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Custo de pré-natal na política pública de Marília: um estudo de caso; Cost of prenatal care in public policy in Marília: a case study

Gonçalves, Eleny Rosa Guimarães
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 09/11/2012 PT
Relevância na Pesquisa
36.3%
O presente trabalho investigou os custos do programa de atenção pré-natal na perspectiva subsidiar as decisões dos gestores de saúde. Objetivos: estimar o custo unitário da atenção pré-natal USF pesquisada; evidenciar as atividades e os seus direcionadores de custo entre as atividades do cuidado pré-natal e discutir o custo unitário obtido entre a USF pesquisada e o preconizado pelo protocolo do MS. Metodologia: pesquisa de caráter retrospectivo e exploratório na forma de um estudo de caso. Foi utilizada em Marília SP, em uma USF que atende 794 famílias de baixa renda, com 772 mulheres entre 15 e 49 anos. Como critérios de inclusão: todas as gestantes matriculadas no programa de pré-natal em de 2010; realização mínima de quatro consultas de pré-natal e uma de puerpério; sem restrição de idade. As fontes de informações foram: prontuário familiar e dados administrativos do Fundo Municipal de Saúde da Secretaria Municipal da Saúde (SMS), sendo usado o instrumento específico de coleta de dados clínicos por gestante. A valoração do trabalho dos profissionais foi baseada no montante bruto de salários reais, extraindo o valor correspondente à parcela de tempo dedicado aos cuidados por gestante. Os preços de medicamentos...

The administrative costs of community-based health insurance: a case study of the community health fund in Tanzania

Borghi, Josephine; Makawia, Suzan; Kuwawenaruwa, August
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
36.3%
Community-based health insurance expansion has been proposed as a financing solution for the sizable informal sector in low-income settings. However, there is limited evidence of the administrative costs of such schemes. We assessed annual facility and district-level costs of running the Community Health Fund (CHF), a voluntary health insurance scheme for the informal sector in a rural and an urban district from the same region in Tanzania. Information on resource use, CHF membership and revenue was obtained from district managers and health workers from two facilities in each district. The administrative cost per CHF member household and the cost to revenue ratio were estimated. Revenue collection was the most costly activity at facility level (78% of total costs), followed by stewardship and management (13%) and pooling of funds (10%). Stewardship and management was the main activity at district level. The administration cost per CHF member household ranged from USD 3.33 to USD 12.12 per year. The cost to revenue ratio ranged from 50% to 364%. The cost of administering the CHF was high relative to revenue generated. Similar studies from other settings should be encouraged.

Bulgaria - Reforming the regime of states fees

World Bank
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
46.54%
The Government of Bulgaria requested the World Bank to analyze the legal, institutional and administrative framework for setting state fees and provide recommendations based on good international practice. How big is the problem compared to the many other issues the government wants to reform in order to improve the business climate in Bulgaria? So far there are no comprehensive studies of the level of administrative fees in the European Union (EU) area. Such studies would be of great value to assess the magnitude of the problem. There are, however, several arguments in support of reforming the regime of state fees in Bulgaria now. Firstly, business associations in Bulgaria agree also confirmed by a recent unpublished government report - that state fees at the central level became an uncontrolled area in which authorities apply their own judgment and interests without considering the impact on businesses often to the disadvantage of the private sector. Secondly, if the Government of Bulgaria (GoB) does not curb the current regime system...

Evidence on Cost-sharing in Health Care : Applications to Hungary : Executive Summary

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
36.3%
This study, done at the request of the Hungarian government, presents evidence on cost-sharing in the health sector, and its application in Hungary. It presents results on the impact of cost-sharing on revenues in health facilities and insurance, financial sustainability, informal payments, overall service use, and equity in access. Five keyfindings emerge: cost-sharing could lead to a reduction in unnecessary care provided to insured patients who do not have to pay the full price of care; cost-sharing could help reduce informal payments and keep patient payments in the system; cost-sharing with exemption policies are a prerequisite to provide equity in access to care; cost-sharing could support cost containment strategies; experience from OECD countries provides examples of successful cost-sharing policies. Based on these findings. the study recommends that Hungary continues to monitor and evaluate the impact of cost-sharing on access, to identify possible negative effects on equity in service use. In Hungary...

