Quality Cost Research Articles

Hospital spending and length of stay attributable to perioperative adverse events for inpatient hip, knee, and spine surgery: a retrospective cohort study

BackgroundThe incremental hospital cost and length of stay (LOS) associated with adverse events (AEs) has not been well characterized for planned and unplanned inpatient spine, hip, and knee surgeries.MethodsRetrospective cohort study of hip, knee, and spine surgeries at an academic hospital in 2011–2012. Adverse events were prospectively collected for 3,063 inpatient cases using the Orthopaedic Surgical AdVerse Event Severity (OrthoSAVES) reporting tool. Case costs were retrospectively obtained and inflated to equivalent 2021 CAD values. Propensity score methodology was used to assess the cost and LOS attributable to AEs, controlling for a variety of patient and procedure factors.ResultsThe sample was 55% female and average age was 64; 79% of admissions were planned. 30% of cases had one or more AEs (82% had low-severity AEs at worst). The incremental cost and LOS attributable to AEs were $8,500 (95% confidence interval [CI]: 5100–11,800) and 4.7 days (95% CI: 3.4–5.9) per admission. This corresponded to a cumulative $7.8 M (14% of total cohort cost) and 4,290 bed-days (19% of cohort bed-days) attributable to AEs. Incremental estimates varied substantially by (1) admission type (planned: $4,700/2.4 days; unplanned: $20,700/11.5 days), (2) AE severity (low: $4,000/3.1 days; high: $29,500/11.9 days), and (3) anatomical region (spine: $19,800/9 days; hip: $4,900/3.8 days; knee: $1,900/1.5 days). Despite only 21% of admissions being unplanned, adverse events in these admissions cumulatively accounted for 59% of costs and 62% of bed-days attributable to AEs.ConclusionsThis study comprehensively demonstrates the considerable cost and LOS attributable to AEs in orthopaedic and spine admissions. In particular, the incremental cost and LOS attributable to AEs per admission were almost five times as high among unplanned admissions compared to planned admissions. Mitigation strategies focused on unplanned surgeries may result in significant quality improvement and cost savings in the healthcare system.

Costing the mental health harms of sexual and physical violence in adulthood: a prevalence-based analysis

Abstract Background When economists estimate how much violence ‘costs’, they rarely address the longer-term mental health harms resulting from sexual violence or the combined impact of sexual and physical violence, nor have most gender-disaggregated costs. Methods We applied prevalence-based modelling techniques to estimate the annual cost of experience of violence in adulthood, in terms of reduced quality of life and health service costs. Data were drawn from multiple sources, including the general population probability sample Adult Psychiatric Morbidity Survey. Prevalence and duration estimates used weighted data. Adjusted marginal effects for limiting mental health conditions and substance dependence were estimated for experience of sexual violence, physical violence, and sexual and physical violence combined. Disability weights were applied to estimate associated reduced quality of life and relative risks applied to health service delivery costs. Findings The estimated cost in 2019 of long-term reduced quality of life adults in England experienced because of violence during their adult years was £3,767 mil (€4,290 mil), with associated healthcare costs of £4,130 mil (€4703 mil). Both the costs of long-term lost quality of life and healthcare were higher in women than men. The costs associated with combined sexual and physical violence were particularly high, with an estimated 96% of these costs resulting from experiences of violence in women. Combined sexual and physical violence in women was associated with the highest cost per victim. Conclusions Sexual and physical violence both have substantial and independent associations with long-term mental distress, substance dependence and treatment and service use. Violence reduction interventions have the potential to reduce health service costs and increase population level quality of life. Future costings of sexual violence should fully incorporate the long-term impacts on mental health and gender-disaggregate estimate.

Nutritional and non-nutritional content in food: targets for front-to-package labels

Abstract A global shift from traditional to “Westernized” dietary patterns is being considered responsible for the substantial worsening of global diets and the consequent impact on human health. The need for easily accessible, palatable, and affordable food has driven an industry-led globalization of the markets with products easily available worldwide often at cost of nutritional quality, with evidence of substantial substitution of local food production/consumption. A growingly large share of commercial food products are dangerously high in added sugar, starch and/or fat and poor in vitamins and fiber. Additional concerns also rely on the poorly investigated role of food chemical additives on human health, with substantial documented effects on human gut microbiota and potential threats for long term exposure. Given the poor nutritional profile, the unknown effects of industrial additives, and the “substitution effect” for healthy foods, the consumption of industrially processed foods is of great interest for public health experts because the massive market invasion and the potential global impact on the general population. More importantly, foods quality and level of processing is currently not of concern for nutritional guidelines while it started being questioned for its role on general public health.

