Indirect Expenditure Research Articles

Taxpayers' Share of US Prescription Drug and Insulin Costs: a Cross-Sectional Study.

Drug prices affect government budgets directly through spending on public programs like Medicare and Medicaid, and indirectly via private coverage for public employees and tax subsidies for private insurance. Yet, the Senate parliamentarian ruled that the Senate could not use streamlined Budget Reconciliation to extend the Inflation Reduction Act's controls on insulin co-payment or drug prices to private insurers on the grounds that their expenditures do not affect the federal budget. To quantify insulin and other drug costs borne by federal, state, and local governments, including direct expenditures and indirect government subsidies that flow through private insurers. Cross-sectional analysis of expenditures for outpatient retail prescription drugs reported by respondents and their pharmacies in the 2019 Medical Expenditure Panel Survey (adjusted downward for drug rebates), supplemented with information on employment-related insurance from the US Office of Management and Budget and other sources. The civilian non-institutionalized US population. Direct (payments by public health insurance programs) and indirect (taxpayer-funded payments via private insurers) government expenditures for outpatient retail drugs. Direct government expenditures for outpatient retail prescription drugs totaled $154.85 billion in 2019, including $15.68 billion for insulin. Indirect government expenditures channeled through private insurers totaled $53.59 billion (including $5.48 billion for insulins). Those indirect expenditures encompassed $32.32 billion in tax subsidies for employer-sponsored private coverage, $25 million for subsidies to private Affordable Care Act marketplace plans, and $21.24 billion for government-paid premiums for public employees and retirees. Overall, government expenditures for outpatient retail prescription drugs totaled $208.44 billion, 58.76% of all-payer spending and 65.96% of spending for insulin. Governments directly or indirectly fund most drug purchases, including substantial expenditures that flow through private insurers. Hence, prices paid by private insurers impact government budgets, supporting the view that government should be allowed to regulate drug prices.

Patient evaluated economic impact of keratoconus in New Zealand

ABSTRACT Clinical relevance Few studies have investigated the economic burden of keratoconus to patients and society including a patient’s lifetime expenditure. Analysing disease cost is important in advocating funding and planning for appropriate management and treatment. Background Keratoconus can be an expensive disease, including costs associated with visual rehabilitation and surgery. This study aimed to assess direct and indirect expenditures incurred by keratoconus subjects, to estimate the lifetime per capita cost and the total costs of keratoconus per year in Auckland, New Zealand. Methods A cross-sectional study where participants with keratoconus were recruited from public and private clinics to complete an anonymous questionnaire. A keratoconus health expenditure questionnaire was used to assess direct and indirect expenditures for participants. Estimated lifetime per capita costs and total direct and indirect costs associated with keratoconus were calculated. Results Responses from 110 participants were recorded. Most participants (55.5%) were between the ages of 21 and 30, 59.1% were male, and Pacific People were over-represented (14.5%) compared to the national population. The prevalence of visual rehabilitation was low with 74.5% of participants never wearing contact lenses and 32.7% of subjects wearing spectacles purchased over 24 months prior. Few participants (26.5%) had subsidised care, including private health insurance with optical cover or the contact lens subsidy. Total direct and indirect costs are estimated to be NZD 30.9 million per year with an estimated lifetime per capita out-of-pocket cost of NZD 79,254. Conclusion Subjects with keratoconus experience significant direct and indirect costs with limited subsidisation from the government and private health insurance. The significant out-of-pocket costs required for managing keratoconus are likely a significant barrier to accessing appropriate visual rehabilitation in New Zealand.

Out-of-pocket and indirect expenditure of spina bifida and hydrocephalus patients admitted for inpatient treatment and follow-up at two university-affiliated hospitals in Ethiopia.

