Displaying publications 1 - 20 of 21 in total

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  1. Bavanandan S, Ahmad G, Teo AH, Chen L, Liu FX
    Value Health Reg Issues, 2016 May;9:8-14.
    PMID: 27881266 DOI: 10.1016/j.vhri.2015.06.003
    OBJECTIVES: To investigate the 5-year health care budget impact of variable distribution of adult patients treated with peritoneal dialysis (PD) and in-center hemodialysis (ICHD) on government funding in Malaysia.

    METHODS: An Excel-based budget impact model was constructed to assess dialysis-associated costs when changing dialysis modalities between PD and ICHD. The model incorporates the current modality distribution and accounts for Malaysian government dialysis payments and erythropoiesis-stimulating agent costs. Epidemiological data including dialysis prevalence, incidence, mortality, and transplant rates from the Malaysian renal registry reports were used to estimate the dialysis patient population for the next 5 years. The baseline scenario assumed a stable distribution of PD (8%) and ICHD (92%) over 5 years. Alternative scenarios included the prevalence of PD increasing by 2.5%, 5.0%, and 7.5% or decreasing 1% yearly over 5 years. All four scenarios were accompanied with commensurate changes in ICHD.

    RESULTS: Under the current best available cost information, an increase in the prevalent PD population from 8% in 2014 to 18%, 28%, or 38% in 2018 is predicted to result in 5-year cumulative savings of Ringgit Malaysia (RM) 7.98 million, RM15.96 million, and RM23.93 million, respectively, for the Malaysian government. If the prevalent PD population were to decrease from 8% in 2014 to 4.0% by 2018, the total expenditure for dialysis treatments would increase by RM3.19 million over the next 5 years.

    CONCLUSIONS: Under the current cost information associated with PD and HD paid by the Malaysian government, increasing the proportion of patients on PD could potentially reduce dialysis-associated costs in Malaysia.

    Matched MeSH terms: Budgets
  2. Drummond MF, Augustovski F, Bhattacharyya D, Campbell J, Chaiyakanapruk N, Chen Y, et al.
    Value Health, 2022 Aug;25(8):1257-1267.
    PMID: 35931428 DOI: 10.1016/j.jval.2022.02.006
    Health technology assessment (HTA) has been growing in use over the past 40 years, especially in its impact on decisions regarding the reimbursement, adoption, and use of new drugs, devices, and procedures. In countries or jurisdictions with "pluralistic" healthcare systems, there are multiple payers or sectors, each of which could potentially benefit from HTA. Nevertheless, a single HTA, conducted centrally, may not meet the needs of these different actors, who may have different budgets, current standards of care, populations to serve, or decision-making processes. This article reports on the research conducted by an ISPOR Health Technology Assessment Council Working Group established to examine the specific challenges of conducting and using HTA in countries with pluralistic healthcare systems. The Group used its own knowledge and expertise, supplemented by a narrative literature review and survey of US payers, to identify existing challenges and any initiatives taken to address them. We recommend that countries with pluralistic healthcare systems establish a national focus for HTA, develop a uniform set of HTA methods guidelines, ensure that HTAs are produced in a timely fashion, facilitate the use of HTA in the local setting, and develop a framework to encourage transparency in HTA. These efforts can be enhanced by the development of good practice guidance from ISPOR or similar groups and increased training to facilitate local use of HTA.
    Matched MeSH terms: Budgets*
  3. NURUL FARHANA SENAWI, NOR FATIMAH CHE SULAIMAN, NOR FATIMAH CHE SULAIMAN
    MyJurnal
    Government expenditure plays an important role in the country’s economic growth. Budget allocations through the annual budget presented have their strategies to ensure that the allocated budget can improve the growth and development in Malaysia and also can be enjoyed by all Malaysian. The government’s expenditure has contributed to the expansion of this country’s development from various sectors. However, there are various problems involving government expenditure such as low level of health, homeless poor people, weak public transportation and illegal immigrants. The purpose of this study is to examine the relationship between government expenditure on health, education, housing, transportation and defence sectors towards economic growth. The data used is secondary data from 1980-2017 for 38 years from the Department of Statistics, Malaysia and World Bank Data. The method used in this study is Descriptive Analysis and Autoregressive Distributed Lagged Model (ARDL). The result showed that economic growth and government expenditure on health, education, transportation, and defence has a long-run relationship. Therefore, the government should increase more expenditure on crucial sectors such as education, transportation, defence and health that will strengthen economic growth in the long run.
    Matched MeSH terms: Budgets
  4. Madden L, Bojko MJ, Farnum S, Mazhnaya A, Fomenko T, Marcus R, et al.
    Int J Drug Policy, 2017 11;49:48-53.
    PMID: 28957756 DOI: 10.1016/j.drugpo.2017.07.025
    BACKGROUND: Opioid agonist therapies (OAT) like methadone and buprenorphine maintenance treatment remain markedly under-scaled in Ukraine despite adequate funding. Clinicians and administrators were assembled as part of an implementation science strategy to scale-up OAT using the Network for Improvement of Addiction Treatment (NIATx) approach.

