making on energy efficiency and alternative energy. - Highlights: ► We investigated consumer responses to energy efficiency incentives. ► These included tax credits and interest-free loans for six types of energy products. ► We found that tax credits are more effective than interest-free loans. ► The current tax credit rates are insufficient for expensive products (e.g., solar panels). ► A higher amount of incentives is required for the lower-income (<$50 K/yr) households.

  20. Investment incentives in the Korean electricity market

    International Nuclear Information System (INIS)

    Park, Jung-Yeon; Ahn, Nam-Sung; Yoon, Yong-Beum; Koh, Kyung-Ho; Bunn, Derek W.


    This paper develops a model-based analysis of the effects of various capacity incentive systems on new investment in the Korean electricity market. The restructuring process in Korea allocated power generation to six firms, competing within a wholesale market, albeit strictly on a cost basis. Because of this cost-based pool, capacity payments were also introduced to encourage new investment. However, it is an open question whether the current fixed capacity payment scheme is enough to secure resource adequacy, and consideration is being given to alternative mechanisms such as the use of LOLP. Using a detailed market simulation model, based on system dynamics, we compare these approaches in terms of how they may influence the investors' decisions and thereby determine the system reserve margin. The simulation results suggest that there may be serious problems in staying with the current fixed capacity payments in order to achieve resource adequacy. In contrast, an LOLP-based capacity mechanism may, in the longer term, increase the reserve margin compared with a fixed capacity payment. More generally, this paper indicates how crucial the effective modeling of the investment behavior of the independent power producers is for adequate policy support, even if they only constitute a fringe in a substantially centrally influenced market

  1. Incentive Mechanism Model Design for Sharing of Information Resources in Rural Areas


    Gao, Xirong; Shan, Lingling


    In order to solve the issues concerning the cross-unit sharing of information resources in rural areas, we analyze the incentive problem of the sharing of information resources in rural areas using the incentive theory method; establish corresponding incentive mechanism model (It is divided into positive incentive model and negative incentive model, and only when the two models guarantee each other and are used at the same time can they be effective). Based on this, we put forward the institu...

  2. Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda. (United States)

    Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K


    Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

  3. A Privacy-Preserving Incentive Mechanism for Participatory Sensing Systems

    Directory of Open Access Journals (Sweden)

    Xiaoguang Niu


    Full Text Available The proliferation of mobile devices has facilitated the prevalence of participatory sensing applications in which participants collect and share information in their environments. The design of a participatory sensing application confronts two challenges: “privacy” and “incentive” which are two conflicting objectives and deserve deeper attention. Inspired by physical currency circulation system, this paper introduces the notion of E-cent, an exchangeable unit bearer currency. Participants can use the E-cent to take part in tasks anonymously. By employing E-cent, we propose an E-cent-based privacy-preserving incentive mechanism, called EPPI. As a dynamic balance regulatory mechanism, EPPI can not only protect the privacy of participant, but also adjust the whole system to the ideal situation, under which the rated tasks can be finished at minimal cost. To the best of our knowledge, EPPI is the first attempt to build an incentive mechanism while maintaining the desired privacy in participatory sensing systems. Extensive simulation and analysis results show that EPPI can achieve high anonymity level and remarkable incentive effects.

  4. A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

    Directory of Open Access Journals (Sweden)

    Femke Jansen


    Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

  5. Effect of Climate Change and Transaction Costs on Performance of a Groundwater Market (United States)

    Khan, H. F.; Brown, C.


    With surface water resources becoming increasingly stressed, groundwater extraction, much of it unmanaged, has increased globally. Incentive-based policies, such as the cap-and-trade system, have been shown to be useful in the context of groundwater management. Previous research has shown that optimal groundwater markets (i.e. incentives-based policy) outperforms water quotas (command and control policy) with regards to both economic and environmental outcomes. In this work, we investigate whether these advantages of a water market over water quotas hold when assumptions of perfect information are violated due to climate change and hydrogeologic heterogeneity. We also assess whether the benefits of a cap-and-trade system outweigh the costs of implementing it, and how changes in future climate affect the performance a cap-and trade system. We use a sub-basin of the Republican River Basin, overlying the Ogallala aquifer in the High Plains of the United States, as a case study. We develop a multi-agent system model where individual benefits of each self-interested agent are maximized subject to bounds on irrigation requirements and water use permits. This economic model is coupled with a calibrated physically based groundwater model for the study region. Results show that permitting farmers to trade results in increased economic benefits and reduced environmental violations. However, the benefits of trading are dependent on the total allocations and the resulting level of water demand. We quantify third party impacts and environmental externalities for different water allocations, and highlight the unequal distributional effects of uniform water allocations resulting in `winners' and `losers'. The study reveals that high transaction costs can reduce the efficiency of the cap-and-trade system even below that of water quotas. Future changes in climate are shown to significantly influence the dynamics of the water market, and emphasize the need to address climate

  6. Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review. (United States)

    Konnopka, Alexander; Leichsenring, Falk; Leibing, Eric; König, Hans-Helmut


    To review cost-of-illness studies (COI) and cost-effectiveness analyses (CEA) conducted for anxiety disorders. Based on a database search in Pubmed, PsychINFO and NHS EED, studies were classified according to various criteria. Cost data were inflated and converted to 2005 US-$ purchasing power parities (PPP). We finally identified 20 COI and 11 CEA of which most concentrated on panic disorder (PD) and generalized anxiety disorder (GAD). Differing inclusion of cost categories limited comparability of COI. PD and GAD tended to show higher direct costs per case, but lower direct cost per inhabitant than social and specific phobias. Different measures of effectiveness severely limited comparability of CEA. Overall CEA analysed 26 therapeutic or interventional strategies mostly compared to standard treatment, 8 of them resulting in lower better effectiveness and costs than the comparator. Anxiety disorders cause considerable costs. More research on phobias, more standardised inclusion of cost categories in COI and a wider use of comparable effectiveness measures (like QALYs) in CEA is needed.