In Ethiopia approximately 3,200,000 babies are born annually and 41.09 per 10,000 live births are affected by spina bifida. Hydrocephalus (HCP) is another common pediatric neurosurgical condition with studies in Ethiopia showing the most common etiology is post spina bifida closure. The out-of-pocket expense (OOPE) and indirect expense of patients treated surgically for spina bifida and hydrocephalus during the first year of life were assessed. A prospective hospital-based study was done on patients treated surgically for spina bifida and HCP in two university-affiliated hospitals, between April 1st, 2022, and April 1st, 2023. Data on direct and indirect expenses were collected during inpatient care and follow-up. Catastrophic health expenditure (CHE) was assessed, defined as total expenditure exceeding 10% of the total annual household expenditure. A total of 245 patients were eligible for analysis. The median annual total expenditure of households for treatment was ETB 11,510.00 with ETB 5700.00 being indirect expenditure. Forty-nine percent of the households suffered CHE. In multivariate analysis, the factors which were found to have a statistically significant association with CHE were the hospital where the patient received the treatment, the household's wealth quintile, the place of residency, and pre-admission duration of stay. Our study revealed a high CHE in households with spina bifida and HCP. We recommend working on primary prevention of spina bifida, expanding surgical services regionally to minimize costs associated with travel for surgical care, and reducing pre-admission duration of stay by improving evaluation and investigations at outpatient clinics.

Determining direct, indirect healthcare and social costs for diabetic retinopathy management: a systematic review

IntroductionDiabetic retinopathy (DR) is a rapidly growing global public health threat; it affects 1 in 3 people with diabetes and is still the leading cause of blindness among the working-age population. The management of diabetic retinopathy is becoming more advanced and effective but is highly expensive compared to other ocular diseases.AimTo report direct medical, indirect medical, and nonmedical costs of diabetic retinopathy in developed and developing countries through a systematic review.MethodsRelated articles published in the PubMed, Google Scholar, and EMBASE electronic databases from 1985 to 2022 were identified using the keywords direct medical and indirect medical and social costs of diabetic retinopathy. However, previous systematic reviews, abstracts, and case reports were excluded.ResultsThirteen articles were eligible for assessing the economic burden of diabetes management and its complications. Our analysis revealed that increasing prevalence and severity of diabetic retinopathy (DR) are associated with higher direct and indirect healthcare expenditures. The impact of DR on working-age adults, leading to irreversible blindness in advanced stages, underscores the urgent need for cost-effective prevention and management strategies.DiscussionThis study systematically reviewed the direct medical, indirect medical, and nonmedical costs of DR in developed and developing countries. Our findings highlight the significant economic burden of DR, emphasizing the importance of implementing effective prevention and management measures to alleviate costs and enhance patient outcomes.ConclusionThe substantial financial burden of DR necessitates a re-evaluation of current screening and management programs. Revision of these programs is crucial to improve quality of care, reduce costs, and ultimately achieve Sustainable Development Goal 3, which aims to ensure good health and well-being for all.

Estimated economic costs of dental implants among older South Korean adults, 2015-2018.

Dental implants are a considerable financial burden for elderly people and their caregivers. This study aimed to calculate the estimated economic costs of dental implants on the Korean older population. The economic costs of dental implants for adults aged 75 years and older were estimated from a societal perspective, considering both direct and indirect expenditures. We used data from the Korean National Health Insurance Service for the period 2015-2018 to estimate the medical costs. Noninsured medical costs were estimated from research on medical expenses by the National Health Insurance Review and Assessment Service. Indirect costs related to transportation fees and time loss were obtained. The Cochran Armitage trend test was performed to examine the trend of the economic burden of dental implants. The estimated economic costs showed from 2015 to 2018 (total costs: $26.54-55.66 million, total costs after discount: $17.11-39.56 million). Direct costs, including insured and noninsured medical costs, represented from $25.81 to $47.03 million. Indirect costs, including transportation and time costs, ranged from $0.73 to $1.63 million. The impact of the total dental implant costs was 0.0018%-0.0034% of the Korean annual gross domestic product and 1.03%-1.59% of the annual total costs of dental care benefits. The estimated economic burden of dental implants significantly increased from 2015 to 2018 in older South Korean adults. These results will provide a foundation and guidance for further health economic studies on the burden of dental implants in the elderly population.

