Submitted by Fabricia Fialho Reginato (fabriciar) on 2015-07-15T23:34:05Z No. of bitstreams: 1 CarolineDalSottoBoff.pdf: 985951 bytes, checksum: 9d755abfbe9920145ba558da1946fc19 (MD5) / Made available in DSpace on 2015-07-15T23:34:05Z (GMT). No. of bitstreams: 1 CarolineDalSottoBoff.pdf: 985951 bytes, checksum: 9d755abfbe9920145ba558da1946fc19 (MD5) Previous issue date: 2011-07-06 / Nenhuma / O presente trabalho teve como objetivo reconhecer os custos intangíveis vinculados a fatores intangíveis existentes nos relatórios de administração das empresas da Bovespa do segmento tradicional, durante os anos de 2007 a 2009. O referencial teórico foi fundamentado no valor de mercado das empresas, nos fatores intangíveis (positivos e negativos), esses sendo os recursos ativos e passivos intangíveis e, por fim, nos custos intangíveis. Através dos relatórios de administração das empresas listadas no segmento tradicional da Bovespa, utilizou-se o programa Wordstat para verificar quais eram as palavras mais citadas, das quais se utilizaram somente as quinhentas primeiras. Dentre as mais citadas, foram extraídas as que possuíam vínculo a fatores intangíveis. Dessas foram feitas associações resultando em seis fatores intangíveis. Identificaram-se os três mais citados em cada setor da Bovespa e os custos intangíveis vinculados a eles. Concluiu-se que as evidências encontradas nos relatórios de administração relativas aos custos intangíveis variam entre os setores, pois os fatores prioritários eram igualmente distintos por setor. Entretanto, os custos destacados por cada fator eram muito semelhantes ou de mesma origem. Pode-se observar que, dentre as empresas consultadas, nem todas apresentaram em seus relatórios de administração informações suficientes para uma análise dos fatores e dos custos intangíveis. / This study aimed to recognize the intangible costs related to intangible factors existing in the reports of directors of companies in the traditional segment of the Bovespa during the years 2007 to 2009. The theoretical framework was based on market value offirms in intangible factors (positive and negative), these resources are intangible assets and liabilities and, finally, the intangible costs. Through the reports of directors of companies listed on Bovespa traditional segment, we used the program Wordstat to see which were the most frequently cited of which used only the 500 / 1. Among the most cited are from those Who had ties tointangibles. These associations were made resulting in six intangibles. Identified the three most cited in each sector of the Bovespa and the intangible costs associated with them. It was concluded that the evidence found in the reports of directors relating to intangible costs vary across sectors, since these factors were also distinguished by priority sector. However, the costshighlighted by each factor were very similar or the same source. It can be observed that among the companies surveyed, not allreports submitted in his administration enough information for an analysis of factors and intangible costs.

Made available in DSpace on 2015-03-05T19:15:17Z (GMT). No. of bitstreams: 0 Previous issue date: 26 / Nenhuma / O objetivo deste estudo é contribuir com a mensuração de custos intangíveis. Inicialmente, fez-se uma revisão da literatura sobre Estratégia, Ativos Intangíveis, Fatores Intangíveis, Custos Intangíveis, Custeio ABC e matriz de relação. Na sequência, detalhou-se o modelo proposto por Diehl (1997) para a mensuração de custos intangíveis e acrescentou-se a priorização dos fatores intangíveis por meio de técnicas qualitativas como a entrevista não estruturada e a matriz de priorização a partir da seleção dos atributos constantes na estratégia empresarial comparados com os fatores intangíveis mais citados pelos gestores. Tal modelo foi aplicado na empresa de Trens Urbanos de Porto Alegre (Trensurb S/A). O período para análise dos custos intangíveis foi de novembro de 2007 a outubro de 2008, em razão de ser o período cujo sistema interno de custeio encontrava-se completo e fidedigno aos dados contábeis. Com a priorização do fator intangível imagem empresarial, foi possível mensurar o que foi gasto para manter esse / Present research subject is measuring intangible costs. First of all, it was done a literature revision on Strategy, Intangible Assets, Intangible Factors, Intangible Costs, ABC Costing and relation matrix. On sequence, it is detailed model proposed by Diehl (1997) for intangible cost measurement. It is added intangible factor preference qualitative techniques as per non-structured interview and preference matrix from attributes selection regarding management strategy, compared with the most intangible factors quoted by management. Such model was applied at Porto Alegre’s Trens Urbanos company - Trensurb S/A. Intangible costs analysis period was from November, 2007 to October 2008 when costing internal system is complete and reliable with accounting data. From the intangible factor selection “company image”, it was possible measuring how much was spend to maintain such intangible factor on the last twelve months at the organization. Since methodology applying it was verified its applicability, over all on org

Health economists, national decision-makers and global health specialists have been interested in calculating the cost of a disease for many years. Only more recently they started to generate more comprehensive frameworks and tools to estimate the full range of healthcare related costs of illness in a user’s perspective in resource-poor settings. There is now an ongoing trend to guide health policy, and identify the most effective ways to achieve universal health coverage. The user fee exemptions health financing schemes, which grounded the tuberculosis control strategy, have been designed to improve access to essential care for ill individuals with a low capacity to pay. After decades of functioning and substantial progress in tuberculosis detection rate and treatment success, this thesis analyses the extent of the coverage (financial and social protection) of two disease control programs in West Africa. Learning from the concept of the medical poverty trap (Whitehead, Dahlgren, et Evans 2001) and available framework related to the economic consequences of illness (McIntyre et al. 2006), a conceptual framework and a data collection tool have been developed to incorporate the direct, indirect and intangible costs and consequences of illness incurred by chronic patients. In several ways, we have sought to provide baseline for comprehensive analysis and standardized methodology to allow comparison across settings, and to contribute to the development of evidence-based knowledge.