    METHODS: Nominal Group Technique (NGT), a key ingredient of the NIATx toolkit, was directed by three trained coaches within a learning collaborative of 18 OAT clinicians and administrators to identify barriers to increase OAT capacity at the regional "oblast" level, develop solutions, and prioritize local change projects. NGT findings were supplemented from detailed notes collected during the NGT discussion.

    RESULTS: The top three identified barriers included: (1) Strict regulations and inflexible policies dictating distribution and dispensing of OAT; (2) No systematic approach to assessing OAT needs on regional or local level; and (3) Limited funding and financing mechanisms combined with a lack of local/regional control over funding for OAT treatment services.

    CONCLUSIONS: NGT provides a rapid strategy for individuals at multiple levels to work collaboratively to identify and address structural barriers to OAT scale-up. This technique creates a transparent process to address and prioritize complex issues. Targeting these priorities allowed leaders at the regional and national level to advocate collectively for approaches to minimize obstacles and create policies to improve OAT services.

    Matched MeSH terms: Budgets
  5. Aziz NL
    Stud Fam Plann, 1978 Sep;9(9):41-2.
    PMID: 734714 DOI: 10.2307/1965636
    Matched MeSH terms: Budgets
  6. Ghilan K, Mehmood A, Ahmed Z, Nahari A, Almalki MJ, Jabour AM, et al.
    Saudi J Biol Sci, 2021 Jan;28(1):643-650.
    PMID: 33424351 DOI: 10.1016/j.sjbs.2020.10.055
    Background: Efficiency remains one of the most important drivers of decision making in health care system. Fund allocators need to receive structured information about the cost healthcare services from hospitals for better decisions related to resource allocation and budgeting. The objective of the study was to estimate the unit cost for health services offered to inpatients in King Fahd Central hospital (KFCH) Jazan during the financial year 2018.

    Methods: We applied a retrospective approach using a top-down costing method to estimate the cost of health care services. Clinical and Administrative departments divided into cost centres, and the unit cost was calculated by dividing the total cost of final care cost centres into the total number of patients discharged in one year. The average cost of inpatient services was calculated based on the average cost of each ward and the number of patients treated.

    Results: The average cost per patient stayed in KFCH was SAR 19,034, with the highest cost of SAR 108,561 for patients in the Orthopedic ward. The average cost of the patient in the Surgery ward, Plastic surgery, Neurosurgery, Medical ward, Pediatric ward and Gynecology ward was SAR 33,033, SAR 29,425, SAR 23,444, SAR 20,450, SAR 9579 and SAR 8636 respectively.

    Conclusion: This study provides necessary information about the cost of health care services in a tertiary care setting. This information can be used as a primary tool and reference for further studies in other regions of the country. Hence, this data can help to provide a better understanding of tertiary hospital costing in the region to achieve the privatization objective.

    Matched MeSH terms: Budgets
  7. Mohd-Tahir NA, Li SC
    PLoS One, 2019;14(2):e0212832.
    PMID: 30817790 DOI: 10.1371/journal.pone.0212832
    INTRODUCTION: Renin-angiotensin system inhibitors (RAS) drugs have a proteinuria-reducing effect that could prevent the progression of kidney disease in diabetic patients. Our study aimed to assess the budget impact based on healthcare payer perspective of increasing uptake of RAS drugs into the current treatment mix of standard anti-hypertensive treatments to prevent progression of kidney disease in patient's comorbid with hypertension and diabetes.

