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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
241

DIGITALISERING INOM BANKSEKTORN : Hur uppfattar svenska storbanker och FinTech bolag de möjligheter och hot som uppkommer i samband med den ökande digitaliseringen? / DIGITIZING IN THE BANKING SECTOR : How do the big Swedish banks and FinTech companies perceive the different opportunities and threats related to the increased digitalization?

Babawi, Sadeer, Güner, Johannes January 2019 (has links)
Inledning: En stor del av den svenska ekonomin vilar på den svenska banksektorn. I och med den ökande digitaliseringen som blivit än mer påtaglig på senare tid har konkurrenssituationen bidragit till ett nytt utgångsläge än tidigare. Idag talas det om nya konkurrenter i banksektorn, som FinTech bolag, internationella banker och andra aktörer som börjar utmana svenska storbanker om fler marknadsandelar. Syfte och problemformulering: Syftet med arbetet är att identifiera, beskriva och förklara hur svenska storbanker och FinTech bolag uppfattar möjligheterna och hoten i samband med den ökande digitaliseringen inom banksektorn. Detta är för att försöka skapa en förståelse för förändringen av banksektorn i samband med digitaliseringen. Hur uppfattar svenska storbanker och FinTech bolag de möjligheter och hot som uppkommer i samband med den ökande digitaliseringen? Teoretisk referensram: De teorier som har använts under studien är isomorfismen med underbegreppen tvingande, imiterande och normativ isomorfism samt Porters strategiteori, femkraftsmodellen. En SWOT analys har använts för att enklare kunna identifiera bankernas styrkor, svagheter, möjligheter och hot i samband med digitaliseringen. Studien har även använt sig av tidigare forskning och tagit hänsyn till strävan efter legitimitet och krav på kostnadseffektivisering. Detta har använts som stöd till det empiriska resultat som samlats in för att enklare kunna analysera och därmed få problemformuleringen besvarad. Metod: Det empiriska materialet har samlats in med en kvalitativ metod. 5 informanter har medverkat i semistrukturerade intervjuer. Slutsats: Författarna till studien har identifierat och beskrivit flera faktorer till hur de uppfattar de möjligheter och de hot som finns i samband med den ökande digitaliseringen. Informanterna belyste både möjligheter och hot, exempelvis att regelverket PSD2 ökar konkurrensen och förbättrar situationen för mindre aktörer att konkurrera mot de större bankerna. Studien har även begränsats till svenska storbanker och FinTech bolag. / Introduction: A big part of the Swedish economy rests on the shoulders of the Swedish bank sector. Because of the increasing digitalization in recent times, the difference in competition has become substantially more evident and it has received a completely new starting point compared to before. The newest and most recent additions to the competition within the banking sector are examples such as FinTech companies, international banks and other parties that are also starting to compete with the big Swedish banks for market shares. Purpose and problem formulation: The purpose of this study is to describe the way the big Swedish banks and FinTech companies perceive the different opportunities and threats related to the increased digitalization that we see today. This will allow us to try and create an understanding of what the future might look like and what has already changed within the banking sector ever since the introduction of digitalization. How do the big Swedish banks and FinTech companies perceive the different opportunities and threats related to the increased digitalization? Theoretical frame of reference: The theories that have been used during the study are isomorphism with the notion of compelling, imitating and normative isomorphism as well as Porter's strategy theory, the five force model. A SWOT analysis has been used to more easily identify the banks' strengths, weaknesses, opportunities and threats during the digitization. The study has also used previous research and taken into account the quest for legitimacy and demands for cost efficiency. This has become a support for the empirical results that have been collected in order to be able to analyze more easily, reach a conclusion and thus get the problem formulation answered. Method: The empirical material has been collected with a qualitative method. 5 informants have participated in semi-structured interviews. Conclusion: The authors of the study have identified, described and explained several factors as to how they perceive opportunities and threats during the increasing digitization. The informants shared both opportunities and threats, such as the fact that the PSD2 regulations increase competition and improve the situation for smaller players to compete against the big banks. The study has also been limited to big Swedish banks and FinTech companies.
242

Análise de custo-efetividade do tratamento supervisionado e autoadministrado da tuberculose / Cost-effectiveness analysis of supervised and self-administered treatment of tuberculosis.

