Economic evaluation of environmental epidemiological projects in national industrial complexes.

PubMed

Shin, Youngchul

2017-01-01

In this economic evaluation of environmental epidemiological monitoring projects, we analyzed the economic feasibility of these projects by determining the social cost and benefit of these projects and conducting a cost/benefit analysis. Here, the social cost was evaluated by converting annual budgets for these research and survey projects into present values. Meanwhile, the societal benefit of these projects was evaluated by using the contingent valuation method to estimate the willingness-to-pay of residents living in or near industrial complexes. In addition, the extent to which these projects reduced negative health effects (i.e., excess disease and premature death) was evaluated through expert surveys, and the analysis was conducted to reflect the unit of economic value, based on the cost of illness and benefit transfer method. The results were then used to calculate the benefit of these projects in terms of the decrease in negative health effects. For residents living near industrial complexes, the benefit/cost ratio was 1.44 in the analysis based on resident surveys and 5.17 in the analysis based on expert surveys. Thus, whichever method was used for the economic analysis, the economic feasibility of these projects was confirmed.

Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond's Checklist: A Narrative Review.

PubMed

Rezapour, Aziz; Jafari, Abdosaleh; Mirmasoudi, Kosha; Talebianpour, Hamid

2017-09-01

Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond's checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English) in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles' structure was analyzed by Drummond's standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond's criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies.

Quality Assessment of Published Articles in Iranian Journals Related to Economic Evaluation in Health Care Programs Based on Drummond’s Checklist: A Narrative Review

PubMed Central

Rezapour, Aziz; Jafari, Abdosaleh; Mirmasoudi, Kosha; Talebianpour, Hamid

2017-01-01

Health economic evaluation research plays an important role in selecting cost-effective interventions. The purpose of this study was to assess the quality of published articles in Iranian journals related to economic evaluation in health care programs based on Drummond’s checklist in terms of numbers, features, and quality. In the present review study, published articles (Persian and English) in Iranian journals related to economic evaluation in health care programs were searched using electronic databases. In addition, the methodological quality of articles’ structure was analyzed by Drummond’s standard checklist. Based on the inclusion criteria, the search of databases resulted in 27 articles that fully covered economic evaluation in health care programs. A review of articles in accordance with Drummond’s criteria showed that the majority of studies had flaws. The most common methodological weakness in the articles was in terms of cost calculation and valuation. Considering such methodological faults in these studies, it is anticipated that these studies would not provide an appropriate feedback to policy makers to allocate health care resources correctly and select suitable cost-effective interventions. Therefore, researchers are required to comply with the standard guidelines in order to better execute and report on economic evaluation studies. PMID:29234174

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

Using the Delphi technique in economic evaluation: time to revisit the oracle?

PubMed

Simoens, S

2006-12-01

Although the Delphi technique has been commonly used as a data source in medical and health services research, its application in economic evaluation of medicines has been more limited. The aim of this study was to describe the methodology of the Delphi technique, to present a case for using the technique in economic evaluation, and to provide recommendations to improve such use. The literature was accessed through MEDLINE focusing on studies discussing the methodology of the Delphi technique and economic evaluations of medicines using the Delphi technique. The Delphi technique can be used to provide estimates of health care resources required and to modify such estimates when making inter-country comparisons. The Delphi technique can also contribute to mapping the treatment process under investigation, to identifying the appropriate comparator to be used, and to ensuring that the economic evaluation estimates cost-effectiveness rather than cost-efficacy. Ideally, economic evaluations of medicines should be based on real-patient data. In the absence of such data, evaluations need to incorporate the best evidence available by employing approaches such as the Delphi technique. Evaluations based on this approach should state the limitations, and explore the impact of the associated uncertainty in the results.

Health economic assessment: a methodological primer.

PubMed

Simoens, Steven

2009-12-01

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments.

Health Economic Assessment: A Methodological Primer

PubMed Central

Simoens, Steven

2009-01-01

This review article aims to provide an introduction to the methodology of health economic assessment of a health technology. Attention is paid to defining the fundamental concepts and terms that are relevant to health economic assessments. The article describes the methodology underlying a cost study (identification, measurement and valuation of resource use, calculation of costs), an economic evaluation (type of economic evaluation, the cost-effectiveness plane, trial- and model-based economic evaluation, discounting, sensitivity analysis, incremental analysis), and a budget impact analysis. Key references are provided for those readers who wish a more advanced understanding of health economic assessments. PMID:20049237

Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs

PubMed Central

van Dieten, H. E M; Bos, I.; van Tulder, M. W; Lems, W.; Dijkmans, B.; Boers, M.

2000-01-01

A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence.
  Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

 PMID:11005773

Systematic review of the cost effectiveness of prophylactic treatments in the prevention of gastropathy in patients with rheumatoid arthritis or osteoarthritis taking non-steroidal anti-inflammatory drugs.

PubMed

van Dieten, H E; Korthals-de Bos, I B; van Tulder, M W; Lems, W F; Dijkmans, B A; Boers, M

2000-10-01

A systematic review on the cost effectiveness of prophylactic treatments of non-steroidal anti-inflammatory drug (NSAID) induced gastropathy in patients with osteoarthritis or rheumatoid arthritis was conducted. Two reviewers conducted the literature search and the review. Both full and partial economic evaluations published in English, Dutch, or German were included. The criteria list published in the textbook of Drummond was used to determine the quality of the economic evaluations. The methodological quality of three randomised controlled trials (RCTs) in which the economic evaluations obtained probability estimates of NSAID induced gastropathy and adverse events was assessed by a list of internal validity criteria. The conclusions were based on a rating system consisting of four levels of evidence. Ten economic evaluations were included; three were based on RCTs. All evaluations studied misoprostol as prophylactic treatment: in one evaluation misoprostol was studied as a fixed component in a combination with diclofenac (Arthrotec). All economic evaluations comprised analytical studies containing a decision tree. The three trials were of high methodological quality. Nine economic evaluations were considered high quality and one economic evaluation was considered of low methodological quality. There is strong evidence (level "A") that the use of misoprostol for the prevention of NSAID induced gastropathy is cost effective, and limited evidence (level "C") that the use of Arthrotec is cost effective. Although the levels of evidence used in this review are arbitrary, it is believed that a qualitative analysis is useful: quantitative analyses in this field are hampered by the heterogeneity of economic evaluations. Existing criteria to evaluate the methodological quality of economic evaluations may need refinement for use in systematic reviews.

Economic Evaluation of Text-Messaging and Smartphone-Based Interventions to Improve Medication Adherence in Adolescents with Chronic Health Conditions: A Systematic Review.

PubMed

Badawy, Sherif M; Kuhns, Lisa M

2016-10-25

The rate of chronic health conditions (CHCs) in children and adolescents has doubled in the past 20 years, with increased health care costs. Technology-based interventions have demonstrated efficacy to improving medication adherence. However, data to support the cost effectiveness of these interventions are lacking. The objective of this study is to conduct an economic evaluation of text-messaging and smartphone-based interventions that focus on improving medication adherence in adolescents with CHCs. Searches included PubMed MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, and Inspec. Eligibility criteria included age (12-24 years old), original articles, outcomes for medication adherence, and economic outcomes. Our search identified 1118 unique articles that were independently screened. A total of 156 articles met inclusion criteria and were then examined independently with full-text review. A total of 15 articles met most criteria but lacked economic outcomes such as cost effectiveness or cost-utility data. No articles met all predefined criteria to be included for final review. Only 4 articles (text messaging [n=3], electronic directly observed therapy [n=1]) described interventions with possible future cost-saving but no formal economic evaluation. The evidence to support the cost effectiveness of text-messaging and smartphone-based interventions in improving medication adherence in adolescents with CHCs is insufficient. This lack of research highlights the need for comprehensive economic evaluation of such interventions to better understand their role in cost-savings while improving medication adherence and health outcomes. Economic evaluation of technology-based interventions can contribute to more evidence-based assessment of the scalability, sustainability, and benefits of broader investment of such technology tools in adolescents with CHCs.

United States transportation fuel economics (1975 - 1995)

NASA Technical Reports Server (NTRS)

Alexander, A. D., III

1975-01-01

The United States transportation fuel economics in terms of fuel resources options, processing alternatives, and attendant economics for the period 1975 to 1995 are evaluated. The U.S. energy resource base is reviewed, portable fuel-processing alternatives are assessed, and selected future aircraft fuel options - JP fuel, liquid methane, and liquid hydrogen - are evaluated economically. Primary emphasis is placed on evaluating future aircraft fuel options and economics to provide guidance for future strategy of NASA in the development of aviation and air transportation research and technology.

Economic evaluations in pain management: principles and methods.

PubMed

Asche, Carl V; Seal, Brian; Jackson, Kenneth C; Oderda, Gary M

2006-01-01

This paper describes how investigators may design, conduct, and report economic evaluations of pharmacotherapy for pain and symptom management. Because economic evaluation of therapeutic interventions is becoming increasingly important, there is a need for guidance on how economic evaluations can be optimally conducted. The steps required to conduct an economic evaluation are described to provide this guidance. Economic evaluations require two or more therapeutic interventions to be compared in relation to costs and effects. There are five types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, (4) cost-consequence, and (5) cost-benefit analyses. The six required steps are: identify the perspective of the study; identify the alternatives that will be compared; identify the relevant costs and effects; determine how to collect the cost and effect data; determine how to perform calculation for cost and effects data; and determine the manner in which to depict the results and draw comparisons.

A systematic review of model-based economic evaluations of diagnostic and therapeutic strategies for lower extremity artery disease.

PubMed

Vaidya, Anil; Joore, Manuela A; ten Cate-Hoek, Arina J; Kleinegris, Marie-Claire; ten Cate, Hugo; Severens, Johan L

2014-01-01

Lower extremity artery disease (LEAD) is a sign of wide spread atherosclerosis also affecting coronary, cerebral and renal arteries and is associated with increased risk of cardiovascular events. Many economic evaluations have been published for LEAD due to its clinical, social and economic importance. The aim of this systematic review was to assess modelling methods used in published economic evaluations in the field of LEAD. Our review appraised and compared the general characteristics, model structure and methodological quality of published models. Electronic databases MEDLINE and EMBASE were searched until February 2013 via OVID interface. Cochrane database of systematic reviews, Health Technology Assessment database hosted by National Institute for Health research and National Health Services Economic Evaluation Database (NHSEED) were also searched. The methodological quality of the included studies was assessed by using the Philips' checklist. Sixteen model-based economic evaluations were identified and included. Eleven models compared therapeutic health technologies; three models compared diagnostic tests and two models compared a combination of diagnostic and therapeutic options for LEAD. Results of this systematic review revealed an acceptable to low methodological quality of the included studies. Methodological diversity and insufficient information posed a challenge for valid comparison of the included studies. In conclusion, there is a need for transparent, methodologically comparable and scientifically credible model-based economic evaluations in the field of LEAD. Future modelling studies should include clinically and economically important cardiovascular outcomes to reflect the wider impact of LEAD on individual patients and on the society.

Economic Evaluation of the Production Magnesium Oxide Nanoparticles via Liquid-Phase Route

NASA Astrophysics Data System (ADS)

Nandiyanto, A. B. D.; Fariansyah, R.; Ramadhan, M. F.; Abdullah, A. G.; Widiaty, I.

2018-02-01

The purpose of this study was to evaluate the production of magnesium oxide (MgO) nanoparticles. The evaluation was done in two perspectives: engineering and economic evaluation. The engineering perspective concerned about the analysis of the production rate based on the available apparatuses and raw materials, completed with mass balance calculation. The economic analysis was conducted based on several economic parameters: gross profit margin (GPM), internal return rate (IRR), payback period (PBP), cumulative net present value (CNPV), break even point (BEP), and profit to investment (PI). The engineering perspective showed that the production of MgO is feasibly done in small scale industry. This is verified by the potential production using current available apparatuses and raw materials in the market. Economic analysis obtained that the present project is profitable. But, for some cases, further studies must be done to get the present production process is attractive for investor.

The cost-effectiveness of exercise-based cardiac rehabilitation: a systematic review of the characteristics and methodological quality of published literature.

PubMed

Edwards, Katherine; Jones, Natasha; Newton, Julia; Foster, Charlie; Judge, Andrew; Jackson, Kate; Arden, Nigel K; Pinedo-Villanueva, Rafael

2017-10-19

This descriptive review aimed to assess the characteristics and methodological quality of economic evaluations of cardiac rehabilitation (CR) programs according to updated economic guidelines for healthcare interventions. Recommendations will be made to inform future research addressing the impact of a physical exercise component on cost-effectiveness. Electronic databases were searched for economic evaluations of exercise-based CR programs published in English between 2000 and 2014. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement was used to review the methodological quality of included economic evaluations. Fifteen economic evaluations met the review inclusion criteria. Assessed study characteristics exhibited wide variability, particularly in their economic perspective, time horizon, setting, comparators and included costs, with significant heterogeneity in exercise dose across interventions. Ten evaluations were based on randomised controlled trials (RCTs) spanning 6-24 months but often with weak or inconclusive results; two were modelling studies; and the final three utilised longer time horizons of 3.5-5 years from which findings suggest that long-term exercise-based CR results in lower costs, reduced hospitalisations and a longer cumulative patient lifetime. None of the 15 articles met all the CHEERS quality criteria, with the majority either fully or partially meeting a selection of the assessed variables. Evidence exists supporting the cost-effectiveness of exercise-based CR for cardiovascular disease patients. However, variability in CR program delivery and weak consistency between study perspective and design limits study comparability and therefore the accumulation of evidence in support of a particular exercise regime. The generalisability of study findings was limited due to the exclusion of patients with comorbidities as would typically be found in a real-world setting. The use of longer time-horizons would be more comparable with a chronic condition and enable economic assessments of the long-term effects of CR. As none of the articles met recent reporting standards for the economic assessment of healthcare interventions, it is recommended that future studies adhere to such guidelines.

[Parameter of evidence-based medicine in health care economics].

PubMed

Wasem, J; Siebert, U

1999-08-01

In the view of scarcity of resources, economic evaluations in health care, in which not only effects but also costs related to a medical intervention are examined and a incremental cost-outcome-ratio is build, are an important supplement to the program of evidence based medicine. Outcomes of a medical intervention can be measured by clinical effectiveness, quality-adjusted life years, and monetary evaluation of benefits. As far as costs are concerned, direct medical costs, direct non-medical costs and indirect costs have to be considered in an economic evaluation. Data can be used from primary studies or secondary analysis; metaanalysis for synthesizing of data may be adequate. For calculation of incremental cost-benefit-ratios, models of decision analysis (decision tree models, Markov-models) often are necessary. Methodological and ethical limits for application of the results of economic evaluation in resource allocation decision in health care have to be regarded: Economic evaluations and the calculation of cost-outcome-rations should only support decision making but cannot replace it.

Advantages of the net benefit regression framework for economic evaluations of interventions in the workplace: a case study of the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.

PubMed

Hoch, Jeffrey S; Dewa, Carolyn S

2014-04-01

Economic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not well known. To illustrate regression-based economic evaluation, we present a case study investigating the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. We implement net benefit regression to illustrate its strengths and limitations. Net benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges. Economic evaluations of person-level data (eg, from a clinical trial) should use net benefit regression to facilitate analysis and enhance results.

Influenza vaccines in low and middle income countries: a systematic review of economic evaluations.

PubMed

Ott, Jördis J; Klein Breteler, Janna; Tam, John S; Hutubessy, Raymond C W; Jit, Mark; de Boer, Michiel R

2013-07-01

Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and cost-saving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner.

Economic evaluation of a solar hot-water system--Palm Beach County, Florida

NASA Technical Reports Server (NTRS)

1981-01-01

Report projects solar-energy costs and savings for residential hot-water system over 20 year period. Evaluation uses technical and economic models with inputs based on working characteristics of installed system. Primary analysis permits calculation of economic viability for four other U.S. sites.

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

Design of Economic Evaluations of Mindfulness-Based Interventions: Ten Methodological Questions of Which to Be Mindful.

PubMed

Edwards, Rhiannon Tudor; Bryning, Lucy; Crane, Rebecca

Mindfulness-based interventions (MBIs) are being increasingly applied in a variety of settings. A growing body of evidence to support the effectiveness of these interventions exists and there are a few published cost-effectiveness studies. With limited resources available within public sectors (health care, social care, and education), it is necessary to build in concurrent economic evaluations alongside trials in order to inform service commissioning and policy. If future research studies are well-designed, they have strong potential to investigate the economic impact of MBIs. The particular challenge to the health economist is how best to capture the ways that MBIs help people adjust to or build resilience to difficult life circumstances, and to disseminate effectively to enable policy makers to judge the value of the contribution that MBIs can make within the context of the limited resourcing of public services. In anticipation of more research worldwide evaluating MBIs in various settings, this article suggests ten health economics methodological design questions that researchers may want to consider prior to conducting MBI research. These questions draw on both published standards of good methodological practice in economic evaluation of medical interventions, and on the authors' knowledge and experience of mindfulness-based practice. We argue that it is helpful to view MBIs as both complex interventions and as public health prevention initiatives. Our suggestions for well-designed economic evaluations of MBIs in health and other settings, mirror current thinking on the challenges and opportunities of public health economics.

Measuring value for money: a scoping review on economic evaluation of health information systems.

PubMed

Bassi, Jesdeep; Lau, Francis

2013-01-01

To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Forty-two papers were selected and 33 were deemed high quality (scores ≥ 8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified.

Economic evaluation of occupational health and safety programmes in health care.

PubMed

Guzman, J; Tompa, E; Koehoorn, M; de Boer, H; Macdonald, S; Alamgir, H

2015-10-01

Evidence-based resource allocation in the public health care sector requires reliable economic evaluations that are different from those needed in the commercial sector. To describe a framework for conducting economic evaluations of occupational health and safety (OHS) programmes in health care developed with sector stakeholders. To define key resources and outcomes to be considered in economic evaluations of OHS programmes and to integrate these into a comprehensive framework. Participatory action research supported by mixed qualitative and quantitative methods, including a multi-stakeholder working group, 25 key informant interviews, a 41-member Delphi panel and structured nominal group discussions. We found three resources had top priority: OHS staff time, training the workers and programme planning, promotion and evaluation. Similarly, five outcomes had top priority: number of injuries, safety climate, job satisfaction, quality of care and work days lost. The resulting framework was built around seven principles of good practice that stakeholders can use to assist them in conducting economic evaluations of OHS programmes. Use of a framework resulting from this participatory action research approach may increase the quality of economic evaluations of OHS programmes and facilitate programme comparisons for evidence-based resource allocation decisions. The principles may be applicable to other service sectors funded from general taxes and more broadly to economic evaluations of OHS programmes in general. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Economic evaluation of pharmacogenomics: a value-based approach to pragmatic decision making in the face of complexity.

PubMed

Snyder, Susan R; Mitropoulou, Christina; Patrinos, George P; Williams, Marc S

2014-01-01

Evidence of the value of pharmacogenomic testing is needed to inform policymakers and clinicians for decision making related to adoption and coverage, and to facilitate prioritization for research and development. Pharmacogenomics has an important role in creating a more efficient healthcare system, and this article addresses how economic evaluation can strategically target evidence gaps for public health priorities with examples from pharmacogenomic medicine. This article begins with a review of the need for and use of economic evaluations in value-based decision making for pharmacogenomic testing. Three important gaps are described with examples demonstrating how they can be addressed: (1) projected impact of hypothetical new technology, (2) pre-implementation assessment of a specific technology, and (3) post-implementation assessment from relevant analytical stakeholder perspectives. Additional needs, challenges and approaches specific to pharmacogenomic economic evaluation in the developing world are also identified. These pragmatic approaches can provide much needed evidence to support real-world value-based decision making for pharmacogenomic-based screening and treatment strategies. © 2014 S. Karger AG, Basel.

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

NASA Astrophysics Data System (ADS)

1980-09-01

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

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

PubMed

Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

2018-01-01

A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.

Solar energy system economic evaluation final report for SEMCO-Loxahatchee, Loxahatchee National Wildlife refuge, Palm Beach County, Florida

NASA Technical Reports Server (NTRS)

1980-01-01

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

Solar energy system economic evaluation for Seeco Lincoln, Lincoln, Nebraska. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1980-09-01

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

The use of economic evaluation in CAM: an introductory framework

PubMed Central

2010-01-01

Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM. PMID:21067622

The use of economic evaluation in CAM: an introductory framework.

PubMed

Ford, Emily; Solomon, Daniela; Adams, Jon; Graves, Nicholas

2010-11-11

For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities.In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.

Economic evaluations in shoulder pathologies: a systematic review of the literature.

PubMed

Kuye, Ifedayo O; Jain, Nitin B; Warner, Lauren; Herndon, James H; Warner, Jon J P

2012-03-01

Economic evaluations provide decision makers with a tool for reducing health care costs because they assess both the costs and consequences of health care interventions. This study reviewed the quality of published economic evaluations for shoulder pathologies. A MEDLINE search was conducted to identify articles published from 1980 to 2010 that contained "cost" or "economic" combined with terms for several shoulder disorders and treatments. We selected studies that fit the definition of 1 of the 4 routinely performed economic evaluations: cost-minimization, cost-effectiveness, cost-utility, and cost-benefit analyses. Study quality was determined by measuring adherence to 6 established health economic principles, as described in the literature. The search retrieved 942 studies. Of these, 32 were determined to be economic evaluations, and 53% of the economic evaluations were published from 2005 to 2010. Only 8 of the 32 studies (25%) adhered to all 6 health economic principles. Publication in a nonsurgical journal (P < .05) or in more recent years (P < .01) was significantly associated with higher quality. Future health care resource allocation will likely be based on the economic feasibility of treatments. Although the number and quality of economic evaluations of shoulder disorders have risen in recent years, the current state of the literature is poor. Given that availability of such data may factor in private and public reimbursement decisions, there is a clear demand for more rigorous economic evaluations. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Defining a staged-based process for economic and financial evaluations of mHealth programs.

PubMed

LeFevre, Amnesty E; Shillcutt, Samuel D; Broomhead, Sean; Labrique, Alain B; Jones, Tom

2017-01-01

Mobile and wireless technology for health (mHealth) has the potential to improve health outcomes by addressing critical health systems constraints that impede coverage, utilization, and effectiveness of health services. To date, few mHealth programs have been implemented at scale and there remains a paucity of evidence on their effectiveness and value for money. This paper aims to improve understanding among mHealth program managers and key stakeholders of how to select methods for economic evaluation (comparative analysis for determining value for money) and financial evaluation (determination of the cost of implementing an intervention, estimation of costs for sustaining or expanding an intervention, and assessment of its affordability). We outline a 6 stage-based process for selecting and integrating economic and financial evaluation methods into the monitoring and evaluation of mHealth solutions including (1) defining the program strategy and linkages with key outcomes, (2) assessment of effectiveness, (3) full economic evaluation or partial evaluation, (4) sub-group analyses, (5) estimating resource requirements for expansion, (6) affordability assessment and identification of models for financial sustainability. While application of these stages optimally occurs linearly, finite resources, limited technical expertise, and the timing of evaluation initiation may impede this. We recommend that analysts prioritize economic and financial evaluation methods based on programmatic linkages with health outcomes; alignment with an mHealth solution's broader stage of maturity and stage of evaluation; overarching monitoring and evaluation activities; stakeholder evidence needs; time point of initiation; and available resources for evaluations.

Societal and Economic Engagement of Universities in Finland: An Evaluation Model

ERIC Educational Resources Information Center

Ritsila, Jari; Nieminen, Mika; Sotarauta, Markku; Lahtonen, Jukka

2008-01-01

This paper is based on the work of an expert team invited by the Ministry of Education of Finland to develop criteria and an evaluation framework for societal and economic engagement for use in university performance management. The paper maps out possible indicators for the societal and economic engagement of universities in the light of national…

Bamboo vs. crops: An integrated emergy and economic evaluation of using bamboo to replace crops in south Sichuan Province, China

EPA Science Inventory

Based on long-term monitoring conducted in Chang-ning county, a pilot site of the ‘Grain for Green Program’ (GFGP), an integrated emergy and economic method was applied to evaluate the dynamic ecological-economic performance of 3 kinds of bamboo systems planted on slo...

Measuring value for money: a scoping review on economic evaluation of health information systems

PubMed Central

Bassi, Jesdeep; Lau, Francis

2013-01-01

Objective To explore how key components of economic evaluations have been included in evaluations of health information systems (HIS), to determine the state of knowledge on value for money for HIS, and provide guidance for future evaluations. Materials and methods We searched databases, previously collected papers, and references for relevant papers published from January 2000 to June 2012. For selection, papers had to: be a primary study; involve a computerized system for health information processing, decision support, or management reporting; and include an economic evaluation. Data on study design and economic evaluation methods were extracted and analyzed. Results Forty-two papers were selected and 33 were deemed high quality (scores ≥8/10) for further analysis. These included 12 economic analyses, five input cost analyses, and 16 cost-related outcome analyses. For HIS types, there were seven primary care electronic medical records, six computerized provider order entry systems, five medication management systems, five immunization information systems, four institutional information systems, three disease management systems, two clinical documentation systems, and one health information exchange network. In terms of value for money, 23 papers reported positive findings, eight were inconclusive, and two were negative. Conclusions We found a wide range of economic evaluation papers that were based on different assumptions, methods, and metrics. There is some evidence of value for money in selected healthcare organizations and HIS types. However, caution is needed when generalizing these findings. Better reporting of economic evaluation studies is needed to compare findings and build on the existing evidence base we identified. PMID:23416247

The Development Evaluation of Economic Zones in China.

PubMed

Liu, Wei; Shi, Hong-Bo; Zhang, Zhe; Tsai, Sang-Bing; Zhai, Yuming; Chen, Quan; Wang, Jiangtao

2018-01-02

After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China's economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed.

The Development Evaluation of Economic Zones in China

PubMed Central

Shi, Hong-Bo; Zhang, Zhe; Zhai, Yuming; Chen, Quan; Wang, Jiangtao

2018-01-01

After the Chinese reform and opening up, the construction of economic zones, such as Special Economic Zones, Hi-tech Zones and Bonded Zones, has played an irreplaceable role in China’s economic development. Currently, against the background of Chinese economic transition, research on development evaluation of economic zones has become popular and necessary. Similar research usually focuses on one specific field, and the methods that are used to evaluate it are simple. This research aims to analyse the development evaluation of zones by synthesis. A new hybrid multiple criteria decision making (MCDM) model that combines the DEMATEL technique and the DANP method is proposed. After establishing the evaluation criterion system and acquiring data, the influential weights of dimensions and criteria can be calculated, which will be a guide for forming measures of development. Shandong Peninsula Blue Economic Zone is used in the empirical case analysis. The results show that Transportation Conditions, Industrial Structure and Business Climate are the main influencing criteria and measures based on these criteria are proposed. PMID:29301304

Influenza vaccines in low and middle income countries

PubMed Central

Ott, Jördis J.; Klein Breteler, Janna; Tam, John S.; Hutubessy, Raymond C.W.; Jit, Mark; de Boer, Michiel R.

2013-01-01

Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. Methods: PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Results: Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and cost-saving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Conclusion: Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner. PMID:23732900

Valuing Our Communities: Ethical Considerations for Economic Evaluation of Community-Based Prevention.

PubMed

Crowley, Max; Jones, Damon

2017-12-01

Restricted public budgets and increasing efforts to link the impact of community interventions to public savings have increased the use of economic evaluation. While this type of evaluation can be important for program planning, it also raises important ethical issues about how we value the time of local stakeholders who support community interventions. In particular, researchers navigate issues of scientific accuracy, institutional inequality, and research utility in their pursuit of even basic cost estimates. We provide an example of how we confronted these issues when estimating the costs of a large-scale community-based intervention. Principles for valuing community members' time and conducting economic evaluations of community programs are discussed. © Society for Community Research and Action 2017.

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

A Systematic Review of the State of Economic Evaluation for Health Care in India.

PubMed

Prinja, Shankar; Chauhan, Akashdeep Singh; Angell, Blake; Gupta, Indrani; Jan, Stephen

2015-12-01

Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India. A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist. Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%). The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can inform and benefit policy making, and at the same time build capacity of health-care professionals in understanding the economic principles of health-care delivery system.

Economic development evaluation based on science and patents

NASA Astrophysics Data System (ADS)

Jokanović, Bojana; Lalic, Bojan; Milovančević, Miloš; Simeunović, Nenad; Marković, Dusan

2017-09-01

Economic development could be achieved through many factors. Science and technology factors could influence economic development drastically. Therefore the main aim in this study was to apply computational intelligence methodology, artificial neural network approach, for economic development estimation based on different science and technology factors. Since economic analyzing could be very challenging task because of high nonlinearity, in this study was applied computational intelligence methodology, artificial neural network approach, to estimate the economic development based on different science and technology factors. As economic development measure, gross domestic product (GDP) was used. As the science and technology factors, patents in different field were used. It was found that the patents in electrical engineering field have the highest influence on the economic development or the GDP.

Presentation of economic evaluation results.

PubMed

Chaikledkaew, Usa

2014-05-01

The first HTA guidelines for Thailand included a chapter outlining a set of guidelines on how best to report the findings of health economic evaluations, based on a review of best practice and existing guidelines on the presentation of economic evaluation results from around the world. In this second edition of HTA guidelines for Thailand, the recommendations build on the first edition by using a case study to illustrate how the guidelines can be applied in a real research context. The guidelines propose that all reporting include ten key elements: defining the scope of the study, selection of comparator(s), defining the type of economic evaluation, measurement of costs, measurement of clinical effects, handling time in economic evaluation studies, handling uncertainty and sensitivity analysis, presentation of the results, discussion of the results, and disclosure of funding and authors conflict of interest.

Economic evaluations of clinical pharmacy services: 2006-2010.

PubMed

Touchette, Daniel R; Doloresco, Fred; Suda, Katie J; Perez, Alexandra; Turner, Stuart; Jalundhwala, Yash; Tangonan, Maria C; Hoffman, James M

2014-08-01

Studies have consistently evidenced the positive clinical, economic, and humanistic benefits of pharmacist-directed patient care in a variety of settings. Given the vast differences in clinical outcomes associated with evaluated clinical pharmacy services (CPS), more detail as to the nature of the CPS is needed to better understand observed differences in economic outcomes. With the growing trend of outpatient pharmacy services, these economic evaluations serve as viable decision-making tools in choosing the most effective and cost-effective pharmacy programs. We previously conducted three systematic reviews to evaluate the economic impact of CPS from 1988 to 2005. In this systematic review, our objectives were to describe and evaluate the quality of economic evaluations of CPS published between 2006 and 2010, with the goal of informing administrators and practitioners as to their cost-effectiveness. We searched the scientific literature by using the Medline, International Pharmaceutical Abstracts, Embase, and Cumulative Index to Nursing and Allied Health Literature databases to identify studies describing CPS published from 2006 to 2010. Studies meeting our inclusion criteria (original research articles that evaluated CPS and described economic and clinical outcomes) were reviewed by two investigators. Methodology used, economic evaluation type, CPS setting and type, and clinical and economic outcome results were extracted. Results were informally compared with previous systematic reviews. Of 3587 potential studies identified, 25 met inclusion criteria. Common CPS settings were hospital (36%), community (32%), and clinic or hospital-based ambulatory practices (28%). CPS types were disease state management (48%), general pharmacotherapeutic monitoring (24%), target drug programs (8%), and patient education (4%). Two studies (8%) listed CPS as medication therapy management. Costs were evaluated in 24 studies (96%) and sufficiently described in 13 (52%). Clinical or humanistic outcomes were evaluated in 20 studies (80%) and were sufficiently described in 18 (72%). Control groups were included in 16 (70%) of 23 studies not involving modeling. Study assumptions and limitations were stated and justified in eight studies (32%). Conclusions and recommendations were considered justified and based on results in 24 studies (96%). Eighteen studies (72%) involved full economic evaluation. The mean ± SD study quality score for full economic evaluations (18 studies) was 60.4 ± 22.3 of a possible 100 points. Benefit-cost ratios from three studies ranged from 1.05:1 to 25.95:1, and incremental cost-effectiveness ratios of five studies were calculated and reported. Fewer studies documented the economic impact of CPS from 2006-2010 than from 2001-2005, although a higher proportion involved controlled designs and were full economic evaluations. Evaluations of ambulatory practices were increasingly common. CPS were generally considered cost-effective or provided a good benefit-cost ratio. © 2014 Pharmacotherapy Publications, Inc.

Economic theory and nursing administration research--is this a good combination?

PubMed

Jones, Terry L; Yoder, Linda

2010-01-01

Economic theory is used to describe and explain decision making in the context of scarce resources. This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing.

Economic Theory and Nursing Administration Research—Is This a Good Combination?

PubMed Central

Jones, Terry L.; Yoder, Linda

2017-01-01

TOPIC Economic theory is used to describe and explain decision making in the context of scarce resources. PURPOSE This paper presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research. SOURCES OF INFORMATION The description of economic theory and the proposed applications for nursing are based on current nursing, healthcare, and economic literature. Evaluation of the potential usefulness of economic theory in guiding nursing administration research is based on the criteria of significance and testability as described by Fawcett and Downs. CONCLUSIONS While economic theory can be very useful in explaining how decisions about nursing time allocation and nursing care production are made, it will not address the issue of how they should be made. Normative theories and ethical frameworks also must be incorporated in the decision-making process around these issues. Economic theory and nursing administration are a good fit when balanced with the values and goals of nursing. PMID:20137023

Solar energy system economic evaluation: Contemporary Newman, Georgia

NASA Technical Reports Server (NTRS)

1980-01-01

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

Solar energy system economic evaluation: Contemporary Newman, Georgia

NASA Astrophysics Data System (ADS)

1980-09-01

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

MEDICAL DEVICE PRICES IN ECONOMIC EVALUATIONS.

PubMed

Akpinar, Ilke; Jacobs, Philip; Husereau, Don

2015-01-01

Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices. We conducted a review of the economic concepts and implications of methods used for economic evaluations of the eleven most implanted medical devices from the Canadian perspective. We found Canadian economic studies for five of the eleven medical devices and identified nineteen Canadian studies. Overall, the device costs were important components of total procedure cost, with an average ratio of 44.1 %. Observational estimates of the device costs were obtained from buyers or sellers in 13 of the 19 studies. Although most of the devices last more than 1 year, standard costing methods for capital equipment was never used. In addition, only eight studies included a sensitivity analysis for the device cost. None of the sensitivity analyses were based on actual price distributions. Economic evaluations are potentially important for policy making, but although they are being conducted, there is no standardized approach for incorporating medical device prices in economic analyses. Our review provides suggestions for improvements in how the prices are incorporated for economic evaluations of medical devices.

Effects of Special Use Airspace on Economic Benefits of Direct Flights

NASA Technical Reports Server (NTRS)

Datta, Koushik; Barrington, Craig; Foster, John D. (Technical Monitor)

1996-01-01

A methodology for estimating the economic effects of Special Use Airspace (SUA) on direct route flights is presented in this paper. The methodology is based on evaluating operating costs of aircraft and analyzing the different ground-track distances traveled by flights under different air traffic scenarios. Using this methodology the following objectives are evaluated: optimistic bias of studies that assume accessible SUAs the maximum economic benefit of dynamic use of SUAs and the marginal economic benefit of the dynamic use of individual SUAs.

Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

PubMed

Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

2017-06-01

The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

Economic evaluation in the context of rare diseases: is it possible?

PubMed

Silva, Everton Nunes da; Sousa, Tanara Rosângela Vieira

2015-03-01

This study analyzes the available evidence on the adequacy of economic evaluation for decision-making on the incorporation or exclusion of technologies for rare diseases. The authors conducted a structured literature review in MEDLINE via PubMed, CRD, LILACS, SciELO, and Google Scholar (gray literature). Economic evaluation studies had their origins in Welfare Economics, in which individuals maximize their utilities based on allocative efficiency. There is no widely accepted criterion in the literature to weigh the expected utilities, in the sense of assigning more weight to individuals with greater health needs. Thus, economic evaluation studies do not usually weigh utilities asymmetrically (that is, everyone is treated equally, which in Brazil is also a Constitutional principle). Healthcare systems have ratified the use of economic evaluation as the main tool to assist decision-making. However, this approach does not rule out the use of other methodologies to complement cost-effectiveness studies, such as Person Trade-Off and Rule of Rescue.

Economic Evaluation in Global Perspective: A Bibliometric Analysis of the Recent Literature.

PubMed

Pitt, Catherine; Goodman, Catherine; Hanson, Kara

2016-02-01

We present a bibliometric analysis of recently published full economic evaluations of health interventions and reflect critically on the implications of our findings for this growing field. We created a database drawing on 14 health, economic, and/or general literature databases for articles published between 1 January 2012 and 3 May 2014 and identified 2844 economic evaluations meeting our criteria. We present findings regarding the sensitivity, specificity, and added value of searches in the different databases. We examine the distribution of publications between countries, regions, and health areas studied and compare the relative volume of research with disease burden. We analyse authors' country and institutional affiliations, journals and journal type, language, and type of economic evaluation conducted. More than 1200 economic evaluations were published annually, of which 4% addressed low-income countries, 4% lower-middle-income countries, 14% upper-middle-income countries, and 83% high-income countries. Across country income levels, 53, 54, 86, and 100% of articles, respectively, included an author based in a country within the income level studied. Biomedical journals published 74% of economic evaluations. The volume of research across health areas correlates more closely with disease burden in high-income than in low-income and middle-income countries. Our findings provide an empirical basis for further study on methods, research prioritization, and capacity development in health economic evaluation. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Management of business economic growth as function of resource rents

NASA Astrophysics Data System (ADS)

Prljić, Stefan; Nikitović, Zorana; Stojanović, Aleksandra Golubović; Cogoljević, Dušan; Pešić, Gordana; Alizamir, Meysam

2018-02-01

Economic profit could be influenced by economic rents. However natural resource rents provided different impact on the economic growth or economic profit. The main focus of the study was to evaluate the economic growth as function of natural resource rents. For such a purpose machine learning approach, artificial neural network, was used. The used natural resource rents were coal rents, forest rents, mineral rents, natural gas rents and oil rents. Based on the results it is concluded that the machine learning approach could be used as the tool for the economic growth evaluation as function of natural resource rents. Moreover the more advanced approaches should be incorporated to improve more the forecasting accuracy.

Economic evaluation of vaccines in Canada: A systematic review.

PubMed

Chit, Ayman; Lee, Jason K H; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M

2016-05-03

Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Searches in multiple databases were conducted using the terms "vaccine," "economics" and "Canada." Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes to review and assess the findings of the economic evaluations of vaccines.

Issues in the economic evaluation of influenza vaccination by injection of healthy working adults in the US: a review and decision analysis of ten published studies.

PubMed

Hogan, Thomas J

2012-05-01

The objective was to review recent economic evaluations of influenza vaccination by injection in the US, assess their evidence, and conclude on their collective findings. The literature was searched for economic evaluations of influenza vaccination injection in healthy working adults in the US published since 1995. Ten evaluations described in nine papers were identified. These were synopsized and their results evaluated, the basic structure of all evaluations was ascertained, and sensitivity of outcomes to changes in parameter values were explored using a decision model. Areas to improve economic evaluations were noted. Eight of nine evaluations with credible economic outcomes were favourable to vaccination, representing a statistically significant result compared with a proportion of 50% that would be expected if vaccination and no vaccination were economically equivalent. Evaluations shared a basic structure, but differed considerably with respect to cost components, assumptions, methods, and parameter estimates. Sensitivity analysis indicated that changes in parameter values within the feasible range, individually or simultaneously, could reverse economic outcomes. Given stated misgivings, the methods of estimating influenza reduction ascribed to vaccination must be researched to confirm that they produce accurate and reliable estimates. Research is also needed to improve estimates of the costs per case of influenza illness and the costs of vaccination. Based on their assumptions, the reviewed papers collectively appear to support the economic benefits of influenza vaccination of healthy adults. Yet the underlying assumptions, methods and parameter estimates themselves warrant further research to confirm they are accurate, reliable and appropriate to economic evaluation purposes.

Prolonging fuel cell stack lifetime based on Pontryagin's Minimum Principle in fuel cell hybrid vehicles and its economic influence evaluation

NASA Astrophysics Data System (ADS)

Zheng, C. H.; Xu, G. Q.; Park, Y. I.; Lim, W. S.; Cha, S. W.

2014-02-01

The lifetime of fuel cell stacks is a major issue currently, especially for automotive applications. In order to take into account the lifetime of fuel cell stacks while considering the fuel consumption minimization in fuel cell hybrid vehicles (FCHVs), a Pontryagin's Minimum Principle (PMP)-based power management strategy is proposed in this research. This strategy has the effect of prolonging the lifetime of fuel cell stacks. However, there is a tradeoff between the fuel cell stack lifetime and the fuel consumption when this strategy is applied to an FCHV. Verifying the positive economic influence of this strategy is necessary in order to demonstrate its superiority. In this research, the economic influence of the proposed strategy is assessed according to an evaluating cost which is dependent on the fuel cell stack cost, the hydrogen cost, the fuel cell stack lifetime, and the lifetime prolonging impact on the fuel cell stack. Simulation results derived from the proposed power management strategy are also used to evaluate the economic influence. As a result, the positive economic influence of the proposed PMP-based power management strategy is proved for both current and future FCHVs.

Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature.

PubMed

Meregaglia, Michela; Cairns, John

2015-01-01

The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

Modeling companion diagnostics in economic evaluations of targeted oncology therapies: systematic review and methodological checklist.

PubMed

Doble, Brett; Tan, Marcus; Harris, Anthony; Lorgelly, Paula

2015-02-01

The successful use of a targeted therapy is intrinsically linked to the ability of a companion diagnostic to correctly identify patients most likely to benefit from treatment. The aim of this study was to review the characteristics of companion diagnostics that are of importance for inclusion in an economic evaluation. Approaches for including these characteristics in model-based economic evaluations are compared with the intent to describe best practice methods. Five databases and government agency websites were searched to identify model-based economic evaluations comparing a companion diagnostic and subsequent treatment strategy to another alternative treatment strategy with model parameters for the sensitivity and specificity of the companion diagnostic (primary synthesis). Economic evaluations that limited model parameters for the companion diagnostic to only its cost were also identified (secondary synthesis). Quality was assessed using the Quality of Health Economic Studies instrument. 30 studies were included in the review (primary synthesis n = 12; secondary synthesis n = 18). Incremental cost-effectiveness ratios may be lower when the only parameter for the companion diagnostic included in a model is the cost of testing. Incorporating the test's accuracy in addition to its cost may be a more appropriate methodological approach. Altering the prevalence of the genetic biomarker, specific population tested, type of test, test accuracy and timing/sequence of multiple tests can all impact overall model results. The impact of altering a test's threshold for positivity is unknown as it was not addressed in any of the included studies. Additional quality criteria as outlined in our methodological checklist should be considered due to the shortcomings of standard quality assessment tools in differentiating studies that incorporate important test-related characteristics and those that do not. There is a need to refine methods for incorporating the characteristics of companion diagnostics into model-based economic evaluations to ensure consistent and transparent reimbursement decisions are made.

New integrated information system for pusan national university hospital.

PubMed

Kim, Hyung Hoi; Cho, Kyung-Won; Kim, Hye Sook; Kim, Ju-Sim; Kim, Jung Hyun; Han, Sang Pil; Park, Chun Bok; Kim, Seok; Chae, Young Moon

2011-03-01

This study presents the information system for Pusan National University Hospital (PNUH), evaluates its performance qualitatively, and conducts economic analysis. Information system for PNUH was designed by component-based development and developed by internet technologies. Order Communication System, Electronic Medical Record, and Clinical Decision Support System were newly developed. The performance of the hospital information system was qualitatively evaluated based on the performance reference model in order to identify problem areas for the old system. The Information Economics approach was used to analyze the economic feasibility of hospital information system in order to account for the intangible benefits. Average performance scores were 3.16 for input layer, 3.35 for process layer, and 3.57 for business layer. In addition, the cumulative benefit to cost ratio was 0.50 in 2011, 1.73 in 2012, 1.76 in 2013, 1.71 in 2014, and 1.71 in 2015. The B/C ratios steadily increase as value items are added. While overall performance scores were reasonably high, doctors were less satisfied with the system, perhaps due to the weak clinical function in the systems. The information economics analysis demonstrated the economic profitability of the information systems if all intangible benefits were included. The second qualitative evaluation survey and economic analysis were proposed to evaluate the changes in performance of the new system.

Parameterising User Uptake in Economic Evaluations: The role of discrete choice experiments.

PubMed

Terris-Prestholt, Fern; Quaife, Matthew; Vickerman, Peter

2016-02-01

Model-based economic evaluations of new interventions have shown that user behaviour (uptake) is a critical driver of overall impact achieved. However, early economic evaluations, prior to introduction, often rely on assumed levels of uptake based on expert opinion or uptake of similar interventions. In addition to the likely uncertainty surrounding these uptake assumptions, they also do not allow for uptake to be a function of product, intervention, or user characteristics. This letter proposes using uptake projections from discrete choice experiments (DCE) to better parameterize uptake and substitution in cost-effectiveness models. A simple impact model is developed and illustrated using an example from the HIV prevention field in South Africa. Comparison between the conventional approach and the DCE-based approach shows that, in our example, DCE-based impact predictions varied by up to 50% from conventional estimates and provided far more nuanced projections. In the absence of observed uptake data and to model the effect of variations in intervention characteristics, DCE-based uptake predictions are likely to greatly improve models parameterizing uptake solely based on expert opinion. This is particularly important for global and national level decision making around introducing new and probably more expensive interventions, particularly where resources are most constrained. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Economic evaluations of homeopathy: a review.

PubMed

Viksveen, Petter; Dymitr, Zofia; Simoens, Steven

2014-03-01

Economic evaluations of commonly used complementary and alternative medicine (CAM) therapies such as homeopathy are needed to contribute to the evidence base on which policy makers, clinicians, health-care payers, as well as patients base their health-care decisions in an era of constrained resources. To review and assess existing economic evaluations of homeopathy. Literature search was made to retrieve relevant publications using AMED, the Cochrane Library, CRD (DARE, NHS EED, HTA), EMBASE, MEDLINE, and the journal Homeopathy (former British Homoeopathic Journal). A hand search of relevant publications was carried out. Homeopathy researchers were contacted. Identified publications were independently assessed by two authors. Fifteen relevant articles reported on 14 economic evaluations of homeopathy. Thirteen studies reported numbers of patients: a total of 3,500 patients received homeopathic treatment (median 97, interquartile range 48-268), and 10 studies reported on control group participants (median 57, IQR 40-362). Eight out of 14 studies found improvements in patients' health together with cost savings. Four studies found that improvements in homeopathy patients were at least as good as in control group patients, at comparable costs. Two studies found improvements similar to conventional treatment, but at higher costs. Studies were highly heterogeneous and had several methodological weaknesses. Although the identified evidence of the costs and potential benefits of homeopathy seemed promising, studies were highly heterogeneous and had several methodological weaknesses. It is therefore not possible to draw firm conclusions based on existing economic evaluations of homeopathy. Recommendations for future research are presented.

Solar energy system economic evaluation for Elcam-Tempe, Tempe, Arizona and Elcam-San Diego, San Diego, California

NASA Technical Reports Server (NTRS)

1980-01-01

The long term economic performance of the solar energy system at its installation site is analyzed and four additional locations selected to demonstrate the viability of the design over a broad range of environmental and economic conditions. The economic analysis of the solar energy systems that were installed at Tempe, Arizona and San Diego, California, is developed for these and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f Chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over a projected twenty year life: life cycle savings; year of positive savings; and year of payback for the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainites in constituent system and economic variables is also investigated. The results demonstrate that the solar energy system is economically viable at all of the sites for which the analysis was conducted.

Solar energy system economic evaluation. Final report for SEECO Lincoln, Lincoln, Nebraska

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1980-09-01

The economic analysis of the solar energy system that was installed at Lincoln, Nebraska is developed for this and four other sites typical of a wide range of environmental and economic conditions in the continental United States. This analysis is accomplished based on the technical and economic models in the f-chart design procedure with inputs based on the characteristics of the installed system and local conditions. The results are expressed in terms of the economic parameters of present worth of system cost over a projected twenty year life: life cycle savings, year of positive savings and year of payback formore » the optimized solar energy system at each of the analysis sites. The sensitivity of the economic evaluation to uncertainties in constituent system and economic variables is also investigated. Although budget constraints preclude an economic reevaluation of each of the sites, a similar site, Carlsbad, New Nexico, was done. When 1985 escalated values for fuel, costs, mass production, and improved design and installation techniques were applied, a significantly higher degree of savings was realized.« less

[Economic Evaluation of Integrated Care Systems - Scientific Standard Specifications, Challenges, Best Practice Model].

PubMed

Pimperl, A; Schreyögg, J; Rothgang, H; Busse, R; Glaeske, G; Hildebrandt, H

2015-12-01

 Transparency of economic performance of integrated care systems (IV) is a basic requirement for the acceptance and further development of integrated care. Diverse evaluation methods are used but are seldom openly discussed because of the proprietary nature of the different business models. The aim of this article is to develop a generic model for measuring economic performance of IV interventions.  A catalogue of five quality criteria is used to discuss different evaluation methods -(uncontrolled before-after-studies, control group-based approaches, regression models). On this -basis a best practice model is proposed.  A regression model based on the German morbidity-based risk structure equalisation scheme (MorbiRSA) has some benefits in comparison to the other methods mentioned. In particular it requires less resources to be implemented and offers advantages concerning the relia-bility and the transparency of the method (=important for acceptance). Also validity is sound. Although RCTs and - also to a lesser -extent - complex difference-in-difference matching approaches can lead to a higher validity of the results, their feasibility in real life settings is limited due to economic and practical reasons. That is why central criticisms of a MorbiRSA-based model were addressed, adaptions proposed and incorporated in a best practice model: Population-oriented morbidity adjusted margin improvement model (P-DBV(MRSA)).  The P-DBV(MRSA) approach may be used as a standardised best practice model for the economic evaluation of IV. Parallel to the proposed approach for measuring economic performance a balanced, quality-oriented performance measurement system should be introduced. This should prevent incentivising IV-players to undertake short-term cost cutting at the expense of quality. © Georg Thieme Verlag KG Stuttgart · New York.

Economic benefit evaluation for renewable energy transmitted by HVDC based on production simulation (PS) and analytic hierarchy process(AHP)

NASA Astrophysics Data System (ADS)

Zhang, Jinfang; Zheng, Kuan; Liu, Jun; Huang, Xinting

2018-02-01

In order to support North and West China’s RE (RE) development and enhance accommodation in reasonable high level, HVDC’s traditional operation curves need some change to follow the output characteristic of RE, which helps to shrink curtailment electricity and curtailment ratio of RE. In this paper, an economic benefit analysis method based on production simulation (PS) and Analytic hierarchy process (AHP) has been proposed. PS is the basic tool to analyze chosen power system operation situation, and AHP method could give a suitable comparison result among many candidate schemes. Based on four different transmission curve combinations, related economic benefit has been evaluated by PS and AHP. The results and related index have shown the efficiency of suggested method, and finally it has been validated that HVDC operation curve in following RE output mode could have benefit in decreasing RE curtailment level and improving economic operation.

Quality of life instruments for economic evaluations in health and social care for older people: a systematic review.

PubMed

Makai, Peter; Brouwer, Werner B F; Koopmanschap, Marc A; Stolk, Elly A; Nieboer, Anna P

2014-02-01

Gaining health may not be the main goal of healthcare services aimed at older people, which may (also) seek to improve wellbeing. This emphasizes the need of finding appropriate outcome measures for economic evaluation of such services, particularly in long-term care, capturing more than only health-related quality of life (HrQol). This review assesses the usefulness of HrQol and wellbeing instruments for economic evaluations specifically aimed at older people, focusing on generic and preference-based questionnaires measuring wellbeing in particular. We systematically searched six databases and extracted instruments used to assess HrQol and wellbeing outcomes. Instruments were compared based on their usefulness for economic evaluation of services aimed at older people (dimensions measured, availability of utility scores, extent of validation). We identified 487 articles using 34 generic instruments: 22 wellbeing (two of which were preference-based) and 11 HrQol instruments. While standard HrQol instruments measure physical, social and psychological dimensions, wellbeing instruments contain additional dimensions such as purpose in life and achievement, security, and freedom. We found four promising wellbeing instruments for inclusion in economic evaluation: Ferrans and Powers QLI and the WHO-Qol OLD, ICECAP-O and the ASCOT. Ferrans and Powers QLI and the WHO-Qol OLD are widely validated but lack preference-weights while for ICECAP-O and the ASCOT preference-weights are available, but are less widely validated. Until preference-weights are available for the first two instruments, the ICECAP-O and the ASCOT currently appear to be the most useful instruments for economic evaluations in services aimed at older people. Their limitations are that (1) health dimensions may be captured only partially and (2) the instruments require further validation. Therefore, we currently recommend using the ICECAP-O or the ASCOT alongside the EQ-5D or SF-6D when evaluating interventions aimed at older people. Copyright © 2013 Elsevier Ltd. All rights reserved.

The cost-effectiveness of family/family-based therapy for treatment of externalizing disorders, substance use disorders and delinquency: a systematic review.

PubMed

Goorden, Maartje; Schawo, Saskia J; Bouwmans-Frijters, Clazien A M; van der Schee, Evelien; Hendriks, Vincent M; Hakkaart-van Roijen, Leona

2016-07-13

Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency. A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included. Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis. The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.

Improving a web-based employability intervention for work-disabled employees: results of a pilot economic evaluation.

PubMed

Noben, Cindy; Evers, Silvia; Genabeek, Joost van; Nijhuis, Frans; de Rijk, Angelique

2017-04-01

Purpose The purpose of this study is to improve web-based employability interventions for employees with work-related health problems for both intervention content and study design by means of a pilot economic evaluation. Methods Uptake rate analysis for the intervention elements, cost effectiveness, cost utility and subgroup analyses were conducted to identify potential content-related intervention improvements. Differences in work ability and quality-adjusted life years and overall contribution of resource items to the total costs were assessed. These were used to guide study design improvements. Results Sixty-three participants were a-select allocated to either the intervention (n = 29) or the control (n = 34) group. Uptake regarding the intervention elements ranged between 3% and 70%. Cost-effectiveness and cost-utility analyses resulted in negative effects although higher total costs. Incremental effects were marginal (work ability -0.51; QALY -0.01). Conclusions The web-based tool to enhance employability among work disabled employees requires improvements regarding targeting and intensity; outcome measures selected and collection of cost data. With respect to the studies of disability and rehabilitation, the findings and methods presented in this pilot economic evaluation could guide the assessment of future assistive "e-health" technologies. IMPLICATIONS FOR REHABILITATION The methods presented in this pilot economic evaluation have large potentials to guide the assessment of future assistive e-health technologies addressing work-disabilities. The findings show that the web-based tool requires content related improvements with respect to targeting and intensity to enhance employability among work disabled employees. The findings show that the web-based tool would benefit from improvements related to the study design by more adequately selecting and collecting both outcome measures and cost data. The burden attributable to large-scale studies and implementation issues were prevented as the outcomes of the pilot economic evaluation did not support the implementation of the web-based tool.

Economics of residue harvest: Regional partnership evaluation

USDA-ARS?s Scientific Manuscript database

Economic analyses on the viability of corn (Zea mays, L.) stover harvest for bioenergy production have largely been based on simulation modeling. While some studies have utilized field research data, most field-based analyses have included a limited number of sites and a narrow geographic distributi...

The Role of Information Provision in Economic Evaluations of Newborn Bloodspot Screening: A Systematic Review.

PubMed

Wright, Stuart J; Jones, Cheryl; Payne, Katherine; Dharni, Nimarta; Ulph, Fiona

2015-12-01

The extent to which economic evaluations have included the healthcare resource and outcome-related implications of information provision in national newborn bloodspot screening programmes (NBSPs) is not currently known. To identify if, and how, information provision has been incorporated into published economic evaluations of NBSPs. A systematic review of economic evaluations of NBSPs (up to November 2014) was conducted. Three electronic databases were searched (Ovid: Medline, Embase, CINAHL) using an electronic search strategy combining a published economic search filter with terms related to national NBSPs and screening-related technologies. These electronic searches were supplemented by searching the NHS Economic Evaluations Database (NHS EED) and hand-searching identified study reference lists. The results were tabulated and summarised as part of a narrative synthesis. A total of 27 economic evaluations [screening-related technologies (n = 11) and NBSPs (n = 16)] were identified. The majority of economic evaluations did not quantify the impact of information provision in terms of healthcare costs or outcomes. Five studies did include an estimate of the time cost associated with information provision. Four studies included a value to reflect the disutility associated with parental anxiety caused by false-positive results, which was used as a proxy for the impact of imperfect information. A limited evidence base currently quantifies the impact of information provision on the healthcare costs and impact on the users of NBSPs; the parents of newborns. We suggest that economic evaluations of expanded NBSPs need to take account of information provision otherwise the impact on healthcare costs and the outcomes for newborns and their parents may be underestimated.

Regulating the economic evaluation of pharmaceuticals and medical devices: a European perspective.

PubMed

Cookson, Richard; Hutton, John

2003-02-01

Throughout the developed world, economic evaluation of costly new pharmaceuticals and medical devices became increasingly widespread and systematic during the 1990s. However, serious concerns remain about the validity and relevance of this economic evidence, and about the transparency and accountability of its use in public sector reimbursement decisions. In this article, we summarise current concerns in Europe, based on interviews with European health economists from industry, universities, research institutes and consulting firms. We identify five challenges for European policy-makers, and conclude that there is considerable scope for improving decision-making without damaging incentives to innovate. The challenges are: (1). full publication of the economic evidence used in reimbursement decisions; (2). the redesign of licensing laws to improve the relevance of economic data available at product launch; (3). harmonisation of economic evaluation methodologies; (4). development of methodologies for evaluation of health inequality impacts; and (5). negotiation of price-performance deals to facilitate the use of economic evidence in post-launch pricing review decisions, as information is gathered from studies of product performance in routine use.

[On the economical issues of prevention].

PubMed

Zakorkina, N A

2007-01-01

It is revealed that the implementation level of the preventive activities impact the economic losses related to morbidity. One ruble invested into the preventive actions reduces the economical losses up to 392 rubles. Thus, the methodological approach to the evaluation of the preventive measures targeted to the morbidity of the adolescents are to be based on the economical profitability.

[Evaluation on the eco-economic benefits of small watershed in Beijing mountainous area: a case of Yanqi River watershed].

PubMed

Xiao, Hui-Jie; Wei, Zi-Gang; Wang, Qing; Zhu, Xiao-Bo

2012-12-01

Based on the theory of harmonious development of ecological economy, a total of 13 evaluation indices were selected from the ecological, economic, and social sub-systems of Yanqi River watershed in Huairou District of Beijing. The selected evaluation indices were normalized by using trapezoid functions, and the weights of the evaluation indices were determined by analytic hierarchy process. Then, the eco-economic benefits of the watershed were evaluated with weighted composite index method. From 2004 to 2011, the ecological, economic, and social benefits of Yanqi River watershed all had somewhat increase, among which, ecological benefit increased most, with the value changed from 0.210 in 2004 to 0.255 in 2011 and an increment of 21.5%. The eco-economic benefits of the watershed increased from 0.734 in 2004 to 0.840 in 2011, with an increment of 14.2%. At present, the watershed reached the stage of advanced ecosystem, being in beneficial circulation and harmonious development of ecology, economy, and society.