  7. Teacher Pension Incentives and Labor Market Behavior: Evidence from Missouri Administrative Teacher Data. Conference Paper 2009-11 (United States)

    Ni, Shawn; Podgursky, Michael; Ehlert, Mark


    Policy discussions about teacher quality and teacher "shortages" often focus on recruitment and retention of young teachers. However, attention has begun to focus on the incentive effects of teacher retirement benefit systems, particularly given their rising costs and the large unfunded liabilities. In this paper we analyze accrual of…

  8. Impact of financial environmental incentives in the potential of electric power generation on the sugar cane plants

    International Nuclear Information System (INIS)

    Pinto, Claudio Plaza; Walter, Arnaldo


    The aim of the work is to present the electric power generation from biomass and the economic potential from sugar cane plants in Brazil. Computerized electricity costs simulation are presented and several financial incentives and external market effects are considered. The results are also presented and criticized

  9. Incentives and moral hazard

    DEFF Research Database (Denmark)

    Wendimu, Mengistu Assefa; Henningsen, Arne; Czekaj, Tomasz Gerard


    system and thus, the incentives to the workers. We compare the productivity of these two production schemes using a cross-sectional plot-level data set. As sugarcane production depends on various exogenous factors that are measured as categorical variables (e.g., soil type, cane variety, etc.), we...

  10. Incentives for Recruiters (United States)


    promotions, with prizes for the kids: anything from football ti’kets to trips to Disneyland ." [Ref. 10:p. 68] Any publisher who wants a successful...such as a trip to Disneyland . The latter focuses more on providing an 29 incentive to the carrier to get a certain number of new customers in a short

  11. Dynamic Incentives in Organizations

    DEFF Research Database (Denmark)

    Ruckes, Martin; Rønde, Thomas


    to this inertial tendency is either to increase the financial incentives to encourage searching or to accept no searching. The former response increases search efforts and total profits; the latter response has the opposite results. Inertia can be removed by restructuring the firm in period 2, but this may create...

  12. Effects of a preceptorship programme on turnover rate, cost, quality and professional development. (United States)

    Lee, Tso-Ying; Tzeng, Wen-Chii; Lin, Chia-Huei; Yeh, Mei-Ling


    The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development. A high turnover rate of nurses is a common global problem. How to improve nurses' willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well-designed preceptorship programmes could possibly decrease turnover rates and improve professional development. A quasi-experimental research design was used. First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi-experimental design was used to evaluate the preceptorship programme. Data on new nurses' turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor's teaching and preceptor's perception were measured. After conducting the preceptorship programme, the turnover rate was 46.5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50-0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance. The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses. Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.

  13. Cost effectiveness and efficiency in assistive technology service delivery. (United States)

    Warren, C G


    In order to develop and maintain a viable service delivery program, the realities of cost effectiveness and cost efficiency in providing assistive technology must be addressed. Cost effectiveness relates to value of the outcome compared to the expenditures. Cost efficiency analyzes how a provider uses available resources to supply goods and services. This paper describes how basic business principles of benefit/cost analysis can be used to determine cost effectiveness. In addition, basic accounting principles are used to illustrate methods of evaluating a program's cost efficiency. Service providers are encouraged to measure their own program's effectiveness and efficiency (and potential viability) in light of current trends. This paper is meant to serve as a catalyst for continued dialogue on this topic.

  14. Design of cost effective antennas for instrumentation radars

    CSIR Research Space (South Africa)

    Botha, L


    Full Text Available The cost of antennas for instrumentation radars are determined by the development cost. By re-use of the reflector system cost effective antennas can be designed. The factors governing the design of such antennas are described here....

  15. An Assessment Of The Effectiveness Of Collaborative Cost ...

    African Journals Online (AJOL)

    This paper presents the effects of Collaborative Cost Reduction Model (CCRM) as a control Approach to reduce the high cost implication that causes the slow pace of migration process from IPV4 to IPV6 in Nigeria. This study reveals that CCRM can be applied to achieve Cost Reduction in collocation efforts in ...

  16. Cost-effectiveness of rotavirus vaccination in Turkey

    Directory of Open Access Journals (Sweden)

    Tulin Koksal


    Conclusion: At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections.

  17. Cost of childhood diarrhoea in rural South Africa: exploring cost-effectiveness of universal zinc supplementation. (United States)

    Chhagan, Meera K; Van den Broeck, Jan; Luabeya, Kany-Kany Angelique; Mpontshane, Nontobeko; Bennish, Michael L


    To describe the cost of diarrhoeal illness in children aged 6-24 months in a rural South African community and to determine the threshold prevalence of stunting at which universal Zn plus vitamin A supplementation (VAZ) would be more cost-effective than vitamin A alone (VA) in preventing diarrhoea. We conducted a cost analysis using primary and secondary data sources. Using simulations we examined incremental costs of VAZ relative to VA while varying stunting prevalence. Data on efficacy and societal costs were largely from a South African trial. Secondary data were from local and international published sources. The trial included children aged 6-24 months. The secondary data sources were a South African health economics survey and the WHO-CHOICE (CHOosing Interventions that are Cost Effective) database. In the trial, stunted children supplemented with VAZ had 2·04 episodes (95 % CI 1·37, 3·05) of diarrhoea per child-year compared with 3·92 episodes (95 % CI 3·02, 5·09) in the VA arm. Average cost of illness was $Int 7·80 per episode (10th, 90th centile: $Int 0·28, $Int 15·63), assuming a minimum standard of care (oral rehydration and 14 d of therapeutic Zn). In simulation scenarios universal VAZ had low incremental costs or became cost-saving relative to VA when the prevalence of stunting was close to 20 %. Incremental cost-effectiveness ratios were sensitive to the cost of intervention and coverage levels. This simulation suggests that universal VAZ would be cost-effective at current levels of stunting in parts of South Africa. This requires further validation under actual programmatic conditions.

