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Dissertations / Theses on the topic 'Cost of Australia'

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Published: 10 December 2022

Last updated: 19 July 2025

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Xydias, Maria. "Cost of quality reporting in manufacturing organisations in Australia /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09CM/09cmx91.pdf.

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Pham, Quynh. "International Funding Cost and Mortgage Interest Rate Transmission in Australia." Thesis, Griffith University, 2018. http://hdl.handle.net/10072/385133.

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This document is constructed from four interrelated empirical papers examining the mortgage interest-rate pass-through mechanism in the Australian banking market over the period 1997:1–2015:12 employing an anonymous sample of 20 banks anonymised. In particular, the transmission from both the bank international funding cost and the cash rate to the effective interest rate on the variable home loans for owner-occupiers, both asymmetries (downward and upward) and symmetries (homogeneity or heterogeneity), are investigated in parallel in the short run and in the long run. Furthermore, the effects of the recent Great Recession (GFC) on this transmission mechanism are carefully considered in different manners while controlling for nonlinearity, slope heterogeneity, complex cross-sectional dependencies arising from both observed and unobserved common factors in panel data. The economic imperative of this examination focuses on seven key reasons: (i) the paramount importance of the Australian mortgage market to monetary policy transmission, housing and financial soundness in Australia, and to the stability of global banking and financial markets, (ii) the salient characteristics of the mortgage products, (iii) the high oligopoly of the mortgage market and banking sector, (iv) the heavy reliance of Australian banks on wholesale funding to finance their mortgages, (v) the increased public concern about bank mortgage rate-setting behaviour and a proliferated attention of regulators (Australian Prudential Regulation Authority [APRA], Reserve Bank of Australia [RBA] and related bodies) towards the enhancement of banking competition and financial soundness, (vi) the small quantity of the literature on the policy rate–mortgage rate transmission using micro-data, considering the substantially dire effect of the GFC on this asymmetric transmission in Australia, and (vii) a lack of knowledge about the role of bank international funding cost on mortgage rate pass-through mechanisms in Australia. The first empirical essay explores Australian mortgage interest-rate pass-through: does international funding cost matter? This study contributes significantly to the existing literature on the policy rate–mortgage rate association, with two key novelties. This is the first empirical analysis of the transmission from changes in international funding cost to mortgage interest rates at individual Australian banks and provides fresh convincing evidence for this cointegrating relationship. This essay is the first comprehensive analysis of the cash rate transmission to mortgage rates for Australia with regards to impact, short-term cumulative and long-term asymmetries. From a wider governing perspective, this bank-based interest-rate finding is supportive of the development of a comprehensive proxy for bank marginal funding cost, as opposed to the implementation of the cash rate. This study further contributes to the descriptive literature that argues ‘international funding cost affects bank mortgage rate-setting behaviour’ by providing new insights: that the significant positive asymmetries of mortgage rate adjustments to changes in the international funding cost and the cash rate exist in the long term for virtually all individual banks. The instant and short-term cumulative asymmetries have also occurred in several sampled banks, but they show wide discrepancies in size and sign. The long-term positive asymmetry and short-term heterogeneous asymmetry in the funding cost transmission provide empirical support to the market power of Australian banks in pricing. These findings of the first study suggest that, while the regulators revise and reform their banking governance regimes, they should seriously consider the key factor of bank market power, as well as bringing stronger customer protection procedures into effect. Finally, this essay explores three components, international funding cost, the cash rate, and mortgage rate pass-through, showing for the first time a strong interactive effect of foreign funding cost and the cash rate on mortgage rates at an individual level. The finding suggests that the prudential bodies, APRA and RBA, should carefully consider the international funding cost–mortgage rate nexus if they are striving against potential housing finance and economic fragility. In this study, I conclude that mortgage rate adjustments are being significantly adjusted in response to international funding cost shocks for individual banks, while the cash rate drives mortgage rates in both short term and long term. The nature of these transmission mechanisms is asymmetric in three dimensions: immediate, in the short run and in the long run. The second empirical essay, building on the first study, provides a comprehensive analysis of the asymmetric association between bank funding costs and mortgage rates, considering account the effect of the crisis and the bank-specific and time effects on this transmission. This initial study examines such a relationship in a small open economy but its mortgage market is one of the eight world-leading mortgage markets, based on the EMF (2016) statistics. The Australian ratio of total outstanding residential loans (home loans) to GDP is the fourth highest (60%), just behind the Netherlands (95%), the UK (68%), and the US (63%), but well above the four others, Spain (52%), France (44%), Germany (42%) and Japan (41%). However, based on their ratios of total mortgages (home loans and housing loans for investors) to GDP in the IMF (2017) database, Australia (105%) stands closely behind only the Netherlands (110%), but far above most of the others, the US (80%), the UK (90%), and the rest (around 50–60%). Therefore, it is of paramount importance to identify whether the crisis has any impact on the transmission of funding costs to mortgage rates in Australia, given the collapse of the US sub-mortgage market and the 2007–11 systemic banking crises in the US, Greece, Spain, Belgium, Iceland, Ireland, which are associated with a housing credit boom similar to Australia’s current position (Laeven & Valencia, 2013). Moreover, it is crucial to assess whether international funding cost attributes to the recent ‘out-of-cycle’ mortgage price-setting conduct of Australian banks after the GFC. This essay contributes further econometrically to the literature by investigating the effect of both bank-specific and time dimension on the interest-rate transmission mechanisms that have been disregarded in the prior literature. This empirical essay finds that, although the cash rate transmission in Australia has been weakened since the GFC, banks have still continued setting their mortgage rates in an upward asymmetric manner, increasing faster than falling. Importantly, this study ascertains that the post-crisis effects of foreign funding costs on mortgage rates are stronger than the pre-crisis and GFC influences. The findings indicate that the cash rate has been unable to reduce the bank markups charged over funding costs after the crisis. This study concludes that, since the GFC, Australian banks’ pricing behaviour has remained positively asymmetric in the long term, but it has significantly transformed from a cash-rate-based model to a foreign-funds-rate-based model. Therefore, this study proposes several important policy implications—for significant reforms of the RBA, and with stronger competition and customer protection schemes for the APRA and Australian Competition and Consumer Commission [ACCC]. The third empirical essay further explores heterogeneity in mortgage interest-rate pass-through at an Australian bank level by answering three research questions: (i) Do unobservables affect the interest-rate transmission, both symmetric and asymmetric, when considering both bank-specific effect and time dimensions? (ii) Is the nature of the long-term interest-rate transmission, both symmetry and asymmetry, accurately homogeneous? (iii) Does the international funding cost still affect the mortgage rate when controlling for cross-sectional dependence? This is the first study in the literature on monetary policy rate transmission to empirically investigate the effect of unobserved factors on the transmission while carefully testing the cross-sectional dependence properties of the macro panel data. As finance and banking environments are highly integrated, locally and internationally, it is important to examine the role of unobservables in bank price-setting behaviour, considering cross-sectional dependence inherent in panel data. Thus, this study provides convincing evidence to understand far more deeply and accurately the bank funding cost–mortgage rate nexus. A richer line of research has hitherto investigated heterogeneity in the interest-rate transmission mechanism outside and in Australia; however, these studies have mostly disregarded the presence of complex cross-sectional dependencies, both observed and unobserved common factors which arise from national and global economic shocks. As far as could be ascertained, none of the prior studies nationally and globally investigate the effect of the unobservables and cross-sectional dependences on these monetary policy transmission mechanisms, both symmetric and asymmetric. Intuitively, the literature assumes that interest rate properties are cross-sectionally invariant. However, this study argues that the omission of unobservables and cross-sectional dependence in the existing literature can produce seriously biased estimated results, with their subsequently misleading inference. The empirical results of this essay show that the transmission mechanisms, both symmetric and asymmetric, have been significantly affected by unobservables which are attributed to the strong presence of complex cross-sectional dependencies in panels. Contrary to intuition, and as hypothesised, this essay finds that, at the bank level, the nature of these long-term transmission mechanisms is heterogeneous. The estimated results of the international funding cost effect on mortgage rate pass-through have been significantly robust. From a practical viewpoint, these findings raise questions about the standard design of monitoring focused homogeneous transmission recommendations. Thus, this study calls for an innovative configuration in modelling interest-rate pass-through. Consistent with the second essay, this study documents the strong impairment of the long-term cash-rate transmission since the crisis, while bank mortgage price-setting behaviour has become closer to their foreign funding cost developments. The fourth essay is motivated by the findings of the cash-rate transmission breakdown in these two previous essays. The researcher conducts an empirical examination of the effects of macroeconomic conditions and credit risk premium on the mortgage rate-setting behaviour of Australian banks prior to, during and after the GFC to provide deep insight into the third literature strand of this transmission mechanism. This leading work finds significant evidence of the influential roles of the unemployment, changeability in the Australian dollar value, volatility in the bank foreign-funding markets, and business and consumer confidence in affecting the asymmetric pass-through of the mortgage rates since the crisis. The findings of this paper therefore shed light on the implementation of forthcoming monetary policy reforms. These outcomes are beneficial for depository institutions and prudential supervisors as well. It is fundamental for commercial banks to deeply understand these determinants when they design and pursue their pricing strategies because these determinants of the mortgage rates could affect the asymmetric adjustments of other bank rates differently (Perera & Wickramanayake, 2016). The findings are useful for the APRA and ACCC in maintaining and enhancing market competition, banking soundness and financial stability. The findings confirm a strong integration between financial instability and monetary transmission that would benefit prudential legislators in designing and configuring more appropriate schemes of maintaining financial stability. This thesis also extends the prior literature by employing a bank-based interest-rate dataset at high weekly-frequency in a single-country study. The use of micro-data in the study of asymmetry and heterogeneity in interest-rate pass-through is actually important for making the findings relatively advantageous to those of the macro-data analyses. This research therefore provides cooperative insights to complement monetary policy that in aggregated-data work are possible to miss or mask (ECB, 2017a). This thesis based on the findings of these interrelated studies concludes that: (i) international funding cost is a statistically driving factor of bank mortgage rates in Australia for individuals or bank-specific groups given the presence of cross-sectional dependence, (ii) the nature of the transmission from international funding cost to mortgage rates is upwardly asymmetric in the long term, (iii) wide discrepancies in mortgage price-setting occur in the short run, (iv) since the crisis, banks have partially repriced their mortgage rates only in the monetary easing episodes; however, their mortgage rates have, for the most part, fully responded to an international funding cost shift, decreasing at a greater rate than they increase, (v) these long-term transmission mechanisms, both symmetric and asymmetric, are significantly heterogeneous, (vi) when controlling for macroeconomic conditions, bank mortgage rates have responded asymmetrically and sizably to instant shocks in the cash rate, but they insignificantly respond to cash rate shocks in the long run. The mortgage rates however have considerably repriced towards the deteriorating labour market, the appreciation and depreciation in the Australian dollar value, the volatility of banks’ foreign-funding markets, as well as changes in business and consumer confidence. This research provides empirical support to the transmission of the cash rate, considering (i) the nexus of international funding cost and mortgage rates and (ii) the nexus of macroeconomic environment and mortgage rates; therefore, proposes important policy implications. Thesis (PhD Doctorate) Doctor of Philosophy (PhD) Dept Account,Finance & Econ Griffith Business School Full Text

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Gallego, Gisselle. "Access to High Cost Medicines in Australian Hospitals." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1008.

