Making decisions of when to intervene on bridges taking into consideration more than owner costs is a growing field of interest in earthquake engineering. In particular, bridges can be considered critical links in hig...Making decisions of when to intervene on bridges taking into consideration more than owner costs is a growing field of interest in earthquake engineering. In particular, bridges can be considered critical links in highway networks because of their seismic vulnerability in terms of direct and indirect losses. This paper aims at defining a general criteria capable of taking into account both these costs in a simplified and efficient formulation. Indirect losses generally neglected elsewhere, are taken into consideration by applying a formulation that assesses investment efficiency. The presented formulation follows the one proposed for buildings by L. Kantorovich, 1975. Direct costs are computed from a Performance Based Earthquake Engineering （PBEE） methodology by the Pacific Earthquake Engineering Research （PEER） center. The problem considers two competitive objectives （maximizing economic efficiency and minimizing costs） in a multi-objective structural optimization procedure. The formulation has been applied to a case study aimed at strengthening a benchmark bridge. The optimum investment has been assessed between several isolated configurations.展开更多
Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases...Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.展开更多
Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the manage...Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.4 and p = 0.012) and prostaglandin analogues (OR of 38.2 and p Conclusion: This first study on the direct cost of POAG management in Lomé showed that the economic burden glaucoma represents for the patient, his family and society. The data from this study will allow health decision-makers to adopt strategies to mitigate the effects of glaucoma on the economy.展开更多
Last years the most profitable line of activity in agriculture is considered with milk production. The-effectiveness of this project depends primarily on the direct costs and the obtained of purchase price. Therefore ...Last years the most profitable line of activity in agriculture is considered with milk production. The-effectiveness of this project depends primarily on the direct costs and the obtained of purchase price. Therefore the aim of this work was to analyze the financial results of dairy farms in the east part of Mazovia region. Completing the research in 2010, to the owners of 36 farms were sent a questionnaire containing 18 questions. The obtained data were used to characterize the various research facilities. And then the whole population was devoted on the 6 production groups, depend on the number of physical units of dairy cows. Moreover, based on survey data, an analysis of the profitability of milk production was done. It was the following economic values： direct costs, revenue, gross margin and the index of production profitability. Also the statistical analysis by calculating the Pearson linear correlation coefficient （r） and coefficient of determination （R2） was done. The study showed that the highest annual yield of milk from a cow at the level of 7500 kg, reached the farmers with the area of l 9.7 ha of with the density of 1.82 BFU/ha and with 8 years of cow utilization. Respondents from this group also received the highest value of effectiveness index （184.60%）. In addition, the performed regression analysis showed significant positive correlation between the effectiveness index and the surface agricultural lands occurring in the farms, density of agricultural lands, and efficiency from a cow and the price of milk.展开更多
One of the prime objectives of maintenance is to minimize the total maintenance costs. Total maintenance costs include direct costs and maintenance dependent costs. Direct costs include labor, material, and overheads....One of the prime objectives of maintenance is to minimize the total maintenance costs. Total maintenance costs include direct costs and maintenance dependent costs. Direct costs include labor, material, and overheads. Whereas maintenance dependent costs refer to the costs of lost production or loss of revenue due to breakdown maintenance.展开更多
BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to ...BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to conventional maintenance therapy remained unclarified.AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer.METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy(CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs.RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications(odds ratio: 0.527, P = 0.010), higher utility value for quality of life(coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management(coefficient-0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers $55260 to gain one quality-adjusted life year(QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita(GDPPC)] was 86.4%.CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.展开更多
AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources,...AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.展开更多
Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of ...Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.展开更多
