Incremental Cost Benefit Ratio Research Articles

Effect of insecticides as seed treatment against termite in chickpea

Eight insecticides were evaluated as seed treatments against termite in chickpea, and imidacloprid 600 FS (5 ml/kg) was found to be the most effective followed by thiamethoxam 30 FS (5ml/kg) and imidacloprid 17.8 SL (5 ml/kg). Imidacloprid 600 FS @ 3 ml/kg seed, clothianidin 50 WDG @ 2g/kg and fipronil 5 SC@ 4 ml/kg seed were found moderately effective. The maximum grain yield (1346 kg ha−1) was observed with imidacloprid 600 FS (5 ml/kg) and this also gave maximum profit (Rs 17362 ha−1). However, maximum incremental cost benefit ratio of 35.19 was obtained with only fipronil.

Economic impact of the POP mode on distribution network reconstruction in the ‘coal‐to‐electricity’ project of the grid company in China: a new electricity transaction mode

AbstractThe ‘coal to electricity’ carried out by the grid company has had poor economic performance during its life cycle. This paper aims to investigate the economic impact of the package deal of off‐peak electricity transaction mode (POP) on the ‘coal‐to‐electricity’ project in comparison with peak and valley electricity price (PVP). The incremental net present value and the incremental benefit–cost ratio are selected as the main economical evaluating indicators. Taking a coal‐to‐electricity project in a region of Beijing, China, as an example to study the economic benefit of the grid company in POP. The results indicate that the economic benefit of the grid company is increased by 48% in POP compared to that in PVP. The incremental benefit–cost ratio is less than 1, which demonstrates that POP is conducive to improving the current loss status of the grid company. It is helpful to raise the grid company's enthusiasm for conducting the coal‐to‐electricity project. Finally, corresponding suggestions are put forward to help the grid company in improving the negative economic benefit. © 2019 Society of Chemical Industry and John Wiley & Sons, Ltd.

Cost-benefit analysis of a national influenza vaccination program in preventing hospitalisation costs in Australian adults aged 50–64 years old

IntroductionInfluenza causes a significant burden among Australian adults aged 50–64, however, vaccine coverage rates remain suboptimal. The National Immunisation Program (NIP) currently funds influenza vaccinations in this age group only for those at high risk of influenza complications. AimsThe main aim of this study was to determine whether a strategy of expanding the government-funded vaccination program to all adults 50–64 in preventing influenza-related hospitalisations will be cost beneficial to the government. MethodsA cost-benefit analysis from a governmental perspective was performed using parameters informed by publicly available databases and published literature. Costs included cost of vaccinations and general practitioner consultation while benefits included the savings from averted respiratory and acute myocardial infarction (AMI) hospitalisations. ResultsIn the base-case scenario, the proposed policy would prevent 314 influenza/pneumonia, 388 other respiratory and 1482 AMI hospitalisations in a year. The government would save $8.03 million with an incremental benefit-cost ratio of 1.40. Most savings were due to averted AMI hospitalisations. In alternative scenarios cost savings ranged from saving of $31.4 million to additional cost to the government of $15.4 million, with sensitive variation in vaccine administration practices (through general practitioner or pharmacists) and vaccine effectiveness estimates. DiscussionExtension of the NIP to include adults 50–64 years of age is likely to be cost beneficial to the government, although this finding is sensitive to vaccine administration cost, which varies if provided through general practitioners or pharmacists; and to variation in vaccine effectiveness. An increased role of pharmacists in immunisation programs would likely result in cost savings in an expanded adult immunisation program.