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In the public hospital sector in Australia there is no dedicated scheme to offset costs associated with high cost medications (HCMs) to the institution or the public. (1) Concerns exist as to the equity of access and appropriate mechanisms to manage access to HCMs in public hospitals. (2) There are gaps in the literature as to how decisions are made, and in particular, decision-making processes by which ethical, clinical and economic considerations maybe taken into account. To date, limited work has been conducted regarding the use and funding of HCMs in public hospitals. There are no published data on perceptions, concerns and attitudes, among health care decision-makers or among the community-at-large about access to HCMs in public hospitals. The research reported in this thesis describes the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. The investigation triangulated quantitative and qualitative methods used to collect and analyse data. Four studies were conducted to describe the decision-making process and explore the perceptions, concerns and attitudes of health care decision-makers and the perceptions of members of the general public regarding access to HCMs in public hospitals. The first study, reported in Chapter Three, was a review of individual patient use (IPU) requests for non-formulary HCMs. This study showed that these requests had a significant impact on the capped expenditure of a public hospital. Subsequent to this review, a new policy and procedure for managing requests for HCMs for IPU was established. A high-cost drugs subcommittee (HCD-SC) operating under the auspices of the Drug and Therapeutics Committee (DTC) was created. The second study, reported in Chapter Four, described the operations of the newly formed HCD-SC. This study also evaluated the decision-making process using the ethical framework “accountability for reasonableness”. (3) Different factors were involved in decisions about access to HCMs and decisions were not solely based on effectiveness and cost. HCD-SC members considered it was important to have consistency in the way decisions were being made. The evaluation of this process allowed identification of good practices and gaps which were considered as opportunities for improvement. The third study, reported in Chapter Five, found that health care decision-makers in an Area Health Service echoed the concerns and agreed about the problems associated with access to HCMs expressed by the HCD-SC members. These studies concluded that the majority of decision-makers wanted an explicit, systematic process to allocate resources to HCMs. These studies also identified tensions between funding systems and hospital decision-making. According to participants there were no mechanisms in place to systematically capture, analyse and share the lessons learned between the macro level (ie. Federal, Pharmaceutical Benefits Scheme - PBS) and the meso level (ie. Institution, public hospital) regarding funding for HCMs. Furthermore, decision-makers considered there are strong incentives for cost-shifting between the Commonwealth and the States. Health care decision-makers also acknowledged the importance of public participation in decision-making regarding allocation of resources to HCMs in public hospitals. However the results of these studies showed that those decisions were not generally made in consultation with the community. Decision-makers perceived that the general public does not have good general knowledge about access to HCMs in public hospitals. A survey of members of the general public, reported in Chapter Six, was then conducted. The survey aimed to gather information about the knowledge and views of members of the general public about access to HCMs in public hospitals. Results of this fourth study showed that respondents had good general knowledge but were poorly informed about the specifics of funding of hospitals and HCMs in private and public hospitals. The results also offered support for the development of a process to involve community members in discussion on policy on the provision of treatment and services within health care institutions and specifically, to seek the views of members of the public on the provision of HCMs and expensive services within public hospitals. In summary, the research reported in this thesis has addressed the gaps in the literature as to how decisions are made, and in particular, the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. In a move towards more explicitness in decision-making regarding the allocation of scarce health care resources, the findings from these studies provide an evidence base for developing strategies to improve decision-making processes regarding access to HCMs the public sector.

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Gallego, Gisselle. "Access to High Cost Medicines in Australian Hospitals." University of Sydney, 2006. http://hdl.handle.net/2123/1008.

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Doctor of Philosophy(PhD) In the public hospital sector in Australia there is no dedicated scheme to offset costs associated with high cost medications (HCMs) to the institution or the public. (1) Concerns exist as to the equity of access and appropriate mechanisms to manage access to HCMs in public hospitals. (2) There are gaps in the literature as to how decisions are made, and in particular, decision-making processes by which ethical, clinical and economic considerations maybe taken into account. To date, limited work has been conducted regarding the use and funding of HCMs in public hospitals. There are no published data on perceptions, concerns and attitudes, among health care decision-makers or among the community-at-large about access to HCMs in public hospitals. The research reported in this thesis describes the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. The investigation triangulated quantitative and qualitative methods used to collect and analyse data. Four studies were conducted to describe the decision-making process and explore the perceptions, concerns and attitudes of health care decision-makers and the perceptions of members of the general public regarding access to HCMs in public hospitals. The first study, reported in Chapter Three, was a review of individual patient use (IPU) requests for non-formulary HCMs. This study showed that these requests had a significant impact on the capped expenditure of a public hospital. Subsequent to this review, a new policy and procedure for managing requests for HCMs for IPU was established. A high-cost drugs subcommittee (HCD-SC) operating under the auspices of the Drug and Therapeutics Committee (DTC) was created. The second study, reported in Chapter Four, described the operations of the newly formed HCD-SC. This study also evaluated the decision-making process using the ethical framework “accountability for reasonableness”. (3) Different factors were involved in decisions about access to HCMs and decisions were not solely based on effectiveness and cost. HCD-SC members considered it was important to have consistency in the way decisions were being made. The evaluation of this process allowed identification of good practices and gaps which were considered as opportunities for improvement. The third study, reported in Chapter Five, found that health care decision-makers in an Area Health Service echoed the concerns and agreed about the problems associated with access to HCMs expressed by the HCD-SC members. These studies concluded that the majority of decision-makers wanted an explicit, systematic process to allocate resources to HCMs. These studies also identified tensions between funding systems and hospital decision-making. According to participants there were no mechanisms in place to systematically capture, analyse and share the lessons learned between the macro level (ie. Federal, Pharmaceutical Benefits Scheme - PBS) and the meso level (ie. Institution, public hospital) regarding funding for HCMs. Furthermore, decision-makers considered there are strong incentives for cost-shifting between the Commonwealth and the States. Health care decision-makers also acknowledged the importance of public participation in decision-making regarding allocation of resources to HCMs in public hospitals. However the results of these studies showed that those decisions were not generally made in consultation with the community. Decision-makers perceived that the general public does not have good general knowledge about access to HCMs in public hospitals. A survey of members of the general public, reported in Chapter Six, was then conducted. The survey aimed to gather information about the knowledge and views of members of the general public about access to HCMs in public hospitals. Results of this fourth study showed that respondents had good general knowledge but were poorly informed about the specifics of funding of hospitals and HCMs in private and public hospitals. The results also offered support for the development of a process to involve community members in discussion on policy on the provision of treatment and services within health care institutions and specifically, to seek the views of members of the public on the provision of HCMs and expensive services within public hospitals. In summary, the research reported in this thesis has addressed the gaps in the literature as to how decisions are made, and in particular, the decision-making process and criteria used by health care decision-makers to allocate resources to HCMs in public hospitals. In a move towards more explicitness in decision-making regarding the allocation of scarce health care resources, the findings from these studies provide an evidence base for developing strategies to improve decision-making processes regarding access to HCMs the public sector.

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Wong, Leon Keat Leong Accounting Australian School of Business UNSW. "The pricing or mispricing of earnings quality in Australia." Awarded By:University of New South Wales. Accounting, 2009. http://handle.unsw.edu.au/1959.4/43569.

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This thesis investigates the pricing (or mispricing) of earnings quality in Australia. It investigates whether information in earnings quality is used by investors in valuing firms, evidenced by an association between earnings quality and the cost of equity. In the alternate form, the question may be posed as whether earnings quality is mispriced by investors such that there may be opportunities to earn abnormal profits from trading strategies based on earnings quality. Ten earnings quality constructs are studied: total accruals, unexpected accruals, cash-to-profit, accrual quality, persistence, predictability, smoothness, relevance, conservatism and timeliness. In the cost of equity pricing tests, when earnings quality is proxied using one construct (accrual quality), it is found to be associated with the cost of equity. However, when the additional nine constructs are included in the regression models, accrual quality loses statistical significance. Various other constructs are found to be associated with the cost of equity depending on the choice of the cost of equity proxy. In the trading strategy tests, there is some initial evidence of trading strategy opportunities for firms with high quality earnings. However, after deleting outlier observations with annual buy-and-hold returns of greater than 200% the potential for earning abnormal returns from a hedge portfolio strategy disappears. The existence of Australian evidence on the accruals anomaly provides a convenient basis to validate the results of the earnings quality trading strategy tests. Although no clear evidence on the accruals anomaly is found, results are obtained which appear to be consistent with prior Australian evidence of the accruals anomaly, depending on the research design choices made. Overall, the evidence on whether earnings quality is priced or mispriced in Australia is best viewed as inconclusive. It highlights the importance of conducting thorough robustness tests and suggests a need for caution by researchers in making inferences from a narrow set of earnings quality constructs and research design specifications.

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Pollock, Kirrily Suzanne. "The economic cost of farm-related fatalities and the perceptions and management of health and safety on Australiam farms." Thesis, The University of Sydney, 2010. http://hdl.handle.net/2123/7146.

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Farm-related fatalities are a significant problem in Australian agriculture. Over the period 2001–04, there were 404 fatalities that occurred as a direct consequence of visiting, residing or working on a farm. This research is comprised of two separate, but related components; the economic cost of farm-related fatalities and the farm health and safety study; a qualitative study into farmer perceptions and behaviour relating to farm safety. This study employed a human capital approach to establish the economic costs of farmrelated fatalities to the Australian economy. Fatalities were selected for analysis as they are the most reliable, accurate and comprehensive form of farm injury data available. A study was conducted on 335 farm enterprises to examine farmer perceptions and estimates of performance relating to the culture of safety and their systems and procedures to manage health and safety and major hazards on their farms. Finally, the changes farmers were making to health and safety on their farms, the motivating drivers for those changes, and what they perceived to be the risks and hazards on their farms were also assessed. Modelling of direct and indirect costs associated with farm-related fatalities estimated that the 404 traumatic deaths over the period 2001–04 cost the Australian economy $650.6 million, in 2008 dollars. This equates to 2.7 per cent of the 2008 farm gross domestic product (GDP) due to potentially preventable farm accidents and injuries. The top five agents causing death (tractors, ATVs, drownings, utilities and 2 wheel motorcycles) accounted for exactly half of the fatalities, and 46.7 per cent ($303.5 million) of the economic cost. Significant differences in gender, age and industry were revealed in attitudes and perceptions of farm safety and the management of health and safety and major hazards. Farm enterprises also provided a considerable level of detail on the changes and improvement they had made to farm safety, the reasons and motivations behind those changes, as well as details on what they perceived as the key risks and hazards on their farms. The outcomes of this research have questioned some of the preconceived ideas relating to farmers’ perceptions, attitudes and practices in relation to farm safety and have also identified potential new approaches and target populations for increasing adoption and implementation of farm safety recommendations. The challenge is for farm safety researchers, Farmsafe Australia, work safety authorities, industry and farmer groups and health practitioners to encourage further investment and resources into farm health and safety research, which will enable them to capitalise on these findings and re-evaluate farm safety strategies and initiatives to reduce the level of risk on Australian farms and therefore, the incidence of fatal and non-fatal injury and the cost of to the Australian economy.

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Choquenot, David, and n/a. "Feral donkeys in northern Australia : population dynamics and the cost of control." University of Canberra. Applied Science, 1988. http://erl.canberra.edu.au./public/adt-AUC20061113.145306.

