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PubMed1984

Regional economic-demographic modelling and projection: review of an international conference.

A review of the papers presented at the International Conference on Forecasting Regional Population Change and Its Economic Determinants and Consequences, held at Airlie House, Virginia, from May 26 to 29, 1982, is provided. "This review...concludes that [regional economic-demographic] modelling is at an early stage of development and currently provides only an adjunct to more conventional methods of regional forecasting. Given expected future improvements in the theory, data and techniques of economic-demographic modelling, such models could soon provide a worthwhile alternative."

Congresses as Topic↗
PubMed1988

A non-linear goal programming approach to modeling intraregional economic development.

"This paper provides a one-period normative model that may be used as a guide or benchmark by which the economic planner may develop policies and plans for regional economic development. The model can accomodate a region that could be as large as a small country or as small as a city, provided sufficient relevant data are available." The authors outline "a procedure for modeling and solving economic planning and analysis problems with 'intergoal trade-offs' while retaining the deviational variable as a measure of satisfaction....[They present] a generalized regional polynomial goal programming model with some suggested objectives and constraints [and illustrate] the approach with a hypothetical example."

Economics↗
PubMed1983

Rural and urban population changes and the stages of economic development: a unified approach.

The long-term aspects of the process of economic development and urbanization are examined. A model is presented that shows the dynamics of economic development from the earliest to the more advanced stages. "The model is able to explain not only the occurrence of a downturn in the rural population after the initial phase of population growth both in rural and urban areas, but also the delayed occurrence of such a downturn in many present-day developing countries. The author then focuses [on] the later stages of economic development and explains two alternative courses of urbanization, namely, the reversal process and the continual-growth process, as special cases of the general model; which of the courses occurs depends on the value of the elasticity of urban agglomeration-economies."

Demography↗
PubMed2001

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

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.

Antibodies, Bacterial↗
PubMedDate not supplied

Informal care and economic appraisal: a discussion of possible methodological approaches.

The role played by informal carers in the care of people with chronic disabilities is well known. Given its importance, it is essential to consider the evaluation methodology applied in economic appraisals of different care options. Few studies attempt any evaluation and those that do use varied, inconsistent and controversial methodologies. This paper aims to elicit the major issues and methodological problems related to economic appraisal of informal care. The main concern over the present methods utilized is the lack of explicit exploration of the benefits, as perceived by carers. Carers, through their decision to care it is argued, will consider both costs and benefits. Although concepts encompassed by benefits tend to be less tangible they may considerably outweigh any financial burdens. Various methods have been utilized in the past. Financial outlays are fairly straightforwardly costed, personal effort on the part of carers causes more problems. Methods applied include: the cost of substitute services; state benefits; and travel time values. The most useful is probably the latter, although it is not problem-free. Assessing benefits relating to concepts of direct and indirect utility and welfare is more complex and difficult to measure. Despite considerable literature on carers' attitudes, often these concepts are not applied (especially to residential care options) or if they are, negative aspects are emphasized (with domiciliary care). A useful application of economic appraisal would elicit optimal solutions to care dilemmas. Producing economic burden information about informal care may not be particularly constructive. Brief assessment of eight scenarios of care, considering cost differences for the public sector and the preferences of patient and carer gives insight to the problem. It emphasizes the complexity of the issue and the essential role likely to be placed on care managers in helping carers to maximize the net benefit of their efforts.

Caregivers↗
PubMed1998

Primeval health economics in Britain: a personal retrospect of the pre-HESG (Health Economists' Study Group) period.

There is a danger that the history of health economics in Britain comes to be regarded as roughly co-terminous with the history of the Health Economists' Study Group (HESG). As one of the founders of that Group, I would take some pride from that, if it were true. But it is not. Just as primitive human societies existed before recorded history, so there was primeval health economics in Britain prior to 1972. There is probably more of this primeval health economics than even I know about, but as one of the ancient relics of that period I have been offered the opportunity to reminisce about what I saw during those dark ages! When one reaches the advanced age of 70, there is no escaping the fact that your past is bound to be more extensive (and probably more enjoyable) than your future, which is why the old enjoy looking back more than they enjoy looking forward! I am no exception. Hence this essay, which may either be seen as a rather self-indulgent bout of nostalgia concerning the early days of health economics in Britain, or as an archaeological enterprise, exhibiting, for all to wonder at, the treasures to be found at carefully selected ancient (i.e., pre-HESG) sites in Britain. Either way, my purpose is to suggest that most of the fundamental issues with which health economists have grappled in the last 25 years had already been identified and addressed in a careful way during the decade preceding the formation of the HESG.

