Добірка наукової літератури з теми "Cost-Benefit; Full-Income"

Objective: Existing evidence suggests that vocational rehabilitation services, in particular individual placement and support (IPS), are effective in assisting people with schizophrenia and related conditions gain open employment. Despite this, such services are not available to all unemployed people with schizophrenia who wish to work. Existing evidence suggests that while IPS confers no clinical advantages over routine care, it does improve the proportion of people returning to employment. The objective of the current study is to investigate the net benefit of introducing IPS services into current mental health services in Australia. Method: The net benefit of IPS is assessed from a health sector perspective using cost–benefit analysis. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis of the net benefit, defined as the benefits of IPS (comprising transfer payments averted, income tax accrued and individual income earned) minus the costs. The second stage involves application of ‘second-filter’ criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using the multivariate probabilistic sensitivity analysis. Results: The costs of IPS are $A10.3M (95% uncertainty interval $A7.4M–$A13.6M), the benefits are $A4.7M ($A3.1M–$A6.5M), resulting in a negative net benefit of $A5.6M ($A8.4M–$A3.4M). Conclusions: The current analysis suggests that IPS costs are greater than themonetary benefits. However, the evidence-base of the current analysis is weak. Structural conditions surrounding welfare payments in Australia create disincentives to full-time employment for people with disabilities.

Apricot (Prunus armeniaca L.) is one of the major horticultural produce and an important source of income as well as livelihood in Ladakh, Himachal Pradesh and North-eastern part of India. However, it is also full of nutritional and functional health benefits. Despite all the advantages associated with the fruit, shorter shelf life is major hindrance in attaining its potential economic benefit to the farmers. Apricot drying is most common in these regions t raditionally done by the farmers. Solar dryer developed by ICAR-Central Arid Zone Research Institute (CAZRI) at its regional station, Leh is helping in extending shelf life of apricot and its availability throughout the year. This study was carried out during 2017–19 aimed to estimate the techno-economic benefit on adoption of the dryer by individual farmer or processor. It is found that adopter need to make investment of `1.10 lakh in fixed capital and requires `1.22 lakh annually to process one metric tonnes of the fruit. The annual cost of production was determined as `133,000 with depreciation of `11,000 for project of 1 metric tonne fresh fruit. Estimates indicate that adopter could generate net income of `78,000 annually. Profitability analysis yielded net profit ratio, pay-back period, benefit-cost ratio and break-even point of 37%, 1.23 years, 1.52, and 123.50 kg, respectively.

e20682 Background: In Japan, reconstruction of medical service system for cancer patients is urgent necessity. On medical service system, economist Michael E. Porter and Elizabeth Olmsted Teisberg advocated that value in health care is determined in addressing the patient's particular medical condition over the full cycle of care. In our facility, we adopted their concept to our cancer care system. Methods: In our facility, the cancer care team conducted by medical oncologists provides the best value across the full span of care services. In order to manage our care delivery value chain (CDVC) for advanced cancer, we innovated 'Annshin Card' system. 'Annshin means comfort in Japan. This card functions as a key among the patients, home nursing teams and us. We analyzed 772 patients from the tumor registry of our hospital from 7/12/2010 to 12/31/2012. The following factors were evaluated: (1) the overall incidence rate of emergency visit among patients with an 'Annshin cards', (2) the length of hospitalization and the rate of mortality at our palliative care unit (PCU) as hospitalizing indicators and (3) the medical profession income and expenditure rate as an indicator of cost-benefit. Results: (1) Of 772 patients, 419 patients were adopted 'Annshin card' system. Among patients with an 'Annshin card', the overall incidence rate of an emergency visit was 2.0 visits per 100 patients per month (/100/month). (2) Of 772 patients, 411 patients have been hospitalized in PCU and 748 events of hospitalization to PCU occurred. On 748 events, the average length of hospitalization was 19.8 [ 0-263 ] days; leaving hospital mortality was 274 events (36.6%). (3) On the medical profession income and expenditure rate, before vs. after launching our system, 85.3% vs. 95.8%, respectively. Conclusions: Our CDVC for advanced cancer not only reduced the emergency visit rate, but improved the indicators of hospitalization. Furthermore this system brought cost-benefit. We suppose that the concept of care cycles is effective for cancer patient management.