  18. Quality-based financial incentives in health care: can we improve quality by paying for it? (United States)

    Conrad, Douglas A; Perry, Lisa


    This article asks whether financial incentives can improve the quality of health care. A conceptual framework drawn from microeconomics, agency theory, behavioral economics, and cognitive psychology motivates a set of propositions about incentive effects on clinical quality. These propositions are evaluated through a synthesis of extant peer-reviewed empirical evidence. Comprehensive financial incentives--balancing rewards and penalties; blending structure, process, and outcome measures; emphasizing continuous, absolute performance standards; tailoring the size of incremental rewards to increasing marginal costs of quality improvement; and assuring certainty, frequency, and sustainability of incentive payoffs--offer the prospect of significantly enhancing quality beyond the modest impacts of prevailing pay-for-performance (P4P) programs. Such organizational innovations as the primary care medical home and accountable health care organizations are expected to catalyze more powerful quality incentive models: risk- and quality-adjusted capitation, episode of care payments, and enhanced fee-for-service payments for quality dimensions (e.g., prevention) most amenable to piece-rate delivery.

  19. Cost-effectiveness and the socialization of health care. (United States)

    Musgrove, P


    The more health care is socialized, the more cost-effectiveness is an appropriate criterion for expenditure. Utility-maximizing individuals, facing divisibility of health care purchases and declining marginal health gains, and complete information about probable health improvements, should buy health care according to its cost-effectiveness. Absent these features, individual health spending will not be cost-effective; and in any case, differences in personal utilities and risk aversion will not lead to the same ranking of health care interventions for everyone. Private insurance frees consumers from concern for cost, which undermines cost-effectiveness, but lets them emphasize effectiveness, which favors value for money. This is most important for costly and cost-effective interventions, especially for poor people. Cost-effectiveness is more appropriate and easier to achieve under second-party insurance. More complete socialization of health care, via public finance, can yield greater efficiency by making insurance compulsory. Cost-effectiveness is also more attractive when taxpayers subsidize others' care: needs (effectiveness) take precedence over wants (utility). The gain in effectiveness may be greater, and the welfare loss from Pareto non-optimality smaller, in poor countries than in rich ones.

  20. Incentives Between Firms (and Within)


    Robert Gibbons


    This paper reviews the significant progress in Üagency theoryÝ (i.e., the economic theory of incentives) during the 1990s, with an eye toward applications to supply transactions. I emphasize six recent models, in three pairs: (1) new foundations for the theory of incentive contracts, (2) new directions in incentive theory, and (3) new applications to supply transactions. By reviewing these six models, I hope to establish three things. First, the theory of incentive contracts needed and receiv...

  1. The effect of costs on the future of nuclear power

    International Nuclear Information System (INIS)

    Walske, C.


    The author discusses the future of the nuclear power industry from an economics and cost-factor point of view, from the point of view of plant management, as it affects and requires personnel training, as R and D cost and competition is involved, as end-user cost is involved, and as efficiency and cost effectiveness of nuclear power fare in comparison with other sources of electrical energy

  2. Environmental policy and technological change: The effects of economic incentives and direct regulation on energy-saving innovation (United States)

    Newell, Richard G., Jr.

    Over the long run, the impacts of environmental policies will be greatly affected by the influence these policies have on the rate and direction of technological change. In particular, the roles played by energy prices and product regulation in energy-saving technology innovation are exceptionally important considerations in modeling climate change and evaluating alternative policy options. We analyze the effects of energy prices and energy-efficiency regulations on the menu of air conditioner and water heater models available on the market over a period of more than three decades, measuring their innovation in terms of improvements in the products' underlying characteristics. Through estimation of a series of "characteristics transformation surfaces," we find that during less than four decades, substantial innovation in these products reduced the total capital and operating costs of air conditioning by one-half and water heating by more than one-fifth. Although the overall rate of innovation in these products appears to be independent of energy prices and regulations, the evidence suggests that the direction of innovation may be responsive to energy price changes. This would imply that energy price increases induced innovation in a direction that lowered the capital cost tradeoffs inherent in producing more energy-efficient products. The evidence supporting "regulation-induced" changes in these tradeoffs is much weaker. Our estimates indicate that about one- to two-fifths of the energy-efficiency improvements in these products from 1973 to 1993 were associated with historical changes in energy prices. We also find that this responsiveness to price changes increased substantially after product labeling requirements came into effect, and that minimum efficiency standards had a significant positive effect on average efficiency levels. Nonetheless, a sizeable portion of historical efficiency improvements in these technologies is associated with the products' overall

  3. The Kyoto Protocol Is Cost-effective

    Directory of Open Access Journals (Sweden)

    Marino Gatto


    Full Text Available Despite recent advances, there is a high degree of uncertainty concerning the climate change that would result from increasing atmospheric greenhouse gas concentrations. Also, opponents of the Kyoto Protocol raised the key objection that reducing emissions would impose an unacceptable economic burden on businesses and consumers. Based on an analysis of alternative scenarios for electricity generation in Italy, we show that if the costs in terms of damage to human health, material goods, agriculture, and the environment caused by greenhouse gas emissions are included in the balance, the economic argument against Kyoto is untenable. Most importantly, the argument holds true even if we exclude global external costs (those due to global warming, and account for local external costs only (such as those due to acidic precipitation and lung diseases resulting from air pollution.

  4. Cost effectiveness of dilute chemical decontamination

    International Nuclear Information System (INIS)

    Le Surf, J.E.; Weyman, G.D.


