Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain)

Background: Assessing of the costs of treating disease is necessary to demonstrate cost-effectiveness and to estimate the budget impact of new interventions and therapeutic innovations. However, there are few comprehensive studies on resource use and costs associated with lung cancer patients in clinical practice in Spain or internationally. The aim of this paper was to assess the hospital cost associated with lung cancer diagnosis and treatment by histology, type of cost and stage at diagnosis in the Spanish National Health Service. Methods: A retrospective, descriptive analysis on resource use and a direct medical cost analysis were performed. Resource utilisation data were collected by means of patient files from nine teaching hospitals. From a hospital budget impact perspective, the aggregate and mean costs per patient were calculated over the first three years following diagnosis or up to death. Both aggregate and mean costs per patient were analysed by histology, stage at diagnosis and cost type. Results: A total of 232 cases of lung cancer were analysed, of which 74.1% corresponded to non-small cell lung cancer (NSCLC) and 11.2% to small cell lung cancer (SCLC); 14.7% had no cytohistologic confirmation. The mean cost per patient in NSCLC ranged from 13,218 Euros in Stage III to 16,120 Euros in Stage II. The main cost components were chemotherapy (29.5%) and surgery (22.8%). Advanced disease stages were associated with a decrease in the relative weight of surgical and inpatient care costs but an increase in chemotherapy costs. In SCLC patients, the mean cost per patient was 15,418 Euros for limited disease and 12,482 Euros for extensive disease. The main cost components were chemotherapy (36.1%) and other inpatient costs (28.7%). In both groups, the Kruskall-Wallis test did not show statistically significant differences in mean cost per patient between stages. Conclusions: This study provides the costs of lung cancer treatment based on patient file reviews, with chemotherapy and surgery accounting for the major components of costs. This cost analysis is a baseline study that will provide a useful source of information for future studies on cost-effectiveness and on the budget impact of different therapeutic innovations in Spain.

Collaboration strategies and technological innovation: a contractual perspective of the relationship between firms and techonological centers

In this paper, a theoretical framework for analyzing the selection of governance structures for implementing collaboration agreements between firms and Technological Centers is presented and empirically discussed. This framework includes Transaction Costs and Property Rights’ theoretical assumptions, though complemented with several proposals coming from the Transactional Value Theory. This last theory is used for adding some dynamism in the governance structure selection. As empirical evidence of this theoretical explanation, we analyse four real experiences of collaboration between firms and one Technological Center. These experiences are aimed to represent the typology of relationships which Technological Centers usually face. Among others, a key interesting result is obtained: R&D collaboration activities do not need to always be organized through hierarchical solutions. In those cases where future expected benefits and/or reputation issues could play an important role, the traditional more static theories could not fully explain the selected governance structure for managing the R&D relationship. As a consequence, these results justify further research about the adequacy of the theoretical framework presented in this paper in other contexts, for example, R&D collaborations between firms and/or between Universities or Public Research Centers and firms.

Empiricism in ecological economics: a perspective from complex systems theory

Economies are open complex adaptive systems far from thermodynamic equilibrium, and neo-classical environmental economics seems not to be the best way to describe the behaviour of such systems. Standard econometric analysis (i.e. time series) takes a deterministic and predictive approach, which encourages the search for predictive policy to ‘correct’ environmental problems. Rather, it seems that, because of the characteristics of economic systems, an ex-post analysis is more appropriate, which describes the emergence of such systems’ properties, and which sees policy as a social steering mechanism. With this background, some of the recent empirical work published in the field of ecological economics that follows the approach defended here is presented. Finally, the conclusion is reached that a predictive use of econometrics (i.e. time series analysis) in ecological economics should be limited to cases in which uncertainty decreases, which is not the normal situation when analysing the evolution of economic systems. However, that does not mean we should not use empirical analysis. On the contrary, this is to be encouraged, but from a structural and ex-post point of view.

An input-output analysis of the "key" sectors in CO2 emissions from a production perspective: an application to the spanish economy

Here we present an approach that allows the identification of the "key" productive sectors responsible for CO2 emission. For this purpose, we develop an input–output methodology from a supply perspective. We focus on the impact of an increase in the value-added of the different productive sectors on total CO2 emissions and we identify the productive sectors responsible for the increase in CO2 emissions when there is an increase in the income of the economy. The approach shows the contribution of the various sectors to CO2 emission from a production perspective and allows us to identify the sectors that deserve more consideration for mitigation policies. This analysis is complementary to the input–output analysis from a demand perspective. The methodology is applied to the Spanish economy.

Colombian international trade from a physical perspective: towards an ecologial "Prebisch Thesis"

Prebisch's approach to economic development was based on the notion that there is an international historical division of labour. Peripheral countries are specialized in exporting primary goods while centre countries export industrial goods. The Terms of trade for peripheral countries tend to deteriorate. This approach can be extendend to ecological issues. The international Centre-Periphery division does not only involve the monetary exchange of goods and capital, but also the physical exchange in which Southern countries provide materials and energy so that Northern countries can develop their socioconomic metabolism. This metabolism process is guaranteed through cheap prices for primary goods. This paper aims to apply and extend Prebisch's thought on unequal exchange, both monetary and ecological, in relation to colombian trade in the period 1970-2002, using material flow analysis.

