Average Social Cost Research Articles

A single dose for me, A wealth of protection for us: The public health cost of individualism in the rollout of COVID-19 vaccine

ObjectiveThis study examines whether individualism weakens the effectiveness of the COVID-19 vaccine eligibility expansions in the United States in 2021, and assesses the associated social benefits or costs associated with individualism. MethodsWe construct a county-level composite individualism index as a proxy of culture and the fraction of vaccine eligible population as a proxy of vaccination campaign (mean: 41.34%). We estimate whether the COVID-19 vaccine eligibility policy is less effective in promoting vaccine coverage, reducing in COVID-19 related hospitalization and death using a linear two-way fixed effect model in a sample of 2866 counties for the period between early December 2020 and July 1, 2021. We also test whether individualism shapes people's attitudes towards vaccine using a linear probability model in a sample of 625,308 individuals aged 18–65 (mean age: 43.3; 49% male; 59.1% non-Hispanic white, 19.1% Hispanic, 12% African American; 5.9% Asian) from the Household Pulse Survey. ResultsThe effects of expanded vaccine eligibility are diminished in counties with greater individualism, as evidenced by lower effectiveness in increasing vaccination rates and reducing outpatient doctor visits primarily for COVID-related symptoms and COVID deaths. Moreover, our results show that this cultural influence on attitudes towards vaccine is more pronounced among the less educated, but unrelated to race. ConclusionAssuming an average level of vaccine eligibility policies and an average intensity of individualism across the nation, we calculate that the average social cost associated with an individualistic culture amid the pandemic is approximately $50.044 billion, equivalent to 1.32% of the total U.S. health care spending in 2019. Our paper suggests that strategies to promote public policy compliance should be tailored to accommodate cultural and social contexts.

Valuation of forest‐management and wildfire disturbance on water and carbon fluxes in mountain headwaters

AbstractRecent drought, wildfires and rising temperatures in the western US highlight the urgency of increasing resiliency in overstocked forests. However, limited valuation information hinders the broader participation of beneficiaries in forest management. We assessed how historical disturbances in California's Central Sierra Nevada affected live biomass, forest water use and carbon uptake and estimated marginal values of these changes. On average, low‐severity wildfire caused greater declines in forest evapotranspiration (ET), gross primary productivity (GPP) and live biomass than did commercial thinning. Low‐severity wildfires represent proxies for prescribed burns and both function as biomass removal to alleviate overstocked conditions. Increases in potential runoff over 15 years post‐disturbance were valued at $108,000/km2 for commercial thinning versus $234,000/km2 for low‐severity wildfire, based on historical water prices. Respective declines in GPP were valued at −$305,000 and −$1,317,000/km2, based on an average social cost of carbon. Considering biomass levels created by commercial thinning and low‐severity fire as more‐sustainable management baselines for overstocked forests, carbon uptake over 15 years post‐disturbance can be viewed as a benefit rather than loss. Realizing this benefit upon management re‐entry may require sequestering thinned material. High‐severity wildfire and clearcutting resulted in greater declines in ET and thus greater potential water benefits but also substantial declines in GPP and live carbon. These lessons from historical disturbances indicate what benefit ranges from fuels treatments can be expected from more‐sustainable management of mixed‐conifer forests and the importance of setting an appropriate baseline.

The distortion of distributed facility location

We study the distributed facility location problem, where a set of agents with positions on the line of real numbers are partitioned into disjoint districts, and the goal is to choose a point to satisfy certain criteria, such as optimize an objective function or avoid strategic behavior. A mechanism in our distributed setting works in two steps: For each district it chooses a point that is representative of the positions reported by the agents in the district, and then decides one of these representative points as the final output. We consider two classes of mechanisms: Unrestricted mechanisms which assume that the agents directly provide their true positions as input, and strategyproof mechanisms which deal with strategic agents and aim to incentivize them to truthfully report their positions. For both classes, we show tight bounds on the best possible approximation in terms of several minimization social objectives, including the well-known average social cost (average total distance of agents from the chosen point) and max cost (maximum distance among all agents from the chosen point), as well as other fairness-inspired objectives that are tailor-made for the distributed setting, in particular, the max-of-average and the average-of-max.

