An exploratory cost-benefits analysis of vocational rehabilitation.

Cover title.

A COST-BENEFIT ANALYSIS OF A 25% RPS IN MICHIGAN

Michigan depends heavily on fossil fuels to generate electricity. Compared with fossil fuels, electricity generation from renewable energy produces less pollutants emissions. A Renewable Portfolio Standard (RPS) is a mandate that requires electric utilities to generate a certain amount of electricity from renewable energy sources. This thesis applies the Cost-Benefits Analysis (CBA) method to investigate the impacts of implementing a 25% in Michigan by 2025. It is found that a 25% RPS will create about $20.12 billion in net benefits to the State. Moreover, if current tax credit policies will not change until 2025, its net present value will increase to about $26.59 billion. Based on the results of this CBA, a 25% RPS should be approved. The result of future studies on the same issue can be improved if more state specific data become available.

Report : enabling team collaboration with pervasive and mobile computing : cost benefit analysis methodology

Construction is an information intensive industry in which the accuracy and timeliness of information is paramount. It observed that the main communication issue in construction is to provide a method to exchange data between the site operation, the site office and the head office. The information needs under consideration are time critical to assist in maintaining or improving the efficiency at the jobsite. Without appropriate computing support this may increase the difficulty of problem solving. Many researchers focus their research on the usage of mobile computing devices in the construction industry and they believe that mobile computers have the potential to solve some construction problems that leads to reduce overall productivity. However, to date very limited observation has been conducted in terms of the deployment of mobile computers for construction workers on-site. By providing field workers with accurate, reliable and timely information at the location where it is needed, it will support the effectiveness and efficiency at the job site. Bringing a new technology into construction industry is not only need a better understanding of the application, but also need a proper preparation of the allocation of the resources such as people, and investment. With this in mind, an accurate analysis is needed to provide clearly idea of the overall costs and benefits of the new technology. A cost benefit analysis is a method of evaluating the relative merits of a proposed investment project in order to achieve efficient allocation of resources. It is a way of identifying, portraying and assessing the factors which need to be considered in making rational economic choices. In principle, a cost benefit analysis is a rigorous, quantitative and data-intensive procedure, which requires identification all potential effects, categorisation of these effects as costs and benefits, quantitative estimation of the extent of each cost and benefit associated with an action, translation of these into a common metric such as dollars, discounting of future costs and benefits into the terms of a given year, and summary of all cost and benefit to see which is greater. Even though many cost benefit analysis methodologies are available for a general assessment, there is no specific methodology can be applied for analysing the cost and benefit of the application of mobile computing devices in the construction site. Hence, the proposed methodology in this document is predominantly adapted from Baker et al. (2000), Department of Finance (1995), and Office of Investment Management (2005). The methodology is divided into four main stages and then detailed into ten steps. The methodology is provided for the CRC CI 2002-057-C Project: Enabling Team Collaboration with Pervasive and Mobile Computing and can be seen in detail in Section 3.

A cost-effectiveness analysis of a telephone-linked care intervention for individuals with Type 2 diabetes

AIM: To assess the cost-effectiveness of an automated telephone-linked care intervention, Australian TLC Diabetes, delivered over 6 months to patients with established Type 2 diabetes mellitus and high glycated haemoglobin level, compared to usual care. METHODS: A Markov model was designed to synthesize data from a randomized controlled trial of TLC Diabetes (n=120) and other published evidence. The 5-year model consisted of three health states related to glycaemic control: 'sub-optimal' HbA1c ≥58mmol/mol (7.5%); 'average' ≥48-57mmol/mol (6.5-7.4%) and 'optimal' <48mmol/mol (6.5%) and a fourth state 'all-cause death'. Key outcomes of the model include discounted health system costs and quality-adjusted life years (QALYS) using SF-6D utility weights. Univariate and probabilistic sensitivity analyses were undertaken. RESULTS: Annual medication costs for the intervention group were lower than usual care [Intervention: £1076 (95%CI: £947, £1206) versus usual care £1271 (95%CI: £1115, £1428) p=0.052]. The estimated mean cost for intervention group participants over five years, including the intervention cost, was £17,152 versus £17,835 for the usual care group. The corresponding mean QALYs were 3.381 (SD 0.40) for the intervention group and 3.377 (SD 0.41) for the usual care group. Results were sensitive to the model duration, utility values and medication costs. CONCLUSION: The Australian TLC Diabetes intervention was a low-cost investment for individuals with established diabetes and may result in medication cost-savings to the health system. Although QALYs were similar between groups, other benefits arising from the intervention should also be considered when determining the overall value of this strategy.