Aged↗
PubMed2003

How important are economic factors in choice of medical specialty?

An ongoing debate exists among health care researchers about the mechanism that allocates physicians across medical specialties, and appropriate policy measures to correct imbalances that may arise from time to time. Most researchers believe that choice of residency program by medical school graduates is key to understanding how physicians are distributed across specialties, but there is much disagreement about whether economic or non-economic factors are most influential in determining this choice. We undertake an empirical investigation of two potentially important economic factors: income and leisure. To do so, we specify a two way error component regression model to estimate the effects of expected earnings and available leisure time, and uncertainty of earnings and leisure, on specialty choices of medical residents. Our findings indicate that economic factors are an important influence in the specialty choice process; in particular, medical residents are attracted to specialties that offer the prospect of longer and more certain annual vacations, higher earnings, shorter residency programs, and more certain work schedules. Our results suggest that employment contracts that provide generous annual vacation time and promise regular weekly work schedules may be more effective than increased earnings in correcting the current perceived shortage of primary care physicians.

Career Choice↗
PubMed1979

Economic, life, and disorder changes: time-series analyses.

Implicit in recent social science research and political discussions is a model linking the economy to mental disorder through the intervening constructs of life change and trauma. Using time-series analysis of a 16-month survey in Kansas City, Missouri (n = 1,140), economic and noneconomic life events and the Midtown scale were predicted using a variety of economic measures for the standard metropoliton statistical area. Both life event variables and the symptom measure were related positively to unemployment, and absolute economic change measures lagged 1 and 2 months. However, the life event variables were not strongly associated with the Midtown scale. Most striking of the subgroup findings was that, on the Midtown scale, the low-income group was more responsive than the middle-income group to economic fluctuations.

Adolescent↗
PubMed1993

Socio-economic factors and mortality in Switzerland.

This review paper is concerned with the topic of mortality differences by socio-economic group in Switzerland. After a short introduction to the topic and the pitfalls associated with it, the paper reviews work done in the course of a ten year programme investigating socio-economic mortality differentials in Switzerland. This programme was carried out by a working group at the Department of Social and Preventive Medicine of the University of Berne. The paper reviews methodological difficulties and pitfalls and relates the Swiss results to findings from other countries including England and Wales and Sweden. The disadvantages of socially isolated groups such as children of single women are shown. The relatively high mortality of groups under economic pressure, such as skilled manual workers in Switzerland, is demonstrated. The Swiss situation is interesting in that skilled manual workers have a higher mortality than the unskilled and semi-skilled groups. It is concluded that this is not an artifact but may be due to the fact that only Swiss workers were investigated and that Switzerland has a large proportion of foreign workers, especially in the less skilled groups. In addition, some results of an investigation of cancer mortality by occupation are reported too. Apart from some occupation-specific findings, there are some interesting cross-references to socio-economic differential mortality.

Adolescent↗
PubMed1995

The behavioral economics of concurrent drug reinforcers: a review and reanalysis of drug self-administration research.

In economics, goods can function as substitutes, complements, or be independent of one another. These concepts refer to increases, decreases, or no change in the consumption of one item as the price of a second item increases. This review examined whether these economic terms can be used to describe relationships between concurrently available reinforcers in drug self-administration research. Sixteen drug self-administration studies that examined the effects of concurrent reinforcers were identified through a MEDLINE search. Across these studies, the following substances were employed: caffeinated coffee, cocaine, etonitazene, ethanol, heroin, food, methadone, morphine, nicotine cigarettes, pentobarbital, phencyclidine, sucrose and water. These studies were reanalyzed and the results were shown to be consistent with these economic notions. These analyses also showed that relationships among the concurrently available reinforcers were reliable within and across studies, that concurrently available reinforcers can affect each other asymmetrically, and that the relative price may determine the magnitude of effect for substitutes. These findings suggest that these economic concepts may be useful in characterizing the type and magnitude of interactions between concurrently available reinforcers and may suggest potential mechanisms that determine these relationships.

