The purpose of this study is to assess the measurement properties of EQ-5D-5L compared to EQ-5D-3L in psoriasis patients. Methods A cross-sectional survey was carried out at an academic dermatology ...clinic in Hungary. Psoriasis patients completed the EQ-5D-3L, EQ-5D-5L and Dermatology Life Quality Index (DLQI) questionnaires, and Psoriasis Area and Severity Index (PASI) was assessed. The UK value sets were used to calculate the 3L and 5L index scores. We tested the feasibility, ceiling effect, redistribution properties, the level of inconsistency and informativity (Shannon and Shannon Evenness indices). Spearman's rank-order correlations were performed between EQ-5D, EQ VAS, DLQI and PASI scores. Known-groups validity was evaluated by comparing age groups, clinical subtypes and treatment groups. Results Mean age of the 238 patients was 47 years, and 36.6% of them received biological therapy. Mean EQ-5D index score was 0.77 (SD: 0.26) with the 3L and 0.84 (SD: 0.19) with the 5L. The overall ceiling effect decreased from 37.1 (3L) to 32.9% (5L). Shannon index improved significantly for most dimensions, but Shannon Evenness index improved only in three dimensions. Compared to the 3L, the 5L version confirmed a better convergent validity with PASI, but not with the DLQI. Known-groups validity was equally demonstrated both for the 5L and 3L. Conclusions The EQ-5D-5L seems to improve measurement properties by reducing ceiling effects, strengthening correlations with PASI and improving informativity. Follow-up studies are needed to test responsiveness and reliability in psoriasis.
Deployment of customer-sited photovoltaics (PV) in the United States has expanded rapidly in recent years, driven by falling PV system prices, the advent of customer financing options, and various ...forms of policy support at the federal, state, and local levels. With the success of these efforts, heated debates have surfaced in a number of U.S. states about the impacts of customer-sited PV on utility shareholders and ratepayers. We performed a scoping analysis using a financial model to quantify the financial impacts of customer-sited PV on utility shareholders and ratepayers and to assess the magnitude of these impacts under alternative utility conditions. We find that customer-sited PV generally reduces utility collected revenues greater than reductions in costs leading to a revenue erosion effect and lost future earnings opportunities. We also find that average retail rates increase as utility costs are spread over a relatively smaller sales base. We analyze these results under various assumptions about utility operating and regulatory environments and find that these impacts can vary greatly depending upon the specific circumstances of the utility. Based on this analysis, we highlight potential implications for policymakers and identify key issues warranting further analysis.
•Customer-sited PV erodes utility revenues and avoids future utility investments.•Reductions in utility sales greater than utility costs increases average rates.•Impacts of customer-sited PV can vary depending on specific circumstances of utility.
This book conducts a micro-level analysis of various determinants of infrastructure sector performance that affect development. This book focuses on the distribution segment of three basic ...infrastructure services: electricity, water and sanitation, and fixed telecommunications. This books aims to answer four main sets of questions: what are the main performance trends in the region, and how heterogeneous are they?; how does the performance of state-owned and private utilities differ?; how does the institutional design of regulatory agencies affect sector performance?; and what management mechanisms create incentives for improved performance?. This book begins by describing the main elements that characterize sector performance, defined as the delivery of reliable, affordable service that complies with certain quality standards. It focuses on the relationship between sector performance and the following determinants: private sector participation, regulatory agencies, and corporate governance. It also examines related aspects, such as contract design, market structure, and, for telecommunications, market competition. This book first explains the dynamics of utility performance and the interactions between key internal variables and utility performance in each sector. The book is organized as follows: chapter one is introduction. Chapter two outlines changes in the electricity distribution, water and sanitation, and fixed telecommunications sectors in the Latin America and the Caribbean (LAC) region over the past 15 years. This chapter tells multiple stories of the substantial improvement in these sectors and fills in knowledge gaps by benchmarking utility performance at the regional, country, and utility levels. Chapter three synthesizes the impact private sector participation has had on electricity distribution, water and sewerage, and fixed-line telecommunications. This chapter also identifies whether private sector participation characteristics such as the sale method; investor nationality; and award criterion affect performance. Chapter four explores the institutional design of regulatory agencies and the link between regulatory governance and sector performance. Chapter five assesses the governance of state-owned enterprises (SOEs) in infrastructure, based on survey results from 45 SOEs in the water and electricity distribution sector of LAC. Chapters six examines other potential determinants for sector performance, including corruption, cost recovery, contract arrangements, and competition. Chapter seven summarizes the book s main results and describes the array of possibilities for moving forward.
When the clock strikes midnight on December 31st we embrace the new year with a fresh start. However, utilities do not have the luxury of starting the new year from a clean slate. As each year ...passes, the utility's role grows more complicated; arrearages are increasing year‐over‐year, the planet is getting warmer and weather events are more severe, calls for decarbonization are getting louder, and the world is demanding the energy industry take action. While utilities are not in the business of solving the world's problems, regulators, policy makers and the general public expects results.
The traditional energy utility business model is under pressure, and energy services are expected to play an important role for the energy transition. Experts and scholars argue that utilities need ...to innovate their business models, and transform from commodity suppliers to service providers. The transition from a product-oriented, capital-intensive business model based on tangible assets, towards a service-oriented, expense-intensive business model based on intangible assets may present great managerial and organizational challenges. Little research exists about such transitions for capital-intensive commodity providers, and particularly energy utilities, where the challenges to servitize are expected to be greatest. This qualitative paper explores the barriers to servitization within selected Swiss and German utility companies through a series of interviews with utility managers. One of them is ‘asset transformation’, the shift from tangible to intangible assets as major input factor for the value proposition, which is proposed as a driver for the complexity of business model transitions. Managers need to carefully manage those challenges, and find ways to operate both new service and established utility business models aside. Policy makers can support the transition of utilities through more favorable regulatory frameworks for energy services, and by supporting the exchange of knowledge in the industry.
