Five-year Budget Research Articles

Evaluating the budget impact of Empagliflozin in managing heart failure with reduced ejection fraction: Proposing strategic policies for Malaysian public healthcare.

Sodium-glucose co-transporter-2 (SGLT2) inhibitors such as Empagliflozin, are increasingly recommended as part of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) in many developed nations. This recommendation is based on robust clinical evidence showing that adding Empagliflozin to GDMT improves heart failure symptoms, clinical outcomes, functional status, and overall quality of life. In Malaysia, where healthcare is predominantly public and heavily subsidized, the introduction of new treatments can significantly impact costs, requiring detailed economic assessments. This study evaluates the budget impact of incorporating Empagliflozin into GDMT for HFrEF from the perspective of the public healthcare system. A five-year budget impact model was developed, integrating local data such as population, drug use, costs, clinical outcomes, and healthcare expenses. In the current scenario (GDMT alone), the projected five-year expenditure is MYR 6.12 billion (USD 3.92 billion). With Empagliflozin, the total cost rises by 0.71% to MYR 6.16 billion (USD 3.95 billion), driven by drug acquisition costs of MYR 160.12 million (USD 102.64 million) and adverse event costs of MYR 211,543 (USD 135,604). However, these costs are offset by savings from reduced HF hospitalizations, fewer cardiovascular deaths, and improved renal outcomes. Sensitivity analysis identified hospitalization costs, the price of Empagliflozin, and cardiovascular deaths in diabetic patients as key factors influencing the budget impact. Policymakers can improve the affordability of Empagliflozin through strategies like price negotiations, cost-sharing, and focusing on high-risk groups to optimize healthcare expenditure while ensuring effective treatment access.

Role of the State in Dealing With Fake News on Social Media

The state’s role in dealing with fake news on social media remains little understood. The objectives of this study are the following: 1) to identify the steps and process that the state can take in verifying and managing fake news on online social media, 2) to examine the means that different agencies have in developing and implementing policies to regulate fake news on online social media, and 3) To draw conclusions from this research and present them in the form of a guideline for improving the governmental policies on the regulation of fake news on social media. A mixed-methods approach was used. Qualitative data were collected from document analysis and interviews. Quantitative research was done through data collection in a questionnaire survey. Variables were determined to measure the factors affecting the implementation of an online fake news control policy. The quantitative research showed that different policies have different impacts on the following issues. (1) The organization with the highest mean clarity in determining the steps for verifying and managing fake news is the Ministry of Digital Economy and Society. (2) The highest mean support for the implementation of fake news verification and management is the Ministry of Interior. (3) The Ministry of the Interior had the highest mean data collection and convenient searching for information to verify fake news. (4) The Ministry of Digital Economy and Society has the highest mean in communication and coordination across agencies. (5) The department with the highest mean sufficient types, channels, and methods for communication and coordination with agencies in fake news verification is the Ministry of Transportation. (6) The position with the highest mean ability to shorten communication and coordination steps is the director. The researcher suggests the following. (1) All agencies should establish clear steps and process for fake news identification and designate personnel to verify it. This includes empowering agencies to conduct legal proceedings. Each agency only has coordinators who have separate job responsibilities, which increases their workload and reduces their power to take legal action. (2) Types of news should be clearly categorized. News that can be easily verified, such as official ministerial announcements, should be immediately responded to through normal channels. News that is new and has not had official confirmation by the ministry or has not been scientifically endorsed should receive expert study. A data center can be set up in each ministry to respond to the population online. (3) For verification of fake news on social media, the state authorized a five-year budget to the Ministry of Digital Economy and Society to manage the National Anti-Fake News Center. However, other agencies should also receive sufficient funding for this mission. (4) In addition to using the channels of the National Anti-Fake News Center, the government should cooperate with mainstream media to find fake news on a daily basis.

Cost-Utility Analysis of Community Case Management for Malaria Control in Burundi.