    METHODS: A Markov model of a Malaysian hypothetical cohort aged ≥30 years (N = 14,589,900) was used to estimate the total and per-member-per-month (PMPM) costs of RAS uptake. This involved an incidence and prevalence rate of 9.0% and 10.53% of patients with diabetes and hypertension respectively. Transition probabilities of health stages and costs were adapted from published data.

    RESULTS: An increasing uptake of RAS drugs would incur a projected total treatment cost ranged from MYR 4.89 billion (PMPM of MYR 27.95) at Year 1 to MYR 16.26 billion (PMPM of MYR 92.89) at Year 5. This would represent a range of incremental costs between PMPM of MYR 0.20 at Year 1 and PMPM of MYR 1.62 at Year 5. Over the same period, the care costs showed a downward trend but drug acquisition costs were increasing. Sensitivity analyses showed the model was minimally affected by the changes in the input parameters.

    CONCLUSION: Mild impact to the overall healthcare budget has been reported with an increased utilization of RAS. The long-term positive health consequences of RAS treatment would reduce the cost of care in preventing deterioration of kidney function, thus offsetting the rising costs of purchasing RAS drugs. Optimizing and increasing use of RAS drugs would be considered an affordable and rational strategy to reduce the overall healthcare costs in Malaysia.

    Matched MeSH terms: Budgets
  8. Ashutosh, Kumar Singh, Billy, Pik Lik Lau, Terence, Peng Lian Tan
    MyJurnal
    In this paper, we introduce T-DepExp system to simulate the transitive dependence based coalition formation (CF). It is a multi-agent based simulation (MABS) tool that aims to enhance cooperation between agents through transitive dependence. Previously, the transitive dependence was introduced by An and his colleagues for expressing the indirect dependence between agents in their cooperation. However, it did not receive much attention. Although it has a few problems need to be addressed, we try to propose our own mechanism to increase the efficiency of the transitive dependence based CF. To simulate MAS dependence relationship, we have included two fundamental dependence relationships in this MABS tool, which are AND-Dependence and OR-Dependence. In addition, the architecture of the T-DepExp system is presented and discussed. It allows possible integration of other features such as budget mechanism and trust model. Subsequently, hypothesis for the experiments and experimental setup are explained. The overall system will be demonstrated for its functionality and the experimental results will also be discussed.
    Matched MeSH terms: Budgets
  9. Tahir, M.M., Haron, N.A., Alias, A.H., Harun, A.N., Muhammad, I.B., Baba, D.L.
    MyJurnal
    The control of cost and time in construction projects is one of the most important issues in construction since the emergence of the construction industry. A successful project should meet not only quality output standards, but also time and budget objectives. The management and control of cost and time in construction is fundamental in every project. An effective cost and time management and control technique for construction projects is important in managing risk of cost overrun and delay in completion of projects. Construction projects are becoming more complex as they now involve many stakeholders from different disciplines. The emergence of Building Information Model (BIM), an alternative technology is believed to solve issues related to project cost and time control as it efficiently increases collaboration between stakeholders. The aim of this paper is to review and summarise the causes of delay and cost overrun in construction industries, which are the main causes of disputes and abandonment of projects in the industry. It was found that delays and cost overrun eat deep into the industry and leave the construction industry with a bad image for decades even with rapid advancement in technology. The review of the applications of BIM showed that most of the applications are geared towards minimising construction cost and time spent on projects. This means that the use of BIM in the management of construction projects has great impact on project cost and time.
    Matched MeSH terms: Budgets
  10. Matta AM
    Med Law, 2007 Jun;26(2):213-30.
    PMID: 17639847
    Starting with the duty of Governments to provide adequate resources for the establishment and development of health services, this paper draws on experiences in four developed countries to illustrate the problems and their outcomes. The examples chosen demonstrate the contrast in philosophies and approach to resource allocation for health care.
    Matched MeSH terms: Budgets
  11. Muhammad Syazni, Aidalina Mahmud, Suhainizam Muhamad Saliluddin
    MyJurnal
    Introduction: Dengue fever currently remains as one of the major public health issues in Malaysia. Dengue inci-dence in Malaysia has been increasing in the last 20 years. Dengue fever has been causing an economic burden to the country each year. Vector control is one of the preventions and control activities to reduce its incidence. Vector control activities, especially fogging is a resource-intensive activity. It uses most of the allocated budget of a district health office (33%). The major cost components of the prevention and control activities were human resources and pesticides with 60.7% were for human resources and 13.6% of the costs were for pesticides. Therefore, it is important to know, cost of each fogging activity and the factors that contribute to that cost. The objective of this study was to determine the costs of fogging activities carried out by Hulu Langat Health District Office, Selangor, Malaysia. Meth-ods: This study was a retrospective descriptive and analytical study using data from the Hulu Langat District Health Office for the year 2018. Cost analysis of fogging activities was carried out using the activity-based costing method-ology. The factors associated with, and predictors of, the costs of fogging activities were determined using chi-square and multiple linear regression. Results: In 2018, Hulu Langat District Health Office carried out total of 2,063 fogging activities. The average cost of each fogging activity was estimated as RM 1,579. Types of insecticides was statistically significant associated and predictive factor of the cost of fogging activity. Conclusion: The present study showed that the estimated average cost per fogging activity is RM 1,579 and water-based insecticide was found to be the cheaper option compared to oil-based insecticide. However, as this study did not determine the effectiveness of these insec-ticides, recommendations cannot be made as to which insecticide should be used.
