Showing papers on "Cost effectiveness published in 1983"

Mergers and the Performance of the Acquiring Firm.

Abstract: Do mergers provide real benefits to acquiring firms? If not. as empirical studies completed mostly in the field of finance conclude, then why do firms continue to merge? If mergers do provide real benefits, as the literature of industrial organizations and strategic management suggest, then why haven't the empirical studies found any evidence of real benefits? By integrating the conclusions on mergers from the above three disciplines, these questions are addressed.

Turnaround Strategies for Mature Industrial-Product Business Units

Abstract: A study of short-term turnaround attempts by mature industrial-product business units found that efficiency-oriented moves, but not entrepreneurial initiatives, were associated with successful turn...

Cost-Effectiveness: A Primer

Abstract: Introduction to Cost Analysis Establishing an Analytic Framework The Concept and Measurement of Costs Placing Values on Ingredients Analyzing Costs Benefits, Effects, and Utility The Use of Cost Evaluations

Influenza Vaccination: Cost-effectiveness and Public Policy

Abstract: Cost-effectiveness analysis was used to evaluate influenza vaccination. From 1971-1972 through 1977-1978, vaccination of an elderly person 65 years of age or older saved net medical care costs while improving health. Vaccination of younger high-risk adults aged 15 through 64 years also improved health for a low net cost per year of healthy life gained. By covering influenza vaccination during those years, the Medicare program would have incurred a net cost for each vaccination of $13 per year of healthy life gained for medical costs connected with influenza and $791 per year gained including costs of treating other illnesses in later life. The analysis indicates the need for epidemiologic research on the extent of influenza and the mechanism of its spread. The results also raise the issue of public policy to promote influenza vaccination among high-risk persons as a low-cost, preventive technology. ( JAMA 1983;249:3189-3195)

Psychological preparation for invasive medical and dental procedures.

Abstract: Psychological preparation for invasive medical and dental procedures has been based on the rationale that high levels of preprocedural fear are detrimental to patients' subsequent adaptation. After a brief survey of the theoretical and empirical evidence pertaining to this rationale, the major psychological approaches designed to alleviate preprocedural concern and enhance recovery are discussed. Outcome studies that have employed informative, psychotherapeutic, modeling, behavioral, cognitive-behavioral, and/or hypnotic techniques are summarized and evaluated. Although the research suggests that each of these approaches can be effective, such serious methodological problems as heterogeneity of sample characteristics, limited range of outcome measures, and lack of manipulation checks prevent definitive conclusions. Legal-ethical concerns and the issue of cost effectiveness are also considered. Suggestions are made for future research and theory development.

Cost-effectiveness of hormone replacement therapy in the menopause.

Abstract: Costs, risks, and benefits of estrogen-progestin therapy in the menopause were compared with those for estrogen alone, using techniques of cost-effectiveness analysis. With the progestin added, reduced costs of endometrial monitoring and treatment of endometrial lesions more than offset the increased cost of the drug regimen with a net saving of $230-$430 per patient, depending on the duration of treatment. An estimated gain in life expectancy with estrogen-progestin compared to estrogen alone may be partly offset by a perceived reduction in the quality of life owing to the prolongation of menstruation in women receiving progestin. Overall, based on currently available evidence, estrogen-progestin therapy appears to be cost-effective, except in women who consider the adverse effects of continued menstruation to offset the relief of menopausal symptoms. These conclusions must be viewed as tentative, pending further clarification of the roles of estrogens and progestins in cardiovascular disease and breast cancer.

Cost increases due to demand uncertainty in mrp lot sizing

Abstract: This paper analyzes the cost increases due to demand uncertainty in single-level MRP lot sizing on a rolling horizon. It is shown that forecast errors have a tremendous effect on the cost effectiveness of lot-sizing techniques even when these forecast errors are small. Moreover, the cost differences between different techniques become rather insignificant in the presence of forecast errors. Since most industrial firms face demand uncertainty to some extent, our findings may have important managerial implications. Various simulation experiments give insight into both the nature and the magnitude of the cost increases for different heuristics. Analytical results are developed for the constant-demand case with random noise and forecasting by exponential smoothing. It is also shown how optimal buffers can be obtained by use of a simple model. Although the analysis in this paper is restricted to simplified cases, the results merit further consideration and study. This paper is one of the first to inject forecast errors into MRP lot-sizing research. As such it attempts to deal with one of the major objections against the practical relevance of previous research in this area.

