Non-cost Factors Research Articles

Cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease.

The study aims to compare cost and non-cost factors associated with delays in receiving medical care in adults with atherosclerotic cardiovascular disease (ASCVD). Using 2014-2018 data from the Centers for Disease Control and Prevention (CDC) Behaviour Risk Factor Surveillance System (BRFSS) survey (N = 508,203), multivariate logistic regression models were developed to compute the adjusted odds ratio of reasons for delays in medical care in adults with ASCVD. Our study population of 61,227 adults with ASCVD (9.1%) had higher odds of any medical care delay (aOR 1.50, 95% CI 1.43-1.57), delay due to cost (aOR 1.55, 95% CI 1.45-1.65), long clinic wait times (aOR 1.21, 95% CI 1.04-1.39) and lack of transportation (aOR 1.64, 95% CI 1.47-1.84) than those without ASCVD. Novel public health and health policy approaches are urgently needed to reduce the cost- and non-cost-related barriers that adults with ASCVD encounter when accessing healthcare services.

Probabilistic cost-based decision-making matrix: IDIQ vs. DBB contracting

Public departments of transportation (DOTs) are increasingly adopting alternative contracting methods (ACMs), such as Indefinite Delivery/Indefinite Quantity (IDIQ) agreements, to shorten project delivery and increase scheduling flexibility. However, the challenge remains to decide when an IDIQ contract would offer better value for money in a project compared to the conventional Design-Bid-Build (DBB) method. This paper proposes an IDIQ project selection framework that incorporates expected construction costs to identify suitable candidate projects. Historical bid data, an alternate cost indexing system, nonlinear regression analysis, and the Monte Carlo simulation technique are used to create and compare IDIQ and DBB probabilistic construction cost estimates. The study demonstrates the effectiveness of the framework using a single-award IDIQ granted through the Minnesota Department of Transportation (MnDOT) and past bidding information for projects awarded between January 2008 and April 2015. Additionally, the paper acknowledges the limitations of the study, including its reliance on MnDOT data, the exclusion of non-cost factors, and the assumption of project homogeneity. The study also provides valuable recommendations for future research to address these limitations and enhance the understanding and practical implementation of IDIQ contracting in the construction industry.

Konkurentnost preduzeća u industriji mleka

In the face of globalization and its effects, the company's competitiveness remains an essential element for their growth and survival. This contribution aims to shed light on competitive advantage as a source of company's competitiveness, by analyzing the competitive intensity in the milk industry based on Porter's competitive forces supported by a multiple case study of Bejaia companies operating in the Algerian milk industry. For this paper, we studied large private industries with more than 20 years of experience in their fields of activity and with a common cost strategy. The results of study showed that the competitive intensity in this industry is important and that the competitive advantage is governed by a set of cost and non-cost factors that allow the studied cases to strengthen their positions by relying on their competitive advantages.

Determinants of Mental Healthcare-Seeking Behavior of Postpartum Women in Ibadan, Nigeria.

The mental healthcare-seeking behavior of postpartum mothers has received little attention in Nigeria. Previous studies in the country have focused on determinants of physical health-seeking behavior, choice of maternal healthcare provider, prevalence, and determinants of maternal mental illness, yet, determinants of maternal mental health-seeking behavior among Nigerian women has been understudied. This study, therefore, examined the determinants of mental health-seeking behavior among postpartum women in Ibadan, Nigeria. Maternal mental illness, which was proxied using postpartum depression, was computed using the Edinburgh Postpartum Depression Scale. Data for the study were obtained through a survey method using a 9-page questionnaire. A 3-stage sampling technique was employed. The first stage was a stratified sampling to disaggregate the health facilities offering postnatal and immunization services on the basis of ownership of public and private healthcare providers. In the second stage, seven healthcare facilities comprising three (3) private and four (4) public healthcare were purposively selected based on the number of attendees. The final stage was a random selection of 390 postpartum mothers attending postnatal and immunization clinics across seven healthcare facilities. The prevalence of depression among the mothers was 20.8%. While only 39.5% of the depressed women sought care, 22.3% of the non-sufferers also sought mental healthcare. This revealed that both sufferers and non-sufferers sought mental healthcare. Also, a higher incidence of postpartum depression among the sufferers increased the likelihood of seeking mental healthcare. Age, family history of postpartum depression, and having the desired gender of child were determinants of mental health-seeking behavior. Among the sufferers of postpartum depression who failed to seek care, a low perceived need for mental healthcare, the perception that the depressive symptoms will go on their own, as well as fear of being stigmatized as a “weak mother”, were reasons for not seeking mental healthcare. Thus, to promote mental healthcare, the non-cost factors, like availability and accessibility to a mental healthcare facility should be addressed. To achieve this, mental healthcare sensitization programs should be integrated into maternal healthcare at all levels, and mothers attending antenatal clinics should be routinely screened for early symptoms of depression in the postpartum period.

Structured Approach for Best-Value Evaluation Criteria: US Design–Build Highway Procurement

AbstractIn best-value procurement, current practice shows that cost is frequently more influential than noncost factors, and consequently, the lowest bidder is chosen in most cases; thus, a best-va...

A Pragmatic Approach to Estimating Nondiscriminatory Non-tariff Trade Costs

Despite the growing importance of non-tariff measures (NTMs) in trade policy, many common methods for estimating their costs exhibit significant challenges in terms of data requirements or the lack of specificity in the estimates they produce. I propose an extension to existing approaches that mitigates many of these limitations. Following earlier work by Fontagne et al. (2011), I estimate a measure of the aggregate nondiscriminatory trade costs present in each country. Then, in a novel second stage, I decompose the estimated trade costs into individual components such as the costs associated with specific NTMs. Additionally, the second stage allows for the identification and removal of non-cost factors that erroneously contributed to the aggregate cost estimates. The methodology provides a means by which to accurately estimate the effects of specific NTMs using widely available data and standard econometric techniques. I test the methodology using a typical gravity dataset and detailed NTM data. The results provide specific cost estimates for SPS measures and TBTs across many sectors and demonstrate that aggregate measures of non-discriminatory trade costs can significantly reflect non-cost factors.

Chronic myeloid leukemia patients and treatment-free remission attitudes: a multicenter survey.

BackgroundTreatment-free remission (TFR) is becoming an essential goal for chronic myeloid leukemia (CML) patients in clinical practice. Few studies have emphasized patient attitudes or preferences about discontinuing tyrosine kinase inhibitors treatment. This study aimed to evaluate the characteristics of Chinese CML patients and their views and perspectives on TFR.MethodsA total of 329 CML patients participated in this multicenter, questionnaire-based, standardized, semi-structured, interview-guided, open-ended, cross-sectional study. Information about demographics, diagnosis information, treatment history, quality of life (QoL), and TFR preference was collected.ResultsThe adherence rate was 50% (N=163) and sex dependent (males, OR=2.24, 95% CI=1.40–3.58). Physical activity, symptom burden, mood impact, and daily impact were found to be better among adherent patients. Thirty-four percent of the patients were willing to attempt TFR positively. The reasons for preferring TFR were due to side effects (56%) followed by high cost (52%), inconvenience (42%), and pregnancy need (41%). Multivariate analysis indicated that patients who were younger (OR=0.96, 95% CI=0.94–0.99) with shorter disease duration (OR=0.90, 95% CI=0.82–0.98) and higher disease symptom burden (OR=1.08, 95% CI=0.98–1.21) were more likely positive about TFR.ConclusionPatients who were younger with shorter disease duration and higher disease symptom burden were more likely to try TFR. They expressed several perceived noncost factors of TFR. Our data may help promote the management of CML and designing of clinical trials for TFR in some developed regions of China.

Financing Cost and Private Investment in Ghana

This study has investigated empirically the effect of financing cost on private investment in Ghana, over the period 1970 to 2010. To this end, the variables employed were classified as cost factors (interest rate, exchange rate, inflation rate) and non-cost factors (public investment, output, credit availability, external debt) of private investment. The Johansen co-integration technique was used to estimate the long-run private investment function for Ghana. Also, the Error Correction Model was used to determine the short-run dynamics. The study finds that all the cost factors had negative and statistically significant impact on private investment in Ghana, in the long-run. On the other hand, in the long-run, the non-cost factors impacted positively on private investment in Ghana, but external debt had an adverse effect. It also, finds that all the variables used, co-integrated with private investment in the long-run. This study provides original evidence that high cost of financing is associated with low private sector participation in investment activities in Ghana. Accordingly, the study recommends among others that long term policies should be directed towards cost control and macroeconomic stabilization in order to boost private investment activities or programs in developing nations particularly, Ghana.