Gomes, Michela Prestes 27 March 2013 (has links)
A tuberculose (TB) é uma doença infecto contagiosa causada pelo Bacilo de Koch (Mycobacterium tuberculosis), sua forma mais frequente é a tuberculose pulmonar, e tem cura quando o tratamento é realizado corretamente. É uma das importantes causas de mortalidade no mundo, e apresenta alta prevalência e incidência no Brasil, o qual se encontra entre os países com maiores números de casos da doença. O objetivo desse trabalho foi efetuar um estudo sobre custo-efetividade do tratamento para tuberculose (abordando as estratégias de tratamento supervisionado e autoadministrado), buscando evidencias para estimar custos diretos (no distrito oeste de Ribeirão Preto-SP) e custos indiretos (para algumas regiões deste município). Por ser uma doença associada às condições sociais e econômicas (nelas incluídas o Brasil), buscou-se observar as deficiências das organizações e gestão do sistema de saúde, através da análise dos custos gerados pela TB. Foi efetuado um estudo epidemiológico, descritivo, pesquisa avaliativa, visando coletar dados sócio-demográficos, e características sobre acompanhamento e evolução do tratamento através dos prontuários dos doentes de TB para estimativa de custos diretos, e também estimar os custos indiretos através de entrevista com os pacientes. A fim de efetuarmos a análise de custo-efetividade do tratamento diretamente observado (TDO) e autoadministrado (TAA) da TB. Foram amplamente discutidos a qualidade dos dados, e realizadas as estimativas dos custos: direto, resultando em R$ 1075,39 (para estratégia TDO) e R$806,98 (estratégia TAA); e indireto, resultando em R$2001,39 (para TDO) e R$974,53 (para TAA). Encontrou-se uma Razão de Custo-efetividade Incremental (RCEI) negativo de 8.0562 por tratamento concluído da estratégia TDO em relação ao TAA. Palavras / Tuberculosis (TB) is an infectious disease caused by Kochs bacillus (Mycobacterium tuberculosis), most frequently presented as pulmonary tuberculosis. It is fully curable with the right treatment. TB is an important cause of death worldwide and presents high prevalence and incidence in Brazil, one of the countries with the highest number of cases. The aim of this study was to evaluate the cost-effectiveness of tuberculosis treatment (directly observed treatment DOT, and self-administered treatment SAT), searching evidence in order to estimate direct (in the Western district of Ribeirão Preto-SP) and indirect (for some regions of this city) costs. Due to the fact TB is associated with social and economical conditions (including in Brazil), an analysis of costs generated by TB was carried out, by observing the deficiencies of organizations and management of the health system. A descriptive epidemiological study of an evaluative research was carried out to collect socio-demographic data and characteristics of evolution and follow-up of TB treatment, to estimate the direct costs through the analysis of medical forms of patients, and indirect costs through interviews with patients. In order to evaluate the cost-effectiveness of DOT and SAT strategies for TB treatment, the quality of data was analyzed and estimates of direct and indirect costs were calculated. The results show a negative incremental cost-effectiveness ratio (ICER) of 8,0562 for DOTS strategy compared to SAT strategy.
243

Saúde Pública no Brasil: proposta de um modelo de avaliação de custo-efetividade utilizando o IDSUS / Public Health in Brazil: a proposal for a cost-effectiveness evaluation model using IDSUS

Oliveira, Lilian Ribeiro de 18 June 2014 (has links)
O Sistema Único de Saúde (SUS), modelo universalista que existe atualmente no Brasil, encontra-se em posição de destaque dentre as políticas sociais vigentes. Num contexto de aumento de recursos e crescimento da demanda, o SUS constantemente sofre alterações que visam aumentar a qualidade, o acesso e a efetividade do serviço prestado; dessa forma, são necessários instrumentos para acompanhar seu desempenho. Não obstante, este trabalho versa em seu marco teórico sobre a trajetória do Sistema Único de Saúde e as avaliações de políticas públicas em saúde, visto que a incorporação de novas ferramentas é incontestavelmente importante para a produtividade do recurso destinado à saúde pública no Brasil - cada vez mais, a utilização de novas tecnologias e processos contribuirá para a adequada tomada de decisão dos gestores, melhores políticas públicas de saúde e um sistema verdadeiramente universal e funcional. Uma das novas ferramentas utilizadas pelo SUS é o IDSUS, que se propõe a medir o desempenho de cada município e região em relação ao acesso e à efetividade do sistema. O índice é composto por 24 indicadores, em que 14 medem o acesso à saúde e 10 se referem à efetividade do sistema. Oportunamente, para este trabalho utilizou-se como universo amostral o Grupo Homogêneo 2, divisão estabelecida pelo IDSUS para classificar os municípios de acordo com características similares de estrutura e condições de saúde. O grupo formado por 94 municípios do país foi analisado por meio de dados provenientes das bases do IDSUS e Siops, para o ano de 2011, e dados complementares do IBGE e PNUD. Após a estruturação dessas informações, procedeu-se à análise estatística descritiva e à análise de clusters, com o intuito de reagrupar os municípios semelhantes de acordo com as variáveis estabelecidas: nota do IDSUS, população e receita total em saúde per capita. Diante disso, o objetivo deste trabalho foi propor um modelo de análise de custo-efetividade para comparar as notas alcançadas no IDSUS do Grupo Homogêneo 2, diante da nova configuração de agrupamento, com as respectivas receitas totais per capita destinadas à saúde pública, além de serem detalhadas as análises por bloco de financiamento, no total de cinco, de acordo com especificações do Ministério da Saúde. A análise de custo-efetividade foi escolhida pelo fato de, dentre as ferramentas de análise econômica, permitir mensurar tanto benefícios monetários quanto benefícios sociais. Mesmo com a divisão dos municípios por grupos homogêneos e após a utilização de variáveis como população e receita para reagrupá-los, os resultados evidenciaram que existem municípios que apresentam características heterogêneas. Outro achado encontra-se na utilização e no cruzamento de duas bases distintas (IDSUS e Siops), o que proporcionou a visualização sobre o impacto dos recursos em saúde no desempenho dos municípios; isso parece complementar a avaliação de desempenho já realizada. Além disso, a análise de custo-efetividade culminou na verificação de que não só o montante de recurso financeiro impacta no melhor desempenho, como também outras variáveis, a exemplo de população e formas de alocação do recurso nos blocos de financiamento. Espera-se que este trabalho sirva como uma ferramenta de consolidação de informações e tomadas de decisão para os gestores, posto que são observados não só os dados clínicos, mas também a efetividade na alocação dos recursos no sistema de saúde. Vislumbra-se a possibilidade de contribuição para a melhoria de instrumentos de avaliação já utilizados pelo SUS. / The Public Health System (SUS), universalist model that currently exists in Brazil, is in a prominent position compared to the existing social politics. In a context of increased resources and demand, SUS is constantly changed toward to increase quality, access and effectiveness of the services; this way, tools are needed to monitor its performance. Nevertheless, the theoretical framework of this dissertation focus on SUS trajectory and the reviews of public health politics, as the incorporation of new tools is undeniably important to the funds productivity for public health in Brazil - the use of new technologies and processes will increasingly contribute to adequate decision making of managers, better public health politics and a truly universal and functional system. One of the new tools used by SUS is IDSUS, which purposes to measure the performance of each municipality and region in relation to access and effectiveness of the system. The index consists of 24 indicators: 14 measure access to health and 10 refer to the effectiveness of the system. The Homogeneous Group 2 was used as a sampling universe, division established by IDSUS to classify municipalities according to similar characteristics of structure and health conditions. The group formed by 94 municipalities in the country was analyzed using data from IDSUS and SIOPS bases, for the year 2011, and additional data from IBGE and PNUD. After structuring this information, it was carried to a descriptive statistical analysis and a cluster analysis in order to regroup similar municipalities in accordance with the established variables: IDSUS performance, population and total revenue in health per capita. Therefore, the aim of this study was to propose a model of cost-effectiveness to compare IDSUS performance achieved in Homogeneous Group 2, according to the new group setting, with its per capita total revenues for public health, besides the details of analyzes for finance package, totaling five, according to specifications of Ministry of Health. The cost-effectiveness was chosen because, among the economic analysis tools, it allows to measure both monetary and social benefits. Even with the division of municipalities by homogeneous groups and after the usage of variables such as population and income to regroup them, the results have shown there are municipalities with heterogeneous characteristics. Another finding is in use and intersection of two distinct bases (IDSUS and SIOPS), which provided visualizing the impact of health care resources in the performance of municipalities; it seems to complement the performance evaluation that was already made. Moreover, the cost-effectiveness culminated in the verification that not only the amount of financial resource impacts in better performance, but also other variables (population and ways of resource allocation in finance packages, for example). It is hoped that this work will serve as a tool to consolidate information and decision-making for managers, as not only the clinical data are observed, but also effectiveness in the resources allocation in the health system. It is seen the possibility of contributing to improve the assessment tools already used by SUS.
244