Cost effectiveness of alcoholism treatment in partial vs inpatient settings. Six-month outcomes.

Abstract: Six-month outcomes for alcohol misusers assigned to extended inpatient hospitalization and to partial hospitalization were comparable for alcohol consumption and social and vocational roles. However, the subjective well-being of partial hospital patients was greater and their treatment costs were lower.

Appointment reminders to reduce no-show rates. A stratified analysis of their cost-effectiveness

Abstract: To determine whether reminders are cost-effective for an adult primary care internal medicine center, we randomized 590 scheduled, follow-up appointments to no reminder, computer-generated letter reminders, and telephoned reminders. The no-show rate was reduced from 24% in the control group to 14% in the reminder groups, and letter and telephoned reminders were equally effective. An economic analysis showed that about two thirds of the savings realized from reminders was generated in 23% of the patients whose prior predicted probability of a no-show appointment was above 20%. However, in our primary care center, computer-generated letter reminders were estimated to be cost-effective whenever the probability of a no-show was above 5%, and telephoned or manual letter reminders were estimated to be cost-effective whenever the probability of a no-show was above about 11%. Based on our sensitivity analysis, telephoned or manual letter reminders should be cost-effective in many other ambulatory settings as well, although in some settings, reminders may be restricted to patients at high risk for no-show behavior. (JAMA1983;250:1742-1745)

Cost Benefit Analysis of Placing Moderately and Severely Handicapped Individuals into Competitive Employment.

Abstract: This paper presents an analysis of costs incurred and tax monies saved, over an approximately 4-year period, through the successful implementation of an ongoing job training and placement program. The focus of the analysis is on the amount of money saved rather than on the wages earned by moderately and severely handicapped workers. Factors in the cost analysis include number of months the client had been working, amount of staff hours expended on the client at the job site, amount of funds expended proportionately on each client, Supplemental Social Security Income saved, estimated cost of day programming for the client if no job placement had been made, Targeted Job Tax Credit Program costs, and amount of state and federal taxes withheld. After almost 4 years, the public's cumulative savings totaled $620,576, while expenditures totaled $530,300. Thus, the total direct financial benefit to taxpayers is $90,376. Since initiation of the program, the clients' cumulative earnings are over $500,000.

Chemical Bath Deposition of Thin Film Cadmium Selenide for Photoelectrochemical Cells

Abstract: Chemical bath deposition provides an attractive, low cost method of producing cadmium chalcogenide thin films. Intimate contact between the bath solution and the substrate material permits uniform deposition on substrates of complex geometry, presently difficult with spray pyrolysis, vacuum evaporation, or electrodeposition techniques. For CdSe, rigorous control of deposition conditions promotes the formation of a hexagonal, specularly reflecting deposit rather than a less desirable sphalerite (cubic) powdery deposit. Scanning electron microscopy reveals a small grained layered plate morphology similar to that produced by the evaporation method. Specularly reflecting CdSe films can be formed over large area substrates at a thickness optimal for their use as photoelectrochemical cells (PEC). Employing polysulfide as the redox couple, conversion efficiencies as high as 6.8% have been achieved in the authors' laboratory for these films using a tungstenhalogen white light source.

Computer-Assisted Testing and Assessment: Current Status and Implications for the Future.

Abstract: This article provides a rationale for computer-assisted testing and assessment, describes systems currently in use, and examines potential benefits, potential problems, and future implications.

Selective application of CT in the management of laryngeal trauma

Abstract: The clinical course of five patients with varying degrees of laryngeal trauma are presented to illustrate the predictive value of computed tomography (CT) in the management of laryngeal trauma. Computed tomography visualizes well the laryngeal skeleton, soft tissues and airway in the injured larynx. Cost effectiveness of CT scanning is an important consideration, and the authors have chosen their case examples to restrict this examination to selected patients.

Scoring system to improve cost effectiveness of open access endoscopy.