The community case management (CCM) program for malaria control is a community-based strategy implemented to regulate malaria in children in Burundi. This study compared the cost and utility of implementing the CCM program combined with health facility management (HFM) versus HFM alone for malaria control in children under five in Burundi. This study constructed a five-year Markov model with one-week cycles to estimate cost-utility and budget impact analysis (BIA). The model defined 10 health states, simulating the progression of the disease and the risk of recurrent malaria in children under five years of age. Cost data were empirically collected and presented for 2019. Incremental cost per disability-adjusted life year (DALY) averted, and a five-year budget was estimated. One-way and probabilistic sensitivity analyses (PSAs) were then performed. From provider and societal perspectives, combining the CCM program with HFM for malaria control in Burundi was more cost-effective than implementing HFM alone. The addition of CCM, using artesunate amodiaquine (ASAQ) as the first-line treatment, increased by US$1.70, and US$ 1.67 per DALY averted from the provider and societal perspectives, respectively. Using Artemether Lumefantrine (AL) as the first-line treatment, adding the CCM program to HFM increased by US$ 1.92, and US$ 1.87 per DALY averted from the provider and societal perspectives. At a willingness-to-pay of one GDP/capita, the CCM program remained a 100% chance of being cost-effective. In addition, implementing the program for five years requires a budget of US$ 15 800 486-19 765 117. Implementing the CCM program and HFM is value for money for malaria control in Burundi. The findings can support decision-makers in Burundi in deciding on resource allocation, especially during the program's scale up.

Economic evaluation of rotavirus vaccination in children of Bhutan

BackgroundDiarrhoea remains one of the top ten causes of under-five child morbidity in Bhutan, and rotavirus is a significant cause of child diarrhoeal hospitalisations. This study sought to determine the health outcomes, cost-effectiveness, and budget and human resource implications of introducing rotavirus vaccines in the routine immunisation program to inform Bhutan’s decision-making process. MethodsWe used UNIVAC model (version 1.3.41) to evaluate the cost-effectiveness of a rotavirus vaccination programme compared with no vaccination from a government perspective. We also projected the impact of rotavirus vaccination on human resources and budget. Acost-effectiveness threshold was determined to be 0.5 times the gross domestic product (GDP) per capita (equivalent to the United States dollar ($) 1,537) per Disability-Adjusted Life-Year (DALY) averted.One-way deterministic and probabilistic sensitivity analyses, and threshold analyses were performed to capture parameter uncertainties. ResultsIn Bhutan, a rotavirus vaccination programme over 10 years (2020 to 2029) can avert between 104 and 115 DALYs, at an incremental cost ranging from $322,000 to $1,332,000. The incremental cost-effectiveness ratio (ICER) across four vaccination programmes compared to no vaccination scenario were $9,267, $11,606, $3,201, and $2,803 per DALY averted for ROTARIX, RotaTeq, ROTAVAC, and ROTASIIL, respectively. The net five-year budget impact of introducing a rotavirus vaccination programme ranged from $0.20 to $0.81 million. The rotavirus vaccination programme has a potential to reduce the workload of health care workers such as paediatricians, nurses, dieticians, and pharmacists; however, the programme would require an additional 1.93–2.88 full-time equivalent of health assistants. ConclusionAt the current cost-effectiveness threshold, routine rotavirus vaccination in Bhutan is unlikely to be cost-effective with any of the currently available vaccines. However, routine vaccination with ROTASIIL was under the cost-effectiveness threshold of one times the GDP per capita ($3,074). ROTASIIL and ROTAVAC would provide the best value for money in Bhutan.

Abstract No. 625 Factors influencing successful implementation of a joint internal medicine–interventional radiology bedside procedure service at a large academic center