Exploring the Impact of Artificial Intelligence and Digital Transformation on Auditing Practices in Saudi Arabia: A Cross-Sectional Study

The advent of digital technologies and the increasing adoption of artificial intelligence (AI) have transformed various industries and firms, including auditing. Manual auditing procedures have proven to be time-consuming and labor-intensive, leading to lower audit quality and higher costs. The integration of digital transformation and AI in auditing practices offers potential solutions to enhance efficiency and effectiveness in Saudi Arabia. Therefore, this research focuses on examining the impact of digital technologies and AI on audit efficiency, effectiveness, challenges faced during adoption, adjustments in auditors' roles, and the regulatory and ethical considerations arising from the integration. A cross-sectional research design was adopted to collect data from a sample of 400 participants through an online survey, analyzed by statistical tools, including descriptive statistics and correlation and examined the relationships between variables. The findings indicate a positive relationship between the level of digital transformation and the adoption of AI in auditing practices in Saudi Arabia, along with significant challenges, such as resistance to change, technological infrastructure, skills gap, and regulatory compliance concerns, paving a way for further advancements in the field of auditing and digital transformation.

Robotics Software: Past, Present, and Future

Robotics is powered by software. Software tools control the rate of innovation in robotics research, drive the growth of the robotics industry, and power the education of future innovators and developers. Nearly 900,000 open-source repositories on GitHub are tagged with the keyword robotics—a potentially vast resource, but only a fraction of those are truly accessible in terms of quality, licensability, understandability, and total cost of ownership. The challenge is to match this resource to the needs of students, researchers, and companies to power cutting-edge research and real-world industrial solutions. This article reviews software tools for robotics, including both those created by the community at large and those created by the authors, as well as their impact on education, research, and industry.

Location and Types of Treatment for Prostate Cancer After the Veterans Choice Program Implementation

The Veterans Choice Program (VCP) was implemented in 2014 to help veterans gain broader access to specialized care outside of the Veterans Health Administration (VHA) facilities by providing them with purchased community care (CC). To describe the prevalence and patterns in VCP-funded purchased CC after the implementation of the VCP among veterans with prostate cancer. This cohort study used VHA administrative data on veterans with prostate cancer diagnosed between January 1, 2015, and December 31, 2018. These veterans were regular VHA primary care users. Analyses were performed from March to July 2023. Driving distance (in miles) from residence to nearest VHA tertiary care facility. The location (VHA or purchased CC) in which treatment decisions were made was ascertained by considering 3 factors: (1) location of the diagnostic biopsy, (2) location of most of the postdiagnostic prostate-specific antigen laboratory testing, and (3) location of most of the postdiagnostic urological care encounters. The main outcome was receipt of definitive treatment and proportion of purchased CC by treatment type (radical prostatectomy [RP], radiotherapy [RT], or active surveillance) and by distance to nearest VHA tertiary care facility. Quality was evaluated based on receipt of definitive treatment for Gleason grade group 1 prostate cancer (low risk/limited treatment benefit by guidelines). The cohort included 45 029 veterans (mean [SD] age, 67.1 [6.9] years) with newly diagnosed prostate cancer; of these patients, 28 866 (64.1%) underwent definitive treatment. Overall, 56.8% of patients received definitive treatment from the purchased CC setting, representing 37.5% of all RP care and 66.7% of all RT care received during the study period. Most patients who received active surveillance management (92.5%) remained within the VHA. Receipt of definitive treatment increased over the study period (from 5830 patients in 2015 to 9304 in 2018), with increased purchased CC for patients living farthest from VHA tertiary care facilities. The likelihood of receiving definitive treatment of Gleason grade group 1 prostate cancer was higher in the purchased CC setting (adjusted relative risk ratio, 1.79; 95% CI, 1.65-1.93). This cohort study found that the percentage of veterans receiving definitive treatment in VCP-funded purchased CC settings increased significantly over the study period. Increased access, however, may come at the cost of low care quality (overtreatment) for low-risk prostate cancer.

Joint duration-cost-quality optimization model for complex product supply chains under contingency conditions.

