Cost engineering and costing in Hawthorn Leslie Shipbuilders, 1886–1915

This research examines cost engineering and costing in a British shipbuilding firm in the late nineteenth – early twentieth century. The firm maintained separate systems of contract accounting, costing and reporting for directors and employed internal data from these systems in performance measurement, the development of managerial incentives and the enforcement of managerial accountability. An apparent gap in the information required to manage the firm in a cyclical and highly competitive industry during a period of rapid organisational and technological change was filled by an informal and personal cost engineering system developed by the shipbuilding manager. The shipbuilding manager's cost engineering system employed a wide range of both internal and external data for use in cost management and in cost estimation, pricing and tendering. Thus cost engineering and costing developed to serve different purposes and developed in different spheres and along different trajectories.     

资本结构视角下的再保险行为分析

再保险不仅是保险公司的风险管理措施,也是保险行业特有的一种融资方式.本文从资本结构的财务视角重新审视再保险行为,试图搭建再保险融资的基本财务理论框架,在分析再保险融资特点与优缺点的基础上,结合行业实际,对如何做好再保险融资,实现企业价值最大化提出了相关意见和建议.     

Modelling the Risks Associated with the Increased Importation of Fresh Produce from Emerging Supply Sources Outside the EU to the UK

The risk of non‐indigenous plant pests entering the UK via international trade in fresh produce is increasing. The objective of this article is to identify existing and emerging supply sources for UK fresh produce importers and examine the extent to which they could provide invasion pathways. We tested the hypothesis that increased imports of fresh produce from new sources outside the European Union could increase the risks of non‐indigenous insect pests. We use a bio‐economic model approach in which the number of species arrivals is a function of the volume of imports, whereas the volume of imports itself is a function of gross domestic product, relative import prices and seasonality. The study has identified clear trends, which show import volumes of fresh produce and species detections increasing from new supply sources. If this trend continues in the future, then the UK inspection agency should expect to confront species from new suppliers in much greater numbers, given that import volumes of fresh produce are income elastic.     

交易成本与新型农村合作医疗制度可持续发展

新型农村合作医疗制度的试点极大地推进了我国农村医疗保障制度的构建过程,但是该项制度推进并不顺利。本文试从交易成本理论视角,分析当前新农合制度存在较高的交易成本导致制度创新不足。在此基础上,本文提出要使新农合制度可持续发展,政府必须从制度完善和机制创新两个方面降低交易成本,以提高新农合制度绩效。     

Health-related quality-of-life in patients after elective surgery for abdominal aortic aneurysm

Abstract

Purpose:

The purpose of this study was to describe the health-related quality-of-life (QoL) in patients after elective surgery for abdominal aortic aneurysm (AAA) compared to a normal population and to study the association between QoL and number of years since surgery.

Methods:

All Danish men who underwent elective surgery for AAA at the age of 65 or more in the period from 1989–2007 in Denmark were invited to participate in the survey. Of 722 patients, 375 were alive and 328 (87%) responded. The instruments EQ-5D (European Quality of life), EQ-VAS and SF-12 (Short Form Health Survey) were applied for measuring health-related QoL. Multiple regression analysis was used to study the association between QoL and number of years since AAA surgery.

Results:

A significantly poorer QoL was found in patients having had AAA surgery compared to the normal population as measured with the SF-12 and the EQ-VAS, but not with EQ-5D. A negative association between QoL and years following surgery was found with EQ-VAS and SF-12 (PCS), but not with the other instruments.

Discussion:

Factors such as selection bias because of mortality and non-response may have resulted in an over-estimate of the QoL in patients having had AAA surgery, thus the difference in QoL compared to the normal population was probably under-estimated. The cross-section design was inefficient for the study of the association between QoL and years since surgery, and EQ-5D may be an insensitive instrument for measuring QoL in AAA patients after surgery.

Limitations:

The main limitation of the study was the cross-sectional design. Males with a higher risk of death were under-represented in the sample.

Conclusion:

A poorer quality-of-life was found in patients having had elective AAA surgery compared to the normal population.     

Cost of skeletal-related events in European patients with solid tumours and bone metastases: data from a prospective multinational observational study

Abstract

Objectives:

Patients with bone metastases often experience skeletal-related events (SREs: radiation or surgery to bone, pathologic fracture, and spinal cord compression). This study examined health resource utilization and costs associated with SREs.