    Matched MeSH terms: Budgets
  12. Aniza, I., Hossein, M., Otgonbayar, R., Munkhtuul, Y.
    MyJurnal
    Introduction : Economic evaluations can provide “value-for money” information to those making decisions about the allocation of limited health care resources. In particular, economic evaluations can be used to identify interventions that are worth providing and those that are not. Furthermore, evaluations can be used with other approaches to help set priorities, such as program-budgeting marginal-analysis.
    Methodology : Compile and systematically describe from the publications, articles and reports on economic evaluation in healthcare decision making.
    Result : A high quality economic evaluation should provide decision makers with information that is useful, relevant, and timely. In addition, evaluations should be based on rigorous analytical methods, be balanced and impartial (credible), and be transparent and accessible to the reader. There are many situations where economic evaluations can assist decision makers: decisions by various levels of government or administrative bodies (e.g., regional health authorities, hospitals, drug plans) to fund a program, service or technology, pricing decisions by government regulators and technology manufacturers, clinical practice guidelines, priorities for research funding by governments and researchbased firms, post-marketing surveillance and updates of economic information based on the use of the technology in the “real world” (which can then be used to inform one of the other types of decisions).
    Conclusion: This requires that decision makers take a broad view of the impact of a technology, and decision that are more explicit and transparent. The ultimate test of an evaluation is whether it leads to better decision in the presence of uncertainty, and results in the more efficient and effective use of resources.
    Matched MeSH terms: Budgets
  13. Jafri Mohd Rohani, Hood Atan, Wan Harun Wan Hamid, Mohamed Fitri Johari, Wan Lokman Wan Bedurdin, Hafizah Ithnin
    MyJurnal
    Currently accident cost calculations involve lengthy process of data collection procedures. Accident cost
    calculations can be categorized into direct and indirect costs. Many manufacturing industries are having difficulties
    in identifying and quantifying the accident cost category. Besides, it involves manual data collection which is time
    consuming and has high tendency to make errors throughout the process. The data collection process also involves
    various parties. For example, getting direct cost data from human resource department while indirect cost data need
    to be obtained from manufacturing and safety department. The objective of this study is to propose Web-Based
    interactive Accident Cost Calculator (WBACC) for manufacturing industries. This WBACC has two options; option
    1: calculations based on input data at the time of accident. Option 2: calculations based on historical data such as
    previous accident records. Option 1 is much simpler because it only requires accident demographic data while option
    2 is much more complex. However, option 2 is more accurate compared to option 1. This proposed WBACC can be
    used by safety and health practitioners to convince their top management in making decisions especially on safety
    budget allocation.
    Matched MeSH terms: Budgets
  14. Firdaus Abd Latib, Haziq Zul Asyraf Zahari, Abdul Rahim Abdul Hamid, Kevin Chester Wong How Yee
    MyJurnal
    The probability of the construction accident to happen is high due the nature of
    Construction work that involves complex activities, methods, machineries, materials
    and hazards. The occupational safety and health (OSH) law and regulations are
    mandatory for every construction project to uphold. Responsibilities to ensure the
    safety and health at the workplace lies with those who create the risk and with those
    who work with the risk. The owner or client of the construction project has the upper
    hand in determining the standard of OSH implementation in their project through
    contract documents. If the contract documents comprehensively spell out OSH
    requirements and cover all OSH cost, then the issues of contractor not implementing
    OSH measures could be minimized. The objective of this study is to identify
    Occupational Safety and Health requirements (OSH) in the contract document of
    selected construction projects. To achieve this objective, a total of seven contract
    document was collected from several construction companies. The qualitative analysis
    was performed to identify the extent of OSH requirements and costs are being
    mentioned in the contract documents. The finding shows that most of the contract
    document contains very little emphasis on OSH requirements and budgeting. Only one
    contract contains, an appendix that spell out about the safe work practices for
    construction works. The visible allocated budget for OSH requirements for all seven
    contracts is very minute range from 0.21% to 1.99% of contract value. In order to
    ensure that occupational safety and health is properly implemented, safety needs must
    be included in the budget because implementation it is not free, this can be achieved
    by making it a permanent feature in all bills of quantity of the project.
    Matched MeSH terms: Budgets
  15. Azam M
    Heliyon, 2020 Dec;6(12):e05853.
    PMID: 33426342 DOI: 10.1016/j.heliyon.2020.e05853
