This research investigates financial, technical and attitudinal factors affectine the selection of coai as a space heating fuel in Local Authorities' non-domestic premises. Financial factors are explored by incorporating statistics of a sample of The City of Bradford Metropolitan Council's sites into a computer model that takes into account: the spread of capital costs of installing coal or other fuels. delivered fuel costs. maintenance and operating costs. and seasonal boiler efficiencies. The sensitivity of the mooei to changes in costs. boiler efficiencies. and financial selection criteria are investigated. Assuming a five year payback criterion and prices as found at the end of 1966, three percent of the space-heating ruel use or the Local Authority's premises is found to be viable for coal. The model is sensitive principally to changes in capital costs. and the availability of gas if a high cost for oit is assumed. Technical tactors are investigated by describing the properties or coal ana available comoustion equipment. Attitudes to the use of coal are researched by interviewing a sample of otticers and members in six Local Authorities in Yorksnire ana Humberside. Interviewees were particularly encouraged to describe their impressions and beliels. The scope of the study is expanded by the use of a postal survey of all United Kingdom Local Authorities. A variety or different topics are considered in the survey. These include the presence and content of fuel selection policies. the use and cost of fuels. financial criteria adopted in assessing projects, availability fr as supplies, and attitudes to the use of coal. The response rate to the questionnaire was over 40%. The study concludes with recommendations to The City or Braotora Metropolitan Council and British Coal.

Approved for public release, distribution is unlimited / The purpose of this thesis is to perform a cost-effectiveness analysis on proposals, submitted by vendors, for a telecommunication system. This thesis will be used as a guide in the decision-making process of choosing the most cost-effective system for the Bachelor Officers Quarters of the Naval Postgraduate School. In addition to cost-effectivness, this study includes a discussion of the analysis criteria, a review of the Statement of Work and an evaluation of the lease/purchase decision.

acase@tulane.edu

Current economic evaluations do not explicitly acknowledge that there are multiple decision points throughout the lifecycle of new health technologies which, in the presence of uncertainty and irreversible consequences of those decisions, influence value. Real options analysis (ROA) has been proposed to overcome these limitations. However, applications to date all assumed that decisions influencing the arrival of information are made by the same actors making the decisions on adoption. The aim of this thesis is to explicitly incorporate into health technology assessment (HTA) the impact of uncertainty on decision making about new health technologies in the presence of irreversibilities. I present a series of analyses comparing “traditional” economic evaluation methods to applications of ROA using the case study of drug-eluting stents (DES). The conventional application of ROA allowed for flexibility in decisions incorporating all economic consequences of changing decisions. Over and above uncertainty surrounding the current estimate of value, three major components contributing to the economic value of the new technology were assumed to also change over time. This type of analysis can be used to determine the optimal initial decision allowing for changes in decisions and the optimal timing for review. However, it assumes that new information will always be revealed, regardless of the original decision on adoption. To reflect the combined impact of coverage, pricing and research decisions in HTA and therefore to make information arrival endogenous, a more complex approach is suggested: a Real Options Game (ROG) combining ROA with a game theoretical approach. In the ROG the HTA body and the manufacturer are assumed to play a sequential, incomplete information game, where the manufacturer has control over the arrival of information. The manufacturer decides whether to submit evidence, reduce price and conduct more research, while the HTA body decides on adoption. The DES analysis modelled a series of decision points between 2005 and 2010, with decisions not depending on hindsight, but allowing for predicted changes in value, incorporating a drift in information and responses by the other party. Payoffs were estimated for both players using a probabilistic Markov model. Optimal strategies incorporating the impact of earlier decisions on research were determined. HTA is a dynamic and interactive process, therefore results of the ROA analyses sometimes suggested a different course of action compared to traditional analyses. The best decision may depend on predictions of how other parties will react, as well as likely evolution of the evidence base and the costs of decision reversal.

No description available.