Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach.

Objective: To use a population-level, public-hospital approach to compare the prevalence and cost of musculoskeletal diseases (MSD) with other clinical specialties.

Methods: A healthcare utilization survey of 4 million individual records over 4 years, from all major public hospitals in the state of Victoria (estimated population 4.8 million residents in 2000/01) from 1997/98 to 2000/01. Main outcome measures were inpatient episodes of care, bed-days, and outpatient clinic encounters. MSD was defined as the combination of orthopedics and rheumatology.

Results: After obstetrics, MSD was the most frequent outpatient service, with orthopedics accounting for 9.9% of all visits in 2000/01. The proportion of MSD outpatient encounters (on average 11.6% of the total) was constant over the study period. Among 26 medical specialties, MSD had the sixth highest number of inpatient episodes (6.2% in 2000/01), following renal dialysis (14.6%), general surgery (8.2%), obstetrics (7.6%), gastroenterology (7.1%), and general medicine (6.7%). MSD was the fifth highest consumer of bed-days, occupying on average 7.7% of all beds per annum in the period 1997/98 to 2000/01, behind psychiatry (10.1%), respiratory medicine (8.5%), rehabilitation (8.3%), and general medicine (7.8%). MSD was the third most-costly discipline in 2000/01, with total costs of over A dollars 169 million (9.7% of total inpatient costs that year), behind respiratory medicine (11.6%) and general surgery (11.5%).

Conclusion: Compared to other diseases, MSD consumes a substantial proportion of healthcare resources in Victorian public hospitals. These data have important implications for allocation of healthcare resources, clinical care pathways, and prevention strategies.

Cost-efficacy of surgically induced weight loss for the management of type 2 diabetes : a randomized controlled trial

OBJECTIVE -- To determine the within-trial cost-efficacy of surgical therapy relative to conventional therapy for achieving remission of recently diagnosed type 2 diabetes in class I and II obese patients.

RESEARCH DESIGN AND METHODS -- Efficacy results were derived from a 2-year randomized controlled trial. A health sector perspective was adopted, and within-trial intervention costs included gastric banding surgery, mitigation of complications, outpatient medical consultations, medical investigations, pathology, weight loss therapies, and medication. Resource use was measured based on data drawn from a trial database and patient medical records and valued based on private hospital costs and government schedules in 2006 Australian dollars (AUD). An incremental cost-effectiveness analysis was undertaken.

RESULTS -- Mean 2-year intervention costs per patient were 13,400 AUD for surgical therapy and 3,400 AUD for conventional therapy, with laparoscopic adjustable gastric band (LAGB) surgery accounting for 85% of the difference. Outpatient medical consultation costs were three times higher for surgical patients, whereas medication costs were 1.5 times higher for conventional patients. The cost differences were primarily in the first 6 months of the trial. Relative to conventional therapy, the incremental cost-effectiveness ratio for surgical therapy was 16,600 AUD per case of diabetes remitted (currency exchange: 1 AUD = 0.74 USD).

CONCLUSIONS -- Surgical therapy appears to be a cost-effective option for managing type 2 diabetes in class I and II obese patients.

Recognition of idle resources in time-driven activity-based costing and resource consumption accounting models

Despite its theoretical superiority over traditional volume-based costing models, the Activity-Based Costing (ABC) model has failed to replace traditional volume-based costing models in most organisations. In response to the problems of the model, Time-Driven Activity-Based Costing (TDABC) and Resource Consumption Accounting (RCA) models have been developed as costing models for next generation cost management systems. A key feature that distinguishes TDABC and RCA models from traditional volume-based costing models and the ABC model is the recognition of idle resources in resource pools.

This paper presents a discussion on implications of recognising idle resources in TDABC and RCA models on developments, maintenance and uses of cost management systems. A hypothetical case is presented to illustrate conversions of an ABC-based costing model to ones that are based on the TDABC and RCA models, and the resulting new allocation of resource costs.

Social and environmental accounting research : major contributions and future directions for developing countries

A review is provided of major contributions in social and environmental accounting literature focussing on the issues of developing countries. The review of prior research shows that the major contributions have been related to the motivations for social and environmental disclosure. However, other important research areas such ethical/accountability issues and how to cost externalities which have already been considered within the context of developed countries are yet to emerge within the
developing country context. Contemporary social and environmental issues such as climate change and greenhouse gas emissions affecting the global community also appear to be key issues of research to scholars in both developed and developing countries. Finally, some future research directions are identified.

Nature, extent and antecedents of risk management in accounting, law and biotechnology firms in Australia

This paper provides empirical evidence on the nature and the extent of risks faced by small and medium-sized biotechnology and professional service firms (accounting and law) in Australia, as well as on the style of their adopted risk management methods and approaches. The findings of the study indicate that the top three risks faced by these firms are related to reputation, recruiting and retaining skilled staff, and cost management. The study also finds that more than half of the respondent firms manage risk in an integrated manner. The results of this study provide useful insights into the nature, extent and driving forces of risk management practices in these firms.

