WorldWideScience

Sample records for calculate unit costs

  1. Unit Cost Compendium Calculations

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Unit Cost Compendium (UCC) Calculations raw data set was designed to provide for greater accuracy and consistency in the use of unit costs across the USEPA...

  2. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital.

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2015-05-17

    Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran.‎ This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS.‎ The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department.

  3. Application of the Activity-Based Costing Method for Unit-Cost Calculation in a Hospital

    Science.gov (United States)

    Javid, Mahdi; Hadian, Mohammad; Ghaderi, Hossein; Ghaffari, Shahram; Salehi, Masoud

    2016-01-01

    Background: Choosing an appropriate accounting system for hospital has always been a challenge for hospital managers. Traditional cost system (TCS) causes cost distortions in hospital. Activity-based costing (ABC) method is a new and more effective cost system. Objective: This study aimed to compare ABC with TCS method in calculating the unit cost of medical services and to assess its applicability in Kashani Hospital, Shahrekord City, Iran. Methods: This cross-sectional study was performed on accounting data of Kashani Hospital in 2013. Data on accounting reports of 2012 and other relevant sources at the end of 2012 were included. To apply ABC method, the hospital was divided into several cost centers and five cost categories were defined: wage, equipment, space, material, and overhead costs. Then activity centers were defined. ABC method was performed into two phases. First, the total costs of cost centers were assigned to activities by using related cost factors. Then the costs of activities were divided to cost objects by using cost drivers. After determining the cost of objects, the cost price of medical services was calculated and compared with those obtained from TCS. Results: The Kashani Hospital had 81 physicians, 306 nurses, and 328 beds with the mean occupancy rate of 67.4% during 2012. Unit cost of medical services, cost price of occupancy bed per day, and cost per outpatient service were calculated. The total unit costs by ABC and TCS were respectively 187.95 and 137.70 USD, showing 50.34 USD more unit cost by ABC method. ABC method represented more accurate information on the major cost components. Conclusion: By utilizing ABC, hospital managers have a valuable accounting system that provides a true insight into the organizational costs of their department. PMID:26234974

  4. Example of cost calculations for an operating room and a post-anaesthesia care unit.

    Science.gov (United States)

    Raft, J; Millet, F; Meistelman, C

    2015-08-01

    The aim of this study was to evaluate the cost of an operating room using data from our hospital. Using an accounting-based method helped us. Over the year 2012, the sum of direct and indirect expenses with cost sharing expenses allowed us to calculate the cost of the operating room (OR) and of the post-anaesthesia care unit (PACU). The cost of the OR and PACU was €10.8 per minute of time offered. Two thirds of the direct expenses were allocated to surgery and one third to anaesthesia. Indirect expenses were 25% of the direct expenses. The cost of medications and single use medical devises was €111.45 per anaesthesia. The total cost of anaesthesia (taking into account wages and indirect expenses) was €753.14 per anaesthesia as compared to the total cost of the anaesthesia. The part of medications and single use devices for anaesthesia was 14.8% of the total cost. Despite the difficulties facing cost evaluation, this model of calculation, assisted by the cost accounting controller, helped us to have a concrete financial vision. It also shows that a global reflexion is necessary during financial decision-making. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  5. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

  6. PROSPECTS OF MANAGEMENT ACCOUNTING AND COST CALCULATION

    Directory of Open Access Journals (Sweden)

    Marian ŢAICU

    2014-11-01

    Full Text Available Progress in improving production technology requires appropriate measures to achieve an efficient management of costs. This raises the need for continuous improvement of management accounting and cost calculation. Accounting information in general, and management accounting information in particular, have gained importance in the current economic conditions, which are characterized by risk and uncertainty. The future development of management accounting and cost calculation is essential to meet the information needs of management.

  7. REVIEW OF METHODOLOGIES FOR COSTS CALCULATING OF RUMINANTS IN SLOVAKIA

    Directory of Open Access Journals (Sweden)

    Zuzana KRUPOVÁ

    2012-09-01

    Full Text Available The objective of this work was to synthesise and analyse the methodologies and the biological aspects of the costs calculation in ruminants in Slovakia. According to literature, the account classification of cost items is most often considered for construction of costing formula. The costs are mostly divided into fixed (costs independent from volume of herd’s production and variable ones (costs connected with improvement of breeding conditions. Cost for feeds and beddings, labour costs, other direct costs and depreciations were found as the most important cost items in ruminants. It can be assumed that including the depreciations into costs of the basic herd takes into consideration the real costs simultaneously invested into raising of young animals in the given period. Costs are calculated for the unit of the main and by-products and their classification is influenced mainly by the type of livestock and production system. In dairy cows is usually milk defined as the main product, and by- products are live born calf and manure. The base calculation unit is kilogram of milk (basic herd of cows and kilogram of gain and kilogram of live weight (young breeding cattle. In suckler cows is a live-born calf the main product and manure is the by-product. The costs are mostly calculated per suckler cow, live-born calf and per kilogram of live weight of weaned calf. Similar division of products into main and by-products is also in cost calculation for sheep categories. The difference is that clotted cheese is also considered as the main product of basic herd in dairy sheep and greasy wool as the by-products in all categories. Definition of the base calculation units in sheep categories followed the mentioned classification. The value of a by-product in cattle and sheep is usually set according to its quantity and intra- plant price of the by-product. In the calculation of the costs for sheep and cattle the “structural ewe” and “structural cow

  8. Cost calculation in agricultural enterprises in theory and practice

    Directory of Open Access Journals (Sweden)

    Wojciech Ziętara

    2009-01-01

    Full Text Available The article is dedicated to evolution of the production costs calculation theory in agriculture from the second half of XVIII century till present times. The author emphasized long lasting dispute among the economists about usefulness of the full account of unit costs of production in evaluation of production profitability. Moreover, utility of the part-costs account in evaluation of production competitiveness, as well as their value in evaluation of the production processes and structure (using optimisation methods was analysed. Additionally article describes current problems of cost calculation in agriculture.

  9. The operational cost of a urology unit.

    Science.gov (United States)

    Abeygunasekera, Anuruddha M; Duminda, M T; Chamintha, Thushara; Jayasingha, Ruwan

    2008-06-01

    To assess the operational cost of a urology unit, individual cost for certain index operations in urology, and to develop a framework to audit finances of a unit. A financial audit. Urology unit in a teaching hospital. Data of cost in providing urology services during one month were collected. It included three main areas: ward, operating theatre and outpatient clinic. Direct costs included staff wages, drugs, consumables, investigations and food. Indirect expenses such as administration, water, electricity and cleaning services were also calculated. For each type of operation a relative value was assigned depending on the nature of the operation. When direct expenses were not available, the hospital was divided into different cost centres and apportioning of the cost was done accordingly. The monthly operational cost of running a 19 bed urology unit with three operating sessions a week was Rs. 1 294 259. Staff wages constituted 61.2% of the cost. The cost of performing a pyelolithotomy was Rs. 18 669. Transurethral resection of the prostate (TURP) was done at a cost of Rs. 21 271. When the basic principles and the framework are understood, clinicians can perform financial audit and cost analysis of their units.

  10. Cost Calculation Model for Logistics Service Providers

    Directory of Open Access Journals (Sweden)

    Zoltán Bokor

    2012-11-01

    Full Text Available The exact calculation of logistics costs has become a real challenge in logistics and supply chain management. It is essential to gain reliable and accurate costing information to attain efficient resource allocation within the logistics service provider companies. Traditional costing approaches, however, may not be sufficient to reach this aim in case of complex and heterogeneous logistics service structures. So this paper intends to explore the ways of improving the cost calculation regimes of logistics service providers and show how to adopt the multi-level full cost allocation technique in logistics practice. After determining the methodological framework, a sample cost calculation scheme is developed and tested by using estimated input data. Based on the theoretical findings and the experiences of the pilot project it can be concluded that the improved costing model contributes to making logistics costing more accurate and transparent. Moreover, the relations between costs and performances also become more visible, which enhances the effectiveness of logistics planning and controlling significantly

  11. [Calculation of workers' health care costs].

    Science.gov (United States)

    Rydlewska-Liszkowska, Izabela

    2006-01-01

    In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference

  12. Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services.

    Science.gov (United States)

    Rajabi, A; Dabiri, A

    2012-01-01

    Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.

  13. COMPARATIVE ANALYSIS FOR THE PRACTICAL PRACTICE OF COST CALCULATION

    Directory of Open Access Journals (Sweden)

    Veronika Fenyves

    2015-07-01

    Full Text Available Basic topic of our treatise is to introduce the system of cost calculation. Our reason for choice of this topic is that, in the economic environment of today, it is very important for a production company to have the most possible accurate knowledge about costs of the activity. This informational demand emerges in case of more and more managing entities since the cost cutback is often the only tool for retaining the competitiveness – of course, within certain frameworks. There is a frequent question among the corporate owners and management: “How could our costs be cut – even if only to a small extent?” One of the devices is the moderation of the activity costs, in order to do this it is essential to know how much the production of the unit of product costs for the company, that is to say, how many its first cost is. Our goal is to aim the attention at values and importance of the management information system as well as information obtained during determination of the cost, the differences in results of the individual cost calculation methods and the reasons of differences. In addition, our intention was to know and acquaint a complex cost calculation procedure in depth during which we endeavoured to form a system theory of a kind.

  14. CALCULATION OF COMPANY COSTS THROUGH THE DIRECT-COSTING CALCULATION METHOD

    Directory of Open Access Journals (Sweden)

    Florin-Constantin DIMA

    2013-06-01

    Full Text Available The cost of production has as its starting point the purchase cost of raw materials and consumables, as well as their processing cost and the calculation of the production cost involves complex aspects. This article is based on the two major concepts of costs calculation, namely the concept of full costs and the concept of partial costs, and it analyses the direct-costing calculation method. Necessity of the Development of calculation methods to ensure rapid determination of the cost of production, and the establishment of indicators broad spectrum of information necessary for making decisions to streamline a business activity conducted by direct-costing method. Direct-costing method appeared in the U.S. for the first time in 1934 (applied by Jonathan Harris and G. Charter Harrison. Subsequently, this method was applied to European countries (England, France, Germany etc.. We stopped on this method because it is considered a modern method of costing. Therefore, we analyzed both advantages and limitations of the method in question

  15. Analisis Unit Cost Sectio Caesaria dengan Metode Activity Based Costing di Rumah Sakit Bhayangkara Yogyakarta

    Directory of Open Access Journals (Sweden)

    Tsalisah Damayanti

    2017-01-01

    Full Text Available This study aims to analyze the unit cost of sectio Caesaria by ABC method, second to analyze the differences between the unit cost calculation of Sectio Caesaria by ABC method with applied cost. Unit cost analysis was conducted at Sectio Caesaria procedure without comorbidities or complications. Data that used in the form of primary data interviews with specialists Obgyn and secondary data financial data and hospitals profiles. The result of the calculation of unit cost of Sectio Caesaria service through Activity Based Costing approach is still lower than INA CBG’s tariff.

  16. Calculating the cost of a healthcare project.

    Science.gov (United States)

    Stichler, Jaynelle F

    2008-02-01

    Nearly $200 billion of healthcare construction is expected by the year 2015, and nurse leaders must expand their knowledge and capabilities in healthcare design. This bimonthly department prepares nurse leaders to use the evidence-based design process to ensure that new, expanded, and renovated hospitals facilitate optimal patient outcomes, enhance the work environment for healthcare providers, and improve organizational performance. In this article, the author introduces important project budget terms and a method of calculating an estimation of probable cost for a building project.

  17. Low cost balancing unit design

    Science.gov (United States)

    Golembiovsky, Matej; Dedek, Jan; Slanina, Zdenek

    2017-06-01

    This article deals with the design of a low-cost balancing system which consist of battery balancing units, accumulator pack units and coordinator unit with interface for higher level of battery management system. This solution allows decentralized mode of operation and the aim of this work is implementation of controlling and diagnostic mechanism into an electric scooter project realized at Technical university of Ostrava. In todays world which now fully enjoys the prime of electromobility, off-grid battery systems and other, it is important to seek the optimal balance between functionality and the economy side of BMS that being electronics which deals with secondary cells of batery packs. There were numerous sophisticated, but not too practical BMS models in the past, such as centralized system or standalone balance modules of individual cells. This article aims at development of standalone balance modules which are able to communicate with the coordinator, adjust their parameters and ensure their cells safety in case of a communication failure. With the current worldwide cutting cost trend in mind, the emphasis was put on the lowest price possible for individual component. The article is divided into two major categories, the first one being desing of power electronics with emphasis on quality, safety (cooling) and also cost. The second part describes development of a communication interface with reliability and cost in mind. The article contains numerous graphs from practical measurements. The outcome of the work and its possible future is defined in the conclusion.

  18. 49 CFR 639.25 - Calculation of lease cost.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.25 Calculation of lease cost. (a) For purposes of this part, the lease cost of a capital asset is— (1) The cost to lease the asset for the same... obtain the capital asset. (b) The estimated lease costs must be reasonable, based on realistic market...

  19. THE COST CALCULATION AND ANALYSIS BY MEANS OF THE STANDARD COST METHOD

    Directory of Open Access Journals (Sweden)

    ADRIANA MONICAŢEGLEDI

    2014-05-01

    Full Text Available Originally known as the Estimated Cost System, it has evolved, nowadays being called Standard Cost Accounting. Standard cost calculation method is based on scheduled cost, pre-calculated, set before the start of the manufacturing process itself. This method allows the determination of the elements that influence the amount of costs and their deviations from the predetermined costs.

  20. Calculating cost savings in utilization management.

    Science.gov (United States)

    MacMillan, Donna

    2014-01-01

    A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

  1. A calculation program for electricity generation costs using LOTUS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Ki; Lee, Man Ki [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1994-12-01

    This program is designed in order to calculate electricity generation cost by different energy sources, and menu type is adopted for user convenience. This program also graphically shows the share of capital investment cost, O and M cost, and fuel cost. Sensitivity analysis about discount rate can also be carried out by this program, taking into consideration the important role of the discount rate in the generation costs calculation. (Author) 7 refs., 1 fig., 3 tabs.

  2. BURDEN OF DISEASE CALCULATION, COST OF ILLNESS ...

    African Journals Online (AJOL)

    CIU

    individual's relatives and the society can channel such resources and energy to other uses that would ..... European countries. Useful Steps in BoD Calculation and CoI Analysis. The first useful step in the calculation is the outcome tree. Others are perspective of evaluation ... illustrating their conditional dependency. The first ...

  3. Rooftop Unit Comparison Calculator User Manual

    Energy Technology Data Exchange (ETDEWEB)

    Miller, James D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-04-30

    This document serves as a user manual for the Packaged rooftop air conditioners and heat pump units comparison calculator (RTUCC) and is an aggregation of the calculator’s website documentation. Content ranges from new-user guide material like the “Quick Start” to the more technical/algorithmic descriptions of the “Methods Pages.” There is also a section listing all the context-help topics that support the features on the “Controls” page. The appendix has a discussion of the EnergyPlus runs that supported the development of the building-response models.

  4. Calculation of freight externality costs for South Africa

    Directory of Open Access Journals (Sweden)

    Stefaan Swarts

    2012-11-01

    Full Text Available The purpose of this study is to quantify the marginal external costs associated with freight transport in South Africa. Six cost elements are included as externality cost items, namely, costs related to accidents, emissions, roadway land availability, policing, noise and congestion. Inputs in the calculations were a gravity-oriented freight flow model, a road transport cost model, actual transport costs for other modes, a warehousing cost survey, an inventory delay calculation and various national sources of information such as accident statistics and government budgets. Estimation techniques resulted in advances for externality cost measurement in South Africa. The quantification of the cost elements will be used to update the South African Freight Demand Model. The results show that the cost of transportation would have been 20% more if external factors were taken into account. The marginal rates of externalities can be used to develop scenarios based on alternative choices for South Africa's freight transport infrastructure configuration.

  5. Hydrogen Station Cost Estimates: Comparing Hydrogen Station Cost Calculator Results with other Recent Estimates

    Energy Technology Data Exchange (ETDEWEB)

    Melaina, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Penev, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-09-01

    This report compares hydrogen station cost estimates conveyed by expert stakeholders through the Hydrogen Station Cost Calculation (HSCC) to a select number of other cost estimates. These other cost estimates include projections based upon cost models and costs associated with recently funded stations.

  6. Burden of disease calculation, cost of illness analysis and demand ...

    African Journals Online (AJOL)

    Burden of disease calculation, cost of illness analysis and demand for death: a theoretical review. ... International Journal of Development and Management Review ... The works of Murray and co-workers on calculating Burden of Disease (BoD), and even the analysis of Cost of Illness (CoI), to fully understand the priority ...

  7. Processor Units Reduce Satellite Construction Costs

    Science.gov (United States)

    2014-01-01

    As part of the effort to build the Fast Affordable Science and Technology Satellite (FASTSAT), Marshall Space Flight Center developed a low-cost telemetry unit which is used to facilitate communication between a satellite and its receiving station. Huntsville, Alabama-based Orbital Telemetry Inc. has licensed the NASA technology and is offering to install the cost-cutting units on commercial satellites.

  8. Metode Activity Based Costing dalam Penentuan Unit Cost Eksisi Fibroadenoma Mammae

    Directory of Open Access Journals (Sweden)

    Afiazka Luthfita

    2016-07-01

    Full Text Available Indonesian began to operate health insurance program on 2014 with payment scheme by INA-CBG’s (Indonesian Case Based Group. That make hospital to have appropriate tariff calculation. Breast fibroadenoma (FAMmust have appropriate tariff calculation because it will be increasing. One of calculating method that can be used is Activity Based Costing (ABC because this method can measure accurately cost out of any activity, improve the precision and accuracy in the details of charging fees. This study was descriptive quantitative. This study is limited to patient with FAM cases that occurred in 2015 in patients using BPJS class III and without complications. The unit cost of service excision FAM still under INA-CBG’s rates, calculations by the ABC method is higher than the unit cost PKU Muhammadiyah Hospital. The management should be re-evaluated the tariff of this service.

  9. Recursive Delay Calculation Unit for Parametric Beamformer

    DEFF Research Database (Denmark)

    Nikolov, Svetoslav; Jensen, Jørgen Arendt; Tomov, Borislav Gueorguiev

    2006-01-01

    This paper presents a recursive approach for parametric delay calculations for a beamformer. The suggested calculation procedure is capable of calculating the delays for any image line defined by an origin and arbitrary direction. It involves only add and shift operations making it suitable...

  10. Low-cost inertial measurement unit.

    Energy Technology Data Exchange (ETDEWEB)

    Deyle, Travis Jay

    2005-03-01

    Sandia National Laboratories performs many expensive tests using inertial measurement units (IMUs)--systems that use accelerometers, gyroscopes, and other sensors to measure flight dynamics in three dimensions. For the purpose of this report, the metrics used to evaluate an IMU are cost, size, performance, resolution, upgradeability and testing. The cost of a precision IMU is very high and can cost hundreds of thousands of dollars. Thus the goals and results of this project are as follows: (1) Examine the data flow in an IMU and determine a generic IMU design. (2) Discuss a high cost IMU implementation and its theoretically achievable results. (3) Discuss design modifications that would save money for suited applications. (4) Design and implement a low cost IMU and discuss its theoretically achievable results. (5) Test the low cost IMU and compare theoretical results with empirical results. (6) Construct a more streamlined printed circuit board design reducing noise, increasing capabilities, and constructing a self-contained unit. Using these results, we can compare a high cost IMU versus a low cost IMU using the metrics from above. Further, we can examine and suggest situations where a low cost IMU could be used instead of a high cost IMU for saving cost, size, or both.

  11. Unit labour costs, productivity and international competitiveness

    NARCIS (Netherlands)

    Ark, Bart van; Stuivenwold, Edwin; Ypma, Gerard

    2005-01-01

    This paper provides international comparisons of relative levels of unit labour costs (ULC) for several OECD countries relative to the United States. The estimates are based on the Total Economy Database and the 60-Industry Database of the Groningen Growth and Development Centre (GGDC), and are also

  12. Hospital financing: calculating inpatient capital costs in Germany with a comparative view on operating costs and the English costing scheme.

    Science.gov (United States)

    Vogl, Matthias

    2014-04-01

    The paper analyzes the German inpatient capital costing scheme by assessing its cost module calculation. The costing scheme represents the first separated national calculation of performance-oriented capital cost lump sums per DRG. The three steps in the costing scheme are reviewed and assessed: (1) accrual of capital costs; (2) cost-center and cost category accounting; (3) data processing for capital cost modules. The assessment of each step is based on its level of transparency and efficiency. A comparative view on operating costing and the English costing scheme is given. Advantages of the scheme are low participation hurdles, low calculation effort for G-DRG calculation participants, highly differentiated cost-center/cost category separation, and advanced patient-based resource allocation. The exclusion of relevant capital costs, nontransparent resource allocation, and unclear capital cost modules, limit the managerial relevance and transparency of the capital costing scheme. The scheme generates the technical premises for a change from dual financing by insurances (operating costs) and state (capital costs) to a single financing source. The new capital costing scheme will intensify the discussion on how to solve the current investment backlog in Germany and can assist regulators in other countries with the introduction of accurate capital costing. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Classical capacity per unit cost for quantum channels

    Science.gov (United States)

    Jarzyna, Marcin

    2017-09-01

    In most communication scenarios, sending a symbol encoded in a quantum state requires spending resources such as energy, which can be quantified by a cost of communication. A standard approach in this context is to quantify the performance of communication protocol by classical capacity, quantifying the maximal amount of information that can be transmitted through a quantum channel per single use of the channel. However, different figures of merit are also possible and a particularly well-suited one is the classical capacity per unit cost, which quantifies the maximal amount of information that can be transmitted per unit cost. I generalize this concept to account for the quantum nature of the information carriers and communication channels and show that if there exists a state with cost equal to zero, e.g., a vacuum state, the capacity per unit cost can be expressed by a simple formula containing maximization of the relative entropy between two quantum states. This enables me to analyze the behavior of photon information efficiency for general communication tasks and show simple bounds on the capacity per unit cost in terms of quantities familiar from quantum estimation theory. I calculate also the capacity per unit cost for general Gaussian quantum channels.

  14. Unit Cost Handbook : a Financial Management Tool for Today & Tomorrow

    OpenAIRE

    2012-01-01

    This handbook is intended to acquaint Department of Defense (DoD) executives and managers with the subject of unit cost. It provides an overall familiarization with unit cost and the management challenges, opportunities and benefits unit cost management offers.

  15. Activity-based costing: a practical model for cost calculation in radiotherapy.

    Science.gov (United States)

    Lievens, Yolande; van den Bogaert, Walter; Kesteloot, Katrien

    2003-10-01

    The activity-based costing method was used to compute radiotherapy costs. This report describes the model developed, the calculated costs, and possible applications for the Leuven radiotherapy department. Activity-based costing is an advanced cost calculation technique that allocates resource costs to products based on activity consumption. In the Leuven model, a complex allocation principle with a large diversity of cost drivers was avoided by introducing an extra allocation step between activity groups and activities. A straightforward principle of time consumption, weighed by some factors of treatment complexity, was used. The model was developed in an iterative way, progressively defining the constituting components (costs, activities, products, and cost drivers). Radiotherapy costs are predominantly determined by personnel and equipment cost. Treatment-related activities consume the greatest proportion of the resource costs, with treatment delivery the most important component. This translates into products that have a prolonged total or daily treatment time being the most costly. The model was also used to illustrate the impact of changes in resource costs and in practice patterns. The presented activity-based costing model is a practical tool to evaluate the actual cost structure of a radiotherapy department and to evaluate possible resource or practice changes.

  16. Bulk Electric Load Cost Calculation Methods: Iraqi Network Comparative Study

    Directory of Open Access Journals (Sweden)

    Qais M. Alias

    2016-09-01

    Full Text Available It is vital in any industry to regain the spent capitals plus running costs and a margin of profits for the industry to flourish. The electricity industry is an everyday life touching industry which follows the same finance-economic strategy. Cost allocation is a major issue in all sectors of the electric industry, viz, generation, transmission and distribution. Generation and distribution service costing’s well documented in the literature, while the transmission share is still of need for research. In this work, the cost of supplying a bulk electric load connected to the EHV system is calculated. A sample basic lump-average method is used to provide a rough costing guide. Also, two transmission pricing methods are employed, namely, the postage-stamp and the load-flow based MW-distance methods to calculate transmission share in the total cost of each individual bulk load. The three costing methods results are then analyzed and compared for the 400kV Iraqi power grid considered for a case study.

  17. Unit Costs for Lunar-Derived Propellants

    Science.gov (United States)

    Blair, Brad R.

    2004-02-01

    The estimated propellant production cost per metric ton will be derived and presented for solar system transportation waypoints. Background on recent and ongoing space resource propellant supply models will be presented, with a review of architectural assumptions, costs and expected markets. Integrated economic and engineering models (Duke et al., 2003; Duke, Blair and Diaz, 2002; Lamassoure et al. 2003; and Blair et al., 2002) estimate production costs, expected productivity of the mining and processing system, reusable transportation element behavior, fuel depot activity and revenues based on projected market conditions. Results of these economic models are used to derive total and marginal unit costs for propellant at fuel depot facilities for the purpose of facilitating the commercial development of space and to aid program and logistic planning for human space exploration missions.

  18. Cost calculations for decommissioning and dismantling of nuclear research facilities

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, I. (Studsvik Nuclear AB (Sweden)); Backe, S. (Institute for Energy Technology (Norway)); Cato, A.; Lindskog, S. (Swedish Nuclear Power Inspectorate (Sweden)); Efraimsson, H. (Swedish Radiation Protection Authority (Sweden)); Iversen, Klaus (Danish Decommissioning (Denmark)); Salmenhaara, S. (VTT Technical Research Centre of Finland (Finland)); Sjoeblom, R. (Tekedo AB, (Sweden))

    2008-07-15

    Today, it is recommended that planning of decommission should form an integral part of the activities over the life cycle of a nuclear facility (planning, building and operation), but it was only in the nineteen seventies that the waste issue really surface. Actually, the IAEA guidelines on decommissioning have been issued as recently as over the last ten years, and international advice on finance of decommissioning is even younger. No general international guideline on cost calculations exists at present. This implies that cost calculations cannot be performed with any accuracy or credibility without a relatively detailed consideration of the radiological prerequisites. Consequently, any cost estimates based mainly on the particulars of the building structures and installations are likely to be gross underestimations. The present study has come about on initiative by the Swedish Nuclear Power Inspectorate (SKI) and is based on a common need in Denmark, Finland, Norway and Sweden. The content of the report may be briefly summarised as follows. The background covers design and operation prerequisites as well as an overview of the various nuclear research facilities in the four participating countries: Denmark, Finland, Norway and Sweden. The purpose of the work has been to identify, compile and exchange information on facilities and on methodologies for cost calculation with the aim of achieving an 80 % level of confidence. The scope has been as follows: 1) to establish a Nordic network 2) to compile dedicated guidance documents on radiological surveying, technical planning and financial risk identification and assessment 3) to compile and describe techniques for precise cost calculations at early stages 4) to compile plant and other relevant data A separate section is devoted in the report to good practice for the specific purpose of early but precise cost calculations for research facilities, and a separate section is devoted to techniques for assessment of cost

  19. The calculation of costs of postal network and universal postal service based on standard and average cost principles

    Directory of Open Access Journals (Sweden)

    Blagojević Mladenka Z.

