Understanding agricultural land leasing in Ireland: a transaction cost approach.

Formal written land leasing contracts offer an alternative to land purchase for those farmers wishing to expand their land area and provide greater security relative to informal short-term rental agreements and are particularly important for beginning farmers with resources insufficient to purchase land. Formal land leasing contracts vary in terms of their duration, but there is limited understanding about the determinants of contract duration in developed countries. In this research, we use econometric techniques and transaction level data to explore the determinants of duration for agricultural land lease contracts for two regions in Ireland. Under the transaction cost economics approach, the research explores the role of legal status, price and non-price conditions in influencing the contract duration. Results indicate that the legal status of the tenant is a significant factor in influencing the duration. Provisions such as break clauses appear positively related to duration and confirm the theoretical expectation that long-term contracts create a demand for processes that enable adaptation over the course of long-term exchange.

Institutional Arrangements for Providing HIV and AIDS Services in Uganda: A Transaction Cost Economics Analysis.

Transaction cost economics (TCE) theory predicts that features of institutional arrangements determine the intensity of their governance instruments. Consequently, institutional features link to transaction costs, but the linkages have received little attention in the public health literature. This study sought to address this gap. It examined the governance features of institutional arrangements and their transaction cost implications for providing HIV prevention and social support services in Uganda. The analysis was based on 4 proposed TCE governance instruments: administrative controls, adaptation, incentives and contract laws. These governance instruments were assessed in 3 modes of delivery( institutional arrangments) for HIV and AIDS Services in Uganda: Contracting-Out - the case of DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe); a Public-Non-Governmental Organisation (NGO) partnership - the case of the CHAI (Community-led HIV/AIDS Initiative); and direct Public Sector Delivery. These assessed delivery modes follow Williamson's TCE framework of 3 institutional arrangements to deliver goods and services, notably market, hybrid (partnership) and internal (hierarchy) delivery, with related governance features. Within this framework, the discriminating alignment hypothesis guided the analysis. According to the hypothesis, the delivery modes of goods and services result in smaller transaction costs when their governance features are as predicted by TCE. The hypothesis was assessed by analysing, with qualitative methods, the differences in HIV and AIDS services characteristics across the 3 arrangements and their differences with theory prediction, and hence the difference in transaction cost implications. The study found that the delivery arrangements that minimised cost are those whose HIV and AIDS services were aligned with the TCE theory prediction. The aligned 'public-NGO partnership' arrangement (CHAI) had fewer sources of transactional costs than the misaligned arrangements - 'contracting-out' (DREAMS) and 'public sector'. The analysis revealed that the DREAMS and public sector delivery models suffered some flaws in efficiencies. DREAMS had high administrative controls, high-powered tangible incentive intensity and intensive monitoring mechanisms for performance adaptation due to the lack of 'trust' on the part of the financing agency, contrary to the TCE prediction. In contrast with the TCE prediction, low administrative controls in the public sector arose from the failure to invest in performance monitoring systems. The high-powered incentive intensity and low administrative controls observed in the CHAI arrangement primarily stemmed from the reliance on informal institutions (trust, social expectations and reputation) rather than principal-agent arms-length sanctions. These results suggest that the level of transaction costs is associated with features of institutional arrangements. The valuable insights from TCE could contribute to policymaking during the design of institutional arrangements to efficiently deliver HIV and AIDS services.

Economics and outcomes of sotalol in-patient dosing approaches in patients with atrial fibrillation.