    The origin and basic principles of the dilute chemical decontamination (DCD) concept are described and illustrated by reference to the CAN-DECON process. The estimated dose savings from the actual application of the process at several reactors are presented and discussed. Two methods of performing a cost/benefit appraisal are described and discussed. This methodology requires more study by the nuclear industry, including collection by station staff of relevant data on which future cost/benefit appraisals may be based. Finally, three illustrative cases are examinated to show the breakeven point and potential savings achievable by DCD with different initial radiation fields and different amounts of work to be done. The overall conclusion is that there are many situations in which DCD is desirable to reduce radiation exposure of workers, to save costs to the station, and to ease the performance of maintenance and repair work on reactor systems

  5. [Cost effectiveness in treatment of acute myeloid leukemia]. (United States)

    Nordmann, P; Schaffner, A; Dazzi, H


    Although the rise in health costs is a widely debated issue, in Switzerland it was until recently taken for granted that patients are given the best available treatment regardless of cost. An example of a disease requiring costly treatment is acute myelogenous leukaemia (AML). To relate cost to benefit we calculated expenditure per life years gained. To assess costs we determined the real cost of treatment up to total remission, followed by consolidation or withdrawal of treatment or death. For survival time exceeding the 2-year observation period we used data from recent literature. The average cost of treatment ranges up to 107,592 Swiss francs (CHF). In 1997 we treated 23 leukaemia patients at Zurich University Hospital and gained a total of 210 life years. This represents an average cost of CHF 11,741 per life year gained. Chief cost items were therapy and personnel costs for nursing staff, followed by hotel business and personnel costs for doctors and diagnosis. Our results for AML treatment are far removed from the $61,500 ranging up to $166,000 discussed in the literature as the "critical" QALY (quality adjusted life years) value. This is the first time the actual costs of AML therapy have been shown for a Swiss cohort. Despite high initial treatment costs and success only in a limited number of patients, the expenditure per QALY is surprisingly low and shows clearly the effectiveness of apparently costly acute medicine.

  6. Take the money and run? Redemption of a gift card incentive in a clinician survey

    Directory of Open Access Journals (Sweden)

    Jane S. Chen


    Full Text Available Abstract Background Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Methods Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women’s primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177. An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. Results 63.5 % of clinicians who responded to the survey used the gift card, and only one provider who didn’t participate used the gift card (1.6 %. Many of those who participated did not redeem their gift cards (36.5 % of respondents. The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Conclusions Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

  7. Take the money and run? Redemption of a gift card incentive in a clinician survey. (United States)

    Chen, Jane S; Sprague, Brian L; Klabunde, Carrie N; Tosteson, Anna N A; Bitton, Asaf; Onega, Tracy; MacLean, Charles D; Harris, Kimberly; Schapira, Marilyn M; Haas, Jennifer S


    Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women's primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177). An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. 63.5% of clinicians who responded to the survey used the gift card, and only one provider who didn't participate used the gift card (1.6%). Many of those who participated did not redeem their gift cards (36.5% of respondents). The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

  8. Incentives for energy efficiency in the EU emission trading scheme

    Energy Technology Data Exchange (ETDEWEB)

    Schleich, Joachim [Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (ISI), Karlsruhe (Germany); Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States); Rogge, Karoline [Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (ISI), Karlsruhe (Germany); ETH Zurich (Switzerland). Group for Sustainability and Technology; Betz, Regina [New South Wales Univ. (Australia). Centre for Energy and Environmental Markets


    This paper explores the incentives for energy efficiency induced by the European Union Emissions Trading Scheme (EU ETS) for installations in the energy and industry sectors. Our analysis of the National Allocation Plans for 27 EU Member States for phase 2 of the EU ETS (2008-2012) suggests that the price and cost effects for improvements in carbon and energy efficiency in the energy and industry sectors will be stronger than in phase 1 (2005-2007), but only because the European Commission has substantially reduced the number of allowances to be allocated by the Member States. To the extent that companies from these sectors (notably power producers) pass through the extra costs for carbon, higher prices for allowances translate into stronger incentives for demand- side energy efficiency. With the cuts in allocation to energy and industry sectors these will be forced to greater reductions, thus the non-ET sectors like household, tertiary and transport will have to reduce less, which is more in line with the cost-efficient share of emission reductions. The findings also imply that domestic efficiency improvements in the energy and industry sectors may remain limited since companies can make substantial use of credits from the Kyoto mechanisms. The analysis of the rules for existing installations, new projects and closures suggests that incentives for energy efficiency are higher in phase 2 than in phase 1 because of the increased application of benchmarking to new and existing installations and because a lower share of allowances will be allocated for free. Nevertheless, there is still ample scope to further improve the EU ETS so that the full potential for energy efficiency can be realized. (orig.)

  9. Cost-effectiveness, feed utilization and body composition of african ...

    African Journals Online (AJOL)

    Cost-effectiveness, feed utilization and body composition of african sharptooth catfish ( Clarias gariepinus , Burchell 1822) fingerlings fed locally formulated and commercial pelleted diets in tarpaulin tanks.

  10. Canadian incentives for oil and gas exploration. [Applicability to USA

    Energy Technology Data Exchange (ETDEWEB)


    During the 1970s a number of different exploration and production incentive programs were put in place in Canada, in particular in the Province of Alberta, Canada's principal oil- and gas-producing province. The DOE/RA is evaluating Canadian incentives for oil and gas exploration, and this study is intended to provide information that will help guide DOE/RA in determining the applicability of Canadian incentive programs in US energy policy. The study describes and documents the fiscal structure in which the Canadian oil industry operates. The incentive features of pricing policy, taxation policy, and provincial royalty systems are discussed. A principal focus of the study is on one of the most important of Canada's specific incentive programs, the Alberta Exploratory Drilling Incentive Credit Program (EDICP). The study describes and evaluates the effect of the EDICP on increased oil and gas exploration activity. Similarly, the study also reviews and evaluates other specific incentive programs such as the Alberta Geophysical Incentive Program, Frontier Exploration Allowances, and various tar sand and heavy oil development incentives. Finally the study evaluates the applicability of Canadian incentives to US energy policy.

  11. The relationship between cost system complexity, purposes of use, and cost system effectiveness

    NARCIS (Netherlands)

    Schoute, M.