Stated Preference Estimates of the Average Social Cost of Carbon

Stated Preference Estimates of the Average Social Cost of Carbon

Assessing the Social Costs of Mixed Transport Systems with a Dominance of Motorcycles

When undertaking strategic planning to identify potential options for a detailed assessment, it is important to compare the total costs of existing mixed transport systems with the introduction of different new public transport (PT) modes. Hence, this study develops a social cost model for situation of mixed transport system which has a dominance of motorcycles where a new PT technology (e.g. Bus Rapid Transit - BRT, Monorail or elevated Metro) or an exclusive bus lane is being considered. The innovative aspects of this research are to develop equations to estimate the average operating speed of each mode and to the allocation of infrastructure costs to several transport modes sharing the facilities in motorcycle dominated mixed traffic environments. Based on a four-lane per direction mixed traffic corridor in Hanoi, Vietnam, the results show the lowest average social cost (ASC) mixed transport systems for different ranges of demand. Moreover, all mixed traffic options with BRT, Monorail, elevated Metro or exclusive bus lanes are better than the existing situation in terms of ASC and it is suggested that their feasibility is examined in a detailed assessment. The mixed transport social cost model can be modified to suit other local conditions where conventional bus, car and motorcycle share facilities and a new PT mode is operated. Additionally, transport planners and decision makers in such local situations, which are particularly common in South East Asia, can draw on the findings of this study.

KEY ASPECTS OF THE ANALYSIS OF LABOUR RESOURCES-BASED RETURN AND LABOUR COSTS-BASED RETURN OF THE ENTERPRISE IN THE CONTEXT OF CONTEMPORARY SITUATION

The issue of the effective use of workforce is relevant at all phases and stages of each enterprise’s development. The importance and relevance of this issue are even greater in the context of high inflation rate in the country and the impact of different crises – health, economic, price, energy, social, and now the military crisis, due to the conflict and the war in the vicinity of the Bulgarian frontier.The first object of study in this publication is the indicator of labour resources-based return, which shows the final effective use of the enterprise’s workforce. This indicator is analysed as a separate object of the analysis to identify the strength and direction of direct factors that affect its dynamic. These factors are as follows:1. changes in the labour productivity and2. changes in the sales return.The second object of study refers to the labour costs-based return indicator, which characterises the final effectiveness of costs incurred by the enterprise for the functioning of the workforce it has hired, and namely, costs for staff salaries and social security. This indicator is also analysed as a separate object of the analysis. It identifies the strength and direction of direct factors’ impact on the dynamics of this indicator. These factors are as follows:1. changes in the labour productivity;2. changes in the average wages per staff member;3. changes in the average social security costs per staff member; and4. changes in the sales return.Their objectively existing correlation is a prerequisite for correlating these two objects.The subject matter of this publication covers the methodological aspects of the analysis of labour resources-based return and the analysis of labour costs-based return.The author’s objective is to suggest approved methodologies for analysis of the labour resources-based return and for analysis of labour costs-based return, which are applicable to and useful for the business practice. This publication suggests guidelines for deeper analysis methodologies by correlating the factors affecting the change of the annual labour productivity with the factors affecting the return calculated both on the basis of labour resources and on the basis of labour costs as well. Such correlation may result in objective symbiosis among the use of working time, efficient use of manpower (labour productivity) and labour resources-based and labour costs-based return.

On Evolutionary Vaccination Game in Activity-Driven Networks

Since human face-to-face communications change over time, their perceived probabilities associated with uncertain outcomes usually present a nonlinear fashion in reality. This article incorporates both humans active characteristics and risk perception into epidemic spreading and explores a comprehensive evolutionary vaccination game in activity-driven networks. According to the weighting effect, the individuals’ activity rate thresholds are obtained in different cases under the framework of the pure Nash equilibrium. Furthermore, how the number of connected edges of activated individuals <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$m$ </tex-math></inline-formula> and infection rate <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\lambda $ </tex-math></inline-formula> affect individuals’ vaccination, decision-making is theoretically analyzed. It is proven that some unvaccinated individuals gradually become vaccinated individuals with the increase of <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$m$ </tex-math></inline-formula> or <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\lambda $ </tex-math></inline-formula> . Moreover, there is a unique pure Nash equilibrium social state (Pareto optimization), and the pure Nash equilibrium together with Pareto optimization has the same equilibrium for our proposed evolutionary vaccination game, which provides an alternative condition judging the stability of game system. In the case of complete information and individual complete rationality, the factors, including vaccination cost, individuals’ activity rate, the number of connected edges of activated individuals, and infection rate, have a significant influence on the final average social cost.