    Undeniably, peace and long-term sustainable economic development are the prime agenda of all countries. This study aims to empirically evaluate the impact of military spending on economic growth for a panel of 35 non-OECD countries over 1988-2019. A multivariate regression model based on the augmented production function is used to achieve the objective of the study. The panel autoregressive distributed lag (ARDL)/pooled mean group (PMG) technique is employed, while, in addition the robust least squares and fixed-effect estimators are implemented for the robustness of the results. This study found a clear negative effect of military spending on economic growth. The pairwise Dumitrescu Hurlin panel causality test results exhibit bi-directional causality between military expenses and economic growth. Overall, these estimates provide strong support that military expenditure is not beneficial rather detrimental to economic growth. The empirical findings of this study suggest that policymakers need to redesign the military budget to stimulate economic growth and improve social welfare.
    Matched MeSH terms: Budgets
  16. van Doorslaer E, O'Donnell O, Rannan-Eliya RP, Somanathan A, Adhikari SR, Garg CC, et al.
    Health Econ, 2007 Nov;16(11):1159-84.
    PMID: 17311356
    Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81% of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources. Bangladesh, China, India, Nepal and Vietnam rely most heavily on OOP financing and have the highest incidence of catastrophic payments. Sri Lanka, Thailand and Malaysia stand out as low to middle income countries that have constrained both the OOP share of health financing and the catastrophic impact of direct payments. In most low/middle-income countries, the better-off are more likely to spend a large fraction of total household resources on health care. This may reflect the inability of the poorest of the poor to divert resources from other basic needs and possibly the protection of the poor from user charges offered in some countries. But in China, Kyrgyz and Vietnam, where there are no exemptions of the poor from charges, they are as, or even more, likely to incur catastrophic payments.
    Matched MeSH terms: Budgets
  17. Faleiros DR, Alvares-Teodoro J, Nunes da Silva E, Godman BB, Gonçalves Pereira R, Gurgel Andrade EI, et al.
    PMID: 33971778 DOI: 10.1080/14737167.2021.1927716
    Objectives: Budget Impact Analyses (BIA) of medicines helps managers in promoting health systems' sustainability when assessing the role and value of new medicines. However, it is not clear whether BIAs typically underestimate or overestimate the impact on real-world budgets. This retroactive analysis seeks to compare estimated values obtained by a BIA and Real-World Evidence (RWE) to guide discussions.Methods: The estimated values were obtained through a BIA concerning the incorporation of adalimumab for the treatment of Rheumatoid Arthritis into the Brazilian Unified Health System (SUS) carried out retroactively and per international guidelines. RWE data was extracted from SUS computerized systems. We subsequently compared the number of treatments, costs, and Incremental Budget Impact (IBI).Results - The total number of treatments was underestimated by 10% (6,243) and the total expenditure was overestimated by 463% (US$ 4.7 billion). In five years, the total difference between the estimated values and real IBI reached US$ 1.1 billion. A current expenditure of US$ 1.0 was observed for every US$ 5.60 of estimated expenditure.Conclusion - The higher estimates from the BIA might cause decision makers to be more cautious with the introduction of a new medicine to reduce the opportunity costs for other interventions.
    Matched MeSH terms: Budgets
  18. Tavana M, Khosrojerdi G, Mina H, Rahman A
    Eval Program Plann, 2019 12;77:101703.
    PMID: 31442587 DOI: 10.1016/j.evalprogplan.2019.101703
    The primary goal in project portfolio management is to select and manage the optimal set of projects that contribute the maximum in business value. However, selecting Information Technology (IT) projects is a difficult task due to the complexities and uncertainties inherent in the strategic-operational nature of the process, and the existence of both quantitative and qualitative criteria. We propose a two-stage process to select an optimal project portfolio with the aim of maximizing project benefits and minimizing project risks. We construct a two-stage hybrid mathematical programming model by integrating Fuzzy Analytic Hierarchy Process (FAHP) with Fuzzy Inference System (FIS). This hybrid framework provides the ability to consider both the quantitative and qualitative criteria while considering budget constraints and project risks. We also present a real-world case study in the cybersecurity industry to exhibit the applicability and demonstrate the efficacy of our proposed method.
    Matched MeSH terms: Budgets
  19. Drake R
    Br J Nurs, 2013 Jan-Feb;22(2):95-100.
    PMID: 23587892
    In 2010, the Royal College of Nursing asked: 'What is the optimal level and mix of nurses required to deliver quality care as cost-effectively as possible?' This question implies there is a relationship between staffing levels, quality of care and financial efficiency. This paper examines the relationship between the staff budget, the number of staff required to achieve a target level of care and the actual number of staff employed in seven hospitals in Malaysia. It seeks to critically evaluate local challenges arising from staff budgeting/planning procedures, identify general issues that apply beyond Malaysian healthcare institutions and, finally, to propose a model that combines finance, staffing and level of care.
    Matched MeSH terms: Budgets/statistics & numerical data
  20. Ngan TT, Ramanathan K, Saleh MRBM, Schliemann D, Ibrahim Tamin NSB, Su TT, et al.
    BMJ Open, 2023 Mar 21;13(3):e066925.
    PMID: 36944471 DOI: 10.1136/bmjopen-2022-066925
    OBJECTIVES: The 2020-2022 research project 'Colorectal Cancer Screening Intervention for Malaysia' (CRC-SIM) evaluated the implementation of a home-based CRC screening pilot in Segamat District. This budget impact analysis (BIA) assessed the expected changes in health expenditure of the Malaysian Ministry of Health budget in the scenario where the pilot programme was implemented nationwide vs current opportunistic screening.