In 2016, our institution implemented a novel bedside procedure service jointly managed by the Department of Medicine (DOM) and Division of Interventional Radiology (IR), termed the Joint IM-IR Central Procedure Service (CPS). Since implementation, this service has resulted in significantly reduced complications, higher-than-predicted case volume, and overall positive cost-benefit. Here, we describe the development of the Joint IM-IR CPS at a large academic center and identify key aspects of the business proposal which aided in obtaining funding, with the goal of promoting successful adoption of similar services at other hospital systems. Documents created by DOM and IR leadership during development of the service were critically reviewed, including the business proposal, narrative of benefits, short- and long-term financial projections, and interim performance reports. Informal interviews were conducted with CPS leadership to understand the implementation process. The Joint IM-IR CPS introduced the following major structural changes: expanded full-time procedural staff trained by IR; centralized scheduling and image storage through existing IR structures; and dedicated IR suite for back-up and overflow coverage. Persuasive safety benefits delineated in the business proposal included: enhanced house-staff training in all departments through IR, decreased complications (defined by MHACS), and increased provider and patient satisfaction (measured by HCAHPS and internal surveys). Valued financial benefits included: decreased length-of-stay and decreased legal claims (estimated with historical cost data). To secure funding, the service’s financial viability was demonstrated via comprehensive calculation of labor and non-labor costs, as well as a five-year budget plan accounting for variables over time such as high up-front costs, inflation, and increasing procedure demand. Collaboration between IR and DOM can greatly improve outcomes and productivity of hospital bedside procedure services. Clear presentation of the benefits and financial requirements, both immediate and future, are key for obtaining institutional approval and funding for such services.

Budgeting in Uruguay Towards modern budgeting practices in Uruguay

Uruguay is the only country in the world which has a five-year budget. A budget is prepared by each new government taking office and voted within 6 months of its swearing in, for the whole five-year government term. Each year, an annual revision (“budget update”) takes place, where the government reports budget implementation to the Parliament and some adjustments to the coming year’s budget can be made. Uruguay has done significant improvements in budget management in the last decade since 2005, achieving great results in terms of financial stability and funding predictability for spending institutions. The governance of the budget process has shifted, with the leadership for the budget process being now in the National Budget Unit and the Macroeconomic Assessment Unit (both located in the Ministry of Economy and Finance), and the Office of Planning and Budget (located in the Presidency) developing planning functions. While the new roles and responsibilities seem quite clear today, they are not yet institutionalised. This budget review aims to provide a detailed description of how Uruguay’s budget institutions work today and present roles and responsibilities of each actor in the budget process. It also analyses Uruguay’s budget practices in the light of OECD countries best practices, and proposes policy recommendations for further modernising Uruguay’s budget process, in particular in the areas of aligning the budget with medium-term strategic planning and measuring results. EL codes: H50, H61, H80 Keywords: Uruguay, Five-year budget, Budget process, Strategic planning

Analisis Kinerja Keuangan Daerah Tahun Anggaran 2011 – 2015 Di Kabupaten Sumedang Provinsi Jawa Barat

AbstractLocal financial performance is one measure to see the ability of local in the running local autonomy, especially in implementing fiscal decentralization. Seeing this, the authors are interested in doing research with the title "ANALYSIS OF FINANCIAL PERFORMANCE OF FISCAL YEAR 2011 - 2015 SUMEDANG REGENCY WEST JAVA" to measure how much of Sumedang implement fiscal decentralization by looking at the financial performance.The research combines qualitative research to strengthen the quantitative calculation results with sequential explonatory research model (mixed method). Quantitative data analysis carried out by calculating of the local financial performance with the regression analysis to measure the relative influence the independent variable of the financial performance. While the analysis of qualitative data through interviews to the relevant parties to strengthen the results of quantitative measurements.Result showed that the financial performance of Sumedang seen from the calculation shows the ratio of Degree of Fiscal Decentralization less criteria, with an average calculation of 12% over the five-year budget. Regional Financial Independence Ratio shows a instructive relationship. Growth ratio showed an fluctuated. Effectiveness and efficiency ratios showed criteria PAD is very effective and very efficient. Liquidity ratio to the current ratio is 2.87 while the current ratio shows 2.59. And Asset Turnover ratio shows the number of 10%. Based on these research also known factors that significantly influence the financial performance of Sumedang are PAD and Asset whereas Transferhave negatifely significant influence to financial performance with the contribution of the effect of 100%. The Goverment of Sumedang have some efforts done to increase financial performance through socialiszation, Land Value Zona program, repeated data collection, and intensification or extensification of local tax. Keywords: Local Financial Performance, PAD, Transfer.