Análise da relação custo-efetividade do tratamento com DCI - Desfibrilador Cardioversor Implantável / Cost-effectiveness analysis of implantable cardioverter defibrillator therapy (ICD)

Matos, Afonso José de 23 March 2007 (has links)
Objetivo: Análise da relação custo-efetividade do tratamento com o uso do DCI - Desfibrilador Cardioversor Implantável comparado com o tratamento clínico alternativo através de medicamentos. Revisão de literatura: O estudo contemplou a revisão da conceituação das técnicas de avaliação econômica e de apropriação de custos de procedimentos hospitalares, bem como experiências sobre a análise da relação custo-efetividade aplicadas às intervenções médicas consideradas na pesquisa. Métodos: O estudo utilizou a unidade de Custo por AVG - Ano de Vida Ganho, como expressão do indicador de custo-efetividade. A metodologia compreendeu a definição da perspectiva da pesquisa (Sistema Único de Saúde na qualidade de principal financiador do implante de DCIs, no Brasil), elaboração dos protocolos padrões de tratamento, cálculo dos custos totais dos tratamentos baseados em indicadores praticados por hospitais de referência, os quais encontram-se estimados para o período de dez anos e ajustados para valor presente à taxa de desconto de 6% ao ano. No âmbito da efetividade, foram utilizados parâmetros da literatura, os quais encontram-se baseados nos anos de vida ganhos do tratamento com o uso do DCI, em relação ao tratamento clínico. Resultados: O custo por AVG alcançado pelo estudo foi de R$ 20.530,00, cerca de US$ 9.550. Esse indicador de efetividade foi calculado com base nos parâmetros de custo incremental de R$ 54.200,00 e expectativa de vida de 2,64 anos, decorrentes do uso do DCI comparado com o tratamento clínico. Discussão: O estudo considerou comparações com indicadores da literatura, faixas de atratividade, análises de sensibilidade, impactos sobre financiamento e limitações da pesquisa. Conclusões: O índice de custo-efetividade do tratamento com DCI mostrou-se favorável, sob as condições de atratividade ajustadas à realidade brasileira, embora enfrente dificuldades de financiamento por parte do SUS, considerando o substancial impacto financeiro das indicações de uso do referido tratamento. / Objective: Cost-effectiveness analysis of implantable cardioverter defibrillator therapy (ICD) compared with conventional drug therapy. Literature review: The study comprised the conceptualization of techniques of economic evaluation, the methodology of appropriation of hospital procedure costs and different experiences on cost-effectiveness analysis applied to medical interventions considered in this research. Methods: The study used the unit Cost per Life-Year Gained (LYG) as an index of cost-effectiveness. The methodology included the definition of the research scope (Sistema Único de Saúde as the main payor of the ICD\'s implant, in Brazil), creation of standard protocols of treatment, and calculation of treatment total cost based on indicators used by well known hospitals, which are estimated for ten years and adjusted to a discount rate of 6% a year. Concerning effectiveness, some parameters from the literature were applied, which are demonstrated by LYG with the implant of ICD, compared to the alternative drug therapy. Results: The cost per life-year gained reached by the study was of R$ 20,530.00, approximately US$ 9,550. This ratio of effectiveness was calculated on the basis of the parameters of additional cost of R$ 54,200.00 and the life expectancy of 2.64 years with the use of ICD compared to the drug treatment. Discussion: The study considered comparisons with indicators comprised in the literature, range of attractiveness, sensitivity analysis, impact over financing and limitations of research. Conclusions: The chosen cost-effectiveness indicator for ICD therapy was favorable, under the adjusted attractiveness conditions adapted to the actual Brazilian health care sector. This conclusion holds in spite of the present financial difficulties experienced by SUS, and the substantial financial impact this kind of therapy may generate.
245

