Long-term Financial Sustainability Research Articles

Budget impact analysis of participating in sponsored clinical trials in cancer within the Colombian healthcare system: A real-world evidence approach.

e23031 Background: Clinical trials (CTs) are a key element in researching and developing new technologies for cancer. Assessing the economic impact of CTs and the potential savings for healthcare systems in Low- and Middle-Income Countries (LMICs) is vital to guide healthcare decision-making. This research aims to quantify the budget impact for the Colombian Health System of including hematology and oncology patients in sponsored clinical trials. Methods: This study uses real-world data (RWD) from CTIC, a high-complexity cancer center from Bogotá, Colombia. We followed the Budget Impact Analysis methodology defined by the local HTA agency using data for five tumors retrieved from an institutional data lake resource using clinical information and related costs. Tumors were selected based on their prevalence and economic burden. CTIC’s clinical experts validated the cost-generating events for each disease. The eligible population for phase 3 clinical trials was estimated from the literature and CTIC oncology units’ leaders’ opinions. Prevalent and incident population data were obtained from the Colombian High-Cost Account (CAC). Results: There are 7,703 potential patients to be included in CTs, representing a total cost of 217,544,023 for 2023 USD (1 USD = 4,325 COP). If at least 25% of patients with these tumors were included in CTs in 2023, the approximate cost would be 54,386,006 USD. Advanced prostate cancer represented the highest cost, given its prevalence and CT inclusion opportunity. Conclusions: With approximately USD 24 billion spent on healthcare (USD 5 billion in drugs), Colombia could save around 4% of its drug expenditure if all potential candidates were to be included in cancer CTs. Furthermore, assuming similar average costs per patient, inclusion rates, and population growth for 5-years, this could represent savings of around USD 1.1 billion. These savings would ease the reimbursement and access to innovation for Colombian patients, improving health outcomes and enhancing long-term financial sustainability. [Table: see text]

Cloud Storage Cost Optimization: Advanced Techniques and Case Studies

The growing usage of cloud storage has revolutionized data management by offering unparalleled scalability and accessibility. However, optimizing cloud storage prices remains challenging, sometimes leading to significant unforeseen costs. This article explores a wide range of advanced techniques and practical case studies that enable enterprises to effectively navigate the intricacies of cost optimization across top cloud providers, including Google Cloud Platform (GCP), Microsoft Azure, and Amazon Web Services (AWS). Beyond selecting the most appropriate storage type for individual workloads (block, blob, or file storage), we explore advanced strategies that unlock substantial cost savings. From leveraging contractual negotiations for high-volume storage users to utilizing dedicated data transfer devices for streamlined on-premises migration, this paper equips readers with a diverse arsenal of optimization tools. We explore best practices for data lifecycle management, such as tiered backups and granular retention policies, to optimize beyond merely technical solutions. This way, we ensure that data is held at the most affordable tier depending on its frequency of access and compliance with legal requirements. By consistently analyzing cloud storage consumption and adapting responsive strategies to changing requirements, enterprises may retain optimal performance while ensuring long-term financial sustainability. This paper serves as a valuable resource for organizations seeking to master the intricacies of cloud storage cost optimization. By implementing the advanced techniques and best practices outlined herein, cloud users can confidently unlock significant cost savings and maximize the return on their cloud storage investments.

Evaluating the Cost-Efficiency and Financial Sustainability of Cloud-Based ATE Solutions in Testing Environments

The introduction of cloud-based solutions in testing environments, especially in Automated Test Equipment (ATE), is bringing a big change in the way organizations approach testing processes. This change is driven by the potential for enhanced cost-efficiency and financial sustainability. As testing requirements continue to evolve, the scalability, flexibility, and accessibility offered by cloud-based ATE solutions present promising opportunities for optimizing resource utilization and reducing operational costs. This study aims to evaluate the economic feasibility of adopting cloud-based ATE solutions. It explores their impact on both short-term and long-term financial sustainability. By examining factors such as upfront investment, operational expenses, and the overall return on investment, this research seeks to provide insights into the practical implications of transitioning to cloud-based ATE solutions for organizations seeking to streamline their testing processes.