The Graphical Evaluation and Review Technique (GERT) and complex networks are used to simulate and analyse complex product supply chain networks based on the characteristics of complex product supply chain networks. And the traditional GERT is improved by constructing a grey parametric GERT network with restricted output results, taking into account the fact that the duration, product quality and product cost of each supplier in a complex product supply chain are interval values rather than definite values, and that customers have restrictions on the duration, product quality and product cost of the final product. The functional relationship between product quality, product cost and duration is analysed, and two satisfaction functions for duration and cost are constructed in order to quantify the multi-objective requirements of shortening duration, saving product cost and guaranteeing product quality for complex products under emergency situations. Then, a duration-cost-quality model for complex product supply chains in contingency situations is constructed to obtain the better duration, product cost and product quality of each supplier by optimising the indicator parameters in the network. Finally, the scientific validity and effectiveness of the model and method are verified by means of arithmetic example. The results show that the method is able to analyse the optimal duration, product quality and product cost of each supplier, and the main manufacturer can obtain an optimised combination of duration, cost and quality for a complex product supply chain in different contingency situation. To further promote the sustainable and secure development of complex product supply chains, this paper also suggests the integration of data sharing and blockchain technology with complex product supply chains to develop dynamic supply chain feedback management systems.

Research on Optimization of Manufacturing Resource Allocation in China from the Perspective of Economics

Manufacturing industry is the material basis of national economy and the main body of industrialization. Highly developed manufacturing industry is a necessary condition for industrialization and an important symbol of a country's comprehensive competitiveness. The inter-manufacturing effect emphasizes the static resource allocation between manufacturing industries, while the entry and exit of manufacturing industries emphasize the process of dynamic resource allocation between manufacturing industries. The previous literature on environmental regulation paid more attention to the influence of environmental regulation on the technological progress of manufacturing industry, and the research on the resource allocation effect of environmental regulation was insufficient, and even less on the dynamic resource allocation effect of manufacturing industry. In this regard, this paper optimizes the allocation of manufacturing resources in China from the perspective of economics, and the rapid economic growth will also provide opportunities for the leap-forward development of productive forces. Under the condition of not affecting the current production plan and production state, the manufacturing industry can optimize the use of idle resources of its own manufacturing units and integrate the superior resources of external manufacturing units to manufacture complex products that meet the requirements of users with faster speed, better quality and lower cost, so as to win the market.

Deformation rate of engineered wood flooring with response surface methodology and adaptive network-based fuzzy inference system.

Controlling the deformation rate is the key to improving the product quality of engineered wood flooring. In this work, the changes in the deformation rate of engineered wood flooring were in focus with cold-pressing, response surface methodology, and adaptive network-based fuzzy inference system were used to explore the relationship between deformation rate and processing parameters, including adhesive spreading rate, pressing time, and pressing pressure. According to the results, the deformation rate was positively related to pressing time, while it increased first and then decreased with both the increase of adhesive spreading rate and pressing pressure. Meanwhile, a mathematical model was developed, and the significant influence of each term on the deformation rate was analyzed. This model had high feasibility and can be used to describe the relationship between the deformation rate and processing parameters. Furthermore, an adaptive network-based fuzzy inference system model was established. It has higher accuracy than that of the response surface methodology model, and it can be used for predicting deformation rate and optimizing processing parameters. Finally, an optimal processing conditions with the lowest deformation rate was determined as follows: 147 g/m2 adhesive spreading rate, 12s pressing time, and 1.2 MPa pressing pressure, and it hope to be adopted in the industrial processing of engineered wood flooring with respective of the higher product quality and lower production costs.

Process Approach in Determining the Accounting Model and Quality Cost Analysis

Every year the requirements of consumers to the quality of products are steadily increasing and expanding. A company seeking to strengthen its position in a competitive market must constantly invest in quality. To determine the volume of investments, making strategic decisions, complete and reliable information on the costs of quality is required. The backbone of any organization is the business process, so the quality cost model should reflect the total costs of each process, not randomly selected quality costs. The process approach in the classification of quality costs allows raising hidden costs to the surface, which makes it possible to evaluate and optimize them. Since not all quality costs are obvious, this makes them difficult to accurately measure and quantify. There are also many areas where quality assurance activities and processes overlap. To determine the classification of quality costs based on a process approach, the article uses a typical process model of a quality management system for an automotive enterprise and an optimal quality model, also known as the Prevention-Assessment-Failure (PAF) model. This classification in the future will allow you to analyze and manage quality costs, and will also become a source of necessary information for making strategic decisions. Thus, with the help of this classification of costs, it is possible to achieve a balance between meeting the quality requirements of consumers and the costs incurred for this purpose. Also, the classification of quality costs presented in the article makes it possible to evaluate the effectiveness of measures aimed at improving quality, and, in general, the effectiveness of the quality management system implemented at the enterprise.

