This paper examines a variety of issues within the context of two main themes: the formation of travel demand models and economic evaluation measures which are mutually consistent within a theory of rational choice; and a consideration of the structure of models which are representations of the trip decision process over several dimensions: location, mode, and route. Random utility theory is invoked to explore both the role and properties of composite costs or index prices in the 'recursive' approach to the structuring of travel choice models, and their significance in the economic evaluation problem. It is shown that the specification of these costs must be made very precisely, with respect to the demand model form chosen, in order to retain the underlying assumption that the traveller is an optimal decisionmaker. It is argued that the structure of 'simultaneous' models currently in use is inconsistent with the form of utility function assumed to generate those models. Furthermore, it is shown that the 'simultaneous' and 'recursive' forms are special cases of a more general choice model structure which takes specific account of correlation or 'commonality' of trip attributes. A number of applications are discussed in which consistent demand models and perceived user benefit measures are constructed. These include the formation of strategic transport planning models and of models for mixed-mode, multimode, and multiroute systems. The formalism allows definitive answers to be given to a number of problems of current interest in transportation planning, which have been incorrectly or incompletely treated.
In this paper, postcoded data are used to develop spatial interaction models for the registration of individuals with different health centres. With use of a cell-based representation of urban space, indices of accessibility to and market areas for such services are devised. The empirical work relates to a study area in the City of Bristol, and reveals patterns of use of general practitioners at a level of detail not previously available. Some implications for locational planning in the primary health-care sector are also considered.
The model of oligopoly between N retail stores, treated in the second paper of this series, is extended to consider competition between groups or 'chains' within which the location and sizes of stores are coordinated to promote organizational objectives. This model of oligopolistic competition between multistore organizations is expressed through an optimization process, and an algorithm for its solution is proposed. Numerical examples are used to explore the effects of organizational structure on system profitability and accessibility benefits to consumers.
The sizes and locations of an arbitrary number of retail stores in oligopolistic competition are sought through a representation and solution of an N-centre profit-maximizing model. The Nash-Cournot equilibrium states, which correspond to this competitive configuration are determined under variation in the number of stores and the parameters which govern spatial behaviour of consumers. This allows a comparison to be made of configurations generated by competitive processes with those which maximize consumer benefits. The relationship between profits and store numbers is explored theoretically and numerically.
In this paper a new approach is developed to the analysis of stratified housing and employment systems which exhibit interdependencies between movers in the allocation process. Vacancy chain models, derived within a mathematical programming framework, are presented and their properties are compared both conceptually and numerically with standard models. The advantages of the new approach are illustrated in cases which require constraints to characterise the demand for or supply of stock.
Building on the tabular analyses exemplified in our first paper and widely used in the medical literature, we use generalised linear models to provide a formal, statistical approach to the analysis of mortality and deprivation relationships, and their change over time. Three types of fixed effects model are specified and estimated with the same ward-level data sets for Wales examined in our first paper. They are: Poisson models for analysing mortality and deprivation at a single cross section in time; repeated-measures Poisson models for analysing mortality–deprivation relations, not only at cross sections in time, but also their changes over time; and logit models focusing on temporal changes in mortality–deprivation relationships. Nonlinear effects of deprivation on mortality have been explored by using dummy variables representing deprivation categories to establish the connection between formal statistical models and the tabular approach.
In this paper we examine the relationship between premature mortality and material deprivation both over time (the intercensal period, 1981–91) and over space (for the population in wards and ward groups in Wales). Our focus is on the methods of analysis for small area (ward-based) multiple cross-section mortality data and their application to the substantive issue of the persistent and widening inequalities in Wales. In this paper we examine all-cause deaths and mortality by specific disease classes for groups (quintiles) of wards ranked according to standard measures of material deprivation. Although there have been reductions in premature mortality across all deprivation groups in Wales, over the decade, the gap has widened between the most and least deprived areas. Mortality decline in the largest disease category (circulatory) was found to be significantly lower in the most deprived quintile of wards than in the rest of Wales. Compared with results from the North of England, mortality decline in Wales has been rather greater.
In this paper some of the conceptual and empirical issues in the specification and aggregation of deprivation measures used as a basis for resource allocation in the primary health sector are explored. The problems of deriving deprivation payments to general practitioners (GPs) from data pertaining to individuals are examined, and two empirical studies which draw out methodological issues are described. In the first study, a Bristol database is used to explore the spatial aggregation issue in ranking GP practices on a selected measure of deprivation. In the second, a database relating to English wards is used to investigate the sensitivity of deprivation payments to the statistical transformation and standardisation in the specification of the deprivation index. It is argued that the aggregation and specification issues should be confronted directly in the conceptual and practical developments of current approaches.
In three related papers the economic and spatial characteristics of a set of retail stores locating under welfare-maximizing and profit-maximizing criteria are explored. In this first paper, a set of location-spatial interaction models is formulated and the locations and sizes of stores which maximize the accessibility benefits to consumers are determined. An algorithm for computing such configurations is proposed and a set of numerical examples is used to explore the variation of these configurations under changes in the number of stores and the parameters which govern the spatial behaviour of consumers.
