A cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand

A randomized controlled trial was carried out to measure the societal costs of realtime teledermatology compared with those of conventional hospital care in New Zealand. Two rural health centres were linked to a specialist hospital via ISDN at 128 kbit/s. Over 10 months, 203 patients were referred for a specialist dermatological consultation and 26 were followed up, giving a total of 229 consultations. Fifty-four per cent were randomized to the teledermatology consultation and 46% to the conventional hospital consultation. A cost-minimization analysis was used to calculate the total costs of both types of dermatological consultation. The total cost of the 123 teledermatology consultations was NZ$34,346 and the total cost of the 106 conventional hospital consultations was NZ$30,081. The average societal cost of the teledermatology consultation was therefore NZ$279.23 compared with NZ$283.79 for the conventional hospital consultation. The marginal cost of seeing an additional patient was NZ$135 via teledermatology and NZ$284 via conventional hospital appointment. From a societal viewpoint, and assuming an equal outcome, teledermatology was a more cost-efficient use of resources than conventional hospital care.

An analysis of why telehealth systems in Australia have not always succeeded

Telehealth programmes are rather similar to humans in the way that they are planned, develop, grow and ultimately die or disappear. To achieve good life expectancy for a telehealth programme there appear to be three major needs: nurturing, which includes the provision of money, ideas, education, training and innovation; experience, which involves an integrated management process, the achievement of long and wide patterns of usage, the development of updated policies and procedures and the involvement of multiple disciplines; success, which involves evidence of outcomes, evaluation and research, and, most important, the sharing of information through scientific and popular press publications, and conferences and collaborations with internal and external groups. The future of telehealth in Australia is at a watershed. There are now a substantial number of programmes, and there has been a large amount of financial and human investment in telehealth around the nation. There is, however, no forum for national leadership, no national association and little support at federal government level.

Solicitors disciplinary hearings in Queensland 1930-2000: a statistical analysis

This article reports on the results of a study undertaken by the author together with her research assistant, Heather Green. The study collected and analysed data from all disciplinary tribunal decisions heard in Queensland since 1930 in an attempt to provide empirical information which has previously been lacking. This article will outline the main features of the disciplinary system in Queensland, describe the research methodology used in the present study and then report on some findings from the study. Reported findings include a profile of solicitors who have appeared before a disciplinary hearing, the types of matters which have attracted formal discipline and the types of orders made by the tribunal. Much of the data is then presented on a time scale so as to reveal any changes over time.

Analysis of the gate capacitance measurement technique and its application for the evaluation of hot-carrier degradation in submicrometer MOSFETs

The use of gate-to-drain capacitance (C-gd) measurement as a tool to characterize hot-carrier-induced charge centers in submicron n- and p-MOSFET's has been reviewed and demonstrated. By analyzing the change in C-gd measured at room and cryogenic temperature before and after high gate-to-drain transverse field (high field) and maximum substrate current (I-bmax) stress, it is concluded that the degradation was found to be mostly due to trapping of majority carriers and generation of interface states. These interface states were found to be acceptor states at top half of band gap for n-MOSFETs and donor states at bottom half of band gap for p-MOSFETs. In general, hot electrons are more likely to be trapped in gate oxide as compared to hot holes while the presence of hot holes generates more interface states. Also, we have demonstrated a new method for extracting the spatial distribution of oxide trapped charge, Q(ot), through gate-to-substrate capacitance (C-gb) measurement. This method is simple to implement and does not require additional information from simulation or detailed knowledge of the device's structure. (C) 2001 Elsevier Science Ltd. All rights reserved.

Addressing shortcomings in the Household Responsibility System - Empirical analysis of the Two-Farmland System in Shandong Province

Despite apparent overwhelming benefits, implementation of the Household Responsibility System (HRS) in China contained a number of flaws. The Two-Farmland System (TFS), which originated in Pingdu City in Shandong Province, sought to address the twin problems of land fragmentation and economies of size. A stochastic frontier production function analysis that isolates the impacts of land allocation reforms suggests that the TFS increased efficiency by around 7%. This article highlights the need for empirical analysis to assess objectively the merits or otherwise of particular reforms. (C) 2002 Elsevier Science Inc. All rights reserved.