Information on the costs and benefits of eHealth interventions is needed, not only to document value for money and to support decision making in the field, but also to form the basis for developing ...business models and to facilitate payment systems to support large-scale services. In the absence of solid evidence of its effects, key decision makers may doubt the effectiveness, which, in turn, limits investment in, and the long-term integration of, eHealth services. However, it is not realistic to conduct economic evaluations of all eHealth applications and services in all situations, so we need to be able to generalize from those we do conduct. This implies that we have to select the most appropriate methodology and data collection strategy in order to increase the transferability across evaluations. This paper aims to contribute to the understanding of how to apply economic evaluation methodology in the eHealth field. It provides a brief overview of basic health economics principles and frameworks and discusses some methodological issues and challenges in conducting cost-effectiveness analysis of eHealth interventions. Issues regarding the identification, measurement, and valuation of costs and benefits are outlined. Furthermore, this work describes the established techniques of combining costs and benefits, presents the decision rules for identifying the preferred option, and outlines approaches to data collection strategies. Issues related to transferability and complexity are also discussed.
We use data from the Head Start Impact Study (HSIS) to evaluate the cost-effectiveness of Head Start, the largest early childhood education program in the United States. Head Start draws roughly a ...third of its participants from competing preschool programs, many of which receive public funds. We show that accounting for the fiscal impacts of such program substitution pushes estimates of Head Start’s benefit-cost ratio well above one under a wide range of assumptions on the structure of the market for preschool services and the dollar value of test score gains. To parse the program’s test score impacts relative to home care and competing preschools, we selection-correct test scores in each care environment using excluded interactions between experimental assignments and household characteristics. We find that Head Start generates larger test score gains for children who would not otherwise attend preschool and for children who are less likely to participate in the program.
The article first describes characteristics of major infrastructure projects. Second, it documents a much neglected topic in economics: that ex ante estimates of costs and benefits are often very ...different from actual ex post costs and benefits. For large infrastructure projects the consequences are cost overruns, benefit shortfalls, and the systematic underestimation of risks. Third, implications for cost–benefit analysis are described, including that such analysis is not to be trusted for major infrastructure projects. Fourth, the article uncovers the causes of this state of affairs in terms of perverse incentives that encourage promoters to underestimate costs and overestimate benefits in the business cases for their projects. But the projects that are made to look best on paper are the projects that amass the highest cost overruns and benefit shortfalls in reality. The article depicts this situation as ‘survival of the unfittest’. Fifth, the article sets out to explain how the problem may be solved, with a view to arriving at more efficient and more democratic projects, and avoiding the scandals that often accompany major infrastructure investments. Finally, the article identifies current trends in major infrastructure development. It is argued that a rapid increase in stimulus spending, combined with more investments in emerging economies, combined with more spending on information technology is catapulting infrastructure investment from the frying pan into the fire.
This research integrates the international business and entrepreneurship literatures by examining the independent influences of innovativeness, proactiveness, and risk-taking on the ability of a firm ...to broaden its scope across international markets. For each dimension of entrepreneurial orientation, a cost–benefit framework is applied to highlight the trade-offs associated with different levels in the internationalization context. Based on a unique dataset of 500 SMEs spanning 10 industries, the results reflect the consequences of being “stuck in the middle” with respect to their strategic posture on innovativeness and proactiveness, but reveal a nuanced role for risk-taking behavior. The non-uniform and non-linear relationships from the findings contribute to a better understanding of when the individual dimensions of entrepreneurial orientation help or hinder entrepreneurial firms in the internationalization process.
•EO exerts multi-faceted impact on firm internationalization through its sub-dimensions.•Resource-limited firms do not need to achieve high levels on each sub-dimension in order to internationalize.•Being moderate on innovativeness and proactiveness leads to lower international scope than adopting extreme positions.•Moderate levels of risk-taking facilitate greater international scope than either low or high levels on this dimension.•The relationship between EO and firm outcomes is more nuanced and non-linear in the internationalization context.
To improve the air quality in winter, clean heating policy was implemented in “2 + 26” cities of China in 2016, which mainly included replacing coal with gas or electricity. Tremendous financial ...subsidies have been provided by city and central governments. This new heating mode changed the heating fee-cost to residents. This paper estimates the economic costs to both governments and residents, and evaluates the environmental and public health benefits by combining a difference-in-differences model with an exposure-response function. Results show that the total costs of clean heating were up to 43.1 billion yuan. Governments and residents account for 44% and 56% of the total costs, respectively. In terms of benefits, the clean heating project is effective for air pollution control and brings health economic benefits of about 109.85 billion yuan (95% CI: 22.40–159.83). The clean heating policy was identified as a net-positive benefit program with environmental and public health improvements. However, the inequality in subsidies from different cities governments increases the heating burden on low-income households and leads to heating poverty for households in the less developed regions. We provide suggestions for implementation in future clean heating campaigns and in subsidy mechanism design in China and for other developing countries.
