Direct Expenditures Research Articles

Response of Agriculture Production to Change of Foreign Direct Investment and Public Agriculture Expenditure in South Africa: A Monte Carlo Simulation Analysis

The rationale of this paper was to investigate the response of agriculture production to the simultaneous shock of foreign direct investment and public agricultural spending in South Africa during 1991-2019. Data were collected from secondary sources and analyzed using Monte Carlo simulation. Results revealed that agriculture production is maximized at 1,73% if Foreign direct investment inflows, agricultural credit, and the number of employees increase by 10% while public spending is decreased by 10%. Hence, it is recommended that policymakers should combine FDI inflows in agriculture, and agricultural credit in a complementary manner, with emphasis to attract more extensive farm workers to ensure the sustainability of production in the agriculture sector in South Africa. This paper contributes to enhance agriculture sector by using the best combination of input in agriculture in order to maximize production.

Personal Financial Burdens of Multiple Myeloma: A Deep Dive into the Patient's Journey Using Qualitative Interview

Background: As multiple myeloma (MM) treatments continue to advance rapidly potentially enabling patients to coexist with MM as a chronic disease, understanding the personal financial burden these patients and their family caregivers bear is critical. Most previous studies have analyzed direct medical costs mainly focusing on medication and hospital visits, but a broader analysis covering the overall financial burden on the disease journey has not been extensively explored. Our study aims to explore and understand the diverse types of financial burdens experienced by MM patients who are newly diagnosed or relapsed and their family caregivers personally aside from medical expenditures along their disease and treatment journey. Methods: We used cross-sectional study using mixed methods by integrating quantitative and qualitative data. The study was conducted at Samsung Medical Centre in Seoul, Korea from October 2021 to December 2022. Patients and their caregivers were recruited at out-patient clinics, and 60-90 minutes semi-structured interviews were conducted via face-to-face or telephone. We used thematic analysis to identify and organize qualitative data into the patterns of theme. Quantitative data including clinical and socio-demographic information of the study participants were obtained from survey and/or patients' Electronic Medical Records. Results: Overall, 80 participants were enrolled: 41 patients and 39 family caregivers. Clinical/socio-demographic information and the distribution of study participants are on the Table 1. In our study direct medical costs (e.g., treatment and medication fee) itself demonstrated minimal impact on personal financial burdens since cancer patients cover only about 5% of the total medical expense upon public healthcare insurance policy in Korea. Surprisingly, more than half of patients were reported to have experienced greater financial burdens in indirect or non-medical expenses. Five main types of personal financial burdens incurred by MM and its treatment were categorized through thematic analysis with quotes from qualitative interview in Figure 2. Within the realm of medical costs, some patients experienced financial burden with the inadequate support before their diagnosis is determined or with non-reimbursed medication on active treatment. Moreover, the additional financial burden from non-medical costs manifested conspicuously both directly and indirectly. Such as time and money for the transportation for outpatient treatment, unpaid leave for hospital visits or hospitalization and productivity loss significantly impacted both patients and caregivers. Interestingly, symptoms from disease or adverse events led to considerable unexpected personal spending in some cases. For instance, neuropathy, a common side effect of MM treatment, compelled some patients to purchase a vehicle with autonomous cruise or resort to increased taxi use due to fears related to driving. Other costs included services or aids (massage, bath or thermo-therapy) for neuropathy home remedies, increased grocery expenses due to appetite loss, and housekeeping expenses arising from fatigue and insomnia. Similarly, ‘health-conscious consumption’ was also observed to increase in some case, such as dietary supplements or organic foods. A cost that is difficult to generalize but shouldn't be overlooked in a long-term, macro perspective is the loss of opportunity costs due to disease or treatment (e.g. decrease in long-term investments, giving up job-seeking activities). This was particularly noticeable in those who were younger or self-employed. Discussion: Everyone has their own individual circumstances, and the financial impact of these circumstances varies considerably, making quantification challenging. Moreover, the significance of a given sum of money can vary individually. Thus, we sought to examine the economic impacts and financial burden on the disease journey within the diverse lives of individuals through a qualitative lens. Our qualitative approach revealed that the financial burden of disease/treatment in each individual's life can be felt incomparably greater than what previous quantitative research had estimated only for direct medical expenditures. Our findings should also underscore the need for comprehensive strategies to alleviate the personal financial burdens borne by MM patients and their caregivers.