The cost of ecological and environmental protection is a core part of ecological compensation standards and consists of direct costs, opportunity costs and development. This paper uses Naqu, a section of the Chang Tan...The cost of ecological and environmental protection is a core part of ecological compensation standards and consists of direct costs, opportunity costs and development. This paper uses Naqu, a section of the Chang Tang Nature Reserve, Tibet as a case study to assess direct and opportunity costs of wildlife conservation to herdsmen. A standard sheep unit has been established for determining the animal carrying capacity of grasslands across China, and we used this to convert wild animals into standard sheep units. This approach links the grassland ecosystem, herbivorous wild animals and their valuation together. Our results show that the total cost of wildlife conservation reached 5.69 billion Chinese Yuan （CNY）. The opportunity cost was 4.5 billion CNY, accounting for 79% and direct cost. The biggest economic loss to herdsmen was the opportunity cost in Chang Tang Nature Reserve and means that herdsmen have to give up economic income from livestock husbandry when grazing is banned. Opportunity cost assessment is integral to establishing ecological compensation. The average value of wildlife conservation was 1482 CNY per capita and 57 CNY per hectare according to population and the area of moderately and seriously degraded grassland. The period of ecological compensation should last five to ten years after grazing is banned.展开更多
Pollutant gases emitted from the civil jet are doing more and more harm to the environ- ment with the rapid development of the global commercial aviation transport. Low environmental impact has become a new requiremen...Pollutant gases emitted from the civil jet are doing more and more harm to the environ- ment with the rapid development of the global commercial aviation transport. Low environmental impact has become a new requirement for aircraft design. In this paper, estimation method for emis- sion in aircraft conceptual design stage is improved based on the International Civil Aviation Orga- nization （ICAO） aircraft engine emissions databank and the polynomial curve fitting methods. The greenhouse gas emission （CO2 equivalent） per seat per kilometer is proposed to measure the emis- sions. An approximate sensitive analysis and a multi-objective optimization of aircraft design for tradeoff between greenhouse effect and direct operating cost （DOC） are performed with five geom- etry variables of wing configuration and two flight operational parameters. The results indicate that reducing the cruise altitude and Mach number may result in a decrease of the greenhouse effect but an increase of DOC. And the two flight operational parameters have more effects on the emissions than the wing configuration. The Pareto-optimal front shows that a decrease of 29.8% in DOC is attained at the expense of an increase of 10.8% in greenhouse gases.展开更多
Background:H7N9 continues to cause human infections and remains a pandemic concern.Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation,including inf...Background:H7N9 continues to cause human infections and remains a pandemic concern.Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation,including infectious disease prevention and control investment.However,there are limited data on such impacts.Methods:Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed.Patients’direct medical costs of hospitalization were derived from their hospital bills.A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics.Results:The mean direct cost of hospitalization for H7N9 was estimated to be¥71060(95%CI,48180–104820),i.e.,US$10996(95%CI,7455–16220),and was¥12060(US$1861),¥136120(US$21001)and¥218610(US$33728)for those who had mild or severe symptoms or who died,respectively.The principal components of the total fees differed among patients with different disease severity,although medication fees were always the largest contributors.Disease severity,proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient’s direct medical cost of hospitalization.Conclusions:The direct medical costs of hospitalized patients with H7N9 are significant,and far surpass the annual per capita income of Jiangsu Province,China.The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation.Trial registration:Not applicable.This is a survey study with no health care intervention implemented on human participants.展开更多
文摘Making decisions of when to intervene on bridges taking into consideration more than owner costs is a growing field of interest in earthquake engineering. In particular, bridges can be considered critical links in highway networks because of their seismic vulnerability in terms of direct and indirect losses. This paper aims at defining a general criteria capable of taking into account both these costs in a simplified and efficient formulation. Indirect losses generally neglected elsewhere, are taken into consideration by applying a formulation that assesses investment efficiency. The presented formulation follows the one proposed for buildings by L. Kantorovich, 1975. Direct costs are computed from a Performance Based Earthquake Engineering （PBEE） methodology by the Pacific Earthquake Engineering Research （PEER） center. The problem considers two competitive objectives （maximizing economic efficiency and minimizing costs） in a multi-objective structural optimization procedure. The formulation has been applied to a case study aimed at strengthening a benchmark bridge. The optimum investment has been assessed between several isolated configurations.
