Outsourcing and benchmarking in a rural public hospital : does economic theory provide the complete answer?

INTRODUCTION: The ideology and pronouncements of the Australian Government in introducing 'competitive neutrality' to the public sector has improved efficiency and resource usage. In the health sector, the Human Services Department directed that non-clinical and clinical areas be market tested through benchmarking services against the private sector, with the possibility of outsourcing. These services included car parking, computing, laundry, engineering, cleaning, catering, medical imaging (radiology), pathology, pharmacy, allied health and general practice. Managers, when they choose between outsourcing, and internal servicing and production, would thus ideally base their decision on economic principles. Williamson's transaction cost theory studies the governance mechanisms that can be used to achieve economic efficiency and proposes that the optimal organisation structure is that which minimises transaction costs or the costs of exchange. Williamson proposes that four variables will affect such costs, namely: (i) frequency of exchange; (ii) asset specificity; (iii) environmental uncertainty; and (iv) threat of opportunism. This paper provides evidence from a rural public hospital and examines whether Williamson's transaction cost theory is applicable. d into an analysis that relies solely on transaction

Sustainability: meaning and measurement with application to agriculture

Sustainability refers to having the ability to meet present needs without impacting on future generations to meet their needs. It incorporates social, economic and environmental aspects, and as a measure of sustainability, a range of sustainability indicators at the economy, regional, and individual level, have been suggested. However, given the complex and multidisciplinary nature of the concept, an interdisciplinary approach is necessary. Sustainability is not something that is easily measurable, and the aim of this paper is to present a conceptual framework for quantifying sustainability on the basis of social economic efficiency. According to neoclassical economic theory, economic activity will only be sustained by the private sector as long as it is profitable. However, private economic decisions do not always ensure long-term sustainability of environmental resources or production. The approach suggested here is to derive a measure of social economic efficiency as a measure of sustainability. For dairy farmers, increased productivity has been emphasized, while recognizing the need to reduce greenhouse emissions, pests and disease, nutrient run-off into the environment and degradation of the soil structure. By incorporating environmental and economic impacts, a fuller measure of efficiency, social economic efficiency, and sustainability of the farming practice can be developed.

Neoliberal policy agendas and the problem of inequality in higher education: the Ethiopian case

Under the influence of the external policy pressure of donors such as the World Bank, higher education in Ethiopia has witnessed a series of institutional and system-wide reforms. This article reviews selected policy documents to show key neo-liberal policy agendas endorsed in the reforms and explicate how they have affected social equity in the subsystem. The analysis shows that higher education reforms in Ethiopia, primarily framed by concerns of economic efficiency, have constrained social equity in two important ways. First, at a discursive level, the problem of inequality is represented as a lack of access and a disadvantage in the human capital formation of the nation. Second, the drive for greater efficiency and reduced costs in the educational provision embedded in the reforms is inconsistent with the need for the financial and political commitments required to benefit marginalised members of the society through relevant equity instruments. If the equity policy provisions should be instrumental in ensuring participation, retention and successful completion, and thereby supporting the social mobility of disadvantaged groups, they need to draw on a broad social justice perspective.

CH2 energy harvesting systems : economic use and efficiency

This paper looks at the City of Melbourne's new office development CH₂ as a case study of world class energy performance. In particular, the integrated design of conventionally independent systems has led to the potential to deliver significant savings to the Council and to deliver better environmental conditions to building occupants that in turn may contribute to satisfaction, well-being and Productivity. It is concluded that this project has the potential
to be an iconic example of effective implementation of ESD (environmental sustainable design) principles and therefore act as a demonstration project to others. Energy efficiency of more than 50% of current benchmarks for Melbourne is effected. Energy harvesting is defined as arising from squander, waste and nature, which is a new concept introduced in this paper to better describe the design decision process.

A data envelopment analysis of the efficiency of Victorian TAFE Institutes

In recent years the provision of vocational education and training has been recognised as having a vital role to play in improving Australia's economic performance and in alleviating the hardship of the long term unemployed. The importance of education and training gives rise to the issue of operating educational institutions with a high level of efficiency. In this article, Data Envelopment Analysis is used to derive estimates of the technical and scale efficiency of Victorian Technical and Further Education Institutes in 1995. The results reveal substantial dispersion in technical and scale efficiencies. Regression analysis is used to identify variables which are associated with technical inefficiency.

Is the treatment of economic loss by the Australian courts in torts cases anomalous?

The well developed economic theory of tort liability has never been able to comfortably accommodate negligence cases causing pure economic loss as opposed to physical damage or injury. In fact, contrary to received opinion, Australian Courts at least, are increasingly allocating pure economic losses to achieve predominantly an efficiency objective, with corrective justice notions relegated into the background. Consequently, it is difficult to classify these cases as anomalous in the sense of falling outside the efficiency paradigm.

Measurement of the economic impact of visual impairment from age-related macular degeneration in Australia

The purpose of this report was to: (i) outline the potential value of health economic studies into age-related macular degeneration (AMD); (ii) provide an overview of health economic studies pertinent to AMD; and (iii) outline the basic frame work of cost-of-illness studies (a useful first step in applying economic methods). The detection and management of sensory loss in the elderly plays a key role in the Australian Government's Healthy Ageing Strategy. Age-related macular degeneration is currently the leading cause of blindness in elderly Australians. Although a large proportion of AMD cases remain untreatable, the introduction of photo­dynamic therapy provides a relatively expensive and possibly cost-effective innovation for others. Antioxidant therapy has also been proven effective in reducing progression of early to late disease. The discipline of economics can contribute to an understanding of AMD prevention and treatment through: (i) describing the current burden of disease; (ii) predicting the changes in the burden of disease over time, and (iii) evaluating the efficiency of different interventions. Cost-of-illness studies have been performed in many fields of medicine. Little work, however, has been done on describing the economic impact from AMD. A number of different economic evaluation methods can be used in judging the efficiency of possible interventions to reduce the disease burden of AMD. Although complementary in nature, each has specific uses and limitations. Studies of the economic impact of eye diseases are both feasible and necessary for informed health care decision-making.