Out-of-Pocket Expenditure for Antenatal Care Amid Free Health Care Provision: Evidence From a Large Pregnancy Cohort in Rural Sri Lanka.

Global evidence suggests that high out-of-pocket (OOP) expenditure negatively affects health service utilization and creates an economic burden on households during pregnancy. This study aimed to estimate the magnitude and associated factors of OOP expenditure for antenatal care (ANC) in a rural Sri Lankan setting by following up with a large pregnancy cohort (The Rajarata Pregnancy Cohort [RaPCo]) in Anuradhapura District, Sri Lanka. Data were collected from July 2019 to May 2020. An interviewer-administered questionnaire was used to collect socioeconomic data and OOP expenditures in the first trimester. Self-administered questionnaires were used monthly to collect OOP expenditures in the second and third trimesters. In-depth financial information of 1,558 pregnant women was analyzed using descriptive statistics, nonparametric statistics, and a multiple linear regression model. The majority of participants used both government and private health facilities for ANC. The mean (standard deviation [SD]) OOP expenditure per ANC visit was US$4.18 (US$4.19), and the mean (SD) OOP expenditure for total ANC was US$57.74 (US$80.96). Pregnant women who used only free government health services also spent 28% and 14% of OOP expenditure on medicines and laboratory investigations. Household income (P<.001), household expenditure (P<.1), used health care mode (P<.05), maternal morbidities (P<.05), and the number of previous pregnancies (P<.1) were the statistically significant independent predictors of OOP expenditure. OOP expenditure per visit for ANC equals half of the daily household expenditure. Despite having freely available government health facilities, most pregnant women tend to use both government and private health facilities and incur higher OOP expenditure. Free government health care users also incur a direct medical OOP expenditure for medicines and laboratory investigations. Monthly household income, expenditure, used health care mode, maternal morbidities, and the number of previous pregnancies are independent predictors of OOP expenditure.

Equity implications of net-zero emissions: A multi-model analysis of energy expenditures across income classes under economy-wide deep decarbonization policies

With companies, states, and countries targeting net-zero emissions around midcentury, there are questions about how these targets alter household welfare and finances, including distributional effects across income groups. This paper examines the distributional dimensions of technology transitions and net-zero policies with a focus on welfare impacts across household incomes. The analysis uses a model intercomparison with a range of energy-economy models using harmonized policy scenarios reaching economy-wide, net-zero CO2 emissions across the United States in 2050. We employ a novel linking approach that connects output from detailed energy system models with survey microdata on energy expenditures across income classes to provide distributional analysis of net-zero policies. Although there are differences in model structure and input assumptions, we find broad agreement in qualitative trends in policy incidence and energy burdens across income groups. Models generally agree that direct energy expenditures for many households will likely decline over time with reference and net-zero policies. However, there is variation in the extent of changes relative to current levels, energy burdens relative to reference levels, and electricity expenditures. Policy design, primarily how climate policy revenues are used, has first-order impacts on distributional outcomes. Net-zero policy costs, in both absolute and relative terms, are unevenly distributed across households, and relative increases in energy expenditures are higher for lowest-income households. However, we also find that recycled revenues from climate policies have countervailing effects when rebated on a per-capita basis, offsetting higher energy burdens and potentially even leading to net progressive outcomes. Model results also show carbon Laffer curves, where revenues from net-zero policies increase but then decline with higher stringencies, which can diminish the progressive effects of climate policies. We also illustrate how using annual income deciles for distributional analysis instead of expenditure deciles can overstate the progressivity of emissions policies by overweighting revenue impacts on the lowest-income deciles.

Analysis of The Financial Performance of Regional Development Planning Agencies (BAPPEDA) A Study in Serang City, Indonesia

This research aims to assess the Financial Performance of regional development planning agencies (BAPPEDA) Serang City government during 2020-2022. This financial performance measurement is more focused on the budget realization report (LRA). Based on expenditure analysis, namely expenditure compatibility analysis which is divided into direct expenditure and indirect expenditure, expenditure growth analysis, expenditure effectiveness analysis, expenditure efficiency analysis and expenditure variance analysis. The results of the analysis show that the financial performance of the BAPPEDA from 2020-2022 seen from the analysis of expenditure compatibility shows poor financial performance, because the total indirect expenditure is 66% and for direct expenditure is 34%, so it can be said that it has not paid attention to regional development. From the analysis of expenditure growth is said to be good, with an overall value of 5%. Judging from the ratio of the effectiveness of budget use is said to be effective with a total of 96%. Judging from the efficiency ratio, it is said to be efficient with a total of 33%. From the analysis of expenditure variances it is said to be good, with a total overall comparison of 96%. So in this case BAPPEDA has been able to make budget savings.

