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At least 1,279 records · Page 71Linked to original sources
PubMed2005

Economic impacts of the mortality rate for suckling pigs in the United States.

OBJECTIVE: To measure economic impacts attributable to the mortality rate for suckling pigs in the United States. DESIGN: Economic analysis that incorporated data from various sources. SAMPLE POPULATION: Suckling pigs on U.S. swine farms. PROCEDURE: Economic impacts associated with the mortality rate for suckling pigs during 1995 were estimated from supply-and-demand curves for pork and from an estimate of the elasticity of production for pigs entering the grower-finisher phase of production. RESULTS: A decrease in the mortality rate for suckling pigs would have caused an increase in pork production and a decrease in price and total value of production. Assuming no suckling pigs had died during 1995, consumer surplus would have increased by (mean +/- SE) 430 +/- 160 million dollars, whereas producer surplus would have decreased by 180 +/- 140 million dollars. The total gain to the US economy would have been 250 +/- 30 million dollars. CONCLUSIONS AND CLINICAL RELEVANCE: Researchers who attempt to estimate the economic impact of mortality and morbidity rates of livestock should not ignore the influence of demand and the possibility of price adjustments. Consumers would stand to benefit from an increase in pork production associated with a reduction in the mortality rate for suckling pigs, whereas the swine industry would experience an economic loss. Individual producers need to compare the costs of measures intended to reduce the mortality rate for suckling pigs with the anticipated benefits.

Animal Husbandry↗
PubMed1995

Hospital adoption of medical technology: an empirical test of alternative models.

OBJECTIVE: This study examines hospital motivations to acquire new medical technology, an issue of considerable policy relevance: in this case, whether, when, and why hospitals acquire a new capital-intensive medical technology, magnetic resonance imaging equipment (MRI). STUDY DESIGN: We review three common explanations for medical technology adoption: profit maximization, technological preeminence, and clinical excellence, and incorporate them into a composite model, controlling for regulatory differences, market structures, and organizational characteristics. All four models are then tested using Cox regressions. DATA SOURCES: The study is based on an initial sample of 637 hospitals in the continental United States that owned or leased an MRI unit as of 31 December 1988, plus nonadopters. Due to missing data the final sample consisted of 507 hospitals. The data, drawn from two telephone surveys, are supplemented by the AHA Survey, census data, and industry and academic sources. PRINCIPAL FINDING: Statistically, the three individual models account for roughly comparable amounts of variance in past adoption behavior. On the basis of explanatory power and parsimony, however, the technology model is "best." Although the composite model is statistically better than any of the individual models, it does not add much more explanatory power adjusting for the number of variables added. CONCLUSIONS: The composite model identified the importance a hospital attached to being a technological leader, its clinical requirements, and the change in revenues it associated with the adoption of MRI as the major determinants of adoption behavior. We conclude that a hospital's adoption behavior is strongly linked to its strategic orientation.

Capital Expenditures↗
PubMed2000

A model of the health and economic impact of posttransfusion hepatitis C: application to cost-effectiveness analysis of further expansion of HCV screening protocols.

BACKGROUND: Cost-effectiveness analyses are needed to decide the value of further expansion of the screening protocols for HCV in blood donors. However, such analyses are hampered by imperfect knowledge of the health and economic repercussions of posttransfusion hepatitis C (PTHC). STUDY DESIGN AND METHODS: A Monte Carlo simulation of a Markov model representing the outcomes of patients transfused with HCV-infective blood was used to estimate the health and economic impact of PTHC and to calculate the cost-effectiveness ratio of various HCV screening methods. RESULTS: Median survival for hypothetical patients with PTHC and for controls without hepatitis was 11.25 and 11.75 years, respectively. Overall, 12.3 percent of patients receiving HCV-infective blood will develop chronic hepatitis, 9.3 percent will progress to liver failure, and 9. 25 percent will eventually die of liver disease after a median time of 20.75 years (range, 6-70). Ninety-one percent of the infected blood recipients had no reduction in life expectancy due to PTHC, and the average loss per patient was 0.754 years. The present value of the lifetime health costs incurred by patients with PTHC is $6330 per case. HCV antibody testing increases the patients' life expectancy by 20.4 hours per blood collection tested, and it results in net savings by decreasing the number of patients that will require treatment for liver disease in the future. Adding HCV NAT increases the patients' life expectancy by 0.08 hours per blood collection tested, at a cost-effectiveness ratio of $1,829,611 per QALY gained. CONCLUSION: PTHC has low health benefits because of the advanced age of many blood recipients. Testing donors for HCV antibodies results in net savings for the health care system, despite low health benefits. Adding HCV NAT would produce little additional gain at a very high cost.