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(1) Rate of increase was measured for feral donkey populations in parts of northern Australia as the average exponential rate of increase, r, in a population subjected to substantial reduction. (2) The annual rate of increase was estimated to be r = 0.21. This estimate was compared with the exponential rate of increase in another recovering donkey population and found to be in close agreement. (3) Ultimate and proximate factors regulating the abundance of feral donkey populations were examined by monitoring and sampling two populations; one at or close to equilibrium density, the other below equilibrium density and recovering from reduction. (4) The size of the population at equilibrium density remained stable over the 12 months of monitoring while the size of the recovering population increased by 20 percent (r = 0.18/yr). (5) Growth and body condition were significantly depressed in the population at equilibrium density suggesting that donkey populations are limited by the food resources available to them. (6) Breeding occured over a discrete season, with births occurring between September and February. 11 (7) Fecundity was high, with more than 75 percent of mature females breeding in each year, and was independent of population density. (8) Adult and juvenile mortality were density dependent, with mortality over the first six months of life the most important demographic factor influencing rate of increase in donkey populations, and hence population abundance. (9) Implications of the estimated rate of population increase for the cost of long-term control of feral donkey populations were examined by constructing numerical models predicting the relative cost of ongoing control. (10) These models were constructed using functions to describe density dependent variation in population productivity and the cost per donkey removed. (11) The cost of removing donkeys at various population densities was estimated using predator-prey theory. The cost, measured in hours of helicopter time per removal, was found theoretically and empirically to take the form of an inverted functional response curve, with cost saturated at high donkey densities. (12) The utility of models predicting the cost of continuing pest control is illustrated by comparing the relative costs of two potential strategies for feral donkey control.

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Cheng, Qinglu. "Cost-effectiveness of guideline-based care for venous leg ulcers in Australia." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/134462/1/Qinglu_Cheng_Thesis.pdf.

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This thesis investigated the cost-effectiveness of guideline-based care to manage patients with venous leg ulcers in the Australian setting. It showed that both the healthcare system and patients affected by venous leg ulcers would benefit from implementing and funding guideline-based care. This research provided important evidence to policy makers on the most efficient use of scarce health resources to manage venous leg ulcers. It is expected that these results will support changes to the reimbursement structure to increase access to guideline-based care for venous leg ulcers in Australia.

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Carter, Hannah Elizabeth. "The productivity costs of premature mortality in Australia." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/17129.

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Increasingly scarce resources within the health care setting have seen economic evaluations become critical tools in informing government funding decisions. While strong methodological principles exist for the measurement and valuation of health care costs, there has been less focus on estimating the productivity related costs of disease. This is despite evidence highlighting the strong impact that these costs have on economic outcomes. Where productivity costs have been estimated previously, limitations in both scope and methodology exist. The purpose of this thesis was to quantify the productivity related costs of all cause premature mortality in Australia using a consistent and rigorous methodology. Estimates of the future working years and personal income forgone due to premature mortality across a number of age, sex, disease and socioeconomic categories were produced. These costs were then applied to determine their impact on the cost effectiveness outcome of a health policy intervention. The foundation of this work was the development of a new microsimulation model, LifeLossMOD. LifeLossMOD was developed to assign a counterfactual life trajectory to each individual that died prematurely in 2003. These trajectories were modelled to 2030 and assumed to reflect a scenario that would have eventuated if an individual’s premature death in 2003 was prevented. The model accounted for individual variability in age, sex and socio-economic status at the time of death in projecting counterfactual events. Premature deaths occurring in 2003 were estimated to account for over 284,000 working years forgone and $13.8 billion in lifetime income forgone, when modelled to 2030. Male deaths accounted for 81% of the total income loss, which was concentrated in individuals aged 35-64 at the time of death. Premature deaths from cancer and cardiovascular disease together accounted for over half of the total impact. Injuries and mental disorders were associated with the highest average loss in income per death. When productivity costs were incorporated into a cost-effectiveness analysis of a health policy intervention and modelled over 25 years, there was a significant improvement in the estimated net financial benefit of the intervention. The results presented here highlight the magnitude of the productivity costs associated with premature mortality, and the distribution of these costs across a number of population and disease subgroups. This may provide valuable information to decision makers allocating resources between competing health priorities. At the broader societal level, these results provide a compelling case for greater investment in population health as a means of contributing to economic growth.

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Walleser, Silke. "The cost-effectiveness of screening for chlamydia trachomatis." Thesis, The University of Sydney, 2005. https://hdl.handle.net/2123/27921.

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Objective: The aim of this study is to examine the cost—effectiveness of a hypothetical screening programme for chlamydia trachomatis compared to no screening, based on annual opportunistic testing of all women 25 years of age or younger consulting a GP. Methods: A decision-analytic modelling approach is used to determine the incremental cost-effectiveness ratio (lCER) of screening compared to no screening over 25 years. The analysis measures Australian health care costs and benefits are assessed in terms of quality adjusted life years (QALYs). Results: The analysis resulted in a cost per QALY of $2,968 for screening. Univariate sensitivity analyses on all model variables show a wide range for the cost-effectiveness, from dominance (where screening is effective and saves money overall) to an ICER of $20,359 per QALY. Conclusions: This study is the first to present the cost-effectiveness of screening for Chlamydia in Australia, which compares favourably to other interventions currently funded. However, the model results reflect uncertainties around the effectiveness of screening and natural history of chlamydia and consequently, any conclusions on whether screening for chlamydia is a worthwhile intervention cannot be drawn at this stage. Implications: Further primary data collection is needed on the natural history of Chlamydia and on the effectiveness of screening, to be established by a randomised controlled trial.

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Holden, Elizabeth (Libby). "Health and Productivity: Psychological Distress is a Major Factor in Productivity Loss for a Range of Health Conditions Affecting Australian Workers." Thesis, Griffith University, 2011. http://hdl.handle.net/10072/365430.

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The global economic uncertainties, an ageing Australian workforce, increasing health care costs, and increasing rates of chronic disease all combine to create an urgency to better understand the relationship between health and productivity. Little is known about the impacts of health status on productivity in Australia. Even less is known about the impacts of co-morbid psychological distress on productivity losses for individual health conditions and clusters of non-randomly occurring health conditions, both in Australia and internationally. This study addresses these gaps in knowledge by exploring associations between health and productivity, adjusting for known demographic and working conditions factors, in a large sample of working Australians. Thesis (PhD Doctorate) Doctor of Philosophy (PhD) School of Medicine Griffith Health Full Text

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Jadambaa, Amarzaya. "Bullying in Australia: Prevalence, health outcomes, cost outcomes, and economic evaluation of bullying prevention." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/206147/1/Amarzaya_Jadambaa_Thesis.pdf.

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Bullying among children and adolescents is a major public health problem. The negative consequences of bullying are not limited to health problems, nor to experiences in childhood and adolescence, and can persist into adulthood. This research found that one in seven Australian children experienced bullying victimisation; bullying victimisation contributes a significant proportion of the burden of disease; a substantial annual cost to Australian society results from bullying; and further investment in bullying prevention is an efficient use of scarce healthcare resources. This thesis makes an important contribution to the field of bullying and the vital role of bullying intervention programmes.

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Antioch, Kathryn M. "Improving cost effectiveness, distributional justice and allocative efficiency in hospital funding and service delivery in Australia and internationally." Monash University, Dept. of Epidemiology and Preventive Medicine, 2004. http://arrow.monash.edu.au/hdl/1959.1/5296.

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Felmingham, Casey. "Residential construction and demolition waste in Perth, Western Australia: Cost benefit analysis of best practices." Thesis, Felmingham, Casey (2015) Residential construction and demolition waste in Perth, Western Australia: Cost benefit analysis of best practices. Honours thesis, Murdoch University, 2015. https://researchrepository.murdoch.edu.au/id/eprint/29858/.

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In Perth, Western Australia the construction and demolition (C&D) industry contributes 50% of all waste generated. The recovery rate in WA for C&D waste is currently only 38% which is very poor compared to European countries as they are exceeding 80%. This project aimed to assess C&D waste generation in Perth to determine how waste recovery could be improved. Waste from three construction sites and two demolition sites was collected and collated to determine waste generation and composition and to identify areas for improvement. Also landfill sites, skip bin operators, and resource recovery facilities were surveyed on the cost of waste disposal to determine the most cost effective option. This study showed that the residential construction industry would generate approximately 881,000 tonnes of waste during 2015 using the predicted housing figures from HIA and UDIA. Also it shows that there is great variation with the generation of demolition waste due to the different site characteristics, which was shown by the two demolition sites of different sizes both generating nearly 300 tonnes of waste. Resource recovery was found to be the most cost effective option out of landfill, skip bins and resource recovery. The waste streams produced highlight that the main area of concern is rubble materials, concrete, sand, dirt, and broken bricks and tiles. Therefore better waste management of these wastes and possible recycling into waste derived materials is recommended. The findings from this study indicate that large scale changes are needed within the industry to increase resource recovery rates in WA, such as legislation change, more education, and the possible introduction of subsidy programs.

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Bhuyan, Muhammad Hasnat Morshed. "Identifying the cost optimised electricity system transformation pathway to 100% renewable electricity for Western Australia." Thesis, Bhuyan, Muhammad Hasnat Morshed (2019) Identifying the cost optimised electricity system transformation pathway to 100% renewable electricity for Western Australia. Masters by Coursework thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/51410/.

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In the context of reaching the state, federal, and global climate target, it is crucial to decarbonise the electricity sector of Western Australia. The purpose of the study is to develop exploratory scenarios to explore the cost optimised electricity generation mix for a transition to decarbonized electricity system of Western Australia with 100% renewable energy integration. The research also studies the features, advantage, and disadvantages of different energy modelling tools for the study. OSeMOSYS energy model with MoManI interface, a flexible, easy to learn and open-source energy model, is used to develop the electricity model for Western Australia. The dissertation shows a detailed procedure to develop the electricity system model of Western Australia. The model developed in this study constructs two scenarios, which are Business as Usual (BAU) and 100% RE. These two scenarios will help the energy planners to understand how cost-effective the electricity system decarbonisation will be. The result generated from the model is analysed through comparative analysis in the technoeconomic and environmental perspective. The focus of the analysis of the result is future electricity generation mix, installed capacity and total cost of the electricity system in 2040, especially under the 100% RE scenario. The result demonstrates that wind technology will be central to the lowest cost electricity system transformation pathway. After wind, the solar technologies, especially the rooftop solar PV technology, will play an important role in the decarbonisation of the electricity system. The model result also shows that there won’t be any production from coal technologies after 2038 in the BAU scenario and after 2018 in 100% RE scenario. According to the model result, storage capacities of 2.32 GW in 2019 and 1.16 GW in 2028 will help the transition of the electricity system to 100% renewable energy.

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Fan, Lijun. "Effectiveness and cost analysis of a hospital in the nursing home program in Queensland, Australia." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101165/1/Lijun_Fan_Thesis.pdf.

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This thesis evaluated the effectiveness and cost-saving potential of a health service delivery model in Queensland Australia, the Hospital in the Nursing Home program. The research adopted a before-after controlled study design, comparing the outcomes between an intervention hospital and a control hospital during the pre- and post-intervention periods. Findings from the research supported that the intervention was preferred over the current practice, which reduced the attendances to emergency departments (EDs) and inpatient hospitals from patients in residential aged care facilities, shortened their length of ED stay, and saved the overall costs.

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Kelly, Gregory. "Development of a Sustainability Index for Local Roads in Southeast Queensland, Australia." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/415807.