Incremental burden on health-related quality of life, health service utilization and direct medical expenditures associated with cognitive impairment among non-institutionalized people with diabetes aged 65 years and older.

To quantify the incremental health and economic burden associated with cognitive impairment (CI) among non-institutionalized people with diabetes ≥65 years in the United States. Using 2016-2019 Medical Expenditure Panel Surveys data, we identified participants ≥65 years with diabetes. We used propensity score weighting to quantify the CI-associated incremental burden on health-related quality of life measured by the 12-item Short Form Survey (SF-12), including the mental component summary score, physical component summary score and health utility. We also compared the annual health service utilization and expenditures on ambulatory visits, prescriptions, home care, emergency room (ER), hospitalizations and total annual direct medical expenditures. We included 5094 adults aged ≥65 with diabetes, of whom 804 had CI. After propensity score weighting, CI was associated with a lower mental component summary score (-8.4, p < .001), physical component summary score (-5.2, p < .001) and health utility (-0.12, p < .001). The CI group had more ambulatory visits (+4.4, p = .004) and prescriptions (+9.9, p < .001), with higher probabilities of having home care (+11.3%, p < .001) and ER visits (+8.2%, p = .001). People with CI spent $5441 (p < .001) more annually, $2039 (p = .002) more on prescriptions, $2695 (p < .001) more on home care and $118 (p < .001) more on ER visits. There is no statistically significant difference in the utilization and expenditure of hospitalizations. CI was associated with worse health-related quality of life, higher health service utilization and expenditures. Our findings can be used to monitor the health and economic burden of CI in non-institutionalized older persons with diabetes.

The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework.

Background: Migraine is a highly prevalent and incapacitating neurological disorder associated with the highest global disability burden in people aged 15 to 49 years. Europe has the fourth-highest prevalence of migraine, after North America, South America, and Central America, and above Asia and Africa. Migraine leads to relatively modest direct healthcare expenditure but has substantial indirect costs due to reduced productivity. Methods: The economic burden of migraine was estimated in comparison with the general population of the United Kingdom (UK) using an analytical fiscal modeling framework applying the government cost perspective. Published measures of migraine's impact on labor participation were applied to rates of economic activity/inactivity of the general population. The model estimates lifetime changes to earnings from employment, direct and indirect taxes paid, and financial support requirements over the life course. Incremental differences between those affected and unaffected by migraine are reported as net fiscal consequences to public accounts. Fiscal costs are reported as the discounted average per capita over a 20-year time horizon and for the entire annual UK cohort with prevalent migraine. Results: People affected by migraine are more likely to be absent from work, unemployed, and disabled, and to retire early. A 44-year-old individual affected by migraine was associated with £19 823 in excess fiscal costs to the UK government, £1379 per year living with the condition, compared with someone not affected by the disease. Annually, migraine was estimated to represent £12.20 billion to the public economy, approximately £130.63 per migraine episode. The model predicted annual productivity losses in the health and social care workforce to be £2.05 billion and total annual productivity losses to be over £5.81 billion. Conclusions: This fiscal analysis monetizes the occupational consequences of migraine to the UK government, both in terms of lost tax revenue and transfer payments. The findings are substantial and useful to characterize disease severity and to inform the body of evidence considered by decision makers appraising the cost-effectiveness of health technologies.

