Estimating the money flow in the economy attributed to rotavirus disease and vaccination in the Netherlands using a Social Accounting Matrix (SAM) framework

Background: The economics of rotavirus gastroenteritis in infants <5 years old is well-known within healthcare. The financial consequences for families, employers and authorities are not so well explored. The present study evaluates how vaccine prevention changes money flows among e involved in the management of disease, and its consequences. Methods: A Social Accounting Matrix (SAM) framework has been developed reflecting the distribution of income and spending at equilibrium affected by rotavirus disease among all those concerned for 1 year. The data came from official sources and published literature. A comparison of the financial equilibrium between with and without a national rotavirus immunization program has been conducted, along with sensitivity analysis for the results. Results: The total financial cost difference at equilibrium between presence and absence of rotavirus vaccination was +euro26.758 million over one year as a net economic surplus. The payment of vaccination (euro19.194 million) by the government was offset by the increase in tax revenue (euro14.561 million) and by the lower spending in treatment care (euro7.998 million). Conclusion: Studying the financial flows between different transacting agents can demonstrate the financial burden of a disease and the benefits of its prevention on agents' income and spending

Resposta de um cultivar de pêssego com caroço aderente à irrigação por défice regulado

Regulated deficit irrigation (RDI) involves inducing water stress during specific fruit growth phases by irrigating at less than full evapotranspiration. The objectives of this research were to study the effects of RDI perfomed at stage II of fruit growth and postharvest, on productivity of clingstone peaches, fruit quality as well as photosynthetic rate and midday leaf water potential. The research was conducted in a commercial clingstone peach (Prunus persica L. Batch cv. A-37) orchard in Greece. Trees were irrigated by means of microsprinklers and their frequency was determined using local meteorological station data and the FAO 56 Pennman-Monteith method. Photosynthetic rate was measured by a portable infrared gas analyzer. Midday leaf water potential was measured by the pressure chamber technique. During the years 2005 and 2006, the treatment RDII with irrigation applied at growth stage II of the peach tree did not affect productivity, fresh and dry mass of fruits. RDII reduced preharvest fruit drop in comparison to the control. RDII as well as the combined treatment RDII plus RDIP with irrigation applied at postharvest, at both years reduced shoot length of the vigorous shoots inside the canopy. RDII in comparison to the control increased the soluble solids content of the fruits and the ratio soluble solids/acidity. However it did not affect fruit acidity and fruit firmness. RDII as well as RDII plus RDIP in 2006 increased 'double' fruits and fruits with open cavity in comparison to the control and RDIP. Water savings were considerable and associated with the climatic conditions of each year.A irrigação por défice regulado (RDI) envolve a indução de défice de água durante fases específicas do crescimento das frutas, irrigando a taxas menores que a evapotranspiração. Os objetivos desse estudo foram verificar os efeitos da RDI no estágio II do crescimento das frutas e no periodo pós-colheita, avaliando a produtividade de pêssegos, a qualidade dos frutos, bem como a taxa fotossintética e o potencial da água na folha. A pesquisa foi desenvolvida em um pomar comercial de pêssegos com caroço aderente (Prunus persica L. Batch cv. A-37) da Grécia. As árvores foram irrigadas por meio de microaspersores e sua frequência foi determinada por meio de dados meteorológicos obtidos em estação automática e o método FAO 56 Pennman-Monteith para determinação de evepotranspiração. A taxa de fotossíntese foi medida por analisador de gás na faixa do infravermelho. O potencial da água na folha foi medido ao meio-dia usando a técnica da câmara de pressão. Durante 2005 e 2006 o tratamento RDII com irrigação aplicada no estágio II não apresentou efeito sobre a produção, pesos seco e fresco dos frutos. RDII reduziu a queda de frutos antes da colheita, em relação ao controle. RDII, como também o tratamento combinado de RDII mais RDIP com irrigação aplicada em pós-colheita, reduziu o comprimento de ramos vigorosos dentro do dossel nos dois anos de estudo. Em comparação com o controle, RDII aumentou o conteúdo de sólidos solúveis dos frutos e a relação sólidos solúveis/acidez, mas não afetou a acidez dos frutos e a firmeza da polpa. Em 2006 RDII e RDII mais RDIP aumentaram os `frutos dobrados' e frutos com cavidade aberta, em comparação com o controle. A economia de água foi considerável e associada às condições climáticas de cada ano

Measuring intra-hospital clinic efficiency and productivity : an application to a Greek university general hospital

In this paper we use Data Envelopment Analysis and the Malmquist Productivity Index and its decompositions to assess the productive efficiency and productivity of the in-patient clinics of a large Greek University General Hospital. Clinics are represented by means of a simple model whereby they use inputs (labor and capital) to produce outputs (in-patient days and patient discharges). The efficiency model is input oriented and assumes constant returns to scale. Model validation analyses showed that this model appears to be externally valid. The framework proposed here is a simple and useful tool for informing intra-hospital management decisions.peer-reviewe

Health care services performance measurement : theory, methods and empirical evidence

Despite the growing international literature in the field of efficiency and productivity measurement there are very limited Greek applications partly due to inadequate and incomplete datasets. The aim of this article is to illustrate the main methodologies for health care services efficiency and productivity measurement, to present their strengths and weaknesses and to discuss the existing evidence from applications in other countries. Notwithstanding the fact that the related methodologies have been recently developed these methods may help practitioners and health care decisions makers in improving health care management in Greece.peer-reviewe

Measuring across hospital efficiency and productivity : the case of second regional health authority of Attica

The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998 - 2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998- 2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.peer-reviewe