Back pain is the 6th most costly condition in the United States and is responsible for the most workdays lost. Approximately 33 million American adults suffered from back and neck problems in 2005. The societal cost of chronic back pain (CBP) has not been calculated from a US perspective. Longitudinal data files from Panels 12, 13, and 14 of the Medical Expenditure Panel Survey (MEPS) were used to estimate excess direct (ambulatory visits, inpatient admissions, emergency room visits, and prescription medication) costs and indirect (lost productivity) costs for persons 18 years and older reporting CBP compared to those not reporting back pain. Persons were included in the CBP group if they reported back pain (ICD-9-CM codes 720, 721, 722, 723, 724, 737, 805, 806, 839, 846, 847) in at least 3 consecutive interview rounds. The complex sampling design of MEPS was taken into account to get accurate national estimates. All costs were adjusted to 2011 using Consumer Price Indices. All mean costs were computed using age-stratified regression models, after adjusting for demographic and clinical covariates. Utilization of provider-based complementary and alternative medicine (CAM) among CBP patients was studied, and differences in costs between CAM users and non-users examined. Based on this analysis, the prevalence of CBP in the adult US population was estimated to be 3.76%. Total all-cause costs for CBP patients were estimated to be $187 billion over 2 years (direct costs = $176 billion, indirect cost = $11 billion). Overall estimates of excess costs of CBP over 2 years per person for direct medical costs were $37,129 ($25,273 vs. $48,984; p<0.001). This breaks down to $11,711 ($14,929 vs. $3,219; p<0.001) for ambulatory visits; $3,560 ($6,514 vs. $2,914; p<0.001) for inpatient admissions; $300 ($690 vs. $390; p<0.001) for emergency department visits; and $19,849 ($23,873 vs. $4,024; p<0.001) for prescription medications. Excess indirect costs for CBP patients were $1,668 ($2,329 vs. $661; p<0.001). Thirty-seven percent of CBP patients reported at least one CAM visit. There was no significant difference in overall costs between CAM users and non-users. The high cost of chronic back pain in the US population has potential implications for prioritizing policy, and in attempting to improve care and outcomes for these patients. / text

The aim of this thesis is to create a calculation system of indirect costs in the commercial company. This calculation could be used in the accounting system of the company and thanks to that would be indirect cost divided automatically into individual items of goods. The calculation system is based on particular coefficients which are assigned in individual types of costs. New created system is tested on the specific sample of goods from the company. It is good to see weaknesses and deficiencies in suggested calculation. Conclusions from this analyse are specific values of profitability ratio Return on sales in every goods. The management of the company has to decide whether to revalue their goods or not. The decision is connected also with margin groups, in group A (which includes main goods) they could afford to move with selling prices. This prediction is based on outcome from competition analysis.

Prevalence of obesity worldwide has increased rapidly in the last decade. In the Czech Republic, a similar trend has been observed. Every fifth adult has a problem with obesity, a fact which puts the Czech Republic among the countries with the highest obesity rates in European and global context. Obesity is a risk factor leading to a number of serious diseases. The growing prevalence of obesity is directly causing higher health care spending and also incurs costs indirectly, in terms of productivity losses. Present thesis is the first study in the Czech Republic, providing an estimate of both direct and indirect costs related to the obesity. Using a cost-of-illness method, the overall social costs of obesity in the Czech Republic for 2013 were estimated at 12.1 billion CZK which corresponds to 0.3% of GDP in the given year. Direct costs accounted for two thirds of this amount. The highest costs, attributable to the obesity, were inflicted by back pain diseases, arthritis, ischemic heart diseases and type 2 diabetes.

No description available.