Economic evaluation of factorial randomised controlled trials: challenges, methods and recommendations

PubMed Central

Gray, Alastair

2017-01-01

Increasing numbers of economic evaluations are conducted alongside randomised controlled trials. Such studies include factorial trials, which randomise patients to different levels of two or more factors and can therefore evaluate the effect of multiple treatments alone and in combination. Factorial trials can provide increased statistical power or assess interactions between treatments, but raise additional challenges for trial‐based economic evaluations: interactions may occur more commonly for costs and quality‐adjusted life‐years (QALYs) than for clinical endpoints; economic endpoints raise challenges for transformation and regression analysis; and both factors must be considered simultaneously to assess which treatment combination represents best value for money. This article aims to examine issues associated with factorial trials that include assessment of costs and/or cost‐effectiveness, describe the methods that can be used to analyse such studies and make recommendations for health economists, statisticians and trialists. A hypothetical worked example is used to illustrate the challenges and demonstrate ways in which economic evaluations of factorial trials may be conducted, and how these methods affect the results and conclusions. Ignoring interactions introduces bias that could result in adopting a treatment that does not make best use of healthcare resources, while considering all interactions avoids bias but reduces statistical power. We also introduce the concept of the opportunity cost of ignoring interactions as a measure of the bias introduced by not taking account of all interactions. We conclude by offering recommendations for planning, analysing and reporting economic evaluations based on factorial trials, taking increased analysis costs into account. © 2017 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd. PMID:28470760

Review of US Comparative Economic Evidence for Treatment of Metastatic Renal Cell Carcinoma after Failure of First-Line VEGF Inhibitor Therapy

PubMed Central

Wong, Michael K.; Wang, Xufang; Chulikavit, Maruit J.; Liu, Zhimei

2013-01-01

Background In 2006, the economic burden of metastatic renal cell carcinoma (mRCC) was estimated to be up to $1.6 billion worldwide and has since grown annually. With the continuing increase of the economic burden of this disease in the United States, there is a growing need for economic analyses to guide treatment and policy decisions for this patient population. Objective To evaluate available comparative economic data on targeted therapies for patients with mRCC who have failed first-line targeted therapies. Method A broad and comprehensive literature review was conducted of US-based studies between January 1, 2005, and February 11, 2013, evaluating comparative economic evidence for targeted agents that are used as second-line therapy or beyond. Based on the specific search parameters that focused on cost-effectiveness and economic comparisons between vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFr) inhibitors and mammalian target of rapamycin (mTOR) inhibitors, only 7 relevant, US-based economic evaluations were found appropriate for inclusion in the analysis. All authors, who are experts in the health economics and outcomes research field, reviewed the search results. Studies of interest were those with a targeted agent, VEGF/VEGFr or mTOR inhibitor, in at least 1 study arm. Discussion As a group, targeted therapies were found to be cost-effective options in treating patients with refractory mRCC in the United States. Oral therapies showed an economic advantage over intravenous agents, presumably because oral therapies have a lower impact on outpatient resources. Based on 3 studies, everolimus has been shown to have an economic advantage over temsirolimus and to be cost-effective compared with sorafenib. No economic comparison between everolimus and axitinib, the only 2 drugs with a National Comprehensive Cancer Network category 1 recommendation for use after the failure of VEGFr tyrosine kinase inhibitors, is available. Conclusion The limited and heterogeneous sum of the currently available economic evidence does not allow firm conclusions to be drawn about the most cost-effective targeted treatment option in the second-line setting and beyond in patients with mRCC. It is hoped that ongoing head-to-head therapeutic trials and biomarker studies will help improve the economic efficiency of these expensive agents. PMID:24991363

Pharmaceutical priority setting and the use of health economic evaluations: a systematic literature review.

PubMed

Erntoft, Sandra

2011-06-01

To investigate which factors and criteria are used in priority setting of pharmaceuticals, in what contexts health economic evaluations are used, and barriers to the use of health economic evaluations at micro, meso, and macro health-care levels. The search for empirical articles was based on the MeSH index (Medical Substance Heading), including the search terms "economic evaluation," "cost-effectiveness analysis," "cost-utility analysis," "cost-benefit analysis," "pharmacoeconomic," AND "drug cost(s)," AND "eligibility determination," AND "decision-making," AND "rationing," AND formulary. The following databases were searched: PubMed, EconLit, Cochrane, Web of Science, CINAHL, and PsycINFO. More than 3100 studies were identified, 31 of which were included in this review. The use of health economic evaluations at all three health-care levels was investigated in three countries (United States [US], United Kingdom [UK], and Sweden). Postal and telephone survey methods dominated (n = 17) followed by interviews (n = 13), document analysis (n = 10), and observations of group deliberations (n = 9). The cost-effectiveness criterion was most important at the macro level. A number of contextual uses of health economic evaluations were identified, including importantly the legitimizing of decisions, structuring the priority-setting process, and requesting additional budgets to finance expensive pharmaceuticals. Factors that seem to support the increased use of health economic evaluations are well-developed frameworks for evaluations, the presence of health economic skills, and an explicit priority-setting process. Differences in how economic evaluations are used at macro, meso, and micro levels are attributed to differences in the preconditions at each level. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-06-01

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

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-04-01

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

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-05-01

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

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-03-25

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

Economic evaluation in patient safety: a literature review of methods.

PubMed

de Rezende, Bruna Alves; Or, Zeynep; Com-Ruelle, Laure; Michel, Philippe

2012-06-01

Patient safety practices, targeting organisational changes for improving patient safety, are implemented worldwide but their costs are rarely evaluated. This paper provides a review of the methods used in economic evaluation of such practices. International medical and economics databases were searched for peer-reviewed publications on economic evaluations of patient safety between 2000 and 2010 in English and French. This was complemented by a manual search of the reference lists of relevant papers. Grey literature was excluded. Studies were described using a standardised template and assessed independently by two researchers according to six quality criteria. 33 articles were reviewed that were representative of different patient safety domains, data types and evaluation methods. 18 estimated the economic burden of adverse events, 3 measured the costs of patient safety practices and 12 provided complete economic evaluations. Healthcare-associated infections were the most common subject of evaluation, followed by medication-related errors and all types of adverse events. Of these, 10 were selected that had adequately fulfilled one or several key quality criteria for illustration. This review shows that full cost-benefit/utility evaluations are rarely completed as they are resource intensive and often require unavailable data; some overcome these difficulties by performing stochastic modelling and by using secondary sources. Low methodological transparency can be a problem for building evidence from available economic evaluations. Investing in the economic design and reporting of studies with more emphasis on defining study perspectives, data collection and methodological choices could be helpful for strengthening our knowledge base on practices for improving patient safety.

Emergy evaluation of water utilization benefits in water-ecological-economic system based on water cycle process

NASA Astrophysics Data System (ADS)

Guo, X.; Wu, Z.; Lv, C.

2017-12-01

The water utilization benefits are formed by the material flow, energy flow, information flow and value stream in the whole water cycle process, and reflected along with the material circulation of inner system. But most of traditional water utilization benefits evaluation are based on the macro level, only consider the whole material input and output and energy conversion relation, and lack the characterization of water utilization benefits accompanying with water cycle process from the formation mechanism. In addition, most studies are from the perspective of economics, only pay attention to the whole economic output and sewage treatment economic investment, but neglect the ecological function benefits of water cycle, Therefore, from the perspective of internal material circulation in the whole system, taking water cycle process as the process of material circulation and energy flow, the circulation and flow process of water and other ecological environment, social economic elements were described, and the composition of water utilization positive and negative benefits in water-ecological-economic system was explored, and the performance of each benefit was analyzed. On this basis, the emergy calculation method of each benefit was proposed by emergy quantitative analysis technique, which can realize the unified measurement and evaluation of water utilization benefits in water-ecological-economic system. Then, taking Zhengzhou city as an example, the corresponding benefits of different water cycle links were calculated quantitatively by emergy method, and the results showed that the emergy evaluation method of water utilization benefits can unify the ecosystem and the economic system, achieve uniform quantitative analysis, and measure the true value of natural resources and human economic activities comprehensively.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS)--explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force.

PubMed

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

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting because substantial information must be conveyed to allow scrutiny of study findings. Despite a growth in published reports, existing reporting guidelines are not widely adopted. There is also a need to consolidate and update existing guidelines and promote their use in a user-friendly manner. A checklist is one way to help authors, editors, and peer reviewers use guidelines to improve reporting. The task force's overall goal was to provide recommendations to optimize the reporting of health economic evaluations. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines into one current, useful reporting guidance. The CHEERS Elaboration and Explanation Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force facilitates the use of the CHEERS statement by providing examples and explanations for each recommendation. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. Previously published checklists or guidance documents related to reporting economic evaluations were identified from a systematic review and subsequent survey of task force members. A list of possible items from these efforts was created. A two-round, modified Delphi Panel with representatives from academia, clinical practice, industry, and government, as well as the editorial community, was used to identify a minimum set of items important for reporting from the larger list. Out of 44 candidate items, 24 items and accompanying recommendations were developed, with some specific recommendations for single study-based and model-based economic evaluations. The final recommendations are subdivided into six main categories: 1) title and abstract, 2) introduction, 3) methods, 4) results, 5) discussion, and 6) other. The recommendations are contained in the CHEERS statement, a user-friendly 24-item checklist. The task force report provides explanation and elaboration, as well as an example for each recommendation. The ISPOR CHEERS statement is available online via Value in Health or the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices - CHEERS Task Force webpage (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope that the ISPOR CHEERS statement and the accompanying task force report guidance will lead to more consistent and transparent reporting, and ultimately, better health decisions. To facilitate wider dissemination and uptake of this guidance, we are copublishing the CHEERS statement across 10 health economics and medical journals. We encourage other journals and groups to consider endorsing the CHEERS statement. The author team plans to review the checklist for an update in 5 years. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Understanding chemotherapy treatment pathways of advanced colorectal cancer patients to inform an economic evaluation in the United Kingdom

PubMed Central

Shabaruddin, F H; Elliott, R A; Valle, J W; Newman, W G; Payne, K

2010-01-01

Background: Accurate description of current practice within advanced colorectal cancer (CRC) specialties were needed to inform an economic evaluation of the UGT1A1 pharmacogenetic test for irinotecan in the United Kingdom. Methods: The study was based on a literature review and elicitation of expert opinion. The expert panel comprised 44 consultant oncologists in NHS Hospital Trusts across England. Results: Ten first-line, 10 second-line and 12 third-line chemotherapy regimens were reported, reflecting wide variations in treatment pathways. Predominant pathways emerged with: first-line treatment with oxaliplatin-based regimens, second-line treatment with irinotecan-based regimens and third-line treatment with mitomycin-based regimens. Experts estimated the frequency of febrile neutropaenia 8.4% (95% CI: 6.7–10.0), septic neutropaenia 4.7% (95% CI: 3.4–6.0) and severe diarrhoea 13.1% (95% CI: 10.8–15.5). Approaches for the clinical management of neutropaenia within the NHS were described. Conclusions: This study identified wide variations in the clinical management of advanced CRC patients. Descriptions of current treatment pathways are necessary for economic evaluations. Variations in clinical practice must be reflected in the model to ensure the findings from an economic evaluation of UGT1A1 testing are sufficient to inform policy regarding the cost-effective use of NHS resources. PMID:20661248

Consumer & Home Economics In-Service/Curriculum Development.

ERIC Educational Resources Information Center

McGillicuddy (Shirley) & Associates, Sierra Madre, CA.

Mt. San Antonio Community College District's Consumer/Home Economics In-Service/Curriculum Development Project was designed to provide activities to meet staff development and program improvement needs. The choice of activities was based on evaluation data from previous home economics projects, and priorities identified by the Consumer/Home…

Community Evaluation for Economic Development. Small Town Strategy.

ERIC Educational Resources Information Center

Gault, George H.; Coppedge, Robert O.

Many communities have economic development efforts, which are generally undertaken in an attempt to create productive employment opportunities and to strengthen the local tax base. Unfortunatley, the economic development efforts of many communities, especially rural communities, are not productive ones. Many rural development efforts fail because…

Health economic evaluations in orthodontics: a systematic review

PubMed Central

Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

2016-01-01

Summary Background: Economic evaluation is assuming increasing importance as an integral component of health services research. Aim: To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. Materials/methods: The literature review was conducted in four steps, according to Goodman’s model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). Results: The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. Conclusion: This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently insufficient evidence available about the health economics of orthodontic interventions. Further investigation is warranted. PMID:26070925

Health economic evaluations in orthodontics: a systematic review.

PubMed

Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

2016-06-01

Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently insufficient evidence available about the health economics of orthodontic interventions. Further investigation is warranted. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Conducting systematic reviews of economic evaluations.

PubMed

Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

2015-09-01

In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other types of evidence. The updated JBI guidance will be useful for researchers wanting to synthesize evidence about economic questions, either as stand-alone reviews or part of comprehensive or mixed method evidence reviews. Although the updated methodology produced by the work of the working group has improved the JBI guidance for systematic reviews of economic evaluations, there are areas where further work is required. These include adjusting the critical appraisal tool to separate out questions addressing intervention cost and effectiveness measurement; providing more explicit guidance for assessing generalizability of findings; and offering a more robust method for evidence synthesis that facilitates achieving the more ambitious review objectives.

A systematic and critical review of model-based economic evaluations of pharmacotherapeutics in patients with bipolar disorder.

PubMed

Mohiuddin, Syed

2014-08-01

Bipolar disorder (BD) is a chronic and relapsing mental illness with a considerable health-related and economic burden. The primary goal of pharmacotherapeutics for BD is to improve patients' well-being. The use of decision-analytic models is key in assessing the added value of the pharmacotherapeutics aimed at treating the illness, but concerns have been expressed about the appropriateness of different modelling techniques and about the transparency in the reporting of economic evaluations. This paper aimed to identify and critically appraise published model-based economic evaluations of pharmacotherapeutics in BD patients. A systematic review combining common terms for BD and economic evaluation was conducted in MEDLINE, EMBASE, PSYCINFO and ECONLIT. Studies identified were summarised and critically appraised in terms of the use of modelling technique, model structure and data sources. Considering the prognosis and management of BD, the possible benefits and limitations of each modelling technique are discussed. Fourteen studies were identified using model-based economic evaluations of pharmacotherapeutics in BD patients. Of these 14 studies, nine used Markov, three used discrete-event simulation (DES) and two used decision-tree models. Most of the studies (n = 11) did not include the rationale for the choice of modelling technique undertaken. Half of the studies did not include the risk of mortality. Surprisingly, no study considered the risk of having a mixed bipolar episode. This review identified various modelling issues that could potentially reduce the comparability of one pharmacotherapeutic intervention with another. Better use and reporting of the modelling techniques in the future studies are essential. DES modelling appears to be a flexible and comprehensive technique for evaluating the comparability of BD treatment options because of its greater flexibility of depicting the disease progression over time. However, depending on the research question, modelling techniques other than DES might also be appropriate in some cases.

The undervalued self: social class and self-evaluation.

PubMed

Kraus, Michael W; Park, Jun W

2014-01-01

Social class ranks people on the social ladder of society, and in this research we examine how perceptions of economic standing shape the way that individuals evaluate the self. Given that reminders of one's own subordinate status in society are an indicator of how society values the self in comparison to others, we predicted that chronic lower perceptions of economic standing vis-à-vis others would explain associations between objective social class and negative self-evaluation, whereas situation-specific reminders of low economic standing would elicit negative self-evaluations, particularly in those from lower-class backgrounds. In Study 1, perceptions of social class rank accounted for the positive relationship between objective material resource measures of social class and self-esteem. In Study 2, lower-class individuals who received a low (versus equal) share of economic resources in an economic game scenario reported more negative self-conscious emotions-a correlate of negative self-evaluation-relative to upper-class individuals. Discussion focused on the implications of this research for understanding class-based cultural models of the self, and for how social class shapes self-evaluations chronically.

Comprehensive benefit analysis of regional water resources based on multi-objective evaluation

NASA Astrophysics Data System (ADS)

Chi, Yixia; Xue, Lianqing; Zhang, Hui

2018-01-01

The purpose of the water resources comprehensive benefits analysis is to maximize the comprehensive benefits on the aspects of social, economic and ecological environment. Aiming at the defects of the traditional analytic hierarchy process in the evaluation of water resources, it proposed a comprehensive benefit evaluation of social, economic and environmental benefits index from the perspective of water resources comprehensive benefit in the social system, economic system and environmental system; determined the index weight by the improved fuzzy analytic hierarchy process (AHP), calculated the relative index of water resources comprehensive benefit and analyzed the comprehensive benefit of water resources in Xiangshui County by the multi-objective evaluation model. Based on the water resources data in Xiangshui County, 20 main comprehensive benefit assessment factors of 5 districts belonged to Xiangshui County were evaluated. The results showed that the comprehensive benefit of Xiangshui County was 0.7317, meanwhile the social economy has a further development space in the current situation of water resources.

Do health economic evaluations using observational data provide reliable assessment of treatment effects?

PubMed Central

2013-01-01

Economic evaluation in modern health care systems is seen as a transparent scientific framework that can be used to advance progress towards improvements in population health at the best possible value. Despite the perceived superiority that trial-based studies have in terms of internal validity, economic evaluations often employ observational data. In this review, the interface between econometrics and economic evaluation is explored, with emphasis placed on highlighting methodological issues relating to the evaluation of cost-effectiveness within a bivariate framework. Studies that satisfied the eligibility criteria exemplified the use of matching, regression analysis, propensity scores, instrumental variables, as well as difference-in-differences approaches. All studies were reviewed and critically appraised using a structured template. The findings suggest that although state-of-the-art econometric methods have the potential to provide evidence on the causal effects of clinical and policy interventions, their application in economic evaluation is subject to a number of limitations. These range from no credible assessment of key assumptions and scarce evidence regarding the relative performance of different methods, to lack of reporting of important study elements, such as a summary outcome measure and its associated sampling uncertainty. Further research is required to better understand the ways in which observational data should be analysed in the context of the economic evaluation framework. PMID:24229445

The added value of thorough economic evaluation of telemedicine networks.

PubMed

Le Goff-Pronost, Myriam; Sicotte, Claude

2010-02-01

This paper proposes a thorough framework for the economic evaluation of telemedicine networks. A standard cost analysis methodology was used as the initial base, similar to the evaluation method currently being applied to telemedicine, and to which we suggest adding subsequent stages that enhance the scope and sophistication of the analytical methodology. We completed the methodology with a longitudinal and stakeholder analysis, followed by the calculation of a break-even threshold, a calculation of the economic outcome based on net present value (NPV), an estimate of the social gain through external effects, and an assessment of the probability of social benefits. In order to illustrate the advantages, constraints and limitations of the proposed framework, we tested it in a paediatric cardiology tele-expertise network. The results demonstrate that the project threshold was not reached after the 4 years of the study. Also, the calculation of the project's NPV remained negative. However, the additional analytical steps of the proposed framework allowed us to highlight alternatives that can make this service economically viable. These included: use over an extended period of time, extending the network to other telemedicine specialties, or including it in the services offered by other community hospitals. In sum, the results presented here demonstrate the usefulness of an economic evaluation framework as a way of offering decision makers the tools they need to make comprehensive evaluations of telemedicine networks.

75 FR 38082 - Solicitation of Applications for the Research and Evaluation Program: FY 2010 Triple Bottom Line...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-01

...Pursuant to the Research and Evaluation program, the Economic Development Administration (EDA) seeks applications to research, develop, and disseminate metrics to enable policymakers and practitioners to more effectively understand how to assess the triple bottom line (economic, environmental, and social impacts) of various economic development activities. EDA's mission is to lead the Federal economic development agenda by promoting innovation and competitiveness, preparing American regions for growth and success in the worldwide economy. Through its Research and Evaluation program, EDA works towards fulfilling its mission by funding research and technical assistance projects to promote competitiveness and innovation in distressed rural and urban regions throughout the United States and its territories. By working in conjunction with its research partners, EDA will help States, local governments, and community-based organizations to achieve their highest economic potential.

Economic evaluations of pharmacist-managed services in people with diabetes mellitus: a systematic review.

PubMed

Wang, Y; Yeo, Q Q; Ko, Y

2016-04-01

To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.

Assessment of Methodological Quality of Economic Evaluations in Belgian Drug Reimbursement Applications

PubMed Central

Simoens, Steven

2013-01-01

Objectives This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. Materials and Methods For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Results Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Conclusions Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation. PMID:24386474

Assessment of methodological quality of economic evaluations in belgian drug reimbursement applications.

PubMed

Simoens, Steven

2013-01-01

This paper aims to assess the methodological quality of economic evaluations included in Belgian reimbursement applications for Class 1 drugs. For 19 reimbursement applications submitted during 2011 and Spring 2012, a descriptive analysis assessed the methodological quality of the economic evaluation, evaluated the assessment of that economic evaluation by the Drug Reimbursement Committee and the response to that assessment by the company. Compliance with methodological guidelines issued by the Belgian Healthcare Knowledge Centre was assessed using a detailed checklist of 23 methodological items. The rate of compliance was calculated based on the number of economic evaluations for which the item was applicable. Economic evaluations tended to comply with guidelines regarding perspective, target population, subgroup analyses, comparator, use of comparative clinical data and final outcome measures, calculation of costs, incremental analysis, discounting and time horizon. However, more attention needs to be paid to the description of limitations of indirect comparisons, the choice of an appropriate analytic technique, the expression of unit costs in values for the current year, the estimation and valuation of outcomes, the presentation of results of sensitivity analyses, and testing the face validity of model inputs and outputs. Also, a large variation was observed in the scope and depth of the quality assessment by the Drug Reimbursement Committee. Although general guidelines exist, pharmaceutical companies and the Drug Reimbursement Committee would benefit from the existence of a more detailed checklist of methodological items that need to be reported in an economic evaluation.

Applying health economics for policy decision making: do devices differ from drugs?

PubMed

Sorenson, Corinna; Tarricone, Rosanna; Siebert, Markus; Drummond, Michael

2011-05-01

Medical devices pose unique challenges for economic evaluation and associated decision-making processes that differ from pharmaceuticals. We highlight and discuss these challenges in the context of cardiac device therapy, based on a systematic review of relevant economic evaluations. Key challenges include practical difficulties in conducting randomized clinical trials, allowing for a 'learning curve' and user characteristics, accounting for the wider organizational impacts of introducing new devices, and allowing for variations in product characteristics and prices over time.

Survival modeling for the estimation of transition probabilities in model-based economic evaluations in the absence of individual patient data: a tutorial.

PubMed

Diaby, Vakaramoko; Adunlin, Georges; Montero, Alberto J

2014-02-01

Survival modeling techniques are increasingly being used as part of decision modeling for health economic evaluations. As many models are available, it is imperative for interested readers to know about the steps in selecting and using the most suitable ones. The objective of this paper is to propose a tutorial for the application of appropriate survival modeling techniques to estimate transition probabilities, for use in model-based economic evaluations, in the absence of individual patient data (IPD). An illustration of the use of the tutorial is provided based on the final progression-free survival (PFS) analysis of the BOLERO-2 trial in metastatic breast cancer (mBC). An algorithm was adopted from Guyot and colleagues, and was then run in the statistical package R to reconstruct IPD, based on the final PFS analysis of the BOLERO-2 trial. It should be emphasized that the reconstructed IPD represent an approximation of the original data. Afterwards, we fitted parametric models to the reconstructed IPD in the statistical package Stata. Both statistical and graphical tests were conducted to verify the relative and absolute validity of the findings. Finally, the equations for transition probabilities were derived using the general equation for transition probabilities used in model-based economic evaluations, and the parameters were estimated from fitted distributions. The results of the application of the tutorial suggest that the log-logistic model best fits the reconstructed data from the latest published Kaplan-Meier (KM) curves of the BOLERO-2 trial. Results from the regression analyses were confirmed graphically. An equation for transition probabilities was obtained for each arm of the BOLERO-2 trial. In this paper, a tutorial was proposed and used to estimate the transition probabilities for model-based economic evaluation, based on the results of the final PFS analysis of the BOLERO-2 trial in mBC. The results of our study can serve as a basis for any model (Markov) that needs the parameterization of transition probabilities, and only has summary KM plots available.

[Principles of health economic evaluation for use by caregivers].

PubMed

Derumeaux-Burel, Hélène; Derancourt, Christian; Rambhojan, Christine; Branchard, Olivier; Hayes, Nathalie; Bénard, Antoine

2017-01-01

The aim of health economic evaluation is to maximize health gains from limited resources. By definition, health economic evaluation is comparative, based on average costs and outcomes of compared interventions. Incremental costs and outcomes are used to calculate the cost-effectiveness ratio, which represents the average incremental cost per gained unit of effectiveness (i.e.: a year of life) with the evaluated intervention compared to the reference. The health economic rationale applies to all health domains. We cannot spend collective resources (health insurance) without asking ourselves about their potential alternative uses. This reasoning is useful to caregivers for understanding resources allocation decisions and healthcare recommandations. Caregivers should grab this field of expertise because they are central in this strategic reflection for defining the future French healthcare landscape. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Economic evaluation of vaccines in Canada: A systematic review

PubMed Central

Chit, Ayman; Lee, Jason K. H.; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M.

2016-01-01

ABSTRACT Background: Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. Objective: We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Methods: Searches in multiple databases were conducted using the terms “vaccine,” “economics” and “Canada.” Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Results: 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. Conclusions: We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes to review and assess the findings of the economic evaluations of vaccines. PMID:26890128

Systematic review of the economic evaluations of novel therapeutic agents in multiple myeloma: what is the reporting quality?

PubMed

Aguiar, P M; Lima, T M; Storpirtis, S

2016-04-01

Given the increasing healthcare costs and the recent introduction of novel agents in the treatment for multiple myeloma (MM), an incurable haematologic malignancy, more efficient use of existing resources is fundamental. The objective of this study was to systematically review economic evaluations of the use of novel agents in MM and assess their reporting quality. A literature search was performed in PubMed/Medline, Latin American and Caribbean Health Sciences Literature, Cost-Effectiveness Analysis Registry and the National Health Services Economic Evaluation Database for economic evaluations up to June 2015. The search strategy included Medical Subject Headings terms or text words related to MM, economic evaluations and drugs. Full economic evaluations of bortezomib, thalidomide or lenalidomide in patients with MM that were published in English, Portuguese or Spanish were included. Two independent authors performed study selection, data extraction and quality assessment using 24 items from the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Of the 132 potentially relevant records identified, eight satisfied the inclusion criteria. Most studies were cost-effectiveness analyses combined with cost-utility analyses (n = 6) from the public payer perspective (n = 4) and were performed in Europe (n = 6) on patients with refractory or relapsed MM (n = 5). All studies were based on economic models, with four of them using discrete event simulation. We found bortezomib-based therapies to be one of the more commonly selected treatment strategies for comparison (n = 7). Overall, the intervention was more effective and costlier than the alternative strategy (average of $54 630 per life year; $68 261 per quality-adjusted life year-QALY). The CHEERS' total score was 14·6 (SD = 2·6) with the most frequent problems being the lack of precision measures for all model parameters, no evaluation of heterogeneity of the results by subgroup analyses and no description of the role the funder in the identification, design, conduct and reporting of the analysis. Most analyses of the novel therapeutic agents determined that they were cost-effective in MM at a threshold of up to $100 000/QALY. Nevertheless, the poor reporting quality of the economic studies requires improvement to ensure greater transparency. © 2016 John Wiley & Sons Ltd.

3. How comprehensive can we be in the economic assessment of vaccines?

PubMed Central

2017-01-01

ABSTRACT In two previous papers we argued on current vaccines economic assessment not fully comprehensive when using the incremental cost-utility analysis normally applied for treatments. Many differences exist between vaccines and drug treatments making vaccines economic evaluation more cumbersome. Four challenges overwhelmingly present in vaccines assessment are less important for treatments: requirements for population, societal perspectives, budget impact evaluation, and time focused objectives (control or elimination). Based on this, economic analysis of vaccines may need to be presented to many different stakeholders with various evaluation preferences, in addition to the current stakeholders involved for drugs treatment assessment. Then, we may need a tool making the inventory of the different vaccines health economic assessment programmes more comprehensive. The cauliflower value toolbox has been developed with that aim, and its use is illustrated here with rotavirus vaccine. Given the broader perspectives for vaccine assessment, it provides better value and cost evaluations. Cost-benefit analysis may be the preferred economic assessment method when considering substitution from treatment to active medical prevention. Other economic evaluation methods can be selected (i.e. optimisation modelling, return on investment) when project prioritisation is the main focus considered and when stakeholders would like to influence the development of the healthcare programme. PMID:29785253

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

NASA Technical Reports Server (NTRS)

1980-01-01

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

Economic evaluations and randomized trials in spinal disorders: principles and methods.

PubMed

Korthals-de Bos, Ingeborg; van Tulder, Maurits; van Dieten, Hiske; Bouter, Lex

2004-02-15

Descriptive methodologic recommendations. To help researchers designing, conducting, and reporting economic evaluations in the field of back and neck pain. Economic evaluations of both existing and new therapeutic interventions are becoming increasingly important. There is a need to improve the methods of economic evaluations in the field of spinal disorders. To improve the methods of economic evaluations in the field of spinal disorders, this article describes the various steps in an economic evaluation, using as example a study on the cost-effectiveness of manual therapy, physiotherapy, and usual care provided by the general practitioner for patients with neck pain. An economic evaluation is a study in which two or more interventions are systematically compared with regard to both costs and effects. There are four types of economic evaluations, based on analysis of: (1) cost-effectiveness, (2) cost-utility, (3) cost-minimization, and (4) cost-benefit. The cost-utility analysis is a special case of cost-effectiveness analysis. The first step in all these economic evaluations is to identify the perspective of the study. The choice of the perspective will have consequences for the identification of costs and effects. Secondly, the alternatives that will be compared should be identified. Thirdly, the relevant costs and effects should be identified. Economic evaluations are usually performed from a societal perspective and include consequently direct health care costs, direct nonhealth care costs, and indirect costs. Fourthly, effect data are collected by means of questionnaires or interviews, and relevant cost data with regard to effect measures and health care utilization, work absenteeism, travel expenses, use of over-the-counter medication, and help from family and friends, are collected by means of cost diaries, questionnaires, or (telephone) interviews. Fifthly, real costs are calculated, or the costs are estimated on the basis of real costs, guideline prices, or tariffs. Finally, in the statistical analysis the mean direct, indirect, and total costs of the alternatives are compared, using bootstrapping techniques. Incremental cost-effectiveness ratios are graphically presented on a cost-effectiveness plane and acceptability curves are calculated. Economic evaluations require specific methods. These recommendations may be helpful in improving the quality of economic evaluations of new and existing therapeutic interventions in the field of spinal disorders.

Economic evaluations of health technologies in Dutch healthcare decision-making: a qualitative study of the current and potential use, barriers, and facilitators.

PubMed

Roseboom, Kitty J; van Dongen, Johanna M; Tompa, Emile; van Tulder, Maurits W; Bosmans, Judith E

2017-01-26

The use of economic evaluations in healthcare decision-making can potentially help decision-makers in allocating scarce resources as efficiently as possible. Over a decade ago, the use of such studies was found to be limited in Dutch healthcare decision-making, but their current use is unknown. Therefore, this study aimed to provide insight into the current and potential use of economic evaluations in Dutch healthcare decision-making and to identify barriers and facilitators to the use of such studies. Interviews containing semi-structured and structured questions were conducted among Dutch healthcare decision-makers. Participants were purposefully selected and special efforts were made to include decision-makers working at the macro- (national), meso- (local/regional), and micro-level (patient setting). During the interviews, a topic list was used that was based on the research questions and a literature search, and was developed in consultation with the Dutch National Healthcare Institute. Responses to the semi-structured questions were analyzed using a constant comparative approach. As for the structured questions, participants' definitions of various economic evaluation concepts were scored as either being "correct" or "incorrect" by two researchers, and summary statistics were prepared. Sixteen healthcare decision-makers were interviewed and two health economists. Decision-makers' knowledge of economic evaluations was only modest, and their current use appeared to be limited. Nonetheless, decision-makers recognized the importance of economic evaluations and saw several opportunities for extending their use at the macro- and meso-level, but not at the micro-level. The disparity between the limited use and recognition of the importance of economic evaluations is likely due to the many barriers decision-makers experience preventing their use (e.g. lack of resources, lack of formal willingness-to-pay threshold). Possible facilitators for extending the use of economic evaluations include, amongst others, educating decision-makers and the general population about economic evaluations and presenting economic evaluation results in a clearer and more understandable way. This study demonstrated that the current use and impact of economic evaluations in Dutch healthcare decision-making is limited at best. Therefore, strategies are needed to overcome the barriers that currently prevent economic evaluations from being used extensively.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement

PubMed Central

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531108

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement

PubMed Central

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (http://www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. PMID:23531194

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-05-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance.The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in 5 years. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-03-25

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

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. Copyright © 2013. Published by Elsevier Inc.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-04-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website: (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hope CHEERS will lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. We encourage other journals and groups, to endorse CHEERS. The author team plans to review the checklist for an update in five years. Copyright © 2013. Published by EM Inc USA.

Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

PubMed

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

2013-01-01

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user-friendly manner. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance. The primary audiences for the CHEERS statement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user-friendly, 24-item checklist. A copy of the statement, accompanying checklist, and this report can be found on the ISPOR Health Economic Evaluations Publication Guidelines Task Force website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). The hope is that CHEERS will lead to better reporting and, ultimately, better health decisions. To facilitate dissemination and uptake, the CHEERS statement is being co-published across 10 health economics and medical journals. Other journals and groups are encouraged to endorse CHEERS. The author team plans to review the checklist for an update in 5 years.

Economic evaluation of algae biodiesel based on meta-analyses

NASA Astrophysics Data System (ADS)

Zhang, Yongli; Liu, Xiaowei; White, Mark A.; Colosi, Lisa M.

2017-08-01

The objective of this study is to elucidate the economic viability of algae-to-energy systems at a large scale, by developing a meta-analysis of five previously published economic evaluations of systems producing algae biodiesel. Data from original studies were harmonised into a standardised framework using financial and technical assumptions. Results suggest that the selling price of algae biodiesel under the base case would be 5.00-10.31/gal, higher than the selected benchmarks: 3.77/gal for petroleum diesel, and 4.21/gal for commercial biodiesel (B100) from conventional vegetable oil or animal fat. However, the projected selling price of algal biodiesel (2.76-4.92/gal), following anticipated improvements, would be competitive. A scenario-based sensitivity analysis reveals that the price of algae biodiesel is most sensitive to algae biomass productivity, algae oil content, and algae cultivation cost. This indicates that the improvements in the yield, quality, and cost of algae feedstock could be the key factors to make algae-derived biodiesel economically viable.

[Trends on generation and reproduction of knowledge about economic evaluation and health].

PubMed

Arredondo, A; Parada, I

2001-08-01

This paper identifies the trends and recent progress in the generation and reproduction of knowledge on health economic evaluation. Analysis is organized along nine public health action fields, namely: health determinants and predictors, economic value of health, healthcare demand, healthcare supply, microeconomic evaluation of healthcare, healthcare market balance, evaluation of policy instruments, general evaluation of the health system, and healthcare planning, regulation and supervision. Each action field is defined to place the reader in the proper setting and level of analysis. In addition, thematic research topics developed in each action field are proposed and discussed. The generation and reproduction of knowledge on the different action fields was based on the review of the bibliographic databases MEDLINE and LILACS for the 1992-2000 period. Results lead to the conclusion that development and application of economic evaluation of healthcare has been uneven across different countries and that there is a growing increase of applications starting in 1994, the year of initiation of healthcare reform in Latin America.

The Potential to Forgo Social Welfare Gains through Overrelianceon Cost Effectiveness/Cost Utility Analyses in the Evidence Base for Public Health

PubMed Central

Cohen, D. R.; Patel, N.

2009-01-01

Economic evaluations of clinical treatments most commonly take the form of cost effectiveness or cost utility analyses. This is appropriate since the main—sometimes the only—benefit of such interventions is increased health. The majority of economic evaluations in public health, however, have also been assessed using these techniques when arguably cost benefit analyses would in many cases have been more appropriate, given its ability to take account of nonhealth benefits as well. An examination of the nonhealth benefits from a sample of studies featured in a recent review of economic evaluations in public health illustrates how overfocusing on cost effectiveness/cost utility analyses may lead to forgoing potential social welfare gains from programmes in public health. Prior to evaluation, programmes should be considered in terms of the potential importance of nonhealth benefits and where these are considerable would be better evaluated by more inclusive economic evaluation techniques. PMID:20049165

ACCP: economic evaluations of clinical pharmacy services: 2001-2005.

PubMed

Perez, Alexandra; Doloresco, Fred; Hoffman, James M; Meek, Patrick D; Touchette, Daniel R; Vermeulen, Lee C; Schumock, Glen T

2009-01-01

The objectives of this review were to summarize and evaluate studies that measured the economic impact of clinical pharmacy services published between 2001 and 2005 (inclusive) and to provide guidance on methodologic considerations to individuals performing such research in the future. A systematic literature search using the MEDLINE and International Pharmaceutical Abstracts databases was conducted to identify published economic evaluations of clinical pharmacy services. Studies were screened and then randomly assigned to reviewers, who reassessed inclusion and exclusion criteria and abstracted prespecified data from each study. Among the many characteristics examined in each study were study design and type of economic evaluation, setting and type of clinical pharmacy service, study quality, and results. Ninety-three articles were included in the final analysis. These studies were published in 43 different journals, most of which (68 [73.1%]) were pharmacy-based. Most studies were performed in hospitals (40 [43.0%]), ambulatory care clinics or physician's offices (20 [21.5%]), or community pharmacies (16 [17.2%]). The most common types of clinical pharmacy services evaluated were general pharmacotherapeutic monitoring services (32 [34.4%]), target drug programs (27 [29%]), and disease state-management services (21 [22.6%]). Full economic evaluations were performed in just less than half (45 [48.4%]) of the studies, and a positive economic benefit associated with clinical pharmacy services was noted in 31 (69%) of the 45 studies. Among 15 studies reporting data necessary to determine a benefit:cost ratio, the pooled median value was 4.81:1-meaning that for every $1 invested in clinical pharmacy services, $4.81 was achieved in reduced costs or other economic benefits. The quality of studies varied widely, with less than one half considered to be good to fair (40 [43.0%]); however, the proportion of studies using appropriate study designs increased compared with previous reviews. Based on the evidence examined in this review, clinical pharmacy services continue to provide a significant return on investment, but improvements are still needed in the methods used to evaluate the economic impact of these services.

Outcomes-Based Education Integration in Home Economics Program: An Evaluative Study

ERIC Educational Resources Information Center

Limon, Mark Raguindin; Castillo Vallente, John Paul

2016-01-01

This study examined the factors that affect the integration of Outcomes-Based Education (OBE) in the Home Economics (HE) education curriculum of the Technology and Livelihood Education (TLE) program of a State University in the northern part of the Philippines. Descriptive survey and qualitative design were deployed to gather, analyze, and…

A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population

PubMed Central

Ong, Katherine S; Kelaher, Margaret; Anderson, Ian; Carter, Rob

2009-01-01

Background Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services. Methods Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation. Results Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. Conclusion Cost-based weights have the potential to provide a pragmatic method of equity weight construction which is both understandable to policy makers and sensitive to the needs of target groups. It could improve the evidence base for resource allocation decisions, and be generalised to other disadvantaged groups who share similar concepts of equity. Development of this decision-making tool represents a potentially important avenue for further health economics research. PMID:19807930

Traumatic brain injury: methodological approaches to estimate health and economic outcomes.

PubMed

Lu, Juan; Roe, Cecilie; Aas, Eline; Lapane, Kate L; Niemeier, Janet; Arango-Lasprilla, Juan Carlos; Andelic, Nada

2013-12-01

The effort to standardize the methodology and adherence to recommended principles for all economic evaluations has been emphasized in medical literature. The objective of this review is to examine whether economic evaluations in traumatic brain injury (TBI) research have been compliant with existing guidelines. Medline search was performed between January 1, 1995 and August 11, 2012. All original TBI-related full economic evaluations were included in the study. Two authors independently rated each study's methodology and data presentation to determine compliance to the 10 methodological principles recommended by Blackmore et al. Descriptive analysis was used to summarize the data. Inter-rater reliability was assessed with Kappa statistics. A total of 28 studies met the inclusion criteria. Eighteen of these studies described cost-effectiveness, seven cost-benefit, and three cost-utility analyses. The results showed a rapid growth in the number of published articles on the economic impact of TBI since 2000 and an improvement in their methodological quality. However, overall compliance with recommended methodological principles of TBI-related economic evaluation has been deficient. On average, about six of the 10 criteria were followed in these publications, and only two articles met all 10 criteria. These findings call for an increased awareness of the methodological standards that should be followed by investigators both in performance of economic evaluation and in reviews of evaluation reports prior to publication. The results also suggest that all economic evaluations should be made by following the guidelines within a conceptual framework, in order to facilitate evidence-based practices in the field of TBI.

A review of typhoid fever transmission dynamic models and economic evaluations of vaccination.

PubMed

Watson, Conall H; Edmunds, W John

2015-06-19

Despite a recommendation by the World Health Organization (WHO) that typhoid vaccines be considered for the control of endemic disease and outbreaks, programmatic use remains limited. Transmission models and economic evaluation may be informative in decision making about vaccine programme introductions and their role alongside other control measures. A literature search found few typhoid transmission models or economic evaluations relative to analyses of other infectious diseases of similar or lower health burden. Modelling suggests vaccines alone are unlikely to eliminate endemic disease in the short to medium term without measures to reduce transmission from asymptomatic carriage. The single identified data-fitted transmission model of typhoid vaccination suggests vaccines can reduce disease burden substantially when introduced programmatically but that indirect protection depends on the relative contribution of carriage to transmission in a given setting. This is an important source of epidemiological uncertainty, alongside the extent and nature of natural immunity. Economic evaluations suggest that typhoid vaccination can be cost-saving to health services if incidence is extremely high and cost-effective in other high-incidence situations, when compared to WHO norms. Targeting vaccination to the highest incidence age-groups is likely to improve cost-effectiveness substantially. Economic perspective and vaccine costs substantially affect estimates, with disease incidence, case-fatality rates, and vaccine efficacy over time also important determinants of cost-effectiveness and sources of uncertainty. Static economic models may under-estimate benefits of typhoid vaccination by omitting indirect protection. Typhoid fever transmission models currently require per-setting epidemiological parameterisation to inform their use in economic evaluation, which may limit their generalisability. We found no economic evaluation based on transmission dynamic modelling, and no economic evaluation of typhoid vaccination against interventions such as improvements in sanitation or hygiene. Copyright © 2015. Published by Elsevier Ltd.

The undervalued self: social class and self-evaluation

PubMed Central

Kraus, Michael W.; Park, Jun W.

2014-01-01

Social class ranks people on the social ladder of society, and in this research we examine how perceptions of economic standing shape the way that individuals evaluate the self. Given that reminders of one’s own subordinate status in society are an indicator of how society values the self in comparison to others, we predicted that chronic lower perceptions of economic standing vis-à-vis others would explain associations between objective social class and negative self-evaluation, whereas situation-specific reminders of low economic standing would elicit negative self-evaluations, particularly in those from lower-class backgrounds. In Study 1, perceptions of social class rank accounted for the positive relationship between objective material resource measures of social class and self-esteem. In Study 2, lower-class individuals who received a low (versus equal) share of economic resources in an economic game scenario reported more negative self-conscious emotions—a correlate of negative self-evaluation—relative to upper-class individuals. Discussion focused on the implications of this research for understanding class-based cultural models of the self, and for how social class shapes self-evaluations chronically. PMID:25538654

Green Net Value Added as a Sustainability Metric Based on Life Cycle Assessment: An Application to Bounty® Paper Towel

EPA Science Inventory

Sustainability measurement in economics involves evaluation of environmental and economic impact in an integrated manner. In this study, system level economic data are combined with environmental impact from a life cycle assessment (LCA) of a common product. We are exploring a co...

[Is rehabilitation worth it? : Review of economic evaluations of rehabilitation in Germany].

PubMed

Krauth, Christian; Bartling, Tim

2017-04-01

Because of demographic change, the rehabilitation sector in Germany is going to face increasing demands in the future. Limited budgets make the optimal allocation of resources a top priority. To support decisions about the optimal scope and design of rehabilitation, studies on health economics are of utmost importance. The aim of this article is to provide an overview of the evaluation of rehabilitation with regard to health economics in Germany.Based on a comprehensive literature research, 17 studies on the cost-effectiveness of rehabilitation in Germany were identified. The health economics evaluation focuses on four main topics: patient education (5 studies), the comparison of outpatient and inpatient rehabilitation (7 studies), medico-occupational rehabilitation programs (2 studies) and aftercare programs (3 studies). All four topics show that innovative rehabilitation technologies can be cost-effective. Significant potential savings in program costs of 25-35% are demonstrated in outpatient rehabilitation (with comparable effectiveness with inpatient care). Designated patient education programs often lead to significant savings with indirect costs, by reducing periods of unfitness to work and extending the long-term ability to work. This review article also points out that some relevant areas of rehabilitation, such as the flexibilization of rehabilitation programs or the efficient organization of access to rehabilitation, have not been evaluated sufficiently on the basis of health economics. This article ends with the requirement to carry out more economics-based rehabilitation studies.

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

PubMed Central

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

2016-01-01

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

Economic Evaluation of Hospital and Community Pharmacy Services.

PubMed

Gammie, Todd; Vogler, Sabine; Babar, Zaheer-Ud-Din

2017-01-01

To review the international body of literature from 2010 to 2015 concerning methods of economic evaluations used in hospital- and community-based studies of pharmacy services in publicly funded health systems worldwide, their clinical outcomes, and economic effectiveness. The literature search was undertaken between May 2, 2015, and September 4, 2015. Keywords included "health economics" and "evaluation" "assessment" or "appraisal," "methods," "hospital" or "community" or "residential care," "pharmacy" or "pharmacy services" and "cost minimisation analysis" or "cost utility analysis" or "cost effectiveness analysis" or "cost benefit analysis." The databases searched included MEDLINE, PubMed, Google Scholar, Science Direct, Springer Links, and Scopus, and journals searched included PLoS One, PLoS Medicine, Nature, Health Policy, Pharmacoeconomics, The European Journal of Health Economics, Expert Review of Pharmacoeconomics and Outcomes Research, and Journal of Health Economics. Studies were selected on the basis of study inclusion criteria. These criteria included full-text original research articles undertaking an economic evaluation of hospital- or community-based pharmacy services in peer-reviewed scientific journals and in English, in countries with a publicly funded health system published between 2010 and 2015. 14 articles were included in this review. Cost-utility analysis (CUA) was the most utilized measure. Cost-minimization analysis (CMA) was not used by any studies. The limited use of cost-benefit analyses (CBAs) is likely a result of technical challenges in quantifying the cost of clinical benefits, risks, and outcomes. Hospital pharmacy services provided clinical benefits including improvements in patient health outcomes and reductions in adverse medication use, and all studies were considered cost-effective due to meeting a cost-utility (per quality-adjusted life year) threshold or were cost saving. Community pharmacy services were considered cost-effective in 8 of 10 studies. Economic evaluations of hospital and community pharmacy services are becoming increasingly commonplace to enable an understanding of which health care services provide value for money and to inform policy makers as to which services will be cost-effective in light of limited health care resources.

A reference case for economic evaluations in osteoarthritis: an expert consensus article from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

PubMed

Hiligsmann, Mickaël; Cooper, Cyrus; Guillemin, Francis; Hochberg, Marc C; Tugwell, Peter; Arden, Nigel; Berenbaum, Francis; Boers, Maarten; Boonen, Annelies; Branco, Jaime C; Maria-Luisa, Brandi; Bruyère, Olivier; Gasparik, Andrea; Kanis, John A; Kvien, Tore K; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Pinedo-Villanueva, Rafael; Pinto, Daniel; Reiter-Niesert, Susanne; Rizzoli, René; Rovati, Lucio C; Severens, Johan L; Silverman, Stuart; Reginster, Jean-Yves

2014-12-01

General recommendations for a reference case for economic studies in rheumatic diseases were published in 2002 in an initiative to improve the comparability of cost-effectiveness studies in the field. Since then, economic evaluations in osteoarthritis (OA) continue to show considerable heterogeneity in methodological approach. To develop a reference case specific for economic studies in OA, including the standard optimal care, with which to judge new pharmacologic and non-pharmacologic interventions. Four subgroups of an ESCEO expert working group on economic assessments (13 experts representing diverse aspects of clinical research and/or economic evaluations) were charged with producing lists of recommendations that would potentially improve the comparability of economic analyses in OA: outcome measures, comparators, costs and methodology. These proposals were discussed and refined during a face-to-face meeting in 2013. They are presented here in the format of the recommendations of the recently published Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement, so that an initiative on economic analysis methodology might be consolidated with an initiative on reporting standards. Overall, three distinct reference cases are proposed, one for each hand, knee and hip OA; with diagnostic variations in the first two, giving rise to different treatment options: interphalangeal or thumb-based disease for hand OA and the presence or absence of joint malalignment for knee OA. A set of management strategies is proposed, which should be further evaluated to help establish a consensus on the "standard optimal care" in each proposed reference case. The recommendations on outcome measures, cost itemisation and methodological approaches are also provided. The ESCEO group proposes a set of disease-specific recommendations on the conduct and reporting of economic evaluations in OA that could help the standardisation and comparability of studies that evaluate therapeutic strategies of OA in terms of costs and effectiveness. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Methodological considerations in service use assessment for children and youth with mental health conditions; issues for economic evaluation.

PubMed

Woolderink, M; Lynch, F L; van Asselt, A D I; Beecham, J; Evers, S M A A; Paulus, A T G; van Schayck, C P

2015-05-01

Economic evaluations are increasingly used in decision-making. Accurate measurement of service use is critical to economic evaluation. This qualitative study, based on expert interviews, aims to identify best approaches to service use measurement for child mental health conditions, and to identify problems in current methods. Results suggest considerable agreement on strengths (e.g., availability of accurate instruments to measure service use) and weaknesses, (e.g., lack of unit prices for services outside the health sector) or alternative approaches to service use measurement. Experts also identified some unresolved problems, for example the lack of uniform definitions for some mental health services.

Economic geology of lunar Helium-3

NASA Technical Reports Server (NTRS)

Schmitt, Harrison H.

1988-01-01

Economic geology evaluation of lunar He-3 should answer the question: Can lunar He-3 be sold on Earth with sufficient profit margins and low enough risk to attract capital investment in the enterprise. Concepts that relate to economic geology of recovering He-3 from the lunar maria are not new to human experience. A parametric cost and technology evaluation scheme, based on existing and future data, is required to qualitatively and quantitatively assess the comprehensive economic feasibility and return on investment of He-3 recovery from the lunar maria. There are also many political issues which must be considered as a result of nuclear fusion and lunar mining.

78 FR 19649 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

...- year pilot study. This study, to be conducted in the exclusive economic zone (EEZ) of the Gulf of... effectiveness of a more timely electronic data reporting system; and evaluate the potential social and economic... conduct a pilot study to evaluate the efficacy of an allocation-based management strategy, which if proven...

Paediatric health economic evaluations: a world view.

PubMed

Ungar, Wendy J

2007-01-01

As economic evaluation methods evolve, their applicability to special populations, such as children, has received increased scrutiny. The objective was to review paediatric health economic evaluations published over the last quarter century, comment on trends, discuss gaps between developed and developing nations, and point to future directions for research. Data compiled for the Paediatric Economic Database Evaluation (PEDE) project to 2003 were used to describe temporal and geographic trends and evaluate the frequency of intervention categories and conditions studied. The volume of paediatric health economic evaluations rose rapidly since 1980. Studies of infective/parasitic diseases, congenital anomalies and complications of pregnancy accounted for the majority. Prevention rather than treatment was emphasized. Most evaluations performed since 1998 (78%) were cost-effectiveness analyses. Cost-utility analyses were rare. The US produced half of all publications, with the U.K. contributing 12%. Economic evaluations from developing countries were uncommon, despite an urgent need for evidence-based decision-making in these regions. The interventions studied reflected local health priorities; HIV and malaria prevention were more commonly studied in developing nations, whereas treatments for asthma and birth malformations were more often evaluated in developed nations. Despite global initiatives to combat disease, developing nations rely on foreign research to inform implementation of local health programs. There is a need for better methods for data transfer and extrapolation. Future research must focus on paediatric models of costs and consequences and the development of tools to measure long-term effects.

New decision-making processes for the pricing of health technologies in Japan: The FY 2016/2017 pilot phase for the introduction of economic evaluations.

PubMed

Shiroiwa, Takeru; Fukuda, Takashi; Ikeda, Shunya; Takura, Tomoyuki

2017-08-01

Economic evaluation is used for decision-making processes in healthcare technologies in many developed countries. In Japan, no health economic data have been requested for drugs, medical devices, and interventions till date. However, economic evaluation is gradually gaining importance, and a trial implementation of the cost-effectiveness evaluation of drugs and medical devices has begun. Discussions on economic evaluation began in May 2012 within a newly established sub-committee of the Chuikyo, referred to as the "Special Committee on Cost Effectiveness." After four years of discussions, this committee determined that during the trial implementation, the results of the cost-effectiveness evaluation would be used for the re-pricing of drugs and medical devices at the end of fiscal year (FY) 2017. Chuikyo selected 13 products (7 drugs and 6 medical devices) as targets for this evaluation. These products will be evaluated until the end of FY 2017 based on the following process: manufacturers will submit the data of economic evaluation; the National Institute of Public Health will coordinate the review process; academic groups will perform the actual review of the submitted data, and the expert committee will appraise these data. This represents the first step to introducing cost-effectiveness analysis in the Japanese healthcare system. We believe that these efforts will contribute to the efficiency and sustainability of the Japanese healthcare system. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Counting Jobs and Economic Impacts from Distributed Wind in the United States (Poster)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tegen, S.

This conference poster describes the distributed wind Jobs and Economic Development Imapcts (JEDI) model. The goal of this work is to provide a model that estimates jobs and other economic effects associated with the domestic distributed wind industry. The distributed wind JEDI model is a free input-output model that estimates employment and other impacts resulting from an investment in distributed wind installations. Default inputs are from installers and industry experts and are based on existing projects. User input can be minimal (use defaults) or very detailed for more precise results. JEDI can help evaluate potential scenarios, current or future; informmore » stakeholders and decision-makers; assist businesses in evaluating economic development impacts and estimating jobs; assist government organizations with planning and evaluating and developing communities.« less

Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs.

PubMed

Moret, Whitney M

2018-03-21

Economic strengthening practitioners are increasingly seeking data collection tools that will help them target households vulnerable to HIV and poor child well-being outcomes, match households to appropriate interventions, monitor their status, and determine readiness for graduation from project support. This article discusses efforts in 3 countries to develop simple, valid tools to quantify and classify economic vulnerability status. In Côte d'Ivoire, we conducted a cross-sectional survey with 3,749 households to develop a scale based on the definition of HIV-related economic vulnerability from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) for the purpose of targeting vulnerable households for PEPFAR-funded programs for orphans and vulnerable children. The vulnerability measures examined did not cluster in ways that would allow for the creation of a small number of composite measures, and thus we were unable to develop a scale. In Uganda, we assessed the validity of a vulnerability index developed to classify households according to donor classifications of economic status by measuring its association with a validated poverty measure, finding only a modest correlation. In South Africa, we developed monitoring and evaluation tools to assess economic status of individual adolescent girls and their households. We found no significant correlation with our validation measures, which included a validated measure of girls' vulnerability to HIV, a validated poverty measure, and subjective classifications generated by the community, data collector, and respondent. Overall, none of the measures of economic vulnerability used in the 3 countries varied significantly with their proposed validation items. Our findings suggest that broad constructs of economic vulnerability cannot be readily captured using simple scales to classify households and individuals in a way that accounts for a substantial amount of variance at locally defined vulnerability levels. We recommend that researchers and implementers design monitoring and evaluation instruments to capture narrower definitions of vulnerability based on characteristics programs intend to affect. We also recommend using separate tools for targeting based on context-specific indicators with evidence-based links to negative outcomes. Policy makers and donors should avoid reliance on simplified metrics of economic vulnerability in the programs they support. © Moret.

[Reasearch progress in health economic evaluation of colorectal cancer screening in China].

PubMed

Huang, Huiyao; Shi, Jufang; Dai, Min

2015-08-01

Burden of colorectal cancer is rising in China. More attention and financial input have been paid to it by central government that colorectal cancer screening program has been carried out recently in many areas in China. Diversity of screening strategies and limited health resources render selecting the best strategy in a population-wide program a challenging task that economy was also required to be considered except safety and efficacy. To provide a reference for the subsequent further economic evaluation, here we reviewed the evidence available on the economic evaluation of colorectal cancer screening in China. Meanwhile, information related to screening strategies, participation and mid-term efficacy of screening, information and results on economic evaluation were extracted and summarized. Three of the four studies finally included evaluated strategies combining immunochemical fecel occult blood test (iFOBT) with high-risk factor questionnaire as initial screening, colonoscopy as diagnostic screening. There was a consensus regarding the efficacy and effectiveness of screening compared to no screening. Whereas the lack and poor comparability between studies, multi-perspective and multi-phase economic evaluation of colorectal cancer screening is needed, relying on current population-based screening program to conduct a comprehensive cost accounting.

Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions.

PubMed

Bustamante Madsen, Lizell; Eddleston, Michael; Schultz Hansen, Kristian; Konradsen, Flemming

2018-03-01

Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. To conduct a systematic review and quality appraisal of the economic evaluations of interventions aimed at preventing suicidal behavior. A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. In total, 25 documents encompassing 30 economic evaluations were included in the review. Of the identified evaluations, 10 studies were found to be of poor quality, 14 were of average quality, and six studies were considered of good quality. The majority of evaluations found the interventions to be cost-effective. Several limitations were identified and discussed in the article. A notable few economic evaluations were identified. The studies were diverse, primarily set in high-income countries, and often based on modeling, emphasizing the need for more primary research into the topic. The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects.

