日本評価研究7巻1号 The Japanese Journal of Evaluation Studies Vol. 7, No. 1

【Article】 Economic Burden of Disease and Cost Benefit Analysis of Emergency Medical Service (EMS) System in Romania 《PDFで全文ダウンロード》 Takao Ozaki The University of Tokyo Marius Enescu 　　　 The Ministry of Health, Romania Moazzam Ali Chushi Kuroiwa The University of tokyo Abstract 　　　　The objective of the research is to provide an analytical model of the economic Cost-Benefit Analysis (CBA) and resultant policy recommendations, with the proposed emergency medical service (EMS) project in Constanta County (714,923 population, 2005), Romania, in view. The economic cost of investment is US$ 31.5 million as per 2006 price level. The economic benefits are due to (i) incremental benefits attributable to EMS at the Constanta Emergency Hospital (CEH) as measured by willingness to pay (WTP) for healthier life, and (ii) social cost-saved (recovery of Productivity foregone due to emergent injury and diseases) measured by disability-adjusted life years (DALY). WTP was estimated by Contingent Valuation Method (CVM)-Double-bounded Dichotomous Choice method (449 interviewees) resulting in US$ 1.6 million par annum (US$ 214.8 per household, 8.9 percent of average household disposable income in Constanta). DALY in Constanta in 2005 is estimated at 118,885 person-years while applying the ﾒratio methodﾓ of total DALY to death DALY (7,286 deceased) and the disability adjustment factors (weighed average 0.67). With his and the productive beneficiaries (age group 15-59) of EMS at CEH (5,812 DALY) and the annual household disposable income in Constanta average (US$2,420.7), financial-benefits-converted to the social cost-saved is US$ 12.7 million (SCF=0.9), totaling to US$ 14.3 million of economic benefit per year. The economic internal rate of return (EIRR) is 32.2 percent, thereby quantitatively revealing high economic viability (efficiency in scarce resource allocation) of the concerned EMS project in Constanta. Keywords Economic Cost Benefit Analysis (E-CBA), DALY, Willingness to Pay (WTP), Economic Internal Rate of Return (EIRR), Emergency Medical Service (EMS), Romania