Фармакоэкономическое исследование применения эверолимуса для иммуносупрессивной терапии после пересадки почки

Objective: to calculate cost difference between two approaches for immunosuppressive therapy after renal transplantation: everolimus plus reducedexposure cyclosporine and mycophenolic acid plus standard-exposure cyclosporine. Methods. We calculated the two-year difference in costs that resulted from effectiveness and safety differences of alternatives employing the probability-statistical model. Data on safety and efficiency were taken from D. Cibrik et al. (2013) randomized control trial. We also estimated the budget impact for everolimus inclusion into 7 expensive diseases program (7EDP). 7 EDP is the special federal program of drug provision for patients suffering from 7 certain diseases and health states including organ posttransplantation period. Results. Everolimus plus reduced-exposure cyclosporine leads to cost reduction by 161 RUB thousands (17%) per patient in a two-year period. The reduction mainly results from cheaper medication in everolimus plus reduced-exposure cyclosporine approach compared to mycophenolic acid plus standard-exposure cyclosporine. Everolimus inclusion into 7 expensive diseases program leads to reduction in federal budget spending starting from the first year; the total five-year budget savings are 275 RUB millions.

THE POSSIBLE INFLUENCE OF RISK MANAGEMENT, FORECASTING, AND PERSONNEL TRAINING IN PHYSICAL ASSET MANAGEMENT

The work presented in this paper highlights the possible effects of risk management, forecasting, and personnel training in the physical asset management environment. Each section is taken separately, and an argument is formed as to why it is important and what portion of the physical asset management five-year budget each should receive. This paper considers the long-term and short-term benefits in its conclusion that risk management should receive 60 per cent of the budget, personnel training 25 per cent, and forecasting the final 15 per cent.

Budget impact analysis of peritoneal dialysis vs. conventional in-center hemodialysis in the United Kingdom

Objectives: The increasing prevalence of patients with end-stage renal disease (ESRD) is driving up the costs of dialysis care dramatically. The National Institute of Clinical Excellence (NICE) has projected significant cost savings by increasing the proportion of patients on peritoneal dialysis (PD). This study investigates the five-year budget impact on UK national healthcare spending on dialysis of changing the distribution of adult patients undergoing peritoneal dialysis and in-center hemodialysis (ICHD). Methods: An Excel®-based budget impact model was constructed to assess dialysis-associated costs when changing adult patients between PD and ICHD. The model incorporates the current modality distribution in the UK and accounts for dialysis payments, drug costs (including ESAs), and the costs and probabilities of adverse events including access failure, access infection, pneumonia, and cardiovascular events. Data from the UK Renal Registry reports were used to estimate the size of the UK adult dialysis patient population for the next five years. The baseline scenario assumed a stable distribution of PD (15%) and ICHD (82%) over five years; the remaining 3% is assumed to be home hemodialysis. Alternative scenarios included: 1). increasing the prevalence of PD by 1.5% each year for five years; 2). increasing the prevalence of PD by 3.0% each year for five years; 3). decreasing the prevalence of PD by 1.5% each year for five years. All three scenarios were accompanied by commensurate changes in ICHD, assuming no change in home hemodialysis. Differences among scenarios were evaluated in terms of costs to UK National Health Services (NHS). Results: Under the current UK national tariff, an increase in the prevalent PD population from 15% in 2013 to 21% or 27% in 2017 is predicted to result in fiveyear cumulative savings for NHS of £28.3 million and £78.9 million, respectively. If the prevalent PD population were to decrease from 15% in 2013 to 9.0% by 2017, the total NHS payment for adult dialysis patients would increase by £73.0 million over the next five years. Conclusions: Under the current UK national tariff, incentives to increase the proportion of patients on PD could help reduce dialysis-associated costs. The main driver of the savings comes from the reduction of the estimated transportation costs. Budget Impact Analysis of Peritoneal Dialysis vs. Conventional In-center Hemodialysis in the United Kingdom Frank Xiaoqing Liu1, Robert Leipold2, Murat Arici3, Usman Farooqui3 1 Baxter Healthcare Corporation, Deerfield, IL 60015 USA; 2 United BioSource Corporation, Bethesda, MD 20814 USA; 3 Baxter Healthcare Ltd., Compton, RG20 7QW United Kingdom. Poster No. SP442

Changes and challenges: Physics in India

To go from having islands of excellence to being a major world player in science, India must solve such problems as a dearth of teachers and a divide between research and teaching.