    This paper uses survey data from 133 Dutch, medium-sized manufacturing firms to examine the associations between cost system complexity (in terms of the applied overhead absorption procedures), purposes of use, and cost system effectiveness. First, factor analysis identifies two underlying

  12. Atomoxetine's Effect on Societal Costs in Sweden (United States)

    Myren, Karl-Johan; Thernlund, Gunilla; Nylen, Asa; Schacht, Alexander; Svanborg, Par


    Objective: To compare societal costs between patients treated with atomoxetine and placebo in Sweden. Method: Ninety-nine pediatric ADHD patients were randomized to a 10-week double-blind treatment with atomoxetine (n = 49) or placebo (n = 50). All parents received four sessions of psycho-education. Parents filled out a resource utilization…

  13. Cost, production and effectiveness of masticated fireline. (United States)

    Elizabeth Dodson; Dana Mitchell


    Fire managers are continuously looking for improved methods to construct fireline with minimal resource damage. One option for fireline construction that has so far received limited attention is the use of mastication equipment. This study evaluated a masticating disk mounted on a self-leveling feller- buncher for the cost, speed, and adherence to fireline...

  14. Cost effectiveness of dilute chemical decontamination

    International Nuclear Information System (INIS)

    LeSurf, J.E.; Weyman, G.D.

    The basic principles of dilute chemical decontamination are described, as well as the method of application. Methods of computing savings in radiation dose and costs are presented, with results from actual experience and illustrative examples. It is concluded that dilute chemical decontamination is beneficial in many cases. It reduces radiation exposure of workers, saves money, and simplifies maintenance work

  15. Globalisation and National Incentives for Protecting Environmental Goods


    Alkuin Kölliker


    This article tries to explain national incentives for protecting environmental goods either autonomously or collectively; it explores how globalisation has affected those incentives; and it suggests how national environmental policy might respond so as to ensure its effectiveness. The central argument is that national incentives for environmental protection may to a considerable extent be explained by a combination of the type of environmental good to be protected (in terms of public goods th...

  16. Stock-based Compensation Plans and Employee Incentives


    Jan Zabojnik


    Standard principal-agent theory predicts that large firms should not use employee stock options and other stock-based compensation to provide incentives to non-executive employees. Yet, business practitioners appear to believe that stock-based compensation improves incentives, and mounting empirical evidence points to the same conclusion. This paper provides an explanation for why stock-based incentives can be effective. In the model of this paper, employee stock options complement individual...

  17. Issues in the Design of Saving and Investment Incentives


    David F. Bradford


    This paper examines the characteristics of and interactions among measures to effect saving and investment incentives ("S-I incentives")in the context of an income tax system that is inadequately indexed for inflation. Examples are proposals for more rapid depreciation of buildings and equipment and proposals to exempt larger amounts of interest income. SI incentives are classified into "consumption tax" and "direct grant" types, and it is shown that these differ in their influence on portfol...

  18. Small Cash Incentives Can Encourage Primary Care Visits By Low-Income People With New Health Care Coverage. (United States)

    Bradley, Cathy J; Neumark, David


    In a randomized controlled trial, we studied low-income adults newly covered by a primary care program to determine whether a cash incentive could encourage them to make an initial visit to a primary care provider. Subjects were randomly assigned to one of four groups: three groups whose members received $10 to complete a baseline survey during an interview and who were randomized to incentives of $50, $25, or $0 to visit their assigned primary care provider within six months after enrolling in the study; and a nonincentivized control group not contacted by the research team. Subjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77 percent and 74 percent, respectively), compared to subjects in the $0 incentive group (68 percent). The effects of the intervention were about twice as large when we compared the proportions of subjects in the $50 and $25 incentive groups who visited their providers and the proportion in the nonincentivized group (61 percent). Cash incentive programs may steer newly covered low-income patients toward primary care, which could result in improved health outcomes and lower costs. Project HOPE—The People-to-People Health Foundation, Inc.

  19. Third-Party Incentive Strategies and Conflict Management in Africa

    DEFF Research Database (Denmark)

    Emmanuel, Nikolas G.


    Dr. Nikolas Emmanuel's examines the use of an incentives approach in managing intrastate conflict in Africa because in many cases, risks and costs make applications of hard power alone unfeasible. Furthermore, simply ignoring episodes of civil conflict in the hope that they will "burn themselves...... out"� does not appear to be a viable alternative. That said, both noncoercive and coercive incentive strategies exist and have been deployed by third parties in a variety of conflict situations. Such incentives seek to manage conflict by encouraging political bargaining. The clear intention...... parties can help manage conflicts. Second, it offers a typology of the available incentive strategies, classifying them along noncoercive and coercive lines. Thus, the article outlines the possibilities offered by an incentives approach, focusing on examples drawn from recent African cases....

  20. Incentive regulation of nuclear power plants by state Public Utility Commissions

    International Nuclear Information System (INIS)

    Martin, R.L.; Olson, J.; Hendrickson, P.


    Economic performance incentives established by state Public Utility Commissions (PUCs) currently are applicable to the construction or operation of approximately 73 nuclear power reactors owned by 27 utilities with investment greater than 10% in 18 states. The NRC staff monitors development of the incentives and periodically provides an updated report on all nuclear plant incentives to its headquarters and regional offices. The staff maintains contact with the PUCs and the utilities responsible for implementing the incentives in order to obtain the updated information and to consider potential safety effects of the incentives. This report on incentive regulation of nuclear power plants by state PUCs presents the NRC staff's concerns on potential safety effects of economic performance incentives. It also includes a plant-by-plant survey that describes the mechanics of each incentive and discusses the financial effects of the incentive on the utility-owner(s) of the plant

  1. Incentive regulation of nuclear power plants by state public utility commissions

    International Nuclear Information System (INIS)

    Petersen, J.C.