Abstract: The introduction of an open access general practitioner endoscopy service may result in many unnecessary examinations being performed. In an attempt to prevent this, 235 patients attending for endoscopy were interviewed and the results analysed to determine which factors best discriminated between those with major disease (ulcers, cancers, oesophageal strictures; n = 48) and those without (n = 187). The six characteristics which best discriminated between the two groups were increasing age, history of vomiting, male sex, smoking, and a past history of peptic ulcer or hiatus hernia. With the use of these six features a scoring system was devised, designed to give an indication of the likelihood of finding such disease in an individual patient. This was assessed prospectively in a further 356 patients. The results showed that by utilising this scoring system it would be possible to reduce the number of examinations performed by 30% yet still detect 98% of serious disease. If confirmed in further prospective studies, this scoring system (or a modification) could more accurately assess individual priority for endoscopy and enable optimum use to be made of limited resources.

Application of a set of learning curve models to repetitive tasks

Abstract: As part of a research project into the cost effectiveness of training, various experiments were held in telephone exchanges in the UK. Data from those experiments and from other sources in the literature were used to compare the efficiency of a selection of models of learning. The method of comparison was based on an extension of an iterative two-parameter curve-fitting algorithm which used a Taylor series approximation of the function of the model of learning investigated. The most practical model found was the time-constant model sometimes known as the Bevis model.

Multidose vials versus single-dose vials: a study in sterility and cost-effectiveness.

Abstract: A total of 197 multidose injectable vials were collected from 10 different nursing stations and evaluated for sterility. Experimental contamination studies were undertaken, and the cost-effectiveness of multidose vials was compared with that of single-dose vials. Our results showed that bacterial contamination of multidose injectable vials was not a significant hazard; in addition, contrary to common belief, the use of multidose vials was not always successful as a cost-containment measure.

Is More Better? The Effectiveness of Spending on Compensatory Education.

Abstract: The current national emphasis on ap praising the relative size of the pub lic and private sectors makes this a par ticularly appropriate time for assessing the effectiveness of public services. Such as sessments should be made by an objective review of the accumulation of evidence ? not by ideological rhetoric or uncritical acceptance of the latest study as a revela tion of the "truth.'' In the national educa tion arena, early intervention or compen satory education ? on which the federal government is estimated to have spent about $1.5 billion on more than 1.5 mil lion children in fiscal year 19791 ? is one of the major areas currently being as sessed by government2 and the courts.3 What do we know about the effec tiveness of compensatory education from the appraisals that are already complete? Although scholars have not agreed com pletely about the empirical and conceptual issues involved in measuring the education process, it is nonetheless possible to take stock of what we have learned so far. Re searchers do not agree about the criteria for success of compensatory education, . but we can learn much from reading the differences in the results of their studies. This article reports the findings of our detailed examination of 47 studies on the overall effectiveness of compensatory ed ucation. One thing is clear: Virtually none

A Portable System For Ocean Bottom Imaging and Charting

Abstract: The Sea Mapping and Remote Characterization (Sea MARC) system is a sophisticated means of data acquisition in support of geophysical, acoustic, oceanographic, and hydrographic activities in all water depths. Typical real-time Sea MARC outputs can include ocean floor bathymetry, slant range corrected side-scan images, and sub-bottom profiles; these can be made at survey rates up to 10 square miles per hour. In addition to real-time displays, the Sea MARC data (along with ship's data and navigation information) are recorded on magnetic tape for later processing at on-shore computer facilities. Designed to be highly modular and flexible in configuration, the Sea MARC system comprises four primary sub-systems: an instrumented towfish, a telemetry and towing cable, a self-powered shipboard handling system and an on-deck data processing center. The system can be readily adapted to meet the data acquisition needs of a wide range of applications, from physical oceanography and marine geophysics to pipeline route surveys, drilling lease site investigations, and ocean mineral deposit characterization. During the past two years, while engaged by commercial, governmental, and academic agencies, one Sea MARC system has successfully imaged more than 10,000 square miles of ocean floor, including: the Mississippi and Laurentian fans, deepwater fracture zones, polymetallic sulfide deposits on the Juan de Fuca Ridge, and the continental margins of the U.S. and Canadian east coast. The use of a portable system for data acquisition as just described provides a cost effectiveness that cannot be matched by large, special purpose ships. As the outfitting and operating costs of these ships continues to escalate, systems such as the Sea MARC will perform an increasing portion of the offshore ocean survey activities that previously were the exclusive realm of large, dedicated oceanographic vessels.

Assessing the cost-effectiveness of prevention.