The Hidden Economic Consequences of Migraine to the UK Government: Burden-of-Disease Analysis Using a Fiscal Framework

Background: Migraine is a highly prevalent and incapacitating neurological disorder associated with the highest global disability burden in people aged 15 to 49 years. Europe has the fourth-highest prevalence of migraine, after North America, South America, and Central America, and above Asia and Africa. Migraine leads to relatively modest direct healthcare expenditure but has substantial indirect costs due to reduced productivity. Methods: The economic burden of migraine was estimated in comparison with the general population of the United Kingdom (UK) using an analytical fiscal modeling framework applying the government cost perspective. Published measures of migraine’s impact on labor participation were applied to rates of economic activity/inactivity of the general population. The model estimates lifetime changes to earnings from employment, direct and indirect taxes paid, and financial support requirements over the life course. Incremental differences between those affected and unaffected by migraine are reported as net fiscal consequences to public accounts. Fiscal costs are reported as the discounted average per capita over a 20-year time horizon and for the entire annual UK cohort with prevalent migraine. Results: People affected by migraine are more likely to be absent from work, unemployed, and disabled, and to retire early. A 44-year-old individual affected by migraine was associated with £19 823 in excess fiscal costs to the UK government, £1379 per year living with the condition, compared with someone not affected by the disease. Annually, migraine was estimated to represent £12.20 billion to the public economy, approximately £130.63 per migraine episode. The model predicted annual productivity losses in the health and social care workforce to be £2.05 billion and total annual productivity losses to be over £5.81 billion. Conclusions: This fiscal analysis monetizes the occupational consequences of migraine to the UK government, both in terms of lost tax revenue and transfer payments. The findings are substantial and useful to characterize disease severity and to inform the body of evidence considered by decision makers appraising the cost-effectiveness of health technologies.

Out-of-pocket expenditure on healthcare amongst households of an urban village in Delhi

Background: Poor urban households residing in an unplanned overcrowded settlement, are at a higher risk of morbidities and healthcare expenditure which can be impoverishing. Effective assessment of healthcare expenditure of households living in an urban village is needed to mitigate and protect the vulnerable households from catastrophic health expenditure. The objective of the study was to find out the mean out-of-pocket expenditure on healthcare, and catastrophic health expenditure amongst households of an urban village of Delhi. Methods: This 18-month duration cross-sectional study was carried out in an urban village of Delhi, Aliganj amongst households residing for the last one year. A sample size of 188 was statistically calculated, and households were selected using systematic random sampling. A pre-designed, pre-tested, semi-structured and interviewer administered questionnaire was used in Hindi to elicit and record information. Data was recorded and coded in MS Excel, and analysis was done using licensed SPSS v.26. Tables was generated, and cross-tables were used to assess statistical association with Chi-square or Fischer Exact tests, as required. Multivariate logistic regression was applied to the variables found having a statistically significant association on cross-tables (p&lt;0.05). Results: The mean out-of-pocket expenditure borne by a household was INR 20,125.5 (SD± 50,772.3), with a median expenditure of INR 1800. Eighty percent of OOPE was incurred as direct expenditure and 56% was spent in private health facilities. Conclusions: The households of an urban village of Aliganj, Delhi, have high out-of-pocket expenditure (60.6%), and catastrophic health expenditure (22.9%).

Reconsidering agricultural credits and agricultural production nexus from a global perspective

AbstractAccess to credit has been a key component in protecting a country's agriculture sector against uncertainties and climate‐related shocks. Agricultural credits may also increase both agribusiness sectors' and farming‐related commercial activities' exposure to world markets. This study aims to investigate agricultural credits' short‐run and long‐run effects on agricultural production using control variables such as foreign direct investments, inflation rate, and government expenditures. We found that credits to agriculture affect value‐added agriculture positively in the long‐run; specifically, when agricultural credits increase by 1%, value‐added agriculture will increase by 0.19%; that is, an increase in credits to the agricultural sector leads to a significant increase in value‐added agriculture, while FDI and government size both reduce agricultural value‐added across countries. The findings of the pairwise causation test show that bidirectional causal links exist among almost all variables, validating feedback among agricultural value‐added, credit to agriculture, FDI, government expenditures, and inflation.