    2017-01-01

    Full Text Available The provision of universal postal service involves high costs for operator, especially in rural areas. The aim of this paper is to propose and test tool for managing the cost of providing universal postal service and maintaining the postal network in order to facilitate understanding of the problem in the sector. The proposed approach use standard prices and standard quantities (the redefined number of postal units, the number of employees, etc. as well as average costs for calculation of the costs of the universal postal service and postal network. The methodology provides the efficiency analysis, benchmarking and identification of causes of poor performance of management and resource allocation. It can be used for postal operators that do not have modern accounting systems.

  20. Analysis of Unit Process Cost for an Engineering-Scale Pyroprocess Facility Using a Process Costing Method in Korea

    Directory of Open Access Journals (Sweden)

    Sungki Kim

    2015-08-01

    Full Text Available Pyroprocessing, which is a dry recycling method, converts spent nuclear fuel into U (Uranium/TRU (TRansUranium metal ingots in a high-temperature molten salt phase. This paper provides the unit process cost of a pyroprocess facility that can process up to 10 tons of pyroprocessing product per year by utilizing the process costing method. Toward this end, the pyroprocess was classified into four kinds of unit processes: pretreatment, electrochemical reduction, electrorefining and electrowinning. The unit process cost was calculated by classifying the cost consumed at each process into raw material and conversion costs. The unit process costs of the pretreatment, electrochemical reduction, electrorefining and electrowinning were calculated as 195 US$/kgU-TRU, 310 US$/kgU-TRU, 215 US$/kgU-TRU and 231 US$/kgU-TRU, respectively. Finally the total pyroprocess cost was calculated as 951 US$/kgU-TRU. In addition, the cost driver for the raw material cost was identified as the cost for Li3PO4, needed for the LiCl-KCl purification process, and platinum as an anode electrode in the electrochemical reduction process.

  1. How to calculate avoided costs in a cogeneration cycle

    Energy Technology Data Exchange (ETDEWEB)

    Hoover, H.

    1985-09-01

    When calculating the value of heat recovered from engine exhaust in a cogeneration cycle, some energy managers and engineers use the 3413 standard of evaluation: that is, that 3413 Btu of recovered engine exhaust heat has a financial value equivalent to the cost of one kilowatt hour of utility-purchased electricity. The standard establishing 3413 Btu as the equivalent of one kilowatt hour is valid where the heat output from a 1000-watt electric resistance heater is used to add 3413 Btu from electric resistance heat to 23.70 pounds of water in one hour. The temperature of that amount of water will, in one hour, increase 144/sup 0/F (3413/23.70 = 144). To avoid the latent heat range, the starting temperature of the water must not be greater than 67/sup 0/F at sea level. Unless the 3413 standard is understood, it can lead to expensive mistakes in projected avoided costs.

  2. COSTING OF QUALITY IN BUSINESS BASE UNIT SEVERAL PRODUCTIONS, CIENFUEGOS

    Directory of Open Access Journals (Sweden)

    Gómez Alfonso, Elizabeth

    2013-01-01

    Full Text Available The calculation of quality costs as a component of the System of Quality Management, is a must for Cuban business managers, to provide a technique identified as an advanced instrument of management, which will lead to improved competitiveness and serve as an informative source. Identify and calculate the costs of quality, as well as propose measured plans, to promote a decrease in operating expenses, which can be used as a tool to improve processes. The Business Unit of Several Base Productions of Cienfuegos presents the fault to give way to Business Improvement and certification of its Quality Management System, according to the norm ISO 9001:2008 and the decree law 281, so that the objective research was to estimate the costs of quality processes in the company. To achieve this level were used empirical methods and techniques such as direct observation, document review and work in groups, which allowed to calculate the costs of quality in all processes. The results obtained are applicable to companies that operate in the Cuban economy and according to the Cuban economic model implemented from the year 2011.

  3. A practical approach for calculating reliable cost estimates from observational data: application to cost analyses in maternal and child health.

    Science.gov (United States)

    Salemi, Jason L; Comins, Meg M; Chandler, Kristen; Mogos, Mulubrhan F; Salihu, Hamisu M

    2013-08-01

    Comparative effectiveness research (CER) and cost-effectiveness analysis are valuable tools for informing health policy and clinical care decisions. Despite the increased availability of rich observational databases with economic measures, few researchers have the skills needed to conduct valid and reliable cost analyses for CER. The objectives of this paper are to (i) describe a practical approach for calculating cost estimates from hospital charges in discharge data using publicly available hospital cost reports, and (ii) assess the impact of using different methods for cost estimation in maternal and child health (MCH) studies by conducting economic analyses on gestational diabetes (GDM) and pre-pregnancy overweight/obesity. In Florida, we have constructed a clinically enhanced, longitudinal, encounter-level MCH database covering over 2.3 million infants (and their mothers) born alive from 1998 to 2009. Using this as a template, we describe a detailed methodology to use publicly available data to calculate hospital-wide and department-specific cost-to-charge ratios (CCRs), link them to the master database, and convert reported hospital charges to refined cost estimates. We then conduct an economic analysis as a case study on women by GDM and pre-pregnancy body mass index (BMI) status to compare the impact of using different methods on cost estimation. Over 60 % of inpatient charges for birth hospitalizations came from the nursery/labor/delivery units, which have very different cost-to-charge markups (CCR = 0.70) than the commonly substituted hospital average (CCR = 0.29). Using estimated mean, per-person maternal hospitalization costs for women with GDM as an example, unadjusted charges ($US14,696) grossly overestimated actual cost, compared with hospital-wide ($US3,498) and department-level ($US4,986) CCR adjustments. However, the refined cost estimation method, although more accurate, did not alter our conclusions that infant/maternal hospitalization costs

  4. 47 CFR 65.305 - Calculation of the weighted average cost of capital.

    Science.gov (United States)

    2010-10-01

    ... Carriers § 65.305 Calculation of the weighted average cost of capital. (a) The composite weighted average cost of capital is the sum of the cost of debt, the cost of preferred stock, and the cost of equity... 47 Telecommunication 3 2010-10-01 2010-10-01 false Calculation of the weighted average cost of...

  5. Energy cost calculations for exercise prescription: an update.

    Science.gov (United States)

    Swain, D P

    2000-07-01

    Recent research has resulted in a number of recommended changes in how fitness professionals should prescribe target workloads and calculate the energy cost of exercise. The principal changes are in the use of oxygen consumption reserve (VO2R) as an alternative to percentage of maximal oxygen consumption (VO2max) for prescribing exercise intensity, the use of net VO2 rather than gross VO2 for the calculation of caloric expenditure during exercise, and a modification of the American College of Sports Medicine (ACSM) equation for calculating the oxygen cost of leg cycle ergometry. The VO2R method of prescribing exercise workloads is similar to the heart rate reserve (HRR) method of prescribing target heart rates, i.e. the target workload is established at a given percentage of the difference between maximal and resting VO2. Several recent studies have shown that there is a discrepancy between the exercise intensity at given percentages of HRR and VO2max, but that HRR and VO2R yield equivalent exercise intensities. The use of VO2R in exercise prescription provides more accurate target workloads, especially for individuals with a low fitness level. Net VO2 during exercise is that amount above resting VO2 due to the exercise itself. A recent recommendation is to employ net VO2 in the calculation of the caloric expenditure during exercise, so as not to overestimate potential bodyweight loss. Several recent studies of leg cycling ergometry have yielded equations for the estimation of VO2 that include a term for unloaded cycling, i.e. the oxygen cost of moving the legs against zero resistance. The equations from these studies provide more accurate estimations of cycling VO2 than the existing ACSM equation, and a new standardised equation has been developed and adopted by the ACSM. The new equation is especially useful for improving the accuracy of VO2 estimates during low intensity leg cycle ergometry. The ACSM equation for bench stepping has also been modified to include

  6. Synthesis on construction unit cost development : technical report.

    Science.gov (United States)

    2009-01-01

    Availability of historical unit cost data is an important factor in developing accurate project cost estimates. : State highway agencies (SHAs) collect data on historical bids and/or production rates, crew sizes and mixes, : material costs, and equip...

  7. Calculation of the Average Cost per Case of Dengue Fever in Mexico Using a Micro-Costing Approach

    Science.gov (United States)

    2016-01-01

    Introduction The increasing burden of dengue fever (DF) in the Americas, and the current epidemic in previously unaffected countries, generate major costs for national healthcare systems. There is a need to quantify the average cost per DF case. In Mexico, few data are available on costs, despite DF being endemic in some areas. Extrapolations from studies in other countries may prove unreliable and are complicated by the two main Mexican healthcare systems (the Secretariat of Health [SS] and the Mexican Social Security Institute [IMSS]). The present study aimed to generate specific average DF cost-per-case data for Mexico using a micro-costing approach. Methods Expected medical costs associated with an ideal management protocol for DF (denoted ´ideal costs´) were compared with the medical costs of current treatment practice (denoted ´real costs´) in 2012. Real cost data were derived from chart review of DF cases and interviews with patients and key personnel from 64 selected hospitals and ambulatory care units in 16 states for IMSS and SS. In both institutions, ideal and real costs were estimated using the program, actions, activities, tasks, inputs (PAATI) approach, a micro-costing technique developed by us. Results Clinical pathways were obtained for 1,168 patients following review of 1,293 charts. Ideal and real costs for SS patients were US$165.72 and US$32.60, respectively, in the outpatient setting, and US$587.77 and US$490.93, respectively, in the hospital setting. For IMSS patients, ideal and real costs were US$337.50 and US$92.03, respectively, in the outpatient setting, and US$2,042.54 and US$1,644.69 in the hospital setting. Conclusions The markedly higher ideal versus real costs may indicate deficiencies in the actual care of patients with DF. It may be necessary to derive better estimates with micro-costing techniques and compare the ideal protocol with current practice when calculating these costs, as patients do not always receive optimal care

  8. Calculation of the Average Cost per Case of Dengue Fever in Mexico Using a Micro-Costing Approach.

    Science.gov (United States)

    Zubieta-Zavala, Adriana; Salinas-Escudero, Guillermo; Ramírez-Chávez, Adrian; García-Valladares, Luis; López-Cervantes, Malaquias; López Yescas, Juan Guillermo; Durán-Arenas, Luis

    2016-08-01

    The increasing burden of dengue fever (DF) in the Americas, and the current epidemic in previously unaffected countries, generate major costs for national healthcare systems. There is a need to quantify the average cost per DF case. In Mexico, few data are available on costs, despite DF being endemic in some areas. Extrapolations from studies in other countries may prove unreliable and are complicated by the two main Mexican healthcare systems (the Secretariat of Health [SS] and the Mexican Social Security Institute [IMSS]). The present study aimed to generate specific average DF cost-per-case data for Mexico using a micro-costing approach. Expected medical costs associated with an ideal management protocol for DF (denoted ´ideal costs´) were compared with the medical costs of current treatment practice (denoted ´real costs´) in 2012. Real cost data were derived from chart review of DF cases and interviews with patients and key personnel from 64 selected hospitals and ambulatory care units in 16 states for IMSS and SS. In both institutions, ideal and real costs were estimated using the program, actions, activities, tasks, inputs (PAATI) approach, a micro-costing technique developed by us. Clinical pathways were obtained for 1,168 patients following review of 1,293 charts. Ideal and real costs for SS patients were US$165.72 and US$32.60, respectively, in the outpatient setting, and US$587.77 and US$490.93, respectively, in the hospital setting. For IMSS patients, ideal and real costs were US$337.50 and US$92.03, respectively, in the outpatient setting, and US$2,042.54 and US$1,644.69 in the hospital setting. The markedly higher ideal versus real costs may indicate deficiencies in the actual care of patients with DF. It may be necessary to derive better estimates with micro-costing techniques and compare the ideal protocol with current practice when calculating these costs, as patients do not always receive optimal care.

  9. HOW TO CALCULATE THE ENVIRONMENTAL COSTS? CASE COMPANY GRAFICA CIENFUEGOS

    Directory of Open Access Journals (Sweden)

    Keitel, Becerra

    2011-01-01

    Full Text Available The world urgently needs to protect the environment, many companies and organizations devote huge resources to reach that goal and achieve sustainable development as the highest standard of achievement for any country or organization. It then becomes imperative to determine how much the companies spend on the environment, taking into account that the Entities have an implicit contract with society and the environment, the product of the resources used and waste and waste pouring, which is why one needs to calculate and record the environmental costs of products to enhance the environmental management of the entity and thus promote an excellent decision-making. The following research seeks a procedure which allows solving this problem, making its composition with the use of various techniques within which highlights the environmental checklists and product life cycle, which also allows knowing separately as each process and product impacts the environment.

  10. [Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

    Science.gov (United States)

    Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

    2011-08-01

    Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

  11. Improvement of Cost Calculation in Constructions – Application of the Standard Cost Method

    Directory of Open Access Journals (Sweden)

    Adela Breuer

    2010-12-01

    Full Text Available Grace to the analysis of several commercial companies effectively performed “on the field”, we could remark the necessity to change the method of cost calculation, our motivation being related to the simplification of calculations and the reduction of the labour volume, but especially the necessity to know in due time the deviations occurred as well as the causes having led to their apparition. The importance of knowing the deviations in due time results from the very basic characteristics of the constructions execution, i.e. the performance of works during several budgetary years, which leads to the modifications of prices and materials, the introduction of new technologies, and to the performance of open air activities, making the execution of constructions works be influenced by the atmospheric condition. But the most important aspect of knowing the deviations is the correct determination of expenses and their inscribing in the corresponding period, in view of determining the result of the budgetary year. Our proposal for the enhancement of the method of cost calculation in constructions is the application of the standard cost method in the variant “single standard cost”.

  12. Manual for Reducing Educational Unit Costs in Latin American Countries.

    Science.gov (United States)

    Centro Multinacional de Investigacion Educativa, San Jose (Costa Rica).

    Designed for educational administrators, this manual provides suggestions for reducing educational unit costs in Latin America without reducing the quality of the education. Chapter one defines unit cost concepts and compares the costs of the Latin American countries. Chapter two deals with the different policies which could affect the principal…

  13. Using Work Breakdown Structure Models to Develop Unit Treatment Costs

    Science.gov (United States)

    This article presents a new cost modeling approach called work breakdown structure (WBS), designed to develop unit costs for drinking water technologies. WBS involves breaking the technology into its discrete components for the purposes of estimating unit costs. The article dem...

  14. Foundations of Financial Accounting Organization and Cost Calculation using Activity-Based Costing Method in Romanian Textile Industry

    Directory of Open Access Journals (Sweden)

    Sorinel Capusneanu

    2006-09-01

    Full Text Available The purpose of first part of this article consists in attempting to establish the management accounting and cost calculation basis of the ABC method in Romania. After general characterization of the ABC method and origin establishment of the ABC method the premises analysis are treated which are the basis of management accounting and cost calculation through ABC method in Romania. There are established the role and implications of the processes, activities and cost objects on management accounting and cost calculation, in the attempt to classify the expenses which accomplish the production cost, accordingly to ABC method.

  15. Foundations of Financial Accounting Organization and Cost Calculation using Activity-Based Costing Method in Romanian Textile Industry

    Directory of Open Access Journals (Sweden)

    Sorinel Capusneanu

    2006-11-01

    Full Text Available The purpose of first part of this article consists in attempting to establish the management accounting and cost calculation basis of the ABC method in Romania. After general characterization of the ABC method and origin establishment of the ABC method the premises analysis are treated which are the basis of management accounting and cost calculation through ABC method in Romania. There are established the role and implications of the processes, activities and cost objects on management accounting and cost calculation, in the attempt to classify the expenses which accomplish the production cost, accordingly to ABC method.

  16. Calculation of comparative utilisation and cost: a South African ...

    African Journals Online (AJOL)

    N2O should probably be used conservatively as it increases the anaesthetic cost and contributes to pollution and ozone depletion. Propofol TCI can be considered instead of sevoflurane inhalational anaesthesia for longer procedures. Keywords: cost of anaesthesia; inhalational anaesthesia, intravenous anaesthesia, ...

  17. CALCULATING THE SOCIAL COSTS OF CARBON WITHOUT KNOWING PREFERENCES COMMENT ON "A RAPID ASSESSMENT MODEL FOR UNDERSTANDING THE SOCIAL COST OF CARBON"

    OpenAIRE

    REYER GERLAGH

    2014-01-01

    The Social Costs of Carbon (SCC) equals the marginal welfare loss associated with one unit of emitted CO2, divided by the marginal welfare gain associated with one unit of consumption. In stochastic assessments, both the nominator and denominator can depend on uncertain parameters; specifically they depend on the (implicit) scaling of the welfare function with the parameters. I discuss some pitfalls when calculating the expected value or the certainty equivalent of the SCC, and show that a mi...

  18. The costs of producing a unit of blood in Zimbabwe

    NARCIS (Netherlands)

    Mafirakureva, Nyashadzaishe; Nyoni, Herbert; Nkomo, Sisodwa Z; Jacob, Jeffery S; Chikwereti, Radhi; Musekiwa, Zamile; Khoza, Star; Mvere, David A; Emmanuel, Jean C; Postma, Maarten J; van Hulst, Marinus

    2015-01-01

    BACKGROUND: There is lack of published data on the costs of blood and blood transfusion in sub-Saharan Africa. This study aimed to assess the unit costs of producing blood in Zimbabwe using an activity-based costing (ABC) method. STUDY DESIGN AND METHODS: A management accounting approach, based on

  19. Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations.

    Science.gov (United States)

    Holmes, Lisa; Landsverk, John; Ward, Harriet; Rolls-Reutz, Jennifer; Saldana, Lisa; Wulczyn, Fred; Chamberlain, Patricia

    2014-04-01

    Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

  20. 47 CFR 65.300 - Calculations of the components and weights of the cost of capital.

    Science.gov (United States)

    2010-10-01

    ... the cost of capital. 65.300 Section 65.300 Telecommunication FEDERAL COMMUNICATIONS COMMISSION... METHODOLOGIES Exchange Carriers § 65.300 Calculations of the components and weights of the cost of capital. (a... unreasonable. (b) Excluded from cost of capital calculations made pursuant to § 65.300 shall be those sources...

  1. Cost unit accounting based on a clinical pathway: a practical tool for DRG implementation.

    Science.gov (United States)

    Feyrer, R; Rösch, J; Weyand, M; Kunzmann, U

    2005-10-01

    Setting up a reliable cost unit accounting system in a hospital is a fundamental necessity for economic survival, given the current general conditions in the healthcare system. Definition of a suitable cost unit is a crucial factor for success. We present here the development and use of a clinical pathway as a cost unit as an alternative to the DRG. Elective coronary artery bypass grafting was selected as an example. Development of the clinical pathway was conducted according to a modular concept that mirrored all the treatment processes across various levels and modules. Using service records and analyses the process algorithms of the clinical pathway were developed and visualized with CorelTM iGrafix Process 2003. A detailed process cost record constituted the basis of the pathway costing, in which financial evaluation of the treatment processes was performed. The result of this study was a structured clinical pathway for coronary artery bypass grafting together with a cost calculation in the form of cost unit accounting. The use of a clinical pathway as a cost unit offers considerable advantages compared to the DRG or clinical case. The variance in the diagnoses and procedures within a pathway is minimal, so the consumption of resources is homogeneous. This leads to a considerable improvement in the value of cost unit accounting as a strategic control instrument in hospitals.

  2. Independent calculation of monitor units for VMAT and SPORT

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xin; Bush, Karl; Ding, Aiping; Xing, Lei, E-mail: lei@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California 94305 (United States)

    2015-02-15

    Purpose: Dose and monitor units (MUs) represent two important facets of a radiation therapy treatment. In current practice, verification of a treatment plan is commonly done in dose domain, in which a phantom measurement or forward dose calculation is performed to examine the dosimetric accuracy and the MU settings of a given treatment plan. While it is desirable to verify directly the MU settings, a computational framework for obtaining the MU values from a known dose distribution has yet to be developed. This work presents a strategy to calculate independently the MUs from a given dose distribution of volumetric modulated arc therapy (VMAT) and station parameter optimized radiation therapy (SPORT). Methods: The dose at a point can be expressed as a sum of contributions from all the station points (or control points). This relationship forms the basis of the proposed MU verification technique. To proceed, the authors first obtain the matrix elements which characterize the dosimetric contribution of the involved station points by computing the doses at a series of voxels, typically on the prescription surface of the VMAT/SPORT treatment plan, with unit MU setting for all the station points. An in-house Monte Carlo (MC) software is used for the dose matrix calculation. The MUs of the station points are then derived by minimizing the least-squares difference between doses computed by the treatment planning system (TPS) and that of the MC for the selected set of voxels on the prescription surface. The technique is applied to 16 clinical cases with a variety of energies, disease sites, and TPS dose calculation algorithms. Results: For all plans except the lung cases with large tissue density inhomogeneity, the independently computed MUs agree with that of TPS to within 2.7% for all the station points. In the dose domain, no significant difference between the MC and Eclipse Anisotropic Analytical Algorithm (AAA) dose distribution is found in terms of isodose contours

  3. National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation

    Science.gov (United States)

    Stormwater discharges continue to cause impairment of our Nation’s waterbodies. EPA has developed the National Stormwater Calculator (SWC) to help support local, state, and national stormwater management objectives to reduce runoff through infiltration and retention using green i...

  4. School Size and Unit Costs: International Evidence and Its Usefulness.

    Science.gov (United States)

    Bray, Mark

    1988-01-01

    Reviews studies of unit costs among schools of differing size in United Kingdom, United States, Canada, Australia, and Sudan. Concludes that studies suggest economies of scale in larger schools, but extent of economies and point where schools encounter diseconomies vary widely. Notes that control for quality is problematic. (DHP)

  5. Steam Technical Brief: How to Calculate the True Cost of Steam

    Energy Technology Data Exchange (ETDEWEB)

    None

    2010-06-25

    This BestPractice Steam Technical Brief helps you calculate the true cost of steam. Knowing the correct cost is important for many reasons and all of them have to do with improving the company's bottom line.

  6. Calculation of costs of pregnancy- and puerperium-related care: experience from a hospital in a low-income country.

    Science.gov (United States)

    Sarowar, M G; Medin, E; Gazi, R; Koehlmoos, T P; Rehnberg, C; Saifi, R; Bhuiya, A; Khan, J

    2010-06-01

    Calculation of costs of different medical and surgical services has numerous uses, which include monitoring the performance of service-delivery, setting the efficiency target, benchmarking of services across all sectors, considering investment decisions, commissioning to meet health needs, and negotiating revised levels of funding. The role of private-sector healthcare facilities has been increasing rapidly over the last decade. Despite the overall improvement in the public and private healthcare sectors in Bangladesh, lack of price benchmarking leads to patients facing unexplained price discrimination when receiving healthcare services. The aim of the study was to calculate the hospital-care cost of disease-specific cases, specifically pregnancy- and puerperium-related cases, and to indentify the practical challenges of conducting costing studies in the hospital setting in Bangladesh. A combination of micro-costing and step-down cost allocation was used for collecting information on the cost items and, ultimately, for calculating the unit cost for each diagnostic case. Data were collected from the hospital records of 162 patients having 11 different clinical diagnoses. Caesarean section due to maternal and foetal complications was the most expensive type of case whereas the length of stay due to complications was the major driver of cost. Some constraints in keeping hospital medical records and accounting practices were observed. Despite these constraints, the findings of the study indicate that it is feasible to carry out a large-scale study to further explore the costs of different hospital-care services.

  7. Volumetric calculation using low cost unmanned aerial vehicle (UAV) approach

    Science.gov (United States)

    Rahman, A. A. Ab; Maulud, K. N. Abdul; Mohd, F. A.; Jaafar, O.; Tahar, K. N.

    2017-12-01

    Unmanned Aerial Vehicles (UAV) technology has evolved dramatically in the 21st century. It is used by both military and general public for recreational purposes and mapping work. Operating cost for UAV is much cheaper compared to that of normal aircraft and it does not require a large work space. The UAV systems have similar functions with the LIDAR and satellite images technologies. These systems require a huge cost, labour and time consumption to produce elevation and dimension data. Measurement of difficult objects such as water tank can also be done by using UAV. The purpose of this paper is to show the capability of UAV to compute the volume of water tank based on a different number of images and control points. The results were compared with the actual volume of the tank to validate the measurement. In this study, the image acquisition was done using Phantom 3 Professional, which is a low cost UAV. The analysis in this study is based on different volume computations using two and four control points with variety set of UAV images. The results show that more images will provide a better quality measurement. With 95 images and four GCP, the error percentage to the actual volume is about 5%. Four controls are enough to get good results but more images are needed, estimated about 115 until 220 images. All in all, it can be concluded that the low cost UAV has a potential to be used for volume of water and dimension measurement.

  8. Embodied Energy Calculation in Mitigating Environmental Impact of Low-Cost Housing Construction

    Directory of Open Access Journals (Sweden)

    Larasati ZR Dewi

    2017-01-01

    Full Text Available Reduction of the negative impacts of building construction, or mitigation, should be done in the early phase of a project. Particular method that can be used to reduce the negative impact is Embodied Energy (EE calculation. This research develops a method to calculate the total EE of materials used in building construction by using the Material Selection Analysis (MSA based on Indonesia’s Construction Work Unit Price Analysis (WUPA. MSA breaks down the types, its unit, and total volume of materials within an object. Using the EE data from Inventory Carbon and Energy (ICE Bath, in the UK, this research calculate the embodied energy in three small house types in Indonesia: Type 21 M2, Type 36 M2, and Type 45 M2. The result reveals a negative correlation between building’s area and EE value. Nonetheless, the EE value is positively related to the volume of material used. Proposed strategies to decrease the value of EE in low cost housing construction manly; a design approach in improving the efficiency of material usage, b materials substitution to material with lower value of EE, especially on material on large volume of usage, c socialization of EE value to stakeholders as consideration in determining the choice of materials used, thus, environmental mitigation is expected to be an important aspect in determining the design decisions and the choice of materials used.

