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The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

CODOGNO, Jamile S.; FERNANDES, Romulo A.; SARTI, Flavia M.; FREITAS JUNIOR, Ismael F.; MONTEIRO, Henrique L.
Fonte: BIOMED CENTRAL LTD Publicador: BIOMED CENTRAL LTD
Tipo: Artigo de Revista Científica
Português
Relevância na Pesquisa
36.88%
Background: Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment. Methods: Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire. Results: Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029). Conclusions: Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.

O regime jurídico do gasto tributário no direito brasileiro; The legal regimen of tax expenditures in Brazilian law

Henriques, Elcio Fiori
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 10/08/2009 Português
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36.91%
Os benefícios fiscais produzem efeitos financeiros similares aos das despesas públicas, mais especificamente as subvenções, na medida em que ambos são instrumentos utilizados para transferir ao particular beneficiado recursos financeiros que a priori pertenceriam ao Estado. Nesse sentido, foi criado nos Estados Unidos nas décadas de 1960 e 1970 o conceito de tax expenditure, traduzido para o português para renúncia de receita ou gasto tributário, o qual representa a quantificação dos efeitos financeiros dos benefícios fiscais. Tal enunciado quantitativo, uma vez integrado ao processo orçamentário, torna possível a comparação do custo financeiro dos benefícios fiscais com as despesas diretas de mesma finalidade, tornando a instituição de tais normas tributárias mais controlada e transparente. No Brasil, somente com a Constituição Federal de 1988 foram instituídos controles sobre os gastos tributários, determinando o texto constitucional a necessidade de inclusão de um relatório de gastos tributários anexo à proposta orçamentária, bem como a competência fiscalizatória dos órgãos de controle interno e externo para a fiscalização da aplicação das renúncias de receita. Tal controle foi intensificado com a promulgação da Lei Complementar n. 101/2000...

Os determinantes dos gastos educacionais e seus impactos sobre a qualidade do ensino; The determinants of educational expenditures and their impacts on school performance

Amaral, Luiz Felipe Leite Estanislau do
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 12/05/2011 Português
Relevância na Pesquisa
36.88%
O objetivo dessa dissertação é estimar de forma apropriada o impacto dos gastos públicos em educação sobre o desempenho escolar. Tal questão ainda não está devidamente esclarecida na literatura especializada: de fronte de uma aparente ausência de relação entre as variáveis, determinados autores argumentam que esse é um resultado da estrutura de incentivos dos sistemas públicos de ensino enquanto outros argumentam que se trata de um problema de identificação empírica, especificamente de endogeneidade dos gastos. O presente trabalho busca usar, no Brasil, a transição do FUNDEF para o FUNDEB como instrumento para os gastos municipais no ensino fundamental. O FUNDEF e o FUNDEB são fundos de redistribuição de recursos que devem ser empregados obrigatoriamente no ensino. O primeiro teve vigência de 1996 a 2006 e se restringia ao ensino fundamental enquanto o segundo teve início em 2007 e engloba todo o ensino básico. Argumenta-se que tal transição pode ser encarada de como exógena e, com isso, técnicas de variáveis instrumentais são usadas para obter o impacto de aumentos nos gastos no ensino fundamental por aluno no ensino fundamental sobre a nota padronizada da Prova Brasil, tanto quarta e oitava série...

The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

Codogno, Jamile S.; Fernandes, Romulo A.; Sarti, Flavia Medeiros; Freitas Junior, Ismael F.; Monteiro, Henrique Luiz
Fonte: Biomed Central Ltd. Publicador: Biomed Central Ltd.
Tipo: Artigo de Revista Científica Formato: 7
Português
Relevância na Pesquisa
36.88%
Background: Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment.Methods: Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire.Results: Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029).Conclusions: Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.

Burkina Faso - Public Expenditures Review : Rural Water and Sanitation Sector

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Português
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36.93%
The review aims at supporting efforts of the government in water and sanitation sector in rural and semi-urban areas. It carries out analysis of sector expenditures evolution during the period 2001-2006 and proposes recommendations likely to help better cope with the current and future challenges. The present review covers only public expenditures of the Ministry of Agriculture, Hydraulics, and Halieutics Resources (MAHRH) to the profit of Rural Water and Sanitation Supply (RWSS). Expenditures of other ministries (education, and health), as well as projects of local development, from Non-Governmental Organization (NGO), and private individuals, for whom data are not available, are excluded. The review of public expenditure in RWSS shows that RWSS sector has experienced dramatic development and that performance in terms of creation of water points is relatively satisfactory during the 2001-2006 periods in Burkina Faso. The annual volume of new water points is about 1.950 points. Facilities realized during this period theoretically made it possible to supply more than three million Burkinabe and the rate of access of populations to drinking water was 60 percent in 2006...

Kyrgyz Republic : Review of Social Policy and Expenditures, Volume 1. Overview of Health, Education and Social Protection Issues

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Português
Relevância na Pesquisa
36.96%
In the first half of 1999, Kyrgyz authorities agreed with the International Development Association (IDA) that a review of Kyrgyz social expenditures, giving particular emphasis to health and education expenditures, would be valuable. This report presents findings from the resulting review undertaken between October 1999 and June 2000. The review team looked not only at these expenditures (including social protection) themselves, but also at their efficiency and effectiveness as a means for achieving Kyrgyz objectives in the social policy arena. The review team first examined medium-term priorities for social policy under sharp resource constraints, then considered feasible strategies for achieving these priorities, and finally looked at their implications for policies, administration, and public expenditures. The report is in 2 volumes. Volume 1 provides an overview of the findings on health, education, and social protection. Volume 2 offers more detailed critiques of expenditures and policies on health and education.

Kyrgyz Republic : Review of Social Policy and Expenditures, Volume 2. Health and Education Expenditures

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Português
Relevância na Pesquisa
36.96%
In the first half of 1999, Kyrgyz authorities agreed with the International Development Association (IDA) that a review of Kyrgyz social expenditures, giving particular emphasis to health and education expenditures, would be valuable. This report presents findings from the resulting review undertaken between October 1999 and June 2000. The review team looked not only at these expenditures (including social protection) themselves, but also at their efficiency and effectiveness as a means for achieving Kyrgyz objectives in the social policy arena. The review team first examined medium-term priorities for social policy under sharp resource constraints, then considered feasible strategies for achieving these priorities, and finally looked at their implications for policies, administration, and public expenditures. The report is in 2 volumes. Volume 1 provides an overview of the findings on health, education, and social protection. Volume 2 offers more detailed critiques of expenditures and policies on health and education.

Public Expenditures for Decentralized Governance in Honduras : Towards Restoring Fiscal Consolidation

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Português
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36.99%
Fiscal consolidation remains the central challenge facing Honduras, mainly due to increasing current expenditures. The widening fiscal deficit has been driven by a significant increase in current expenditures. These increased current expenditures, which add rigidity to the budget, have occurred at the expense of investments. The efficiency of spending remains a key constraint. Limited improvements, especially in health and education outcomes despite high allocations to these sectors, suggest the need to improve the efficiency and quality of expenditures. Increased public expenditures have not delivered in terms of growth and improved public services, and whether the country is ready for decentralization remains an open question. Growing fiscal deficits and weak public financial management practices have constrained the ability of the central government to implement and finance the decentralization process. Current decentralization targets would pose significant fiscal challenges to the central government. The deterioration of the fiscal deficit is not a result of fiscal decentralization. However...