Corporate opacity and cost of debt for family firms

This paper uses a sample of Chinese firms to examine the impact of corporate opacity on the relationship between family control and firms’ cost of debt. We find that family control is associated with a lower cost of debt on average, and a negative impact exists mainly in firms with relatively low corporate opacity. We further provide evidence that the moderating effect of corporate opacity becomes more pronounced when investors’ perception of controlling families’ moral hazard of expropriation is higher. Our results are robust to alternative opacity proxies and controlling for endogeneity of family control using the instrumental variable method. Our study highlights that controlling families are heterogeneous in their impact on the shareholder–debtholder relationship in family firms, and debtholders view corporate opacity as an important reference in assessing the extent of potential agency conflicts in China.

Investor protection, firm informational problems, big N auditors, and cost of debt around the world

This paper examines the effects of investor protection, firm informational problems (proxied by firm size, firm age, and the number of analysts following), and Big N auditors on firms' cost of debt around the world. Using data from 1994 to 2006 and over 90,000 firm-year observations, we find that the cost of debt is lower when firms are audited by Big N auditors, especially in countries with strong investor protection. Second, we find that firms with more informational problems (i.e., higher information asymmetry problems) benefit more from Big N auditors in terms of lower cost of debt only in countries with stronger investor protection.

Societal role expectations of management accounting professionals: an Australian study

Purpose This paper seeks to advance the understanding of the relevance of management accounting (MA) as a profession by examining societal role expectations of MA professionals in Australia.Methodology/approach The study presented in this paper is based on a questionnaire survey.Findings Findings of the study show that Australian MA professionals are expected to have skills in cost management, corporate social responsibility, carbon accounting, risk management, business analysis, corporate governance, and asset valuations. The demand of MA professionals exceeded the pool of MA talents in Australia. The role expectations of MA professionals from different stakeholder groups are fairly consistent.Social implications The study adds to the immigration institution discussion by demonstrating that there are inadequate professionals in Australia with the skills and experience in MA to meet the projected demand. Australia has very little option but to fill the supply-side shortfall in the short-term with overseas MA professionals.Originality/value The study adds to the literature of the societal relevance of MA by providing evidence of an increasing demand for MA skills in Australia.

A Simple Accounting-based Valuation Model for the Debt Tax Shield

This paper describes a simple way to integrate the debt tax shield into an accounting-based valuation model. The market value of equity is determined by forecasting residual operating income, which is calculated by charging operating income for the operating assets at a required return that accounts for the tax benefit that comes from borrowing to raise cash for the operations. The model assumes that the firm maintains a deterministic financial leverage ratio, which tends to converge quickly to typical steady-state levels over time. From a practical point of view, this characteristic is of particular help, because it allows a continuing value calculation at the end of a short forecast period.

The Value of Negotiating Cost-Based Transfer Prices

This paper analyzes the potential of one-step transfer prices based on either variable or full costs for coordinating decentralized production and quality-improving investment decisions. Transfer prices based on variable costs fail to induce investments on the upstream stage. In contrast, transfer prices based on full costs provide strong investment incentives for the upstream divisions. However, they fail to coordinate the investment decisions. We show that negotiations prevent such coordination failure. In particular, we find that the firm benefits from a higher degree of decentralization so that total profit increases in the number of parameters being subject to negotiations.

DYPTOP: a cost-efficient TOPMODEL implementation to simulate sub-grid spatio-temporal dynamics of global wetlands and peatlands

Simulating the spatio-temporal dynamics of inundation is key to understanding the role of wetlands under past and future climate change. Earlier modelling studies have mostly relied on fixed prescribed peatland maps and inundation time series of limited temporal coverage. Here, we describe and assess the the Dynamical Peatland Model Based on TOPMODEL (DYPTOP), which predicts the extent of inundation based on a computationally efficient TOPMODEL implementation. This approach rests on an empirical, grid-cell-specific relationship between the mean soil water balance and the flooded area. DYPTOP combines the simulated inundation extent and its temporal persistency with criteria for the ecosystem water balance and the modelled peatland-specific soil carbon balance to predict the global distribution of peatlands. We apply DYPTOP in combination with the LPX-Bern DGVM and benchmark the global-scale distribution, extent, and seasonality of inundation against satellite data. DYPTOP successfully predicts the spatial distribution and extent of wetlands and major boreal and tropical peatland complexes and reveals the governing limitations to peatland occurrence across the globe. Peatlands covering large boreal lowlands are reproduced only when accounting for a positive feedback induced by the enhanced mean soil water holding capacity in peatland-dominated regions. DYPTOP is designed to minimize input data requirements, optimizes computational efficiency and allows for a modular adoption in Earth system models.