The valuation of travel time savings in least developed countries:theoretical and empirical challenges and results from a field study

In developed countries travel time savings can account for as much as 80% of the overall benefits arising from transport infrastructure and service improvements. In developing countries they are generally ignored in transport project appraisals, notwithstanding their importance. One of the reasons for ignoring these benefits in the developing countries is that there is insufficient empirical evidence to support the conventional models for valuing travel time where work patterns, particularly of the poor, are diverse and it is difficult to distinguish between work and non-work activities. The exclusion of time saving benefits may lead to a bias against investment decisions that benefit the poor and understate the poverty reduction potential of transport investments in Least Developed Countries (LDCs). This is because the poor undertake most travel and transport by walking and headloading on local roads, tracks and paths and improvements of local infrastructure and services bring large time saving benefits for them through modal shifts. The paper reports on an empirical study to develop a methodology for valuing rural travel time savings in the LDCs. Apart from identifying the theoretical and empirical issues in valuing travel time savings in the LDCs, the paper presents and discusses the results of an analysis of data from Bangladesh. Some of the study findings challenge the conventional wisdom concerning the time saving values. The Bangladesh study suggests that the western concept of dividing travel time savings into working and non-working time savings is broadly valid in the developing country context. The study validates the use of preference methods in valuing non-working time saving values. However, stated preference (SP) method is more appropriate than revealed preference (RP) method.

How to manual:the valuation of rural travel time savings in least developed countries (LDCs)

The manual is designed to bring out issues that are relevant in the valuation of rural travel time savings in Least Developed Countries (LDCs). It should also be relevant for other developing countries which do not have LDC status but have rural economy features typical of low income developing countries. The manual elaborates step-by-step procedures on how to design and execute studies to estimate the value of time (VoT) savings of rural travellers.

Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust

This paper explores the potential for cost savings in the general Practice units of a Primary Care Trust (PCT) in the UK. We have used Data Envelopment Analysis (DEA) to identify benchmark Practices, which offer the lowest aggregate referral and drugs costs controlling for the number, age, gender, and deprivation level of the patients registered with each Practice. For the remaining, non-benchmark Practices, estimates of the potential for savings on referral and drug costs were obtained. Such savings could be delivered through a combination of the following actions: (i) reducing the levels of referrals and prescriptions without affecting their mix (£15.74 m savings were identified, representing 6.4% of total expenditure); (ii) switching between inpatient and outpatient referrals and/or drug treatment to exploit differences in their unit costs (£10.61 m savings were identified, representing 4.3% of total expenditure); (iii) seeking a different profile of referral and drug unit costs (£11.81 m savings were identified, representing 4.8% of total expenditure). © 2012 Elsevier B.V. All rights reserved.

Using DEA to estimate potential savings at GP units at medical specialty level

The aim of this paper is to identify benchmark cost-efficient General Practitioner (GP) units at delivering health care in the Geriatric and General Medicine (GMG) specialty and estimate potential cost savings. The use of a single medical specialty makes it possible to reflect more accurately the medical condition of the List population of the Practice so as to contextualize its expenditure on care for patients. We use Data Envelopment Analysis (DEA) to estimate the potential for cost savings at GP units and to decompose these savings into those attributable to the reduction of resource use, to altering the mix of resources used and to those attributable to securing better resource 'prices'. The results reveal a considerable potential for savings of varying composition across GP units. © 2013 Elsevier Ltd.

Identifying the scope for savings at inpatient episode level:an illustration applying DEA to chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is characterized by a largely irreversible obstruction of the airways, and is one of the leading causes of chronic morbidity and mortality worldwide. This paper illustrates the use of Data Envelopment Analysis (DEA) to assess the potential for cost savings at COPD inpatient episode level. The analysis uses the length of stay of each episode as a surrogate for expenditure on that episode while allowing for the medical condition of the patient and the quality of care received. We find substantial possible reductions in length of stay which would translate to cost savings. The paper also explores differences both between hospitals and between care teams within hospitals so that cost efficient protocols of treatment can be identified and disseminated.