  9. Variations in the costs of child and adolescent psychiatric in-patient units.

    Science.gov (United States)

    Beecham, Jennifer; Chisholm, Daniel; O'Herlihy, Anne; Astin, Jack

    2003-09-01

    Child and adolescent in-patient care is a highly specialised service, ideally requiring planning at a national level, but there are no routine data collections specifically for these services. To estimate unit costs for child and adolescent psychiatric in-patient units and to analyse the variations in costs between units. Data collection alongside a national survey with cost estimations guided by principles drawn from economic theory. Bivariate and multivariate analyses are employed to identify cost influences. Fifty-eight units could provide sufficient data to allow calculation of the cost per in-patient day; mean= pound 197 (s.d.=71.6; 1999-2000 prices). The management sector, type of provision, number of rooms, capacity and location explained nearly half of the cost variation. Child and adolescent psychiatric in-patient units are an expensive resource, with personnel absorbing two-thirds of the total costs. Costs per in-patient day vary fourfold and the exploration of cost variations can inform commissioning strategies.

  10. An integrated approach to calculate life cycle costs of arms and military equipment

    Directory of Open Access Journals (Sweden)

    Vlada S. Sokolović

    2013-12-01

    , costs are one of the most dominant parameters in decision-making. Modern trends in this area comprehensively perceive all costs during the life cycle of assets.In general, in the analysis of costs in the life cycle of AME there are two sets of costs: visible and invisible (hidden costs. The visible part of the costs is mainly present in decision-making and usually includes the cost of equipping units or purchase of assets. The invisible part of the costs is far more significant. Although it is larger than the visible part and covers more groups of costs, decision-makers often do not take it into account. The hidden costs include: distribution costs, operating costs, maintenance costs, training costs, inventory costs, information systems costs, the cost of disposal and write-offs, etc. The decision making problem about investment in the AME purchase and equipping is obviously of  multicriteria nature, whether an optimum combination of costs for one  technical system (AME is in question, or whether it is a choice of a system of AME among many offered. COST ANALYSIS OF A PARTICULAR  ASSET For the illustration of an integrated approach to the analysis of the cost of assets in their life-cycle, a model from the US Naval Postgraduate School, was adjusted and applied on an example of a real asset. The model is applied to the case of two  squadrons of identical aircraft based at different airports. With regard to the availability, confidentiality, and the variability of costs and reliability of the elements of AME, the calculations in the model are implemented on the basis of the estimated or orientation parameters. Essentially, the goal is to demonstrate the interdependence, mutual relations and influences of parameters and their ultimate impact on the overall cost of military assets. Applying the model to a particular example points to the fact that, in the first years of asset life, the dominant cost is that of asset procurement (cost of acquisition, cost of assets

  11. Unit cost of medical services at different hospitals in India.

    Directory of Open Access Journals (Sweden)

    Susmita Chatterjee

    Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising

  12. Unit Cost of Medical Services at Different Hospitals in India

    Science.gov (United States)

    Chatterjee, Susmita; Levin, Carol; Laxminarayan, Ramanan

    2013-01-01

    Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010–11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital) to Rs. 2,213 (private hospital) (USD 1 = INR 52). The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country’s hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising payment rates

  13. Costly Regional Landslide Events in the United States - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This map layer contains information on costly regional landslide events in the 50 United States and Puerto Rico. The extents of the regional events were drawn from...

  14. Costly Landslide Events in the United States - Direct Download

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This map layer shows point locations of costly individual landslide events in the 50 United States and Puerto Rico. Landslide locations were determined from...

  15. Calculating skill mix: implications for patient outcomes and costs.

    Science.gov (United States)

    Robinson, Sarah; Griffiths, Peter; Maben, Jill

    2009-12-01

    Debate continues about the hierarchy of skilled roles in the nursing workforce. For example, should there be grades of qualified nurses other than registered nurses? Should all registered nurses be prepared to degree level? And to what extent should the nursing workforce comprise staff who are not qualified as nurses? Such questions raise critical issues about how different configurations of staff affect patient care outcomes and whether judgements can be made about their cost effectiveness. This Policy+ article refers to systematically reviewed, international evidence in considering the implications for UK nursing of the inclusion of a second-level qualified nurse in the skill mix of the nursing workforce.

  16. Daily cost of an intensive care unit day: the contribution of mechanical ventilation.

    Science.gov (United States)

    Dasta, Joseph F; McLaughlin, Trent P; Mody, Samir H; Piech, Catherine Tak

    2005-06-01

    To quantify the mean daily cost of intensive care, identify key factors associated with increased cost, and determine the incremental cost of mechanical ventilation during a day in the intensive care unit. Retrospective cohort analysis using data from NDCHealth's Hospital Patient Level Database. A total of 253 geographically diverse U.S. hospitals. The study included 51,009 patients >/=18 yrs of age admitted to an intensive care unit between October 1, 2002, and December 31, 2002. None. Days of intensive care and mechanical ventilation were identified using billing data, and daily costs were calculated as the sum of daily charges multiplied by hospital-specific cost-to-charge ratios. Cost data are presented as mean (+/-sd). Incremental daily cost of mechanical ventilation was calculated using log-linear regression, adjusting for patient and hospital characteristics. Approximately 36% of identified patients were mechanically ventilated at some point during their intensive care unit stay. Mechanically ventilated patients were older (63.5 yrs vs. 61.7 yrs, p mechanically ventilated, and required mechanical ventilation for a mean duration of 5.6 days +/- 9.6. Mean intensive care unit cost and length of stay were 31,574 +/- 42,570 dollars and 14.4 days +/- 15.8 for patients requiring mechanical ventilation and 12,931 +/- 20,569 dollars and 8.5 days +/- 10.5 for those not requiring mechanical ventilation. Daily costs were greatest on intensive care unit day 1 (mechanical ventilation, 10,794 dollars; no mechanical ventilation, 6,667 dollars), decreased on day 2 (mechanical ventilation:, 4,796 dollars; no mechanical ventilation, 3,496 dollars), and became stable after day 3 (mechanical ventilation, 3,968 dollars; no mechanical ventilation, 3,184 dollars). Adjusting for patient and hospital characteristics, the mean incremental cost of mechanical ventilation in intensive care unit patients was 1,522 dollars per day (p Intensive care unit costs are highest during the first 2

  17. COST ESTIMATION MODELS FOR DRINKING WATER TREATMENT UNIT PROCESSES

    Science.gov (United States)

    Cost models for unit processes typically utilized in a conventional water treatment plant and in package treatment plant technology are compiled in this paper. The cost curves are represented as a function of specified design parameters and are categorized into four major catego...

  18. Cost of vaccinating refugees overseas versus after arrival in the United States, 2005.

    Science.gov (United States)

    2008-03-07

    Since 2000, approximately 50,000 refugees have entered the United States each year from various regions of the world. Although persons with immigrant status are legally required to be vaccinated before entering the United States, this requirement does not extend to U.S.-bound persons with refugee status. After 1 year in the United States, refugees can apply for a change of status to that of legal permanent resident, at which time they are required to be fully vaccinated in accordance with recommendations of the Advisory Committee on Immunization Practices (ACIP). A potentially less costly alternative might be to vaccinate U.S.-bound refugees overseas routinely, before they depart from refugee camps. To compare the cost of vaccinating refugees overseas versus after their arrival in the United States, CDC analyzed 2005 data on the number of refugees, cost of vaccine, and cost of vaccine administration. This report summarizes the results of that analysis, which suggested that, in 2005, vaccinating 50,787 refugees overseas would have cost an estimated $7.7 million, less than one third of the estimated $26.0 million cost of vaccinating in the United States. Costs were calculated from the perspective of the U.S. health-care system. To achieve public health cost savings, routine overseas vaccination of U.S.-bound refugees should be considered.

  19. Health care costs attributable to overweight calculated in a standardized way for three European countries

    NARCIS (Netherlands)

    Lette, M.; Bemelmans, W.J.; Breda, J.; Slobbe, L.C.; Dias, J.; Boshuizen, H.C.

    2016-01-01

    This article presents a tool to calculate health care costs attributable to overweight in a comparable and standardized way. The purpose is to describe the methodological principles of the tool and to put it into use by calculating and comparing the costs attributable to overweight for The

  20. Cryptococcal Meningitis Treatment Strategies Affected by the Explosive Cost of Flucytosine in the United States: A Cost-effectiveness Analysis.

    Science.gov (United States)

    Merry, Matthew; Boulware, David R

    2016-06-15

    In the United States, cryptococcal meningitis causes approximately 3400 hospitalizations and approximately 330 deaths annually. The US guidelines recommend treatment with amphotericin B plus flucytosine for at least 2 weeks, followed by fluconazole for a minimum of 8 weeks. Due to generic drug manufacturer monopolization, flucytosine currently costs approximately $2000 per day in the United States, with a 2-week flucytosine treatment course costing approximately $28 000. The daily flucytosine treatment cost in the United Kingdom is approximately $22. Cost-effectiveness analysis was performed to determine the value of flucytosine relative to alternative regimens. We estimated the incremental cost-effectiveness ratio (ICER) of 3 cryptococcal induction regimens: (1) amphotericin B deoxycholate for 4 weeks; (2) amphotericin and flucytosine (100 mg/kg/day) for 2 weeks; and (3) amphotericin and fluconazole (800 mg/day) for 2 weeks. Costs of care were calculated using 2015 US prices and the medication costs. Survival estimates were derived from a randomized trial and scaled relative to published US survival data. Cost estimates were $83 227 for amphotericin monotherapy, $75 121 for amphotericin plus flucytosine, and $44 605 for amphotericin plus fluconazole. The ICER of amphotericin plus flucytosine was $23 842 per quality-adjusted life-year. Flucytosine is currently cost-effective in the United States despite a dramatic increase in price in recent years. Combination therapy with amphotericin and flucytosine is the most attractive treatment strategy for cryptococcal meningitis, though the rising price may be creating access issues that will exacerbate if the trend of profiteering continues. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  1. Unit Cost Analysis of PET-CT at an Apex Public Sector Health Care Institute in India.

    Science.gov (United States)

    Gajuryal, S H; Daga, A; Siddharth, V; Bal, C S; Satpathy, S

    2017-01-01

    PET/CT scan service is one of the capital intensive and revenue-generating centres of a tertiary care hospital. The cost associated with the provisioning of PET services is dependent upon the unit costs of the resources consumed. The study aims to determine the cost of providing PET/CT Scan services in a hospital. This descriptive and observational study was conducted in the Department of Nuclear Medicine at a tertiary apex teaching hospital in New Delhi, India in the year 2014-15. Traditional costing methodology was used for calculating the unit cost of PET/CT scan service. The cost was calculated under two heads that is capital and operating cost. Annualized cost of capital assets was calculated using methodology prescribed by WHO and operating costs was taken on an actual basis. Average number of PET/CT scan performed in a day is 30. The annual cost of providing PET/CT scan services was calculated to be 65,311,719 Indian Rupees (INR) (US$ 1,020,496), while the unit cost of PET scan was calculated to be 9625.92 INR (US$ 150). 3/4th cost was spent on machinery and equipment (75.3%) followed by healthcare personnel (11.37%), electricity (5%), consumables and supplies (4%) engineering maintenance (3.24%), building, furniture and HVAC capital cost (0.76%), and manifold cost (0.05%). Of the total cost, 76% was capital cost while the remaining was operating cost. Total cost for establishing PET/CT scan facility with cyclotron and chemistry module and PET/CT scan without cyclotron and chemistry module was calculated to be INR 610,873,517 (US$9944899) and 226,745,158 (US$3542893), respectively. (US$ 1=INR 64).

  2. [Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

    Science.gov (United States)

    Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

    2008-05-01

    The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

  3. Calculating Optimum sowing factor: A tool to evaluate sowing strategies and minimize seedling production cost

    Science.gov (United States)

    Eric van Steenis

    2013-01-01

    This paper illustrates how to use an excel spreadsheet as a decision-making tool to determine optimum sowing factor to minimize seedling production cost. Factors incorporated into the spreadsheet calculations include germination percentage, seeder accuracy, cost per seed, cavities per block, costs of handling, thinning, and transplanting labor, and more. In addition to...

  4. Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany

    Science.gov (United States)

    2012-01-01

    The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level. First, the paper reviews and assesses the three steps in the G-DRG resource allocation scheme at hospital level: (1) the groundwork; (2) cost-center accounting; and (3) patient-level costing. Second, the paper reviews and assesses the three steps in G-DRG national tariff calculation: (1) plausibility checks; (2) inlier calculation; and (3) the “one hospital” approach. The assessment is based on the two main goals of G-DRG introduction: improving transparency and efficiency. A further empirical assessment attests high costing quality. The G-DRG cost accounting scheme shows high system quality in resource allocation at hospital level, with limitations concerning a managerially relevant full cost approach and limitations in terms of advanced activity-based costing at patient-level. However, the scheme has serious flaws in national tariff calculation: inlier calculation is normative, and the “one hospital” model causes cost bias, adjustment and representativeness issues. The G-DRG system was designed for reimbursement calculation, but developed to a standard with strategic management implications, generalized by the idea of adapting a hospital’s cost structures to DRG revenues. This combination causes problems in actual hospital financing, although resource allocation is advanced at hospital level. PMID:22935314

  5. Opportunity costs of ambulatory medical care in the United States.

    Science.gov (United States)

    Ray, Kristin N; Chari, Amalavoyal V; Engberg, John; Bertolet, Marnie; Mehrotra, Ateev

    2015-08-01

    The typical focus in discussions of healthcare spending is on direct medical costs such as physician reimbursement. The indirect costs of healthcare-patient opportunity costs associated with seeking care, for example-have not been adequately quantified. We aimed to quantify the opportunity costs for adults seeking medical care for themselves or others. Secondary analysis of the 2003-2010 American Time Use Survey (ATUS). We used the nationally representative 2003-2010 ATUS to estimate opportunity costs associated with ambulatory medical visits. We estimated opportunity costs for employed adults using self-reported hourly wages and for unemployed adults using a Heckman selection model. We used the Medical Expenditure Panel Survey to compare opportunity costs with direct costs (ie, patient out-of-pocket, provider reimbursement) in 2010. Average total time per visit was 121 minutes (95% CI, 118-124), with 37 minutes (95% CI, 36-39) of travel time and 84 minutes (95% CI, 81-86) of clinic time. The average opportunity cost per visit was $43, which exceeds the average patient's out-of-pocket payment. Total opportunity costs per year for all physician visits in the United States were $52 billion in 2010. For every dollar spent in visit reimbursement, an additional 15 cents were spent in opportunity costs. In the United States, opportunity costs associated with ambulatory medical care are substantial. Accounting for patient opportunity costs is important for examining US healthcare system efficiency and for evaluating methods to improve the efficient delivery of patient-centered care.

  6. Applying activity-based costing to the nuclear medicine unit.

    Science.gov (United States)

    Suthummanon, Sakesun; Omachonu, Vincent K; Akcin, Mehmet

    2005-08-01

    Previous studies have shown the feasibility of using activity-based costing (ABC) in hospital environments. However, many of these studies discuss the general applications of ABC in health-care organizations. This research explores the potential application of ABC to the nuclear medicine unit (NMU) at a teaching hospital. The finding indicates that the current cost averages 236.11 US dollars for all procedures, which is quite different from the costs computed by using ABC. The difference is most significant with positron emission tomography scan, 463 US dollars (an increase of 96%), as well as bone scan and thyroid scan, 114 US dollars (a decrease of 52%). The result of ABC analysis demonstrates that the operational time (machine time and direct labour time) and the cost of drugs have the most influence on cost per procedure. Clearly, to reduce the cost per procedure for the NMU, the reduction in operational time and cost of drugs should be analysed. The result also indicates that ABC can be used to improve resource allocation and management. It can be an important aid in making management decisions, particularly for improving pricing practices by making costing more accurate. It also facilitates the identification of underutilized resources and related costs, leading to cost reduction. The ABC system will also help hospitals control costs, improve the quality and efficiency of the care they provide, and manage their resources better.

  7. Cost Effectiveness of Contraceptives in the United States

    Science.gov (United States)

    Trussell, James; Lalla, Anjana M.; Doan, Quan V.; Reyes, Eileen; Pinto, Lionel; Gricar, Joseph

    2013-01-01

    Background The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer’s perspective. Methods A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates, and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates. Results Any contraceptive method is superior to “no method”. The three least expensive methods were the copper-T IUD ($647), vasectomy ($713) and LNG-20 IUS ($930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy, and plan disenrollment rates. Conclusion The copper-T IUD, vasectomy, and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy, and time horizon are influential factors that determine the overall value of a contraceptive method. PMID:19041435

  8. Life cycle costing of waste management systems: Overview, calculation principles and case studies

    DEFF Research Database (Denmark)

    Martinez Sanchez, Veronica; Kromann, Mikkel A.; Astrup, Thomas Fruergaard

    2015-01-01

    This paper provides a detailed and comprehensive cost model for the economic assessment of solid waste management systems. The model was based on the principles of Life Cycle Costing (LCC) and followed a bottom-up calculation approach providing detailed cost items for all key technologies within...... a specific technology, while scenario costs were the sum of all technologies involved in a scenario. The cost model allows for the completion of three types of LCC: a Conventional LCC, for the assessment of financial costs, an Environmental LCC, for the assessment of financial costs whose results...... modern waste systems. All technologies were defined per tonne of waste input, and each cost item within a technology was characterised by both a technical and an economic parameter (for example amount and cost of fuel related to waste collection), to ensure transparency, applicability and reproducibility...

  9. Implications of cost optimum calculations on energy performance requirements in Member States

    DEFF Research Database (Denmark)

    Thomsen, Kirsten Engelund; Wittchen, Kim Bjarne

    2015-01-01

    This report summarises the work done within the Concerted Action Energy Performance of Buildings Directive (CA EPBD) from January 2011 to May 2014 in order to meet the European Commission's requirement for calculating cost-optimal levels of buildings’ energy performance for new and existing...... buildings. The requirement for performing the calculations is stated in the Directive on the Energy Performance of Buildings (recast) 2010/31/EU1. The calculation procedure is outlined in the comparative methodology framework2 for calculating cost-optimal levels of minimum energy performance requirements...

  10. THE PARTICULARITIES OF THE COST CALCULATION METHOD ON COMMANDS IN FURNITURE INDUSTRY

    Directory of Open Access Journals (Sweden)

    Felicia Sabou

    2014-10-01

    Full Text Available The paper present the importance of the method on commands in cost calculation and the particularities of the cost calculation method on commands in the furniture industry. This paper presents a hypotetical study on the method on commands, considering the observations made during 2013-2014, on how it is organized and managed accounts management using method on commands.By presenting this hypothetical model about the accounting in management accounting using the method on commands, the paper contributes to the correct application of this method in practice, specifically in management accounting in companies from the furniture industry. In my opinion the method on commands is an appropriate method for achieving management accounting for companies that have as main activity the production of furniture. When applying the method on commands in cost calculation and in management accounting, the companies must to consider the particularities of the cost calculation, in the furniture industry, like: technical and economic factors from this sector, the technical details of each command, the codification of the commands, planning materials and labor costs for each command, monitoring and recording production costs, registration of the direct costs, distribution of the indirect costs on commands, registration of the indirect costs and registration in management accounting.

  11. COSTS AND PROFITABILITY IN FOOD PROCESSING: PASTRY TYPE UNITS

    Directory of Open Access Journals (Sweden)

    DUMITRANA MIHAELA

    2013-08-01

    Full Text Available For each company, profitability, products quality and customer satisfaction are the most importanttargets. To attaint these targets, managers need to know all about costs that are used in decision making. Whatkind of costs? How these costs are calculated for a specific sector such as food processing? These are only a fewquestions with answers in our paper. We consider that a case study for this sector may be relevant for all peoplethat are interested to increase the profitability of this specific activity sector.

  12. Assessing DRG cost accounting with respect to resource allocation and tariff calculation: the case of Germany

    National Research Council Canada - National Science Library

    Vogl, Matthias

    2012-01-01

    The purpose of this paper is to analyze the German diagnosis related groups (G-DRG) cost accounting scheme by assessing its resource allocation at hospital level and its tariff calculation at national level...

  13. Renewable Energy Cost Modeling. A Toolkit for Establishing Cost-Based Incentives in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, Jason S. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Grace, Robert C. [Sustainable Energy Advantage, LLC, Framington, MA (United States); Rickerson, Wilson H. [Meister Consultants Group, Inc., Boston, MA (United States)

    2011-05-01

    This report serves as a resource for policymakers who wish to learn more about levelized cost of energy (LCOE) calculations, including cost-based incentives. The report identifies key renewable energy cost modeling options, highlights the policy implications of choosing one approach over the other, and presents recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, FITs, or similar policies. These recommendations shaped the design of NREL's Cost of Renewable Energy Spreadsheet Tool (CREST), which is used by state policymakers, regulators, utilities, developers, and other stakeholders to assist with analyses of policy and renewable energy incentive payment structures. Authored by Jason S. Gifford and Robert C. Grace of Sustainable Energy Advantage LLC and Wilson H. Rickerson of Meister Consultants Group, Inc.

  14. What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

    Directory of Open Access Journals (Sweden)

    P. Daniel Patterson

    2013-01-01

    Full Text Available Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant. We received complete survey data from 65 fire chiefs (65% response rate. We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1 investment costs, (2 orientation and training costs, (3 medical and pharmaceutical costs, (4 education and continuing education costs, and (5 maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters.

  15. Cost Implications of Hardware Manpower Balance. Phase II - Unit Sustainment Manpower cost Methodology.

    Science.gov (United States)

    1981-06-01

    developing the BCE, _-11hou(3, 6,chei n- lytical groups may actually develop the cr±ai. .r of the Comptroller of the Army COCA ), Cost An,,.ysc~ .crcoa...costs in Section IV since they are applicable only to a limited number of positions or are geographic-dependent (e.g., COLA ). Once all of the above...costs (CE, CSR B ) on the tables. The tables display the data used to produce a total annual unit manpower cost (TCo) for each occupation listed. The

  16. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States.

    Science.gov (United States)

    Smith, Andrew F; Waycaster, Curtis

    2009-11-25

    The aim of this study was to estimate both the direct and indirect annual costs of treating bacterial conjunctivitis (BC) in the United States. This was a cost of illness study performed from a U.S. healthcare payer perspective. A comprehensive review of the medical literature was supplemented by data on the annual incidence of BC which was obtained from an analysis of the National Ambulatory Medical Care Survey (NAMCS) database for the year 2005. Cost estimates for medical visits and laboratory or diagnostic tests were derived from published Medicare CPT fee codes. The cost of prescription drugs was obtained from standard reference sources. Indirect costs were calculated as those due to lost productivity. Due to the acute nature of BC, no cost discounting was performed. All costs are expressed in 2007 U.S. dollars. The number of BC cases in the U.S. for 2005 was estimated at approximately 4 million yielding an estimated annual incidence rate of 135 per 10,000. Base-case analysis estimated the total direct and indirect cost of treating patients with BC in the United States at $ 589 million. One- way sensitivity analysis, assuming either a 20% variation in the annual incidence of BC or treatment costs, generated a cost range of $ 469 million to $ 705 million. Two-way sensitivity analysis, assuming a 20% variation in both the annual incidence of BC and treatment costs occurring simultaneously, resulted in an estimated cost range of $ 377 million to $ 857 million. The economic burden posed by BC is significant. The findings may prove useful to decision makers regarding the allocation of healthcare resources necessary to address the economic burden of BC in the United States.

  17. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States

    Directory of Open Access Journals (Sweden)

    Smith Andrew F

    2009-11-01

    Full Text Available Abstract Background The aim of this study was to estimate both the direct and indirect annual costs of treating bacterial conjunctivitis (BC in the United States. This was a cost of illness study performed from a U.S. healthcare payer perspective. Methods A comprehensive review of the medical literature was supplemented by data on the annual incidence of BC which was obtained from an analysis of the National Ambulatory Medical Care Survey (NAMCS database for the year 2005. Cost estimates for medical visits and laboratory or diagnostic tests were derived from published Medicare CPT fee codes. The cost of prescription drugs was obtained from standard reference sources. Indirect costs were calculated as those due to lost productivity. Due to the acute nature of BC, no cost discounting was performed. All costs are expressed in 2007 U.S. dollars. Results The number of BC cases in the U.S. for 2005 was estimated at approximately 4 million yielding an estimated annual incidence rate of 135 per 10,000. Base-case analysis estimated the total direct and indirect cost of treating patients with BC in the United States at $ 589 million. One- way sensitivity analysis, assuming either a 20% variation in the annual incidence of BC or treatment costs, generated a cost range of $ 469 million to $ 705 million. Two-way sensitivity analysis, assuming a 20% variation in both the annual incidence of BC and treatment costs occurring simultaneously, resulted in an estimated cost range of $ 377 million to $ 857 million. Conclusion The economic burden posed by BC is significant. The findings may prove useful to decision makers regarding the allocation of healthcare resources necessary to address the economic burden of BC in the United States.

  18. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States

    Science.gov (United States)

    2009-01-01

    Background The aim of this study was to estimate both the direct and indirect annual costs of treating bacterial conjunctivitis (BC) in the United States. This was a cost of illness study performed from a U.S. healthcare payer perspective. Methods A comprehensive review of the medical literature was supplemented by data on the annual incidence of BC which was obtained from an analysis of the National Ambulatory Medical Care Survey (NAMCS) database for the year 2005. Cost estimates for medical visits and laboratory or diagnostic tests were derived from published Medicare CPT fee codes. The cost of prescription drugs was obtained from standard reference sources. Indirect costs were calculated as those due to lost productivity. Due to the acute nature of BC, no cost discounting was performed. All costs are expressed in 2007 U.S. dollars. Results The number of BC cases in the U.S. for 2005 was estimated at approximately 4 million yielding an estimated annual incidence rate of 135 per 10,000. Base-case analysis estimated the total direct and indirect cost of treating patients with BC in the United States at $ 589 million. One- way sensitivity analysis, assuming either a 20% variation in the annual incidence of BC or treatment costs, generated a cost range of $ 469 million to $ 705 million. Two-way sensitivity analysis, assuming a 20% variation in both the annual incidence of BC and treatment costs occurring simultaneously, resulted in an estimated cost range of $ 377 million to $ 857 million. Conclusion The economic burden posed by BC is significant. The findings may prove useful to decision makers regarding the allocation of healthcare resources necessary to address the economic burden of BC in the United States. PMID:19939250

  19. [Activity-based costing methodology to manage resources in intensive care units].