INTRODUCTION: There exists variability in the administration of in-patient sotalol therapy for symptomatic atrial fibrillation (AF). The impact of this variability on patient in-hospital and 30-day posthospitalization costs and outcomes is not known. Also, the cost impact of intravenous sotalol, which can accelerate drug loading to therapeutic levels, is unknown. METHODS: One hundred and thirty-three AF patients admitted for oral sotalol initiation at an Intermountain Healthcare Hospital from January 2017 to December 2018 were included. Patient and dosing characteristics were described descriptively and the impact of dosing schedule was correlated with daily hospital costs/clinical outcomes during the index hospitalization and for 30 days. The Centers for Medicare and Medicaid Services reimbursement for 3-day sotalol initiation is $9263.51. Projections of cost savings were made considering a 1-day load using intravenous sotalol that costs $2500.00 to administer. RESULTS: The average age was 70.3 ± 12.3 years and 60.2% were male with comorbidities of hypertension (83%), diabetes (36%), and coronary artery disease (53%). The mean ejection fraction was 59.9 ± 7.8% and the median corrected QT interval was 453.7 ± 37.6 ms before sotalol dosing. No ventricular arrhythmias developed, but bradycardia (<60 bpm) was observed in 37.6% of patients. The average length of stay was 3.9 ± 4.6 (median: 2.2) days. Postdischarge outcomes and rehospitalization rates stratified by length of stay were similar. The cost per day was estimated at $2931.55 (1. $2931.55, 2. $5863.10, 3. $8794.65, 4. $11 726.20). CONCLUSIONS: In-patient oral sotalol dosing is markedly variable and results in the potential of both cost gain and loss to a hospital. In consideration of estimated costs, there is the potential for $871.55 cost savings compared to a 2-day oral load and $3803.10 compared to a 3-day oral load.

Developing and applying a costing tool for hypertension and related cardiovascular disease: Attributable costs to salt/sodium consumption.

This paper proposes a costing tool for hypertension and cardiovascular disease by adapting cost-of-illness methodologies to estimate the attributable burden of excessive salt intake on cardiovascular disease. The methodology estimates the changes in blood pressure that result from each gram change in salt intake and links diet to the direct and indirect costs of cardiovascular diseases (CVD), such as coronary heart disease, stroke, hypertensive disease, aortic aneurysm, heart failure, pulmonary embolism, and rheumatic heart, using the relative risks of disease and the prevalence of salt consumption in the population. The methodology includes (a) identifying major diseases and conditions related to excessive salt intake and relevant economic cost data available, (b) quantifying the relationship between the prevalence of excessive salt intake and the associated risk of disease morbidity and mortality using population attributable risks (PAR), (c) using PARs to estimate the share of total costs directly attributed to excessive salt intake, and (d) undertaking a sensitivity analysis of key epidemiological and economic parameters. The costing tool has estimated that, in 2013, US$ 102.0 million (95% uncertainty interval-UI: US$ 96.2-107.8 million) in public hospitalizations could be saved if the average salt intake of Brazilians were reduced to 5 g/d, corresponding to 9.4% (95% UI: 8.9%-9.9%) of the total hospital costs by CVDs. This methodology of cost of illness associated with salt consumption can be adapted to estimate the burden of other dietary risk factors and support prevention and control policies in Brazil and in other countries.

Current status of ambulatory blood pressure monitoring in Asian countries: A report from the HOPE Asia Network.

Ambulatory blood pressure monitoring (ABPM) can measure 24-hour blood pressure (BP), including nocturnal BP and diurnal variations. This feature of ABPM could be of value in Asian populations for preventing cardiovascular events. However, no study has yet investigated regarding the use of ABPM in actual clinical settings in Asian countries/regions. In this study, 11 experts from 11 countries/regions were asked to answer questionnaires regarding the use of ABPM. We found that its use was very limited in primary care settings and almost exclusively available in referral settings. The indications of ABPM in actual clinical settings were largely similar to those of home BP monitoring (HBPM), that is, diagnosis of white-coat or masked hypertension and more accurate BP measurement for borderline clinic BP. Other interesting indications, such as nighttime BP patterns, including non-dipper BP, morning BP surge, and BP variability, were hardly adopted in daily clinical practice. The use of ABPM as treatment guidance for detecting treated but uncontrolled hypertension in the Asian countries/regions didn't seem to be common. The barrier to the use of ABPM was primarily its availability; in referral centers, patient reluctance owing to discomfort or sleep disturbance was the most frequent barrier. ABPM use was significantly more economical when it was reimbursed by public insurance. To facilitate ABPM use, more simplified indications and protocols to minimize discomfort should be sought. For the time being, HBPM could be a reasonable alternative.

