Evidence-informed priority setting, in particular cost-effectiveness analysis (CEA), can help target resources better to achieve universal health coverage. Central to the application of CEA is the ...use of a cost-effectiveness threshold. We add to the literature by looking at what thresholds have been used in published CEA and the proportion of interventions found to be cost-effective, by type of threshold.
We identified CEA studies in low- and middle-income countries from the Global Health Cost-Effectiveness Analysis Registry that were published between January 1, 2015, and January 6, 2020. We extracted data on the country of focus, type of interventions under consideration, funder, threshold used, and recommendations.
A total of 230 studies with a total 713 interventions were included in this review; 1 to 3× gross domestic product (GDP) per capita was the most common type of threshold used in judging cost-effectiveness (84.3%). Approximately a third of studies (34.2%) using 1 to 3× GDP per capita applied a threshold at 3× GDP per capita. We have found that no study used locally developed thresholds. We found that 79.3% of interventions received a recommendation as “cost-effective” and that 85.9% of studies had at least 1 intervention that was considered cost-effective. The use of 1 to 3× GDP per capita led to a higher proportion of study interventions being judged as cost-effective compared with other types of thresholds.
Despite the wide concerns about the use of 1 to 3× GDP per capita, this threshold is still widely used in the literature. Using this threshold leads to more interventions being recommended as “cost-effective.” This study further explore alternatives to the 1 to 3× GDP as a decision rule.
•The assessment of cost-effectiveness of interventions ex ante can ensure that cost-effective interventions that highly benefit population health are consistently prioritized over interventions that offer comparatively less value.•Cost-effectiveness thresholds (CETs) are essential in determining whether an intervention under consideration is cost-effective or not; nevertheless, there is no international consensus on how they should be determined by countries.•The World Health Organization has distanced itself from the use of 1 to 3× gross domestic product (GDP) per capita per disability-adjusted life-year averted (earlier recommended by World Health Organization-CHOICE) as a CET but they remain the most popular and commonly used thresholds.•More than a third of studies apply the 1 to 3× GDP per capita CET use 3× GDP per capita per disability-adjusted life-year averted yet 3× GDP per capita is a lot higher than other CET.•Using 1 to 3× GDP per capita as a CET has resulted in a higher proportion of study interventions being found as cost-effective in comparison with studies where other types of CET are used. This may lead to a loss of would-be health gains from deployed resources for health.•There is an urgent need to move away from 1 to 3× GDP per capita as a CET and a more appropriate replacement should be found.
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In a recent contribution to the AER, Koopman, Wang, and Wei (2014) proposed a decomposition of a country's gross exports into valueadded components and double-counted terms. It is motivated by ...complex manipulation of basic accounting identities. In this comment we provide an alternative framework based on "hypothetical extraction." This parsimonious approach provides a clear definition of domestic value added in exports and has a natural extension into decompositions of bilateral export flows.
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When Credit Bites Back JORDÀ, ÒSCAR; SCHULARICK, MORITZ; TAYLOR, ALAN M.
Journal of money, credit and banking,
December 2013, Volume:
45, Issue:
s2
Journal Article
Peer reviewed
Using data on 14 advanced countries between 1870 and 2008 we document two key facts of the modern business cycle: relative to typical recessions, financial crisis recessions are costlier, and more ...credit-intensive expansions tend to be followed by deeper recessions (in financial crises or otherwise) and slower recoveries. We use local projection methods to condition on a broad set of macro-economic controls to study how past credit accumulation impacts key macro-economic variables such as output, investment, lending, interest rates, and inflation. The facts that we uncover lend support to the idea that financial factors play an important role in the modern business cycle.
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Determinants of renewable energy consumption in Africa Ergun, Selim Jürgen; Owusu, Phebe Asantewaa; Rivas, Maria Fernanda
Environmental science and pollution research international,
05/2019, Volume:
26, Issue:
15
Journal Article
Peer reviewed
Although the role that renewable energy consumption plays on economic growth and emissions has been widely studied, there are relatively few papers focusing on the determinants of renewable energy ...consumption, and only one study focuses on the factors related to the share of renewables in the energy consumption in Africa. This paper contributes to the literature by filling the gap in knowledge by exploring the nexus between the share of renewables in energy consumption and social and economic variables, for a panel consisting of 21 African countries for the period between 1990 and 2013, extending the set of variables and the time span used by a previous study. Estimating a random-effects generalized least squares regression, we find that countries with a higher Human Development Index and a higher gross domestic product per capita have a lower share of renewable energy in the national grid. On the other hand, an increase in foreign direct investment has been found to be related to higher renewable energy integration. The level of democracy, measured by the Freedom House political rights and civil liberties ratings, does not directly affect the integration level of renewable energy sources. The negative relationship between gross domestic product per capita and the share of renewables contradicts previous findings for developed countries. This contradiction and policy implications are discussed in the light of the review of the energy mix of the selected countries.
For the last period of time, the most important ratings were issues based on the analysis of some financial indicators calculated mostly on the basis of accurate financial data. But times have ...changed and the aspects regarding environmental, social and governance (ESG) indicators are becoming more important every day. This article presents the evolution of ESG ratings, specifically the ESG Global Score Indicator regarding sovereign risk analysis for the states of the European Union.
