This study examines governance and institutional factors that influence how public resources are allocated for nutrition interventions in the context of a developing country—Mozambique—with very high rates of malnutrition. Based on qualitative empirical analysis building on a political economy framework, we explore the importance of two agent-centred and two investment-centred factors that determine how decisions on budget allocation to nutrition are made. The analysis finds that public decisionmakers strongly favour highly visible nutrition investments and those with a short duration between the time that spending is incurred and outcomes or outputs are achieved. Co-ordination has been quite successful among donors, and mainly of a spatial nature. Co-ordination is significantly weaker among government agencies, given the absence of fiscal tools of the co-ordinating agency, and its placement in a sector ministry rather than at a supra-sectoral level. Champions as change agents have had a truly influential role in attracting more funding to nutrition and improving its allocation. But their influence is also fleeting and difficult to sustain. 相似文献
Previous studies used general government data to examine whether national governments’ electoral motives and ideology influenced budget composition in OECD countries. General government data includes, however, the state and local level. Using new data for general and central government over the period 1995–2016, I reexamine political cycles in budget composition. The results suggest that, both at the general and central government level, leftwing governments spent more on education and less on public services than rightwing governments. Defense expenditure was somewhat lower under leftwing than rightwing governments and in election years; especially in federal states. Effects of government ideology on the individual expenditure categories are larger at the central than general government level. Scholars need to re-examine results on ideology-induced effects that have been derived from general government data where central government data should have been used. 相似文献
We study the impact of the domestic stability pact on the accuracy of budget forecasts of Italian municipalities. Identification of the causal effect exploits a quasi-natural experiment generated by the removal in 2001 of the fiscal restraints on budget decisions for municipalities with fewer than 5000 inhabitants and by stricter budgetary restrictions and severe penalties for noncompliers in 2002. We find that relaxing fiscal rules had a sizeable impact on budget forecast errors, especially in 2002. In fact, revenue (expenditure) forecast errors for municipalities with fewer than 5000 inhabitants became 26% (22%) larger than in the past. 相似文献
Aims: This study aimed to evaluate the budget impact of niraparib and olaparib in patients with platinum-sensitive, recurrent ovarian cancer from a US third party payer perspective.
Materials and methods: A budget impact model was constructed to assess the additional per member per month (PMPM) costs associated with the introduction of niraparib and olaparib, two poly ADP-ribose polymerase ribose polymerase (PARP) inhibitors recently approved to be used in platinum-sensitive, recurrent ovarian cancer patients with and without a gBRCA mutation. The model assessed both pharmacy costs and medical costs. Pharmacy costs included adjusted drug costs, coinsurance, and dispensing fees. Medical costs included costs associated with disease monitoring and management of adverse events from the treatment. Epidemiological data from the literature were used to estimate the target population size. The analysis used 1-year time frame, and patients were assumed on treatment until disease progression or death. All costs were computed in 2017 USD. One-way sensitivity analyses were conducted to evaluate the model robustness.
Results: In a hypothetical plan of 1,000,000 members, 206 patients were estimated to be potential candidates for niraparib or olaparib maintenance treatment after applying all epidemiological parameters. At listed 30-day supply WAC prices of $14,750 for niraparib and $13,482 for olaparib, budget impacts of these two drugs were $0.169 PMPM and $0.156 PMPM, respectively, most of which were contributed by pharmacy costs. Sensitivity analyses suggested that assumptions around market share, platinum-sensitive rate after first treatment, and WAC prices affected results the most.
Limitations: In this model, it was assumed that adopting niraparib and olaparib would not affect utilization of existing medications. Also, the estimated clinical parameters from clinical trials could differ from real-world data. 相似文献
We prove an existence result for the principal–agent problem with adverse selection under general assumptions on preferences and allocation spaces. Instead of assuming that the allocation space is finite-dimensional or compact, we consider a more general coercivity condition which takes into account the principal’s cost and the agents’ preferences. Our existence proof is simple and flexible enough to adapt to partial participation models as well as to the case of type-dependent budget constraints. 相似文献
This study analyzes the efficiency and productivity change within government subsidy recipients of a national technology innovation research and development (R&D) program. We examine 6,990 government‐sponsored, completed R&D projects during the last three performance follow‐up survey years from 2010 to 2012, and present a design of the sample of panel data to cope with the typical R&D performance time lag using a set of massive observations associated with completed R&D projects for the past 7 years from 2005 to 2011. In particular, data envelopment analysis is adopted to measure the efficiency and productivity change, which is measured in the Malmquist index. Parametric and nonparametric statistical tests are carried out to check for statistically significant differences among the characteristics regarding the types of government subsidy recipients. This study's major findings are as follows. First, during the entire period analyzed (2010–2012), there was a similar yearly pattern of statistically significant differences in the government subsidy means among the recipient types. In contrast, there were no obviously equivalent differences in the efficiency and productivity change. Second, the productivity had increased year on year, but the increments were reduced from year to year. Third, the productivity change was induced mainly by the Frontier‐shift, which indicates overall technology innovation progress, compared with the Catch‐up, which only indicates a simple increase in the efficiency. In particular, in this empirical analysis, the recipient types of ‘national laboratory’ and ‘large company’ had relatively larger sizes of government subsidies per project. However, the efficiency and productivity change of these types was not better than the others. This implies, therefore, that the government should control the ratio of the subsidy to the total R&D budget with an appropriate upper limit.
I empirically evaluate the productivity change within a national technology innovation R&D program.
I design a sample of panel data to cope with the typical R&D performance time lag using massive observations.
There is no obvious relationship between the government subsidy size and R&D productivity change.
Some particular types of government subsidy recipient are inferior in terms of R&D productivity change.
It practically implies that the government should control the ratio of the subsidy to the total R&D budget.
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