PARKEA.PE

Avila Ruiz, Jhonathan Jhoni, Díaz Mio, Cristhian José Augusto, Hurtado Gamarra, Claudia Miluska, Torres Cruz, Ray Urcino 09 July 2019 (has links)
El desarrollo de negocios modernos va de la mano con el avance de la tecnología actual. En un mundo globalizado como el nuestro es necesario adaptar las necesidades actuales a las nuevas formas de consumo y dedicar tiempo a observar las necesidades que se van formando en el camino. Es de éste modo como nace Parkea.pe, una aplicación móvil que servirá de ayuda a la problemática actual de escasez de Estacionamientos en la capital, Lima. El presente trabajo explica los motivos por los cuales se consideró hacer frente al problema detectado en la ciudad. De igual manera, la investigación previa del sector y situación actual nacional, permiten dar luz a una gama de posibles oportunidades y amenazas que se presentarían a lo largo del desarrollo. Este proyecto va de la mano con un nuevo modelo de negocio que se propone llevar a cabo junto con diversas herramientas de marketing y talento humano. / The development of modern business goes hand in hand with the advancement of current technology. In a globalized world like ours, it is necessary to adapt current needs to new forms of consumption and spend time observing the needs that are forming along the way. It is in this way that Parkea.pe was born, a mobile application that will help the current problem of scarcity of parking in the capital, Lima. The present work explains the reasons why it was considered to face the problem detected in the city. In the same way, the previous research of the sector and current national situation, allow to give light to a range of possible opportunities and threats that would appear throughout the development. This project goes hand in hand with a new business model that is proposed to be carried out along with various marketing tools and human talent. / Trabajo de investigación
246

Análise de custo-efetividade do tratamento supervisionado e autoadministrado da tuberculose / Cost-effectiveness analysis of supervised and self-administered treatment of tuberculosis.

Michela Prestes Gomes 27 March 2013 (has links)
A tuberculose (TB) é uma doença infecto contagiosa causada pelo Bacilo de Koch (Mycobacterium tuberculosis), sua forma mais frequente é a tuberculose pulmonar, e tem cura quando o tratamento é realizado corretamente. É uma das importantes causas de mortalidade no mundo, e apresenta alta prevalência e incidência no Brasil, o qual se encontra entre os países com maiores números de casos da doença. O objetivo desse trabalho foi efetuar um estudo sobre custo-efetividade do tratamento para tuberculose (abordando as estratégias de tratamento supervisionado e autoadministrado), buscando evidencias para estimar custos diretos (no distrito oeste de Ribeirão Preto-SP) e custos indiretos (para algumas regiões deste município). Por ser uma doença associada às condições sociais e econômicas (nelas incluídas o Brasil), buscou-se observar as deficiências das organizações e gestão do sistema de saúde, através da análise dos custos gerados pela TB. Foi efetuado um estudo epidemiológico, descritivo, pesquisa avaliativa, visando coletar dados sócio-demográficos, e características sobre acompanhamento e evolução do tratamento através dos prontuários dos doentes de TB para estimativa de custos diretos, e também estimar os custos indiretos através de entrevista com os pacientes. A fim de efetuarmos a análise de custo-efetividade do tratamento diretamente observado (TDO) e autoadministrado (TAA) da TB. Foram amplamente discutidos a qualidade dos dados, e realizadas as estimativas dos custos: direto, resultando em R$ 1075,39 (para estratégia TDO) e R$806,98 (estratégia TAA); e indireto, resultando em R$2001,39 (para TDO) e R$974,53 (para TAA). Encontrou-se uma Razão de Custo-efetividade Incremental (RCEI) negativo de 8.0562 por tratamento concluído da estratégia TDO em relação ao TAA. Palavras / Tuberculosis (TB) is an infectious disease caused by Kochs bacillus (Mycobacterium tuberculosis), most frequently presented as pulmonary tuberculosis. It is fully curable with the right treatment. TB is an important cause of death worldwide and presents high prevalence and incidence in Brazil, one of the countries with the highest number of cases. The aim of this study was to evaluate the cost-effectiveness of tuberculosis treatment (directly observed treatment DOT, and self-administered treatment SAT), searching evidence in order to estimate direct (in the Western district of Ribeirão Preto-SP) and indirect (for some regions of this city) costs. Due to the fact TB is associated with social and economical conditions (including in Brazil), an analysis of costs generated by TB was carried out, by observing the deficiencies of organizations and management of the health system. A descriptive epidemiological study of an evaluative research was carried out to collect socio-demographic data and characteristics of evolution and follow-up of TB treatment, to estimate the direct costs through the analysis of medical forms of patients, and indirect costs through interviews with patients. In order to evaluate the cost-effectiveness of DOT and SAT strategies for TB treatment, the quality of data was analyzed and estimates of direct and indirect costs were calculated. The results show a negative incremental cost-effectiveness ratio (ICER) of 8,0562 for DOTS strategy compared to SAT strategy.
247

