Optimizing community case management strategies to achieve equitable reduction of childhood pneumonia mortality:An application of Equitable Impact Sensitive Tool (EQUIST) in five low- and middle-income countries

BACKGROUND: The aim of this study was to populate the Equitable Impact Sensitive Tool (EQUIST) framework with all necessary data and conduct the first implementation of EQUIST in studying cost–effectiveness of community case management of childhood pneumonia in 5 low– and middle–income countries with relation to equity impact. METHODS: Wealth quintile–specific data were gathered or modelled for all contributory determinants of the EQUIST framework, namely: under–five mortality rate, cost of intervention, intervention effectiveness, current coverage of intervention and relative disease distribution. These were then combined statistically to calculate the final outcome of the EQUIST model for community case management of childhood pneumonia: US$ per life saved, in several different approaches to scaling–up. RESULTS: The current ‘mainstream’ approach to scaling–up of interventions is never the most cost–effective. Community–case management appears to strongly support an ‘equity–promoting’ approach to scaling–up, displaying the highest levels of cost–effectiveness in interventions targeted at the poorest quintile of each study country, although absolute cost differences vary by context. CONCLUSIONS: The relationship between cost–effectiveness and equity impact is complex, with many determinants to consider. One important way to increase intervention cost–effectiveness in poorer quintiles is to improve the efficiency and quality of delivery. More data are needed in all areas to increase the accuracy of EQUIST–based estimates

Energy performance assessment of HVAC systems by inspection and monitoring

The paper discusses the collection and processing of energy performance data as part of the inspection of HVAC systems, aimed at identifying technically feasible and cost-effective Energy Conservation Opportunities (ECO), as required by EPBD. Case studies developed by the HARMONAC project have shown that low-cost or no-cost ECO's - mostly related to system operation and management - can be identified with an effective system monitoring. Building Management Systems (BMS) may be a powerful tool for this task, provided their HW and SW architecture is designed with adequate attention to energy monitoring. Dedicated instrumentation - such as electricity meters and temperature loggers - may also be employed as an alternative / integration to BMS monitoring. The paper also discusses the application of data analysis tools - such as "carpet plots" and "energy signatures" - to the identification of component malfunctioning, control problems, inadequate maintenance, or system schedule optimization, and to the evaluation of achieved energy saving

Drivers of cost system development in hospitals: Results of a survey.

While many hospitals are under pressure to become more cost efficient, new costing systems such as Activity-based costing (ABC) may form a solution. However, the factors that may facilitate (or inhibit) cost system changes towards ABC have not yet been disentangled in a specific hospital context. Via a survey study of hospitals, we discovered that cost system development in hospitals could largely be explained by hospital specific factors. Issues such as the support of the medical parties towards cost system use, the awareness of problems with the existing legal cost system, the way hospitals and physicians arrange reimbursements, should be considered if hospitals refine their cost system. Conversely, ABC-adoption issues that were found to be crucial in other industries are less important. Apparently, installing a cost system requires a different approach in hospital settings. Especially, results suggest that hospital management should not underestimate the interest of the physician in the process of redesigning cost systems.Activity based costing; Cost control; Factors; Hospital context; Hospitals; Industry; Management; Organizational change; Problems; Processes; Studies; Systems;

Asymmetric Cost Behavior: Exploring Ethical Issues Facing Management

Asymmetric cost behavior or cost stickiness is a relatively new phenomenon in accounting. Cost accounting initially assumed that traditional cost behaviors follow a symmetrical pattern, whereas sales and costs rise and fall equivalently with each other. Extending the research of Anderson, Banker and Janakiraman (2003) which introduced a theory that contradicted the normal symmetrical cost behavior by suggesting that internal factors, such as management decisions impact spending resulting in asymmetric cost behavior or cost stickiness. The objective of this paper is to explore whether asymmetric cost behavior or cost stickiness impacts corporate earnings of enterprises and if so, does this inadvertently create ethical issues for decision-making by management, as they may benefit in compensation from these decisions. By examining the link between Sales General and Administrative expenses (SG&A) and earnings, this paper shows how asymmetrical behavior influences management decision making cost. The conclusions, recommendations and implications reached in this study are generalizable and appropriate for use in developing best practices

Approaches on the Operational Performance of Production Systems

The performance concept originated from the concept of firm management. The performance management of the firm involves improving its value-cost relationship, which means that the firm will be able to build a product or service, in terms of achieving cost and profitability targets, and compare the results with strategic forecasts. In addition, performance management also requires the firm's ability to develop a dynamic and continuous progress. In such conditions, its performance evaluation is not an objective in itself, but a means used by the organization to achieve progress. The paper will address issues which relate to improving performance and all the instruments used for this purpose.management, competitiveness, operational performance, performance management, production systems.

