Resource allocation

2021 ◽  
pp. 119-130
Author(s):  
Anna Smajdor ◽  
Jonathan Herring ◽  
Robert Wheeler
Keyword(s):  
Resource Allocation ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Quality Adjusted Life Years ◽  
Medical Resources ◽  
Life Years ◽  
Ethical Basis ◽  
Quality Adjusted Life

This chapter explores the issues around the rationing of medical resources. It considers the different ways in which restrictions are imposed on what treatments are available and the ethical basis on which these assessments are based. This includes the controversial 'quality adjusted life years' method which is used to determine a cost/benefit analysis of different treatments. The chapter also examines how rationing is consistent with broader themes of justice.

Quantifying the Non-Use Value of Biodiversity in Cost–Benefit Analysis: The Dutch Biodiversity Points

2021 ◽  
pp. 1-26
Author(s):  
Frits Bos ◽  
Arjan Ruijs
Keyword(s):  
Marine Protected Area ◽  
Cost Benefit Analysis ◽  
Quantitative Measure ◽  
Cost Benefit ◽  
Use Value ◽  
Benefit Analysis ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
The Impact

Abstract Biodiversity points are a quantitative measure for biodiversity. For over a decade, biodiversity points are being applied in the Netherlands for measuring the impact of roads, enclosure dams, and other water management projects on the non-use value of biodiversity. Biodiversity points are quite similar to the quality-adjusted life years used for cost-effectiveness analysis of healthcare treatments. Biodiversity points can be calculated by multiplying the size of the ecotope (e.g., number of hectare), the ecological quality of the ecotope (0–100 %), and the ecological scarcity of each type of ecotope. For many infrastructure projects, the impact on the non-use value of biodiversity can be a principal purpose or a major co-benefit or trade-off, for example, for a park, a fish sluice, a road, an ecoduct, an enclosure dam, or a marine protected area. Biodiversity points are a simple, transparent, and standardized way to aggregate and quantify the qualitative or ordinal assessments by ecological experts. For measuring the non-use value of biodiversity, they are also more informative than valuation by revealed or stated preferences methods. This paper provides the first overview of the application of this method in the Dutch practice of cost–benefit analysis. It also discusses its merits and limitations. The calculation and use of biodiversity points are illustrated by four case studies.

Economics, Ethics and Environmental Problems

1986 ◽  
Vol 1 (3) ◽  
pp. 139-153 ◽  
Author(s):  
Peter Söderbaum
Keyword(s):  
Resource Allocation ◽  
Economic Analysis ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Environmental Problems ◽  
Neoclassical Economics ◽  
Benefit Analysis ◽  
Ecological Ethics ◽  
Alternative Approaches ◽  
The Way

The relevance and usefulness of mainstream or neoclassical economics has been questioned more in some fields of inquiry than in others. Against the background of an attempt to characterize environmental problems, the fruitfulness of conventional ideas of economic analysis, as carried out in practice in the form of cost-benefit analysis, is questioned. Alternative approaches judged to be more compatible with environmental problems are indicated. It is argued that cost-benefit analysis represents a closed ethic or ideology and that approaches which open the way for various possible ethical or ideological standpoints are more promising. Different principles of resource allocation or housekeeping should be considered and the idea of only one “scientifically correct” or “true” principle abandoned. Non-monetary principles of housekeeping, such as specific versions of ecological ethics, are not “less economic” than the now dominant monetary principles.

scholarly journals Promoting The Integrated Community Case Management of Under-Five Pneumonia In Nigeria: A Cost-Benefit Analysis

2020 ◽  
Author(s):  
Charles Okafor ◽  
Obinna Ekwunife
Keyword(s):  
Case Management ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
World Health ◽  
Benefit Analysis ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Cost And Benefit ◽  
Under Five ◽  
Life Years

Abstract BackgroundWhile evidence-based recommendations for the management of under-five pneumonia at the community level were made by the World Health Organisation, the implementation remains poor in Nigeria. Initiatives to promote the integrated community case management (iCCM) of pneumonia through the proprietary and patent medicine vendors (PPMVs) have been poorly utilized possibly due to low financial support and perceived benefit. This study provides cost and benefit estimates and implications of promoting the iCCM through the PPMVs’ education and support. The outcome of this study will help inform healthcare decisions in Nigeria. MethodsThis study was a cost-benefit analysis using simulation-based decision-analytic Markov model. Two approaches were compared, the current scenario which is the use of amoxicillin dispersible tablet (DT) and amoxicillin DT plus promotion. Health outcomes include disability-adjusted life years averted (converted to monetary benefit) and severe pneumonia hospitalisation cost averted. Both the cost and benefit were expressed in 2018 US dollars. ResultsThe incremental benefit-cost ratio of promoting the iCCM was 1.37, while the total net-benefit was $3.31 (95% CI: $2.08 – 4.76) million from the whole country perspective, which will offset over three-quarter of the promotion cost. Implementing the promotion exercise at a cost above $6.82 million will not be a worthwhile decision. ConclusionPromoting the iCCM for the treatment of pneumonia in children under-five through education and support of the PPMVs holds promises to harness the benefits amoxicillin DT and provide a high return on investment. A nationwide promotion exercise should be considered especially in remote areas of the country.