The South Florida Ecosystem Portfolio Model - A Map-Based Multicriteria Ecological, Economic, and Community Land-Use Planning Tool

USGS Publications Warehouse

Labiosa, William B.; Bernknopf, Richard; Hearn, Paul; Hogan, Dianna; Strong, David; Pearlstine, Leonard; Mathie, Amy M.; Wein, Anne M.; Gillen, Kevin; Wachter, Susan

2009-01-01

The South Florida Ecosystem Portfolio Model (EPM) prototype is a regional land-use planning Web tool that integrates ecological, economic, and social information and values of relevance to decision-makers and stakeholders. The EPM uses a multicriteria evaluation framework that builds on geographic information system-based (GIS) analysis and spatially-explicit models that characterize important ecological, economic, and societal endpoints and consequences that are sensitive to regional land-use/land-cover (LULC) change. The EPM uses both economics (monetized) and multiattribute utility (nonmonetized) approaches to valuing these endpoints and consequences. This hybrid approach represents a methodological middle ground between rigorous economic and ecological/ environmental scientific approaches. The EPM sacrifices some degree of economic- and ecological-forecasting precision to gain methodological transparency, spatial explicitness, and transferability, while maintaining credibility. After all, even small steps in the direction of including ecosystem services evaluation are an improvement over current land-use planning practice (Boyd and Wainger, 2003). There are many participants involved in land-use decision-making in South Florida, including local, regional, State, and Federal agencies, developers, environmental groups, agricultural groups, and other stakeholders (South Florida Regional Planning Council, 2003, 2004). The EPM's multicriteria evaluation framework is designed to cut across the objectives and knowledge bases of all of these participants. This approach places fundamental importance on social equity and stakeholder participation in land-use decision-making, but makes no attempt to determine normative socially 'optimal' land-use plans. The EPM is thus a map-based set of evaluation tools for planners and stakeholders to use in their deliberations of what is 'best', considering a balancing of disparate interests within a regional perspective. Although issues of regional ecological sustainability can be explored with the EPM (for example, changes in biodiversity potential and regional habitat fragmentation), it does not attempt to define or evaluate long-term ecological sustainability as such. Instead, the EPM is intended to provide transparent first-order indications of the direction of ecological, economic, and community change, not to make detailed predictions of ecological, economic, and social outcomes. In short, the EPM is an attempt to widen the perspectives of its users by integrating natural and social scientific information in a framework that recognizes the diversity of values at stake in South Florida land-use planning. For terrestrial ecosystems, land-cover change is one of the most important direct drivers of changes in ecosystem services (Hassan and others, 2005). More specifically, the fragmentation of habitat from expanding low-density development across landscapes appears to be a major driver of terrestrial species decline and the impairment of terrestrial ecosystem integrity, in some cases causing irreversible impairment from a land-use planning perspective (Brody, 2008; Peck, 1998). Many resource managers and land-use planners have come to realize that evaluating land-use conversions on a parcel-by-parcel basis leads to a fragmented and narrow view of the regional effects of natural land-cover loss to development (Marsh and Lallas, 1995). The EPM is an attempt to integrate important aspects of the coupled natural-system/human-system view from a regional planning perspective. The EPM evaluates proposed land-use changes, both conversion and intensification, in terms of relevant ecological, economic, and social criteria that combine information about probable land-use outcomes, based on ecological and environmental models, as well as value judgments, as expressed in user-modifiable preference models. Based on on-going meetings and interviews with stakeholders and potential tool users we foc

Including adverse drug events in economic evaluations of anti-tumour necrosis factor-α drugs for adult rheumatoid arthritis: a systematic review of economic decision analytic models.

PubMed

Heather, Eleanor M; Payne, Katherine; Harrison, Mark; Symmons, Deborah P M

2014-02-01

Anti-tumour necrosis factor-α drugs (anti-TNFs) have revolutionised the treatment of rheumatoid arthritis (RA). More effective than standard non-biological disease-modifying anti-rheumatic drugs (nbDMARDs), anti-TNFs are also substantially more expensive. Consequently, a number of model-based economic evaluations have been conducted to establish the relative cost-effectiveness of anti-TNFs. However, anti-TNFs are associated with an increased risk of adverse drug events (ADEs) such as serious infections relative to nbDMARDs. Such ADEs will likely impact on both the costs and consequences of anti-TNFs, for example, through hospitalisations and forced withdrawal from treatment. The aim of this review was to identify and critically appraise if, and how, ADEs have been incorporated into model-based cost-effectiveness analyses of anti-TNFs for adult patients with RA. A systematic literature review was performed. Electronic databases (Ovid MEDLINE; Ovid EMBASE; Web of Science; NHS Economic Evaluations Database) were searched for literature published between January 1990 and October 2013 using electronic search strategies. The reference lists of retrieved studies were also hand searched. In addition, the National Institute for Health and Care Excellence technology appraisals were searched to identify economic models used to inform UK healthcare decision making. Only full economic evaluations that had used an economic model to evaluate biological DMARDs (bDMARDs) (including anti-TNFs) for adult patients with RA and had incorporated the direct costs and/or consequences of ADEs were critically appraised. To be included, studies also had to be available as a full text in English. Data extracted included general study characteristics and information concerning the methods used to incorporate ADEs and any associated assumptions made. The extracted data were synthesised using a tabular and narrative format. A total of 43 model-based economic evaluations of bDMARDs for adult RA were identified from 2,483 initially identified studies (2,473 published; ten technology appraisals). Of these, nine studies had incorporated the incidence and costs of ADEs and were critically reviewed. One study also explicitly estimated the potential consequences for patient utility. There was a general lack of detail specifically reporting on how ADEs were included in the economic models. Furthermore, there was substantial heterogeneity amongst the nine studies concerning the (i) application of risk-related terminology; (ii) method of incorporating the incidence, costs and consequences of ADEs; and (iii) ADE-related assumptions. Model-based economic evaluations have played an integral role in healthcare reimbursement and funding decisions relating to anti-TNFs for adult patients with RA. However, current economic models have not routinely or systematically considered the direct costs or consequences of ADEs, which may bias the estimates of the relative cost-effectiveness of anti-TNFs. Omitting information on relevant costs and consequences of interventions for RA will affect the validity of the associated recommendations for informed decision making. To improve current practice it is recommended that (i) greater efforts be made to provide appropriate long-term safety data on the use of anti-TNFs in adult RA; (ii) empirical research be undertaken to identify and quantify the impact of, and possible methods for, including ADEs in economic models to inform future good practice guidelines; and (iii) economic modelling guidelines and reference cases be updated to explicitly identify ADEs as an important treatment outcome and address how they might be incorporated into economic models. Improved consideration of the possible implications of ADEs in economic models will ensure that healthcare decision makers are provided with reliable and accurate information with which to make efficient reimbursement and financing decisions.

Performance and economics of advanced energy conversion systems for coal and coal-derived fuels

NASA Technical Reports Server (NTRS)

Corman, J. C.; Fox, G. R.

1978-01-01

The desire to establish an efficient Energy Conversion System to utilize the fossil fuel of the future - coal - has produced many candidate systems. A comparative technical/economic evaluation was performed on the seven most attractive advanced energy conversion systems. The evaluation maintains a cycle-to-cycle consistency in both performance and economic projections. The technical information base can be employed to make program decisions regarding the most attractive concept. A reference steam power plant was analyzed to the same detail and, under the same ground rules, was used as a comparison base. The power plants were all designed to utilize coal or coal-derived fuels and were targeted to meet an environmental standard. The systems evaluated were two advanced steam systems, a potassium topping cycle, a closed cycle helium system, two open cycle gas turbine combined cycles, and an open cycle MHD system.

A Pilot Cost-Effectiveness Analysis of the Economic and Educational Impact of the Mountain-Plains Education and Economic Development Program, Inc. A Research Study for Department of Health, Education and Welfare, National Institute of Education. Revised May 1976.

ERIC Educational Resources Information Center

Stromsdorfer, Ernst W.; Moayed-Dadkhah, Kamran

Presenting a cost-benefit analysis of the Mountain-Plains Career Education Program (a family based program for the economically deprived in the mountain plains states operating out of Glasgow Air Force Base in Montana) and the methodological basis for a full and more detailed study, this evaluation includes: (1) discussion of theoretical issues…

[Health economics and antibiotic therapy].

PubMed

Leclercq, P; Bigdéli, M

1995-01-01

In the field of antibiotic therapy, particularly the methods of economic evaluation hold one's attention within the wide range of health economics' applications. Several tools allow a comparison of the outcomes of alternative strategies and thereby guide choices to the most appropriate solutions. After a brief recall of the methods classically used to evaluate health care strategy, the authors stress the importance and difficulty of fixing and applying a correct and satisfactory procedure for evaluation. An evaluation example of antibiotic therapy allows to illustrate the application of the principles confronting a field in which competition is intense and economic stakes stay large--a fact which naturally yields to seek after objective decision making criteria. The health care policies drawn by public authorities as well as the marketing strategies of the health sector trade are partly based on such evaluations. If these techniques are not intended for the practitioner in the first place, they should not be indifferent to him since they influence health authorities and thereby indirectly affect the therapeutic freedom of the physician.

Two Essays on Increasing the Learning Effectiveness of Economics Education

ERIC Educational Resources Information Center

McLean, William J.

2010-01-01

Scope and Method of Study: This study develops, implements, and evaluates a new economics teaching pedagogy based on the U.S. Army's systems approach to training model. Using the approach, tasks are identified that compose the task domain for the Principles of Microeconomics course. From the 130 identified tasks, 73 are used by Economics of…

Proof of Economic Viability of Blended Learning Business Models

ERIC Educational Resources Information Center

Druhmann, Carsten; Hohenberg, Gregor

2014-01-01

The discussion on economically sustainable business models with respect to information technology is lacking in many aspects of proven approaches. In the following contribution the economic viability is valued based on a procedural model for design and evaluation of e-learning business models in the form of a case study. As a case study object a…

Economic evaluations and usefulness of standardized nursing terminologies.

PubMed

Stone, Patricia W; Lee, Nam-Ju; Giannini, Melinna; Bakken, Suzanne

2004-01-01

To review different types of economic analyses commonly found in healthcare literature, discuss methodologic considerations in framing economic analyses, identify useful resources for economic evaluations, and describe the current and potential roles of standardized nursing terminologies in providing cost and outcome data for economic analysis. The Advanced Billing Concepts Code Resource-based Relative Value Scale and Nursing Outcomes Classification. Using case studies, the applicability of standardized nursing terminologies in cost-effectiveness analysis is demonstrated. While there is potential to inform specific questions, comparisons across analyses are limited because of the many outcome measures. Including a standardized quality-of-life measure in nursing terminologies would allow for the calculation of accepted outcome measures and dollars per quality adjusted life years gained. The nurse's ability to assess and contribute to all aspects of rigorous economic evidence is an essential competency for responsible practice.

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

PubMed

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

2010-06-01

Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making. Copyright 2010 Elsevier Ltd. All rights reserved.

[Economic evaluation on breast cancer screening in mainland China: a systematic review].

PubMed

Wang, L; Shi, J F; Huang, H Y; Zhu, J; Li, J; Fang, Y; Dai, M

2016-12-10

Objective: To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research. Methods: A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI, Wanfang and VIP) during 1995-2015. Data related to descriptive characteristics, rates on participation and detection for population-based studies, methods for model-based studies, types of economic evaluation and results, were extracted. A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies. Results: Of the 356 records searched in the databases, 13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods). Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old, but terminated at the age of 59 years or older. The screening modalities included single-used clinical breast examination, mammography and ultrasound or combined applications. Study persepectives were described in 7 studies, with 5 from the healthcare providers, and 2 from societal angles. Only 5 studies discounted cost or effectiveness. Out of 11 papers, 9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection, with median as 145.0 thousand Chinese Yuan (CNY), ranging from 49.7 thousand to 2 293.0 thousand CNY. From 4 papers with results of cost-utility analysis (CUA), the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted, were evaluated. The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015). In 13 studies, the quality of reporting varied, with an average score of 14.5 (range: 9.5-21.0). In the domains of study perspective, discounting, ICER and uncertainty, all the scores of equalities were relatively levels. Conclusions: Currently, evidence on economic evaluation of breast cancer screening in mainland China remained limited and weakly comparable, particularly model-based studies. Comprehensive analysis from societal perspective and QALY or DALY related cost-utility analysis should be implemented.

Economic evaluation of preventive dental programs: what can they tell us?

PubMed

Morgan, Mike; Mariño, Rodrigo; Wright, Clive; Bailey, Denise; Hopcraft, Matthew

2012-10-01

The role of public health program planners is to determine the effectiveness of public health programs, what recommendations should be made, what future initiatives should be taken, and what policies should be developed. At a basic level, to choose between competing alternatives, two characteristics of an intervention must be considered; these are its outcome and its cost. Based on cost and outcome, planners must select the option that offers the most advantages. Economic evaluation is commonly adopted by decision makers in the health sector to investigate the effectiveness of public health programs and to help plan future initiatives. Economic evaluation assists decision makers who must weigh the information it provides in the context of many and often competing options. In this way, an economic evaluation is an aid to decision making rather than the decision itself. Economic evaluation is becoming essential for informed decision making, with potential implications for public health policy and practice and for clinical practice too. While economic evaluations are commonly used in decision-making processes about health programs, few examples exist in the oral health literature. In the case of preventive oral health programs, economic analysis is often difficult, largely because it makes demands on epidemiological and demographic data that are hard to meet. This study will address the concepts and tools required to conduct economic evaluations of prevention programs. The emphasis will be on oral health and preventive dental programs, although the concepts presented could be useful for other public health programs by practitioners and managers with the aim of producing effective and efficient oral health programs. © 2012 John Wiley & Sons A/S.

Health economic evaluations help inform payers of the best use of scarce health care resources.

PubMed

O'Reilly, Daria; Gaebel, Kathryn; Xie, Feng; Tarride, Jean-Eric; Goeree, Ron

2011-09-01

The number of new health technologies has risen over the past decade. These new technologies usually are more effective but they also cost more compared to existing ones. In a publicly funded health care system such as Canada, the aim is to maximize the health of the population within the resources available. As a result, it is unavoidable that choices and trade-offs have to be made because there will always be more treatment options than resources will allow (i.e., scarcity of resources) as well as alternative uses for those resources (i.e., opportunity costs). The objective of this paper is to provide an overview of economic evaluations and how these tools can be used to help inform payers of the best use of scarce health care resources. This descriptive paper includes a summary of key consepts and definitions in economic appraisal and draws upon recently published papers as illustrations. Background on the necessity and role of economic evaluations is provided, followed by a description of the approaches for, and types of, economic evaluations. Two illustrative examples are used and some implications for rural, remote and circumpolar communities are discussed. There are 2 main approaches for conducting an economic evaluation (trial- and model-based) and 3 types of evaluations which can be considered to inform payers of the best use of health care resources (cost-effectiveness, cost-utility and cost-benefit analyses). Techniques of economic evaluation are useful tools and an important input into the decision-making process. Although these techniques have universal application, there are issues specific to rural, remote and circumpolar communities which can affect the results of economic appraisals.

Economic Studies in Motor Neurone Disease: A Systematic Methodological Review.

PubMed

Moore, Alan; Young, Carolyn A; Hughes, Dyfrig A

2017-04-01

Motor neurone disease (MND) is a devastating condition which greatly diminishes patients' quality of life and limits life expectancy. Health technology appraisals of future interventions in MND need robust data on costs and utilities. Existing economic evaluations have been noted to be limited and fraught with challenges. The aim of this study was to identify and critique methodological aspects of all published economic evaluations, cost studies, and utility studies in MND. We systematically reviewed all relevant published studies in English from 1946 until January 2016, searching the databases of Medline, EMBASE, Econlit, NHS Economic Evaluation Database (NHS EED) and the Health Economics Evaluation Database (HEED). Key data were extracted and synthesised narratively. A total of 1830 articles were identified, of which 15 economic evaluations, 23 cost and 3 utility studies were included. Most economic studies focused on riluzole (n = 9). Six studies modelled the progressive decline in motor function using a Markov design but did not include mutually exclusive health states. Cost estimates for a number of evaluations were based on expert opinion and were hampered by high variability and location-specific characteristics. Few cost studies reported disease-stage-specific costs (n = 3) or fully captured indirect costs. Utilities in three studies of MND patients used the EuroQol EQ-5D questionnaire or standard gamble, but included potentially unrepresentative cohorts and did not consider any health impacts on caregivers. Economic evaluations in MND suffer from significant methodological issues such as a lack of data, uncertainty with the disease course and use of inappropriate modelling framework. Limitations may be addressed through the collection of detailed and representative data from large cohorts of patients.

Which BRCA genetic testing programs are ready for implementation in health care? A systematic review of economic evaluations.

PubMed

D'Andrea, Elvira; Marzuillo, Carolina; De Vito, Corrado; Di Marco, Marco; Pitini, Erica; Vacchio, Maria Rosaria; Villari, Paolo

2016-12-01

There is considerable evidence regarding the efficacy and effectiveness of BRCA genetic testing programs, but whether they represent good use of financial resources is not clear. Therefore, we aimed to identify the main health-care programs for BRCA testing and to evaluate their cost-effectiveness. We performed a systematic review of full economic evaluations of health-care programs involving BRCA testing. Nine economic evaluations were included, and four main categories of BRCA testing programs were identified: (i) population-based genetic screening of individuals without cancer, either comprehensive or targeted based on ancestry; (ii) family history (FH)-based genetic screening, i.e., testing individuals without cancer but with FH suggestive of BRCA mutation; (iii) familial mutation (FM)-based genetic screening, i.e., testing individuals without cancer but with known familial BRCA mutation; and (iv) cancer-based genetic screening, i.e., testing individuals with BRCA-related cancers. Currently BRCA1/2 population-based screening represents good value for the money among Ashkenazi Jews only. FH-based screening is potentially very cost-effective, although further studies that include costs of identifying high-risk women are needed. There is no evidence of cost-effectiveness for BRCA screening of all newly diagnosed cases of breast/ovarian cancers followed by cascade testing of relatives, but programs that include tools for identifying affected women at higher risk for inherited forms are promising. Cost-effectiveness is highly sensitive to the cost of BRCA1/2 testing.Genet Med 18 12, 1171-1180.

State of health economic evaluation research in Saudi Arabia: a review.

PubMed

Al-Aqeel, Sinaa A

2012-01-01

If evaluation of economic evidence is to be used increasingly in Saudi Arabia, a review of the published literature would be useful to inform policy decision-makers of the current state of research and plan future research agendas. The purpose of this paper is to provide a critical review of the state of health economic evaluation research within the Saudi context with regard to the number, characteristics, and quality of published articles. A literature search was conducted on May 8, 2011 to identify health economic articles pertaining to Saudi Arabia in the PubMed, Embase, and EconLit databases, using the following terms alone or in combination: "cost*", "economics", "health economics", "cost-effectiveness", "cost-benefit", "cost minimization", "cost utility analysis", and "Saudi". Reference lists of the articles identified were also searched for further articles. The tables of contents of the Saudi Pharmaceutical Journal and the Saudi Medical Journal were reviewed for the previous 5 years. The search identified 535 citations. Based on a reading of abstracts and titles, 477 papers were excluded. Upon reviewing the full text of the remaining 58 papers, 43 were excluded. Fifteen papers were included. Ten were categorized as full economic evaluations and five as partial economic evaluations. These articles were published between 1997 and 2010. The majority of the studies identified did not clearly state the perspective of their evaluation. There are many concerns about the methods used to collect outcome and costs data. Only one study used some sort of sensitivity analysis to assess the effects of uncertainty on the robustness of its conclusions. This review highlights major flaws in the design, analysis, and reporting of the identified economic analyses. Such deficiencies mean that the local economic evidence available to decision-makers is not very useful. Thus, building research capability in health economics is warranted.

Wind Energy Conversion System Analysis Model (WECSAM) computer program documentation

NASA Astrophysics Data System (ADS)

Downey, W. T.; Hendrick, P. L.

1982-07-01

Described is a computer-based wind energy conversion system analysis model (WECSAM) developed to predict the technical and economic performance of wind energy conversion systems (WECS). The model is written in CDC FORTRAN V. The version described accesses a data base containing wind resource data, application loads, WECS performance characteristics, utility rates, state taxes, and state subsidies for a six state region (Minnesota, Michigan, Wisconsin, Illinois, Ohio, and Indiana). The model is designed for analysis at the county level. The computer model includes a technical performance module and an economic evaluation module. The modules can be run separately or together. The model can be run for any single user-selected county within the region or looped automatically through all counties within the region. In addition, the model has a restart capability that allows the user to modify any data-base value written to a scratch file prior to the technical or economic evaluation.

Applying evidence from economic evaluations to translate cancer survivorship research into care.

PubMed

de Moor, Janet S; Alfano, Catherine M; Breen, Nancy; Kent, Erin E; Rowland, Julia

2015-09-01

This paper summarizes recommendations stemming from the meeting, Applying Evidence from Economic Evaluations to Translate Cancer Survivorship Research into Care, hosted by the National Cancer Institute. The meeting convened funded investigators, experts in cancer control, survivorship, health economics, and team science to identify the economic and health services data needed to facilitate the dissemination of cancer survivorship interventions into care and how survivorship and health economic investigators can successfully collaborate together and with other stakeholders. Recommendations from the meeting are as follows. First, investigators must engage key stakeholders early in the planning process to understand the outcomes and cost domains on which they base decisions. Second, evaluations of intervention efficacy and value should be conducted using standardized and comparable measures and analytic approaches to enable comparisons across studies. Finally, a health economist should be included during the planning phase of the study so that the economic evaluation is pursued in concert with the survivorship intervention. Economic analyses, from the perspective of key stakeholders, must be incorporated into survivorship intervention research. The results from these analyses should be disseminated in a manner that is transparent, accessible, and comparable across studies. To optimize cancer survivors' health and quality of life, it is essential deliver high-quality and high-value care. Incorporating economic analyses into survivorship intervention research can inform the translation of effective interventions into practice.

Emergy analysis of an industrial park: the case of Dalian, China.

PubMed

Geng, Yong; Zhang, Pan; Ulgiati, Sergio; Sarkis, Joseph

2010-10-15

With the rapid development of eco-industrial park projects in China, evaluating their overall eco-efficiency is becoming an important need and a big challenge academically. Developing ecologically conscious industrial park management requires analysis of both industrial and ecological systems. Traditional evaluation methods based on neoclassical economics and embodied energy and exergy analyses have certain limitations due to their focus with environmental issues considered secondary to the maximization of economic and technical objectives. Such methods focus primarily on the environmental impact of emissions and their economic consequences. These approaches ignore the contribution of ecological products and services as well as the load placed on environmental systems and related problems of carrying capacity of economic and industrial development. This paper presents a new method, based upon emergy analysis and synthesis. Such a method links economic and ecological systems together, highlighting the internal relations among the different subsystems and components. The emergy-based method provides insight into the environmental performance and sustainability of an industrial park. This paper depicts the methodology of emergy analysis at the industrial park level and provides a series of emergy-based indices. A case study is investigated and discussed in order to show the emergy method's practical potential. Results from DEDZ (Dalian Economic Development Zone) case show us the potential of emergy synthesis method at the industrial park level for environmental policy making. Its advantages and limitations are also discussed with avenues for future research identified. Copyright © 2010 Elsevier B.V. All rights reserved.

Health economics and European Renal Best Practice--is it time to bring health economics into evidence-based guideline production in Europe?

PubMed

Haller, Maria C; Vanholder, Raymond; Oberbauer, Rainer; Zoccali, Carmine; Van Biesen, Wim

2014-11-01

Medical management of patients with kidney disease is complex and resource intensive. In times of limited health care budgets, economic evaluations have become more important over the past few years in identifying interventions with a beneficial cost-effectiveness to maximize the benefits served from the available resources. However, integrating evidence from health-economic evaluations into clinical practice guidelines remains a challenge. European Renal Best Practice (ERBP), the official guideline body of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) herewith presents some lines of thought that need consideration in the discussion on incorporating health-economic considerations into clinical guideline development. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

A systematic review of modelling approaches in economic evaluations of health interventions for drug and alcohol problems.

PubMed

Hoang, Van Phuong; Shanahan, Marian; Shukla, Nagesh; Perez, Pascal; Farrell, Michael; Ritter, Alison

2016-04-13

The overarching goal of health policies is to maximize health and societal benefits. Economic evaluations can play a vital role in assessing whether or not such benefits occur. This paper reviews the application of modelling techniques in economic evaluations of drug and alcohol interventions with regard to (i) modelling paradigms themselves; (ii) perspectives of costs and benefits and (iii) time frame. Papers that use modelling approaches for economic evaluations of drug and alcohol interventions were identified by carrying out searches of major databases. Thirty eight papers met the inclusion criteria. Overall, the cohort Markov models remain the most popular approach, followed by decision trees, Individual based model and System dynamics model (SD). Most of the papers adopted a long term time frame to reflect the long term costs and benefits of health interventions. However, it was fairly common among the reviewed papers to adopt a narrow perspective that only takes into account costs and benefits borne by the health care sector. This review paper informs policy makers about the availability of modelling techniques that can be used to enhance the quality of economic evaluations for drug and alcohol treatment interventions.

Evaluating ecoregion-based height-diameter relationships of five economically important Appalachian hardwood species in West Virginia

Treesearch

John R. Brooks; Harry V., Jr. Wiant

2007-01-01

Five economically important Appalachian hardwood species were selected from five ecoregions in West Virginia. A nonlinear extra sum of squares procedure was employed to test whether the height-diameter relationships, based on measurements from the 2000 inventory from West Virginia, were significantly different at the ecoregion level. For all species examined, the null...

Designing and Evaluating an EAP Reading Textbook: English for Political Science and Economics

ERIC Educational Resources Information Center

Sauzier-Uchida, Emi

2009-01-01

This study aims to report an attempt to design and organise a content-based EAP reading course in political science and economics at a university in Japan, and to shed some light on learners' actual practices and preferences through the use of survey- and interview-based research participated in by 438 students. A principal axis of this project…

OPTIMIZING USABILITY OF AN ECONOMIC DECISION SUPPORT TOOL: PROTOTYPE OF THE EQUIPT TOOL.

PubMed

Cheung, Kei Long; Hiligsmann, Mickaël; Präger, Maximilian; Jones, Teresa; Józwiak-Hagymásy, Judit; Muñoz, Celia; Lester-George, Adam; Pokhrel, Subhash; López-Nicolás, Ángel; Trapero-Bertran, Marta; Evers, Silvia M A A; de Vries, Hein

2018-01-01

Economic decision-support tools can provide valuable information for tobacco control stakeholders, but their usability may impact the adoption of such tools. This study aims to illustrate a mixed-method usability evaluation of an economic decision-support tool for tobacco control, using the EQUIPT ROI tool prototype as a case study. A cross-sectional mixed methods design was used, including a heuristic evaluation, a thinking aloud approach, and a questionnaire testing and exploring the usability of the Return of Investment tool. A total of sixty-six users evaluated the tool (thinking aloud) and completed the questionnaire. For the heuristic evaluation, four experts evaluated the interface. In total twenty-one percent of the respondents perceived good usability. A total of 118 usability problems were identified, from which twenty-six problems were categorized as most severe, indicating high priority to fix them before implementation. Combining user-based and expert-based evaluation methods is recommended as these were shown to identify unique usability problems. The evaluation provides input to optimize usability of a decision-support tool, and may serve as a vantage point for other developers to conduct usability evaluations to refine similar tools before wide-scale implementation. Such studies could reduce implementation gaps by optimizing usability, enhancing in turn the research impact of such interventions.

Costing evidence for health care decision-making in Austria: A systematic review.

PubMed

Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata; Simon, Judit

2017-01-01

With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. A systematic literature review of English and German language peer-reviewed as well as grey literature (2004-2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods.

Costing evidence for health care decision-making in Austria: A systematic review

PubMed Central

Mayer, Susanne; Kiss, Noemi; Łaszewska, Agata

2017-01-01

Background With rising healthcare costs comes an increasing demand for evidence-informed resource allocation using economic evaluations worldwide. Furthermore, standardization of costing and reporting methods both at international and national levels are imperative to make economic evaluations a valid tool for decision-making. The aim of this review is to assess the availability and consistency of costing evidence that could be used for decision-making in Austria. It describes systematically the current economic evaluation and costing studies landscape focusing on the applied costing methods and their reporting standards. Findings are discussed in terms of their likely impacts on evidence-based decision-making and potential suggestions for areas of development. Methods A systematic literature review of English and German language peer-reviewed as well as grey literature (2004–2015) was conducted to identify Austrian economic analyses. The databases MEDLINE, EMBASE, SSCI, EconLit, NHS EED and Scopus were searched. Publication and study characteristics, costing methods, reporting standards and valuation sources were systematically synthesised and assessed. Results A total of 93 studies were included. 87% were journal articles, 13% were reports. 41% of all studies were full economic evaluations, mostly cost-effectiveness analyses. Based on relevant standards the most commonly observed limitations were that 60% of the studies did not clearly state an analytical perspective, 25% of the studies did not provide the year of costing, 27% did not comprehensively list all valuation sources, and 38% did not report all applied unit costs. Conclusion There are substantial inconsistencies in the costing methods and reporting standards in economic analyses in Austria, which may contribute to a low acceptance and lack of interest in economic evaluation-informed decision making. To improve comparability and quality of future studies, national costing guidelines should be updated with more specific methodological guidance and a national reference cost library should be set up to allow harmonisation of valuation methods. PMID:28806728

PRIORITIES FOR HEALTH ECONOMIC METHODOLOGICAL RESEARCH: RESULTS OF AN EXPERT CONSULTATION.

PubMed

Tordrup, David; Chouaid, Christos; Cuijpers, Pim; Dab, William; van Dongen, Johanna Maria; Espin, Jaime; Jönsson, Bengt; Léonard, Christian; McDaid, David; McKee, Martin; Miguel, José Pereira; Patel, Anita; Reginster, Jean-Yves; Ricciardi, Walter; Rutten-van Molken, Maureen; Rupel, Valentina Prevolnik; Sach, Tracey; Sassi, Franco; Waugh, Norman; Bertollini, Roberto

2017-01-01

The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps. The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps. The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities. The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the "-omics" approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.

Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

PubMed

Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob

2018-06-01

Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.

Fundamental principles of conducting a surgery economic analysis study.

PubMed

Kotsis, Sandra V; Chung, Kevin C

2010-02-01

The use of economic evaluation in surgery is scarce. Economic evaluation is used even less so in plastic surgery, in which health-related quality of life is of particular importance. This article, part of a tutorial series on evidence-based medicine, focuses on the fundamental principles of conducting a surgery economic analysis. The authors include the essential aspects of conducting a surgical cost-utility analysis by considering perspectives, costs, outcomes, and utilities. The authors also describe and give examples of how to conduct the analyses (including calculating quality-adjusted life-years and discounting), how to interpret the results, and how to report the results. Although economic analyses are not simple to conduct, a well-conducted one provides many rewards, such as recommending the adoption of a more effective treatment. For comparing and interpreting economic analysis publications, it is important that all studies use consistent methodology and report the results in a similar manner.

Cost-effectiveness of manual therapy for the management of musculoskeletal conditions: a systematic review and narrative synthesis of evidence from randomized controlled trials.

PubMed

Tsertsvadze, Alexander; Clar, Christine; Court, Rachel; Clarke, Aileen; Mistry, Hema; Sutcliffe, Paul

2014-01-01

The purpose of this study was to systematically review trial-based economic evaluations of manual therapy relative to other alternative interventions used for the management of musculoskeletal conditions. A comprehensive literature search was undertaken in major medical, health-related, science and health economic electronic databases. Twenty-five publications were included (11 trial-based economic evaluations). The studies compared cost-effectiveness and/or cost-utility of manual therapy interventions to other treatment alternatives in reducing pain (spinal, shoulder, ankle). Manual therapy techniques (e.g., osteopathic spinal manipulation, physiotherapy manipulation and mobilization techniques, and chiropractic manipulation with or without other treatments) were more cost-effective than usual general practitioner (GP) care alone or with exercise, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. Chiropractic manipulation was found to be less costly and more effective than alternative treatment compared with either physiotherapy or GP care in improving neck pain. Preliminary evidence from this review shows some economic advantage of manual therapy relative to other interventions used for the management of musculoskeletal conditions, indicating that some manual therapy techniques may be more cost-effective than usual GP care, spinal stabilization, GP advice, advice to remain active, or brief pain management for improving low back and shoulder pain/disability. However, at present, there is a paucity of evidence on the cost-effectiveness and/or cost-utility evaluations for manual therapy interventions. Further improvements in the methodological conduct and reporting quality of economic evaluations of manual therapy are warranted in order to facilitate adequate evidence-based decisions among policy makers, health care practitioners, and patients. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Economic evaluation of long-term impacts of universal newborn hearing screening.

PubMed

Chiou, Shu-Ti; Lung, Hou-Ling; Chen, Li-Sheng; Yen, Amy Ming-Fang; Fann, Jean Ching-Yuan; Chiu, Sherry Yueh-Hsia; Chen, Hsiu-Hsi

2017-01-01

Little is known about the long-term efficacious and economic impacts of universal newborn hearing screening (UNHS). An analytical Markov decision model was framed with two screening strategies: UNHS with transient evoked otoacoustic emission (TEOAE) test and automatic acoustic brainstem response (aABR) test against no screening. By estimating intervention and long-term costs on treatment and productivity losses and the utility of life years determined by the status of hearing loss, we computed base-case estimates of the incremental cost-utility ratios (ICURs). The scattered plot of ICUR and acceptability curve was used to assess the economic results of aABR versus TEOAE or both versus no screening. A hypothetical cohort of 200,000 Taiwanese newborns. TEOAE and aABR dominated over no screening strategy (ICUR = $-4800.89 and $-4111.23, indicating less cost and more utility). Given $20,000 of willingness to pay (WTP), the probability of being cost-effective of aABR against TEOAE was up to 90%. UNHS for hearing loss with aABR is the most economic option and supported by economically evidence-based evaluation from societal perspective.

Economic evidence for the prevention and treatment of atopic eczema: a protocol for a systematic review.

PubMed

Sach, Tracey Helen; McManus, Emma; Mcmonagle, Christopher; Levell, Nick

2016-05-27

Eczema, synonymous with atopic eczema or atopic dermatitis, is a chronic skin disease that has a similar impact on health-related quality of life as other chronic diseases. The proposed research aims to provide a comprehensive systematic assessment of the economic evidence base available to inform economic modelling and decision making on interventions to prevent and treat eczema at any stage of the life course. Whilst the Global Resource of Eczema Trials (GREAT) database collects together the effectiveness evidence for eczema, there is currently no such systematic resource on the economics of eczema. It is important to gain an overview of the current state of the art of economic methods in the field of eczema in order to strengthen the economic evidence base further. The proposed study is a systematic review of the economic evidence surrounding interventions for the prevention and treatment of eczema. Relevant search terms will be used to search MEDLINE, EMBASE, Database of Abstracts of Reviews of Effects, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, National Health Service (NHS) Economic Evaluation Database, Health Technology Assessment, Cumulative Index to Nursing and Allied Health Literature, EconLit, Scopus, Cost-Effectiveness Analysis Registry and Web of Science in order to identify relevant evidence. To be eligible for inclusion studies will be primary empirical studies evaluating the cost, utility or full economic evaluation of interventions for preventing or treating eczema. Two reviewers will independently assess studies for eligibility and perform data abstraction. Evidence tables will be produced presenting details of study characteristics, costing methods, outcome methods and quality assessment. The methodological quality of studies will be assessed using accepted checklists. The systematic review is being undertaken to identify the type of economic evidence available, summarise the results of the available economic evidence and critically appraise the quality of economic evidence currently available to inform future economic modelling and resource allocation decisions about interventions to prevent or treat eczema. We aim to use the review to offer guidance about how to gather economic evidence in studies of eczema and/or what further research is necessary in order to inform this. PROSPERO CRD42015024633.

Towards more sustainable management of European food waste: Methodological approach and numerical application.

PubMed

Manfredi, Simone; Cristobal, Jorge

2016-09-01

Trying to respond to the latest policy needs, the work presented in this article aims at developing a life-cycle based framework methodology to quantitatively evaluate the environmental and economic sustainability of European food waste management options. The methodology is structured into six steps aimed at defining boundaries and scope of the evaluation, evaluating environmental and economic impacts and identifying best performing options. The methodology is able to accommodate additional assessment criteria, for example the social dimension of sustainability, thus moving towards a comprehensive sustainability assessment framework. A numerical case study is also developed to provide an example of application of the proposed methodology to an average European context. Different options for food waste treatment are compared, including landfilling, composting, anaerobic digestion and incineration. The environmental dimension is evaluated with the software EASETECH, while the economic assessment is conducted based on different indicators expressing the costs associated with food waste management. Results show that the proposed methodology allows for a straightforward identification of the most sustainable options for food waste, thus can provide factual support to decision/policy making. However, it was also observed that results markedly depend on a number of user-defined assumptions, for example on the choice of the indicators to express the environmental and economic performance. © The Author(s) 2016.

Osteopathic manipulative treatment: A systematic review and critical appraisal of comparative effectiveness and health economics research.

PubMed

Steel, Amie; Sundberg, Tobias; Reid, Rebecca; Ward, Lesley; Bishop, Felicity L; Leach, Matthew; Cramer, Holger; Wardle, Jon; Adams, Jon

2017-02-01

In recent years, evidence has emerged regarding the effectiveness of osteopathic manipulative treatments (OMT). Despite growing evidence in this field, there is need for appropriate research designs that effectively reflect the person-centred system of care promoted in osteopathy and provide data which can inform policy decisions within the healthcare system. The purpose of this systematic review is to identify, appraise and synthesise the evidence from comparative effectiveness and economic evaluation research involving OMT. A database search was conducted using CINAHL, PubMed, PEDro, AMED, SCOPUS and OSTMED.DR, from their inception to May 2015. Two separate searches were undertaken to identify original research articles encompassing the economic evaluation and comparative effectiveness of OMT. Identified comparative effectives studies were evaluated using the Cochrane risk of bias tool and appraised using the Good Reporting of Comparative Effectiveness (GRACE) principles. Identified economic studies were assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Sixteen studies reporting the findings of comparative effectiveness (n = 9) and economic evaluation (n = 7) research were included. The comparative effectiveness studies reported outcomes for varied health conditions and the majority (n = 6) demonstrated a high risk of bias. The economic evaluations included a range of analyses and considerable differences in the quality of reporting were evident. Despite some positive findings, published comparative effectiveness and health economic studies in OMT are of insufficient quality and quantity to inform policy and practice. High quality, well-designed, research that aligns with international best practice is greatly needed to build a pragmatic evidence base for OMT. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cross-Country Evidence on the Impact of Shifting Economic and Strategic Landscapes on the Global Defense Industrial Base

DTIC Science & Technology

2010-11-04

aspects of the defense industrial base for US and European contractors, as demand in their domestic markets for these products lessens. Increased...Cold War, the defense industrial base in the US has witnessed many changes and continues to face new challenges. The purpose of this study is to...evaluate the evolution of the US and global defense industrial base in response to the shifting economic and strategic landscape. Specifically, it examines

[Valuation of health-related quality of life and utilities in health economics].

PubMed

Greiner, Wolfgang; Klose, Kristina

2014-01-01

Measuring health-related quality of life is an important aspect in economic evaluation of health programmes. The development of utility-based (preference-based) measures is advanced by the discipline of health economics. Different preference measures are applied for valuing health states to produce a weighted health state index. Those preference weights should be derived from a general population sample in case of resource allocation on a collective level (as in current valuation studies of the EuroQol group). Copyright © 2014. Published by Elsevier GmbH.

NASA-UVa Light Aerospace Alloy and Structures Technology Program: Aluminum-Based Materials for High Speed Aircraft

NASA Technical Reports Server (NTRS)

Starke, E. A., Jr. (Editor)

1996-01-01

This report is concerned with 'Aluminum-Based Materials for High Speed Aircraft' which was initiated to identify the technology needs associated with advanced, low-cost aluminum base materials for use as primary structural materials. Using a reference baseline aircraft, these materials concept will be further developed and evaluated both technically and economically to determine the most attractive combinations of designs, materials, and manufacturing techniques for major structural sections of an HSCT. Once this has been accomplished, the baseline aircraft will be resized, if applicable, and performance objectives and economic evaluations made to determine aircraft operating costs. The two primary objectives of this study are: (1) to identify the most promising aluminum-based materials with respect to major structural use on the HSCT and to further develop those materials, and (2) to assess these materials through detailed trade and evaluation studies with respect to their structural efficiency on the HSCT.

Early evaluation and value-based pricing of regenerative medicine technologies.

PubMed

Koerber, Florian; Rolauffs, Bernd; Rogowski, Wolf

2013-11-01

Since the first pioneering scientists explored the potential of using human cells for therapeutic purposes the branch of regenerative medicine has evolved to become a mature industry. The focus has switched from 'what can be done' to 'what can be commercialized'. Timely health economic evaluation supports successful marketing by establishing the value of a product from a healthcare system perspective. This article reports results from a research project on early health economic evaluation in collaboration with developers, clinicians and manufacturers. We present an approach to determine an early value-based price for a new treatment of cartilage defects of the knee from the area of regenerative medicine. Examples of using evaluation results for the purpose of business planning, market entry, preparing the coverage decision and managed entry are discussed.

Systematic Review of the Costs and Benefits of Prescribed Cannabis-Based Medicines for the Management of Chronic Illness: Lessons from Multiple Sclerosis.

PubMed

Herzog, Samuel; Shanahan, Marian; Grimison, Peter; Tran, Anh; Wong, Nicole; Lintzeris, Nicholas; Simes, John; Stockler, Martin; Morton, Rachael L

2018-01-01

Cannabis-based medicines (CBMs) may offer relief from symptoms of disease; however, their additional cost needs to be considered alongside their effectiveness. We sought to review the economic costs and benefits of prescribed CBMs in any chronic illness, and the frameworks used for their economic evaluation. A systematic review of eight medical and economic databases, from inception to mid-December 2016, was undertaken. MeSH headings and text words relating to economic costs and benefits, and CBMs were combined. Study quality was assessed using relevant checklists and results were synthesised in narrative form. Of 2514 identified records, ten studies met the eligibility criteria, all for the management of multiple sclerosis (MS). Six contained economic evaluations, four studies reported utility-based quality of life, and one was a willingness-to-pay study. Four of five industry-sponsored cost-utility analyses for MS spasticity reported nabiximols as being cost-effective from a European health system perspective. Incremental cost-effectiveness ratios per quality-adjusted life-year (QALY) gained for these five studies were £49,257 (UK); £10,891 (Wales); €11,214 (Germany); €4968 (Italy); and dominant (Spain). Nabiximols for the management of MS spasticity was not associated with statistically significant improvements in EQ-5D scores compared with standard care. Study quality was moderate overall, with limited inclusion of both relevant societal costs and discussions of potential bias. Prescribed CBMs are a potentially cost-effective add-on treatment for MS spasticity; however, this evidence is uncertain. Further investment in randomised trials with in-built economic evaluations is warranted for a wider range of clinical indications. PROSPERO Registration Number: CRD42014006370.

Economic evaluation of health promotion interventions for older people: do applied economic studies meet the methodological challenges?

PubMed

Huter, Kai; Dubas-Jakóbczyk, Katarzyna; Kocot, Ewa; Kissimova-Skarbek, Katarzyna; Rothgang, Heinz

2018-01-01

In the light of demographic developments health promotion interventions for older people are gaining importance. In addition to methodological challenges arising from the economic evaluation of health promotion interventions in general, there are specific methodological problems for the particular target group of older people. There are especially four main methodological challenges that are discussed in the literature. They concern measurement and valuation of informal caregiving, accounting for productivity costs, effects of unrelated cost in added life years and the inclusion of 'beyond-health' benefits. This paper focuses on the question whether and to what extent specific methodological requirements are actually met in applied health economic evaluations. Following a systematic review of pertinent health economic evaluations, the included studies are analysed on the basis of four assessment criteria that are derived from methodological debates on the economic evaluation of health promotion interventions in general and economic evaluations targeting older people in particular. Of the 37 studies included in the systematic review, only very few include cost and outcome categories discussed as being of specific relevance to the assessment of health promotion interventions for older people. The few studies that consider these aspects use very heterogeneous methods, thus there is no common methodological standard. There is a strong need for the development of guidelines to achieve better comparability and to include cost categories and outcomes that are relevant for older people. Disregarding these methodological obstacles could implicitly lead to discrimination against the elderly in terms of health promotion and disease prevention and, hence, an age-based rationing of public health care.

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

PubMed Central

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

2016-01-01

Background Context Low back pain (LBP) is one of the leading causes of disability worldwide and among the most common reasons for seeking primary sector care. Chiropractors, physical therapists and general practitioners are among those providers that treat LBP patients, but there is only limited evidence regarding the effectiveness and economic evaluation of care offered by these provider groups. Purpose To estimate the clinical effectiveness and to systematically review the literature of full economic evaluation of chiropractic care compared to other commonly used care approaches among adult patients with non-specific LBP. Study Design Systematic reviews of interventions and economic evaluations. Methods A comprehensive search strategy was conducted to identify 1) pragmatic randomized controlled trials (RCTs) and/or 2) full economic evaluations of chiropractic care for low back pain compared to standard care delivered by other healthcare providers. Studies published between 1990 and 4th June 2015 were considered. Primary outcomes included pain, functional status and global improvement. Study selection, critical quality appraisal and data extraction were conducted by two independent reviewers. Data from RCTs with low risk of bias were included in a meta-analysis to determine effect estimates. Cost estimates of full economic evaluations were converted to 2015 USD and results summarized using Slavin’s qualitative best-evidence synthesis. Results Six RCTs and three full economic evaluations were scientifically admissible. Five RCTs with low risk of bias compared chiropractic care to exercise therapy (n = 1), physical therapy (n = 3) and medical care (n = 1). Overall, we found similar effects for chiropractic care and the other types of care and no reports of serious adverse events. Three low to high quality full economic evaluations studies (one cost-effectiveness, one cost-minimization and one cost-benefit) compared chiropractic to medical care. Given the divergent conclusions (favours chiropractic, favours medical care, equivalent options), mixed-evidence was found for economic evaluations of chiropractic care compared to medical care. Conclusion Moderate evidence suggests that chiropractic care for LBP appears to be equally effective as physical therapy. Limited evidence suggests the same conclusion when chiropractic care is compared to exercise therapy and medical care although no firm conclusion can be reached at this time. No serious adverse events were reported for any type of care. Our review was also unable to clarify whether chiropractic or medical care is more cost-effective. Given the limited available evidence, the decision to seek or to refer patients for chiropractic care should be based on patient preference and values. Future studies are likely to have an important impact on our estimates as these were based on only a few admissible studies. PMID:27487116

Introduction to health economics and decision-making: Is economics relevant for the frontline clinician?

PubMed

Goeree, Ron; Diaby, Vakaramoko

2013-12-01

In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.

An overview of the effectiveness and efficiency of HIV prevention programs.

PubMed Central

Holtgrave, D R; Qualls, N L; Curran, J W; Valdiserri, R O; Guinan, M E; Parra, W C

1995-01-01

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs. PMID:7630989

Health Economics of Nutrition Intervention in Asia: Cost of Malnutrition.

PubMed

Mizumoto, Kaori; Murakami, Genki; Oshidari, Kenro; Trisnantoro, Laksono; Yoshiike, Nobuo

2015-01-01

Asia has recorded the fastest economic growth in the world. However, some countries are still struggling with economic stagnation and poverty. Even in the emerging countries, there are economic disparities between urban and rural areas within a country. Reflecting the situations, nutritional issues in Asia came to be the antithetical situation of excess and insufficiency. The rate of overweight and obesity keeps increasing, especially in emerging countries. Meanwhile, underweight is still a critical problem in the region. Although the importance of nutrition is well recognized for social and economic development, it is difficult to identify the immediate outcome of nutrition interventions. Evidence-based decision-making is an important element of quality health care and efficiency and effectiveness are always key words. Along with enhanced attention to accountability and transparency of budget use in health services, attention to the economic evaluation of nutrition interventions has increased in recent years. In this symposium, we will review the current situation of nutritional issues and economic evaluation of nutrition interventions in Asia through experience of an international organization, the basis and trends for health care economics, and also efforts have been made in an Asian country. Discussion will be made about efficient and effective ways to evaluate projects/programmes for nutrition improvement.

Let's Stop Trying to Quantify Household Vulnerability: The Problem With Simple Scales for Targeting and Evaluating Economic Strengthening Programs

PubMed Central

Moret, Whitney M

2018-01-01

Introduction: Economic strengthening practitioners are increasingly seeking data collection tools that will help them target households vulnerable to HIV and poor child well-being outcomes, match households to appropriate interventions, monitor their status, and determine readiness for graduation from project support. This article discusses efforts in 3 countries to develop simple, valid tools to quantify and classify economic vulnerability status. Methods and Findings: In Côte d'Ivoire, we conducted a cross-sectional survey with 3,749 households to develop a scale based on the definition of HIV-related economic vulnerability from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) for the purpose of targeting vulnerable households for PEPFAR-funded programs for orphans and vulnerable children. The vulnerability measures examined did not cluster in ways that would allow for the creation of a small number of composite measures, and thus we were unable to develop a scale. In Uganda, we assessed the validity of a vulnerability index developed to classify households according to donor classifications of economic status by measuring its association with a validated poverty measure, finding only a modest correlation. In South Africa, we developed monitoring and evaluation tools to assess economic status of individual adolescent girls and their households. We found no significant correlation with our validation measures, which included a validated measure of girls' vulnerability to HIV, a validated poverty measure, and subjective classifications generated by the community, data collector, and respondent. Overall, none of the measures of economic vulnerability used in the 3 countries varied significantly with their proposed validation items. Conclusion: Our findings suggest that broad constructs of economic vulnerability cannot be readily captured using simple scales to classify households and individuals in a way that accounts for a substantial amount of variance at locally defined vulnerability levels. We recommend that researchers and implementers design monitoring and evaluation instruments to capture narrower definitions of vulnerability based on characteristics programs intend to affect. We also recommend using separate tools for targeting based on context-specific indicators with evidence-based links to negative outcomes. Policy makers and donors should avoid reliance on simplified metrics of economic vulnerability in the programs they support. PMID:29496734

Rural inland waterways economic impact kit : users guide

DOT National Transportation Integrated Search

2000-08-01

The primary objective of the project was to develop a PC-based kit allowing users to evaluate the economic impact of existing rural inland waterways ports and terminals. By using the Kit, the importance to a community of a port and terminals can be q...

Rural inland waterways economic impact kit : analysis manual

DOT National Transportation Integrated Search

2000-08-01

The primary objective of the project was to develop a PC-based kit allowing users to evaluate the economic impact of existing rural inland waterways ports and terminals. By using the Kit, the importance to a community of a port and terminals can be q...

Indicators and Metrics for Evaluating the Sustainability of Chemical Processes

EPA Science Inventory

A metric-based method, called GREENSCOPE, has been developed for evaluating process sustainability. Using lab-scale information and engineering assumptions the method evaluates full-scale epresentations of processes in environmental, efficiency, energy and economic areas. The m...

[Health assessment and economic assessment in health: introduction to the debate on the points of intersection].

PubMed

Sancho, Leyla Gomes; Dain, Sulamis

2012-03-01

The study aims to infer the existence of a continuum between Health Assessment and Economic Assessment in Health, by highlighting points of intersection of these forms of appraisal. To achieve this, a review of the theoretical foundations, methods and approaches of both forms of assessment was conducted. It was based on the theoretical model of health evaluation as reported by Hartz et al and economic assessment in health approaches reported by Brouwer et al. It was seen that there is a continuum between the theoretical model of evaluative research and the extrawelfarist approach for economic assessment in health, and between the normative theoretical model for health assessment and the welfarist approaches for economic assessment in health. However, in practice the assessment is still conducted using the normative theoretical model and with a welfarist approach.

Assessing the potential of economic instruments for managing drought risk at river basin scale

NASA Astrophysics Data System (ADS)

Pulido-Velazquez, M.; Lopez-Nicolas, A.; Macian-Sorribes, H.

2015-12-01

Economic instruments work as incentives to adapt individual decisions to collectively agreed goals. Different types of economic instruments have been applied to manage water resources, such as water-related taxes and charges (water pricing, environmental taxes, etc.), subsidies, markets or voluntary agreements. Hydroeconomic models (HEM) provide useful insight on optimal strategies for coping with droughts by simultaneously analysing engineering, hydrology and economics of water resources management. We use HEMs for evaluating the potential of economic instruments on managing drought risk at river basin scale, considering three criteria for assessing drought risk: reliability, resilience and vulnerability. HEMs allow to calculate water scarcity costs as the economic losses due to water deliveries below the target demands, which can be used as a vulnerability descriptor of drought risk. Two generic hydroeconomic DSS tools, SIMGAMS and OPTIGAMS ( both programmed in GAMS) have been developed to evaluate water scarcity cost at river basin scale based on simulation and optimization approaches. The simulation tool SIMGAMS allocates water according to the system priorities and operating rules, and evaluate the scarcity costs using economic demand functions. The optimization tool allocates water resources for maximizing net benefits (minimizing total water scarcity plus operating cost of water use). SIMGAS allows to simulate incentive water pricing policies based on water availability in the system (scarcity pricing), while OPTIGAMS is used to simulate the effect of ideal water markets by economic optimization. These tools have been applied to the Jucar river system (Spain), highly regulated and with high share of water use for crop irrigation (greater than 80%), where water scarcity, irregular hydrology and groundwater overdraft cause droughts to have significant economic, social and environmental consequences. An econometric model was first used to explain the variation of the production value of irrigated agriculture during droughts, assessing revenue responses to varying crop prices and water availability. Hydroeconomic approaches were then used to show the potential of economic instruments in setting incentives for a more efficient management of water resources systems.

Evaluating the Effects of Vocational Training in Africa (based on the "African Economic Outlook 2008"), OECD Development Centre Policy Insights, No. 61

ERIC Educational Resources Information Center

Kingombe, Christian

2008-01-01

The impact of vocational training on economic growth and poverty reduction in African countries is unknown. Without such knowledge, however, countries and donors cannot formulate appropriate policies. Even the 35 countries surveyed in the 2008 "African Economic Outlook" can only supply approximate data. More and better data are needed to…

LABORATORY SCALE EVALUATION OF HYDRA-TONE GRAFF-OFF™ COCONUT OIL BASED DEGREASER

EPA Science Inventory

This technical and economic assessment evaluated the effectiveness of a biodegradable, coconut oil-based degreaser called Graff-Off™. In immersion (cold) cleaning and rinse tests, Graff-Off™ was compared to a conventional chlorinated solvent 1,1,1 trichloroethane (TCA) and to an ...

The Evaluation of School-Based Violence Prevention Programs: A Meta-Analysis

ERIC Educational Resources Information Center

Park-Higgerson, Hyoun-Kyoung; Perumean-Chaney, Suzanne E.; Bartolucci, Alfred A.; Grimley, Diane M.; Singh, Karan P.

2008-01-01

Background: Youth violence and related aggressive behaviors have become serious public health issues with physical, economic, social, and psychological impacts and consequences. This study identified and evaluated the characteristics of successful school-based violence prevention programs. Methods: Twenty-six randomized controlled trial (RCT),…

Comprehensive evaluation of environmental and economic benefits of China's urban underground transportation construction projects.

PubMed

Yang, Xiaobin; Chen, Zhilong; Guo, Dongjun

2015-07-01

Urban underground transportation projects are introduced to address problems of scarce green land and traffic pollution. As construction of urban underground transportation is still in its infancy, there is no definite quantitative measurement on whether the construction is beneficial and what influences it will place on the region in China. This study intends to construct a comprehensive evaluation method for evaluating social, economic and environmental benefits of urban underground transportation projects and proposes the concept, role and principle for evaluation of environmental and economic benefits. It figures out relationship between the environment and factors of city development. It also summarizes three relevant factors, including transportation, biophysics and social economy, and works out indicators to evaluate the influence of urban underground transportation construction. Based on Contingent Valuation Method (CVM), Cost of Illness Approach (CIA), Human Capital Approach (HCA), this paper constructs 13 monetization calculation models for social, economic and environmental benefits in response to seven aspects, namely, reducing noise pollution and air pollution, using land efficiently, improving traffic safety, reducing traffic congestion, saving shipping time and minimizing transportation costs.

Technical Performance and Economic Evaluation of Evaporative and Membrane-Based Concentration for Biomass-Derived Sugars

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sievers, David A.; Stickel, Jonathan J.; Grundl, Nicholas J.

Several conversion pathways of lignocellulosic biomass to advanced biofuels require or benefit from using concentrated sugar syrups of 600 g/L or greater. And while concentration may seem straightforward, thermal sugar degradation and energy efficiency remain major concerns. This study evaluated the trade-offs in product recovery, energy consumption, and economics between evaporative and membrane-based concentration methods. The degradation kinetics of xylose and glucose were characterized and applied to an evaporator process simulation. Though significant sugar loss was predicted for certain scenarios due to the Maillard reaction, industrially common falling-film plate evaporators offer short residence times (<5 min) and are expected tomore » limit sugar losses. Membrane concentration experiments characterized flux and sugar rejection, but diminished flux occurred at >100 g/L. A second step using evaporation is necessary to achieve target concentrations. Techno-economic process model simulations evaluated the overall economics of concentrating a 35 g/L sugar stream to 600 g/L in a full-scale biorefinery. A two-step approach of preconcentrating using membranes and finishing with an evaporator consumed less energy than evaporation alone but was more expensive because of high capital expenses of the membrane units.« less

Technical Performance and Economic Evaluation of Evaporative and Membrane-Based Concentration for Biomass-Derived Sugars

DOE PAGES

Sievers, David A.; Stickel, Jonathan J.; Grundl, Nicholas J.; ...

2017-09-18

Several conversion pathways of lignocellulosic biomass to advanced biofuels require or benefit from using concentrated sugar syrups of 600 g/L or greater. And while concentration may seem straightforward, thermal sugar degradation and energy efficiency remain major concerns. This study evaluated the trade-offs in product recovery, energy consumption, and economics between evaporative and membrane-based concentration methods. The degradation kinetics of xylose and glucose were characterized and applied to an evaporator process simulation. Though significant sugar loss was predicted for certain scenarios due to the Maillard reaction, industrially common falling-film plate evaporators offer short residence times (<5 min) and are expected tomore » limit sugar losses. Membrane concentration experiments characterized flux and sugar rejection, but diminished flux occurred at >100 g/L. A second step using evaporation is necessary to achieve target concentrations. Techno-economic process model simulations evaluated the overall economics of concentrating a 35 g/L sugar stream to 600 g/L in a full-scale biorefinery. A two-step approach of preconcentrating using membranes and finishing with an evaporator consumed less energy than evaporation alone but was more expensive because of high capital expenses of the membrane units.« less

A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.

PubMed

Kidholm, Kristian; Kristensen, Mie Borch Dahl

2018-04-01

Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.

Coal gasification systems engineering and analysis. Appendix E: Cost estimation and economic evaluation methodology

NASA Technical Reports Server (NTRS)

1980-01-01

The cost estimation and economic evaluation methodologies presented are consistent with industry practice for assessing capital investment requirements and operating costs of coal conversion systems. All values stated are based on January, 1980 dollars with appropriate recognition of the time value of money. Evaluation of project economic feasibility can be considered a two step process (subject to considerable refinement). First, the costs of the project must be quantified and second, the price at which the product can be manufacturd must be determined. These two major categories are discussed. The summary of methodology is divided into five parts: (1) systems costs, (2)instant plant costs, (3) annual operating costs, (4) escalation and discounting process, and (5) product pricing.

Is it worth investing in mental health promotion and prevention of mental illness? A systematic review of the evidence from economic evaluations

PubMed Central

Zechmeister, Ingrid; Kilian, Reinhold; McDaid, David

2008-01-01

Background While evidence on the cost of mental illness is growing, little is known about the cost-effectiveness of programmes in the areas of mental health promotion (MHP) and mental disorder prevention (MDP). The paper aims at identifying and assessing economic evaluations in both these areas to support evidence based prioritisation of resource allocation. Methods A systematic review of health and non health related bibliographic databases, complemented by a hand search of key journals and analysis of grey literature has been carried out. Study characteristics and results were qualitatively summarised. Economic evaluations of programmes that address mental health outcome parameters directly, those that address relevant risk factors of mental illness, as well as suicide prevention interventions were included, while evaluations of drug therapies were excluded. Results 14 studies fulfilled the inclusion criteria. They varied in terms of topic addressed, intervention used and study quality. Robust evidence on cost-effectiveness is still limited to a very small number of interventions with restricted scope for generalisability and transferability. The most favourable results are related to early childhood development programmes. Conclusion Prioritisation between MHP and MDP interventions requires more country and population-specific economic evaluations. There is also scope to retrospectively add economic analyses to existing effectiveness studies. The nature of promotion and prevention suggests that innovative approaches to economic evaluation that augment this with information on the challenges of implementation and uptake of interventions need further development. PMID:18211677

Current impact of gene technology on healthcare. A map of economic assessments.