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A high-quality transportation system is a necessity in a modern economy. The road network is a common, and perhaps the most significant, component of a transportation system and an essential part of all modern economies. Road systems are developed to enable the safe movement of passenger vehicles and freight at reasonable speed. Meeting this objective is essential for an efficient economy. A functional road network is not only an important part of the transportation system but also an expensive investment. Good policy requires that infrastructure investment should provide a return on the investment. This investment warrants judicious management to ensure the infrastructure is maintained in a cost-effective manner. This study proposed and developed the concept of a new Sustainability Index for Roads (SIR) using the three pillars of sustainability namely, economic, social and environmental. The reasons for implementing an index solely for roads are: to minimise the cost of road rehabilitation (has a high ongoing cost) (economic); involve the community (has little knowledge to make informed decisions) (social); and, to reduce the environmental impact of annual road rehabilitation programs across Australia (environmental). This SIR provides an alternative approach to determine the optimal future target Pavement Condition Index (PCI) for a local government authority (LGA). The newly developed SIR includes a community consultation option to make a more informed decision when choosing a future target PCI. This decision involves balancing the community’s expectations (social pillar) regarding the annual road rehabilitation budget (economic pillar) with particular reference to the return on investment (ROI) for their annual road budget and both the financial and environmental costs (environmental pillar) of the different pavement design options for the rehabilitation of roads. This study also produced a new tool for estimating the Return on Investment for the local government that provided their data for this study, for the rehabilitation of their road network. The study also provided a transparent low-cost method, to engage community representatives to consider what the community was willing to fund, using the ROI as above. The study also investigated the two most common road rehabilitation design types that incur different environmental impacts, from the local government works program. The study demonstrated that there is a difference in the environmental harm caused by the different road rehabilitation designs and that this difference can be shown in terms of costs to be incurred. The SIR developed in this study equips the community with the knowledge to make informed decisions about the pavement condition and environmental harm they are willing to fund, paving the way for better road management by the relevant authority. The SIR is the community’s chosen Pavement Condition Index (PCI) after consideration the new ROI curve (Future PCI Versus annual Budgets) relative to the achieved PCI is an alternative road network specific measure of asset sustainability to the current Queensland ASR. Thesis (PhD Doctorate) Doctor of Philosophy (PhD) School of Eng & Built Env Science, Environment, Engineering and Technology Full Text

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Crino, Michelle Anne. "Food environment interventions to address obesity and related non-communicable diseases in Australia." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/18511.

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In less than 30 years the prevalence of overweight and obesity has nearly doubled worldwide. Unhealthy food environments encourage unhealthy diets and energy overconsumption, which is a prevailing driver of unhealthy weight gain, and are seen as an important contributor to the obesity epidemic. This thesis aimed to identify potential public health actions to improve the nutritional composition of the Australian packaged food environment in an effort to address obesity and related non-communicable diseases (NCDs). The research comprises of three components: (i) a review of the existing evidence on the contributions of the food supply to obesity and related-NCDs, including a cross-sectional analysis of the Australian packaged food supply; (ii) a cross-sectional analysis on currently implemented food environment interventions to address obesity and NCDs; (iii) a modelled assessment on the potential health impacts and cost-benefits of implementing selected food environment interventions in Australia. Analyses of the Australian packaged food environment found that the proportion of foods defined as discretionary was 53.0% and proportion of foods defined as highly processed was 60.5%. Population-wide food supply interventions addressing sodium and trans fat reduction have proven highly effective and comparable efforts are now required to target obesity. The evidence suggests that strategies focusing upon reducing the energy density and portion size of foods will be more effective than those targeting specific macronutrients. Specifically, cost-effectiveness analyses of a portion size cap and energy reduction of sugar-sweetened beverages were ‘dominant’, and likely to offer excellent ‘value for money’ as obesity prevention measures in Australia. Governments around the world have recognised the need to implement public health policies and initiatives to curb the epidemic at hand. The nutritional composition of the food environment is one such area where action is needed. Globally there is a strong need for a governance framework which monitors and reports on the implementation and impact of such initiatives to determine what is working, and to hold key stakeholders such as the food industry accountable for their contribution or lack thereof.

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Senanayake, Sameera Jayan. "Prediction of graft survival and cost effectiveness of kidney transplantation according to donor quality levels in Australia." Thesis, Queensland University of Technology, 2021. https://eprints.qut.edu.au/211469/1/Sameera%20Jayan_Senanayake_Thesis.pdf.

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This thesis sought to better understand how quality of donor kidneys and allocating kidneys based on the presumed longevity can increase value for money in donor kidney use. It showed that remaining on dialysis in the hope of receiving a superior-quality kidney is not a cost-effective strategy for any age group. If the Australian kidney allocation system can enable low-quality kidneys for older recipients, this will reduce discard rates, and promote the best value for all donated kidneys. The new index developed to predict graft failure demonstrated adequate potential to make pre-transplantation predictions about the longevity of a donated kidney.

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Zheng, Henry Public Health &amp Community Medicine Faculty of Medicine UNSW. "Walking interventions to prevent coronary heart disease in Australia - quantifying effect size, dose-response and cost reductions." Awarded by:University of New South Wales. Public Health & Community Medicine, 2009. http://handle.unsw.edu.au/1959.4/44750.

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Coronary heart disease (CHD) is the single largest cause of death in Australia. Lack of physical activity is a primary risk factor for CHD. The thesis aimed to quantify the efficacy of walking in reducing CHD risk. Meta-analyses were performed for the quantification with the application of random-effect meta-regression models. The thesis also aimed to quantify reductions in CHD-related direct healthcare costs, productivity loss and disease burden resulting from walking interventions in Australia, using the population attributable fraction model, the work and leisure models, and the consumer surplus model. Economic evaluations were also conducted to estimate CHD-related productivity loss using the human capital and the friction methods. The results indicated that 30 minutes of normal walking a day for 5-7 days a week compared to physical inactivity reduced CHD risk by 24%. There existed a dose-response relationship between walking and CHD risk reduction. An increment of approximately 30 minutes of normal walking a day for 5 days a week reduced CHD risk by 19%. The annual productivity loss resulting from CHD was estimated at AU$1.79 billion based on the human capital method and AU$25.05 million under the friction method. 30 minutes of normal walking a day for 5-7 days a week by the country???s ???sufficient??? walking population was shown to generate an estimated $126.73 million in net direct healthcare savings annually. The net economic savings could increase to AU$419.9 million if the whole inactive population engaged in ???sufficient??? walking. The study also found that 30 minutes of normal walking a day for 5-7 days a week reduced the burden of CHD by an estimated 25,065 DALYs and the productivity loss by AU$162.65 million annually under the leisure model. If the whole inactive population engaged in such walking, the total disease burden and productivity loss could be reduced by approximately one third. The findings present epidemiological and economic evidence in support of the national physical activity guidelines, which encourage the general public to engage in moderate physical activity including walking for a minimum of 30 minutes a day for 5-7 days a week.

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Fox, James P. "Downtime reduction analysis of the Australia Post flat mail optical character reader." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/28479/1/James_Fox_Thesis.pdf.

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Machine downtime, whether planned or unplanned, is intuitively costly to manufacturing organisations, but is often very difficult to quantify. The available literature showed that costing processes are rarely undertaken within manufacturing organisations. Where cost analyses have been undertaken, they generally have only valued a small proportion of the affected costs, leading to an overly conservative estimate. This thesis aimed to develop a cost of downtime model, with particular emphasis on the application of the model to Australia Post’s Flat Mail Optical Character Reader (FMOCR). The costing analysis determined a cost of downtime of $5,700,000 per annum, or an average cost of $138 per operational hour. The second section of this work focused on the use of the cost of downtime to objectively determine areas of opportunity for cost reduction on the FMOCR. This was the first time within Post that maintenance costs were considered along side of downtime for determining machine performance. Because of this, the results of the analysis revealed areas which have historically not been targeted for cost reduction. Further exploratory work was undertaken on the Flats Lift Module (FLM) and Auto Induction Station (AIS) Deceleration Belts through the comparison of the results against two additional FMOCR analysis programs. This research has demonstrated the development of a methodical and quantifiable cost of downtime for the FMOCR. This has been the first time that Post has endeavoured to examine the cost of downtime. It is also one of the very few methodologies for valuing downtime costs that has been proposed in literature. The work undertaken has also demonstrated how the cost of downtime can be incorporated into machine performance analysis with specific application to identifying high costs modules. The outcome of this report has both been the methodology for costing downtime, as well as a list of areas for cost reduction. In doing so, this thesis has outlined the two key deliverables presented at the outset of the research.

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Fox, James P. "Downtime reduction analysis of the Australia Post flat mail optical character reader." Queensland University of Technology, 2007. http://eprints.qut.edu.au/28479/.

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Humphreys, Ben. "When will it be cost effective for consumers to disconnect from central grids for distributed generation in Australia?" Thesis, Humphreys, Ben (2013) When will it be cost effective for consumers to disconnect from central grids for distributed generation in Australia? Masters by Coursework thesis, Murdoch University, 2013. https://researchrepository.murdoch.edu.au/id/eprint/21901/.

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Rapid and significant reductions in the costs of solar photovoltaic technology and considerable rises in grid electricity prices have prompted the question: When will it be cost effective for consumers to disconnect from central grids for distributed generation in Australia? This report seeks to give insight into this question by comparing standalone solar PV and storage system levelised cost forecasts to centralised grid electricity price forecasts. The report also, based on literature research, discusses the impacts and issues associated with increased distributed generation in general on the current electricity market and incumbent utilities. The future costs of Photovoltaic (PV) with storage systems were forecast using single factor experience curves. The Homer energy modelling software was then used to optimise the systems and calculate the levelised cost of electricity (LCOE) for each scenario. Future electricity prices were estimated based on data from AEMOc (2012). The analysis treats the two as independent variables; therefore, it does not account for interrelationships that exist in reality. Consequently, the results are best viewed as a range of possible outcomes that, given the breadth of the range covered, are likely to include the actual outcome. The analysis focuses on small consumers such as residential, and small to medium businesses, because it was thought that this consumer group was most likely to have premises suitable for a PV system that met most of their electricity consumption. This consumer group consumes a significant amount of Australia’s total electricity: estimated at between 30 and 50 percent based on data from IEA (2012) and AEMO (2010). The analysis considered multiple scenarios: grid electricity against standalone PV with storage, and grid electricity against 50 percent and 75 percent PV penetration levels. All scenarios considered low electricity price states with an average price of $0.30/kWh and high price states with an average price of $0.40/kWh. The analysis revealed that solar PV with storage could be competitive with the grid in supplying 50 to 75 percent of a small consumer’s electricity demand within the short term (<5 years), and on a standalone basis in the medium term (<10 years). It is expected that this will lead to reduced demand for grid electricity, falling revenues for incumbent utilities and, therefore, a negative impact on their profitability. As a result of falling demand, network service providers will likely need to raise per unit charges in order to recover the revenue required to meet their regulated return on asset base. This will drive electricity prices higher, thus increasing the competitiveness of distributed generation (DG), and other technologies such as energy efficiency and energy management for that matter. In turn, consumers’ demand for grid electricity will reduce, and the uptake of DG will increase, which will reduce the networks’ ability to recover revenue further. Because of falling demand, generators face lower wholesale prices, compressed margins, and the risk of stranded assets. This scenario of falling demand and rising prices is commonly referred in the literature as the ‘death spiral’ (Kind, 2013; Nelson & Simshauser, 2012; Newbury, 2013; Severance, 2011). A review of literature identified DG as being potentially disruptive to the existing electricity market. Based on case studies of disruptive technologies in other industries, DG can be expected to cause significant market changes and create significant risks for incumbents, especially those in monopoly situations. Interview based research in Australia and Germany suggests that most incumbent electricity utilities are not well prepared to handle competition from DG, are slow in realising the threat to their business model, and are failing to see the market opportunities. Government intervention is likely given the significant amount of recent government and industry reports on the topic; this will influence the uptake of DG technologies, and subsequently the time it will take for them to become competitive at high penetration levels or on a standalone basis. Some recommended changes such as removal of price regulation, time of use pricing, demand pricing, and integrated network planning that includes DG would tend to increase the uptake of DG technologies, subsequently driving down DG costs faster. However, other recommended changes such as high fixed charges, additional fixed charges specifically for PV owners, and penetration limitations by network service providers would act to slow the uptake and cost reductions of DG. While intervention is likely, what intervention is difficult to say with confidence at this point in time given that the recent change of Federal Government has put in doubt the relevance of existing government literature on the topic. In addition, the crowded energy policy space often changes policy significantly between white/inquiry paper and enactment.

