Página 1 dos resultados de 82339 itens digitais encontrados em 0.042 segundos

Avaliações econômicas de programas de vacinação: as estimativas de custos em intervenções preventivas; Economic evaluations of vaccination programmes: cost estimates of preventive interventions

Valentim, Joice
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 14/10/2009 PT
Relevância na Pesquisa
36.32%
Esta tese representa o aprofundamento do estudo das estimativas de custos, componente integrante e determinante das avaliações econômicas, enquanto parte do projeto de pesquisa Estudos de custo-efetividade da incorporação de novas vacinas à rotina do Programa Nacional de Imunizações: Rotavírus, Varicela, Pneumocócica conjugada, Meningocócica C conjugada e Hepatite A desenvolvido por solicitação do Programa Nacional de Imunização/PNI da Secretaria de Vigilância em Saúde/SVS do Ministério da Saúde, a partir de 2005. A tese teve como objetivo analisar as condições de uso, dificuldades e repercussões de diferentes métodos de estimativas de custos em estudos de custo-efetividade de vacinas de duas tecnologias específicas, vacinas contra rotavírus e varicela, assim como a relação entre as estimativas de custos e os resultados. As estimativas de custos estão condicionadas pelas características gerais da doença sob análise (aguda no caso de rotavírus e com seqüela no caso de varicela), assim como por questões metodológicas gerais (escolha teórico-conceitual, métodos e fontes de dados) e especificidades do caso brasileiro. Para esta tese, houve maior detalhamento das estimativas de custos diretos no cuidado da doença...

Trade-offs de custos logísticos; Logistics cost trade-offs

Amaral, Juliana Ventura
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 04/10/2012 PT
Relevância na Pesquisa
36.32%
Ao longo das últimas décadas, a crescente pressão competitiva vem ampliando a necessidade de empenho integrado da logística para melhorar, conjuntamente, o atendimento aos consumidores e a lucratividade. O atendimento aos clientes pede o oferecimento de nível de serviço que maximize as utilidades de tempo e de lugar e a busca pela geração de lucros reconhece que a logística, ao oferecer o nível de serviço definido, deve minimizar seu custo total. O custo total logístico não responde às normais técnicas de corte de custos: os custos logísticos movem-se em diferentes direções e a redução de um custo invariavelmente conduz ao aumento de outros custos ou à diminuição do serviço oferecido ao cliente. Como consequência, os profissionais logísticos precisam identificar e explorar os trade-offs de custos logísticos para encontrar e sustentar o balanço entre os custos incorridos e o serviço oferecido. Nesse contexto, o objetivo da presente dissertação foi verificar se os profissionais logísticos: (1) têm conhecimento dos trade-offs de custos logísticos e (2) avaliam os trade-offs de custos logísticos, ao desenharem e implementarem suas soluções. Para atingir esses objetivos, este trabalho caracterizou as atividades logísticas e seus respectivos elementos de custos...

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
36.33%
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...

Disclosure socioambiental e custo de capital próprio de companhias abertas no Brasil; Social and environmental disclosure and cost of equity capital of public companies in Brazil

Rover, Suliani
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 18/02/2013 PT
Relevância na Pesquisa
36.31%
O objetivo do trabalho é investigar a relação entre o disclosure voluntário socioambiental e o custo de capital próprio de companhias abertas no Brasil. Com base na Teoria da Divulgação Voluntária, espera-se uma relação negativa entre o disclosure socioambiental e o custo de capital próprio. Para tanto, selecionou-se as 91 empresas que compõem o Índice Brasil (IBrX), consideradas como as mais negociadas na Bolsa de Valores de São Paulo (BOVESPA). A pesquisa é composta por dois períodos de análise. O primeiro compreende os anos de 2001 a 2010 e foi utilizado na análise para verificar a relação entre a publicação do Relatório de Sustentabilidade e o custo de capital próprio, enquanto o segundo período, de 2008 a 2010, se constitui na base de análise para examinar a relação entre o disclosure socioambiental e o custo de capital próprio. A métrica de disclosure voluntário socioambiental foi elaborada a partir de 20 pesquisas, na qual resultou em 80 subcategorias, sendo 40 referentes à divulgação social e 40 relacionadas ao meio ambiente. Por meio da análise de conteúdo de 272 Demonstrações Financeiras e de 178 Relatórios de Sustentabilidade, mensurou-se o nível de disclosure socioambiental das empresas. O custo de capital próprio foi estimado por uma abordagem ex ante mediante a utilização dos modelos de Claus e Thomas (2001)...

Gestão estratégica de custos: uma contribuição para a construção de sua estrutura conceitual; Strategic cost management: a contribution to construction of your conceptual framework

Slavov, Tiago Nascimento Borges
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 28/02/2013 PT
Relevância na Pesquisa
36.34%
A falta de uma Estrutura Conceitual para Gestão Estratégica de Custos - GEC acabou por incorporar ao tema deste estudo toda uma gama de conceitos associados a custos, prejudicando seu desenvolvimento científico e sua aplicação prática. Trabalhos que se propõem a definir e delimitar seus conceitos apresentam divergências e contradições conceituais do que vem a ser, de fato, uma GESTÃO ESTRATÉGICA de custos. Com o problema evidenciado da falta de uma definição para a GEC, os principais elementos que compõem sua estrutura conceitual - seus meios (artefatos) e objetivos (eventos) - também apresentam problemas conceituais. Assim, este trabalho visou i) apresentar uma definição coerente para a GEC, sistematizando os conceitos de gestão, gestão estratégica, custos e gestão de custos e ii) identificar os eventos e artefatos da Gestão Estratégica de Custos e Gestão Operacional de Custos, suportando a análise com os elementos conceituais identificados na primeira etapa (i). Para tanto, houve mister do desenvolvimento de uma pesquisa exploratória e descritiva, com natureza teórica do problema, problema este de caráter qualitativo, com abordagem predominante crítico-dialética. Dada a contribuição pretendida para a construção de uma Estrutura Conceitual para a GEC...

Where to Use Cost Effectiveness Techniques Rather Than Cost Benefit Analysis

Mackie, Peter; Nellthorp, John; Laird, James
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Relevância na Pesquisa
36.32%
Cost Benefit Analysis, and the measures of economic performance that can be derived from it (see Note 6: When and How to Use NPV, IRR and Adjusted IRR), is the preferred method for demonstrating the economic justification of transport investments. Such an approach, however, relies on the ability to be able to measure costs and benefits in monetary terms (see Note 5: Framework), which renders it problematic for projects where the majority of benefits cannot be readily monetised. Such a project could be a Low Volume Rural Road (see Note 21: Low Volume Rural Roads). In such situations consideration should be given to the use of measures derived from cost effectiveness or weighted cost effectiveness (also known as Multi Criteria Analysis) techniques as the basis for the decision regarding whether to invest or not. Cost effectiveness techniques are also a very useful tool for project screening or ranking. Such a screening process ensures that projects that are subjected to a more detailed analysis (including cost benefit analysis) are those that best fit with the objectives of the investment (e.g. poverty alleviation). Section 1 of this note outlines the situations in which cost effectiveness techniques should be used...

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
36.34%
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...

Arab Republic of Egypt : Cost Assessment of Environmental Degradation

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
36.33%
The report is a first step in a process towards the use of environmental damage cost assessments, for priority setting, and as an instrument for integrating environment, into economic, and social development. The report provides estimates of damage, and remediation cost for several areas of the environment, and, as areas of priority are identified, further analysis would be required for more accurate estimates. The damage cost of environmental degradation in Egypt in 1999, is estimated at 3.2-6.4 percent of GDP, with a mean estimate of 4.8 of GDP. In addition, the damage cost to the global environment is estimated at 0.6 percent of GDP. The cost of air pollution is assessed at 1.1-3.2 percent of GDP (urban outdoor and rural indoor), followed by soil degradation at 1.0-1.4 percent (erosion and salinity). In the area of water, the damage cost is estimated at 0.7-1.2 percent of GDP (mostly from the lack of safe water, sanitation and hygiene). Cost of coastal zone degradation is estimated at 0.2.-0.4 percent of GDP...

The Cost Structure of the Clean Development Mechanism

Rahman, Shaikh M.; Larson, Donald F.; Dinar, Ariel
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
36.33%
This paper examines the cost of producing emission reduction credits under the Clean Development Mechanism. Using project-specific data, cost functions are estimated using alternative functional forms. The results show that, in general, the distribution of projects in the pipeline does not correspond exclusively to the cost of generating anticipated credits. Rather, investment choices appear to be influenced by location and project type considerations in a way that is consistent with variable transaction costs and investor preferences among hosts and classes of projects. This implies that comparative advantage based on the marginal cost of abatement is only one of several factors driving Clean Development Mechanism investments. This is significant since much of the conceptual and applied numerical literature concerning greenhouse gas mitigation policies relies on presumptions about relative abatement costs. The authors also find that Clean Development Mechanism projects generally exhibit constant or increasing returns to scale. In contrast...

Cost-Effectiveness Measurement in Development : Accounting for Local Costs and Noisy Impacts

Evans, David K.; Popova, Anna
Fonte: World Bank Group, Washington, DC Publicador: World Bank Group, Washington, DC
EN_US
Relevância na Pesquisa
36.35%
As evidence from rigorous impact evaluations grows in development, there have been more calls to complement impact evaluation analysis with cost analysis, so that policy makers can make investment decisions based on costs as well as impacts. This paper discusses important considerations for implementing cost-effectiveness analysis in the policy making process. The analysis is applied in the context of education interventions, although the findings generalize to other areas. First, the paper demonstrates a systematic method for characterizing the sensitivity of impact estimates. Second, the concept of context-specificity is applied to cost measurement: program costs vary greatly across contexts -- both within and across countries -- and with program complexity. The paper shows how adapting a single cost ingredient across settings dramatically shifts cost-effectiveness measures. Third, the paper provides evidence that interventions with fewer beneficiaries tend to have higher per-beneficiary costs, resulting in potential cost overestimates when extrapolating to large-scale applications. At the same time...

Cost-sensitive classification based on Bregman divergences

Santos Rodríguez, Raúl
Fonte: Universidade Carlos III de Madrid Publicador: Universidade Carlos III de Madrid
Tipo: Tese de Doutorado Formato: application/pdf
ENG
Relevância na Pesquisa
36.36%
The main object of this PhD. Thesis is the identification, characterization and study of new loss functions to address the so-called cost-sensitive classification. Many decision problems are intrinsically cost-sensitive. However, the dominating preference for cost-insensitive methods in the machine learning literature is a natural consequence of the fact that true costs in real applications are di fficult to evaluate. Since, in general, uncovering the correct class of the data is less costly than any decision error, designing low error decision systems is a reasonable (but suboptimal) approach. For instance, consider the classification of credit applicants as either being good customers (will pay back the credit) or bad customers (will fail to pay o part of the credit). The cost of classifying one risky borrower as good could be much higher than the cost of classifying a potentially good customer as bad. Our proposal relies on Bayes decision theory where the goal is to assign instances to the class with minimum expected cost. The decision is made involving both costs and posterior probabilities of the classes. Obtaining calibrated probability estimates at the classifier output requires a suitable learning machine, a large enough representative data set as well as an adequate loss function to be minimized during learning. The design of the loss function can be aided by the costs: classical decision theory shows that cost matrices de ne class boundaries determined by posterior class probability estimates. Strictly speaking...

Custo de oportunidade da Reserva Legal do Código Florestal entre 1995/1996 e 2006 e seus determinantes; The Forest Code opportunity cost between 1995/1996 and 2006, its evolution and its determinants

Campos, Samuel Alex Coelho
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 07/07/2015 PT
Relevância na Pesquisa
36.33%
A produção agropecuária está sujeita a diversas restrições, como as restrições legais impostas pelo Código Florestal, o qual restringe a área utilizada para a produção agropecuária dentro do imóvel rural, o que implica em custo para os produtores agropecuários e que é representado pela renda renunciada e aumento dos custos pela alocação dos insumos de forma a reduzir a necessidade da área que deve ser mantida com florestas nativas. Esse custo pode variar entre os produtores em razão das características da propriedade e do produtor. Neste contexto, o objetivo desse estudo é mensurar o custo de oportunidade da área ocupada com Reserva Legal e seus determinantes, confrontando os produtores representativos do estado de São Paulo e do Mato Grosso nos anos de 1995 e 2006. O produtor representativo foi obtido dividindo o valor total das variáveis em nível municipal pelo número de estabelecimentos. O custo de oportunidade foi estimado utilizando a metodologia proposta por Zhou, Ang e Poh (2006) e os seus determinantes foram estimados por meio de um modelo de econometria espacial. Os resultados indicaram que a eficiência técnica e a eficiência técnica ambiental dos produtores foram pequenas nos anos analisados em ambos os estados considerados. Um produtor é eficiente tecnicamente se ele obtém o máximo de produção possível dado os insumos utilizados. A eficiência ambiental também objetiva minimizar o desmatamento. O estado do Mato Grosso destacou-se pela baixa eficiência produtiva em 1995/96...

