The role of economic evaluation in mental health care

Objective: A consequence of the integration of psychiatry into acute and public health medicine is that psychiatrists are being asked to evaluate their services. There is pressure on mental health-care systems because it is recognized that funds should be directed where they can provide the best health outcomes, and also because there are resource constraints which limit our capacity to meet all demands for health care. This pressure can be responded to by evaluation which demonstrates the effectiveness and efficiency of psychiatric treatment. This paper seeks to remind psychiatrists of the fundamental principles of economic evaluation in the hope that these will enable psychiatrists to understand the methods used in evaluation and to work comfortably with evaluators. Method: The paper reviews the basic principles behind economic evaluation, illustrating these with reference to case studies. It describes: (i) the cost of the burden of illness and treatment, and how these costs are measured; (ii) the measurement of treatment outcomes, both as changes in health status and as resources saved; and (iii) the various types of economic evaluation, including cost-minimization, cost-effectiveness, cost-utility and cost-benefit analysis. Results: The advice in the paper provides psychiatrists with the necessary background to work closely with evaluators. A checklist of the critical questions to be addressed is provided as a guide for those undertaking economic evaluations. Conclusions: If psychiatrists are willing to learn the basic principles of economic evaluation and to apply these, they can respond to the challenges of evaluation.

The role of R&D technology in asymmetric research joint ventures

We characterize asymmetric equilibria in two-stage process innovation games and show that they are prevalent in the different models of R&D technology considered in the literature. Indeed, cooperation in R&D may be accompanied by high concentration in the product market. We show that while such an increase may be profitable, it may be socially inefficient.

The Role of Non-Market Valuation in Forest Management and Recreation Policy

Forests, and particularly those where native and mixed species are gown, provide a variety of non-wood values, important among which are recreation and environmental services. Substantial progress has been made in recent years in estimating economic values on these services. A considerable amount of research on forest values has been carried out recently in tropical and sub-tropical eastern Australia, some of which is reported in the following papers. The need for estimates of non-wood forest benefits is apparent, and it is clear that further development of techniques and a greater understanding of the way these values can be integrated into public-sector decision making is required.

Spatial inequality in the Australian youth labour market: The role of neighbourhood composition

Australia has experienced a polarization of income and labour market outcomes over the past 20 years (GREGORY and HUNTER, 1995; HARDING, 1996). This has taken an increasingly spatial dimension (HUNTER. 1995a, 1995b), giving rise to concerns that the spatial pooling of disadvantage may hamper the labour market outcomes of youth growing up in poorer residential areas. This paper explores the role that the differential neighbourhood 'quality' of an individual's residential area at age 16 has on their labour market outcomes at age 18 and age 21. Evidence is found that youth who live in poorer quality neighbourhoods face an increased likelihood of being unemployed at both the age of 18 and 21, even after controlling for personal and family characteristics.

The role of social capital in the promotion of conservation farming: The case of 'landcare' in the southern Philippines

'Social capital' refers to the relationships of trust, communication, and cooperation that facilitate collective action in a community. It is particularly relevant to soil conservation in developing countries, which requires collective efforts to raise awareness of soil degradation, provide effective training in soil conservation practices, and implement soil conservation measures on individual farms. The Landcare Program in the Southern Philippines promotes simple conservation practices in upland environments through establishing and supporting community landcare groups and municipal landcare associations, thus augmenting the social capital of farmers in these locations. An evaluation of the Landcare Program in Barangay Ned, South Cotabato, based on a survey of 313 farm households and case studies of nine landcare groups, shows that, despite extreme isolation and difficult working conditions, farmers responded by rapidly forming landcare groups and a landcare association, and adopting contour barriers on their maize farms. They utilized the bonding social capital inhering in their local communities to build stocks of bridging social capital, linking them to information, training and resources from outside their immediate locality. A logistic regression model of the factors affecting adoption of contour barriers shows that farmers who had undergone the practical, farmer-based training provided by the Landcare Program, and who were members of a landcare group, were significantly more likely to adopt conservation measures. These results confirm the value of investing in social capital to promote soil conservation. Copyright (c) 2005 John Wiley & Sons, Ltd.