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Luckner, Helene [Verfasser], and Christian [Akademischer Betreuer] Gericke. "Effective and cost-effective strategies to prevent overweight and obesity in South Australia / Helene Luckner. Betreuer: Christian Gericke." Berlin : Universitätsbibliothek der Technischen Universität Berlin, 2012. http://d-nb.info/102919257X/34.

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Salam, Neil. "A Techno-economic and cost benefit analysis of the Ultrabattery for residential applications with solar photovoltaics in Western Australia." Thesis, Salam, Neil (2017) A Techno-economic and cost benefit analysis of the Ultrabattery for residential applications with solar photovoltaics in Western Australia. Masters by Coursework thesis, Murdoch University, 2017. https://researchrepository.murdoch.edu.au/id/eprint/40396/.

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In this report I will summarize the key findings from modeling and literature review on the Ultrabatteries technology from a Techno-economic analysis perspective. Key findings: - The Ultrabattery has fewer technical obstacles than Lithium as presented. - The Ultrabattery may have a payback of as low as 5 years compared with Lithium’s 7 years as modeled under assumptions. - There is scope for this technology and potential for residential storage growth in the WA market. - Developments in the market in economics of electricity and the photovoltaic (PV) and energy storage system improvements in cost will help the growth of the market.

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McCreanor, Victoria Helen Rarity. "Identifying high-value care for coronary artery disease in Australia." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/130756/1/Victoria_McCreanor_Thesis.pdf.

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This project compared the cost-effectiveness of drug therapy, stents and surgery for Australian patients with heart disease, modelling their long-term treatment trajectories, costs and health outcomes. It showed that drug therapy is high-value and that the health system, and Australians, would benefit from targeted rather than routine use of stents. This research provides policy recommendations to reduce the use of low-value care and increase the use of high-value care for Australian patients with heart disease.

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Carter, Robert C. (Robert Charles) 1950. "The macro economic evaluation model (MEEM) : an approach to priority setting in the health sector." Monash University, Dept. of Management, 2001. http://arrow.monash.edu.au/hdl/1959.1/8672.

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Lee, Kah Seng. "The impact of cost containment reforms to the Pharmaceutical Benefits Scheme (PBS) on prescribing volumes and expenditure in Australia: 1992-2011." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/836.

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Objectives: To investigate the impact of cost containment measures on PBS prescribing volumes and expenditure. Methods: Segmented linear regression models were used to analyse the time series data from Medicare Australia’s PBS Statistics. Seven measures and four new listing dates of statins were investigated. Results: Many of the cost containment measures were effective in containing costs. Conclusions: The safety net 20 days rule was estimated to be the most effective in reducing drugs utilisation and expenditure.

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Zhang, Guomin. "Factors Influencing the Implementation of Raised Floor System for the Fitout of Office Buildings in the Australian Context." Thesis, Queensland University of Technology, 2005. https://eprints.qut.edu.au/16082/1/Guomin_Zhang_Thesis.pdf.

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The study described in this thesis investigates how the implementation of raised floor system (RFS) for the fitout of office buildings can be promoted in the Australian construction industry. It essentially achieves this goal through justifying the RFS fitout advantages, improving industry practitioners' awareness of the innovative technology, and identifying the barriers hindering RFS application, and exploring integrated approaches to overcome these barriers. Due to increasing levels of technological, environmental and organizational changes in office buildings, the traditional office building fitout method cannot deliver flexible services economically and in a timely manner. RFS is highlighted for its superior underfloor distribution technologies and ability to promote healthy workplace environments and organizational flexibilities. Despite the many benefits RFS may bring, this innovative technology has not been widely used. Therefore, for countries with potential growth in the office building market, including Australia, how to make this state-of-the-art fitout technology more acceptable is of great importance. To encourage the RFS implementation in office buildings, the research set up five objectives: (1) to justify the RFS advantages for office building fitout compared with traditional fitout method; (2) to identify and present appropriate specifications of RFS products and applications in order to improve industry practitioners' awareness on RFS fitout; (3) to identify and seek potential solutions to barriers hindering RFS fitout implementation; (4) to integrate the barriers and their solutions into RFS project delivery using constructability study; and (5) to formulate guidelines for RFS fitout implementation in office buildings in the Australian construction industry. A comprehensive research methodology consisting of questionnaire, semi-structured interview, site observations, focus groups, life cycle cost (LCC) comparison, and constructability study was structured to support the exploratory research. With a combined qualitative and quantitative data analysis method, the questionnaire and interview surveys revealed the low level recognition of RFS within the industry, and identified 20 significant influence factors (SIFs) and 15 real problems associated with RFS fitout implementation. The site observations and focus groups validated the survey findings and justified the RFS fitout advantages. Then, the LCC comparison established a model and verified the LCC benefits of RFS fitout through a case study. The final discussion on the SIFs, real problems and their solutions uncovered 36 project level critical factors pertaining to RFS fitout design, construction, operation and maintenance. A constructability study was employed to integrate these key factors into RFS fitout project delivery, such as construction knowledge inputs, team skills, and RFS fitout programs. More importantly, five key issues with significant influences were revealed. Further investigation of these key issues led to a framework for the constructability implementation, a contracting strategy with nominated specialist contractors under CM/GC, and a process-based conceptual model for the selection of RFS products. Based on these findings, a set of guidelines for the RFS fitout implementation in office buildings was formulated as a contribution to practice. Questionnaires were again used to invite comments on the key issues and guidelines, and the results proved the validity of the research outcomes.

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Zhang, Guomin. "Factors Influencing the Implementation of Raised Floor System for the Fitout of Office Buildings in the Australian Context." Queensland University of Technology, 2005. http://eprints.qut.edu.au/16082/.

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O'Driscoll, Catherine T. "A study to determine the quality of life and experiences for liver and kidney transplant recipients and living kidney donors in Western Australia : the economic implications." University of Western Australia. School of Surgery, 2008. http://theses.library.uwa.edu.au/adt-WU2009.0077.

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The use of quality-of-life as an outcome measure provides detailed information about the effectiveness of medical treatments than morbidity or mortality rates alone. The use of quality-of-life data in the clinical setting can inform patients regarding treatment options, treatment benefits and costs. In competing health care markets, outcome measurement is regarded as important as it is concerned with the impact of health care practice and affects health policy decisions. Doessel (1978) conducted the first Australian study on the cost-effectiveness analysis of renal replacement therapies. The study was based on Klarman, Francis & Rosenthal's (1968) the study, where the output was measured in terms of the number of life years gained from kidney transplantation, and a twenty-five percent weight was allocated in an attempt to capture quality-of-life from kidney transplantation. Doessel (1978) used two sources of data: Australian data (Disney 1974) and European data (Gurland et al. 1973; Shiel et al. 1974). The study measured life years gained, and agreed with the Klarman et al. (1974) findings that transplantation is the most effective way to increase life expectancy of persons with chronic renal disease (Butler & Doessel 1989). The outputs of the alternative treatments were not reported in monetary terms; the study focused on life years gained as the output measure. Hence the importance of this current study, which includes a cost-effectiveness analysis for cadaver liver, and living kidney transplantation for end-stage liver and kidney disease patients. Calls to respect patient autonomy and to produce patient-centered outcomes have recently brought the patients point of view back into the center of clinical medicine (Sullivan 2003). Survival rates indicate one measure of outcome however they do not reflect patients perceptions of health benefit or experiences. Noting that patients psychosocial effect on functioning is of more concern to them than their physical Thesis Preamble iii ability, that more accurate knowledge of patients conditions be measured prior to transplantation (Tarter et al. 1991). Recently researchers advocated investigating transplant patients' states of health to assess the social benefit of these expensive health care services from their perspective (Joralemon & Fujinaga 1997). The current study's mixed method, bridges the gaps in treatment outcome measurements, as the mixed method applied (Creswell 1994; Sim & Sharp 1998) prospectively measured quality-oflife, determined health utility, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The study reported the living donors experience of the donation process, described their needs; expressed using a new psychosocial model supporting future living kidney donor's during the donation process.

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Merollini, Katharina M. D. "Evaluation of the cost-effectiveness of strategies claiming to reduce the risk of surgical site infections following primary total hip arthroplasty." Thesis, Queensland University of Technology, 2012. https://eprints.qut.edu.au/54667/1/Katharina_Merollini_Thesis.pdf.

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Background Total hip arthroplasty (THA) is a commonly performed procedure and numbers are increasing with ageing populations. One of the most serious complications in THA are surgical site infections (SSIs), caused by pathogens entering the wound during the procedure. SSIs are associated with a substantial burden for health services, increased mortality and reduced functional outcomes in patients. Numerous approaches to preventing these infections exist but there is no gold standard in practice and the cost-effectiveness of alternate strategies is largely unknown. Objectives The aim of this project was to evaluate the cost-effectiveness of strategies claiming to reduce deep surgical site infections following total hip arthroplasty in Australia. The objectives were: 1. Identification of competing strategies or combinations of strategies that are clinically relevant to the control of SSI related to hip arthroplasty 2. Evidence synthesis and pooling of results to assess the volume and quality of evidence claiming to reduce the risk of SSI following total hip arthroplasty 3. Construction of an economic decision model incorporating cost and health outcomes for each of the identified strategies 4. Quantification of the effect of uncertainty in the model 5. Assessment of the value of perfect information among model parameters to inform future data collection Methods The literature relating to SSI in THA was reviewed, in particular to establish definitions of these concepts, understand mechanisms of aetiology and microbiology, risk factors, diagnosis and consequences as well as to give an overview of existing infection prevention measures. Published economic evaluations on this topic were also reviewed and limitations for Australian decision-makers identified. A Markov state-transition model was developed for the Australian context and subsequently validated by clinicians. The model was designed to capture key events related to deep SSI occurring within the first 12 months following primary THA. Relevant infection prevention measures were selected by reviewing clinical guideline recommendations combined with expert elicitation. Strategies selected for evaluation were the routine use of pre-operative antibiotic prophylaxis (AP) versus no use of antibiotic prophylaxis (No AP) or in combination with antibiotic-impregnated cement (AP & ABC) or laminar air operating rooms (AP & LOR). The best available evidence for clinical effect size and utility parameters was harvested from the medical literature using reproducible methods. Queensland hospital data were extracted to inform patients’ transitions between model health states and related costs captured in assigned treatment codes. Costs related to infection prevention were derived from reliable hospital records and expert opinion. Uncertainty of model input parameters was explored in probabilistic sensitivity analyses and scenario analyses and the value of perfect information was estimated. Results The cost-effectiveness analysis was performed from a health services perspective using a hypothetical cohort of 30,000 THA patients aged 65 years. The baseline rate of deep SSI was 0.96% within one year of a primary THA. The routine use of antibiotic prophylaxis (AP) was highly cost-effective and resulted in cost savings of over $1.6m whilst generating an extra 163 QALYs (without consideration of uncertainty). Deterministic and probabilistic analysis (considering uncertainty) identified antibiotic prophylaxis combined with antibiotic-impregnated cement (AP & ABC) to be the most cost-effective strategy. Using AP & ABC generated the highest net monetary benefit (NMB) and an incremental $3.1m NMB compared to only using antibiotic prophylaxis. There was a very low error probability that this strategy might not have the largest NMB (<5%). Not using antibiotic prophylaxis (No AP) or using both antibiotic prophylaxis combined with laminar air operating rooms (AP & LOR) resulted in worse health outcomes and higher costs. Sensitivity analyses showed that the model was sensitive to the initial cohort starting age and the additional costs of ABC but the best strategy did not change, even for extreme values. The cost-effectiveness improved for a higher proportion of cemented primary THAs and higher baseline rates of deep SSI. The value of perfect information indicated that no additional research is required to support the model conclusions. Conclusions Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalised patients, save lives and enhance resource allocation. By implementing a more beneficial infection control strategy, scarce health care resources can be used more efficiently to the benefit of all members of society. The results of this project provide Australian policy makers with key information about how to efficiently manage risks of infection in THA.