Prioritizing components of package of integrated pest management in Indian mustard (Brassica juncea) in India for better economic benefit

Almost one-fourth of India's oilseed production is contributed by Brassicas. The Indian mustard [Brassica juncea] crop is affected by several biotic stresses in India, including aphid, white rust, Alternaria blight and Sclerotinia rot, which affect crop yields. Field trials were conducted at three locations during three crop seasons (2013–16) to evaluate treatments appropriate for mitigation of crop stresses and to obtain accurate assessments for seed yields and economic benefits as a part of a prioritized component-wise Integrated Pest Management strategy for the oilseed Brassica crop. The records from diverse sites and seasons concerning infestations by biotic stresses were assembled and scrutinized. The highest reduction in the severity of white rust disease was observed due to seed treatment by metalaxyl M 31.8 ES @ 6 ml/kg seed in one experiment and by a foliar spray of a combination of mancozeb 68% + metalaxyl 4% @ 1.7 g a.i./l in another trial, the latter being economically inferior to other fungitoxicants. The highest incremental benefit cost ratio (IBCR) was noted with the treatment of seed by an aqueous extract of garlic bulb (2% w/v) in one trial and by application of Trichoderma harzianum @ 1 g/l in another trial over sprays on crop foliage over two years and over three levels of nitrogen. Thiamethoxam 25 WG @ 1 g a.i./10 l ranked better than all other spray treatments in decreasing population of aphid in the top 10 cm main shoot at two sites. Pre-sowing application of T. harzianum @ 2.5 kg/ha soil provided better mustard seed yield in combination with spray with thiamethoxam 25 WG @ 1 g a.i./10 l on crop foliage and treatment of seed with T. harzianum @ 10 g/kg seed. Though the seed yield of mustard crop was the best with the integration of applications of T. harzianum on seed, to the soil along with spray of thiamethoxam 25 WG @ 1 g a.i./10 l on crop foliage at 50 days after sowing, it did not give the highest IBCR (16.6) among treatments. Contrastingly, treatment of seed with T. harzianum alone gave the highest IBCR (112.6), where the seed yield was relatively much lower (1469 kg/ha) whilst treatment of seed with fresh aqueous extract of garlic bulb @ 2% w/v also provided a high (80.4) IBCR. This paper highlights the impact of input costs, which allows growers to decide inputs based on the prevalence of biotic stress(es), the decision on intervention based on the importance of the same with an idea about the resultant quantifiable and monetary impact.

Evaluation of pest management practices against sucking pests of Bt cotton

The impact of non-pesticide farmer’s practice (Jind district, Haryana) adopted by a group of farmers on pestpopulation, natural enemies and yield parameters was studied and compared with Integrated Pest Management strategyand pesticide based farmers’ practice within same villages where this group has implemented their pest managementstrategy in Bt cotton. Comparison of population per three leaves of sucking pests (average of 3 years) indicated lowestpopulation of whitefly (adult), jassid and thrips (nymph and adult) in IPM module (7.18, 3.37 and 7.17) followedby NIFP, non-insecticidal farmer’s practice (7.70, 3.48 and 7.62) and FP, farmer’s practice (9.64, 4.14 and 9.69)respectively. While studying the interaction among sucking pest and natural enemies it was interesting to note thatthe population, in both the cases, increased gradually and after attaining the peak activity there was a declining trend.Socio-economic studies also supported the above results. In present study, the mean seed cotton yield during 2015,2016, 2017 in IPM fields was 13.75, 22.45 and 17.42 q/ha, in NIFP it was 14.20, 18.10 and 13.70 as against 8.85,16.75 and 9.30 q/ha in pesticide based farmers’ practice, respectively. The incremental benefit cost ratio in IPM fieldswas 2.87, 3.56, 3.81 and it was 4.09, 3.53, 3.66 in NIFP fields as against 1.60, 1.99, 1.82 in FP during 2015, 2016and 2017, respectively. It is evident that by adopting IPM strategy, sucking pests in Bt cotton can be successfullymanaged along with conservation of natural enemies with minimum application of insecticides.