Energy affects the economic growth and development of a country. Renewable energy has become an important part of the world’s energy consumption. The use of fossil fuel energy contributes to global ...warming and carbon dioxide emissions, and has a detrimental effect on the environment. The long-run and short-run causality relationships between electric power consumption, renewable electricity output, renewable energy consumption, fossil fuel energy consumption, energy use, carbon dioxide emissions, and gross domestic product per capita for Pakistan over the period of 1990–2017 were investigated in this paper using the autoregressive distributed lag bounds testing approach to cointegration. The augmented Dickey–Fuller unit root test and the Phillips–Perron unit root test were used to check the stationarity of the variables, while the Johansen cointegration test was applied to check the robustness of the long-run relationships. The Granger causality test under the vector error correction model extracted during the short-run estimation showed a unidirectional relationship among all variables except for the relationship between gross domestic product per capita and carbon dioxide emission, which was bidirectional (feedback hypothesis). The evidence showed that in the long run, carbon dioxide emissions, electric power consumption, and renewable electricity output had a positive and significant relationship with the gross domestic product per capita, while the relationship of renewable energy consumption, energy use, and fossil fuel energy consumption with the gross domestic product per capita had a negative effect. Overall, the long-run effects of the variables were found to have a stronger effect on the gross domestic product per capita than the short-run dynamics, which indicated that the findings were heterogeneous. The evidence suggests that the government of Pakistan should take steps to enhance the use of renewable energy resources to resolve the energy crisis in the country and introduce new policies to reduce carbon dioxide emissions.
While global Gross Domestic Product (GDP) has increased more than three-fold since 1950, economic welfare, as estimated by the Genuine Progress Indicator (GPI), has actually decreased since 1978. We ...synthesized estimates of GPI over the 1950–2003 time period for 17 countries for which GPI has been estimated. These 17 countries contain 53% of the global population and 59% of the global GDP. We compared GPI with Gross Domestic Product (GDP), Human Development Index (HDI), Ecological Footprint, Biocapacity, Gini coefficient, and Life Satisfaction scores. Results show a significant variation among these countries, but some major trends. We also estimated a global GPI/capita over the 1950–2003 period. Global GPI/capita peaked in 1978, about the same time that global Ecological Footprint exceeded global Biocapacity. Life Satisfaction in almost all countries has also not improved significantly since 1975. Globally, GPI/capita does not increase beyond a GDP/capita of around $7000/capita. If we distributed income more equitably around the planet, the current world GDP ($67trillion/yr) could support 9.6billion people at $7000/capita. While GPI is not the perfect economic welfare indicator, it is a far better approximation than GDP. Development policies need to shift to better account for real welfare and not merely GDP growth.
•Global GPI/capita peaked in 1978.•Globally, GPI/capita does not increase beyond a GDP/capita of around $6,500/capita.•With more equitable distribution, current world GDP ($67trillion/yr) could support 9.6billion people at $7,000/capita.•Life satisfaction in almost all countries has also not improved significantly since 1975.
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As fundamental data, gross domestic product (GDP) and electricity consumption can be used to effectively evaluate economic status and living standards of residents. Some scholars have estimated ...gridded GDP and electricity consumption. However, such gridded data have shortcomings, including overestimating real GDP growth, ignoring the heterogeneity of the spatiotemporal dynamics of the grid, and limited time-span. Simultaneously, the Defense Meteorological Satellite Program's Operational Linescan System (DMSP/OLS) and National Polar-orbiting Partnership's Visible Infrared Imaging Radiometer (NPP/VIIRS) nighttime light data, adopted in these studies as a proxy tool, still facing shortcomings, such as imperfect matching results, discontinuity in temporal and spatial changes. In this study, we employed a series of methods, such as a particle swarm optimization-back propagation (PSO-BP) algorithm, to unify the scales of DMSP/OLS and NPP/VIIRS images and obtain continuous 1 km × 1 km gridded nighttime light data during 1992-2019. Subsequently, from a revised real growth perspective, we employed a top-down method to calculate global 1 km × 1 km gridded revised real GDP and electricity consumption during 1992-2019 based on our calibrated nighttime light data.
The fading American dream Chetty, Raj; Grusky, David; Hell, Maximilian ...
Science (American Association for the Advancement of Science),
04/2017, Volume:
356, Issue:
6336
Journal Article
Peer reviewed
Open access
We estimated rates of “absolute income mobility”—the fraction of children who earn more than their parents—by combining data from U.S. Census and Current Population Survey cross sections with panel ...data from de-identified tax records. We found that rates of absolute mobility have fallen from approximately 90% for children born in 1940 to 50% for children born in the 1980s. Increasing Gross Domestic Product (GDP) growth rates alone cannot restore absolute mobility to the rates experienced by children born in the 1940s. However, distributing current GDP growth more equally across income groups as in the 1940 birth cohort would reverse more than 70% of the decline in mobility. These results imply that reviving the “American dream” of high rates of absolute mobility would require economic growth that is shared more broadly across the income distribution.
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