Blood Transfusion↗
PubMedDate not supplied

An economic comparison of chloroquine and sulfadoxine-pyrimethamine as first-line treatment for malaria in South Africa: development of a model for estimating recurrent direct costs.

The relative cost-effectiveness of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) as first-line antimalarial therapy in southern Africa is of great interest to policymakers, clinicians and researchers in the subregion. A model was developed to access the cost-effectiveness of replacing CQ with SP as first-line treatment in Mpumalanga, South Africa, where malaria is seasonal and the population is non-immune. In-vivo drug resistance levels were used to derive a 'resistance variable' for each drug, which was used to compare the costs to the public healthcare provider associated with either therapeutic option. Costs including drugs, staff time, transport, maintenance, utilities, training and consumables were determined and subjected to Monte Carlo simulation and subsequent analysis to generate an average cost-effectiveness ratio (ACER) with confidence intervals for each drug. SP was found to be 4.8 (95% CI 3.3-6.7) times more cost-effective than CQ in Mpumalanga at 1997 resistance levels and costs, despite the far greater cost per treatment course of SP (US$ 4.02 as opposed to US$ 0.22 for CQ) in South Africa. At the price of SP in Kenya and Uganda (US$ 0.47-4.80 per treatment course), the ACER for SP does not change materially, increasing to between 5.1 and 5.6. Resistance emerged as the factor that most influenced the ACER of a specific drug. Indirect costs, compliance, changes in effectiveness and costs over time and costs of adverse events were not included in the model owing to paucity of data and logistical difficulties. Since most of these are likely to be similar in both drug models, the relative ACER is unlikely to be significantly altered by their inclusion.

Adult↗
PubMed1999

Economic impact of a drug information service.

OBJECTIVE: A cost-avoidance model was developed to determine potential cost savings or "avoidance" that results from a drug information service (DIS) responding to drug information requests. DESIGN: Patient-specific questions received by the DIS were reviewed and evaluated. A panel determined whether a drug misadventure event may have occurred if the DIS had not been consulted. Potential outcomes from drug information requests were classified using a decision-tree model. A severity rating was then attached to each applicable request to predict potential cost savings of the DIS. RESULTS: Seventy-seven of the 570 drug information responses received in the six-week study period had assessable potential cost savings to the institution. During the study interval, potential cost savings were estimated to be $195,000. Projected to one year, potential cost savings reached $1.7 million. Of the savings noted, most were attributable to prevention of increased monitoring or additional treatment. Using a sensitivity analysis, annual potential cost savings ranged from $417,792 to $2,052,740 per year. Based on the estimated annual costs related to maintaining a DIS of $145,950, the resultant range of benefit/cost ratio is 2.9:1 to 13.2:1. CONCLUSIONS: This model demonstrates that the DIS at our institution provides potential cost savings. This model may be modified to evaluate potential cost savings in other areas of pharmacy practice.

Cost Savings↗
PubMed1977

[Productive life-span of dairy cows and its economic significance. III. Economic evaluation: results obtained by model calculations (authors transl)].