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Luechaikajohnpan, Pinijsorn Economics Australian School of Business UNSW. "Collaboration and international trade." Publisher:University of New South Wales. Economics, 2008. http://handle.unsw.edu.au/1959.4/40905.

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Over the last two decades there has been a tremendous increase in collaboration among competing firms. A significant number of these collaborations are international. This thesis explores the incentives and welfare consequences of collaboration in the context of international trade. We consider two types of cross-border collaborations. The first is collaboration by sharing a part of firms' value creating activities, such as technology development, product design and distribution. This saves on production costs but reduces product distinctiveness. Firms collaborate if and only if the reduction in product distinctiveness is lower than a threshold level. We find that the threshold increases with an increase in trade costs. That is, an increase in trade costs makes collaboration more likely. Higher trade cost lowers competition, which in turn enables the firms to save on fixed costs while forgoing some product distinctiveness. Furthermore, we demonstrate that contrary to standard intuition, higher trade cost could enhance consumers' welfare by inducing competitors to collaborate. We extend our model to endogenise location choice by the firms where collaboration requires co-location (due to the benefit of local spillovers or joint investment in key infrastructures). Unlike the original model, we find that an increase in trade costs can discourage collaboration. In both circumstances, we find that an increase in trade cost can improve consumer surplus. The second type of collaboration considered in this thesis is licensing. We extend the standard licensing literature to an environment where firms compete in the domestic as well as foreign market. We examine how trade cost affects the licensing decision as well as the optimal payment mechanism. We find that an increase in trade costs reduces the possibility of licensing. Concerning the payment mechanism, we find that (i) either royalty or (ii) a two-part tariff (involving a fixed fee as well as royalty payments) is optimal. An increase in trade costs reduces the likelihood of royalty only being the optimal payment mechanism.

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Smith, Lia. "Biodiversity monitoring using environmental DNA: Can it detect all fish species in a waterbody and is it cost effective for routine monitoring?" Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2017. https://ro.ecu.edu.au/theses/1985.

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The challenges associated with environmental monitoring such as the impact on the environment and the financial costs are problems we face when trying to conserve freshwater systems around the world. The need for precise and accurate results that are cost effective is important so that we can achieve our conservation goals. The overall aim of this study was to explore Next-Generation - metabarcoding for the detection of feral and native freshwater fish species based on the DNA shed by individual organisms into the water column. Cytochrome c oxidase I (COI) primers were developed for this study using DNA from six freshwater species expected to be found in the waterbody. These primers, along with 16S rRNA (16S) primers, were assessed to ensure that the molecular method was robust and suitable for use in the field. Along with the cost effectiveness of the molecular method when compared to the more traditional surveying method of Fyke net surveying. This study comprised development of field and lab protocols for the detection of freshwater fish species in a lentic system. Both the COI and 16S primer sets showed results that were comparable to previous Fyke net surveys, though both primer sets detected species that the other did not. Further qPCR analysis showed that there were differences in detection for both primers for each of the species. The molecular surveying of the waterbody has been proven sensitive enough to detect Maccullochella peelii. This species has a very low abundance in the waterbody (believed to be n=1) so these results suggest that this method can be used to target low abundance species. The outcome of this study highlighted the need for multi-location sampling within a waterbody as increasing the number of locations sampled, led to an increase in the number of species detected. Along with the multi-location sampling, it was also important to sample throughout the year to account for seasonal variability. The eDNA study emphasized the importance of having knowledge of both the ecology and the biology of the species targeted so that a robust monitoring method can be implemented. As well as comparing the apparent accuracy of Fyke netting and the eDNA approach in the study waterbody, a cost benefit analysis comparing the relative costs of multiplex DNA surveying, single species molecular surveying, and Fyke net surveying was undertaken. Molecular environmental surveying was found to be a cost effective method for monitoring, as the analysis suggested single species monitoring would break even after only 95 waterbodies were surveyed, and multiplex surveying would break even after 145 waterbodies, under the proposed scenario. The cost benefit analysis explored the costs associated with all three methods, including lab set up costs, along with the number of waterbodies that could be surveyed on both a weekly and yearly basis.

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Robson, Sally Jane. "International market entry : determinants of Australian exports and direct investment to the United Kingdom." Thesis, Queensland University of Technology, 2003. https://eprints.qut.edu.au/15844/1/Sally_Robson_Thesis.pdf.

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Australia and the UK are both prominent economies in the international arena and share a strong trade and investment relationship. Interestingly, the UK while being a significant destination for Australian exports is an even more significant destination for Australian direct investment, a case anomalous to international trends. Analysis of this case elicits the question as to what factors differentiate between the firms that export and those that FDI. It is imperative to understand the differentiating factors between exports and direct investment as market entry decisions are decisive to the success of firms in international markets. A number of theories of international market entry have developed over the last quarter century, the ownership, location, and internationalisation model (OLI) is used in this study. The importance of the variables developed in this model are identified, and assessed as to their relevance to entry of Australian firms into the UK market through FDI or Exports. Qualitative information is used to support initial quantitative profiling. Results of the investigation indicate that while some variables were at times decisive, they were not predictive at all in other situations. The full interaction of the variables in the model was therefore concluded to be essential to fully differentiate between exports and FDI in all cases.

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Robson, Sally Jane. "International Market Entry: Determinants of Australian Exports and Direct Investment to the United Kingdom." Queensland University of Technology, 2003. http://eprints.qut.edu.au/15844/.

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Tonti-Filippini, Justi. "The economic efficacy (in terms of cost and quality outcomes) of outsourcing IT services and cleaning services by large Australian companies and government business enterprises." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2010. https://ro.ecu.edu.au/theses/1868.

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On-shore outsourcing has been common in Australia for a number of decades across a range of business services in both the public and private sectors. Given this, there is less literature examining Australian on-shore outsourcing than one would reasonably expect. Whilst the literature examines the general motives for organisations to outsource and the economic effects of outsourcing for those organisations, it generally does not examine whether there are any differences in the motives, management strategies and techniques, and economic outcomes associated with the outsourcing of high skill functions compared to the outsourcing of low skill functions. The literature also devotes less attention than may be expected to the role of managerial strategy in determining the economic outcomes and relative successes of outsourcing projects. This study aims to contribute a bounded examination of these issues to the academic literature, by presenting an in-depth comparative investigation of the on-shore outsourcing of (high skill) IT services and (low skill) cleaning services by large Australian Government Business Entities (GBEs) and private sector companies, from each organisation’s decision to outsource to the end of their outsourcing lifecycle (relationship). The study will; identify and explain any differences (or lack of differences) in the cited motives for Australian GBEs and companies to outsource IT and cleaning services; discuss the economic impact of outsourcing decisions upon these GBEs and companies; examine the strategies used by those organisations in outsourcing cleaning and IT services, and the effects of these chosen strategies upon the economic outcomes of outsourcing for each organisation; and explain any differences (or the lack of difference) between the economic outcomes of outsourcing cleaning and IT services. The study was conducted over a number of years, using a triangulated mixed methods design involving thirteen case study organisations (with in-depth semi structured interviews with a large number of primary interview subjects at each case study organisation site) and data triangulation using corroborative interviews, company and public records, service provider records, service provider (corroborative) interviews, and focus group data.

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Lamminmaki, Dawne, and n/a. "Outsourcing in the Hotel Industry: A Management Accounting Perpective." Griffith University. School of Accounting and Finance, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040920.091600.

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The broad objective of this thesis is to develop an understanding of factors affecting outsourcing in the hotel industry and also the role played by management accounting in hotel outsourcing. The thesis draws on transaction cost economics (TCE), agency, contingency, and labour process theories in the context of appraising factors motivating outsourcing. Two empirical phases have been undertaken in the study. The first phase involved a series of interviews with general managers and financial controllers in large South East Queensland hotels. The second phase involved two distinct questionnaire surveys of large Australian hotels. The first was administered to hotel general managers, and the second was administered to hotel financial controllers. Significant findings arising from the study include: 1. In light of the substantial international literature describing hotel outsourcing, it appears that outsourcing in Australian hotels is relatively limited. This appears to be particularly the case with respect to food and beverage related activities. 2. Mixed support is offered for the TCE model. Both the survey and interview data provide some support for TCE's prescription that frequently conducted activities will not tend to be outsourced. Two specific extensions are offered to this aspect of the model, however. Firstly, where activities are conducted to a minimal extent, it can be uneconomic to outsource. Secondly, where large activities are undertaken by a group of organisations, their enhanced purchasing power can result in inexpensive outsourcing arrangements. With respect to TCE's uncertainty proposition, support is offered for the view that the propensity to outsource will be greater where behavioural uncertainty is lower. No support has been offered with respect to environmental uncertainty. The interview data provides some support for TCE's asset specificity proposition, however, minimal support was found in the survey phase. Despite this, the many dimensions of asset specificity (eg. site specificity, human asset specificity, etc) provided a useful checklist of issues to be considered in relation to the outsourcing decision. 3. Negligible support was found for labour process theory (LPT) in the interview phase of the study. In light of this, and the need to narrow the studys focus in the survey phase, LPT was not pursued further. LPT is a difficult construct to operationalise, given the social desirability error that may result. This may partially account for the absence of significant LPT findings in the interview phase. 4. The survey data provides some support for the agency theory view that risky activities will tend to be outsourced. 5. Considerable cross-hotel variation exists in management of, and accounting's involvement in, outsourcing decision making and control systems. Accounting appraisal of outsourcing proposals rarely includes long term oriented, sophisticated techniques such as "net present value". It appears this may be because outsourcing decisions are not conducted in the context of the formal capital budgeting process. 6. High performing hotels and hotels that conduct their outsourcing decisions in the context of a long term outsourcing strategic agenda have more sophisticated outsourcing management systems.

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Lamminmaki, Dawne. "Outsourcing in the Hotel Industry: A Management Accounting Perspective." Thesis, Griffith University, 2003. http://hdl.handle.net/10072/367429.