One of the dilemmas that information systems (IS) decision-makers encounter is the identification of the often hidden costs associated with IS adoption, particularly since most of them are reported to be external to the traditional IS budget. The review of the IS literature has identified that much effort to date has focused on the identification and measurement of direct costs, and that much less attention has been paid to indirect costs. One of the main problems reported in the literature associated with looking at indirect costs is that they are intangible and difficult to quantify, and there is evidence suggesting that these indirect costs are rarely completely budgeted for, and thus deserve a much closer consideration by decision-makers. This research investigates this view, arguing that one element of indirect costs, that is, indirect human costs (lRCs), is underestimated and little understood. The author argues that it is not possible to estimate or evaluate IHCs without first identifying all their components, yet there is an absence of models that show how such costs are allocated for IS adoption. This underpins the necessity of the present research. Proposed here is a framework of nine sequential phases for accommodating indirect human costs. In addition to this, 1) three conjectures, 2) cost taxonomy and 3) an interrelationship-mapping cost driver model of IRCs, are proposed based on the literature analysis and underpinning the conceptual phases of the framework. To test the conjectures and validate the models proposed, a case research strategy using case settings were carried out in the private sector. Empirical findings validates the models proposed and reveal that indirect human costs are perceived as costs associated with IS adoption, nevertheless not included in the evaluation process or investment proposals. However, during the empirical research, new cost factors and drivers emerged, which resulted in modifications being made to the previously proposed conceptual models. In doing so, it provides investment decision-makers with novel frames of reference and an extensive list of IRCs that can be used during both the IS budget proposals and the evaluation process of the IS investment.

Research object – agricultural enterprises. Research subject – methodics of plant production cost calculation. Research aim – to analyze references and practical methods employed in plant produce cost calculation and to propose methodics improvements of plant production cost calculation. Objectives: 1) to analyze the essence of expenditure and production cost; 5) to examine the structure of production cost and to substantiate the expedience of expenditure calculation into cost; 6) to study methodics of plant production cost calculation in agricultural enterprises; 7) to submit proposals for improvement methodics of plant production cost calculation based on references study and research results. Research methods – logical and comparative analysis and synthesis of literature by Lithuanian and foreign authors, questionnaire questioning of agricultural enterprises, methods of logical and graphic modeling. After the study of produce cost essence, indices and their composition, calculation system and plant produce cost calculation methodology applied at agricultural enterprises, proposals were submitted for improvement methodics of plant production cost calculation.

The thesis deals with the optimum production costs with consideration of price. In the theoretical part the Public Contract Act, entry documentation and periods for offer formation are described. The next part is focused on costs and calculations. In particular, direct and indirect costs, variable and fixed costs, standard calculation pattern as well as dynamic calculation are described. The practical output of the thesis is production costs setting by means of supplier enquiries about material and constunction and assembly works. The practical part also concludes cost calculations to a fictitious company.

Kiekvienai gamybinę veiklą vykdančiai ar paslaugas teikiančiai įmonei tikslus gaminamos produkcijos ar paslaugų savikainos įvertinimas pinigine reikšme yra itin svarbus klausimas. Savikainos skaičiavimų metodų ir būdų yra labai daug, jų parinkimą įmonei lemia taikomos gamybos pobūdis ir jos organizavimas, įmonės vykdoma veikla, aplinka ir kiti veiksniai. Norint teisingai apskaičiuoti produktų savikainą, visas įmonės patiriamas išlaidas pirmiausia reikia tinkamai identifikuoti, tiesiogines priskirti konkretiems gaminimas, o netiesiogines išlaidas racionaliai paskirstyti tarp numatytų objektų, kurių savikainą reikia apskaičiuoti. Tačiau pagal gamybos pobūdį parinktas savikainos kalkuliavimo metodas dažniausiai nėra pats tinkamiausias netiesioginėms išlaidoms apskaityti ir paskirstyti. Tuo tarpu autoriai tyrę ABC sistemą, savo straipsniuose pažymi, kad šiuo metu su netiesioginių išlaidų paskirstymo užduotimi geriausiai susidoroja būtent ABC metodas. Norint pasinaudoti pagal gamybos pobūdį parinkto metodo (šiuo atveju procesinio fazinio metodo) ir ABC sistemos privalumais susiduriama su problema: mokslinėje literatūroje procesinis ir ABC produkcijos kalkuliavimo metodai pateikiami atskirai, neanalizuojama galimybė šiuos metodus sujungti į vieną savikainos kalkuliavimo modelį. Darbo objektas – procesinio fazinio ir ABC savikainos kalkuliavimo metodų ypatybės bei privalumai. Darbo tikslas – sukurti savikainos skaičiavimo modelį, kuris leistų tiksliai ir efektyviai apskaičiuoti... [toliau žr. visą tekstą] / Exact value of production or service costs is important issue for all manufacturing or service companies. There are many methods and approaches of costing. The mode of production, the organization of production, company activities, environment and other factors influence method to use for production costing. In order to get correct calculation of production costs, all costs incurred by company firstly must be properly indentified, direct costs should be assigned, overhead allocated to objects which cost must be calculated. However, method of calculation chosen by nature of the production is not most appropriate for accounting and allocating indirect costs. Meanwhile the authors, who analyzed the ABC system, points out that ABC method the indirect cost allocation task handle most notably. In order to use benefits of ABC method and method chosen by nature of production (in this case process phase costing method) encountered a problem: process costing and ABC methods are presented separately into science or professional literature, no one does not examine the possibility to use these two methods in single production costs calculation model. The object – features and benefits of process phase costing and ABC methods. The aim – to design a costing model which can accurately and effectively calculate the direct cost of products, rationally allocate cost of company activities to production. The objectives: • To analyze the nuances of choice cost calculation method by company... [to full text]