Supply Chain Management in Using DEMATEL Method

Supply Chain Management. Introduction: The management of the flow of goods and services that starts at the point of origin and concludes with consumption is known as supply chain management. Additionally, it includes the transportation and storage of basic supplies used in ongoing projects, inventory, and fully furnished commodities. Monitoring and tying together the manufacturing, transport, and shipment of goods and services is the primary goal of supply chain management. Companies that have excellent and tight control over internal inventory, production, distribution, internal productions, and sales can do this. The flow of commodities, services, and knowledge from the manufacturer to the consumer is depicted in the above diagram. The image shows the transfer of a good from a producer to a manufacturer. Research significance: improved client relationships and services are developed. improves the delivery of goods and services with the least amount of delay. increases productivity and operational efficiency. reduces the expense of storage and transportation. cuts down on both direct and indirect expenditures. aids in attaining the timely delivery of the appropriate goods to the appropriate location. improves inventory management, enabling just-in-time stock model execution to be carried out successfully. helps businesses adjust to the challenges posed by economic instability, rising consumer demands, and related variations. Methodology: the decision-making trial and evaluation laboratory (dematel) is regarded as an efficient technique for locating the causal links in a complex system. It focuses on assessing the interdependencies between elements and identifying the crucial ones using a visual structural model. Alternative: Alignment mechanisms, Cross functional process changes, Information systems, Performance measurement, People empowerment. Evaluation preference: Alignment mechanisms, Cross functional process changes, Information systems, Performance measurement, Alliance design, People empowerment. Results: from the result, it is seen that Alignment mechanisms got the first rank whereas the, People empowerment is having the lowest rank. Conclusion: as can be seen, Alignment mechanisms has the lowest rating while, People empowerment has the top rank.

Police perspectives on the economic considerations of providing healthcare in short-term custodial settings in Australia.

Providing appropriate healthcare to people in short-term police custody settings (i.e. watch-houses) is challenging due to the complexity of detainee health needs and the limitations of the custodial environment. However, little is known about how detainee healthcare is managed in Australia, including economic considerations. This study had two aims: (1) to understand police perspectives on the costs associated with the delivery of healthcare to watch-house detainees in Queensland, Australia and (2) to scope the applicability of the Prison Healthcare Expenditure Reporting Checklist (PHERC) tool for the Australian watch-house context. The study employed an exploratory qualitative descriptive approach. A purposive sample comprised 16 watch-house staff from six regions in Queensland, Australia, interviewed between April and November 2021. A key finding was that police viewed healthcare expenditure as a major, but largely unavoidable cost for Australian watch-houses. Participants reported that direct expenditure comprised mostly of in-house healthcare services (of which there were a variety of models), but also costs of medication and health-related consumables. Indirect costs included costs of escorting and guarding detainees requiring transfer to hospital for health assessment and treatment. Participants reported that the PHERC was not applicable to the Australian watch-house context. Future research should explore the cost-effectiveness of different watch-house healthcare delivery models and how best to measure this.

Direct Medical Expenses and Influencing Factors of MDR/RR-TB in Eastern China: Based on Data from Multi-Hospital Information Systems.

Multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis (TB) is related to high healthcare costs. However, studies on direct healthcare expenditure in different settings remain inconclusive. Hence, we aimed to examine the direct medical expenses (DME) of patients with MDR/RR-TB and assessed which patient characteristics were associated with higher costs. DME was evaluated using records from the hospital information system in three cities with different economic levels in Zhejiang Province, Eastern China, matching with data (including socio-demographics, disease treatment status, etc.) collected in the Tuberculosis Management Information System. A logistic regression model was used to identify variables associated with higher costs. Of 193 patients with MDR/RR-TB, the average DME was $10,491 (interquartile range (IQR) $4679-16,710), consisting of $2696 (IQR $1019-5100) out-of-pocket costs, medical reimbursement, and subsidies, accounting for 32%, 50.3% and 14%, respectively. A total of 74.2% and 56% of DME were for drugs and anti-TB drugs, respectively. Only 16.9% of the patients were treated with an all-oral regimen. Higher DME was significantly associated with local residents 7.29 (95% confidence interval (CI) [2.62-20.3]), hospitalization experience 7.63 (95% (CI) [2.54-22.95]), longer duration of treatment 6.63 (95% CI [2.27-19.35]), and lower health insurance reimbursement 5.65 (95% CI [1.90-16.79]). DME of patients with MDR/RR-TB was still significant, and domestic migrants, hospitalization, long treatment duration, and high health insurance rates increased the financial burden on MDR/RR-TB patients. Reasonable intervention programs should be developed to reduce the medical burden of patients with MDR/RR-TB, according to the DME and its component of MDR-TB patients, besides the economic status of their regions.

