Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.SikkimValue of Life: The intrinsic moral worth ascribed to a living being. (Bioethics Thesaurus)Economics: The science of utilization, distribution, and consumption of services and materials.Aesculus: A plant genus of the family HIPPOCASTANACEAE (or SAPINDACEAE by some) that contains antimicrobial protein 1 and escin. A. hippocastanum is used in folk medicine for treating chronic venous insufficiency.Fees, Dental: Amounts charged to the patient as payer for dental services.Models, Economic: Statistical models of the production, distribution, and consumption of goods and services, as well as of financial considerations. For the application of statistics to the testing and quantifying of economic theories MODELS, ECONOMETRIC is available.Costs and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Cost Savings: Reductions in all or any portion of the costs of providing goods or services. Savings may be incurred by the provider or the consumer.Health Care Costs: The actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications. It is differentiated from HEALTH EXPENDITURES, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost.Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.United StatesTreatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Models, Econometric: The application of mathematical formulas and statistical techniques to the testing and quantifying of economic theories and the solution of economic problems.Direct Service Costs: Costs which are directly identifiable with a particular service.Choice Behavior: The act of making a selection among two or more alternatives, usually after a period of deliberation.Decision Trees: A graphic device used in decision analysis, series of decision options are represented as branches (hierarchical).Drug Costs: The amount that a health care institution or organization pays for its drugs. It is one component of the final price that is charged to the consumer (FEES, PHARMACEUTICAL or PRESCRIPTION FEES).Hospital Costs: The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).Absenteeism: Chronic absence from work or other duty.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Reward: An object or a situation that can serve to reinforce a response, to satisfy a motive, or to afford pleasure.Quality-Adjusted Life Years: A measurement index derived from a modification of standard life-table procedures and designed to take account of the quality as well as the duration of survival. This index can be used in assessing the outcome of health care procedures or services. (BIOETHICS Thesaurus, 1994)
Risk management: HSE principles for Cost Benefit Analysis in support of ALARPHSE principles for Cost Benefit Analysis (CBA) in support of ALARP. decisions.. Purpose. This guide has been drawn up to help ... for a given benefit, the higher these risks, the higher the degree of disproportion (i.e., the ratio costs to benefits) can be ... Sensitivity analysis. What is sensitivity analysis?. * A sensitivity analysis consists of varying one or more of the parameters ... of Cost Benefit Analysis (CBA). This guide is particularly concerned with the correct use of CBA. as part of 'as low as ...
Journal of Benefit-Cost Analysis, Cambridge University Press | IDEAS/RePEcA Benefit-Cost Analysis and Cost-Effectiveness Analysis. by Bowden, A. Brooks & Belfield, Clive *603-627 Benefits and Costs of ... 1-27 Indirect Effects in Cost-Benefit Analysis. by Rouwendal, Jan *1-30 Institutional Safeguards for Cost Benefit Analysis: ... 1-12 An Empirical Estimate of the Labor Response Function for Benefit-Cost Analysis. by Vitaliano, Donald F. *1-25 Benefit-Cost ... 263-300 A cost-benefit analysis of Tulsa's IDA program. by Greenberg, David H. *301-333 Congressional modification of benefit- ...
Benefit-Cost Analysis for Crime PolicyHow do we decide how to allocate criminal justice resources in a way that minimizes the social harms from both crime and policy efforts to control crime?
ITS International - Cost Benefit AnalysisCost benefit goes under the microscopeConventional cost benefit analysis (CBA) of plans for urban smart mobility initiatives ... Australia trials shortened cost benefit evaluationA shortened and tailored cost benefit assessment is helping show the worth of ... An Australian 'rapid cost-benefit assessment' method, introduced to help... *. New Zealand seeks comprehensive CBA frameworkNew ... New Zealand seeks comprehensive CBA framework New report highlights how assessing the financial benefit of deploying ITS is an ...
"Cost-Benefit and Cost-Effectiveness Analyses" by Peter E....Cost-Benefit and Cost-Effectiveness Analyses. Encyclopedia of Health Services Research * Peter E. Hilsenrath, University of the ... "Cost-Benefit and Cost-Effectiveness Analyses" Los Angeles, CAEncyclopedia of Health Services Research (2009) p. 245 - 248 ...
The Principles of Practical Cost-Benefit Analysis, Book by Robert Sugden (Paperback) | chapters.indigo.caBuy the Paperback Book The Principles of Practical Cost-Benefit Analysis by Robert Sugden at Indigo.ca, Canada's largest ... The Principles of Practical Cost-Benefit Analysis. byRobert Sugden, Alan Williams. Paperback , October 1, 1978. ... Title:The Principles of Practical Cost-Benefit AnalysisFormat:PaperbackDimensions:288 pages, 9.21 × 6.14 × 0.63 inPublished: ... Customer Reviews of The Principles of Practical Cost-Benefit Analysis. Write a Review. (not you?) ...
