Refine
Year of publication
- 2004 (14) (remove)
Document Type
- Contribution to a Periodical (14) (remove)
Has Fulltext
- no (14)
Is part of the Bibliography
- no (14)
Keywords
- Airbag yarns (1)
- Airbags (1)
- Approximation Theory (1)
- Asian market (1)
- Aspect ratio (1)
- Attenuation (1)
- Boundary conditions (1)
- Chemical fibers (1)
- Chickenpox (1)
- Electric excitation (1)
Airbag-Markt - Quo vadis?
(2004)
The simplifications used while creating a model for structure borne transmission from a wood stud to a gypsum board mounted on RCs are discussed.
Above 400 Hz power transmission is determined by stud translation, is propotional to the number of RCs, and is independent of number and location of fasteners between gypsum board and RCs.
In this frequency range it is possible to use the mobility approach if RCs can be approximated by a series of idealised springs located at points of intersection between stud and RCs. The dynamic stiffness of each spring is equal to that of the RC at a stud.
The assumptions relating to power flow as a function of position and number of fasteners between the gypsum board and RC's was examined. It was observed that studs had both a rotational and translation motion but the translation displacement coupled more strongly than rotation. It was also observed that if the rotation velocity was less than or equal to the translation velocity, then structure borne transmission due to the rotation component could be ignored for frequencies below 2500 Hz. The results show that there is little effect associated with either the location or the number of fasteners attaching the gypsum board to the RC's about 315 Hz.
In diesem Beitrag wird zunächst auf die Problematik einer Kostenzuordnung auf Forschung, Lehre und Krankenversorgung in Universitätsklinika näher eingegangen. Im zweiten Abschnitt wird anhand einer aktuellen Untersuchung zur Lage der Hochschulmedizin aufgezeigt, wie derzeit in Deutschland der Landeszuschuss für Forschung und Lehre an die Universitätsklinika und später innerhalb der Klinika an die einzelnen Fachabteilungen verteilt wird. Als eine mögliche Basis für eine Trennungsrechnung schält sich die Arbeitszeitverteilung der ärztlichen Mitarbeiter heraus, die oft anhand von Befragungen ermittelt wird. Deswegen werden im dritten Kapitel die Ergebnisse einer solchen Befragung in einer Abteilung eines Universitätsklinikums dargestellt und die Möglichkeiten sowie Grenzen für eine Kostenzuordnung diskutiert.
For cost–benefit analysis, health technologies with multiple effects should be valued in a single scenario by a holistic willingness‐to‐pay (WTP) measure. Recent studies instead used decomposed scenarios in which respondents report their WTP for each individual effect. Evidence can be found that the sum of such decomposed WTPs overestimates the holistic WTP, i.e. the holistic WTP is sub‐additive. This sum of decomposed WTPs can lead to wrong conclusions on the efficiency of health technologies. This is also relevant in decision making about new technologies that are valued separately in different surveys. To date, no utility‐theoretical and empirically validated aggregation function for decomposed WTPs exists. Within an expected utility model, this paper identifies as a reason for sub‐additivity – beside risk aversion with respect to wealth – a negative influence of better health on the marginal utility of wealth, i.e. marginal utility of wealth is smaller in better health states. Assuming mutual utility independence of health and wealth, a theoretically founded aggregation function covering these two impacts is derived. In a contingent valuation study, 92 patients with diabetes were asked to state their WTP for reductions of the risk of several diabetic complications in decomposed as well as in holistic scenarios. The patients had preferences with a significant negative influence of health on the marginal utility of wealth. Sub‐additivity occurred and theoretically founded aggregation could considerably lower the degree of overestimation. These results suggest that the theoretically founded aggregation function might reduce problems of sub‐additivity that can be economically relevant. Further empirical testing of the approach is indicated.
Introduction
Universal varicella vaccination of infants in Germany was shown to be effective and cost-saving by the EVITA-model (Economic Varicella VaccInation Tool for Analysis).[1] However, affordability proves to be a “fourth hurdle”. The objective of this study is to examine budget impacts of universal varicella vaccination from a payer’s (sickness funds’) perspective.
Methods
The validated, dynamic infections disease model EVITA was used to analyse budget impacts over 30 years. Universal vaccination of children in their second life year was compared to the currently recommended risk-group strategy. In the USA, universal varicella vaccination was implemented in 1996. Based on US-experience, three scenarios for the development of the coverage rates have been estimated. The price level of 2002 was used. Future costs were not discounted to show the full budget impact in future years. Aspects concerning the incidence of herpes zoster have not been included in the analysis.
Results
Under the current risk-group strategy, an annual average of 721,400 cases, 38,700 complications and 5,500 hospitalisations occur in Germany. Annual varicella costs for sickness funds amount to 73 million €, 50 % thereof due to sick-leave costs of parents staying at home to care for their sick child covered by sickness funds. Other costs relate to hospitalisations (24 %), physician services (12 %), medication (11 %) and vaccination (3 %). With a universal vaccination strategy, morbidity is on average reduced by 75 % to 80 % (this and the following results depend on the analysed scenario). Vaccination costs rise to a maximum of 42–43 million € p. a. within about 10–12 years and therefore account — at maximum — for about 0.03 % of the total payers’ health care budget. Other varicella costs however decrease by more than 80 % in the same time. Overall varicella costs rise by 8 % to 13 % in the first few years because of the additional investment in vaccination. In the 6th to 8th year, however, savings in treatment and work loss costs compensate vaccination costs, leading to net savings. Over 30 years, average annual varicella costs decrease by 31 % to 33 % to a level between 49 and 51 million €. Sensitivity analyses showed only marginal variations in these results with maximum coverage rate, price of vaccine, and work loss costs being the most influential variables.
Conclusions
Under the current risk-group vaccination strategy, varicella causes a high burden of disease resulting in considerable utilisation of health care resources and related costs. Universal vaccination can effectively reduce morbidity and utilisation. This strategy has a small impact on overall health care costs. For a short time, investment in varicella vaccination causes additional costs, which are low compared to current annual varicella costs, and does not influence sickness funds’ premiums. Reduced morbidity rapidly leads to savings and significant net-savings occur in 6–8 years.
Objective. The authors performed a methodological comparison of the usual standard gamble with methods that could also be used in mailed questionnaires.Methods.Ninety-two diabetic patients valued diabetes-related health states twice. In face-to-face interviews, the authors used an iterative standard gamble (ISG) in which the probabilities were varied in a ping-pong manner and a self-completion method (SC) with top-down titration as search procedure (SC-TD) in 2 independent subsamples of 46 patients. Three months later, all patients received a mailed questionnaire in which the authors used the self-completion method with bottom-up (SCBU) and SC-TD as search procedures.Results.ISG and SCTD showed feasibility and consistency in the interviews. The ISG resulted in significantly higher utilities than the SC-TD. Two thirds of the mailed questionnaires provided useful results indicating some problems of feasibility. Utilities measured by SC-BU and SC-TD did not differ significantly showing procedural invariance. Further, patients indicated ambivalence when given the choice not to definitely state their preferences.Conclusions.The results show that different strategies to collect standard gamble utilities can yield different results. Compared with the usually applied ISG, the SC method is feasible in interviews and provides a consistent alternative that is less costly when used in mailed questionnaires, although its practicability has to be improved in this later setting.