Efficient Delivery Models Research Articles

Restructuring economic development in the Auckland region

The purpose of this article is to investigate the pending deterritorialisation of the local government structure in the Auckland region and the creation of a supercity as a result for the Royal Commission on Auckland's Governance. This research examines the literature and the theory behind the suggested governance changes. Various local and regional economic development delivery models are also evaluated. The literature indicates that the responsibility for crafting an Economic Development Strategy and policies remain with the proposed supercity and service delivery (implementing the strategy) be assigned to a regional Economic Development Agency (EDA) and its satellite local EDAs. The Royal Commission suggests that the responsibility for delivering economic development services should reside with a regional EDA. Nevertheless, many local stakeholders are advocating for the establishment of a larger external EDA as a Council Controlled Organisation (CCO). This analysis indicates that a “hub and spoke” operational structure for both the new regional entity and the regional EDA CCO with three sub-regional offices would be an efficient delivery model. A “hub and spoke” model enables close contact with the business communities in the various sub-regions.

Costs of managing conditions associated with obesity among Australian teenagers

To determine the health-care charges associated with monitoring and managing, over 1 year, the cases of elevated insulin concentration, elevated alanine aminotransferase concentration and dyslipidaemia due to overweight or obesity among 15-19-year-old Australian males and females. Fasting blood samples (n= 500) were collected in 2004 from a representative population sample of adolescents (n= 496; mean age 15.3 years) attending schools in Sydney, Australia. Full service charges and Medicare expenditures for specialist medical and dietary consultations, pathology tests and radiological investigations, over 1 year, under efficient and inefficient health-care delivery models, including and excluding participants in the healthy body mass index (BMI) category. Under an inefficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A305.1 million per annum (M pa). Exclusion of participants in the healthy BMI category resulted in an annual Medicare expenditure of $A170.0M pa. Under an efficient delivery model and including all participants with elevated risk factors, the Medicare expenditure was $A295.5M pa. Exclusion of participants in the healthy BMI category reduced annual Medicare expenditure to $A164.8M pa. Medicare expenditure for 15-19-year-olds would increase by 48% if only cases among overweight and obese adolescents were treated and by 85% if all cases were identified and treated. Short-term management of the health consequences of overweight and obesity among adolescents will increase Medicare expenditure on this group by at least 48%. Failure to treat will delay, but compound, health-care expenditure.