Defining, Measuring, and Benchmarking Administrative Expenditures of Mandatory Social Security Programs

Sluchynsky, Oleksiy
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Trabalho em Andamento
EN_US
Relevância na Pesquisa
36.48%
This study provides a framework for comparison and benchmarking of administrative expenditures of public and private social security programs. The paper presents the genesis of the inquiries into the subject, reviewing some of the most relevant literature on administrative expenditures and the costs of mandatory programs produced over the past two decades. The quantitative analysis builds on the extensive body of literature, but our framework evolved considerably from earlier studies. Our dataset includes over 100 observations and a broad set of explanatory variables. The authors developed and compared a number of standardized cost indices discussing their advantages and limitations. The author also discusses major cost components and their shares in total program costs. The analysis explains over 90 percent of variation in administrative expenditures. It confirms some of the hypotheses expressed in the earlier studies and presents new evidence of driving factors for costs. The author developed three different specifications for statistical analysis. The first set looks at the impact of design of a program on total costs. The second group of specifications assesses differences in costs of managing pension liabilities between the public and private mandatory pension schemes. Finally...

Monitoring Health Care Using National Administrative Data Collections

Kelman, Christopher William
Fonte: Universidade Nacional da Austrália Publicador: Universidade Nacional da Austrália
Tipo: Thesis (PhD); Doctor of Philosophy (PhD)
EN
Relevância na Pesquisa
36.29%
With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation. ¶ ... ¶ The aims of the project were: · To examine the potential for using administrative data to generate outcome measures and surveillance indicators. · To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework. · To compare the Australian health-service data system with the current international state-of-the-art. · To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity. ¶ The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. ... ¶ In the second part of the thesis...

Telecommunication System for Bachelor Officers Quarters: Cost-Effectiveness and Lease / Purchase Analysis

Fritz, James, B.
Fonte: Escola de Pós-Graduação Naval Publicador: Escola de Pós-Graduação Naval
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
46.04%
Approved for public release, distribution is unlimited; The purpose of this thesis is to perform a cost-effectiveness analysis on proposals, submitted by vendors, for a telecommunication system. This thesis will be used as a guide in the decision-making process of choosing the most cost-effective system for the Bachelor Officers Quarters of the Naval Postgraduate School. In addition to cost-effectivness, this study includes a discussion of the analysis criteria, a review of the Statement of Work and an evaluation of the lease/purchase decision.

Updated cost effectiveness analysis of the Navy drug and alcohol rehabilitation program

Erb, Katherine D. C.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 47 p.
EN_US
Relevância na Pesquisa
46.04%
Approved for public release; distribution is unlimited.; A previous cost benefit analysis of the Navy drug and alcohol rehabilitation program equated the value of benefits to the avoided replacement costs of the service members successfully rehabilitated. This thesis updates this study. In particular, this thesis considers the replacement cost model and identifies an improvement to the previous methodology. The previous model misspecifies average replacement costs and overestimates the program benefits. A new rehabilitation treatment model is developed within this thesis. The value of the rehabilitation benefit is based on the Navy's desired manning objective. This more accurately reflects the rehabilitation benefit as the Navy downsizes its force structure.; Lieutenant, United States Navy

A user's manual for the Cost Effectiveness Analysis Spreadsheet Model for aircraft engines (CEAMOD Version 2.0)

Reeves, Ross R.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 353 p.
EN_US
Relevância na Pesquisa
46.01%
Approved for public release; distribution is unlimited.; This thesis provides a comprehensive procedures manual and user's guide which will enable both current users and beginners to understand and employ Version 2.0 of the Cost Effectiveness Analysis model (CEAMOD), which is written in EXCEL spreadsheet software, in their service's aircraft engine Component Improvement Programs (CIP). The purpose of the CEAMOD is to project the possible savings which would be achieved from an Engineering Change Proposal's (ECP) implementation. The thesis begins by describing the model's background, basic assumptions, and format. Next, a detailed description of each page and the cell formulas used in each column of the spreadsheet are provided. A 'getting started' user's guide was also created to provide the user with the basic information necessary to actually use the CEA Deck/EXCEL spreadsheet software. An example of each page of the CEA model is provided as well as the Standard History File fleet input pages.; Lieutenant, United States Navy