    DESIGN: Budget impact analysis. Assumptions and costs in the opportunistic and novel CRC screening scenarios were derived from a previous evaluation of opportunistic CRC screening in community health clinics across Malaysia and the CRC-SIM research project, respectively.

    SETTING: National level (with supplement analysis for district level). The BIA was conducted from the viewpoint of the federal government and estimated the annual financial impact over a period of 5 years.

    RESULTS: The total annual cost of the current practice of opportunistic screening was RM1 584 321 (~I$1 099 460) of which 80% (RM1 274 690 or ~I$884 587) was expended on the provision of opportunistic CRC to adults who availed of the service. Regarding the implementation of national CRC screening programme, the net budget impact in the first year was estimated to be RM107 631 959 (~I$74 692 546) and to reach RM148 485 812 (~I$103 043 589) in the fifth year based on an assumed increased uptake of 5% annually. The costs were calculated to be sensitive to the probability of adults who were contactable, eligible and agreeable to participating in the programme.

    CONCLUSIONS: Results from the BIA provided direct and explicit estimates of the budget changes to when implementing a population-based national CRC screening programme to aid decision making by health services planners and commissioners in Malaysia about whether such programme is affordable within given their budget constraint. The study also illustrates the use and value of the BIA approach in low-income and middle-income countries and resource-constrained settings.

    Matched MeSH terms: Budgets
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