Economic evaluation indirect costs

Consideration should be given to the input costs, that is, the costs of providing the service, as part of the economic evaluation. These costs should include direct and indirect costs if possible. Where charges are used, they should be appropriately labeled and interpreted as such. 

The Hoar report determined the cost of corrosion for the industry sectors of the economy (2). The cost of corrosion for each industry sector was added together to arrive at the cost of corrosion for the entire UK economy. The report identified the sources for the cost of corrosion by sectors of the economy. It evaluated and summarized the direct expenditures (costs to owner/operator) in each economic sector. Indirect costs (costs for user) were not included in the studies. 

The health economic evaluation model and the COl model are closely related. The consumption of agents of production causes direct costs. Indirect costs are a monetary expression for the loss of economic wealth, that is, the impact of a health intervention is the reduction of indirect costs. The increase of health is reflected by the reduction of intangible costs. 

Hanvelt et al. (1994) estimated the nationwide indirect costs of mortality due to HIV/AIDS in Canada. A descriptive, population-based economic evaluation study was conducted. Data from Statistics Canada were used, which contained information about aU men aged 25-64 years for whom HIV/AIDS or another selected disease was listed as the underlying cause of death from 1987 to 1991. Based on the human capital approach, the present value of future earnings lost for men was calculated. The estimated total loss from 1987 to 1991 was US 2.11 billion, with an average cost of US 558,000 per death associated with HIV/AIDS. Future production loss due to HIV/AIDS was more than double during the period 1987 to 1991, from US 0.27 to US 0.60 billion. A more comprehensive update of this smdy was presented by Hanvelt et al. (1996). The same database and the same data section but for the calendar years 1987-1993 was used. The indirect cost of future production due to HIV/AIDS in Canada based on the human capital approach for that period was estimated to be US 3.28 billion. The authors also calculated the willingness-to-pay to prevent premature death due to HIV/AIDS, which was estimated based on... 

The main modes of economic evaluation have a common aim in their approach to cost measurement, which—if a societal perspective is adopted (the most appropriate in mental health contexts see below)—is to range widely across all direct and indirect costs (Table 1.1). Every resource impact and every opportunity cost are to be included. The types of evaluation differ with respect to their measurement of outcomes. In seeking to turn these economic evaluative principles into empirical studies a number of practical decisions must be taken. A fuller account of the following discussion is provided by, for example, Drummond et al (1997) and Gold et al (1996). 

The perspective of society is the broadest of all perspectives because it is the only one that considers the benefit to society as a whole. Theoretically, all direct and indirect costs are included in an economic evaluation performed from a societal perspective. Costs from this perspective include patient morbidity and mortality and the overall costs of giving and receiving medical care. An evaluation from this perspective also would include aU the important consequences an individual could experience. In countries with nationalized medicine, society is the predominant perspective. 

The economic evaluation consists of a study-grade (-20 , +40 ) determination of capital investment, first-year annual revenue requirements, and levelized annual revenue requirements. The capital investments are based on major equipment costs (developed from the flow diagram and the material balance) and factored costs for installation, ancillary equipment, and indirect investments. The capital investments are based on mid-1982 costs. 

Pharmaco-economic evaluations are new as a tool to control prices. In essence, regulators (or other purchasers) try to establish fair prices on the basis of complicated calculations, taking into account the costs of other treatments, the costs of disease for society and so on. The costs of a drug are thus set against its direct and indirect benefits, as compared with alternative drugs and treatments, and its possible disadvantages and risks. The essential question is how much the drug is worth to the community. 

When economic evaluation deals with a particular population, it may fail provide a breakdown for each sub-population. Even where the cost/effectiveness ratio is poor for the total population, it may nevertheless prove to be favourable for a particular sub-group. Patient preferences for different interventions may also need to be addressed. Inconsistency in the inclusion/exclusion of indirect costs (such as those for informal caregivers) and societal costs will also affect these ratios. 

If utilities are generated inside the facility, such as cooling water, the capital cost for outside the battery limits facilities are evaluated by APEA. Using the specified indirect cost, discount rate, tax, and interest, the discounted cash flow and the economic indicators are generated by APEA with the method described in Section Economic Sustainability Analysis. Parameters for economic evaluations and prices of the raw materials and products are shown in Table 6.8. Utility costs for electricity, steam, and... 

Economic Analysis is vital to justify the implementation of new diagnostic tests into resource limited health-care systems. POCTs are often more expensive on a test-by-test basis due to the scaling and portability of devices and not benefiting from the efficiency of large-scale multiplex laboratory testing of multiple samples. However, POCT can have benefits further down the clinical pathway such as those described in Table 2.1. These indirect cost savings can only be established by performing a comparative evaluation of the clinical pathway with and without the test. 

Derailment costs are also complex, in part because the economic impact of a derailment extends far beyond the asset costs. There are delay minutes, environmental impact, societal impact, and so on, and different countries will evaluate these in different ways. Typically the reported costs are simply the direct costs, of which 80% pertain to infrastructure and 20% to rolling stock the indirect costs, in the absence of real numbers, can be assumed to be approximately the same as the direct costs. 

Table 12.1 summarizes five major types of pharmacoeconomic evaluations cost-consequence, cost-benefit, cost-effectiveness, cost-minimization, and cost-utility (Drummond et al., 1997 Kielhorn and Graf von der Schulenburg, 2000). In a cost-consequence analysis, a comprehensive list of relevant costs and outcomes (consequences) of alternative therapeutic approaches are presented in tabular form. Costs and outcomes are typically organized according to their relationship to cost (direct and indirect), quality of life, patient preferences, and clinical outcomes (see taxonomy below). No attempt is made to combine the costs and outcomes into an economic ratio, and the interpretation of the analysis is left in large part to the reader. 

Many have proposed that evaluation of drug therapy and pharmacists value-added services should include assessments of economic, clinical, and humanistic outcomes. The economic, clinical, and humanistic outcomes (ECHO) model assumes that the outcomes of medical care can be classified along the three dimensions of economic, clinical, and humanistic outcomes (Kozma, Reeder, and Schultz, 1993). Clinical outcomes are defined as medical events that occur as a result of disease or treatment. Economic outcomes are defined as the direct, indirect, and intangible costs compared with the consequences of medical treatment alternatives. Humanistic outcomes are defined as the consequences of disease or treatment on patient functional status or quality of life. All three of these outcomes need to be balanced simultaneously to assess value. 

The total socio-economic impact of acid-related diseases is difficult, and perhaps impossible, to evaluate. To judge from dyspepsia, the overwhelming cost factor is indirect, which probably is also true for other acid-related conditions. 

The last step of a PBEE loss assessment is the probabilistic estimation of performances through DVs. DVs represent the outcome parameters of PBEE and allow a transformation of engineering evaluations in terms of variables of interest for stakeholders (e.g., dollars, deaths, downtime) see Porter (2003). Different studies are available in literature for the evaluation of direct and indirect losses (e.g., Mitrani-Reiser 2007), and results of such studies are now the basis of the loss assessment framework provided by FEMA P-58-1 (2012). It is worth noting that loss analysis works on repair costs and downtime that, in turn, are strictly related to the social and economical environment in which they are evaluated. 

The economics of the site must be analysed for technical feasibility. The netback is calculated by subtracting the annualised capital and operating costs from the annualised products sales price to set the upper bound of the annualised feedstock cost. If the annualised feedstock market price is less than the netback estimated, the plant will make money. The capital cost is evaluated in terms of the direct (inside and outside battery limits, i.e. ISBL and OSBL) and indirect capital costs. The ISBL comprises the cost of equipment which can be estimated using... 

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