CERN's next five-year budget is reduced, but preserves projects

CERN's next five-year budget is reduced, but preserves projects

The Last Assistant Professor: Professionalization and the Non-academic Job Market

My spouse was recently appointed to a tenure-track position at a reputable university college. Like many job searches these days, it was long and difficult: she had a degree from a big-name graduate program, half a dozen articles in major journals, a book from a well-regarded university press, and of course plenty of teaching experience, but even so it took seven years, scores of applications, and several on-campus interviews before the day came for which so many job seekers wait. When the phone finally rang, when we had done whooping and hollering with delight, with relief, I congratulated her for having become the last assistant professor. I probably had Mary Shelley's apocalyptic tale The Last Man more on my mind than Frank Donoghue's The Last Professors: The Corporate University and the Fate of the Humanities, but, either way, the title seemed apt. With the abrupt hiring freezes that followed the economic downturn in 2009 and the increasing willingness of university administrations, both here and south of the border, to replace tenure-track faculty with so-called limited-duties instructors, it seemed that she had grabbed the brass ring at the last possible instant. Things have not gotten appreciably better in the months that have followed. The hiring freeze is only slowly giving way in Canada, and the situation seems to have only deteriorated south of the border, where the New York Times, among other publications, has been devoting an increasing amount of ink to the proposition that in this time of rampant budget deficits at both public and private postsecondary institutions tenure has become a luxury few can afford. To these trends and concerns, I want to introduce another factor, one that has received less notice but which may, in fact, have as much if not more of an impact on the odds of getting a tenure-track position in the future. The factor I have in my mind is the shift in focus at many Canadian universities from undergraduate to graduate education. This shift has been especially evident in Ontario, where the provincial government's last five-year budget plan for postsecondary education held out large incentives for graduate training. My own school, for example, has doubled its graduate intake over the last five years and expects to double it again. When pressed as to the rationale for such dramatic increases at a time when many schools have frozen or drastically cut back on new hires, a couple of arguments have been offered: 1. In a knowledge-based economy, where specialist training is required to keep pace with the rapid growth of knowledge in the most important fields (read: medical science, computer science, engineering), a three-or four-year ba is no longer sufficient. If Canada is to remain competitive in the global information economy, we will need more mas and phds, highly skilled workers who, the reasoning goes, will readily find employment in industry. 2. phds on average outearn other college graduates within five years of finishing their degrees, regardless of whether or not they secure employment in a field related to their education. In some ways, this second point is the key argument, for underlying it is a supposition, perhaps new to graduate programs in the humanities: graduate degrees are no longer to be thought of, in the first instance, as providing training for academic employment, either at colleges or universities. Marketing studies have shown that there is a largely untapped demand for graduate training, especially for students from outside Canada and the U.S. If you know what the Bologna Accord is, or if you've been asked to include a statement of learning outcomes on your syllabi, then you have already felt this shift toward the globalization of education, the time when students will be able to move relatively freely between institutions and receive credit for their studies at each. North American schools feel that they stand to gain the most from the increased movement of students across borders at the graduate level and have stepped up the marketing of their ma and phd programs, in Asia especially. …

BASF aims to uncover opportunities in Asia

BASF's various projects in Asia are coming together more or less as planned, the company asserted in Singapore recently. Although the economic crisis will slow sales growth in Asia in 1998, it will otherwise provide special opportunities to enter new markets. Of particular note, BASF hinted that it was getting ready to raise its stakes in Japan. Speaking at a media briefing, BASF's top three managers in Asia repeated the broad outline of the firm's regional strategy: strengthen local presence in every Asian country, but build the largest facilities in China, Malaysia, and India. The company said it has set aside a $4.4 billion, five-year budget to implement projects its board has already approved. But BASF might invest more, it indicated. In addition to the sums that its board has approved, funds are available for unforeseen investment opportunities, essentially acquisitions of existing production facilities. We are not bargain hunting in Asia, we are looking for ...