Cost-effectiveness Analysis, Cost-Benefit Analysis - AMA Manual of StyleSuch interventions may be prohibitively expensive, or they may benefit only a small number of people at the expense of a large ... Cost-effectiveness Analysis, Cost-Benefit Analysis Cost-effectiveness Analysis, Cost-Benefit Analysis ... Cost-effectiveness and cost-benefit analyses comprise a set of mathematical techniques to ... costs that would eventually negate any immediate savings or benefit. Thus, it is possible that interventions that appear less ...
Cost-benefit vs benefit-only analysis | decision theoryCost-benefit analysis versus benefit-only analysis. Posted on 28 January 2009. by John ... In short, Draper recommended a cost-benefit analysis rather than the typical (statistical) benefit-only analysis. Very ... I would think that in many cases, if you did a cost-benefit analysis of whether it's worthwhile to to work out a utility ... Equivalently, problems are set up to minimize expected cost. Cost may be a literal monetary cost, but it could be some other ...
"Cost-Benefit Analysis and the Structure of the Administrative State: T" by Richard L. ReveszIn large part, cost-benefit analysis of financial regulation cannot currently be performed successfully because of ... lack the capacity to do cost-benefit analyses of acceptable quality. Fortunately, there are good Executive Branch models that ... the Environmental Protection Agency in building significant economic expertise to aid the preparation of cost-benefit analyses ... analysis is feasible for environmental regulation but not for financial regulation because of the difference in the benefits ...
government economic policy | finance | Britannica.comThe failure of cost-benefit analysis to provide answers to the problems of valuing life, or the quality of life, is a ... Cost-benefit analysis. Once decisions have been made on how the limited national budget should be divided between different ... One difficulty with cost-benefit analysis is that every government agency has an incentive to estimate favourable ratios for ... Putting a sensible value on human life has been a continuing difficulty for those carrying out cost-benefit analyses, even ...
Advances in cost-effectiveness analysis of health interventionsDownloadable (with restrictions)! Recent work has clarified the welfare implications of the application of cost-effectiveness analysis to the allocation of health care. Although cost-effectiveness analysis shares many similarities with cost-benefit analysis, it did not develop as an outgrowth of neoclassical welfare economics. Consequently, even though the welfare implications of public decisionmaking based on cost-benefit analysis have long been understood, until recently the conditions under which decisions made on the basis of cost-effectiveness criteria lead to potential Pareto improvement had received little attention.This chapter describes the welfare economic foundations of cost-effectiveness analysis and how such foundations can be applied to resolve controversies in the application ...
The Precarious Legality of Cost-Benefit Analysis | Legal PlanetCost-benefit analysis has become a ubiquitous part of regulation, enforced by the Office of Management and Budget. A weak cost-benefit analysis means that the
Molinism or Cost Benefit Analysis ~ HQI know that Molinism (see here for definition and explanation of Molinism) is a very serious project and has garnered some very serious theologians and philosophers, but every time I try to get my head around it (especially W.L Craig's version) I cannot help thinking that molinism sounds like a transcendental Cost Benefit Analysis. Something like this ...
HKU Scholars Hub: Possible Impact of Incremental Cost-Effectiveness Ratio (ICER) on Decision Making for Cancer Screening in...Objectives: The aim of this paper was to critically review the literature on the cost effectiveness of cancer screening interventions, and examine the incremental cost-effectiveness ratios (ICERs) that may influence government recommendations on cancer screening strategies and funding for mass implementation in the Hong Kong healthcare system. Methods: We conducted a literature review of cost-effectiveness studies in the Hong Kong population related to cancer screening published up to 2015, through a hand search and database search of PubMed, Web of Science, Embase, and OVID Medline. Binary data on the government's decisions were obtained from the Cancer Expert Working Group, Department of Health. Mixed-effect logistic regression analysis was used to examine the impact of ICERs on decision making. Using Youden's index, an optimal ICER threshold value for positive decisions was examined by area under receiver operating characteristic curve ...
National Broadband Network (NBN) cost-benefit analysis released - ABC News (Australian Broadcasting Corporation)A cost-benefit analysis of the National Broadband Network (NBN) shows the Federal Government's plan would provide an $18 billion boost to the economy. An independent panel commissioned by the Government found the Coalition's multi-technology plan to roll out high-speed internet had greater net benefits than Labor's model of fibre to the premises. Communications Minister Malcolm Turnbull said the review modelled four scenarios and found the Government's model would deliver about $18 billion in net benefits compared to almost $2 billion under Labor. But the Opposition said the report was not the independent analysis that was promised and was not worth the paper it was written on.
"Rethinking Cost-Benefit Analysis" by Eric Posner and Matthew D. AdlerEric Posner & Matthew D. Adler, "Rethinking Cost-Benefit Analysis" (John M. Olin Program in Law and Economics Working Paper No. 72, 1999).. ...