Alcohol Drinking↗
PubMed2000

Deconstructing relative reinforcing efficacy and situating the measures of pharmacological reinforcement with behavioral economics: a theoretical proposal.

BACKGROUND: Relative reinforcing efficacy has been assumed to be a homogeneous phenomenon referring to the behavior-strengthening or behavior-maintaining effects of a drug reinforcer. However, a variety of studies suggest that relative reinforcing efficacy may be heterogeneous. OBJECTIVES: The purpose of this theoretical proposal is to examine the difficulties associated with this conception of reinforcing efficacy and to explore whether relative reinforcing efficacy is a homogenous concept or whether it is composed of several functionally related heterogeneous phenomena. In examining this issue, we explore whether behavioral economic theory may address some of the challenges to the current conception of relative reinforcing efficacy and use this theory to suggest how the differing measures of reinforcing efficacy may relate to one another. RESULTS: Results indicate that peak-response rate and breakpoint are related to the economic measure of maximal output and elasticity of demand, respectively. Preference is related to and predicted by the relative location of the demand curves obtained under single schedule conditions. This behavioral economic analysis may provide a theoretical understanding of reinforcement that can reconcile results of studies that both support and fail to support the notion of reinforcing efficacy as a homogenous phenomenon. CONCLUSIONS: If this theoretical proposal is validated by additional studies, then like other natural phenomena found to be heterogeneous, the study of drug reinforcers may require the adoption of several new scientific terms, such as those used in behavioral economics, each of which has analytical precision and refers to homogeneous phenomena.

Animals↗
PubMed2005

Do open-cycle hatcheries relying on tourism conserve sea turtles? Sri Lankan developments and economic-ecological considerations.

By combining economic analysis of markets with ecological parameters, this article considers the role that tourism-based sea turtle hatcheries (of an open-cycle type) can play in conserving populations of sea turtles. Background is provided on the nature and development of such hatcheries in Sri Lanka. The modeling facilitates the assessment of the impacts of turtle hatcheries on the conservation of sea turtles and enables the economic and ecological consequences of tourism, based on such hatcheries, to be better appreciated. The results demonstrate that sea turtle hatcheries serving tourists can make a positive contribution to sea turtle conservation, but that their conservation effectiveness depends on the way they are managed. Possible negative effects are also identified. Economic market models are combined with turtle population survival relationships to predict the conservation impact of turtle hatcheries and their consequence for the total economic value obtained from sea turtle populations.

Animals↗
PubMed2005

Reimbursement and clinical guidance for pharmaceuticals in Sweden: do health-economic evaluations support decision making?

Introduction of the new Pharmaceutical Benefits Board (LFN; 1 October 2002) has markedly changed the principles of pricing and reimbursement of drugs in Sweden. The Board is required to make decisions based on information on cost-effectiveness, and pharmaceutical companies must submit economic evaluations when relevant as part of their applications for reimbursement. This study examined experience to date regarding the use of health-economic evaluations and cost-effectiveness information by the LFN. We also describe activities and the use of cost-effectiveness analysis by Swedish local formulary committees organized by the 21 county councils. It is concluded that economic evaluations have supported decision making by LFN, although cost-effectiveness seems to be of varying importance in different situations. While the use of health-economic evaluations and the outcome of decision making by LFN are similar to comparable committees in other countries, there is presently a gap in this sense between the LFN and Swedish local formulary committees. Coordinated decision making is much needed but may be difficult to implement as the perspective, expertise, and objectives of the two public authorities differ.

Cost Control↗
PubMed2006

The impact of economic globalisation on health.

The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.

Bioethical Issues↗
PubMed1981

The economic implication in pregnancy outcome.