Sex workers can be screened too often : a cost-effectiveness analysis in Victoria, Australia

Objectives Commercial sex is licensed in Victoria, Australia such that sex workers are required to have regular tests for sexually transmitted infections (STIs). However, the incidence and prevalence of STIs in sex workers are very low, especially since there is almost universal condom use at work. We aimed to conduct a cost-effectiveness analysis of the financial cost of the testing policy versus the health benefits of averting the transmission of HIV, syphilis, chlamydia and gonorrhoea to clients. Methods We developed a simple mathematical transmission model, informed by conservative parameter estimates from all available data, linked to a cost-effectiveness analysis. Results We estimated that under current testing rates, it costs over $A90 000 in screening costs for every chlamydia infection averted (and $A600 000 in screening costs for each quality-adjusted life year (QALY) saved) and over $A4 000 000 for every HIV infection averted ($A10 000 000 in screening costs for each QALY saved). At an assumed willingness to pay of $A50 000 per QALY gained, HIV testing should not be conducted less than approximately every 40 weeks and chlamydia testing approximately once per year; in comparison, current requirements are testing every 12 weeks for HIV and every 4 weeks for chlamydia. Conclusions Mandatory screening of female sex workers at current testing frequencies is not cost-effective for the prevention of disease in their male clients. The current testing rate required of sex workers in Victoria is excessive. Screening intervals for sex workers should be based on local STI epidemiology and not locked by legislation.

At what price? A cost-effectiveness analysis comparing trial of labour after previous caesarean versus elective repeat caesarean delivery

Background: Elective repeat caesarean delivery (ERCD) rates have been increasing worldwide, thus prompting obstetric discourse on the risks and benefits for the mother and infant. Yet, these increasing rates also have major economic implications for the health care system. Given the dearth of information on the cost-effectiveness related to mode of delivery, the aim of this paper was to perform an economic evaluation on the costs and short-term maternal health consequences associated with a trial of labour after one previous caesarean delivery compared with ERCD for low risk women in Ireland.Methods: Using a decision analytic model, a cost-effectiveness analysis (CEA) was performed where the measure of health gain was quality-adjusted life years (QALYs) over a six-week time horizon. A review of international literature was conducted to derive representative estimates of adverse maternal health outcomes following a trial of labour after caesarean (TOLAC) and ERCD. Delivery/procedure costs derived from primary data collection and combined both "bottom-up" and "top-down" costing estimations.Results: Maternal morbidities emerged in twice as many cases in the TOLAC group than the ERCD group. However, a TOLAC was found to be the most-effective method of delivery because it was substantially less expensive than ERCD ((sic)1,835.06 versus (sic)4,039.87 per women, respectively), and QALYs were modestly higher (0.84 versus 0.70). Our findings were supported by probabilistic sensitivity analysis.Conclusions: Clinicians need to be well informed of the benefits and risks of TOLAC among low risk women. Ideally, clinician-patient discourse would address differences in length of hospital stay and postpartum recovery time. While it is premature advocate a policy of TOLAC across maternity units, the results of the study prompt further analysis and repeat iterations, encouraging future studies to synthesis previous research and new and relevant evidence under a single comprehensive decision model.

Valuing maternity care: a comparison of stated preference methods with an application to cost-benefit analysis