<p><p>To begin, filling a knowledge gap (Russell 2004), we have performed microeconomic research on the households’ costs-and-consequences-of-tuberculosis in Burkina Faso and Benin. The two case studies have been conducted both in rural and urban resource-poor settings between 2007 and 2009. This thesis provides new empirical findings on the remaining financial, social and ‘healthcare delivery related organizational’ barriers to access diagnosis and treatment services that are delivered free-of-charge to the population. The direct costs associated with illness incurred by the tuberculosis pulmonary smear-positive patients have constituted a severe economic burden for these households living in permanent budget constraints. Most of these people have spent catastrophic health expenditure to cure tuberculosis and, at the same time, have faced income loss caused by the care-seeking. To cope with the substantial direct and indirect costs of tuberculosis, the patients have shipped their families in impoverishing strategies to mobilize funds for health such as depleting savings, being indebted and even selling livestock and property. Damaging asset portfolios of the disease-affected households on the long run, the coping strategies result in a public health threat. In resource-poor settings, the lack of financial protection for health may impose inability to meet basic needs such as the rights to education, housing, food, social capital and access to primary healthcare. Special feature of our work lies in the breakdown of the information gathered. We have been able to demonstrate significant differences in the volume and nature of the amounts spent across the successive stages of the care-seeking pathway. Notably, pre-diagnosis spending has been proved critical both in the rural and urban contexts. Moreover, disaggregated cost data across income quintiles have highlighted inequities in relation to the direct costs and to the risk of incurring catastrophic health expenditure because of tuberculosis. As part of the case studies, the tuberculosis control strategies have failed to protect the most vulnerable care users from delayed diagnosis and treatment, from important spending even during treatment – including significant medical costs, and from hidden costs that might have been exacerbated by poor health systems. To such devastating situations, the tuberculosis patients have had to endure other difficulties; we mean intangible costs such as pain and suffering including stigmatization and social exclusion as a result of being ill or attending tuberculosis care facilities. The analysis of all the social and economic consequences for tuberculosis-affected households over the entire care-seeking pathway has been identified as an essential element of future cost-of-illness evaluations, as well as the need to conduct benefit incidence assessment to measure equity.<p><p>This work has allowed identifying a series of policy weaknesses related to the three dimensions of the universal health coverage for tuberculosis (healthcare services, population and financial protection coverage). The findings have highlighted a gap between the standard costs foreseen by the national programs and the costs in real life. This has suggested that the current strategies lack of patient-centered care, context-oriented approaches and systemic vision resulting in a quality issue in healthcare delivery system (e.g. hidden healthcare related costs). Besides, various adverse effects on households have been raised as potential consequences of illness; such as illness poverty trap, social stigma, possible exclusion from services and participation, and overburdened individuals. These effects have disclosed the lack of social protection at the country level and call for the inclusion of tuberculosis patients in national social schemes. A last policy gap refers to the lack of financial protection and remaining inequities with regards to catastrophic health expenditure still occurring under use fee exemptions strategies. Thereby, one year before 2015 – the deadline set for the Millennium Development Goals – it is a matter of priority for Benin and Burkina Faso and many other countries to tackle adverse effects of the remaining social, economic and health policy and system related barriers to tuberculosis control. These factors have led us to emphasize the need for countries to develop sustainable knowledge. <p><p>National decision-makers urgently need to document the failures and bottlenecks. Drawing on the findings, we have considered different ways to strengthen local capacity and generate bottom-up decision-making. To get there, we have shaped a decision framework intended to produce local evidence on the root causes of the lack of policy responsiveness, synthesize available evidence, develop data-driven policies, and translate them into actions.<p><p>Beyond this, we have demonstrated that controlling tuberculosis was much more complex than providing free services. The socio-economic context in which people affected by this disease live cannot be dissociated from health policy. The implications of microeconomic research on the households’ costs and responses to tuberculosis may have a larger scope than informing implementation and adaptation of national disease-specific strategies. They can be of great interest to support the definition of guiding principles for further research on social protection schemes, and to produce evidence-based targets and indicators for the reduction and the monitoring of economic burden of illness. In this thesis, we have build on prevailing debates in the field and formulated different assumptions and proposals to inform the WHO Global Strategy and Targets for Tuberculosis Prevention, Care and Control After 2015. For us, to reflect poor populations’ needs and experiences, global stakeholders should endorse bottom-up and systemic policy-making approaches towards sustainable people-centered health systems.<p><p>The findings of the thesis and the various global and national challenges that have emerged from case studies are crucial as the problems we have seen for tuberculosis in West Africa are not limited to this illness, and far outweigh the geographical context of developing countries.<p><p><p>Keywords: Catastrophic health expenditure, Coping strategies, Cost-of-illness studies, Direct, indirect and intangible costs, Evidence-based Public health, Financial and Social protection for health, Health Economics, Health Policy and Systems, Informed Decision-making, Knowledge translation, People-centered policy-making, Systemic approach, Universal Health Coverage<p> / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished