A cost comparison of hand hygiene regimens

The cost and quality of two hand hygiene regimens were compared. A waterless alcohol-based rub was significantly less costly than traditional handwashing because of reduced time required, and was associated with significantly better quality.     

浅谈施工项目的成本考核

施工企业在激烈的市场竞争条件下,必然会加强对内部的成本控制.对项目实施经济责任制,明确项目(经理)的责权利,是施工企业特别是国有施工企业常用的管理手段,被称为实施项目法管理的牛鼻子.     

The impact of frailty on the economic evaluation of geriatric surgery: hospital costs and opportunity costs based on meta-analysis

Abstract

Objectives: We used a systematic review and meta-analysis to analyze the difference in costs between surgery for frail and non-frail elderly patients. The opportunity cost of frailty in geriatric surgery is estimated using the results.

Methodology: Two literature reviews were carried out between 2000 and 2019: (1) studies comparing total hospital costs of frail and non-frail surgical patients; (2) studies evaluating the length of hospital stay and cost for surgical geriatric patients. We performed a meta-analysis of the items selected in the first review. We subsequently calculated the opportunity cost of frail patients, based on the design of a cost/time variable.

Results: Twelve articles in the first review were selected (272,717 non-frail and 16,461 frail). Fourteen articles were selected from the second review. Frail patients had higher hospital costs than non-frail patients (22,282.541 € and 16,388.844, p?<?.001) and a longer hospital stay (10.16 days and 8.4 (p?<?.001)). The estimated opportunity cost in frail patients is 1,019.56 € (cost/time unit factor of 579.30 €/day).

Conclusions: Frail surgical geriatric patients generate a higher total hospital cost, and an opportunity cost arising from not operating in the best possible state of health. Preoperatively treating the frailty of elderly patients will improve the use of health resources     

A close eye on the invisible hand

The paper shows how, and under what minimal information supply conditions, a market finds its competitive equilibrium price and thus solves the so-called tatonnement process, without sellers and buyers knowing the equilibrium price in advance. The information premises must be understood as a basic first approach, and do not necessarily mimic the real market process. Demonstration of a discovery process under these information handling conditions is an important finding for an evolutionary market theory. Additional information-processing elements should augment the efficiency of the discovery process. The results of the simulated market process set out above raise new questions. The role of institutional elements (such as the relevance of demand flexibility or “certainty” of knowledge in the learning process, etc.) is discussed further outside the context of the simulation model, providing new insight into the market process.     

Outcomes from use of an evidence-based practice guideline

The aim of evidence-based guidelines is primarily to improve patient outcomes without adding to the existing cost of care because both payers and policymakers want to identify health care costs that do not result in benefit to the patient. The purpose of the reported project was to generate a practice guideline for the treatment of uncomplicated acute cystitis in a female population, to determine the extent to which the guideline would be used by providers and to measure the cost and quality of outcomes from its use. A retrospective chart review was used to gather pre-guideline practice and cost data. Measurements included the type, frequency, and duration of antibiotic therapy and the use of urine cultures and both complications and routine followup visits. The implementation of an outpatient practice guideline resulted in a significant change in antibiotic prescribing and a trend toward a change in ordering cultures and clinic followup. There was also a significant decrease in treatment costs.     

Market frictions: A unified model of search costs and switching costs

It is well known that search costs and switching costs can create market power by constraining the ability of consumers to change suppliers. While previous research has examined each cost in isolation, this paper demonstrates the benefits of examining the two types of friction in unison. The paper shows how subtle distinctions between the two costs can provide important differences in their effects upon consumer behaviour, competition and welfare. In addition, the paper also illustrates a simple empirical methodology for estimating separate measures of both costs, while demonstrating a potential bias that can arise if only one cost is considered.     

交易成本：软件盗版的一个经济学注释

盗版软件影响软件市场的发展,长期以来却屡禁不绝。从产权经济学上分析,软件是具有公共性的商品。矫正软件公共性所导致的交易成本过高,被认为是盗版问题的主要经济学根源,造成了在打击盗版方面执法效果不佳。只有关注交易成本的影响,才能更加合理有效的对软件产权进行保护。     

The effect of differential shift costs on capital utilization

This paper presents the results of a micro study of the influence of the shift differential factor on utilization rates in Kenyan manufacturing. Qualitative information about the nature of technology and of shift differentials is incorporated into models of the choice of utilization rate under the alternative assumptions of constant returns to scale and increasing returns to scale. Econometric tests are then used to show that 1971 data is consistent with the theoretical predictions, although the results suggest that the quantitative significance of the shift differential factor in causing excess capacity should not be overstated.     