Between specialization and globalization. The marketing of agrarian products and its environmental impacts seen from a historical perspective: the province of Barcelona in the mid-nineteenth century

Ecological economics has five good reasons to consider that economic globalisation, spurred by commercial and financial fluxes, to be one of the main driving forces responsible for causing environmental degradation to our planet. The first, is the energy consumption and the socio-environmental impacts which long-distance haulage entails. The second, is the ever-increasing flow of goods to far-away destinations which renders their recycling practically impossible. This is particularly significant, because it prevents the metabolic lock of the nutrients present in food and other agrarian products from taking place. The third, is that the high degree of specialization attained in agriculture, forestry, cattle, mining and industry in each region, generates deleterious effects not only on the eco-landscape structure of the uses of the soil, but on the capability to provide habitat and environmental functions to maintain biodiversity as well

Sport and multiculturalism: an European perspective

Opening conference of the academic course 2005/06 of the Olympic Studies Centre (CEO-UAB), given by Dr. Ian P. Henry, director of the Institute for Sport and Leisure Policy at Loughborough University (United Kingdom). The paper is structured around addressing three themes: how concepts of multiculturalism or interculturalism, nationality and citizenship can be linked to sports policy; how we can conceptualise (and therefore evaluate) the benefits which might be claimed to accrue from sporting projects in terms of multicultural or integration policy; and finally the issue of gender, multiculturalism and sports policy.

The biophysical perspective of a middle income economy: material flows in Mexico

We analyse natural resource use dynamics in the Mexican economy during the last three decades. Despite low and uneven economic growth, the extraction and use of materials in the Mexican economy has continuously increased during the last 30 years. In this period, population growth rather than economic growth was the main driving force for biophysical growth. In addition, fundamental changes have taken place in the primary sectors, in manufacturing, and in household consumption and these are reflected in an increasing emphasis on the use of fossil fuels and construction materials. Mexico’s economy has been strongly influenced by international trade since the country commenced competing in international markets. In the 1970s, Mexico mainly exported primary resources. This pattern has changed and manufactured goods now have a much greater importance due to a boom in assembling industries. In contrast with other Latin American countries, Mexico has achieved a diversification of production, moving towards technology-intensive products and a better mix in its export portfolio. However, crude oil exports still represent the single most important export good. Mexico’s material consumption is still well below the OECD average but is growing fast and the current resource use patterns may well present serious social and environmental problems to the medium and long term sustainability of Mexico’s economy and community. Information on natural resource use and resource productivity could provide valuable guidance for economic policy planning in Mexico.

Economic effects of road accessibility in the Pyrenees: user perspective

At present, Spain faces one of the key moments in planning the future design of the infrastructure network. As a consequence of the critical role played by haulage in intra-European trade, the most important investments are those that guarantee that road haulage traffic can move freely at the borders. That is why it is necessary to make serious evaluations of the economic and social profitability of these investments. Normally the most significant social benefit of investment projects in transport infrastructure is time saving, which in turn changes traffic intensity. In this article we analyse the changes in the user excess caused by public investment in transport infrastructure planned by the Spanish government and which will be located on the border between Spain and France. In particular, we study the increase in network user surplus for HGV traffic in the Spanish and French border zones in the Pyrenees.

Ciencia, industria e ideología en la Cataluña del siglo XX: el Instituto Ravetllat-Pla en Sudamérica entre 1924 y 1936

En 1923, Ramón Plá i Armengol (1880-1958) fundó el Instituto Ravetllat-Pla para la comercialización y producción de dos productos antituberculosos (Hemo-Antitoxina y Suero Ravetllat-Pla) fundamentados en una teoría heterodoxa postulada por el veterinario Joaquim Ravetllat i Estech (1871-1923). A través del instituto creó una gran red internacional científico-comercial principalmente en Latinoamérica. Plá i Armengol fue doctor en medicina y participó activamente en la lucha antituberculosa en Cataluña sin dejar de lado su militancia socialista. A través de estos dos productos, logró crear un mercado que se sustentaba en una teoría heterodoxa que integraban sus principios e ideología.

Trends in economic research: an international perspective

Given the recent efforts in several countries to reorganize the research institutional setting to improve research productivity, our analysis addresses the following questions: To which extent has the recent awareness over international quality standards in economics around the world been reflected in research performance? How have individual countries fared? Do research quantity and quality indicators tell us the same story? We concentrate on trends taking place since the beginning of the 1990s and rely on a very comprehensive database of scientific journals, to provide a cross-country comparison of the evolution of research in economics. Our findings indicate that Europe is catching-up with the US but, in terms of influential research, the US maintains a dominant position. The main continental European countries, Germany, France, Italy and Spain, experienced some of the largest growth rates in economic scientific output. Other European countries, namely the UK, Norway, the Netherlands, Denmark, and Sweden, have shown remarkable progress in per capita output. Collaborative research seems to be a key factor explaining the relative success of some European countries, in particular when it comes to publishing in top journals, attained predominantly through international collaborations.

Simulating the Impact of Sectorial Productivity Gains on Two Regional Economies: Key Sectors from a Supply Side Perspective

In this paper we simulate and analyse the economic impact that sectorial productivity gains have on two regional Spanish economies (Catalonia and Extremadura). In particular we study the quantitative effect that each sector’s productivity gain has on household welfare (real disposable income and equivalent variation), on the consumption price indices and factor relative prices, on real production (GDP) and on the government’s net income (net taxation revenues of social transfers to households). The analytical approach consists of a computable general equilibrium model, in which we assume perfect competition and cleared markets, including factor markets. All the parameters and exogenous variables of the model are calibrated by means of two social accounting matrices, one for each region under study. The results allow us to identify those sectors with the greatest impact on consumer welfare as the key sectors in the regional economies. Keywords: Productivity gains, key sectors, computable general equilibrium