Out-of-Pocket Expenditure and Challenges Faced by Patients Undergoing Heart Valve Replacement in Follow-Up Care at a Tertiary Care Center in South India: A Mixed Methods Study.

Background Heart valve replacement surgery is one of the most commonly performed cardiac surgeries in India. Post-surgery, the patient requires lifetime anticoagulation therapy with regular follow-up, leading to financial and nonfinancial burdens for the patients. This study aimed to determine the out-of-pocket (OOP) expenditure (OOPE) for follow-up visits to the heart valve clinic and explore and assess the challenges faced by patients during these follow-ups. Methodology This mixed methods study was conducted at a tertiary care center from June 2018 to August 2018, focusing on patients attending the Valve Replacement clinic. The qualitative component of the study involved conducting three focus group discussions, which were transcribed and manually analyzed using thematic analysis to generate categories. The monthly OOPE and the proportion of irregular patients were assessed using a pretested and validated questionnaire developed based on the findings from the qualitative study. The data from the quantitative study were entered into EpiData version 3.1 (EpiData, Odense, Denmark) and analyzed using Stata 14 (StataCorp., College Station, TX). Results The median (interquartile range [IQR]) total OOPE for patients was Rs. 765 (475-1,100). The median (IQR) direct and indirect expenditures were Rs. 420 (210-600) and Rs. 590 (330-948), respectively. The patients faced difficulties in the categories of financial, travel, hospital, family, and personal. Out of a total of 143 participants, 86 (60.14%) had incurred catastrophic health expenditures. The cost also significantly increased with the presence of an accompanying person and longer travel durations. Conclusions The major difficulties faced by the patients were distance and expense. Telemedicine can help overcome these challenges by decentralizing follow-up care to the primary care level.

Local Government Financial Performance Reviewed from Financial Ratios and Indexes

This research aims to analyze the financial performance of the Ambon City regional government in terms of financial ratios in implementing regional autonomy. This research is a descriptive qualitative research type. Using documentation study data collection techniques or by tracing which is done by collecting secondary data, namely regional government financial report data for 2012 - 2015 from related agencies. The data analysis technique used is the descriptive analysis technique to assess financial performance, namely the regional independence ratio, effectiveness ratio, regional financial activity/harmony ratio and regional financial growth ratio, assessing financial capability using the degree of fiscal autonomy ratio and routine capability index. The research results found that the Regional Financial Independence Ratio (RKKD) of Ambon City during the three year observation period from 2013 to 2015 was on a scale of 0% - 25%, which means it was classified as "poor". Regional Financial Activity/Harmony Ratio (RAKD) for Direct Expenditures (BL) and Indirect Expenditures (BTL) in Ambon City, where during the observation period Indirect Expenditures (BTL) had a large portion compared to Direct Expenditures. The amount of indirect expenditure has reached more than 65%, which means that the Ambon City Government spends more on personnel expenditure than on public services. Growth ratio, it is known that of the four elements of the APBD, namely PAD, TPD, Indirect Expenditure and Direct Expenditure, the Ambon City government was only able to maintain good PAD growth during the observation period from 2013 to 2015, the rest of the growth rate still needs to be improved. The DOF ratio of Ambon City during the three year observation period from 2013 to 2015 was "very poor", below 10%, and that means that the Ambon City Government has very poor ability to finance government activities. The Routine Capacity Index (IKR) for the three year observation period from 2013 to 2015 shows that the ability of the Ambon City government to spend routine expenditures with local original income is still "deficient", namely less than 20% or in other words more than 80% of the City's routine expenditures. Ambon is covered by funds from the center.