    This report on incentive regulation of nuclear power plants by state public utility commissions (PUCs). Economic performance incentives established by state PUCs are applicable to the construction or operation of about 45 nuclear power reactors owned by 30 utilities in 17 states. The NRC staff monitors development of the incentives and periodically provides an updated report on all nuclear plant incentives to its regional offices. The staff maintains contact with the PUCs and the utilities responsible for implementing the incentives in order to obtain the updated information and to consider potential safety effects of the incentives. This report presents the NRC staff's concerns on potential safety effects of economic performance incentives. It also includes a plant-by-plant survey that describes the mechanics of each incentive and discusses the financial effects of the incentive on the utility-owner(s) of the plant

  2. Team incentives in relational contracts

    International Nuclear Information System (INIS)

    Kvaloey, Ola


    Incentive schemes for teams are compared. I ask: under which conditions are relational incentive contracts based on joint performance evaluation, relative performance evaluation and independent performance evaluation self-enforceable. The framework of Che and Yoo (2001) on team incentives is combined with the framework of Baker, Gibbons and Murphy (2002) on relational contracts. In a repeated game between one principal and two agents, I find that incentives based on relative or independent performance are expected to dominate when the productivity of effort is high, while joint performance evaluation dominates when productivity is low. Incentives based on independent performance are more probable if the agents own critical assets. (author)

  3. Cost effectiveness analysis of indoor radon control measures

    International Nuclear Information System (INIS)

    Fujimoto, Kenzo


    The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

  4. Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review. (United States)

    Tambor, Marzena; Pavlova, Milena; Golinowska, Stanisława; Arsenijevic, Jelena; Groot, Wim


    To motivate people to lead a healthier life and to engage in disease prevention, explicit financial incentives, such as monetary rewards for attaining health-related targets (e.g. smoking cessation, weight loss or increased physical activity) or disincentives for reverting to unhealthy habits, are applied. A review focused on financial incentives for health promotion among older people is lacking. Attention to this group is necessary because older people may respond differently to financial incentives, e.g. because of differences in opportunity costs and health perceptions. To outline how explicit financial incentives for healthy lifestyle and disease prevention work among older persons, this study reviews the recent evidence on this topic. We applied the method of systematic literature review and we searched in PUBMED, ECONLIT and COCHRANE LIBRARY for studies focused on explicit financial incentives targeted at older adults to promote health and stimulate primary prevention as well as screening. The publications selected as relevant were analyzed based on directed (relational) content analysis. The results are presented in a narrative manner complemented with an appendix table that describes the study details. We assessed the design of the studies reported in the publications in a qualitative manner. We also checked the quality of our review using the PRISMA 2009 checklist. We identified 15 studies on the role of explicit financial incentives in changing health-related behavior of older people. They include both, quantitative studies on the effectiveness of financial rewards as well as qualitative studies on the acceptability of financial incentives. The quantitative studies are characterized by a great diversity of designs and provide mixed results on the effects of explicit financial incentives. The results of the qualitative studies indicate limited trust of older people in the use of explicit financial incentives for health promotion and prevention. More

  5. Risk management versus incentives

    International Nuclear Information System (INIS)

    Aven, E.; Lovas, K.; Osmundsen, P.


    Portfolio theory indicates that risk management should take place at the group level. Hedging at the project level or in the individual business areas may lead to suboptimal results. However, the efficiency of a profit centre depends on its management's being able to influence factors that are crucial to the unit's financial results. Price hedging could be one such factor. In the wider perspective, this constitutes part of the balancing between centralisation and decentralisation. This article covers important elements of risk management and incentive design. It goes on to discuss the balancing of overall risk management at the group level and incentive design in profit centres and corporate units. Throughout the article, the oil industry serves as a case. (author)

  6. Cost-effectiveness of antiplatelet drugs after percutaneous coronary intervention. (United States)

    Wisløff, Torbjørn; Atar, Dan


    Clopidogrel has, for long time, been accepted as the standard treatment for patients who have undergone a percutaneous coronary intervention (PCI). The introduction of prasugrel-and more recently, ticagrelor-has introduced a decision-making problem for clinicians and governments worldwide: to use the cheaper clopidogrel or the more effective, and also more expensive prasugrel or ticagrelor. We aim to give helpful contributions to this debate by analysing the cost-effectiveness of clopidogrel, prasugrel, and ticagrelor compared with each other. We modified a previously developed Markov model of cardiac disease progression. In the model, we followed up cohorts of patients who have recently had a PCI until 100 years or death. Possible events are revascularization, bleeding, acute myocardial infarction, and death. Our analysis shows that ticagrelor is cost-effective in 77% of simulations at an incremental cost-effectiveness ratio of €7700 compared with clopidogrel. Ticagrelor was also cost-effective against prasugrel at a cost-effectiveness ratio of €7800. Given a Norwegian cost-effectiveness threshold of €70 000, both comparisons appear to be clearly cost-effective in favour of ticagrelor. Ticagrelor is cost-effective compared with both clopidogrel and prasugrel for patients who have undergone a PCI.

  7. Cost-effectiveness of Chlamydia antibody tests in subfertile women. (United States)

    Fiddelers, A A A; Land, J A; Voss, G; Kessels, A G H; Severens, J L


    For the evaluation of tubal function, Chlamydia antibody testing (CAT) has been introduced as a screening test. We compared six CAT screening strategies (five CAT tests and one combination of tests), with respect to their cost-effectiveness, by using IVF pregnancy rate as outcome measure. A decision analytic model was developed based on a source population of 1715 subfertile women. The model incorporates hysterosalpingography (HSG), laparoscopy and IVF. To calculate IVF pregnancy rates, costs, effects, cost-effectiveness and incremental costs per effect of the six different CAT screening strategies were determined. pELISA Medac turned out to be the most cost-effective CAT screening strategy (15 075 per IVF pregnancy), followed by MIF Anilabsystems (15 108). A combination of tests (pELISA Medac and MIF Anilabsystems; 15 127) did not improve the cost-effectiveness of the single strategies. Sensitivity analyses showed that the results are robust for changes in the baseline values of the model parameters. Only small differences were found between the screening strategies regarding the cost-effectiveness, although pELISA Medac was the most cost-effective strategy. Before introducing a particular CAT test into clinical practice, one should consider the effects and consequences of the entire screening strategy, instead of only the diagnostic accuracy of the test used.