A cost model for estimating operating and support costs for U.S. Navy (nuclear) submarines

Allison, William J.
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado Formato: xiv, 61 p.
EN_US
Relevância na Pesquisa
36.33%
Approved for public release, distribution is unlimited; This thesis attempts to formulate a parametric cost model to estimate the annual operating and support (O&S) cost of future U.S. Navy (nuclear) submarines, based on presumed physical characteristics and manpower expectations. Source data for the analysis is obtained from the Navy's VAMOSC database. Using regression analysis techniques, cost estimating relationships are developed for three assumed cost drivers - manpower, length, and submerged displacement. However, the analysis reveals that there is no significant relationship between annual O&S cost and the three assumed cost drivers. Therefore, an alternative method of estimating annual O&S cost is presented using probabilistic assessment of cost based on the empirical annual O&S cost distribution. The probabilistic assessment method allows decision-makers and cost analysts to estimate the annual O&S cost for which there is a desired probability that the true annual O&S cost of a new submarine will not be exceeded. For example, historically, 80 percent of all SSNs have experienced annual O&S costs of less than $27 M (CY99$), while the remaining 20 percent have experienced annual O&S costs greater than $27 M (CY99$). So, loosely speaking...

Analysis of implementing lifetime energy cost, including fully burdened cost of fuel and energy footprints of contractors, as mandatory decision factors in navy acquisition

Murphy, Doug; Wilson, Chris
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Formato: xvi, 79 p. : ill.( some color) ; 28 cm.
Relevância na Pesquisa
36.32%
MBA Professional Report; The Secretary of the Navy (SECNAV), the Honorable Ray Mabus, in an address to the Navy Energy Forum, announced as a new acquisition policy that the "lifetime energy cost of a building or a system, and the fully burdened cost of fuel in powering those, will be a mandatory evaluation factor used when awarding contracts." Secretary Mabus went on to say, "we will also use the overall energy efficiency and the energy footprint of a competing company as an additional factor in acquisition decisions" (Mabus, 2009). Secretary Mabus made this announcement and shared three other green and efficiency goals for the Department of the Navy. His address now puts the onus on the Navy acquisition community to implement the broad policy goals that he outlined. A challenge to the community will be how to implement these goals with a uniform, objective, and definable standard that is able to withstand the scrutiny of congress, which requires full and open competition, the business models of the defense industry, and the legal challenges that are sure to follow as a result of competition. This project analyzes the challenges of implementing Secretary Mabus's announcement. Our analysis further defines the problem, offers recommendations for proceeding...

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
36.34%
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

Applying Abatement Cost Curve Methodology for Low-Carbon Strategy in Changning District, Shanghai

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Policy Note; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
36.32%
The speed and scale of urbanization provide an unprecedented opportunity in the coming years to invest in clean energy technologies to contain carbon emissions from the country's sprawling cities. Therefore, supporting low carbon cities is one of the government's top priorities. Shanghai municipal and changning district governments are firmly committed to the transition to a low-carbon city and requested for the World Bank's support in making changning district and Shanghai leaders in designing novel and efficient ways to achieve carbon-intensity-reduction targets. This report documents the methodology of and key findings from applying abatement cost curves and scenarios to set low-carbon targets and define cost-effective low-carbon investment programs in Changning district, Shanghai. At the request of changning district government, the Bank team supported a Shanghai energy conservation institution, assisted by an international firm, in conducting a comprehensive survey of buildings in Hongqiao area in the changning district...

Costs and Cost-Effectiveness of 9-Valent Human Papillomavirus (HPV) Vaccination in Two East African Countries

Kiatpongsan, Sorapop; Kim, Jane J.
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
36.35%
Background: Current prophylactic vaccines against human papillomavirus (HPV) target two of the most oncogenic types, HPV-16 and -18, which contribute to roughly 70% of cervical cancers worldwide. Second-generation HPV vaccines include a 9-valent vaccine, which targets five additional oncogenic HPV types (i.e., 31, 33, 45, 52, and 58) that contribute to another 15–30% of cervical cancer cases. The objective of this study was to determine a range of vaccine costs for which the 9-valent vaccine would be cost-effective in comparison to the current vaccines in two less developed countries (i.e., Kenya and Uganda). Methods and Findings: The analysis was performed using a natural history disease simulation model of HPV and cervical cancer. The mathematical model simulates individual women from an early age and tracks health events and resource use as they transition through clinically-relevant health states over their lifetime. Epidemiological data on HPV prevalence and cancer incidence were used to adapt the model to Kenya and Uganda. Health benefit, or effectiveness, from HPV vaccination was measured in terms of life expectancy, and costs were measured in international dollars (I$). The incremental cost of the 9-valent vaccine included the added cost of the vaccine counterbalanced by costs averted from additional cancer cases prevented. All future costs and health benefits were discounted at an annual rate of 3% in the base case analysis. We conducted sensitivity analyses to investigate how infection with multiple HPV types...