Natural plant extracts as an economical and ecofriendly alternative for harvesting microalgae.

The study investigated the ability of plant based natural coagulants from Azadirachta indica; Ficus indica; Moringa oleifera; Citrus sinensis; Punica granatum and Musa acuminata to harvest the microalgal biomass. Influence of eluent type (water and NaCl) and concentration (1-5 N) on coagulant extraction; coagulant dosage (1-5 g) and volume (20-100 ml); pH (6-12) and algal concentration (0.1-1 g l-1) on harvesting were analyzed. The results obtained were compared with alum and chitosan. FTIR and biochemical analysis confirmed the presence of bioactive compounds to aid coagulation. Biomass removal efficiency of 75.50% was obtained with M. oleifera extracts (8 mg ml-1) at pH 7.5-7.8, within 100 min. The harvesting efficiency increased to 95.76% when 4 mg ml-1M. oleifera extracts was combined with 0.75 mg ml-1 chitosan. The life cycle and cost analysis acknowledged the eco-friendly coagulants as strong alternative for conventional coagulants used in microalgal harvesting, thereby improvising the overall bioprocess.

The Global Platform Economy: A New Offshoring Institution Enabling Emerging-Economy Microproviders.

Global online platforms match firms with service providers around the world, in services ranging from software development to copywriting and graphic design. Unlike in traditional offshore outsourcing, service providers are predominantly one-person microproviders located in emerging-economy countries not necessarily associated with offshoring and often disadvantaged by negative country images. How do these microproviders survive and thrive? We theorize global platforms through transaction cost economics (TCE), arguing that they are a new technology-enabled offshoring institution that emerges in response to cross-border information asymmetries that hitherto prevented microproviders from participating in offshoring markets. To explain how platforms achieve this, we adapt signaling theory to a TCE-based model and test our hypotheses by analyzing 6 months of transaction records from a leading platform. To help interpret the results and generalize them beyond a single platform, we introduce supplementary data from 107 face-to-face interviews with microproviders in Southeast Asia and Sub-Saharan Africa. Individuals choose microprovidership when it provides a better return on their skills and labor than employment at a local (offshoring) firm. The platform acts as a signaling environment that allows microproviders to inform foreign clients of their quality, with platform-generated signals being the most informative signaling type. Platform signaling disproportionately benefits emerging-economy providers, allowing them to partly overcome the effects of negative country images and thus diminishing the importance of home country institutions. Global platforms in other factor and product markets likely promote cross-border microbusiness through similar mechanisms.

Linking Supply Chain Governance and Biosecurity in the Context of HPAI Control in Western Java: A Value Chain Perspective.

Despite extensive efforts to control the highly pathogenic avian influenza (HPAI), it remains endemic in Western Java, Indonesia. To understand the limited effectiveness of HPAI control measures, it is important to map the complex structure of the poultry sector. The governance of the poultry value chain in particular, could play a pivotal role, yet there is limited information on the different chain governance structures and their impacts on HPAI control. This article uses value chain analysis (VCA), focusing on an in-depth assessment of governance structures as well as transaction cost economics and quantitative estimates of the market power of different chain actors, to establish a theoretical framework to examine biosecurity and HPAI control in the Western Java poultry chain. During the research, semi-structured interviews were conducted with key value-chain stakeholders, and the economic performance of identified actors was estimated. Results indicated the co-existence of four different poultry value chains in West Java: the integrator chain, the semi-automated slaughterhouse chain, the controlled slaughter-point chain, and the private slaughter-point chain. The integrator chain was characterized by the highest levels of coordination and a tight, hierarchical governance. In contrast, the other three types of value chains were less coordinated. The market power of the different actors within the four value chains also differed. In more integrated chains, slaughterhouses held considerable market power, while in more informal value chains, market power was in the hands of traders. The economic effects of HPAI and biosecurity measures also varied for the identified actors in the different value chains. Implementation of biosecurity and HPAI control measures was strongly related to the governance structure of the chain, with interactions between different chains and governance structures accentuating the risk of HPAI. Our findings highlight that a proper understanding of the chain governance structure is vital to improve the effectiveness of HPAI control measures, by making the interventions more specific and fit-for-purpose given the incentive structures present in different chains.