Healthcare expenditure trends among adult stroke patients in the United States, 2011-2020

BackgroundIn the US, between 2018 and 2019, approximately $57 billion were expended on stroke and related conditions. The aim of this study was to understand trends in direct healthcare expenditures among stroke patients using novel cost estimation methods and a nationally representative database. MethodsThis study was a retrospective analysis of 193,003 adults, ≥18 years of age, using the Medical Expenditure Panel Survey during 2009-2016. Manning and Mullahy's two-part model were used to calculate adjusted mean and incremental medical expenditures after adjusting for covariates. ResultsThe mean (Standard Deviation) direct annual healthcare expenditure among stroke patients was $16,979.0 ($16,222.0- $17,736.0) and was nearly 3 times greater than non-stroke participants which were $5,039.7 ($4,951.0-$5,128.5) and were mainly spent on inpatient services, prescription medications, and office-based visits. Stroke patients had an additional healthcare expenditure of $4096.0 (3543.9, 4648.1) per person per year, compared to participants without stroke after adjusting for covariates (P<0.001). The total mean annual direct healthcare expenditure for stroke survivors increased from $16,142.0 (15,017.0-17,267.0) in 2007-2008 to $16,979.0 (16,222.0-17,736.0) in 2015-2016. ConclusionOur study showed that stroke survivors had significantly greater healthcare expenses, compared to non-stroke individuals, mainly due to higher expenditures on inpatient services, prescription drugs, and office visits. These findings are concerning because the prevalence of stroke is projected to increase due to aging population and increased survival rates.

Analysis of the Effect of Regional Expenditure Management on the Level of Community Welfare in Papua Province

The objectives of this research are (1) to find out how much direct and indirect spending affect the poverty rate through economic growth, (2) to find out how much direct and indirect spending affect the HDI level through economic growth, (3) find out how much direct spending and indirect spending affect the gini ratio through economic growth. To fulfill the research objectives and test the hypotheses that have been set, the analysis used is path analysis to facilitate data processing, so the analysis used in processing the data is the Amos Program Version 22. The research results show that: a direct relationship between direct expenditure variables and growth The economic correlation shows a positive but not significant correlation. The direct expenditure variable has a negative and significant effect on poverty, both directly and through the economic growth variable. The results show that the direct spending of the Papua provincial government has an indirect effect on the poverty rate in this area. The direct expenditure variable has a positive effect on improving HDI performance, both directly and through economic growth variables. That is, the correlation between direct spending on regional inequality shows a positive relationship, both directly and through economic growth variables. Indirect spending variables have a negative relationship to economic growth in Papua province. The correlation between indirect spending on poverty levels in Papua province shows negative relationship, both directly and through economic growth. Indirect expenditure variables have a negative correlation with HDI performance, both directly and through economic growth variables. Furthermore, indirect expenditure variables have a positive correlation with regional inequality in this area, both indirectly directly or through intervening variables of economic growth.

A 14-Year Longitudinal Analysis of Healthcare Expenditure on Dementia and Related Factors (DEMENCOST Study).

The large number of dementia cases produces a great pressure on health and social care services, which requires efficient planning to meet the needs of patients through infrastructure, equipment, and financial, technical, and personal resources adjusted to their demands. Dementia analysis requires studies with a very precise patient characterization of both the disease and comorbidities present, and long-term follow-up of patients in clinical aspects and patterns of resource utilization and costs generated. To describe and quantify direct healthcare expenditure and its evolution from three years before and up to ten years after the diagnosis of dementia, compared to a matched group without dementia. Retrospective cohort design with follow-up from 6 to 14 years. We studied 996 people with dementia (PwD) and 2,998 controls matched for age, sex, and comorbidity. This paper adopts the provider's perspective as the perspective of analysis and refers to the costs actually incurred in providing the services. Aggregate costs and components per patient per year were calculated and modelled. Total health expenditure increases in PwD from the year of diagnosis and in each of the following 7 years, but not thereafter. Health status and mortality are factors explaining the evolution of direct costs. Dementia alone is not a statistically significant factor in explaining differences between groups. The incremental direct cost of dementia may not be as high or as long as studies with relatively short follow-up suggest. Dementia would have an impact on increasing disease burden and mortality.