Cost/benefit analysis of Commander, Naval Surface Force, U.S. Pacific Fleet's Supply Maintenance Training Team

Buzon, Carlos D., II; Huggins, Michael D.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 116 p.
EN_US
Relevância na Pesquisa
46.08%
Approved for public release; distribution is unlimited; This thesis is an attempt to accomplish a cost/benefit analysis of Commander, Naval Surface Force, U.S. Pacific Fleet's (COMNAVSURFPAC) Supply Maintenance Training Team (SMTT). The effectiveness of the SMIT program is also evaluated. Data were gathered from surveys of current and former Supply Officers of COMNAVSURFPAC ships, with the Shipboard Non-tactical Automated Data Processing II system installed and which had received all or part of an SMTT assistance visit. Interviews were conducted with selected Navy and civilian contractor members of the SMTT staff. Data were also gathered from various records and reports maintained by the SMTT staff and by COMNAVSURFPAC's Supply Assistance Center. The nature of the cost/benefit data of the SMTT program did not lend itself to a homogenous comparison of costs to benefits. The authors have determined that an attempt to "homogenize" the data with the use of economic "shadow prices" was of little value in meeting the "measurable performance" criteria of the cost/benefit analysis. Therefore, in strict terms, a cost/effectiveness analysis was accomplished. The analysis indicated that the SMTT program has resulted in positive gains in afloat supply operations. Many intangible benefits are derived from the assistance visit and there are indications of tangible benefits in the form of dollar and manhour savings. The trend of the data shows a valuable program to the fleet. Although not definitive due to data limitations...

Parametric cost estimation for amphibious assault vehicle's life cycle cost

Peters, Norman L.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: 122 p.
EN_US
Relevância na Pesquisa
46.08%
Approved for public release; distribution is unlimited; This thesis investigates the need to predict life cycle cost in the most effective and efficient manner through the development of cost estimating relationships (CERs) using only performance input parameters. Utilizing statistical software especially designed for program managers, parametric cost estimating relationship module (PACER), CERs were developed and then evaluated for statistical soundness. The object of this study was to develop a means by which the program manager could estimate fairly accurately total life cycle costs. With this information in hand, the program manager could determine of a weapons system is affordable early in the acquisition process. The result of this study was the derivation of three predictive models that relate cost to required performance parameters. Based solely upon performance requirements, a relationship between cost and performance was established and their impact upon life cycle costs.; http://archive.org/details/parametriccostes00pete; Captain, United States Marine Corps

Cost and Capability Evaluation of the Marine Corps Combined Arms Regiment (CAR)

Gentry, Robin G.
Fonte: Monterey, California. Naval Postgraduate School. Publicador: Monterey, California. Naval Postgraduate School.
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
46.07%
Upon consultation with NPS faculty, the School has determined that this thesis may be released to the public, its distribution is unlimited effective August 25, 2011.; One result of the break-up of the Soviet Union is that the DOD has been forced to reevaluate the roles of each of the Armed Services based on the declining resource pool. From the Marine Corps' evaluation of itself came the Combined Arms Regiment (CAR) concept. The objective of this study was to develop an estimate of the Life Cycle Cost (LCC) of the two possible vehicles used with the CAR and the CAR's components. Standard cost factors are used to cost out the various organizations involved. Two supporting analyses done in this study are: an evaluation of the Marine Corps' role in national security and how the CAR could be used to support that security role, and a comparison of the vehicle option operating characteristics which was done to enrich the dimensions under which the CAR could be evaluated. The results of the study are a tool which can help Marine Corps planners make more informed decisions in regards to the CAR concept. The final conclusion, based on the assumption that any CAR would act as a follow-on element of the MAGTF, was that although the CAR(LAV) was a workable option...