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The broad objective of this thesis is to develop an understanding of factors affecting outsourcing in the hotel industry and also the role played by management accounting in hotel outsourcing. The thesis draws on transaction cost economics (TCE), agency, contingency, and labour process theories in the context of appraising factors motivating outsourcing. Two empirical phases have been undertaken in the study. The first phase involved a series of interviews with general managers and financial controllers in large South East Queensland hotels. The second phase involved two distinct questionnaire surveys of large Australian hotels. The first was administered to hotel general managers, and the second was administered to hotel financial controllers. Significant findings arising from the study include: 1. In light of the substantial international literature describing hotel outsourcing, it appears that outsourcing in Australian hotels is relatively limited. This appears to be particularly the case with respect to food and beverage related activities. 2. Mixed support is offered for the TCE model. Both the survey and interview data provide some support for TCE's prescription that frequently conducted activities will not tend to be outsourced. Two specific extensions are offered to this aspect of the model, however. Firstly, where activities are conducted to a minimal extent, it can be uneconomic to outsource. Secondly, where large activities are undertaken by a group of organisations, their enhanced purchasing power can result in inexpensive outsourcing arrangements. With respect to TCE's uncertainty proposition, support is offered for the view that the propensity to outsource will be greater where behavioural uncertainty is lower. No support has been offered with respect to environmental uncertainty. The interview data provides some support for TCE's asset specificity proposition, however, minimal support was found in the survey phase. Despite this, the many dimensions of asset specificity (eg. site specificity, human asset specificity, etc) provided a useful checklist of issues to be considered in relation to the outsourcing decision. 3. Negligible support was found for labour process theory (LPT) in the interview phase of the study. In light of this, and the need to narrow the study’s focus in the survey phase, LPT was not pursued further. LPT is a difficult construct to operationalise, given the social desirability error that may result. This may partially account for the absence of significant LPT findings in the interview phase. 4. The survey data provides some support for the agency theory view that risky activities will tend to be outsourced. 5. Considerable cross-hotel variation exists in management of, and accounting's involvement in, outsourcing decision making and control systems. Accounting appraisal of outsourcing proposals rarely includes long term oriented, sophisticated techniques such as "net present value". It appears this may be because outsourcing decisions are not conducted in the context of the formal capital budgeting process. 6. High performing hotels and hotels that conduct their outsourcing decisions in the context of a long term outsourcing strategic agenda have more sophisticated outsourcing management systems. Thesis (PhD Doctorate) Doctor of Philosophy (PhD) School of Accounting and Finance Faculty of Commerce and Management Full Text

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Koo, Tay Tae-Ryang Aviation Faculty of Science UNSW. "The effects of low-cost carriers on regional dispersal of domestic visitors in Australia: examinations of the effects on visitors' dispersal sourced from intra-modal and inter-modal differentials." Awarded By:University of New South Wales. Aviation, 2009. http://handle.unsw.edu.au/1959.4/44281.

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This thesis was conceived in the context of post-2000 proliferation of Australian low-cost carriers and regional dispersal policy of the Australian government. The broad aim of this thesis is to examine the effects of low-cost carriers on regional dispersal of domestic visitors. Based on existing theoretical frameworks of tourists?? spatial behaviour and multi-destination travel itinerary, two theoretical constructs - intra-modal and inter-modal effects ?? were developed to conceptualise the regional dispersal effects of low-cost carriers. The former refers to differences between low-cost carriers and other models of airline business, and the latter refers to differences between low-cost carriers and other modes of transport. Logit models and national-level revealed preference data were used to examine the intra-modal effects, while stated choice method was used to examine the inter-modal effects on two representative regional tourism destinations - Ballina-Byron and Cairns - in Australia. This thesis provides evidence that suggest low-cost carrier air arrivals tend to disperse for reasons that are different from network carrier air arrivals, supporting the significance of intra-modal effects on regional dispersal. It is claimed that the intra-modal effect is one reason why some destinations observe high growth in airport activity as a result of low-cost carrier entry, but the levels of tourism activities do not match that extrapolated from the level of growth in the incoming air traffic. Two case studies have shown that (1) ground transport policy can completely offset the negative effects on tourists?? dispersal propensity stemming from pre-determined trip characteristics, although the effectiveness of such policy variables varies significantly across destinations; and (2) significant discounts in airfares are sufficient to trigger a modal switch, even in situations when a car is the most suitable mode for the trip, suggesting a real possibility of a bypass of ground-mode-reliant regions. The findings should be of interest to regional destination managers with low-cost carrier services as much as for managers in peripheral destinations without low-cost carrier services.

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Vincent, Eve Mary. "Forces of destruction, acts of creation : aboriginality, identity and native title, on the far west coast of South Australia." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/13502.

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Kelman, Christopher William, and christopher kelman@cmis csiro au. "Monitoring Health Care Using National Administrative Data Collections." The Australian National University. National Centre for Epidemiology and Population Health, 2001. http://thesis.anu.edu.au./public/adt-ANU20020620.151547.

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With the inevitable adoption of information technology into all areas of human pursuit, the potential benefits for health care should not be overlooked. In Australia, details of most health care encounters are currently recorded for administrative purposes. This results in an impressive electronic data-bank that could provide a national resource for health service evaluation. ¶ Evaluation of health services has become increasingly important to provide indicators of the benefits, risks and cost-effectiveness of treatments. However, if administrative data are to be used for this purpose, several questions must first be addressed: Are the current data collections accessible? What outcome measures can be derived from these data? Can privacy issues be managed? Could the quality of the data be improved? Is the existing infrastructure adequate to supply data for evaluation purposes? Could the existing system provide a basis for the development of an integrated health information system? ¶ The aims of the project were: · To examine the potential for using administrative data to generate outcome measures and surveillance indicators. · To investigate the logistics of gaining access to these data for the purpose of research. This to be achieved within the current ethical, political and financial framework. · To compare the Australian health-service data system with the current international state-of-the-art. · To develop suggestions for expansion of the present system as part of an integrated health record and information system. This system to manage patient records and provide data for quality management, treatment surveillance and cost-effectiveness evaluation as a routine activity. ¶ The thesis is presented in two parts. In the first part, a historical cohort study is described that involved patients with implantable medical devices. The potential to evaluate outcomes was investigated using all national health-service information currently available in electronic form. Record linkage techniques were used to combine and augment the existing data collections. Australias national health databases are to varying degrees, amenable to such linkage and cover doctor visits, pharmaceuticals, hospital admissions and deaths. The study focused on medical devices as an illustrative case but the results are applicable to the routine assessment of all medical and surgical interventions. ¶ For the Australian Medical Devices study, the records of 5,316 patients who had medical device implants in 1993-94 were selected from the archives of a major private health insurer. Five groups of medical implants were studied: heart valves, pacemakers, hips, vascular grafts and intra-optic lenses. Outcomes for these patients, including death, re-operation and health service utilisation, were compared and analysed. ¶ A comparison study was performed using data from the Manitoba Health database in Winnipeg, Canada. Manitoba provides a very similar demographic group to that found in Australia and is an example of a prototype integrated-health-information system. One of the principal advantages for research is that personally identified data about medical and hospital services are collected for all patients. Selection bias is eliminated because individual consent is not required for this type of research and all selected patients could be included in the study. ¶ The two studies revealed many barriers to the use of administrative data for health outcomes research. Service event data for the Australian cohort could be collected but only after long delays and hospital morbidity data were not available for the entire cohort. In contrast to the situation in Australia, the Manitoba data were both accessible and complete, but were lacking in detail in some areas. ¶ Analysis of the collected data demonstrated that without the addition of clinical data only general indications of trends could be deduced. However, with minimal supplementary clinical data, it was possible to examine differences in performance between brands of medical devices thus indicating one of the uses for this type of data collection. ¶ In the second part of the thesis, conclusions are presented about the potential uses and limitations of the existing system and its use as a basis for the development of a national Integrated Health Record and Information System (IHRIS). The need for the establishment of a systemic quality management system for health care is discussed. ¶ The study shows that linked administrative data can provide information about health outcomes which is not readily available from other sources. If expanded and integrated, the system that is currently used to collect and manage administrative data, could provide the basis for a national health information system. This system would provide many benefits for health care. Benefits would include the monitoring, surveillance and cost-effectiveness analysis of new and existing treatments involving medical devices, drugs and surgical procedures. An integrated health information system could thus provide for both clinical and administrative needs, while in addition providing data for research. ¶ Unfortunately, in Australia, the use of administrative data for this purpose is not currently feasible. The principal barrier is the existence of a culture within the Australian health care system which is not supportive of research and is deficient in quality and safety measures. ¶ Recent initiatives by both the Commonwealth and state governments have supported the introduction of measures to improve quality and safety in health care. It is argued here that an Integrated Health Record and Information System (IHRIS) would provide an essential component of any such scheme. The results of this study have important policy implications for health care management in both the administrative and clinical domains.

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Georgiou, Jonathan. "Exploring the benefits of attracting, recruiting and retaining mature age employees up to and beyond the traditional age of retirement: Perspectives from Western Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1632.

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There has been a recent upsurge in media attention surrounding Australia’s ageing workforce. A review of academic, media and grey literature highlighted inadequacies in existing workplace polices, as well as flaws in financial and social security schemes. Of particular concern were persistent negative attitudes and counterproductive policies regarding mature age employees (MAEs). Poor retention rates among this cohort of workers aged 45 years and over are leading to skilled labour shortages and losses in corporate knowledge. This expected mass exodus of mature cohorts into retirement has been predicted to negatively impact the socio-economic sustainability of ageing societies world-wide and is a pertinent issue for Western Australia (WA). The overarching objective of this study was to identify the ‘place’ of mature cohorts within WA workplaces and promote strategies that will improve the employment conditions and overall quality of life of ageing workforces. Research questions aimed to address the need for greater mature age employment up to and beyond pensionable age; identify ‘gaps’ in policies and programmes; and explore how mature cohorts were perceived (valued) and the extent their departure may affect WA society (labour force). By using a mixed methods research design, this Doctoral dissertation developed a conceptual framework for limiting significant issues individuals, businesses and society may experience as a result of WA’s ageing workforce; whilst simultaneously promoting the benefits of maturity and mature age employment. This Re-Model draws upon the community development work principles of social justice, empowerment and social capital; and is further contextualised by methods of best practice identified from the triangulation of secondary sources, quantitative data and qualitative inquiry. Primary data collection involved the completion of 362 surveys, followed by 27 semistructured interviews and four focus group activities, with a cross section of MAEs, volunteers, their employers, retirees and unemployed cohorts from across WA. Over one-third of current MAEs, employers and volunteers in this study reported they intended working later than the traditional age of retirement, with 71 per cent of this sample planning to semi-retire. Furthermore, almost 60 per cent of a sample that had previously exited the labour force was working at the time of data collection as semi-retirees or rehired retirees (rehirees). Collectively, these statistics indicated that despite predictions of mass disengagement among mature cohorts, most of this crosssection of Western Australians are seeking to remain in (or re-enter) the WA workforce beyond pensionable age. However, quantitative and qualitative findings revealed several barriers to their continued engagement, including access to ‘age-friendly’ workplaces; a dearth of targeted training (career) development and employment assistance; and a lack of value attributed to mature age skills and experience, particularly deleterious in WA’s youth-centric culture. Primary data also highlighted several enabling factors for mature age employment. ‘Flexibility’ and ‘autonomy of choice’ were cited as key dimensions across all aspects of paid work, volunteering and retirement – whether in terms of worklife- balance; the individuation of training and development; or options available to those transitioning out of traditional employment. Data indicated that sustainable cultural change required more than just the removal of negative policies or introduction of punitive legislation. Maintaining a positive outlook among mature age individuals and simultaneously educating (younger) co-workers, employers, policy-makers (stakeholders) and society about the virtues of maturity and non-traditional work (skills) were considered essential to changing societal attitudes, behaviour and culture.