Evaluation of fungicides against foot and stem rot and Phoma leaf spot of roselle and their impact on fibre yield

Foot and stem rot (FSR) and Phoma leaf spot caused by Phytophthora parasitica var. sabdariffae and Phoma sabdariffae are the two major diseases, affecting the roselle cultivation across India and worldwide. The efficacy of different group of fungicides like, Acetamida-Dithiocarbamate, Methoxyacrylates, Trifloxystrobin and Tebuconazole, Phenyl amide and Copper compound were assessed under field conditions against FSR and Phoma leaf spot. Duncan’s multiple range test (DMRT) was used to determine significant difference (p < 0.05) between the treatments. Seed treatment with cymoxanil 8% + mancozeb 64% WP @ 3 g kg−1 seed + prophylactic foliar spraying of cymoxanil 8% + mancozeb 64% WP @ 0.3% at 30 and 45 days of crop age showed lowest disease incidence (3.66 and 2.93%) against FSR and Phoma leaf spot disease as compared to the untreated control (9.73 and 7.66%) and exhibited higher plant height (350 cm), high basal diameter (17.51 cm), highest benefit–cost ratio (2.1), more incremental benefit–cost ratio (15.6) and highest fibre yield (26.53 q/ha) over untreated control.

Field efficacy and economics of newer insecticides against defoliators infesting castor (Ricinus communis L.)

Field experiments were conducted during kharif season of 2014-15 and 2015-16 to evaluate the field efficacy of newer insecticides emamectin benzoate 5WG @ 0.5 g/l, lufenuron 5EC @ 1 ml /l, flubendiamide 39.35 EC @ 0.2 ml/l, chlorantraniliprole 18.5SC@ 0.3 ml/l, lambda cyhalothrin @ 1 ml/l along with conventional insecticides like profenophos 50EC @ 2 ml/l, indoxacarb 14.5SC @ 1 ml/l, thiodicarb 75 WP @ 1 g/l against castor semilooper, tobacco caterpillar and hairy caterpillars in castor. The experiments were conducted in a randomized block design with eight treatments along with an untreated control and replicated thrice. The results revealed that the maximum percentage of larval reduction was in chlorantraniliprole 18.5 SC@ 0.3 ml/l followed by flubendiamide 38EC @ 0.2 ml/1. Highest seed yield of 1543 kg/ha was obtained from chlorantraniliprole treated plots, followed by that obtained with flubendiamide (1410 kg/ha) and profenophos (1375 kg/ha) treated plots with 93.5 and 88.7 per cent increase over control respectively as against minimum yield of 729 kg/ha in the untreated control. The favourable incremental cost-benefit ratio of 1: 6.25 was obtained with profenophos 50 EC @ 2 ml/l.

Economics and energetics in hybrid sunflower cultivation as influenced by irrigation and fertilizer management practices

The objective of the study was to assess economic feasibility and environmental sustainability in sunflower cultivation as influenced by irrigation and fertilization. A field experiment was conducted during the winter (November-March) of 2011-12 and 2012-2013 in farmer’s field at Madandanga under Chakdaha block of Nadia district in West Bengal (23°22.221'N latitude and 88°22.221'E longitude with an altitude of 12 m above mean sea level), under sub-humid subtropical climatic condition. The crop irrigated thrice (I30/60/80) outperformed other crops which had reduced moisture (I30 and I30/60) in respect of gross revenue (GR). Irrespective of irrigation levels, application of N80P40K40B1.5S25 treatment paid the highest additional GR over RDF. The higher incremental cost-benefit ratio (ICBR) for ‘Aditya’ was observed with N80P40K40B1.5 at all irrigation levels. Estimated energy indices revealed that net energy gain (NEG) was the highest with the supply of N80P40K40B1.5S25 at all irrigation levels. However, maximum values of energy ratio (ER) and energy productivity (EP) were recorded with N80P40K40B1.5 while total specific energy (SE) was higher with N80P40K40S25 for all irrigation levels. Recommended dose of fertilizer (N80P40K40) was observed to be the most energy-intensive treatment with higher energy intensiveness (EI) values. The treatment N80P40K40VC5 was found to be the most energy-efficient treatment with lowest energy intensiveness (EI) values at all irrigation levels, closely followed by the N80P40K40B1.5S25 treatment.