PubMed

Rogowski, Wolf

2007-02-01

It has been claimed that gene technology will induce revolutionary changes in healthcare. This paper investigates how and to what extent these changes have been economically assessed. A generic framework was developed to distinguish between methodologically similar evaluations of healthcare technology. Methodological issues and the current state of economic evidence concerning human DNA technology were extracted from publications within these groups of evaluations. Economic evaluations of "healthcare consisting of gene technology" were identified primarily for in vitro diagnostics for hereditary disease and others for pharmacogenetics and molecular pathology. "Healthcare enabled by gene technology" is far more encompassing and includes, e.g., biotechnology drugs for which various health economic evaluations can be found. Yet here, the impact of gene technology intertwines with the impact of other technologies and is therefore hardly susceptible to evaluation. The fields of evaluation may be classified best according to the two dimensions "purpose" and "stage of development". Current evaluations cover screening, diagnostic and treatment technologies in investigational, new and established stages. Apart from prenatal screening, healthcare consisting of gene technology was cost saving only for genotype tests replacing continuous phenotype tests and for one pharmacogenetic test. Conclusive evidence of favourable cost-effectiveness ratios is available only for few conditions. Hypotheses about the impact of gene technology on healthcare must be explicit about the definition of "genetic" medicine. A general statement regarding healthcare enabled by gene technology is not possible. Based on current evidence, an era of healthcare consisting of gene technology built on widespread predictive testing is not desirable from a health economic viewpoint.

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting.

PubMed

Boyer, Nicole R S; Miller, Sarah; Connolly, Paul; McIntosh, Emma

2016-04-01

The Strengths and Difficulties Questionnaire (SDQ) is a behavioural screening tool for children. The SDQ is increasingly used as the primary outcome measure in population health interventions involving children, but it is not preference based; therefore, its role in allocative economic evaluation is limited. The Child Health Utility 9D (CHU9D) is a generic preference-based health-related quality of-life measure. This study investigates the applicability of the SDQ outcome measure for use in economic evaluations and examines its relationship with the CHU9D by testing previously published mapping algorithms. The aim of the paper is to explore the feasibility of using the SDQ within economic evaluations of school-based population health interventions. Data were available from children participating in a cluster randomised controlled trial of the school-based roots of empathy programme in Northern Ireland. Utility was calculated using the original and alternative CHU9D tariffs along with two SDQ mapping algorithms. t tests were performed for pairwise differences in utility values from the preference-based tariffs and mapping algorithms. Mean (standard deviation) SDQ total difficulties and prosocial scores were 12 (3.2) and 8.3 (2.1). Utility values obtained from the original tariff, alternative tariff, and mapping algorithms using five and three SDQ subscales were 0.84 (0.11), 0.80 (0.13), 0.84 (0.05), and 0.83 (0.04), respectively. Each method for calculating utility produced statistically significantly different values except the original tariff and five SDQ subscale algorithm. Initial evidence suggests the SDQ and CHU9D are related in some of their measurement properties. The mapping algorithm using five SDQ subscales was found to be optimal in predicting mean child health utility. Future research valuing changes in the SDQ scores would contribute to this research.

Systematic Review of Economic Models Used to Compare Techniques for Detecting Peripheral Arterial Disease.

PubMed

Moloney, Eoin; O'Connor, Joanne; Craig, Dawn; Robalino, Shannon; Chrysos, Alexandros; Javanbakht, Mehdi; Sims, Andrew; Stansby, Gerard; Wilkes, Scott; Allen, John

2018-04-23

Peripheral arterial disease (PAD) is a common condition, in which atherosclerotic narrowing in the arteries restricts blood supply to the leg muscles. In order to support future model-based economic evaluations comparing methods of diagnosis in this area, a systematic review of economic modelling studies was conducted. A systematic literature review was performed in June 2017 to identify model-based economic evaluations of diagnostic tests to detect PAD, with six individual databases searched. The review was conducted in accordance with the methods outlined in the Centre for Reviews and Dissemination's guidance for undertaking reviews in healthcare, and appropriate inclusion criteria were applied. Relevant data were extracted, and studies were quality assessed. Seven studies were included in the final review, all of which were published between 1995 and 2014. There was wide variation in the types of diagnostic test compared. The majority of the studies (six of seven) referenced the sources used to develop their model, and all studies stated and justified the structural assumptions. Reporting of the data within the included studies could have been improved. Only one identified study focused on the cost-effectiveness of a test typically used in primary care. This review brings together all applied modelling methods for tests used in the diagnosis of PAD, which could be used to support future model-based economic evaluations in this field. The limited modelling work available on tests typically used for the detection of PAD in primary care, in particular, highlights the importance of future work in this area.

A Systematic Review and Critical Appraisal of Economic Evaluations of Pharmacological Interventions for People with Bipolar Disorder.

PubMed

Mavranezouli, Ifigeneia; Lokkerbol, Joran

2017-03-01

Bipolar disorder (BD) is a chronic mood disorder that causes substantial psychological and financial burden. Various pharmacological treatments are effective in the management and prevention of acute episodes of BD. In an era of tighter healthcare budgets and a need for more efficient use of resources, several economic evaluations have evaluated the cost effectiveness of treatments for BD. The aim of this study was to systematically review and appraise published economic evaluations of pharmacological interventions for BD. A systematic search combining search terms specific to BD with a health economics search filter was conducted on six bibliographic databases (EMBASE, MEDLINE, PsycINFO, HTA, NHS EED, CENTRAL) in order to identify trial- or model-based full economic evaluations of pharmacological treatments of any phase of the disorder that were published between 1 January 1990 and 18 December 2015. Studies that met the inclusion criteria were critically appraised using the Quality of Health Economic Studies (QHES) checklist, and synthesised in a narrative way. The review included 19 economic studies, which varied with regard to the type and number of interventions assessed, the study design, the phase of treatment (acute or maintenance), the source of efficacy data and the method for evidence synthesis, the outcome measures, the time horizon and the countries/settings in which the studies were conducted. The study quality was variable but the majority of studies were of high or fair quality. Pharmacological interventions are cost effective, compared with no treatment, in the management of BD, both in the acute and maintenance phases. However, it is difficult to draw safe conclusions on the relative cost effectiveness between drugs due to differences across studies and limitations characterising many of them. Future economic evaluations need to consider the whole range of treatment options available for the management of BD and adopt appropriate methods for evidence synthesis and economic modelling, to explore more robustly the relative cost effectiveness of pharmacological interventions for people with BD.

Economic Evaluation alongside Multinational Studies: A Systematic Review of Empirical Studies

PubMed Central

Oppong, Raymond; Jowett, Sue; Roberts, Tracy E.

2015-01-01

Purpose of the study This study seeks to explore methods for conducting economic evaluations alongside multinational trials by conducting a systematic review of the methods used in practice and the challenges that are typically faced by the researchers who conducted the economic evaluations. Methods A review was conducted for the period 2002 to 2012, with potentially relevant articles identified by searching the Medline, Embase and NHS EED databases. Studies were included if they were full economic evaluations conducted alongside a multinational trial. Results A total of 44 studies out of a possible 2667 met the inclusion criteria. Methods used for the analyses varied between studies, indicating a lack of consensus on how economic evaluation alongside multinational studies should be carried out. The most common challenge appeared to be related to addressing differences between countries, which potentially hinders the generalisability and transferability of results. Other challenges reported included inadequate sample sizes and choosing cost-effectiveness thresholds. Conclusions It is recommended that additional guidelines be developed to aid researchers in this area and that these be based on an understanding of the challenges associated with multinational trials and the strengths and limitations of alternative approaches. Guidelines should focus on ensuring that results will aid decision makers in their individual countries. PMID:26121465

Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review.

PubMed

Shroufi, Amir; Chowdhury, Rajiv; Anchala, Raghupathy; Stevens, Sarah; Blanco, Patricia; Han, Tha; Niessen, Louis; Franco, Oscar H

2013-03-28

While there is good evidence to show that behavioural and lifestyle interventions can reduce cardiovascular disease risk factors in affluent settings, less evidence exists in lower income settings.This study systematically assesses the evidence on cost-effectiveness for preventive cardiovascular interventions in low and middle-income settings. Systematic review of economic evaluations on interventions for prevention of cardiovascular disease. PubMed, Web of Knowledge, Scopus and Embase, Opensigle, the Cochrane database, Business Source Complete, the NHS Economic Evaluations Database, reference lists and email contact with experts. we included economic evaluations conducted in adults, reporting the effect of interventions to prevent cardiovascular disease in low and middle income countries as defined by the World Bank. The primary outcome was a change in cardiovascular disease occurrence including coronary heart disease, heart failure and stroke. After selection of the studies, data were extracted by two independent investigators using a previously constructed tool and quality was evaluated using Drummond's quality assessment score. From 9731 search results we found 16 studies, which presented economic outcomes for interventions to prevent cardiovascular disease in low and middle income settings, with most of these reporting positive cost effectiveness results.When the same interventions were evaluated across settings, within and between papers, the likelihood of an intervention being judged cost effective was generally lower in regions with lowest gross national income. While population based interventions were in most cases more cost effective, cost effectiveness estimates for individual pharmacological interventions were overall based upon a stronger evidence base. While more studies of cardiovascular preventive interventions are needed in low and mid income settings, the available high-level of evidence supports a wide range of interventions for the prevention of cardiovascular disease as being cost effective across all world regions.

Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review.

PubMed

Cook, Wendy A; Morrison, Megan L; Eaton, Linda H; Theodore, Brian R; Doorenbos, Ardith Z

The United States has a complex healthcare system that is undergoing substantial reformations. There is a need for high-quality, economic evaluations of nursing practice. An updated review of completed economic evaluations relevant to the field of nursing within the U.S. healthcare system is timely and needed. The purpose of this study was to evaluate and describe the quantity and quality of economic evaluations in nursing-relevant research performed in the United States between 1997 and 2015. Four databases were searched. Titles, abstracts, and full-text content were reviewed to identify studies that analyzed both costs and outcomes, relevant to nursing, performed in the United States, and used the quality-adjusted life year to measure effectiveness. For included studies, data were extracted from full-text articles using criteria from U.S. Public Health Service's Panel on Cost-Effectiveness in Health and Medicine. Twenty-eight studies met the inclusion criteria. Most (n = 25, 89%) were published in the last decade of the analysis, from 2006 to 2015. Assessment of quality, based on selected items from the panel guidelines, found that the evaluations did not consistently use the recommended societal perspective, use multiple resource utilization categories, use constant dollars, discount future costs and outcomes, use a lifetime horizon, or include an indication of uncertainty in results. The only resource utilization category consistently included across studies was healthcare resources. Only 28 nursing-related studies meeting the inclusion criteria were identified as meeting robust health economic evaluation methodological criteria, and most did not include all important guideline items. Despite increases in absolute numbers of published studies over the past decade, economic evaluation has been underutilized in U.S. nursing-relevant research in the past two decades.

Medico-economic evaluation of healthcare products. Methodology for defining a significant impact on French health insurance costs and selection of benchmarks for interpreting results.

PubMed

Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Biot, Claire; Blachier, Corinne; Braun, Eric; Debroucker, Frédérique; Detournay, Bruno; Ferretti, Carine; Granger, Muriel; Jouan-Flahault, Chrystel; Lussier, Marie-Dominique; Meyer, Arlette; Muller, Sophie; Pigeon, Martine; De Sahb, Rima; Sannié, Thomas; Sapède, Claudine; Vray, Muriel

2014-01-01

Decree No. 2012-1116 of 2 October 2012 on medico-economic assignments of the French National Authority for Health (Haute autorité de santé, HAS) significantly alters the conditions for accessing the health products market in France. This paper presents a theoretical framework for interpreting the results of the economic evaluation of health technologies and summarises the facts available in France for developing benchmarks that will be used to interpret incremental cost-effectiveness ratios. This literature review shows that it is difficult to determine a threshold value but it is also difficult to interpret then incremental cost effectiveness ratio (ICER) results without a threshold value. In this context, round table participants favour a pragmatic approach based on "benchmarks" as opposed to a threshold value, based on an interpretative and normative perspective, i.e. benchmarks that can change over time based on feedback. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Assessing the economic impact of Rx-to-OTC switches: systematic review and guidelines for future development.

PubMed

Cohen, J; Millier, A; Karray, S; Toumi, M

2013-01-01

Switching drugs from prescription to non-prescription status (Rx-to-OTC) presents a unique set of challenges and opportunities to policy-makers and the industry in terms of managing health outcomes, pharmaceutical spending, and steering of consumer choices of therapy. Decision-analytic models are used to address uncertainty and produce reasonable estimates of the economic impact of switches for payers. This article presents a critical literature review of existing models which assess the economic impact of Rx-to-OTC switches, and provides guidelines in which future economic evaluations of Rx-to-OTC switches could be improved. A comprehensive search strategy was implemented in Medline and Embase, to retrieve published economic evaluations on Rx-to-OTC switches from 1995-2010. The research digest of the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) was reviewed for potentially relevant abstracts for the past 3 years. Each model used was critically evaluated in terms of structure, relevance of inputs, methodology used, and robustness of results. Worldwide, the economic impact of Rx-to-OTC switches has only been evaluated in a total of 12 peer-reviewed publications. Ten out of 12 studies were US-based, and two European-based. The models covered various disease categories, including allergy, hypercholesterolemia, gastroenterology, contraception, pulmonology, and virology. Seventy-five per cent of the models predicted cost savings for payers and patients. Limitations of the models mainly included use of strong assumptions and non-inclusion of specific populations due to lack of data. Guidelines were developed to help future model development. They cover structural issues on decision context, health states, and clinical outcomes, and other considerations for model specifications. Although reviewed studies lacked quality, this review of economic evidence of Rx-to-OTC switches suggests that switches may produce cost savings to public and private payers. This is especially important in light of the trend towards more switches.

An ecological basis for ecosystem management

Treesearch

M. R. Kaufmann; R. T. Graham; D. A. Boyce; W. H. Moir; L. Perry; R. T. Reynolds; R. L. Bassett; P. Mehlhop; C. B. Edminster; W. M. Block; P. S. Corn

1994-01-01

Guiding principles based on conservation biology are applied in assessing ecosystem needs. Ecosystem, economic, and social needs are integrated in a decision model in which the guiding principles are used as a primary filter for evaluating proposed actions. Management practices consistent with the guiding principles are likely to lead to ecological, economic, and...

Evaluation of Computer-Assisted Instruction in Principles of Economics.

ERIC Educational Resources Information Center

Coates, Dennis; Humphreys, Brad R.

2001-01-01

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

Promoting health equity in European children: Design and methodology of the prospective EPHE (Epode for the Promotion of Health Equity) evaluation study

PubMed Central

2014-01-01

Background Reducing health inequalities is a top priority of the public health agendas in Europe. The EPHE project aims to analyse the added value of a community-based interventional programme based on EPODE methodology, adapted for the reduction of socio-economic inequalities in childhood obesity. The interventions that will be implemented by this project focus on four energy balance-related behaviours (fruit and vegetable consumption, tap water intake, physical inactivity, sleep duration) and their determinants. This article presents the design of the effect evaluation of the EPHE project. Methods/Design This is a prospective two-year follow-up evaluation study, which will collect data on the energy balance-related behaviours and potential environmental determinants of 6–8 year olds, depending on the socio-economic status of the parents. For this purpose a parental self-reported questionnaire is constructed. This assesses the socio-economic status of the parents (5 items) and the dietary (12 items), sedentary (2 items) and sleeping (4 items) behaviour of the child. Alongside potential family-environmental determinants are assessed. The EPHE parental questionnaire will be disseminated in schools of a selected medium-sized city in seven European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands). Discussion This study will evaluate the effects of the EPHE community-based interventional programmes. Furthermore, it will provide evidence for children’s specific energy balance-related behaviours and family environmental determinants related to socio-economic inequalities, in seven European countries. PMID:24690078

Engineering Analysis and Economic Evaluation of the Synthesis of Composite CuO/ZnO/ZrO2 Nanocatalyst

NASA Astrophysics Data System (ADS)

Nandiyanto, A. B. D.; Hayati, W. R.; Aziz, T. A.; Ragadhita, R.; Abdullah, A. G.; Widiaty, I.

2018-02-01

The purpose of this study was to evaluate the synthesis process of composite CuO/ZnO/ZrO2 (CZZ) nanocatalyst. The CZZ nanocatalyst is used as a catalyst in the hydrogenation reaction, which is used to convert harmful CO2 gas into liquid fuels such as methanol. In this study, CZZ produced using the sol-gel autocombustion method was selected as a model of the production procedure. The evaluation was conducted into two factors: engineering and economic analysis. Engineering analysis was analyzed based on the available apparatuses and raw materials in online web. Then, these data were used and compared with the mass balance approximation. The economic analysis was done using several economic parameters, including such as gross margin, internal rate return, payback period, cumulative net value, break even point (BEP), profitability index on sales to investment. Engineering analysis showed the present method can be applied using available apparatuses and raw materials in market. Economic analysis result confirmed that the present project is profitable. The analysis concluded that the present project for the production of CZZ nanocatalyst is prospective in small scale industry and profitable (by positive values in all economic parameters).

EVALUATION OF FILTRATION AND DISTILLATION METHODS FOR RECYCLING AUTOMOTIVE COOLANT.

EPA Science Inventory

This evaluation addresses the product quality, waste reduction, and economic issues involved in recycling automotive and heavy-duty engine coolants at a New Jersey Department of Transportation garage. The specific recycling units evaluated are based on the technologies of filtrat...

Strategic Defense Initiative Demonstration/Validation Program Environmental Assessment. Ground-Based Surveillance and Tracking System (GSTS),

DTIC Science & Technology

1987-08-01

conflicts between the facility and local standards, and to evaluate the probability of conflict resulting from any planned expansions. 2-2 Visual Resources...on staffing and housing for the facility itself is contained in Table 2-7. Additional data on the socio - economic background of Ebeye, including...resources, noise, and socio - economics. As a result of that evaluation, consequences vere assigned to one of three categories: insignificant, mitigable, or

A macro-economic framework for evaluation of cyber security risks related to protection of intellectual property.

PubMed

Andrijcic, Eva; Horowitz, Barry

2006-08-01

The article is based on the premise that, from a macro-economic viewpoint, cyber attacks with long-lasting effects are the most economically significant, and as a result require more attention than attacks with short-lasting effects that have historically been more represented in literature. In particular, the article deals with evaluation of cyber security risks related to one type of attack with long-lasting effects, namely, theft of intellectual property (IP) by foreign perpetrators. An International Consequence Analysis Framework is presented to determine (1) the potential macro-economic consequences of cyber attacks that result in stolen IP from companies in the United States, and (2) the likely sources of such attacks. The framework presented focuses on IP theft that enables foreign companies to make economic gains that would have otherwise benefited the U.S. economy. Initial results are presented.

Techno-economic analysis for a sugarcane biorefinery: Colombian case.

PubMed

Moncada, Jonathan; El-Halwagi, Mahmoud M; Cardona, Carlos A

2013-05-01

In this paper a techno-economic analysis for a sugarcane biorefinery is presented for the Colombian case. It is shown two scenarios for different conversion pathways as function of feedstock distribution and technologies for sugar, fuel ethanol, PHB, anthocyanins and electricity production. These scenarios are compared with the Colombian base case which simultaneously produce sugar, fuel ethanol and electricity. A simulation procedure was used in order to evaluate biorefinery schemes for all the scenarios, using Aspen Plus software, that include productivity analysis, energy calculations and economic evaluation for each process configuration. The results showed that the configuration with the best economic, environmental and social performance is the one that considers fuel ethanol and PHB production from combined cane bagasse and molasses. This result served as the basis to draw recommendations on technological and economic feasibility as well as social aspects for the implementation of such type of biorefinery in Colombia. Copyright © 2012 Elsevier Ltd. All rights reserved.

Effects of scarcity, aesthetics and ecology on wildlife auction prices of large African mammals.

PubMed

Dalerum, Fredrik; Miranda, María; Muñiz, Cristina; Rodríguez, Plácido

2018-02-01

For successful integration of biological conservation into economic markets, economic processes need to capture ecological values. South African wildlife ranching is a tourist-based activity that generates unique information on the economic value of wildlife species. We used public data from South African wildlife auctions to evaluate if annual prices 1991-2012 related to species characteristics associated with scarcity, aesthetics and ecology of South African carnivores and ungulates. While none of the species characteristics influenced carnivore prices, ungulate prices were related to characteristics associated with novelty and aesthetics, which relative importance had increased over time. We raise both ecological and economic concerns for this apparent focus. Our results also suggest a potential importance of non-species-related factors, such as market and buyer characteristics. We encourage further evaluation of the relative influences of species characteristics versus factors that are intrinsically linked to economic processes on price variations in South African wildlife.

Emergy-based comparative analysis on industrial clusters: economic and technological development zone of Shenyang area, China.

PubMed

Liu, Zhe; Geng, Yong; Zhang, Pan; Dong, Huijuan; Liu, Zuoxi

2014-09-01

In China, local governments of many areas prefer to give priority to the development of heavy industrial clusters in pursuit of high value of gross domestic production (GDP) growth to get political achievements, which usually results in higher costs from ecological degradation and environmental pollution. Therefore, effective methods and reasonable evaluation system are urgently needed to evaluate the overall efficiency of industrial clusters. Emergy methods links economic and ecological systems together, which can evaluate the contribution of ecological products and services as well as the load placed on environmental systems. This method has been successfully applied in many case studies of ecosystem but seldom in industrial clusters. This study applied the methodology of emergy analysis to perform the efficiency of industrial clusters through a series of emergy-based indices as well as the proposed indicators. A case study of Shenyang Economic Technological Development Area (SETDA) was investigated to show the emergy method's practical potential to evaluate industrial clusters to inform environmental policy making. The results of our study showed that the industrial cluster of electric equipment and electronic manufacturing produced the most economic value and had the highest efficiency of energy utilization among the four industrial clusters. However, the sustainability index of the industrial cluster of food and beverage processing was better than the other industrial clusters.

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological review of health technology assessments.

PubMed

Shinkins, Bethany; Yang, Yaling; Abel, Lucy; Fanshawe, Thomas R

2017-04-14

Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests.

Teacher Evaluation Policy and Conflicting Theories of Motivation

ERIC Educational Resources Information Center

Firestone, William A.

2014-01-01

Current interest in teacher evaluation focuses disproportionately on measurement issues and performance-based pay without an overarching theory of how evaluation works. To develop such a theory, I contrast two motivation theories often used to guide thinking about teacher evaluation. External motivation theory relies on economics and extrinsic…

Consumer preferences for reduced packaging under economic instruments and recycling policy.

PubMed

Yamaguchi, Keiko; Takeuchi, Kenji

2016-02-01

This study was conducted using a web-based survey and bidding game in contingent valuation method to evaluate consumer preferences for packaging with less material. Results revealed that people who live in a municipality implementing unit-based pricing of waste have a higher willingness-to-pay (WTP) for a product. Economic instruments can affect the purchase of products with reduced packaging because a higher disposal cost increases the attractiveness of source reduction. However, unit-based pricing combined with plastic separation for recycling reduces WTP. This result suggests that recycling policy weakens the effect of economic instruments on source reduction of waste. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The influence of intellectual capital in performance evaluation: a case-study in the hospital sector].

PubMed

Bonacim, Carlos Alberto Grespan; Araújo, Adriana Maria Procópio de

2010-06-01

This paper contributes to public institutions with the adaptation of a performance evaluation tool based on private companies. The objective is to demonstrate how the impact of an educational activity might be measured in the economic value added for the society of a public university hospital. The paper was divided in four parts, despite the introductory and methodological aspects and the final remarks. First, the hospital sector is explained, specifically in the context of the public university hospitals. Then, the definitions, the nature and measure of the intellectual capital are presented, followed by the disclosure of the main economic performance evaluation models. Finally, an adapted model is presented, under the approach of the value based management, considering adjustments of the return and the respective investment measures, showing the impacts of the intellectual capital management and the education activity on the economic result of those institutions. The study was developed based on a methodology supported by a bibliographical research, using a comparative method procedure in the descriptive modality. At last, it is highlighted the importance of accountability for the society regarding the use of public resources and how this study can help in this way.

Usefulness and economic evaluation of ADSL-based live interactive teledermatology in areas with shortage of dermatologists.

PubMed

Dekio, Itaru; Hanada, Eisuke; Chinuki, Yuko; Akaki, Tatsuya; Kitani, Mitsuhiro; Shiraishi, Yuko; Kaneko, Sakae; Furumura, Minao; Morita, Eishin

2010-11-01

To overcome the problem of maldistribution of dermatologists in rural areas, live interactive teleconsultation systems are being used in some countries. However, these systems are not in common use because few evaluations on their efficiency and economic viability were reported. We constructed an easy-to-use asymmetric digital subscriber line (ADSL)-based live interactive teleconsultation system and conducted 150 trial sessions between two rural hospitals and Shimane University Hospital. The clinical usefulness and economic advantages of this system were evaluated using data obtained from the trials. The system efficiently captured images at a resolution sufficient for specialized consultations: follicular openings were visible in the images obtained from a distance of 2 m. This system is more advantageous than a conventional clinic if the following condition is fulfilled: y ≤ 6.00 x-3.86 [x, time required for one-way travel (h); y, time required for consultation (h)]. Our two lines in trial fulfilled this condition. Asymmetric digital subscriber line-based live interactive teleconsultation technology is beneficial in many rural hospitals that do not have a dermatologist. © 2010 The International Society of Dermatology.

Systematic overview of economic evaluations of health-related rehabilitation.

PubMed

Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

2016-01-01

Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Applying the natural disasters vulnerability evaluation model to the March 2011 north-east Japan earthquake and tsunami.

PubMed

Ruiz Estrada, Mario Arturo; Yap, Su Fei; Park, Donghyun

2014-07-01

Natural hazards have a potentially large impact on economic growth, but measuring their economic impact is subject to a great deal of uncertainty. The central objective of this paper is to demonstrate a model--the natural disasters vulnerability evaluation (NDVE) model--that can be used to evaluate the impact of natural hazards on gross national product growth. The model is based on five basic indicators-natural hazards growth rates (αi), the national natural hazards vulnerability rate (ΩT), the natural disaster devastation magnitude rate (Π), the economic desgrowth rate (i.e. shrinkage of the economy) (δ), and the NHV surface. In addition, we apply the NDVE model to the north-east Japan earthquake and tsunami of March 2011 to evaluate its impact on the Japanese economy. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

[Evaluation of sustainable development of Dalian Economic and Technological Development Zone based on MuSIASEM theory].

PubMed

Geng, Yong; Liu, Xiao-qing; Zhang, Pan; Liu, Ye

2010-10-01

Based on the theory of multiple-scale integrated assessment of societal and ecosystem metabolism (MuSIASEM), a comprehensive evaluation was made on the human activity time, exosomatic energy input, and added value of Dalian Economic and Technological Development Zone in 2000-2007. During the study period, the life quality of local citizens increased year after year, while the agricultural industry dwindled. Manufacturing industry was still the main pillar industry, but its energy consumption was greater. Service industry was at its early stage, falling behind manufacturing industry. The exosomatic metabolic level of the whole zone and its various industries had an obvious increase, and the energy intensity decreased continuously. With the fact that both the human activity time and the exosomatic energy input had a ceaseless decrease, the economic added value increased steadily, and the zone was under its way towards sustainable development.

An economic evaluation of solar radiation management.

PubMed

Aaheim, Asbjørn; Romstad, Bård; Wei, Taoyuan; Kristjánsson, Jón Egill; Muri, Helene; Niemeier, Ulrike; Schmidt, Hauke

2015-11-01

Economic evaluations of solar radiation management (SRM) usually assume that the temperature will be stabilized, with no economic impacts of climate change, but with possible side-effects. We know from experiments with climate models, however, that unlike emission control the spatial and temporal distributions of temperature, precipitation and wind conditions will change. Hence, SRM may have economic consequences under a stabilization of global mean temperature even if side-effects other than those related to the climatic responses are disregarded. This paper addresses the economic impacts of implementing two SRM technologies; stratospheric sulfur injection and marine cloud brightening. By the use of a computable general equilibrium model, we estimate the economic impacts of climatic responses based on the results from two earth system models, MPI-ESM and NorESM. We find that under a moderately increasing greenhouse-gas concentration path, RCP4.5, the economic benefits of implementing climate engineering are small, and may become negative. Global GDP increases in three of the four experiments and all experiments include regions where the benefits from climate engineering are negative. Copyright © 2015 Elsevier B.V. All rights reserved.

The role of decision analytic modeling in the health economic assessment of spinal intervention.

PubMed

Edwards, Natalie C; Skelly, Andrea C; Ziewacz, John E; Cahill, Kevin; McGirt, Matthew J

2014-10-15

Narrative review. To review the common tenets, strengths, and weaknesses of decision modeling for health economic assessment and to review the use of decision modeling in the spine literature to date. For the majority of spinal interventions, well-designed prospective, randomized, pragmatic cost-effectiveness studies that address the specific decision-in-need are lacking. Decision analytic modeling allows for the estimation of cost-effectiveness based on data available to date. Given the rising demands for proven value in spine care, the use of decision analytic modeling is rapidly increasing by clinicians and policy makers. This narrative review discusses the general components of decision analytic models, how decision analytic models are populated and the trade-offs entailed, makes recommendations for how users of spine intervention decision models might go about appraising the models, and presents an overview of published spine economic models. A proper, integrated, clinical, and economic critical appraisal is necessary in the evaluation of the strength of evidence provided by a modeling evaluation. As is the case with clinical research, all options for collecting health economic or value data are not without their limitations and flaws. There is substantial heterogeneity across the 20 spine intervention health economic modeling studies summarized with respect to study design, models used, reporting, and general quality. There is sparse evidence for populating spine intervention models. Results mostly showed that interventions were cost-effective based on $100,000/quality-adjusted life-year threshold. Spine care providers, as partners with their health economic colleagues, have unique clinical expertise and perspectives that are critical to interpret the strengths and weaknesses of health economic models. Health economic models must be critically appraised for both clinical validity and economic quality before altering health care policy, payment strategies, or patient care decisions. 4.

[Coupling coordination evaluation method between eco-environment quality and economic development level in contiguous special poverty-stricken areas of China].

PubMed

Wang, Yan-hui; Li, Jing-yi

2015-05-01

It is one of the important strategies in the new period of national poverty alleviation and development to maintain the basic balance between the ecological environment and economic development, and to promote the coordinated sustainable development of economy and ecological environment. Taking six contiguous special poverty-stricken areas as the study areas, a coupling coordination evaluation method between eco-environment quality and economic development level in contiguous special poverty-stricken areas was explored in this paper. The region' s ecological poverty index system was proposed based on the natural attribute of ecological environment, and the ecological environment quality evaluation method was built up by using AHP weighting method, followed by the design of the coupling coordination evaluation method between the ecological environment indices and the county economic poverty comprehensive indices. The coupling coordination degrees were calculated and their spatial representation differentiations were analyzed respectively at district, province, city, and county scales. Results showed that approximately half of the counties in the study areas achieved the harmoniously coordinated development. However, the ecological environmental quality and the economic development in most counties could not be synchronized, where mountains, rivers and other geographic features existed roughly as a dividing line of the coordinated development types. The phenomena of dislocation between the ecological environment and economic development in state-level poor counties were more serious than those of local poor counties.

Seminar presentation on the economic evaluation of the space shuttle system

NASA Technical Reports Server (NTRS)

1973-01-01

The proceedings of a seminar on the economic aspects of the space shuttle system are presented. Emphasis was placed on the problems of economic analysis of large scale public investments, the state of the art of cost estimation, the statistical data base for estimating costs of new technological systems, and the role of the main economic parameters affecting the results of the analyses. An explanation of the system components of a space program and the present choice of launch vehicles, spacecraft, and instruments was conducted.

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

PubMed

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

2014-01-01

For many years, the legal situation within the statutory health insurance (SHI) system in Germany has allowed for health economic evaluations. There are various reasons why health economic evaluations have played virtually no role in decision making until now: to begin with, a method for the evaluation of the relation between benefits and costs which needed to be in accordance with the legal requirements had to be developed, the outcome of which was the efficiency frontier approach. Subsequent health care reforms have led to changing objectives and strategies. Currently, price negotiations of newly launched drugs are based on an early benefit assessment of dossiers submitted by pharmaceutical manufacturers. Other reasons might be the presently very comfortable financial situation of the statutory health insurance system as well as a historically grown societal fear and discomfort towards what is perceived to be a rationing of medicinal products. For the time being, it remains open how long the German health care system can afford to continue neglecting the benefits of health economic evaluations for drug and non-drug interventions, and when it will be time to wake this sleeping beauty. Copyright © 2014. Published by Elsevier GmbH.

The Economic, Energy, and Environmental Impacts of the Energy-Related Inventions Program

DOE R&D Accomplishments Database

Brown, M.A.; Wilson, C.R.; Franchuk, C.A.; Cohn, S.M.; Jones, D.

1994-07-01

This report provides information on the economic, energy, and environmental impacts of inventions supported by the Energy-Related Inventions Program (ERIP) -- a program jointly operated by the US Department of Energy and the National Institute of Standards and Technology (NIST). It describes the results of the latest in a series of ERIP evaluation projects that have been completed since 1980. The period of interest is 1980 through 1992. The evaluation is based on data collected in 1993 through mail and telephone surveys of 253 program participants, and historical data collected during previous evaluations for an additional 189 participants.

Economic Evaluation Enhances Public Health Decision Making

PubMed Central

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

2015-01-01

Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking “how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?” is important when making decisions about resource allocation and scaling of interventions. PMID:26157792

MOBILE ON-SITE RECYCLING OF METALWORKING FLUIDS

EPA Science Inventory

This evaluation addresses the product quality, waste reduction, and economic issues involved in recycling metalworking fluids through a mobile recycling unit. The specific recycling unit evaluated is based on the technology of filtration, pasteurization, and centrifugation. Metal...

Response to alternative genetic-economic indices for Holsteins across 2 generations

USDA-ARS?s Scientific Manuscript database

Four U.S. genetic-economic indexes for dairy cattle were retrofitted to demonstrate the progress that could have been made for currently evaluated traits if selection had been based on those indexes across 2 generations. Holstein AI bulls (106,471) were categorized by quintile for each index, and 25...

Cost-effectiveness analyses and their role in improving healthcare strategies.

PubMed

Rodriguez, Maria I; Caughey, Aaron B

2013-12-01

In this era of healthcare reform, attention is focused on increasing the quality of care and access to services, while simultaneously reducing the cost. Economic evaluations can play an important role in translating research to evidence-based practice and policy. Cost-effectiveness analysis (CEA) and its utility for clinical and policy decision making among U.S. obstetricians and gynecologists is reviewed. Three case examples demonstrating the value of this methodology in decision making are considered. A discussion of the methodologic principles of CEA, the advantages, and the limitations of the methodology are presented. CEA can play an important role in evidence-based decision making, with value for clinicians and policy makers alike. These studies are of particular interest in the field of obstetrics and gynecology, in which uncertainty from epidemiologic or clinical trials exists, or multiple perspectives need to be considered (maternal, neonatal, and societal). As with all research, it is essential that economic evaluations are conducted according to established methodologic standards. Interpretation and application of results should occur with a clear understanding of both the value and the limitations of economic evaluations.

Economic evaluation of emergency obstetric care training: a systematic review.

PubMed

Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

2017-12-04

Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a need to scale-up and standardise processes that capture both cost and effectiveness of training and to agree on suitable economic evaluation models that allow for comparability across settings. PROSPERO_CRD42016041911 .

Cost-effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials.

PubMed

Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Yamauchi, Keita

2016-06-01

A systematic review of the cost-effectiveness of occupational therapy for older people was conducted. MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library, OT seeker and unpublished trials registers were searched. Reference lists of all potentially eligible studies were searched with no language restrictions. We included trial-based full economic evaluations that considered both costs and outcomes in occupational therapy for older people compared with standard care (i.e. other therapy) or no intervention. We reviewed each trial for methodological quality using the Cochrane risk of bias tool and assessed the quality of economic evaluations using a Drummond checklist. In the results of this review, we included five eligible studies (1-5) that were randomized controlled trials with high-quality economic evaluation. Two studies were full economic evaluations of interventions for fall prevention (1 and 2); two studies were full economic evaluations of preventive occupational therapy interventions (3 and 4; one was a comparison of an occupational therapy group with a social work group); one study was a full economic evaluation of occupational therapy for individuals with dementia (5). Two of the studies (one was preventive occupational therapy [3] and the other was occupational therapy for dementia [5]) found a significant effect and confirmed the cost-effectiveness of occupational therapy for older people compared with the control group. These studies found that occupational therapy for older people was clinically effective and cost-effective in comparison with standard care or other therapies. With reference to their clinical implication, these intervention studies (using a client-centred approach) suggested potentially cost-effective means to motivate clients to maintain their own health. However, this review has limitations because of the high heterogeneity of the reviewed studies on full economic evaluations of occupational therapy for older people. Future studies on the cost-effectiveness of occupational therapy in older people are strongly warranted. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations

PubMed Central

Herman, Patricia M; Poindexter, Beth L; Witt, Claudia M; Eisenberg, David M

2012-01-01

Objective A comprehensive systematic review of economic evaluations of complementary and integrative medicine (CIM) to establish the value of these therapies to health reform efforts. Data sources PubMed, CINAHL, AMED, PsychInfo, Web of Science and EMBASE were searched from inception through 2010. In addition, bibliographies of found articles and reviews were searched, and key researchers were contacted. Eligibility criteria for selecting studies Studies of CIM were identified using criteria based on those of the Cochrane complementary and alternative medicine group. All studies of CIM reporting economic outcomes were included. Study appraisal methods All recent (and likely most cost-relevant) full economic evaluations published 2001–2010 were subjected to several measures of quality. Detailed results of higher-quality studies are reported. Results A total of 338 economic evaluations of CIM were identified, of which 204, covering a wide variety of CIM for different populations, were published 2001–2010. A total of 114 of these were full economic evaluations. And 90% of these articles covered studies of single CIM therapies and only one compared usual care to usual care plus access to multiple licensed CIM practitioners. Of the recent full evaluations, 31 (27%) met five study-quality criteria, and 22 of these also met the minimum criterion for study transferability (‘generalisability’). Of the 56 comparisons made in the higher-quality studies, 16 (29%) show a health improvement with cost savings for the CIM therapy versus usual care. Study quality of the cost-utility analyses (CUAs) of CIM was generally comparable to that seen in CUAs across all medicine according to several measures, and the quality of the cost-saving studies was slightly, but not significantly, lower than those showing cost increases (85% vs 88%, p=0.460). Conclusions This comprehensive review identified many CIM economic evaluations missed by previous reviews and emerging evidence of cost-effectiveness and possible cost savings in at least a few clinical populations. Recommendations are made for future studies. PMID:22945962

[Evaluation of comprehensive capacity of resources and environments in Poyang Lake Eco-economic Zone].

PubMed

Song, Yan-Chun; Yu, Dan

2014-10-01

With the development of the society and economy, the contradictions among population, resources and environment are increasingly worse. As a result, the capacity of resources and environment becomes one of the focal issues for many countries and regions. Through investigating and analyzing the present situation and the existing problems of resources and environment in Poyang Lake Eco-economic Zone, seven factors were chosen as the evaluation criterion layer, namely, land resources, water resources, biological resources, mineral resources, ecological-geological environment, water environment and atmospheric environment. Based on the single factor evaluation results and with the county as the evaluation unit, the comprehensive capacity of resources and environment was evaluated by using the state space method in Poyang Lake Eco-economic Zone. The results showed that it boasted abundant biological resources, quality atmosphere and water environment, and relatively stable geological environment, while restricted by land resource, water resource and mineral resource. Currently, although the comprehensive capacity of the resources and environments in Poyang Lake Eco-economic Zone was not overloaded as a whole, it has been the case in some counties/districts. State space model, with clear indication and high accuracy, could serve as another approach to evaluating comprehensive capacity of regional resources and environment.

[Coupling coordinated development of ecological-economic system in Loess Plateau].

PubMed

Zhang, Qing-Feng; Wu, Fa-Qi; Wang, Li; Wang, Jian

2011-06-01

Based on system theory, a coupling coordinated development model of ecological-economic system in Loess Plateau was established, and the evaluation criteria and basic types of the coordinated development of the ecological-economic system were proposed. The county-level coupling coordinated development of the ecological-economic system was also discussed, based on the local characteristics. The interactions between the ecological and economic systems in Loess Plateau could be divided into four stages, i.e., seriously disordered development stage, mild-disordered development stage, low-level coordinated development stage, and high level well-coordinated development stage. At each stage, there existed a cyclic process of profit and loss-antagonist-running-dominant-synchronous development. The coupling development degree of the ecological-economic system in Loess Plateau was overall at a lower level, being about 62.7% of the counties at serious disorder, 30.1% of the counties at mild disorder, and 7.1% of the counties at low but coordinated level. The coupling development degree based on the model established in this study could better reflect the current social-economic and ecological environment situations, especially the status of coordination. To fully understand the coupling of ecological-economic system and to adopt appropriate development mode would be of significance to promote the county-level coordinated development in Loess Plateau.

Analysis of electric power industry restructuring

NASA Astrophysics Data System (ADS)

Al-Agtash, Salem Yahya

1998-10-01

This thesis evaluates alternative structures of the electric power industry in a competitive environment. One structure is based on the principle of creating a mandatory power pool to foster competition and manage system economics. The structure is PoolCo (pool coordination). A second structure is based on the principle of allowing independent multilateral trading and decentralized market coordination. The structure is DecCo (decentralized coordination). The criteria I use to evaluate these two structures are: economic efficiency, system reliability and freedom of choice. Economic efficiency evaluation considers strategic behavior of individual generators as well as behavioral variations of different classes of consumers. A supply-function equilibria model is characterized for deriving bidding strategies of competing generators under PoolCo. It is shown that asymmetric equilibria can exist within the capacities of generators. An augmented Lagrangian approach is introduced to solve iteratively for global optimal operations schedules. Under DecCo, the process involves solving iteratively for system operations schedules. The schedules reflect generators strategic behavior and brokers' interactions for arranging profitable trades, allocating losses and managing network congestion. In the determination of PoolCo and DecCo operations schedules, overall costs of power generation (start-up and shut-down costs and availability of hydro electric power) as well as losses and costs of transmission network are considered. For system reliability evaluation, I examine the effect of PoolCo and DecCo operating conditions on the system security. Random component failure perturbations are generated to simulate the actual system behavior. This is done using Monte Carlo simulation. Freedom of choice evaluation accounts for schemes' beneficial opportunities and capabilities to respond to consumers expressed preferences. An IEEE 24-bus test system is used to illustrate the concepts developed for economic efficiency evaluation. The system was tested over two years time period. The results indicate 2.6684 and 2.7269 percent of efficiency loss on average for PoolCo and DecCo, respectively. These values, however, do not represent forecasts of efficiency losses of PoolCo- and DecCo-based competitive industries. Rather, they are illustrations of the efficiency losses for the given IEEE test system and based on the modeling assumptions underlying framework development.

The Impact of Regression to the Mean on Economic Evaluation in Quasi-Experimental Pre-Post Studies: The Example of Total Knee Replacement Using Data from the Osteoarthritis Initiative.

PubMed

Schilling, Chris; Petrie, Dennis; Dowsey, Michelle M; Choong, Peter F; Clarke, Philip

2017-12-01

Many treatments are evaluated using quasi-experimental pre-post studies susceptible to regression to the mean (RTM). Ignoring RTM could bias the economic evaluation. We investigated this issue using the contemporary example of total knee replacement (TKR), a common treatment for end-stage osteoarthritis of the knee. Data (n = 4796) were obtained from the Osteoarthritis Initiative database, a longitudinal observational study of osteoarthritis. TKR patients (n = 184) were matched to non-TKR patients, using propensity score matching on the predicted hazard of TKR and exact matching on osteoarthritis severity and health-related quality of life (HrQoL). The economic evaluation using the matched control group was compared to the standard method of using the pre-surgery score as the control. Matched controls were identified for 56% of the primary TKRs. The matched control HrQoL trajectory showed evidence of RTM accounting for a third of the estimated QALY gains from surgery using the pre-surgery HrQoL as the control. Incorporating RTM into the economic evaluation significantly reduced the estimated cost effectiveness of TKR and increased the uncertainty. A generalized ICER bias correction factor was derived to account for RTM in cost-effectiveness analysis. RTM should be considered in economic evaluations based on quasi-experimental pre-post studies. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

A review of economic evaluations of behavior change interventions: setting an agenda for research methods and practice.

PubMed

Alayli-Goebbels, Adrienne F G; Evers, Silvia M A A; Alexeeva, Daria; Ament, André J H A; de Vries, Nanne K; Tilly, Jan C; Severens, Johan L

2014-06-01

The objective of this study was to review methodological quality of economic evaluations of lifestyle behavior change interventions (LBCIs) and to examine how they address methodological challenges for public health economic evaluation identified in the literature. Pubmed and the NHS economic evaluation database were searched for published studies in six key areas for behavior change: smoking, physical activity, dietary behavior, (illegal) drug use, alcohol use and sexual behavior. From included studies (n = 142), we extracted data on general study characteristics, characteristics of the LBCIs, methodological quality and handling of methodological challenges. Economic evaluation evidence for LBCIs showed a number of weaknesses: methods, study design and characteristics of evaluated interventions were not well reported; methodological quality showed several shortcomings and progress with addressing methodological challenges remained limited. Based on the findings of this review we propose an agenda for improving future evidence to support decision-making. Recommendations for practice include improving reporting of essential study details and increasing adherence with good practice standards. Recommendations for research methods focus on mapping out complex causal pathways for modeling, developing measures to capture broader domains of wellbeing and community outcomes, testing methods for considering equity, identifying relevant non-health sector costs and advancing methods for evidence synthesis. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evidence used in model-based economic evaluations for evaluating pharmacogenetic and pharmacogenomic tests: a systematic review protocol

PubMed Central

Peters, Jaime L; Cooper, Chris; Buchanan, James

2015-01-01

Introduction Decision models can be used to conduct economic evaluations of new pharmacogenetic and pharmacogenomic tests to ensure they offer value for money to healthcare systems. These models require a great deal of evidence, yet research suggests the evidence used is diverse and of uncertain quality. By conducting a systematic review, we aim to investigate the test-related evidence used to inform decision models developed for the economic evaluation of genetic tests. Methods and analysis We will search electronic databases including MEDLINE, EMBASE and NHS EEDs to identify model-based economic evaluations of pharmacogenetic and pharmacogenomic tests. The search will not be limited by language or date. Title and abstract screening will be conducted independently by 2 reviewers, with screening of full texts and data extraction conducted by 1 reviewer, and checked by another. Characteristics of the decision problem, the decision model and the test evidence used to inform the model will be extracted. Specifically, we will identify the reported evidence sources for the test-related evidence used, describe the study design and how the evidence was identified. A checklist developed specifically for decision analytic models will be used to critically appraise the models described in these studies. Variations in the test evidence used in the decision models will be explored across the included studies, and we will identify gaps in the evidence in terms of both quantity and quality. Dissemination The findings of this work will be disseminated via a peer-reviewed journal publication and at national and international conferences. PMID:26560056

How to prepare a systematic review of economic evaluations for clinical practice guidelines: database selection and search strategy development (part 2/3).

PubMed

Thielen, F W; Van Mastrigt, Gapg; Burgers, L T; Bramer, W M; Majoie, Hjm; Evers, Smaa; Kleijnen, J

2016-12-01

This article is part of the series "How to prepare a systematic review of economic evaluations (EES) for informing evidence-based healthcare decisions", in which a five-step approach is proposed. Areas covered: This paper focuses on the selection of relevant databases and developing a search strategy for detecting EEs, as well as on how to perform the search and how to extract relevant data from retrieved records. Expert commentary: Thus far, little has been published on how to conduct systematic review EEs. Moreover, reliable sources of information, such as the Health Economic Evaluation Database, have ceased to publish updates. Researchers are thus left without authoritative guidance on how to conduct SR-EEs. Together with van Mastrigt et al. we seek to fill this gap.

Aligning Cost Assessment with Community-Based Participatory Research: The Kin Keeper (superscript SM) Intervention

ERIC Educational Resources Information Center

Meghea, Cristian Ioan; Williams, Karen Patricia

2015-01-01

The few existing economic evaluations of community-based health promotion interventions were reported retrospectively at the end of the trial. We report an evaluation of the costs of the Kin Keeper(superscript SM) Cancer Prevention Intervention, a female family-focused educational intervention for underserved women applied to increase breast and…

An evaluation of SEASAT-A candidate ocean industry economic verification experiments

NASA Technical Reports Server (NTRS)

1977-01-01

A description of the candidate economic verification experiments which could be performed with SEASAT is provided. Experiments have been identified in each of the areas of ocean-based activity that are expected to show an economic impact from the use of operational SEASAT data. Experiments have been identified in the areas of Arctic operations, the ocean fishing industry, the offshore oil and natural gas industry, as well as ice monitoring and coastal zone applications.

Economic evaluations of interventions to manage hyperphosphataemia in adult haemodialysis patients: A systematic review.

PubMed

Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Evers, Silvia Maa

2016-03-01

Managing hyperphosphataemia in haemodialysis patients is resource-intensive. A search for cost-effective interventions in this field is needed to inform decisions on the allocation of healthcare resources. NHSEED, MEDLINE, EMBASE and CINAHL were searched for full economic evaluations of hyperphosphataemia-managing interventions in adult haemodialysis patients, published between 2004 and 2014, in English, French, Dutch or German. Incremental cost-effectiveness ratios of the interventions were up-rated to 2013US$ using Purchasing Power Parity conversion rates and Consumer Price Indices. The quality of included studies was assessed using the Extended Consensus on Health Economic Criteria List. Twelve out of the 1681 retrieved records fulfilled the inclusion criteria. They reported only on one aspect of hyperphosphataemia management, which is the use of phosphate binders (calcium-based and calcium-free, in first-line and sequential use). No economic evaluations of other phosphorus-lowering interventions were found. The included articles derived from five countries and most of them were funded by pharmaceutical companies. The incremental cost-effectiveness ratios of phosphate binders ranged between US$11 461 and US$157 760 per quality-adjusted life-year gained. Calcium-based binders (especially calcium acetate) appear to be the optimal cost-effective first- and second-line therapy in prevalent patients, while the calcium-free binder, lanthanum carbonate, might provide good value for money, as second-line therapy, in incident patients. The studies' overall quality was suboptimal. Drawing firm conclusions was not possible due to the quality heterogeneity and inconsistent results. Future high-quality economic evaluations are needed to confirm the findings of this review and to address other interventions to manage hyperphosphataemia in this population. © 2015 Asian Pacific Society of Nephrology.

[Methods for the costing process in the field of economic evaluation of a rehabilitation program for patients with chronic obstructive lung diseases].

PubMed

Hessel, F P; Wittmann, M; Petro, W; Wasem, J

2000-07-01

Studies in health economics especially economic evaluations of health care technologies and programmes are getting more and more important. However, in Germany there are no established, validated and commonly used instruments for the costing process. For the economic evaluation of a rehabilitation programme for patients with chronic lung diseases such as asthma and chronic bronchitis we developed methods for identification, measurement and validation of resource use during the inpatient rehabilitation programme and during the outpatient follow-up period. These methods are based on methodological considerations as well as on practical experience from conducting a pilot study. With regard to the inpatient setting all relevant diagnostic and therapeutic resource uses could be measured basing on routine clinical documentation and validated by using the cost accounting of the clinic. For measuring the use of resources during the follow-up period in an outpatient setting no reliable administrative data are accessible. Hence, we compared a standardised retrospective patient questionnaire used in a 20-minute interview (n = 50) and a cost diary for the continuing documentation by the patient over a period of 4 weeks (n = 50). Both tools were useful for measuring all relevant resource uses in sufficient detail, but because of higher participation rates and lower dropouts the structured interview appears to be more suitable. Average total costs per month were 1591 DM (interview), respectively 1867 DM (cost diary). Besides productivity loss, costs for medication and GP visits caused the relatively highest resource uses. Practicable instruments were developed for the costing process as part of an economic evaluation in a German rehabilitation setting for pulmonary diseases. After individual modification, these could also be used for different indications and in other institutional settings.

What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions.

PubMed

Iribarren, Sarah J; Cato, Kenrick; Falzon, Louise; Stone, Patricia W

2017-01-01

Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62-100, STD 14.18) and the top quartile reported 91.3-100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health-related outcome and reported economic data, many did not report all recommended economic outcome items and were lacking in comprehensive analysis. The identified economic evaluations varied by disease or condition focus, economic outcome measurements, perspectives, and were distributed unevenly geographically, limiting formal meta-analysis. Further research is needed in low and low-middle income countries and to understand the impact of different mHealth types. Following established economic reporting guidelines will improve this body of research.

What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions

PubMed Central

Cato, Kenrick; Falzon, Louise; Stone, Patricia W.

2017-01-01

Background Mobile health (mHealth) is often reputed to be cost-effective or cost-saving. Despite optimism, the strength of the evidence supporting this assertion has been limited. In this systematic review the body of evidence related to economic evaluations of mHealth interventions is assessed and summarized. Methods Seven electronic bibliographic databases, grey literature, and relevant references were searched. Eligibility criteria included original articles, comparison of costs and consequences of interventions (one categorized as a primary mHealth intervention or mHealth intervention as a component of other interventions), health and economic outcomes and published in English. Full economic evaluations were appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist and The PRISMA guidelines were followed. Results Searches identified 5902 results, of which 318 were examined at full text, and 39 were included in this review. The 39 studies spanned 19 countries, most of which were conducted in upper and upper-middle income countries (34, 87.2%). Primary mHealth interventions (35, 89.7%), behavior change communication type interventions (e.g., improve attendance rates, medication adherence) (27, 69.2%), and short messaging system (SMS) as the mHealth function (e.g., used to send reminders, information, provide support, conduct surveys or collect data) (22, 56.4%) were most frequent; the most frequent disease or condition focuses were outpatient clinic attendance, cardiovascular disease, and diabetes. The average percent of CHEERS checklist items reported was 79.6% (range 47.62–100, STD 14.18) and the top quartile reported 91.3–100%. In 29 studies (74.3%), researchers reported that the mHealth intervention was cost-effective, economically beneficial, or cost saving at base case. Conclusions Findings highlight a growing body of economic evidence for mHealth interventions. Although all studies included a comparison of intervention effectiveness of a health-related outcome and reported economic data, many did not report all recommended economic outcome items and were lacking in comprehensive analysis. The identified economic evaluations varied by disease or condition focus, economic outcome measurements, perspectives, and were distributed unevenly geographically, limiting formal meta-analysis. Further research is needed in low and low-middle income countries and to understand the impact of different mHealth types. Following established economic reporting guidelines will improve this body of research. PMID:28152012

Current issues in the economics of vaccination against dengue.

PubMed

Tozan, Yesim

2016-01-01

Dengue is a major public health concern in tropical and subtropical areas of the world. The prospects for dengue prevention have recently improved with the results of efficacy trials of a tetravalent dengue vaccine. Although partially effective, once licensed, its introduction can be a public health priority in heavily affected countries because of the perceived public health importance of dengue. This review explores the most immediate economic considerations of introducing a new dengue vaccine and evaluates the published economic analyses of dengue vaccination. Findings indicate that the current economic evidence base is of limited utility to support country-level decisions on dengue vaccine introduction. There are a handful of published cost-effectiveness studies and no country-specific costing studies to project the full resource requirements of dengue vaccine introduction. Country-level analytical expertise in economic analyses, another gap identified, needs to be strengthened to facilitate evidence-based decision-making on dengue vaccine introduction in endemic countries.

Economic comparison between conventional and disposables-based technology for the production of biopharmaceuticals.

PubMed

Novais, J L; Titchener-Hooker, N J; Hoare, M

2001-10-20

Time to market, cost effectiveness, and flexibility are key issues in today's biopharmaceutical market. Bioprocessing plants based on fully disposable, presterilized, and prevalidated components appear as an attractive alternative to conventional stainless steel plants, potentially allowing for shorter implementation times, smaller initial investments, and increased flexibility. To evaluate the economic case of such an alternative it was necessary to develop an appropriate costing model which allows an economic comparison between conventional and disposables-based engineering to be made. The production of an antibody fragment from an E. coli fermentation was used to provide a case study for both routes. The conventional bioprocessing option was costed through available models, which were then modified to account for the intrinsic differences observed in a disposables-based option. The outcome of the analysis indicates that the capital investment required for a disposables-based option is substantially reduced at less than 60% of that for a conventional option. The disposables-based running costs were evaluated as being 70% higher than those of the conventional equivalent. Despite this higher value, the net present value (NPV) of the disposables-based plant is positive and within 25% of that for the conventional plant. Sensitivity analysis performed on key variables indicated the robustness of the economic analysis presented. In particular a 9-month reduction in time to market arising from the adoption of a disposables-based approach, results in a NPV which is identical to that of the conventional option. Finally, the effect of any possible loss in yield resulting from the use of disposables was also examined. This had only a limited impact on the NPV: for example, a 50% lower yield in the disposable chromatography step results in a 10% reduction of the disposable NPV. The results provide the necessary framework for the economic comparison of disposables and conventional bioprocessing technologies. Copyright 2001 John Wiley & Sons, Inc.

Economic evaluations of eHealth technologies: A systematic review.

PubMed

Sanyal, Chiranjeev; Stolee, Paul; Juzwishin, Don; Husereau, Don

2018-01-01

Innovations in eHealth technologies have the potential to help older adults live independently, maintain their quality of life, and to reduce their health system dependency and health care expenditure. The objective of this study was to systematically review and appraise the quality of cost-effectiveness or utility studies assessing eHealth technologies in study populations involving older adults. We systematically searched multiple databases (MEDLINE, EMBASE, CINAHL, NHS EED, and PsycINFO) for peer-reviewed studies published in English from 2000 to 2016 that examined cost-effectiveness (or utility) of eHealth technologies. The reporting quality of included studies was appraised using the Consolidated Health Economic Evaluation Reporting Standards statement. Eleven full text articles met the inclusion criteria representing public and private health care systems. eHealth technologies evaluated by these studies includes computerized decision support system, a web-based physical activity intervention, internet-delivered cognitive behavioral therapy, telecare, and telehealth. Overall, the reporting quality of the studies included in the review was varied. Most studies demonstrated efficacy and cost-effectiveness of an intervention using a randomized control trial and statistical modeling, respectively. This review found limited information on the feasibility of adopting these technologies based on economic and organizational factors. This review identified few economic evaluations of eHealth technologies that included older adults. The quality of the current evidence is limited and further research is warranted to clearly demonstrate the long-term cost-effectiveness of eHealth technologies from the health care system and societal perspectives.

[Evaluation of economic forest ecosystem services in China].

PubMed

Wang, Bing; Lu, Shao-Wei

2009-02-01

This paper quantitatively evaluated the economic forest ecosystem services in the provinces of China in 2003, based on the long-term and continuous observations of economic forest ecosystems in this country, the sixth China national forest resources inventory data, and the price parameter data from the authorities in the world, and by applying the law of market value, the method of substitution of the expenses, and the law of the shadow project. The results showed that in 2003, the total value of economic forest ecosystem services in China was 11763.39 x 10(8) yuan, and the total value of the products from economic forests occupied 19.3% of the total ecosystem services value, which indicated that the economic forests not only provided society direct products, but also exhibited enormous eco-economic value. The service value of the functions of economic forests was in the order of water storage > C fixation and O2 release > biodiversity conservation > erosion control > air quality purification > nutrient cycle. The spatial pattern of economic forest ecosystem services in the provinces of China had the same trend with the spatial distribution of water and heat resources and biodiversity. To understand the differences of economic forest ecosystem services in the provinces of China was of significance in alternating the irrational arrangement of our present forestry production, diminishing the abuses of forest management, and establishing high grade, high efficient, and modernized economic forests.