Cost-benefit analysis - Kingston University Research RepositoryNormand, Charles and Bowling, Ann (1998) Cost-benefit analysis. In: Swash, Michael, (ed.) Outcomes in neurological and neurosurgical disorders. Cambridge, U.K. : Cambridge University Press. pp. 35-46. ISBN 052144327x ...
One year cost effectiveness of sirolimus eluting stents compared with bare metal stents in the treatment of single native de...Effectiveness was assessed by using the composite of 12 month MACE, which were all-cause death, non-fatal myocardial infarction, and target lesion revascularisation (either surgical or percutaneous). With respect to costs, the analysis was limited to the direct medical costs. The balance between costs and effects after 12 months was assessed by computing the incremental cost effectiveness ratio (the average one year costs per patient treated with drug eluting stents minus the average one year costs with bare stent implantation divided by the percentage change in MACE-free survivors after one year).. For cost effectiveness, two scenarios were investigated. The first scenario reflects the actual protocol driven resource use and effectiveness observed in the RAVEL study (which included a six month angiogram). For the estimation of the costs and effects of this ...
Liquid-based cytology in cervical screening: an updated rapid and systematic review and economic analysis - White Rose...Objectives: To update an earlier published report reviewing the effectiveness and cost-effectiveness of liquid-based cytology (LBC). Data sources: Electronic bibliographic databases, relevant articles, sponsor submissions and various health services research-related resources. Review methods: The selected data were reviewed and assessed with respect to the quality of the evidence. Pooled estimates of the parameters of interest were derived from the original and the updated studies. Meta-analyses were undertaken where appropriate. The mathematical model developed for the original rapid review of LBC was adapted to synthesise the updated data to estimate costs, survival and quality-adjusted survival of patients tested using LBC and using Papanicolaou (Pap) smear testing. Cost data from published sources were incorporated into the above model to allow economic, as well as clinical, implications of treatment to be assessed. The primary incremental ...
O2-S4.02 Cost-effectiveness of screening for Chlamydia trachomatis in Dutch pregnant women | Sexually Transmitted InfectionsResults In the base-case analysis (current base-case test cost €12), the costs to detect 1000 pregnant women with C trachomatis were estimated at €378 300. Cost savings on complications were estimated at €924 600 resulting in net cost savings. Sensitivity analysis showed that net cost savings remained for a broad range of variation in underlying assumptions such as test costs (up to €32), proportion of complications that can be averted (between 25% and 75%), risk for PID (0.4% to 40%), and any other parameter within plausible ranges (between + to −25%). Cost savings were most sensitive to preterm delivery, but remained when preterm delivery was excluded (making the model comparable to other cost-effectiveness analyses). Scenario analysis showed even more cost savings with targeted screening for women's age ...
DI-fusion Incremental cost-effectiveness evaluation of vaccinating...DI-fusion, le Dépôt institutionnel numérique de l'ULB, est l'outil de référencementde la production scientifique de l'ULB.L'interface de recherche DI-fusion permet de consulter les publications des chercheurs de l'ULB et les thèses qui y ont été défendues.
Anomalies in Net Present Value, Returns and | Michael C. I. Nwogugu | Palgrave MacmillanThis book explores why Modified Internal Rate of Return (MIRR) and Net Present Value (NPV) are not necessarily accurate or efficient tools for valuation
Illustrating Potential Efficiency Gains from Using Cost-Effectiveness Evidence to Reallocate Medicare Expenses - The...In the U.S., cost-effectiveness research has been associated with rationing of health care. But the authors assert that "rather than using [cost-effectiveness analysis] to reduce spending, it can identify how to increase aggregate population health while maintaining existing spending levels." Including cost-effectiveness in coverage determinations could add substantial gains to beneficiaries' health and increase the nation's return on health care spending.. ...
Astro Teller: Cost-Benefit Analyses at X | Stanford eCornerAstro Teller explains how the audaciousness of an idea for generating electricity once shared in Alphabet's moonshot factory outweighs its impracticality in his mind. He discusses how committing resources to a bad idea costs his organization more than turning down a good idea before looking into it. "Humanity is in no danger of running out of huge problems to work on," Teller says.. ...
Noahpinion: The Iraq War: a cost-benefit analysisThe "deal of ruin"-incremental decay-is seductive. In some ways, the most pleasant place to live is a colossus in gradual decline. Great powers aren't Sudan or the Congo, where you're sliding from the Dump category to the Even Crummier Dump category. Genteel decline from the heights can be eminently civilized, especially to those of a leftish bent. Francophile Americans passing through bucolic Provençal villages with their charmingly state-regulated charcuteries and gnarled old peasants wholly subsidized by the European Union's Common Agricultural Policy can be forgiven for wondering if global hegemony is all it's cracked up to be. Okay, the empire busted up, but the capital still has magnificent architecture, handsome palaces, treasure houses of great art, a world-class orchestra, fabulous restaurants, stylish women.... You still have the opera house, but it's easier to get a parking space. Who wouldn't enjoy such "decline"? To be sure, everything new-or, anyway, everything new that works-is ...