Cost, Contractors and Scale: An Empirical Analysis of the California Solar Market

ABSTRACT This paper presents an empirical analysis of the rapidly growing California rooftop solar photovoltaic market using detailed data of over 100,000 solar installations between 2007 and 2014. The rapid fall in the cost of solar panels stand central in the expansion of this market. I use a semi-parametric regression model to aid identification of cost factors by decomposing time-varying and cross-sectional components. I find that the use of Chinese manufactured panels are associated with costs that are 6% lower. Economies of scale at the local level (number of yearly installations in a zip code) and at the installation level (size of the installation) are also associated with lower costs. Higher subsidies, and higher contractor market-share are associated with higher costs. I use an exploratory analysis of the dominant contractor, SolarCity, to discuss non-cost factors in the expansion of the solar photovoltaic market.

Evaluation of non-cost factors affecting the life cycle cost: an exploratory study

Purpose This paper aims to identify the main non-cost factors affecting accurate estimation of life cycle cost (LCC) in building projects. Design/methodology/approach Ten factors affecting LCC in building project cost estimates are identified through literature and interviews. A questionnaire survey is conducted to rank these factors in order of priority and provide the views of cost practitioners about the significance of these factors in the accurate estimation of LCC. The data from 138 construction building projects completed in UK were collected and analysed via multiple regression to discover the relationship between capital and LCCs and between non-cost factors and cost estimation at each stage of the life cycle (capital, operation, maintenance and LCC). Findings The results of analysis of existing LCC data of completing project and survey data from cost professionals are mostly consistent with many literature views and provide a reasonable description of the non-cost factors affecting the accuracy of estimates. Originality/value The value of this study is in the method used, which involves analysis of existing life data and survey data from cost professionals. The results provide a plausible description of the non-cost factors affecting the accuracy of estimates.

Teaching life cycle assessment in environmental engineering: a disinfection case study for students

To help educators increase the extent and effectiveness of integrating sustainability into undergraduate education, a case study in life cycle assessment (LCA) is developed and presented using the context of disinfection of wastewater. Design and operating parameters are presented for three alternatives: chlorine/sulfur dioxide, ultraviolet (UV) light, and sodium hypochlorite/sodium sulfite. The case study includes student learning objectives, design assumptions, system boundaries, supporting calculation files, descriptions of LCA simulation scenarios, expected simulation results, and interpretation. LCA simulations, using the ISO methodology approach, are performed with varying assumptions about design flows, study duration, electricity fuel mixes, an alternative LCIA methodology, and weighting scenarios. Results are presented primarily at the midpoint level, and the effects of weighting are illustrated using a ternary plot. Life cycle costing is performed by calculating net present worth cost of construction materials and selected ongoing operation and maintenance costs. After interpreting simulation results, students should be able understand and apply several LCA skills including identifying significant impact categories, describing tradeoffs between different life stages, identifying “hot-spots” in the life cycles, illustrating the impacts and limitations of weighting, and observing differences across LCIA methodologies. Using the assumptions herein, chlorine disinfection results in larger initial impacts due to the larger basin required for hydraulic retention time (HRT), but operating impacts associated with electricity consumption cause the UV impacts to overtake those of the chlorine alternative. The results are sensitive to the LCIA method, the electricity grid’s fuel mix, and the electricity consumed per unit of wastewater disinfected. Finally, consideration of non-environmental and non-cost factors (risk, safety) provide students with an opportunity to reflect on broader societal impacts. Adaptable for various audiences and to provide differing levels of technical rigor, the case study should aid students in understanding and becoming proficient in performing LCA to facilitate life cycle thinking. It is the author’s hope that by providing a transparent, comprehensive LCA case study comparing engineering alternatives, educators can better integrate life cycle thinking and systems thinking into engineering curricula.

