Showing papers on "Cost effectiveness published in 1974"

The Measurement of Organizational Effectiveness: A Review of Relevant Research and Opinion

Abstract: : The general topic of defining organization effectiveness is addressed While no succinct definition is provided, a construct of organizational effectiveness is recognized Existing theory, research, and practice surrounding the construct has been searched and current measurement techniques have been cataloged along with summaries of various theories and models Alternative methodological approaches and manifest characteristics of organizations in terms of effectiveness are considered A compilation of independent, dependent, and intervening variables is presented Suggestions are offered for future research in the Navy setting in the area of organizational effectiveness

Selection of Diseases and Tests in Pediatric Screening

Abstract: The availability of a suitable screening test does not justify screening for a disease unless the disease is important, relatively prevalent, and amenable to early treatment. Screening for a disease which has the necessary characteristics cannot be justified unless there is an acceptable, reliable and valid test which can be carried out at reasonable cost. Screening which is carried out without knowledge and consideration of these criteria is likely to be wasteful of scarce medical resources and may actually do more harm than good.

Differences in Profit and Nonprofit Organizations: A Study of Effectiveness and Efficiency in General Short-Stay Hospitals.

Abstract: 1 Research for this paper was supported by Grant Number HS-00028 from the National Center for Health Services Research and Development. Support of the Tennessee Mid-South Regional Medical Program also facilitated the research, Comments by Anthony Obserschall on an earlier version of this paper are appreciated. as is the computer assistance of Thomas James. Results of a study of small short-stay profit and nonprofit hospitals show significant differences in organizational relationships. The proportionate number of management and support personnel is negatively associated with the occupancy rate and the proportionate number of production personnel is more positively associated with occupancy rate in profit hospitals but not in nonprofit hospitals. Average daily charges are associated with community wealth for profit hospitals, but not for nonprofit hospitals. It is suggested that the profitmaking orientation of hospitals is a significant contextual property which influences the relationships of hospital structure and community wealth to hospital efficiency and effectiveness.'

Practical surface acoustic wave devices

Abstract: A tutorial discussion is presented on selected surface acoustic wave (SAW) devices for the use of engineers and electronic systems designers. Currently practical components for use in radar systems, communications systems, and as frequency domain filters are described. Emphasis is placed on nondispersive and dispersive delay lines, devices for generating and detecting various radar waveforms, devices for generating and detecting fixed and programmable biphase and multiphase codes, and broad-band and narrow-band filters. The device possibilities of several new approaches are described, including multistrip couplers, nonlinear convolvers, reflective structures, and overlay films. It is concluded that, while SAW devices have found many applications in large radar systems because of their size, cost effectiveness, and reliability, wide-scale applications, for example as frequency domain filters, will be needed to justify continued research in this field. Wide-scale applications will come as systems engineers realize the potential of these devices and confidently design them into their systems.

An accountability model for counselors

Abstract: A sound counselor accountability system would collate counselor accomplishments with costs. Better decisions could then be made about effective methods, staffing, student needs, and training. The system would define the domain of counselor responsibilities, use student behavior changes as evidence of counselor accomplishments, state counselor activities as costs, promote self-improvement, permit reports of failures and unknown outcomes, be designed by users, and be subject to revision. An illustrative accountability report shows how the cost, but not the value, of an outcome can be estimated. Experimentation is needed in order to answer the practical implementation problems of the system.

An Axiomatic Approach to Cost Allocation for Public Investment

Abstract: : The authors developed a cost allocation scheme for collective investments which had such properties as total costs being covered and insensitivity to ordering of simulataneous demands. In this paper one will derive the same scheme from a set of axioms. These axioms may be viewed as a constitution which participants in a collective investment agree to as being a fair way of allocating costs. The cost allocation principle is to be agreed to prior to agreement on the amount of investment; the amount of investment is then determined by collective bargaining. (Author)

Health and Labor Force Participation.