Análise de custo-efetividade de teste rápido para o diagnóstico de casos novos de malária em doze municípios endêmicos do Estado do Pará / Cost-effectiveness analysis of rapid test for the diagnosis of new malaria cases in twelve endemic municipalities of the State of Pará, Brazil

Oliveira, Maria Regina Fernandes de 09 February 2009 (has links)
Introdução: A malária humana apresenta sintomas inespecíficos e exige diagnóstico laboratorial e identificação da espécie para o seu manejo. O diagnóstico baseia-se na microscopia, exame barato, que exige profissionais experientes. Nos últimos anos surgiram testes imunocromatográficos de execução rápida e custo mais elevado em comparação à microscopia. Estudos de validação demonstraram sensibilidade e especificidade comparáveis à microscopia, podendo ser alternativa confiável em áreas sem laboratório. Objetivo: Realizar análise de custo-efetividade do uso do OptiMAL® - teste rápido (TR) registrado no Brasil e validado em áreas endêmicas - comparado à microscopia. Métodos: A perspectiva da análise foi a do sistema público de saúde brasileiro SUS, o horizonte analítico de seis meses e o ano de 2006, a referência temporal. Doze municípios do Estado do Pará constituíram a área de estudo. Foi construído modelo de decisão considerando dois desfechos: casos diagnosticados adequadamente e casos conduzidos adequadamente em três cenários: o cenário 1 corresponde a 100% dos exames realizados, o cenário 2 considera somente os exames feitos nas áreas com laboratório e o cenário 3 corresponde a 30% dos exames, realizados em áreas isoladas. Os parâmetros epidemiológicos principais foram prevalência da malária entre indivíduos sintomáticos e acurácia - sensibilidade e especificidade - dos métodos diagnósticos, cujas estimativas foram obtidas a partir do Sistema de Informação de Vigilância Epidemiológica da Malária e literatura científica. Foram estimados custos diretos médicos e não-médicos, considerando diretrizes nacionais e dados municipais. Fontes de dados de custos incluíram o Sistema de Informação de Insumos Estratégicos, a Tabela de Procedimentos do SUS e o Sistema de Informação Hospitalar do SUS. Foram estimadas as razões média e adicional de custo-efetividade (RCEA) e realizada análise de sensibilidade. O software utilizado foi o TreeAge Pro 2005. Resultados: O TR foi dominado pela microscopia nos cenários 1 e 2. Em áreas isoladas a estratégia microscopia apresentou RCEA de R$1.193,00 por caso diagnosticado adequadamente e de R$1.016,67 por caso conduzido adequadamente quando comparada com o OptiMAL®. O TR tornou-se mais custo-efetivo nos dois desfechos dos três cenários com a redução da acurácia da gota espessa, na análise de sensibilidade. Conclusões: o TR foi menos custo-efetivo em todos os cenários, quando a acurácia da microscopia manteve-se elevada. / Introduction: Diagnosis of malaria is based on blood microscopy, a lowcost procedure that requires experienced technicians. Rapid immunochromatography tests (RDT) were developed with the advantage of being easy-to-use tools but with higher costs. RDT validation showed similar accuracy compared to microscopy suggesting that the RDT could be a reliable alternative in areas without lab facilities. Objective: To perform costeffectiveness analysis for the use of OptiMAL® in comparison with the thick blood smear microscopy. Methods: The study was conducted from the perspective of the Brazilian Public Health System, the analytic horizon was of six months, and the time frame was 2006. The analysis was performed through a decision tree with two outcomes: properly diagnosed cases and properly conducted cases. There were defined three scenarios in 12 municipalities of the State of Pará: the scenario 1 considered the whole malaria tests performed in 2006; the scenario 2 considered the malaria tests performed in the endemic areas with access to lab facilities; and the scenario 3 considered the 30% malaria tests performed in areas without lab facilities. The main epidemiological measures were the prevalence of malaria and the accuracy of the diagnostic methods. Epidemiological estimates were obtained from the Brazilian Malaria Surveillance Information System and the scientific literature. Direct medical and non-medical costs were estimated taking into consideration the national guidelines and the data obtained from the municipalities. Cost data sources were the Information System for Strategic Resources from the Health Surveillance Secretariat, the Reimbursement Values Table and the Hospital Information System of the Brazilian Public Health System. The average and the incremental costeffectiveness ratio (ICER) were estimated and it was conducted a sensitivity analysis. Data were analyzed with the TreeAge Pro 2005 software. Results: RDT strategy was dominated by the microscopy strategy in the scenarios 1 and 2. The ICER for the microscopy strategy in the scenario 3 was R$1,193.00 per properly diagnosed case and it was R$1,016.67 per properly conducted case compared with the OptiMAL® strategy. The sensitivity analysis showed that the RDT was cost-effective for both outcomes in all the scenarios when the thick blood smear accuracy was reduced. Conclusions: The RDT is the least cost effective strategy, providing that microscopy accuracy is high.
248