Managing biological invasions: the cost of inaction

Ecological and socioeconomic impacts from biological invasions are rapidly escalating worldwide. While effective management underpins impact mitigation, such actions are often delayed, insufficient or entirely absent. Presently, management delays emanate from a lack of monetary rationale to invest at early invasion stages, which precludes effective prevention and eradication. Here, we provide such rationale by developing a conceptual model to quantify the cost of inaction, i.e., the additional expenditure due to delayed management, under varying time delays and management efficiencies. Further, we apply the model to management and damage cost data from a relatively data-rich genus (Aedes mosquitoes). Our model demonstrates that rapid management interventions following invasion drastically minimise costs. We also identify key points in time that differentiate among scenarios of timely, delayed and severely delayed management intervention. Any management action during the severely delayed phase results in substantial losses (>50% of the potential maximum loss). For Aedes spp., we estimate that the existing management delay of 55 years led to an additional total cost of approximately $4.57 billion (14$ 32.31 billion, or more than seven times the observed inaction cost. These results highlight the need for more timely management of invasive alien species—either pre-invasion, or as soon as possible after detection—by demonstrating how early investments rapidly reduce long-term economic impacts

Customer Cybersecurity and Supplier Cost Management Strategy

In this paper, we explore the spillover effect of customer firms’ data breaches on their upstream supplier firms’ cost management strategies, proxied by cost stickiness. Our primary analyses suggest that data breaches suffered by customer firms are associated with a decrease in cost stickiness among supplier firms. Furthermore, the reductions in supplier cost stickiness are stronger if suppliers are managed by CEOs from national cultural groups with high uncertainty avoidance, low long-term orientations, and/or low individualism. In sum, the findings contribute to both Information Systems (IS) and Operations Management (OM) disciplines in terms of data breach, cost management strategy, and the role of national culture in OM. In particular, the findings can facilitate the management and regulation of data breaches for managers and regulators

Global professional standards for project cost management

AbstractThis paper explores the need for global professional standards in the project cost management field. A range of global standards and guides have been developed for the project management profession as a whole but there have not been any developed specifically for project cost management (other than as a subset of project management standards). It will be argued that project cost management (be it Quantity Surveying, Cost Engineering, Project Controls or cost management carried out by Project Managers) is a specialist technical field that requires its own specific standards. The paper will examine the various national and regional professional standards that have been developed for the Quantity Surveying, Cost Engineering and Project Controls professions by various countries and professional associations around the world. It then examines the issues surrounding the lack of global standards for these professions and explores the benefits of developing over-arching strategies to produce global standards/programs. The paper then describes current initiatives to develop these specific global standards. This will include the International Construction Measurement Standard (ICMS) that is in the early stages of development. The research methodology underpinning this study comprises a review of professional standards around the world and interviews with practitioners and members of professional cost management associations within the International Cost Engineering Council (ICEC). The paper concludes with a range of recommendations and strategies to help address these issues

Understanding the cost of change Function: A basis for using an effective small step change strategy

This paper develops the cost of change function under the Continuous Improvement (CI) paradigm advocated by quality gurus such as Deming, Taguchi, and Shingo. CI is considered to be focusing on "frame bending" or minor changes while Organizational Change (OC) is considered to be focusing on "frame breaking " or major changes. The cost of change function is modified to be a discrete function incorporating a "monitoring" cost component and a "doing" cost element, which leads to a better understanding of the multiple tradeoffs: a) between the number of smaller steps to be taken to achieve the desired or planned change and the total cost of change, and b) between the total cost of change and the time needed to achieve the desired change. It is proposed to seek validation of the modified cost of change function by interviewing senior management personnel, who have project management and/or change management experience, such as managing six-sigma projects