  8. Dopamine receptor blockade attenuates the general incentive motivational effects of noncontingently delivered rewards and reward-paired cues without affecting their ability to bias action selection. (United States)

    Ostlund, Sean B; Maidment, Nigel T


    Environmental cues affect our behavior in a variety of ways. Despite playing an invaluable role in guiding our daily activities, such cues also appear to trigger the harmful, compulsive behaviors that characterize addiction and other disorders of behavioral control. In instrumental conditioning, rewards and reward-paired cues bias action selection and invigorate reward-seeking behaviors, and appear to do so through distinct neurobehavioral processes. Although reward-paired cues are known to invigorate performance through a dopamine-dependent incentive motivational process, it is not known if dopamine also mediates the influence of rewards and reward-paired cues over action selection. The current study contrasted the effects of systemic administration of the nonspecific dopamine receptor antagonist flupentixol on response invigoration and action bias in Pavlovian-instrumental transfer, a test of cue-elicited responding, and in instrumental reinstatement, a test of noncontingent reward-elicited responding. Hungry rats were trained on two different stimulus-outcome relationships (eg, tone-grain pellets and noise-sucrose solution) and two different action-outcome relationships (eg, left press-grain and right press-sucrose). At test, we found that flupentixol pretreatment blocked the response invigoration generated by the cues but spared their ability to bias action selection to favor the action whose outcome was signaled by the cue being presented. The response-biasing influence of noncontingent reward deliveries was also unaffected by flupentixol. Interestingly, although flupentixol had a modest effect on the immediate response invigoration produced by those rewards, it was particularly potent in countering the lingering enhancement of responding produced by multiple reward deliveries. These findings indicate that dopamine mediates the general incentive motivational effects of noncontingent rewards and reward-paired cues but does not support their ability to bias

  9. Effect of a Game-Based Intervention Designed to Enhance Social Incentives to Increase Physical Activity Among Families: The BE FIT Randomized Clinical Trial. (United States)

    Patel, Mitesh S; Benjamin, Emelia J; Volpp, Kevin G; Fox, Caroline S; Small, Dylan S; Massaro, Joseph M; Lee, Jane J; Hilbert, Victoria; Valentino, Maureen; Taylor, Devon H; Manders, Emily S; Mutalik, Karen; Zhu, Jingsan; Wang, Wenli; Murabito, Joanne M


    Gamification, the application of game design elements such as points and levels in nongame contexts, is often used in digital health interventions, but evidence on its effectiveness is limited. To test the effectiveness of a gamification intervention designed using insights from behavioral economics to enhance social incentives within families to increase physical activity. The Behavioral Economics Framingham Incentive Trial (BE FIT) was a randomized clinical trial with a 12-week intervention period and a 12-week follow-up period. The investigation was a community-based study between December 7, 2015, and August 14, 2016. Participants in the modified intent-to-treat analysis were adults enrolled in the Framingham Heart Study, a long-standing cohort of families. All participants tracked daily step counts using a wearable device or a smartphone, established a baseline, selected a step goal increase, and received daily individual feedback on goal performance by text message or email for 24 weeks. Families in the gamification arm could earn points and progress through levels based on physical activity goal achievement during the 12-week intervention. The game design was meant to enhance collaboration, accountability, and peer support. The primary outcome was the proportion of participant-days that step goals were achieved during the intervention period. Secondary outcomes included the proportion of participant-days that step goals were achieved during the follow-up period and the change in the mean daily steps during the intervention and follow-up periods. Among 200 adults comprising 94 families, the mean age was 55.4 years, and 56.0% (n = 112) were female. During the intervention period, participants in the gamification arm achieved step goals on a significantly greater proportion of participant-days (0.53 vs 0.32; adjusted difference, 0.27; 95% CI, 0.20-0.33; P gamification arm declined but remained significantly greater than that in the control arm for the

  10. Opposing incentives for collaboration

    DEFF Research Database (Denmark)

    Dorch, Bertil F.; Wien, Charlotte; Larsen, Asger Væring

    , and gives a bonus for publications done through inter-institutionary collaboration. Credits given to universities are fractionalized between the participating universities. So far credits are not assigned to the individual authors but only to their institutions. However, it turns out that research...... collaboration is associated with a higher number of citations than single authorship which may present the author with two opposing incentives for research collaboration....

  11. Incentives and Prosocial Behaviour


    Bénabou, Roland; Tirole, Jean


    We build a theory of prosocial behaviour that combines heterogeneity in individual altruism and greed with concerns for social reputation or self-respect. The presence of rewards or punishments creates doubt as to the true motive for which good deeds are performed, and this ‘overjustification effect’ can result in a net crowding out of prosocial behaviour by extrinsic incentives. The model also allows us to identify settings that are conducive to multiple social norms of behaviour, and those ...

  12. Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value? (United States)

    Savitz, Lucy A; Savitz, Samuel T


    Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e.g. years of life or quality-adjusted years of life) and the numerator is the incremental cost associated with that health gain. For higher cost interventions, the lower the ratio of costs to effects, the higher the value. While CEA is not new, the approach continues to be refined with enhanced statistical techniques and standardized methods. This article describes the CEA approach and also contrasts it to optional approaches, in order for readers to fully appreciate caveats and concerns. CEA as an economic evaluation tool can be easily misused owing to inappropriate assumptions, over reliance, and misapplication. Twelve issues to be considered in using CEA results to drive healthcare delivery decision-making are summarized. Appropriately recognizing both the strengths and the limitations of CEA is necessary for informed resource allocation in achieving the maximum value for healthcare services provided.