文摘Introduction: Malaria is both a disease caused by poverty and a cause of poverty. Malaria is the leading cause of morbidity and mortality in Mali and is among the ten countries with the highest number of malaria cases and deaths. The objective was to estimate the direct economic cost borne by families in the treatment of severe malaria in children aged 0 - 5 years at the CSREF in Fana. Methodology: The study was cross-sectional, conducted from July 2017 to June 2018 with inclusion criteria and prospective data collection. The methodology was based on estimating the direct economic cost of severe malaria. Results: The sample consisted of 109 cases out of a total of 944 hospitalizations;59% of whom were boys and the 25 - 36 month age group was the most affected. The complications frequently encountered were severe anemia (50 cases) or 45.8%;convulsions (35 cases) or 32.1% and finally severe sepsis (8 cases) or 7.3%. The average direct cost was 25,324 Franc CFA (58.95 US Dollars) of which 66% represented the costs of medicines and consumables against 4% for the consultation. This cost was more than half the minimum wage in Mali. Conclusion: Despite the difficulties in estimating the cost in hospitals, the results obtained give us an estimate of the economic burden borne by families in the management of severe malaria cases among children in the district of Fana. Support is needed for parents in the fight against malaria in rural Mali.
文摘Background: There are few studies on the cost of glaucoma management in developing country, especially in Togo, there are no data on the cost of POAG management. Aims: To determine the annual direct cost of the management of POAG, to evaluate the annual economic weight of the management of POAG and to determine the factors associated with the annual economic weight of the management. Methods: We conducted a retrospective and descriptive study over a period of 12 months from January 1 to December 31, 2019 based on the records of patients followed for POAG in AFIA Eye Clinic in Lomé-Togo. The annual direct cost was defined by the sum of the costs of consultations, explorations and treatments. We defined the direct cost per patient and per year and related to the average annual income. It was said to be catastrophic at 20% or more of the estimated annual income. Chi 2 and Fisher tested the comparison of proportions. We conducted univariate and multivariate logistic regression to search correlations. Results: During the study period, 150 patient records were included. The average age was 47.24 ± 17.09 years and the sex ratio was 0.82. The cost of the diagnosis was 112.18 ± 22.26 €. The average cost of consultations was 19.46 ± 11.35 € and that of explorations was 92.71 ± 10.91 €. The annual cost of treatment per patient was 165.52 ± 110.16 €. The annual global direct cost of POAG management per patient was 277.69 ± 132.42 €. Compared to the annual income of 1166.29 €, the economic weight of the glaucoma management was 23.8%. This direct cost was catastrophic for 32.1% of patients in the study (44/150 of people with no care). Compared to the guaranteed inter-professional minimum wage (SMIG) of 640.30 €, the economic direct cost weight was 43.3%. Risk factors significantly associated with the direct cost were age over 40 (OR = 1.05 and p = 0.032), liberal profession (OR = 4.72 and p = 0.04), the absence of health insurance (OR = 6.68 and p = 0.017) and the use carbonic anhydrase inhibitors (OR = 7.4 and p = 0.012) and prostaglandin analogues (OR of 38.2 and p Conclusion: This first study on the direct cost of POAG management in Lomé showed that the economic burden glaucoma represents for the patient, his family and society. The data from this study will allow health decision-makers to adopt strategies to mitigate the effects of glaucoma on the economy.
文摘Last years the most profitable line of activity in agriculture is considered with milk production. The-effectiveness of this project depends primarily on the direct costs and the obtained of purchase price. Therefore the aim of this work was to analyze the financial results of dairy farms in the east part of Mazovia region. Completing the research in 2010, to the owners of 36 farms were sent a questionnaire containing 18 questions. The obtained data were used to characterize the various research facilities. And then the whole population was devoted on the 6 production groups, depend on the number of physical units of dairy cows. Moreover, based on survey data, an analysis of the profitability of milk production was done. It was the following economic values： direct costs, revenue, gross margin and the index of production profitability. Also the statistical analysis by calculating the Pearson linear correlation coefficient （r） and coefficient of determination （R2） was done. The study showed that the highest annual yield of milk from a cow at the level of 7500 kg, reached the farmers with the area of l 9.7 ha of with the density of 1.82 BFU/ha and with 8 years of cow utilization. Respondents from this group also received the highest value of effectiveness index （184.60%）. In addition, the performed regression analysis showed significant positive correlation between the effectiveness index and the surface agricultural lands occurring in the farms, density of agricultural lands, and efficiency from a cow and the price of milk.