Improving the delivery of veterinary services in Africa: insights from the empirical application of transaction costs theory in Uganda and Kenya.

This paper presents a summary of findings from a research project that examined institutional arrangements for providing animal health services in Uganda and Kenya. Given the need to find solutions to the pervasive governance challenges encountered in the delivery of veterinary services in Africa, the study applied transaction economics theory to generate recommendations on how to improve the delivery of these services and minimise livestock production risks, including those that pose a risk to human health, e.g. zoonoses. The most notable recommendations are as follows: i) lower- and middle-income countries should invest in creating an enabling environment that supports the relationship between professional veterinarians and para-professionals, to ensure the timely reporting, treatment and control of animal diseases; ii) the provision of veterinary extension services should not focus solely on household 'heads', but also on other household members, such as wives and children, and on herdsmen; iii) strong government engagement is required in the provision of veterinary services for pastoral or extensive livestock production systems, because normal market forces have failed to attract professional veterinarians and trained para-professionals from the private sector to work in these sectors; iv) farmers must be empowered to hold service providers accountable, by the development and trialling of tools that would enable them to measure the quality of services that they receive and to verify the qualifications of different service providers; v) investment in veterinary education is vital, to ensure that enough qualified veterinary staff are available to offer veterinary services to farmers.

L'auteur propose une synthèse des principales conclusions d'un projet de recherche consacré aux dispositifs institutionnels élaborés en Ouganda et au Kenya pour encadrer la prestation des services de santé animale. Face à la nécessité de trouver des solutions aux graves difficultés de gouvernance qui entravent la prestation de services vétérinaires en Afrique, cette étude s'est fondée sur la théorie des transactions économiques pour formuler quelques recommandations sur les moyens d'améliorer la prestation de ces services et de minimiser les risques affectant la production animale, y compris ceux qui peuvent menacer la santé publique, à savoir les zoonoses. Les principales recommandations de l'étude sont les suivantes : i) les pays à faible revenu et à revenu intermédiaire devraient s'investir dans la création d'un environnement propice à la coopération entre les vétérinaires professionnels et les para-professionnels vétérinaires, afin d'assurer la notification rapide, le traitement et la prophylaxie des maladies animales ; ii) les prestations de services vétérinaires de proximité ne doivent pas se limiter aux seuls « chefs de famille ¼ mais s'adresser également aux autres membres des foyers (les épouses et les enfants) ainsi qu'aux gardiens des troupeaux; iii) une mobilisation forte des pouvoirs publics est nécessaire pour assurer la prestation de services vétérinaires au sein des systèmes d'élevage pastoral ou extensif, dans la mesure où les forces spontanées du marché ont échoué à attirer les vétérinaires libéraux et les para-professionnels qualifiés du secteur privé dans ces territoires ; iv) les éleveurs doivent disposer des moyens de demander des comptes aux prestataires de services, ce qui suppose de concevoir et de tester des outils leur permettant d'évaluer la qualité des services rendus et de vérifier les qualifications des différents prestataires de services ; v) l'investissement dans l'enseignement de la médecine vétérinaire est d'une importance capitale pour garantir que les effectifs des personnels vétérinaires qualifiés sont suffisants pour assurer une prestation de services adéquate aux éleveurs.