Geographic Resource Allocation Based on Cost Effectiveness: An Application to Malaria Policy | SpringerLinkStarting with the costs and effect estimates for all intervention options in all geo-units, all dominated interventions (those that are more costly and less effective than an alternative intervention within the same geo-unit) are excluded. Incremental cost-effectiveness ratios (ICERs) are calculated for all interventions using the null or 'no additional intervention' scenario as the comparator. Priority setting is then broken down into a series of decisions. The first decision selects the intervention option with the lowest ICER from all non-excluded options in all geo-units. This selection is the choice that produces the maximum expected health gains for the investment (though it may be replaced by a subsequent selection in the same geo-unit). The cost of the intervention is subtracted from the budget, and the ICERs for the remaining interventions in the same geo-unit are recalculated using the selected intervention as the comparator (see ...
Cost-effectiveness of cardiovascular magnetic resonance in the diagnosis of coronary heart disease: an economic evaluation...Results Based on the characteristics of patients in the CE-MARC study, only two strategies appear potentially cost-effective for diagnosis of CHD, both including CMR. The choice is between two strategies: one in which CMR follows a positive or inconclusive ETT, followed by CA if CMR is positive or inconclusive (Strategy 3 in the model); and the other where CMR is followed by CA if CMR is positive or inconclusive (Strategy 5 in the model). The more cost-effective of these two rests on the threshold cost per QALY gained below which health systems define an intervention as cost-effective. Strategy 3 appears cost-effective at the lower end of the threshold range used in the UK (£20 000 per QALY gained), while Strategy 5 appears cost-effective at the higher end of the threshold range (£30 000 per QALY). The results are robust to various sources of uncertainty although prior likelihood of CHD requiring ...
Global health - The Full WikiGlobal health is a research field at the intersection of medical and social science disciplines--including demography, economics, epidemiology, political economy and sociology. From different disciplinary perspectives, it focuses on determinants and distribution of health in international contexts.. An epidemiological perspective identifies major global health problems. A medical perspective describes the pathology of major diseases, and promotes prevention, diagnosis, and treatment of these diseases.. An economic perspective, emphasizes the cost-effectiveness and cost-benefit approaches for both individual and population health allocation. Aggregate analysis, eg from the perspective of governments and N.G.O.s, focuses on analysis for the health sector. Cost-effectiveness analysis compares the costs and health effects of an intervention to assess whether health investments ...
Why the EPA Can't Manage To Block This Gnarly Herbicide - Mother JonesIn the U.S., lingering scientific questions justify delays in regulatory decisions. Since the mid-seventies, the E.P.A. has issued regulations restricting the use of only five industrial chemicals out of more than eighty thousand in the environment. Industries have a greater role in the American regulatory process-they may sue regulators if there are errors in the scientific record-and cost-benefit analyses are integral to decisions: a monetary value is assigned to disease, impairments, and shortened lives and weighed against the benefits of keeping a chemical in use. Lisa Heinzerling, the senior climate-policy counsel at the E.P.A. in 2009 and the associate administrator of the office of policy in 2009 and 2010, said that cost-benefit models appear "objective and neutral, a way to free ourselves from the chaos of politics." But the complex algorithms "quietly condone a tremendous amount of risk." She added that the ...
PSSRU | WelcomeThis is the website for the Personal Social Services Research Unit at the University of Kent at Canterbury and the London School of Economics and Political Science. Since 1974 PSSRU has undertaken high-quality, independent research in social and health care, which has had an important influence on theory, and policy development and reform in England and elsewhere. Our work is underpinned by the production of welfare framework and focuses on needs, resources and outcomes. We continue to work in the fields of adult and children's social and health care, including mental health, long-term care funding, cost and outcome measurement, and cost-effectiveness evaluation. We are funded from a variety of sources and collaborate closely with a number of research units and academic departments elsewhere. ...
29 Health-care policy makers probably are to benefit the most fro | HSP signaling29 Health-care policy makers probably are to benefit the most from the pragmatism concept.. The availability of comparative data from routine practice with cost-effectiveness data will help policy makers to efficiently allocate resources and manpower. Nevertheless, there is no indication that decision makers will have the same priorities or interpretation of the same results.30 Inhibitors,research,lifescience,medical Even so, policy makers might have different points of view and hierarchy systems than clinicians and/or patients. A "one-size-fits-all" approach might not serve anyone at the end of the day.30 Moreover, in the light of patientcentered medicine, the knowledge that a treatment is effective Inhibitors,research,lifescience,medical in a routine setting does not give specific quantifiable answers under individual cases, eg, what is the effect of the treatment in a 70-year old woman with dementia and type 2 diabetes? Finally, in very few areas can 100% pragmatic trials ...