Introduction: More than half of all patients seeking care for chest pain do not have a cardiac cause for this pain. Despite recurrent episodes of chest pain, many patients are discharged without a clear explanation of the cause for their pain. A lack of explanation may result in a misinterpretation of the pain as being cardiac-related, causing worry and uncertainty, which in turn leads to substantial use of healthcare resources. Psychological distress has been associated with non-cardiac chest pain (NCCP), but there is limited research regarding the relationship between different psychological factors and their association with healthcare utilization. There is a need for interventions to support patients to manage their chest pain, decrease psychological distress, and reduce healthcare utilization and costs. Aim: The overall aim of this thesis was to improve care for patients with  non-cardiac chest pain by describing related psychological distress, healthcare utilization and societal costs, and by evaluating an Internet-delivered cognitive behavioural intervention. Designs and methods: This thesis presents results from four quantitative studies. Studies I and II had a longitudinal descriptive and comparative design. The studies used the same initial cohort. Patients were consecutively approached within 2 weeks from the day of discharge from a general hospital in southeast Sweden. In study I, 267 patients participated (131 with NCCP, 66 with acute myocardial infarction (AMI), and 70 with angina pectoris (AP)). Out of these, 199 patients (99 with NCCP, 51 with AMI, 49 with AP) participated in study II. Participants were predominantly male (about 60 %) with a mean age of 67 years. Data was collected on depressive symptoms (Study I), healthcare utilization (Study I, II), and societal costs (Study II). Study III had a cross-sectional explorative and descriptive design. Data was collected consecutively on depressive symptoms, cardiac anxiety and fear of body sensations in 552 patients discharged with diagnoses of NCCP (51 % women, mean age 64 years) from four hospitals in southeast Sweden. Patients were approached within one month from the day of discharge. Study IV was a pilot randomized controlled study including nine men and six women with a median age of 66 years, who were randomly assigned to an intervention (n=7) or control group (n=8). The intervention consisted of a four-session guided Internet-delivered cognitive behavioural therapy (CBT) program containing psychoeducation, exposure to physical activity, and relaxation. The control group received usual care. Data was collected on chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. Results: Depressive symptoms were prevalent in 20 % (Study IV) and 25 % (Study I, III) of the patients, and more than half of the patients still experienced depressive symptoms one year later (Study I). There were no significant differences in prevalence and severity of depressive symptoms between patients diagnosed with NCCP, AMI or AP. Living alone and younger age were independently related to more depressive symptoms (Study I). Cardiac anxiety was reported by 42 % of the patients in study III and 67 % of the patients in study IV. Fear of body sensations was reported by 62 % of the patients in study III and 93 % of the patients in study IV. On average, patients with NCCP had 54 contacts with primary care or the outpatient clinic per patient during the two-year study period. This was comparable to the number of contacts among patients with AMI (50 contacts) and AP (65). Patients with NCCP had on average 2.6 hospital admissions during the two years, compared to 3.6 for patients with AMI and 3.9 for patients with AP (Study II). Four out of ten patients reported seeking healthcare at least twice during the last year due to chest pain (Study III). On average, 14 % of patients with NCCP were on sick-leave annually, compared to 18 % for patient with AMI and 25 % for patient with AP. About 11-12 % in each group received a disability pension. The mean annual societal costs for patients with NCCP, AMI and AP were €10,068, €15,989 and €14,737 (Study II). Depressive symptoms (Study I, III), cardiac anxiety (Study III) and fear of body sensations (Study III) were related to healthcare utilization. Cardiac anxiety was the only variable independently associated with healthcare utilization (Study III). In the intervention study (Study IV), almost all patients in both the intervention and control groups improved with regard to chest pain  frequency, cardiac anxiety, fear of body sensations, and depressive symptoms. There was no significant difference between the groups. The intervention was perceived as feasible and easy to manage, with comprehensible language, adequate and varied content, and  manageable homework assignments. Conclusions: Patients with NCCP experienced recurrent and persistent chest pain and psychological distress in terms of depressive symptoms, cardiac anxiety and fear of body sensations. The prevalence and severity of depressive symptoms in patients with NCCP did not differ from patients with AMI and patients with AP. NCCP was significantly associated with healthcare utilization and patients had similar amount of primary care and outpatient clinic contacts as patients with AMI. The estimated cumulative annual national societal cost for patients with NCCP was more than double that of patients with AMI and patients with AP, due to a larger number of patients with NCCP. Depressive symptoms, cardiac anxiety and fear of body sensations were related to increased healthcare utilization, but cardiac anxiety was the only variable independently associated with healthcare utilization. These findings imply that screening and treatment of psychological distress should be considered for implementation in the care of patients with NCCP. By reducing cardiac anxiety, patients may be better prepared to handle chest pain. A short guided Internet-delivered CBT program seems to be feasible. In the pilot study, patients improved with regard to chest pain frequency, cardiac anxiety, fear of body sensations, and depressive symptoms, but this did not differ from the patients in the control group who received usual care. Larger studies with longer follow-up are needed to evaluate both the short and long- term effects of this intervention.