A parametric approach to institutional quality and bank cost inefficiency in diversity context: The case of Italy

AbstractEffective government rules and regulations, as well as the ability of the regulator to curb corruption and promote voice and accountability, can influence the ability of bank management to allocate resources and ensure high performance. Based on this assumption, we aim to find out whether institutional quality is able to improve bank performance in Italy. To do so, we rely mainly on the diversity of banks, thus capturing the different behaviors of the two main categories, i.e. cooperative and for‐profit banks. Using a parametric method, the results show a clear impact of most dimensions of institutional quality on reducing banks’ cost inefficiency. Some robustness checks, especially regarding the role of market structure, confirm our findings.

Impact of heated basements on the performance of borehole GHEs

Increasing urban development is leading to a growing demand for subsurface utilisation. As more infrastructure is built into the subsurface, heat from tunnels, sewers, and basements, among others, alter the thermal state of the ground, acting as sources and sinks of heat, leading to a net-increase of underground temperatures, a phenomenon known as the Subsurface Urban Heat Island (SUHI) [7-8]. This additional heat can have impacts on, for example, health and maintenance of underground structures, increased ventilation costs for underground spaces, and quality and quantity of groundwater flow [1,2]. However, this additional heat in the subsurface can also be harvested by ground-source heat pump (GSHP) systems to provide heating to buildings [3-6], operating more efficiently due to the higher ground temperatures and reducing these temperatures through operation, thus mitigating the risks and impacts of SUHI.
 This work demonstrates how heated basements can contribute to the operation of GSHP systems to provide heating. The area of Downing College, located in central Cambridge, UK, is used as a case study site, investigating how much of the college’s heating demand a number of geothermal boreholes could provide, when the heat from the building basements is taken into account and when it is not. Measured gas consumption data from the college are used to estimate the heat demand. The geology of the site is obtained by importing historical borehole records for the wider Cambridge area into the British Geological Survey (BGS) Groundhog® Desktop Geoscientific Information System and constraining the domain using BGS generated superficial deposit and bedrock geology maps, thus producing a 3D lithological profile for the region*, while the hydrological conditions were obtained using measured water level time-series data, from water wells in the area, curtesy of the Environment Agency. A total of 88 boreholes are considered, placed symmetrically in the college courtyard, between the main buildings. Typical single U-loop borehole configurations are used with pipes of 32 mm outer diameter. Acknowledging that the effect of heated basements is greater in shallower regions of the subsurface, two typical borehole length values are considered: 50 m, providing about 40% of the required heating load, and 100 m, providing 100%. The operation is simulated over 50 years, using a full 3D numerical model coupling heat transfer, groundwater flow, and pipe flow governing equations, created in COMSOL Multiphysics®. The temperature of the heated basements is assumed to be maintained at 18 °C throughout the simulation. During the first 10 years, the GHEs are not operating, to allow heat accumulation in the ground to occur from the heated basements, following which, 40 years of operating GHEs are simulated.
 The results of the simulations suggest that an increase in performance occurs when heated basements are present. For all scenarios, the fluid temperatures keep decreasing over time, as the ground temperature around the boreholes keeps decreasing, making it more difficult to extract heat. Over the 50 years of simulation, the fluid temperature reaches a minimum of -3.20 °C and -2.13 °C for the 50 m GHEs, and 4.52 °C and 3.88 °C for 100 m GHEs, in both cases the first value being the simulation with heated basements and the second without. The COP values over time are presented in Figure 1-right, showing the difference in COP between the cases with and without heated basements increasing over time for both 50 m and 100 m GHEs, for the former at a higher rate.
 This increase corresponds to the increase in the average fluid temperature between the cases with and without heated basements, also shown in the figure, and reaches a maximum difference of about 0.08 for the 50 m GHEs and 0.05 for the 100 m GHEs, corresponding to a fluid temperature difference of about 1.10 °C and 0.65 °C, respectively. These figures correspond to a reduction in operating costs (assuming an electricity rate of £0.34 per kWh) of £17,352 for 50 m GHEs and £18,197 for 100 m GHEs. While for this case these values are relatively small considering 40 years of operation, the fluid temperature difference suggests that more energy can be extracted by the GHE borheoles when heated basements are present, especially for shorter boreholes, and thus potential savings could be obtained by reducing the number of GHEs.