Health Economics for Non-Health-Economists | 2-Day Training CourseUnderstand Health Economic Evaluations - Distinguish Good Form Bad Ones - How to Use & Integrate HECON Studies - and More! - by Prof Lieven Annemans
Apache Maven Invoker - Project InformationThis document provides an overview of the various documents and links that are part of this project's general information. All of this content is automatically generated by Maven on behalf of the project.. ...
Incremental cost-effectiveness ratio: The incremental cost-effectiveness ratio (ICER) is a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention. It is defined by the difference in cost between two possible interventions, divided by the difference in their effect.SikkimMcCloskey critique: The McCloskey critique refers to a critique of post-1940s "official modernist" methodology in economics, inherited from logical positivism in philosophy. The critique maintains that the methodology neglects how economics can be done, is done, and should be done to advance the subject.Aesculus chinensis: Aesculus chinensis, the Chinese horse chestnut (Chinese:七叶树 qi ye shu), is a tree species in the genus Aesculus found in eastern Asia.Penalized present value: The Penalized Present Value (PPV) is a method of Capital Budgeting under risk developed by Fernando Gómez-Bezares in the 1980s.Pavement life-cycle cost analysis: In September 1998, the United States Department of Transportation (DoT) introduced risk analysis, a probabilistic approach to account for the uncertainty of the inputs of the cost/benefit evaluation of pavement projects, into its decision-making policies. The traditional (deterministic) approach did not consider the variability of inputs.Precautionary savings: Precautionary saving is saving (non-expenditure of a portion of income) that occurs in response to uncertainty regarding future income. The precautionary motive to delay consumption and save in the current period rises due to the lack of completeness of insurance markets.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.Cancer screeningList of Parliamentary constituencies in Kent: The ceremonial county of Kent,Basic Occupational Health Services: The Basic Occupational Health Services are an application of the primary health care principles in the sector of occupational health. Primary health care definition can be found in the World Health Organization Alma Ata declaration from the year 1978 as the “essential health care based on practical scientifically sound and socially accepted methods, (…) it is the first level of contact of individuals, the family and community with the national health system bringing health care as close as possible to where people live and work (…)”.Recursive partitioning: Recursive partitioning is a statistical method for multivariable analysis. Recursive partitioning creates a decision tree that strives to correctly classify members of the population by splitting it into sub-populations based on several dichotomous independent variables. The process is termed recursive because each sub-population may in turn be split an indefinite number of times until the splitting process terminates after a particular stopping criterion is reached.Aging (scheduling): In Operating systems, Aging is a scheduling technique used to avoid starvation. Fixed priority scheduling is a scheduling discipline, in which tasks queued for utilizing a system resource are assigned a priority each.Reward system: The reward system is a group of neural structures that are critically involved in mediating the effects of reinforcement. A reward is an appetitive stimulus given to a human or some other animal to alter its behavior.Disease burden: Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs), both of which quantify the number of years lost due to disease (YLDs).
(1/8073) Evaluating cost-effectiveness of diagnostic equipment: the brain scanner case.
An approach to evaluating the cost-effectiveness of high-technology diagnostic equipment has been devised, using the introduction of computerised axial tomography (CAT) as a model. With the advent of CAT scanning, angiography and air encephalography have a reduced, though important, role in investigating intracranial disease, and the efficient use of conventional equipment requires the centralisation of neuroradiological services, which would result in major cash savings. In contrast, the pattern of demand for CAT scanning, in addition to the acknowledged clinical efficiency of the scanner and its unique role in the head-injured patient, ephasies the need for improved access to scanners. In the interest of the patients the pattern of service must change. (+info)
(2/8073) The use of targets to improve the performance of health care providers: a discussion of government policy.
The aim of this discussion paper is to examine the advantages and drawbacks of employing targets, or performance indicators, to improve the performance of those delivering health care services. The paper is based on an examination of two target-setting policies initiated by Government: the 1992 Health of the Nation strategy and the 1990 General Practitioners' Contract. It is argued that the introduction of both the General Practitioners' Contract and the Health of the Nation have indeed been accompanied by improvements in performance, however, there are a number of problems with targets. They tend to focus on those things that are most easily measured, and they may foster complacency on the part of providers who have already achieved upper target limits, and defensiveness on the part of those performing badly. National targets may skew local priorities; they may also be unrealistic and unattainable for particular, less privileged population groups. They may serve to widen inequalities in health, and can exacerbate the 'inverse care law' by encouraging providers to direct their efforts at the more advantaged sections of society, where such efforts are more likely to pay off in terms of overall improvements in the target level achieved. Finally, the achievement of some targets will not necessarily result in better health outcomes. The paper concludes that a target-setting approach to improving the quality of care must be based on the use of appropriate indicators, and must take account of differences between more and less advantaged sections of society. (+info)
(3/8073) Economic consequences of the progression of rheumatoid arthritis in Sweden.