Cost, Contractors and Scale: An Empirical Analysis of the California Solar Market

I present an empirical analysis of the rapidly growing California rooftop solar photovoltaic market using detailed data of over 100,000 solar installations between 2007 and 2014. The rapid fall in the cost of solar panels stand central in the expansion of this market. I use a semi-parametric regression model to aid identification of cost factors by decomposing time-varying and cross-sectional components. I find that the use of Chinese manufactured panels are associated with costs that are 6% lower. Economies of scale at the local level (number of yearly installations in a zip code) and at the installation level (size of the installation) are also associated with lower costs. Higher subsidies, and higher contractor market-share are associated with higher costs. I use an exploratory analysis of the dominant contractor, SolarCity, to discuss non-cost factors in the expansion of the solar photovoltaic market.

Aligning supply chain transportation strategy with industry characteristics

Purpose – The purpose of this paper is to propose that transportation modal mix in global supply chains is a result of the strategic alignment between industry characteristics and supply chain strategies. Design/methodology/approach – Using annual US trade statistics and manufacturing industry data for the years 2002-2009 between the USA and its top 12 Asian trading partners, this study applies various regression methods to examine key factors associated with the transport modal decision. Findings – The results show that industry characteristics have an impact on the transportation modal mix in global supply chains. Manufacturing industries use more air freight and less ocean freight when facing positive sales surprises, high-monthly demand variation, a high-contribution margin ratio, a high cost of capital, and increased competition. Practical implications – The findings provide important insights for logistics managers and freight forwarders. While transportation cost remains an important concern, a logistics manager must also consider non-cost factors such as competition, working capital, and demand uncertainties in their modal decisions. Freight forwarders should be supply chain solution providers who consider all of these industry factors and suggest a proper mix of transportation modes for their customers. Originality/value – This study is among the first efforts to examine the impact of industry characteristics on the transportation modal mix in global supply chains. This study first develops a theoretical framework for the modal choice decision for international transportation movements and then, using an extensive and innovative data set, provides new findings regarding current air freight practices in global supply chains.

IDENTIFICATION OF THE KEY FACTORS FOR ACCURATE LIFE-CYCLE COST ESTIMATION FOR CONSTRUCTION

A major limitation of Life-Cycle Cost (LCC) estimation/prediction modelling is the current typical reliance only on those factors that can be readily quantified and come easily to hand. While estimation of the cost of the most common labor, material and plant resources receive consideration because of their high visibility factor, there are several non-cost factors (low visibility factors) affecting the estimate that are often overlooked and, it is argued here, require equal consideration in estimation processes that seek optimum accuracy. Unfortunately, such (low-visibility) factors are neglected or ignored by current prediction models. Identification of these non-cost factors (low visibility factors) affects LCC estimate accuracy and can improve estimation process confidence. This paper critically reviews secondary research on identification of these important non-cost factors and subsequently determines their influence on the accuracy level(s) of construction cost estimation.

Analysis of the energy and environmental effects of green car deployment by an integrating energy system model with a forecasting model

By 2020, Korea has set itself the challenging target of reducing nationwide greenhouse gas emissions by 30%, more than the BAU (Business as Usual) scenario, as the implementation goal required to achieve the new national development paradigm of green growth. To achieve such a target, it is necessary to diffuse innovative technologies with the capacity to drastically reduce greenhouse gas emissions. To that end, the ripple effect of diffusing innovative technologies on the energy and environment must be quantitatively analyzed using an energy system analysis model such as the MARKAL (Market Allocation) model. However, energy system analysis models based on an optimization methodology have certain limitations in that a technology with superior cost competitiveness dominates the whole market and non-cost factors cannot be considered. Therefore, this study proposes a new methodology for overcoming problems associated with the use of MARKAL models, by interfacing with a forecasting model based on the discrete-choice model. The new methodology was applied to green car technology to verify its usefulness and to study the ripple effects of green car technology on greenhouse gas reduction. The results of this study can be used as a reference when establishing a strategy for effectively reducing greenhouse gas emissions in the transportation sector, and could be of assistance to future studies using the energy system analysis model.