Institutional and familial cost of patients in continuous ambulatory peritoneal dialysis

Villarreal-Ríos,Enrique; Cárdenas-Maldonado,Cecilia; Vargas-Daza,Emma Rosa; Galicia-Rodríguez,Liliana; Martínez-González,Lidia; Baca-Baca,Roberto
Fonte: Associação Médica Brasileira Publicador: Associação Médica Brasileira
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 EN
Relevância na Pesquisa
36.34%
Objective: to determine the cost of institutional and familial care for patients with chronic kidney disease replacement therapy with continuous ambulatory peritoneal dialysis. Methods: a study of the cost of care for patients with chronic kidney disease treated with continuous ambulatory peritoneal dialysis was undertaken. The sample size (151) was calculated with the formula of the averages for an infinite population. The institutional cost included the cost of outpatient consultation, emergencies, hospitalization, ambulance, pharmacy, medication, laboratory, x-rays and application of erythropoietin. The family cost included transportation cost for services, cost of food during care, as well as the cost of medication and treatment materials acquired by the family for home care. The analysis included averages, percentages and confidence intervals. Results: the average annual institutional cost is US$ 11,004.3. The average annual family cost is US$ 2,831.04. The average annual cost of patient care in continuous ambulatory peritoneal dialysis including institutional and family cost is US$ 13,835.35. Conclusion: the cost of chronic kidney disease requires a large amount of economic resources, and is becoming a serious problem for health services and families. It's also true that the form of patient management in continuous ambulatory peritoneal dialysis is the most efficient in the use of institutional resources and family.

The cost-effectiveness of pneumococcal conjugate vaccination in Australia

Butler, James; McIntyre, Peter; MacIntyre, C Raina; Gilmour, Robin; Howarth, Ann; Sander, B
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
36.33%
Background: Pneumococcal conjugate vaccine, 7 valent (PCV7) is the most costly vaccine yet considered for publicly funded programs. In mid 2001, Australia funded PCV7 for high-risk groups only (indigenous children and children with certain underlying medical conditions). World wide, non-industry-funded studies and studies using cost-utility measures are sparse. We undertook an independent economic analysis of PCV7 compared with no vaccination in the non high-risk Australian childhood population using cost-utility and cost-effectiveness measures. Methods: The incidence of invasive pneumococcal disease (IPD), non-bacteraemic pneumonia and otitis media was estimated using representative urban Australian data, or by extrapolation from comparable industrialised countries. A decision-analytic model was developed for a hypothetical birth cohort using the age-specific vaccine coverage from the Californian randomised controlled trial of PCV7. Health outcomes were measured by life-years saved and deaths and disability-adjusted life-years (DALYs) averted. In line with government guidelines, only direct costs were considered in 1997-1998 Australian dollars. Results: For a birth cohort of 250,000, the gross cost of vaccination is $ 78.6 million. Subtracting treatment cost savings...

Impact of pharmacist's interventions on cost of drug therapy in intensive care unit

Saokaew,Surasak; Maphanta,Sirada; Thangsomboon,Pornchanok
Fonte: Pharmacy Practice (Internet) Publicador: Pharmacy Practice (Internet)
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/06/2009 ENG
Relevância na Pesquisa
36.36%
Pharmacist participation in patient care team has been shown to reduce incidence of adverse drug events, and overall drug costs. However, impact of pharmacist participation in the multidisciplinary intensive care team on cost saving and cost avoidance has little been studied in Thailand. Objective: To describe the characteristics of the interventions and to determine pharmacist's interventions led to change in cost saving and cost avoidance in intensive care unit (ICU). Methods: A Prospective, standard care-controlled study design was used to compare cost saving and cost avoidance of patients receiving care from patient care team (including a clinical pharmacist) versus standard care (no pharmacist on team). All patients admitted to the medical intensive care unit 1 and 2 during the same period were included in the study. The outcome measures were overall drug cost and length of ICU stay. Interventions made by the pharmacist in the study group were documented. The analyses of acceptance and cost saving and/or cost avoidance were also performed. Results: A total of 65 patients were admitted to either ICU 1 or 2 during the 5 week- study period. The pharmacist participated in patient care and made total of 127 interventions for the ICU-1 team. Ninety-eight percent of the interventions were accepted and implemented by physicians. The difference of overall drug cost per patient between two groups was 182.01 USD (1...