Did we get our money's worth? Bridging economic and behavioral measures of program success in adolescent drug prevention.

PubMed

Griffith, Kevin N; Scheier, Lawrence M

2013-11-08

The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of "cost efficiency". The languages and methods of each respective discipline don't necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy.

Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

PubMed

Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

2016-08-24

Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the available health economic analyses in Africa and internationally.

Empirical Research on Ecological Development Level of Resource-based Industries-Base on the data of the Silk Road Economic Belt Core Zone

NASA Astrophysics Data System (ADS)

Wang, Lei; Yan, Min

2017-11-01

Industrial ecology is the epitome of sustainable development in industry level, is one effective gateway to realizing green transformation. On the basis of industrial ecology development, including resource efficiency and environmental efficiency of ecological evaluation index system, this paper evaluates the level of industrial ecology development of resource-based industries in Xinjiang using entropy method. Research shows that the overall ecological development level of resource-based industries has remained at continuous improved trend with slow improvement in resource efficiency, and relative faster improvement in environmental efficiency. With economic development entering into the period of new normal at the end of the “twelfth five year plan”, the resource efficiency of ecological development of resource-based industries demonstrated a downward trend. The overall level of industrial ecology also faced with certain fluctuations, various ecological development level of resource-based industries also presented a downward trend. To promote ecological development of resource-based industries in Xinjiang, countermeasures and suggestions are initiated.

Implementing an advanced waste separation step in an MBT plant: assessment of technical, economic and environmental impacts.

PubMed

Meirhofer, Martina; Piringer, Gerhard; Rixrath, Doris; Sommer, Manuel; Ragossnig, Arne Michael

2013-10-01

Heavy fractions resulting from mechanical treatment stages of mechanical-biological waste treatment plants are posing very specific demands with regard to further treatment (large portions of inert and high-caloric components). Based on the current Austrian legal situation such a waste stream cannot be landfilled and must be thermally treated. The aim of this research was to evaluate if an inert fraction generated from this waste stream with advanced separation technologies, two sensor-based [near-infrared spectroscopy (NIR), X-ray transmission (XRT)] and two mechanical systems (wet and dry) is able to be disposed of. The performance of the treatment options for separation was evaluated by characterizing the resulting product streams with respect to purity and yield. Complementing the technical evaluation of the processing options, an assessment of the economic and global warming effects of the change in waste stream routing was conducted. The separated inert fraction was evaluated with regard to landfilling. The remaining high-caloric product stream was evaluated with regard to thermal utilization. The results show that, in principal, the selected treatment technologies can be used to separate high-caloric from inert components. Limitations were identified with regard to the product qualities achieved, as well as to the economic expedience of the treatment options. One of the sensor-based sorting systems (X-ray) was able to produce the highest amount of disposeable heavy fraction (44.1%), while having the lowest content of organic (2.0% C biogenic per kg waste input) components. None of the high-caloric product streams complied with the requirements for solid recovered fuels as defined in the Austrian Ordinance on Waste Incineration. The economic evaluation illustrates the highest specific treatment costs for the XRT (€ 23.15 per t), followed by the NIR-based sorting system (€ 15.67 per t), and the lowest costs for the air separation system (€ 10.79 per t). Within the ecological evaluation it can be shown that the results depend strongly on the higher heating value of the high caloric light fraction and on the content of C biogenic of the heavy fraction. Therefore, the XRT system had the best results for the overall GWP [-14 kg carbon dioxide equivalents (CO2 eq) per t of input waste] and the NIR-based the worst (193 kg CO2 eq per t of input waste). It is concluded that three of the treatment options would be suitable under the specific conditions considered here. Of these, sensor-based sorting is preferable owing to its flexibility.

Cervical degenerative disease: systematic review of economic analyses.

PubMed

Alvin, Matthew D; Qureshi, Sheeraz; Klineberg, Eric; Riew, K Daniel; Fischer, Dena J; Norvell, Daniel C; Mroz, Thomas E

2014-10-15

Systematic review. To perform an evidence-based synthesis of the literature assessing the cost-effectiveness of surgery for patients with symptomatic cervical degenerative disc disease (DDD). Cervical DDD is a common cause of clinical syndromes such as neck pain, cervical radiculopathy, and myelopathy. The appropriate surgical intervention(s) for a given problem is controversial, especially with regard to quality-of-life outcomes, complications, and costs. Although there have been many studies comparing outcomes and complications, relatively few have compared costs and, more importantly, cost-effectiveness of the interventions. We conducted a systematic search in PubMed/MEDLINE, EMBASE, the Cochrane Collaboration Library, the Cost-Effectiveness Analysis registry database, and the National Health Service Economic Evaluation Database for full economic evaluations published through January 16, 2014. Identification of full economic evaluations that were explicitly designed to evaluate and synthesize the costs and consequences of surgical procedures or surgical intervention with nonsurgical management in patients with cervical DDD were considered for inclusion, based on 4 key questions. Five studies were included, each specific to 1 or more of our focus questions. Two studies suggested that cervical disc replacement may be more cost-effective compared with anterior cervical discectomy and fusion. Two studies comparing anterior with posterior surgical procedures for cervical spondylotic myelopathy suggested that anterior surgery was more cost-effective than posterior surgery. One study suggested that posterior cervical foraminotomy had a greater net economic benefit than anterior cervical discectomy and fusion in a military population with unilateral cervical radiculopathy. No studies assessed the cost-effectiveness of surgical intervention compared with nonoperative treatment of cervical myelopathy or radiculopathy, although it is acknowledged that existing studies demonstrate the cost-effectiveness of surgical intervention for these 2 clinical entities. A paucity of high-quality economic literature exists regarding cost-effectiveness of surgical intervention for cervical DDD. Future research is necessary to validate the findings of the few studies that do exist to guide decisions for surgery by the physician and patient with respect to cost-effectiveness. 2.

Economic burden of seasonal influenza in the United States.

PubMed

Putri, Wayan C W S; Muscatello, David J; Stockwell, Melissa S; Newall, Anthony T

2018-05-22

Seasonal influenza is responsible for a large disease and economic burden. Despite the expanding recommendation of influenza vaccination, influenza has continued to be a major public health concern in the United States (U.S.). To evaluate influenza prevention strategies it is important that policy makers have current estimates of the economic burden of influenza. To provide an updated estimate of the average annual economic burden of seasonal influenza in the U.S. population in the presence of vaccination efforts. We evaluated estimates of age-specific influenza-attributable outcomes (ill-non medically attended, office-based outpatient visit, emergency department visits, hospitalizations and death) and associated productivity loss. Health outcome rates were applied to the 2015 U.S. population and multiplied by the relevant estimated unit costs for each outcome. We evaluated both direct healthcare costs and indirect costs (absenteeism from paid employment) reporting results from both a healthcare system and societal perspective. Results were presented in five age groups (<5 years, 5-17 years, 18-49 years, 50-64 years and ≥65 years of age). The estimated average annual total economic burden of influenza to the healthcare system and society was $11.2 billion ($6.3-$25.3 billion). Direct medical costs were estimated to be $3.2 billion ($1.5-$11.7 billion) and indirect costs $8.0 billion ($4.8-$13.6 billion). These total costs were based on the estimated average numbers of (1) ill-non medically attended patients (21.6 million), (2) office-based outpatient visits (3.7 million), (3) emergency department visit (0.65 million) (4) hospitalizations (247.0 thousand), (5) deaths (36.3 thousand) and (6) days of productivity lost (20.1 million). This study provides an updated estimate of the total economic burden of influenza in the U.S. Although we found a lower total cost than previously estimated, our results confirm that influenza is responsible for a substantial economic burden in the U.S. Copyright © 2018. Published by Elsevier Ltd.

Bamboo vs. crops: an integrated emergy and economic evaluation of using bamboo to replace crops in south Sichuan Province, China.

PubMed

Lu, Hong-Fang; Cai, Chun-Ju; Zeng, Xian-Shu; Campbell, Daniel E; Fan, Shao-Hui; Liu, Guang-Lu

2018-03-10

Based on long-term monitoring conducted in Chang-ning county, a pilot site of the 'Grain for Green Program' (GFGP), an integrated emergy and economic method was applied to evaluate the dynamic ecological-economic performance of 3 kinds of bamboo systems planted on sloping farmland. The results confirmed the positive effects of all 3 kinds of bamboo systems on water conservation and soil erosion control. The benefits gained progressively increased during the first 8 years after conversion, going from 4639 to 16127 EMyuan/ha/yr on average. All three bamboo plantations were much more sustainable than common agricultural crops planted on sloping land (CP) on both the short and long-term scales with their Emergy Sustainability Index (ESI) and Emergy Index for Sustainable Development (EISD), respectively, being 14.07-325.71 and 80.35-265.80 times that of CP. However, all 3 bamboo plantations had a Net Economic Benefit (NEB) less than that of CP during the first 8 years after conversion. Even with the government-mandated ecological compensation applied, the annual NEB EC s of the Bambusa rigida (BR) and Phyllostachys pubescense (PP) plantations were, respectively, 3922.03 and 7422.77 yuan/ha/yr lower than the NEB of CP. Emergy-based evaluation of ecosystem services provides an objective reference for applying ecological compensation in strategy-making, but it cannot wholly solve the economic viability problem faced by all bamboo plantations. Inter-planting annual herbs or edible fungus, such as Dictyophora echinovolvata , within bamboo forests, especially in young bamboo plantations, might be a direction for optimizing bamboo cultivation that would improve its economic viability.

Lessons from trial-based cost-effectiveness analyses of mental health interventions: why uncertainty about the outcome, estimate and willingness to pay matters.

PubMed

Hoch, Jeffrey S; Dewa, Carolyn S

2007-01-01

The principal aim of this article is to share lessons learned by the authors while conducting economic evaluations, using clinical trial data, of mental health interventions. These lessons are quite general and have clear relevance for pharmacoeconomic studies. In addition, we explore how net benefit regression can be used to enhance consideration of key issues when conducting an economic evaluation based on clinical trial data. The first study we discuss found that cost-effectiveness results varied markedly based on the choice of both the patient outcome and the willingness to pay for more of that outcome. The importance of willingness to pay was also highlighted in the results from the second study. Even with a set willingness-to-pay value, most of the time the probability that the new treatment was cost effective was not 100%. In the third study, the cost effectiveness of the new treatment varied by patient characteristics. These observations have important implications for pharmacoeconomic studies. Namely, analysts must carefully consider choice of patient outcome, willingness to pay, patient heterogeneity and the statistical uncertainty inherent in the data. Net benefit regression is a useful technique for exploring these crucial issues when undertaking an economic evaluation using patient-level data on both costs and effects.

Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for advanced recurrent or refractory ovarian cancer: a systematic review and economic evaluation.

PubMed

Edwards, Steven J; Barton, Samantha; Thurgar, Elizabeth; Trevor, Nicola

2015-01-01

Ovarian cancer is the fifth most common cancer in the UK, and the fourth most common cause of cancer death. Of those people successfully treated with first-line chemotherapy, 55-75% will relapse within 2 years. At this time, it is uncertain which chemotherapy regimen is more clinically effective and cost-effective for the treatment of recurrent, advanced ovarian cancer. To determine the comparative clinical effectiveness and cost-effectiveness of topotecan (Hycamtin(®), GlaxoSmithKline), pegylated liposomal doxorubicin hydrochloride (PLDH; Caelyx(®), Schering-Plough), paclitaxel (Taxol(®), Bristol-Myers Squibb), trabectedin (Yondelis(®), PharmaMar) and gemcitabine (Gemzar(®), Eli Lilly and Company) for the treatment of advanced, recurrent ovarian cancer. Electronic databases (MEDLINE(®), EMBASE, Cochrane Central Register of Controlled Trials, Health Technology Assessment database, NHS Economic Evaluations Database) and trial registries were searched, and company submissions were reviewed. Databases were searched from inception to May 2013. A systematic review of the clinical and economic literature was carried out following standard methodological principles. Double-blind, randomised, placebo-controlled trials, evaluating topotecan, PLDH, paclitaxel, trabectedin and gemcitabine, and economic evaluations were included. A network meta-analysis (NMA) was carried out. A de novo economic model was developed. For most outcomes measuring clinical response, two networks were constructed: one evaluating platinum-based regimens and one evaluating non-platinum-based regimens. In people with platinum-sensitive disease, NMA found statistically significant benefits for PLDH plus platinum, and paclitaxel plus platinum for overall survival (OS) compared with platinum monotherapy. PLDH plus platinum significantly prolonged progression-free survival (PFS) compared with paclitaxel plus platinum. Of the non-platinum-based treatments, PLDH monotherapy and trabectedin plus PLDH were found to significantly increase OS, but not PFS, compared with topotecan monotherapy. In people with platinum-resistant/-refractory (PRR) disease, NMA found no statistically significant differences for any treatment compared with alternative regimens in OS and PFS. Economic modelling indicated that, for people with platinum-sensitive disease and receiving platinum-based therapy, the estimated probabilistic incremental cost-effectiveness ratio [ICER; incremental cost per additional quality-adjusted life-year (QALY)] for paclitaxel plus platinum compared with platinum was £24,539. Gemcitabine plus carboplatin was extendedly dominated, and PLDH plus platinum was strictly dominated. For people with platinum-sensitive disease and receiving non-platinum-based therapy, the probabilistic ICERs associated with PLDH compared with paclitaxel, and trabectedin plus PLDH compared with PLDH, were estimated to be £25,931 and £81,353, respectively. Topotecan was strictly dominated. For people with PRR disease, the probabilistic ICER associated with topotecan compared with PLDH was estimated to be £324,188. Paclitaxel was strictly dominated. As platinum- and non-platinum-based treatments were evaluated separately, the comparative clinical effectiveness and cost-effectiveness of these regimens is uncertain in patients with platinum-sensitive disease. For platinum-sensitive disease, it was not possible to compare the clinical effectiveness and cost-effectiveness of platinum-based therapies with non-platinum-based therapies. For people with platinum-sensitive disease and treated with platinum-based therapies, paclitaxel plus platinum could be considered cost-effective compared with platinum at a threshold of £30,000 per additional QALY. For people with platinum-sensitive disease and treated with non-platinum-based therapies, it is unclear whether PLDH would be considered cost-effective compared with paclitaxel at a threshold of £30,000 per additional QALY; trabectedin plus PLDH is unlikely to be considered cost-effective compared with PLDH. For patients with PRR disease, it is unlikely that topotecan would be considered cost-effective compared with PLDH. Randomised controlled trials comparing platinum with non-platinum-based treatments might help to verify the comparative effectiveness of these regimens. This study is registered as PROSPERO CRD42013003555. The National Institute for Health Research Health Technology Assessment programme.

The Evaluation of Land Ecological Safety of Chengchao Iron Mine Based on PSR and MEM

NASA Astrophysics Data System (ADS)

Jin, Xiangdong; Chen, Yong

2018-01-01

Land ecological security is of vital importance to local security and sustainable development of mining activities. The study has analyzed the potential causal chains between the land ecological security of Iron Mine mining environment, mine resource and the social-economic background. On the base of Pressure-State-Response model, the paper set up a matter element evaluation model of land ecological security, and applies it in Chengchao iron mine. The evaluation result proves to be effective in land ecological evaluation.

Economic Impacts of Infrastructure Damages on Industrial Sector

NASA Astrophysics Data System (ADS)

Kajitani, Yoshio

This paper proposes a basic model for evaluating economic impacts on industrial sectors under the conditions that multiple infrastructures are simultaneously damaged during the earthquake disasters. Especially, focusing on the available economic data developed in the smallest spatial scale in Japan (small area statistics), economic loss estimation model based on the small area statistics and its applicability are investigated on. In the detail, a loss estimation framework, utilizing survey results on firms' activities under electricity, water and gas disruptions, and route choice models in Transportation Engineering, are applied to the case of 2004 Mid-Niigata Earthquake.

Refined genetic algorithm -- Economic dispatch example

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sheble, G.B.; Brittig, K.

1995-02-01

A genetic-based algorithm is used to solve an economic dispatch (ED) problem. The algorithm utilizes payoff information of perspective solutions to evaluate optimality. Thus, the constraints of classical LaGrangian techniques on unit curves are eliminated. Using an economic dispatch problem as a basis for comparison, several different techniques which enhance program efficiency and accuracy, such as mutation prediction, elitism, interval approximation and penalty factors, are explored. Two unique genetic algorithms are also compared. The results are verified for a sample problem using a classical technique.

Bridging the gap: exploring the barriers to using economic evidence in healthcare decision making and strategies for improving uptake.

PubMed

Merlo, Gregory; Page, Katie; Ratcliffe, Julie; Halton, Kate; Graves, Nicholas

2015-06-01

Evidence from economic evaluations is often not used to inform healthcare policy despite being well regarded by policy makers and physicians. This article employs the accessibility and acceptability framework to review the barriers to using evidence from economic evaluation in healthcare policy and the strategies used to overcome these barriers. Economic evaluations are often inaccessible to policymakers due to the absence of relevant economic evaluations, the time and cost required to conduct and interpret economic evaluations, and lack of expertise to evaluate quality and interpret results. Consistently reported factors that limit the translation of findings from economic evaluations into healthcare policy include poor quality of research informing economic evaluations, assumptions used in economic modelling, conflicts of interest, difficulties in transferring resources between sectors, negative attitudes to healthcare rationing, and the absence of equity considerations. Strategies to overcome these barriers have been suggested in the literature, including training, structured abstract databases, rapid evaluation, reporting checklists for journals, and considering factors other than cost effectiveness in economic evaluations, such as equity or budget impact. The factors that prevent or encourage decision makers to use evidence from economic evaluations have been identified, but the relative importance of these factors to decision makers is uncertain.

Pharmacological management of chronic lower back pain: a review of cost effectiveness.

PubMed

Haas, Marion; De Abreu Lourenco, Richard

2015-06-01

Lower back pain is one of the most prevalent musculoskeletal conditions in the developed world and accounts for significant health services use. The American College of Physicians and the American Pain Society have published a joint clinical guideline that recommends providing patients with information on prognosis and self-management, the use of medications with proven benefits and, for those who do not improve, consideration be given to the use of spinal manipulation (for acute lower back pain only), interdisciplinary rehabilitation, exercise, acupuncture, massage, yoga, cognitive behavioural therapy or relaxation. The purpose of this review was to evaluate published economic evaluations of pharmacological management for chronic lower back pain. A total of seven studies were eligible for inclusion in there view. The quality of the economic evaluations undertaken in the included studies was not high. This was primarily because of the nature of the underlying clinical evidence, most of which did not come from rigorous randomised controlled trials (RCTs), and the manner in which it was incorporated into the economic evaluations. All studies provided reasonable information about what aspects of healthcare and other resource use were identified, measured and valued. However, the reporting of total costs was not uniform across studies. Measures of pain and disability were the most commonly collected outcomes measures. Two studies collected information on quality of life directly from participants while two studies modelled this information based on the literature. Future economic evaluations of interventions for chronic lower back pain, including pharmacological interventions, should be based on the results of well-conducted RCTs where the measurement of costs and outcomes such as quality of life and quality-adjusted life-years is included in the trial protocol, and which have a follow-up period sufficient to capture meaningful changes in both costs and outcomes. In the absence of RCT data, economic models should be used to estimate future costs and outcomes using robust methods.

Accounting for institutional change in health economic evaluation: a program to tackle HIV/AIDS and gender violence in Southern Africa.

PubMed

Jan, Stephen; Pronyk, Paul; Kim, Julia

2008-02-01

There has been growing interest in the application of institutionalist perspectives in the health economics literature. This paper investigates the institutionalist notion of social value and its use in economic evaluation with particular reference to a program to address HIV/AIDS and gender violence in Southern Africa (IMAGE). Institutions are the rules that govern the conduct between individuals, groups and organisations. Their social value stems from their capacity to reduce the uncertainty in human interactions thereby both reducing transaction costs and, importantly, enabling the initiation and sustainability of various activities (instrumental value). Furthermore, institutions tend to be formed around certain ethical positions and as a consequence, act in binding future decision making to these positions (intrinsic value). Incorporating such notions of social value within a conventional welfare-based measure of benefit is problematic as institutional development is not necessarily consistent with individual utility. An institutionalist approach allows for these additional domains to be factored into economic evaluation. IMAGE is an intervention to reduce gender violence and HIV through microfinance, health education and community development, and involves significant initial investment in institution-building activities, notably through training activities with program staff and community members. The key to employing an institutionalist approach to the evaluation of IMAGE is in understanding the nature of those actions that can be seen as institution-building and determining: (1) the instrumental value of follow-up activities by appropriate amortisation of transaction costs over an horizon that reflects the economies gained from the intervention; and (2) the intrinsic value of any transformation in the community through a cost-consequences approach informed by an a priori conceptual model. This case study highlights how health sector interventions can effect institutional changes and how these are captured within a theory-based economic evaluation framework.

Cost effective interventions for the prevention of cardiovascular disease in low and middle income countries: a systematic review

PubMed Central

2013-01-01

Background While there is good evidence to show that behavioural and lifestyle interventions can reduce cardiovascular disease risk factors in affluent settings, less evidence exists in lower income settings. This study systematically assesses the evidence on cost-effectiveness for preventive cardiovascular interventions in low and middle-income settings. Methods Design: Systematic review of economic evaluations on interventions for prevention of cardiovascular disease. Data sources: PubMed, Web of Knowledge, Scopus and Embase, Opensigle, the Cochrane database, Business Source Complete, the NHS Economic Evaluations Database, reference lists and email contact with experts. Eligibility criteria for selecting studies: we included economic evaluations conducted in adults, reporting the effect of interventions to prevent cardiovascular disease in low and middle income countries as defined by the World Bank. The primary outcome was a change in cardiovascular disease occurrence including coronary heart disease, heart failure and stroke. Data extraction: After selection of the studies, data were extracted by two independent investigators using a previously constructed tool and quality was evaluated using Drummond’s quality assessment score. Results From 9731 search results we found 16 studies, which presented economic outcomes for interventions to prevent cardiovascular disease in low and middle income settings, with most of these reporting positive cost effectiveness results. When the same interventions were evaluated across settings, within and between papers, the likelihood of an intervention being judged cost effective was generally lower in regions with lowest gross national income. While population based interventions were in most cases more cost effective, cost effectiveness estimates for individual pharmacological interventions were overall based upon a stronger evidence base. Conclusions While more studies of cardiovascular preventive interventions are needed in low and mid income settings, the available high-level of evidence supports a wide range of interventions for the prevention of cardiovascular disease as being cost effective across all world regions. PMID:23537334

Economic evaluation of Community Level Interventions for Pre-eclampsia (CLIP) in South Asian and African countries: a study protocol.

PubMed

Khowaja, Asif R; Mitton, Craig; Bryan, Stirling; Magee, Laura A; Bhutta, Zulfiqar A; von Dadelszen, Peter

2015-05-26

Globally, hypertensive disorders of pregnancy, particularly pre-eclampsia and eclampsia, are the leading cause of maternal and neonatal mortality, and impose substantial burdens on the families of pregnant women, their communities, and healthcare systems. The Community Level Interventions for Pre-eclampsia (CLIP) Trial evaluates a package of care applied at both community and primary health centres to reduce maternal and perinatal disabilities and deaths resulting from the failure to identify and manage pre-eclampsia at the community level. Economic evaluation of health interventions can play a pivotal role in priority setting and inform policy decisions for scale-up. At present, there is a paucity of published literature on the methodology of economic evaluation of large, multi-country, community-based interventions in the area of maternal and perinatal health. This study protocol describes the application of methodology for economic evaluation of the CLIP in South Asia and Africa. A mixed-design approach i.e. cost-effectiveness analysis (CEA) and qualitative thematic analysis will be used alongside the trial to prospectively evaluate the economic impact of CLIP from a societal perspective. Data on health resource utilization, costs, and pregnancy outcomes will be collected through structured questionnaires embedded into the pregnancy surveillance, cross-sectional survey and budgetary reviews. Qualitative data will be collected through focus groups (FGs) with pregnant women, household male-decision makers, care providers, and district level health decision makers. The incremental cost-effectiveness ratio will be calculated for healthcare system and societal perspectives, taking into account the country-specific model inputs (costs and outcome) from the CLIP Trial. Emerging themes from FGs will inform the design of the model, and help to interpret findings of the CEA. The World Health Organization (WHO) strongly recommends cost-effective interventions as a key aspect of achieving Millennium Development Goal (MDG)-5 (i.e. 75 % reduction in maternal mortality from 1990 levels by 2015). To date, most cost-effectiveness studies in this field have focused specifically on the diagnostic and clinical management of pre-eclampsia, yet rarely on community-based interventions in low-and-middle-income countries (LMICs). This study protocol will be of interest to public health scientists and health economists undertaking community-based trials in the area of maternal and perinatal health, particularly in LMICs. ClinicalTrials.gov: NCT01911494.

Evaluation of PersianCAT Agent's Accepting Policy in Continuous Double Auction, Participant in CAT 2007 Competition

NASA Astrophysics Data System (ADS)

Honari, Sina; Fos-Hati, Amin; Ebadi, Mojtaba; Gomrokchi, Maziar

As there is a growing tendency towards online auctions, online Multi Agent Systems for economic activities like stock exchanges is more in demand. CAT (CATallactics) competition has produced a great opportunity for researchers since 2007 to put their theories into practice in a real-time economic-based competition, combining traders and brokers. As one of participants, we evaluated our new accepting policy by putting it to challenge. In this paper we give a general overview of one of our policies in the market.

Environmental and economic comparisons of the satellite power system and six alternative energy technologies

NASA Astrophysics Data System (ADS)

Whitfield, R. G.; Habegger, L. J.; Levine, E. P.; Tanzman, E.

1981-04-01

The satellite power system (SPS) was compared with alternative systems on life cycle cost and environmental impacts. Environmental and economic effects are evaluated and subdivided into the following issue areas: human health and safety, environmental welfare, resources (land, materials, energy, water, labor), macroeconomics, socioeconomics, and institutional. These evaluations are based on technology characterization data and alternative futures scenarios, developed as part of CDEP. The technologies and the scenarios are described. The cost and performance of the SPS and the alternative technologies provide the basis of the macroeconomic analyses.

A systematic review of instruments for measuring outcomes in economic evaluation within aged care.

PubMed

Bulamu, Norma B; Kaambwa, Billingsley; Ratcliffe, Julie

2015-11-09

This paper describes the methods and results of a systematic review to identify instruments used to measure quality of life outcomes in older people. The primary focus of the review was to identify instruments suitable for application with older people within economic evaluations conducted in the aged care sector. Online databases searched were PubMed, Medline, Scopus, and Web of Science, PsycInfo, CINAHL, Embase and Informit. Studies that met the following criteria were included: 1) study population exclusively above 65 years of age 2) measured health status, health related quality of life or quality of life outcomes more broadly through use of an instrument developed for this purpose, 3) used a generic preference based instrument or an older person specific preference based or non-preference based instrument or both, and 4) published in journals in the English language after 2000. The most commonly applied generic preference based instrument in both the community and residential aged care context was the EuroQol - 5 Dimensions (EQ-5D), followed by the Adult Social Care Outcomes Toolkit (ASCOT) and the Health Utilities Index (HUI2/3). The most widely applied older person specific instrument was the ICEpop CAPability measure for Older people (ICECAP-O) in both community and residential aged care. In the absence of an ideal instrument for incorporating into economic evaluations in the aged care sector, this review recommends the use of a generic preference based measure of health related quality of life such as the EQ-5D to obtain quality adjusted life years, in combination with an instrument that has a broader quality of life focus like the ASCOT, which was designed specifically for evaluating interventions in social care or the ICECAP-O, a capability measure for older people.

A proposed model for economic evaluations of major depressive disorder.

PubMed

Haji Ali Afzali, Hossein; Karnon, Jonathan; Gray, Jodi

2012-08-01

In countries like UK and Australia, the comparability of model-based analyses is an essential aspect of reimbursement decisions for new pharmaceuticals, medical services and technologies. Within disease areas, the use of models with alternative structures, type of modelling techniques and/or data sources for common parameters reduces the comparability of evaluations of alternative technologies for the same condition. The aim of this paper is to propose a decision analytic model to evaluate long-term costs and benefits of alternative management options in patients with depression. The structure of the proposed model is based on the natural history of depression and includes clinical events that are important from both clinical and economic perspectives. Considering its greater flexibility with respect to handling time, discrete event simulation (DES) is an appropriate simulation platform for modelling studies of depression. We argue that the proposed model can be used as a reference model in model-based studies of depression improving the quality and comparability of studies.

Cost of illness and economic evaluation in rare diseases.

PubMed

López-Bastida, Julio; Oliva-Moreno, Juan

2010-01-01

Rare diseases are a major cause of morbidity and mortality in high income countries and have major repercussions on individuals and health care systems. This chapter examines the health economy of rare diseases from two different perspectives: firstly, the study of the economic impact of rare diseases (Cost of Illness studies); and, secondly, cost-effectiveness evaluation, which evaluates both the costs and results of the health care technologies applied in rare diseases. From the point of view of economics, health resource allocation is based on the principle of scarcity, as there are not - and never will be- sufficient resources for all worthy objectives. Hence, policy makers should balance costs and health outcomes. Rare diseases may well represent a significant societal burden that should rightly receive appropriate prioritisation of health care resources. As new and seemingly expensive health care technologies are developed for rare diseases, it will become increasingly important to evaluate potential and real impact of these new technologies in both dimensions: social costs and health outcomes.

Is home-based palliative care cost-effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot.

PubMed

McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon

2013-12-01

The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. Economic evaluation of a pilot randomised controlled trial with 28 days follow-up. Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits. PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty. The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.

[Calculation of standardised unit costs from a societal perspective for health economic evaluation].

PubMed

Bock, J-O; Brettschneider, C; Seidl, H; Bowles, D; Holle, R; Greiner, W; König, H H

2015-01-01

Due to demographic aging, economic evaluation of health care technologies for the elderly becomes more important. A standardised questionnaire to measure the health-related resource utilisation has been designed. The monetary valuation of the resource use documented by the questionnaire is a central step towards the determination of the corresponding costs. The aim of this paper is to provide unit costs for the resources in the questionnaire from a societal perspective. The unit costs are calculated pragmatically based on regularly published sources. Thus, an easy update is possible. This paper presents the calculated unit costs for outpatient medical care, inpatient care, informal and formal nursing care and pharmaceuticals from a societal perspective. The calculated unit costs can serve as a reference case in health economic evaluations and hence help to increase their comparability. © Georg Thieme Verlag KG Stuttgart · New York.

Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature.

PubMed

Haghparast-Bidgoli, Hassan; Kiadaliri, Aliasghar Ahmad; Skordis-Worrall, Jolene

2014-01-01

To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data.

Do economic evaluation studies inform effective healthcare resource allocation in Iran? A critical review of the literature

PubMed Central

2014-01-01

To aid informed health sector decision-making, data from sufficient high quality economic evaluations must be available to policy makers. To date, no known study has analysed the quantity and quality of available Iranian economic evaluation studies. This study aimed to assess the quantity, quality and targeting of economic evaluation studies conducted in the Iranian context. The study systematically reviewed full economic evaluation studies (n = 30) published between 1999 and 2012 in international and local journals. The findings of the review indicate that although the literature on economic evaluation in Iran is growing, these evaluations were of poor quality and suffer from several major methodological flaws. Furthermore, the review reveals that economic evaluation studies have not addressed the major health problems in Iran. While the availability of evidence is no guarantee that it will be used to aid decision-making, the absence of evidence will certainly preclude its use. Considering the deficiencies in the data identified by this review, current economic evaluations cannot be a useful source of information for decision makers in Iran. To improve the quality and overall usefulness of economic evaluations we would recommend; 1) developing clear national guidelines for the conduct of economic evaluations, 2) highlighting priority areas where information from such studies would be most useful and 3) training researchers and policy makers in the calculation and use of economic evaluation data. PMID:25050084

Pharmacoeconomic guidelines and their implementation in the positive list system in South Korea.

PubMed

Bae, Eun Young; Lee, Eui Kyung

2009-01-01

This article reviews the change in the reimbursement and pricing system in South Korea, which was the precursor to the eventual implementation of evidence-based decision-making. There has been pressure on Korea's National Health Insurance system to control its skyrocketing expenditures on drugs. As a result, a series of cost-containment policies have been implemented. The idea of economic evidence-based decision-making was first introduced in Korea in 2001 when the government announced cost-effectiveness as one of the criteria for reimbursement decisions. After this announcement, the Health Insurance Review and Assessment Service (HIRA) developed guidelines, which became the standard for economic evaluations. In 2006, the drug listing system for reimbursement was changed from a negative to a positive system under the drug expenditure rationalization plan. Under this new system, only drugs that are proven economically and clinically valuable can be listed, and applicants have to submit economic evaluation studies to support the cost-effectiveness of their drugs. Once new applications are submitted, HIRA reviews them, and the Drug Reimbursement Evaluation Committee (DREC) decides whether or not to recommend the submitted drugs. In its reimbursement decisions, the DREC considers not only cost-effectiveness but also the availability of therapeutic alternatives, the severity of the condition treated, and the impact on the budget, among other measures. After the introduction of the positive list system, 56% of drugs were determined to be appropriate for reimbursement by the DREC. Despite limited human resources, experience, and quality local data, Korea is continuing to make efforts to establish a system of evidence-based decision-making.

Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review.

PubMed

Lopatina, Elena; Donald, Faith; DiCenso, Alba; Martin-Misener, Ruth; Kilpatrick, Kelley; Bryant-Lukosius, Denise; Carter, Nancy; Reid, Kim; Marshall, Deborah A

2017-07-01

Advanced practice nurses (e.g., nurse practitioners and clinical nurse specialists) have been introduced internationally to increase access to high quality care and to tackle increasing health care expenditures. While randomised controlled trials and systematic reviews have demonstrated the effectiveness of nurse practitioner and clinical nurse specialist roles, their cost-effectiveness has been challenged. The poor quality of economic evaluations of these roles to date raises the question of whether current economic evaluation guidelines are adequate when examining their cost-effectiveness. To examine whether current guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles. Our methodological review was informed by a qualitative synthesis of four sources of information: 1) narrative review of literature reviews and discussion papers on economic evaluation of advanced practice nursing roles; 2) quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials; 3) review of guidelines for economic evaluation; and, 4) input from an expert panel. The narrative literature review revealed several challenges in economic evaluations of advanced practice nursing roles (e.g., complexity of the roles, variability in models and practice settings where the roles are implemented, and impact on outcomes that are difficult to measure). The quality assessment of economic evaluations of nurse practitioner and clinical nurse specialist roles alongside randomised controlled trials identified methodological limitations of these studies. When we applied the Guidelines for the Economic Evaluation of Health Technologies: Canada to the identified challenges and limitations, discussed those with experts and qualitatively synthesized all findings, we concluded that standard guidelines for economic evaluation are appropriate for economic evaluations of nurse practitioner and clinical nurse specialist roles and should be routinely followed. However, seven out of 15 current guideline sections (describing a decision problem, choosing type of economic evaluation, selecting comparators, determining the study perspective, estimating effectiveness, measuring and valuing health, and assessing resource use and costs) may require additional role-specific considerations to capture costs and effects of these roles. Current guidelines for economic evaluation should form the foundation for economic evaluations of nurse practitioner and clinical nurse specialist roles. The proposed role-specific considerations, which clarify application of standard guidelines sections to economic evaluation of nurse practitioner and clinical nurse specialist roles, may strengthen the quality and comprehensiveness of future economic evaluations of these roles. Copyright © 2017 Elsevier Ltd. All rights reserved.

Defining quality health care with outcomes assessment while achieving economic value.

PubMed

Shaw, L J; Miller, D D

2000-02-01

The effectiveness of a procedure is increasingly guided by the evaluation of patient outcomes. Outcomes data is used to develop clinical pathways of care and to define appropriate resource-use levels without sacrificing quality of care. Integration of the economic implications of medical services into an outcome-based guideline allows for the development of disease-management strategies. In cardiovascular medicine, risk reduction is associated with high cost due to the "pay-back" of new technologies and therapies. A major challenge is to define a balance between "high tech" care and cost. This paper devises an outpatient evidence-based guideline using clinical and economic outcomes data for the diagnosis of coronary disease.

Contemporary health care economics: an overview.

PubMed

McLaughlin, Nancy; Ong, Michael K; Tabbush, Victor; Hagigi, Farhad; Martin, Neil A

2014-11-01

Economic evaluations provide a decision-making framework in which outcomes (benefits) and costs are assessed for various alternative options. Although the interest in complete and partial economic evaluations has increased over the past 2 decades, the quality of studies has been marginal due to methodological challenges or incomplete cost determination. This paper provides an overview of the main types of complete and partial economic evaluations, reviews key methodological elements to be considered for any economic evaluation, and reviews concepts of cost determination. The goal is to provide the clinician neurosurgeon with the knowledge and tools needed to appraise published economic evaluations and to direct high-quality health economic evaluations.

Economic evaluation of home-based telebehavioural health care compared to in-person treatment delivery for depression.

PubMed

Bounthavong, Mark; Pruitt, Larry D; Smolenski, Derek J; Gahm, Gregory A; Bansal, Aasthaa; Hansen, Ryan N

2018-02-01

Introduction Home-based telebehavioural healthcare improves access to mental health care for patients restricted by travel burden. However, there is limited evidence assessing the economic value of home-based telebehavioural health care compared to in-person care. We sought to compare the economic impact of home-based telebehavioural health care and in-person care for depression among current and former US service members. Methods We performed trial-based cost-minimisation and cost-utility analyses to assess the economic impact of home-based telebehavioural health care versus in-person behavioural care for depression. Our analyses focused on the payer perspective (Department of Defense and Department of Veterans Affairs) at three months. We also performed a scenario analysis where all patients possessed video-conferencing technology that was approved by these agencies. The cost-utility analysis evaluated the impact of different depression categories on the incremental cost-effectiveness ratio. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model assumptions. Results In the base case analysis the total direct cost of home-based telebehavioural health care was higher than in-person care (US$71,974 versus US$20,322). Assuming that patients possessed government-approved video-conferencing technology, home-based telebehavioural health care was less costly compared to in-person care (US$19,177 versus US$20,322). In one-way sensitivity analyses, the proportion of patients possessing personal computers was a major driver of direct costs. In the cost-utility analysis, home-based telebehavioural health care was dominant when patients possessed video-conferencing technology. Results from probabilistic sensitivity analyses did not differ substantially from base case results. Discussion Home-based telebehavioural health care is dependent on the cost of supplying video-conferencing technology to patients but offers the opportunity to increase access to care. Health-care policies centred on implementation of home-based telebehavioural health care should ensure that these technologies are able to be successfully deployed on patients' existing technology.

A field test of procedures for evaluating and scheduling white-pine weevil control

Treesearch

Robert P. Ford; Robert L. Talerico; D. Gordon Mott

1965-01-01

Procedures have recently been developed that permit economic and biological information to be integrated in making decisions about the need for control against the white-pine weevil, and in scheduling control in young white pine plantations. The procedures are based upon studies of the magnitude of economic losses that result from weevil attack in white pine and upon...

Science You Can Use Bulletin: Wildfire triage: Targeting mitigation based on social, economic, and ecological values

Treesearch

Karl Malcolm; Matthew Thompson; Dave Calkin; Mark Finney; Alan Ager

2012-01-01

Evaluating the risks of wildfire relative to the valuable resources found in any managed landscape requires an interdisciplinary approach. Researchers at the Rocky Mountain Research Station and Western Wildland Threat Assessment Center developed such a process, using a combination of techniques rooted in fire modeling and ecology, economics, decision sciences, and the...

An Evaluation of Social Adaptation Skills of Children with and without Preschool Education Background Based on Their Mothers' Views

ERIC Educational Resources Information Center

Gunindi, Yunus

2013-01-01

This study was designed to discover if preschool teaching affects children's development of social skills and behaviours. Mothers of 50 children from middle socio-economic class families attending preschools and mothers of 50 children from the same socio-economic class families not attending preschools were included in the study. "Social…

Community-based school feeding during Indonesia's economic crisis: implementation, benefits, and sustainability.

PubMed

Studdert, Lisa J; Soekirman; Rasmussen, Kathleen M; Habicht, Jean-Pierre

2004-06-01

The Indonesian Government initiated a community-based national school-feeding program in 1996. Implementation was decentralized and involved multiple participants. In 1998 we evaluated the implementation of the program and the perceived benefits for community stakeholders using a survey of principals in 143 randomly selected schools and follow-up with in-depth interviews and observations in a subsample of 16 communities. The evaluation covered the period of the 1998 Asian economic crisis, affording the opportunity to assess its impact on the program. The program was implemented in all targeted schools, with excellent community participation. Feeding was sustained through the crisis, in spite of a dramatic escalation in food costs. The families of schoolchildren, farmers, and those who prepared food received economic benefits. The snacks replaced those sold at schools and were of better nutritional value. The children benefited because the snacks compensated for losses in the home diet resulting from the economic crisis. Characteristics of the program that may be important in explaining its success include the involvement of a range of community stakeholders, engagement with existing village administrative structures, scope for local community adaptation and innovation, and the use of local foods that dispersed benefits and ensured sustained implementation during the crisis.

Health economic evaluation: important principles and methodology.

PubMed

Rudmik, Luke; Drummond, Michael

2013-06-01

To discuss health economic evaluation and improve the understanding of common methodology. This article discusses the methodology for the following types of economic evaluations: cost-minimization, cost-effectiveness, cost-utility, cost-benefit, and economic modeling. Topics include health-state utility measures, the quality-adjusted life year (QALY), uncertainty analysis, discounting, decision tree analysis, and Markov modeling. Economic evaluation is the comparative analysis of alternative courses of action in terms of both their costs and consequences. With increasing health care expenditure and limited resources, it is important for physicians to consider the economic impact of their interventions. Understanding common methodology involved in health economic evaluation will improve critical appraisal of the literature and optimize future economic evaluations. Copyright © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

Economic analysis of the health impacts of housing improvement studies: a systematic review.

PubMed

Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

2013-10-01

Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid 'balance sheet' approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy.

Research on Air Quality Evaluation based on Principal Component Analysis

NASA Astrophysics Data System (ADS)

Wang, Xing; Wang, Zilin; Guo, Min; Chen, Wei; Zhang, Huan

2018-01-01

Economic growth has led to environmental capacity decline and the deterioration of air quality. Air quality evaluation as a fundamental of environmental monitoring and air pollution control has become increasingly important. Based on the principal component analysis (PCA), this paper evaluates the air quality of a large city in Beijing-Tianjin-Hebei Area in recent 10 years and identifies influencing factors, in order to provide reference to air quality management and air pollution control.

A literature review of economic evaluations for a neglected tropical disease: human African trypanosomiasis ("sleeping sickness").

PubMed

Sutherland, C Simone; Yukich, Joshua; Goeree, Ron; Tediosi, Fabrizio

2015-02-01

Human African trypanosomiasis (HAT) is a disease caused by infection with the parasite Trypanosoma brucei gambiense or T. b. rhodesiense. It is transmitted to humans via the tsetse fly. Approximately 70 million people worldwide were at risk of infection in 1995, and approximately 20,000 people across Africa are infected with HAT. The objective of this review was to identify existing economic evaluations in order to summarise cost-effective interventions to reduce, control, or eliminate the burden of HAT. The studies included in the review were compared and critically appraised in order to determine if there were existing standardised methods that could be used for economic evaluation of HAT interventions or if innovative methodological approaches are warranted. A search strategy was developed using keywords and was implemented in January 2014 in several databases. The search returned a total of 2,283 articles. After two levels of screening, a total of seven economic evaluations were included and underwent critical appraisal using the Scottish Intercollegiate Guidelines Network (SIGN) Methodology Checklist 6: Economic Evaluations. Results from the existing studies focused on the cost-effectiveness of interventions for the control and reduction of disease transmission. Modelling was a common method to forecast long-term results, and publications focused on interventions by category, such as case detection, diagnostics, drug treatments, and vector control. Most interventions were considered cost-effective based on the thresholds described; however, the current treatment, nifurtomix-eflornithine combination therapy (NECT), has not been evaluated for cost-effectiveness, and considerations for cost-effective strategies for elimination have yet to be completed. Overall, the current evidence highlights the main components that play a role in control; however, economic evaluations of HAT elimination strategies are needed to assist national decision makers, stakeholders, and key funders. These analyses would be of use, as HAT is currently being prioritized as a neglected tropical disease (NTD) to reach elimination by 2020.

Finding the economics in economic entomology.

PubMed

Onstad, David W; Knolhoff, Lisa M

2009-02-01

To recommend new pest management tactics and strategies to farmers and policy makers, economic entomologists must evaluate the economics of biologically reasonable approaches. We collected data to determine how frequently these economic evaluations occur. We discovered from our survey of entomological journals representing the discipline of economic entomology that < 1% of research papers published since 1972 include economic evaluations of pest management tactics. At least 85% of these analyses were performed by entomologists and not economists. Much of the research on economic evaluations is performed without special funds granted by agencies separate from the authors' institutions. In the United States, USDA competitive grants supported 20% of the economic evaluations published since 2000. However, only approximately 12% of the projects funded since 2000 by three sections of the USDA (Crops at Risk, Risk Avoidance and Mitigation Program, and Pest Management Alternatives Program) resulted in publications concerning economic evaluations. If the purpose of economic entomology is to ultimately determine the value of different kinds of tactics, the discipline may need to take steps to enhance the research that supports these evaluations.

Principles of pharmacoeconomics and their impact on strategic imperatives of pharmaceutical research and development.

PubMed

Bodrogi, József; Kaló, Zoltán

2010-04-01

The importance of evidence-based health policy is widely acknowledged among health care professionals, patients and politicians. Health care resources available for medical procedures, including pharmaceuticals, are limited all over the world. Economic evaluations help to alleviate the burden of scarce resources by improving the allocative efficiency of health care financing. Reimbursement of new medicines is subject to their cost-effectiveness and affordability in more and more countries. There are three major approaches to calculate the cost-effectiveness of new pharmaceuticals. Economic analyses alongside pivotal clinical trials are often inconclusive due to the suboptimal collection of economic data and protocol-driven costs. The major limitation of observational naturalistic economic evaluations is the selection bias and that they can be conducted only after registration and reimbursement. Economic modelling is routinely used to predict the cost-effectiveness of new pharmaceuticals for reimbursement purposes. Accuracy of cost-effectiveness estimates depends on the quality of input variables; validity of surrogate end points; and appropriateness of modelling assumptions, including model structure, time horizon and sophistication of the model to differentiate clinically and economically meaningful outcomes. These economic evaluation methods are not mutually exclusive; in practice, economic analyses often combine data collection alongside clinical trials or observational studies with modelling. The need for pharmacoeconomic evidence has fundamentally changed the strategic imperatives of research and development (R&D). Therefore, professionals in pharmaceutical R&D have to be familiar with the principles of pharmacoeconomics, including the selection of health policy-relevant comparators, analytical techniques, measurement of health gain by quality-adjusted life-years and strategic pricing of pharmaceuticals.

Principles of pharmacoeconomics and their impact on strategic imperatives of pharmaceutical research and development

PubMed Central

Bodrogi, József; Kaló, Zoltán

2010-01-01

The importance of evidence-based health policy is widely acknowledged among health care professionals, patients and politicians. Health care resources available for medical procedures, including pharmaceuticals, are limited all over the world. Economic evaluations help to alleviate the burden of scarce resources by improving the allocative efficiency of health care financing. Reimbursement of new medicines is subject to their cost-effectiveness and affordability in more and more countries. There are three major approaches to calculate the cost-effectiveness of new pharmaceuticals. Economic analyses alongside pivotal clinical trials are often inconclusive due to the suboptimal collection of economic data and protocol-driven costs. The major limitation of observational naturalistic economic evaluations is the selection bias and that they can be conducted only after registration and reimbursement. Economic modelling is routinely used to predict the cost-effectiveness of new pharmaceuticals for reimbursement purposes. Accuracy of cost-effectiveness estimates depends on the quality of input variables; validity of surrogate end points; and appropriateness of modelling assumptions, including model structure, time horizon and sophistication of the model to differentiate clinically and economically meaningful outcomes. These economic evaluation methods are not mutually exclusive; in practice, economic analyses often combine data collection alongside clinical trials or observational studies with modelling. The need for pharmacoeconomic evidence has fundamentally changed the strategic imperatives of research and development (R&D). Therefore, professionals in pharmaceutical R&D have to be familiar with the principles of pharmacoeconomics, including the selection of health policy-relevant comparators, analytical techniques, measurement of health gain by quality-adjusted life-years and strategic pricing of pharmaceuticals. PMID:20132213

A systematic review of economic evaluations of seasonal influenza vaccination for the elderly population in the European Union.

PubMed

Shields, Gemma E; Elvidge, Jamie; Davies, Linda M

2017-06-10

The Council of the European Union (EU) has recommended that action should be taken to increase influenza vaccination in the elderly population. The aims were to systematically review and critically appraise economic evaluations for influenza vaccination in the elderly population in the EU. Electronic searches of the NHS Economic Evaluation, Health Technology Assessment, MEDLINE and Embase databases were run to identify full economic evaluations. Two levels of screening were used, with explicit inclusion criteria applied by two independent reviewers at each stage. Prespecified data extraction and critical appraisal were performed on identified studies. Results were summarised qualitatively. Of the 326 search results, screening identified eight relevant studies. Results varied widely, with the incremental cost-effectiveness ratio ranging from being both more effective and cheaper than no intervention to costing €4 59 350 per life-year gained. Cost-effectiveness was most sensitive to variations in influenza strain, vaccination type and strategy, population and modelling characteristics. Most studies suggest that vaccination is cost-effective (seven of eight studies identified at least one cost-effective scenario). All but one study used economic models to synthesise data from different sources. The results are uncertain due to the methods used and the relevance and robustness of the data used. Sensitivity analysis to explore these aspects was limited. Integrated, controlled prospective clinical and economic evaluations and surveillance data are needed to improve the evidence base. This would allow more advanced modelling techniques to characterise the epidemiology of influenza more accurately and improve the robustness of cost-effectiveness estimates. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Opportunity for peri-urban Perth groundwater trade

NASA Astrophysics Data System (ADS)

Gao, Lei; Connor, Jeff; Doble, Rebecca; Ali, Riasat; McFarlane, Don

2013-07-01

Groundwater trade is widely advocated for reallocating scarce groundwater resources between competing users, and managing over-allocated and declining aquifers. However, groundwater markets are still in their infancy, and the potential benefits and opportunities need investigation, particularly where there is a need to reduce the extraction from declining aquifers. This article evaluates economic impacts of reducing groundwater extraction for irrigation use in peri-urban Perth, Australia, where irrigation, a lake-based ecosystem, and public water supply are highly dependent on a declining groundwater resource. We present an assessment of market-based water trading approaches to reduce groundwater extraction with an economic model representing diversity in returns to groundwater use across a population of irrigators. The results indicate that potential economic costs of a proportional reduction in available groundwater for irrigation are 18-21% less if groundwater trade is possible. We also evaluate a water buyback from irrigation to provide public water supply as an alternative to new infrastructure. We find that buying back up to around 50% of current irrigation allocations could create new public water supply only at the cost of 0.32-0.39 million per GL, which is less than one fifth of the costs of new desalinisation or recycled water supply options (2-3 million per GL). We conclude that, with rapid development of computer and internet based trading platforms that allows fast, efficient and low cost multiple party trading, it is increasingly feasible to realise the economic potentials of market-based trade approaches for managing overexploited aquifers.

An Analysis of energy consumption and economic growth of Cobb-Douglas production function based on ECM

NASA Astrophysics Data System (ADS)

Guo, Wei-wei

2018-02-01

Energy is one of the important factors affecting economic growth, the motive force of the economic development of countries in the world, essential for the world economic development and people’s living material resources, an important resource of the relationship between the national economies. The paper sums up the evaluation and literatures on energy consumption and economic growth at home and abroad, thinks “southern talk” as the energy consumption and economic growth in the time division, makes a series of empirical tests on the relationship between total energy consumption and economic growth in China from 1978 to 1991 and from 1992 to 2016.The results show that total energy consumption is a one-way causal relationship between economic growths in china, Economic growth has a strong dependence on energy, there is a co-integration relationship between energy consumption and economic growth. However, economic growth depends on the energy consumption decreased year by year in China, The way of economic growth is changing from the extensive economic growth mode to intensive mode of economic growth.

MOBILE ON-SITE RECYCLING OF METALWORKING FLUIDS

EPA Science Inventory

Product quality, waste reduction, and economic issues were evaluated for a technology designed to recycle metalworking fluids. mulsion-type fluids were tested at two sites and a synthetic fluid was tested at a third site. he specific recycling unit evaluated is based on the techn...

CAV-OX CAVITATION OXIDIATION PROCESS - MAGNUM WATER TECHNOLOGY, INC. - APPLICATIONS ANALYSIS REPORT

EPA Science Inventory

This report evaluates the ability of the CAV-OX cavitation oxidation process to remove volatile organic compounds (VOC) present in aqueous wastes. This report also presents economic data based on the Superfund Innovative Technology Evaluation (SITE) Program demonstration and nine...

Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.

PubMed

Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan

2017-02-01

Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was identified. Because of the overall low methodological quality clear cut conclusions cannot be drawn. Robust and large scales economic evaluations about skin conditions and disease in aged populations are needed in the future. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

Economic Evaluation of Environmental Health Interventions to Support Decision Making

PubMed Central

Hutton, Guy

2008-01-01

Environmental burden of disease represents one quarter of overall disease burden, hence necessitating greater attention from decision makers both inside and outside the health sector. Economic evaluation techniques such as cost-effectiveness analysis and cost-benefit analysis provide key information to health decision makers on the efficiency of environmental health interventions, assisting them in choosing interventions which give the greatest social return on limited public budgets and private resources. The aim of this article is to review economic evaluation studies in three environmental health areas—water, sanitation, hygiene (WSH), vector control, and air pollution—and to critically examine the policy relevance and scientific quality of the studies for selecting and funding public programmers. A keyword search of Medline from 1990–2008 revealed 32 studies, and gathering of articles from other sources revealed a further 18 studies, giving a total of 50 economic evaluation studies (13 WSH interventions, 16 vector control and 21 air pollution). Overall, the economic evidence base on environmental health interventions remains relatively weak—too few studies per intervention, of variable scientific quality and from diverse locations which limits generalisability of findings. Importantly, there still exists a disconnect between economic research, decision making and programmer implementation. This can be explained by the lack of translation of research findings into accessible documentation for policy makers and limited relevance of research findings, and the often low importance of economic evidence in budgeting decisions. These findings underline the importance of involving policy makers in the defining of research agendas and commissioning of research, and improving the awareness of researchers of the policy environment into which their research feeds. PMID:21572840

The integral indicator of socio-economic assessment in regard to resource-oriented territories development in Russia

NASA Astrophysics Data System (ADS)

Chuvashova, M. N.; Avramchikova, N. T.; Zelenkov, P. V.; Petrosyan, M. O.

2016-04-01

Economic peculiarity of Russian resource-oriented territories are based on a focal type of industrial complex, differentiation of economies within a principle of mining and processing of natural resources. To improve the economic condition and integrate into the world innovative process is essential to solve the problem of eliminating the prevalence of resourse focus in the industrial economic structure that could ensure the overcoming of the existing spa- cial dissociation and market mechanisms development in innovative promotion. The monitoring system, involving the integral indicator of socioeconomic and territorial potential assessment, has suggested by the authors. The integral indicator could guarantee the objective evaluation of economic condition within a territory that is vital for the governmental authorities to design strategies providing the economic development of administrative territories.

Biorefineries based on coffee cut-stems and sugarcane bagasse: furan-based compounds and alkanes as interesting products.

PubMed

Aristizábal M, Valentina; Gómez P, Álvaro; Cardona A, Carlos A

2015-11-01

This work presents a techno-economic and environmental assessment for a biorefinery based on sugarcane bagasse (SCB), and coffee cut-stems (CCS). Five scenarios were evaluated at different levels, conversion pathways, feedstock distribution, and technologies to produce ethanol, octane, nonane, furfural, and hydroxymethylfurfural (HMF). These scenarios were compared between each other according to raw material, economic, and environmental characteristics. A single objective function combining the Net Present Value and the Potential Environmental Impact was used through the Analytic Hierarchy Process approach to understand and select the best configurations for SCB and CCS cases. The results showed that the configuration with the best economic and environmental performance for SCB and CCS is the one that considers ethanol, furfural, and octane production (scenario 1). The global economic margin was 62.3% and 61.6% for SCB and CCS respectively. The results have shown the potential of these types of biomass to produce fuels and platform products. Copyright © 2015 Elsevier Ltd. All rights reserved.

Computer-Based Automation of Discrete Product Manufacture: A preliminary Discussion of Feasibility and Impact

DTIC Science & Technology

1974-07-01

automated manufacturing processes and a rough technoeconomic evaluation of those concepts. Our evaluation is largely based on estimates; therefore, the...must be subjected to thorough analysis and experimental verification before they can be considered definitive. They are being published at this time...hardware and sensor technology, manufacturing engineering, automation, and economic analysis . Members of this team inspected over thirty manufacturing

Did We Get Our Money’s Worth? Bridging Economic and Behavioral Measures of Program Success in Adolescent Drug Prevention

PubMed Central

Griffith, Kevin N.; Scheier, Lawrence M.

2013-01-01

The recent U.S. Congressional mandate for creating drug-free learning environments in elementary and secondary schools stipulates that education reform rely on accountability, parental and community involvement, local decision making, and use of evidence-based drug prevention programs. By necessity, this charge has been paralleled by increased interest in demonstrating that drug prevention programs net tangible benefits to society. One pressing concern is precisely how to integrate traditional scientific methods of program evaluation with economic measures of “cost efficiency”. The languages and methods of each respective discipline don’t necessarily converge on how to establish the true benefits of drug prevention. This article serves as a primer for conducting economic analyses of school-based drug prevention programs. The article provides the reader with a foundation in the relevant principles, methodologies, and benefits related to conducting economic analysis. Discussion revolves around how economists value the potential costs and benefits, both financial and personal, from implementing school-based drug prevention programs targeting youth. Application of heterogeneous costing methods coupled with widely divergent program evaluation findings influences the feasibility of these techniques and may hinder utilization of these practices. Determination of cost-efficiency should undoubtedly become one of several markers of program success and contribute to the ongoing debate over health policy. PMID:24217178

Evaluation of a novel waste heat recovery system for the cement industry using multi-criteria analysis (MCA) approach

NASA Astrophysics Data System (ADS)

Han, Yue; Guo, Junshan; Zheng, Wei; Ding, Junqi; Zhu, Lingkai; Che, Yongqiang; Zhang, Yanpeng

2017-12-01

Based on a novel waste heat recovery project established in a cement plant, this paper aims to evaluate the performance of the project using multi-criteria analysis (MCA) approach. Economic, environmental, social, and technical perspectives were concerned and analyzed. Different sustainability criteria and indicators related with the project were evaluated through ranking/rating process and pairwise comparison. Results have shown similar outcomes, that ten out of eleven criteria are favorable at a high standard, which reveals the project’s success. Although the project has performed so well in economic, environmental and technical terms, social aspects have some weak points, and measures should be taken to improve social benefit.