Abstract: Models are estimated to analyze the influence of health on labor force participation. It was found that the participation of blacks is more likely to be reduced by health factors than that of whites; that the primary importance of education derives from its association with skills and ability rather than health. Public transfer payments influence but do not control participation of nonseverely disabled workers. Including health measures can increase the explanatory power of labor force models. Better information on health of workers would allow separation of the cost of disability into those reducible through delivery of health care and those more appropriately dealt with through labor market policies.

Roadside safety improvement programs on freeways - a cost-effective priority approach

Abstract: This report documents and presents the results of a study that establishes a rational approach to the development of highway safety improvement programs. A system has been devised for ranking improvements based on their costs and their effectiveness in reducing accidents. The cost- effectiveness analysis provides a framework for comparison of alternative actions on a common basis. The approach is described and illustrated by a comprehensive example. For derivation of the analysis approach, use was made of general or typical numerical values. By substitution of state or regional data, the approach can be converted into an analytical tool. The existing form and data have value in bringing out the probability aspects of roadside elements in safety. /NCHRP/

Quantitative Methods for Preliminary Design of Water Quality Surveillance Systems

Abstract: To assure attainment and maintenance of desired water quality levels in our rivers and streams, systematic monitoring must be performed. A preliminary phase of the design of water quality surveillance systems is the specification of sampling frequencies and station locations throughout the basin; that is, the development of an adequate space/time sampling plan. The purpose of this paper is to present some quantitative methods which have been developed to identify candidate sets of sampling frequencies and station locations, and to establish priorities for implementing the different frequencies and locations. These methods are useful in the cost/effectiveness trade-off analyses in surveillance system design, and are based on the surveillance system objective of pollution abatement in which it is desired to detect violations in state-federal water quality standards. A spatial priority measure is developed which is dependent both on the water quality profile in the stream and on the information obtained from monitoring stations located in other reaches. Also, a temporal sampling priority rating is presented which is a measure of the effectiveness of the surveillance system with respect to its ability to detect the violations in the standards. To illustrate the quantitative methods, the procedures are applied to the Wabash River Basin.

The Economics of Resource Recovery from Municipal Solid Waste

Abstract: A prototypical operating statement similar to that used by business firms has been shown to be a useful decision-making tool for a community choosing a solid waste management system. When applied to resource recovery, it highlights the economics of recovery and the values of the input parameters necessary to achieve economic viability, whether in the case of public or private ownership ( 23 ). In most communities, refuse processing to recover material resources must be based on more than one source of revenue. In addition to the revenues from the sale of by-products, there must be revenues from processing the incoming refuse and from a user, or dump, fee. In the first case discussed, that of materials recovery by a front end system, resource recovery is shown to be economically feasible for those communities in which the present cost of disposal is relatively high. The indifferent community was one having a current cost of $7.72 per ton; more accurately, this would be the cost for the near-term future. It is not necessary that current costs be used, since many communities are merely "dumping" their refuse. The indifference decision should be based on the cost of an environmentally sound alternative. Energy recovery from municipal solid waste can increase the number of communities in which resource recovery will be an economic adjunct to a solid waste management system. The analysis presented here was based on the assumption that the value of the fuel recovered exactly offset the additional capital and operating costs of the utility which burns it. There could be costs above and beyond this; similarly, there could be a saving by taking into account the economic value of the organic fraction as fuel. However, it is believed that the assumption under which the materials-plus-energy case was analyzed seems to be realistic at this time.

Cost effectiveness of early detection of disease.

Abstract: A methodological framework for the cost-effectiveness evaluation of diagnostic tests for mass screening is presented. The decision rule is based on disease incidence, probabilities of test error, the cost of the test and of treatment for found cases, and the economic value (expected lifetime earnings or equivalent) of additional length or quality of life for those cured of the disease. The decision rule is applied to the Pap test for cervical cancer, with results showing that as a one-time screening device the test is cost-effective from society's standpoint. Extensions of the method would permit estimation of the disease incidence at which a given test or treatment would be cost-effective; would permit estimation of the breakeven price of test and treatment with given disease incidence; and would allow determination of optimal testing frequency.