Orally delivered drugs offer significant benefits in the fight against viral infections, and cost-effective production is critical to their impact on pandemic response in low- and middle-income countries. One example, molnupiravir, a COVID-19 therapy developed by Emory, Ridgeback, and Merck & Co., had potential to benefit from significant cost of goods (COGs) reductions for its active pharmaceutical ingredient (API), including starting materials. A holistic approach to identifying, developing, and evaluating optimized synthetic routes, which includes detailed COGs modeling, provides a rapid means to increase the availability, uptake and application of molnupiravir and other antivirals in global markets. Identification and development of alternate processes for the synthesis of molnupiravir has been conducted by the Medicines for All Institute at Virginia Commonwealth University (M4ALL) and the Green and Turner Labs at the University of Manchester. Both groups developed innovative processes based on synthetic route design and biocatalysis aimed at lowering costs and improving global access. The authors then performed COGs modeling to assess cost saving opportunities. This included a focus on manufacturing environments and facilities amenable to global public health and the identification of key parameters using sensitivity analyses. While all of the evaluated routes provide efficiency benefits, the best options yielded 3-6 fold API COGs reductions leading to treatment COGs as low as <$3/regimen. Additionally, key starting materials and cost drivers were quantified to evaluate the robustness of the savings. Finally, COGs models can continue to inform the focus of future development efforts on the most promising routes for additional cost savings. While the full price of a treatment course includes other factors, these alternative API synthetic approaches have significant potential to help facilitate broader access in low- and middle-income countries. As other promising therapeutics are developed, a similar process could enable rapid cost reductions while enhancing global access.

Purpose – Numerous scholars have studied the propensity and related determinants of marital infidelity across socioeconomic and demographic groups. However, the broader social and economic consequences of infidelity remain an unexplored question, particularly the macroeconomic consequences from the individual impacts on families and households. The paper aims to discuss these issues. Design/methodology/approach – Using income data from the Bureau of Labor and Statistics, the purpose of this paper is twofold: first, to analyze the relationship between the probability of infidelity and income and second, to quantify the cost of marital infidelity on individual families and taxpayers. The results confirm that infidelity makes individual households poorer, but goes further to reveal widespread negative externalities that fall to taxpayers from the consequences of family fragmentation. Findings – The results of this study indicate a review of government policy since numerous government policies contradict the incentive to stay married. Future research should consider additional estimations of the full range of costs related to infidelity and family fragmentation with particular focus on the public programs that may absorb the brunt of the negative externalities resulting from divorce. Research limitations/implications – This research confirms earlier research that infidelity has a high probability of causing divorce. Combined with this research, the analysis confirms a statistically significant negative relationship between infidelity and income and that when infidelity causes divorce, the results are substantial public economic and social costs. By definition public economic and social costs are borne by society, resulting in increased taxpayer burdens for society at large. Practical implications – Previously, the consequences of infidelity were a largely unexplored question. There had been some work on the probability of infidelity but little beyond this. Further, there had been minimal literature on the social efficiency of infidelity, especially research focussing on the external costs imposed on third parties such as children and taxpayers (Smith, 2012). This work took earlier research further by first confirming the negative impact on household income based on the probability of infidelity. Additionally, this is the only study that has examined the economic consequences of divorce due to infidelity. This research confirms that the presence of infidelity, especially when it leads to divorce, results in substantial economic and social externalities resulting from family fragmentation. Future research would benefit from a more in depth understanding of the characteristics that relate to the increased probability of infidelity, separate from and in conjunction with divorce. Furthermore, examining costs as they relate to specific programs, like Temporary Assistance for Needy Families, may clarify the impact of family fragmentation on specific programs. Additionally, the results from this study can be incorporated into larger sets of findings focussing on government policy to better understand the full range of social implications from infidelity. Social implications – Future research should consider additional estimations of the full range of costs related to infidelity and family fragmentation, with particular focus on the public programs that may absorb the brunt of the negative externalities resulting from divorce. The most pertinent policies influencing the rate of marriage and divorce in the USA are the income tax code, Social Security spousal and survivor benefits, the Earned Income Tax Credit, child support enforcement, Temporary Assistance to Needy Families, food stamps, Medical, Supplemental Security Income, and WIC (Burstein, 2007). A review of these policies and their incentive structure related to family cohesiveness should be considered as a part of larger cost/benefit analysis of these programs. Originality/value – This work took earlier research further by first confirming the negative impact on household income based on the probability of infidelity. Additionally, this is the only study that has examined the economic consequences of divorce due to infidelity. This research confirms that the presence of infidelity, especially when it leads to divorce, results in substantial economic and social externalities resulting from family fragmentation.