A reduction of the forced replacement rate is found to be of major economic importance on the farm level. In the model, the income earned from a fifth lactation of a cow showing an average production is approximately Dfl 440 higher than the earned income per annum over the average herd life of 4.3 lactations. A farm with a herd of fifty cows showing average production and an average herd life of 5.3 years will have approximately Dfl 9600 more earned income each year than a similar farm with an average herd life of 3.3 years. The yield resulting from a longer herd life is subject to the law of diminishing returns. For the annual income from a dairy herd, a sixth lactation is of less importance than a fifth lactation, etc. The economic importance of a long herd life appears to be remarkably stable, i.e. hardly affected by: (a) The average productive capacity of the herd as regards milk and/or meat. (Note: Differences in milk-producing capacity within a herd have a marked effect on the economic value of an additional lactation by an individual cow). (b) The presence or absence of a moderate genetic improvement (1 per cent per annum) in milk-yield.

Animals↗
PubMed1998

Economic evaluation of neonatal health protection programs for cattle.

OBJECTIVE: To develop an economic tool that can be used to help cattle producers evaluate benefits of neonatal health programs. DESIGN: Computer simulation of a multiple-year spreadsheet model, using economic and production variables. SAMPLE POPULATION: Records for a university research farm beef herd. PROCEDURE: Data from the university research farm beef herd for each year from 1990 to 1995 were evaluated to determine economic benefits for the cow-calf enterprise that would result from a decrease in morbidity and mortality. A baseline economic evaluation of returns to variable costs was performed, using actual production and marketing information. Actual economic performance was contrasted with a projected simulation in which morbidity and mortality were decreased. Sensitivity analysis for the simulation model assessment of a neonatal health program was also performed. RESULTS: Mean-per-cow increase in net income for the herd during the 6-year period for morbidity and mortality reductions of 20, 40, and 60% was $7.44, $14.93, and $22.42, respectively. Sensitivity analysis revealed that net income per cow was not sensitive to errors in projections of morbidity and mortality. CLINICAL IMPLICATIONS: Identifying potential economic benefits for implementing a neonatal health plan and quantifying the costs to implement each component of the plan can be used by veterinarians and their clients when formulating a proactive strategy to provide the greatest potential for economic reward.

Animals↗
PubMedDate not supplied

Isolated rat kidney perfused with dextran and bovine serum albumin: a stable model for investigating renal drug handling.

INTRODUCTION: The rat isolated perfused kidney (IPK) preparation is a very useful model for pharmacokinetic and pharmacologic studies. Bovine serum albumin (BSA) is the oncotic agent used most commonly in IPK models, but the protein is expensive and varies significantly in quality. The present study evaluated the use of dextran to replace a large proportion of BSA as the oncotic agent, to establish a more reliable and economic IPK model for pharmacokinetic studies. METHODS: The right kidneys of male Sprague-Dawley rats were isolated and perfused in recirculating mode with Krebs-Henseleit pH 7.4 buffer containing amino acids, glucose and 65 g/l BSA (BSA group, n=11) or 6.5 g/l BSA plus 36 g/l dextran (dextran/BSA group, n=6). (14)C-Inulin was added to the perfusate to permit estimation of glomerular filtration rate (GFR). An antiviral guanosine analogue, AM188, was administered to the IPK perfusate to investigate its renal disposition. During the 130-min experimental period, urine was collected in 10-min intervals and perfusate was collected at the midpoint of these intervals. RESULTS: The kidney functional parameters were generally better and more stable in the dextran/BSA IPKs when compared to the BSA group. At a similar perfusate flow rate, the IPKs in the dextran/BSA group exhibited lower renal artery perfusion pressure, a higher GFR, and more extensive tubular reabsorption of water, glucose, and sodium. These functional parameters were acceptable and stable throughout the whole experimental period in the dextran/BSA group. The renal clearance of AM188 was higher in the dextran/BSA group compared with that in the BSA group. DISCUSSION: Using a large proportion of dextran and a small proportion of BSA as oncotic agent in perfusate provides an improved IPK preparation. This offers a reliable and economic rat IPK model for pharmacokinetic studies.