    Science.gov (United States)

    Alvear V, Sandra; Canteros G, Jorge; Jara M, Juan; Rodríguez C, Patricia

    2013-11-01

    An accurate estimation of resources use by individual patients is crucial in hospital management. To measure financial costs of health care actions in intensive care units of two public regional hospitals in Chile. Prospective follow up of 716 patients admitted to two intensive care units during 2011. The financial costs of health care activities was calculated using the Activity-Based Costing methodology. The main activities recorded were procedures and treatments, monitoring, response to patient needs, patient maintenance and coordination. Activity-Based Costs, including human resources and assorted indirect costs correspond to 81 to 88% of costs per disease in one hospital and 69 to 80% in the other. The costs associated to procedures and treatments are the most significant and are approximately $100,000 (Chilean pesos) per day of hospitalization. The second most significant cost corresponds to coordination activities, which fluctuates between $86,000 and 122,000 (Chilean pesos). There are significant differences in resources use between the two hospitals studied. Therefore cost estimation methodologies should be incorporated in the management of these clinical services.

  20. Cost effectiveness of chest pain unit care in the NHS

    Directory of Open Access Journals (Sweden)

    Wailoo Allan

    2008-08-01

    Full Text Available Abstract Background Acute chest pain is responsible for approximately 700,000 patient attendances per year at emergency departments in England and Wales. A single centre study of selected patients suggested that chest pain unit (CPU care could be less costly and more effective than routine care for these patients, although a more recent multi-centre study cast doubt on the generalisability of these findings. Methods Our economic evaluation involved modelling data from the ESCAPE multi-centre trial along with data from other sources to estimate the comparative costs and effects of CPU versus routine care. Cost effectiveness ratios (cost per QALY were generated from our model. Results We found that CPU compared to routine care resulted in a non-significant increase in effectiveness of 0.0075 QALYs per patient and a non-significant cost decrease of £32 per patient and thus a negative incremental cost effectiveness ratio. If we are willing to pay £20,000 for an additional QALY then there is a 70% probability that CPU care will be considered cost-effective. Conclusion Our analysis shows that CPU care is likely to be slightly more effective and less expensive than routine care, however, these estimates are surrounded by a substantial amount of uncertainty. We cannot reliably conclude that establishing CPU care will represent a cost-effective use of health service resources given the substantial amount of investment it would require.

  1. A process mapping model for calculating indirect costs of workplace accidents.

    Science.gov (United States)

    Jallon, Romain; Imbeau, Daniel; de Marcellis-Warin, Nathalie

    2011-10-01

    This article follows an earlier one in which four criteria and four bases for the development of an indirect-cost calculation model adapted to the accuracy requirements and time constraints of workplace decision-makers were established. A two-level model for calculating indirect costs using process mapping of the organizational response to a workplace accident is presented. The model is based on data collected in interviews with those employees in charge of occupational health and safety in 10 companies of various sizes in different industry sectors. This model is the first to use process mapping to establish the indirect costs of workplace accidents. The approach allows easy identification of the duration and frequency of actions taken by stakeholders when a workplace accident occurs, facilitates the collection of the information needed to calculate indirect costs and yields a usable, precise result. A simple graphic representation of an organization's accident processes helps the user understand each accident's cost components, allowing the identification and reduction of inefficiencies in the overall process. By facilitating data collection and shortening the time needed to assess indirect costs of workplace accidents, this indirect cost calculation tool is better suited for workplace use than those currently available. Copyright © 2011 National Safety Council and Elsevier Ltd. All rights reserved.

  2. Using Standard-Sole Cost Method for Performance Gestion Accounting and Calculation Cost in the Machine Building Industry

    Directory of Open Access Journals (Sweden)

    Cleopatra Sendroiu

    2006-07-01

    Full Text Available The main purpose of improving and varying cost calculation methods in the machine building industry is to make them more operational and efficient in supplying the information necessary to the management in taking its decisions. The present cost calculation methods used in the machine building plants - global method and the method per orders - by which a historical cost is determined a posteriori used in deducting and post factum justification of manufacturing expenses does not offer the management the possibility to fully satisfy its need for information. We are talking about a change of conception in applying certain systems, methods and work techniques, according to the needs of efficient administration of production and the plant seen as a whole. The standard-cost method best answers to the needs of the effective management of the value side of the manufacturing process and raising economic efficiency. We consider that, in the machine building industry, these objectives can be achieved by using the standard - sole cost alternative of the standard-cost method.

  3. Using Standard-Sole Cost Method for Performance Gestion Accounting and Calculation Cost in the Machine Building Industry

    Directory of Open Access Journals (Sweden)

    Aureliana Geta Roman

    2006-09-01

    Full Text Available The main purpose of improving and varying cost calculation methods in the machine building industry is to make them more operational and efficient in supplying the information necessary to the management in taking its decisions. The present cost calculation methods used in the machine building plants – global method and the method per orders – by which a historical cost is determined a posteriori used in deducting and post factum justification of manufacturing expenses does not offer the management the possibility to fully satisfy its need for information. We are talking about a change of conception in applying certain systems, methods and work techniques, according to the needs of efficient administration of production and the plant seen as a whole. The standard-cost method best answers to the needs of the effective management of the value side of the manufacturing process and raising economic efficiency. We consider that, in the machine building industry, these objectives can be achieved by using the standard - sole cost alternative of the standard-cost method.

  4. Purchasing motors in the light of full-cost calculation; Beschaffung von Motoren unter der Vollkostenbetrachtung

    Energy Technology Data Exchange (ETDEWEB)

    Mauchle, P.; Schnyder, G.

    2006-07-01

    This final report published by the Swiss Federal Office of Energy (SFOE) presents the results of a study made on how full-cost calculation can help define the optimal purchasing strategy for electrical drives. According to the authors, taking total life-cycle costs into consideration also guarantees economical operation and helps avoid unexpected service costs. The report describes the goals of the project and co-operation with industry and users. Factors influencing life-cycle costs are looked at in detail, including investments, installation and operator-training, operation and monitoring as well as maintenance and repair. Also, energy costs are looked at, as are environmental aspects and the disposal of drives taken out of service. The calculation of the economic feasibility of two types of motor is looked at. Sample Calls for Tender are presented and software for the evaluation of offers is briefly discussed.

  5. Calculation of Complexity Costs – An Approach for Rationalizing a Product Program

    DEFF Research Database (Denmark)

    Hansen, Christian Lindschou; Mortensen, Niels Henrik; Hvam, Lars

    2012-01-01

    of suggested Life Cycle Complexity Factors (LCCFs). The suggested method has been tested in an action based research study with promising results. The case study shows how the allocation of complexity costs on individual product variants provides previously unknown insights into the true cost structure......This paper proposes an operational method for rationalizing a product program based on the calculation of complexity costs. The method takes its starting point in the calculation of complexity costs on a product program level. This is done throughout the value chain ranging from component...... inventories at the factory sites, all the way to the distribution of finished goods from distribution centers to the customers. The method proposes a step-wise approach including the analysis, quantification and allocation of product program complexity costs by the means of identifying of a number...

  6. Cost of illness of hyponatremia in the United States

    Directory of Open Access Journals (Sweden)

    Paramore Clark

    2006-05-01

    Full Text Available Abstract Background Hyponatremia is a disorder of fluid and electrolyte balance characterized by a relative excess of body water relative to body sodium content. It is the most common electrolyte disorder encountered in clinical medicine and is associated with negative outcomes in many chronic diseases. However, there is limited information in the literature about health care resource use and costs attributable to the effects of the condition. The purpose of this analysis was to estimate the annual cost of illness of hyponatremia in the United States. Methods The study utilized a prevalence-based cost of illness framework that incorporated data from publicly available databases, published literature and a consensus panel of expert physicians. Panel members provided information on: classification of hyponatremia patients, treatment settings for hyponatremia (i.e., hospital, emergency room, doctor's office, and health care resource use associated with the diagnosis and treatment of hyponatremia. Low and high prevalence scenarios were estimated and utilized in a spreadsheet-based cost of illness model. Costs were assigned to units of resources and summarized across treatment settings. Results The prevalence estimate for hyponatremia ranged from 3.2 million to 6.1 million persons in the U.S. on an annual basis. Approximately 1% of patients were classified as having acute and symptomatic hyponatremia, 4% acute and asymptomatic, 15%–20% chronic and symptomatic, and 75–80% chronic and asymptomatic. Of patients treated for hyponatremia, 55%–63% are initially treated as inpatients, 25% are initially treated in the emergency room, and 13%–20% are treated solely in the office setting. The direct costs of treating hyponatremia in the U.S. on an annual basis were estimated to range between $1.6 billion and $3.6 billion. Conclusion Treatment of hyponatremia represents a significant healthcare burden in the U.S. Newer therapies that may reduce the

  7. Life cycle costing of waste management systems: overview, calculation principles and case studies.

    Science.gov (United States)

    Martinez-Sanchez, Veronica; Kromann, Mikkel A; Astrup, Thomas Fruergaard

    2015-02-01

    This paper provides a detailed and comprehensive cost model for the economic assessment of solid waste management systems. The model was based on the principles of Life Cycle Costing (LCC) and followed a bottom-up calculation approach providing detailed cost items for all key technologies within modern waste systems. All technologies were defined per tonne of waste input, and each cost item within a technology was characterised by both a technical and an economic parameter (for example amount and cost of fuel related to waste collection), to ensure transparency, applicability and reproducibility. Cost items were classified as: (1) budget costs, (2) transfers (for example taxes, subsidies and fees) and (3) externality costs (for example damage or abatement costs related to emissions and disamenities). Technology costs were obtained as the sum of all cost items (of the same type) within a specific technology, while scenario costs were the sum of all technologies involved in a scenario. The cost model allows for the completion of three types of LCC: a Conventional LCC, for the assessment of financial costs, an Environmental LCC, for the assessment of financial costs whose results are complemented by a Life Cycle Assessment (LCA) for the same system, and a Societal LCC, for socio-economic assessments. Conventional and Environmental LCCs includes budget costs and transfers, while Societal LCCs includes budget and externality costs. Critical aspects were found in the existing literature regarding the cost assessment of waste management, namely system boundary equivalency, accounting for temporally distributed emissions and impacts, inclusions of transfers, the internalisation of environmental impacts and the coverage of shadow prices, and there was also significant confusion regarding terminology. The presented cost model was implemented in two case study scenarios assessing the costs involved in the source segregation of organic waste from 100,000 Danish households and

  8. A time study of physicians' work in a German university eye hospital to estimate unit costs.

    Directory of Open Access Journals (Sweden)

    Jan Wolff

    Full Text Available Technical efficiency of hospital services is debated since performance has been heterogeneous. Staff time represents the main resource in patient care and its inappropriate allocation has been identified as a key factor of inefficiency. The aim of this study was to analyse the utilisation of physicians' work time stratified by staff groups, tasks and places of work. A further aim was to use these data to estimate resource use per unit of output.A self-reporting work-sampling study was carried during 14-days at a University Eye Hospital. Staff costs of physicians per unit of output were calculated at the wards, the operating rooms and the outpatient unit.Forty per cent of total work time was spent in contact with the patient. Thirty per cent was spent with documentation tasks. Time spent with documentation tasks declined monotonically with increasing seniority of staff. Unit costs were 56 € per patient day at the wards, 77 € and 20 € per intervention at the operating rooms for inpatients and outpatients, respectively, and 33 € per contact at the outpatient unit. Substantial differences in resources directly dedicated to the patient were found between these locations.The presented data provide unprecedented units costs in inpatient Ophthalmology. Future research should focus on analysing factors that influence differences in time allocation, such as types of patients, organisation of care processes and composition of staff.

  9. Methodology to Calculate the Costs of a Floating Offshore Renewable Energy Farm

    Directory of Open Access Journals (Sweden)

    Laura Castro-Santos

    2016-04-01

    Full Text Available This paper establishes a general methodology to calculate the life-cycle cost of floating offshore renewable energy devices, applying it to wave energy and wind energy devices. It is accounts for the contributions of the six main phases of their life-cycle: concept definition, design and development, manufacturing, installation, exploitation and dismantling, the costs of which have been defined. Moreover, the energy produced is also taken into account to calculate the Levelized Cost of Energy of a floating offshore renewable energy farm. The methodology proposed has been applied to two renewable energy devices: a floating offshore wave energy device and a floating offshore wind energy device. Two locations have been considered: Aguçadoura and São Pedro de Moel, both in Portugal. Results indicate that the most important cost in terms of the life-cycle of a floating offshore renewable energy farm is the exploitation cost, followed by the manufacturing and the installation cost. In addition, the best area in terms of costs is the same independently of the type of floating offshore renewable energy considered: Aguçadoura. However, the results in terms of Levelized Cost of Energy are different: Aguçadoura is better when considering wave energy technology and the São Pedro de Moel region is the best option when considering floating wind energy technology. The method proposed aims to give a direct approach to calculate the main life-cycle cost of a floating offshore renewable energy farm. It helps to assess its feasibility and evaluating the relevant characteristics that influence it the most.

  10. Accelerating VASP electronic structure calculations using graphic processing units

    KAUST Repository

    Hacene, Mohamed

    2012-08-20

    We present a way to improve the performance of the electronic structure Vienna Ab initio Simulation Package (VASP) program. We show that high-performance computers equipped with graphics processing units (GPUs) as accelerators may reduce drastically the computation time when offloading these sections to the graphic chips. The procedure consists of (i) profiling the performance of the code to isolate the time-consuming parts, (ii) rewriting these so that the algorithms become better-suited for the chosen graphic accelerator, and (iii) optimizing memory traffic between the host computer and the GPU accelerator. We chose to accelerate VASP with NVIDIA GPU using CUDA. We compare the GPU and original versions of VASP by evaluating the Davidson and RMM-DIIS algorithms on chemical systems of up to 1100 atoms. In these tests, the total time is reduced by a factor between 3 and 8 when running on n (CPU core + GPU) compared to n CPU cores only, without any accuracy loss. © 2012 Wiley Periodicals, Inc.

  11. A simple approach to calculate active power of electrosurgical units

    Directory of Open Access Journals (Sweden)

    André Luiz Regis Monteiro

    Full Text Available Abstract Introduction: Despite of more than a hundred years of electrosurgery, only a few electrosurgical equipment manufacturers have developed methods to regulate the active power delivered to the patient, usually around an arbitrary setpoint. In fact, no manufacturer has a method to measure the active power actually delivered to the load. Measuring the delivered power and computing it fast enough so as to avoid injury to the organic tissue is challenging. If voltage and current signals can be sampled in time and discretized in the frequency domain, a simple and very fast multiplication process can be used to determine the active power. Methods This paper presents an approach for measuring active power at the output power stage of electrosurgical units with mathematical shortcuts based on a simple multiplication procedure of discretized variables – frequency domain vectors – obtained through Discrete Fourier Transform (DFT applied on time-sampled voltage and current vectors. Results Comparative results between simulations and a practical experiment are presented – all being in accordance with the requirements of the applicable industry standards. Conclusion An analysis is presented comparing the active power analytically obtained through well-known voltage and current signals against a computational methodology based on vector manipulation using DFT only for time-to-frequency domain transformation. The greatest advantage of this method is to determine the active power of noisy and phased out signals with neither complex DFT or ordinary transform methodologies nor sophisticated computing techniques such as convolution. All results presented errors substantially lower than the thresholds defined by the applicable standards.

  12. State-Level Lifetime Medical and Work-Loss Costs of Fatal Injuries - United States, 2014.

    Science.gov (United States)

    Luo, Feijun; Florence, Curtis

    2017-01-13

    Injury-associated deaths have substantial economic consequences in the United States. The total estimated lifetime medical and work-loss costs associated with fatal injuries in 2013 were $214 billion (1). In 2014, unintentional injury, suicide, and homicide (the fourth, tenth, and seventeenth leading causes of death, respectively) accounted for 194,635 deaths in the United States (2). In 2014, a total of 199,756 fatal injuries occurred in the United States, and the associated lifetime medical and work-loss costs were $227 billion (3). This report examines the state-level economic burdens of fatal injuries by extending a previous national-level study (1). Numbers and rates of fatal injuries, lifetime costs, and lifetime costs per capita were calculated for each of the 50 states and the District of Columbia (DC) and for four injury intent categories (all intents, unintentional, suicide, and homicide). During 2014, injury mortality rates and economic burdens varied widely among the states and DC. Among fatal injuries of all intents, the mortality rate and lifetime costs per capita ranged from 101.9 per 100,000 and $1,233, respectively (New Mexico) to 40.2 per 100,000 and $491 (New York). States can engage more effectively and efficiently in injury prevention if they are aware of the economic burden of injuries, identify areas for immediate improvement, and devote necessary resources to those areas.

  13. Managerial Accounting Principles and Cost Calculation Used by Economic Entities in the Coal Mining Industry

    OpenAIRE

    Boca (Rakos) Ileana – Sorina; Vatasoiu Cristian Ionel

    2011-01-01

    Considering the specialized work in managerial accounting, this paper aims to show which cost calculation principles are actually applied in the coal mining industry today. The methodology used in this scientific approach is of qualitative nature, using the following methods: direct observation and interview.

  14. NATIONAL STORMWATER CALCULATOR: LOW IMPACT DEVELOPMENT STORMWATER CONTROL COST ESTIMATION PROGRAMMING & FUTURE ENHANCEMENTS

    Science.gov (United States)

    National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation Programming & Future EnhancementsJason Berner1; Michael Tryby1; Scott Struck2, Dan Pankani2, Marion Deerhake3, Michelle Simon11. USEPA2. GeoSyntec, Inc.3. RTI, Inc.The National Stormwater Ca...

  15. Development of a risk-based mine closure cost calculation model

    CSIR Research Space (South Africa)

    Du Plessis, A

    2006-06-01

    Full Text Available . This research is important because currently there are a number of mines that do not have sufficient financial provision to close and rehabilitate the mines. The magnitude of the lack of funds could be reduced or eliminated if the closure cost calculation...

  16. An extensible, low-cost drifter control unit

    Science.gov (United States)

    Giudici, Andrea; Torsvik, Tomas; Soomere, Tarmo

    2017-04-01

    We introduce an extensible, low-cost drifter control unit, which is developed for use with surface drifters that are deployed in inland water bodies or near-coast regions. The control unit is custom-built on top of a small footprint micro controller. It makes use of a GPS receiver for position tracking, a GSM radio for data transmission, and two sensor buses to handle analog and digital data measured by an array of external sensors. A cloud-based data collection platform receives and stores the data transmitted over GPRS from the drifter. The control unit was found to perform satisfactorily in operational testing, providing data at sub-Hz frequency for position and temperature during extended time. Test deployments revealed some issues related to power consumption spikes. Even though the unit is fully functional in the present form and shows, on average, low energy consumption , battery packs with relatively large maximum output power are required to ensure its operation within prolonged periods of time. We expect that a further development of the power supply unit together with a careful de-synchronization scheme of sensors' operation would smooth those peaks without any loss of the quality of recorded information.

  17. Comparison of United States and Canadian Glaucoma Medication Costs and Price Change from 2006 to 2013

    Directory of Open Access Journals (Sweden)

    Matthew B. Schlenker

    2015-01-01

    Full Text Available Objective. Compare glaucoma medication costs between the United States (USA and Canada. Methods. We modelled glaucoma brand name and generic medication annual costs in the USA and Canada based on October 2013 Costco prices and previously reported bottle overfill rates, drops per mL, and wastage adjustment. We also calculated real wholesale price changes from 2006 to 2013 based on the Average Wholesale Price (USA and the Ontario Drug Benefit Price (Canada. Results. US brand name medication costs were on average 4x more than Canadian medication costs (range: 1.9x–6.9x, averaging a cost difference of $859 annually. US generic costs were on average the same as Canadian costs, though variation exists. US brand name wholesale prices increased from 2006 to 2013 more than Canadian prices (US range: 29%–349%; Canadian range: 9%–16%. US generic wholesale prices increased modestly (US range: −23%–58%, and Canadian wholesale prices decreased (Canadian range: −38%–0%. Conclusions. US brand name glaucoma medications are more expensive than Canadian medications, though generic costs are similar (with some variation. The real prices of brand name medications increased more in the USA than in Canada. Generic price changes were more modest, with real prices actually decreasing in Canada.

  18. About real cost calculations for biogas from vinasse biodigestion and its energy utilization

    Energy Technology Data Exchange (ETDEWEB)

    Salomon, K.R. [Universidade Federal de Alagoas (UFAL), Maceio, AL (Brazil)]. E-mail: kaka_salomon@yahoo.com.br; Lora , E.E.S.; Rocha, M.H. [Universidade Federal de Itajuba (UNIFEI), MG (Brazil). Thermal Systems Study Group]. E-mails: electo@unifei.edu.br; mateus.rocha@unifei.edu.br

    2008-07-01

    The sharp increase in ethanol production has drawn attention to the increase in the production of n residues, mainly stillage, a by-product from the ethanol agro-industry. As it is a highly polluting effluent that is generated in great volumes, its transport and disposal is not simple. Stillage Is a product that results from the distillation and fermentation of the sugarcane in the process of ethanol production. Today there are new environmental standards that restrict the disposal of the stillage in the soil. The anaerobic biodigestion comes as an alternative treatment for the stillage. One of the advantages of the biodigestion is that the stillage fertilization potential continues to be the same after the process and, this way, the effluent can be taken to the fields through fertirrigation. The main advantages are the conservation of the nutrients, mainly phosphor and nitrogen contents, and the increase in the pH for the application in the soil. This paper presents a methodology for the calculation of the biogas cost obtained from stillage biodigestion, considering the benefits of the fertirrigation with the effluent generated in the digester. Later an analysis of the economical feasibility of the use of the biogas obtained from the stillage anaerobic digestion in different scenarios is carried out, among them there are: electric power generation with alternative internal combustion, with gas turbines and micro-turbines, with the 'substituted' bagasse burned together with the biogas in the boilers, with the sales of the substituted bagasse (for electric power generation in another unit) and with the use of the biogas in spray dryers with the subsequent sales of dried yeasts. It is also considered an analysis under an environmental point of view of the use of the biogas that includes the possibility of selling the certificates of avoided emissions (carbon credits) due to the use of the biogas in substitution to fossil fuels. The most important results

  19. Analysis of Unit Process Cost for an Engineering-Scale Pyroprocess Facility Using a Process Costing Method in Korea

    National Research Council Canada - National Science Library

    Sungki Kim; Wonil Ko; Sungsig Bang

    2015-01-01

    ...) metal ingots in a high-temperature molten salt phase. This paper provides the unit process cost of a pyroprocess facility that can process up to 10 tons of pyroprocessing product per year by utilizing the process costing method...

  20. Conventional method for the calculation of the global energy cost of buildings; Methode conventionnelle de calcul du cout global energetique des batiments

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-05-01

    A working group driven by Electricite de France (EdF), Chauffage Fioul and Gaz de France (GdF) companies has been built with the sustain of several building engineering companies in order to clarify the use of the method of calculation of the global energy cost of buildings. This global cost is an economical decision help criterion among others. This press kit presents, first, the content of the method (input data, calculation of annual expenses, calculation of the global energy cost, display of results and limitations of the method). Then it fully describes the method and its appendixes necessary for its implementation: economical and financial context, general data of the project in progress, environmental data, occupation and comfort level, variants, investment cost of energy systems, investment cost for the structure linked with the energy system, investment cost for other invariant elements of the structure, calculation of consumptions (space heating, hot water, ventilation), maintenance costs (energy systems, structure), operation and exploitation costs, tariffs and consumption costs and taxes, actualized global cost, annualized global cost, comparison between variants. The method is applied to a council building of 23 flats taken as an example. (J.S.)

  1. The analysis of unit costs of preparing hot water for various sources of heat

    Directory of Open Access Journals (Sweden)

    Mazur Aleksandra

    2017-01-01

    Full Text Available The article presents an analysis of energy consumption and the cost of its production by the systems of supply of hot water depending on the applied heat sources and destination of a building. The calculations have taken into account the efficiency of the adopted installation solutions that have a direct impact on energy consumption. The following parameters have been determined: the size of the seasonal demand for hot water, an annual amount of fuel needed to its production and annual operating costs. The calculations have been performed for residential buildings and public buildings, whilst maintaining the same usable space. The aim of the article is to determine the rate of the amount of fuel, needed to heat to the desired temperature, a unit volume of water depending on the type of heat source and destination of a premises. For the adopted variants of installation, the ratio of production costs of unit volume of hot water has been also determined. The indicators of the fuel amount and the cost of hot water pointed out in the article may be one of the criteria for selection of an effective system for the preparation of hot water.

  2. [Process-oriented cost calculation in interventional radiology. A case study].

    Science.gov (United States)

    Mahnken, A H; Bruners, P; Günther, R W; Rasche, C

    2012-01-01

    Currently used costing methods such as cost centre accounting do not sufficiently reflect the process-based resource utilization in medicine. The goal of this study was to establish a process-oriented cost assessment of percutaneous radiofrequency (RF) ablation of liver and lung metastases. In each of 15 patients a detailed task analysis of the primary process of hepatic and pulmonary RF ablation was performed. Based on these data a dedicated cost calculation model was developed for each primary process. The costs of each process were computed and compared with the revenue for in-patients according to the German diagnosis-related groups (DRG) system 2010. The RF ablation of liver metastases in patients without relevant comorbidities and a low patient complexity level results in a loss of EUR 588.44, whereas the treatment of patients with a higher complexity level yields an acceptable profit. The treatment of pulmonary metastases is profitable even in cases of additional expenses due to complications. Process-oriented costing provides relevant information that is needed for understanding the economic impact of treatment decisions. It is well suited as a starting point for economically driven process optimization and reengineering. Under the terms of the German DRG 2010 system percutaneous RF ablation of lung metastases is economically reasonable, while RF ablation of liver metastases in cases of low patient complexity levels does not cover the costs.