Making long-term economic growth more sustainable: evaluating the costs and benefits

Currently, traditional development issues such as economic stagnation, poverty, hunger, and illness as well as newer challenges like environmental degradation and globalisation demand attention. Sustainable development, including its economic, environmental and social elements, is a key goal of decisionmakers. Optimal economic growth has also been a crucial goal of both development theorists and practitioners. This paper examines the conditions under which optimal growth might be sustainable, by assessing the costs and benefits of growth. Key environmental and social aspects are considered. The Ecol-Opt-Growth-1 model analyses economic–ecological interactions, including resource depletion, pollution, irreversibility, other environmental effects, and uncertainty. It addresses some important issues, including savings, investment, technical progress, substitutability of productive factors, intergenerational efficiency, equity, and policies to make economic growth more sustainable—a basic element of the sustainomics framework. The empirical results support growing concerns that costs of growth may outweigh its benefits, resulting in unsustainability. Basically, in a wide range of circumstances, long term economic growth is unsustainable due to increasing environmental damage. Nevertheless, the model has many options that can be explored by policy makers, to make the development path more sustainable, as advocated by sustainomics. One example suggests that government supported abatement programs are needed to move towards sustainable development, since the model runs without abatement were infeasible. The optimal rate of abatement increases over time. Abatement of pollution is necessary to improve ecosystem viability and increase sustainability. Further research is necessary to seek conditions under which alternative economic growth paths are likely to become sustainable.

From efficiency to effectiveness :a new management model of social inclusion

This paper challenges the tendency in the contemporary management literature to conceptualize management within a micro-framework that focuses on short-term efficiency and privatized economic gain. Based on a literature review of social-relation theories, we propose a new management model of social inclusion for general management across contexts with a particular concern for profit-for organizations. The model conceptualizes management within a systemic societal framework where its effectiveness is demonstrated for society, organizations, groups and individuals.  We suggest that management based on the collectivistic values of shared humanity and social inclusion (not only organization) is expected to reduce management-led systematic marginalization in the workplace and social whole. For the purpose of this paper, we define management as “mutually interdependent activities that add value to individuals’, groups’, organizations’ and societal wellbeing by ensuring social inclusion at each of these dimensions.” We term this management process ‘Management Process of Social Inclusion’ as it extends management perspectives to not only organizational effectiveness but societal effectiveness. The paper concludes by proposing several propositions and implications for future research.

Competition and efficiency : overseas students and technical efficiency in Australian and New Zealand universities

Economic theory suggests that competitive pressures will impact on organisational efficiency. In recent years, universities in Australia and New Zealand have faced increased competition for students. The aim of this paper is to explore the efficiency of Australian and New Zealand public universities and to investigate the impact of competition for students from overseas on efficiency. Output distance functions are estimated using panel data for the period 1995-2002 for Australia and 1997-2003 for New Zealand. The results show that competition for overseas students has led to increased efficiency in Australian universities. However, competition for overseas students appears to have had no effect on efficiency in New Zealand.

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.

Fiji’s garment industry : an economic analysis

The May 2000 civilian coup has had a detrimental effect on investor confidence in Fiji. Political instability and uncertainty surrounds the economy and the garment industry – one of the successful products of the Export Oriented Industrialization strategy – is the most affected. Investment in this sector has stalled and a total of 7 garment factories have closed operations with the likelihood of others following the same direction if the political impasse and uncertainty continues. In light of the continuing demise of the industry, this paper enlightens the contribution of the industry to Fiji’s economy in terms of exports and employment creation. The paper also presents an analysis of the profitability and operating efficiency status of the industry and contends that the industry is a viable one. It also presents policy makers with some recommendations that can be considered in light of reinvigorating investment in the garment industry.

Sources of economic growth in Bangladesh : 1972/73 - 1995/1996

Attempts to estimate the total factor productivity (TFP) of the economy of Bangladesh during the period 1972/73 - 1995/96 and finds that it has been declining. This indicates a failure to increase efficiency in the use of the factors of production, such as total cropped land, total employed labour and gross capital stock. This failure has been causing slower and more volatile economic growth in Bangladesh with respect to many South, East and South-East Asian countries.

Understanding the economic dynamics behind growth-inequality relationships

In this paper, a dynamic general equilibrium (DGE) model of growth–inequality relationships, with missing credit markets, knowledge spillover and self-employed agents, is calibrated to New Zealand data. The model explains how two distinct policy shocks involving redistribution and immigration imply, subsequently, two completely opposite outcomes. Agents’ inability to borrow aggravates a negative macroeconomic effect of heterogeneity on growth. Redistribution mitigates that effect but creates microeconomic disincentives on saving and work-effort. Consequently, immigration shocks that perturb variance of efficiency induce a negative growth–inequality relationship, while redistribution shocks, in New Zealand’s case, produce larger fluctuations in incentives than in macro benefits, implying a positive growth–inequality relationship.