A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population

Background : Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services.

Methods : Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation.

Results : Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation.

Conclusion : Cost-based weights have the potential to provide a pragmatic method of equity weight construction which is both understandable to policy makers and sensitive to the needs of target groups. It could improve the evidence base for resource allocation decisions, and be generalised to other disadvantaged groups who share similar concepts of equity. Development of this decision-making tool represents a potentially important avenue for further health economics research.

Critical analysis of action research-based inservice teacher education : four case histories

Changing the nature of institutionalised education is the central theme of the thesis. The potential for radical changes to classroom teaching and to inservice teacher education is considered through four curriculum and teaching reform projects structured by action -research. The problems explored through the thesis are at the levels of teaching, institutional and research practices. It is argued that the professional activity of teachers, administrators, consultants, teacher educators and researchers can be understood to be tightly bound and determined by rules for acceptable professional ways of acting which are often unquestioned and unexamined by educators themselves. It is further argued that institutionalised education is dominated by ways of thinking and acting that are inherently individualistic. The thesis analyses the ideological character of this 'individualistic1 structuring of educational practice, identifying belief systems that hold the lived reality of educators and students in place. The thesis endeavours to show that the bureaucratic character of institutionalised education primarily serves and maintains the interests of dominant groups. The thesis examines the possibilities for radical reform in classroom teaching, the support teachers need when embarking on curriculum and teaching change processes, and the possible outcomes of such reform. The thesis also examines the interaction between the institutional practices of schools, universities and regional offices in the Ministry of Education in Victoria, Australia on these reform processes in classrooms. Finally, the thesis examines the potential of action research as a research and educative process in the professional development of educators who are both critically aware of the ideological nature of institutionalised education and committed to collective social action. From the analyses of the four action research projects the thesis concludes that action research has the potential to transform institutionalised education when its own practice is firstly, developed as a liberating pedagogy and not as research projects structured by individualistic and paternalistic interests; secondly, is driven by a commitment to the political struggle for equity and social justice; and thirdly, is itself an expression of communitarian work. The thesis concludes that the transformative processes associated with action research under these conditions hold the promise of democratising the 'individualistic' character of institutional education.

The halloween effect and Japanese equity prices : myth or exploitable anomaly

Bouman and Jacobsen (American Economic Review 92(5), 1618–1635, 2002) examine monthly stock returns for major world stock markets and conclude that returns are significantly lower during the May–October periods versus the November–April periods in 36 of 37 markets examined. They argue that, in general, the Halloween strategy outperforms the buy and hold strategy thereby casting doubt on the validity of the efficient market paradigm. More recently, Maberly and Pierce (Econ Journal Watch 1(1), 29–46, 2004) re-examine the evidence for U.S. equity prices and conclude that Bouman and Jacobsen’s results are not robust to alternative model specifications. Extending prior research, this paper examines the robustness of the Halloween strategy to alternative model specifications for Japanese equity prices. The Halloween effect is concentrated in the period prior to the introduction of Nikkei 225 index futures in September 1986. After the internationalization of Japanese financial markets in the mid-1980s, the Halloween effect disappears.

Indigenous higher education student equity : focusing on what works

The rates of higher education access, participation and completion for Indigenous students are much lower than those for non-Indigenous students in Australia. This paper argues for a research-led focus on what works in terms of Indigenous  student equity in higher education. Undertaking independent evaluation of  existing initiatives and leveraging the experience of hundreds of successful Indigenous graduates, it may be possible to articulate some of the ways in which success has been, and can be, achieved, despite the challenges that face Indigenous students. In other words, it may be possible to articulate some aspects of what works for some Indigenous people in relation to higher education. A focus on articulating strategies that Indigenous individuals and communities might adopt in relation to higher education should be developed alongside the management of systemic problems through a range of means. The “successfocused” approach would provide one of a suite of approaches that may be helpful in addressing Indigenous student equity.

An exploratory survey of Australia's informal venture capitalists : a predicate to theory building in the context of international angel research

In Australia, as it is all over the world, finding and acquiring equity capital is one of the major problems facing entrepreneurs who are starting or growing entrepreneurial ventures. The informal venture capital market, made up of high net worth non-institutional private equity investors (or ‘business Angels’) provides risk capital directly to new and growing businesses and has been shown to be considerably more significant than institutional providers as a source of finance for entrepreneurial businesses. Building upon and comporting with Angel research undertaken overseas, this study generated and evaluated data resulting from an investigation of Australian business Angels which focused upon three primary research questions: (i) Who are Australia's Informal Venture Capitalists (Business Angels)? (ii) How do they behave? (iii) What are their investment criteria? Analysis of answers resulting from a survey of 36 carefully screened respondents produced a descriptive profile, depicted in twelve key graphs, of Australian Angels' identifying characteristics, patterns of investment behaviour and investment criteria. The study initiates Australian Angel research into the developing international continuum of formal Angel research and can serve as the generator of empirically sensible hypotheses for future research and theory development.

Is education becoming irrelevant in our research?

It is argued in this paper that in a culture of ‘performativity’ research into ‘education’ is often avoided. It is observed in many research publications that attention is given to techniques of learning, teaching, management, social equity, identity formation, leadership and delivery of the curriculum, without a justification being offered as to why such instrumental approaches should be regarded as being ‘educational’. Often research quite unproblematically adopts rational economic justifications couched in terms of ‘efficiency’ and ‘effectiveness’. Such approaches are however identified as nihilistic and not educational (Blake et al., 2000).

Is 'education' becoming irrelevant in our research?