An eco-efficient and economical optimum evaluation technique for the forest road networks: the case of the mountainous forest of Metsovo, Greece.

PubMed

Tampekis, Stergios; Samara, Fani; Sakellariou, Stavros; Sfougaris, Athanassios; Christopoulou, Olga

2018-02-12

The sustainable forest management can be achieved only through environmentally sound and economically efficient and feasible forest road networks and transportation systems that can potentially improve the multi-functional use of forest resources. However, road network planning and construction suggest long-term finance that require a capital investment (cash outflow), which would be equal to the value of the total revenue flow (cash inflow) over the whole lifecycle project. This paper emphasizes in an eco-efficient and economical optimum evaluation method for the forest road networks in the mountainous forest of Metsovo, Greece. More specifically, with the use of this technique, we evaluated the forest roads' (a) total construction costs, (b) annual maintenance cost, and (c) log skidding cost. In addition, we estimated the total economic value of forest goods and services that are lost from the forest roads' construction. Finally, we assessed the optimum eco-efficient and economical forest roads densities based on linear equations that stem from the internal rate of return method (IRR) and have been presented graphically. Data analysis and its presentation are achieved with the contribution of geographic information systems (GIS). The technique which is described in this study can be for the decision makers an attractive and useful implement in order to select the most eco-friendly and economical optimum solution to plan forest road network or to evaluate the existing forest transportation systems. Hence, with the use of this method, we can combine not only the multi-objective utilization of natural resources but also the environmental protection of forest ecosystems.

Economic analysis of the health impacts of housing improvement studies: a systematic review

PubMed Central

Fenwick, Elisabeth; Macdonald, Catriona; Thomson, Hilary

2013-01-01

Background Economic evaluation of public policies has been advocated but rarely performed. Studies from a systematic review of the health impacts of housing improvement included data on costs and some economic analysis. Examination of these data provides an opportunity to explore the difficulties and the potential for economic evaluation of housing. Methods Data were extracted from all studies included in the systematic review of housing improvement which had reported costs and economic analysis (n=29/45). The reported data were assessed for their suitability to economic evaluation. Where an economic analysis was reported the analysis was described according to pre-set definitions of various types of economic analysis used in the field of health economics. Results 25 studies reported cost data on the intervention and/or benefits to the recipients. Of these, 11 studies reported data which was considered amenable to economic evaluation. A further four studies reported conducting an economic evaluation. Three of these studies presented a hybrid ‘balance sheet’ approach and indicated a net economic benefit associated with the intervention. One cost-effectiveness evaluation was identified but the data were unclearly reported; the cost-effectiveness plane suggested that the intervention was more costly and less effective than the status quo. Conclusions Future studies planning an economic evaluation need to (i) make best use of available data and (ii) ensure that all relevant data are collected. To facilitate this, economic evaluations should be planned alongside the intervention with input from health economists from the outset of the study. When undertaken appropriately, economic evaluation provides the potential to make significant contributions to housing policy. PMID:23929616

The AgMIP Framework to Evaluate Agricultural Pathways

NASA Technical Reports Server (NTRS)

Ruane, Alex

2015-01-01

This talk will describe the community and research framework that AgMIP has built to enable evidence-based adaptation investment. We provide expertise on the ground and connect various disciplines in order to allow specific adaptations to be evaluated for their biophysical and socio-economic ramifications.

Resource-use measurement based on patient recall: issues and challenges for economic evaluation.

PubMed

Thorn, Joanna C; Coast, Joanna; Cohen, David; Hollingworth, William; Knapp, Martin; Noble, Sian M; Ridyard, Colin; Wordsworth, Sarah; Hughes, Dyfrig

2013-06-01

Accurate resource-use measurement is challenging within an economic evaluation, but is a fundamental requirement for estimating efficiency. Considerable research effort has been concentrated on the appropriate measurement of outcomes and the policy implications of economic evaluation, while methods for resource-use measurement have been relatively neglected. Recently, the Database of Instruments for Resource Use Measurement (DIRUM) was set up at http://www.dirum.org to provide a repository where researchers can share resource-use measures and methods. A workshop to discuss the issues was held at the University of Birmingham in October 2011. Based on material presented at the workshop, this article highlights the state of the art of UK instruments for resource-use data collection based on patient recall. We consider methodological issues in the design and analysis of resource-use instruments, and the challenges associated with designing new questionnaires. We suggest a method of developing a good practice guideline, and identify some areas for future research. Consensus amongst health economists has yet to be reached on many aspects of resource-use measurement. We argue that researchers should now afford costing methodologies the same attention as outcome measurement, and we hope that this Current Opinion article will stimulate a debate on methods of resource-use data collection and establish a research agenda to improve the precision and accuracy of resource-use estimates.

An economic evaluation of highly purified HMG and recombinant FSH based on a large randomized trial.

PubMed

Wechowski, Jaroslaw; Connolly, Mark; McEwan, Philip; Kennedy, Richard

2007-11-01

Public funding for IVF is increasingly being challenged by health authorities in an attempt to minimize health service costs. In light of treatment rationing, the need to consider costs in relation to outcomes is paramount. To assess the cost implications of gonadotrophin treatment options, an economic evaluation comparing highly purified human menopausal gonadotrophin (HP-HMG) and recombinant FSH (rFSH) has been conducted. The analysis is based on individual patient data from a large randomized controlled trial (n = 731) in a long agonist IVF protocol. The economic evaluation uses a discrete event simulation model to assess treatment costs in relation to live births for both treatments based on published UK costs. After one cycle the mean costs per IVF treatment for HP-HMG and rFSH were pound2396 (95% CI pound2383-2414) and pound2633 ( pound2615-2652), respectively. The average cost-saving of pound237 per IVF cycle using HP-HMG allows one additional cycle to be delivered for every 10 cycles. With maternal and neonatal costs applied, the median cost per IVF baby delivered with HP-HMG was pound8893 compared with pound11,741 for rFSH (P < 0.001). The cost-saving potential of HP-HMG in IVF was still apparent after varying critical cost parameters in the probabilistic sensitivity analysis.

Health Care Economics: A Study Guide for Neuroradiology Fellows, Part 2.

PubMed

Weiner, S L; Tu, R; Javan, R; Taheri, M R

2018-01-01

In this second article, we continue the review of current health care economics as it relates to radiologists, specifically framed by topics defined by the Accreditation Council for Graduate Medical Education in the evaluation of neuroradiology fellows. The discussion in this article is focused on topics pertaining to levels 4 and 5, which are the more advanced levels of competency defined by the Accreditation Council for Graduate Medical Education Neuroradiology Milestones on Health Care Economics and System Based Practice. © 2018 by American Journal of Neuroradiology.

[Economic evaluation and rationale for human health risk management decisions].

PubMed

Fokin, S G; Bobkova, T E

2011-01-01

The priority task of human health maintenance and improvement is risk management using the new economic concepts based on the assessment of potential and real human risks from exposure to poor environmental factors and on the estimation of cost-benefit and cost-effectiveness ratios. The application of economic tools to manage a human risk makes it possible to assess various measures both as a whole and their individual priority areas, to rank different scenarios in terms of their effectiveness, to estimate costs per unit of risk reduction and benefit increase (damage decrease).

Joint protection and hand exercises for hand osteoarthritis: an economic evaluation comparing methods for the analysis of factorial trials

PubMed Central

Oppong, Raymond; Nicholls, Elaine; Whitehurst, David G. T.; Hill, Susan; Hammond, Alison; Hay, Elaine M.; Dziedzic, Krysia

2015-01-01

Objectives. Evidence regarding the cost-effectiveness of joint protection and hand exercises for the management of hand OA is not well established. The primary aim of this study is to assess the cost-effectiveness (cost-utility) of these management options. In addition, given the absence of consensus regarding the conduct of economic evaluation alongside factorial trials, we compare different analytical methodologies. Methods. A trial-based economic evaluation to assess the cost-utility of joint protection only, hand exercises only and joint protection plus hand exercises compared with leaflet and advice was undertaken over a 12 month period from a UK National Health Service perspective. Patient-level mean costs and mean quality-adjusted life years (QALYs) were calculated for each trial arm. Incremental cost-effectiveness ratios (ICERs) were estimated and cost-effectiveness acceptability curves were constructed. The base case analysis used a within-the-table analysis methodology. Two further methods were explored: the at-the-margins approach and a regression-based approach with or without an interaction term. Results. Mean costs (QALYs) were £58.46 (s.d. 0.662) for leaflet and advice, £92.12 (s.d. 0.659) for joint protection, £64.51 (s.d. 0.681) for hand exercises and £112.38 (s.d. 0.658) for joint protection plus hand exercises. In the base case, hand exercises were the cost-effective option, with an ICER of £318 per QALY gained. Hand exercises remained the most cost-effective management strategy when adopting alternative methodological approaches. Conclusion. This is the first trial evaluating the cost-effectiveness of occupational therapy-supported approaches to self-management for hand OA. Our findings showed that hand exercises were the most cost-effective option. PMID:25339642

Unpaid work in health economic evaluations.

PubMed

Krol, Marieke; Brouwer, Werner

2015-11-01

Given its societal importance, unpaid work should be included in economic evaluations of health care technology aiming to take a societal perspective. However, in practice this does not often appear to be the case. This paper provides an overview of the current place of unpaid work in economic evaluations in theory and in practice. It does so first by summarizing recommendations regarding the inclusion of unpaid labor reported in health economic textbooks and national guidelines for economic evaluations. In total, three prominent health economic text-books were studied and 28 national health economic guidelines. The paper, moreover, provides an overview of the instruments available to measure lost unpaid labor and reports on a review of the place of unpaid labor in applied economic evaluations in the area of rheumatoid arthritis. The review was conducted by examining methodology of evaluations published between 1 March 2008 and 1 March 2013. The results of this study show that little guidance is offered regarding the inclusion of unpaid labor in economic evaluations in textbooks and guidelines. The review identified five productivity costs instruments including questions about unpaid work and 33 economic evaluations of treatments for rheumatoid arthritis of which only one included unpaid work. The results indicate that unpaid work is rarely included in applied economic evaluations of treatments for rheumatoid arthritis, despite this disease expecting to be associated with lost unpaid work. Given the strong effects of certain diseases and treatments on the ability to perform unpaid work, unpaid work currently receives less attention in economic evaluations than it deserves. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of the mathematical and economic basis for conversion processes in the LEAP energy-economy model

NASA Astrophysics Data System (ADS)

Oblow, E. M.

1982-10-01

An evaluation was made of the mathematical and economic basis for conversion processes in the Long-term Energy Analysis Program (LEAP) energy economy model. Conversion processes are the main modeling subunit in LEAP used to represent energy conversion industries and are supposedly based on the classical economic theory of the firm. Questions about uniqueness and existence of LEAP solutions and their relation to classical equilibrium economic theory prompted the study. An analysis of classical theory and LEAP model equations was made to determine their exact relationship. The conclusions drawn from this analysis were that LEAP theory is not consistent with the classical theory of the firm. Specifically, the capacity factor formalism used by LEAP does not support a classical interpretation in terms of a technological production function for energy conversion processes. The economic implications of this inconsistency are suboptimal process operation and short term negative profits in years where plant operation should be terminated. A new capacity factor formalism, which retains the behavioral features of the original model, is proposed to resolve these discrepancies.

Which interventions are cost-effective for the management of whiplash-associated and neck pain-associated disorders? A systematic review of the health economic literature by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

PubMed

van der Velde, Gabrielle; Yu, Hainan; Paulden, Mike; Côté, Pierre; Varatharajan, Sharanya; Shearer, Heather M; Wong, Jessica J; Randhawa, Kristi; Southerst, Danielle; Mior, Silvano; Sutton, Deborah; Jacobs, Craig; Taylor-Vaisey, Anne

2016-12-01

Whiplash-associated disorders (WAD) and neck pain and associated disorders (NAD) are prevalent conditions that impact society and impose a significant economic burden on health-care systems. Health economic evidence on WAD and NAD interventions has been sparse: only three economic evaluations of interventions for NAD were identified by the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (NPTF). An updated overview is needed to inform health-care policy and guidelines. This study aimed to determine the cost-effectiveness of interventions for grades I-III WAD and NAD in children and adults. Systematic review of health economic literature, best-evidence synthesis. We systematically searched CINAHL, the Cochrane economic databases (Health Technology Assessment, NHS Economic Evaluation Database), EconLit, EMBASE, MEDLINE, PsycINFO, and Tufts CEA Registry from 2000 to 2015 for economic evaluations of WAD and NAD interventions. We appraised relevant evaluations using the Scottish Intercollegiate Guidelines Network Methodology Criteria for Economic Evaluations. We extracted data, including mean costs (standardized to 2013 Canadian dollars [CAD]) and quality-adjusted life years (QALYs), from studies with adequate methodological quality. We recalculated cost-effectiveness statistics based on the standardized currency using a willingness-to-pay of CAD $50,000 per additional QALY. Funding was provided by the Ministry of Finance. Our search identified 1,616 citations. Six studies fulfilled our selection criteria, including three studies previously reviewed by the NPTF. Structured education appears cost-effective for adults with WAD. For adults with NAD, acupuncture added to routine medical care; manual therapy; multimodal care that includes manual therapy; advice and exercise; and psychological care using cognitive-behavioral therapy appear cost-effective. In contrast, adding manual therapy or diathermy to advice and exercise; multimodal care by a physiotherapist or physician; and behavioral-graded activity do not appear cost-effective for adults with NAD. Our review adds to the findings of the NPTF. Recent evidence suggests that structured education is cost-effective for WAD, whereas advice and exercise and multimodal care that include manual therapy are cost-effective for NAD. Obtaining more robust health economic evidence for non-invasive interventions for WAD and NAD in children and adults remains an essential research priority. Copyright © 2015 Elsevier Inc. All rights reserved.

Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries.

PubMed

Angelis, Aris; Lange, Ansgar; Kanavos, Panos

2018-01-01

Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment. A systematic (peer review and grey) literature review was conducted using an analytical framework examining: (1) 'Responsibilities and structure of HTA agencies'; (2) 'Evidence and evaluation criteria considered in HTAs'; (3) 'Methods and techniques applied in HTAs'; and (4) 'Outcomes and implementation of HTAs'. Study countries were France, Germany, England, Sweden, Italy, Netherlands, Poland and Spain. Evidence from the literature was validated and updated through two rounds of feedback involving primary data collection from national experts. All countries assess similar types of evidence; however, the specific criteria/endpoints used, their level of provision and requirement, and the way they are incorporated (e.g. explicitly vs. implicitly) varies across countries, with their relative importance remaining generally unknown. Incorporation of additional 'social value judgements' (beyond clinical benefit assessment) and economic evaluation could help explain heterogeneity in coverage recommendations and decision-making. More comprehensive and systematic assessment procedures characterised by increased transparency, in terms of selection of evaluation criteria, their importance and intensity of use, could lead to more rational evidence-based decision-making, possibly improving efficiency in resource allocation, while also raising public confidence and fairness.

[Construction and application of economy-pollution-environment three-dimensional evaluation model for district].

PubMed

Fan, Xin-Gang; Mi, Wen-Bao; Ma, Zhen-Ning

2015-02-01

For deep analysis on the regional environmental economic system, the paper analyzes the mutual relation of regional economy development, environmental quality, environmental pollution, and builds the theoretical basis. Then, the economy-pollution-environment quality three-dimensional coupling evaluation model for district is constructed. It includes economic development level index, environmental pollution index, and environmental quality index. The model is a cube, which has spatialization and visualization characteristics. The model includes 8 sub cubes, which expresses 8 types of state, e. g. low pollution-inferior quality-low level of economic development etc. The model can be used to evaluate the status of region, divide development phase, analyze evolution trend etc. It has two ways including relative meaning evaluation (RME) and absolute meaning evaluation (AME). Based on the model, Yinchuan City in the Ningxia Hui Autonomous Region is used as an example for the empirical study. Using RME, compared with Guangzhou city, The result shows that the Yinchuan City has been a high pollution-low quality-low level of economic development state for a long period during 1996-2010. After 2007, the state changed to a high pollution-high quality-low level of economic development. Now, the environmental quality of Yinchuan city gets better, but pollutant discharge pressure is high, and tends to be the break point of high environment quality and low environment. With AME, using national standard, the Yinchuan City remains a high pollution-low quality-low level of economic development state during 1996-2010. Empirical research verifies that different target reference areas and relevant national standards have different main parameters, the evaluating result has an flexible range. The dimensionless data enhances the coupling of index. The data position in model increases the visibility to the environmental management decisions. The model improves mismatches of calculated data size, time asymmetry of spatial data, verification of the former multi-target coupling model.

A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty.

PubMed

Martelli, Nicolas; Devaux, Capucine; van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

2015-01-01

Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices.

Protocol for a systematic review of preference-based instruments for measuring care-related outcomes and their suitability for the palliative care setting.

PubMed

McCaffrey, Nikki; Al-Janabi, Hareth; Currow, David; Hoefman, Renske; Ratcliffe, Julie

2016-09-12

Despite informal caregivers' integral role in supporting people affected by disease or disability, economic evaluations often ignore the costs and benefits experienced by this group, especially in the palliative setting. The purpose of this systematic review is to identify preference-based instruments for measuring care-related outcomes and provide guidance on the selection of instrument in palliative care economic evaluations. A comprehensive search of the literature will be conducted from database inception (ASSIA; CINAHL; Cochrane library including DARE, NHS EED, HTA; Econlit; Embase; PsychINFO; PubMed). Published peer-reviewed, English-language articles reporting preference-based instruments for measuring care-related outcomes in any clinical area will be included. One researcher will complete the searches and screen the results for potentially eligible studies. A randomly selected subset of 10% citations will be independently screened by two researchers. Any disagreement will be resolved by consensus among the research team. Subsequently, a supplementary search will identify studies detailing the development, valuation, validation and application of the identified instruments. The degree of suitability of the instruments for palliative economic evaluations will be assessed using criteria in the International Society for Quality of Life Research minimum standards for patient-reported outcome measures, the checklist for reporting valuation studies of multiattribute utility-based instruments and information on the development of the instrument in the palliative setting. A narrative summary of the included studies and instruments will be provided; similarities and differences will be described and possible reasons for variations explored. Recommendations for practice on selection of instruments in palliative care economic analyses will be provided. This is a planned systematic review of published literature. Therefore, ethics approval to conduct this research is not required. Findings will be presented at leading palliative care and health economic conferences and published in a peer-reviewed journal. CRD42016034188. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Educational Accountability and the Need for Comprehensive Evaluation in TAFE.

ERIC Educational Resources Information Center

White, J. L.

This paper seeks to provide a rationale for evaluating Technical and Further Education (TAFE) programs by using a management system approach that is based on corporate planning. The first section reviews the sources of increased demands for accountability in TAFE (societal, economic, government, and legislative sources) and examines various…

Organic Process Technology Valuation: Cyclohexanone Oxime Syntheses

ERIC Educational Resources Information Center

Cannon, Kevin C.; Breen, Maureen P.

2010-01-01

Three contemporary processes for cyclohexanone oxime synthesis are evaluated in a case study. The case study introduces organic chemistry students to basic cost accounting to determine the most economical technology. Technical and financial aspects of these processes are evaluated with problem-based exercises that may be completed by students…

Development of national genomic evaluations for health traits in U.S. Holsteins

USDA-ARS?s Scientific Manuscript database

The objective of this research was to develop genomic evaluation for resistance to six common health events reported in U.S. dairy herds. The diseases of interest were selected based on their frequency, severity, and economic impact. They included hypocalcemia (milk fever), displaced abomasum, ketos...

43 CFR 3141.5-1 - Economic evaluation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Economic evaluation. 3141.5-1 Section 3141... in Special Tar Sand Areas § 3141.5-1 Economic evaluation. Prior to any lease sale for a combined hydrocarbon lease, the authorized officer shall request an economic evaluation of the total hydrocarbon...

43 CFR 3141.5-1 - Economic evaluation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Economic evaluation. 3141.5-1 Section 3141... in Special Tar Sand Areas § 3141.5-1 Economic evaluation. Prior to any lease sale for a combined hydrocarbon lease, the authorized officer shall request an economic evaluation of the total hydrocarbon...

43 CFR 3141.5-1 - Economic evaluation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Economic evaluation. 3141.5-1 Section 3141... in Special Tar Sand Areas § 3141.5-1 Economic evaluation. Prior to any lease sale for a combined hydrocarbon lease, the authorized officer shall request an economic evaluation of the total hydrocarbon...

43 CFR 3141.5-1 - Economic evaluation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Economic evaluation. 3141.5-1 Section 3141... in Special Tar Sand Areas § 3141.5-1 Economic evaluation. Prior to any lease sale for a combined hydrocarbon lease, the authorized officer shall request an economic evaluation of the total hydrocarbon...

Cost Effectiveness of HPV Vaccination: A Systematic Review of Modelling Approaches.

PubMed

Pink, Joshua; Parker, Ben; Petrou, Stavros

2016-09-01

A large number of economic evaluations have been published that assess alternative possible human papillomavirus (HPV) vaccination strategies. Understanding differences in the modelling methodologies used in these studies is important to assess the accuracy, comparability and generalisability of their results. The aim of this review was to identify published economic models of HPV vaccination programmes and understand how characteristics of these studies vary by geographical area, date of publication and the policy question being addressed. We performed literature searches in MEDLINE, Embase, Econlit, The Health Economic Evaluations Database (HEED) and The National Health Service Economic Evaluation Database (NHS EED). From the 1189 unique studies retrieved, 65 studies were included for data extraction based on a priori eligibility criteria. Two authors independently reviewed these articles to determine eligibility for the final review. Data were extracted from the selected studies, focussing on six key structural or methodological themes covering different aspects of the model(s) used that may influence cost-effectiveness results. More recently published studies tend to model a larger number of HPV strains, and include a larger number of HPV-associated diseases. Studies published in Europe and North America also tend to include a larger number of diseases and are more likely to incorporate the impact of herd immunity and to use more realistic assumptions around vaccine efficacy and coverage. Studies based on previous models often do not include sufficiently robust justifications as to the applicability of the adapted model to the new context. The considerable between-study heterogeneity in economic evaluations of HPV vaccination programmes makes comparisons between studies difficult, as observed differences in cost effectiveness may be driven by differences in methodology as well as by variations in funding and delivery models and estimates of model parameters. Studies should consistently report not only all simplifying assumptions made but also the estimated impact of these assumptions on the cost-effectiveness results.

Nutrition economics: towards comprehensive understanding of the benefits of nutrition

PubMed Central

Koponen, Aki; Sandell, Mari; Salminen, Seppo; Lenoir-Wijnkoop, Irene

2012-01-01

There has been an increase in the knowledge and interest on nutrition, and functional foods have gained popularity over the last few decades, and the trend is increasing. Probiotics and prebiotics are among the most studied functional foods. Nutrition economics has been defined as the discipline dedicated to researching and characterising health and economic outcomes in nutrition for the benefit of society. The concept and its application to probiotics and prebiotics will be discussed in terms of health and economic benefits and their evaluation. Health economics and concrete applications showing how to maximise long-term nutritional benefits will contribute to motivate consumers in making food choices based on a rational understanding of their own interest. We present a model that shows that nutrition economics can be used as an analytical tool for product and service network development. PMID:23990809

[Ethics versus economics in public health? On the integration of economic rationality in a discourse of public health ethics].

PubMed

Rothgang, H; Staber, J

2009-05-01

In the course of establishing the discourse of public health ethics in Germany, we discuss whether economic efficiency should be part of public health ethics and, if necessary, how efficiency should be conceptualized. Based on the welfare economics theory, we build a theoretical framework that demands an integration of economic rationality in public health ethics. Furthermore, we consider the possible implementation of welfare efficiency against the background of current practice in an economic evaluation of health care in Germany. The indifference of the welfare efficiency criterion with respect to distribution leads to the conclusion that efficiency must not be the only criteria of public health ethics. Therefore, an ethical approach of principles should be chosen for public health ethics. Possible conflicts between principles of such an approach are outlined.

Nutrition economics: towards comprehensive understanding of the benefits of nutrition.

PubMed

Koponen, Aki; Sandell, Mari; Salminen, Seppo; Lenoir-Wijnkoop, Irene

2012-01-01

There has been an increase in the knowledge and interest on nutrition, and functional foods have gained popularity over the last few decades, and the trend is increasing. Probiotics and prebiotics are among the most studied functional foods. Nutrition economics has been defined as the discipline dedicated to researching and characterising health and economic outcomes in nutrition for the benefit of society. The concept and its application to probiotics and prebiotics will be discussed in terms of health and economic benefits and their evaluation. Health economics and concrete applications showing how to maximise long-term nutritional benefits will contribute to motivate consumers in making food choices based on a rational understanding of their own interest. We present a model that shows that nutrition economics can be used as an analytical tool for product and service network development.

Evaluation of trade influence on economic growth rate by computational intelligence approach

NASA Astrophysics Data System (ADS)

Sokolov-Mladenović, Svetlana; Milovančević, Milos; Mladenović, Igor

2017-01-01

In this study was analyzed the influence of trade parameters on the economic growth forecasting accuracy. Computational intelligence method was used for the analyzing since the method can handle highly nonlinear data. It is known that the economic growth could be modeled based on the different trade parameters. In this study five input parameters were considered. These input parameters were: trade in services, exports of goods and services, imports of goods and services, trade and merchandise trade. All these parameters were calculated as added percentages in gross domestic product (GDP). The main goal was to select which parameters are the most impactful on the economic growth percentage. GDP was used as economic growth indicator. Results show that the imports of goods and services has the highest influence on the economic growth forecasting accuracy.

A step forward in laccase exploitation: Recombinant production and evaluation of techno-economic feasibility of the process.

PubMed

Pezzella, Cinzia; Giacobelli, Valerio Guido; Lettera, Vincenzo; Olivieri, Giuseppe; Cicatiello, Paola; Sannia, Giovanni; Piscitelli, Alessandra

2017-10-10

Protein heterologous production offers viable opportunities to tailor laccase properties to specific industrial needs. The high redox potential laccase POXA1b from Pleurotus ostreatus was chosen as case study of marketable enzyme, due to its desirable properties in terms of activity/stability profile, and already assessed applicability. POXA1b was heterologously produced in Pichia pastoris by investigating the effect of inducible and constitutive expression systems on both the yield and the cost of its production. System performances were first assessed in shaken-flasks and then scaled-up in bioreactor. The production level obtained in the inducible system is 42U/mL, while the activity value achieved with the constitutive one is 60U/mL, the highest obtained in constitutive systems so far. The economic feasibility of recombinant laccase production was simulated, describing the case of an Italian small-medium enterprise. Two scenarios were evaluated: Scenario (I) production based on methanol inducible system; Scenario (II) production based on the constitutive system, fed with glycerol. At all the scales the glycerol-based fermentation is more economic than the methanol-based one. The price forecast for rPOXA1b production is 0.34€kU -1 for glycerol-based process, and is very competitive with the current price of commercial laccase. Copyright © 2017 Elsevier B.V. All rights reserved.

Interprofessional student clinics: an economic evaluation of collaborative clinical placement education.

PubMed

Haines, Terry P; Kent, Fiona; Keating, Jennifer L

2014-07-01

Interprofessional student clinics can be used to create clinical education placements for health professional students in addition to traditional hospital-based placements and present an opportunity to provide interprofessional learning experiences in a clinical context. To date, little consideration has been given in research literature as to whether such clinics are economically viable for a university to run. We conducted an economic evaluation based upon data generated during a pilot of an interprofessional student clinic based in Australia. Cost-minimization analyses of the student clinic as opposed to traditional profession-specific clinical education in hospitals were conducted from university, Commonwealth Government, state government and societal perspectives. Cost data gathered during the pilot study and market prices were used where available, while $AUD currency at 2011 values were used. Per student day of clinical education, the student clinic cost an additional $289, whereas the state government saved $49 and the Commonwealth Government saved $66. Overall, society paid an additional $175 per student day of clinical education using the student clinic as opposed to conventional hospital-based placements, indicating that traditional hospital-based placements are a cost-minimizing approach overall for providing clinical education. Although interprofessional student clinics have reported positive patient and student learning outcomes, further research is required to determine if these benefits can justify the additional cost of this model of education. Considerations for clinic sustainability are proposed.

Specific guidelines for assessing and improving the methodological quality of economic evaluations of newborn screening

PubMed Central

2012-01-01

Background Economic evaluation of newborn screening poses specific methodological challenges. Amongst others, these challenges refer to the use of quality adjusted life years (QALYs) in newborns, and which costs and outcomes need to be considered in a full evaluation of newborn screening programmes. Because of the increasing scale and scope of such programmes, a better understanding of the methods of high-quality economic evaluations may be crucial for both producers/authors and consumers/reviewers of newborn screening-related economic evaluations. The aim of this study was therefore to develop specific guidelines designed to assess and improve the methodological quality of economic evaluations in newborn screening. Methods To develop the guidelines, existing guidelines for assessing the quality of economic evaluations were identified through a literature search, and were reviewed and consolidated using a deductive iterative approach. In a subsequent test phase, these guidelines were applied to various economic evaluations which acted as case studies. Results The guidelines for assessing and improving the methodological quality of economic evaluations in newborn screening are organized into 11 categories: “bibliographic details”, “study question and design”, “modelling”, “health outcomes”, “costs”, “discounting”, “presentation of results”, “sensitivity analyses”, “discussion”, “conclusions”, and “commentary”. Conclusions The application of the guidelines highlights important issues regarding newborn screening-related economic evaluations, and underscores the need for such issues to be afforded greater consideration in future economic evaluations. The variety in methodological quality detected by this study reveals the need for specific guidelines on the appropriate methods for conducting sound economic evaluations in newborn screening. PMID:22947299

REMOVAL AND CONTAINMENT OF LEAD-BASED PAINT VIA NEEDLE SCALERS

EPA Science Inventory

This report describes a comparative technical and economic evaluation of using a dustless needlegun system versus a conventional abrasive grit blasting system in the removal of lead-based paint from steel structures. The objective of the study was to comparatively analyze the ope...

ULTRASONIC CLEANING AS A REPLACEMENT FOR A CHLORO- FLUOROCARBON-BASED SYSTEM

EPA Science Inventory

This report describes the technical and economic evaluation of the replacement of a vapor degreasing system with an ultrasonic cleaning system to clean stainless steel components. Heated inorganic water-based cleaning fluid was utilized in lieu of a chlorofluorocarbon (CFC, freon...

Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial.

PubMed

Schulz, Daniela N; Smit, Eline S; Stanczyk, Nicola E; Kremers, Stef P J; de Vries, Hein; Evers, Silvia M A A

2014-03-20

Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. The economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. A total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. Both the sequential and the simultaneous lifestyle interventions were likely to be cost-effective when it concerned the lifestyle factor, whereas the control condition was when it concerned quality of life. However, there is no accepted cutoff point for the willingness to pay per gain in lifestyle behaviors, making it impossible to draw firm conclusions. Further economic evaluations of lifestyle interventions are needed. Dutch Trial Register NTR2168; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2168 (Archived by WebCite at http://www.webcitation.org/6MbUqttYB).

Development and validation of a Markov microsimulation model for the economic evaluation of treatments in osteoporosis.

PubMed

Hiligsmann, Mickaël; Ethgen, Olivier; Bruyère, Olivier; Richy, Florent; Gathon, Henry-Jean; Reginster, Jean-Yves

2009-01-01

Markov models are increasingly used in economic evaluations of treatments for osteoporosis. Most of the existing evaluations are cohort-based Markov models missing comprehensive memory management and versatility. In this article, we describe and validate an original Markov microsimulation model to accurately assess the cost-effectiveness of prevention and treatment of osteoporosis. We developed a Markov microsimulation model with a lifetime horizon and a direct health-care cost perspective. The patient history was recorded and was used in calculations of transition probabilities, utilities, and costs. To test the internal consistency of the model, we carried out an example calculation for alendronate therapy. Then, external consistency was investigated by comparing absolute lifetime risk of fracture estimates with epidemiologic data. For women at age 70 years, with a twofold increase in the fracture risk of the average population, the costs per quality-adjusted life-year gained for alendronate therapy versus no treatment were estimated at €9105 and €15,325, respectively, under full and realistic adherence assumptions. All the sensitivity analyses in terms of model parameters and modeling assumptions were coherent with expected conclusions and absolute lifetime risk of fracture estimates were within the range of previous estimates, which confirmed both internal and external consistency of the model. Microsimulation models present some major advantages over cohort-based models, increasing the reliability of the results and being largely compatible with the existing state of the art, evidence-based literature. The developed model appears to be a valid model for use in economic evaluations in osteoporosis.

Field and lab evaluation of the use of lime fly ash to replace soil cement as a base course : technical summary.

DOT National Transportation Integrated Search

1997-09-01

The purpose of this project was to design and construct lime/fly ash stabilized base course test sections which would be economical compared to a soil cement stabilized base, utilize a recyclable material, and possibly reduce shrinkage cracking on ba...

Evaluation of modern cotton harvest systems on irrigated cotton: Economic returns

USDA-ARS?s Scientific Manuscript database

A breakeven analysis based on NPV was conducted to compare picker-based and stripper-based harvest systems with and without field cleaners. Under no conditions analyzed was the NPV of a stripper system without a field cleaner greater than a stripper system with a field cleaner. Breakeven curves rela...

REFLECTIONS ON THE NICE DECISION TO REJECT PATIENT PRODUCTION LOSSES.

PubMed

Shearer, James; Byford, Sarah; Birch, Steve

2017-01-01

Patient production losses occur when individuals' capacities to work, whether paid or unpaid, are impaired by illness, treatment, disability, or death. There is controversy about whether and how to include patient production losses in economic evaluations in health care. Patient production losses have not previously been considered when evaluating medications for reimbursement under the U.K. National Health Service. Proposals for value-based assessment of health technologies in the United Kingdom created renewed interest in whether and how to include costs from a wider societal perspective, such as patient production losses, within economic evaluation of healthcare interventions. A narrative review was undertaken of theoretical, ethical, and policy issues that might inform decisions that involve the normative question of whether or not to include patient production losses in economic evaluation. It seems difficult to reconcile the implications of including patient production losses with the objectives of a healthcare system dedicated to providing universal healthcare coverage without regard to patients' ability to pay. Tax payer funded healthcare systems may legitimately adopt maximands other than health gain, but these will be at the opportunity cost of less than maximum health gains.

What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review.

PubMed

Gardiner, Clare; Ingleton, Christine; Ryan, Tony; Ward, Sue; Gott, Merryn

2017-04-01

It is important to understand the costs of palliative and end-of-life care in order to inform decisions regarding cost allocation. However, economic research in palliative care is very limited and little is known about the range and extent of the costs that are involved in palliative care provision. To undertake a systematic review of the health and social care literature to determine the range of financial costs related to a palliative care approach and explore approaches used to measure these costs. A systematic review of empirical literature with thematic synthesis. Study quality was evaluated using the Weight of Evidence Framework. The databases CINAHL, Cochrane, PsycINFO and Medline were searched from 1995 to November 2015 for empirical studies which presented data on the financial costs associated with palliative care. A total of 38 papers met our inclusion criteria. Components of palliative care costs were incurred within four broad domains: hospital care, community or home-based care, hospice care and informal care. These costs could be considered from the economic viewpoint of three providers: state or government, insurers/third-party/not-for-profit organisations and patient and family and/or society. A wide variety of costing approaches were used to derive costs. The evidence base regarding the economics of palliative care is sparse, particularly relating to the full economic costs of palliative care. Our review provides a framework for considering these costs from a variety of economic viewpoints; however, further research is required to develop and refine methodologies.

Economic evaluations and their use in infection prevention and control: a narrative review.

PubMed

Rennert-May, Elissa; Conly, John; Leal, Jenine; Smith, Stephanie; Manns, Braden

2018-01-01

The objective of this review is to provide a comprehensive overview of the different types of economic evaluations that can be utilized by Infection Prevention and Control practitioners with a particular focus on the use of the quality adjusted life year, and its associated challenges. We also highlight existing economic evaluations published within Infection Prevention and Control, research gaps and future directions. Narrative Review. To date the majority of economic evaluations within Infection Prevention and Control are considered partial economic evaluations. Acknowledging the challenges, which include variable utilities within infection prevention and control, a lack of randomized controlled trials, and difficulty in modelling infectious diseases in general, future economic evaluation studies should strive to be consistent with published guidelines for economic evaluations. This includes the use of quality adjusted life years. Further research is required to estimate utility scores of relevance within Infection Prevention and Control.

Agricultural Model for the Nile Basin Decision Support System

NASA Astrophysics Data System (ADS)

van der Bolt, Frank; Seid, Abdulkarim

2014-05-01

To analyze options for increasing food supply in the Nile basin the Nile Agricultural Model (AM) was developed. The AM includes state-of-the-art descriptions of biophysical, hydrological and economic processes and realizes a coherent and consistent integration of hydrology, agronomy and economics. The AM covers both the agro-ecological domain (water, crop productivity) and the economic domain (food supply, demand, and trade) and allows to evaluate the macro-economic and hydrological impacts of scenarios for agricultural development. Starting with the hydrological information from the NileBasin-DSS the AM calculates the available water for agriculture, the crop production and irrigation requirements with the FAO-model AquaCrop. With the global commodity trade model MAGNET scenarios for land development and conversion are evaluated. The AM predicts consequences for trade, food security and development based on soil and water availability, crop allocation, food demand and food policy. The model will be used as a decision support tool to contribute to more productive and sustainable agriculture in individual Nile countries and the whole region.

Overview of methods in economic analyses of behavioral interventions to promote oral health

PubMed Central

O’Connell, Joan M.; Griffin, Susan

2016-01-01

Background Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. Objective To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. Methods We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Discussion Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly. PMID:21656966

Overview of methods in economic analyses of behavioral interventions to promote oral health.

PubMed

O'Connell, Joan M; Griffin, Susan

2011-01-01

Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.

Economic Effects of Increased Control Zone Sizes in Conflict Resolution

NASA Technical Reports Server (NTRS)

Datta, Koushik

1998-01-01

A methodology for estimating the economic effects of different control zone sizes used in conflict resolutions between aircraft is presented in this paper. The methodology is based on estimating the difference in flight times of aircraft with and without the control zone, and converting the difference into a direct operating cost. Using this methodology the effects of increased lateral and vertical control zone sizes are evaluated.

Education for Sustainable Development to Nurture Sensibility and Creativity: An Interdisciplinary Approach Based on Collaboration between "Kateika" (Japanese Home Economics), Art, and Music Departments in a Japanese Primary School

ERIC Educational Resources Information Center

Ito, Yoko; Nakayama, Setsuko

2014-01-01

The objectives of the research reported in this article were to develop and evaluate an interdisciplinary primary school Education for Sustainable Development (ESD) curriculum as a collaboration among the subject areas of "kateika" (Japanese home economics), art, and music. In our curriculum, which focused on the improvement of…

Methodological Issues to Consider When Collecting Data to Estimate Poverty Impact in Economic Evaluations in Low-income and Middle-income Countries.

PubMed

Sweeney, Sedona; Vassall, Anna; Foster, Nicola; Simms, Victoria; Ilboudo, Patrick; Kimaro, Godfather; Mudzengi, Don; Guinness, Lorna

2016-02-01

Out-of-pocket spending is increasingly recognized as an important barrier to accessing health care, particularly in low-income and middle-income countries (LMICs) where a large portion of health expenditure comes from out-of-pocket payments. Emerging universal healthcare policies prioritize reduction of poverty impact such as catastrophic and impoverishing healthcare expenditure. Poverty impact is therefore increasingly evaluated alongside and within economic evaluations to estimate the impact of specific health interventions on poverty. However, data collection for these metrics can be challenging in intervention-based contexts in LMICs because of study design and practical limitations. Using a set of case studies, this letter identifies methodological challenges in collecting patient cost data in LMIC contexts. These components are presented in a framework to encourage researchers to consider the implications of differing approaches in data collection and to report their approach in a standardized and transparent way. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Future trends in power generation cost by power resource

NASA Astrophysics Data System (ADS)

1992-08-01

The Japan Energy Economy Research Institute has been evaluating power generation cost by each power resource every year focusing on nuclear power generation. The Institute is surveying the cost evaluations by power resources in France, Britain and the U.S.A., the nuclear generation advanced nations. The OECD is making power generation cost estimation using a hypothesis which uniforms basically the conditions varying in different member countries. In model power generation cost calculations conducted by the Ministry of International Trade and Industry of Japan, nuclear power generation is the most economical system in any fiscal year. According to recent calculations performed by the Japan Energy Economy Research Institute, the situation is such that it is difficult to distinguish the economical one from others among the power generation systems in terms of generation costs except for thermal power generation. Economic evaluations are given on estimated power generation costs based on construction costs for nuclear and thermal power plants, nuclear fuel cycling cost, and fuel cost data on petroleum, LNG and coal. With regard to the future trends, scenario analyses are made on generation costs, that assume fluctuations in fuel prices and construction costs, the important factors to give economic influence on power generation.

Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011.

PubMed

Evans-Lacko, Sara; Henderson, Claire; Thornicroft, Graham; McCrone, Paul

2013-04-01

Evidence on the economic impact of social marketing anti-stigma campaigns in relation to people with mental illness is limited. To describe the economic impact of the Time to Change (TTC) anti-stigma social marketing campaign, including the potential effects on the wider economy. Data collected for the evaluation of TTC were combined with the social marketing campaign expenditure data to investigate differences in knowledge, attitudes and behaviour in relation to campaign awareness. To evaluate the return on investment, we applied a decision model that estimated the impact on employment for people with depression. Based on average national social marketing campaign costs, the economic benefits outweighed costs even if the campaign resulted in only 1% more people with depression accessing services and gaining employment if they experienced a health improvement. The cost per person with improved intended behaviour was at most £ 4 if we assume the campaign was responsible for 50% of the change. Costs associated with improved knowledge and attitudes, however, were more variable. The findings suggest that the TTC anti-stigma social marketing campaign is a potentially cost-effective and low-cost intervention for reducing the impact of stigma on people with mental health problems.

Economic competitiveness of fuel cell onsite integrated energy systems

NASA Technical Reports Server (NTRS)

Bollenbacher, G.

1983-01-01

The economic competitiveness of fuel cell onsite integrated energy systems (OS/IES) in residential and commercial buildings is examined. The analysis is carried out for three different buildings with each building assumed to be at three geographic locations spanning a range of climatic conditions. Numerous design options and operating strategies are evaluated and two economic criteria are used to measure economic performance. In general the results show that fuel cell OS/IES's are competitive in most regions of the country if the OS/IES is properly designed. The preferred design is grid connected, makes effective use of the fuel cell's thermal output, and has a fuel cell powerplant sized for the building's base electrical load.

A Systematic Review of the Level of Evidence in Economic Evaluations of Medical Devices: The Example of Vertebroplasty and Kyphoplasty

PubMed Central

van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle

2015-01-01

Context Economic evaluations are far less frequently reported for medical devices than for drugs. In addition, little is known about the quality of existing economic evaluations, particularly for innovative devices, such as those used in vertebroplasty and kyphoplasty. Objective To assess the level of evidence provided by the available economic evaluations for vertebroplasty and kyphoplasty. Data Sources A systematic review of articles in English or French listed in the MEDLINE, PASCAL, COCHRANE and National Health Service Economic Evaluation databases, with limits on publication date (up to the date of the review, March 2014). Study Selection We included only economic evaluations of vertebroplasty or kyphoplasty. Editorial and methodological articles were excluded. Data Extraction Data were extracted from articles by two authors working independently and using two analysis grids to measure the quality of economic evaluations. Data Synthesis Twenty-one studies met our inclusion criteria. All were published between 2008 and 2014. Eighteen (86%) were full economic evaluations. Cost-effectiveness analysis (CEA) was the most frequent type of economic evaluation, and was present in 11 (52%) studies. Only three CEAs complied fully with the British Medical Journal checklist. The quality of the data sources used in the 21 studies was high, but the CEAs conforming to methodological guidelines did not use high-quality data sources for all components of the analysis. Conclusions This systematic review shows that the level of evidence in economic evaluations of vertebroplasty and kyphoplasty is low, despite the recent publication of a large number of studies. This finding highlights the challenges to be faced to improve the quality of economic evaluations of medical devices. PMID:26661078

Cost-effectiveness of silver dressings for paediatric partial thickness burns: An economic evaluation from a randomized controlled trial.

PubMed

Gee Kee, E; Stockton, K; Kimble, R M; Cuttle, L; McPhail, S M

2017-06-01

Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome. This study was a trial based economic evaluation (incremental cost effectiveness) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013 to July 2014 and for a one year after re-epithelialization time horizon. Incremental cost effectiveness ratios were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of accounting for infrequent, but high cost, skin grafting surgical procedures. Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) interventions. There was a 99% and 97% probability that Mepilex Ag™ dominated (cheaper and more effective than) Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a priori adjustments, and sensitivity analyses. There was an 82% probability that Acticoat™ with Mepitel dominated Acticoat™ in the primary analysis, although this probability was sensitive to the effect of skin graft procedures. This economic evaluation has demonstrated that Mepilex Ag™ was the dominant dressing choice over both Acticoat™ and Acticoat™ with Mepitel™ in this trial-based economic evaluation and is recommended for treatment of paediatric partial thickness burns ≤10% TBSA. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Research on the evaluation method of rural hollowing based on RS and GIS technology: a case study of the Ningxia Hui autonomous region in China

NASA Astrophysics Data System (ADS)

Yin, Kai; Wen, MeiPing; Zhang, FeiFei; Yuan, Chao; Chen, Qiang; Zhang, Xiupeng

2016-10-01

With the acceleration of urbanization in China, most rural areas formed a widespread phenomenon, i.e., destitute village, labor population loss, land abandonment and rural hollowing. And it formed a unique hollow village problem in China finally. The governance of hollow village was the objective need of the development of economic and social development in rural area for Chinese government, and the research on the evaluation method of rural hollowing was the premise and basis of the hollow village governance. In this paper, several evaluation methods were used to evaluate the rural hollowing based on the survey data, land use data, social and economic development data. And these evaluation indexes were the transition of homesteads, the development intensity of rural residential areas, the per capita housing construction area, the residential population proportion in rural area, and the average annual electricity consumption, which can reflect the rural hollowing degree from the land, population, and economy point of view, respectively. After that, spatial analysis method of GIS was used to analyze the evaluation result for each index. Based on spatial raster data generated by Kriging interpolation, we carried out re-classification of all the results. Using the fuzzy clustering method, the rural hollowing degree in Ningxia area was reclassified based on the two spatial scales of county and village. The results showed that the rural hollowing pattern in the Ningxia Hui Autonomous Region had a spatial distribution characteristics that the rural hollowing degree was obvious high in the middle of the study area but was low around the study area. On a county scale, the specific performances of the serious rural hollowing were the higher degree of extensive land use, and the lower level of rural economic development and population transfer concentration. On a village scale, the main performances of the rural hollowing were the rural population loss and idle land. The evaluation method of rural hollowing constructed in this paper can effectively carry out a comprehensive degree zoning of rural hollowing, which can make orderly decision support plans of hollow village governance for the government.

Onshore Wind Farms: Value Creation for Stakeholders in Lithuania

NASA Astrophysics Data System (ADS)

Burinskienė, Marija; Rudzkis, Paulius; Kanopka, Adomas

With the costs of fossil fuel consistently rising worldwide over the last decade, the development of green technologies has become a major goal in many countries. Therefore the evaluation of wind power projects becomes a very important task. To estimate the value of the technologies based on renewable resources also means taking into consideration social, economic, environmental, and scientific value of such projects. This article deals with economic evaluation of electricity generation costs of onshore wind farms in Lithuania and the key factors that have influence on wind power projects and offer a better understanding of social-economic context behind wind power projects. To achieve these goals, this article makes use of empirical data of Lithuania's wind power farms as well as data about the investment environment of the country.Based on empirical data of wind power parks, the research investigates the average wind farm generation efficiency in Lithuania. Employing statistical methods the return on investments of wind farms in Lithuania is calculated. The value created for every party involved and the total value of the wind farm is estimated according to Stakeholder theory.

The search for relevant outcome measures for cost-utility analysis of systemic family interventions in adolescents with substance use disorder and delinquent behavior: a systematic literature review.

PubMed

Schawo, S; Bouwmans, C; van der Schee, E; Hendriks, V; Brouwer, W; Hakkaart, L

2017-09-19

Systemic family interventions have shown to be effective in adolescents with substance use disorder and delinquent behavior. The interventions target interactions between the adolescent and involved systems (i.e. youth, family, peers, neighbors, school, work, and society). Next to effectiveness considerations, economic aspects have gained attention. However, conventional generic quality of life measures used in health economic evaluations may not be able to capture the broad effects of systemic interventions. This study aims to identify existing outcome measures, which capture the broad effects of systemic family interventions, and allow use in a health economic framework. We based our systematic review on clinical studies in the field. Our goal was to identify effectiveness studies of psychosocial interventions for adolescents with substance use disorder and delinquent behavior and to distill the instruments used in these studies to measure effects. Searched databases were PubMed, Education Resource Information Center (ERIC), Cochrane and Psychnet (PsycBOOKSc, PsycCRITIQUES, print). Identified instruments were ranked according to the number of systems covered (comprehensiveness). In addition, their use for health economic analyses was evaluated according to suitability characteristics such as brevity, accessibility, psychometric properties, etc. One thousand three hundred seventy-eight articles were found and screened for eligibility. Eighty articles were selected, 8 instruments were identified covering 5 or more systems. The systematic review identified instruments from the clinical field suitable to evaluate systemic family interventions in a health economic framework. None of them had preference-weights available. Hence, a next step could be to attach preference-weights to one of the identified instruments to allow health economic evaluations of systemic family interventions.

Measuring the Value of Public Health Systems: The Disconnect Between Health Economists and Public Health Practitioners

PubMed Central

Jacobson, Peter D.; Palmer, Jennifer A.

2008-01-01

We investigated ways of defining and measuring the value of services provided by governmental public health systems. Our data sources included literature syntheses and qualitative interviews of public health professionals. Our examination of the health economic literature revealed growing attempts to measure value of public health services explicitly, but few studies have addressed systems or infrastructure. Interview responses demonstrated no consensus on metrics and no connection to the academic literature. Key challenges for practitioners include developing rigorous, data-driven methods and skilled staff; being politically willing to base allocation decisions on economic evaluation; and developing metrics to capture “intangibles” (e.g., social justice and reassurance value). Academic researchers evaluating the economics of public health investments should increase focus on the working needs of public health professionals. PMID:18923123

Costs of integrating economics and conservation planning.

PubMed

Arponen, Anni; Cabeza, Mar; Eklund, Johanna; Kujala, Heini; Lehtomäki, Joona

2010-10-01

Recent literature on systematic conservation planning has focused strongly on economics. It is a necessary component of efficient conservation planning because the question is about effective resource allocation. Nevertheless, there is an increasing tendency toward economic factors overriding biological considerations. Focusing too narrowly on economic cost may lead us back toward solutions resembling those obtained by opportunistic choice of areas, the avoidance of which was the motivation for development of systematic approaches. Moreover, there are many overlooked difficulties in incorporating economic considerations reliably into conservation planning because available economic data and the free market are complex. For instance, economies based on free markets tend to be shortsighted, whereas biodiversity conservation aims far into the future. Although economic data are necessary, they should not be relied on too heavily or considered separately from other sociopolitical factors. We suggest focusing on development of more-comprehensive ecological-economic modeling, while not forgetting the importance of purely biological analyses that are needed as a point of reference for evaluating conservation outcomes. © 2010 Society for Conservation Biology.

Economical and technical efficiencies evaluation of full scale piggery wastewater treatment BNR plants.

PubMed

Oa, S W; Choi, E; Kim, S W; Kwon, K H; Min, K S

2009-01-01

A method evaluating the economic efficiency of piggery waste treatment plant based on kinetics for nitrogen removal performances is executed in this study and five full scale plants were evaluated, monitored intensively during one year under steady-state conditions. The performance data from those surveyed plants were recalculated by first-order kinetic equation instead of the Monod's equation, and the nitrogen removal kinetics related with COD/TKN ratios. Two plants adapting two extreme strategies for pre treatment, 'excess phase separation', and 'minimum phase separation', were evaluated by the assessment of life cycle cost (LCC). Although the compared two plants use an opposite strategy to each other, similar evaluation results are deduced by nitrogen removal efficiencies and operational and construction costs. But the proportions of constituent elements are as different as two opposite strategies, so electrical and construction costs are inversely proportional to chemical costs and operational costs respectively.

Operational Contract Support: Economic Impact Evaluation and Measures of Effectiveness

DTIC Science & Technology

2017-12-01

NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES...DATES COVERED MBA professional report 4. TITLE AND SUBTITLE OPERATIONAL CONTRACT SUPPORT: ECONOMIC IMPACT EVALUATION AND MEASURES OF EFFECTIVENESS 5...evaluation, expeditionary economics , operational contract support, measure of effectiveness 15. NUMBER OF PAGES 89 16. PRICE CODE 17. SECURITY

Evaluation of handling and reuse approaches for the waste generated from MEA-based CO2 capture with the consideration of regulations in the UAE.

PubMed

Nurrokhmah, Laila; Mezher, Toufic; Abu-Zahra, Mohammad R M

2013-01-01

A waste slip-stream is generated from the reclaiming process of monoethanolamine (MEA) based Post-Combustion Capture (PCC). It mainly consists of MEA itself, ammonium, heat-stable salts (HSS), carbamate polymers, and water. In this study, the waste quantity and nature are characterized for Fluor's Econamine FGSM coal-fired CO2 capture base case. Waste management options, including reuse, recycling, treatment, and disposal, are investigated due to the need for a more environmentally sound handling. Regulations, economic potential, and associated costs are also evaluated. The technical, economic, and regulation assessment suggests waste reuse for NOx scrubbing. Moreover, a high thermal condition is deemed as an effective technique for waste destruction, leading to considerations of waste recycling into a coal burner or incineration. As a means of treatment, three secondary-biological processes covering Complete-Mix Activated Sludge (CMAS), oxidation ditch, and trickling filter are designed to meet the wastewater standards in the United Arab Emirates (UAE). From the economic point of view, the value of waste as a NOx scrubbing agent is 6,561,600-7,348,992 USD/year. The secondary-biological treatment cost is 0.017-0.02 USD/ton of CO2, while the cost of an on-site incinerator is 0.031 USD/ton of CO2 captured. In conclusion, secondary biological treatment is found to be the most economical option.

Stakeholders' perception on including broader economic impact of vaccines in economic evaluations in low and middle income countries: a mixed methods study.

PubMed

van der Putten, Ingeborg M; Evers, Silvia M A A; Deogaonkar, Rohan; Jit, Mark; Hutubessy, Raymond C W

2015-04-10

Current health economic evaluation guidelines mainly concentrate on immediate health gains and cost savings for the individual involved in the intervention. However, it has been argued that these guidelines are too narrow to capture the full impact of vaccination in low and middle income countries. The inclusion of broader economic impact of vaccines (BEIV) has therefore been proposed. Some examples of these are productivity-related gains, macro-economic impact, and different externalities. Despite their potency, the extent to which such benefits can and should be incorporated into economic evaluations of vaccination is still unclear. This mixed methods study aims to assess the relevance of BEIV to different stakeholders involved in the vaccine introduction decision making process. In this mixed method study an internet based survey was sent to attendees of the New and Underutilized Vaccines Initiative meeting in Montreux, Switzerland in 2011. Additionally, semi-structured interviews of 15 minutes each were conducted during the meeting. Study participants included decision makers, experts and funders of vaccines and immunization programs in low and middle income countries. Descriptive analysis of the survey, along with identification of common themes and factors extracted from the interviews and open survey questions was undertaken. Evidence on macro-economic impact, burden of disease and ecological effects were perceived as being most valuable towards aiding decision making for vaccine introduction by the 26 survey respondents. The 14 interviewees highlighted the importance of burden of disease and different types of indirect effects. Furthermore, some new interpretations of BEIVs were discussed, such as the potential negative impact of wastage during immunization programs and the idea of using vaccines as a platform for delivering other types of health interventions. Interviewees also highlighted the importance of using a broader perspective in connection to measuring economic impacts, particularly when attempting to derive the value of newer, more expensive vaccines. According to participants, BEIVs were seen as being equally important as traditional outcome measures used in cost-effectiveness analyses. Such insight can be used to shape research agendas within this field and to eventually create broader, more inclusive practical guidelines for economic evaluations of vaccines.

Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

PubMed

Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

2015-11-01

Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

Rationale and design of the health economics evaluation registry for remote follow-up: TARIFF.

PubMed

Ricci, Renato P; D'Onofrio, Antonio; Padeletti, Luigi; Sagone, Antonio; Vicentini, Alfredo; Vincenti, Antonio; Morichelli, Loredana; Cavallaro, Ciro; Ricciardi, Giuseppe; Lombardi, Leonida; Fusco, Antonio; Rovaris, Giovanni; Silvestri, Paolo; Guidotto, Tiziana; Pollastrelli, Annalisa; Santini, Massimo

2012-11-01

The aims of the study are to develop a cost-minimization analysis from the hospital perspective and a cost-effectiveness analysis from the third payer standpoint, based on direct estimates of costs and QOL associated with remote follow-ups, using Merlin@home and Merlin.net, compared with standard ambulatory follow-ups, in the management of ICD and CRT-D recipients. Remote monitoring systems can replace ambulatory follow-ups, sparing human and economic resources, and increasing patient safety. TARIFF is a prospective, controlled, observational study aimed at measuring the direct and indirect costs and quality of life (QOL) of all participants by a 1-year economic evaluation. A detailed set of hospitalized and ambulatory healthcare costs and losses of productivity that could be directly influenced by the different means of follow-ups will be collected. The study consists of two phases, each including 100 patients, to measure the economic resources consumed during the first phase, associated with standard ambulatory follow-ups, vs. the second phase, associated with remote follow-ups. Remote monitoring systems enable caregivers to better ensure patient safety and the healthcare to limit costs. TARIFF will allow defining the economic value of remote ICD follow-ups for Italian hospitals, third payers, and patients. The TARIFF study, based on a cost-minimization analysis, directly comparing remote follow-up with standard ambulatory visits, will validate the cost effectiveness of the Merlin.net technology, and define a proper reimbursement schedule applicable for the Italian healthcare system. NCT01075516.

Curriculum, Technology, and Education Reform (CTER) Online: Evaluation of an Online Master of Education Program.

ERIC Educational Resources Information Center

Levin, Sandra R.; Levin, James A.; Guell, James G.; Waddoups, Gregory L.

2002-01-01

Describes a Master of Education program at the University of Illinois, Urbana-Champaign called Curriculum, Technology, and Education Reform OnLine (CTER) that is aimed at K-12 teachers. The evaluation based on program stakeholders includes interface design; instructional design; faculty satisfaction; student attitudes; economic viability;…

Fostering Lifelong Learning--Evaluation of a Teacher Education Program for Professional Teachers

ERIC Educational Resources Information Center

Finsterwald, Monika; Wagner, Petra; Schober, Barbara; Luftenegger, Marko; Spiel, Christiane

2013-01-01

Modern economics has placed lifelong learning (LLL) at the center of an intensive ongoing political debate. Evidenced-based interventions are needed, not only in continuing education courses for teachers, but also in schools. This paper introduces evaluation results of TALK, a teacher education program for professional teachers with the objective…

Simulating forage crop production in a northern climate with the Integrated Farm System Model

USDA-ARS?s Scientific Manuscript database

Whole-farm simulation models are useful tools for evaluating the effect of management practices and climate variability on the agro-environmental and economic performance of farms. A few process-based farm-scale models have been developed, but none have been evaluated in a northern region with a sho...