Animals↗
PubMed2003

Modeling the costs of hospital-acquired infections in New Zealand.

OBJECTIVE: To model the economic costs of hospital-acquired infections (HAIs) in New Zealand, by type of HAI. DESIGN: Monte Carlo simulation model. SETTING: Auckland District Health Board Hospitals (DHBH), the largest publicly funded hospital group in New Zealand supplying secondary and tertiary services. Costs are also estimated for predicted HAIs in admissions to all hospitals in New Zealand. PATIENTS: All adults admitted to general medical and general surgical services. METHOD: Data on the number of cases of HAI were combined with data on the estimated prolongation of hospital stay due to HAI to produce an estimate of the number of bed days attributable to HAI. A cost per bed day value was applied to provide an estimate of the economic cost. Costs were estimated for predicted infections of the urinary tract, surgical wounds, the lower and upper respiratory tracts, the bloodstream, and other sites, and for cases of multiple sites of infection. Sensitivity analyses were undertaken for input variables. RESULTS: The estimated costs of predicted HAIs in medical and surgical admissions to Auckland DHBH were dollar 10.12 (US dollar 4.56) million and dollar 8.64 (US dollar 3.90) million, respectively. They were dollar 51.35 (US dollar 23.16) million and dollar 85.26 (US dollar 38.47) million, respectively, for medical and surgical admissions to all hospitals in New Zealand. CONCLUSIONS: The method used produces results that are less precise than those of a specifically designed study using primary data collection, but has been applied at a lower cost The estimated cost of HAIs is substantial but only a proportion of infections can be avoided. Further work is required to identify the most cost-effective strategies for the prevention of HAI.

Costs and Cost Analysis↗
PubMed2002

Local and interregional economic analysis of large US Department of Energy waste management projects.

An economic simulation model was used to understand the local and interregional economic impacts of four alternative waste management technologies proposed for the US Department of Energy's Savannah River nuclear weapons site. The simulations of the four technologies, each of which will cost at least a billion dollars, were done for the period 2000-2015. The analyses show that differences in project costs are not directly reflected in local economic impacts because of differences among the technologies during the design, testing and construction phases; differences in locations where the design and pilot-testing would occur; and choices about how any of the technologies would be funded.

Costs and Cost Analysis↗
PubMed2005

Economic evaluation for conservation of farm animal genetic resources.

The decline in biodiversity of farm animal genetic resources (AnGR) has come to the forefront of concern in the discussion of animal conservation and breeding programmes. To improve decision-making regarding conservation and breeding programmes, a number of evaluation techniques of farm AnGR are available. This paper presents an overview of the different values associated to AnGR and of the techniques for their measurement being employed in the economic literature. Those include linear programming and farm simulation models, dynamic models estimating the value of research and development and econometric models estimating the demand for breed characteristics. While farm programming and simulation models are fairly well developed, they do have large data requirements. Alternatively, contingent valuation methods are available, in particular when the goal is to capture non-market values embedded in breeds.

Animal Husbandry↗
PubMed2003

Pharmacoeconomics of cholinesterase inhibitors in the treatment of Alzheimer's disease.

Cholinesterase inhibitors constitute one of few treatment options available for Alzheimer's disease, the most common cause of dementia. The modest effects and relatively high acquisition costs of these drugs make the health economics of dementia an important subject of study. Simulation models can be used to bring together existing data and make predictions of the long-term cost effectiveness of treatment. Most models have been built around cognitive function as a key parameter based on the observed relationship between cognitive function and costs of care. Patients with more severe disease attain higher total costs of care. Also, these patients have a higher share of formal care costs than do patients with mild disease, who are usually looked after by informal caregivers. The valuation of unpaid care is controversial, and the choice of method may affect results considerably. Another important issue is the measurement of health-related QOL in patients with Alzheimer's disease. The few existing studies have used proxy respondents to elicit utility weights in different disease states; however, this methodology has not been validated. It is likely that the increased drug costs incurred by the use of cholinesterase inhibitors will be offset (at least partly) by savings in other healthcare costs. However, these results should be viewed as preliminary, since we are still awaiting data from long-term follow-up studies. Also, the value of treatment for patients and caregivers in terms of QOL improvements has yet to be established.