How can China achieve its goal of peaking carbon emissions at minimal cost? A research perspective from shadow price and optimal allocation of carbon emissions

The Chinese government has declared a determination at the 75th United Nations General Assembly that China will improve its independent contribution and adopt more powerful measures to peak the carbon emissions before 2030. However, such strict implementation of carbon reduction policies is bound to bring the cost of sacrificing economic development. In such a context, this paper tries to use shadow price to measure the average social cost of emission reduction, marginal abatement cost to depict the pressure to reduce carbon emissions based on non-radial distance function, and provides an optimal scheme for provincial emission reduction to minimize the national cost of emission reduction based on variable-coefficient model. Results show that: First, the average value of shadow price is 15.91 and varies widely among regions, which means on average reducing one unit of carbon emissions will sacrifice 15.914 yuan RMB of economic output, and there exists possibility of carbon transactions across regions; Second, on the one hand, marginal abatement cost of carbon emission for most regions presents an upward tendency over time, which means greater economic costs have to be sacrificed with economic development in the future; On the other hand, marginal abatement cost is much higher in regions with high economic level than that in the economically undeveloped areas, which indicates reducing carbon emissions is becoming increasingly difficult and would pay more economical cost in economically developed regions; Third, the optional allocation scheme of CO2 reduction derived from this research is better than administrative ways of Grandfathering and Benchmarking in terms of minimizing emission reduction cost. Results of this paper indicate that larger carbon trading market can be implemented in China to economically fulfill the commitment of peaking carbon emissions.

A comparative economic assessment of urban transport infrastructure options in low- and middle-income countries

Several innovative public transport (PT) projects have been developed in low- and middle-income countries (LMICs), where cars, motorcycles and buses share the facilities. However, there seems to be very little evidence on assessment methods to analyse the feasibility of different PT modes and identify the most cost-effective mixed transport system. To address this issue, this study develops a comparative economic assessment (CEcoA) based on the PT technologies’ characteristics and the conditions of local transport networks. The assessment integrates four models. First, a social cost model (SCM), that calculates the social costs of each mode and mixed transport systems, is the key model in the assessment. Second, an incremental elasticity analysis (IEA) evaluates changes in total demand by using the demand elasticity with respect to a composite cost. The IEA solves the first drawback of the SCM that demand is assumed to be fixed. Third, an incremental logit model (ILM) estimates changes in modal shares with respect to generalised costs. The ILM overcomes the second disadvantage of the SCM, where preferences of users for all alternative transport modes are not considered. Fourth, a microscopic simulation model (MSM) simulates all existing transport modes’ flows on the local network. The MSM solves the third drawback of the SCM, which only considers an isolated corridor without any interaction between the different modes and any junctions. The assessment was applied to compare an existing mixed transport situation and twelve options with an introduction of new PT technologies (Bus Rapid Transit - BRT, elevated Metro and Monorail) replacing the existing bus services; either wholly or partially, and with or without a congestion charge scheme for private transport (PRV) on a corridor in Hanoi, Vietnam in terms of average social cost (ASC), total demand and PT share. The results show that eight options with BRT or Monorail or Metro are feasible, whilst the BRT option that replaces all existing buses and includes congestion charging is the best alternative in terms of ASC. Transport planners and decision makers can draw on the findings of this research. A congestion charge scheme might be considered for the local conditions to meet specific objectives such as a reduction in ASCs and an increase in modal share of PT. The CEcoA can be a strategic tool for not only planning new PT technologies on corridors in the whole network but also retrospectively evaluating investments of PT modes. Moreover, the methodology of the CEcoA might be applied and modified to various transport networks with an abundance of motorcycles to assess the costs and benefits of new PT modes and mixed transport systems with or without the congestion charge.

The technical impacts of the carbon tax in China

Despite the significant impacts of technology on the socioeconomic effects of climate policies, many previous researchers neglected the induced technical impacts and thus resulted in biased evaluations of climate policies. Hence, it is important that the induced technology should be endogenized in the policy evaluation framework. The purpose of this paper is the quantification of the technical impacts of the Chinese carbon tax using a Computable General Equilibrium (CGE) model. The technical impacts are denoted by the induced technological change (ITC), which is a function of the energy-use efficiency (EUE), energy-production efficiency (EPE), and nonenergy-production efficiency (ENE). The carbon tax will increase the energy cost share because of the internalisation of the abatement costs. This paper empirically shows that the carbon tax will decrease the energy cost share and production efficiency but increase the energy use and nonenergy production efficiency. Under the carbon tax, the ITC will decrease the energy use and production efficiency but increase the nonenergy production efficiency. The ITC will increase the RGDP, decrease the household welfare, and increase the average social cost of carbon (ASCC). This finding implies that the ITC of the carbon tax is biased towards the technical progress of nonenergy sectors; the emission abatement will become costlier under the ITC impacts. Although the quantification method of the technical impacts was from an existing published paper, the CGE analysis of the ITC impacts of the carbon tax in China is original in this paper.