Improving the Fit: How To Use Assessment Data To Connect University Curricula to Workforce Needs.

ERIC Educational Resources Information Center

Jones, Edward; Harrington, Charles F.

Broad-based assessment and evaluation must form the foundation of planning for economic and workforce development engagement opportunities by a college or university. This involves assessing workforce development needs and evaluating how well current curricular offerings respond to those needs. Higher education institutions can successfully…

Credentials versus Performance: Review of the Teacher Performance Pay Research

ERIC Educational Resources Information Center

Podgursky, Michael; Springer, Matthew G.

2007-01-01

In this article we examine the economic case for merit or performance-based pay for K-12 teachers. We review several areas of germane research. The direct evaluation literature on these incentive plans is slender; highly diverse in terms of methodology, targeted populations, and programs evaluated; and primarily focused on short-run motivational…

Algal-Based Renewable Energy for Nevada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fritsen, Christian

2017-03-31

To help in the overall evaluation of the potential for growing algal biomass in high productivity systems, we conducted a study that evaluated water from geothermal sources and cultivated mixed consortia from hot springs in Nevada, we evaluated their growth at moderately high varying temperatures and then evaluated potential manipulations that could possibly increase their biomass and oleaginous production. Studies were conducted at scales ranging from the laboratory benchtop to raceways in field settings. Mixed consortia were readily grown at all scales and growth could be maintained in Nevada year round. Moderate productivities were attained even during the shoulder seasons-more » where temperature control was maintained by hot water and seasonally cold temperatures when there was still plentiful solar radiation. The results enhance the prospects for economic feasibility of developing algal based industries in areas with geothermal energy or even other large alternative sources of heat that are not being used for other purposes. The public may benefit from such development as a means for economic development as well as development of industries for alternative energy and products that do not rely on fossil fuels.« less

Mixed waste paper to ethanol fuel. A technology, market, and economic assessment for Washington

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-01-01

The objectives of this study were to evaluate the use of mixed waste paper for the production of ethanol fuels and to review the available conversion technologies, and assess developmental status, current and future cost of production and economics, and the market potential. This report is based on the results of literature reviews, telephone conversations, and interviews. Mixed waste paper samples from residential and commercial recycling programs and pulp mill sludge provided by Weyerhauser were analyzed to determine the potential ethanol yields. The markets for ethanol fuel and the economics of converting paper into ethanol were investigated.

Life-cycle economics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lunde, P.J.

1982-09-01

In a continuation of previous economic analyses, life-cycle economics of solar projects are discussed using the concept of net present value (NPV) or net worth. The discount rate is defined and illustrated and a life-cycle analysis is worked out based on no down payment and a 25-year loan. The advantages of rising NPV are discussed and illustrated using an energy conserving $100 storm window as an example. Real payback period is discussed and it is concluded that NPV is the only valid method for the evaluation of an investment. Return on investment is cited as a satisfactory alternative method. (MJJ)

Economic evaluation and end-stage renal disease: from basics to bedside.

PubMed

Manns, B J; Taub, K J; Donaldson, C

2000-07-01

Economic evaluation is the comparative analysis of alternative health care interventions in terms of their relative costs (resource use) and effectiveness (health effects). High-quality studies of economic evaluation have been increasingly published in medical journals and read by clinicians, although publication of these studies in nephrology journals has been a more recent phenomenon. This article shows how the basic principles of economics can be applied to health care through the use of economic evaluation. Different types of economic evaluation are discussed, and pitfalls common to such studies are identified. A simple framework is introduced that can be used to interpret the results of economic evaluations. Using this framework, selected therapies for patients with end-stage renal disease (ESRD) are categorized to highlight therapies that are very efficient, encourage their use, and draw attention to therapies in current use that are less effective and more expensive (ie, less efficient) than alternative therapy. Using examples pertinent to care of the patient with ESRD, we show how economic evaluation can be used to link medical outcomes, quality of life, and costs in a common index for multiple therapies with disparate outcome measures. This article highlights the need for clinical studies and economic evaluations of therapies in ESRD for which the effects of the therapy on health outcomes and/or costs are unknown.

[The health economics of attention deficit hyperactivity disorder in Germany. Part 2: Therapeutic options and their cost-effectiveness].

PubMed

Schlander, M; Trott, G-E; Schwarz, O

2010-03-01

Attention deficit hyperactivity disorder (ADHD) has been associated with a continuous increase of health care utilization and thus expenditures. This raises the issue of cost-effectiveness of health care provided for patients with ADHD. Comparative health economic evaluations generate relevant insights and typically report incremental cost-effectiveness ratios (ICERs) of alternatives versus an established standard. Typically, results of cost-effectiveness analyses (CEAs) are reported in terms of incremental cost-effectiveness ratios (ICERs). International evaluations, as well specific adaptations to Germany, indicate an acceptable to attractive cost-effectiveness--according to currently used international benchmarks--of an intense medication management strategy based on stimulants, primarily methylphenidate, with ICERs ranging from 20,000 EUR to 37,000 EUR per quality-adjusted life year (QALY) gained. Economic modeling studies also suggest cost-effectiveness of long-acting modified-release preparations of methylphenidate, owing to improved treatment compliance associated with simplified once daily administration schemes. Atomoxetine, in contrast, appears economically inferior compared to long-acting stimulants, given its higher acquisition costs and at best equal clinical effectiveness. There are currently no data supporting the cost-effectiveness of psychotherapeutic or behavioral interventions. Economic evaluations, which have been published to date, are generally limited by time horizons of up to 1 year and by their prevailing focus on ADHD core symptom improvement only. Therefore, further research into the cost-effectiveness of ADHD treatment strategies seems warranted.

A paradigm shift in the evaluation of information technology in health care.

PubMed

Bonneville, Luc

2005-08-01

This paper examines the notion of productivity, which underlies the reorganization of Quebec's health care system around an information technology-driven virage ambulatoire, or shift to ambulatory (outpatient) care. The reorganization may be traced to a policy decision to address the health care's productivity crisis, a crisis diagnosed in the 1970s based on macroeconomic expenditure trend lines highlighting the "obstacle" to economic growth and to balanced budgets. The information technology-driven virage ambulatoire is aimed at a structural reorganization, based on the principle of: boosting productivity in a service- or information-based economy. The State, thus, relied on analytic categories developed for a particular mode of economic analysis to lead a hospital restructuring program oriented around information technology-based ambulatory care. The result was a refocus from clinical and therapeutic efficiency to administrative imperatives of time, cost, and optimization. Hence, Québec moved to neoliberal productivist system in which clinical and therapeutic effectiveness are subordinated to economic imperatives.

Energy retrofit of an office building by substitution of the generation system: performance evaluation via dynamic simulation versus current technical standards

NASA Astrophysics Data System (ADS)

Testi, D.; Schito, E.; Menchetti, E.; Grassi, W.

2014-11-01

Constructions built in Italy before 1945 (about 30% of the total built stock) feature low energy efficiency. Retrofit actions in this field can lead to valuable energetic and economic savings. In this work, we ran a dynamic simulation of a historical building of the University of Pisa during the heating season. We firstly evaluated the energy requirements of the building and the performance of the existing natural gas boiler, validated with past billings of natural gas. We also verified the energetic savings obtainable by the substitution of the boiler with an air-to-water electrically-driven modulating heat pump, simulated through a cycle-based model, evaluating the main economic metrics. The cycle-based model of the heat pump, validated with manufacturers' data available only at specified temperature and load conditions, can provide more accurate results than the simplified models adopted by current technical standards, thus increasing the effectiveness of energy audits.

Use of Intermediate Endpoints in the Economic Evaluation of New Treatments for Advanced Cancer and Methods Adopted When Suitable Overall Survival Data are Not Available.

PubMed

Beauchemin, Catherine; Lapierre, Marie-Ève; Letarte, Nathalie; Yelle, Louise; Lachaine, Jean

2016-09-01

This study assessed the use of intermediate endpoints in the economic evaluation of new treatments for advanced cancer and the methodological approaches adopted when overall survival (OS) data are unavailable or of limited use. A systematic literature review was conducted to identify economic evaluations of treatments for advanced cancer published between 2003 and 2013. Cost-effectiveness and cost-utility analyses expressed in cost per life-year gained and cost per quality-adjusted life-year using an intermediate endpoint as an outcome measure were eligible. Characteristics of selected studies were extracted and comprised population, treatment of interest, comparator, line of treatment, study perspective, and time horizon. Use of intermediate endpoints and methods adopted when OS data were lacking were analyzed. In total, 7219 studies were identified and 100 fulfilled the eligibility criteria. Intermediate endpoints mostly used were progression-free survival and time to progression, accounting for 92 % of included studies. OS data were unavailable for analysis in nearly 25 % of economic evaluations. In the absence of OS data, studies most commonly assumed an equal risk of death for all treatment groups. Other methods included use of indirect comparison based on numerous assumptions, use of a proxy for OS, consultation with clinical experts, and use of published external information from different treatment settings. Intermediate endpoints are widely used in the economic evaluation of new treatments for advanced cancer in order to estimate OS. Currently, different methods are used in the absence of suitable OS data and the choice of an appropriate method depends on many factors including the data availability.

Monetary conversion factors for economic evaluations of substance use disorders.

PubMed

McCollister, Kathryn; Yang, Xuan; Sayed, Bisma; French, Michael T; Leff, Jared A; Schackman, Bruce R

2017-10-01

Estimating the economic consequences of substance use disorders (SUDs) is important for evaluating existing programs and new interventions. Policy makers in particular must weigh program effectiveness with scalability and sustainability considerations in deciding which programs to fund with limited resources. This study provides a comprehensive list of monetary conversion factors for a broad range of consequences, services, and outcomes, which can be used in economic evaluations of SUD interventions (primarily in the United States), including common co-occurring conditions such as HCV and HIV. Economic measures were selected from standardized clinical assessment instruments that are used in randomized clinical trials and other research studies (e.g., quasi-experimental community-based projects) to evaluate the impact of SUD interventions. National datasets were also reviewed for additional SUD-related consequences, services, and outcomes. Monetary conversion factors were identified through a comprehensive literature review of published articles as well as targeted searches of other sources such as government reports. Eight service/consequence/outcome domains were identified containing more than sixty monetizable measures of medical and behavioral health services, laboratory services, SUD treatment, social services, productivity outcomes, disability outcomes, criminal activity and criminal justice services, and infectious diseases consequences. Unit-specific monetary conversion factors are reported, along with upper and lower bound estimates, whenever possible. Having an updated and standardized source of monetary conversion factors will facilitate and improve future economic evaluations of interventions targeting SUDs and other risky behaviors. This exercise should be repeated periodically as new sources of data become available to maintain the timeliness, comprehensiveness, and quality of these estimates. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

What is the quality of economic evaluations of non-drug therapies? A systematic review and critical appraisal of economic evaluations of radiotherapy for cancer.

PubMed

Barbieri, M; Weatherly, H L A; Ara, R; Basarir, H; Sculpher, M; Adams, R; Ahmed, H; Coles, C; Guerrero-Urbano, T; Nutting, C; Powell, M

2014-10-01

Breast, cervical and colorectal cancers are the three most frequent cancers in women, while lung, prostate and colorectal cancers are the most frequent in men. Much attention has been given to the economic evaluation of pharmaceuticals for treatment of cancer by the National Institute for Health and Care Excellence (NICE) in the UK and similar authorities internationally, while economic analysis developed for other types of anti-cancer interventions, including radiotherapy and surgery, are less common. Our objective was to review methods used in published cost-effectiveness studies evaluating radiotherapy for breast, cervical, colorectal, head and neck and prostate cancer, and to compare the economic evaluation methods applied with those defined in the guidelines used by the NICE technology appraisal programme. A systematic search of seven databases (MEDLINE, EMBASE, CDSR, NHSEED, HTA, DARE, EconLit) as well as research registers, the NICE website and conference proceedings was conducted in July 2012. Only economic evaluations of radiotherapy interventions in individuals diagnosed with cancer that included quality-adjusted life-years (QALYs) or life-years (LYs) were included. Included studies were appraised on the basis of satisfying essential, preferred and UK-specific methods requirements, building on the NICE Reference Case for economic evaluations and on other methods guidelines. A total of 29 studies satisfied the inclusion criteria (breast 14, colorectal 2, prostate 10, cervical 0, head and neck 3). Only two studies were conducted in the UK (13 in the USA). Among essential methods criteria, the main issue was that only three (10%) of the studies used clinical-effectiveness estimates identified through systematic review of the literature. Similarly, only eight (28%) studies sourced health-related quality-of-life data directly from patients with the condition of interest. Other essential criteria (e.g. clear description of comparators, patient group indication and appropriate time horizon) were generally fulfilled, while most of the UK-specific requirements were not met. Based on this review there is a dearth of up-to-date, robust evidence on the cost effectiveness of radiotherapy in cancer suitable to support decision making in the UK. Studies selected did not fully satisfy essential method standards currently recommended by NICE.

Strategies for waste management in small and medium towns of developing countries: a case study of India.

PubMed

Sundaravadivel, M; Vigneswaran, S

2003-01-01

This paper evaluates the issues of waste management in small and medium towns (SMTs) (with population in the range of 10,000-100,000) of India, and identifies the need for a multi-disciplinary approach encompassing technological, economic and financial aspects of the issues to effect improvements. A comprehensive set of cross-disciplinary strategies is suggested to improve the prevailing conditions with environmentally appropriate, economically efficient and financially self-sustaining waste management services. Based on a case study of four SMTs in the State of Tamil Nadu in India, this paper evaluates the application of the suggested strategies and offers policy recommendations.

Re-Evaluating Satellite Solar Power Systems for Earth

NASA Technical Reports Server (NTRS)

Landis, Geoffrey A.

2006-01-01

The Solar Power Satellite System is a concept to collect solar power in space, and then transport it to the surface of the Earth by microwave (or possibly laser) beam, where if is converted into electrical power for terrestrial use. The recent increase in energy costs, predictions of the near-term exhaustion of oil, and prominence of possible climate change due to the "greenhouse effect" from burning of fossil fuels has again brought alternative energy sources to public attention, and the time is certainly appropriate to reexamine the economics of space based power. Several new concepts for Satellite Power System designs were evaluated to make the concept more economically feasible.

On the question of economic efficiency and how to assess it

NASA Astrophysics Data System (ADS)

Petrosyan, M. O.; Kovalev, I. V.; Zelenkov, P. V.; Chuvashova, M. N.; Grishina, I. A.; Pershakova, K. K.

2016-04-01

Over the years, since the world moved to a system of market-based economic relations scientists and businessmen worldwide wonder how to ease and modernize the process of analyzing business performance. During this time, a variety of methods and tools have been developed to deal with this problem. After all, the productivity of the company is directly related to it’s competitive qualities, so the managers are interested in the quality of evaluation of their companies. The article deals with the traditional methods of evaluating the performance of enterprises and some of the tools used in order to improve its quality.

Study on Spatial Spillover Effects of Logistics Industry Development for Economic Growth in the Yangtze River Delta City Cluster Based on Spatial Durbin Model

PubMed Central

Xu, Xinxing

2017-01-01

The overall entropy method is used to evaluate the development level of the logistics industry in the city based on a mechanism analysis of the spillover effect of the development of the logistics industry on economic growth, according to the panel data of 26 cities in the Yangtze River delta. On this basis, the paper uses the spatial durbin model to study the direct impact of the development of the logistics industry on economic growth and the spatial spillover effect. The results show that the direct impact coefficient of the development of the logistics industry in the Yangtze River Delta urban agglomeration on local economic growth is 0.092, and the significant spatial spillover effect on the economic growth in the surrounding area is 0.197. Compared with the labor force input, capital investment and the degree of opening to the world, and government functions, the logistics industry’s direct impact coefficient is the largest, other than capital investment; the coefficient of the spillover effect is higher than other control variables, making it a “strong engine” of the Yangtze River Delta urban agglomeration economic growth. PMID:29207555

Study on Spatial Spillover Effects of Logistics Industry Development for Economic Growth in the Yangtze River Delta City Cluster Based on Spatial Durbin Model.

PubMed

Xu, Xinxing; Wang, Yuhong

2017-12-04

The overall entropy method is used to evaluate the development level of the logistics industry in the city based on a mechanism analysis of the spillover effect of the development of the logistics industry on economic growth, according to the panel data of 26 cities in the Yangtze River delta. On this basis, the paper uses the spatial durbin model to study the direct impact of the development of the logistics industry on economic growth and the spatial spillover effect. The results show that the direct impact coefficient of the development of the logistics industry in the Yangtze River Delta urban agglomeration on local economic growth is 0.092, and the significant spatial spillover effect on the economic growth in the surrounding area is 0.197. Compared with the labor force input, capital investment and the degree of opening to the world, and government functions, the logistics industry's direct impact coefficient is the largest, other than capital investment; the coefficient of the spillover effect is higher than other control variables, making it a "strong engine" of the Yangtze River Delta urban agglomeration economic growth.

Economic evaluation in collaborative hospital drug evaluation reports.

PubMed

Ortega, Ana; Fraga, María Dolores; Marín-Gil, Roberto; Lopez-Briz, Eduardo; Puigventós, Francesc; Dranitsaris, George

2015-09-01

economic evaluation is a fundamental criterion when deciding a drug's place in therapy. The MADRE method (Method for Assistance in making Decisions and Writing Drug Evaluation Reports) is widely used for drug evaluation. This method was developed by the GENESIS group of the Spanish Society of Hospital Pharmacy (SEFH), including economic evaluation. We intend to improve the economic aspects of this method. As for the direction to take, we have to first analyze our previous experiences with the current methodology and propose necessary improvements. economic evaluation sections in collaboratively conducted drug evaluation reports (as the scientific society, SEFH) with the MADRE method were reviewed retrospectively. thirty-two reports were reviewed, 87.5% of them included an economic evaluation conducted by authors and 65.6% contained published economic evaluations. In 90.6% of the reports, a Budget impact analysis was conducted. The cost per life year gained or per Quality Adjusted Life Year gained was present in 14 reports. Twenty-three reports received public comments regarding the need to improve the economic aspect. Main difficulties: low quality evidence in the target population, no comparative studies with a relevant comparator, non-final outcomes evaluated, no quality of life data, no fixed drug price available, dosing uncertainty, and different prices for the same drug. proposed improvements: incorporating different forms of aid for non-drug costs, survival estimation and adapting published economic evaluations; establishing criteria for drug price selection, decision-making in conditions of uncertainty and poor quality evidence, dose calculation and cost-effectiveness thresholds depending on different situations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Critical appraisal of published economic evaluations of home care for the elderly.

PubMed

Ramos, Maria Lucia Teixeira; Ferraz, Marcos Bosi; Sesso, Ricardo

2004-01-01

The goal of the study was to appraise the economic evaluations published between 1980 and 2004 of "home care" for the elderly, focusing on the methodological aspects. MEDLINE was searched to identify and assess economic evaluations (defined as an analysis comparing two or more strategies, involving the assessment of both costs and consequences) related to "home care" exclusively for the elderly (65 years or more) and to critically appraise the methodology using five accepted principles used worldwide for conducting economic evaluations. Twenty-four economic evaluations of "home care" for the elderly were identified and the articles were assessed. All five principles were satisfactorily addressed in two studies (8.3%), four principles in four studies (16.7%), three principles in five studies (20.8%), two principles in eight studies (33.3%) and only one principle in five studies (20.8%). A disparity in the methodology of writing economic evaluations compromises the comparisons among outcomes and lately jeopardizes decisions on the choice of the most appropriate healthcare interventions. The methodological principles represent important guidelines but the discussion of the context of the economic evaluation and the special characteristics of some services and populations should be considered for the appropriate use of economic evaluations.

Helping Students Adapt to Computer-Based Encrypted Examinations

ERIC Educational Resources Information Center

Baker-Eveleth, Lori; Eveleth, Daniel M.; O'Neill, Michele; Stone, Robert W.

2006-01-01

The College of Business and Economics at the University of Idaho conducted a pilot study that used commercially available encryption software called Securexam to deliver computer-based examinations. A multi-step implementation procedure was developed, implemented, and then evaluated on the basis of what students viewed as valuable. Two key aspects…

DCCA analysis of renewable and conventional energy prices

NASA Astrophysics Data System (ADS)

Paiva, Aureliano Sancho Souza; Rivera-Castro, Miguel Angel; Andrade, Roberto Fernandes Silva

2018-01-01

Here we investigate the inter-influence of oil prices and renewable energy sources. The non-stationary time series are scrutinized within the Detrended Cross-Correlation Analysis (DCCA) framework, where the resulting DCCA coefficient provides a useful and reliable index to the evaluate the cross correlation between events at the same time instant as well as at a suitably chosen time lags. The analysis is based on the quotient of two successive daily closing oil prices and composite indices of renewable energy sources in USA and Europe in the period 2006-2015, which was subject to several social and economic driving forces, as the increase of social pressure in favor of the use of non-fossil energy sources and the worldwide economic crisis that started in 2008. The DCCA coefficient is evaluated for different window sizes, extracting information for short and long term correlation between the indices. Particularly, strong correlation between the behavior of the two distinct economic sectors are observed for large time intervals during the worst period of the economic crisis (2008-2012), hinting at a very cautious behavior of the economic agents. Before and after this period, the behavior of two economic sectors are overwhelmingly uncorrelated or very weakly correlated. The results reported here may be useful to select proper strategies in future similar scenarios.

[Coupling between ecological vulnerability and economic poverty in contiguous destitute areas, China: Empirical analysis of 714 poverty-stricken counties.

PubMed

Cao, Shi Song; Wang, Yan Hui; Duan, Fu Zhou; Zhao, Wen Ji; Wang, Zhi Heng; Fang, Na

2016-08-01

Maintaining the coordinated correlation between ecological environment and economic development is one of the important strategies in the new stage of poverty alleviation and development. Taking 714 poverty-stricken counties in contiguous destitute areas as study areas, this paper designed the ecological vulnerability evaluation indicator system based on the ecological sensitivity-resilience-pressure (SRP) conceptual model, as well as the comprehensive poverty evaluation indicators from the perspective of socioeconomic development, so as to build the coupling model to reveal the coupling between ecological vulnerability and economic poverty. The results showed that Hu-Line could act as a feasible partition label to depict the spatial distribution patterns of ecological vulnerability, economic poverty, as well as their coupling degree in contiguous destitute areas, which should be fully taken into consideration the influence of Hu-Line on the east-west pattern classification of national poverty reduction. In addition, there existed a symbiotic positive correlation between ecological vulnerability and economic poverty, therefore, the strategic significance of ecological and environment protection in poverty-stricken areas should be specifically emphasized to reduce economic poverty by synchronously protecting the ecological environment. Approximately half of the counties involved in the study area were in the coordinated type of recession disorders, where the ecological environment quality and the economic development could not be synchronized.

The Evaluation of Appropriateness of OMB Circular A-76 Studies on Revenue-Generating Functions in Defense Working Capital Fund Activities

DTIC Science & Technology

2002-12-01

E. ACTIVITY BASED COSTING (ABC) IN THE WORKING CAPITAL FUND ......................................29 F. UNIQUENESS OF DOD IN THE FREE MARKET ...FREE MARKET SYSTEM ECONOMICS AND WORKING CAPITAL FUNDS .....................................35 B. A-76 AND DEFENSE WORKING CAPITAL FUND DIRECT...Capital Fund applies free market economics and how the foundational theories of the Defense Working Capital Fund and the A-76 study parallel each

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector.

PubMed

van Dongen, Johanna M; Tompa, Emile; Clune, Laurie; Sarnocinska-Hart, Anna; Bongers, Paulien M; van Tulder, Maurits W; van der Beek, Allard J; van Wier, Marieke F

2013-06-03

Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers' knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer's costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this.

Bridging the gap between the economic evaluation literature and daily practice in occupational health: a qualitative study among decision-makers in the healthcare sector

PubMed Central

2013-01-01

Background Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs of decision-makers. As a first step in bridging the gap between the economic evaluation literature and daily practice in occupational health, this study aimed to provide insight into the occupational health decision-making process and information needs of decision-makers. Methods An exploratory qualitative study was conducted with a purposeful sample of occupational health decision-makers in the Ontario healthcare sector. Eighteen in-depth interviews were conducted to explore the process by which occupational health decisions are made and the importance given to the financial implications of OHS interventions. Twenty-five structured telephone interviews were conducted to explore the sources of information used during the decision-making process, and decision-makers’ knowledge on economic evaluation methods. In-depth interview data were analyzed according to the constant comparative method. For the structured telephone interviews, summary statistics were prepared. Results The occupational health decision-making process generally consists of three stages: initiation stage, establishing the need for an intervention; pre-implementation stage, developing an intervention and its business case in order to receive senior management approval; and implementation and evaluation stage, implementing and evaluating an intervention. During this process, information on the financial implications of OHS interventions was found to be of great importance, especially the employer’s costs and benefits. However, scientific evidence was rarely consulted, sound ex-post program evaluations were hardly ever performed, and there seemed to be a need to advance the economic evaluation skill set of decision-makers. Conclusions Financial information is particularly important at the front end of implementation decisions, and can be a key deciding factor of whether to go forward with a new OHS intervention. In addition, it appears that current practice in occupational health in the healthcare sector is not solidly grounded in evidence-based decision-making and strategies should be developed to improve this. PMID:23731570

When to use discrete event simulation (DES) for the economic evaluation of health technologies? A review and critique of the costs and benefits of DES.

PubMed

Karnon, Jonathan; Haji Ali Afzali, Hossein

2014-06-01

Modelling in economic evaluation is an unavoidable fact of life. Cohort-based state transition models are most common, though discrete event simulation (DES) is increasingly being used to implement more complex model structures. The benefits of DES relate to the greater flexibility around the implementation and population of complex models, which may provide more accurate or valid estimates of the incremental costs and benefits of alternative health technologies. The costs of DES relate to the time and expertise required to implement and review complex models, when perhaps a simpler model would suffice. The costs are not borne solely by the analyst, but also by reviewers. In particular, modelled economic evaluations are often submitted to support reimbursement decisions for new technologies, for which detailed model reviews are generally undertaken on behalf of the funding body. This paper reports the results from a review of published DES-based economic evaluations. Factors underlying the use of DES were defined, and the characteristics of applied models were considered, to inform options for assessing the potential benefits of DES in relation to each factor. Four broad factors underlying the use of DES were identified: baseline heterogeneity, continuous disease markers, time varying event rates, and the influence of prior events on subsequent event rates. If relevant, individual-level data are available, representation of the four factors is likely to improve model validity, and it is possible to assess the importance of their representation in individual cases. A thorough model performance evaluation is required to overcome the costs of DES from the users' perspective, but few of the reviewed DES models reported such a process. More generally, further direct, empirical comparisons of complex models with simpler models would better inform the benefits of DES to implement more complex models, and the circumstances in which such benefits are most likely.

The Role of Economic Uncertainty on the Block Economic Value - a New Valuation Approach / Rola Czynnika Niepewności Przy Obliczaniu Wskaźnika Rentowności - Nowe Podejście

NASA Astrophysics Data System (ADS)

Dehghani, H.; Ataee-Pour, M.

2012-12-01

The block economic value (EV) is one of the most important parameters in mine evaluation. This parameter can affect significant factors such as mining sequence, final pit limit and net present value. Nowadays, the aim of open pit mine planning is to define optimum pit limits and an optimum life of mine production scheduling that maximizes the pit value under some technical and operational constraints. Therefore, it is necessary to calculate the block economic value at the first stage of the mine planning process, correctly. Unrealistic block economic value estimation may cause the mining project managers to make the wrong decision and thus may impose inexpiable losses to the project. The effective parameters such as metal price, operating cost, grade and so forth are always assumed certain in the conventional methods of EV calculation. While, obviously, these parameters have uncertain nature. Therefore, usually, the conventional methods results are far from reality. In order to solve this problem, a new technique is used base on an invented binomial tree which is developed in this research. This method can calculate the EV and project PV under economic uncertainty. In this paper, the EV and project PV were initially determined using Whittle formula based on certain economic parameters and a multivariate binomial tree based on the economic uncertainties such as the metal price and cost uncertainties. Finally the results were compared. It is concluded that applying the metal price and cost uncertainties causes the calculated block economic value and net present value to be more realistic than certain conditions.

Economic effectiveness of disease management programs: a meta-analysis.

PubMed

Krause, David S

2005-04-01

The economic effectiveness of disease management programs, which are designed to improve the clinical and economic outcomes for chronically ill individuals, has been evaluated extensively. A literature search was performed with MEDLINE and other published sources for the period covering January 1995 to September 2003. The search was limited to empirical articles that measured the direct economic outcomes for asthma, diabetes, and heart disease management programs. Of the 360 articles and presentations evaluated, only 67 met the selection criteria for meta-analysis, which included 32,041 subjects. Although some studies contained multiple measurements of direct economic outcomes, only one average effect size per study was included in the meta-analysis. Based on the studies included in the research, a meta-analysis provided a statistically significant answer to the question of whether disease management programs are economically effective. The magnitude of the observed average effect size for equally weighted studies was 0.311 (95% CI = 0.272-0.350). Statistically significant differences of effect sizes by study design, disease type and intensity of disease management program interventions were not found after a moderating variable, disease severity, was taken into consideration. The results suggest that disease management programs are more effective economically with severely ill enrollees and that chronic disease program interventions are most effective when coordinated with the overall level of disease severity. The findings can be generalized, which may assist health care policy makers and practitioners in addressing the issue of providing economically effective care for the growing number of individuals with chronic illness.

Model-Based Economic Evaluation of Treatments for Depression: A Systematic Literature Review.

PubMed

Kolovos, Spyros; Bosmans, Judith E; Riper, Heleen; Chevreul, Karine; Coupé, Veerle M H; van Tulder, Maurits W

2017-09-01

An increasing number of model-based studies that evaluate the cost effectiveness of treatments for depression are being published. These studies have different characteristics and use different simulation methods. We aimed to systematically review model-based studies evaluating the cost effectiveness of treatments for depression and examine which modelling technique is most appropriate for simulating the natural course of depression. The literature search was conducted in the databases PubMed, EMBASE and PsycInfo between 1 January 2002 and 1 October 2016. Studies were eligible if they used a health economic model with quality-adjusted life-years or disability-adjusted life-years as an outcome measure. Data related to various methodological characteristics were extracted from the included studies. The available modelling techniques were evaluated based on 11 predefined criteria. This methodological review included 41 model-based studies, of which 21 used decision trees (DTs), 15 used cohort-based state-transition Markov models (CMMs), two used individual-based state-transition models (ISMs), and three used discrete-event simulation (DES) models. Just over half of the studies (54%) evaluated antidepressants compared with a control condition. The data sources, time horizons, cycle lengths, perspectives adopted and number of health states/events all varied widely between the included studies. DTs scored positively in four of the 11 criteria, CMMs in five, ISMs in six, and DES models in seven. There were substantial methodological differences between the studies. Since the individual history of each patient is important for the prognosis of depression, DES and ISM simulation methods may be more appropriate than the others for a pragmatic representation of the course of depression. However, direct comparisons between the available modelling techniques are necessary to yield firm conclusions.

Economic evaluations in gastroenterology in Brazil: A systematic review.

PubMed

de Paiva Haddad, Luciana Bertocco; Decimoni, Tassia Cristina; Turri, Jose Antonio; Leandro, Roseli; de Soárez, Patrícia Coelho

2016-02-06

To systematically review economic evaluations in gastroenterology, relating to Brazil, published between 1980 and 2013. We selected full and partial economic evaluations from among those retrieved by searching the following databases: MEDLINE (PubMed); Excerpta Medica; the Latin American and Caribbean Health Sciences Literature database; the Scientific Electronic Library Online; the database of the Centre for Reviews and Dissemination; the National Health Service (NHS) Economic Evaluation Database; the NHS Health Technology Assessment database; the Health Economics database of the Brazilian Virtual Library of Health; Scopus; Web of Science; and the Brazilian Network for the Evaluation of Health Technologies. Two researchers, working independently, selected the studies and extracted the data. We identified 535 health economic evaluations relating to Brazil and published in the 1980-2013 period. Of those 535 articles, only 40 dealt with gastroenterology. Full and partial economic evaluations respectively accounted for 23 (57.5%) and 17 (42.5%) of the 40 studies included. Among the 23 full economic evaluations, there were 11 cost-utility analyses, seven cost-effectiveness analyses, four cost-consequence analyses, and one cost-minimization analysis. Of the 40 studies, 25 (62.5%) evaluated medications; 7 (17.5%) evaluated procedures; and 3 (7.5%) evaluated equipment. Most (55%) of the studies were related to viral hepatitis, and most (63.4%) were published after 2010. Other topics included gastrointestinal cancer, liver transplantation, digestive diseases and hernias. Over the 33-year period examined, the number of such economic evaluations relating to Brazil, especially of those evaluating medications for the treatment of hepatitis, increased considerably. Further studies are needed in order to ensure that expenditures on health care in Brazil are made as fairly and efficiently as possible.

Economic evaluations in gastroenterology in Brazil: A systematic review

PubMed Central

de Paiva Haddad, Luciana Bertocco; Decimoni, Tassia Cristina; Turri, Jose Antonio; Leandro, Roseli; de Soárez, Patrícia Coelho

2016-01-01

AIM: To systematically review economic evaluations in gastroenterology, relating to Brazil, published between 1980 and 2013. METHODS: We selected full and partial economic evaluations from among those retrieved by searching the following databases: MEDLINE (PubMed); Excerpta Medica; the Latin American and Caribbean Health Sciences Literature database; the Scientific Electronic Library Online; the database of the Centre for Reviews and Dissemination; the National Health Service (NHS) Economic Evaluation Database; the NHS Health Technology Assessment database; the Health Economics database of the Brazilian Virtual Library of Health; Scopus; Web of Science; and the Brazilian Network for the Evaluation of Health Technologies. Two researchers, working independently, selected the studies and extracted the data. RESULTS: We identified 535 health economic evaluations relating to Brazil and published in the 1980-2013 period. Of those 535 articles, only 40 dealt with gastroenterology. Full and partial economic evaluations respectively accounted for 23 (57.5%) and 17 (42.5%) of the 40 studies included. Among the 23 full economic evaluations, there were 11 cost-utility analyses, seven cost-effectiveness analyses, four cost-consequence analyses, and one cost-minimization analysis. Of the 40 studies, 25 (62.5%) evaluated medications; 7 (17.5%) evaluated procedures; and 3 (7.5%) evaluated equipment. Most (55%) of the studies were related to viral hepatitis, and most (63.4%) were published after 2010. Other topics included gastrointestinal cancer, liver transplantation, digestive diseases and hernias. Over the 33-year period examined, the number of such economic evaluations relating to Brazil, especially of those evaluating medications for the treatment of hepatitis, increased considerably. CONCLUSION: Further studies are needed in order to ensure that expenditures on health care in Brazil are made as fairly and efficiently as possible. PMID:26855823

Systematic review of the economic evidence on home visitation programmes for vulnerable pregnant women.

PubMed

Stamuli, Eugena; Richardson, Gerry; Duffy, Steven; Robling, Michael; Hood, Kerry

2015-09-01

A systematic review of the economic evidence on home visitation programmes for young or vulnerable pregnant women was undertaken to provide a summary of the existing literature of these interventions. Relevant studies were identified from a number of sources including large databases, free text search on Google Scholar as well as hand-searching of the obtained references. The search yielded a large number of papers, of which 12 were considered appropriate to be included in the review. These were either full or partial economic evaluations: four studies were cost-benefit analyses, three were cost-effectiveness analyses and the remaining were costing studies. The review highlighted the paucity of good quality economic evaluations in the area of home visiting programmes for young or vulnerable pregnant women. Methods varied substantially between the studies spanning from differing data sources (e.g. single randomized trials or meta-analyses) to different perspectives taken, cost items and outcomes included in the analysis. It is difficult to establish a coherent body of economic evidence for these interventions and draw a firm conclusion on their value for money. Home visiting programmes are complex interventions, with impact on the lives of mothers and their children. The funding of such interventions should be based on rigorous effectiveness and economic evidence. There is a need for well-designed economic evaluations which will follow the appropriate methodological guidelines and also take into account the complexity of such interventions. These analyses should preferably consider multiple perspectives and allow for the fact that the majority of the benefits accrue in the long-term future. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

METHODOLOGICAL QUALITY OF ECONOMIC EVALUATIONS ALONGSIDE TRIALS OF KNEE PHYSIOTHERAPY.

PubMed

García-Pérez, Lidia; Linertová, Renata; Arvelo-Martín, Alejandro; Guerra-Marrero, Carolina; Martínez-Alberto, Carlos Enrique; Cuéllar-Pompa, Leticia; Escobar, Antonio; Serrano-Aguilar, Pedro

2017-01-01

The methodological quality of an economic evaluation performed alongside a clinical trial can be underestimated if the paper does not report key methodological features. This study discusses methodological assessment issues on the example of a systematic review on cost-effectiveness of physiotherapy for knee osteoarthritis. Six economic evaluation studies included in the systematic review and related clinical trials were assessed using the 10-question check-list by Drummond and the Physiotherapy Evidence Database (PEDro) scale. All economic evaluations were performed alongside a clinical trial but the studied interventions were too heterogeneous to be synthesized. Methodological quality of the economic evaluations reported in the papers was not free of drawbacks, and in some cases, it improved when information from the related clinical trial was taken into account. Economic evaluation papers dedicate little space to methodological features of related clinical trials; therefore, the methodological quality can be underestimated if evaluated separately from the trials. Future economic evaluations should follow more strictly the recommendations about methodology and the authors should pay special attention to the quality of reporting.

Predictive global trends in the incidence and mortality of pancreatic cancer based on geographic location, socio-economic status, and demographic shift.

PubMed

Are, Chandrakanth; Chowdhury, Sanjib; Ahmad, Humera; Ravipati, Advaitaa; Song, Tianqiang; Shrikandhe, Shailesh; Smith, Lynette

2016-11-01

Pancreatic Cancer (PC) is a lethal malignancy that accounts for about 4% of cancer-related deaths worldwide. The aim of this study is to describe the influence of geography (based on WHO regions), socio-economic development (based on Human Development Index [HDI]) and demographic shift on the temporal trends in global incidence and mortality of PC. Data (2012-2030) relating to the incidence, mortality of PC and demographic shifts based on WHO regions and HDI areas were extracted from GLOBOCAN 2012. Linear regression was used to evaluate trends in total incidence and mortality. We noted a definite association between PC and higher socio-economic status. Advanced age (age ≥65) contributed to the rising burden in all socio-economic regions of the world except in the Low Human Development (LHD) countries where the disease predominantly affected population <65 years of age. The global burden of PC is expected to rise significantly over the next few decades regardless of geographic location, socio-economic development, age and gender. Advance knowledge of this data can help formulate strategies to specifically target countries and populations that promote public health policy to tackle this lethal disease on the global stage. J. Surg. Oncol. 2016;114:736-742. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Recommendations From the International Colorectal Cancer Screening Network on the Evaluation of the Cost of Screening Programs.

PubMed

Subramanian, Sujha; Tangka, Florence K L; Hoover, Sonja; Nadel, Marion; Smith, Robert; Atkin, Wendy; Patnick, Julietta

2016-01-01

Worldwide, colorectal cancer is the fourth leading cause of death from cancer and the incidence is projected to increase. Many countries are exploring the introduction of organized screening programs, but there is limited information on the resources required and guidance for cost-effective implementation. To facilitate the generating of the economics evidence base for program implementation, we collected and analyzed detailed program cost data from 5 European members of the International Colorectal Cancer Screening Network. The cost per person screened estimates, often used to compare across programs as an overall measure, varied significantly across the programs. In addition, there were substantial differences in the programmatic and clinical cost incurred, even when the same type of screening test was used. Based on these findings, several recommendations are provided to enhance the underlying methodology and validity of the comparative economic assessments. The recommendations include the need for detailed activity-based cost information, the use of a comprehensive set of effectiveness measures to adequately capture differences between programs, and the incorporation of data from multiple programs in cost-effectiveness models to increase generalizability. Economic evaluation of real-world colorectal cancer-screening programs is essential to derive valuable insights to improve program operations and ensure optimal use of available resources.

Economics of Obesity — Learning from the Past to Contribute to a Better Future

PubMed Central

Ananthapavan, Jaithri; Sacks, Gary; Moodie, Marj; Carter, Rob

2014-01-01

The discipline of economics plays a varied role in informing the understanding of the problem of obesity and the impact of different interventions aimed at addressing it. This paper discusses the causes of the obesity epidemic from an economics perspective, and outlines various justifications for government intervention in this area. The paper then focuses on the potential contribution of health economics in supporting resource allocation decision making for obesity prevention/treatment. Although economic evaluations of single interventions provide useful information, evaluations undertaken as part of a priority setting exercise provide the greatest scope for influencing decision making. A review of several priority setting examples in obesity prevention/treatment indicates that policy (as compared with program-based) interventions, targeted at prevention (as compared with treatment) and focused “upstream” on the food environment, are likely to be the most cost-effective options for change. However, in order to further support decision makers, several methodological advances are required. These include the incorporation of intervention costs/benefits outside the health sector, the addressing of equity impacts, and the increased engagement of decision makers in the priority setting process. PMID:24736685

The need for economic evaluation of telemedicine to evolve: the experience in Alberta, Canada.

PubMed

Hailey, David; Jennett, Penny

2004-01-01

Economic evaluation of telemedicine applications is required to provide decision makers in health care with appropriate information on costs and benefits of this information and communications technology. The level of economic evaluation should evolve as telemedicine applications mature. At the basic level, economic evaluation may include basic cost analysis and primarily observational data on nonmonetary benefits. The focus will change as telemedicine programs develop. At this intermediate level, practice patterns and workforce issues are addressed as they affect utilization and costs of telemedicine services. Longer-term economic evaluation, thus far not achieved in telemedicine assessment, should focus on assessment of health outcomes and economic impact. Alberta, Canada has made progress assessing telemedicine applications in psychiatry, radiology, rheumatology, and rehabilitation. Data availability and analytic resources continue to present challenges to economic assessment of telemedicine.

The relationship between economic conditions and postpartum depression in Taiwan: a nationwide population-based study.

PubMed

Chang, Fung-Wei; Lee, Wen-Ying; Liu, Yueh-Ping; Yang, Jing-Jung; Chen, Shu-Pin; Cheng, Kuan-Chen; Lin, Yan-Cen; Ho, Te-Wei; Chiu, Feng-Hsiang; Hsu, Ren-Jun; Liu, Jui-Ming

2016-11-01

Understanding mothers' economic conditions and postpartum depression (PPD) is important for determining how they will take care of themselves and their infants during the postnatal period, especially for low-income families. This study examined the relationship between economic conditions and PPD to elucidate the effect of economic contraction on PPD. Our population-based nationwide study used 2000-2013 the National Health Insurance Research Database of Taiwan. A total of 1240 newly diagnosed PPD patients were recruited. We used the database of the Directorate General of Budget, Accounting, and Statistics of Executive Yuan of Taiwan for national economic indicators. The correlation between economic indicators and PPD was examined. The PPD incidence was positively correlated with yearly unemployment rate, consumer price index, and gross domestic product. During the great recession of 2008-2009, PPD was positively correlated with inflation rate. Consumer price index had a positive correlation with PPD incidence per month when comparing PPD in 2010 with the economic indicators during the great recession. As this retrospective study evaluated macroeconomic indicators, it is unclear whether the macroeconomic indicators' effect on PPD totally reflects the effect of true personal economic status on PPD. There was a significant association between PPD and economic conditions. This study shows that mothers' familial environment plays an important role in the development of PPD. The impact of the worldwide economic downturn of the great recession on women is persistent. This useful finding may give health policy planners a hint of early discovering and dealing with PPD when worldwide economic downturn. Copyright © 2016 Elsevier B.V. All rights reserved.

Use of economic evaluation in decision making: evidence and recommendations for improvement.

PubMed

Simoens, Steven

2010-10-22

Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

An economic evaluation of setting up physical barriers in railway stations for preventing railway injury: evidence from Hong Kong.

PubMed

Law, C K; Yip, P S F

2011-10-01

Setting physical barriers, for example platform screen doors (PSDs), has been proven to be effective in preventing falls onto railway tracks, but its cost-effectiveness is not known. For economic evaluation of public health interventions, the importance of including non-health factors has been noted despite a lack of empirical studies. This study aimed to investigate the effectiveness and cost-effectiveness of PSDs, which are installed in part of the Hong Kong railway system, for preventing railway injuries. Data on railway injuries from 1997 to 2007 were obtained from the railway operators. Poisson regression was used to examine the risk reduction. Two incremental cost-effectiveness ratios (ICER) were calculated to assess the cost-effectiveness based on (1) disability-adjusted life years (DALYs) only and (2) DALYs with potential fare revenue and passengers' waiting time lost due to railway circulation collapse. The PSD installation has effectively reduced railway injuries (adjusted 5-year average percentage change: -68.8%, p<0.0001) with no apparent substitution effect to the other platforms observed. To be cost-effective, the cost of gaining a healthy life year (ICER) should not exceed three times the per capita GDP (US$74,700). The PSD installation would only be cost-effective if the loss of fare revenue and passengers' waiting time, in addition to DALY, were included (ICER: US$65,400), while the ICER based on DALY only would be US$77,900. The challenges of complexity for economic evaluation appear in many community-based health interventions. A more extensive perspective for exploring other outcome measurements and evaluation methods to reflect a fair and appropriate value of the intervention's cost-effectiveness is needed.

What cost components are relevant for economic evaluations of palliative care, and what approaches are used to measure these costs? A systematic review

PubMed Central

Gardiner, Clare; Ingleton, Christine; Ryan, Tony; Ward, Sue; Gott, Merryn

2016-01-01

Background: It is important to understand the costs of palliative and end-of-life care in order to inform decisions regarding cost allocation. However, economic research in palliative care is very limited and little is known about the range and extent of the costs that are involved in palliative care provision. Aim: To undertake a systematic review of the health and social care literature to determine the range of financial costs related to a palliative care approach and explore approaches used to measure these costs. Design: A systematic review of empirical literature with thematic synthesis. Study quality was evaluated using the Weight of Evidence Framework. Data sources: The databases CINAHL, Cochrane, PsycINFO and Medline were searched from 1995 to November 2015 for empirical studies which presented data on the financial costs associated with palliative care. Results: A total of 38 papers met our inclusion criteria. Components of palliative care costs were incurred within four broad domains: hospital care, community or home-based care, hospice care and informal care. These costs could be considered from the economic viewpoint of three providers: state or government, insurers/third-party/not-for-profit organisations and patient and family and/or society. A wide variety of costing approaches were used to derive costs. Conclusion: The evidence base regarding the economics of palliative care is sparse, particularly relating to the full economic costs of palliative care. Our review provides a framework for considering these costs from a variety of economic viewpoints; however, further research is required to develop and refine methodologies. PMID:27670418

Impact of enhanced geothermal systems on US energy supply in the twenty-first century.

PubMed

Tester, Jefferson W; Anderson, Brian J; Batchelor, Anthony S; Blackwell, David D; DiPippo, Ronald; Drake, Elisabeth M; Garnish, John; Livesay, Bill; Moore, Michal C; Nichols, Kenneth; Petty, Susan; Toksoz, M Nafi; Veatch, Ralph W; Baria, Roy; Augustine, Chad; Murphy, Enda; Negraru, Petru; Richards, Maria

2007-04-15

Recent national focus on the value of increasing US supplies of indigenous renewable energy underscores the need for re-evaluating all alternatives, particularly those that are large and well distributed nationally. A panel was assembled in September 2005 to evaluate the technical and economic feasibility of geothermal becoming a major supplier of primary energy for US base-load generation capacity by 2050. Primary energy produced from both conventional hydrothermal and enhanced (or engineered) geothermal systems (EGS) was considered on a national scale. This paper summarizes the work of the panel which appears in complete form in a 2006 MIT report, 'The future of geothermal energy' parts 1 and 2. In the analysis, a comprehensive national assessment of US geothermal resources, evaluation of drilling and reservoir technologies and economic modelling was carried out. The methodologies employed to estimate geologic heat flow for a range of geothermal resources were utilized to provide detailed quantitative projections of the EGS resource base for the USA. Thirty years of field testing worldwide was evaluated to identify the remaining technology needs with respect to drilling and completing wells, stimulating EGS reservoirs and converting geothermal heat to electricity in surface power and energy recovery systems. Economic modelling was used to develop long-term projections of EGS in the USA for supplying electricity and thermal energy. Sensitivities to capital costs for drilling, stimulation and power plant construction, and financial factors, learning curve estimates, and uncertainties and risks were considered.

The Future of the Space Age or how to Evaluate Innovative Ideas

NASA Astrophysics Data System (ADS)

Vollerthun, A.; Fricke, E.

2002-05-01

Based on an initiative of the German Aerospace Industry Association to foster a more transparent and structured funding of German commercial-oriented space projects a three-phased approach is suggested in this paper, to stepwise improve and evaluate proposed concepts for space-related innovations. The objective of this concept was to develop a transparent, structured, and reproducible process to select the right innovative project in terms of political, economical, and technical objectives for funding by e.g. a governmental agency. A stepwise process and related methods, that cover technical as well as economical aspects (and related sensitivities) are proposed. Based on the special needs and requirements of space industry the proposals are compared to a set of predefined top level objectives/requirements. Using an initial trades analysis with the criteria company, technology, product, and market, an initial business case is analyzed. The alternative innovative concepts are in the third process step subject to a very detailed analysis. The full economical and technical scale of the projects is evaluated and metrics for e.g. the 'Return on Investment' or 'Break Even Point' are determined, to compare the various innovations. Risks related to time, cost, and quality are considered, when performing sensitivity analysis by varying the most important factors of the project. Before discussing critical aspects of the proposed process, space-related examples will be presented to show how the process could be applied, and how different concepts should be evaluated.

Design of a trial-based economic evaluation on the cost-effectiveness of employability interventions among work disabled employees or employees at risk of work disability: The CASE-study

PubMed Central

2012-01-01

Background In the Netherlands, absenteeism and reduced productivity due to work disability lead to high yearly costs reaching almost 5% of the gross national product. To reduce the economic burden of sick leave and reduced productivity, different employability interventions for work-disabled employees or employees at risk of work disability have been developed. Within this study, called 'CASE-study' (Cost-effectiveness Analysis of Sustainable Employability), five different employability interventions directed at work disabled employees with divergent health complaints will be analysed on their effectiveness and cost-effectiveness. This paper describes a consistent and transparent methodological design to do so. Methods/design Per employability intervention 142 participants are needed whereof approximately 66 participants receiving the intervention will be compared with 66 participants receiving usual care. Based on the intervention-specific characteristics, a randomized control trial or a quasi-experiment with match-criteria will be conducted. Notwithstanding the study design, eligible participants will be employees aged 18 to 63, working at least 12 h per week, and at risk of work disability, or already work-disabled due to medical restrictions. The primary outcome will be the duration of sick leave. Secondary outcomes are health status and quality of life. Outcomes will be assessed at baseline and then 6, 12 and 18 months later. Economic costs will consist of healthcare costs and cost of lost production due to work disability, and will be evaluated from a societal perspective. Discussion The CASE-study is the first to conduct economic evaluations of multiple different employability interventions based on a similar methodological framework. The cost-effectiveness results for every employability intervention will be published in 2014, but the methods, strengths and weaknesses of the study protocol are discussed in this paper. To contribute to treatment options in occupational health practice and enable the development of guidelines on how to conduct economic evaluation better suited to this field; this paper provides an important first step. Trial registration Four trials involved in the CASE-study are registered with the Netherlands Trial Registry: Care for Work (NTR2886), Health and Motion (NTR3111), Guidance to Excel in Return to Work (NTR3151), Care for Companies/Second Care (NTR3136). PMID:22257557

Towards a social discount rate for the economic evaluation of health technologies in Germany: an exploratory analysis.

PubMed

Schad, Mareike; John, Jürgen

2012-04-01

Over the last decades, methods for the economic evaluation of health care technologies were increasingly used to inform reimbursement decisions. For a short time, the German Statutory Health Insurance makes use of these methods to support reimbursement decisions on patented drugs. In this context, the discounting procedure emerges as a critical component of these methods, as discount rates can strongly affect the resulting incremental cost-effectiveness ratios. The aim of this paper is to identify the appropriate value of a social discount rate to be used by the German Statutory Health Insurance for the economic evaluation of health technologies. On theoretical grounds, we build on the widespread view of contemporary economists that the social rate of time preference (SRTP) is the adequate social discount rate. For quantifying the SRTP, we first apply the market behaviour approach, which assumes that the SRTP is reflected in observable market interest rates. As a second approach, we derive the SRTP from optimal growth theory by using the Ramsey equation. A major part of the paper is devoted to specify the parameters of this equation. Depending on various assumptions, our empirical findings result in the range of 1.75-4.2% for the SRTP. A reasonable base case discount rate for Germany, thus, would be about 3%. Furthermore, we deal with the much debated question whether a common discount rate for costs and health benefits or a lower rate for health should be applied in health economic evaluations. In the German social health insurance system, no exogenously fixed budget constraint does exist. When evaluating a new health technology, the health care decision maker is obliged to conduct an economic evaluation in order to examine whether there is an economically appropriate relation between the value of the health gains and the additional costs which are given by the value of the consumption losses due to the additional health care expenditures. Therefore, a discount rate lower than the SRTP for consumption should be applied if an increase in the consumption value of health is expected. However, given the limited empirical evidence on the relationship between consumption and the value of health, it is hardly possible to make reliable forecasts of this value. Regarding the practice of the German evaluation authority, it is not recommended to use differential discounting in the base case. Instead, the issue of differential discounting should be addressed in sensitivity analyses. Reducing the discount rate for health compared to the rate for costs by a figure in the range between near 0% and 3% may be considered to be appropriate for Germany.

Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

PubMed

Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

2013-02-01

Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the efficiency of healthcare.

Timely and complete publication of economic evaluations alongside randomized controlled trials.

PubMed

Thorn, Joanna C; Noble, Sian M; Hollingworth, William

2013-01-01

Little is known about the extent and nature of publication bias in economic evaluations. Our objective was to determine whether economic evaluations are subject to publication bias by considering whether economic data are as likely to be reported, and reported as promptly, as effectiveness data. Trials that intended to conduct an economic analysis and ended before 2008 were identified in the International Standard Randomised Controlled Trial Number (ISRCTN) register; a random sample of 100 trials was retrieved. Fifty comparator trials were randomly drawn from those not identified as intending to conduct an economic study. The trial start and end dates, estimated sample size and funder type were extracted. For trials planning economic evaluations, effectiveness and economic publications were sought; publication dates and journal impact factors were extracted. Effectiveness abstracts were assessed for whether they reached a firm conclusion that one intervention was most effective. Primary investigators were contacted about reasons for non-publication of results, or reasons for differential publication strategies for effectiveness and economic results. Trials planning an economic study were more likely to be funded by government (p = 0.01) and larger (p = 0.003) than other trials. The trials planning an economic evaluation had a mean of 6.5 (range 2.7-13.2) years since the trial end in which to publish their results. Effectiveness results were reported by 70 %, while only 43 % published economic evaluations (p < 0.001). Reasons for non-publication of economic results included the intervention being ineffective, and staffing issues. Funding source, time since trial end and length of study were not associated with a higher probability of publishing the economic evaluation. However, studies that were small or of unknown size were significantly less likely to publish economic evaluations than large studies (p < 0.001). The authors' confidence in labelling one intervention clearly most effective did not affect the probability of publication. The mean time to publication was 0.7 years longer for cost-effectiveness data than for effectiveness data where both were published (p = 0.001). The median journal impact factor was 1.6 points higher for effectiveness publications than for the corresponding economic publications (p = 0.01). Reasons for publishing in different journals included editorial decision making and the additional time that economic evaluation takes to conduct. Trials that intend to conduct an economic analysis are less likely to report economic data than effectiveness data. Where economic results do appear, they are published later, and in journals with lower impact factors. These results suggest that economic output may be more susceptible than effectiveness data to publication bias. Funders, grant reviewers and trialists themselves should ensure economic evaluations are prioritized and adequately staffed to avoid potential problems with bias.

Generalisability in economic evaluation studies in healthcare: a review and case studies.

PubMed

Sculpher, M J; Pang, F S; Manca, A; Drummond, M F; Golder, S; Urdahl, H; Davies, L M; Eastwood, A

2004-12-01

To review, and to develop further, the methods used to assess and to increase the generalisability of economic evaluation studies. Electronic databases. Methodological studies relating to economic evaluation in healthcare were searched. This included electronic searches of a range of databases, including PREMEDLINE, MEDLINE, EMBASE and EconLit, and manual searches of key journals. The case studies of a decision analytic model involved highlighting specific features of previously published economic studies related to generalisability and location-related variability. The case-study involving the secondary analysis of cost-effectiveness analyses was based on the secondary analysis of three economic studies using data from randomised trials. The factor most frequently cited as generating variability in economic results between locations was the unit costs associated with particular resources. In the context of studies based on the analysis of patient-level data, regression analysis has been advocated as a means of looking at variability in economic results across locations. These methods have generally accepted that some components of resource use and outcomes are exchangeable across locations. Recent studies have also explored, in cost-effectiveness analysis, the use of tests of heterogeneity similar to those used in clinical evaluation in trials. The decision analytic model has been the main means by which cost-effectiveness has been adapted from trial to non-trial locations. Most models have focused on changes to the cost side of the analysis, but it is clear that the effectiveness side may also need to be adapted between locations. There have been weaknesses in some aspects of the reporting in applied cost-effectiveness studies. These may limit decision-makers' ability to judge the relevance of a study to their specific situations. The case study demonstrated the potential value of multilevel modelling (MLM). Where clustering exists by location (e.g. centre or country), MLM can facilitate correct estimates of the uncertainty in cost-effectiveness results, and also a means of estimating location-specific cost-effectiveness. The review of applied economic studies based on decision analytic models showed that few studies were explicit about their target decision-maker(s)/jurisdictions. The studies in the review generally made more effort to ensure that their cost inputs were specific to their target jurisdiction than their effectiveness parameters. Standard sensitivity analysis was the main way of dealing with uncertainty in the models, although few studies looked explicitly at variability between locations. The modelling case study illustrated how effectiveness and cost data can be made location-specific. In particular, on the effectiveness side, the example showed the separation of location-specific baseline events and pooled estimates of relative treatment effect, where the latter are assumed exchangeable across locations. A large number of factors are mentioned in the literature that might be expected to generate variation in the cost-effectiveness of healthcare interventions across locations. Several papers have demonstrated differences in the volume and cost of resource use between locations, but few studies have looked at variability in outcomes. In applied trial-based cost-effectiveness studies, few studies provide sufficient evidence for decision-makers to establish the relevance or to adjust the results of the study to their location of interest. Very few studies utilised statistical methods formally to assess the variability in results between locations. In applied economic studies based on decision models, most studies either stated their target decision-maker/jurisdiction or provided sufficient information from which this could be inferred. There was a greater tendency to ensure that cost inputs were specific to the target jurisdiction than clinical parameters. Methods to assess generalisability and variability in economic evaluation studies have been discussed extensively in the literature relating to both trial-based and modelling studies. Regression-based methods are likely to offer a systematic approach to quantifying variability in patient-level data. In particular, MLM has the potential to facilitate estimates of cost-effectiveness, which both reflect the variation in costs and outcomes between locations and also enable the consistency of cost-effectiveness estimates between locations to be assessed directly. Decision analytic models will retain an important role in adapting the results of cost-effectiveness studies between locations. Recommendations for further research include: the development of methods of evidence synthesis which model the exchangeability of data across locations and allow for the additional uncertainty in this process; assessment of alternative approaches to specifying multilevel models to the analysis of cost-effectiveness data alongside multilocation randomised trials; identification of a range of appropriate covariates relating to locations (e.g. hospitals) in multilevel models; and further assessment of the role of econometric methods (e.g. selection models) for cost-effectiveness analysis alongside observational datasets, and to increase the generalisability of randomised trials.