SISTEM INFORMASI PENGELOLAAN KEUANGAN MENGGUNAKAN METODE CASH BASIS PADA DESA SUKOMULYO

The Sukomulyo Village Office is a government agency located at Jln. Raya No 01 Sukomulyo Kaliwungu Selatan Kendal Regency, Central Java. This current system records budget receipts as well as receipts from within the village and expenditure of funds every month. Transactions that occur in the treasury section are operational transactions for budget receipts and revenues from within the village as well as operational transactions for disbursement of Village expenditure funds. The village office has receipts and expenditures of funds every month. Revenue is divided into two, namely revenue from within the village and outside the village. From within the village, namely, village original income, village treasury land, village market, village hall rental, etc. From outside the village, namely, ADD (Village Budget) funds which are from weighing fund income, other legitimate village income, central government assistance, district assistance, provincial assistance, etc. Expenditures are also divided into two, namely direct expenditure and indirect expenditure. Direct expenditure, namely, village head's salary, village secretary's PLH salary, village head election costs, village meeting costs, indirect expenditure, namely, operational expenditure of LKMD (Village Community Activity Institute), expenditure on PKK activities, expenditure on youth organization activities, capital costs of LKD (Village Activity Institute) , assistance with Poskesdes activities, assistance with social activities.

Measuring the Effect of Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojna (AB-PMJAY) on Health Expenditure among Poor Admitted in a Tertiary Care Hospital in the Northern State of India.

Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojna (AB-PMJAY) as a financial risk protection scheme intends to reduce catastrophic health expenditure (CHE), especially among poor. The current study was carried out to assess the utility of AB-PMJAY in terms of reduction in CHE from before and after admission in a tertiary hospital in the northern state of India. It was a hospital-based cross-sectional study carried out from August 2020 to October 2021 at a public tertiary hospital of Himachal Pradesh, India. Data were collected from surgery- and medicine-allied (SA and MA) specialties. Along with socio-demographic details, information for total monthly family expenditure (TMFE), out-of-pocket expenditure (OOPE), and indirect illness-related expenditure (IIE) was recorded before and after hospital admission. CHE was considered as more than 10.0% OOPE of THFE and more than 40.0% of capacity to pay (CTP). A total of 336 participants with a mean age of 46 years were recruited (MA: 54.6%). The majority (~93.0%) of participants had illness of fewer than 6 months. The mean TMFE was observed to be INR 4213.1 (standard deviation: 2483.7) and found to be similar across specialties. The OOPE share of TMFE declined from 76.1% (before admission) to 30.0% (after admission). Before admission, CHE was found among 65.5% (10.0% of THFE) and 54.2% (40.0% of CTP) participants. It reduced to about 29.0% (based on both THE and CTP) after admission to hospital. AB-PMJAY scheme found to be useful in reducing CHE in a tertiary hospital.

The burden of end-stage renal disease in Khartoum, Sudan: cost of illness study

Background and purpose The incidence of end-stage renal disease (ESRD) in Sudan is increasing, affecting the economic status of patients, caregivers and society. This study aimed to measure ESRD’s costs, including direct and morbidity indirect expenditures, and to investigate any associated factors and financial consequences. Materials and methods This cross-sectional study used a standardized questionnaire to collect data from 150 ESRD patients who had been receiving dialysis for at least one year before the time of data collection at 13 specialized renal centres in Khartoum state. Data about sociodemographic, clinical, and economic factors were gathered, and their relationship to the cost of ESRD was examined using both bivariate (Man Whitney test, Kruskal Wallis test and Spearman correlation) and multivariate analytical procedures (multivariate linear regression). Results This study reported a median direct per capita ESRD cost of 38 600 SDG ($1 723.2 PPP) annually with an interquartile range of 69 319.3 SDG ($3 094.6 PPP). The median morbidity indirect cost was estimated to be 0.0 ± 3 352 SDG ($ 0.0 ± 149.6 PPP) per annum. In 28.8% of cases, the patients were their family’s primary income earner and over 85% were covered by medical insurance. Our study found that none of the study variables were significantly associated with the total cost of ESRD. Conclusion and limitations Our findings point out considerable direct out-of-pocket expenses and productivity losses for patients and their households. However, these results should be carefully applied for comparison between the different countries due to differences in the cost of medical interventions and insurance coverage. Further longitudinal studies and studies on health finance and insurance policies are recommended.