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Sweeny, Kim. "Accounting for growth in the Pharmaceutical Benefits Scheme." Thesis, full-text, 2008. https://vuir.vu.edu.au/1960/.

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This thesis investigates the contribution to the growth in expenditure on medicines listed on the Pharmaceutical Benefits Scheme (PBS) from three inter-related sources: (i) the addition of new medicines offering an expanding range of treatments for disease, (ii) PBS processes for determining the prices of medicines and their conditions of listing and (iii) the demand by patients for PBS medicines. In doing so it uses trend analysis presented in both tabular and graphic form, expenditure decomposition techniques based on index and indicator numbers, and econometric analysis. Using novel techniques and interpretations, it addresses some key aspects of decomposition analysis including the treatment of new and disappearing goods and the potential bias arising from changing market shares among substitutable medicines. The analysis is undertaken for the period from 1991-92 to 2005-06. An important consequence of the cost-effectiveness and reference pricing techniques used by the PBS, is that the quantity index calculated within the decomposition of PBS expenditure can be interpreted as a measure of the quality-adjusted amount of medicines consumed by patients. This is virtually equivalent to the growth in expenditure of about 12% per annum. On average prices of medicines fell over time, modestly in nominal terms and to a greater extent in real terms. Based on the results of econometric analysis, new evidence is presented on the relative influences of copayments, safety net limits, the number of PBS medicines listed and their conditions of listing on the demand for PBS medicines by different categories of patients. Elasticities with respect to patient price are in the range -1.1 to -1.4 for General Non-Safety Net patients and in the range -0.5 to -0.9 for Concessional Non-Safety Net patients.

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Carter, Hannah Elizabeth. "The productivity costs of premature mortality in Australia." Thesis, University of Sydney, 2017. https://eprints.qut.edu.au/112374/1/112374.pdf.

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Whitten, Stuart Max Business Australian Defence Force Academy UNSW. "Provision of environmental goods on private land: a case study of Australian wetlands." Awarded by:University of New South Wales - Australian Defence Force Academy. School of Business, 2003. http://handle.unsw.edu.au/1959.4/38661.

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The management of natural resources located on private lands often involves a perceived conflict between the mix of private and public benefit outputs they produce. Governments have tended to respond through legislation to restrict and redirect private decisions about resource management. However, the legislative response faces a lack of information about the costs and benefits of alternative management and policy instruments. A pertinent example of this debate is the management of wetlands on private lands. The goal in this thesis is to advance the design of policy relating to the production of environmental outputs on private lands. This goal is achieved by first estimating the welfare impacts of alternative private land management strategies on the wider community. These estimates are used as inputs into the development of alternative policy instruments that are then evaluated in terms of their potential cost-effectiveness in influencing private management. Two case studies of wetland management on private land in Australia are presented ??? the Upper South East Region of South Australia, and, the Murrumbidgee River Floodplain in New South Wales. The conceptual approach described in the first part of the thesis includes a description of the resource management problem and the strengths and weaknesses of the alternative decision frameworks widely employed in Australia. Identification of the cause and nature of transaction costs in the management process is the focus in this discussion. The welfare impacts of alternative wetland management strategies are investigated through the construction of a bio-economic model for each of the case study areas. The approach integrates biophysical analysis of changing wetland management with the value society places on wetlands. Outputs from this process are used in the development of a range of policy instruments directed towards influencing wetland management. The impact of poorly quantified and uncertain transaction costs on the potential cost-effectiveness of these options is evaluated using threshold policy analysis. The empirical results show that the perception of a conflict between the private and public values generated by resource management is accurate. For example, scenarios changing wetland management in the Upper South East of South Australia on the Murrumbidgee River floodplain in New South Wales were shown to generate net benefits of $5.2m and $5.1m respectively. Hence, changing wetland management could generate increased community welfare. The potential for these findings to be translated into wetland policy is less conclusive. Policies directed towards wetland management (in part or in whole) incur a range of transaction costs and deliver differential wetland protection benefits. Ten ???best bet??? policies are identified, but more information is required to determine conclusively whether a net benefit results to the wider community when transaction costs are included.

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Leamon, Gregory Robert Petroleum Engineering Faculty of Engineering UNSW. "Petroleum well costs." Awarded by:University of New South Wales. School of Petroleum Engineering, 2006. http://handle.unsw.edu.au/1959.4/30599.

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This is the first academic study of well costs and drilling times for Australia???s petroleum producing basins, both onshore and offshore. I analyse a substantial database of well times and costs sourced from government databases, industry and over 400 recent well completion reports. Three well phases are studied - Pre-Spud, Drilling and Completion. Relationships between well cost factors are considered, including phase time, phase cost, daily cost, rig day rate, well depth, basin, rig type, water depth, well direction, well objective (e.g. exploration), and type of completion (P&A or producer). Times and costs are analysed using scatter plots, frequency distributions, correlation and regression analyses. Drilling times are analysed for the period 1980 to 2004. Well time and variability in well time tend to increase exponentially with well depth. Technical Limits are defined for both onshore and offshore drilling times to indicate best performance. Well costs are analysed for the period 1996 to 2004. Well costs were relatively stable for this period. Long term increases in daily costs were offset to some extent by reductions in drilling times. Onshore regions studied include the Cooper/Eromanga, Surat/Bowen, Otway and Perth Basins. Offshore regions studied include the Carnarvon Basin shallow and deepwater, the Timor Sea and Victorian Basins. Correlations between regional well cost and well depth are usually high. Well costs are estimated based on well location, well depth, daily costs and type of completion. In 2003, the cost of exploration wells in Australia ranged from A$100,000 for shallow coal seam gas wells in the Surat/Bowen Basins to over A$50 million for the deepwater well Gnarlyknots-1 in the Great Australian Bight. Future well costs are expected to be substantially higher for some regions. This study proposes methods to index historical daily costs to future rig day rates as a means for estimating future well costs. Regional well cost models are particularly useful for the economic evaluation of CO2 storage sites which will require substantial numbers of petroleum-type wells.

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Davies, Lorna Annette. "The low cost treatment of landfill leachate using constructed wetlands." Thesis, University of Leeds, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275678.

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Rudzki, Stephan J. "The cost of injury to the Australian army." Phd thesis, 2009. http://hdl.handle.net/1885/110379.

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This thesis is the first study to have determined a comprehensive estimate of the cost of injury to the Australian Army. The approach used was that of a cost of illness study, which summarised the economic burden of injury and provides information for stakeholders, allowing them to make informed decisions on the allocation of scarce healthcare resources. Cost of illness (COI) studies serve a different purpose to that of health economic evaluations which are focused on evaluating the cost of an intervention rather than estimating the cost of a particular disease. A "top down" approach to analysis was adopted utilising high level organisational databases to obtain cost data. This thesis adopted the primary perspective of government, but also considered costs from a societal and individual perspective. Estimating the economic burden of injury in a defined population is dependant on the availability of data of sufficient quality and scope, which is often lacking. This was the case in this thesis where available datasets contained data of poor quality or insufficient detail to provide accurate injury cost data. A number of assumptions were required in order to develop estimates of the contribution of injury to different sources of cost. There is a clear requirement for Defence to improve it injury surveillance and introduce an electronic health record to facilitate this. Efforts must also be made to link clinical data with cost data to better inform decision makers about the relative benefits achieved from the considerable cost resulting from injury. The cost of injury has three components; direct costs; indirect costs; and intangible costs. Direct costs considered in this analysis included external medical and compensation costs, as well as compensation liabilities calculated by the Australian Government Actuary. Indirect costs included productivity losses, with invalid pensions also included because they constitute a significant cost to Government not usually included in (COI) studies. An additional analysis of the net present value of lost wages was conducted on those soldiers who were invalided from the Army. A novel approach, termed the Capital Investment Model, was used to estimate the loss of training investment as a result of premature separation from the Army due to injury. Intangible costs were not included in this study because of the difficulty in placing a monetary value on these aspects of injury. Direct injury costs in 1996 were estimated to be between $40.75 and $42.36M with outstanding compensation liabilities of $270M. Indirect costs were estimated to be $10.74M with invalid pension liabilities of $63.82M. Capital losses due to premature separation from the Army due to injury were estimated to be $10.1 OM. The total cost of injury to the Australian Army (in 1996 dollars) was estimated to be between $61.59M and $63.20M, with estimated pension and compensation liabilities of $333.82M. Injury causes a significant financial impost. This is also the first study to compare the cost and outcomes of a range of spinal surgical procedures reflective of general orthopaedic community practice. It adopted a "bottom up" approach to analysis, where detailed data was obtained from individual records and a patient survey. This allowed for outcome and cost analysis by subgroup. A number of findings were consistent with the literature, in particular the dissociation between pain score and functional capacity. Increasing complexity of surgical intervention increased costs with no improvement in clinical outcome and alarming levels of radiological exposure was found. Radiation exposure could not be compared to other studies as they did not report the distribution of radiological investigations. The decision to undergo surgery appears to be based on the baseline level of pain and the fear of it worsening rather than specific clinical indications. The use of effective nonoperative methods of reducing pain offers the prospect of significantly reducing the patient demand for surgery and its attendant cost. The greatest injury-related cost savings from a societal perspective are obtained from interventions that promote early return to work and minimize lost productivity. Preventing an injury prevents the associated cost, so efforts in the area of injury prevention are critical in reducing the burden of injury. The significant reduction in injury observed from the Defence Injury Prevention Program highlights the benefit of effective primary prevention programs. Equally, once an injury occurs, secondary prevention efforts seek to achieve maximum restoration of function with minimal morbidity and cost. The results of the spinal surgery study have shown that improvement in primary outcome measures are not effect by the cost of the chosen intervention and efforts to achieve pain relief through non-operative means,in order to prevent surgical intervention, should be a high priority for research, not just in Army but in the broader community.

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Hardy, Robyn Mary. "Cost shifting : an Australian perspective." Phd thesis, 2011. http://hdl.handle.net/1885/150827.

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Abstract:

This is a study about cost shifting and how it might be more precisely defined and explained. Cost shifting is essentially a public policy issue, although it can and does occur between private sector agents. Cost shifting has been variously defined by academics and practitioners, however, the definitions to date mix cost shifting with cost sharing and subsidisation. Mostly they mention the transfer of costs from one level of government to another through direct or indirect action. The definitions to date concentrate on a few claimed causal factors such as unclear roles and responsibilities in government, multiple tiers of governance, and budget maximising behaviour. These are not satisfactory explanations because they do not provide sufficient depth of analysis about the parties to cost shifting, the drivers nor the policy conditions in which cost shifting transactions take place in Australia. Despite the numerous claims made by government actors in Australia about cost shifting to and from other governments, it is usually not recognised as a significant policy issue; although it is regarded as contentious. Where it is recognised as an issue, it is addressed through the application of rules of funding and inter-governmental agreements. Cost shifting is closely associated with government and policy power and inter-governmental power relationships. This thesis suggests that cost shifting begs further analysis because it continues to be regularly raised as a public policy issue. The exact quantum of cost shifting is unknown, but the Australian Local Government Association would argue that it is in the order of $1 billion per annum in terms of cost shifting to local government from higher levels of government - Commonwealth and state (House of Representatives, 2003). Even if this is remotely accurate, this is not an inconsiderable sum. The contribution of this thesis is a better definition of cost shifting. Direct and indirect, deliberate and unintentional cost shifting are all examined in this study. Three case studies are provided to demonstrate different facets of cost shifting in Australia. These explorations will show the original contribution of this thesis in providing a deeper definition and a more comprehensive explanation of the sites and scope of cost shifting in Australia.

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