Integrated management of Macrophomina blight of mungbean (Vigna radiata L.) caused by Macrophomina phaseolina (Tassi) Goid

Macrophomina blight disease has become a major constraint in recent years for successful and profitable cultivation of mungbean. The efficacy of different fungicides, bioagents and phytoextract in pot and field were evaluated against Macrophomina blight of mungbean. Among the foliar spray treatments (pot culture), Carbendazim 12 WP + Mancozeb 63 WP (@ 0.2%) recorded significantly highest reduction of incidence and intensity, respectively of (82.35 and 85.18%) followed by @ 0.1% Carbendazim (75.00 and 78.61%). Bioagents @ 0.5% Trichoderma harzianum (45.58 and 50.00%) and botanical @ 10% Allium sativum (41.47 and 43.64%) and Allium cepa (36.77 and 39.40%) were found effective, but B. subtilis was less effective. During Kharif, 2011–12 and 2012–2013, among the foliar spray treatments, Carbendazim 12 WP + Mancozeb 63 WP (@ 0.2%) recorded significantly least mean Macrophomina blight incidence (14.63 and 17.29%) and intensity (11.87 and 13.82%) and significantly highest mean disease reduction (67.07 and 69.17%),with significantly highest seed yield (539.63 and 535.60 kg/ha) over unsprayed control (yield 358.31 and 351.58 kg/ha), respectively and bioagents T. harzianum recorded seed yield of 484.92 and 480.52 kg/ha followed by botanicals A. sativum (470.60 and 467.29 kg/ha) and bacterial bioagent B. subtilis (432.32 and 430.52 kg/ha) recorded lowest yield among all treatments. Considering incremental cost: benefit ratio (ICBR) during Kharif, 2011–2012 and 2012–2013, the most economical treatment which recorded highest ICBR was the fungicide, Carbendazim (ICBR 1:14.83 and 1:18.38), respectively. Of the 40 mungbean cultivars/varieties evaluated (pot culture), one (BPMR-145) was found resistant. In field, during Kharif, 2011–2012 and 2012–2013, out of forty cultivars/varieties, the one cultivar BPMR-145 was found resistant and again two cultivars JL-781 and Kopargaon were found susceptible in both the year.

The optimum bus route selection for sustainable operation (case study: Tangerang bus lane)

The aim of this paper is to select the optimum route option on a bus lane corridor based on operational and economical characteristics. In this research the Tangerang Bus Lane is chosen as a case study. The operational characteristics analyzed are total boarding passenger, total number of bus, bus productivity, bus cost structure and estimated fare. Based on the previous works the operational cost and potential revenue are calculated for both route options, and then an incremental benefit cost ratio analysis is conducted to obtain the most feasible route to operate. The result shows that the alternative route still consistently in providing a better performance compared with the current route.

Bio-efficacy and economics of newer insecticides against whitefly (Trialeurodes ricini) infesting castor

A field experiment was conducted to evaluate the efficacy of newer insecticides against whitefly in castor during kharif season 2016 and 2017 at Tapioca andCastor Research Station,Tamil Nadu Agricultural University, Yethapur, Tamil Nadu. Based on whiteflies number/3 leaves/plant and per cent reduction over control recorded after two sprays concluded that all the treatments showed significant difference in reducing whiteflies over control. Among the insecticides, buprofezin 25 SC @ 0.8ml/l was found significantly most effective followed by profenophos 50 EC @ 2ml/l, imidacloprid 17.8 SL@0.5ml/l, dimethoate 30 EC @ 1.7ml/l and flonicamid 50 WG@0.2g/l for reducing the whiteflies population. Highest seed yield was obtained with buprofezin 25 SC @ 0.8 ml/l (2034 kg/ha) followed by flonicamid 50 WG @ 0.2g/l (1723 kg/ha) as against 694 kg/ha in untreated control. The maximum incremental cost-benefit ratio of 1: 16.74 was obtained with application of buprofezin 25 SC @ 0.8 ml/l.

Are GrainPro Cocoons™ an effective alternative to conventional phosphine fumigation in large-scale control of stored-maize insect pests?

There is a dearth of comprehensive data regarding the performance of large-scale hermetic maize storage in sub-Saharan Africa (SSA) as an alternative to the sole and widely used phosphine fumigant. Trials were therefore conducted at three sites in Zimbabwe for up to 12 months to evaluate the performance of 20 tonne-capacity GrainPro Cocoons™ compared with conventional phosphine fumigation practice. A split-plot experimental design was used consisting of two main plots, namely: the cocoon and fumigated stack with three sub-plots being depth positions: top, middle and bottom. At each site, sampling was conducted at setting-up and at termination. Samples were assessed for insect population, grain damage, weight loss, germination and moisture content. There were no significant differences between the main plots for grain damage, weight loss, insect pest population/kg and germination after 4 months of storage. Hermetic storage was significantly more effective than fumigation practice in preserving germination after 8 and 12 months; and in reducing grain damage, weight loss, and insect population after 12 months of storage (P < 0.05). An economic analysis using the cocoon instead of conventional fumigation, based on an incremental benefit-cost ratio (BCR), showed no benefit of the alternative when considering the local retail price. However, the alternative was beneficial with a BCR of 1.11 when import tariffs were removed from the initial cost. These findings show that with supporting national policies, cocoons can be a cost-effective alternative to phosphine fumigation. Other environmental and human safety gains of using cocoons are priceless.

VP36 Benefit Cost Analysis Of Electronic Claims Processing System In Ghana

Introduction:Since the inception of the Ghana National Health Insurance Scheme (NHIS), it has been pursuing a number of provider payment mechanisms that could not only control the continuous escalating costs of claims payout, but also facilitate the claims processing time. In lieu of this, electronic processing of claims (E-claims) was introduced in 2013 as part of the World Bank supported Health Insurance project that sought to facilitate the financial and operational management of the NHIS. It was piloted in 29 health facilities up to March 2014. They reported cost savings made by the NHIS using E-claims, creating interest in scaling it up. However, the comparative effectiveness and cost effectiveness of E-claims to the health system compared to manual claims processing is unknown. Therefore, to provide decision makers with the appropriate information to choose between manual and E-claims processing, this study sought to evaluate the cost-benefit of E-claims.Methods:A benefit-cost analysis was used to evaluate the efficiency of E-claims from the perspective of the health system. Health providers and the purchaser (NHIS claims processing center) were the study population. Resource use and costs were obtained from the study population. The volumes and values of claims reimbursed and the claims rejection rate were used as the benefits of claims processing. The incremental benefit-cost ratio (IBCR) was estimated for the provider, purchaser and the entire health system. Analysis was conducted in Microsoft Excel.Results:The total cost per claim for providers were USD 1,177.04 and USD 1,240.65 for E-claims and paper claims respectively. The total cost per E-claims and paper claims for the purchaser were 592.17 and 502.19 respectively. Total benefit per E-claim and paper claim processing for the providers were USD 8,562.90 and USD 8,888.37 respectively while that for the purchaser was USD 11,037.62 and USD 8,737.60 respectively. Processing claims electronically led to incremental gains by both providers and purchasers. Providers gained additional USD 2008.51 while the purchaser gained USD 2,300.02. The IBCR was estimated at −19.75, 25.56 and 5.10 for all providers, purchaser and both providers and purchaser of the health system respectively. Thus the IBCR was less than 1for the providers and more than 1 for purchaser and both purchaser and providers.Conclusions:The electronic processing of claims is more efficient compared to manual processing in the Ghana NHIS. This provides decision makers with evidence for scaling it up to all the facilities in Ghana.

Evaluation of insecticides against melon fruit fly Bactrocera cucurbitae coquillett on cucumber

Field evaluation of eight insecticides against melon fruit fly Bactrocera cucurbitae Coquillett (Diptera: Tephritidae) was carried out on cucumber. The results revealed superiority of cartap hydrochloride 50%SP @375g a.i/ha, tolfenpyrad 15%EC @150 g a.i/ha and fipronil 5%SC @50g a.i/ha sprays in suppressing fruit infestation, both by weight and on number basis. When these insecticides were applied as bait in their field spray recommended doses mixed with 10% gur and water, maximum attraction and mortality of adults was observed with the cartap hydrochloride bait. The economics of the treatments revealed maximum incremental benefit of Rs. 14, 025/ha with cartap hydrochloride having an incremental cost benefit ratio (ICBR) of 1: 3.53. This was followed by Rs. 8630/ha with fipronil having an ICBR of 1: 1.61.