Determinan Kinerja Keuangan Pemerintah Daerah dengan Belanja Modal sebagai Variabel Moderating (Studi Empiris Pada Kabupaten/Kota di Provinsi Jambi)

Regional Budget of Revenue and Expenditure Management in Jambi Province is not yet optimal, due to the inadequate ratio between direct and indirect expenditure. The purposes of this research are to: 1) examine the impact of District Own-Source Revenue and equalization fund 1individually towards local government financial performance on regency/city of Jambi Province 12016-2020; 2) examine the significance of District Own-Source Revenue and equalization fund impact simultaneously towards local government financial performance on regency/city of Jambi Province 12016-2020; dan 3) examine whether capital expenditures is capable to become the moderating variable 1between District Own-Source Revenue and equalization fund with local government financial performance on regency/city of Jambi Province 2016-2020. This research uses the type of causal research. The population of this research is regency/city government in Jambi Province which consists of 9 regencies and 2 cities. Data analysis technique that is used in this research is multiple linear regression analysis. The result indicates that: 1) individually District Own-Source Revenue gives positive and significant impact towards local government financial performance, meanwhile equalization fund gives negative and significant impact towards local government financial performance; 2) both District Own-Source Revenue and equalization Fund significantly impact local government financial performance; and 3) based on residual test results, it shows that capital expenditures is the only variable that is able to moderate the correlation between District Own-Source Revenue towards local government financial performance.

The non-consumptive economic value of wildlife: the case of three cetacean species

The conservation of wildlife is one of the most pressing issues in the current times, but wildlife conservation economic values have often been largely ignored due to an absence of market prices, as setting an economic value on biodiversity or whole ecosystems can be challenging. Nevertheless, valuing wildlife can be of great significance to improve decision-making in the conservation field, as it can provide a complementary perspective based on economic principles. Whale-watching provides an opportunity for the economic valuation of wildlife. Specifically, it offers a framework in which the economic revenue allows the economic valuation of the targeted cetaceans to be estimated through the direct and indirect expenditure of the tourists who purchase whale-watching tours. Here, we performed an economic analysis based on population abundances of the three main species targeted by the whale-watching companies in the Strait of Gibraltar (Spain): long-finned pilot whales (Globicephala melas), common dolphins (Delphinus delphis) and killer whales (Orcinus orca). These species generated a total annual income of €4,089,056, €1,876,833, and €505,389, respectively, and each individual would generate an average of €14,048, €951, and €36,099 each year, respectively. Incorporating life expectancy, this corresponded to a total population value of €112,426,185, €16,685,147, and €19,171,107, respectively, over their lifetime. These values provide an idea of the potential contribution of cetaceans to the local economy but only represent their non-consumptive value based on tourism. Our results reinforce the idea that a sustainable, high-quality whale-watching culture, under ACCOBAMS High-Quality Whale-Watching requirements, should be promoted to ensure a sustainable industry, stable economic income and the viability of cetacean populations in the Strait of Gibraltar.

Price tag of glaucoma care is minor compared with the total direct and indirect costs of glaucoma: Results from nationwide survey and register data.