There is no economic case for new coal plants in India

India is the world’s third-largest emitter of CO2 and coal-fired power plants contribute approximately half of India’s CO2 emissions. Indian government policies assume a significant expansion of coal-fired power in India over the next two decades. This paper compares the costs of coal and renewable power, including quantifiable domestic external costs, in 2018 as well as projections for 2025. Our estimate for the environmental cost of coal is 2.4 US ¢/KWh (1.64 ▪/KWh) in the financial year 2018–19. The average cost of electricity from nearly all coal plants in India is greater than the cost of new solar and wind generators in 2018–19 when environmental costs are taken into account. More than 50% of the coal capacity has a social operating cost that is higher than the average social cost of power from renewables. By 2025, the cost of electricity from renewables with storage will be comparable to the domestic social costs of the cheapest new coal plants. We emphasize that this analysis holds without any accounting of climate change impacts in the form of a cost of carbon. There is, therefore, no economic case for new coal plants in India.

The Urbanisation Impacts on the Policy Effects of the Carbon Tax in China

In the literature, very few studies have focused on how urbanisation will influence the policy effects of a climate policy even though urbanisation does have profound socioeconomic impacts. This paper has explored the interrelations among the urbanisation, carbon emissions, GDP, and energy consumption in China using the autoregressive distributed lag (ARDL) model. Then, the unit urbanisation impacts are inputted into the policy evaluation framework of the Computable General Equilibrium (CGE) model in 2015–2030. The results show that the urbanisation had a positive impact on the GDP but a negative impact on the carbon emissions in 1980–2014. These impacts were statistically significant, but its impact on the energy consumption was not statistically significant. In 2015–2030, the urbanisation will have negative impacts on the carbon emissions and intensity. It will decrease the GDP and the household welfare under the carbon tax. The urbanisation will increase the average social cost of carbon (ASCC). Hence, the urbanisation will reinforce the policy effects of the carbon tax on the emissions and welfare.

The impact of climate risk valuation on the regional mitigation strategies

Different assumptions and methodologies prompt divergent policy recommendationgs for combatting climate change. Although climate scientists would like to be as precise as possible, policymakers with different attitudes towards climate change will always choose the result that matches their own value judgments. This paper discusses the impact of climate change attitudes on optimal mitigation in 15 regions. The climate change attitude is refined by a meta-analysis of 27 climate damage estimations and distilled into five damage functions. The optimal mitigation is calculated using the non-cooperative scenario of the regional integrated model of climate economy (RICE). The results show that the optimal mitigation paths in developing countries are more sensitive to climate change attitudes than they are in developed countries. In 2100, the range of optimal emissions represents 20% of the average optimal emissions by developing countries, which is twice the value of average optimal emissions by developed countries. The average social carbon cost in developing countries is 20 times higher than that in developed countries. This large uncertainty may be the combined result of high shadow prices of capital and large quantities of future emissions in these developing countries.

Burden of Pediatric Central Nervous System Infection and Cost-Benefit Simulation of Multiplex Polymerase Chain Reaction in Japan.

To investigate the clinical use of multiplex polymerase chain reaction (mPCR) in Japan, epidemiological and clinical data for central nervous infections are needed. Here, we report on the epidemiology and economic burden of central nervous system infections and a simulation of the cost-benefit analysis of the Filmarray® Meningitis/Encephalitis (FAME) test for possible clinical use in Japan. We performed FAME tests on samples from 27 patients with pleocytosis aged between 0 and 20 years seen in six community hospitals in Nara and Osaka prefectures. All clinical management procedures were performed without knowledge of the mPCR test results. We analyzed the clinical data and calculated the required reduction in average length of stay for the FAME test to be cost-beneficial. Among the 27 cases, the FAME test revealed causal pathogens in 13 cases (48.1%). The average medical and social costs per case were ¥299,118 ($2,719.2) and ¥171,768 ($1,561.5), respectively. The minimal needed reduction in average length of stay for the FAME test to be cost-beneficial was 0.32- 0.86 days per meningitis case. The result can be informative for evaluating the cost-effectiveness of the clinical use of the FAME test in Japan.