This paper presents a summary of findings on the design and evaluation of an urban park-and-ride system. Three main aspects are presented: the construction of mixed-mode demand models; the calculation of user benefits; and the consideration of optimization procedures for the design process. The problems of determining the optimal number, location, parking charges, and sizes of car parks are considered. Discussion is appropriate to car—bus and car—rail interchange.
This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12-14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long-term control and how to measure it and (ii) to prioritize future areas of research for the measurement of the core domain of quality of life (QoL) in children. Moderated whole-group and small-group consensus discussions were informed by presentations of qualitative studies, systematic reviews and validation studies. Small-group allocations were performed a priori to ensure that each group included different stakeholders from a variety of geographical regions. Anonymous whole-group voting was carried out using handheld electronic voting pads according to pre-defined consensus rules. It was agreed by consensus that the long-term control domain should include signs, symptoms, quality of life and a patient global instrument. The group agreed that itch intensity should be measured when assessing long-term control of eczema in addition to the frequency of itch captured by the symptoms domain. There was no recommendation of an instrument for the core outcome domain of quality of life in children, but existing instruments were assessed for face validity and feasibility, and future work that will facilitate the recommendation of an instrument was agreed upon.
Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill & Melinda Gates Foundation. ; We would like to thank the countless individuals who have contributed to the Global Burden of Disease Study 2015 in various capacities. The data reported here have been supplied by the US Renal Data System (USRDS). Data for this research was provided by MEASURE Evaluation, funded by the United States Agency for International Development (USAID). Collection of these data was made possible by the US Agency for International Development (USAID) under the terms of cooperative agreement GPO-A-00-08-000_D3-00. Views expressed do not necessarily reflect those of USAID, the US Government, or MEASURE Evaluation. Parts of this material are based on data and information provided by the Canadian institute for Health Information. However, the analyses, conclusions, opinions and statements expressed herein are those of the author and not those of the Canadian Institute for Health information. The Palestinian Central Bureau of Statistics granted the researchers access to relevant data in accordance with license no SLN2014-3-170, after subjecting data to processing aiming to preserve the confidentiality of individual data in accordance with the General Statistics Law, 2000. The researchers are solely responsible for the conclusions and inferences drawn upon available data. This paper uses data from SHARE Waves 1, 2, 3 (SHARELIFE), 4 and 5 (DOIs: 10.6103/SHARE.w1.500, 10.6103/SHARE.w2.500, 10.6103/SHARE.w3.500, 10.6103/SHARE.w4.500, 10.6103/SHARE.w5.500), see Börsch-Supan and colleagues, 2013, for methodological details. The SHARE data collection has been primarily funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193, COMPARE: CIT5-CT-2005-028857, SHARELIFE: CIT4-CT-2006-028812) and FP7 (SHARE-PREP: number 211909, SHARE-LEAP: number 227822, SHARE M4: number 261982). Additional funding from the German Ministry of Education and Research, the US National Institute on Aging (U01_AG09740-13S2, P01_AG005842, P01_AG08291, P30_AG12815, R21_AG025169, Y1-AG-4553-01, IAG_BSR06-11, and OGHA_04-064) and from various national funding sources is gratefully acknowledged. This study has been realised using the data collected by the Swiss Household Panel (SHP), which is based at the Swiss Centre of Expertise in the Social Sciences FORS. The project is financed by the Swiss National Science Foundation. The following individuals would like to acknowledge various forms of institutional support: Simon I Hay is funded by a Senior Research Fellowship from the Wellcome Trust (#095066), and grants from the Bill & Melinda Gates Foundation (OPP1119467, OPP1093011, OPP1106023 and OPP1132415). Amanda G Thrift is supported by a fellowship from the National Health and Medical Research Council (GNT1042600). Panniyammakal Jeemon is supported by the Wellcome Trust-DBT India Alliance, Clinical and Public Health, Intermediate Fellowship (2015–2020). Boris Bikbov, Norberto Percio, and Giuseppe Remuzzi acknowledge that work related to this paper has been done on the behalf of the GBD Genitourinary Disease Expert Group supported by the International Society of Nephrology (ISN). Amador Goodridge acknowledges funding from Sistema Nacional de Investigadores de Panamá-SNI. José das Neves was supported in his contribution to this work by a Fellowship from Fundação para a Ciência e a Tecnologia, Portugal (SFRH/BPD/92934/2013). Lijing L Yan is supported by the National Natural Sciences Foundation of China grants (71233001 and 71490732). Olanrewaju Oladimeji is an African Research Fellow at Human Sciences Research Council (HSRC) and Doctoral Candidate at the University of KwaZulu-Natal (UKZN), South Africa, and would like to acknowledge the institutional support by leveraging on the existing organisational research infrastructure at HSRC and UKZN. Nicholas Steel received funding from Public Health England as a Visiting Scholar in the Institute for Health Metrics and Evaluation in 2016. No individuals acknowledged received additional compensation for their efforts. ; Peer-reviewed ; Publisher Version