Decision criteria for selecting air source heat pump technology in UK low carbon housing

The use of low or zero carbon technologies has been encouraged in the UK, one of which is air source heat pump (ASHP). However, the current ASHP uptake in UK housing is low, far behind that in Europe and America. This paper aims to contribute to knowledge of utilising ASHP by examining the decision criteria for selecting ASHP and exploring underlying considerations of UK housebuilders. The research was carried out through a case study with a housebuilder and seven nation-wide suppliers, engaging four new-build projects. A wide range of decision criteria were identified. Despite the dominance of cost considerations, non-cost factors also imposed significant commercial implications on the housebuilder’s technology selection. For achieving more effective ASHP selection, a structured approach is suggested to manage the decision criteria and appreciate the stakeholders’ roles and relationships regarding technology uptake. Improved practice should enable a more informed technology decision culture in UK housing.

The Role of Cost Related Factors in the Competitiveness of European Services

The emergence of service offshoring places competitiveness at the centre of the discussion on international trade and business. Service competitiveness factors remain a field that is largely unexplored. This paper addresses the role of cost related factors explaining service competitiveness. It empirically tests trade performance of 15 European countries in 8 service markets in order to observe the role of cost factors, country effects and industry specific patterns. A model based on cross section and panel data regressions is suggested in order to test the influence of cost determinants and their elasticities. Results show great heterogeneity among service activities and suggest the importance of non-cost related factors within European Union countries.

Health need and the use of alternative medicine among adults who do not use conventional medicine

BackgroundWe hypothesize that a substantial portion of individuals who forgo conventional care in a given year turn to some form of alternative medicine. This study also examines whether individuals who use only alternative medicine will differ substantially in health and sociodemographic status from individuals using neither alternative medicine nor conventional care in a given year. To identify those factors that predict alternative medicine use in those not using conventional care, we employed the socio-behavioral model of healthcare utilization.MethodsThe current study is a cross-sectional regression analysis using data from the 2002 National Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50 states and the District of Columbia.Results19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although 39.5% of these individuals (14.7 million) reported having one or more problems with their health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine. Users of alternative medicine had more health needs and were more likely to delay conventional care because of both cost and non-cost factors compared to those not using alternative medicine. While individual predisposing factors (gender, education) were positively associated with alternative medicine use, enabling factors (poverty status, insurance coverage) were not.ConclusionsWe found that a quarter of individuals who forgo conventional care in a given year turn towards alternative medicine. Our study suggests that the potential determinants of using only alternative medicine are multifactorial. Future research is needed to examine the decision process behind an individual's choice to use alternative medicine but not conventional medicine and the clinical outcomes of this choice.

Factors Influencing Cost-Related Nonadherence to Medication in Older Adults: A Conceptually Based Approach

Objective Although multiple noncost factors likely influence a patient's propensity to forego treatment in the face of cost pressures, little is known about how patients' sociodemographic characteristics, physical and behavioral health comorbidities, and prescription regimens influence cost-related nonadherence (CRN) to medications. We sought to determine both financial and nonfinancial factors associated with CRN in a nationally representative sample of older adults. Methods We used a conceptual model developed by Piette and colleagues that describes financial and nonfinancial factors that could increase someone's risk of CRN, including income, comorbidities, and medication regimen complexity. We used data from the 2004 wave of the Health and Retirement Study and the 2005 HRS Prescription Drug Study to examine the influence of factors within each of these domains on measures of CRN (including not filling, stopping, or skipping doses) in a nationally representative sample of Americans age 65+ in 2005. Results Of the 3071 respondents who met study criteria, 20% reported some form of CRN in 2005. As in prior studies, indicators of financial stress such as higher out-of-pocket payments for medications and lower net worth were significantly associated with CRN in multivariable analyses. Controlling for these economic pressures, relatively younger respondents (ages 65–74) and depressive symptoms were consistent independent risk factors for CRN. Conclusions Noncost factors influenced patients' propensity to forego treatment even in the context of cost concerns. Future research encompassing clinician and health system factors should identify additional determinants of CRN beyond patients' cost pressures.

Noncost factors affect drug adherence rates in elderly

Noncost factors affect drug adherence rates in elderly