Assessing the social costs of urban transport infrastructure options in low and middle income countries

ABSTRACTThis paper develops cost models for urban transport infrastructure options in situations where motorcycles and various forms of taxis are important modes of transport. The total social costs (TSCs) of conventional bus, Bus Rapid Transit (BRT), Monorail, Metro (Elevated Rail), car, motorcycle, Taxi and Uber are calculated for an urban corridor covering operator, user and external costs. Based on the parameters for a 7 km corridor in Hanoi, Vietnam, the results show the lowest average social cost (ASC) transport modes for different ranges of demand. Motorcycle might be the best option at low demand levels while conventional bus has advantages with low-medium demand. At medium demand levels, bus-based technologies and Monorail are competitive options while Metro, with a higher person capacity, is the best alternative at the highest demand levels. Compared to other modes, the ASCs of car and Taxi/Uber are greater because of high capital cost (related to vehicles) per passenger and low occupancy. Transport planners and decision makers in low and middle income countries (LMICs) can draw on the findings of this study. However, various limitations are identified and additional research is suggested.

Economic costs and health-related quality of life associated with individual specific reminiscence: Results from the InspireD Feasibility Study.

Recent studies have focused on the use of technology to support reminiscence but there remains a dearth of research on the health costs and benefits associated with this intervention. The aim of this study was to estimate costs and quality of life associated with a home based, individual specific reminiscence intervention, facilitated by an iPad app for people living with dementia and their family carers, with a view to informing a future cost-effectiveness analysis. Use of community health and social care services, hospital services, prescribed medication and informal caregiving was assessed using an adapted version of the Client and Socio-Demographic Service Receipt Inventory (CSRI) at baseline and 3-month follow-up. Quality of life was assessed at baseline, 6-week and 3-month follow-up using the EQ5D, DEMQOL and DEMQOL proxy instruments. Results showed that average health and social care costs were £29,728 per person at baseline (T0) and £33,436 after 3 months (T2). Higher T2 costs were largely accounted for by higher informal caregiving costs. There was an overall increase in health-related quality of life over the duration of the intervention, although there were notable differences in index scores generated by the EQ5D (0.649, 0.652 and 0.719) and DEMQOL instruments (0.845, 0.968 and 0.901). The study concluded that a full cost-effectiveness analysis could incorporate a similar range of cost-categories with minor amendments to the CSRI to improve the accuracy of cost estimation. Furthermore, a larger sample size, randomisation and longer follow-up period are required to allow potential effects of the intervention to be realised and differences between intervention and control groups to be accurately detected.

An Analysis of Social Cost in School Level Education of Nepal

Social costs in education plays decisive role for education development and economic growth of a nation. In this context, this article tries to analyze the size, trend and growth rate of social cost in the education sector of Nepal by disaggregating it into total social cost, recurrent social cost, capital social cost, unit cost and marginal cost in community based school education of Nepal. The study is based on the secondary data obtained from official documents of Nepal’s Government such as flash report, budget speech, red book and so on. The time series data from 2011 AD to 2015 AD were collected for the analysis by using convenience non-random sampling method. The overall finding of the study shows that the share of the annual average social cost in education is 15.84 percent of the total cost of the government of Nepal. In other words, the government has allocated annual average Rs 68930697.6 thousands as social cost in educational sector during the study years. The average annual growth rate of this cost is 5.15 percent. The study also indicates that annual average total social cost is Rs 68930697.6 thousands, recurrent social cost is Rs 5,71,63,418.79 thousands and capital social cost is Rs 1,17,67,278.81 thousands in Nepal. Similarly, annual average total social cost is estimated to be Rs 3,33,35,928.80 thousands. The total social unit cost per teacher and total social unit cost per student are Rs 196.39 thousands and 5.51 thousands respectively. The annual average marginal social cost per teacher and marginal social cost per student are Rs 1308.08 thousands and -202.96 thousands respectively. The negative sign indicates that student enrolment has decreased over the study period. The findings of the study conclude that there is no any predictable relationship among student enrolment, teaching and non-teaching staffs and social cost of education in case of Nepal. However, UNESCO (1999) had analyzed public investment on education of 16 countries and it found that their average investment on education was 19.2 percent of GDP. Therefore, Nepal government should increase in educational investment from its current status of 15.80 percent to at least more than it in the coming years to develop educational sector of Nepal.