Life cycle cost: an examination of its application in the United States, and potential for use in the Australian Defense Forces

Clarke, John D.
Fonte: Monterey, California: Naval Postgraduate School Publicador: Monterey, California: Naval Postgraduate School
Tipo: Tese de Doutorado Formato: viii, 108 p. ill.
EN_US
Relevância na Pesquisa
46.11%
Approved for public release; distribution is unlimited.; This research has two objectives: firstly, to examine the application of life cycle costing in the United States; and secondly, to discuss its potential for use in the decision making of the Australian Defense Forces. It has been found that despite almost 30 years of application in the United States, life cycle cost for the most part, is given little real attention in decision making. Reasons for this include: an institutional emphasis that accords greater attention to acquisition cost than life cycle cost; and the dominance of a budgeteers view of life cycle cost as a technique for affordability analysis, an approach which the current state of the data does not readily support. Life cycle cost's greatest potential is as a criteria to evaluate and tradeoff design and logistics issues, but it receives comparatively little emphasis in the U.S. in these areas. For Australia to avoid the problems experienced in the U.S., there needs to be acceptance at all levels of the concept of life cycle cost, and what it is trying to achieve. Since the cornerstone of the techniques of life cycle cost analysis is the data, an accounting system capable of capturing direct and indirect costs is needed. This study contains seven broad points for Australia to consider in implementing the techniques and concept of life cycle cost.; Lieutenant...

A Comparison of the marginal cost of commissioning officers through the U.S. Naval Academy, Naval Reserve Officers Training Corps, and Officer Candidate School

Strano, Michael A.
Fonte: Monterey, California: Naval Postgraduate School Publicador: Monterey, California: Naval Postgraduate School
Tipo: Tese de Doutorado Formato: viii, 85 p.
EN_US
Relevância na Pesquisa
46.13%
Approved for public release;distribution is unlimited; This thesis calculates and compares the marginal cost of graduating a naval officer from the United States Naval Academy (USNA), Naval Reserve Officers Training Corps (NROTC), and Officer Candidate School (OCS). After defining the variable and fixed cost functions for each commissioning source, the total cost, average cost, and marginal cost per graduate are calculated for fiscal year 1989 graduates. Compared to average cost, the marginal cost per Academy graduate is more in line with the marginal cost per graduate for NROTC, and OCS. The results support the conclusion that a majority of the Naval Academy's costs are fixed in the short-run and that savings realized by reducing the number of graduates would be overstated by using average cost. This thesis recommends using marginal cost to estimate savings from reductions in officer accessions in the short-run.; Lieutenant, United States Navy

Administrative Barriers to Foreign Investment in Developing Countries

Morisset, Jacques; Lumenga Neso, Olivier
Fonte: World Bank, Washington, D.C. Publicador: World Bank, Washington, D.C.
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
36.38%
Recent international experience has shown that excessively complex administrative procedures, required to establish, and operate a business, discourage inflows of foreign direct investment. The authors present a new database on the administrative costs faced by private investors in 32 developing countries. The database is much more comprehensive than the existing sources, as it contains not only information on general entry procedures, such as business and tax registration, but also captures regulation on land access, site development, import procedures, and inspections, The data include measures on the number of procedures, direct monetary costs, and time. The cost of administrative procedures vary significantly across countries. The most important barriers appear to be the delays associated with securing land access, and obtaining building permits, which in several countries, take more than two years. Countries that impose excessive administrative costs on entry, tend to be equally intrusive in firm operations...

Administrative Costs and the Organization of Individual Retirement Account Systems : A Comparative Perspective

James, Estelle; Smalhout, James; Vittas, Dimitri
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
36.35%
What is the most cost-effective way to organize individual accounts that are part of a mandatory social security system? Defined-contribution individual account components of social security systems are criticized for being too expensive. The authors investigate the cost-effectiveness of two methods for constructing mandatory individual accounts: a) Investing through the retail market with relatively open choice among investment companies (the method first used by Chile and adopted by most Latin American countries). b) Investing through the institutional market with constrained choice. For the retail market, they use data from mandatory pension funds in Chile and other Latin American countries and from voluntary mutual funds in the United States. For the institutional market, they use data from systems in Bolivia and Sweden and from larger pension plans and the federal Thrift Saving Plan in the United States. The institutional approaches aggregate numerous small accounts into large blocks of money and negotiate fees on a centralized basis...