Environmental Accounting and Financial Performance of Conoil Plc in Nigeria

This study investigated the relationship between environmental accounting and financial performance of Conoil. The ex-post facto research design was employed in this case study of the sampled oil gas giant in Nigeria due to its comprehensive disclosure of environmental expenditures in its annual reports. The study utilized secondary data obtained from annual reports and accounts, downloads from Nigerian Exchange Group (NXG), and the company websites covering the period 2008 to 2022. The study employed descriptive statistics, correlation analysis, and Ordinary Least Squares (OLS) regression using Eview9 econometric software for data analysis. The correlation analysis result indicates that environmental restoration costs (ERC) are negatively correlated with profit after tax (PAT) and return on assets (ROA), while a positive correlation exists between PAT and ROA, providing insights into Conoil Plc's financial and environmental performance dynamics. The regression analyses reveal that while environmental restoration costs have a significant negative impact on return on assets (ROA), neither ERC nor health, safety, and environmental expenses (HSE) significantly influence profit after tax (PAT), indicating the nuanced relationship between environmental accounting metrics and financial performance in Conoil Plc's operations. The research additionally recommended that the corporation should regularly carry out environmental audits to evaluate adherence to environmental rules and pinpoint opportunities for enhancing environmental performance. The company should allocate resources towards renewable energy projects to reduce reliance on fossil fuels, mitigate environmental impact, and enhance long-term financial sustainability.

Balancing the Books: the Economics of Healthcare Treatments and Business Sustainability

This article delves into the intricate relationship between healthcare treatments and business sustainability, exploring the economic implications of medical interventions on the financial health of businesses. Through a comprehensive analysis of existing literature, case studies, and economic models, this article aims to elucidate the complex interplay between healthcare expenditures, employee well-being, and the long-term financial sustainability of businesses. By uncovering the economic considerations inherent in healthcare decision-making, this exploration offers valuable insights for businesses seeking to strike a balance between fostering a healthy workforce and maintaining financial viability.

Recent innovations in long-term care coverage and financing: a rapid scoping review

ObjectivesTo identify, chart and analyse the literature on recent initiatives to improve long-term care (LTC) coverage, financial protection and financial sustainability for persons aged 60 and older.DesignRapid scoping review.Data sourcesFour...

Implementation of Point of Care Sexually Transmitted Infections Testing in a Community Clinic Setting.

The rates of sexually transmitted infections (STIs) in the United States, including chlamydia and gonorrhea, are rising. Point-of-care (POC) testing could increase access to testing and treatment. This evaluation found POC STI testing to be concordant with the results of traditional laboratory testing for 100% of patients who were tested. Ninety-five percent of the patients reported being satisfied with the experience, and 66% preferred it to traditional laboratory testing. The most commonly reported reason for preferring the test was the short amount of time it took to receive results. However, insurance reimbursed less than 30% of what was billed for the POC tests. Low insurance reimbursement rates could be a barrier to implementation long-term financial sustainability of POC STI testing.

Dampak Stabilitas Keuangan Daerah terhadap Ketahanan Keuangan Pemerintah Daerah

This research investigates the impact of local financial stability on the financial resilience of local governments. The study examines the relationship between financial stability, efficient budget management, wise debt control, long-term financial sustainability, and the financial resilience of local governments. The research employs a quantitative approach, utilizing regression analysis to analyze the data collected from various local governments. The findings indicate a significant positive influence of financial stability, efficient budget management, wise debt control, and long-term financial sustainability on the financial resilience of local governments. The study contributes to the understanding of the crucial factors affecting the financial well-being of local governments and provides insights for policymakers to enhance financial planning and resilience.

Are ageing Nordic welfare states sustainable? An analysis of pension and care policies in Finland and Sweden

Introduction: The article discusses the aging population in Nordic countries, focusing on Sweden and Finland, where the median age has steadily increased since 1950. The text emphasizes the impact of demographic changes on the old-age dependency ratio and the subsequent implications for the welfare stateObjective: It is examination and comparison of the aging policies of Nordic countries, with a specific focus on Finland and Sweden. The author aims to shed light on the differences in pension and long-term care systems between these two nations, challenging the perception of a common "Nordic pension model."Materials and methods: The article employs a theoretical background based on the "intergenerational reciprocity trichotomy" developed by André Masson. The methodological approach utilized in the research is that of a "comparative case study." The author analyzes the pension and long-term care systems of Finland and Sweden, reviewing key indicators, policy documents, and relevant research literature.Results: While the Swedish system is financially robust, it encounters political challenges due to low public pension levels, prompting discussions about potential reforms, such as increasing contribution rates for higher benefits. Finland's public pension system, characterized by stable political support, raises concerns about long-term financial sustainability. The decision-making model, led by social partners, may shift to a more parliamentary approach as trade union density decreases and aging-related issues become more significant for the electorate. Both countries have successfully promoted high employment rates among older workers, but long-term care policies pose a greater challenge to the sustainability of their welfare models. The growing importance of family and informal care, coupled with a reliance on migrant workers for healthcare, highlights the strain on the welfare systems. Demographic changes increase pressure on pro-old welfare policies, particularly in long-term care, with Sweden better positioned than Finland to sustain elevated spending towards the elderly.