The economic implication in pregnancy outcome is evaluated in a Spanish homogeneous population. The potential risk is assessed for: prematurity, intrauterine growth retardation, perinatal mortality and major malformation. The husband's employment appears worthless as an economic parameter. The best estimators of economic level in our population are the total income per capita and the monthly food allowance per capita. Study results clearly support the relationship between poverty and prematurity, intrauterine growth retardation and major malformation. No correlation is found between perinatal mortality and lower economic conditions, which differs from previous reports. The author suggests that perinatal problems be differentiated from each other in studies of risk factors.

Congenital Abnormalities↗
PubMed1982

Economic cycles and health. Towards a sociological understanding of the impact of the recession on health and illness.

Does the impact of large scale and long term unemployment have a negative influence on the health of a community? This paper critically examines research evidence at a macro and micro level of analysis debating the major theoretical issues, and the difficulty in establishing causality between changing mortality patterns over time and fluctuations in the business cycle. It is argued that macro analysis cannot stand on its own as an explanation but needs to be combined with an understanding of the career progression of the unemployed and the stages of psychological transition that occur to bridge the gap between macro and micro environments, and give some understanding of the changes in health status that may be observed in a population following a period of unemployment or economic uncertainty. Both quantitative and qualitative research suggest that not only is the health of those actually at risk but also their immediate family and the community at large during a recession. From this proposition two significant factors emerge in the literature which could explain the association between unemployment rates and changing patterns of mortality. Firstly stress is highlighted in most of the research reviewed, and could be the linking factor for material reasons and also those of social well being. Secondly health status, like that of unemployment is not equally shared in the United Kingdom community, but rather shouldered on a class basis, the most consistent finding being an inverse relationship between economic status and mortality placing the burden squarely on the lower social economic groups who are most vulnerable to unemployment. Taken together all the evidence suggests the inferences made from the macro statistics despite the difficulties in demonstrating causality, suggesting a strong link between mortality rates and cycles of economic activity.

Adult↗
PubMed2006

The effect of urban quality improvements on economic activity.

This paper is concerned with the link between urban quality improvements and economic activity. A key question is whether improvements in the urban environment which might be achieved, for instance, through pedestrianisation, will affect business location choices--for example, are office or retail businesses particularly keen to locate in more pleasant urban places? The paper outlines the current state of development of the literature with respect to the influence of urban quality on economic activity, and proposes a framework for forecasting economic impacts based on three communities of reference: customers, employees, and the businesses themselves. The results from original modelling of a case study area in Manchester, England are reported and suggest that the positive uplifts that may be expected from environmental improvement programmes may well be on a scale which is significant. The research is obviously important for the urban regeneration and renaissance agendas which posit attractive and well-designed environments as a way to create the right conditions for promoting economic growth.

Community-Institutional Relations↗
PubMed2006

Alternative decision analysis modeling in the economic evaluation of tumor necrosis factor inhibitors for rheumatoid arthritis.

OBJECTIVES: To provide a review of the studies that use decision models in the economic evaluation of tumor necrosis factor (TNF) inhibitors in rheumatoid arthritis (RA) and to address some important issues surrounding the choice of such modeling techniques in these economic evaluations. METHODS: A systematic literature search was conducted by 1 author from the literature published from January 1996 to March 2005 through Medline, Embase, and Cochrane library databases. RESULTS: The review yielded 29 studies that used decision models. Only 10 studies used a decision model in the economic analysis of the TNF inhibitors and were included in the final review. Decision model types included the following in the review articles: decision tree (2), Markov model (7), and discrete event simulation (1). These models vary in complexity and their choice depends on the course of disease, the impact of treatment, and the available data. CONCLUSIONS: Based on the results derived from alternative modeling techniques, it is safe to say that all methods can provide useful information with regard to economic evaluations of TNF inhibitors. Even though different modeling techniques provide an appropriate representation of available data, their results should be interpreted contingent on the input data, assumptions, sensitivity analyses, and other alternative scenario analyses. RELEVANCE: The transparency in the models will encourage end users such as policymakers and prescribers to make informed judgments regarding the appropriateness of the methods and the validity of the results.

Antirheumatic Agents↗