Children’s Cost-Benefit Assessment of Lies Across Three Cultures

2021 ◽  
Author(s):  
Cynthia Xinran Guo ◽  
Philippe Rochat
Keyword(s):  
Resource Allocation ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Urban China ◽  
Assessment Model ◽  
Benefit Assessment ◽  
Cultural Environment ◽  
Benefit Analysis ◽  
Different Types ◽  
Child Friendly

We examined 4- to 11-year-old children’s evaluation of six types of lies arranged along a cost-benefit assessment model factoring both the lie-teller and the lie recipient. Children were from three distinct cultural environments: rural Samoa (n = 99), urban China (n = 49), and urban U.S. (n = 109). Following the simple script of six different stories involving a lie-teller and a lie recipient, children were asked to evaluate the character who lied and whether it deserved reward or punishment using a child-friendly Likert scale. From the time children produce both anti- and prosocial lies, our results show that their evaluation of lies rests on a cost-benefit analysis of both the lie-teller and the lie recipient. Such analysis varies depending on age, type of lie, and the child’s cultural environment. In general, Samoan children tended to rate lies more negatively, and they were less differential in their evaluation of the different types of lies compared to both Chinese and U.S. children. We interpret these results as reflecting the differences across cultures in explicit moral teaching and children’s relative experience in resource allocation.

scholarly journals A social cost-benefit analysis of two One Health interventions to prevent toxoplasmosis

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A W M Suijkerbuijk ◽  
E A B Over ◽  
M Opsteegh ◽  
H Deng ◽  
P F van Gils ◽  
...  
Keyword(s):  
Foodborne Pathogens ◽  
Social Cost ◽  
Cost Benefit Analysis ◽  
Meat Products ◽  
Cost Benefit ◽  
Benefit Analysis ◽  
Public Health Perspective ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Input Parameters

Abstract Background In the Netherlands, toxoplasmosis ranks third in disease burden among foodborne pathogens, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. We performed a Social Cost-Benefit Analysis (SCBA) to evaluate the net value of two potential interventions, freezing meat and improving biosecurity in pig farms, for the Dutch society. Methods We assessed the costs and benefits of the two interventions and compared them with the current practice of education, especially during pregnancy. A ‘minimum scenario’ and a ‘maximum scenario’ was assumed, using input parameters with least benefits to society and input parameters with most benefits to society, respectively. Results The freezing meat intervention was far more effective than the biosecurity intervention. Despite high freezing costs, freezing two meat products: steak tartare and mutton leg yielded net social benefits in both the minimum and maximum scenario, ranging from €10.6 million to €31 million for steak tartare and €0.6 million to €1.5 million for mutton leg. The biosecurity intervention would result in net costs in all scenarios ranging from €1 million to €2.5 millions. Conclusions From a public health perspective (i.e. reducing the burden of toxoplasmosis) freezing steak tartare and leg of mutton is to be considered.

scholarly journals The Cost-Benefit Fallacy: Why Cost-Benefit Analysis Is Broken and How to Fix It

2021 ◽  
pp. 1-25
Author(s):  
Bent Flyvbjerg ◽  
Dirk W. Bester
Keyword(s):  
Resource Allocation ◽  
Cost Benefit Analysis ◽  
Statistical Significance ◽  
Cost Benefit ◽  
Policy Implications ◽  
Benefit Analysis ◽  
Costs And Benefits ◽  
Cost Overruns ◽  
Public Investments ◽  
The Cost

Abstract Most cost-benefit analyses assume that the estimates of costs and benefits are more or less accurate and unbiased. But what if, in reality, estimates are highly inaccurate and biased? Then the assumption that cost-benefit analysis is a rational way to improve resource allocation would be a fallacy. Based on the largest dataset of its kind, we test the assumption that cost and benefit estimates of public investments are accurate and unbiased. We find this is not the case with overwhelming statistical significance. We document the extent of cost overruns, benefit shortfalls, and forecasting bias in public investments. We further assess whether such inaccuracies seriously distort effective resource allocation, which is found to be the case. We explain our findings in behavioral terms and explore their policy implications. Finally, we conclude that cost-benefit analysis of public investments stands in need of reform and we outline four steps to such reform.