London bus tendering: the impact on costs

Bids for cost contracts in London Regional Transport bus routes between 1986 and 1993 are analysed for three purposes: to estimate costs for different types of bus operation; to test hypotheses about bidding under competition; to estimate cost savings attributable to tendering. There is no statistically significant difference in costs of operation between public and private sector operators on the tendered network. Bidding behaviour conforms to some features predicted by theoretical models. The estimated cost saving from tendering is 20%.     

Changing costs and the impact on RSV prophylaxis

Abstract

Objective:

Acquisition costs of palivizumab have increased in Canada since 2007. This analysis aims to re-evaluate the cost effectiveness of palivizumab in Canada for premature infants born between 32 and 35 weeks’ gestational age using updated 2010 healthcare costs compared to those used in a 2007 decision analytic model.

Methods:

New costs (CAN$) were acquired from the same Health Canada and Ontario Ministry of Health sources that were utilized in the previously published 2007 model. Palivizumab prices were acquired from Abbott Laboratories Ltd., current as of August 2010.

Results:

Incremental cost-effectiveness ratios (ICERs) rose by $742, going from $30,618/QALY to $31,360/QALY. ICER changes increased from a range of $801,297 to $820,701 for infants with zero risk factors to a decrease from $808 to $192 for infants with four or more risk factors.

Conclusions:

Palivizumab ICERs remained fairly stable from 2007 to 2010. The original recommendation stating that palivizumab is cost effective in infants born between 32 and 35 weeks’ GA with two or more risk factors, or who are at moderate-to-high risk based on a risk assessment model, does not change. Analyses founded on evolving country-specific variables are needed in order to accurately reassess the cost effectiveness of interventions as costs change worldwide.

Limitations:

There are a limited number of publications reporting mortality in premature Canadian infants with RSV as a primary outcome. In addition, conclusions drawn from this analysis are country-specific and limited to premature infants dwelling in Canada.     

Structural estimation of congestion costs

We estimate a structural model of congestion costs using a Bayesian Nash equilibrium approach: The individual's preference for traveling depends on the anticipated level of congestion, which in turn is determined by travelers’ decisions of mobility. The model is estimated using a French transportation household survey. Results confirm the presence of incomplete information and show that aversion to congestion is 6.6% lower during peak times than during off-peak times. A traveler's willingness-to-pay to save 1 min in traffic is estimated at 0.73 euros during peak times and 0.25 euros during off-peak times.     

The welfare costs of corruption

Corruption has been shown to affect a variety of economic indicators, especially GDP per capita. However, as GDP is not a genuine indicator of welfare, it may reflect the welfare costs of corruption only in an incomplete way. This article uses self-rated subjective well-being as an empirical approximation to general welfare and shows that cross-national welfare?–?operationalized in this way?–?is affected by corruption not only indirectly through GDP, but also directly through nonmaterial factors. This article estimates the size of these effects as well as their monetary equivalent. The direct effect?–?not previously investigated in the corruption literature?–?is found to be substantially larger than the indirect effect.     

The macroeconomic costs of conflict

Macroeconomic costs of conflict are generally very large, with GDP per capita about 28 percent lower ten years after conflict onset. This is overwhelmingly driven by private consumption, which falls by almost 25 percent ten years after conflict onset. Conflict is also associated with dramatic declines in official trade, with exports (imports) estimated to be 58 (34) percent lower ten years after conflict onset. The onset of conflict often also induces significant refugee outflows to neighboring non-advanced countries in the short run, and relatively small but very persistent refugee outflows to advanced countries over the long run. To alleviate reverse causality concerns between GDP and conflict onset, we control for pre-conflict GDP forecasts from the IMF World Economic Outlook and show that similar results are obtained with and without pre-conflict GDP forecasts.     

The costs of uncoordinated regulation

Patents encourage firms to undertake research and development by protecting innovator revenues from competition. Controls on pollution of the environment are intended to close the gap between the private and social costs of natural resource use. This paper examines the incentives that are created by the interaction of these two separate pieces of regulation. A model is developed that shows how an incumbent, patent-holding firm can take advantage of environmental regulation to exclude rivals from her market.