Alzheimer Disease↗
PubMed2006

Screening for glaucoma in Canada: a systematic review of the literature.

BACKGROUND: To provide a recommendation on screening for glaucoma in Canada based on a review of recent evidence available in the literature. METHODS: A systematic literature review was performed to identify publications from MEDLINE, EMBASE, HealthSTAR, and Cochrane databases from 1990 to 2005. Relevant articles were categorized as economic studies, epidemiologic and intervention studies, or policy papers. Web sites and publications from provincial, state, national, and international health authorities were reviewed for policy recommendations and guidelines. RESULTS: We identified 39 articles (34 epidemiology and intervention, and 5 economic studies) for the review. From the economic studies, 2 were simple cost analyses and 3 were full economic evaluations (cost-effectiveness). Gaps were observed from these economic studies, where incremental cost-effectiveness analyses of modelled screening programmes were not observed. A large number of alternatives (i.e., screening techniques) and diverse outcome measures were found in the 34 epidemiology and intervention studies. This shows that evidence on the effectiveness of glaucoma screening programmes is available to be used in future modelled analyses. Neutral recommendation made by the Canadian Task Force on Periodic Health Examination regarding glaucoma screening in Canada could be related to the lack of reliable data and models used in past cost-effectiveness analyses. INTERPRETATION: A need exists to reevaluate the cost-effectiveness of a screening programme for glaucoma in Canada with updated efficacy and cost data. Health and monetary benefits could be improved compared with current practice and decision-makers would have the best available data when reevaluating the policy on screening for glaucoma.

Canada↗
PubMed1995

[The Oficina Botanica (1788-1835): an institution dedicated to the study of American plants].

By this work we pretend to analyze the reasons for the failure of the scientific enlightened politics, utilizing as example the study, from the beginning until the final of its existence, of a scientific institution, the Botanical Office. Created in full process of decadence of the political and economical enlightened model, it was capable of carrying out a great economical and organizational effort and on the botanical expeditions to the Spanish America, but it didn't undertake, in an effective way, a following step, to show to the world the natural wealth of the American possessions.

Americas↗
PubMed1989

Subsidy policies with capital accumulation: maintaining employment levels.

The authors study a dual economy model of growth and unemployment in the presence of Harris-Todaro type labor migration. The model is a discrete time model of economic growth with a given population but endogenous migration of labor. The economy tries to reach development in the quickest possible time while not allowing unemployment to rise above a socially acceptable level. The authors also characterize situations under which maximizing the accumulation of capital in each period is optimal and study how particular taxes and subsidies affect unemployment and capital accumulation. Finally, they show that a higher initial capital stock does not necessarily mean a quicker attainment of self- sustained full employment.

Commerce↗
PubMed1995

The production model as a basis for conducting economic evaluations of regional poison control centers.

To identify the significant inputs, activities, and outputs of a regional poison control center, a production model is described and its potential application to the conduct of economic evaluations delineated. The model can help the researcher identify the significant inputs (costs) incurred through the provision of poison control center services. These inputs directly influence the activities that the poison center is capable of undertaking. Activities undertaken by a poison center are intermediate steps between the inputs and outputs, and serve to convert the various inputs into associated outputs. They form the basis for determining the outputs produced by the poison center services. The outputs derived from poison center services provide the conceptual framework for assessing the effectiveness of a poison center in an economic analysis. Also described are potential applications of the production model in conducting poison center cost-effectiveness and cost-benefit analyses.

Cost-Benefit Analysis↗