Abstract: In an era of limited resources, cost-effectiveness analysis and cost-benefit analysis (CEA/CBA) can be significant policy-making aids. Because the often stated belief that prevention is cost-effective has not been systematically examined, we surveyed about 250 CEA/CBA articles concerning prevention. We found that few authors have followed generally accepted methodological standards, which raised questions concerning the validity of their findings and conclusions. In addition, prevention itself is a problem in CEA/CBA because of such factors as the long intervals between interventions and outcomes, problems which have rarely been considered in the CEA/CBA prevention literature. At the same time, a number of high quality studies concerning prevention indicates that United States policy makers have not aggressively pursued significant opportunities to improve health through prevention, for example by immunizing the elderly and by screening for and treating hypertension. We recommend that analysts follow general methodological principles in CEA/CBA prevention studies to assure both valid and credible results.

Effective use of landsat data in hydrologic models

Abstract: In a cooperative demonstration project, NASA and the US Army Corps of Engineers (Corps) compared conventional and Landsat-derived land-use data for use in hydrologic models, and the resulting discharge frequency curves were analyzed When a grid-based data-management system was used on a cell-by-cell basis (size about 11 acres or 045 hectare), Landsat classification accuracy was only 64 percent, but, when the grid cells were aggregated into watersheds, the classification accuracy increased to about 95 percent When both conventional and Landsat land-use data were input to the HEC-1 model for generating discharge frequency curves, the differences in calculated discharge were judged insignificant for subbasins as small as 10mi2 (259 km2) For basins larger than 10mi2 (259km2), use of the Landsat approach is more cost-effective than use of conventional methods Digital Landsat data can also be used effectively by local and regional agencies for hydrologic analysis by incorporating the data into grid-based data-management systems The transfer of this new technology is well under way through inclusion in some Corps training courses and through use by both county government personnel and private consultants

Cost-effectiveness of community psychiatric nurse or out-patient psychiatrist care of neurotic patients

Abstract: In a prospective controlled investigation chronic patients, the majority with neurotic conditions, were randomly allocated either to community psychiatric nurses (CPN) as the main therapist or to routine out-patient psychiatrist follow-up. There was no statistically significant difference in the mean public expenditure for the two modes of care. The direct costs of psychiatric care comprised a small proportion of total public expenditure and were initially greater in the nursing group. Subsequently, and over the whole 18-month study period, nursing was the cheaper option in terms of these direct costs. Clinical and social outcomes were comparable in both follow-up groups. Consumer satisfaction was significantly greater among CPN patients. On balance, these results confirm the benefit of community psychiatric nursing for this patient group.

Drugs, society & human behavior

Abstract: This text looks at drug use from psychological, medical, social and legal perspectives, describing the effects of each type of drug in terms of brain function, psychology and health and social functioning. This edition discusses many new topics of current interest, including coverage of steroids in sport, smoking heroin and the cost effectiveness of treatment programmes. Extended coverage is given to alcohol related physiology and social issues.

Clinical effectiveness and cost-effectiveness of monitoring blood pressure of hypertensive employees at work.

Abstract: In this randomized controlled trial, the value of using occupational health nurses (OHNs) to monitor the care of hypertensive employees at work was compared with regular care (RC) delivered in the community. One year after entry, the blood pressure level, medication history, compliance with treatment, and cost of hypertensive care of the participants were determined by independent evaluators. The reduction in diastolic blood pressure (DBP), the measure of effectiveness, was 10.5 +/- 1.1 mm Hg (mean +/- SEM) in the OHN group and 7.7 +/- 1.1 mm Hg in the RC group, and the proportion under good blood pressure control was 41.8% and 31.0% respectively. These between-group differences were not statistically significant. Although the employees in the OHN group were more medicated and had a lower treatment dropout rate, neither difference was statistically significant. In addition, the proportion of employees who were compliant with prescribed medication was virtually identical in both groups. The cost of the care received by employees in the OHN group of $ 404.14 for the year was substantially higher than that of $ 250.15 in the RC group with the difference principally related to the cost of visiting the OHNs and a significant difference in drug cost (p less than 0.006). The incremental cost-effectiveness (C/E) ratio of $ 53.67 per mm Hg DBP reduction per year for onsite blood pressure monitoring was higher than the base C/E ratio of $ 32.65 per mm Hg for regular care. Our findings indicate that monitoring the blood pressure of hypertensive employees at work is neither clinically effective nor cost-effective.(ABSTRACT TRUNCATED AT 250 WORDS)