El autor resume las conclusiones de un proyecto de investigación en el que se estudiaron los dispositivos institucionales destinados a prestar servicios zoosanitarios en Uganda y Kenia. Dada la necesidad de encontrar soluciones para los omnipresentes problemas de buen gobierno que lastran la prestación de servicios veterinarios en África, en el estudio se aplicó la teoría de la economía de transacción para formular una serie de recomendaciones sobre la manera de mejorar la prestación de dichos servicios y reducir al mínimo los riesgos para la producción ganadera, en particular aquellos que entrañen una amenaza para la salud humana, como las zoonosis. Las recomendaciones más destacadas son las siguientes: i) los países de nivel bajo o medio de renta deben invertir en la creación de condiciones que favorezcan la relación entre los veterinarios profesionales y los paraprofesionales, con objeto de lograr una mayor puntualidad en la notificación, el tratamiento y el control de las enfermedades animales; ii) la prestación de servicios de divulgación veterinaria no debe ir dirigida únicamente a los «cabezas de familia¼, sino también a los demás miembros de la unidad familiar (esposa e hijos, por ejemplo) y a los encargados de cuidar de los rebaños; iii) en sistemas de producción ganadera pastoral o extensiva la prestación de servicios veterinarios exige una fuerte participación del sector público, puesto que los mecanismos de mercado no han servido para atraer a veterinarios profesionales y a paraprofesionales cualificados del sector privado para que trabajen en esos sectores; iv) es preciso habilitar a los pequeños productores para que sean exigentes con los proveedores de servicios, elaborando y aplicando experimentalmente herramientas que los capaciten para enjuiciar la calidad de los servicios que reciben y comprobar las cualificaciones de los distintos proveedores de servicios; v) es esencial invertir en la enseñanza de la veterinaria a fin de lograr que haya una dotación suficiente de veterinarios cualificados para ofrecer servicios veterinarios a los productores.

The effect of governance mechanisms on food safety in the supply chain: Evidence from the Lebanese dairy sector.

BACKGROUND: Food safety is a key public health issue worldwide. This study aims to characterise existing governance mechanisms - governance structures (GSs) and food safety management systems (FSMSs) - and analyse the alignment thereof in detecting food safety hazards, based on empirical evidence from Lebanon. RESULTS: Firm-to-firm and public baseline are the dominant FSMSs applied in a large-scale, while chain-wide FSMSs are observed only in a small-scale. Most transactions involving farmers are relational and market-based in contrast to (large-scale) processors, which opt for hierarchical GSs. Large-scale processors use a combination of FSMSs and GSs to minimise food safety hazards albeit potential increase in coordination costs; this is an important feature of modern food supply chains. The econometric analysis reveals contract period, on-farm inspection and experience having significant effects in minimising food safety hazards. However, the potential to implement farm-level FSMS is influenced by formality of the contract, herd size, trading partner choice, and experience. CONCLUSION: Public baseline FSMSs appear effective in controlling food safety hazards; however, this may not be viable due to the scarcity of public resources. We suggest public policies to focus on long-lasting governance mechanisms by introducing incentive schemes and farm-level FSMSs by providing loans and education to farmers. © 2016 Society of Chemical Industry.

Selection of asset investment models by hospitals: examination of influencing factors, using Switzerland as an example.

Hospitals are responsible for a remarkable part of the annual increase in healthcare expenditure. This article examines one of the major cost drivers, the expenditure for investment in hospital assets. The study, conducted in Switzerland, identifies factors that influence hospitals' investment decisions. A suggestion on how to categorize asset investment models is presented based on the life cycle of an asset, and its influencing factors defined based on transaction cost economics. The influence of five factors (human asset specificity, physical asset specificity, uncertainty, bargaining power, and privacy of ownership) on the selection of an asset investment model is examined using a two-step fuzzy-set Qualitative Comparative Analysis. The research shows that outsourcing-oriented asset investment models are particularly favored in the presence of two combinations of influencing factors: First, if technological uncertainty is high and both human asset specificity and bargaining power of a hospital are low. Second, if assets are very specific, technological uncertainty is high and there is a private hospital with low bargaining power, outsourcing-oriented asset investment models are favored too. Using Qualitative Comparative Analysis, it can be demonstrated that investment decisions of hospitals do not depend on isolated influencing factors but on a combination of factors. Copyright © 2016 John Wiley & Sons, Ltd.

Accountable Care Organizations and Transaction Cost Economics.