•The paper analyses the expected transformation of utilities into service-providers.•Service and utility business models possess very different attributes.•The former is based on intangible, the latter on tangible assets.•The transformation into a service-provider is related with great challenges.•Asset transformation is proposed as a barrier for business model innovation.
The creation of a flexible, efficient, digitized, dependable and resilient power grid may well be the best route to increasing energy efficiency and security, as well as boosting the potential of ...renewable and distributed power sources. This book covers smart grids from A-Z, providing a complete treatment of the topic, covering both policy and technology, explaining the most recent innovations supporting its development, and clarifying how the smart grid can support the integration of renewable energy resources. Among the most important topics included are smart metering, renewable energy storage, plug-in hybrids, flexible demand response, strategies for offsetting intermittency issues, micro-grids for off-grid communities, and specific in-depth coverage of wind and solar power integration. The content draws lessons from an international panel of contributors, whose diverse experiences implementing smart grids will help to provide templates for success.
Provides critical information on the technological, design and policy issues that must be taken into account to ensure that the smart grid is implemented successfully
Demonstrates how smart grids can help utilities adhere to increased renewable portfolio standards
Provides examples of successful microgrid/smart metering projects from around the world that can act as templates for developers, operators and investors embarking upon similar projects
In recent years, the federal government’s increasing inability to address major societal challenges has arguably hampered America’s commitment to renewable energy initiatives. Individual U.S. states ...have stepped into this void and adopted their own policies, leading some to believe that the states can propel America’s renewable energy industry forward. However, we know little about how legislative and regulatory dynamics within America’s states might accelerate or hinder renewable energy policy creation. In Following in Footsteps or Marching Alone?, Srinivas Parinandi explores how states have devised their own novel policies, and how the political workings of legislatures and public utilities commissions have impacted state renewable energy policy design. Through the meticulous study of nearly three decades of state-level renewable energy policy-making, he finds that their creation is primarily driven by legislatures, and that ideologically liberal legislatures largely push the envelope. The book suggests that having a predominantly state-driven renewable energy effort can lead to uneven and patchwork-based policy development outcomes, and a possible solution is to try to more successfully federalize these issues. Parinandi urges readers, scholars, and policy practitioners to consider whether a state-led effort is adequate enough to handle the task of building momentum for renewable energy in one of the world’s largest electricity markets.
The welfare implications of safe water and sanitation cannot be overstated. The economic gains from provision of improved services to millions of unserved Africans in enormous. The international ...adoption of Millennium Development Goals brought the inadequacies of service provision sharply into focus. With only 58% and 31% enjoying access to water and sanitation services respectively, Sub-Saharan Africa is the only continent that is off-track in achieving the MDGs in 2015. The problem is compounded by the fact that a rigorous and credible baseline did not exist on coverage to improved water and sanitation and resources required to meet the MDGs. This book aims to contribute to this gap by collecting a wealth of primary and secondary information to present the most up-to-date and comprehensive quantitative snapshot of water and sanitation sectors. The book evaluates the challenges to the water and sanitation sectors within the urban and rural areas and deepen our understanding of drivers of coverage expansion in the context of financing, institutional reforms, and efficiency improvements. Finally, the book establishes the investment needs for water and sanitation with a target of meeting the MDGs and compares with the existing financing envelopes, disaggregated by proportions that can be recouped by efficiency gains and net financing gaps. The directions for the future draw on lessons learned from best practices and present the menu of choices available to African countries. There is no recipe book that neatly lays out the possible steps the country should adopt to enhance coverage and quality of service. The challenges differ to a significant extent among African countries and solutions must be tailored to individual national or regional conditions.
By the late 1990s, the technical and financial performance of the power sector in India had deteriorated to the point where the Government of India had to step in to bail out the state utilities, ...almost all of which were vertically integrated state electricity boards (SEBs). Considering that the dismal performance of state utilities reflected internal and external shortfalls in governance, the new Electricity Act of 2003 (EA 2003) mandated the unbundling and corporatization of the SEBs, along with the establishment of independent regulators. This was expected to bring about a more accountable and commercial performance culture, with concomitant results in improved utility performance. The rest of this review is organized as follows. Chapter two summarizes the institutional context and relevant developments over the past two decades. Chapter three focuses on the corporate governance agenda adopted by the government and its implementation, specifically relating to the structure and functioning of utility boards of directors. Chapter four reviews SERC regulatory governance. Chapter five analyzes the correlation between key indicators of the quality of regulatory and corporate governance and utility financial performance. And chapter six concludes.
Electricity restructuring in the 1990s ended the era of vertically integrated monopolies in many states, allowing nonutility generators to sell electricity to utilities and, in fewer states, allowing ...retail service providers to buy electricity from generators and sell to end-use customers. We review the economic arguments for restructuring and the resulting effects in subsequent years. We argue that the greatest political motivation for restructuring was rent shifting, not efficiency improvements. Although electricity restructuring has brought efficiency improvements, it has generally been viewed as a disappointment because the price-reduction promises made by some advocates were based on politically unsustainable rent transfers. In reality, electricity rate changes since restructuring have been driven more by exogenous factors, such as generation technology advances and natural gas price fluctuations, than by restructuring. We argue that a similar dynamic underpins the current political momentum behind distributed generation, primarily rooftop solar photovoltaic systems, which remains costly from a societal viewpoint, but privately economic owing to the rent transfers it enables.
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