  3. Procedure for the record, calculation and analysis of costs at the Post Company of Cuba.

    Directory of Open Access Journals (Sweden)

    María Luisa Lara Zayas

    2012-12-01

    Full Text Available The Cuban Company is immersed in important changes, which lead to a new economic model that requires to increase the productivity of work and to enlarge the economic efficiency by means of rational use of material resources, financial and humans. In the present work it is proposed a procedure based on the application of cost techniques, for the record, calculation and costs analysis of activities in the Post Company of Cuba in Sancti Spiritus with the objective to obtain a major efficiency from the rational use of resources.

  4. A calculation program for harvesting and transportation costs of energy wood; Energiapuun korjuun ja kuljetuksen kustannuslaskentaohjelmisto

    Energy Technology Data Exchange (ETDEWEB)

    Kuitto, P.J.

    1996-12-31

    VTT Energy is compiling a large and versatile calculation program for harvesting and transportation costs of energy wood. The work has been designed and will be carried out in cooperation with Metsaeteho and Finntech Ltd. The program has been realised in Windows surroundings using SQLWindows graphical database application development system, using the SQLBase relational database management system. The objective of the research is to intensify and create new possibilities for comparison of the utilization costs and the profitability of integrated energy wood production chains with each other inside the chains

  5. Cost calculations for decommissioning and dismantling of nuclear research facilities, Phase 1

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Inga [StudsvikNuclear AB (Sweden); Backe, S. [Institute for Energy Technology (Norway); Iversen, Klaus [Danish Decommissioning (Denmark); Lindskog, S [Swedish Nuclear Power Inspectorate (Sweden); Salmenhaara, S. [VTT Technical Research Centre of Finland (Finland); Sjoeblom, R. [Tekedo AB (Sweden)

    2006-11-15

    Today, it is recommended that planning of decommission should form an integral part of the activities over the life cycle of a nuclear facility. However, no actual international guideline on cost calculations exists at present. Intuitively, it might be tempting to regard costs for decommissioning of a nuclear facility as similar to those of any other plant. However, the presence of radionuclide contamination may imply that the cost is one or more orders of magnitude higher as compared to a corresponding inactive situation, the actual ratio being highly dependent on the level of contamination as well as design features and use of the facility in question. Moreover, the variations in such prerequisites are much larger than for nuclear power plants. This implies that cost calculations cannot be performed with any accuracy or credibility without a relatively detailed consideration of the radiological and other prerequisites. Application of inadequate methodologies especially at early stages has often lead to large underestimations. The goals of the project and the achievements described in the report are as follows: 1) Advice on good practice with regard to: 1a) Strategy and planning; 1b) Methodology selection; 1c) Radiological surveying; 1d) Uncertainty analysis; 2) Techniques for assessment of costs: 2a) Cost structuring; 2b) Cost estimation methodologies; 3) Compilation of data for plants, state of planning, organisations, etc.; 3a) General descriptions of relevant features of the nuclear research facilities; 3b) General plant specific data; 3c) Example of the decommissioning of the R1 research reactor in Sweden; 3d) Example of the decommissioning of the DR1 research reactor in Denmark. In addition, but not described in the present report, is the establishment of a Nordic network in the area including an internet based expert system. It should be noted that the project is planned to exist for at least three years and that the present report is an interim one

  6. Thermal analysis of Malaysian double storey housing - low/medium cost unit

    Science.gov (United States)

    Normah, M. G.; Lau, K. Y.; Yusoff, S. Mohd.

    2012-06-01

    Almost half of the total energy used today is consumed in buildings. In the tropical climate, air-conditioning a housing unit takes much of the energy bill. Malaysia is no exception. Malaysian double storey terrace housing is popular among developers and buyers. Surveys have shown that housing occupants are much dissatisfied with the thermal comfort and artificial cooling is often sought. The objective of this study is to assess the thermal comfort of the low and medium-cost double storey housing in the area surrounding Universiti Teknologi Malaysia. A simulation program using the Weighting Factor Method calculates the heat transfer interaction, temperature distribution, and PMV level in three types of housing units in relation to the size. Fanger's PMV model based on ISO Standard 7730 is used here because it accounts for all parameters that affect the thermal sensation of a human within its equation. Results showed that both the low and medium-cost housing units studied are out of the comfortable range described by ASHRAE Standard 55 with the units all complied with the local bylaws. In view of the uncertainties in energy supply, future housing units should consider natural ventilation as part of the passive energy management.

  7. Methodology for Calculating Cost-per-Mile for Current and Future Vehicle Powertrain Technologies, with Projections to 2024: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, M.; Timbario, T. A.; Timbario, T. J.; Laffen, M.

    2011-01-01

    Currently, several cost-per-mile calculators exist that can provide estimates of acquisition and operating costs for consumers and fleets. However, these calculators are limited in their ability to determine the difference in cost per mile for consumer versus fleet ownership, to calculate the costs beyond one ownership period, to show the sensitivity of the cost per mile to the annual vehicle miles traveled (VMT), and to estimate future increases in operating and ownership costs. Oftentimes, these tools apply a constant percentage increase over the time period of vehicle operation, or in some cases, no increase in direct costs at all over time. A more accurate cost-per-mile calculator has been developed that allows the user to analyze these costs for both consumers and fleets. The calculator was developed to allow simultaneous comparisons of conventional light-duty internal combustion engine (ICE) vehicles, mild and full hybrid electric vehicles (HEVs), and fuel cell vehicles (FCVs). This paper is a summary of the development by the authors of a more accurate cost-per-mile calculator that allows the user to analyze vehicle acquisition and operating costs for both consumer and fleets. Cost-per-mile results are reported for consumer-operated vehicles travelling 15,000 miles per year and for fleets travelling 25,000 miles per year.

  8. Cost and usage patterns of antibiotics in a tertiary care neurosurgical unit

    Directory of Open Access Journals (Sweden)

    Manish Singh Sharma

    2012-01-01

    Full Text Available Objectives: The routine use of prophylactic antibiotics in neurosurgery has been shown to significantly reduce surgical site infection rates. The documentation of non-surgical site, nosocomial infections in neurosurgical patients remains limited, despite this being a stimulus for prolific antibiotic usage. The actual quantum of antibiotic use in neurosurgery and its role in infection control remain both undocumented and controversial. The authors address this issue with a cost-effectiveness study using historical controls. Materials and Methods: Bacteriologically positive body fluid samples were used to quantify infection rates in the year 2006 and compared with those in the year 1997. Itemized drug lists obtained from dedicated neurosurgical intensive care units and wards were used to quantify antibiotic usage and calculate their costs. Results were compared using both historical and internal controls. The monetary conversion factor used was INR 40=US$1. Results: A total of 3114 consecutive elective and emergency neurosurgical procedures were performed during the study period. 329 patients (10.6% were recorded to have bacteriologically positive body fluid samples, and 100,250 units of antibiotics were consumed costing Rs. 14,378,227.5 ($359,455.7. On an average, an operated patient received 32.2 units of antibiotics valued at Rs. 4,617 ($115.4. The crude infection rates were recorded to have reduced significantly in comparison to 1997, but did not differ between mirror intra-departmental units with significantly different antibiotic usage. Conclusions: Antibiotics accounted for 31% of the per capita cost of consumables for performing a craniotomy in the year 2006. This estimate should be factored into projecting future package costs.

  9. Burden of disease and costs of aneurysmal subarachnoid haemorrhage (aSAH in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Gray Alastair

    2010-04-01

    Full Text Available Abstract Background To estimate life years and quality-adjusted life years (QALYs lost and the economic burden of aneurysmal subarachnoid haemorrhage (aSAH in the United Kingdom including healthcare and non-healthcare costs from a societal perspective. Methods All UK residents in 2005 with aSAH (International Classification of Diseases 10th revision (ICD-10 code I60. Sex and age-specific abridged life tables were generated for a general population and aSAH cohorts. QALYs in each cohort were calculated adjusting the life tables with health-related quality of life (HRQL data. Healthcare costs included hospital expenditure, cerebrovascular rehabilitation, primary care and community health and social services. Non-healthcare costs included informal care and productivity losses arising from morbidity and premature death. Results A total of 80,356 life years and 74,807 quality-adjusted life years were estimated to be lost due to aSAH in the UK in 2005. aSAH costs the National Health Service (NHS £168.2 million annually with hospital inpatient admissions accounting for 59%, community health and social services for 18%, aSAH-related operations for 15% and cerebrovascular rehabilitation for 6% of the total NHS estimated costs. The average per patient cost for the NHS was estimated to be £23,294. The total economic burden (including informal care and using the human capital method to estimate production losses of a SAH in the United Kingdom was estimated to be £510 million annually. Conclusion The economic and disease burden of aSAH in the United Kingdom is reported in this study. Decision-makers can use these results to complement other information when informing prevention policies in this field and to relate health care expenditures to disease categories.

  10. Cost of reactive nitrogen release from human activities to the environment in the United States

    Science.gov (United States)

    Sobota, Daniel J.; Compton, Jana E.; McCrackin, Michelle L.; Singh, Shweta

    2015-02-01

    Leakage of reactive nitrogen (N) from human activities to the environment can cause human health and ecological problems. Often these harmful effects are not reflected in the costs of food, fuel, and fiber that derive from N use. Spatial analyses of damage costs attributable to source at management-relevant scales could inform decisions in areas where anthropogenic N leakage causes harm. We used recently compiled data describing N inputs in the conterminous United States (US) to assess potential damage costs associated with anthropogenic N. We estimated fates of N leaked to the environment (air/deposition, surface freshwater, groundwater, and coastal zones) in the early 2000s by multiplying watershed-level N inputs (8-digit US Geologic Survey Hydrologic Unit Codes; HUC8s) with published coefficients describing nutrient uptake efficiency, leaching losses, and gaseous emissions. We scaled these N leakage estimates with mitigation, remediation, direct damage, and substitution costs associated with human health, agriculture, ecosystems, and climate (per kg of N) to calculate annual damage cost (US dollars in 2008 or as reported) of anthropogenic N per HUC8. Estimates of N leakage by HUC8 ranged from pollution were important across HUC8s. However, significant data gaps remain in our ability to fully assess N damages, such as damage costs from harmful algal blooms and drinking water contamination. Nationally, potential health and environmental damages of anthropogenic N in the early 2000s totaled 210 billion yr-1 USD (range: 81-441 billion yr-1). While a number of gaps and uncertainties remain in these estimates, overall this work represents a starting point to inform decisions and engage stakeholders on the costs of N pollution.

  11. DIDEM - An integrated model for comparative health damage costs calculation of air pollution

    Science.gov (United States)

    Ravina, Marco; Panepinto, Deborah; Zanetti, Maria Chiara

    2018-01-01

    Air pollution represents a continuous hazard to human health. Administration, companies and population need efficient indicators of the possible effects given by a change in decision, strategy or habit. The monetary quantification of health effects of air pollution through the definition of external costs is increasingly recognized as a useful indicator to support decision and information at all levels. The development of modelling tools for the calculation of external costs can provide support to analysts in the development of consistent and comparable assessments. In this paper, the DIATI Dispersion and Externalities Model (DIDEM) is presented. The DIDEM model calculates the delta-external costs of air pollution comparing two alternative emission scenarios. This tool integrates CALPUFF's advanced dispersion modelling with the latest WHO recommendations on concentration-response functions. The model is based on the impact pathway method. It was designed to work with a fine spatial resolution and a local or national geographic scope. The modular structure allows users to input their own data sets. The DIDEM model was tested on a real case study, represented by a comparative analysis of the district heating system in Turin, Italy. Additional advantages and drawbacks of the tool are discussed in the paper. A comparison with other existing models worldwide is reported.

  12. The impact of unit cost reductions on gross profit: Increasing or decreasing returns?

    Directory of Open Access Journals (Sweden)

    Ely Dahan

    2011-09-01

    Full Text Available We suggest that marketers actively participate in reducing unit costs during new product development, consistent with the theme of integrated marketing and manufacturing. Most marketing managers misjudge the impact on gross profit of reducing variable unit manufacturing costs, mistakenly believing that such cost reductions yield decreasing or linear returns while they actually generate increasing returns.

  13. Numerical-analytical method of calculating insulated double-glazed units deflection under climatic (internal load

    Directory of Open Access Journals (Sweden)

    Plotnikov Aleksandr Aleksandrovich

    Full Text Available Glass unit consists of glasses hermetically-united together. The cavity of an insulating glass unit contains a fixed volume of air (gas. In the process of production regular air with atmospheric pressure and temperature is sealed inside a glass unit. During operation the atmospheric pressure is constantly changing, but the pressure inside remains constant (at a constant temperature. A change of temperature or of the external air pressure results in a pressure difference and therefore in a load on the glass panes. The action may exceed the usual load considerably. This pressure effects the glasses of the unit, deforms them, lowers the thermotechnical properties of glass units and can lead to their destruction. The action of the inside pressure can be seen all around as convex and concaved glasses, which destroys the architectural look of buildings. It is obvious that it is incorrect to calculate thin glass plates on such a load only by classical methods of strength of materials theory. In this case we need a special calculation method. The effects of a change in temperature, altitude or meteorological pressure are easily covered by the definition of an isochore pressure. This is necessary, to determine the change of pressure due to the temperature induced gas expansion in the cavity of the insulating glass according to the ideal gas law. After the integration of the analytical plate solution and the ideal gas law, the final pressure states can easily be calculated by coupling the change of volume and the change of pressure.

  14. THE ADVANTAGES OF TREATING INDIRECT COSTS BY THE ABC METHOD ALSO IN THE TOURISM UNITS

    OpenAIRE

    Bogdan Ravas

    2012-01-01

    In this context that the indirect costs represent a large portion of the total cost and the cost inductors relate only to production volume but not to other factors, the ABC method ables direct allocation of costs to products and services compared to traditional concepts of cost calculation. Feature of ABC is the idea of not allocate common costs, indirect operating the services through false and arbitrary quotas, but in accordance with the effective participation of services, as objects of c...

  15. CALCULATION OF POWER AND CHOICE OF BASIC FUNCTIONAL UNITS OF WIND POWER ELECTRIC-INSTALLATION

    OpenAIRE

    Kvitko A. V.; Goncharov A. Y.

    2014-01-01

    This article discusses the basic analytical expressions for the calculation of power generators and select features basic functional units of wind turbines, allowing the design phase to conduct a preliminary assessment of the effectiveness of wind power stations, which supplies specific consumers of electric power

  16. Accurate costs of blood transfusion: a microcosting of administering blood products in the United Kingdom National Health Service.

    Science.gov (United States)

    Stokes, Elizabeth A; Wordsworth, Sarah; Staves, Julie; Mundy, Nicola; Skelly, Jane; Radford, Kelly; Stanworth, Simon J

    2018-01-30

    In an environment of limited health care resources, it is crucial for health care systems which provide blood transfusion to have accurate and comprehensive information on the costs of transfusion, incorporating not only the costs of blood products, but also their administration. Unfortunately, in many countries accurate costs for administering blood are not available. Our study aimed to generate comprehensive estimates of the costs of administering transfusions for the UK National Health Service. A detailed microcosting study was used to cost two key inputs into transfusion: transfusion laboratory and nursing inputs. For each input, data collection forms were developed to capture staff time, equipment, and consumables associated with each step in the transfusion process. Costing results were combined with costs of blood product wastage to calculate the cost per unit transfused, separately for different blood products. Data were collected in 2014/15 British pounds and converted to US dollars. A total of 438 data collection forms were completed by 74 staff. The cost of administering blood was $71 (£49) per unit for red blood cells, $84 (£58) for platelets, $55 (£38) for fresh-frozen plasma, and $72 (£49) for cryoprecipitate. Blood administration costs add substantially to the costs of the blood products themselves. These are frequently incurred costs; applying estimates to the blood components supplied to UK hospitals in 2015, the annual cost of blood administration, excluding blood products, exceeds $175 (£120) million. These results provide more accurate estimates of the total costs of transfusion than those previously available. © 2018 AABB.

  17. 19 CFR 351.407 - Calculation of constructed value and cost of production.

    Science.gov (United States)

    2010-04-01

    ... input. (c) Allocation of costs. In determining the appropriate method for allocating costs among... lease expenses, material costs, and factory overhead. The Secretary will not consider sales expenses...

  18. ABC estimation of unit costs for emergency department services.

    Science.gov (United States)

    Holmes, R L; Schroeder, R E

    1996-04-01

    Rapid evolution of the health care industry forces managers to make cost-effective decisions. Typical hospital cost accounting systems do not provide emergency department managers with the information needed, but emergency department settings are so complex and dynamic as to make the more accurate activity-based costing (ABC) system prohibitively expensive. Through judicious use of the available traditional cost accounting information and simple computer spreadsheets. managers may approximate the decision-guiding information that would result from the much more costly and time-consuming implementation of ABC.

  19. Cost of pain medication to treat adult patients with nonmalignant chronic pain in the United States.

    Science.gov (United States)

    Rasu, Rafia S; Vouthy, Kiengkham; Crowl, Ashley N; Stegeman, Anne E; Fikru, Bithia; Bawa, Walter Agbor; Knell, Maureen E

    2014-09-01

    Nonmalignant chronic pain (NMCP) is a public health concern. Among primary care appointments, 22% focus on pain management. The American Academy of Pain Medicine guidelines for NMCP recommend combination medication therapy (including analgesics, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, antidepressants, and anticonvulsants) as a key component to effective treatment for many chronic pain diagnoses. However, there has been little evidence outlining the costs of pain medications in adult patients with NMCP in the United States, an area that necessitates further consideration as the nation moves toward value-based benefit design. To estimate the cost of pain medication attributable to treating adult patients with NMCP in the United States and to analyze the trend of outpatient pain visits. This cross-sectional study used the National Ambulatory Medical Care Survey (NAMCS) data from 2000-2007. The Division of Health Care Statistics, National Center for Health Statistics, and the Centers for Disease Control and Prevention conducted the survey. The study included patients aged ≥18 years with chronic pain diagnoses (identified by the ICD-9-CM codes: primary, secondary, and tertiary). Patients prescribed at least 1 pain medication were included in the cost analysis. Pain-related prescription medications prescribed during ambulatory care visits were retrieved by using NAMCS drug codes/National Drug Code numbers. National pain prescription frequencies (weighted) were obtained from NAMCS data, using the statistical software STATA. We created pain therapy categories (drug classes) for cost analysis based on national pain guidelines. Drug classes used in this analysis were opioids/opioid-like agents, analgesics/NSAIDs, tricyclic antidepressants, selective serotonin reuptake inhibitors, antirheumatics/immunologics, muscle relaxants, topical products, and corticosteroids. We calculated average prices based on the 3 lowest average wholesale prices reported in the

  20. Subject-specific geometrical detail rather than cost function formulation affects hip loading calculation.

    Science.gov (United States)

    Wesseling, Mariska; De Groote, Friedl; Bosmans, Lode; Bartels, Ward; Meyer, Christophe; Desloovere, Kaat; Jonkers, Ilse

    2016-11-01

    This study assessed the relative importance of introducing an increasing level of medical image-based subject-specific detail in bone and muscle geometry in the musculoskeletal model, on calculated hip contact forces during gait. These forces were compared to introducing minimization of hip contact forces in the optimization criterion. With an increasing level of subject-specific detail, specifically MRI-based geometry and wrapping surfaces representing the hip capsule, hip contact forces decreased and were more comparable to contact forces measured using instrumented prostheses (average difference of 0.69 BW at the first peak compared to 1.04 BW for the generic model). Inclusion of subject-specific wrapping surfaces in the model had a greater effect than altering the cost function definition.

  1. Calculating the Social Costs of Carbon without knowing preferences : Comment on “A rapid assessment model for understanding the social cost of carbon”

    NARCIS (Netherlands)

    Gerlagh, R.

    The Social Costs of Carbon (SCC) equals the marginal welfare loss associated with one unit of emitted CO2, divided by the marginal welfare gain associated with one unit of consumption. In stochastic assessments, both the nominator and denominator can depend on uncertain parameters; specifically they

  2. Applying graphics processor units to Monte Carlo dose calculation in radiation therapy.

    Science.gov (United States)

    Bakhtiari, M; Malhotra, H; Jones, M D; Chaudhary, V; Walters, J P; Nazareth, D

    2010-04-01

    We investigate the potential in using of using a graphics processor unit (GPU) for Monte-Carlo (MC)-based radiation dose calculations. The percent depth dose (PDD) of photons in a medium with known absorption and scattering coefficients is computed using a MC simulation running on both a standard CPU and a GPU. We demonstrate that the GPU's capability for massive parallel processing provides a significant acceleration in the MC calculation, and offers a significant advantage for distributed stochastic simulations on a single computer. Harnessing this potential of GPUs will help in the early adoption of MC for routine planning in a clinical environment.

  3. Employing OpenCL to Accelerate Ab Initio Calculations on Graphics Processing Units.

    Science.gov (United States)

    Kussmann, Jörg; Ochsenfeld, Christian

    2017-06-13

    We present an extension of our graphics processing units (GPU)-accelerated quantum chemistry package to employ OpenCL compute kernels, which can be executed on a wide range of computing devices like CPUs, Intel Xeon Phi, and AMD GPUs. Here, we focus on the use of AMD GPUs and discuss differences as compared to CUDA-based calculations on NVIDIA GPUs. First illustrative timings are presented for hybrid density functional theory calculations using serial as well as parallel compute environments. The results show that AMD GPUs are as fast or faster than comparable NVIDIA GPUs and provide a viable alternative for quantum chemical applications.

  4. Applying graphics processor units to Monte Carlo dose calculation in radiation therapy

    Directory of Open Access Journals (Sweden)

    Bakhtiari M

    2010-01-01

    Full Text Available We investigate the potential in using of using a graphics processor unit (GPU for Monte-Carlo (MC-based radiation dose calculations. The percent depth dose (PDD of photons in a medium with known absorption and scattering coefficients is computed using a MC simulation running on both a standard CPU and a GPU. We demonstrate that the GPU′s capability for massive parallel processing provides a significant acceleration in the MC calculation, and offers a significant advantage for distributed stochastic simulations on a single computer. Harnessing this potential of GPUs will help in the early adoption of MC for routine planning in a clinical environment.

  5. How can activity-based costing methodology be performed as a powerful tool to calculate costs and secure appropriate patient care?

    Science.gov (United States)

    Lin, Blossom Yen-Ju; Chao, Te-Hsin; Yao, Yuh; Tu, Shu-Min; Wu, Chun-Ching; Chern, Jin-Yuan; Chao, Shiu-Hsiung; Shaw, Keh-Yuong

    2007-04-01

    Previous studies have shown the advantages of using activity-based costing (ABC) methodology in the health care industry. The potential values of ABC methodology in health care are derived from the more accurate cost calculation compared to the traditional step-down costing, and the potentials to evaluate quality or effectiveness of health care based on health care activities. This project used ABC methodology to profile the cost structure of inpatients with surgical procedures at the Department of Colorectal Surgery in a public teaching hospital, and to identify the missing or inappropriate clinical procedures. We found that ABC methodology was able to accurately calculate costs and to identify several missing pre- and post-surgical nursing education activities in the course of treatment.

  6. A systematic review of low back pain cost of illness studies in the United States and internationally.

    Science.gov (United States)

    Dagenais, Simon; Caro, Jaime; Haldeman, Scott

    2008-01-01

    The economic burden of low back pain (LBP) is very large and appears to be growing. It is not possible to impact this burden without understanding the strengths and weaknesses of the research on which these costs are calculated. To conduct a systematic review of LBP cost of illness studies in the United States and internationally. Systematic review of the literature. Medline was searched to uncover studies about the direct or indirect costs of LBP published in English from 1997 to 2007. Data extracted for each eligible study included study design, population, definition of LBP, methods of estimating costs, year of data, and estimates of direct, indirect, or total costs. Results were synthesized descriptively. The search yielded 147 studies, of which 21 were deemed relevant; 4 other studies and 2 additional abstracts were found by searching reference lists, bringing the total to 27 relevant studies. The studies reported on data from Australia, Belgium, Japan, Korea, the Netherlands, Sweden, the UK, and the United States. Nine studies estimated direct costs only, nine indirect costs only, and nine both direct and indirect costs, from a societal (n=18) or private insurer (n=9) perspective. Methodology used to derive both direct and indirect cost estimates differed markedly among the studies. Among studies providing a breakdown on direct costs, the largest proportion of direct medical costs for LBP was spent on physical therapy (17%) and inpatient services (17%), followed by pharmacy (13%) and primary care (13%). Among studies providing estimates of total costs, indirect costs resulting from lost work productivity represented a majority of overall costs associated with LBP. Three studies reported that estimates with the friction period approach were 56% lower than with the human capital approach. Several studies have attempted to estimate the direct, indirect, or total costs associated with LBP in various countries using heterogeneous methodology. Estimates of the

  7. Density functional theory calculation on many-cores hybrid central processing unit-graphic processing unit architectures.

    Science.gov (United States)

    Genovese, Luigi; Ospici, Matthieu; Deutsch, Thierry; Méhaut, Jean-François; Neelov, Alexey; Goedecker, Stefan

    2009-07-21

    We present the implementation of a full electronic structure calculation code on a hybrid parallel architecture with graphic processing units (GPUs). This implementation is performed on a free software code based on Daubechies wavelets. Such code shows very good performances, systematic convergence properties, and an excellent efficiency on parallel computers. Our GPU-based acceleration fully preserves all these properties. In particular, the code is able to run on many cores which may or may not have a GPU associated, and thus on parallel and massive parallel hybrid machines. With double precision calculations, we may achieve considerable speedup, between a factor of 20 for some operations and a factor of 6 for the whole density functional theory code.

  8. 16 CFR Appendix K to Part 305 - Representative Average Unit Energy Costs

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Representative Average Unit Energy Costs K Appendix K to Part 305 Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF...) Pt. 305, App. K Appendix K to Part 305—Representative Average Unit Energy Costs This Table contains...

  9. Consideration concerning the costs of the 300 kW wind units developed in Romania

    Energy Technology Data Exchange (ETDEWEB)

    Gyulai, F.; Bej, A. [Technical Univ. of Timisoara (Romania). Wind Energy Research Center

    1995-12-31

    A demonstrative wind farm with four research units, 300 kW each, is in developing stage in Romania. The article shows economic analysis of these experimental wind units and their cost structure focusing in component costs, performance, manufacturing technology and installing work. (author)

  10. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  11. Cost comparison of unit dose and traditional drug distribution in a long-term-care facility.