Using a Transaction Cost Economics (TCE) approach, this paper explores which organizational forms Accountable Care Organizations (ACOs) may take. A critical question about form is the amount of vertical integration that an ACO may have, a topic central to TCE. We posit that contextual factors outside and inside an ACO will produce variable transaction costs (the non-production costs of care) such that the decision to integrate vertically will derive from a comparison of these external versus internal costs, assuming reasonably rational management abilities. External costs include those arising from environmental uncertainty and complexity, small numbers bargaining, asset specificity, frequency of exchanges, and information "impactedness." Internal costs include those arising from human resource activities including hiring and staffing, training, evaluating (i.e., disciplining, appraising, or promoting), and otherwise administering programs. At the extreme, these different costs may produce either total vertical integration or little to no vertical integration with most ACOs falling in between. This essay demonstrates how TCE can be applied to the ACO organization form issue, explains TCE, considers ACO activity from the TCE perspective, and reflects on research directions that may inform TCE and facilitate ACO development.

Addressing governance challenges in the provision of animal health services: A review of the literature and empirical application transaction cost theory.

Providing adequate animal health services to smallholder farmers in developing countries has remained a challenge, in spite of various reform efforts during the past decades. The focuses of the past reforms were on market failures to decide what the public sector, the private sector, and the "third sector" (the community-based sector) should do with regard to providing animal health services. However, such frameworks have paid limited attention to the governance challenges inherent in the provision of animal health services. This paper presents a framework for analyzing institutional arrangements for providing animal health services that focus not only on market failures, but also on governance challenges, such as elite capture, and absenteeism of staff. As an analytical basis, Williamson's discriminating alignment hypothesis is applied to assess the cost-effectiveness of different institutional arrangements for animal health services in view of both market failures and governance challenges. This framework is used to generate testable hypotheses on the appropriateness of different institutional arrangements for providing animal health services, depending on context-specific circumstances. Data from Uganda and Kenya on clinical veterinary services is used to provide an empirical test of these hypotheses and to demonstrate application of Williamson's transaction cost theory to veterinary service delivery. The paper concludes that strong public sector involvement, especially in building and strengthening a synergistic relation-based referral arrangement between paraprofessionals and veterinarians is imperative in improving animal health service delivery in developing countries.

Transaction Cost Analysis of the New Drug Application Process: A Case Study of a Multinational Pharmaceutical Company in Japan.

The aim of this study was to measure the transaction costs of a new drug application (NDA) process in Japan in a case study of a multinational pharmaceutical company. The NDA process was viewed as involving transactions among 3 organizations: the headquarters, the Japanese subsidiary, and the Pharmaceuticals and Medical Devices Agency. Transaction costs were calculated by multiplying the time for each transaction by an hourly wage. Work time for the NDA process totaled 14,710.6 hours and was estimated to cost US$558,000 in human resource-related expenditure in the company. The total time for intracompany transactions was 7662.5 hours (52.1% of all transactions), which was similar to that of transactions with the Pharmaceuticals and Medical Devices Agency (7048.1 hours, 47.9%). Also found was a press-and-slack procedure in time course observation. In conclusion, the current NDA system in Japan imposes a considerable time and cost burden behind that of the visible official process on a multinational company.

The effect of hospital-physician integration on health information technology adoption.

The US federal government has recently made a substantial investment to enhance the US health information technology (IT) infrastructure. Previous literature on the impact of IT on firm performance across multiple industries has emphasized the importance of a process of co-invention whereby organizations develop complementary practices to achieve greater benefit from their IT investments. In health care, employment of physicians by hospitals can confer greater administrative control to hospitals over physicians' actions and resources and thus enable the implementation of new technology and initiatives aimed at maximizing benefit from use of the technology. In this study, I tested for the relationship between hospital employment of physicians and hospitals' propensity to use health IT. I used state laws that prohibit hospital employment of physicians as an instrument to account for the endogenous relationship with hospital IT use. Hospital employment of physicians is associated with significant increases in the probability of hospital health IT use. Therefore, subsidization of health IT among hospitals not employing physicians may be less efficient. Furthermore, state laws prohibiting hospitals from employing physicians may inhibit adoption of health IT, thus working against policy initiatives aimed at promoting use of the technology.