Family business succession: opportunities from the Victorian wine industry

PurposeThis paper aims to examine the opportunities of continuous family succession in operating small-to-medium-sized wineries (SMWs) in Victoria, Australia.Design/methodology/approachUsing case studies from Victoria, an exploratory qualitative approach was used to explore the benefits of continuous family succession in this conceptual paper. This included interviewing participants from wineries about their perceptions about family business succession. Themed analysis was applied to highlight the findings and overall conclusions about why the wine industry was affected more than other industries with regard to family business succession issues.FindingsThe three main findings of this study include family succession is extremely important in building a story customers can relate to; family reinvestment opportunities for financial sustainability and innovation of the winery and family succession for future employment and legacy. These three findings highlight the way family business succession is integral to the successfulness of the wine industry.Practical implicationsSmall-to-medium-sized wineries (SMWs) have many challenges including long-term financial sustainability and innovation opportunities. To assist in overcoming these challenges, the findings suggest winery owners need to create lasting legacy through story-telling, competitive advantage and family linkage (succession). This will assist wineries to create marketing campaigns focussing on family succession and brand attachment, seven opportunities for family reinvestment and innovation leading to financial sustainability and competitive advantage.Originality/valueThere is little research investigating family succession in the Victorian wine industry even though it is common practice and essential to marketing and communication campaigns. This paper supports continuous family succession as a legitimate marketing technique and long-term financial sustainability and innovation for small-to-medium-sized wineries (SMWs) through reinvestment opportunities. This is the first time small-to-medium-sized wineries have been defined as SMWs and reinvestment opportunities have been identified by wine stakeholders.

Good Corporate Governance, Leverage and Corporate Financial Performance in the Jakarta Islamic Index

Purpose – This study aims to estimate the effect of Good Corporate Governance and Leverage on the Financial Performance of companies listed on the Jakarta Islamic Index in 2016 to 2020.
 Methodology/approach – This study is a confirmatory research with a quantitative approach. The secondary data in this study obtained from the Jakarta Islamic Index (JII), with a total sample of 14 companies registered in the analysis period and have complete data related to the variables studied. Panel data regression analysis was used in this study by selecting the Random Effect Model as the estimation method.
 Findings – It was found that institutional ownership, which is one of the measurement proxies for Good Corporate Governance, has a positive effect on variations in the company's financial performance achievements. This study has proven that institutional ownership has an important role in minimizing agency conflicts that occur between managers and shareholders. If institutional ownership is implemented properly and in line with the company's vision, the financial performance will be excellent and in the long-term financial sustainability will be created.
 Novelty/value – This study proves that institutional ownership is a driving factor in increasing corporate financial performance proxied by Return on Equity (ROE).

E-government implementation's impact on Saudi vision 2030 to become an international logistic center

<p>This study examined the influence of electronic government (e-government) implementation for the Ministry of Transport on fulfilling Saudi vision 2030 by transforming the Kingdom of Saudi Arabia (KSA) into a logistics center linking three continents. Saudi vision 2030 aims to cut transportation costs by improving infrastructure, shorten importing and exporting times by streamlining and automating operations, and increase supply chain transparency through sector reform. Implementing e-government would improve government services and engagement through information and communication technology (ICT). This article focuses on four primary areas: i) making KSA a logistics center; ii) increasing the chance of living throughout the Kingdom; and iii) promoting long-term financial sustainability. The study is founded on the idea that logistics is a crucial component for competitive advantage and transportation (by land, sea, or air) is a logistical sub-process for Saudi enterprises that benefit from transport networks similar to the best in the world. The Kingdom's strategic location at the junction of three continents gives its transport sector a geographical competitive advantage that provides access to important emerging markets and critical sea lanes. Despite the optimistic future of the transport and logistics industries in KSA, some important hurdles must be overcome.</p>

Caught in a Matrix of Factors: A Pilot Study of Female Retirees Receiving Below-Minimum Pension Payments