Methods:

Data presented are from the European cohort (Germany, Italy, Spain, and the UK) of patients with solid tumours enrolled in a multi-national, prospective, observational study in patients with solid tumours or multiple myeloma. Patients with Eastern Cooperative Oncology Group score 0–2 and life expectancy ≥6 months, who experienced an SRE up to 97 days before enrolment, were eligible. Health resource utilization associated with SREs (including number/length of inpatient stays, numbers of procedures and outpatient visits) were collected through chart review for up to 97 days before enrolment and prospectively during follow-up. Country-specific cost calculations were performed.

Results:

In total, 478 eligible patients contributed 893 SREs to this analysis. Radiation to bone occurred most frequently (66% of total). Spinal cord compression (7%) and surgery to bone (10%) were the least common events, but most likely to require inpatient stays. The most costly SREs were also spinal cord compression (mean per SRE across countries, €4884–€12,082) and surgery to bone (€3348–€9407). Inpatient stays were the main cost drivers.

Limitations:

Health resource utilization used to calculate the costs associated with SREs may have been under-estimated as a result of exclusion of patients with low performance status or life expectancy; unavailable information and exclusion of resource consumption associated with pain. Thus, the estimate of associated costs is likely to be conservative.

Conclusions:

SREs result in considerable health resource utilization, imposing a substantial financial burden driven by inpatient stays. Treatments that prevent/delay SREs may help ease this burden, thereby providing cost savings across European healthcare systems.     

Medical resource use and costs associated with chylomicronemia

Abstract

Background:

The prevalence of severe hypertriglyceridemia (TG?>?1000?mg/dl) is estimated at 150–400 per 100,000 individuals in North America. Severe hypertriglyceridemia in the fasting state is associated with increased acute pancreatitis risk and is a sign of chylomicronemia which reflects the accumulation in the bloodstream of chylomicrons, the large lipoprotein particles produced in the gut after a meal.

Objective:

To assess medical resource use and costs associated with chylomicronemia.

Methods:

Patients with chylomicronemia of different causes (≥2 diagnoses with ICD-9 code 272.3) were identified from a large US claims database (years 2000 to 2009) and matched 1:1 to controls free of chylomicronemia based on age, gender, demographics, comorbidities, and use of lipid lowering drugs. During a 1-year study period, medical resource use and costs associated with chylomicronemia or acute pancreatitis were compared between matched cases and controls.

Results:

Among 6472 matched pairs, annual per-patient medical costs, calculated independently of the occurrence of acute pancreatitis, were significantly greater by $808 for chylomicronemia cases vs controls ($8029 vs $7220, p?<?0.01), half of which was attributable to chylomicronemia-related services (p?<?0.01). Chylomicronemia cases with a history of acute pancreatitis (n?=?46) had greater rates of inpatient visits (p?<?0.05) and greater average costs for subsequent acute pancreatitis or abdominal pain (p?<?0.01) as well as greater total medical costs ($33,587 vs $4402, p?<?0.01) vs matched controls. The average episode of acute pancreatitis (n?=?104 episodes) generated medical costs of $31,820, almost entirely due to inpatient stays.

Limitations:

Triglyceride levels were not available to characterize disease severity.

Conclusions:

Patients with chylomicronemia, and especially those with a history of acute pancreatitis, incurred significantly greater total medical costs compared with individuals without chylomicronemia but with an otherwise comparable health profile.     

对我国企业成本管理模式选择的探讨

当今的经济环境已经发生很大变化，世界范围内的竞争压力，服务产业的增长，以及信息和生产技术的进步已经改变了经济的性质，并引起众多企业经营经济业务的方式发生显著的改变。经济环境的变化同样催生和加速了新的成本管理模式的诞生，面对复杂的竞争环境，企业如何在传统的成本管理方式和新的成本管理模式之间进行取舍和过渡，已经成为大多数国内企业面临的重要课题、本文围绕我国企业如何建立和运作新的成本管理模式，在全面分析全面成本管理、作业成本管理和成本企画三种成本管理模式的特点和当前我国企业成本管理现状及存在的问题的基础上，提出了我国企业成本管理模式应该以作业成本核算与全面成本管理融合的成本管理新模式，从新的角度给出了问题的解决思路。