QALY: An Ethical Issue that Dare Not Speak its Name

2007 ◽  
Vol 14 (1) ◽  
pp. 72-82 ◽  
Author(s):  
Peter Hirskyj
Keyword(s):  
Health Care ◽  
Resource Allocation ◽  
Potential Effect ◽  
Quality Adjusted Life Years ◽  
The Public ◽  
Alternative Formula ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Definition Of ◽  
Quality Adjusted Life

The current British Government's policy towards resource allocation for health care has been informed by the commissioned Wanless Report. This makes a case for the use of quality adjusted life years (QALYs) to form a rationale for resourcing health care and has implications for the staff and patients who work in and use the health service. This article offers a definition of the term ‘QALY’ and considers some of the strengths and weaknesses of this approach to resource distribution. An account is also given of an alternative formula, the DALY (disability adjusted life years), which can address some of the problems that are associated with QALYs. The values of the public, patients and nurses are identified and linked to the potential effect of a QALY formula. The implications of QALY use are applied to the health care of patients and a discussion is offered with regard to whether this method of resource allocation can be considered as just.

A Cost-Benefit Analysis of an Overseas Volunteer Mission to the Local Healthcare System

2021 ◽  
pp. 000313482199868
Author(s):  
Mahir Gachabayov ◽  
Lulejeta A. Latifi ◽  
Renato Rivera ◽  
Fancy S. Baluyot ◽  
Rifat Latifi
Keyword(s):  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
Benefit Analysis ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Number Of Patients ◽  
The Cost ◽  
Local Healthcare ◽  
Over Time

Background The aim of this study was to comparatively evaluate the sustainability and cost-benefit of the Operation Giving Back Bohol surgical volunteerism mission (SVM) carried out in Bohol Province, Philippines, over twelve consecutive missions. Methods This was a cost-benefit analysis of prospectively collected financial data from twelve consecutive surgical volunteerism missions held between 2006 and 2018. The overall cost of an SVM and cost per patient were the endpoints of interest. Disability-adjusted life years (DALYs) and costs thereof were calculated for each patient undergoing surgery in the twelve SVMs. Results A mean of 112 ± 22 patients were included per year of the SVM. A statistically significant increasing trend in the overall cost of SVMs over time was found ( R2 = .469; P = .014). A nonsignificant decreasing trend in the cost per patient over time was found ( R2 = .007; P = .795). A total of 8811.71 DALYs were averted in the twelve SVMs. DALYs averted per year ranged between 474.02 (2009) and 969.16 (2012). Cost per a DALY averted ranged between $466.9 (2006) and $865.6 (2009). Comparison of the latter with GDP per capita showed that this SVM was “very cost-effective.” Conclusion The SVM contributes substantially to the health care system both clinically and financially. A total of 8812 DALYs were averted in these twelve SVMs. Costs per a DALY averted did not significantly change over the mission years. Increasing the number of patients served has increased the total cost of the mission with no impact on the cost per patient.

Risk and Governance Part II: Policy in a Complex and Plurally Perceived World

1998 ◽  
Vol 33 (3) ◽  
pp. 330-354 ◽  
Author(s):  
Michael Thompson ◽  
Steve Rayner ◽  
Steven Ney
Keyword(s):  
Risk Assessment ◽  
Public Policy ◽  
Risk Perception ◽  
Policy Analysis ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Probabilistic Risk Assessment ◽  
Benefit Analysis ◽  
Life Years ◽  
Definition Of

OUR CONCLUSION, IN PART I,* WAS THAT THE ABANDONMENT OF THE expert/lay dichotomy as the basis for understanding risk perception, whilst essential, is not going to be easy. We argued that:1) Objectivism (the idea that we can clearly distinguish between what the risks really are and what people variously and erroneously believe them to be) has to give way to constructivism (the idea that risk is inherently subjective: something that we project onto whatever it is that is ‘out there’).2) To impose a single definition of what the problem is, which is what so much of policy analysis and science-for-public-policy does, is to exclude all those who happen not to share that particular way of framing things. Since people are unlikely to support a policy that is aimed at solving what they do not see to be the problem, approaches that insist on singularity (and on single metrics — cost: benefit analysis, for instance, probabilistic risk assessment, qualityadjusted life years and so on) will inevitably be low on consent, surprise-prone, unref lexive, brittle and undemocratic.

ESTIMATING THE BAYESIAN LOSS FUNCTION

2001 ◽  
Vol 17 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Mohan V. Bala ◽  
Josephine Mauskopf
Keyword(s):  
Loss Function ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Bayesian Decision ◽  
Quality Adjusted Life Years ◽  
Promising Alternative ◽  
Societal Welfare ◽  
Classical Statistics ◽  
Life Years ◽  
Using Data

Current health economic literature does not provide clear guidelines on how uncertainty around cost-effectiveness estimates should be incorporated into economic decision models. Bayesian analysis is a promising alternative to classical statistics for incorporating uncertainty in economic analysis. Estimating a loss function that relates outcomes to societal welfare is a key component of Bayesian decision analysis. Health economists commonly compute the loss function based on the quality-adjusted life-years associated with each outcome. However, if welfare economics is adopted as the theoretical foundation of the analysis, a loss function based in cost-benefit analysis (CBA) may be more appropriate. CBA has not found wide use in health economics due to practical issues associated with estimating such a loss function. In this paper, we present a method based in conjoint analysis for estimating the CBA loss function that can be applied in practice. We illustrate the use of the methodology using data from a pilot study.

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