Valuing surfing ecosystems: an environmental economics and natural resources management perspective

Surfing ecosystems—surf breaks and their surrounding areas—can provide multifaceted benefits, including support for tourism industries, personal and social wellbeing and shoreline protection. Previous research has predominantly concentrated on quantifying direct expenditures, sidelining non-market values, and failing to consider the interactions between multiple ecosystem components. To address these gaps, this paper provides a review of key principles of environmental economics and natural resource management in relation to surfing ecosystems. We examine how the value of surfing ecosystems can affect (and be affected by) factors related to environmental sustainability, tourism demands and economic development. We propose a novel framework for characterizing the values of surfing ecosystems and conducting economic assessments, based on six main features: (i) surf breaks, (ii) surfing resources, (iii) surfing ecosystems, (iv) economic values, (v) economic valuation, (vi) equity and sustainability. This structured approach may serve to improve decision-making processes concerning environmental changes that impact surfing ecosystems, including tourism management plans and environmental regulations. Our study aligns with broader global initiatives to better account for ocean-based values and support sustainable, nature-based tourism.

Analisis Kinerja Keuangan Badan Perencanaan Pembangunan Daerah (BAPPEDA) Provinsi Aceh

This research aims to determine the extent of shopping compatibility at Bappeda of Aceh Province during 2017-2021 based on analysis of direct and indirect expenditure growth at Bappeda of Aceh Province during 2017-2021. This research method used is descriptive quantitative with data collection techniques through documentation. The subjects of this study are the parties involved in the research that is the Head of Finance Section of the Bappeda Aceh Province. The object of this study is the Financial Performance of Bappeda Aceh Province by looking at the Budget Realization Report (LRA) for five fiscal years during 2017-2021. The result of the study indicate that the compatibility of direct and indirect spending during 2017-2021 is categorized as good. This is because the percentage of direct compatibility during 2017-2021 is greater than the percentage of indirect spending. The biggest decrease in testing direct spending on total spending is in 2019 which is 61%. The lowest percentage in the indirect analysis of total spending is in 2021, which is 34%. The growth of spending with the fiscal years during 2017-2021 is positive or negative. The results of the analysis on the growth of spending in 2017-2018 was positive of 12%. Furthermore, in 2018-2019 it was negative of -3%, in 2019-2020 it was positive of 3%, and in 2020-2021 it was positive of 1%.

Economic aspects of the fixed combinations of lipid lowering medicines in group risks patients

Relevance. Cardio-vascular diseases (CVD) are the one of the main reasons of mortality and disability. Hypercholesterinemia is a factor of CVD progression, and thus it should be corrected. Combination of statin + ezetemib is an effective option of a medical technology for this purpose. Pharmacoeconomic analysis of rosuvastatin and ezetemib fixed combination (FC) has been performed in this work in comparison with free combination (FrC) of these drugs.Materials and methods. Modelling of FC vs FrC in groups of CVD risk has been performed on 1–5 years horizon based on the local epidemiologic published data with aim of economic analysis. Efficacy of FC and FrC, direct medical costs, including cost of drugs, hospitalizations etc. were taken into account also. ICER has been calculated and compared with willingness to pay.Results. FC usage instead FrC can prevent 2960–3055 deaths and 8880–9164 admissions to hospital caused CVD. FC decrease of ambulance cost as well as others direct medical expenditures in compare with FrC treatment on 9,3 bln RUR per 5 years. ICER has been calculated and has negative (dominant) result.Conclusion. FC usage is an economic dominant technology in compare with FrC for hypercholesterolemia control.

Socio-Psychological, Economic and Environmental Effects of Forest Fires

One of the most common forest disturbances, fire, has a significant influence on the people, societies, economies, and environment of countries all over the world. This study explores the different environmental and socioeconomic effects of forest fires to establish priorities for countries in battling and mitigating the harmful effects of forest fires based on data collected from 382 professionals working in Greece’s forestry and agriculture sectors. Secondary data, especially from Statista, were further utilized to enhance the analytical comparisons and conclusions of this study. Wildfires in Greece destroy agricultural land and greatly impact the rural economy and community. This study showed that forest fires have led to several economic costs, mainly affecting the incomes of different investors in the forest sector in Greece. It was revealed that the overall cost of a fire is determined by the direct and indirect expenditures as well as the price of fire control and preventative methods. Direct expenses are broken down into two categories: direct damage that occurs immediately and direct losses that are caused immediately after a fire. Governments should take the initiative to create and expand bilateral and/or multilateral cooperation and coordination, as well as exchange necessary financial resources, technology, and training, to reduce the effects of forest fires in a fragile international man-made and natural environment.