    Science.gov (United States)

    Lepinski, P W; Thielke, T S; Collins, D M; Hanson, A

    1986-11-01

    Unit dose and traditional drug distribution systems were compared in a 352-bed long-term-care facility by analyzing nursing time, medication-error rate, medication costs, and waste. Time spent by nurses in preparing, administering, charting, and other tasks associated with medications was measured with a stop-watch on four different nursing units during six-week periods before and after the nursing home began using unit dose drug distribution. Medication-error rate before and after implementation of the unit dose system was determined by patient profile audits and medication inventories. Medication costs consisted of patient billing costs (acquisition cost plus fee) and cost of medications destroyed. The unit dose system required a projected 1507.2 hours less nursing time per year. Mean medication-error rates were 8.53% and 0.97% for the traditional and unit dose systems, respectively. Potential annual savings because of decreased medication waste with the unit dose system were $2238.72. The net increase in cost for the unit dose system was estimated at $615.05 per year, or approximately $1.75 per patient. The unit dose system appears safer and more time-efficient than the traditional system, although its costs are higher.

  12. [Cost analysis of hospital care for newborns at risk: comparison of an Intermediate Neonatal Care Unit and a Kangaroo Unit].

    Science.gov (United States)

    Entringer, Aline Piovezan; Gomes, Maria Auxiliadora de Sousa Mendes; Pinto, Márcia; Caetano, Rosângela; Magluta, Cynthia; Lamy, Zeni Carvalho

    2013-06-01

    The aim of this study was to compare the direct costs of implementation of the Kangaroo Method and an Intermediate Neonatal Care Unit, from the perspective of the Brazilian Unified National Health System (SUS) in Rio de Janeiro, Brazil. Newborns were eligible for inclusion if they were clinically stable and were able to receive care in those two modalities. A decision tree model was developed that incorporated baseline variables and costs into a hypothetical cohort of 1,000 newborns, according to the literature and expert opinions. Daily cost was BR$343.53 for the second stage of the Kangaroo Unit and BR$394.22 for the Intermediate Neonatal Care Unit. The total cost for the hypothetical cohort was BR$5,710,281.66 for the second and third stages of the Kangaroo Unit and R$7,119,865.61 for the Intermediate Neonatal Care Unit. The Intermediate Neonatal Care Unit cost 25% more than the Kangaroo Unit. The study can contribute to decision-making in health, in addition to providing support for studies related to economic evaluation in neonatal health.

  13. Acceleration of orbital-free first principles calculation with graphics processing unit GPU

    Science.gov (United States)

    Aoki, M.; Tomono, H.; Iitaka, T.; Tsumuraya, K.

    2010-03-01

    Computational material design requires efficient algorithms and high-speed computers for calculating and predicting material properties. The orbital-free first principles calculation (OF-FPC) method, which is a tool for calculating and designing material properties, is an O(N) method and is suitable for large-scaled systems. The stagnation in the development of CPU devices with high mobility of electron carriers has driven the development of parallel computing and the production of CPU devices with finer spaced wiring. We, for the first time, propose another method to accelerate the computation using Graphics Processing Unit (GPU). The implementation of the Fast Fourier Transform (CUFFT) library that uses GPU, into our in-house OF-FPC code, reduces the computation time to half of that of the CPU.

  14. New cost estimates for carbon sequestration through afforestation in the United States

    Science.gov (United States)

    Anne Sofie Elburg Nielsen; Andrew J. Plantinga; Ralph J. Alig

    2014-01-01

    This report provides new cost estimates for carbon sequestration through afforestation in the United States. We extend existing studies of carbon sequestration costs in several important ways, while ensuring the transparency of our approach. We clearly identify all components of our cost estimates so that other researchers can reconstruct our results as well as use our...

  15. A systematic review of the unit costs of allied health and community services used by older people in Australia

    Directory of Open Access Journals (Sweden)

    Farag Inez

    2013-02-01

    Full Text Available Abstract Background An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. Method A comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made. Results The number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72. Conclusions Utilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.

  16. 49 CFR 639.23 - Calculation of purchase or construction cost.

    Science.gov (United States)

    2010-10-01

    ... TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.23... cost of a capital asset is— (1) The estimated cost to purchase or construct the asset; plus (2... capital asset. (b) The estimated cost to purchase or construct must be— (1) Reasonable; (2) Based on...

  17. National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation Programming & Future Enhancements - abstract

    Science.gov (United States)

    The National Stormwater Calculator (NSC) makes it easy to estimate runoff reduction when planning a new development or redevelopment site with low impact development (LID) stormwater controls. The Calculator is currently deployed as a Windows desktop application. The Calculator i...

  18. Reducing costs by clustering maintenance activities for multiple critical units

    NARCIS (Netherlands)

    de Jonge, Bram; Klingenberg, Warse; Teunter, Ruud; Tinga, Tiedo

    Advances in sensor technology have enabled companies to make significant progress towards achieving condition-based maintenance (CBM). CBM provides the opportunity to perform maintenance actions more effectively. However, scheduling maintenance at the unit level may imply a high maintenance

  19. Reducing costs by clustering maintenance activities for multiple critical units

    NARCIS (Netherlands)

    de Jonge, Bram; Klingenberg, Warse; Teunter, Ruud; Tinga, Tiedo

    2015-01-01

    Advances in sensor technology have enabled companies to make significant progress towards achieving condition-based maintenance (CBM). CBM provides the opportunity to perform maintenance actions more effectively. However, scheduling maintenance at the unit level may imply a high maintenance

  20. Cost Indexing and Unit Price Adjustments for Construction Materials

    Science.gov (United States)

    2012-10-30

    This project was focused on the assimilation of information regarding unit price adjustment clauses, or PACs, : that are offered for construction materials at the state Departments of Transportation (DOTs). It is intended to : provide the South Carol...

  1. Indirect cost burden of migraine in the United States.

    Science.gov (United States)

    Hawkins, Kevin; Wang, Sara; Rupnow, Marcia F T

    2007-04-01

    The purpose of this study was to determine the indirect cost burden associated with migraine. Data were obtained from Thomson-Medstat's Health and Productivity Management (HPM) database for the 2002 through 2003 calendar years. The migraine cohort was composed of patients who had a diagnosis of migraine or migraine-specific abortive prescription medication, or both. A control cohort of patients without migraine was matched to patients in the migraine cohort. The average annual indirect burden of illness (BOI) of migraine and a national indirect BOI were estimated. Annual indirect expenditures were significantly higher in the migraine group compared with the control group ($4453 vs $1619; Ppresenteeism, was estimated to be $12 billion (mostly attributed to absenteeism). Migraine imparts a substantial indirect cost burden. Projected to a national level, this amounts to an annual cost to US employers of approximately $12 billion.

  2. Renewable Energy Cost Modeling: A Toolkit for Establishing Cost-Based Incentives in the United States; March 2010 -- March 2011

    Energy Technology Data Exchange (ETDEWEB)

    Gifford, J. S.; Grace, R. C.; Rickerson, W. H.

    2011-05-01

    This report is intended to serve as a resource for policymakers who wish to learn more about establishing cost-based incentives. The report will identify key renewable energy cost modeling options, highlight the policy implications of choosing one approach over the other, and present recommendations on the optimal characteristics of a model to calculate rates for cost-based incentives, feed-in tariffs (FITs), or similar policies. These recommendations will be utilized in designing the Cost of Renewable Energy Spreadsheet Tool (CREST). Three CREST models will be publicly available and capable of analyzing the cost of energy associated with solar, wind, and geothermal electricity generators. The CREST models will be developed for use by state policymakers, regulators, utilities, developers, and other stakeholders to assist them in current and future rate-setting processes for both FIT and other renewable energy incentive payment structures and policy analyses.

  3. Market value calculation and the solution of circularity between value and the weighted average cost of capital WACC

    Directory of Open Access Journals (Sweden)

    Ignacio Vélez-Pareja

    2009-12-01

    Full Text Available Most finance textbooks present the Weighted Average Cost of Capital (WACC calculation as: WACC = Kd×(1-T×D% + Ke×E%, where Kd is the cost of debt before taxes, T is the tax rate, D% is the percentage of debt on total value, Ke is the cost of equity and E% is the percentage of equity on total value. All of them precise (but not with enough emphasis that the values to calculate D% y E% are market values. Although they devote special space and thought to calculate Kd and Ke, little effort is made to the correct calculation of market values. This means that there are several points that are not sufficiently dealt with: Market values, location in time, occurrence of tax payments, WACC changes in time and the circularity in calculating WACC. The purpose of this note is to clear up these ideas, solve the circularity problem and emphasize in some ideas that usually are looked over. Also, some suggestions are presented on how to calculate, or estimate, the equity cost of capital.

  4. 48 CFR 1845.7101-3 - Unit acquisition cost.

    Science.gov (United States)

    2010-10-01

    ... ensure that the excluded costs (maintenance, training, etc.) are not reported as part of the software's... systems, subsystems, and spare parts and components furnished or acquired and charged to work in process... designs, develops, fabricates or purchases property for NASA and part of the fees paid to the contractor...

  5. [Prevention of Occupational Injuries Related to Hands: Calculation of Subsequent Injury Costs for the Austrian Social Occupational Insurance Institution (AUVA)].

    Science.gov (United States)

    Rauner, M S; Mayer, B; Schaffhauser-Linzatti, M M

    2015-08-01

    Occupational injuries cause short-term, direct costs as well as long-term follow-up costs over the lifetime of the casualties. Due to shrinking budgets accident insurance companies focus on cost reduction programmes and prevention measures. For this reason, a decision support system for consequential cost calculation of occupational injuries was developed for the main Austrian social occupational insurance institution (AUVA) during three projects. This so-called cost calculation tool combines the traditional instruments of accounting with quantitative methods such as micro-simulation. The cost data are derived from AUVA-internal as well as external economic data sources. Based on direct and indirect costs, the subsequent occupational accident costs from the time of an accident and, if applicable, beyond the death of the individual casualty are predicted for the AUVA, the companies in which the casualties are working, and the other economic sectors. By using this cost calculation tool, the AUVA classifies risk groups and derives related prevention campaigns. In the past, the AUVA concentrated on falling, accidents at construction sites and in agriculture/forestry, as well as commuting accidents. Currently, among others, a focus on hand injuries is given and first prevention programmes have been initiated. Hand injuries represent about 38% of all casualties with average costs of about 7,851 Euro/case. Main causes of these accidents are cutting injuries in production, agriculture, and forestry. Beside a low, but costly, number of amputations with average costs of more than 100,000 Euro/case, bone fractures and strains burden the AUVA-budget with about 17,500 and 10,500 € per case, respectively. Decision support systems such as this cost calculation tool represent necessary instruments to identify risk groups and their injured body parts, causes of accidents, and economic activities, which highly burden the budget of an injury company, and help derive

  6. MARCH calculations performed for the TMI-2 (Three Mile Island Unit) analysis exercise program

    Energy Technology Data Exchange (ETDEWEB)

    Wooton, R.O.

    1988-01-01

    As part of the validation effort for the MARCH portion of the Source Term Code Package, the U.S. Nuclear Regulatory Commission has requested Battelle Columbus to participate in the Three Mile Island Unit (TMI-2) Analysis Exercise Program. Previous TMI-2 calculations (1980) had been performed using the original MARCH 1.1 version of the code. MARCH was written to calculate thermal-hydraulic phenomena for reactor accidents leading to core meltdown. The accident sequences normally considered by MARCH users are relatively uncomplicated. For example, multiple changes in emergency core cooling injection, steam generator auxiliary feedwater flow rates, and cycling of primary system steam relief valves are not generally considered in severe-accident analysis. All of these things were done during the TMI-2 accident. In addition, at TMI-2 the core meltdown sequence was interrupted by the restoration of core cooling after achieving significant melting. In order to perform meaningful TMI-2 calculations, it has been found necessary to add a number of modeling enhancements to MARCH. These modeling changes are discussed along with the results of the TMI-2 MARCH calculations in this paper.

  7. Toward large-scale many-fermion calculations on Graphics Processing Units

    Science.gov (United States)

    Wendt, Kyle; Drut, Joaquin; Lahde, Timo

    2010-11-01

    We apply Graphics Processing Units (GPUs) to simulations of quantum many-body systems. Specifically, we study the performance of sparse matrix-vector multiplication and preconditioned conjugate gradient iteration on the NVIDIA Tesla c1060 GPU card. These operations are of direct relevance to Hybrid Monte Carlo calculations at finite temperature and density. We report a CPU-GPU performance comparison for the Fermi Hubbard model in d+1 space-time dimensions, where we find speedup factors in excess of 40. We present an overview of our algorithm, possible optimization strategies and projected performance on the recently released NVIDIA Fermi architecture.

  8. Comminution of logging residues with a tub grinder: Calculation of productivity and procurement cost of wood chips

    OpenAIRE

    Yoshioka, Takuyuki; Sakurai, Rin; Aruga, Kazuhiro; Nitami, Toshio; Sakai, Hideo; Kobayashi, Hiroshi

    2006-01-01

    An experiment on comminution of logging residues with a tub grinder was carried out in order to calculate the productivity and procurement cost of wood chips. At the investigated site, the tub grinder had a hammer mill crusher at the bottom of the tub, and a grapple loader and a bucket loader worked as auxiliary machines for the grinder. As a result, the productivity of the tub grinder was 60.0 loose m3/PMH0, and the total comminuting cost was calculated as 5.637 US$/m3, indicating that th...

  9. An EPQ Model with Unit Production Cost and Set-Up Cost as Functions of Production Rate

    Directory of Open Access Journals (Sweden)

    Behrouz Afshar-Nadjafi

    2013-01-01

    Full Text Available Extensive research has been devoted to economic production quantity (EPQ problem. However, no attention has been paid to problems where unit production and set-up costs must be considered as functions of production rate. In this paper, we address the problem of determining the optimal production quantity and rate of production in which unit production and set-up costs are assumed to be continuous functions of production rate. Based on the traditional economic production quantity (EPQ formula, the cost function associated with this model is proved to be nonconvex and a procedure is proposed to solve this problem. Finally, utility of the model is presented using some numerical examples and the results are analyzed.

  10. THE METHODOLOGY FOR CALCULATING OF LABOR COSTS OF MEDICAL PERSONNEL IN MARKET CONDITIONS

    Directory of Open Access Journals (Sweden)

    S. V. Katasonov

    2015-01-01

    Full Text Available The article presents the approximate calculations of working time of physician to work with the patient and documentation. On the base of these calculations they outline the possible ways to optimize the work of the medical staff.

  11. Weather data for simplified energy calculation methods. Volume III. Western United States: TRY data

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, A.R.; Moreno, S.; Deringer, J.; Watson, C.R.

    1984-08-01

    The objective is to provide a source of weather data for direct use with a number of simplified energy calculation methods available today. Complete weather data for a number of cities in the United States are provided for use in the following methods: degree hour, modified degree hour, bin, modified bin, and variable degree day. This report contains sets of weather data for 24 cities in the continental United States using Test Reference Year (TRY) source weather data. The weather data at each city has been summarized in a number of ways to provide differing levels of detail necessary for alternative simplified energy calculation methods. Weather variables summarized include dry bulb and wet bulb temperature, percent relative humidity, humidity ratio, wind speed, percent possible sunshine, percent diffuse solar radiation, total solar radiation on horizontal and vertical surfaces, and solar heat gain through standard DSA glass. Monthly and annual summaries, in some cases by time of day, are available. These summaries are produced in a series of nine computer generated tables.

  12. Solving the negative impact of congestion in the postanesthesia care unit: a cost of opportunity analysis.

    Science.gov (United States)

    Ruiz-Patiño, Alejandro; Acosta-Ospina, Laura Elena; Rueda, Juan-David

    2017-04-01

    Congestion in the postanesthesia care unit (PACU) leads to the formation of waiting queues for patients being transferred after surgery, negatively affecting hospital resources. As patients recover in the operating room, incoming surgeries are delayed. The purpose of this study was to establish the impact of this phenomenon in multiple settings. An operational mathematical study based on the queuing theory was performed. Average queue length, average queue waiting time, and daily queue waiting time were evaluated. Calculations were based on the mean patient daily flow, PACU length of stay, occupation, and current number of beds. Data was prospectively collected during a period of 2 months, and the entry and exit time was recorded for each patient taken to the PACU. Data was imputed in a computational model made with MS Excel. To account for data uncertainty, deterministic and probabilistic sensitivity analyses for all dependent variables were performed. With a mean patient daily flow of 40.3 and an average PACU length of stay of 4 hours, average total lost surgical opportunity time was estimated at 2.36 hours (95% CI: 0.36-4.74 hours). Cost of opportunity was calculated at $1592 per lost hour. Sensitivity analysis showed that an increase of two beds is required to solve the queue formation. When congestion has a negative impact on cost of opportunity in the surgical setting, queuing analysis grants definitive actions to solve the problem, improving quality of service and resource utilization. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Production rates and costs of cable yarding wood residue from clearcut units

    Science.gov (United States)

    Chris B. LeDoux

    1984-01-01

    Wood residue is a little used source of fiber, chips, and fuel because harvest costs are largely unknown. This study calculates incremental production rates and costs for yarding and loading logging residue in clearcut old-growth Douglas-fir/western hemlock forests. Harvest operations were observed for two timber sales in western Oregon. Three different cable yarding...

  14. Weather data for simplified energy calculation methods. Volume IV. United States: WYEC data

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, A.R.; Moreno, S.; Deringer, J.; Watson, C.R.

    1984-08-01

    The objective of this report is to provide a source of weather data for direct use with a number of simplified energy calculation methods available today. Complete weather data for a number of cities in the United States are provided for use in the following methods: degree hour, modified degree hour, bin, modified bin, and variable degree day. This report contains sets of weather data for 23 cities using Weather Year for Energy Calculations (WYEC) source weather data. Considerable overlap is present in cities (21) covered by both the TRY and WYEC data. The weather data at each city has been summarized in a number of ways to provide differing levels of detail necessary for alternative simplified energy calculation methods. Weather variables summarized include dry bulb and wet bulb temperature, percent relative humidity, humidity ratio, wind speed, percent possible sunshine, percent diffuse solar radiation, total solar radiation on horizontal and vertical surfaces, and solar heat gain through standard DSA glass. Monthly and annual summaries, in some cases by time of day, are available. These summaries are produced in a series of nine computer generated tables.

  15. Economics of immunization information systems in the United States: assessing costs and efficiency

    Directory of Open Access Journals (Sweden)

    Urquhart Gary A

    2006-08-01

    Full Text Available Abstract Background One of the United States' national health objectives for 2010 is that 95% of children aged Methods Data were collected from a national sampling frame of the 56 states/cities that received federal immunization grants under U.S. Public Health Service Act 317b and completed the federal 1999 Immunization Registry Annual Report. The sampling frame was stratified by IIS functional status, children's enrollment in the IIS, and whether the IIS had been developed as an independent system or was integrated into a larger system. These sites self-reported IIS developmental and operational program costs for calendar years 1998–2002 using a standardized data collection tool and underwent on-site interviews to verify reported data with information from the state/city financial management system and other financial records. A parametric cost-per-patient-record (CPR model was estimated. The model assessed the impact of labor and non-labor resources used in development and operations tasks, as well as the impact of information technology, local providers' participation and compliance with federal IIS performance standards (e.g., ensuring the confidentiality and security of information, ensure timely vaccination data at the time of patient encounter, and produce official immunization records. Given the number of records minimizing CPR, the additional amount of resources needed to meet national health goals for the year 2010 was also calculated. Results Estimated CPR was as high as $10.30 and as low as $0.09 in operating IIS. About 20% of IIS had between 2.9 to 3.2 million records and showed CPR estimates of $0.09. Overall, CPR was highly sensitive to local providers' participation. To achieve the 2010 goals, additional aggregated costs were estimated to be $75.6 million nationwide. Conclusion Efficiently increasing the number of records in IIS would require additional resources and careful consideration of various strategies to minimize CPR

  16. Cost optimal and nearly zero-energy buildings (nZEB) definitions, calculation principles and case studies

    CERN Document Server

    Kurnitski, Jarek

    2013-01-01

    This book introduces technical definitions, system boundaries, energy calculation methods and input data for setting primary energy based minimum/cost optimal and nZEB requirements in national energy frames. Offers five case studies of nZEB office buildings.

  17. Key cost drivers of pharmaceutical clinical trials in the United States.

    Science.gov (United States)

    Sertkaya, Aylin; Wong, Hui-Hsing; Jessup, Amber; Beleche, Trinidad

    2016-04-01

    The increasing cost of clinical research has significant implications for public health, as it affects drug companies' willingness to undertake clinical trials, which in turn limits patient access to novel treatments. Thus, gaining a better understanding of the key cost drivers of clinical research in the United States is important. The study which is based on a report prepared by Eastern Research Group, Inc., for the US Department of Health and Human Services, examined different factors, such as therapeutic area, patient recruitment, administrative staff, and clinical procedure expenditures, and their contribution to pharmaceutical clinical trial costs in the United States by clinical trial phase. The study used aggregate data from three proprietary databases on clinical trial costs provided by Medidata Solutions. We evaluated per-study costs across therapeutic areas by aggregating detailed (per patient and per site) cost information. We also compared average expenditures on cost drivers with the use of weighted mean and standard deviation statistics. Therapeutic area was an important determinant of clinical trial costs by phase. The average cost of a Phase 1 study conducted at a US site ranged from US$1.4 million (pain and anesthesia) to US$6.6 million (immunomodulation), including estimated site overhead and monitoring costs of the sponsoring organization. A Phase 2 study cost from US$7.0 million (cardiovascular) to US$19.6 million (hematology), whereas a Phase 3 study cost ranged from US$11.5 million (dermatology) to US$52.9 (pain and anesthesia) on average. Across all study phases and excluding estimated site overhead costs and costs for sponsors to monitor the study, the top three cost drivers of clinical trial expenditures were clinical procedure costs (15%-22% of total), administrative staff costs (11%-29% of total), and site monitoring costs (9%-14% of total). The data were from 2004 through 2012 and were not adjusted for inflation. Additionally

  18. Logistics Cost Calculation of Implementation Warehouse Management System: A Case Study

    Directory of Open Access Journals (Sweden)

    Kučera Tomáš

    2017-01-01

    Full Text Available Warehouse management system can take full advantage of the resources and provide efficient warehousing services. The paper aims to show advantages and disadvantages of the warehouse management system in a chosen enterprise, which is focused on logistics services and transportation. The paper can bring new innovative approach for warehousing and presents how logistics enterprise can reduce logistics costs. This approach includes cost reduction of the establishment, operation and savings in the overall assessment of the implementation of the warehouse management system. The innovative warehouse management system will be demonstrated as the case study, which is classified as a qualitative scientific method, in the chosen logistics enterprise. The paper is based on the research of the world literature, analyses of the internal logistics processes, data and finally enterprise documents. The paper discovers costs related to personnel costs, handling equipment costs and costs for material identification. Implementation of the warehouse management system will reduce overall logistics costs of warehousing and extend the warehouse management system to other parts of the logistics chain.

  19. The daily cost of ICU patients: A micro-costing study in 23 French Intensive Care Units.

    Science.gov (United States)

    Lefrant, Jean-Yves; Garrigues, Bernard; Pribil, Céline; Bardoulat, Isabelle; Courtial, Frédéric; Maurel, Frédérique; Bazin, Jean-Étienne

    2015-06-01

    To estimate the daily cost of intensive care unit (ICU) stays via micro-costing. A multicentre, prospective, observational, cost analysis study was carried out among 21 out of 23 French ICUs randomly selected from French National Hospitals. Each ICU randomly enrolled 5 admitted adult patients with a simplified acute physiology II score ≥ 15 and with at least one major intensive care medical procedure. All health-care human resources used by each patient over a 24-hour period were recorded, as well as all medications, laboratory analyses, investigations, tests, consumables and administrative expenses. All resource costs were estimated from the hospital's perspective (reference year 2009) based on unitary cost data. One hundred and four patients were included (mean age: 62.3 ± 14.9 years, mean SAPS II: 51.5 ± 16.1, mean SOFA on the study day: 6.9 ± 4.3). Over 24 hours, 29 to 186 interventions per patient were performed by different caregivers, leading to a mean total time spent for patient care of 13:32 ± 05:00 h. The total daily cost per patient was € 1425 ± € 520 (95% CI = € 1323 to € 1526). ICU human resources represented 43% of total daily cost. Patient-dependent expenses (€ 842 ± € 521) represented 59% of the total daily cost. The total daily cost was correlated with the daily SOFA score (r = 0.271, P = 0.006) and the bedside-time given by caregivers (r = 0.716, P ICU care in French National Hospitals is strongly correlated with the duration of bedside-care carried out by human resources. Copyright © 2015. Published by Elsevier Masson SAS.

  20. Socioeconomic costs and health-related quality of life in juvenile idiopathic arthritis: a cost-of-illness study in the United Kingdom.

    Science.gov (United States)

    Angelis, Aris; Kanavos, Panos; López-Bastida, Julio; Linertová, Renata; Serrano-Aguilar, Pedro

    2016-08-02

    Juvenile idiopathic arthritis (JIA) refers to a number of rare chronic inflammatory diseases. Although JIA imposes a significant societal burden, limited data are available on the cost of JIA. The study's objective is to quantify the socioeconomic burden of JIA patients in the United Kingdom (UK), along with their health-related quality of life (HRQoL). A bottom-up, cross-sectional, cost-of-illness analysis of 23 patients was carried out. To collect data on demographic characteristics, health resource utilization, informal care, productivity losses and HRQoL, questionnaires were administered to and completed by patients or their caregivers. The EuroQol five dimensions (EQ-5D) instrument was used to measure HRQoL. This study found that the average annual cost for a JIA patient was €31,546, with direct health care costs equalling €14,509 (46.0 % of total costs), direct non-health care costs amounting to €8,323 (26.4 %) and productivity losses being €8,715 (27.6 %). This was calculated using unit costs for 2012. The largest expenditures on average were accounted for by early retirement (27.0 %), followed by informal care (24.1 %), medications (21.1 %), outpatient and primary health care visits (13.2 %) and diagnostic tests (7.9 %). Important differences existed between JIA patients in need of caregiver assistance and those with no need (€39,469 vs. €25,452 respectively). Among adult JIA patients, mean EQ-5D index scores and visual analogue scale (VAS) scores were found to be 0.26 and 49.00 respectively; the same scores among caregivers were 0.66 and 67.14 respectively. JIA poses a significant cost burden on the UK society. Over half of the total average costs (54 %) are related to non-health care and productivity losses. HRQoL of JIA patients is considerably worse than the UK general population.