文摘One of the prime objectives of maintenance is to minimize the total maintenance costs. Total maintenance costs include direct costs and maintenance dependent costs. Direct costs include labor, material, and overheads. Whereas maintenance dependent costs refer to the costs of lost production or loss of revenue due to breakdown maintenance.
基金Supported by Zhejiang Medical and Health Science and Technology Project,No. 2020KY608Natural Science Foundation of Zhejiang Province,No. LQ19H030013。
文摘BACKGROUND Infliximab was the first approved biologic treatment for moderate to severe Crohn's disease(MS-CD) in China. However, the cost-effectiveness of infliximab maintenance therapy(IMT) for MS-CD relative to conventional maintenance therapy remained unclarified.AIM To assess the cost-effectiveness of IMT for MS-CD in Chinese patients from the perspective of Chinese public insurance payer.METHODS A cohort of MS-CD patients managed in a Chinese tertiary care hospital was created to compare IMT with conventional maintenance therapy(CMT) for clinical outcomes and direct medical costs over a 1-year observation time using conventional regression analyses. A decision-analytic model with the generated evidence was constructed to assess the cost-effectiveness of IMT relative to CMT using reimbursed medical costs.RESULTS Based on the included 389 patients, IMT was associated with significantly higher disease remission chance [odds ratio: 4.060, P = 0.003], lower risk of developing new complications(odds ratio: 0.527, P = 0.010), higher utility value for quality of life(coefficient 0.822, P = 0.008), and lower total hospital costs related to disease management(coefficient-0.378, P = 0.008) than CMT. Base-case cost-effectiveness analysis estimated that IMT could cost Chinese health insurance payers $55260 to gain one quality-adjusted life year(QALY). The cost-effectiveness of IMT was mainly driven by the estimate of quality of life, treatment efficacy of maintenance therapy, mortality risk associated with active disease, and unit price of infliximab. The probability that IMT was cost-effective at a willingness-to-pay threshold of three times gross domestic product [2018 Chinese gross domestic product per capita(GDPPC)] was 86.4%.CONCLUSION IMT significantly improved real-world health outcomes and cost the Chinese public health insurance payers less than one GDPPC to gain one QALY in Chinese MS-CD patients.
文摘AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.
基金supported by the National Natural Science Foundation of China(No.81101280)the National Special Science and Technology Project for Major Infectious Diseases of China(Grant Nos.2012ZX10004-220,2008ZX10004-011,and 2012ZX10004-201)+1 种基金the China UK Global Health Support Programme(GHSP-CS-OP101)-China’s Experiences in Control of Malaria and Schistosomiasis:Relevant to LMICs through Distillation,Synthesis and Dissemination Approaches,the Public Health Overseas Fund,the Bureau of Health,Shanghai(Grant No.GWHW201216)the Shanghai Public Health Improvement Action Plan 2015–2017,and the Global Fund Project in China.The funders had no role in the study design,data collection and analysis,decision to publish,or preparation of the paper.
文摘Background:In China,malaria has been posing a significant economic burden on households.To evaluate malaria economic burden in terms of both direct and indirect costs has its meaning in improving the effectiveness of malaria elimination program in China.Methods:A number of study sites(eight counties in five provinces)were selected from the malaria endemic area in China,representing the different levels of malaria incidence,risk classification,economic development.A number of households with malaria cases(n=923)were surveyed during the May to December in 2012 to collect information on malaria economic burden.Descriptive statistics were used to characterize the basic profiles of selected malaria cases in terms of their gender,age group,occupation and malaria type.The malaria economic costs were evaluated by direct and indirect costs.Comparisons were carried out by using the chi-square test(or Z-test)and the Mann-Whitney U test among malaria cases with reference to local/imported malaria patients,hospitalized/out patients,and treatment hospitals.Results:The average cost of malaria per case was 1691.23 CNY(direct cost was 735.41 CNY and indirect cost was 955.82 CNY),which accounted for 11.1%of a household’s total income.The average costs per case for local and imported malaria were 1087.58 CNY and 4271.93 CNY,respectively.The average cost of a malaria patient being diagnosed and treated in a hospital at the county level or above(3975.43 CNY)was 4.23 times higher than that of malaria patient being diagnosed and treated at a village or township hospital(938.80 CNY).Conclusion:This study found that malaria has been posing a significant economic burden on households in terms of direct and indirect costs.There is a need to improve the effectiveness of interventions in order to reduce the impact costs of malaria,especially of imported infections,in order to eliminate the disease in China.
