Economic Analysis and Policy moves forward

As Editor of Economic Analysis and Policy (EAP) I am delighted to announce that EAP is now published by Elsevier. EAP is the journal of the Economic Society of Australia (Queensland branch). As a result of this move, four issues of EAP will be published per year instead of the current three. This will include special issues. EAP will now receive wider coverage in the relevant abstracting and indexing services...

Promoting articulated action from diverse stakeholders in response to public policy scenarios: A case analysis of the use of ‘scenario improvisation’ method

In this paper we present a novel application of scenario methods to engage a diverse constituency of senior stakeholders, with limited time availability, in debate to inform planning and policy development. Our case study project explores post-carbon futures for the Latrobe Valley region of the Australian state of Victoria. Our approach involved initial deductive development of two ‘extreme scenarios’ by a multi-disciplinary research team, based upon an extensive research programme. Over four workshops with the stakeholder constituency, these initial scenarios were discussed, challenged, refined and expanded through an inductive process, whereby participants took ‘ownership’ of a final set of three scenarios. These were both comfortable and challenging to them. The outcomes of this process subsequently informed public policy development for the region. Whilst this process did not follow a single extant structured, multi-stage scenario approach, neither was it devoid of form. Here, we seek to theorise and codify elements of our process – which we term ‘scenario improvisation’ – such that others may adopt it.

Predication and propagation : a method for analyzing evaluative meanings in technology policy

In this article I outline and demonstrate a synthesis of the methods developed by Lemke (1998) and Martin (2000) for analyzing evaluations in English. I demonstrate the synthesis using examples from a 1.3-million-word technology policy corpus drawn from institutions at the local, state, national, and supranational levels. Lemke's (1998) critical model is organized around the broad 'evaluative dimensions' that are deployed to evaluate propositions and proposals in English. Martin's (2000) model is organized with a more overtly systemic-functional orientation around the concept of 'encoded feeling'. In applying both these models at different times, whilst recognizing their individual usefulness and complementarity, I found specific limitations that led me to work towards a synthesis of the two approaches. I also argue for the need to consider genre, media, and institutional aspects more explicitly when claiming intertextual and heteroglossic relations as the basis for inferred evaluations. A basic assertion made in this article is that the perceived Desirability of a process, person, circumstance, or thing is identical to its 'value'. But the Desirability of anything is a socially and thus historically conditioned attribution that requires significant amounts of institutional inculcation of other 'types' of value-appropriateness, importance, beauty, power, and so on. I therefore propose a method informed by critical discourse analysis (CDA) that sees evaluation as happening on at least four interdependent levels of abstraction.

Multi-outcome construction policies : comparative analysis of western australian and queensland policies

This document provides an overview of the differences and similarities in the objectives and implementation frameworks of the training and employment policies applying to public construction projects in Western Australia and Queensland. The material in the document clearly demonstrates the extent to which approaches to the pursuit of training objectives in particular have been informed by the experiences of other jurisdictions. The two State governments now have very similar approaches to the promotion of training with the WA government basing a good part of its policy approach on the “Queensland model”. As the two States share many similar economic and other characteristics, and have very similar social and economic goals, this similarity is to be expected. The capacity to benefit from the experiences of other jurisdictions is to be welcomed. The similarity in policy approach also suggests a potential for ongoing collaborations between the State governments on research aimed at further improving training and employment outcomes via public construction projects.

A framework for assessing social policy inclusion proposals

This document outlines a framework that could be used by government agencies in assessing policy interventions aimed at achieving social outcomes from government construction contracts. The framework represents a rational interpretation of the information gathered during the multi-outcomes construction policies project. The multi-outcomes project focused on the costs and benefits of using public construction contracts to promote the achievement of training and employment and public art objectives. The origin of the policy framework in a cost-benefit appraisal of current policy interventions is evidenced by its emphasis on sensitivity to policy commitment and project circumstances (especially project size and scope).The quantitative and qualitative analysis conducted in the multi-outcomes project highlighted, first, that in the absence of strong industry commitment to policy objectives, policy interventions typically result in high levels of avoidance activity, substantial administrative costs and very few benefits. Thus, for policy action on, for example, training or local employment to be successful compliance issues must be adequately addressed. Currently it appears that pre-qualification schemes (similar to the Priority Access Scheme) and schemes that rely on measuring, for example, the training investments of contractors within particular projects do not achieve high levels of compliance and involve significant administrative costs. Thus, an alternative is suggested in the policy framework developed here: a levy on each public construction project – set as a proportion of the total project costs. Although a full evaluation of this policy alternative was beyond the scope of the multi-outcomes construction policies project, it appears to offer the potential to minimize the transaction costs on contractors whilst enabling the creation of a training agency dedicated to improving the supply of skilled construction labour. A recommendation is thus made that this policy alternative be fully researched and evaluated. As noted above, the outcomes of the multi-outcomes research project also highlighted the need for sensitivity to project circumstances in the development and implementation of polices for public construction projects. Ideally a policy framework would have the flexibility to respond to circumstances where contractors share a commitment to the policy objectives and are able to identify measurable social outcomes from the particular government projects they are involved in. This would involve a project-by-project negotiation of goals and performance measures. It is likely to only be practical for large, longer term projects.

Public policy implications of construction innovation research

This report undertakes an exploratory analysis of Construction Innovation research projects in order to answer the question “What are the public policy implications of Construction Innovation research?”

Construction supply chain economic policy implementation for sectoral change : moving beyond the rhetoric

Construction sector policy makers have the opportunity to create improvements and develop economic, social and environmental sustainability through supply chain economics. The idea of the supply chain concept to improve firm behaviour and industry performance is not new. However there has been limited application and little or no measurement to monitor successful implementation. Often purchasing policies have been developed with sound strategic procurement principles but even these have had limited penetration in to the processes and practices of infrastructure agencies. The research reported in this paper documents an action research study currently being undertaken in the Australian construction sector which aims to explore supply chain economic policy implementation for sectoral change by two government agencies. The theory which informs this study is the emerging area of construction supply chain economics. There are five stages to the project including; demand analysis, chain analysis, government agency organizational audit, supplier strategy and strategic alignment. The overall objective is towards the development of a Supplier Group Strategy Map for two public sector agencies. Two construction subsectors are examined in detail; construction and demolition waste and precast concrete. Both of these subsectors are critical to the economic and environmental sustainability performance of the construction sector and the community as a whole in the particular jurisdictions. The local and state government agencies who are at the core of the case studies rely individually on the performance of these sectors. The study is set within the context of a sound state purchasing policy that has however, had limited application by the two agencies. Partial results of the study are presented and early findings indicate that the standard risk versus expenditure procurement model does not capture the complexities of project, owner and government risk considerations. A new model is proposed in this paper, which incorporates the added dimension of time. The research results have numerous stakeholders; they will hold particular value for those interested in regional construction sector economics, government agencies who develop and implement policy and who have a large construction purchasing imprint and the players involved in the two subsectors. Even though this is a study in Australia it has widespread applicability as previous research indicates that procurement reform is of international significance and policy implementation is problematic.

Measuring creative employment : implications for innovation policy

Both creative industries and innovation are slippery fish to handle conceptually, to say nothing of their relationship. This paper faces, first, the problems of definitions and data that can bedevil clear analysis of the creative industries. It then presents a method of data generation and analysis that has been developed to address these problems while providing an evidence pathway supporting the movement in policy thinking from creative output (through industry sectors) to creative input to the broader economy (through a focus on occupations/activity). Facing the test of policy relevance, this work has assisted in moving the ongoing debates about the creative industries toward innovation thinking by developing the concept of creative occupations as input value. Creative inputs as 'enablers' arguably has parallels with the way ICTs have been shown to be broad enablers of economic growth. We conclude with two short instantiations of the policy relevance of this concept: design as a creative input; and creative human capital and education.

Transaction Cost Analysis of PPP Risk Share

PPP (Public Private Partnerships) is a new operation mode of infrastructure projects, which usually undergo long periods and have various kinds of risks in technology, market, politics, policy, finance, society, natural conditions and cooperation. So the government and the private agency should establish the risk-sharing mechanism to ensure the successful implementation of the project. As an important branch of the new institutional economics, transaction cost economics and its analysis method have been proved to be beneficial to the proper allocation of risks between the two parts in PPP projects and the improvement of operation efficiency of PPP risk-sharing mechanism. This paper analyzed the transaction cost of the projects risk-sharing method and the both risk carriers. It pointed out that the risk-sharing method of PPP projects not only reflected the spirit of cooperation between public sector and private agency, but also minimized the total transaction cost of the risk sharing mechanism itself. Meanwhile, the risk takers had to strike a balance between the beforehand cost and the afterwards cost so as to control the cost of risk management. The paper finally suggested three ways which might be useful to reduce the transaction cost: to choose appropriate type of contract of PPP risk-sharing mechanism, to prevent information asymmetry and to establish mutual trust between the two participants.

In Pursuit of Excellence : A Policy Driven Systemic Initiative to Embed Gifted Education

Embedding gifted education practices requires major professional development strategies supported by transparent, credible and enforceable policy. This paper describes an analysis of a state-wide initiative involving the establishment of a series of schools tasked to develop and disseminate gifted education principles. The authors have been involved with this initiative at a number of levels over a ten-year period. Their involvement culminated in a commissioned review of the program. Extensive qualitative data were purposively collected from all stakeholders and the effectiveness of the initiative is examined from a theoretical framework of policy development and excellence. The findings summarised in this proposal, indicate the achievement of excellence at a systemic level was constrained by lack of vision, leadership and commitment to long term achievements of excellence. At a local level evidence exists that excellence can be manifested when there is synchronicity of vision, purpose, decisions, and actions.

Safeguarding Rural Australia : Introduction, Framework and Background to Secondary Data Analysis

This report provides an introduction to our analyses of secondary data with respect to violent acts and incidents relating to males living in rural settings in Australia. It clarifies important aspects of our overall approach primarily by concentrating on three elements that required early scoping and resolution. Firstly, a wide and inclusive view of violence which encompasses measures of violent acts and incidents and also data identifying risk taking behaviour and the consequences of violence is outlined and justified. Secondly, the classification used to make comparisons between the city and the bush together with associated caveats is outlined. The third element discussed is in relation to national injury data. Additional commentary resulting from exploration, examination and analyses of secondary data is published online in five subsequent reports in this series.

Contradictions : Genre, causal layered analysis and analysis of institutional change

In what follows, I put forward an argument for an analytical method for social science that operates at the level of genre. I argue that generic convergence, generic hybridity, and generic instability provide us with a powerful perspectives on changes in political, cultural, and economic relationships, most specifically at the level of institutions. Such a perspective can help us identify the transitional elements, relationships, and trajectories that define the place of our current system in history, thereby grounding our understanding of possible futures.1 In historically contextualising our present with this method, my concern is to indicate possibilities for the future. Systemic contradictions indicate possibility spaces within which systemic change must and will emerge. We live in a system currently dominated by many fully-expressed contradictions, and so in the presence of many possible futures. The contradictions of the current age are expressed most overtly in the public genres of power politics. Contemporary public policy—indeed politics in general-is an excellent focus for any investigation of possible futures, precisely because of its future-oriented function. It is overtly hortatory; it is designed ‘to get people to do things’ (Muntigl in press: 147). There is no point in trying to get people to do things in the past. Consequently, policy discourse is inherently oriented towards creating some future state of affairs (Graham in press), along with concomitant ways of being, knowing, representing, and acting (Fairclough 2000).

A review of the economic consequences of a policy of universal leucodepletion as compared to existing practices

Leucodepletion, the removal of leucocytes from blood products improves the safety of blood transfusion by reducing adverse events associated with the incidental non-therapeutic transfusion of leucocytes. Leucodepletion has been shown to have clinical benefit for immuno-suppressed patients who require transfusion. The selective leucodepletion of blood products by bed side filtration for these patients has been widely practiced. This study investigated the economic consequences in Queensland of moving from a policy of selective leucodepletion to one of universal leucodepletion, that is providing all transfused patients with blood products leucodepleted during the manufacturing process. Using an analytic decision model a cost-effectiveness analysis was conducted. An ICER of $16.3M per life year gained was derived. Sensitivity analysis found this result to be robust to uncertainty in the parameters used in the model. This result argues against moving to a policy of universal leucodepletion. However during the course of the study the policy decision for universal leucodepletion was made and implemented in Queensland in October 2008. This study has concluded that cost-effectiveness is not an influential factor in policy decisions regarding quality and safety initiatives in the Australian blood sector.

Setting hospital infection control policy : a decision-making framework incorporating health economics and healthcare epidemiology

