Due to the fi nancial features specifi c to agricultural cooperatives, the paper constructs a constrained-maximizing model under the assumption that the fi nancial objective of an agricultural cooperative is to maximize the present value of the patron after-tax total income on an infi nite time horizon by choosing the dividend rate, the cash patronage refund rate, and the length of the revolving fund cycles. Th e model is solved numerically in a numerical illustration. In equilibrium, the optimal capital structure is derived for the agricultural cooperative. Th e eff ects of the changes in personal tax rates and discount rates are also explored.Keywords: cash patronage refund rate, constrained-maximizing model, dividend rate, present value 1 The definition of a cooperative is given by the International Co-operative Alliance (http://ica.coop/en/whats-co-op/ co-operative-identity-values-principles).
Introduction In Taiwan, given the discrepancy between current treatment guidelines and reimbursement options, patients might require a tool to support their decision-making process when selecting a regimen for metastatic colorectal cancer, especially therapeutic strategies, and subsequent costs, along with efficacy and safety outcomes. Therefore, we developed a patient decision aid (PDA) to support patients in choosing between treatment options recommended based on the current evidence and those reimbursed by the Taiwanese National Health Insurance. Methods By carefully reviewing the updated data and then interpreting the clinical tool, we conducted a needs assessment using a serial questionnaire to test for a step-by-step adjustment of the PDA. Results Patients, their relatives, and medical team members were most concerned about outcomes, such as overall survival, progression-free survival, objective response rate, tumor shrinkage to resectable status, total medical cost, severe gastrointestinal perforation, and severe skin reaction. After a serial alpha test for quality, we performed quantitative evaluation and beta tests, revealing average scores of more than 4 points (on a scale of 1–5) for both perceptibility and utility. Conclusions The present findings suggest that PDAs are useful and supplement the shared decision-making practice, helping patients make decisions about preferences and consider the pros and cons of treatment regimens, along with insurance reimbursement options.
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