There is strong interest in both developing and developed countries toward expanding health insurance coverage. How should the benefits, and costs, of expanded coverage be measured? While the value of reducing the financial risks that result from insurance coverage have long been recognized, there has been less attention in how best to measure such benefits. In this paper, we first provide a framework for assessing the financial value from health insurance. We focus on three distinct potential benefits: Pooling the risk of unexpected medical expenditures between healthy and sick households, redistributing resources from high- to low-income recipients and smoothing consumption over time. We then use this theoretical framework and an illustrative example to provide practical guidelines for benefit-cost analysis in capturing the full benefits (and costs) of expanding health insurance coverage. We conclude by considering other potential financial effects of broad insurance coverage, such as the ability to consolidate purchases and thus lower input prices.

Background Human immunodeficiency virus (HIV) is the strongest known risk factor for tuberculosis (TB) through its impairment of T-cell immunity. Tuberculosis preventive treatment (TPT) is recommended for people living with HIV (PLHIV) by the World Health Organization, as it significantly reduces the risk of developing TB disease. We conducted a systematic review and meta-analysis of modeling studies to summarize projected costs, risks, benefits, and impacts of TPT use among PLHIV on TB-related outcomes. Methods and findings We searched MEDLINE, Embase, and Web of Science from inception until December 31, 2020. Two reviewers independently screened titles, abstracts, and full texts; extracted data; and assessed quality. Extracted data were summarized using descriptive analysis. We performed quantile regression and random effects meta-analysis to describe trends in cost, effectiveness, and cost-effectiveness outcomes across studies and identified key determinants of these outcomes. Our search identified 6,615 titles; 61 full texts were included in the final review. Of the 61 included studies, 31 reported both cost and effectiveness outcomes. A total of 41 were set in low- and middle-income countries (LMICs), while 12 were set in high-income countries (HICs); 2 were set in both. Most studies considered isoniazid (INH)-based regimens 6 to 2 months long (n = 45), or longer than 12 months (n = 11). Model parameters and assumptions varied widely between studies. Despite this, all studies found that providing TPT to PLHIV was predicted to be effective at averting TB disease. No TPT regimen was substantially more effective at averting TB disease than any other. The cost of providing TPT and subsequent downstream costs (e.g. post-TPT health systems costs) were estimated to be less than $1,500 (2020 USD) per person in 85% of studies that reported cost outcomes (n = 36), regardless of study setting. All cost-effectiveness analyses concluded that providing TPT to PLHIV was potentially cost-effective compared to not providing TPT. In quantitative analyses, country income classification, consideration of antiretroviral therapy (ART) use, and TPT regimen use significantly impacted cost-effectiveness. Studies evaluating TPT in HICs suggested that TPT may be more effective at preventing TB disease than studies evaluating TPT in LMICs; pooled incremental net monetary benefit, given a willingness-to-pay threshold of country-level per capita gross domestic product (GDP), was $271 in LMICs (95% confidence interval [CI] −$81 to $622, p = 0.12) and was $2,568 in HICs (−$32,115 to $37,251, p = 0.52). Similarly, TPT appeared to be more effective at averting TB disease in HICs; pooled percent reduction in active TB incidence was 20% (13% to 27%, p < 0.001) in LMICs and 37% (−34% to 100%, p = 0.13) in HICs. Key limitations of this review included the heterogeneity of input parameters and assumptions from included studies, which limited pooling of effect estimates, inconsistent reporting of model parameters, which limited sample sizes of quantitative analyses, and database bias toward English publications. Conclusions The body of literature related to modeling TPT among PLHIV is large and heterogeneous, making comparisons across studies difficult. Despite this variability, all studies in all settings concluded that providing TPT to PLHIV is potentially effective and cost-effective for preventing TB disease.

