Term Paper: Establishing the Decision Framework

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[. . .] COMPARING COST AND OUTCOMES

Is the information on cost and effects used correctly to rank alternatives? Does it appear that errors or omissions in the estimates of costs and outcomes might be sufficient to alter these rankings? In the case of a CB study, are the costs and benefits used to calculate cost benefit ratios, net present values, or internal rate of return? In the case of CU study, are cost utility ratios calculated and interpreted? The information on cost and effects is correctly used to rank the alternatives. According to the study a program is more cost effective than another if the same outputs are produced at a lower costs or if greater results are produced at the same cost. The study found that the IST alternative did not demonstrate a cost saving until the ninth year at the 5% discount rate but the study also notes that the cost differences were not that substantial so the study found that the cost between the program were equivalent over the long-term. Even though costs for the programs were equivalent the study found that the services provided by the IST program produced greater results. In the analysis 33 of 39 students participating in the IST program were able to remain in regular classrooms and were able to learn adequately. In addition fewer students were retained, referred to MDE and fewer were placed in special education classes. The study found that on every level the IST program produced greater results than the Traditional Program. (Pg. 579) And so the IST alternative was ranked higher than the Traditional program. The study does not appear to have omitted anything that would cause its findings to be inaccurate. The last question is not applicable as this is a study based on cost effectiveness.

Are the differences in estimates among alternatives large enough that you would have confidence in using them as a basis for decisions? Did the authors present results of a sensitivity analysis? How robust are the results with respect to different assumptions about the ingredient requirements, ingredient values, choice of discount rates, estimates of effectiveness, and the weighting of different dimensions of effectiveness?

The results of the analysis do not show a large benefit in using the IST alternative there is not a cost benefit until the ninth year after implementation and overall the cost of the program is equal to the already existing program. The total ten-year cost ratio at a discount of 5% is only 1.02. (Pg.576) In addition the educational benefit that this program provides is not large enough to make a confident decision. The study shows that the amount of students that are placed in special education only decreased by one student a year. (Pg. 572) The authors did present the results of a sensitivity analysis. To test the sensitivity of the outcomes to the assumption of the ten-year placement timeframe, the ten-year cost and cost ratios were recalculated using different numbers of total years that a student would spend in a special education class. This sensitivity analysis showed that cost comparisons were not highly sensitive when using different numbers of years spent in the special education program. In addition to this sensitivity analysis the study conducted an analysis to determine the effects of improving the IST system and reducing the number of students placed in special education. This analysis found that when the number of students in special education IST schools declined, even by one student, the total ten-year cost savings increased.

Pg..577) The final sensitivity analysis combined the first two analysis by varying the amount of years spent in the program with the reduction of students placed in special education. This analysis showed that there was only relative sensitivity of each measure. (Pg.577)

These results are somewhat robust in respect to the discount rate. The rate that was used in the sensitivity analysis was 5%. When the results of the sensitivity analysis is weighed against the different dimensions of effectiveness the study concluded that the reductions of placement into the special education had a profound effect on the amount of cost savings that the IST program could generate even if the reduction was limited to one student not having to be placed in special education.

APPLYING THE RESULTS

5.1. How generalizable are the results to the immediate decision context. Are they generalizable to other decision contexts? For example, could they be applied to alternatives for similar populations and environments in other settings? Is it possible to make cost estimate adjustments that would enable such generalizability? This study was done to explore the cost effectiveness of implementing the IST program into Pennsylvania schools Statewide. The factors used which included data from schools in Pennsylvania that had already implemented the program suggest that the results of the cost effectiveness of this project are generalizable for the entire state of Pennsylvania and other settings throughout the U.S. The study explored the cost involved in implementing the program, which included the quantity of resources needed to complete each step of the two alternatives. These resources needed included the time of personnel to carryout each step. To evaluate the resources needed staff that had participated in both programs were surveyed and asked to estimate the resources required for each step. (pg. 563) By surveying the staffs of various schools that implemented the same program there are certain generalizations that can be made about the study. It can be assumed that the resources needed in these schools would also be needed in other schools throughout the country. The generalizability of this study would be confined to states throughout the country who share similar expenditures for education that Pennsylvania has otherwise those state would not be able to afford the program. Finally the generalization can be made that the traditional special education program needs to be… [END OF PREVIEW]

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