Joint control of emissions permit purchase and production in presence of fixed purchase costs. / CUHK electronic theses & dissertations collection

January 2012 (has links)
碳排放权和其他生产投入类似,是很像大宗商品投入的生产要素。然而,参与碳交易的公司只需要在某个时间,比如一年的结尾实现碳排放权限的减量。碳排放的另一个重要特点是不可忽略的固定交易成本。本文试图揭示参与碳交易的企业应该如何优化协调其生产以及碳排放权的采购决策,以尽量减少其在长期成本。在每个阶段,该公司基于已有的排放权,波动的市场价格和库存水平决定其排放权的购买数量和生产量。我们给出了最优的联合决策结构特征: 最优排放权采购欢是状态依赖型的(s,S)型决策。生产决策基本上是状态依赖型的基库守存决策。分解的启发式计算被发现是有效的计算研究。我们解决方法是定义一类具有一类性质的二维的函数,在一个维度上定义类似K-凸函数的性质,并在另一个维度上定义类似凸函数的性质。 / The trading of emissions permits, as an effective market-based approach for emissions control, is becoming widespread over the world. Similar to any other production input, the emissions permit is a factor of production much like commodity inputs. However, a firm participating in emissions trading has only to balance its permits at the end of a time horizon, say one year. Another key feature of permit trading is the existence of non-negligible, fixed, transaction costs. This paper attempts to shed light on how such a firm should optimally coordinate its production and permit purchasing decisions in order to minimize its total cost in the long run. In each period, the firm has to decide on its permit purchase quantities and production levels based on its on-hand permit and inventory levels as well as the market-prevalent permit price. The latter evolves as a Markov process and the firm also faces random demand. We characterize the optimal joint policy structure: an optimal purchase policy is of the state-dependent (s, S) type and an optimal production decision nearly follows a state-dependent base-stock form. A heuristic based on decomposition is found to be effective from computational studies. Our enabling technique is the identification of a class of two-dimensional functions that in one dimension it looks like K-convex and in another it is similar to convex. / Detailed summary in vernacular field only. / Yuan, Quan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 74-84). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Abstract --- p.i / Abstract in Chinese --- p.ii / Acknowledgements --- p.iii / Contents --- p.vi / List of Tables --- p.viii / List of Figures --- p.ix / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Motivation --- p.1 / Chapter 1.2 --- Purpose of the Work --- p.3 / Chapter 1.3 --- Structure of the Work --- p.4 / Chapter 2 --- Literature Review --- p.6 / Chapter 3 --- Formulations --- p.10 / Chapter 4 --- A New Class of K-convex Functions --- p.13 / Chapter 4.1 --- A Class of K-Convex Functions --- p.13 / Chapter 4.1 --- Convex Functions --- p.13 / Chapter 4.1.2 --- K-convex Functions in R¹ or Z¹ --- p.15 / Chapter 4.1.3 --- K-convex Functions in R[superscript n] or Z[superscript n] --- p.18 / Chapter 4.1.4 --- C²(K) Functions --- p.19 / Chapter 4.2 --- Z¹ Policies --- p.24 / Chapter 4.3 --- Appendix of Chapter 4 --- p.27 / Chapter 5 --- Optimal Policy --- p.43 / Chapter 5.1 --- A Transformation --- p.43 / Chapter 5.2 --- Policy Characterization --- p.44 / Chapter 5.3 --- Appendix of Chapter 5 --- p.48 / Chapter 6 --- Heuristic and Lower Bound --- p.57 / Chapter 7 --- Numerical Study --- p.61 / Chapter 7.1 --- Parameter Setups --- p.61 / Chapter 7.2 --- Non-monotone Trends in Optimal Policy --- p.63 / Chapter 7.3 --- Heuristic Performance --- p.65 / Chapter 8 --- Concluding Remarks --- p.72 / Bibliography --- p.74
249

Antecedents and consequences of logistics outsourcing: an empirical investigation in China. / CUHK electronic theses & dissertations collection