Autonomy with Equity and Accountability : Toward a More Transparent, Objective, Predictable and Simpler (TOPS) System of Central Financing of Provincial-Local Expenditures in Indonesia

Shah, Anwar
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Português
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36.96%
During the past decade, Indonesia has transformed itself from centralized governance to decentralized local governance. Local governments were given extensive expenditure responsibilities while keeping the tax system centralized. To finance decentralized provincial-local expenditures, Indonesia implemented a new system of intergovernmental finance. This paper provides a review of the equity and efficiency implications of the current system of central-provincial-local transfers. It finds that the system of intergovernmental finance represents one of the most complex systems ever implemented by any government in the world. The system is primarily focused on a gap-filling approach to provincial-local finance to ensure revenue adequacy and local autonomy but without accountability to local residents for service delivery performance. This is done through a great degree of academic rigor using highly complex procedures. The complexity leads to a lack of transparency, inequity and uncertainty in allocation as well as creating incentives for jurisdictional fragmentation and reducing own-tax effort. Simpler alternatives are available that have the potential to address equity objectives while also enhancing efficiency and citizen-based accountability. Such alternatives would represent a move away from complex gap filling and special allocation approaches to simple...

How Does Knowledge on Public Expenditures Integrate with the Design of Development Policy Operations?

Independent Evaluation Group
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Relatório
Português
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36.93%
Integration of knowledge with lending is an enduring theme in World Bank strategies at the corporate and country levels. It rests on the widely shared proposition that Bank lending instruments could be more relevant and produce better results if they incorporate key analytical, country level knowledge. To be successful, development interventions must be informed by evidence, and evidence comes from knowledge. This is the idea behind Bank as a ‘solutions bank,’ integrating financial instruments and knowledge products into ‘development solutions’ that deliver results. A recent Independent Evaluation Group (IEG) evaluation suggests that the Bank’s broad economic and sector work and technical assistance strongly inform Bank lending strategies (IEG 2008). PERs, for the purpose of this learning product, are identified as Bank knowledge products with a specific reference in their titles as Public Expenditure Review, whether they are multi-sector or single sector public expenditure reviews. They also include other analytical documents which deal with public expenditure issues...

Tajikistan Government Expenditures : Size, Composition and Trends

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Public Expenditure Review
Português
Relevância na Pesquisa
36.93%
This policy note is part of the World Bank's Programmatic Public Expenditure Review (PER) work program for FY2012-2014. The PER consists of a series of fiscal policy notes, which aim at providing the Government of Tajikistan with recommendations to strengthen budgetary processes and analysis. This policy note, the first in the series, sets the stage for the further in-depth discussion of the issues, identified in the note, based on the analysis of trends and composition of public spending during the period 2007-2013. The note is structured as follows. Section 2 begins with a brief review of macroeconomic context to provide the background for analysis of fiscal policy during the last six years and implications for fiscal policy going forward. Section 3 presents the overall fiscal picture and highlights the fiscal risks to be addressed to sustain the recent progress in fiscal consolidation. Sections 4 and 5 dig deeper in the composition and trends of expenditures and reviews, respectively. Section 6 provides the main conclusions: 1) fiscal consolidation is on track...

Tajikistan : Review of Public Expenditures on Health

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Public Expenditure Review
Português
Relevância na Pesquisa
36.96%
This policy note is part of the World Bank's Programmatic Public Expenditure Review (PER) work program for FY2012-2014. The PER consists of a series of fiscal policy notes, which aim at providing the Government of Tajikistan with recommendations to strengthen budgetary processes and analysis. This policy note, the second in the series, examines public expenditures on health in Tajikistan. After an introductory section, the note describes the institutional and administrative structure of the health sector. Section 3 presents health outcomes and health care utilization indicators. Section 4 describes health financing in Tajikistan and presents the main options to expand fiscal space for health. Section 5 reviews the health financing and organizational reforms implemented in Tajikistan. Section 6 provides the main conclusions: 1) despite progress, health sector outcomes are mixed in Tajikistan and utilization pattern of health services is characterized by significant inequalities; 2) public spending on health is relatively low and skewed towards hospitals rather than outpatient care; 3) the hospital sector is characterized by oversupply of beds...