This research investigates whether a reconfiguration of maternity services, which collocates consultant- and midwifery-led care, reflects demand and value for money in Ireland. Qualitative and quantitative research is undertaken to investigate demand and an economic evaluation is performed to evaluate the costs and benefits of the different models of care. Qualitative research is undertaken to identify women’s motivations when choosing place of delivery. These data are further used to inform two stated preference techniques: a discrete choice experiment (DCE) and contingent valuation method (CVM). These are employed to identify women’s strengths of preferences for different features of care (DCE) and estimate women’s willingness to pay for maternity care (CVM), which is used to inform a cost-benefit analysis (CBA) on consultant- and midwifery-led care. The qualitative research suggests women do not have a clear preference for consultant or midwifery-led care, but rather a hybrid model of care which closely resembles the Domiciliary Care In and Out of Hospital (DOMINO) scheme. Women’s primary concern during care is safety, meaning women would only utilise midwifery-led care when co-located with consultant-led care. The DCE also finds women’s preferred package of care closely mirrors the DOMINO scheme with 39% of women expected to utilise this service. Consultant- and midwifery-led care would then be utilised by 34% and 27% of women, respectively. The CVM supports this hierarchy of preferences where consultant-led care is consistently valued more than midwifery-led care – women are willing to pay €956.03 for consultant-led care and €808.33 for midwifery-led care. A package of care for a woman availing of consultant- and midwifery-led care is estimated to cost €1,102.72 and €682.49, respectively. The CBA suggests both models of care are cost-beneficial and should be pursued in Ireland. This reconfiguration of maternity services would maximise women’s utility, while fulfilling important objectives of key government policy.

A thematic cost-benefit analysis of a marine protected area

The implementation of Marine Protected Areas (MPAs) is ultimately a social endeavour to sustain or improve human well-being via the conservation of marine ecosystems. The degree to which ecological gains are realised can depend upon how economic, ecological and social costs (negative impacts) and benefits (positive impacts) are included in the designation and management process. Without the support of key stakeholder groups whose user rights have been affected by the creation of an MPA, human impacts cannot be reduced. This study analyses a three year dataset to understand the themes associated with the economic, environmental and social costs and benefits of an MPA in Lyme Bay, United Kingdom (UK) following its establishment in 2008. Methodologically, the paper presents an ecosystem based management framework for analysing costs and benefits. Two hundred and forty one individuals were interviewed via questionnaire between 2008 and 2010 to determine perceptions and the level of support towards the MPA. Results reveal that despite the contentious manner in which this MPA was established, support for the MPA is strong amongst the majority of stakeholder groups. The level of support and the reasons given for support vary between stakeholder groups. Overall, the stakeholders perceive the social, economic and environmental benefits of the MPA to outweigh the perceived costs. There have been clear social costs of the MPA policy and these have been borne by mobile and static gear fishermen and charter boat operators. Local support for this MPA bodes well for the development of a network of MPAs around the UK coast under the United Kingdom Marine and Coastal Access Act 2009. However, this initial optimism is at risk if stakeholder expectation is not managed and the management vacuum is not filled.

Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care:societal cost-benefit analysis

Comparison of real time teledermatology with outpatient dermatology in terms of clinical outcomes, cost-benefits, and patient reattendance.

D3.1 Benefits Analysis of the Initial Operational Cruiser-Feeder Concept

The REsearch on a CRuiser Enabled Air Transport Environment (RECREATE) project is considers the introduction and airworthiness of cruiser-feeder operations for civil aircraft. Cruiser-feeder operations are investigated as a promising pioneering idea for the air transport of the future. The soundness of the concept of cruiser-feeder operations for civil aircraft can be understood, taking air-to-air refueling operations as an example. For this example, a comprehensive estimate of the benefits can be made, which shows a fuel burn reduction potential and a CO2 emission reduction of 31% for a typical 6000 nautical miles flight with a payload of 250 passengers. This reduction potential is known to be large by any standard. The top level objective of the RECREATE project is to demonstrate on a preliminary design level that cruiser-feeder operations (as a concept to reduce fuel burn and CO2 emission levels) can be shown to comply with the airworthiness requirements for civil aircraft. The underlying Scientific and Technological (S&T) objectives are to determine and study airworthy operational concepts for cruiser-feeder operations, and to derive and quantify benefits in terms of CO2 emission reduction but also other benefits.

Work Package (WP) 3 has the objective to substantiate the assumed benefits of the cruiser/feeder operations through refined analysis and simulation. In this report, initial benefits evaluation of the initial RECREATE cruiser/feeder concepts is presented. The benefits analysis is conducted in delta mode, i.e. comparison is made with a baseline system. Since comparing different aircraft and air transport systems is never a trivial task, appropriate measures and metrics are defined and selected first. Non-dimensional parameters are defined and values for the baseline system derived.