January 2012 (has links)
在實踐中,越來越多製造企業採用外包物流给专业的第三方物流供应商的方式來降低物流成本。然而,在學術研究領域,大部分現有的物流外包研究主要以描述性和規範性的研究為主,缺乏解釋性或預測性的研究。本文嘗試整合交易成本經濟學、基於資源觀和制度理論,來驗證和解釋物流外包的驅動因素及績效影響。本研究從大陸及香港的200家上市母公司中收取了250家的子公司作為研究樣本,並採用了結構方程模型、層次回歸、路徑分析的統計方法來檢驗相關的理論假設, 研究的結果表明: / 在研究一中,本研究結果發現內部生產資源和能力,例如物流基礎設施、物流資訊系統、內部物流技術,沒有直接影響物流外包。但是,介面性質的資源或能力,例如管理第三方物流供應商的能力和其他職能系統的使用,與物流外包的水準呈正相關。最後,研究還表明內部生產資源和能力通過介面性質的能力,例如管理第三方物流供應商的能力,影響著外包。 / 在研究二中,本研究發現,基於頻率和特質的模仿壓力正向地影響物流外包,基於結果的模仿壓力對物流外包沒有顯著的影響。當製造商對他們內部物流需求不確定,基於頻率的模仿壓力對物流外包的影響將會降低。同時,過高的外部市場不確定性將增加基於結果的模仿壓力對外包物流採用的影響。 / 在研究三,本研究將物流活動分類為基於資產的物流活動和基於非資產的物流活動,然後建立物流外包-運營績效-財務績效的實證模型。實證結果表明基於資產的物流活動外包顯著影響著交付績效和財務績效,但是不影響成本和柔性績效。然而,基於非資產物流活動外包直接顯著影響著成本和柔性績效,但不影響交付績效和財務績效。總而言之,基於資產的物流活動外包直接影響財務績效,但有限影響著運營績效,而基於非資產的物流活動外包通過運營績效來影響財務績效。 / 本文對物流外包和運營管理領域有如下貢獻。首先,本文提出及驗證了資源-能力-外包的理論模型,拓展了傳統資源觀的應用。其次,本研究通過驗證宏觀制度壓力對內部物流運作的影響將制度理論擴展到物流和運營管理領域。最後,本研究通過對基於資產及非資產物流業務外包影響的研究,對運營及財務績效的提升提供了新的啟示。 / An increasing number of manufacturers outsource their inbound and outbound logistics activities to Third-Party-Logistics (3PL) providers to reduce logistics cost. Most previous studies on logistics outsourcing are descriptive and prescriptive in nature, and thus devoid of explanatory or predictive orientation. This dissertation will investigate and explore the antecedents and consequents of logistics outsourcing by integrating transaction cost economics, resource-based view, and institutional theory. Several key hypotheses are tested using structural equation modeling (SEM), hierarchical multiple regression (HMR) and path analysis (PA) based on data collected from 250 subsidiaries of 200 publicly listed manufacturing companies in Mainland China and HK. / In study 1, the results show that internal production resources and capabilities, such as, logistics infrastructure, logistics information systems, internal logistics skill, do not exert a direct influence on logistics outsourcing. Interface resources or capabilities, however, such as 3PL management capabilities and the usage of other functional systems, are positively associated with the degree of logistics outsourcing. At last, the findings also indicate that internal production resources and capabilities influence outsourcing through interface capability, such as 3PL management capability. / In Study 2, this research reveals that frequency-based and trait-based imitative pressures are related with degree of logistics outsourcing, while outcome-based imitative pressures are not. The influence of frequency-based imitative pressure on logistics outsourcing will be decreased when manufacturers are more uncertain about their internal logistics requirements and demand. On the other hand, high external market uncertainty will increase the effect of outcome-based imitative pressure on logistics outsourcing. / In Study 3, the research classifies logistics activities into asset-based logistics activities and non-asset logistics activities and then builds outsourcing-operational performance-financial performance model. Empirical results show that asset-based logistics outsourcing significantly impacts both delivery performance and financial performance, but not cost and flexibility performance. However, non-asset-based logistics outsourcing significantly influences both cost performance and flexibility performance directly, but not delivery and financial performance. In summary, asset-based logistics outsourcing effects financial performance directly, but slightly influences operational performance, while non-asset-based logistics outsourcing influences financial performance mainly through operational performance. / This dissertation makes several contributions to logistics outsourcing & operations management. First, this dissertation proposes and empirically tests a model of resource-capability-outsourcing and thus extends the traditional resource-based view model. Second, this dissertation extends institutional theory into logistics and operations management area by linking macro-institutional pressures to internal logistics operations. Third, this study provides insights on the effects of logistics outsourcing on operational and financial performance by examining the effects of asset-based and non-asset based logistics outsourcing. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Zhuang, Bochao. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 117-137). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendix 5 in Chinese. / ABSTRACT --- p.I / ABSTRACT (CHINESE) --- p.III / ACKNOWLEDGEMENTS --- p.V / LIST OF FIGURES --- p.IX / LIST OF TABLES --- p.X / LIST OF APPENDICES --- p.XI / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Research Motivation --- p.1 / Chapter 1.2 --- Research Objectives --- p.2 / Chapter 1.3 --- Research Methods and Framework of this Dissertation --- p.3 / Chapter Chapter 2 --- Theoretical Background --- p.5 / Chapter 2.1 --- Transaction Cost Economics and Outsourcing --- p.5 / Chapter 2.2 --- Resource-based View and Outsourcing --- p.9 / Chapter 2.2.1 --- RBV and New Streams in RBV --- p.9 / Chapter 2.2.2 --- Resources& Capabilities Classification & Empirical Model in RBV --- p.11 / Chapter 2.2.3 --- Conceptual Work Linking RBV with Outsourcing --- p.13 / Chapter 2.3 --- Institutional Theory and Outsourcing --- p.14 / Chapter 2.4 --- Multi-Theoretical Frameworks from TCE, RBV and IT --- p.16 / Chapter Chapter 3 --- The Effects of Organizational Resources and Capabilities on Logistics Outsourcing --- p.21 / Chapter 3.1 --- Introduction --- p.21 / Chapter 3.2 --- Theoretical Background and Hypotheses --- p.22 / Chapter 3.2.1 --- Infrastructure and Outsourcing --- p.22 / Chapter 3.2.2 --- Capabilities and Outsourcing --- p.24 / Chapter 3.2.3 --- Infrastructure-Capabilities-Outsourcing --- p.25 / Chapter 3.3 --- Research Methodology --- p.28 / Chapter 3.3.1 --- Questionnaire Design and Measures --- p.28 / Chapter 3.3.2 --- Sampling and Data Collection --- p.30 / Chapter 3.3.2 --- Measurement Quality --- p.33 / Chapter 3.4 --- Hypotheses Tests and Results --- p.35 / Chapter 3.5 --- Discussion --- p.37 / Chapter 3.6 --- Conclusion and Limitations --- p.42 / Chapter Chapter 4 --- The Effects of Imitation and Uncertainty on Logistics Outsourcing --- p.44 / Chapter 4.1 --- Introduction --- p.44 / Chapter 4.2 --- Theoretical Background and Hypotheses --- p.44 / Chapter 4.2.1 --- Imitative Pressures and Outsourcing --- p.45 / Chapter 4.2.2 --- Uncertainty, Imitative Pressure and Outsourcing --- p.50 / Chapter 4.3 --- Research Methodology --- p.54 / Chapter 4.3.1 --- Questionnaire Design and Measures --- p.54 / Chapter 4.3.2 --- Sampling and Data Collection --- p.56 / Chapter 4.3.3 --- Measurement Quality --- p.56 / Chapter 4.4 --- Hypotheses Tests and Results --- p.59 / Chapter 4.5 --- Discussion --- p.61 / Chapter 4.6 --- Conclusion and Limitations --- p.69 / Chapter Chapter 5 --- The Effect of Logistics Outsourcing on Operational and Financial Performance --- p.71 / Chapter 5.1 --- Introduction --- p.71 / Chapter 5.2 --- Theoretical Background and Hypotheses --- p.72 / Chapter 5.2.1 --- Literature Review on Outsourcing-Performance --- p.72 / Chapter 5.2.2 --- Outsourcing Types and Operational Performance --- p.74 / Chapter 5.3 --- Research Methodology --- p.79 / Chapter 5.3.1 --- Questionnaire Design and Measures --- p.79 / Chapter 5.3.2 --- Sampling and Data Collection --- p.81 / Chapter 5.3.3 --- Measurement Quality --- p.81 / Chapter 5.4 --- Hypotheses Tests and Results --- p.84 / Chapter 5.5 --- Discussion --- p.85 / Chapter 5.6 --- Conclusion and Limitations --- p.91 / Chapter Chapter 6 --- Overall Conclusions and Future Research --- p.93 / APPENDICES --- p.96 / References --- p.117
250