Does Migration Reshape Expenditures in Rural Households? Evidence from Mexico

Taylor, J. Edward; Mora, Jorge
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
Português
Relevância na Pesquisa
36.93%
Migration reshapes rural economies in ways that may go beyond the contribution of migrant remittances to household income. Consumption and investment expenditures by migrant-sending households may transmit some of the impacts of migration to others inside and outside the rural economy, and they also may shape the potential effects of migration within the source household. Numerous studies have attempted to quantify the impact of migrant remittances on expenditures in migrant-sending households following one of two approaches. The first asks how migrant remittances are spent. It has the advantage of being simple but the significant disadvantage of ignoring the fungibility of income from migrant and nonmigrant sources. Remittances almost certainly have indirect effects on expenditures by way of their contribution to households' total budgets. The second uses a regression approach that considers remittances as an explanatory variable, in addition to total income and other controls, in a household expenditure demand system. It has the advantage of enabling one to test whether remittances affect expenditures in ways that are independent of their contribution to total income. But it does not take into account other ways, besides remittances...

Managing the Effects of Tax Expenditures on National Budgets

Swift, Zhicheng Li
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
Português
Relevância na Pesquisa
37.04%
Tax expenditures, in the form of tax provisions, are government expenditures. They are conceptually and functionally distinct from those tax provisions whose purpose is to raise revenue. Tax expenditure programs are comparable to entitlement programs. Therefore, tax expenditures must be analyzed in spending terms and integrated into the budgetary process to ensure fiscal accountability. In addition, tax expenditures must be audited for performance and the information must be published (with comprehensive analysis) to ensure fiscal transparency. The author analyzes the concept and definition, size, and effects of tax expenditures, as well as the fiscal accountability and transparency of tax expenditure spending. In short, tax expenditures affect (1) the budget balance, (2) budget prioritization in allocation, (3) the effectiveness and efficiency of fiscal resources, and (4) the scope for abuse by taxpayers, government officials and legislators. While reviewing the current practices in tax expenditures against the requirements of fiscal accountability and transparency, she finds that this fiscal area must be strengthened. The author sketches four building blocks to strengthen tax expenditures toward fiscal accountability and transparency...

Tax Expenditures--Shedding Light on Government Spending through the Tax System : Lessons from Developed and Transition Economies

Polackova Brixi, Hana; Valenduc, Christian M.A.; Swift, Zhicheng Li
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
Português
Relevância na Pesquisa
36.98%
Recently developing countries have focused attention on the usefulness of tax expenditures' in shaping prudent and transparent fiscal policy. In adopting a market economy, developing countries commonly use tax expenditures as major fiscal policy instruments. However, with limited theoretical understanding of, and ad hoc experience with, applying tax expenditures, developing countries now confront not only revenue losses higher than they had anticipated but also the erosion of their tax bases in systems that generally have been in existence fewer than 10 years. Fortunately, the experience and practice of developed countries offer insights into understanding and applying tax expenditures. Most developed countries have established tax reporting systems, which provide empirical information on their tax expenditures. Such tax reporting systems tend to be part of a country's overall fiscal system for strengthening government finance and contribute significantly to fiscal transparency. Using the information available...

Costa Rica - Public Expenditure Review : Enhancing the Efficiency of Expenditures

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Public Expenditure Review; Economic & Sector Work
Português
Relevância na Pesquisa
36.91%
Costa Rica, an upper middle-income developing country of 4 million inhabitants, is well known for its socio-economic achievements. Costa Rica's economic growth has averaged 4.7 percent annually over the last 15 years, about 2 percentage points above the rest of Latin America, reflecting its stable macroeconomic and political environment, strong institutions, and a well-educated work force. Costa Rica has followed a successful strategy of outward oriented export-led growth, openness to foreign investment, and gradual trade liberalization that transformed the economy from one highly dependent on agriculture and agro-industry to one that is now led by high-tech computer and electronic industries, services such as transport, communications and banking, non-traditional agriculture, and tourism. The government of Costa Rica realizes that continued economic growth and poverty reduction require an improvement in the quality of infrastructure and social sector services, particularly if Costa Rica is to take full advantage of the greater global market opportunities in the context of Dominican Republic-Central American Free Trade Agreement (DR-CAFTA) and other free trade initiatives. To improve the quality of public services while simultaneously reducing its fiscal vulnerability is challenging...