•Existing situation and problems of clean heating and its subsidy in China.•Economic costs of clean heating were up to 43.1 billion yuan.•Governments and residents account for 44% and 56% of the total costs.•Clean heating program brings health economic co-benefits of about 109.85 billion yuan.•Clean heating was a net positive benefit program.
ABSTRACT
To shed light on the role that academic research plays in Securities and Exchange Commission (SEC) rulemaking, this paper examines the SEC's patterns of consumption of academic research from ...2007 through 2017. We show how the Business Roundtable v. SEC ruling in 2011 increased consideration given to academic research during SEC rulemaking. We find that after the ruling, the SEC cites more papers in its proposed rules and, in particular, more papers that illustrate the costs of regulation. This change in academic citations results in fewer negative comment letters on proposed SEC regulations. We survey academics whose research was cited by the SEC, and the majority respond that the SEC's description of their work is completely or mostly accurate. When we survey general academics, their average rating of the SEC's accuracy is lower, although the rating improves regarding specific SEC quotes citing academic research. Although there is still room for a more substantive discussion of research, having a higher standard of cost‐benefit analysis leads to a more balanced discussion of academic research.
This study reviews the literature on the evaluation of the Olympic Games, within the broader framework of their significance as cultural assets and opportunities for endogenous growth and sustainable ...development of the host city. The study reviews the main approaches to the economic assessment of the Games, from the point of view of the underlying economic concepts and methodologies, as well as of the empirical results obtained. It focuses on the effects that are measured and on those, which even though important, are generally neglected. The methodologies utilized for the quantitative assessments of the Games are reviewed with special emphasis on impact and cost–benefit analysis, both on ex ante and ex post basis. The studies surveyed are analysed from the point of view of different sets of effects on the host city, and for a limited number of cases, on the host country. While the major focus is on hosting the Summer Olympics, some attention is also paid to the bidding cities, the Winter Olympics and the Paralympics. The general findings appear to be controversial with some hints of positive overall effects, but also with a well‐documented tendency to exaggerate the benefits and underestimate the costs of holding the Games in the ex ante versus the ex post studies. The survey finally suggests that ex post cross‐country econometric studies tend to catch sizable differential and persistent benefits ignored by individual studies, especially on macroeconomic and trade variables.
Recently, a number of non-pharmacological interventions for dementia symptoms were evaluated using cost-benefit analysis (CBA) and found to be both effective and socially worthwhile. What is missing ...is a comparison of evaluations for these interventions with pharmaceutical interventions approved by the Food and Drug Administration (FDA) to see which interventions should be given priority in public expenditure budgets aiming to reduce dementia symptoms. This paper fills this knowledge gap by carrying out a CBA of FDA-approved medications using a large national data set provided by the National Alzheimer's Coordinating Center (NACC). We find that the pharmaceutical medications were actually counterproductive, and therefore social welfare would be substantially improved by not investing in these medications. This therefore means that non-pharmaceutical interventions should be given higher priority at this time.
This research investigates the cost-effectiveness of energy performance measures in French residential buildings. We develop an empirical approach based on a multivariate statistical approach and ...Cost-Benefit analysis. The strength of this research relies on the designing of a large cross-sectional database collected in 2013 including rich technical information of about 1,400 dwellings representative of the French residential sector as well as individual recommendations relative to the energy renovations to be implemented, their investment costs, and energy savings potential. We provide valuable information on the cost-effectiveness of energy renovation measures for the entire housing stock. Results show that low-temperature and condensing boilers, as well as floor insulation, are the most cost-effective energy efficiency measures, which could be inconsistent with actual subsidy policies. We demonstrate that the cost-effectiveness of energy renovation measures is widely dependent on dwelling initial characteristics and the value of the inputs used in the economic indicators such as energy-savings amount, energy price, and the discount rate. Moreover, we provide a classification of French dwellings, which may help policymakers, better identify their target. Finally, we show that the renovation of the entire French residential dwelling stock can lead to a great amount of energy–and CO2–reductions but requires significant financial capacity.
•We examine the cost-effectiveness of energy efficiency renovation measures.•We develop a cost-benefit and simulation approach based on a rich data set.•We provide key insights on the profitability of the energy renovation measures.•Low temperature and condensing boilers appear to be the most cost-effective measures.•The renovation of the entire housing stock may lead to a significant CO2 reduction.
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