Pension systems based on an insurance model were originally designed for male breadwinners who worked under permanent contracts without career breaks. Since their inception, women’s participation in the workforce has increased significantly, but on average, their employment career paths are still shorter and less linear compared to those that men enjoy. Demographic changes have prompted many countries to reform their pension systems to ensure long-term financial sustainability. And to varying degrees, such reforms also have looked to address the issue of short careers. In Poland, reforms introduced in 1999 brought about significant changes to the rules governing pension entitlement. That led to the emergence of a new category of retirees—those who had contributed to the pension system for a short period and consequently received very low pensions. This article provides an overview of an exploratory qualitative pilot study conducted in 2018 with nine women who were in receipt of benefits from the Polish universal pension system, which amounted to less than the so-called ‘lowest retirement pension’ being granted at that time. The analysis makes recourse to the concept of employment career and its connection to retirement to identify various life-course determinants that contributed to their situation. These factors include childhood and adolescent adversities that affected educational attainment; domestic and caregiving responsibilities coupled with cultural expectations and insufficient institutional support; the labor market situation, and the inability to document certain employment periods. The research material indicates that a significant portion of the work performed by the interviewees throughout their lives did not translate into a pension benefit, as it either involved unpaid domestic and caregiving duties; or work performed without formal contracts.

FINANCIAL SUSTAINABILITY OF A FIRM: DEBT-BASED OR EQUITY-BASED FINANCING TO PURSUE?

This study examines the potential of utilizing equity-based financing by companies in achieving financial sustainability as compared to debt-based financing. To this end, a conceptual framework of equity-based financing over debt-based financing is developed to provide an understanding of the concept of equity-based financing. Subsequently, this study analyses the credit risk exposure between equity and debt for selected sectors in Malaysia. More specifically, a Monte Carlo method is employed to examine the feasibility of the equity-based financing model in fostering the financial sustainability of companies through simulation of equity-based and debt-based financing models from the global financial crisis (GFC) period to the Covid-19 phase. This study finds that equity-based financing can reduce credit risk exposure when returns are tied to the company’s performance. The findings also show that equity-based financing can achieve financial sustainability regardless of any economic events. To conclude, equity-based financing can thus be a viable capital financing option for companies because it can contribute to long-term financial sustainability.

Social protection in times of plague and beyond

Introduction: As historically verified, countries with comprehensive, well designed social protection systems in place are better prepared to cope with large scale catastrophes of all kinds, always in such situation there is still a need for government interventions other than social protection and larger scale discretionary social protection or related interventions.Objective: The article presents the actions of countries to minimize the negative social effects of the COVID-19 coronavirus pandemic. The text is an attempt to answer how social security systems should be adapted to aforementioned crisis?Materials and methods: The text uses research methods such as: literature criticism and statistical analysis of data and revision of implemented state intervention policies based on reports of Organisation for Economic Cooperation and Development, International Labour Organizaton, European Foundation for the Improvement of Living and Working Conditions and International Monetary Fund.Results: 1) For social security institutions of key importance to ensure continuity of operations of all services of contributory social insurance as well of social assistance - was to ensure continuous payment of all benefits due and quick response to the new entitlement emerging. It is also necessary to ensure that all citizens are fully insured, regardless of the form of contract under which they perform work.2) In many countries, special emergency measures that extended coverage and increased benefits were taken by governments without clearly identifying the sources of funding and very often burdening social security funds with non-statutory expenses and affecting their long-term financial sustainability.3) In the longer run, there is a need to ensure universal health care coverage of the adequate quality, there is a need to develop policies which will secure at least minimum income security to all independently of their labour market status, forms of employment, sex, ethnicity or nationality.

So You Want to Build Your Disease's First Online Patient Registry: An Educational Guide for Patient Organizations Based on US and European Experience.

Patient registries fulfill a number of key roles for clinicians, researchers, non-profit organizations, payers, and policy makers. They can help the field understand the natural history of a condition, determine the effectiveness of interventions, measure safety, and audit the quality of care provided. Successful registries in cystic fibrosis, Duchenne's muscular dystrophy, and other rare diseases have become a model for accelerating progress. However, the complex tasks required to develop a modern registry can seem overwhelming, particularly for those who are not from a technical background. In this Education article, a team of co-authors from across patient advocacy, technology, privacy, and commercial perspectives who have worked on a number of such projects offer a "Registry 101" primer to help get started. We will outline the promise and potential of patient registries with worked case examples, identify some of the key technical considerations you will need to consider, describe the type of data you might want to collect, consider privacy risks to protect your users, sketch out some of the paths towards long-term financial sustainability we have observed, and conclude with plans to mitigate some of the challenges that can occur and signpost interested readers to further resources. While rapid growth in the digital health market has presented numerous opportunities to those at the beginning of their journey, it is important to start with the long-term goals in mind and to benefit from the learnings of those who have walked this path before.

