The purpose of this research is to conduct an evaluation of the return on investment value of Employee Assistance Programmes within the South African context. Assistance to employees originated from the 19th century. The term Employee Assistance Programmes was however formulated in the 1970’s in the United States. The Employee Assistance field has since seen a paradigm shift in its focus, significant growth in its market value (amount of corporate clients internationally investing in EAPs for their employees), the establishment of a regulatory and ethical body through EAPA and its formalization as an academic discipline. This study takes the concept of return on investment value of EAPs further than the ratio of benefit-to-cost. The utilization of different data sources, inclusive of quantitative and qualitative instruments creates an opportunity to explore areas of value perception of different role players in the field. It furthermore maps the subjective and objective experience of behaviour change resulting from personal problems and the journey of change as a result of focused interventions. The consistency of views across different datasources as well as between different industries strengthens the value add claims of EAPs as contributing to the financial bottom line of companies. This study advocates for the importance of programme evaluation as a central part of EAP contracting. It furthermore also highlights the importance of documentation of employee performance for evaluation purposes. It illustrates a journey that can be complicated by the failure to agree to evaluative terms at program inception as well as unstructured data-capturing within companies. Employee behaviour consists of both computable and incomputable elements. Generally the focus of a return on investment study would be the computable components of human behaviour. This investigation however highlights significant elements of risk relating to employee performance challenges that is not easy to include in a ROI but holds significant financial and reputational risks for corporate clients. The influence of individual performance challenges on teams and the challenges it holds for line managers is also highlighted through the qualitative journey of this study. Employee behaviour seems vulnerable to internal and external forces and as a result companies’ productivity can be affected by how individual employees respond to these forces. It could be accepted that interventions that is aimed at stabilising and improving employee behaviour, will inevitably impact work performance and as a result the financial bottom-line of the company. Employee Assistance Programmes often operates in an arena where other programmes aimed at impacting employee behaviour are also present. It is thus difficult to isolate it’s intervention as being one of the main behaviour changing facilitators of the company. This study acknowledges this challenge and changes focus to different data-sources reporting on employee behaviour before and after EAP intervention. The consistency of data across these different data-sources becomes one of the main reporting areas for this study. Eventually the challenges encountered in this study guides the advocacy in the recommendations for a thorough agreement of programme evaluation at inception, the areas that will be included in such evaluations, the availability of Human Resource data to ensure effective evaluation inclusive of ROI assessments, targeted assessments at service provider level with effective software support. / Thesis (DPhil)--University of Pretoria, 2010. / Social Work and Criminology / unrestricted