The estimations of the economic burden of glaucoma have focused on comparing different treatment modalities; hence, the total direct and indirect costs of glaucoma at population level are not well known. To estimate the direct and indirect costs of glaucoma and its treatment in Finland. Economic and glaucoma data were collected from the cross-sectional nationwide Health 2000 health examination survey linked to multiple national registers, which allowed a 13-year follow-up between 1999-2011 among survey participants. Direct costs covered eye- and non-eye-related hospitalizations and outpatient visits, outpatient health care services, and travel costs among participants aged 30 years or older, adjusted for age and sex. Indirect costs covered premature retirement and productivity losses among participants aged 30-64 years. Glaucoma patients (n = 192) were compared with non-glaucomatous population (n = 6,952). The annual additional total direct costs were EUR 2,660/glaucoma patient, EUR 1,769/glaucoma patient with medication, and EUR 3,979/operated glaucoma patient compared with persons without glaucoma. The respective additional total indirect costs were EUR 4,288, EUR 3,246, and EUR 12,902 per year. In total, the additional annual direct and indirect expenditures associated with glaucoma in Finland were EUR 202 million (0.86% of total expenditures of health care) and EUR 71 million (0.03% of the Finnish gross domestic product) arising mainly from non-eye-related hospitalizations and productivity losses, respectively. Glaucoma is associated with an increased health care consumption mainly due to non-eye-related health care, which can be explained by the vision loss as well as increased number of co-morbidities among glaucoma patients. Therefore, glaucoma constitutes a major economic burden for the health care system and society, highlighting the importance of early glaucoma interventions. The difference in direct and indirect costs between glaucoma treatment groups is explained by the uneven distribution of co-morbidities.

Estimating the economic burden of colorectal cancer in China, 2019-2030: A population-level prevalence-based analysis.

Colorectal cancer (CRC) is one of the most common cancers worldwide. Comprehensive data on the economic burden of CRC at a population-level is critical in informing policymaking, but such data are currently limited in China. From a societal perspective, the economic burden of CRC in 2019 was estimated, including direct medical and nonmedical expenditure, disability, and premature-death-related indirect expenditure. Data on disease burden was taken from the GBD 2019 and analyzed using a prevalence-based approach. The per-person direct expenditure and work loss days were from a multicenter study; the premature-death-related expenditure was estimated using a human capital approach. Projections were conducted in different simulated scenarios. All expenditure data were in Chinese Yuan (CNY) and discounted to 2019. In 2019, the estimated overall economic burden of CRC in China was CNY170.5 billion (0.189% of the local GDP). The direct expenditure was CNY106.4 billion (62.4% of the total economic burden), 91.4% of which was a direct medical expenditure. The indirect expenditure was CNY64.1 billion, of which 63.7% was related to premature death. The predicted burden would reach CNY560.0 billion in 2030 given constant trends for disease burden; however, it would be alternatively reduced to <CNY515.2 billion if the cancer prevention and control goals set by the United Nations and China for 2030 are achieved. The population-level economic burden of CRC in China in 2019 seemed noteworthy, with the direct expenditure accounting for more than half. Without effectively reducing exposure to modifiable factors and expanding screening coverage, the burden would continue increasing.

Economic burden of breast cancer in northern Serbia.

Breast cancer is the most common cancer in terms of incidence and mortality among all cancers in women in Vojvodina, the northern region of Serbia. In addition to the effectiveness and safety of therapy, it is important to put emphasis on the cost of treatment, as well as on the optimal allocation of limited resources. This study aimed to assess the overall economic burden of breast cancer in Vojvodina, as well as the ratio of direct and indirect costs in 2019. Costs were estimated using Cost of Illness (COI) evaluation, from a social perspective, based on the prevalence of the disease. The total costs included both direct and indirect expenditures. Direct costs associated with breast cancer comprised expenses linked to screening, hospital treatment, outpatient care, and prescribed medications. Indirect costs were estimated using a human capital approach, encompassing expenditures tied to lost productivity arising from sick leave, early retirement, and premature death. The total cost of breast cancer in Vojvodina during 2019 was estimated to be 15 million euros. Among the total cost, direct costs accounted for 5 million euros, representing 34% of the overall expenses. Hospital treatment costs accounted for 76% of the direct costs, while screening costs represented 1%. Indirect costs amounted to 10 million euros, constituting 66% of the total cost. The primary driver was attributed to production losses caused by premature retirement, which accounted for 50% of the indirect costs. Breast cancer is a huge financial burden on both the health system and society in Vojvodina, accounting for 0.12% GDP. The dominance of indirect costs in total costs, can provide significant guidance to decision-makers in the healthcare system in terms of better allocation of limited resources to breast cancer prevention and early detection strategies.

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.

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.

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.

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%.

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.