It is argued in this paper that in a culture of ‘performativity’ research into ‘education’ is often avoided. It is observed in many research publications that attention is given to techniques of learning, teaching, management, social equity, identity formation, leadership and delivery of the curriculum, without a justification being offered as to why such instrumental approaches should be regarded as being ‘educational’. Often research quite unproblematically adopts rational-economic justifications couched in terms of ‘efficiency’ and ‘effectiveness’. Such approaches are however identified as nihilistic and not educational (Blake et al., 2000)

Child support research in Australia : a critical review

The Australian Child Support Scheme impacts on the lives of many Australian families. Yet the Australian evidence base informing child support policy development is relatively sparse and lacks coherence. In this article, we employ an equity framework to consolidate the published Australian empirical child support research in order to identify gaps in current knowledge and assess the various layers of competing interest inherent therein. While researchers have begun to examine the financial outcomes of the new Australian Child Support Scheme, work is urgently needed to understand the effects that the new scheme has on children, payees and payers, and how these effects operate. We conclude by proposing an agenda for future Australian child support research that focuses on the aims of the scheme and the four equity principles we employ, namely, horizontal, vertical, gender, and intergenerational equity.

Student equity's starring role in Australian higher education : not yet centre field

The field of Australian higher education has changed, is changing and is about to change, repositioned in relation to other ‘‘fields of power’’. It is a sector now well defined by its institutional groupings and by their relative claims to selectivity and exclusivity, with every suggestion of their differentiation growing. The potential of a ‘‘joined-up’’ tertiary education system, of vocational education and training (VET) and universities, has the potential to further rework these relations within Australian higher education, as will lifting the volume caps on university student enrolments. Moreover, Australian universities now compete within an international higher education marketplace, ranked by THES and Shanghai Jiao Tiong league tables. ‘‘Catchment areas’’ and knowledge production have become global. In sum, Australian universities (and agents within them) are positioned differently in the field. And being so variously and variably placed, institutions and agents have different stances available to them, including the positions they can take on student equity. In this paper I begin from the premise that our current stance on equity has been out-positioned, as much by a changing higher education field as by entrenched representations of social groups across regions, institutions, disciplines and degrees. In taking a new stance on equity, the paper is also concerned with the positioning in the field of a new national research centre with a focus on student equity in higher education. In particular, the paper asks what stance this new centre can take on student equity that will resonate on a national and even international scale. And, given a global field of higher education, what definitions of equity and propositions for policy and practice can it offer? What will work in the pursuit of equity?

Student equity in higher education : what to do when the queue is not long or diverse enough

In this paper I outline three broad propositions about or challenges to access and participation in Australian higher education, resulting from the Australian Government’s 20/40 targets for the sector and their attendant requirements for universities, such as the performance indicators for teaching and learning. While some of my analysis could be seen as speculative, in the sense that it represents our best guesses about the future, in aking these arguments I draw on publically available statistics on Australian schooling, vocational education and training (VET) and the higher education sector, as well as on recent research on outreach programs by universities in schools.

Rethinking higher education : implications of the Australian Government’s expansion and equity agenda

In this paper I outline three broad challenges to higher education, implied in the Australian Government’s 20/40 targets and their attendant requirements for universities. In identifying these challenges I draw on publically available statistics on Australian schooling, vocational education and training (VET) and the higher education sector, as well as on recent research on outreach programs by universities in schools.

More towards the centre : searching for field position for student equity in Australian higher education

The field of Australian higher education has changed, is changing and is about to change, as it is repositioned in relation to other ‘fields of power’. It is a sector now well defined by its institutional groupings – the Go8, the IRUs, the ATN and the rest – and by their relative claims to selectivity and exclusivity, with every suggestion of their differentiation growing. Even within these groupings there are distinctions and variations. Moreover, Australian universities now compete within an international higher education marketplace, ranked by THES and Shanghai Jiao Tiong league tables. ‘Catchment areas’ and knowledge production have become global. And the potential of a ‘joined‐up’ tertiary education system, of VET and universities, will rework relations within Australian higher education, as will lifting the volume caps on university student numbers. In sum, Australian universities (and agents within them) are positioned differently in the field, although not in the stable relations imagined by Pierre Bourdieu in the France of the 1960s. And being so variously and variably placed, institutions and agents have different stances available to them, including the positions they can take on student equity. In this paper I begin from the premise that our current shared stance on this has been out‐positioned. Nation‐bound proportional representation loses its equity meaning when the Australian elite send their children to Harvard, Yale, Oxford and Cambridge. The same could also be said, and has been, about equity representations by region, institution, discipline and degree. What then, also, for a new national research centre with a focus on student equity and higher education, for its research agenda and positioning in the field? What stance can it take on student equity that will resonate on a national and even international scale? And, given a global field of higher education, what definitions of equity and propositions for policy and practice can it offer? What will work in the pursuit of equity?

Gender inequality and education : changing local/global relations in a ‘post colonial’ world and the implications for feminist research

This article explores the relationship between education reform and gender equity, both within and between nation states. Utilising feminist critical policy analysis and post-colonial theory, it examines how education reform over the past decade has impacted on gender equity, and how educational reform is itself gendered. It considers the nature of gender restructuring; maps significant shifts in gender equity policy in the wider context of educational and social inequality debates; and through an analysis of recent research on gender identity, schooling and leadership argues that gender can no longer be privileged when identifying and responding to educational inequality. Key assumptions underpinning how social change and education reform delivers equity are questioned, concluding with feminist theorising about how social justice may inform equity policy and practice in culturally diverse educational contexts.