Public services in the UK are increasingly expected to account for their outputs and performance. This article describes a retrospective evaluation of the benefits from the R&D funded by a regional office of the NHS Executive. The methods adopted enabled the various elements of the region's R&D portfolio to be examined and provided a basis for the development of a plan for regular monitoring. The proposals for implementation are now also feeding into a debate as to how health services R&D might best be monitored nationally in a way that is compatible with the norms and practices of research in other contexts. 相似文献
Income smoothing, as defined in Statistical Activity Cost Theory (SACT), is the rational statistical adjustment of periodic accounting earnings to reduce their time volatility around average long-term profit per period. This article demonstrates how overhead cost allocations can be applied to smooth accounting earnings optimally in accordance with this definition. Such an approach parallels earlier work, such as that by Lane and Willett (1997 , 1999 ), in which a depreciation formula was derived and applied for this purpose. In particular, it is shown that, to realize an income smoothing effect in profit making firms, the usual optimal strategy is to over-allocate costs, giving support to the accounting principle of conservatism. 相似文献
The Global Entrepreneurship Monitor research program was designed as a comprehensive assessment of the role of entrepreneurship in national economic growth. The conceptual model reflected in a wide range of factors associated with national variations in entrepreneurial activity and the major contextual features. Empirical tests of the many relationships in the model required four major data collection activities: adult population surveys, unstructured interviews with national experts, self-administered questionnaires completed by national experts, and assembly of relevant standardized measures from existing cross-national data sets. Adult population surveys were implemented to identify those entrepreneurially active, which required a set of precise criteria and careful processing to ensure harmonized counts and prevalence rates across 41 countries. Existing evidence on measures of reliability indicates that the measures met contemporary standards and the project was cost-effective. 相似文献
Telaprevir (TVR,T) and boceprevir (BOC,B) are direct-acting antivirals (DAAs) used for the treatment of chronic genotype 1 hepatitis C virus (HCV) infection. This analysis evaluated the cost-effectiveness of TVR combined with pegylated interferon (Peg-IFN) alfa-2a plus ribavirin (RBV) compared with Peg-IFN alfa-2a and RBV (PR) alone or BOC plus Peg-IFN alfa-2b and RBV in treatment-experienced patients.
Methods:
A Markov cohort model of chronic genotype 1 HCV disease progression reflected the pathway of experienced patients retreated with DAA therapy. The population was stratified by previous response to treatment (i.e., previous relapsers, partial responders, and null responders). Sustained virologic response (SVR) rates were derived from a mixed-treatment comparison that included results from separate Phase III trials of TVR and BOC. Incremental cost per life year (LY) gained and quality-adjusted-life-year (QALY) gained were computed at lifetime, adopting the NHS perspective. Costs and health outcomes were discounted at 3.5%. Uncertainty was assessed using deterministic and probabilistic sensitivity analyses. Sub-group analyses were carried out by interleukin (IL)-28B genotype.
Results:
Higher costs and improved outcomes were associated with T/PR relative to PR alone for all experienced patients (ICER of £6079). T/PR was cost-effective for each sub-group population with high SVR advantage in relapsers (ICER of £2658 vs £7593 and £20,875 for partial and null responders). T/PR remained cost-effective regardless of IL-28B sub-type. Compared to B/PR, T/PR prolonged QALYs by 0.57 and reduced lifetime costs by £13,960 for relapsers. For partial responders T/PR was less costly but less efficacious than B/PR, equating to an ICER of £128,117 per QALY gained.
Limitations:
No head-to-head trial provides direct evidence of better efficacy of T/PR vs B/PR.
Conclusion:
T/PR is cost-effective compared with PR alone in experienced patients regardless of treatment history and IL-28B genotype. Compared to B/PR, T/PR is always cost-saving but only more effective in relapsers. 相似文献
We combine natural science modelling and valuation techniques to present economic analyses of a variety of land use change scenarios generated for the UK National Ecosystem Assessment. Specifically, the agricultural, greenhouse gas, recreational and urban greenspace impacts of the envisioned land use changes are valued. Particular attention is given to the incorporation of spatial variation in the natural environment and to addressing issues such as biodiversity impacts where reliable values are not available. Results show that the incorporation of ecosystem services and their values within analyses can substantially change decisions. 相似文献
This article reviews the rapidly growing literature on structural models of complementary choices. It discusses recent modeling developments and identifies promising areas for future research. 相似文献
In this article, the Chief Responsibility Officer for Aviva Investors examines the potential for financial institutions (FIs) to work in partnership with non‐governmental organizations (NGOs) in advocating changes to public policy that promote sustainable capital markets. Many NGOs have argued that the current form of global economic growth is unsustainable—and they routinely engage in public policy advocacy. However, such advocacy has generally proved ineffective, in large part because most NGOs have a very limited understanding of how capital markets function. Investors, for their part, are increasingly recognizing that key aspects of the global economy are on an unsustainable footing. And some are concerned about the negative implications for the long‐term value of their assets. But with a few notable exceptions, they have not made systematic efforts to work with governments to correct the market failures. NGO‐FI advocacy partnerships could identify specific cases of systemic or sectoral market failures, and recommend long‐term changes to the sectoral operating environment that would affect the cash flows and values of companies operating within that sector in ways designed to “internalize” the effects of negative social and environmental externalities. To foster the development of such partnerships, there is a need for academia to develop learning forums that stimulate the exchange of ideas between the executives within NGOs and FIs in an environment of mutual trust and respect. 相似文献
The term 'IT paradox' has been widely used to describe the apparent failure of much economic research to discover significant productivity gains associated with IT investment. In part this has been ascribed to measurement problems associated with both IT inputs and with outputs in IT-intensive industries. The current paper seeks to circumvent these difficulties by taking the ATM as a clearly defined embodied IT application and then using anaugmented production function approach to isolate its productivity effectsacross a sample of UK building societies, over the period of the ATM'sdiffusion. The paper finds no support for the 'IT paradox' and reports large robust and statistically significant productivity gains associated with ATM introduction. 相似文献