How To Save Gasoline: Public Policy Alternatives for the Automobile

Abstract: This report is the first report is a series of three, which describes a study of alternative measures and public policies for conserving energy used by automobiles. The purpose of the study is twofold: 1) to develop analytical tools to aid in evaluating national energy conservation policies for private auto transportation; and 2) to apply the tools in a systematic analysis and comparison of several alternative policy instruments. The study is concerned with two types of policy instruments; those raising the price of driving and those designed to improve average auto fuel economy through requlatory means. Research findings suggest these policy alternatives: 1) increase the pump price of gasoline through taxes, for short term gasoline savings; 2) improve fuel economy through weight reduction and other technological improvements, for longer term gasoline saving; and 3) decrease the new car price of those automobiles that consume less gasoline. Appendices A, B, D, and E consist of summary descriptions of A) generalized automobile desing model; b) inputs for automobile design measures; D) the automobile fleet mix model; 5) the NAV model. Effectiveness of Emission Controls' is discussed in Appendix C; "Employment Impacts in Five Auto-Related Sectors in P; and "Gasoline Price Change Impacts by Earnings Group" in Appendix G.

Scale modeling of vehicle crashes--techniques, applicability, and accuracy cost effectiveness

Abstract: The utility of scale model experiments for crashworthiness research is examined. In Part I, two examples illustrate the use of scale models in crashworthiness research. It is concluded that scale models can be used in place of full-scale experiments for many applications. In Part II, the cost effectiveness of scale modeling is measured by comparing the costs of full-scale experiments with scaled experiments that meet the same objectives. It is concluded that scaled experiments increase the flexibility, reduce the cost, and hasten the completion of a program. /SAE/

Traditional Birth Attendants—A Key to Rural Maternal and Child Health and Family Planning Services

Abstract: Many countries are currently trying to upgrade the performance of the traditional midwife by initiating training programs to promote safe delivery practices to increase the midwifes (traditional birth attendant TBA) awareness of obstetrical complications and to give the TBA a general health education background with emphasis on maternal and child health nutrition. Personnel relationships status of TBA in the community motivation on the part of the TBA cost effectiveness feasibility of training cultural determinants and community-felt needs are discussed with regard to the process of training TBAs. A search of the relevant literature uncovered problems suggesting a need for certain guidelines some which follow; 1) identification and registration of TBAs in the area 2) determination of cultural beliefs and practices associated with childbearing and 3) establishment of a means of supervision and program evaluation. The employment of these guidelines should allow for more effective and less expensive training and involvement in TBA programs.

Short- and Long-Term Therapeutic Communities: A Follow-up and Cost Effectiveness Comparison

Abstract: The rates of program completion, the rates of court convictions after release from the program, and a cost effectiveness analysis were compared for two therapeutic communities whose major difference is the length of treatment. The longer program was found to be more effective and less costly in the long run, but nonprogram factors were found to emphasize the importance of both the short-and the long-range approaches: the one to provide a long-range and thorough treatment for those who are ready for it, and the other to provide an effective and workable alternative to the criminal justice system.

Screening in Child Health Care: Where Are We Now and Where Are We Going?.

Abstract: The preceding papers1-7 in this symposium discuss criteria for evaluating screening tests and screening programs and demonstrate how these criteria can be applied to several screening techniques of particular current interest. This paper will briefly review how a number of procedures measure up to the suggested criteria for screening tests and suggest some future directions which must be pursued if screening is to be based on science rather than on polemic. WHERE ARE WE NOW? Table I lists a number of diseases, functions and tests which have been considered to be of use in screening. For each of these it also gives my own estimate of how well each disease meets the criteria listed by Frankenburg2 and how well the available tests meet his criteria for effectiveness, direct costs, costs of false positives, and costs of false negatives. In the following paragraphs some of the considerations which led to these judgments are discussed. Phenyketonuria Despite its low frequency, the cost effectiveness of screening for PKU is well demonstrated, tests are adequately sensitive and specific, and with expert management the potentially high costs of false-positive tests can largely be eliminated.3 Galactosemia Though even rarer than PKU, current methods make routine neonatal screening both feasible and cost effective, provided that the test is combined with routine PKU screening.8 Other Inborn Metabolic Errors With the kind of regionalized facilities and planning discussed by Scriver,3 testing for these diseases can be added to routine neonatal screening at very little additional cost. Some of them lend themselves to effective early treatment; with others, genetic counsulling is the only currently available useful intervention.