  1. National Stormwater Calculator: Low Impact Development Stormwater Control Cost Estimation Programming & Future Enhancements - Presentation

    Science.gov (United States)

    The National Stormwater Calculator (NSC) makes it easy to estimate runoff reduction when planning a new development or redevelopment site with low impact development (LID) stormwater controls. The Calculator is currently deployed as a Windows desktop application. The NSC is organ...

  2. Costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home units in Spain.

    Science.gov (United States)

    González-Ramallo, V J; Mirón-Rubio, M; Mujal, A; Estrada, O; Forné, C; Aragón, B; Rivera, A J

    2017-07-01

    The aim of this study was to assess the direct healthcare costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home (HaH) units in Spain. An observational, multicentre, economic evaluation of retrospective cohorts was conducted. Patients were treated at home by the HaH units of three Spanish hospitals between January 2012 and December 2013. From the cost accounting of HaH OPAT (staff, pharmacy, transportation, diagnostic tests and structural), the cost of each outpatient course was obtained following a top-down strategy based on the use of resources. Costs associated with inpatient stay, if any, were estimated based on length of stay and ICD-9-CM diagnosis. There were 1324 HaH episodes in 1190 patients (median age 70 years). The median (interquartile range) stay at home was 10 days (7-15 days). Of the OPAT episodes, 91.5% resulted in cure or improvement on completion of intravenous therapy. The mean total cost of each infectious episode was €6707 [95% confidence interval (CI) €6189-7406]. The mean cost per OPAT episode was €1356 (95% CI €1247-1560), mainly distributed between healthcare staff costs (46%) and pharmacy costs (39%). The mean cost of inpatient hospitalisation of an infectious episode was €4357 (95% CI €3947-4977). The cost per day of inpatient hospitalisation was €519, whilst the cost per day of OPAT was €98, meaning a saving of 81%. This study shows that OPAT administered by HaH units resulted in lower costs compared with inpatient care in Spain. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  3. Societal costs of prescription opioid abuse, dependence, and misuse in the United States.

    Science.gov (United States)

    Birnbaum, Howard G; White, Alan G; Schiller, Matt; Waldman, Tracy; Cleveland, Jody M; Roland, Carl L

    2011-04-01

    The objective of this study was to estimate the societal costs of prescription opioid abuse, dependence, and misuse in the United States. Costs were grouped into three categories: health care, workplace, and criminal justice. Costs were estimated by 1) quantity method, which multiplies the number of opioid abuse patients by cost per opioid abuse patient; and 2) apportionment method, which begins with overall costs of drug abuse per component and apportions the share associated with prescription opioid abuse based on relative prevalence of prescription opioid to overall drug abuse. Excess health care costs per patient were based on claims data analysis of privately insured and Medicaid beneficiaries. Other data/information were derived from publicly available survey and other secondary sources. Total US societal costs of prescription opioid abuse were estimated at $55.7 billion in 2007 (USD in 2009). Workplace costs accounted for $25.6 billion (46%), health care costs accounted for $25.0 billion (45%), and criminal justice costs accounted for $5.1 billion (9%). Workplace costs were driven by lost earnings from premature death ($11.2 billion) and reduced compensation/lost employment ($7.9 billion). Health care costs consisted primarily of excess medical and prescription costs ($23.7 billion). Criminal justice costs were largely comprised of correctional facility ($2.3 billion) and police costs ($1.5 billion).   The costs of prescription opioid abuse represent a substantial and growing economic burden for the society. The increasing prevalence of abuse suggests an even greater societal burden in the future. Wiley Periodicals, Inc.

  4. Update: direct and indirect costs of arthritis and other rheumatic conditions--United States, 1997.

    Science.gov (United States)

    2004-05-14

    The medical and societal impact of arthritis and other rheumatic conditions (AORC) has been characterized with respect to disability, ambulatory care, hospitalization, and economic burden. CDC's estimates of the national and state-specific costs of AORC in the United States in 1997 have been published previously. However, CDC has re-estimated indirect costs by enhancing the statistical methods. This report summarizes the results of that analysis, which indicated that indirect costs were 30.1 billion dollars less than previously estimated. The total cost of AORC in the United States in 1997 was 86.2 billion dollars (including 51.1 billion dollars in direct costs and 35.1 billion dollars in indirect costs), approximately 1% of the U.S. gross domestic product. Total costs attributable to AORC by state ranged from 121 million dollars in Wyoming to 8.4 billion dollars in California. Although indirect costs were lower than estimated previously, costs for arthritis remain high and underscore the need for better interventions to reduce the economic burden of arthritis.

  5. A Substance Use Cost Calculator for US Employers With an Emphasis on Prescription Pain Medication Misuse.

    Science.gov (United States)

    Goplerud, Eric; Hodge, Sarah; Benham, Tess

    2017-11-01

    Substance use disorders are among the most common and costly health conditions affecting Americans. Despite estimates of national costs exceeding $400 billion annually, individual companies may not see how substance use impacts their bottom lines through lost productivity and absenteeism, turnover, health care expenses, disability, and workers' compensation. Data on employed adults (18 years and older) from 3 years (2012 to 2014) of the National Survey on Drug Use and Health Public Use Data Files were analyzed. The results offer employers an authoritative, free, epidemiologically grounded, and easy-to-use tool that gives specific information about how alcohol, prescription pain medication misuse, and illicit drug use is likely impacting workplaces like theirs. Employers have detailed reports of the cost of substance use that can be used to improve workplace policies and health benefits.

  6. Hospital costs associated with nosocomial infections in a pediatric intensive care unit.

    Science.gov (United States)

    Morillo-García, Áurea; Aldana-Espinal, Josefa M; Olry de Labry-Lima, Antonio; Valencia-Martín, Raquel; López-Márquez, Reyes; Loscertales-Abril, Mercedes; Conde-Herrera, Manuel

    2015-01-01

    To estimate the additional cost attributable to nosocomial infection (NI) in a pediatric intensive care unit (PICU) and related factors. A prospective cohort study was conducted in all children admitted to the PICU of a tertiary-care pediatric hospital between 2008 and 2009. Descriptive and bivariate analyses were conducted of total direct costs due to PICU stay and medical procedures in patients with and without NI. A log-linear regression model was performed to determine the factors associated with higher total cost. A total of 443 patients were studied and the prevalence of NI was 11.3%. The difference in the median total cost was €30,791.4 per patient between groups with and without NI. The median cost of PICU length of stay in patients with NI was almost eight times higher than the median cost of patients without NI. In patients with NI, the highest costs related to medical procedures were associated with antibiotics, enteral and parenteral feeding, and imaging tests. In the multivariate model, the factors associated with higher cost were infection, the performance of cardiovascular surgery, urgent admission, a higher pediatric risk mortality score, and the presence of immunosuppression. By contrast, older children and those with surgical admission generated lower cost. NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  7. Unit cost of counseling and patients length of stay in a residential drug treatment setting.

    Science.gov (United States)

    Alemi, Farrokh; Haack, Mary; Holifield, Linda; Claudio, Yvonne; Haqqi, Kashif

    2002-09-01

    Many published reports on cost of counseling give a fixed cost per hour of service. These estimates may be flawed. The purpose of this study is to show, by way of an example, how cost of an hour of counseling depends on the nature of the patient, in general, and length of the patient s stay, in particular. Even though the health care professional provides the same hour of work, the cost of the hour is different for short-stay and long-stay patients. We identified 5-short and 5 long stay patients in a residential treatment program. For each group, we asked the counselors to review the medical records and measure the patients utilization of various service units. We estimated the cost of a unit of service by dividing cost of an average patient by the program utilization of short and long-stay patients. The cost of an hour of counseling for long stay patients was 2/3 less than the cost of short-stay patients. Similar large changes in unit cost of treatment were observed for cost of group counseling or other components of substance abuse treatment. Our data was limited to one case study and may not indicate similar patterns in other treatment programs. The paper suggests that methods of studying cost of treatment should be adjusted to reflect case mix of patients and their expected length of stay. Our analysis shows that higher rates should be set for patients at risk for short stays; conversely lower rates should be set for patients likely to complete treatment. Without adjusting the rate for the case mix of patients, health care institutions have an incentive to avoid the difficult cases and concentrate on long stay cases. A number of instruments that measure severity of illness or difficulty of treatment can be used to anticipate patients length of stay. Then the rate for units of treatment can be set based on patients expected length of stay. This paper presents a questionnaire that can be used to collect cost data and estimate cost per unit of treatment adjusted

  8. The cost-effectiveness of supported employment for adults with autism in the United Kingdom

    Science.gov (United States)

    Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

    2014-01-01

    Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom. Thus, a decision-analytic economic model was developed, which used outcome data from the only trial that has evaluated supported employment for adults with autism in the United Kingdom. The main analysis considered intervention costs, while cost-savings associated with changes in accommodation status and National Health Service and personal social service resource use were examined in secondary analyses. Two outcome measures were used: the number of weeks in employment and the quality-adjusted life year. Supported employment resulted in better outcomes compared with standard care, at an extra cost of £18 per additional week in employment or £5600 per quality-adjusted life year. In secondary analyses that incorporated potential cost-savings, supported employment dominated standard care (i.e. it produced better outcomes at a lower total cost). The analysis suggests that supported employment schemes for adults with autism in the United Kingdom are cost-effective compared with standard care. Further research needs to confirm these findings. PMID:24126866

  9. The Economic Importance and Characteristics of Cost Calculation in the Clothing Industry in Romania

    Directory of Open Access Journals (Sweden)

    Caprian Cristina

    2017-01-01

    The paper ends with the author conclusions regarding the implementation of a cost calculationmethod in the clothing industry as well as the main actions to be taken by clothing companies tohave competitive and innovative products and to cope with fierce competition.

  10. THE APPLICATION OF ACTIVITY BASED COSTING ARE: ELIMINATION IN THE CALCULATION OF COST OF PRODUCTION PT SEMEN TONASA (PERSERO, PANGKEP REGENCY

    Directory of Open Access Journals (Sweden)

    Firman Menne

    2013-07-01

    Full Text Available Economic conditions should be viewed as the catalyst for developing the ability to intelligently manage resources so that the people of Indonesia can be out of the condition. Effective management and efficiency is reflected in good planning and good planning requires good information. In order to plan well the utilization of company resources to fold the duplicate spiders, company management requires system information revealed by clearly and precisely the facts relating to the activity. PT Semen Tonasa is a fabrication company doing business in the field of cement industry and produces two types of cement, cement or Portland cement type 1 can (OPC and Portland cement (PPC Pazzolan. The benefits that can be gained if the company implemented the system of Activity-Based Costing are: elimination is obtained more accurate information, among others, to improve the quality of decision making. In the ABC product only burdened costs of resources and activities that are used and does not burdened by the cost of the resources and activities. This method causes the cost per unit of a more stable and consistent with the purposes of the imposition of costs to the product result in activity.

  11. The direct cost of epilepsy in the United States: A systematic review of estimates.

    Science.gov (United States)

    Begley, Charles E; Durgin, Tracy L

    2015-09-01

    To develop estimates of the direct cost of epilepsy in the United States for the general epilepsy population and sub-populations by systematically comparing similarities and differences in types of estimates and estimation methods from recently published studies. Papers published since 1995 were identified by systematic literature search. Information on types of estimates, study designs, data sources, types of epilepsy, and estimation methods was extracted from each study. Annual per person cost estimates from methodologically similar studies were identified, converted to 2013 U.S. dollars, and compared. From 4,104 publications discovered in the literature search, 21 were selected for review. Three were added that were published after the search. Eighteen were identified that reported estimates of average annual direct costs for the general epilepsy population in the United States. For general epilepsy populations (comprising all clinically defined subgroups), total direct healthcare costs per person ranged from $10,192 to $47,862 and epilepsy-specific costs ranged from $1,022 to $19,749. Four recent studies using claims data from large general populations yielded relatively similar epilepsy-specific annual cost estimates ranging from $8,412 to $11,354. Although more difficult to compare, studies examining direct cost differences for epilepsy sub-populations indicated a consistent pattern of markedly higher costs for those with uncontrolled or refractory epilepsy, and for those with comorbidities. This systematic review found that various approaches have been used to estimate the direct costs of epilepsy in the United States. However, recent studies using large claims databases and similar methods allow estimation of the direct cost burden of epilepsy for the general disease population, and show that it is greater for some patient subgroups. Additional research is needed to further understand the broader economic burden of epilepsy and how it varies across

  12. A calculation program for harvesting and transportation costs of energy and industrial wood; Energiapuun korjuun ja kuljetuksen kustannuslaskentaohjelmisto

    Energy Technology Data Exchange (ETDEWEB)

    Ranta, T. [VTT Energy, Jyvaeskylae (Finland)

    1997-12-01

    A computer based model has been developed for calculating the production costs of industrial wood and wood fuel. Several calculation situations, which might be useful for decision-making in energy wood supply, are included into this software. The model will be easy to use for practical purposes and flexible so that different new model and changes in the basis of calculations are easy to implement. Model will offer open interfaces for importing and exporting information. Model includes selected wood delivery chains and open interfaces for adding data from different procurement sources. The cost analysis model is built on Windows-based software, SQLWindows, using different sources of data (ODBC). With the model it is possible to manage these SQLBase databases with SQL-queries. The data included in the databases origins from various energy wood sources (local communities or part of them, forestry boards planning areas or even stands ready for cutting). By knowing the planned share of first thinnings, final cuttings and other harvesting operations it is possible to estimate the potential amount of wood fuel from each area. Also databases from energy wood users, forest and transportation machinery and distances are available in the system. Using the information it is possible to find out the fuel demand of power and heating plants in each moment (e.g., amount and quality), costs of various machines (harvesters, forwarders, trucks) as well as distances between energy wood sources and users. (orig.)

  13. Cost implications of African swine fever in smallholder farrow-to-finish units: economic benefits of disease prevention through biosecurity.

    Science.gov (United States)

    Fasina, F O; Lazarus, D D; Spencer, B T; Makinde, A A; Bastos, A D S

    2012-06-01

    African swine fever remains the greatest limitation to the development of the pig industry in Africa, and parts of Asia and Europe. It is especially important in West and Central African countries where the disease has become endemic. Biosecurity is the implementation of a set of measures that reduce the risk of infection through segregation, cleaning and disinfection. Using a 122-sow piggery unit, a financial model and costing were used to estimate the economic benefits of effective biosecurity against African swine fever. The outcomes suggest that pig production is a profitable venture that can generate a profit of approximately US$109,637.40 per annum and that an outbreak of African swine fever (ASF) has the potential to cause losses of up to US$910,836.70 in a single year. The implementation of biosecurity and its effective monitoring can prevent losses owing to ASF and is calculated to give a benefit-cost ratio of 29. A full implementation of biosecurity will result in a 9.70% reduction in total annual profit, but is justified in view of the substantial costs incurred in the event of an ASF outbreak. Biosecurity implementation is robust and capable of withstanding changes in input costs including moderate feed price increases, higher management costs and marginal reductions in total outputs. It is concluded that biosecurity is a key to successful pig production in an endemic situation. © 2011 Blackwell Verlag GmbH.

  14. Break-Even Cost for Residential Photovoltaics in the United States: Key Drivers and Sensitivities

    Energy Technology Data Exchange (ETDEWEB)

    Denholm, P.; Margolis, R. M.; Ong, S.; Roberts, B.

    2009-12-01

    Grid parity--or break-even cost--for photovoltaic (PV) technology is defined as the point where the cost of PV-generated electricity equals the cost of electricity purchased from the grid. Break-even cost is expressed in $/W of an installed system. Achieving break-even cost is a function of many variables. Consequently, break-even costs vary by location and time for a country, such as the United States, with a diverse set of resources, electricity prices, and other variables. In this report, we analyze PV break-even costs for U.S. residential customers. We evaluate some key drivers of grid parity both regionally and over time. We also examine the impact of moving from flat to time-of-use (TOU) rates, and we evaluate individual components of the break-even cost, including effect of rate structure and various incentives. Finally, we examine how PV markets might evolve on a regional basis considering the sensitivity of the break-even cost to four major drivers: technical performance, financing parameters, electricity prices and rates, and policies. We find that local incentives rather than ?technical? parameters are in general the key drivers of the break-even cost of PV. Additionally, this analysis provides insight about the potential viability of PV markets.

  15. [Cost analysis as a tool for assessing the efficacy of intensive care units].

    Science.gov (United States)

    Maierhofer, T; Pfisterer, F; Bender, A; Küchenhoff, H; Moerer, O; Burchardi, H; Hartl, W H

    2017-06-16

    The German "Hospital Structure Act" intends to align the state hospital planning on quality criteria. Within this process cost-utility analyses (CUAs) shall be used to assess the efficacy of medical care. To be objective, CUAs of intensive care units (ICUs) require standardization (adjustment) of costs. The present study analyzed the extent to which treatment costs are related to patient-specific baseline variables (such as type and severity of the primary disease). From 2000-2004, a bottom-up procedure was used to quantify total costs on 14 ICUs in nine German university hospitals. Results were combined with demographic data, and data indicating type (ICD-10 codes) and severity (ICU scoring systems) of the primary disease at ICU admission. Various statistical models were tested to identify that which best described the associations between baseline variables and costs. In all, 3803 critically ill patients could be examined. The median of treatment costs per patient was 3199 € (IQR 1768-6659 €). No model allowed an acceptably precise adjustment of costs; the estimated mean absolute prognostic error was at least 3860 € (mean relative prognostic error 66%), when we tested an Extreme Gradient Boosting Model. Instruments which are currently available (cost adjustment based on patient-specific baseline variables) do not allow a standardization of costs, and an objective CUA of ICUs. Factors unknown at baseline may cause a large portion of treatment costs.

  16. [The cost in calculating transport noise disturbances in public decision making].

    Science.gov (United States)

    Quinet, E

    2001-09-01

    The public decision-making methods in transport are based on cost-benefit analysis, by which the consequences of the decision (standards for vehicles, new infrastructures...) are converted in monetary amounts and compared to the cost of implementation of the decision. But some of these consequences, especially those related to environment, are not directly expressed in monetary terms. The article aims at offsetting this difficulty in the case of noise. The possible methods for getting money values of noise are presented; it is shown that the estimates to which they lead are coherent and consistent. Then a comparison is made between the present procedures and the procedures which could be implemented, and it is shown that large gains of efficiency could be obtained.

  17. The Economic Cost of Methamphetamine Use in the United States, 2005

    Science.gov (United States)

    Nicosia, Nancy; Pacula, Rosalie Liccardo; Kilmer, Beau; Lundberg, Russell; Chiesa, James

    2009-01-01

    This first national estimate suggests that the economic cost of methamphetamine (meth) use in the United States reached $23.4 billion in 2005. Given the uncertainty in estimating the costs of meth use, this book provides a lower-bound estimate of $16.2 billion and an upper-bound estimate of $48.3 billion. The analysis considers a wide range of…

  18. Evaluation of syngas production unit cost of bio-gasification facility using regression analysis techniques

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Yangyang; Parajuli, Prem B.

    2011-08-10

    Evaluation of economic feasibility of a bio-gasification facility needs understanding of its unit cost under different production capacities. The objective of this study was to evaluate the unit cost of syngas production at capacities from 60 through 1800Nm 3/h using an economic model with three regression analysis techniques (simple regression, reciprocal regression, and log-log regression). The preliminary result of this study showed that reciprocal regression analysis technique had the best fit curve between per unit cost and production capacity, with sum of error squares (SES) lower than 0.001 and coefficient of determination of (R 2) 0.996. The regression analysis techniques determined the minimum unit cost of syngas production for micro-scale bio-gasification facilities of $0.052/Nm 3, under the capacity of 2,880 Nm 3/h. The results of this study suggest that to reduce cost, facilities should run at a high production capacity. In addition, the contribution of this technique could be the new categorical criterion to evaluate micro-scale bio-gasification facility from the perspective of economic analysis.

  19. The United Nations and the Nordic Four: Cautious Sceptics, Committed Believers, Cost-benefit Calculators

    DEFF Research Database (Denmark)

    Jakobsen, Peter Viggo

    2017-01-01

    published by DAC. This changed in the second part of the 1960s as Nordic decision-makers realized that they by cooperating with each other and by supporting the UN could enhance their own security, promote their values, generate pride at home and enhance their international prestige and influence abroad...

  20. The United Nations and the Nordic Four: Cautious Sceptics, Committed Believers, Cost-benefit Calculators

    DEFF Research Database (Denmark)

    Jakobsen, Peter Viggo

    2017-01-01

    . The Nordics became UN believers playing leading roles within the fields of development assistance and peacekeeping, and maintaining this position became a foreign policy objective in its own right, which was internalized as part of their national and Nordic identities. Being Nordic meant making greater....... The Nordics increased their aid and troop contributions to the EU and NATO for a combination of interest-based and altruistic reasons and this gradually gave the UN a less prominent position in their foreign policy identities. The Nordics has not abandoned the UN, however. While the troops contributions to UN...

  1. The societal cost of heroin use disorder in the United States.

    Directory of Open Access Journals (Sweden)

    Ruixuan Jiang

    Full Text Available Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars.An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose.Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user. One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users.The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder.

  2. Calculation of HELAS amplitudes for QCD processes using graphics processing unit (GPU)

    Science.gov (United States)

    Hagiwara, K.; Kanzaki, J.; Okamura, N.; Rainwater, D.; Stelzer, T.

    2010-11-01

    We use a graphics processing unit (GPU) for fast calculations of helicity amplitudes of quark and gluon scattering processes in massless QCD. New HEGET ( HELAS Evaluation with GPU Enhanced Technology) codes for gluon self-interactions are introduced, and a C++ program to convert the MadGraph generated FORTRAN codes into HEGET codes in CUDA (a C-platform for general purpose computing on GPU) is created. Because of the proliferation of the number of Feynman diagrams and the number of independent color amplitudes, the maximum number of final state jets we can evaluate on a GPU is limited to 4 for pure gluon processes ( gg→4 g), or 5 for processes with one or more quark lines such as qoverline{q}→ 5g and qq→ qq+3 g. Compared with the usual CPU-based programs, we obtain 60-100 times better performance on the GPU, except for 5-jet production processes and the gg→4 g processes for which the GPU gain over the CPU is about 20.

  3. Price competition and hospital cost growth in the United States (1989-1994).

    Science.gov (United States)

    Bamezai, A; Zwanziger, J; Melnick, G A; Mann, J M

    1999-05-01

    In recent years, most health care markets in the United States (US) have experienced rapid penetration by health maintenance organizations (HMOs) and preferred provider organizations (PPOs). During this same period, the US has also experienced slowing health care costs. Using a national database, we demonstrate that HMOs and PPOs have significantly restrained cost growth among hospitals located in competitive hospital markets, but not so in the case of hospitals located in relatively concentrated markets. In relative terms, we estimate that HMOs have contained cost growth more effectively than PPOs.

  4. Cost Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fairey, Philip [BA-PIRC/Florida Solar Energy Center, Cocoa, FL (United States); Parker, Danny [BA-PIRC/Florida Solar Energy Center, Cocoa, FL (United States)

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous United States. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  5. Estimating the Number of Heterosexual Persons in the United States to Calculate National Rates of HIV Infection.

    Directory of Open Access Journals (Sweden)

    Amy Lansky

    Full Text Available This study estimated the proportions and numbers of heterosexuals in the United States (U.S. to calculate rates of heterosexually acquired human immunodeficiency virus (HIV infection. Quantifying the burden of disease can inform effective prevention planning and resource allocation.Heterosexuals were defined as males and females who ever had sex with an opposite-sex partner and excluded those with other HIV risks: persons who ever injected drugs and males who ever had sex with another man. We conducted meta-analysis using data from 3 national probability surveys that measured lifetime (ever sexual activity and injection drug use among persons aged 15 years and older to estimate the proportion of heterosexuals in the United States population. We then applied the proportion of heterosexual persons to census data to produce population size estimates. National HIV infection rates among heterosexuals were calculated using surveillance data (cases attributable to heterosexual contact in the numerators and the heterosexual population size estimates in the denominators.Adult and adolescent heterosexuals comprised an estimated 86.7% (95% confidence interval: 84.1%-89.3% of the U.S. population. The estimate for males was 84.1% (CI: 81.2%-86.9% and for females was 89.4% (95% CI: 86.9%-91.8%. The HIV diagnosis rate for 2013 was 5.2 per 100,000 heterosexuals and the rate of persons living with diagnosed HIV infection in 2012 was 104 per 100,000 heterosexuals aged 13 years or older. Rates of HIV infection were >20 times as high among black heterosexuals compared to white heterosexuals, indicating considerable disparity. Rates among heterosexual men demonstrated higher disparities than overall population rates for men.The best available data must be used to guide decision-making for HIV prevention. HIV rates among heterosexuals in the U.S. are important additions to cost effectiveness and other data used to make critical decisions about resources for

  6. Energy- and cost-efficient lattice-QCD computations using graphics processing units

    Energy Technology Data Exchange (ETDEWEB)

    Bach, Matthias

    2014-07-01

    calculations require a sampling of the phase space. The hybrid Monte Carlo (HMC) algorithm performs this. For this task, a single AMD Radeon HD 7970 GPU provides four times the performance of two AMD Opteron 6220 running an optimized reference code. The same advantage is achieved in terms of energy-efficiency. In terms of normalized total cost of acquisition (TCA), GPU-based clusters match conventional large-scale LQCD systems. Contrary to those, however, they can be scaled up from a single node. Examples of large GPU-based systems are LOEWE-CSC and SANAM. On both, CL{sup 2}QCD has already been used in production for LQCD studies.

  7. Energy savings estimates and cost benefit calculations for high performance relocatable classrooms

    Energy Technology Data Exchange (ETDEWEB)

    Rainer, Leo I.; Hoeschele, Marc A.; Apte, Michael G.; Shendell, Derek G.; Fisk, Wlliam J.