The total social costs of constructing and operating a maglev line using a case study of the riyadh-dammam corridor, Saudi Arabia

Background: Introducing Magnetic Levitation (Maglev) technology in a developing country is a big challenge that needs huge investments in infrastructure, operations and maintenance. Background information about the development of Maglev worldwide to date is included.&#x0D; Aim: Determine a methodology to estimate the full cost of travel and provide insights into the working model developed to include the calculations of the total social costs of building a new Maglev line for the Riyadh-Dammam corridor in Saudi Arabia and understand in what circumstances it is a suitable technology to use.&#x0D; Methods: The Spreadsheet Total Cost Model (STCM) is used to determine the calculations of operator costs, user costs, and environmental costs. However, the operator costs are related to infrastructure construction and maintenance costs, and costs associated with the acquisition, operation and maintenance of Maglev rolling stock. The user costs are dependent on the journey time, including access/egress time, waiting time, and in-vehicle time. The value of time is considered in order to get the user costs calculated. The external costs include air pollution, noise pollution, accident, and climate change per passenger-km.&#x0D; Results: The travel demand has to be forecasted in order to determine the total social costs, using the elasticity approach between the the proposed HSR and Maglev lines in terms of their number of trips and the generalised journey times. In addition, the generalised journey time is based on the in-vehicle time and service interval penalty. The Maglev system is operated at the capacity limit and the change in service is therefore forecasted to increase the Maglev demand by 24.6 % (3.25 million passengers). In terms of the total infrastructure costs, the infrastructure construction and maintenance costs are included and computed to be about € 835.4 million per year, using the capital recovery factor (0.06) based on 35 years of operation and a 5 % social discount rate. The acquiring, operating, and maintaining train’s unit cost is included in the calculation of rolling stock to achieve results of € 22.4 million, € 22.5 million, and € 40.9 million, respectively. In terms of the user costs, the access/egress time is computed as of 33 minutes, using the car, while the in-vehicle travel time and waiting time are resulted of 61.8 minutes and 7.8 minutes, respectively. The external environmental costs are based on accidents, and climate changes of € 8.87 million per year and € 8.13 million per year, respectively. However, the total social costs of Maglev line are computed as € 1.18 billion for 16.45 million passengers per year. This gives an average social cost of € 71.9 per passenger. The comparable figures for High-Speed Rail (HSR) are € 1.10 billion for 13.21 million passengers per year, giving an average social cost of € 83 per passenger.&#x0D; Conclusion: In conclusion, the Riyadh-Dammam Maglev system introduces a new intercity system into Saudi Arabia and brings new competition in the intercity transit market as a part of the future transport developments in the country. The average social cost for HSR is around 16 % higher than Maglev- but that is more proven technology.

Reconfiguring in-patient services for adults with mental health problems: changing the balance of care.

Research suggests that a significant minority of hospital in-patients could be more appropriately supported in the community if enhanced services were available. However, little is known about these individuals or the services they require. To identify which individuals require what services, at what cost. A 'balance of care' (BoC) study was undertaken in northern England. Drawing on routine electronic data about 315 admissions categorised into patient groups, frontline practitioners identified patients whose needs could be met in alternative settings and specified the services they required, using a modified nominal group approach. Costing employed a public-sector approach. Community care was deemed appropriate for approximately a quarter of admissions including people with mild-moderate depression, an eating disorder or personality disorder, and some people with schizophrenia. Proposed community alternatives drew heavily on carer support services, community mental health teams and consultants, and there was widespread consensus on the need to increase out-of-hours community services. The costs of the proposed community care were relatively modest compared with hospital admission. On average social care costs increased by approximately £60 per week, but total costs fell by £1626 per week. The findings raise strategic issues for both national policymakers and local service planners. Patients who could be managed at home can be characterised by diagnosis. Although potential financial savings were identified, the reported cost differences do not directly equate to cost savings. It is not clear whether in-patient beds could be reduced. However, existing beds could be more efficiently used. None.

Studying from Home? Do Private and Public Benefits Go Side by Side?

The objective of this paper is to compare the average annual and total cost of obtaining a university degree in three different universities: an Open and Distance Learning university serving lifelong learning purposes and two conventional universities in Greece. Our findings show substantial differences in average annual costs (per student) among these three universities with the Open and Distance Learning University (Hellenic Open University-HOU) having both the lowest annual average private and university cost. Consequently, HOU has the lowest average social cost. Moreover, comparing the total private cost for obtaining a university degree, the lowest cost is in the HOU despite its longer period of studies. This raises expectation to perspective students of HOU for higher rates of return after graduation. A similar pattern, also, holds for the social cost showing that HOU is socially cost effective. Clearly, our findings suggest that an Open and Distance Learning University that serves lifelong learning purposes is a cost effective investment in creating human capital privately and socially.