The experiment was conducted to determine the organ weight characteristics, carcass yield and cost benefits of Kano Brown goats fed cassava root sievate and cassava leaf meal (CRSCLM) based diets as supplement to (Pennisetum purpureum) using 36 Kano Brown goats of 8 to 10 months of age.Four diets T1, T2, T3,and T4, were formulated at the levels of 0%, 20%, 40% and 60% CRSCLM respectivelyin a completely randomized design. Each animal received a designated treatment diet in the morning for 97 days. Feed offered was based on 3.5% body weight per day; the animals in addition were fed a kg wilted chopped P. purpureum later in the day as basal diet to enhance rumination and fine chewing. Results on carcass indices showed significant (p<0.05) response on live weight at slaughter, empty carcass weight, warm carcass weight, dressing percentage, shoulder, leg, loin, end and shank with T4having relatively best results. The dressing percentage was numerically (49.59%) best at T4. On the offal weights, head and full guts were significantly (p<0.05) improved for T4and T1goats. The organ characteristic proved the safety of using CRSCLM through the significantly (p<0.05) lower organ weights at T4goats. Cost per kg feed, feed cost/weight gainand cost/benefit ratio were positively influenced (p<0.05) at T4with expected income of 4.79 / 1 invested. It could therefore be concluded that Kano Brown goats fed 60% CRSCLM had the best carcass and organ yields at a reduced feed cost. Keywords: Pennisetum purpureum, Kano brown goats, Cassava leaf meal, Cassava root sievate,

Abstract Objectives Improved methods for measuring and valuing the full range of benefits for multi-sector nutrition programs is needed to demonstrate their overall impact and strengthen use of economic evaluation evidence. The objective of this study was to identify and characterize the range of benefits measured in economic evaluations of nutrition programs. Methods A systematic review was conducted of peer-reviewed cost-benefit, -effectiveness, or -utility studies of nutrition programs in low- and middle-income countries from 2010 and after. The nutrition interventions searched for were selected from the Scaling Up Nutrition United Nations Network's Compendium of Actions for Nutrition and categorized into four sectors (food/agriculture, health, social protection, and water/sanitation) to identify variation across disciplines. For each study, two reviewers assessed the types of economic analysis and benefits included in the comparison of costs and outcomes. Results A total of 64 studies comparing costs and benefits were identified. These studies assessed 39 types of nutrition interventions (out of 79 considered), and most commonly were within the health sector (45%), followed by food/agriculture (27%). Eight studies (13%) assessed programs across more than one sector. 38% of the studies conducted cost-utility analyses (calculated cost per disability- or quality-adjusted life year), 58% calculated cost-effectiveness (cost per any other outcome), and 34% calculated cost-benefit analyses (converted all benefits to monetary values to compare with program costs). In terms of types of benefits measured, the majority of studies focused on nutrition disorders and associated morbidity as their main outcome, while food consumption and other nutrition-related practices were relatively rare (less than 5%). Several studies included cost savings from improved nutrition, including both direct costs (e.g., health system and out-of-pocket costs for treating nutrition disorders) and indirect costs (lost productive time due to illness). Conclusions Economic evaluations do not yet exist for a wide range of recommended nutrition actions, and future research should work to address these gaps. In doing so, special consideration should be given to incorporating benefits beyond reduction of nutrition disorders. Funding Sources Bill and Melinda Gates Foundation.

Purpose The purpose of 2017 ALEX® Benefits Communication Survey is to explore what employees think of the ways their companies talk to them about their benefits. Specifically, the survey focuses on whether employees understand the benefits communication material that is put in front of them, and it tries to provide insights on how employers can help employees improve their ability to make informed decisions about their healthcare options. Design/methodology/approach The survey was conducted online from February 24 to March 17, 2017, by Harris Poll on behalf of Jellyvision. It included 2,043 US adults (ages 18+) who were employed full-time, eligible for company-provided benefits and did not currently have health insurance through Medicare, Medicaid or the VA. Data were weighted where necessary by age, gender, race/ethnicity, region, education, income, marital status, household size and propensity to be online for aligning them with their actual proportions in the population. Results of this research were compared with Jellyvision’s April 2016 survey of 2,105 employed adults. Findings Of the employees whose companies offer health insurance benefits, approximately half (49 per cent) say making health insurance decisions is “always very stressful” for them, and 55 per cent say that they would like help from their employer when choosing a plan. One in five employees (21 per cent) say they often regret the benefit choices they make during open enrollment. Further, while 89 per cent say they generally understand their options, only 59 per cent can actually identify the different elements involved in the full cost of their health care. In terms of communication preferences, 65 per cent of employees prefer to look over benefit enrollment instructions outside of working hours. Originality/value Jellyvision commissioned this study to provide employers with valuable insights about how employees process and respond to benefit communications. The data can help employers understand the sources of enrollment-related stress and critical gaps in health insurance and benefits knowledge, which can lead to poor decision-making and regret among employees. The survey also reveals employee communication preferences, which employers can use to optimize their content, drive engagement, and empower employees to make more informed benefit enrollment decisions.