Cost-effectiveness analysis of 10- and 13-valent pneumococcal conjugate vaccines in Peru

Mezones Holguín, Edward, Canelo Aybara, Carlos, David Clark, Andrew, Bess Janusz, Cara, Jaúregui, Bárbara, Escobedo Palza, Seimer, Hernandez, Adrian V., Berhane, Yemane, Vega Porras, Denhiking, González, Marco, Fiestas, Fabián, Toledo , Washington, Michele, Fabiana, Suárez, Víctor J. 24 November 2015 (has links)
Objective To evaluate the cost-effectiveness of introducing the 10-valent pneumococcal conjugate vaccine (PCV10) versus the 13-valent PCV (PCV13) to the National Immunization Schedule in Peru for prevention of pneumococcal disease (PD) in children <5 years of age. Methods The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (version 2.0) was applied from the perspective of the Government of Peru. Twenty successive cohorts of children from birth to 5 years were evaluated. Clinical outcomes were pneumococcal pneumonia (PP), pneumococcal meningitis (PM), pneumococcal sepsis (PS) and acute otitis media from any causes (AOM). Measures included prevention of cases, neurological sequelae (NS), auditory sequelae (AS), deaths and disability adjusted life years (DALYs). A sensitivity analyses was also performed. Findings For the 20 cohorts, net costs with PCV10 and PCV13 were US$ 363.26 million and US$ 408.26 million, respectively. PCV10 prevented 570,273 AOM; 79,937 PP; 2217 PM; 3049 PS; 282 NS; 173 AS; and 7512 deaths. PCV13 prevented 419,815 AOM; 112,331 PN; 3116 PM; 4285 PS; 404 NS; 248 AS; and 10,386 deaths. Avoided DALYs were 226,370 with PCV10 and 313,119 with PCV13. Saved treatment costs were US$ 37.39 million with PCV10 and US$ 47.22 million with PCV13. Costs per DALY averted were US$ 1605 for PCV10, and US$ 1304 for PCV13. Sensitivity analyses showed similar results. PCV13 has an extended dominance over PCV10. Conclusion Both pneumococcal vaccines are cost effective in the Peruvian context. Although the net cost of vaccination with PCV10 is lower, PCV13 prevented more deaths, pneumococcal complications and sequelae. Costs per each prevented DALY were lower with PCV13. Thus, PCV13 would be the preferred policy; PCV10 would also be reasonable (and cost-saving relative to the status quo) if for some reason 13-valent were not feasible. / This study was presented at 9th International Symposium of Pneumococci and Pneumococcal Diseases, Hyderabad, India, March 2014, and supported by the National Council of Science, Technology and Technological Innovation of Peru (CONCYTEC) and International Clinical Epidemiology Network (INCLEN Trust) / This study was made possible through the financial support of the Instituto Nacional de Salud (National Institute of Health, Lima, Peru) and the PROVAC Initiative of the Pan American Health Organization (Washington, DC, USA).

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