Numerical investigation of the effect of topology optimisation methods parameters in the topology quality, the strength, and the computational cost

The literature abounds with many distinct topology optimisation methods, many of which share common parameter configurations. This study demonstrates that alternative parameter configurations may produce better results than common parameters. Additionally, we try to answer two fundamental questions: identifying the most effective topology optimisation method and determining the optimal parameter selection within this optimisation method. In order to respond to these questions, we conducted a comparative and objective analysis of topology optimisation methods.This paper evaluates four prominent topology optimisation methodologies, SIMP, RAMP, BESO, and LSM, based on three essential criteria: structural strength, topology quality, and computational cost. We conducted an in-depth examination of 12,500 topology optimisation results spanning a broad range of critical parameter values. These outcomes were generated using MATLAB codes. In the meantime, we comprehensively compared our findings with the existing literature on this subject.As predicted, our chosen parameters had a substantial effect on the topology quality, structural strength, and computational cost of the topology optimisation outcomes. Across the 12,500 results, many parameter combinations appeared to produce favourable results compared to conventional parameters commonly found in the existing literature.This study focuses exclusively on four specific topology optimisation methods; however, its findings may be extrapolated to apply to other methodologies. Additionally, while it extensively examines the effects of parameters on topology quality, strength, and computational cost, it does not encompass an exploration of these parameters' impacts on other performance criteria.Novel parameter configurations for topology optimisation have been identified, yielding enhanced outcomes in terms of topology quality, structural strength, and computational efficiency.

Field performance and cost-effectiveness of a point-of-care triage test for HIV virological failure in Southern Africa.

Antiretroviral therapy (ART) monitoring using viral load (VL) testing is challenging in high-burden, limited-resources settings. Chemokine IP-10 (interferon gamma-induced protein 10) strongly correlates with human immunodeficiency virus (HIV) VL. Its determination could serve to predict virological failure (VF) and to triage patients requiring VL testing. We assessed the field performance of a semi-quantitative IP-10 lateral flow assay (LFA) for VF screening in South Africa, and the cost-effectiveness of its implementation in Mozambique. A cross-sectional study was conducted between June and December 2021 in three primary health clinics in the Western Cape. Finger prick capillary blood was collected from adults on ART for ≥1 year for direct application onto the IP-10 LFA (index test) and compared with a plasma VL result ≤1 month prior (reference test). We estimated the area under the receiver operating characteristic curves (AUC), sensitivity and specificity, to evaluate IP-10 LFA prediction of VF (VL>1000 copies/ml). A decision tree model was used to investigate the cost-effectiveness of integrating IP-10 LFA combined with VL testing into the current Mozambican ART monitoring strategy. Averted disability-adjusted life years (DALYs) and HIV acquisitions, and incremental cost-effectiveness ratios were estimated. Among 209 participants (median age 38 years and 84% female), 18% had VF. Median IP-10 LFA values were higher among individuals with VF compared to those without (24.0 vs. 14.6; p<0.001). The IP-10 LFA predicted VF with an AUC = 0.76 (95% confidence interval (CI) 0.67-0.85), 91.9% sensitivity (95% CI 78.1-98.3) and 35.1% specificity (95% CI 28.0-42.7). Integrating the IP-10 LFA in a setting with 20% VF prevalence and 61% VL testing coverage could save 13.0% of costs and avert 14.9% of DALYs and 55.7% new HIV acquisitions. Furthermore, its introduction was estimated to reduce the total number of routine VL tests required for ART monitoring by up to 68%. The IP-10 LFA is an effective VF triage test for routine ART monitoring. Combining a highly sensitive, low-cost IP-10 LFA-based screening with targeted VL confirmatory testing could result in significant healthcare quality improvements and cost savings in settings with limited access to VL testing.

Building Cultural and Clinical Bridges: Post-Merger Strategies to Create Synergy, Increase Quality, and Reduce Costs.

Building Cultural and Clinical Bridges: Post-Merger Strategies to Create Synergy, Increase Quality, and Reduce Costs.