Study on Tax Expenditures in Pakistan

Ahmed, Ather Maqsood; Ather, Robina
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper
Português
Relevância na Pesquisa
36.95%
The problems of high fiscal deficit, high current account deficit, and high inflation faced by the government of Pakistan are linked to Pakistan's weak tax revenue effort. There are concerns that revenue in Pakistan is raised in an inefficient way by favoring certain sectors and economic activities over others. The assessment of tax expenditures is often complicated because reporting and accounting practices fall far short of what is used for official government expenditures, which makes it difficult, if not impossible, to evaluate the cost, efficiency and distributional impact of tax expenditures. The purpose of the study is to undertake a detailed assessment of tax expenditure in Pakistan, including an appropriate definition and methodologies for measuring tax expenditures. Considerable effort is required to develop and establish a suitable framework to identify, measure and critically assess the merits of tax expenditures on an annual basis. Pakistan is committed to increasing the transparency of tax policy by providing detailed estimates of tax expenditures. This paper provides a detailed assessment of tax expenditures in Pakistan...

Malaysia Public Expenditures : Managing the Crisis; Challenging the Future

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Public Expenditure Review; Economic & Sector Work
Português
Relevância na Pesquisa
36.91%
Malaysia achieved unprecedented economic growth and dramatic poverty reduction in the two decades prior to 1997. As a result, pressure on public expenditures was alleviated and when the regional financial crisis hit in 1997, the budget was in surplus and public debt had fallen to around 30 percent in GDP. But the crisis brought to the fore issues in public expenditure management that might have remained of less significance in a fast-growing economy: large and increasing off-budget liabilities that could undermine fiscal prudence, accountability, and efficiency in the use of public resources. The government is rethinking its role in tertiary education, tertiary health care, social protection against income risk, and infrastructure. In these areas, there is a potential role for the private sector in provision and financing, and the government's role is gradually shifting from being a provider of these services to a financial supporter and a regulator. In this evolving public-private partnership, the goal of the government is to reduce the fiscal burden while ensuring equity in delivering public services and efficiency in allocating and using public resources. This public expenditure analysis aims to analyze fiscal issues arising from the crisis...

Federal and Industrial Funded Research Expenditures and University Technology Transfer Licensing

Chiang, Trent
Fonte: Universidade Duke Publicador: Universidade Duke
Publicado em 22/04/2013 Português
Relevância na Pesquisa
36.91%
I relate the numbers of university licenses and options to both university research characteristics and research expenditures from federal government or the industry. I use the polynomial distributed lag model for unbalanced panel data to estimate the effects of research expenditures from different sources on licensing activity. I find evidences suggesting both federal and industrial funded research expenditures take 2-3 years from lab to licenses while federal expenditures have higher long-term dynamic effect on number of licenses. Breaking down licenses by different types of partners, I find that federal expenditures have highest effect with small companies while industrial-funded expenditures have higher effect in licenses with large companies and licenses yielding large income. Further research is necessary to analyze the reason for such differences between the effects of research expenditures on licensing activity.; Honors thesis Economics, Econ 496S, Spring 2013

Improving Public Expenditures in Agriculture; Empirical Evidence of the Effectiveness and Efficiency of Agricultural Public Expenditures in Mongolia

Amponsah, Kofi; Annor-Frempong, Charles
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Report; Economic & Sector Work :: Public Expenditure Review; Economic & Sector Work
Português
Relevância na Pesquisa
37.02%
The objective of the agricultural sector public expenditure review (AgPER) was to examine the efficiency and effectiveness of agricultural sector expenditures in Mongolia. The AgPER provides policy makers with a better understanding of: (a) trends in the level and composition of public expenditures in agriculture over the past five to ten years; (b) the economic and functional composition of agriculture expenditures; (c) the budget processes and performance in the agriculture sector; (d) issues inhibiting the effectiveness and efficiency of public expenditures in agriculture.