Field efficacy of newer insecticides against Helicoverpa armigera (Hubner) on chickpea

Field experiment was undertaken at Krishi Vigyan Kendra, Sindewahi (during rabi 2011–12), and at the Agriculture Research Station, Sakoli (during rabi 2012–13 and 2013–14) to evaluate the efficacy of newer insecticides against the gram pod borer, H. armigera (Hubner) on chickpea. The results revealed that, application of emamectin benzoate 5% SG was found more effective followed by-cyhalothrin 5%EC and ethion 50%EC in terms of maximum larval reduction, and lower pod damage translating in higher yield. However, highest incremental cost benefit ratio (ICBR) was exhibited with-cyhalothrin 5% EC followed by ethion 50% EC.

Incremental cost-benefit ratio of certain bio-pesticides against Helicoverpa armigera Hubner (Noctuidae: Lepidoptera) in chickpea

To determine Incremental Cost-Benefit Ratio (ICBR) of certain bio-pesticides and insecticide against 2nd larval instar of Helicoverpa armigera in chickpea, an experiment was conducted during winter 2011. Certain pesticides as sole treatments were tested with standard, low and high doses and in treatment combinations with one half of standard doses of two respective pesticides only once at 50% flowering and podding stage of the crop. Upon crop maturity; total grain yield, additional yield, increased income and net income were obtained for each respective treatment to determine its ICBR. Overall, the treatment combination of ½ Btk + ½ Azadirachtin had the highest ICBR of 1:27.57. The lowest ICBR of 1:5.25 was obtained with Azadirachtin-0.05 %, when other treatments had ICBR from 1:8.51 to 1:23.28.

Evaluation of seed dressing chemicals for the management of sucking pests in summer groundnut (Arachis hypogaea L.)

Field experiments were conducted during summer seasons of 2009-11 to determine the effectiveness of seed treatment with imidacloprid 600 FS @ 2 ml/kg seed, imidacloprid 600 FS @ 4 ml/kg seed, thiamethoxam 70 WS @ 1 g/kg seed, thiamethoxam 70 WS @ 2 g/kg seed, acetamiprid 20 SP @ 2 g/kg seed and carbosulfan 25 DS @ 5 g/kg seed against jassids and thrips in groundnut. Results indicated that significantly lowest population of jassids and thrips was recorded in the treatment of imidacloprid 600 FS @ 4 ml/kg seed and thiamethoxam70 WS @ 2 g/kg seed, respectively. The highest pod yield was recorded from imidacloprid 600 FS @ 4 ml/kg seed (1962 kg/ha) followed by imidacloprid 600 FS @ 2 ml/kg seed (1947 kg/ha), thiamethoxam 70 WS @ 2 g/kg seed (1917 kg/ha) and thiamethoxam 70 WS @ 1 g/kg seed (1897 kg/h). The highest incremental cost benefit ratio (1: 8.76) was observed in imidacloprid 600 FS @ 2 ml/kg seed followed by imidacloprid 600 FS @ 4 ml/kg (1: 5.47), thiamethoxam 70 WS @ 1 g/kg seed (1:4.13) and thiamethoxam 70 WS @ 2 g/kg seed (1:2.60). Based on theefficacyand economics, the study suggests that seed treatment with imidacloprid 600 FS @ 2ml/kg or thiamethoxam 70 WS @ 1 g/kg seed can be opted for inclusion in IPM programme against the sucking pests in groundnut.