ANALISIS PENGENDALIAN KUALITAS PRODUK PADA KONVEKSI NITRA JAYA DI KABUPATEN BADUNG

Declining product quality often occurs during the production process which can affect product quality. Damaged products can be done by the company by controlling the quality of the products produced through many methods such as DMAIC (Define, Measure, Analyze, Improve and Control), Six Sigma and Statistical Quality Control (SQC). This research was conducted at the Nitra Jaya Convection which is located on Jalan Raya Panglan, Banjar Cepaka Kapal, Mengwi District, Badung Regency, Bali. The data analysis technique used is statistical quality control (SQC) by using tools such as check sheets, P-charts, Fishbone diagrams and Quality Costs. The results of the analysis of the cost of production quality at the Nitra Jaya Convection for the 2019 period still show that the actual quality costs incurred by the company are still greater than the optimal quality costs that should be incurred by the company. The actual damage was 116 pcs of uniforms, with a total cost of quality (TQC) of Rp13.244.958. The lowest point or the optimal point of quality costs is at the damage limit of 195 pcs of uniforms with an optimum total cost of quality (TQC) of Rp11.647.055. This shows that quality control has not been implemented optimally.

METHODICAL APPROACHES TO ENHANCING BUSINESS PROCESSES THROUGH INNOVATION IMPLEMENTATION AT THE ENTERPRISE

Abstract. This article describes the importance of developing high technology and a competitive economy in Kazakhstan, as well as the significance of improving business processes and mechanisms to achieve this goal. The success of enterprises depends on the right strategy, competent leadership, the availability of resources and markets, and efficient business processes.&#x0D; The authors discuss the role of innovation in increasing turnover and production growth of enterprises in the modern world. They emphasize the need to quickly adapt production programs to changing customer demands and short product life cycles.&#x0D; Special attention is given to the complexity of assessing the beneficial effect of innovations, and two evaluation criteria are presented: the minimum cost criterion and the integrated quality indicator of innovations. It also mentions the use of expert or statistical methods when it is impossible to establish a quantitative relationship between quality indicators and costs.&#x0D; In addition, the article describes the establishment of a relationship between costs and comprehensive indicators of technical level and economic efficiency using correlation and regression modeling. A methodology is proposed, including traditional normative approaches and the "cost-effectiveness" method.&#x0D; Keywords: foreign economic relations, competitiveness, national economy, innovations, efficiency, quality, technology.

Customer Satisfaction in Automobile Industry in Kathmandu District

This study aims to evaluate the relationship between the satisfaction of customers in terms of after-sales services in the automobile industry in Kathmandu. This study applied a descriptive research design. This study type was quantitative. Since the population is unknown in this study 384 questionnaires were collected from respondents of this research work applying a purposive sampling technique. The population of the study was both two-wheelers and four-wheeler vehicle users from many places in Kathmandu and various backgrounds. Purposive sampling techniques were used in this study. This study applied the self-administered close-ended survey questionnaire. Multiple choice questions based on the Five-Point Likert Scale developed by Rensis Likert were used to mention a level of a statement of disagreement to an agreement where 1 indicates strongly disagree and 5 indicates strongly agree. Data were analyzed based on the majority of respondents/ responses collected out of the total sample size (384) entered in the table of the Five-Point Likert Scale. Respondents who are in favor of an agreement with all of the tables and statements are more than those of disagree. Therefore, it can be concluded that there is a high association between the satisfaction of customers with components of after-sales service i.e., the cost of service, service quality, responsiveness, and speed of service of automobiles in various places in Kathmandu. It can be concluded that these components are associated with customer satisfaction. The automobile industry should be guided by the Kano model to meet the requirements of consumers in terms of products and services.

Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews.

For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness. Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis. Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall. For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending. https://doi.org/10.23641/asha.24168201.

The Management Accounting Usage in Automotive Servitized Companies: An Initial Attempt

Purpose : Prior literature suggests a further exploration on the usage of management accounting (MA) techniques in the servitization context. Servitization is a movement in which companies consciously develop service offerings, which support their products to gain competitive advantage. There are still limited studies of this topic in the context of Indonesian manufacturing companies, thus this paper aims to provide evidence on the usage of MA in servitized manufacturing companies in Indonesia.&#x0D; Method : We employed a qualitative approach as well as a preliminary survey to a number of selected managers and accountants from four different automotive companies.&#x0D; Findings : The result shows that target costing is very crucial to the automotive manufacturing companies nowadays. We discover that competitive position monitoring, quality costing, integrated performance measurement, and brand management accounting are relevant to company’s strategic position. Therefore, we find the connection between the usage of MA and company’s strategic planning.&#x0D; Novelty : From practical point-of-view, our study provides the evidence on the usage of MA in Indonesian servitized-manufacturing business. Also, we build a framework, which represents the relationship between the MA techniques and servitization, that could benefit business through a better understanding about the interconnections between MA usage and servitization level.&#x0D; Keywords : Management Accounting; Servitization; Automotive Companies; Indonesia