The Significance of Market Power in the Financial Sustainability of Emerging Agricultural Cooperatives in the Central Free State of South Africa: A Resource-based View

Introduction: Despite the accessibility of institutional support mechanisms to cooperative firms in South Africa, many emerging agricultural cooperatives in the Central Free State remain underrepresented in the mainstream market, thereby undermining their long-term financial sustainability. Yet, business sustainability literature on cooperative firms foregrounds the theoretical assertion that the existence of market power significantly influences financial sustainability. Purpose: The study set out to debunk the assertion that emerging cooperative firms in the Central Free State have market power that they can exert to increase their financial sustainability. Methodology: Drawing on the resource-based view theory and a review of literature, the study sought to establish whether market dynamics have a direct influence on the financial sustainability of emerging agricultural cooperative firms. Findings: The findings suggest that competition intensity and market concentration undermine the ability of the market power of cooperatives to positively predict long-term financial sustainability. Originality: The study links various indicators of financial sustainability to market power and establishes the influence of each of them on market power—an approach underexplored in entrepreneurial literature.

Evaluation of ammonia fueled engine for a bulk carrier in marine decarbonization pathways

This study highlights that in addition to using ammonia in the maritime sector and integrating it into the ship concept, it is a challenging option for shipowners in terms of capital and operational expenditures. In this study, the typical marine-type fuels used in the main engines of a bulk carrier were compared to ammonia in a Techno-Economic Analysis. The bulk carrier features a conventional main engine system, and operational data was acquired to determine how much ammonia was consumed. The ship is classified using the Energy Efficiency Existing Ship Index (EEXI) and the Carbon Intensity Indicator (CII). To determine its economic viability, Monte-Carlo Simulation is utilized. In addition, a cost scenario for in-service bulk carriers was developed, with an emphasis on their application. Ammonia is used to minimize petroleum consumption, but it is not cost-effective for long-term financial sustainability, and the installation cost is more than 5 million USD. MAC calculation was made according to NPV values and CO2 reduction results and 3816.42 $/tCO2e was obtained. According to the article, ammonia is more suitable for newly built marine vessels. With the study, a method that can be used in the feasibility studies of different alternative technologies for the existing ships of the shipping companies is presented in the literature.

Modelling Waqf Performance and Governance for Public Universities in Malaysia

Islamic philanthropy in Malaysian education system has been well rooted in religion-based traditional educational institutions. Currently, Waqf and Endowment (WAE) grow rapidly at higher education institutions as an income generation and a long-term financial sustainability initiative. The initiative is as a result of budget cut by 20 percent for public universities since 2016 and 2017 but no raise in fee is allowed. This initiative is in line to recommendation in the University Transformation Programme (UniTP), Purple Book shift No 5, the Malaysia Education Blueprint 2015-2025 (Higher Education). Being a non-profit organization, the performance of WAE in Malaysian public universities is expected to be different as compared to commercial entities. The importance of having WAE performance measurement may include the economy, effectiveness and efficiency aspects of its activities towards the intended objectives. The method of the study is based on documents review on performance although the literatures on WAE performance measurement in higher education institution is still lacking. As such, the need to develop a holistic model that covers both aspect of performance measurement and good governance are required consistent with the vision of establishment of WAE to act as one of a perpetual financial source for universities. Hence, this research aimed to propose Waqf Performance Measurement and Governance Model used to evaluate WAE’s reliability and performance in Malaysian public universities. Future research is required to test and verify this model on the initial sample from waqf institutes in public universities. The expected finding of this study is this model can become as a main reference in measuring the performance of WAE in Malaysian public universities embedded with good governance principles, that could result the positive implications in strengthening the WAE’s credibility and stakeholder confidence for universities financial sustainability.

The Self-Sustainability of Federally Qualified Health Centers: Examining the Impact of Medicaid Expansion.

States' decisions to expand Medicaid eligibility would make most low-income uninsured people eligible for Medicaid, while also increasing the financial viability of Federally Qualified Health Centers (FQHCs) by reducing their grant to total revenue ratios. We extracted a national sample of 729 FQHCs for the period 2009 to 2018. The dependent variable was grant to revenue ratio and the independent variable was the states' Medicaid expansion status. FQHCs operating in Medicaid expansion states had lower grant ratios during the postexpansion period. As past decades' funding volatilities have shown, overreliance on one revenue source may increase financial risk. Medicaid expansion can support FQHCs by improving their long-term financial sustainability.