Abstract Pressures to cut public expenditure and to maximize value-adding use of scarce governmental resources are evident across the globe. Decision support tools for pinpointing when the activity is net beneficial are lacking, i.e. accountability is urgently called for but the process for recognizing and validating the best choices in direction and control are yet in their development. The objective of this research is to provide the science in general, and national administrations’ management and overseeing bodies in particular, a new understanding of how well the tasks and missions of the administration are fulfilled in terms of enhanced socio-economic well-being and adding to the value of different functions of society. This study approaches public performance management from the view-point of impact evaluation of a service oriented public product portfolio. The adopted research approach combines both qualitative and quantitative research methods. The research presents a process for evaluating a public organization’s overall benefit to cost ratio, with a case study within transport safety administration. The key findings of this research are that the socio-economic efficiency of a public entity can be quantified and that an operation of a public agency can be socio-economically net beneficial. Practical implications include re-allocation of resources to other more beneficial fields of responsibility, redesign of performance agreements and their indicators and initiating discussion in joint design of sustainable and balanced operational and strategic targets across government. Further research can exploit the methods presented in this study, as it has overcome some of the hurdles in socio-economic evaluation of public entities. With a clearer understanding of performance, government is able to better achieve its mission and its task of ensuring that agencies and other public bodies are functioning efficiently and properly. / Tiivistelmä Paineet julkisten menojen leikkaamiseksi tai hallitsemiseksi sekä julkisten resurssien tehokkaimman mahdollisen käytön varmistamiseksi kasvavat maailmanlaajuisesti. Julkisen toiminnan tulosohjausta tukevat päätöksenteko-työkalut ovat vielä puutteellisia ja varhaisessa kehitysvaiheessa, samalla kun toiminnan kustannusvastaavuutta ja tehokkuutta vaaditaan. Tämän tutkimuksen päätavoite on tuottaa uuttaa tietoa tieteelle ja myös julkishallinnolle siitä, kuinka hyvin viranomaisille asetetut tavoitteet ja tehtävät toteutuvat yhteiskuntataloudelle tuotettavan lisäarvon kannalta, sekä siitä miten lisäarvoa kyetään mittaamaan. Tämä tutkimus lähestyy tulosohjauksen tutkimusta ja kehittämistä palvelukeskeisen julkisorganisaation sekä sen palveluvalikoiman yhteiskunta-taloudellisen vaikuttavuuden arvioinnin keinoin. Valittu lähestymistapa yhdistelee laadullisia ja määrällisiä tutkimusmenetelmiä. Tutkimuksessa esitetään prosessi ja menetelmävalikoima julkisviranomaisen kustannushyötysuhteen määrittelemiseksi Liikenteen turvallisuusvirastoa käsittelevän tapausesimerkin avulla. Tutkimuksen keskeiset löydökset osoittavat, että julkisorganisaation yhteiskuntataloudellinen tehokkuus voidaan määrällistää ja että julkistoimijan toiminta voi olla yhteiskuntataloudellisesti kannattavaa. Käytännön suosituksiin sisältyy resurssien uudelleenohjaaminen tehokkaammin toimiville vastuualueille, tulossopimusten ja erityisesti niihin valittavien mittareiden uudelleensuunnittelu, sekä koko hallinnon kattavan keskustelun ja yhteissuunnittelun aloittaminen kestävän ja tasapainoisen tulosohjauksen aikaansaamiseksi strategisella ja operatiivisella tasolla. Jatkotutkimus ja hallinto voi hyödyntää tässä esitettyjä menetelmiä, nyt kun julkistoimijoiden yhteiskuntataloudellisen vaikuttavuuden arvioimisen haasteita on ratkaistu. Tuloksellisuuden vaatimusten selkeämpi ymmärtäminen mahdollistaa hallinnolle tehokkaamman tulosohjauksen ja siten tukee hallintoa sen pyrkimyksissä varmistaa julkistoimijoiden tehokas ja asianmukainen toiminta.

Environmental management is one of the voluntary tools for environmental policy, which provides instructions to organizations, how they can coordinate their products, activities and services to minimize their negative environmental impacts. This work describes and compares two basic approaches for environmental management system (EMS) implementation - ISO 14001 Standard and EMAS II Regulation in terms of requirements for an organization. Attention is paid to advantages and disadvantages of EMS implementation in an organization too. In analytical part of this work, environmental management is analyzed in light of a number of certified and certifying organizations, after that follows cost-benefit analysis of EMS focused on organizations and SWOT analysis. The goal of this work is to find out on the basis of the results of these analyses, whether environmental management system implementation is a competitive advantage of an organization, or not.

The EU Water Framework Directive (Directive 2000/60 EC) provides numerous requirements, including achievement of good status of all water bodies by 2015. However, meeting this environmental target brings substantial costs. In justified cases, member states may request an extension of the deadline based on disproportionality of costs of meeting the WFD requirements. Definition of disproportionate costs must be based on economic analysis and on the WFD general requirements. This thesis provides a review of proportionate costs in the context of the WFD, identifies main requirements for its practical definition as an exemption and provides a review of foreign methodical approaches to define cost proportionality. It is clear that the Cost-effectiveness analysis (CEA) and the Cost-benefit analysis (CBA) are most commonly used methods to determine the cost proportionality treshold. This thesis discuss the relevance of these methods to define cost proportionality to reach good status of water bodies. The thesis also provides methodology to assess cost proportionality based on modified CBA and analyses ecosystem services of water bodies. In addition, the thesis points out the methodological complications and uncertainties of suggested methodology. Main methodological issues are connected with definition of right scale of analysis and synergy effects of measures, analysis of costs and definition of suitable measures and analysis of benefits and quantification of ecosystem services of water bodies.