Bulgaria - Ex-post impact assessment of the act on limiting administrative regulation and administration control on economic activity

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Pre-2003 Economic or Sector Report
ENGLISH
Relevância na Pesquisa
46.26%
The ex-post impact assessment of the Limiting Administrative Regulation and Administrative Control on Economic Activity Act (LARACEAA) is part of the World Bank's support to the Government of Bulgaria through on-going analytical and advisory work in the area of regulatory reform. The purpose of the present ex-post impact assessment of the LARACEAA is to: (i) assess how the Act has been enforced, (ii) identify and estimate the impacts of the Act, and (iii) provide recommendations for amendments to the Act. Chapter one emphasizes the importance of the Act as part of the Bulgarian Government's role in advancing regulatory reform and improving the business environment; gives the scope of the assessment and presents the sources of information utilized; and delineates general limitations of the analysis. Chapter two outlines a policy framework by discussing coherence with the Governmental and European Union (EU) policies, as well as touching upon relevant documents on regulatory reform, followed by analysis of the goal and objectives of the Act...

Better Regulation for Higher Growth : Bulgaria's Business Regulation - Achievements and Recommendations

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Pre-2003 Economic or Sector Report
ENGLISH
Relevância na Pesquisa
36.45%
Removing regulatory obstacles that create barriers to business is a major objective for economic policymakers. There is broad understanding among policymakers and development practitioners that microeconomic reforms aimed at strengthening property rights, unleashing competition, and reducing the cost of doing business are critical to creating a sound investment climate and promoting economic growth (World Bank 2004; World Bank 2005; Lewis 2004). It is also commonly agreed that these changes need to be credible and sustained for private firms to respond by increasing investment and production (World Bank 2005). This report summarizes the findings of three topical studies of the World Bank: Administrative and Regulatory Barriers to Business (volume two) studies the overall burden of regulation for companies in comparison to other new European Union (EU) peers and specifically assesses Information Technology (IT) and manufacturing companies and the role of key stakeholders. The ex-post impact assessment of the act on limiting administrative regulation and administrative control on economic activity (Volume three) makes an assessment of how the act has been enforced...

Improving Payment Mechanisms in Cash-Based Safety Net Programs

del Ninno, Carlo; Subbarao, Kalanidhi; Kjellgren, Annika; Quintana, Rodrigo
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper
ENGLISH; EN_US
Relevância na Pesquisa
36.3%
Cash transfers have proliferated in the past decade as key policy instruments to tackle vulnerability and inequality. Payment mechanisms (PMs), the backbone of cash transfers, are the channels through which cash travels from the funding source to the hands of beneficiaries. In theory, the harmonization of payment flows in PMs with other program processes is critical to delivering the right benefit to the right people at the right time while minimizing costs. In reality, however, PMs tend to remain disconnected, rendering payments inefficient and plagued by error, fraud and corruption. In recent years, program operators, financial institutions, and technology innovators have developed strategies for streamlining payment flows. These innovations, if properly integrated into program management through a Management Information System (MIS) and supported by rigorous outreach, can not only promote efficiency and transparency but also ensure effectiveness. This paper provides a framework for integrating PMs within program management. It walks the reader through seven basic steps to process payments. It does so by articulating the flow of beneficiary information and funds from the point of beneficiary enrollment to payment reconciliation and grievance redress. It also looks at the framework through the lenses of different cash transfer interventions and the cases of Kenya...

The Hospital's Perspective on Cost Containment

McMahon, Alex
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1980 EN
Relevância na Pesquisa
36.3%
Cost containment has long been a concern of hospitals and the American Hospital Association (AHA). In recent years, however, cost containment has assumed a special prominence in hospitals, becoming both a political and social necessity. The hospitals' and AHA's activities in cost containment fall into four major categories: first, the Voluntary Effort to Contain Health Care Costs, of which AHA is a founding partner; second, administrative effectiveness; third, capital effectiveness, and, finally, medical effectiveness. Some programs to promote administrative effectiveness are shared administrative services, energy conservation, careful attention to staffing patterns and management effectiveness review. Capital effectiveness involves technology assessment and other means of deciding how to make the most of the hospital's dollar. Medical effectiveness can be accomplished by such methods as medical audits, utilization reviews and shared clinical services.