Economics and Public Policy: The Automobile Pollution Case

Abstract: This book represents an economist's approach to the problem of auto pollution controls. In considering possible strategies for pollution abatement, it examines such factors as the benefits of pollution abatement, the question of fuel consumption and fuel composition, the demand for motoring, and the cost and effectiveness of technical alternatives such as abatement devices and unconventional propulsion systems.The author proposes that "A sensible pollution control strategy must consist of programs at the national, state, and regional level, designed to match the costs of abatement to anticipated benefits for each area. The national program should produce new cars which reduce emissions to a degree needed by the majority of the country.... State and regional programs can be designed to deal effectively with the particular problems and conditions in each area."Dr. Dewees concludes that "the speed of technological progress and the cost of the programs favor the effluent charge approach." Certain minimum emission standards for all automobiles would exist under this approach, which would include state and regional pollution charges levied annually in high-benefit areas, a tax on fuel based on its composition, and regional and local motoring reduction programs.The author brings to the difficult policy problem of auto pollution control a detailed economic analysis combined with an understanding of the technical and legal problems that must inevitably be faced if a satisfactory resolution of the problem is to be found.

Can Nursing‐Home Care Be Cost‐Effective?

Abstract: In an effort to find alternatives to the current abandonment of the nursing-home patient, a project was started for the purpose of testing the cost effectiveness of other forms of primary care, i.e., care delivered by the nurse practitioner and the social worker. The goal of the three-year demonstration project is to measure the effectiveness of different combinations of these services in improving the patients' level of functioning and behavior. Preliminary one-year results are presented regarding changes in drug regimens, record keeping, and the care provided by nursing-home staffs.

Automated Multiphasic Screening

Abstract: From our experience with automated multiphasic health tests in more that 20,000 children, we have formed the following tentative conclusions. Multiphasic testing, combining a group of tests for administration at a single session, is less costly in time and inconvenience to the patient and provides more useful information to the evaluating and treating physician than does an uncoordinated set of individual tests. Automation of instruments, use of nonprofessional testers, and computer processing of data can markedly reduce the usual cost of acquiring standard data provided that (1) there is a large number of persons from which standardized data are to be acquired; (2) the acquisition of the data can be scheduled so that specialized equipment and personnel are fully utilized; (3) automated equipment is used only when there is a real advantage over manual equipment. These potential benefits of automated multiphasic testing are severely limited by (1) the lack of knowledge and agreement about what standard information is useful for improving the health care of children; and (2) the problems involved in ensuring appropriate follow-up examinations. Our purpose in presenting these conclusions is not to support or condemn automated multiphasic testing or screening, but rather to point out that a number of unsolved problems exist. They will not be solved unless all who engage in automated multiphasic screening, or any kind of screening, arrange their testing and data keeping procedures so that the new knowledge necessary for evaluating programs and resolving unsolved problems can be gained. Until we have such knowledge, we must be modest and tentative in our claims that automated multiphasic screening can contribute positively to the health care of children.

From Economic to Political Analysis of Library Decision Making

Abstract: IN 1969 THE M.I.T. PREss published a new volume, Systematic Analysis of University Libraries: An Application of Cost-Benefi.t Analysis to the M.I.T. Libraries, which might have signaled the entrance of economic analysis into the area of library decision making. As coauthor of the book, I anxiously awaited the reviews I hoped would follow. 1 To date all reviews missed what I regard as the major point of the book: Although helpful, an economic analysis of a university (or public) library is insufficient because libraries operate as political systems and thus improving libraries requires political analysis. The purpose of this paper is not only to argue that political analysis of university and public libraries should be undertaken in conjunction with economic analyses but also to apply a specific theoretical framework and concept to university and public libraries. The improvement of libraries requires an expansion of analysis beyond technical discussions of procedural changes and per item costs to the broader utilization of social science theory and research. In the past two decades both econo-