Is bigger better for primary care groups and trusts?

SIGLEAvailable from British Library Document Supply Centre-DSC:m01/16032 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Estimating the returns to UK publicly funded cancer-related research in terms of the net value of improved health outcomes

© 2014 Glover et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background - Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes. Methods - To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters. Results - In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes. Conclusions - We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the approach that we originally used in assessing the returns from cardiovascular research. In doing so, we have highlighted a number of weaknesses and key assumptions that need strengthening in further investigations. Nevertheless, these cautious estimates demonstrate that the returns from past cancer research have been substantial, and justify the investments made during the period 1976 to 1995.Wellcome Trust, Cancer Research UK, the National Institute of Health Research, and the Academy of Medical Sciences

The restructuring and privatisation of British Rail: Was it really that bad?

This paper uses a social cost-benefit analysis (SCBA) framework to assess whether rail privatisation in Britain has produced savings in operating costs. The paper shows that major efficiencies have been achieved, consumers have benefited through lower prices, whilst the increased government subsidy has been largely recouped through privatisation proceeds. We also find that output quality is no lower (and is probably better) than under the counterfactual scenario of public ownership (pre-Hatfield). The achievement of further savings is key to delivering improved rail services in the future. This paper finds that a privatised structure, where shareholders demand a return on their investment, has led to significant improvements in operating efficiency - it remains to be seen whether the new regime, with a not-for-profit infrastructure owner, will deliver the same efficiency improvements

Ageing, Poverty, and the Role of a Social Pension in Vietnam

経済学 / EconomicsBy using the Vietnam Household Living Standard Survey in 2004, this paper seeks to quantify the potential role and impacts of a social pension scheme for reducing elderly poverty in Vietnam. We simulate how the poverty rate, poverty gap, and poverty severity of the elderly would have been changed in the counterfactual situation that such a scheme had been introduced to Vietnam in the past. We consider a number of categorical targeting groups of elderly people along with various transfer parameters to assess the impacts of the scheme on social welfare. We find that, depending on the characteristics of the social pension, there would be beneficial poverty reductions, but also large leakages to the non-poor people. For a variety of measures, our results suggest that targeting the elderly in rural areas might be the most effective use of limited resources. Also, simulations for different budgetary constraints show that, even with limited budgeting, a social pension scheme would significantly reduce poverty incidence for the elderly. We also find that for a given program cost, combining lower benefits with lower eligibility requirements is more effective at reducing poverty than providing larger benefits to a more limited group of recipients.JEL Classification Codes: H55, I32, I38Published as: Giang, L. T., and W. D. Pfau. “Aging, Poverty, and the Role of Social Pensions in Vietnam,” Development and Change. Vol. 40, No. 2 (March 2009), p. 333-360

National Association of Teacher Educators of Vocational Home Economics Records - Accession 394

This collection consists of records related to the National Association of Teacher Educators of Vocational Home Economics (NATEVHE). The collection consists of Constitution and Bylaws, minutes, reports, correspondence, committee lists, program notes, newsletters, financial records, and membership records. The NATEVHE was founded to facilitate colleague relationships among home economics teacher educators. The organization was formerly known as the National Association of Teacher Educators of Home Economics, an affiliate of the American Vocational Association. The name changed in 1980. Throughout the following series description, papers before April 1980 are referred to as NATEHE. In addition to financial records and membership lists, the collection contains a limited quantity of membership lists, reports, program notes, and newsletters.https://digitalcommons.winthrop.edu/manuscriptcollection_findingaids/1501/thumbnail.jp

Children of Migrants: The Cumulative Impact of Parental Migration on their Children\u27s Education and Health Outcomes

In the past 15 years, around 160 million Chinese rural workers migrated to cities for work. Because of restrictions on migrant access to local health and education system, many migrant children are left-behind in rural villages and growing up without parental care. This paper examines how parental migration affects children\u27s health and education outcomes in the long run. Using the Rural-Urban Migration Survey in China (RUMiC) data, we measure the share of children\u27s lifetime during which parents were away from home. We instrument this measure of parental absence with weather changes in their home villages when parents were aged 16-25, or when they were most likely to initiate migration. Results show a sizable adverse impact of exposure to parental migration on the health and education outcomes of children, in particular boys. We also find that what the literature has always done (using contemporaneous measure for parental migration) is likely to underestimate the effect of exposure to parental migration on children\u27s outcomes.JEL Classification Codes: J38, I28http://www.grips.ac.jp/list/jp/facultyinfo/yamauchi_chikako

Default Effects, Transaction Costs, and Imperfect Information

経済学 / EconomicsWe develop a decision framework with imperfect information to analyze the effects of transaction costs on the tendency for individuals to remain with a default option. We demonstrate how transaction costs can be a more important source of such default effects than commonly thought. A further, potentially surprising result shows that transaction costs are able to explain why some forms of default effects increase with the number of options.JEL Classification Codes: D03, D83http://www.grips.ac.jp/list/jp/facultyinfo/munro_alistair

Population, Technological Progress and the Welfare of the North-South Trade: A Revisit of the Classic Ricardian Model

This paper analyzes how the technology progress of the South country affects the welfare of the North country in a free trade world. Using the standard Ricardian model of the North-South trade, we show that, import biased technological progress of the South will undermine the welfare of the North, once the cumulative technological progress of the South exceeds a threshold. The relative population size of the South to North affects the threshold. Generally, a relatively larger South country has a lower threshold and the technological difference between the two countries remains even beyond the threshold. To a certain extent, the findings of the paper offer an theoretical explanation about the concerns of rising China in an integrated world economy.JEL Classification Codes: F1http://www.grips.ac.jp/list/jp/facultyinfo/xing_yuqing