  13. Cost-effectiveness of open versus arthroscopic rotator cuff repair. (United States)

    Adla, Deepthi N; Rowsell, Mark; Pandey, Radhakant


    Economic evaluation of surgical procedures is necessary in view of more expensive newer techniques emerging in an increasingly cost-conscious health care environment. This study compares the cost-effectiveness of open rotator cuff repair with arthroscopic repair for moderately size tears. This was a prospective study of 30 consecutive patients, of whom 15 had an arthroscopic repair and 15 had an open procedure. Clinical effectiveness was assessed using Oxford and Constant shoulder scores. Costs were estimated from departmental and hospital financial data. At last follow-up, no difference Oxford and Constant shoulder scores was noted between the 2 methods of repair. There was no significant difference between the groups in the cost of time in the operating theater, inpatient time, amount of postoperative analgesia, number of postoperative outpatient visits, physiotherapy costs, and time off work. The incremental cost of each arthroscopic rotator cuff repair was pound675 ($1248.75) more than the open procedure. This was mainly in the area of direct health care costs, instrumentation in particular. Health care policy makers are increasingly demanding evidence of cost-effectiveness of a procedure. This study showed both methods of repair provide equivalent clinical results. Open cuff repair is more cost-effective than arthroscopic repair and is likely to have lower cost-utility ratio. In addition, the tariff for the arthroscopic procedure in some health care systems is same as open repair. Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  14. Cost-effectiveness analysis of sandhill crane habitat management (United States)

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.


    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  15. Effects of Charitable Versus Monetary Incentives on the Acceptance of and Adherence to a Pedometer-Based Health Intervention: Study Protocol and Baseline Characteristics of a Cluster-Randomized Controlled Trial. (United States)

    Kowatsch, Tobias; Kramer, Jan-Niklas; Kehr, Flavius; Wahle, Fabian; Elser, Niklas; Fleisch, Elgar


    Research has so far benefited from the use of pedometers in physical activity interventions. However, when public health institutions (eg, insurance companies) implement pedometer-based interventions in practice, people may refrain from participating due to privacy concerns. This might greatly limit the applicability of such interventions. Financial incentives have been successfully used to influence both health behavior and privacy concerns, and may thus have a beneficial effect on the acceptance of pedometer-based interventions. This paper presents the design and baseline characteristics of a cluster-randomized controlled trial that seeks to examine the effect of financial incentives on the acceptance of and adherence to a pedometer-based physical activity intervention offered by a health insurance company. More than 18,000 customers of a large Swiss health insurance company were allocated to a financial incentive, a charitable incentive, or a control group and invited to participate in a health prevention program. Participants used a pedometer to track their daily physical activity over the course of 6 months. A Web-based questionnaire was administered at the beginning and at the end of the intervention and additional data was provided by the insurance company. The primary outcome of the study will be the participation rate, secondary outcomes will be adherence to the prevention program, physical activity, and health status of the participants among others. Baseline characteristics indicate that residence of participants, baseline physical activity, and subjective health should be used as covariates in the statistical analysis of the secondary outcomes of the study. This is the first study in western cultures testing the effectiveness of financial incentives with regard to a pedometer-based health intervention offered by a large health insurer to their customers. Given that the incentives prove to be effective, this study provides the basis for powerful health

  16. Tax incentives and enhanced oil recovery techniques

    International Nuclear Information System (INIS)

    Stathis, J.S.


    Tax expenditures-reductions in income tax liability resulting from a special tax provision-are often used to achieve economic and social objectives. The arguments for petroleum production tax incentives usually encompass some combination of enhancing energy security, rewarding risk, or generating additional investment in new technologies. Generally, however, some portion of any tax expenditure is spend on activities that would have occurred anyway. This paper is a review of tax incentives for petroleum production found two to be of questionable merit. Others, including tax preferences for enhanced oil recovery methods, which offered the potential for better returns on the tax dollar. Increased use of enhanced oil recovery techniques could lead to additional environmental costs, however, and these need to be factored into any cost-benefit calculation

  17. Cost effectiveness of haemophilia treatment : a cross-national assessment

    NARCIS (Netherlands)

    Lippert, B; Berger, K; Berntorp, E; Giangrande, P; van den Berg, M; Schramm, W; Siebert, U


    The aim of this study was to assess the incremental cost effectiveness of on-demand versus prophylactic haemophilia therapy in Germany, Sweden, the United Kingdom and The Netherlands from the third-party payers' perspective. Using a decision tree model, the cost effectiveness of on-demand versus

  18. Index method for analyzing cost effectiveness of drilling rigs

    Energy Technology Data Exchange (ETDEWEB)

    Batura, N P; Bocharov, V V


    The method for a complete analysis of the factors determining cost effectiveness of a drilling rig fleet is examined. The system of calculating production indexes from statistical reports is relatively simple and is not difficult to use for production organizations. The analytical results may be used to develop actual measures used to increase cost effectiveness of drilling operations.

  19. Cost-effectiveness of trachoma control in seven world regions.

    NARCIS (Netherlands)

    Baltussen, R.M.P.M.; Sylla, M.; Frick, K.D.; Mariotti, S.P.


    BACKGROUND/AIMS: The fight against blinding trachoma is being addressed with an integrated strategy of surgery, antibiotics, hygiene promotion, and environmental improvement-the SAFE strategy, but its cost-effectiveness is largely unknown. This paper estimates the cost effectiveness of surgery and

  20. The Cost-Effectiveness of NBPTS Teacher Certification (United States)

    Yeh, Stuart S.


    A cost-effectiveness analysis of the National Board for Professional Teaching Standards (NBPTS) program suggests that Board certification is less cost-effective than a range of alternative approaches for raising student achievement, including comprehensive school reform, class size reduction, a 10% increase in per pupil expenditure, the use of…