Wind power installations have seen a significant rise all over the world in the past decade. Further significant growth is expected in the future. The UK’s ambitions for offshore wind installations are reflected through Round 1, 2 and 3 projects. It is expected that Round 3 alone will add at least 25 GW of offshore wind generation into the system. Current research knowledge is mostly limited to smaller wind farms, the aim of this research is to improve offline and online modelling techniques for large offshore wind farms. A critical part of offline modelling is the design of the wind farm. Design of large wind farms particularly requires careful consideration as high capital costs are involved. This thesis develops a novel methodology which leads to a cost-effective and reliable design of an offshore wind farm. A new industrial-grade software tool is also developed during this research. The tool enables multiple offshore wind farm design options to be built and tested quickly with minimal effort using a Graphical User Interface (GUI). The GUI is designed to facilitate data input and presentation of the results. This thesis also develops an improved method to estimate a wind farm’s energy yield. Countries with large-scale penetration of wind farms often carry out wind energy curtailments. Prior knowledge of estimated energy curtailments from a wind farm can be advantageous to the wind farm owner. An original method to calculate potential wind energy curtailment is proposed. In order to perform wind energy curtailments a network operator needs to decide which turbines to shut down. This thesis develops a novel method to identify turbines inside a wind farm that should be prioritised for shut down and given priority when scheduling preventive maintenance of the wind farm. Once the wind farm has been built and connected to the network, it operates as part of a power system. Real-time online simulation techniques are gaining popularity among system operators. These techniques allow operators to carry out simulations using short-term forecasted wind conditions. A novel method is proposed to probabilistically estimate the power production of a wind farm in real-time, taking into account variation in wind speed and effects of turbulence inside the wind farm. Furthermore, a new probabilistic aggregation technique is proposed to establish a dynamic equivalent model of a wind farm. It determines the equivalent number and parameters of wind turbines that can be used to simulate the dynamic response of the wind farm throughout the year.