Thierry van der Pyl and European HPCN trends

As Europe competes in today's global marketplace and strives to influence high-tech research and development, leaders of the European Commission must determine strategic areas of research and development and successfully support and finance projects in these areas. To this end, the EC has set up Framework Programs to define central R&D areas and draft a five-year budget for each program. As the end of the current program, FP4, draws near, those involved with the EC are busy planning for FP5, set to start in 1999. One influential EC voice belongs to Thierry Van der Pyl, head of the HPCN unit in the EC Program on Information Technologies (Esprit). He has been with the Commission since 1984 and has helped shape Europe's HPC R&D programs. The author considers how HPC is a central factor in European research. She considers a user-friendly model, the new networking dimension and the five main Esprit HPCN research areas.

Canada's Envelope Budget: A Strategic Management System

Canada's envelope budget system organizes the budgeting and policy-making process into a strategic decision function which integrates concepts of what to decide with concepts of how to decide, provides policy guidance budget targets by program prior to the start of the budget process, and delegates decisions to different levels based on who needs to make what decisions. This is a conscious effort to integrate macro and micro decisions within a context of scarce resources and should be of great interest to American decision makers, irrespective of whether their jurisdictions are beginning to emerge from prolonged periods of fiscal stress as are many states or whether they are influenced by looming federal deficits and program diminutions. Strategic planning offers decision makers the opportunity either to cut back in an organized way or to spend new resources where they will do the most good. While much of the recent literature on cutback budgeting has dealt with resource scarcity by tactical maneuvers such as across the board cuts which penalize the efficient and necessary with the inefficient and less necessary, there is a body of literature in cutback management which deals with cutback management as strategic planning. Moreover, strategic planning is a familiar, if minor, theme in budget literature. Charles Mottley' traces it to documents first produced by the U.S. Naval War College in 1936 and later into the military's version of PPB. Mottley suggests that one of the reasons for the lack of acceptance of PPB in civilian agencies may have been that it was adopted without the extensive strategic planning process which the military used. In his classic article on the Road to PPB, Allen Schick2 comments that planning, management, and control are always present in the budget process; the planning which Schick cites is strategic planning-emphasizing the process of deciding on the objectives as well as deciding on the resources needed to obtain those objectives. In examining cutback patterns, Levine, Behn, and Cyert3 all have emphasized that piecemeal cutbacks are not enough, that managers must have a vision of the organization and a strategic planning process to help them crystallize and obtain that vision or to change it as conditions change. The difference is that strategic planning allows a leader a proactive stance, as opposed to a reactive, event-controlled, reflexive reaction. Mottley suggests that good leaders are always haunted by the possibility of being unprepared and that that risk increases as technological change accelerates. Strategic planning puts a leader in a position to respond effectively to contin* Canada's envelope budget system is designed to manage both the process and outcome of the Canadian federal budget process. Programs are divided into envelopes and managed by cabinet committees who are given advance targets for their envelopes in the annual budget process based on the performance of the economy. The system functions within a five-year budget plan, emphasizes the provision of policy analysis, cabinet committee government, and substitution of new programs for old programs in the budget base. The envelope system seems to have improved the process of budgeting. While national budget systems do not translate perfectly, American jurisdictions may want to consider certain aspects of the envelope system.

THE FIVE‐YEAR BUDGET

Canadian Public AdministrationVolume 9, Issue 2 p. 201-210 THE FIVE-YEAR BUDGET Jacques Parizeau, Jacques ParizeauSearch for more papers by this author Jacques Parizeau, Jacques ParizeauSearch for more papers by this author First published: June 1966 https://doi.org/10.1111/j.1754-7121.1966.tb00932.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume9, Issue2June 1966Pages 201-210 RelatedInformation