Le virus de l'immunodéficience humaine (VIH) constitue l'une des principales causes de décès dans les pays à revenu faible ou moyen. Le 8 juin 2021, les Nations unies ont adopté la Déclaration politique visant à mettre fin aux inégalités et mettre fin au sida d'ici 2030. Seulement, les besoins en matière de prévention et de traitement antirétroviral dans les pays les moins riches dépassent de loin leur capacité de payer. De plus, le sida touche principalement des groupes de population à risque comme ceux appartenant à des minorités de sexe et de genre. Cette thèse montre que les bénéfices liés à cet investissement massif de la communauté internationale pour mettre fin à l'épidémie de sida d'ici 2030 excède 6 dollar pour chaque dollar investis. Bien que cela soit un investissement attrayant, l’atteinte de l’objectif mondial est loin d’être acquis, notamment concernant les minorités sexuelles et de genres pour qui le risque d’acquérir le VIH est jusqu’à 26 fois plus élevé. Les modèles économiques utilisés ici permettent d’identifier trois facteurs principaux qui freinent l’atteinte des cibles. Premièrement le stigma et la discrimination qui sont la principale barrière à l’accès aux services HIV. Deuxièmement, une trop faible importance est accordée au rôle de la santé mentale sur la vulnérabilité à l’infection par VIH. Finalement, les inégalités qui minent les efforts de la riposte au VIH en diminuant le recours aux tests VIH. Les résultats de cette thèse encouragent les décideurs à prendre en compte l’importance des inégalités, de la santé mentale et de la marginalisation des personnes à haut risque de VIH pour mettre fin au sida
Human immunodeficiency virus (HIV) is one of the leading causes of death in low- and middle-income countries.On June 8, 2021, the United Nations adopted the Political Declaration on Ending Inequality and Ending AIDS by 2030. Nevertheless, the need for prevention and treatment in many of the most affected countries far exceed their ability to pay. In addition, AIDS mainly affects most-at-risk population groups. This thesis shows that the benefits of this massive investment by the international community to end the AIDS epidemic by 2030 exceed 6 for every 1 invested. While this is an attractive investment, achieving the global 95-95-95 HIV target is far from certain, especially for sexual and gender minorities who are up to 26 times more likely to acquire HIV.The economic models used in this research identify three main factors that impede the achievement of the targets. First, stigma and discrimination are the main barrier to accessing HIV services. Second, too little emphasis is placed on the role of mental health in vulnerability to HIV infection. Finally, it demonstrates that inequalities undermine HIV response efforts by reducing the uptake of HIV testing.The findings of this thesis encourage policy makers to consider the importance to address inequality, mental health and homophobia in order to ending AIDS

Investing in young people is crucial to achieve inclusive development and uphold human rights. Adolescence is a unique window of opportunity whereby countries can benefit from investing in their educated, healthy, and gainfully employed young people. Evidence is needed to support how interventions are selected, implemented, and scaled up in developing countries. When nested within human rights–based policy efforts, economic appraisals such as cost–benefit and cost-effectiveness analyses can support policymakers in formulating decisions on the types and extents of investments in adolescents and in sequencing interventions while moving toward the full realization of their rights. This chapter discusses key literature on cost analyses on investments in adolescents in low- and middle-income countries in six intervention areas: education, health, violence, child marriage, child labor, and multisectoral analyses. Evidence and information gaps are then suggested, and the importance of integrating cost analyses into human rights–based approaches to development is considered.