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

PubMed

Lima, Ana Flávia Barros da Silva; Cruz, Luciane Nascimento; Polanczyk, Carisi Anne; Maia, Carlos Renato Moreira

2013-01-01

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

Economic evaluation of the Annual Cycle Energy System (ACES). Volume 1: Executive summary

NASA Astrophysics Data System (ADS)

1980-05-01

Three different classes of building are investigated, namely: single family residence; multifamily residence; and commercial office building. For each building type in each geographic location, the economic evaluation of the annual cycle energy system (ACES) is based on a comparison of the present worth of the ACES to the present worth of a number of conventional systems. The results of this analysis indicate that the economic viability of the ACES is very sensitive to the assumed value of the property tax, maintenance cost, and fuel escalation rates, while it is relatively insensitive to the assumed values of other parameters. Fortunately, any conceivable change in the fuel escalation rates would tend to increase the viability of the ACES concept. An increase in the assumed value of the maintenance cost or property tax would tend to make the ACES concept less viable; a decrease in either would tend to make the ACES concept more viable.

Technical and Economic Evaluation of Advanced Air Cargo Systems

NASA Technical Reports Server (NTRS)

Whitehead, A. H., Jr.

1978-01-01

The current air cargo environment and the relevance of advanced technology aircraft in enhancing the efficiency of the 1990 air cargo system are discussed. NASA preliminary design studies are shown to indicate significant potential gains in aircraft efficiency and operational economics for future freighter concepts. Required research and technology elements are outlined to develop a better base for evaluating advanced design concepts. Current studies of the market operation are reviewed which will develop design criteria for a future dedicated cargo transport. Design features desirable in an all-freighter design are reviewed. NASA-sponsored studies of large, distributed-load freighters are reviewed and these designs are compared to current wide-body aircraft. These concepts vary in gross takeoff weight from 0.5 Gg (one million lbs.) to 1.5 Gg (three million lbs.) and are found to exhibit economic advantages over conventional design concepts.

Economic Considerations on the Follow-Up Practice in Gynecologic Cancers: Few Lights and Many Shadows From a Literature Review.

PubMed

Pagano, Eva; Sobrero, Simona; Cavallero, Camilla; Zola, Paolo; Ciccone, Giovannino

2015-09-01

The aim of this review was to analyze the existing literature on the cost of follow-up in gynecology oncology. We performed a literature search in Medline and NHS CRD (University of Oxford) databases. Research strings were mainly based on MESH terms referring to economic studies and to neoplasms follow-up/aftercare and cancer recurrences. Two independent searches were performed for ovarian neoplasm and uterine neoplasm. Some studies were also identified among the references of the selected articles. Potentially relevant studies were identified based on the title and abstract by 2 independent readers. Finally, the reviewing process selected 2 studies on gynecologic cancers in general, including uterine and ovarian cancers, 3 specific on ovarian cancer, 7 on endometrium, and 9 on cervix. The identified economic literature on economic evaluation of gynecologic cancer follow-up procedures showed to be based on weak evidence of effectiveness and to lack formal methodological approaches. In general, such literature is quite recent, relies on small sample observational studies, and suffers from a lack of financial support. There are few available lights in economic considerations on gynecologic cancer follow-up, represented by all the published studies, and many shadows that require to be clarified by properly designed randomized trials including cost-effectiveness analysis.

Is There a European View on Health Economic Evaluations? Results from a Synopsis of Methodological Guidelines Used in the EUnetHTA Partner Countries.

PubMed

Heintz, Emelie; Gerber-Grote, Andreas; Ghabri, Salah; Hamers, Francoise F; Rupel, Valentina Prevolnik; Slabe-Erker, Renata; Davidson, Thomas

2016-01-01

The objectives of this study were to review current methodological guidelines for economic evaluations of all types of technologies in the 33 countries with organizations involved in the European Network for Health Technology Assessment (EUnetHTA), and to provide a general framework for economic evaluation at a European level. Methodological guidelines for health economic evaluations used by EUnetHTA partners were collected through a survey. Information from each guideline was extracted using a pre-tested extraction template. On the basis of the extracted information, a summary describing the methods used by the EUnetHTA countries was written for each methodological item. General recommendations were formulated for methodological issues where the guidelines of the EUnetHTA partners were in agreement or where the usefulness of economic evaluations may be increased by presenting the results in a specific way. At least one contact person from all 33 EUnetHTA countries (100 %) responded to the survey. In total, the review included 51 guidelines, representing 25 countries (eight countries had no methodological guideline for health economic evaluations). On the basis of the results of the extracted information from all 51 guidelines, EUnetHTA issued ten main recommendations for health economic evaluations. The presented review of methodological guidelines for health economic evaluations and the consequent recommendations will hopefully improve the comparability, transferability and overall usefulness of economic evaluations performed within EUnetHTA. Nevertheless, there are still methodological issues that need to be investigated further.

Evaluation research on jiangsu green economy development capability: a case study of Xuzhou

NASA Astrophysics Data System (ADS)

Sun, Fuhua; Liu, Haiyu; Wang, Zhaoxia

2018-02-01

As a national leading province of economic development and demonstration area of ecological civilization construction, Jiangsu makes a scientific and rational evaluation to its green economy development capability through the construction of index system and model, which is significant for better grasping its green development condition, implementing the “green” development concept and promoting Jiangsu to be a new Jiangsu with “good economy, rich public, favourable environment and civilized society degree”. The paper constructs the evaluation system of green economic development capability based on factor analysis method, adjusts indexes at all levels through factor analysis, calculates the factor score, determines the main influencing factors, analyzes the influence factor score, and puts forward the corresponding policy according to the practical situation of Jiangsu Province.

The effectiveness of interventions to reduce the household economic burden of illness and injury: a systematic review

PubMed Central

Kimman, Merel; Svenstrup, Nina; Lindevig Kjoege, Katharina; Lea Laba, Tracey; Hackett, Maree L; Jan, Stephen

2015-01-01

Abstract Objective To determine the nature, scope and effectiveness of interventions to reduce the household economic burden of illness or injury. Methods We systematically reviewed reports published on or before 31 January 2014 that we found in the CENTRAL, CINAHL, Econlit, Embase, MEDLINE, PreMEDLINE and PsycINFO databases. We extracted data from prospective controlled trials and assessed the risk of bias. We narratively synthesized evidence. Findings Nine of the 4330 studies checked met our inclusion criteria – seven had evaluated changes to existing health-insurance programmes and two had evaluated different modes of delivering information. The only interventions found to reduce out-of-pocket expenditure significantly were those that eliminated or substantially reduced co-payments for a given patient population. However, the reductions only represented marginal changes in the total expenditures of patients. We found no studies that had been effective in addressing broader household economic impacts – such as catastrophic health expenditure – in the disease populations investigated. Conclusion In general, interventions designed to reduce the complex household economic burden of illness and injury appear to have had little impact on household economies. We only found a few relevant studies using rigorous study designs that were conducted in defined patient populations. The studies were limited in the range of interventions tested and they evaluated only a narrow range of household economic outcomes. There is a need for method development to advance the measurement of the household economic consequences of illness and injury and facilitate the development of innovative interventions to supplement the strategies based on health insurance. PMID:25883403

The development of computer networks: First results from a microeconomic model

NASA Astrophysics Data System (ADS)

Maier, Gunther; Kaufmann, Alexander

Computer networks like the Internet are gaining importance in social and economic life. The accelerating pace of the adoption of network technologies for business purposes is a rather recent phenomenon. Many applications are still in the early, sometimes even experimental, phase. Nevertheless, it seems to be certain that networks will change the socioeconomic structures we know today. This is the background for our special interest in the development of networks, in the role of spatial factors influencing the formation of networks, and consequences of networks on spatial structures, and in the role of externalities. This paper discusses a simple economic model - based on a microeconomic calculus - that incorporates the main factors that generate the growth of computer networks. The paper provides analytic results about the generation of computer networks. The paper discusses (1) under what conditions economic factors will initiate the process of network formation, (2) the relationship between individual and social evaluation, and (3) the efficiency of a network that is generated based on economic mechanisms.

The potentials and challenges of algae based biofuels: a review of the techno-economic, life cycle, and resource assessment modeling.

PubMed

Quinn, Jason C; Davis, Ryan

2015-05-01

Microalgae biofuel production has been extensively evaluated through resource, economic and life cycle assessments. Resource assessments consistently identify land as non-limiting and highlight the need to consider siting based on combined geographical constraints of land and other critical resources such as water and carbon dioxide. Economic assessments report a selling cost of fuel that ranges between $1.64 and over $30 gal(-1) consistent with large variability reported in the life cycle literature, -75 to 534 gCO2-eq MJ(-1). Large drivers behind such variability stem from differences in productivity assumptions, pathway technologies, and system boundaries. Productivity represents foundational units in these assessments with current assumed yields in various assessments varying by a factor of 60. A review of the literature in these areas highlights the need for harmonized assessments such that direct comparisons of alternative processing technologies can be made on the metrics of resource requirements, economic feasibility, and environmental impact. Copyright © 2014 Elsevier Ltd. All rights reserved.

Meeting the challenge of funding and allocating resources to mental health across Europe: developing the Mental Health Economics European Network.

PubMed

McDaid, David; Knapp, Martin; Curran, Claire

2006-01-01

There is growing demand for economic analysis to support strategic decision-making for mental health but the availability of economic evidence, in particular on system performance remains limited. The Mental Health Economics European Network (MHEEN) was set up in 2002 with the broad objective of developing a base for mental health economics information and subsequent work in 17 countries. Data on financing, expenditure and costs, provision of services, workforce, employment and capacity for economic evaluation were collected through bespoke questionnaires developed iteratively by the Network. This was augmented by a literature review and analysis of international databases. Findings on financing alone suggest that in many European countries mental health appears to be neglected while mechanisms for resource allocation are rarely linked to objective measure of population mental health needs. Numerous economic barriers and potential solutions were identified. Economic incentives may be one way of promoting change, although there is no 'one size fits all solution. There are significant benefits and synergies to be gained from the continuing development of networks such as MHEEN. In particular the analysis can be used to inform developments in Central and Eastern Europe. For instance there is much that can be learnt on both how the balance of care between institutional and non-institutional care has changed and on the role played by economic incentives in ensuring that resources were used to develop alternative community-based systems.

A Home Away from Home? Chinese Student Evaluations of an Overseas Study Experience

ERIC Educational Resources Information Center

Simpson, Ken; Tan, Weihua

2009-01-01

As the education of international students has developed into a key component of the economic mix for many Western democracies, approaches to the evaluation of success or failure have become increasingly based on the type of buyer-seller relationship that features strongly in the management and marketing literature. As a result, an activity that…

Methodological Considerations in Evaluating Long-Term Systems Change: A Case Study From Eastern Nepal

ERIC Educational Resources Information Center

Koleros, Andrew; Jupp, Dee; Kirwan, Sean; Pradhan, Meeta S.; Pradhan, Pushkar K.; Seddon, David; Tumbahangfe, Ansu

2016-01-01

This article presents discussion and recommendations on approaches to retrospectively evaluating development interventions in the long term through a systems lens. It is based on experiences from the implementation of an 18-month study to investigate the impact of development interventions on economic and social change over a 40-year period in the…

Evaluation of resources and environment carrying capacity and socio-economic pressure in typical ecological regions, China

NASA Astrophysics Data System (ADS)

Qiusen, Huang; Xinyi, Xu

2017-04-01

Since the reform and opening up, the socio-economic pressures have led to increasingly tight resource constraints and serious environmental pollution problems in China, especially for typical ecological regions. The ecological system is under a severe situation and resource and environmental issues have become the bottleneck of economic development. Taking the Chen Barag Banner which has been considered as typical ecological regions as an example, the evaluation indexes system of resources and environment carrying capacity was divided into three subsystems: natural driving force, socio-economic pressure and ecological health. On the basis of the indexes system and related data of Chen Barag Banner in 2014, the evaluation model of resources and environment carrying capacity based on spring model were proposed to analysis the state of resources and environment carrying, and an assessment of influence of socio-economic pressure on the resources and environment system has been conducted by using the discretization method of socio-economic data. The results showed that:(1) The resources and environment system of Baorixile Town, Huhenuoer Town and Bayankuren Town were overloaded among the ten towns, the values of Resources and Environment Carrying Capacity(RECC) / Resources and Environment Carrying State(RECS) were 9.86, 1.37 and 1.22, respectively;(2) The natural driving force index of Xiwuzhuer Town, Hadatu state-owned farm and Bayanhada Town were 0.40, 0.42 and 0.43, respectively, which were lower than others and indicated that the natural conditions in these areas were better than others;(3) The situation of ecological environment Ewenke Town, Hadatu state-owned farm and Tenihe state-owned farm were the best due to the result that the ecological health index of these three towns were 0.21, 0.22 and 0.26, respectively, which were lower than others;(4) The influence of socio-economic pressure on the system of resources and environment in Baorixile Town, Hadatu state-owned farm and Tenihe state-owned farm were the heaviest, the values of social and economic pressure index were 0.61, 0.32 and 0.30 respectively;(5) The discretization result of socio-economic pressure in the scale of 10km*10km space unit was helpful to understand the trend of socio-economic pressure within the township, which couldn't be learned from the result based on the scale of the township;(6) The main factors that affected the environmental carrying capacity of Chen Barag Banner were soil moisture content and per capita water resources;(7) Consumption of water resources and land resources, environmental pollution resulted from the production of agriculture and animal husbandry were the main causes of socio-economic pressures.

Two-Year Outcomes of the Enabling Mothers to Prevent Pediatric Obesity through Web-Based Education and Reciprocal Determinism (EMPOWER) Randomized Control Trial

ERIC Educational Resources Information Center

Knowlden, Adam P.; Conrad, Eric

2018-01-01

Background: Childhood overweight and obesity is a public health epidemic with far-reaching medical, economic, and quality of life consequences. Brief, web-based interventions have received increased attention for their potential to combat childhood obesity. The purpose of our study was to evaluate a web-based, maternal-facilitated childhood…

The Effects of a Counselor-Led, Faith-Based, School-Family-Community Partnership on Student Achievement in a High-Poverty Urban Elementary School

ERIC Educational Resources Information Center

Henry, Lynette M.; Bryan, Julia; Zalaquett, Carlos P.

2017-01-01

School counselors play critical roles in partnerships with faith-based organizations that provide valuable programs for students with economic challenges. This study evaluated the effects of a counselor-led, faith-based, school-family-community partnership on student reading achievement in a high-poverty elementary school. Results indicated…

The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

PubMed

van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

2010-07-06

Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes

PubMed Central

Roberts, Samantha; Barry, Eleanor; Craig, Dawn; Airoldi, Mara; Bevan, Gwyn; Greenhalgh, Trisha

2017-01-01

Objective Explore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals. Design Systematic review of economic evaluations. Data sources and eligibility criteria Database searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes. The International Society for Pharmaco-economics and Outcomes Research’s Questionnaire to Assess Relevance and Credibility of Modelling Studies for Informing Healthcare Decision Making was used to assess study quality. Results 27 studies were included; all had evaluated lifestyle interventions and 12 also evaluated metformin. Primary studies exhibited considerable heterogeneity in definitions of pre-diabetes and intensity and duration of lifestyle programmes. Lifestyle programmes and metformin appeared to be cost effective in preventing diabetes in high-risk individuals (median incremental cost-effectiveness ratios of £7490/quality-adjusted life-year (QALY) and £8428/QALY, respectively) but economic estimates varied widely between studies. Intervention-only programmes were in general more cost effective than programmes that also included a screening component. The longer the period evaluated, the more cost-effective interventions appeared. In the few studies that evaluated other economic considerations, budget impact of prevention programmes was moderate (0.13%–0.2% of total healthcare budget), financial payoffs were delayed (by 9–14 years) and impact on incident cases of diabetes was limited (0.1%–1.6% reduction). There was insufficient evidence to answer the question of (1) whether lifestyle programmes are more cost effective than metformin or (2) whether low-intensity lifestyle interventions are more cost effective than the more intensive lifestyle programmes that were tested in trials. Conclusions The economics of preventing diabetes are complex. There is some evidence that diabetes prevention programmes are cost effective, but the evidence base to date provides few clear answers regarding design of prevention programmes because of differences in denominator populations, definitions, interventions and modelling assumptions. PMID:29146638

Integrating predictive information into an agro-economic model to guide agricultural planning

NASA Astrophysics Data System (ADS)

Block, Paul; Zhang, Ying; You, Liangzhi

2017-04-01

Seasonal climate forecasts can inform long-range planning, including water resources utilization and allocation, however quantifying the value of this information on the economy is often challenging. For rain-fed farmers, skillful season-ahead predictions may lead to superior planning, as compared to business as usual strategies, resulting in additional benefits or reduced losses. In this study, regional-level probabilistic precipitation forecasts of the major rainy season in Ethiopia are fed into an agro-economic model, adapted from the International Food Policy Research Institute, to evaluate economic outcomes (GDP, poverty rates, etc.) as compared with a no-forecast approach. Based on forecasted conditions, farmers can select various actions: adjusting crop area and crop type, purchasing drought resistant seed, or applying additional fertilizer. Preliminary results favor the forecast-based approach, particularly through crop area reallocation.

Energy use in the marine transportation industry. Task III. Efficiency improvements. Draft report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1977-06-02

Research and development areas that hold promise for maritime energy conservation are identified and evaluated. The methodology used is discussed in Chapter II. The technology base of the commercial marine transportation industry relating to energy usage is made up of: main propulsion plants, propulsors, hydrodynamics, vessel operations, and fuels. Fifteen specific program areas in the first four generic technologies are identified and are evaluated. An economic and energy impact analysis and technological risk assessment was performed on the specific program areas and the results are summarized in Chapter III. The first five appendices address the generic technologies. The sixth appendixmore » contains the baseline operating and cost parameters against which the 15 program areas were evaluated, and the last appendix contains sample printouts of the MTEM model used to evaluate the energy consumption and economic impacts associated with the candidate technology areas. (MCW)« less

Incorporating Demand and Supply Constraints into Economic Evaluations in Low-Income and Middle-Income Countries.

PubMed

Vassall, Anna; Mangham-Jefferies, Lindsay; Gomez, Gabriela B; Pitt, Catherine; Foster, Nicola

2016-02-01

Global guidelines for new technologies are based on cost and efficacy data from a limited number of trial locations. Country-level decision makers need to consider whether cost-effectiveness analysis used to inform global guidelines are sufficient for their situation or whether to use models that adjust cost-effectiveness results taking into account setting-specific epidemiological and cost heterogeneity. However, demand and supply constraints will also impact cost-effectiveness by influencing the standard of care and the use and implementation of any new technology. These constraints may also vary substantially by setting. We present two case studies of economic evaluations of the introduction of new diagnostics for malaria and tuberculosis control. These case studies are used to analyse how the scope of economic evaluations of each technology expanded to account for and then address demand and supply constraints over time. We use these case studies to inform a conceptual framework that can be used to explore the characteristics of intervention complexity and the influence of demand and supply constraints. Finally, we describe a number of feasible steps that researchers who wish to apply our framework in cost-effectiveness analyses. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Economic Evaluation of Pediatric Telemedicine Consultations to Rural Emergency Departments.

PubMed

Yang, Nikki H; Dharmar, Madan; Yoo, Byung-Kwang; Leigh, J Paul; Kuppermann, Nathan; Romano, Patrick S; Nesbitt, Thomas S; Marcin, James P

2015-08-01

Comprehensive economic evaluations have not been conducted on telemedicine consultations to children in rural emergency departments (EDs). We conducted an economic evaluation to estimate the cost, effectiveness, and return on investment (ROI) of telemedicine consultations provided to health care providers of acutely ill and injured children in rural EDs compared with telephone consultations from a health care payer prospective. We built a decision model with parameters from primary programmatic data, national data, and the literature. We performed a base-case cost-effectiveness analysis (CEA), a probabilistic CEA with Monte Carlo simulation, and ROI estimation when CEA suggested cost-saving. The CEA was based on program effectiveness, derived from transfer decisions following telemedicine and telephone consultations. The average cost for a telemedicine consultation was $3641 per child/ED/year in 2013 US dollars. Telemedicine consultations resulted in 31% fewer patient transfers compared with telephone consultations and a cost reduction of $4662 per child/ED/year. Our probabilistic CEA demonstrated telemedicine consultations were less costly than telephone consultations in 57% of simulation iterations. The ROI was calculated to be 1.28 ($4662/$3641) from the base-case analysis and estimated to be 1.96 from the probabilistic analysis, suggesting a $1.96 return for each dollar invested in telemedicine. Treating 10 acutely ill and injured children at each rural ED with telemedicine resulted in an annual cost-savings of $46,620 per ED. Telephone and telemedicine consultations were not randomly assigned, potentially resulting in biased results. From a health care payer perspective, telemedicine consultations to health care providers of acutely ill and injured children presenting to rural EDs are cost-saving (base-case and more than half of Monte Carlo simulation iterations) or cost-effective compared with telephone consultations. © The Author(s) 2015.

Health-care decision-making processes in Latin America: problems and prospects for the use of economic evaluation.

PubMed

Iglesias, Cynthia P; Drummond, Michael F; Rovira, Joan

2005-01-01

The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific groups of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.

Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol.

PubMed

Murphy, Jacqueline; Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni; Leal, José

2018-03-14

Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures.We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation.Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be disseminated in a peer-reviewed academic journal and at conferences. CRD42017059473. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Methods Used in Economic Evaluations of Chronic Kidney Disease Testing — A Systematic Review

PubMed Central

Sutton, Andrew J.; Breheny, Katie; Deeks, Jon; Khunti, Kamlesh; Sharpe, Claire; Ottridge, Ryan S.; Stevens, Paul E.; Cockwell, Paul; Kalra, Philp A.; Lamb, Edmund J.

2015-01-01

Background The prevalence of chronic kidney disease (CKD) is high in general populations around the world. Targeted testing and screening for CKD are often conducted to help identify individuals that may benefit from treatment to ameliorate or prevent their disease progression. Aims This systematic review examines the methods used in economic evaluations of testing and screening in CKD, with a particular focus on whether test accuracy has been considered, and how analysis has incorporated issues that may be important to the patient, such as the impact of testing on quality of life and the costs they incur. Methods Articles that described model-based economic evaluations of patient testing interventions focused on CKD were identified through the searching of electronic databases and the hand searching of the bibliographies of the included studies. Results The initial electronic searches identified 2,671 papers of which 21 were included in the final review. Eighteen studies focused on proteinuria, three evaluated glomerular filtration rate testing and one included both tests. The full impact of inaccurate test results was frequently not considered in economic evaluations in this setting as a societal perspective was rarely adopted. The impact of false positive tests on patients in terms of the costs incurred in re-attending for repeat testing, and the anxiety associated with a positive test was almost always overlooked. In one study where the impact of a false positive test on patient quality of life was examined in sensitivity analysis, it had a significant impact on the conclusions drawn from the model. Conclusion Future economic evaluations of kidney function testing should examine testing and monitoring pathways from the perspective of patients, to ensure that issues that are important to patients, such as the possibility of inaccurate test results, are properly considered in the analysis. PMID:26465773

Economic evaluations of non-communicable disease interventions in developing countries: a critical review of the evidence base

PubMed Central

Mulligan, Jo-Ann; Walker, Damian; Fox-Rushby, Julia

2006-01-01

Background Demographic projections suggest a major increase in non-communicable disease (NCD) mortality over the next two decades in developing countries. In a climate of scarce resources, policy-makers need to know which interventions represent value for money. The prohibitive cost of performing multiple economic evaluations has generated interest in transferring the results of studies from one setting to another. This paper aims to bridge the gap in the current literature by critically evaluating the available published data on economic evaluations of NCD interventions in developing countries. Methods We identified and reviewed the methodological quality of 32 economic evaluations of NCD interventions in developing countries. Developing countries were defined according to the World Bank classification for low- and lower middle-income countries. We defined NCDs as the 12 categories listed in the 1993 World Bank report Investing in Health. English language literature was searched for the period January 1984 and January 2003 inclusive in Medline, Science Citation Index, HealthStar, NHS Economic Evaluation Database and Embase using medical subheading terms and free text searches. We then assessed the quality of studies according to a set of pre-defined technical criteria. Results We found that the quality of studies was poor and resource allocation decisions made by local and global policy-makers on the basis of this evidence could be misleading. Furthermore we have identified some clear gaps in the literature, particularly around injuries and strategies for tackling the consequences of the emerging tobacco epidemic. Conclusion In the face of poor evidence the role of so-called generalised cost-effectiveness analyses has an important role to play in aiding public health decision-making at the global level. Further research is needed to investigates the causes of variation among cost, effects and cost-effectiveness data within and between settings. Such analyses still need to take a broad view, present data in a transparent manner and take account of local constraints. PMID:16584546

Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol

PubMed Central

Pritchard, Mark G; Cheng, Lok Yin; Janarthanan, Roshni

2018-01-01

Introduction Hip and knee replacement represents a significant burden to the UK healthcare system. ‘Enhanced recovery’ pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways. Methods and analysis A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures. We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation. Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status. Ethics and dissemination This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be disseminated in a peer-reviewed academic journal and at conferences. PROSPERO registration number CRD42017059473. PMID:29540418

Economic Evaluations of Pathology Tests, 2010-2015: A Scoping Review.

PubMed

Watts, Rory D; Li, Ian W; Geelhoed, Elizabeth A; Sanfilippo, Frank M; St John, Andrew

2017-09-01

Concerns about pathology testing such as the value provided by new tests and the potential for inappropriate utilization have led to a greater need to assess costs and benefits. Economic evaluations are a formal method of analyzing costs and benefits, yet for pathology tests, questions remain about the scope and quality of the economic evidence. To describe the extent and quality of published evidence provided by economic evaluations of pathology tests from 2010 to 2015. Economic evaluations relating to pathology tests from 2010 to 2015 were reviewed. Eight databases were searched for published studies, and details recorded for the country, clinical focus, type of testing, and consideration of sensitivity, specificity, and false test results. The reporting quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist and cost-effectiveness ratios were analyzed for publication bias. We found 356 economic evaluations of pathology tests, most of which regarded developed countries. The most common economic evaluations were cost-utility analyses and the most common clinical focus was infectious diseases. More than half of the studies considered sensitivity and specificity, but few studies considered the impact of false test results. The average Consolidated Health Economic Evaluation Reporting Standards checklist score was 17 out of 24. Cost-utility ratios were commonly less than $10,000/quality-adjusted life-year or more than $200,000/quality-adjusted life-year. The number of economic evaluations of pathology tests has increased in recent years, but the rate of increase has plateaued. Furthermore, the quality of studies in the past 5 years was highly variable, and there is some question of publication bias in reporting cost-effectiveness ratios. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

48 CFR 1252.216-70 - Evaluation of offers subject to an economic price adjustment clause.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subject to an economic price adjustment clause. 1252.216-70 Section 1252.216-70 Federal Acquisition... Text of Provisions and Clauses 1252.216-70 Evaluation of offers subject to an economic price adjustment... Subject to an Economic Price Adjustment Clause (OCT 1994) Offers shall be evaluated without an amount for...

48 CFR 1252.216-70 - Evaluation of offers subject to an economic price adjustment clause.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subject to an economic price adjustment clause. 1252.216-70 Section 1252.216-70 Federal Acquisition... Text of Provisions and Clauses 1252.216-70 Evaluation of offers subject to an economic price adjustment... Subject to an Economic Price Adjustment Clause (OCT 1994) Offers shall be evaluated without an amount for...

48 CFR 1252.216-70 - Evaluation of offers subject to an economic price adjustment clause.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subject to an economic price adjustment clause. 1252.216-70 Section 1252.216-70 Federal Acquisition... Text of Provisions and Clauses 1252.216-70 Evaluation of offers subject to an economic price adjustment... Subject to an Economic Price Adjustment Clause (OCT 1994) Offers shall be evaluated without an amount for...

48 CFR 3052.216-70 - Evaluation of offers subject to an economic price adjustment clause.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subject to an economic price adjustment clause. 3052.216-70 Section 3052.216-70 Federal Acquisition... Evaluation of offers subject to an economic price adjustment clause. As prescribed in (HSAR) 48 CFR 3016.203... Economic Price Adjustment Clause (JUN 2006) Offers shall be evaluated without adding an amount for an...

48 CFR 1252.216-70 - Evaluation of offers subject to an economic price adjustment clause.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subject to an economic price adjustment clause. 1252.216-70 Section 1252.216-70 Federal Acquisition... Text of Provisions and Clauses 1252.216-70 Evaluation of offers subject to an economic price adjustment... Subject to an Economic Price Adjustment Clause (OCT 1994) Offers shall be evaluated without an amount for...

Economic evaluation of a participatory ergonomics intervention in a textile plant.

PubMed

Tompa, Emile; Dolinschi, Roman; Natale, Julianne

2013-05-01

In this study we report on the economic evaluation of a participatory ergonomics process undertaken at a clothing manufacturer in Southwestern Ontario, Canada that employs approximately 300 workers. We undertake a cost-benefit analysis from the company perspective. Intervention costs amounted to $65,787 and intervention benefits $360,614 (2011 Canadian dollars). The net present value was $294,827, suggesting that the intervention was worth undertaking based on the costs and consequences over the measurement period spanning more than four years. Based on these costs and benefits, the benefit-to-cost ratio is 5.5. Overall, the findings from this study suggest that participatory ergonomics interventions can be cost beneficial from the company perspective. Even though the changes were typically low-cost and low-tech interventions implemented by the plant mechanics and maintenance personnel, benefits were realized on both the health and financial fronts. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

AGRI Grain Power ethanol-for-fuel project feasibility-study report. Volume II. Project marketing/economic/financial/ and organization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1981-04-01

The AGRI GRAIN POWER (AGP) project, hereafter referred to as the Project, was formed to evaluate the commercial viability and assess the desireability of implementing a large grain based grass-roots anhydrous ethanol fuel project to be sited near Des Moines, Iowa. This report presents the results of a Project feasibility evaluation. The Project concept is based on involving a very strong managerial, financial and technical joint venture that is extremely expert in all facets of planning and implementing a large ethanol project; on locating the ethanol project at a highly desireable site; on utilizing a proven ethanol process; and onmore » developing a Project that is well suited to market requirements, resource availability and competitive factors. The results of marketing, economic, and financial studies are reported in this volume.« less

A Review of Economic Evaluations of Tobacco Control Programs

PubMed Central

Kahende, Jennifer W.; Loomis, Brett R.; Adhikari, Bishwa; Marshall, LaTisha

2009-01-01

Each year, an estimated 443,000 people die of smoking-related diseases in the United States. Cigarette smoking results in more than $193 billion in medical costs and productivity losses annually. In an effort to reduce this burden, many states, the federal government, and several national organizations fund tobacco control programs and policies. For this report we reviewed existing literature on economic evaluations of tobacco control interventions. We found that smoking cessation therapies, including nicotine replacement therapy (NRT) and self-help are most commonly studied. There are far fewer studies on other important interventions, such as price and tax increases, media campaigns, smoke free air laws and workplace smoking interventions, quitlines, youth access enforcement, school-based programs, and community-based programs. Although there are obvious gaps in the literature, the existing studies show in almost every case that tobacco control programs and policies are either cost-saving or highly cost-effective. PMID:19440269

A systematic review of the evidence for interventions for the prevention and control of meticillin-resistant Staphylococcus aureus (1996-2004): report to the Joint MRSA Working Party (Subgroup A).

PubMed

Loveday, H P; Pellowe, C M; Jones, S R L J; Pratt, R J

2006-05-01

A systematic review was undertaken of the evidence published between 1996 and 2004 on the effectiveness, and associated economic costs, of a range of interventions to prevent and control the transmission of meticillin-resistant Staphylococcus aureus (MRSA) in hospital settings. The review questions focused on screening, patient isolation, use of decolonization strategies, feedback of surveillance data, and environmental hygiene interventions. The reviewers assessed evidence from four recent systematic reviews, 24 non-experimental descriptive studies, five economic evaluations and one recently revised international guideline. The methodological quality of studies retrieved was such that there is currently insufficient high-quality evidence for infection prevention and control interventions in the fields identified for this review. However, evidence from clinically based, non-experimental studies does provide support for the continued use of a range and combination of interventions that contribute to the prevention and control of MRSA within acute hospitals and long-term-care settings. Well-conducted economic evaluations reporting the economic benefits arising from infection prevention and control interventions are lacking.

The GridEcon Platform: A Business Scenario Testbed for Commercial Cloud Services

NASA Astrophysics Data System (ADS)

Risch, Marcel; Altmann, Jörn; Guo, Li; Fleming, Alan; Courcoubetis, Costas

Within this paper, we present the GridEcon Platform, a testbed for designing and evaluating economics-aware services in a commercial Cloud computing setting. The Platform is based on the idea that the exact working of such services is difficult to predict in the context of a market and, therefore, an environment for evaluating its behavior in an emulated market is needed. To identify the components of the GridEcon Platform, a number of economics-aware services and their interactions have been envisioned. The two most important components of the platform are the Marketplace and the Workflow Engine. The Workflow Engine allows the simple composition of a market environment by describing the service interactions between economics-aware services. The Marketplace allows trading goods using different market mechanisms. The capabilities of these components of the GridEcon Platform in conjunction with the economics-aware services are described in this paper in detail. The validation of an implemented market mechanism and a capacity planning service using the GridEcon Platform also demonstrated the usefulness of the GridEcon Platform.

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

PubMed

Jit, Mark; Hutubessy, Raymond

2016-06-01

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

Approach to economic evaluation in primary care: review of a useful tool for primary care reform.

PubMed

McBrien, Kerry A; Manns, Braden

2013-06-01

To present an overview of the methods of economic evaluation in health care, using examples of studies applicable to primary care. The main concepts discussed in this article were derived from expert opinion and substantiated with well respected textbooks and comprehensive Canadian guidelines. Examples of cost-effectiveness estimates were taken from the published literature. We describe the basic principles of economic evaluation and provide an introduction to its interpretation, using examples of studies applicable to primary care. A basic understanding of health economics will allow primary care practitioners to begin to incorporate economic data, including that from economic evaluations when they are available, into resource planning for their practices.

International lessons in new methods for grading and integrating cost effectiveness evidence into clinical practice guidelines.

PubMed

Antioch, Kathryn M; Drummond, Michael F; Niessen, Louis W; Vondeling, Hindrik

2017-01-01

Economic evidence is influential in health technology assessment world-wide. Clinical Practice Guidelines (CPG) can enable economists to include economic information on health care provision. Application of economic evidence in CPGs, and its integration into clinical practice and national decision making is hampered by objections from professions, paucity of economic evidence or lack of policy commitment. The use of state-of-art economic methodologies will improve this. Economic evidence can be graded by 'checklists' to establish the best evidence for decision making given methodological rigor. New economic evaluation checklists, Multi-Criteria Decision Analyses (MCDA) and other decision criteria enable health economists to impact on decision making world-wide. We analyse the methodologies for integrating economic evidence into CPG agencies globally, including the Agency of Health Research and Quality (AHRQ) in the USA, National Health and Medical Research Council (NHMRC) and Australian political reforms. The Guidelines and Economists Network International (GENI) Board members from Australia, UK, Canada and Denmark presented the findings at the conference of the International Health Economists Association (IHEA) and we report conclusions and developments since. The Consolidated Guidelines for the Reporting of Economic Evaluations (CHEERS) 24 item check list can be used by AHRQ, NHMRC, other CPG and health organisations, in conjunction with the Drummond ten-point check list and a questionnaire that scores that checklist for grading studies, when assessing economic evidence. Cost-effectiveness Analysis (CEA) thresholds, opportunity cost and willingness-to-pay (WTP) are crucial issues for decision rules in CEA generally, including end-of-life therapies. Limitations of inter-rater reliability in checklists can be addressed by including more than one assessor to reach a consensus, especially when impacting on treatment decisions. We identify priority areas to generate economic evidence for CPGs by NHMRC, AHRQ, and other agencies. The evidence may cover demand for care issues such as involved time, logistics, innovation price, price sensitivity, substitutes and complements, WTP, absenteeism and presentism. Supply issues may include economies of scale, efficiency changes, and return on investment. Involved equity and efficiency measures may include cost-of-illness, disease burden, quality-of-life, budget impact, cost-effective ratios, net benefits and disparities in access and outcomes. Priority setting remains essential and trade-off decisions between policy criteria can be based on MCDA, both in evidence based clinical medicine and in health planning.

[Threshold value for reimbursement of costs of new drugs: cost-effectiveness research and modelling are essential links].

PubMed

Frederix, Geert W J; Hövels, Anke M; Severens, Johan L; Raaijmakers, Jan A M; Schellens, Jan H M

2015-01-01

There is increasing discussion in the Netherlands about the introduction of a threshold value for the costs per extra year of life when reimbursing costs of new drugs. The Medicines Committee ('Commissie Geneesmiddelen'), a division of the Netherlands National Healthcare Institute ('Zorginstituut Nederland'), advises on reimbursement of costs of new drugs. This advice is based upon the determination of therapeutic value of the drug and the results of economic evaluations. Mathematical models that predict future costs and effectiveness are often used in economic evaluations; these models can vary greatly in transparency and quality due to author assumptions. Standardisation of cost-effectiveness models is one solution to overcome the unwanted variation in quality. Discussions about the introduction of a threshold value can only be meaningful if all involved are adequately informed, and by high quality in cost-effectiveness research and, particularly, economic evaluations. Collaboration and discussion between medical specialists, patients or patient organisations, health economists and policy makers, both in development of methods and in standardisation, are essential to improve the quality of decision making.

Evaluation and selection of sustainable suppliers in supply chain using new GP-DEA model with imprecise data

NASA Astrophysics Data System (ADS)

Jafarzadeh Ghoushchi, Saeid; Dodkanloi Milan, Mehran; Jahangoshai Rezaee, Mustafa

2017-11-01

Nowadays, with respect to knowledge growth about enterprise sustainability, sustainable supplier selection is considered a vital factor in sustainable supply chain management. On the other hand, usually in real problems, the data are imprecise. One method that is helpful for the evaluation and selection of the sustainable supplier and has the ability to use a variety of data types is data envelopment analysis (DEA). In the present article, first, the supplier efficiency is measured with respect to all economic, social and environmental dimensions using DEA and applying imprecise data. Then, to have a general evaluation of the suppliers, the DEA model is developed using imprecise data based on goal programming (GP). Integrating the set of criteria changes the new model into a coherent framework for sustainable supplier selection. Moreover, employing this model in a multilateral sustainable supplier selection can be an incentive for the suppliers to move towards environmental, social and economic activities. Improving environmental, economic and social performance will mean improving the supply chain performance. Finally, the application of the proposed approach is presented with a real dataset.

Direct coal liquefaction baseline design and system analysis. Quarterly report, January--March 1991

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-04-01

The primary objective of the study is to develop a computer model for a base line direct coal liquefaction design based on two stage direct coupled catalytic reactors. This primary objective is to be accomplished by completing the following: a base line design based on previous DOE/PETC results from Wilsonville pilot plant and other engineering evaluations; a cost estimate and economic analysis; a computer model incorporating the above two steps over a wide range of capacities and selected process alternatives; a comprehensive training program for DOE/PETC Staff to understand and use the computer model; a thorough documentation of all underlyingmore » assumptions for baseline economics; and a user manual and training material which will facilitate updating of the model in the future.« less

Direct coal liquefaction baseline design and system analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-04-01

The primary objective of the study is to develop a computer model for a base line direct coal liquefaction design based on two stage direct coupled catalytic reactors. This primary objective is to be accomplished by completing the following: a base line design based on previous DOE/PETC results from Wilsonville pilot plant and other engineering evaluations; a cost estimate and economic analysis; a computer model incorporating the above two steps over a wide range of capacities and selected process alternatives; a comprehensive training program for DOE/PETC Staff to understand and use the computer model; a thorough documentation of all underlyingmore » assumptions for baseline economics; and a user manual and training material which will facilitate updating of the model in the future.« less

Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries.

PubMed

Deogaonkar, Rohan; Hutubessy, Raymond; van der Putten, Inge; Evers, Silvia; Jit, Mark

2012-10-16

Most health economic evaluations of childhood vaccination only capture the health and short-term economic benefits. Measuring broader, long-term effects of vaccination on productivity and externalities could provide a more complete picture of the value of vaccines. MEDLINE, EconLit and NHS-EED databases were searched for articles published between January 1990 and July 2011, which captured broader economic benefits of vaccines in low and middle income countries. Studies were included if they captured at least one of the following categories on broader economic impact: outcome-related productivity gains, behaviour-related productivity gains, ecological externalities, equity gains, financial sustainability gains or macroeconomic benefits. Twenty-six relevant studies were found, including observational studies, economic models and contingent valuation studies. Of the identified broader impacts, outcome-related productivity gains and ecological externalities were most commonly accounted for. No studies captured behaviour-related productivity gains or macroeconomic effects. There was some evidence to show that vaccinated children 8-14 years of age benefit from increased cognitive ability. Productivity loss due to morbidity and mortality was generally measured using the human capital approach. When included, herd immunity effects were functions of coverage rates or based on reduction in disease outcomes. External effects of vaccines were observed in terms of equitable health outcomes and contribution towards synergistic and financially sustainable healthcare programs. Despite substantial variation in the methods of measurement and outcomes used, the inclusion of broader economic impact was found to improve the attractiveness of vaccination. Further research is needed on how different tools and techniques can be used in combination to capture the broader impact of vaccination in a way that is consistent with other health economic evaluations. In addition, more country level evidence is needed from low and middle income countries to justify future investments in vaccines and immunization programs. Finally, the proposed broader economic impact framework may contribute towards better communication of the economic arguments surrounding vaccine uptake, leading to investments in immunization by stakeholders outside of the traditional health care sector such as ministries of finance and national treasuries.

Systematic review of studies evaluating the broader economic impact of vaccination in low and middle income countries

PubMed Central

2012-01-01

Background Most health economic evaluations of childhood vaccination only capture the health and short-term economic benefits. Measuring broader, long-term effects of vaccination on productivity and externalities could provide a more complete picture of the value of vaccines. Method MEDLINE, EconLit and NHS-EED databases were searched for articles published between January 1990 and July 2011, which captured broader economic benefits of vaccines in low and middle income countries. Studies were included if they captured at least one of the following categories on broader economic impact: outcome-related productivity gains, behaviour-related productivity gains, ecological externalities, equity gains, financial sustainability gains or macroeconomic benefits. Results Twenty-six relevant studies were found, including observational studies, economic models and contingent valuation studies. Of the identified broader impacts, outcome-related productivity gains and ecological externalities were most commonly accounted for. No studies captured behaviour-related productivity gains or macroeconomic effects. There was some evidence to show that vaccinated children 8–14 years of age benefit from increased cognitive ability. Productivity loss due to morbidity and mortality was generally measured using the human capital approach. When included, herd immunity effects were functions of coverage rates or based on reduction in disease outcomes. External effects of vaccines were observed in terms of equitable health outcomes and contribution towards synergistic and financially sustainable healthcare programs. Conclusion Despite substantial variation in the methods of measurement and outcomes used, the inclusion of broader economic impact was found to improve the attractiveness of vaccination. Further research is needed on how different tools and techniques can be used in combination to capture the broader impact of vaccination in a way that is consistent with other health economic evaluations. In addition, more country level evidence is needed from low and middle income countries to justify future investments in vaccines and immunization programs. Finally, the proposed broader economic impact framework may contribute towards better communication of the economic arguments surrounding vaccine uptake, leading to investments in immunization by stakeholders outside of the traditional health care sector such as ministries of finance and national treasuries. PMID:23072714

Technology and development requirements for advanced coal conversion systems

NASA Technical Reports Server (NTRS)

1981-01-01

A compendium of coal conversion process descriptions is presented. The SRS and MC data bases were utilized to provide information paticularly in the areas of existing process designs and process evaluations. Additional information requirements were established and arrangements were made to visit process developers, pilot plants, and process development units to obtain information that was not otherwise available. Plant designs, process descriptions and operating conditions, and performance characteristics were analyzed and requirements for further development identified and evaluated to determine the impact of these requirements on the process commercialization potential from the standpoint of economics and technical feasibility. A preliminary methodology was established for the comparative technical and economic assessment of advanced processes.

Assessing performance of feedlot operations using epidemiology.

PubMed

Corbin, Marilyn J; Griffin, Dee

2006-03-01

The progressive feedlot veterinarian must be well versed not only in individual production animal medicine, but also in population-based medicine. Feedlot health programs must be goal oriented, and evaluation of these goals is accomplished through diligent use of record systems and analytic evaluation of these record systems. Basic feedlot monitoring parameters include health and economic parameters in addition to the use of bench marking parameters between and among feed yards. When these parameters have significant changes, steps should be initiated to begin field investigations. Feedlot epidemiology uses several novel applications such as partial budgeting, risk assessment, and packing plant audits to provide scientifically sound and economically feasible solutions for the feeding industry.

Growth of Global Publishing Output of Health Economics in the Twenty-First Century: A Bibliographic Insight.

PubMed

Jakovljevic, Mihajlo Michael; Pejcic, Ana V

2017-01-01

Strong growth of interdisciplinary sciences might find exceptional example in academic health economics. We decided to observe the quantitative output in this science since the beginning of the twenty-first century. Electronic search of the published literature was conducted in four different databases: one medical database-MEDLINE/PubMed, two general databases-Scopus/Elsevier and Web of Science (WoS), and one specialized health economic database-NHS Economic Evaluation Database (EED). The applied combination of key words was carefully chosen to cover the most commonly used terms in titles of publications dealing with conceptual areas of health economics. All bibliographic units were taken into account. Within the time horizon from January 1, 2000 to December 31, 2016, without language or limitations on bibliographic unit types, we identified an output ranging approximately from 60,345 to 88,246 records with applied search strategy in MEDLINE/PubMed, Scopus/Elsevier, and WoS. In NHS EED, we detected 14,761 records of economic evaluations of health interventions during the period in which database was maintained and regularly updated. With slightly more than one-third of the identified records, USA clearly dominates in this field. United Kingdom takes a strong second place with about 12% of identified records. Consistently, USA and UK universities are the most frequent among the top 15 affiliations/organizations of the authors of the identified records. Authors from Harvard University contributed to the largest number of the identified records. There is a clear evidence of both the upward stream of blossoming in health economics publications and its acceleration. Based on this bibliographic data set, it is difficult to distinguish the actual impact growth of this output provided dominantly by academia with modest contribution by pharmaceutical/medicinal device industry and diverse national government-based agencies. Further insight into the citation track record of these individual publications could provide helpful upgrade and a perspective on ongoing development.

Workshop Report: concepts and methods in the economics of nutrition--gateways to better economic evaluation of nutrition interventions.

PubMed

Lenoir-Wijnkoop, I; Nuijten, M J C; Gutiérrez-Ibarluzea, I; Hutton, J; Poley, M J; Segal, L; Bresson, J L; van Ganse, E; Jones, P; Moreno, L; Salminen, S; Dubois, D

2012-11-14

Improving health through better nutrition of the population may contribute to enhanced efficiency and sustainability of healthcare systems. A recent expert meeting investigated in detail a number of methodological aspects related to the discipline of nutrition economics. The role of nutrition in health maintenance and in the prevention of non-communicable diseases is now generally recognised. However, the main scope of those seeking to contain healthcare expenditures tends to focus on the management of existing chronic diseases. Identifying additional relevant dimensions to measure and the context of use will become increasingly important in selecting and developing outcome measurements for nutrition interventions. The translation of nutrition-related research data into public health guidance raises the challenging issue of carrying out more pragmatic trials in many areas where these would generate the most useful evidence for health policy decision-making. Nutrition exemplifies all the types of interventions and policy which need evaluating across the health field. There is a need to start actively engaging key stakeholders in order to collect data and to widen health technology assessment approaches for achieving a policy shift from evidence-based medicine to evidence-based decision-making in the field of nutrition.

Burden of impaired sleep quality on work productivity in functional dyspepsia.

PubMed

Matsuzaki, Juntaro; Suzuki, Hidekazu; Togawa, Koji; Yamane, Tsuyoshi; Mori, Hideki; Komori, Takahiro; Masaoka, Tatsuhiro; Kanai, Takanori

2018-04-01

Impaired sleep quality is common, and can reduce work productivity in patients with functional dyspepsia (FD). The objective of this article is to evaluate whether there is a direct association between the presence of FD and the severity of impaired sleep quality, and to calculate the economic loss due to the decreased work productivity associated with sleep quality. In Study 1, using a web-based survey completed by workers with and without FD, we evaluated impaired sleep quality, work and daily productivity, and the severity of reflux and bowel symptoms. In Study 2, the association between the presence of FD and the severity of impaired sleep quality was validated in a hospital-based cohort. In both Study 1 and 2, although impaired sleep quality was more frequent in participants with FD than in those without FD, the independent association between the presence of FD and the severity of impaired sleep quality was not observed after adjustment for the severity of reflux and bowel symptoms. FD participants with impaired sleep quality reported additional economic loss of 53,500 Japanese yen/month. Although the association between impaired sleep quality and FD was indirect, concomitant impaired sleep quality could worsen economic loss.

Land Ecological Security Evaluation of Underground Iron Mine Based on PSR Model

NASA Astrophysics Data System (ADS)

Xiao, Xiao; Chen, Yong; Ruan, Jinghua; Hong, Qiang; Gan, Yong

2018-01-01

Iron ore mine provides an important strategic resource to the national economy while it also causes many serious ecological problems to the environment. The study summed up the characteristics of ecological environment problems of underground iron mine. Considering the mining process of underground iron mine, we analysis connections between mining production, resource, environment and economical background. The paper proposed a land ecological security evaluation system and method of underground iron mine based on Pressure-State-Response model. Our application in Chengchao iron mine proves its efficiency and promising guide on land ecological security evaluation.

Developing a dementia-specific health state classification system for a new preference-based instrument AD-5D.

PubMed

Nguyen, Kim-Huong; Mulhern, Brendan; Kularatna, Sanjeewa; Byrnes, Joshua; Moyle, Wendy; Comans, Tracy

2017-01-25

With an ageing population, the number of people with dementia is rising. The economic impact on the health care system is considerable and new treatment methods and approaches to dementia care must be cost effective. Economic evaluation requires valid patient reported outcome measures, and this study aims to develop a dementia-specific health state classification system based on the Quality of Life for Alzheimer's disease (QOL-AD) instrument (nursing home version). This classification system will subsequently be valued to generate a preference-based measure for use in the economic evaluation of interventions for people with dementia. We assessed the dimensionality of the QOL-AD to develop a new classification system. This was done using exploratory and confirmatory factor analysis and further assessment of the structure of the measure to ensure coverage of the key areas of quality of life. Secondly, we used Rasch analysis to test the psychometric performance of the items, and select item(s) to describe each dimension. This was done on 13 items of the QOL-AD (excluding two general health items) using a sample of 284 residents living in long-term care facilities in Australia who had a diagnosis of dementia. A five dimension classification system is proposed resulting from the three factor structure (defined as 'interpersonal environment', 'physical health' and 'self-functioning') derived from the factor analysis and two factors ('memory' and 'mood') from the accompanying review. For the first three dimensions, Rasch analysis selected three questions of the QOL-AD ('living situation', 'physical health', and 'do fun things') with memory and mood questions representing their own dimensions. The resulting classification system (AD-5D) includes many of the health-related quality of life dimensions considered important to people with dementia, including mood, global function and skill in daily living. The development of the AD-5D classification system is an important step in the future application of the widely used QOL-AD in economic evaluations. Future valuation studies will enable this tool to be used to calculate quality adjusted life years to evaluate treatments and interventions for people diagnosed with mild to moderate dementia.

Economic Evaluation of Complementary and Alternative Medicine in Oncology: Is There a Difference Compared to Conventional Medicine?

PubMed

Huebner, Jutta; Prott, Franz J; Muecke, Ralph; Stoll, Christoph; Buentzel, Jens; Muenstedt, Karsten; Micke, Oliver

2017-01-01

To analyze the financial burden of complementary and alternative medicine (CAM) in cancer treatment. Based on a systematic search of the literature (Medline and the Cochrane Library, combining the MeSH terms 'complementary therapies', 'neoplasms', 'costs', 'cost analysis', and 'cost-benefit analysis'), an expert panel discussed different types of analyses and their significance for CAM in oncology. Of 755 publications, 43 met our criteria. The types of economic analyses and their parameters discussed for CAM in oncology were cost, cost-benefit, cost-effectiveness, and cost-utility analyses. Only a few articles included arguments in favor of or against these different methods, and only a few arguments were specific for CAM because most CAM methods address a broad range of treatment aim parameters to assess effectiveness and are hard to define. Additionally, the choice of comparative treatments is difficult. To evaluate utility, healthy subjects may not be adequate as patients with a life-threatening disease and may be judged differently, especially with respect to a holistic treatment approach. We did not find any arguments in the literature that were directed at the economic analysis of CAM in oncology. Therefore, a comprehensive approach assessment based on criteria from evidence-based medicine evaluating direct and indirect costs is recommended. The usual approaches to conventional medicine to assess costs, benefits, and effectiveness seem adequate in the field of CAM in oncology. Additionally, a thorough deliberation on the comparator, endpoints, and instruments is mandatory for designing studies. © 2016 S. Karger AG, Basel.

An integrated modelling and multicriteria analysis approach to managing nitrate diffuse pollution: 2. A case study for a chalk catchment in England.

PubMed

Koo, B K; O'Connell, P E

2006-04-01

The site-specific land use optimisation methodology, suggested by the authors in the first part of this two-part paper, has been applied to the River Kennet catchment at Marlborough, Wiltshire, UK, for a case study. The Marlborough catchment (143 km(2)) is an agriculture-dominated rural area over a deep chalk aquifer that is vulnerable to nitrate pollution from agricultural diffuse sources. For evaluation purposes, the catchment was discretised into a network of 1 kmx1 km grid cells. For each of the arable-land grid cells, seven land use alternatives (four arable-land alternatives and three grassland alternatives) were evaluated for their environmental and economic potential. For environmental evaluation, nitrate leaching rates of land use alternatives were estimated using SHETRAN simulations and groundwater pollution potential was evaluated using the DRASTIC index. For economic evaluation, economic gross margins were estimated using a simple agronomic model based on nitrogen response functions and agricultural land classification grades. In order to see whether the site-specific optimisation is efficient at the catchment scale, land use optimisation was carried out for four optimisation schemes (i.e. using four sets of criterion weights). Consequently, four land use scenarios were generated and the site-specifically optimised land use scenario was evaluated as the best compromise solution between long term nitrate pollution and agronomy at the catchment scale.

Economic evaluation in chronic pain: a systematic review and de novo flexible economic model.

PubMed

Sullivan, W; Hirst, M; Beard, S; Gladwell, D; Fagnani, F; López Bastida, J; Phillips, C; Dunlop, W C N

2016-07-01

There is unmet need in patients suffering from chronic pain, yet innovation may be impeded by the difficulty of justifying economic value in a field beset by data limitations and methodological variability. A systematic review was conducted to identify and summarise the key areas of variability and limitations in modelling approaches in the economic evaluation of treatments for chronic pain. The results of the literature review were then used to support the development of a fully flexible open-source economic model structure, designed to test structural and data assumptions and act as a reference for future modelling practice. The key model design themes identified from the systematic review included: time horizon; titration and stabilisation; number of treatment lines; choice/ordering of treatment; and the impact of parameter uncertainty (given reliance on expert opinion). Exploratory analyses using the model to compare a hypothetical novel therapy versus morphine as first-line treatments showed cost-effectiveness results to be sensitive to structural and data assumptions. Assumptions about the treatment pathway and choice of time horizon were key model drivers. Our results suggest structural model design and data assumptions may have driven previous cost-effectiveness results and ultimately decisions based on economic value. We therefore conclude that it is vital that future economic models in chronic pain are designed to be fully transparent and hope our open-source code is useful in order to aspire to a common approach to modelling pain that includes robust sensitivity analyses to test structural and parameter uncertainty.

Economic Assessment of Waterborne Outbreak of Cryptosporidiosis

PubMed Central

Chyzheuskaya, Aksana; Cormican, Martin; Srivinas, Raghavendra; O’Donovan, Diarmuid; Prendergast, Martina; O’Donoghue, Cathal

2017-01-01

In 2007, a waterborne outbreak of Cryptosporidium hominis infection occurred in western Ireland, resulting in 242 laboratory-confirmed cases and an uncertain number of unconfirmed cases. A boil water notice was in place for 158 days that affected 120,432 persons residing in the area, businesses, visitors, and commuters. This outbreak represented the largest outbreak of cryptosporidiosis in Ireland. The purpose of this study was to evaluate the cost of this outbreak. We adopted a societal perspective in estimating costs associated with the outbreak. Economic cost estimated was based on totaling direct and indirect costs incurred by public and private agencies. The cost of the outbreak was estimated based on 2007 figures. We estimate that the cost of the outbreak was >€19 million (≈€120,000/day of the outbreak). The US dollar equivalent based on today’s exchange rates would be $22.44 million (≈$142,000/day of the outbreak). This study highlights the economic need for a safe drinking water supply. PMID:28930007

A systematic review of economic evaluations of health and health-related interventions in Bangladesh

PubMed Central

2011-01-01

Background Economic evaluation is used for effective resource allocation in health sector. Accumulated knowledge about economic evaluation of health programs in Bangladesh is not currently available. While a number of economic evaluation studies have been performed in Bangladesh, no systematic investigation of the studies has been done to our knowledge. The aim of this current study is to systematically review the published articles in peer-reviewed journals on economic evaluation of health and health-related interventions in Bangladesh. Methods Literature searches was carried out during November-December 2008 with a combination of key words, MeSH terms and other free text terms as suitable for the purpose. A comprehensive search strategy was developed to search Medline by the PubMed interface. The first specific interest was mapping the articles considering the areas of exploration by economic evaluation and the second interest was to scrutiny the methodological quality of studies. The methodological quality of economic evaluation of all articles has been scrutinized against the checklist developed by Evers Silvia and associates. Result Of 1784 potential articles 12 were accepted for inclusion. Ten studies described the competing alternatives clearly and only two articles stated the perspective of their articles clearly. All studies included direct cost, incurred by the providers. Only one study included the cost of community donated resources and volunteer costs. Two studies calculated the incremental cost effectiveness ratio (ICER). Six of the studies applied some sort of sensitivity analysis. Two of the studies discussed financial affordability of expected implementers and four studies discussed the issue of generalizability for application in different context. Conclusion Very few economic evaluation studies in Bangladesh are found in different areas of health and health-related interventions, which does not provide a strong basis of knowledge in the area. The most frequently applied economic evaluation is cost-effectiveness analysis. The majority of the studies did not follow the scientific method of economic evaluation process, which consequently resulted into lack of robustness of the analyses. Capacity building on economic evaluation of health and health-related programs should be enhanced. PMID:21771343

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

NASA Technical Reports Server (NTRS)

1982-01-01

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

Model-based transportation performance : a comparative framework and literature synthesis.

DOT National Transportation Integrated Search

2012-03-01

In an era of limited resources and a proliferation of data, there is increasing pressure to conduct careful evaluations of the economic, environmental, and equity effects of investments and policies that influence transportation and land-use systems....