基金National Eleven Five-year Plan Science and Technology Program (2009BADC2B03)
文摘The cost of ecological and environmental protection is a core part of ecological compensation standards and consists of direct costs, opportunity costs and development. This paper uses Naqu, a section of the Chang Tang Nature Reserve, Tibet as a case study to assess direct and opportunity costs of wildlife conservation to herdsmen. A standard sheep unit has been established for determining the animal carrying capacity of grasslands across China, and we used this to convert wild animals into standard sheep units. This approach links the grassland ecosystem, herbivorous wild animals and their valuation together. Our results show that the total cost of wildlife conservation reached 5.69 billion Chinese Yuan （CNY）. The opportunity cost was 4.5 billion CNY, accounting for 79% and direct cost. The biggest economic loss to herdsmen was the opportunity cost in Chang Tang Nature Reserve and means that herdsmen have to give up economic income from livestock husbandry when grazing is banned. Opportunity cost assessment is integral to establishing ecological compensation. The average value of wildlife conservation was 1482 CNY per capita and 57 CNY per hectare according to population and the area of moderately and seriously degraded grassland. The period of ecological compensation should last five to ten years after grazing is banned.
基金supported by the Fundamental Research Funds for the Central Universities (NUAA NN2012071)China Postdoctoral Science Foundation (2011M500919)
文摘Pollutant gases emitted from the civil jet are doing more and more harm to the environ- ment with the rapid development of the global commercial aviation transport. Low environmental impact has become a new requirement for aircraft design. In this paper, estimation method for emis- sion in aircraft conceptual design stage is improved based on the International Civil Aviation Orga- nization （ICAO） aircraft engine emissions databank and the polynomial curve fitting methods. The greenhouse gas emission （CO2 equivalent） per seat per kilometer is proposed to measure the emis- sions. An approximate sensitive analysis and a multi-objective optimization of aircraft design for tradeoff between greenhouse effect and direct operating cost （DOC） are performed with five geom- etry variables of wing configuration and two flight operational parameters. The results indicate that reducing the cruise altitude and Mach number may result in a decrease of the greenhouse effect but an increase of DOC. And the two flight operational parameters have more effects on the emissions than the wing configuration. The Pareto-optimal front shows that a decrease of 29.8% in DOC is attained at the expense of an increase of 10.8% in greenhouse gases.
基金X H,F T,X Q,M Z and C B were supported by Jiangsu Province Science&Technology Demonstration Project for Emerging Infectious Diseases Control and Prevention(grant number BE2015714)C.B.was supported by Natural Science Foundation of China(grant number 81373055)+2 种基金Jiangsu Province Science and Technology Support Pro-gram(social development,grant number BE2012769)the 10th Summit of Six Top Talents of Jiangsu Province(grant number WS-2013-061)Shanghai Municipal Commission of Science and Technology Program(14495810301).
文摘Background:H7N9 continues to cause human infections and remains a pandemic concern.Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation,including infectious disease prevention and control investment.However,there are limited data on such impacts.Methods:Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed.Patients’direct medical costs of hospitalization were derived from their hospital bills.A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics.Results:The mean direct cost of hospitalization for H7N9 was estimated to be¥71060(95%CI,48180–104820),i.e.,US$10996(95%CI,7455–16220),and was¥12060(US$1861),¥136120(US$21001)and¥218610(US$33728)for those who had mild or severe symptoms or who died,respectively.The principal components of the total fees differed among patients with different disease severity,although medication fees were always the largest contributors.Disease severity,proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient’s direct medical cost of hospitalization.Conclusions:The direct medical costs of hospitalized patients with H7N9 are significant,and far surpass the annual per capita income of Jiangsu Province,China.The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation.Trial registration:Not applicable.This is a survey study with no health care intervention implemented on human participants.