OBJECTIVE: To develop a simulation model for analysis of the cost-effectiveness of treatments that affect the progression of rheumatoid arthritis (RA). METHODS: The Markov model was developed on the basis of a Swedish cohort of 116 patients with early RA who were followed up for 5 years. The majority of patients had American College of Rheumatology (ACR) functional class II disease, and Markov states indicating disease severity were defined based on Health Assessment Questionnaire (HAQ) scores. Costs were calculated from data on resource utilization and patients' work capacity. Utilities (preference weights for health states) were assessed using the EQ-5D (EuroQol) questionnaire. Hypothetical treatment interventions were simulated to illustrate the model. RESULTS: The cohort distribution among the 6 Markov states clearly showed the progression of the disease over 5 years of followup. Costs increased with increasing severity of the Markov states, and total costs over 5 years were higher for patients who were in more severe Markov states at diagnosis. Utilities correlated well with the Markov states, and the EQ-5D was able to discriminate between patients with different HAQ scores within ACR functional class II. CONCLUSION: The Markov model was able to assess disease progression and costs in RA. The model can therefore be a useful tool in calculating the cost-effectiveness of different interventions aimed at changing the progression of the disease. (+info)
(4/8073) Use of out-of-plan services by Medicare members of HIP.
Use of out-of-plan services in 1972 by Medicare members of the Health Insurance Plan of Greater New York (HIP) is examined in terms of the demographic and enrollment characteristics of out-of-plan users, types of services received outside the plan, and the relationship of out-of-plan to in-plan use. Users of services outside the plan tended to be more seriously ill and more frequently hospitalized than those receiving all of their services within the plan. The costs to the SSA of providing medical care to HIP enrollees are compared with analogous costs for non-HIP beneficiaries, and the implications for the organization and financing of health services for the aged are discussed. (+info)
(5/8073) Should prophylaxis for Pneumocystis carinii pneumonia in solid organ transplant recipients ever be discontinued?
Solid organ transplant recipients are at risk for Pneumocystis carinii pneumonia (PCP), but the risk of PCP beyond 1 year is poorly defined. We identified 25 cases of PCP in 1,299 patients undergoing solid organ transplantation between 1987 and 1996 at The Cleveland Clinic Foundation (4.8 cases per 1,000 person transplant-years [PTY]). Ten (36%) of 28 PCP cases (transplantation was performed before 1987 in three cases) occurred > or = 1 year after transplantation, and no patient developed PCP while receiving prophylaxis for PCP. The incidence of PCP during the first year following transplantation was eight times higher than that during subsequent years. The highest rate occurred among lung transplant recipients (22 cases per 1,000 PTY), for whom the incidence did not decline beyond the first year of transplantation. We conclude that the incidence of PCP is highest during the first year after transplantation and differs by type of solid organ transplant. Extending the duration of PCP prophylaxis beyond 1 year may be warranted for lung transplant recipients. (+info)
(6/8073) The cost effectiveness of strategies for the treatment of intestinal parasites in immigrants.
BACKGROUND: Currently, more than 600,000 immigrants enter the United States each year from countries where intestinal parasites are endemic. At entry persons with parasitic infections may be asymptomatic, and stool examinations are not a sensitive method of screening for parasitosis. Albendazole is a new, broad-spectrum antiparasitic drug, which was approved recently by the Food and Drug Administration. International trials have shown albendazole to be safe and effective in eradicating many parasites. In the United States there is now disagreement about whether to screen all immigrants for parasites, treat all immigrants presumptively, or do nothing unless they have symptoms. METHODS: We compared the costs and benefits of no preventive intervention (watchful waiting) with those of universal screening or presumptive treatment with 400 mg of albendazole per day for five days. Those at risk were defined as immigrants to the United States from Asia, the Middle East, sub-Saharan Africa, Eastern Europe, and Latin America and the Caribbean. Cost effectiveness was expressed both in terms of the cost of treatment per disability-adjusted life-year (DALY) averted (one DALY is defined as the loss of one year of healthy life to disease) and in terms of the cost per hospitalization averted. RESULTS: As compared with watchful waiting, presumptive treatment of all immigrants at risk for parasitosis would avert at least 870 DALYs, prevent at least 33 deaths and 374 hospitalizations, and save at least $4.2 million per year. As compared with watchful waiting, screening would cost $159,236 per DALY averted. CONCLUSIONS: Presumptive administration of albendazole to all immigrants at risk for parasitosis would save lives and money. Universal screening, with treatment of persons with positive stool examinations, would save lives but is less cost effective than presumptive treatment. (+info)
(7/8073) The use of atypical antipsychotics in the management of schizophrenia.
Long-term drug treatment of schizophrenia with conventional antipsychotics has limitations: an estimated quarter to one third of patients are treatment-resistant; conventional antipsychotics have only a modest impact upon negative symptoms (poverty of thought, social withdrawal and loss of affect); and adverse effects, particularly extrapyramidal symptoms (EPS). Newer, so-called atypical, antipsychotics such as olanzapine, risperidone, sertindole and clozapine (an old drug which was re-introduced in 1990) are claimed to address these limitations. Atypical agents are, at a minimum, at least as effective as conventional drugs such as haloperidol. They also cause substantially fewer extrapyramidal symptoms. However, some other adverse effects are more common than with conventional drugs. For example, clozapine carries a significant risk of serious blood disorders, for which special monitoring is mandatory; it also causes troublesome drowsiness and increased salivation more often than conventional agents. Some atypical agents cause more weight gain or QT prolongation than older agents. The choice of therapy is, therefore, not straightforward. At present, atypical agents represent an advance for patients with severe or intolerable EPS. Most published evidence exists to support the use of clozapine, which has also been shown to be effective in schizophrenia refractory to conventional agents. However, the need for compliance with blood count monitoring and its sedative properties make careful patient selection important. The extent of any additional direct benefit offered by atypical agents on negative symptoms is not yet clear. The lack of a depot formulation for atypical drugs may pose a significant practical problem. To date, only two double-blind studies in which atypical agents were compared directly have been published. Neither provides compelling evidence for the choice of one agent over another. Atypical agents are many times more expensive than conventional drugs. Although drug treatment constitutes only a small proportion of the costs of managing schizophrenia, the additional annual cost of the use of atypical agents in, say, a quarter of the likely U.K. schizophrenic population would be about 56 M pound sterling. There is only limited evidence of cost-effectiveness. Atypical antipsychotics are not currently licensed for other conditions where conventional antipsychotics are commonly used, such as behaviour disturbance or dementia in the elderly. Their dose, and place in treatment in such cases have yet to be determined. (+info)
(8/8073) The reach and effectiveness of a national mass media-led smoking cessation campaign in The Netherlands.
OBJECTIVES: This study examined the reach, effectiveness, and cost-effectiveness of a mass media-led smoking cessation campaign including television shows, a television clinic, a quit line, local group programs, and a comprehensive publicity campaign. METHODS: A random sample of baseline smokers (n = 1338) was interviewed before and after the campaign and at a 10-month follow-up. A nonpretested control group (n = 508) of baseline smokers was incorporated to control for test effects. RESULTS: Most smokers were aware of the campaign, although active participation rates were low. Dose-response relations between exposure and quitting were found. The follow-up point prevalence abstinence rate attributable to the campaign was estimated to be 4.5% after control for test effects and secular trends. The cost per long-term quitter was about $12. CONCLUSIONS: In spite of a massive rise in tobacco promotion expenditures prior to the campaign and the absence of governmental control over the media, the campaign under study may have increased normal cessation rates substantially. (+info)
- Such interventions may be prohibitively expensive, or they may benefit only a small number of people at the expense of a large number of people, or they may lead to significant "downstream" costs that would eventually negate any immediate savings or benefit. (amamanualofstyle.com)
- Thus, it is possible that interventions that appear less effective may actually lead to the greatest societal benefits over the long term. (amamanualofstyle.com)
- Emphasis on theoretical framework for identification and assessment of costs and benefits from society's perspective. (umflint.edu)
- Australia trials shortened cost benefit evaluation A shortened and tailored cost benefit assessment is helping show the worth of C-ITS in Australia. (itsinternational.com)
- An Australian 'rapid cost-benefit assessment' method, introduced to help. (itsinternational.com)
- aids the decision making process by giving monetary values to the costs and benefits and to enable a comparison of like quantities. (hse.gov.uk)
- Likewise, all relevant health and safety and non-health and safety benefits arising from the intervention must be identified and expressed in monetary terms. (hse.gov.uk)
- Cost may be a literal monetary cost, but it could be some other measure of something you want to avoid. (johndcook.com)
- New Zealand seeks comprehensive CBA framework New report highlights how assessing the financial benefit of deploying ITS is an involved and evolving calculation Following a global search, five key action areas have emerged from the New Zealand Transport Agency's recent scoping of a more comprehensive costbenefit analysis framework for evaluating planned ITS deployments. (itsinternational.com)
- New Zealand seeks comprehensive CBA framework New report highlights how assessing the financial benefit of deploying ITS is an involved and evolving calculation Following a global search, five key action areas have. (itsinternational.com)
- It is a defined methodology for valuing costs and benefits that enables broad comparisons to be made between health and safety risk reduction measures on a consistent basis, giving a measure of transparency to the decision making process. (hse.gov.uk)
- GTT Opticom Analytics aids intersection analysis Opticom Analytics enables users of Global Traffic Technologies' (GTT's) GPS-enabled emergency vehicle pre-emption hardware to assess intersection performance, reveal. (itsinternational.com)
- The distinguishing features of cost-benifit analysis are then introduced progressively. (indigo.ca)
- Food aid reform could allow lifesaving assistance to reach up to 4 million more people each year without costing taxpayers a penny more. (care.org)
- The viability and desirability of conducting cost-benefit analysis of financial regulation is a subject of intense academic debate. (nellco.org)
- Opponents claim that such analysis is feasible for environmental regulation but not for financial regulation because of the difference in the benefits that require monetization in the respective areas. (nellco.org)
- In large part, cost-benefit analysis of financial regulation cannot currently be performed successfully because of institutional shortcomings, not analytical difficulties. (nellco.org)
- Compared to Executive Branch agencies, independent agencies, like the major financial regulatory agencies, lack the capacity to do cost-benefit analyses of acceptable quality. (nellco.org)
- And, the financial regulatory agencies could learn from the experience of the Environmental Protection Agency in building significant economic expertise to aid the preparation of cost-benefit analyses. (nellco.org)
- The concept of gross disproportion requires duty-holders to weigh the costs of a proposed control measure against its risk reduction benefits. (hse.gov.uk)
- Specifically, it states that a proposed control measure must be implemented if the 'sacrifice' (or costs) are not grossly disproportionate to the benefits achieved by the measure. (hse.gov.uk)
- They use a measure which substantially discounts those costs, and there is not a sense in which they're wrong in terms of economic logic. (force4good.me)
- The analysis can help make an informed choice between risk reduction options. (hse.gov.uk)
- should better enable the public servant to make cost effective decisions. (indigo.ca)
- In the comments section of a previous post , Ron H and Steven make good points on Cost-Benefit Analysis (CBA). (force4good.me)
- This guide has been drawn up to help explain the uses and limitations of Cost Benefit Analysis (CBA). (hse.gov.uk)
- I know that Molinism (see here for definition and explanation of Molinism) is a very serious project and has garnered some very serious theologians and philosophers, but every time I try to get my head around it (especially W.L Craig's version) I cannot help thinking that molinism sounds like a transcendental Cost Benefit Analysis. (hollowayquarterly.com)
- This 2 page brief highlights how the GRAD program was able to use Climate Vulnerablity and Capacity Analysis (CVCA) to help communities. (care.org)
- Dollar costs are often easy to account for, but it can be much harder to assign values to benefits. (johndcook.com)
- In a CBA, all costs and benefits are expressed in a common currency, usually money, so that a comparison can be made between different options. (hse.gov.uk)
- Convert all costs and benefits into a common currency: Glorons, Hedons, Morons. (hollowayquarterly.com)
- 1-11 [Ir]rationality, Happiness, and Benefit-Cost Analysis: Introduction to the Special Issue by Robinson, Lisa A. (repec.org)
- An introduction to the practice of cost-benefit analysis including practical examples to aid the exposition. (indigo.ca)
- This is an introduction, accessible to non-economists as well as to economists, to the practice of cost-benefit analysis. (indigo.ca)
- Social welfare benefits became important, and many countries introduced graduated tax systems. (britannica.com)
- The Courts (notably in Edwards v. National Coal Board (1949: 1 All ER 743) have decided that, in judging whether duty-holders have done enough to reduce risks, practicable measures to reduce risk can be ruled out as not 'reasonable' only if the sacrifice (in money, time, trouble or otherwise termed costs) involved in taking them would be grossly disproportionate to the risk. (hse.gov.uk)
- Predict outcome of cost and benefits over relevant time period: duration of creation post fall, pre-Armagedon, eternal state. (hollowayquarterly.com)
- CARE is helping rural communities in Ecuador's highlands adapt to the harshness of their changing climate with low-cost, sustainable techniques that have allowed them to once again nourish their families year-round. (care.org)
- Perform sensitivity analysis: Does not thwart divine moral nature or human free will and leaves man to be roughly how God designed him. (hollowayquarterly.com)
- For example, you have to ask "Benefit for whom? (johndcook.com)
- Comprehensive, theoretical overview of cost-benefit analysis. (umflint.edu)
- Non-health and safety benefits are savings and should be included in the CBA as an offset to the duty-holder's costs. (hse.gov.uk)
- In undertaking a CBA, all relevant costs which accrue from the inputs into a health and/or safety intervention must be identified and costed. (hse.gov.uk)
- For many ALARP decisions, the HSE does not expect duty holders to undertake a detailed CBA, and a simple comparison of costs and benefits may suffice. (hse.gov.uk)
- But instead of just selecting the most important variables in a purely statistical sense, he factored in the cost of collecting each variable. (johndcook.com)
- I would think that in many cases, if you did a cost-benefit analysis of whether it's worthwhile to to work out a utility function, you'd probably decide not to. (johndcook.com)
- on the other hand, if a lighthouse is provided for one shipowner, it can be made available to all for no additional cost. (britannica.com)
- Cost benefit goes under the microscope Conventional cost benefit analysis (CBA) of plans for urban smart mobility initiatives needs serious rethinking, according to a recently-completed European study. (itsinternational.com)