Population dynamics and bio-intensive management of sorghum midge, Contarinia sorghicola (Coquillett) in sorghum under southern Tamil Nadu

Surveys on distribution of sorghum midge at southern region of Tamil Nadu during 2011 to 2014 indicated that, midge observed in all areas of three districts. Effect of abiotic factors on sorghum midge revealed that maximum, minimum temperature, wind velocity and sunshine were positive while maximum, minimum relative humidity and rainfall showed negative correlation. Among bio-intensive management strategies, Neem oil 3 per cent showed maximum reduction (63.36), minimum midge incidence/5 panicle (17.5) and maximum grain yield (2498 kg/ha) when compared to control (244 kg/ha). The highest incremental cost benefit ratio (ICBR) obtained in Neem seed kernel extract (NSKE) 5 per cent (1:24.7) followed by Neem leaf extract 5 per cent (1:22.3) treated plots.

Probabilistic Return-on-Investment Analysis of Single-Family Versus Open-Bay Rooms in Neonatal Intensive Care Units-Synthesis and Evaluation of Early Evidence on Nosocomial Infections, Length of Stay, and Direct Cost of Care.

There is increasing evidence that the physical environment of neonatal intensive care units (NICUs), including single-family rooms (SFRs) versus open-bay rooms (OPBYs), has tangible effects on vulnerable patients. The objective of this study was to illustrate the financial implications of SFR versus OPBY units by synthesizing and evaluating the evidence regarding the benefits and costs of each unit from a hospital perspective. We assumed a hypothetical NICU with 40 beds in OPBY rooms, to be replaced with a new NICU with 32 SFRs and 8 OPBYs. We synthesized evidence regarding the comparative benefit of each option on 3 outcomes-nosocomial infections, length of stay, and direct costs. We calculated incremental benefit-cost ratio separately considering each outcome over an analysis period of 5 years. A ratio of more than 1 indicates that the investment is worthwhile. Input parameters were assigned probability distributions representing the degree of uncertainty around their true values. Monte Carlo simulation with 5000 iterations was used to quantify the distribution of benefits and costs. The mean value of the incremental benefit-cost ratio was 0.730 (95% credible interval: 0.724-0.735) when nosocomial infections were considered, 1.298 (1.282-1.315) when reduced length of stay was considered, and 1.794 (1.783-1.804) when direct costs of care were compared. The probability of a benefit-cost ratio of lower than 1 was about 91%, 31%, and 2% in each case, respectively. Cost savings associated with SFR units would justify additional construction and operation costs compared to OPBY units only when evidence on inclusive outcomes such as length of stay or direct costs of care is considered. A specific outcome such as infection rate potentially fails to capture all benefits of SFRs. As more evidence becomes available on full benefits and hazards of SFRs versus OPBYs, future studies should investigate the broader return-on-investment outcomes.

Economic evaluation on different two-dose-vaccination-strategies related to Measles, Mumps and Rubella Combined Attenuated Live Vaccine

To evaluate the economic effect of Measles, Mumps and Rubella Combined Attenuated Live Vaccine (MMR) under different two-dose vaccination programs. A hypothetical birth cohort of 750 000 infants over their lifetime, was followed up from birth through death in Zhejiang province. The current MMR vaccination strategie would include three different ones: 1) Childlern were vaccinated with Measles-Rubella Combined Attenuated Live Vaccine and MMR, respectively at the age of 8 months and 18 months. 2) Children receive MMR at 8 months and 18 months, 3) Strategy 1 plus an additional vaccination of MMR at 4 years of age. Incremental cost-effectiveness ratio (ICER), incremental cost-benefit ratio (ICBR) and incremental net benefit (INB) were applied to calculate the health economic difference for Strategy 2 and Strategy 3 as compared to Strategy 1. Univariate sensitivity analysis was used to assess the robustness of results with main parameters, including the rate of immunization coverage, effectiveness of the vaccines, incidence and burdens of the related diseases, cost of vaccines and the vaccination program itself. ICER, ICBR and INB for Strategy 2 and Strategy 3 appeared as 2 012.51∶1 RMB Yuan per case and 4 238.72∶1 RMB Yuan per case, 1∶3.14 and 1∶1.58, 21 277 800 RMB Yuan and 9 276 500 RMB Yuan, respectively. Only slight changes (<20%) were found under the univariate sensitivity analysis, with varied values on main parameters. Based on the current national immunization program, infants vaccinated with MMR at 8 months of age, generated more health economic effects than the Strategy 3.