Introdução O Transtorno de Déficit de Atenção/hiperatividade (TDAH) tem sido muito estudado, mas informações econômicas referentes ao seu tratamento com o metilfenidato de liberação imediata (MFD-LI) ainda necessitam ser exploradas. Grande parte da população mundial, principalmente aqueles que vivem em países em desenvolvimento, utiliza essa formulação como principal escolha para o tratamento do TDAH. Esses países, por sua condição financeira, necessitam informações de análises econômicas para administrar de forma eficiente os recursos públicos destinados aos setores da saúde. Objetivos Avaliar a eficácia do MFD-LI através de estudos com tempo superior a 12 semanas, e realizar uma análise econômica para o tratamento do TDAH com MFD-LI para crianças e adolescentes brasileiros. Método O estudo foi planejado em cinco etapas: 1) estimativa de custo do não tratamento do TDAH para o Brasil, e estimativa de economia com tratamento com MFD-LI; 2) revisão sistemática da literatura nas principais bases de dados internacionais onde se buscaram estudos abertos com tratamento do TDAH com MFD-LI por tempo igual ou superior a 12 semanas; também foram feitas metanálises e uma metaregressão 3) estudo naturalístico para obterem-se dados de uma amostra brasileira referentes a probabilidades de uso e sucesso com tratamento com MFD-LI por 12 semanas, e estimar os utilities desses indivíduos; 4) painel Delphi com especialistas em TDAH no Brasil; 5) estudo de custo-efetividade para o tratamento do TDAH com MFD-LI no Brasil, utilizando um Modelo de Markov. A perspectiva adotada será a do sistema público de saúde brasileiro como pagador. Resultados Os resultados principais encontrados para cada uma das etapas foram: 1) a estimativa de custos anuais com o TDAH não tratado no Brasil foi de R$ 1.594 bilhões/ano, e da quantia que poderia ser economizada se tratado, R$ 1 bilhão/ano. 2) na revisão sistemática da literatura, de 4.498 resumos, sete foram incluídos para compor a metanálise. O tempo de tratamento variou entre 13 e 104 semanas. O efeito agregado para desatenção e hiperatividade medida pelos pais, respectivamente, foi 0.96 (95%CI 0.60 - 1.32) e 1.12 (95%CI 0.85 - 1.39), e pelos professores 0.98 (95%CI 0.09 - 1.86) e 1.25 (95% CI 0.7 - 1.81). A metaregressão não mostrou associação entre as variáveis idade, qualidade do artigo e tempo de tratamento com heterogeneidade. 3) no estudo naturalístico, de 171 pacientes avaliados, 73 forneceram informações para o baseline, e 56 para a 12a semana de tratamento com MFD-LI. Os utilities para um paciente com TDAH não tratado (baseline) foram 0.69 (crianças) e 0.66 (adolescentes), e estimaram-se ganhos entre 0.09 a 0.10 utilities/mês, se tratados adequadamente. 4) no painel Delphi, de 26 especialistas, 14 responderam o questionário online, e foi estimado que a probabilidade dos pacientes não tratados se manterem sintomáticos na 12a semana seria de 91%, e 9% a probabilidade de melhora espontânea; 5) no estudo de custo-efetividade, para o caso base, estimou-se que o Incremental Cost Effectiveness Ratio (ICER) seja I$9,103/QALY (Quality Adjusted Life Years) para crianças e I$11,883/QALY para adolescentes em um horizonte temporal de 06 anos. Para os cenários mais desfavoráveis, os ICERS mais elevados foram I$95,164/QALY para 50% de sucesso com o tratamento, e I$15,000/QALY para 70% de adesão em um horizonte temporal de 06 anos. Conclusões O MFD-LI é um tratamento eficaz para crianças e adolescentes, por um período superior a 12 semanas. Entretanto, o Brasil pode estar aumentando os custos referentes à saúde por não estar fornecendo um tratamento eficaz e economicamente acessível para o TDAH. O tratamento mostrou ser uma opção custo-efetiva para crianças e adolescentes brasileiros, mesmo em cenários desfavoráveis para o tratamento. / Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a well-known psychiatric disorder, but some economical aspects of the treatment with Methylphenidate Immediate-release (MPH -IR) still need to be explored. A large number of people around the world, most living in Low-Middle Income Countries (LMIC), use this formulation as the first choice for ADHD treatment. These countries, due to their financial condition, need information from health economic analyzes to efficiently manage the public resources allocated to the health sector. Objective To study the efficacy of MPH-IR reviewing studies conducted for more than 12 weeks long, and to perform an economic analysis for the treatment of ADHD with MPH-IR for Brazilian children. Method The study was planned in a five stages process: 1) to estimate the cost of untreated ADHD for Brazil, and to estimate the savings if MPH-IR were adequately provided; 2) systematic review of the literature to identify papers published where young patients with ADHD were treated with MPH-IR for more than 12 weeks, and to perform a meta-analysis and a meta-regression; 3) to conduct a naturalistic study with a Brazilian sample to collect the probabilities of use and success with the MPH-IR treatment for 12 weeks, and to estimate the utilities; 4) to perform a Delphi panel with ADHD Brazilian experts; 5) to conduct a cost-effectiveness analysis for the treatment of ADHD with MPH-IR in Brazil, using a Markov model. The perspective is the one of the Brazilian public health system as the payer. Results The main findings for each step were: 1) the estimated annual expenditures with untreated ADHD in Brazil were R$1.594billon/year, and the estimated amount that could be saved was R$1billion/year; 2) in the systematic review, from 4,498 abstracts, 7 studies were selected. The length of treatment ranged from 13 to 104 weeks. The aggregate effects for inattention and hyperactivity, according to parents evaluations were respectively 0.96 (95%CI 0.60 - 1.32) and 1.12 (95%CI 0.85 - 1.39), and for teachers 0.98 (95%CI 0.09 - 1.86) e 1.25 (95% CI 0.7 - 1.81). There was no evidence of association between heterogeneity and the variables, age, paper quality and length of treatment; 3) in the naturalistic study, from 171 patients assessed, 73 provided information in the baseline, and 56 in the 12th week of MPH-IR treatment. Utilities for an untreated ADHD patient (baseline) were 0.69 (children) and 0.66 (adolescents), and it was estimated a gain ranging from 0.09 to 0.10 utilities/month if subjects were properly treated; 4) in the Delphi Panel, 26 experts were addressed and 14 filled in the online questionnaire. It was estimated the probability of untreated patients to remain symptomatic on the 12th week to be 91%, and the probability of spontaneous improvement, 9%; 5) in the cost-effectiveness analysis, for the base case, it was estimated an Incremental Cost Effectiveness Ratio (ICER) of I$9,103/QALY (Quality Adjusted Life Years) for children and I$11,883/QALY for adolescents, in a time horizon of 6 years. The worst case scenarios were also tested, and the highest ICER were I$95,164/QALY when patient reached 50 % of success with the treatment, and I$15,000/QALY if only 70% of use was observed in a time horizon of 6 years. Conclusions MPH-IR is an efficacious treatment for ADHD children and adolescents for periods longer than 12 weeks. However, Brazil may be probably wasting money due to not provide an efficient and affordable treatment for ADHD such as the MPH-IR. The treatment proved to be cost-effective for children and adolescents living in Brazil, even when the worst case scenarios were tested.