The impact of cruiser/feeder operations such as air-to-air refueling are studied with respect to fuel-burn (or carbon-dioxide), noise and congestion. For this purpose, traffic simulations have been conducted.
Cruiser/feeder operations will have an impact on dispatch reliability as well. An initial assessment of the effect on dispatch reliability has been made and is reported.

Finally, a considerable effort has been made to create the infrastructure for economic delta analysis of the cruiser/feeder concept of operation. First results of the cost analysis have been obtained.

Does Cost-Effectiveness Analysis Have a Role in US Managed Care Drug Formularies? An Empirical Study of Utilization, Costs, Outcomes, and Elasticity of Demand of a Value-Based Formulary

Thesis (Ph.D.)--University of Washington, 2015

Examining Bullying Intervention Motivations Through a Cost/Benefit Analysis

The purpose of the present study was to examine the role of the bystander in bullying situations. A cost/benefit model was explored in researching factors adolescents consider in deciding whether to intervene when witnessing bullying. Adolescents in the present study (N = 101 (50.5% female), between the ages of 12 to 18, M = 15.37 years; SD = 1.71 years) completed self-report questionnaires, and also responded to bullying scenarios, stating how the bystander would react, while explaining potential personal costs and benefits. Adolescents were able to articulate various personal costs and benefits when making the decision to intervene. Conclusions of the present study include: 1) the evolutionary approach is quite informative in illuminating the decision process of the bystander, 2) adolescents’ beliefs about bullying and the role of bystanders are different from their teachers’, and 3) the rather explicit cost/benefit model could be used to develop more targeted anti-bullying programs.

A cost-benefit analysis of culling badgers to control bovine tuberculosis

Bovine tuberculosis (TB) is an important economic problem. The incidence of TB in cattle herds has steadily risen in the UK, and badgers are strongly implicated in spreading disease. Since the mid-1970s the UK government has adopted a number of badger culling strategies to attempt to reduce infection in cattle. In this report, an established model has been used to simulate TB in badgers, transmission to cattle, and control by badger culling. Costs were supplied by the UK Government's Department for Environment Food and Rural Affairs (Defra) for badger trapping and gassing. Regardless of culling intensity or area simulated, an overall reduction in the herd breakdown rate was seen. With a high culling efficacy and no social perturbation, the mean Net Present Value of a few simulated culling strategies in an "ideal world" was positive, meaning the economic benefits outweighed the costs. Further work is required before these results could be considered definitive, as it is necessary to evaluate uncertainties and simulate less than perfect conditions. (c) 2005 Elsevier Ltd. All rights reserved.

Cost-benefit analysis model of badger (Meles meles) culling to reduce cattle herd tuberculosis breakdowns in Britain, with particular reference to badger perturbation

Bovine tuberculosis (TB)is an important economic disease. Badgers (Meles meles) are the wildlife source implicated in many cattle outbreaks of TB in Britain, and extensive badger control is a controversial option to reduce the disease. A badger and cattle population model was developed, simulating TB epidemiology; badger ecology, including postcull social perturbation; and TB-related farm management. An economic cost-benefit module was integrated into the model to assess whether badger control offers economic benefits. Model results strongly indicate that although, if perturbation were restricted, extensive badger culling could reduce rates in cattle, overall an economic loss would be more likely than a benefit. Perturbation of the badger population was a key factor determining success or failure of control. The model highlighted some important knowledge gaps regarding both the spatial and temporal characteristics of perturbation that warrant further research.

Multiple-project discount rates for cost-benefit analysis in construction projects: A formal risk model for microgeneration renewable energy technologies

The traditional economic approach for appraising the costs and benefits of construction project Net Present Values involves the calculation of net returns for each investment option under different discount rates. An alternative approach consists of multiple-project discount rates based on risk modelling. The example of a portfolio of microgeneration renewable energy technology (MRET) is presented to demonstrate that risks and future available budget for re-investment can be taken into account when setting discount rates for construction project specifications in presence of uncertainty. A formal demonstration is carried out through a reversed intertemporal approach of applied general equilibrium. It is demonstrated that risk and the estimated available budget for future re-investment can be included in the simultaneous assessment of the costs and benefits of multiple projects.