Abstracts in English, Xhosa and Afrikaans / The South African Social Security Agency (SASSA) is the mechanism that enables service delivery to alleviate poverty in South Africa through the payment of social grants as mandated by the Social Security Agency Act No. 9 of 2004. The rapid increase of social grant beneficiaries in the past decade, fuelled by social inequality, directly affects the administration cost associated with social grants. This study aimed to investigate the allocation of indirect costs related to the administrative elements that makes it possible for SASSA to pay social grants. Semi-structured interviews were conducted; the study concluded that ABC (activity-based costing) could be implemented as an alternative to the traditional costing (TC) method on a pilot project basis. The study also recommended a framework for SASSA to consider in laying the foundation to start the process of ABC implementation. Drawing from the research conducted, further studies on the implementation of ABC principles within the public sector could be pursued. / Ejensi ya Vuhlayiseki bya Vanhu ya Afrika Dzonga ku nga South African Social Security Agency (SASSA) i ndlela leyi endlaka leswaku mphakelo wa vukorhokeri wu koteka ku hunguta vusweti eAfrika Dzonga hikwalaho ka ku hakeriwa ka timalimpfuneto ta vanhu (social grants) tanihileswi swi pfumeleriweke hi Nawu wa Social Security Agency Act 9 wa 2004. Ku ndlandlamuka ka vavuyeriwa va malimpfuneto ya vanhu swi khumbha hi ku kongomisa tihakelo ta vulawuri leti fambelanaka na timalimpfuneto ta vanhu. Dyondzo leyi yi kongomisiwile eka ku lavisisa mphakelo wa tihakelo to ka ti nga kongomisi leti fambelanaka na swiyenge swa vulawuri leswi endlaka leswaku SASSA yi kota ku hakela timalimpfuneto ta vanhu. Ku endliwe ti-semi-structured interview. Dyondzo yi kumile leswo ti-activity-based costing (ABC) ti nga tirhisiwa hi ndlela yo cincana na maendlelo ya vupimahakelo bya ntolovelo eka projeke ya nkarhinyana. Dyondzo yi bumabumerile leswaku ku anakanyiwa rimba ro nyika mianakanyo yo sungula maendlelo yo tirhisa ABC. / Die “South African Social Security Agency” (SASSA) verlig armoede in Suid-Afrika deur ingevolge die “Social Security Agency Act” 9 van 2004 sosiale toelaes te betaal. Die aansienlike toename in die aantal begunstigdes het ʼn uitwerking op die administrasiekoste van sosiale toelaes. Hierdie studie ondersoek die toewysing van indirekte koste ten opsigte van die administratiewe elemente wat SASSA in staat stel om sosiale toelaes te betaal. Halfgestruktureerde onderhoude is gevoer. In hierdie studie word tot die gevolgtrekking gekom dat aktiwiteitsgebaseerde kosteberekening (ABK) as ʼn alternatief vir en as ʼn proefprojek die tradisionele kosteberamingsmetode geïmplementeer kan word. ʼn Raamwerk word aanbeveel wat as ʼn grondslag kan dien vir die implementering van ABK. / College of Accounting Sciences / M. Phil. (Accounting Sciences)