The fast-increasing issue of antibiotic unavailability or relatively their shortages in the healthcare system has been the point of concern for many countries. With these shortages come unnecessary costs and the need to utilize less optimal treatment thus increasing the risk of antimicrobial resistance and jeopardizing a patient’s health. This thesis is a collaboration with PLATINEA (Platform for Innovation of Existing Antibiotics), aiming to optimize the usage of antibiotics and to increase the availability of important antibiotics in Sweden. To understand the causes that affect antibiotic unavailability, a good view into the antibiotic and pharmaceutical supply chain is important, especially the purchasing systems of it. The complexities in the purchasing system can lead to interruptions in the antibiotics supply chain thus increasing the risk of antibiotic shortages. These shortages in turn increases the risk of antimicrobial resistance, therefore, the purchasing system requires the need to be analysed extensively. This study aims to explore different purchasing systems and conduct cost-benefit analysis of centralized purchasing system in efforts to help reduce shortages of antibiotics in Sweden. This study is based on the existing literature on centralized and decentralized purchasing and also the pharmaceutical supply chain. Qualitative interviews (semi-structured), multiple reports and articles steered the authors in exploring the purchasing systems and mapping the costs and benefits of centralized purchasing. Throughout the research, emphasis was kept on reducing antibiotic shortages. The findings of this study outline the various costs and benefits of a centralized purchasing system and resulted in the implementation recommendation of it over an existing decentralized purchasing system in Sweden.

This thesis deals with the economic evaluation of optimalization of transport infrastructure. Aim of the thesis is to define problematics of economical evaluation of public investment projects and It’s specifics. In analytical part It describes theme of public sector, project life cycle, cost output methods and transport infrastructure evaluation. In the practical part, the project is analysed in the original variant and in case of project suspension for one year. Furthermore, there are perfomed evaluation analyses by sensitivity and quantitative analyzes for both variants.

Annotation This Master’s thesis deals with obtaining grants from EU funds that are specified for railroad development in the Czech Republic – modernization, reconstruction, interconnection and making the railroad traffic accessible for the whole Europe. In parlance of the Czech Republic the word modernization means speeding up the trains. In my Master’s thesis I would like to describe you the way how to evaluate the efficiency of the project “Reconstruction of Railroad Station in Olomouc” by means of main economic indexes (IRR, BCR, NPV) and further familiarize you with the Benefit 7+ form used for raising money from EU structural funds. I also would like to introduce you the procedure of elaborating required scheme used in economic evaluation – cost and benefits analysis (CBA). This scheme is absolutely necessary in order to get the grants from abovementioned EU structural funds concerning any investment project in the Czech Republic.

The Diploma Thesis analyzes the possibilities of financing an existing project of public interest with the accent on financing in the form of Public Private Partnership (PPP). The crucial part of theoretical knowledge presents the above mentioned financing option. The following part introduces the real project including cost analysis and the benefits from its realization. The last part is dedicated to the project realization and its evaluation.