Background: Reducing rates of healthcare acquired infection has been identified by the Australian Commission on Safety and Quality in Health Care as a national priority. One of the goals is the prevention of central venous catheter-related bloodstream infection (CR-BSI). At least 3,500 cases of CR-BSI occur annually in Australian hospitals, resulting in unnecessary deaths and costs to the healthcare system between $25.7 and $95.3 million. Two approaches to preventing these infections have been proposed: use of antimicrobial catheters (A-CVCs); or a catheter care and management ‘bundle’. Given finite healthcare budgets, decisions about the optimal infection control policy require consideration of the effectiveness and value for money of each approach. Objectives: The aim of this research is to use a rational economic framework to inform efficient infection control policy relating to the prevention of CR-BSI in the intensive care unit. It addresses three questions relating to decision-making in this area: 1. Is additional investment in activities aimed at preventing CR-BSI an efficient use of healthcare resources? 2. What is the optimal infection control strategy from amongst the two major approaches that have been proposed to prevent CR-BSI? 3. What uncertainty is there in this decision and can a research agenda to improve decision-making in this area be identified? Methods: A decision analytic model-based economic evaluation was undertaken to identify an efficient approach to preventing CR-BSI in Queensland Health intensive care units. A Markov model was developed in conjunction with a panel of clinical experts which described the epidemiology and prognosis of CR-BSI. The model was parameterised using data systematically identified from the published literature and extracted from routine databases. The quality of data used in the model and its validity to clinical experts and sensitivity to modelling assumptions was assessed. Two separate economic evaluations were conducted. The first evaluation compared all commercially available A-CVCs alongside uncoated catheters to identify which was cost-effective for routine use. The uncertainty in this decision was estimated along with the value of collecting further information to inform the decision. The second evaluation compared the use of A-CVCs to a catheter care bundle. We were unable to estimate the cost of the bundle because it is unclear what the full resource requirements are for its implementation, and what the value of these would be in an Australian context. As such we undertook a threshold analysis to identify the cost and effectiveness thresholds at which a hypothetical bundle would dominate the use of A-CVCs under various clinical scenarios. Results: In the first evaluation of A-CVCs, the findings from the baseline analysis, in which uncertainty is not considered, show that the use of any of the four A-CVCs will result in health gains accompanied by cost-savings. The MR catheters dominate the baseline analysis generating 1.64 QALYs and cost-savings of $130,289 per 1.000 catheters. With uncertainty, and based on current information, the MR catheters remain the optimal decision and return the highest average net monetary benefits ($948 per catheter) relative to all other catheter types. This conclusion was robust to all scenarios tested, however, the probability of error in this conclusion is high, 62% in the baseline scenario. Using a value of $40,000 per QALY, the expected value of perfect information associated with this decision is $7.3 million. An analysis of the expected value of perfect information for individual parameters suggests that it may be worthwhile for future research to focus on providing better estimates of the mortality attributable to CR-BSI and the effectiveness of both SPC and CH/SSD (int/ext) catheters. In the second evaluation of the catheter care bundle relative to A-CVCs, the results which do not consider uncertainty indicate that a bundle must achieve a relative risk of CR-BSI of at least 0.45 to be cost-effective relative to MR catheters. If the bundle can reduce rates of infection from 2.5% to effectively zero, it is cost-effective relative to MR catheters if national implementation costs are less than $2.6 million ($56,610 per ICU). If the bundle can achieve a relative risk of 0.34 (comparable to that reported in the literature) it is cost-effective, relative to MR catheters, if costs over an 18 month period are below $613,795 nationally ($13,343 per ICU). Once uncertainty in the decision is considered, the cost threshold for the bundle increases to $2.2 million. Therefore, if each of the 46 Level III ICUs could implement an 18 month catheter care bundle for less than $47,826 each, this approach would be cost effective relative to A-CVCs. However, the uncertainty is substantial and the probability of error in concluding that the bundle is the cost-effective approach at a cost of $2.2 million is 89%. Conclusions: This work highlights that infection control to prevent CR-BSI is an efficient use of healthcare resources in the Australian context. If there is no further investment in infection control, an opportunity cost is incurred, which is the potential for a more efficient healthcare system. Minocycline/rifampicin catheters are the optimal choice of antimicrobial catheter for routine use in Australian Level III ICUs, however, if a catheter care bundle implemented in Australia was as effective as those used in the large studies in the United States it would be preferred over the catheters if it was able to be implemented for less than $47,826 per Level III ICU. Uncertainty is very high in this decision and arises from multiple sources. There are likely greater costs to this uncertainty for A-CVCs, which may carry hidden costs, than there are for a catheter care bundle, which is more likely to provide indirect benefits to clinical practice and patient safety. Research into the mortality attributable to CR-BSI, the effectiveness of SPC and CH/SSD (int/ext) catheters and the cost and effectiveness of a catheter care bundle in Australia should be prioritised to reduce uncertainty in this decision. This thesis provides the economic evidence to inform one area of infection control, but there are many other infection control decisions for which information about the cost-effectiveness of competing interventions does not exist. This work highlights some of the challenges and benefits to generating and using economic evidence for infection control decision-making and provides support for commissioning more research into the cost-effectiveness of infection control.