    2003-12-01

    This report addresses the results of detailed monitoring completed under Program Element 6 of Lawrence Berkeley National Laboratory's High Performance Commercial Building Systems (HPCBS) PIER program. The purpose of the Energy Simulations and Projected State-Wide Energy Savings project is to develop reasonable energy performance and cost models for high performance relocatable classrooms (RCs) across California climates. A key objective of the energy monitoring was to validate DOE2 simulations for comparison to initial DOE2 performance projections. The validated DOE2 model was then used to develop statewide savings projections by modeling base case and high performance RC operation in the 16 California climate zones. The primary objective of this phase of work was to utilize detailed field monitoring data to modify DOE2 inputs and generate performance projections based on a validated simulation model. Additional objectives include the following: (1) Obtain comparative performance data on base case and high performance HVAC systems to determine how they are operated, how they perform, and how the occupants respond to the advanced systems. This was accomplished by installing both HVAC systems side-by-side (i.e., one per module of a standard two module, 24 ft by 40 ft RC) on the study RCs and switching HVAC operating modes on a weekly basis. (2) Develop projected statewide energy and demand impacts based on the validated DOE2 model. (3) Develop cost effectiveness projections for the high performance HVAC system in the 16 California climate zones.

  8. [Opportunity cost for men who visit family medicine units in the city of Querétaro, Mexico].

    Science.gov (United States)

    Martínez Carranza, Edith Olimpia; Villarreal Ríos, Enrique; Vargas Daza, Emma Rosa; Galicia Rodríguez, Liliana; Martínez González, Lidia

    2010-12-01

    To determine the opportunity cost for men who seek care in the family medicine units (FMU) of the Mexican Social Security Institute (IMSS, Instituto Mexicano del Seguro Social) in the city of Querétaro. A sample was selected of 807 men, ages 20 to 59 years, who sought care through the family medicine, laboratory, and pharmacy services provided by the FMU at the IMSS in Querétaro. Patients referred for emergency services and those who left the facilities without receiving care were excluded. The sample (n = 807) was calculated using the averages for an infinite population formula, with a confidence interval of 95% (CI95%) and an average opportunity cost of US$5.5 for family medicine, US$3.1 for laboratory services, and US$2.3 for pharmacy services. Estimates included the amount of time spent on travel, waiting, and receiving care; the number of people accompanying the patient, and the cost per minute of paid and unpaid job activities. The opportunity cost was calculated using the estimated cost per minute for travel, waiting, and receiving care for patients and their companions. The opportunity cost for the patient travel was estimated at US$0.97 (CI95%: 0.81-1.15), while wait time was US$5.03 (CI95%: 4.08-6.09) for family medicine, US$0.06 (CI95%: 0.05-0.08) for pharmacy services, and US$1.89 (CI95%: 1.56-2.25) for laboratory services. The average opportunity cost for an unaccompanied patient visit varied between US$1.10 for pharmacy services alone and US$8.64 for family medicine, pharmacy, and laboratory services. The weighted opportunity cost for family medicine was US$6.24. Given that the opportunity cost for men who seek services in FMU corresponds to more than half of a minimum salary, it should be examined from an institutional perspective whether this is the best alternative for care.

  9. Cost optimal building performance requirements. Calculation methodology for reporting on national energy performance requirements on the basis of cost optimality within the framework of the EPBD

    Energy Technology Data Exchange (ETDEWEB)

    Boermans, T.; Bettgenhaeuser, K.; Hermelink, A.; Schimschar, S. [Ecofys, Utrecht (Netherlands)

    2011-05-15

    On the European level, the principles for the requirements for the energy performance of buildings are set by the Energy Performance of Buildings Directive (EPBD). Dating from December 2002, the EPBD has set a common framework from which the individual Member States in the EU developed or adapted their individual national regulations. The EPBD in 2008 and 2009 underwent a recast procedure, with final political agreement having been reached in November 2009. The new Directive was then formally adopted on May 19, 2010. Among other clarifications and new provisions, the EPBD recast introduces a benchmarking mechanism for national energy performance requirements for the purpose of determining cost-optimal levels to be used by Member States for comparing and setting these requirements. The previous EPBD set out a general framework to assess the energy performance of buildings and required Member States to define maximum values for energy delivered to meet the energy demand associated with the standardised use of the building. However it did not contain requirements or guidance related to the ambition level of such requirements. As a consequence, building regulations in the various Member States have been developed by the use of different approaches (influenced by different building traditions, political processes and individual market conditions) and resulted in different ambition levels where in many cases cost optimality principles could justify higher ambitions. The EPBD recast now requests that Member States shall ensure that minimum energy performance requirements for buildings are set 'with a view to achieving cost-optimal levels'. The cost optimum level shall be calculated in accordance with a comparative methodology. The objective of this report is to contribute to the ongoing discussion in Europe around the details of such a methodology by describing possible details on how to calculate cost optimal levels and pointing towards important factors and

  10. [Socioeconomic Costs of Asthma in the European Union, United States and Canada: A Systematic Review].

    Science.gov (United States)

    Puig-Junoy, Jaume; Pascual-Argenté, Natàlia

    2017-03-09

    Asthma is responsible for a large number of doctor and emergency visits due to exacerbations and inadequate control of the disease, which give rise to very high associated economic costs. The social cost of asthma comprises both the healthcare and non-healthcare costs. The purpose of this study was to analyse up-to-date estimates of the social cost of asthma, with special reference to the influence of level of severity and degree of control. A systematic review of original cost-of-illness studies of asthma published in English or Spanish between January 2004 and December 2014 and indexed in PubMed, IBECS or IME was conducted. 29 cost-of-illness studies of asthma were identified, 21 of which used the societal perspective. Only 10 studies estimated the incremental cost of asthma with a control group, and none of them refers to EU countries. Of these 10, only 4 were regarded as high-quality evidence, insofar as they combined a matched control with regression models. The annual incremental cost of asthma in adults ranged from €416 to €5,317. The incremental healthcare cost of asthma increased with level of severity, from €964 for intermittent asthma to €11,703 for severe persistent asthma in adults. In adults, the incremental non-healthcare cost of asthma ranged from €136 to €3,461. Selected studies in this review show great heterogeneity due to different population characteristics, study designs and valuation methods, which limits their comparability. However, it can be concluded that incremental healthcare costs of asthma, compared to people without asthma, exceeds seven hundred Euros (valued in 2013) in most of the reviwed estimation for several countries. This figure is greater for studies from the United States. The incremental cost per patient increases very rapidly with level of severity and decreases with asthma patient control.

  11. Automatic teeth axes calculation for well-aligned teeth using cost profile analysis along teeth center arch.

    Science.gov (United States)

    Kim, Gyehyun; Lee, Jeongjin; Seo, Jinwook; Lee, Wooshik; Shin, Yeong-Gil; Kim, Bohyoung

    2012-04-01

    In dental implantology and virtual dental surgery planning using computed tomography (CT) images, the examination of the axes of neighboring and/or biting teeth is important to improve the performance of the masticatory system as well as the aesthetic beauty. However, due to its high connectivity to neighboring teeth and jawbones, a tooth and/or its axis is very elusive to automatically identify in dental CT images. This paper presents a novel method of automatically calculating individual teeth axes. The planes separating the individual teeth are automatically calculated using cost profile analysis along the teeth center arch. In this calculation, a novel plane cost function, which considers the intensity and the gradient, is proposed to favor the teeth separation planes crossing the teeth interstice and suppress the possible inappropriately detected separation planes crossing the soft pulp. The soft pulp and dentine of each individually separated tooth are then segmented by a fast marching method with two newly proposed speed functions considering their own specific anatomical characteristics. The axis of each tooth is finally calculated using principal component analysis on the segmented soft pulp and dentine. In experimental results using 20 clinical datasets, the average angle and minimum distance differences between the teeth axes manually specified by two dentists and automatically calculated by the proposed method were 1.94° ± 0.61° and 1.13 ± 0.56 mm, respectively. The proposed method identified the individual teeth axes accurately, demonstrating that it can give dentists substantial assistance during dental surgery such as dental implant placement and orthognathic surgery.

  12. Lung stress and strain calculations in mechanically ventilated patients in the intensive care unit

    NARCIS (Netherlands)

    P. Blankman (Paul); D. Hasan (Djo); I.G. Bikker (Ido); D.A.M.P.J. Gommers (Diederik)

    2016-01-01

    textabstractBackground Stress and strain are parameters to describe respiratory mechanics during mechanical ventilation. Calculations of stress require invasive and difficult to perform esophageal pressure measurements. The hypothesis of the present study was: Can lung stress be reliably calculated

  13. Variation in Number of Doses, Bottle Volume, and Calculated Yearly Cost of Generic and Branded Latanoprost for Glaucoma.

    Science.gov (United States)

    Queen, Joanna H; Feldman, Robert M; Lee, David A

    2016-03-01

    To evaluate discrepancies in doses per bottle, bottle fill volume, and cost among branded and generic formulations of latanoprost. Comparative economic analysis. This study was conducted at the Ruiz Department of Ophthalmology and Visual Science at The University of Texas Health Science Center at Houston (UTHealth). Four regionally available latanoprost formulations were measured. Number of drops per bottle and actual bottle fill volume were measured for a calculated sample size (10 bottles). Annual cost (using average wholesale price), days use per bottle, drops per milliliter, and number of bottles used per year were calculated. Data were summarized using mean and standard deviation; 1-way analysis of variance and post hoc Tukey's studentized range test were used for comparing means among manufacturers. Pfizer's branded lantanoprost, Xalatan (New York, New York, USA), had the largest fill volume (P Levene 0.14). Annual cost and number of doses per bottle, factors important to patients, vary significantly depending on the manufacturer of latanoprost. Practitioners can better advise patients by being aware of these differences. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 48 CFR 9904.410 - Allocation of business unit general and administrative expenses to final cost objectives.

    Science.gov (United States)

    2010-10-01

    ... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...

  15. 2007 Effect of Changes in Layout Shape on Unit Construction Cost

    African Journals Online (AJOL)

    ezra

    floor space. Ibrahim (2004) used regression analysis to develop such predictive models for assessing the effect of variation in building plan shape on unit construction cost. However, contrary to Chau's conclusions, Ibrahim's results confirmed the predictive powers of the existing plan shape indices and that of using some of ...

  16. An Alternative Method for Computing Unit Costs and Productivity Ratios. AIR 1984 Annual Forum Paper.

    Science.gov (United States)

    Winstead, Wayland H.; And Others

    An alternative measure for evaluating the performance of academic departments was studied. A comparison was made with the traditional manner for computing unit costs and productivity ratios: prorating the salary and effort of each faculty member to each course level based on the personal mix of course taught. The alternative method used averaging…

  17. Bottom-up or top-down: unit cost estimation of tuberculosis diagnostic tests in India

    NARCIS (Netherlands)

    Rupert, S.; Vassall, A.; Raizada, N.; Khaparde, S. D.; Boehme, C.; Salhotra, V. S.; Sachdeva, K. S.; Nair, S. A.; van't Hoog, A. H.

    2017-01-01

    SETTING: Of 18 sites that participated in an implementation study of the Xpert((R)) MTB/R1F assay in India, we selected five microscopy centres and two reference laboratories. OBJECTIVE: To obtain unit costs of diagnostic tests for tuberculosis (TB) and drug-resistant TB. DESIGN: Laboratories were

  18. The Cost-Effectiveness of Supported Employment for Adults with Autism in the United Kingdom

    Science.gov (United States)

    Mavranezouli, Ifigeneia; Megnin-Viggars, Odette; Cheema, Nadir; Howlin, Patricia; Baron-Cohen, Simon; Pilling, Stephen

    2014-01-01

    Adults with autism face high rates of unemployment. Supported employment enables individuals with autism to secure and maintain a paid job in a regular work environment. The objective of this study was to assess the cost-effectiveness of supported employment compared with standard care (day services) for adults with autism in the United Kingdom.…

  19. The unit costs of inpatient hospital days, outpatient visits, and daycare treatments in the fields of oncology and hematology.

    Science.gov (United States)

    Tan, Siok Swan; Van Gils, Chantal W M; Franken, Margreet G; Hakkaart-van Roijen, Leona; Uyl-de Groot, Carin A

    2010-01-01

    Many economic evaluations are conducted in the fields of oncology and hematology, partially owing to the introduction of new expensive drugs in this field. Even though inpatient days, outpatient visits, and daycare treatments are frequently the main drivers of total treatment costs, their unit costs often lack generalizability. Therefore, we aimed to determine the unit costs of inpatient hospital days, outpatient visits, and daycare treatments specifically for oncological and hematological diseases in The Netherlands from the hospital's perspective. Unit costs were collected from 30 oncological and hematological departments of 6 university and 24 general hospitals. Costs included direct labor and indirect labor, hotel and nutrition, overheads and capital. Ordinary least squares regression models were constructed to examine the degree of association between unit costs and hospital and hospital department characteristics. All costs were based on Euro 2007 cost data. At university hospitals, the unit costs per inpatient day were determined at €633 in oncological and €680 in hematological departments. At general hospitals, the mean costs per inpatient day were €400. Unit costs for inpatient hospital days, outpatient visits. and daycare treatments equalled the relative ratio 100:21:44. Direct labor costs were the major cost driver and the type of hospital (university, yes/no) was a strong predictor of unit costs. The present study provided unit costs for inpatient hospital days, outpatient visits, and daycare treatments in the fields of oncology and hematology. The results may be used as Dutch reference unit prices in economic evaluations assessing oncological and hematological diseases. © 2010, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

  20. Economic Cost of Campylobacter, Norovirus and Rotavirus Disease in the United Kingdom.

    Directory of Open Access Journals (Sweden)

    Clarence C Tam

    Full Text Available To estimate the annual cost to patients, the health service and society of infectious intestinal disease (IID from Campylobacter, norovirus and rotavirus.Secondary data analysis.The United Kingdom population, 2008-9.Cases and frequency of health services usage due to these three pathogens; associated healthcare costs; direct, out-of-pocket expenses; indirect costs to patients and caregivers.The median estimated costs to patients and the health service at 2008-9 prices were: Campylobacter £50 million (95% CI: £33m-£75m, norovirus £81 million (95% CI: £63m-£106m, rotavirus £25m (95% CI: £18m-£35m. The costs per case were approximately £30 for norovirus and rotavirus, and £85 for Campylobacter. This was mostly borne by patients and caregivers through lost income or out-of-pocket expenditure. The cost of Campylobacter-related Guillain-Barré syndrome hospitalisation was £1.26 million (95% CI: £0.4m-£4.2m.Norovirus causes greater economic burden than Campylobacter and rotavirus combined. Efforts to control IID must prioritise norovirus. For Campylobacter, estimated costs should be considered in the context of expenditure to control this pathogen in agriculture, food production and retail. Our estimates, prior to routine rotavirus immunisation in the UK, provide a baseline vaccine cost-effectiveness analyses.

  1. Short-term costs of preeclampsia to the United States health care system.

    Science.gov (United States)

    Stevens, Warren; Shih, Tiffany; Incerti, Devin; Ton, Thanh G N; Lee, Henry C; Peneva, Desi; Macones, George A; Sibai, Baha M; Jena, Anupam B

    2017-09-01

    Preeclampsia is a leading cause of maternal morbidity and mortality and adverse neonatal outcomes. Little is known about the extent of the health and cost burden of preeclampsia in the United States. This study sought to quantify the annual epidemiological and health care cost burden of preeclampsia to both mothers and infants in the United States in 2012. We used epidemiological and econometric methods to assess the annual cost of preeclampsia in the United States using a combination of population-based and administrative data sets: the National Center for Health Statistics Vital Statistics on Births, the California Perinatal Quality Care Collaborative Databases, the US Health Care Cost and Utilization Project database, and a commercial claims data set. Preeclampsia increased the probability of an adverse event from 4.6% to 10.1% for mothers and from 7.8% to 15.4% for infants while lowering gestational age by 1.7 weeks (P preeclampsia during the first 12 months after birth was $1.03 billion for mothers and $1.15 billion for infants. The cost burden per infant is dependent on gestational age, ranging from $150,000 at 26 weeks gestational age to $1311 at 36 weeks gestational age. In 2012, the cost of preeclampsia within the first 12 months of delivery was $2.18 billion in the United States ($1.03 billion for mothers and $1.15 billion for infants), and was disproportionately borne by births of low gestational age. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Increasing the competitiveness of maintenance contract rates by using an alternative methodology for the calculation of average vehicle maintenance costs

    Directory of Open Access Journals (Sweden)

    Stephen Carstens

    2008-11-01

    Full Text Available Companies tend to outsource transport to fleet management companies to increase efficiencies if transport is a non-core activity. The provision of fleet management services on contract introduces a certain amount of financial risk to the fleet management company, specifically fixed rate maintenance contracts. The quoted rate needs to be sufficient and also competitive in the market. Currently the quoted maintenance rates are based on the maintenance specifications of the manufacturer and the risk management approach of the fleet management company. This is usually reflected in a contingency that is included in the quoted maintenance rate. An alternative methodology for calculating the average maintenance cost for a vehicle fleet is proposed based on the actual maintenance expenditures of the vehicles and accepted statistical techniques. The proposed methodology results in accurate estimates (and associated confidence limits of the true average maintenance cost and can beused as a basis for the maintenance quote.

  3. Calculation method for computer-generated holograms with cylindrical basic object light by using a graphics processing unit.

    Science.gov (United States)

    Sakata, Hironobu; Hosoyachi, Kouhei; Yang, Chan-Young; Sakamoto, Yuji

    2011-12-01

    It takes an enormous amount of time to calculate a computer-generated hologram (CGH). A fast calculation method for a CGH using precalculated object light has been proposed in which the light waves of an arbitrary object are calculated using transform calculations of the precalculated object light. However, this method requires a huge amount of memory. This paper proposes the use of a method that uses a cylindrical basic object light to reduce the memory requirement. Furthermore, it is accelerated by using a graphics processing unit (GPU). Experimental results show that the calculation speed on a GPU is about 65 times faster than that on a CPU. © 2011 Optical Society of America

  4. Net Costs Due to Seasonal Influenza Vaccination--United States, 2005-2009.

    Directory of Open Access Journals (Sweden)

    Cristina Carias

    Full Text Available Seasonal influenza causes considerable morbidity and mortality across all age groups, and influenza vaccination was recommended in 2010 for all persons aged 6 months and above. We estimated the averted costs due to influenza vaccination, taking into account the seasonal economic burden of the disease.We used recently published values for averted outcomes due to influenza vaccination for influenza seasons 2005-06, 2006-07, 2007-08, and 2008-09, and age cohorts 6 months-4 years, 5-19 years, 20-64 years, and 65 years and above. Costs were calculated according to a payer and societal perspective (in 2009 US$, and took into account medical costs and productivity losses.When taking into account direct medical costs (payer perspective, influenza vaccination was cost saving only for the older age group (65≥ in seasons 2005-06 and 2007-08. Using the same perspective, influenza vaccination resulted in total costs of $US 1.7 billion (95%CI: $US 0.3-4.0 billion in 2006-07 and $US 1.8 billion (95%CI: $US 0.1-4.1 billion in 2008-09. When taking into account a societal perspective (and including the averted lost earnings due to premature death averted deaths in the older age group influenced the results, resulting in cost savings for all ages combined in season 07-08.Influenza vaccination was cost saving in the older age group (65≥ when taking into account productivity losses and, in some seasons, when taking into account medical costs only. Averted costs vary significantly per season; however, in seasons where the averted burden of deaths is high in the older age group, averted productivity losses due to premature death tilt overall seasonal results towards savings. Indirect vaccination effects and the possibility of diminished case severity due to influenza vaccination were not considered, thus the averted burden due to influenza vaccine may be even greater than reported.

  5. Net Costs Due to Seasonal Influenza Vaccination--United States, 2005-2009.

    Science.gov (United States)

    Carias, Cristina; Reed, Carrie; Kim, Inkyu K; Foppa, Ivo M; Biggerstaff, Matthew; Meltzer, Martin I; Finelli, Lyn; Swerdlow, David L

    2015-01-01

    Seasonal influenza causes considerable morbidity and mortality across all age groups, and influenza vaccination was recommended in 2010 for all persons aged 6 months and above. We estimated the averted costs due to influenza vaccination, taking into account the seasonal economic burden of the disease. We used recently published values for averted outcomes due to influenza vaccination for influenza seasons 2005-06, 2006-07, 2007-08, and 2008-09, and age cohorts 6 months-4 years, 5-19 years, 20-64 years, and 65 years and above. Costs were calculated according to a payer and societal perspective (in 2009 US$), and took into account medical costs and productivity losses. When taking into account direct medical costs (payer perspective), influenza vaccination was cost saving only for the older age group (65≥) in seasons 2005-06 and 2007-08. Using the same perspective, influenza vaccination resulted in total costs of $US 1.7 billion (95%CI: $US 0.3-4.0 billion) in 2006-07 and $US 1.8 billion (95%CI: $US 0.1-4.1 billion) in 2008-09. When taking into account a societal perspective (and including the averted lost earnings due to premature death) averted deaths in the older age group influenced the results, resulting in cost savings for all ages combined in season 07-08. Influenza vaccination was cost saving in the older age group (65≥) when taking into account productivity losses and, in some seasons, when taking into account medical costs only. Averted costs vary significantly per season; however, in seasons where the averted burden of deaths is high in the older age group, averted productivity losses due to premature death tilt overall seasonal results towards savings. Indirect vaccination effects and the possibility of diminished case severity due to influenza vaccination were not considered, thus the averted burden due to influenza vaccine may be even greater than reported.

  6. Cost of wind energy: comparing distant wind resources to local resources in the midwestern United States.

    Science.gov (United States)

    Hoppock, David C; Patiño-Echeverri, Dalia

    2010-11-15

    The best wind sites in the United States are often located far from electricity demand centers and lack transmission access. Local sites that have lower quality wind resources but do not require as much power transmission capacity are an alternative to distant wind resources. In this paper, we explore the trade-offs between developing new wind generation at local sites and installing wind farms at remote sites. We first examine the general relationship between the high capital costs required for local wind development and the relatively lower capital costs required to install a wind farm capable of generating the same electrical output at a remote site,with the results representing the maximum amount an investor should be willing to pay for transmission access. We suggest that this analysis can be used as a first step in comparing potential wind resources to meet a state renewable portfolio standard (RPS). To illustrate, we compare the cost of local wind (∼50 km from the load) to the cost of distant wind requiring new transmission (∼550-750 km from the load) to meet the Illinois RPS. We find that local, lower capacity factor wind sites are the lowest cost option for meeting the Illinois RPS if new long distance transmission is required to access distant, higher capacity factor wind resources. If higher capacity wind sites can be connected to the existing grid at minimal cost, in many cases they will have lower costs.

  7. [Cost benefit analysis of body surface cultures at a neonatal unit].

    Science.gov (United States)

    Marugán Isabel, V; Ochoa Sangrador, C; Martín Ureste, I; Brezmes Valdivieso, M F; Casanueva Pascual, T; Carrascal Tejado, A

    2003-12-01

    Infection continues to be a cause of concern in neonatal units. The high cost of the body surface cultures used to study infection and their limited utility is controversial. The medical records of newborns admitted for suspected infection in 1999 were retrospectively reviewed. Request criteria, cost, and the clinical utility of body surface cultures were analyzed. In 1999, body surface cultures were requested in 204 newborns admitted to hospital (70 % of all admitted newborns). Of these, six were diagnosed with bacteremia (6.23/1000; 95 % CI: 5.9-6.5). The most frequently isolated microorganisms were Escherichia coli and Streptococcus agalactiae. The total cost of body surface cultures was 6,510.95 euros (1,083,331 pesetas). In 25 % of cases the results of cultures influenced clinical decision making. The cost necessary to obtain clinical repercussion in a patient was 191.50 euros (31,863 pesetas). Requesting two body surface cultures only (otic and umbilical) halved the cost without diminishing their clinical utility. A considerable percentage of newborns admitted to hospital present suspected infection requiring microbiological studies. Although the cost of body surface cultures is high, the results of these cultures influence diagnostic and therapeutic decisions in a quarter of patients. We do not believe that eliminating the use of these cultures would be beneficial. However, their cost can be reduced by carefully selecting request criteria and by limiting cultures to two samples (otic and umbilical).

  8. Sizing Combined Heat and Power Units and Domestic Building Energy Cost Optimisation

    Directory of Open Access Journals (Sweden)

    Dongmin Yu

    2017-06-01

    Full Text Available Many combined heat and power (CHP units have been installed in domestic buildings to increase energy efficiency and reduce energy costs. However, inappropriate sizing of a CHP may actually increase energy costs and reduce energy efficiency. Moreover, the high manufacturing cost of batteries makes batteries less affordable. Therefore, this paper will attempt to size the capacity of CHP and optimise daily energy costs for a domestic building with only CHP installed. In this paper, electricity and heat loads are firstly used as sizing criteria in finding the best capacities of different types of CHP with the help of the maximum rectangle (MR method. Subsequently, the genetic algorithm (GA will be used to optimise the daily energy costs of the different cases. Then, heat and electricity loads are jointly considered for sizing different types of CHP and for optimising the daily energy costs through the GA method. The optimisation results show that the GA sizing method gives a higher average daily energy cost saving, which is 13% reduction compared to a building without installing CHP. However, to achieve this, there will be about 3% energy efficiency reduction and 7% input power to rated power ratio reduction compared to using the MR method and heat demand in sizing CHP.

  9. Costs Attributable to Overweight and Obesity in Working Asthma Patients in the United States.

    Science.gov (United States)

    Chang, Chongwon; Lee, Seung Mi; Choi, Byoung Whui; Song, Jong Hwa; Song, Hee; Jung, Sujin; Bai, Yoon Kyeong; Park, Haedong; Jeung, Seungwon; Suh, Dong Churl

    2017-01-01

    To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. This study was conducted using the 2003-2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861-$895] and $257 (95% CI: $251-$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253-$260) and $26 (95% CI: $26-$27) per person per year, respectively. Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma.

  10. Nuclide Inventory Calculation Using MCNPX for Wolsung Unit 1 Reactor Decommissioning

    Energy Technology Data Exchange (ETDEWEB)

    Rabir, Mohamad Hairie; Noh, Kyoung Ho; Hah, Chang Joo [KEPCO International Nuclear Graduate School, Daejeon (Korea, Republic of)

    2014-05-15

    The CINDER90 computation process involves utilizing linear Markovian chains to determine the time dependent nuclide densities. The CINDER90 depletion algorithm is implemented the MCNPX code package. The coupled depletion process involves a Monte-Carlo steady-state reaction rate calculation linked to a deterministic depletion calculation. The process is shown in Fig.1. MCNPX runs a steady state calculation to determine the system eigenvalue collision densities, recoverable energies from fission and neutrons per fission events. In order to generate number densities for the next time step, the CINDER90 code takes the MCNPX generated values and performs a depletion calculation. MCNPX then takes the new number densities and caries out a new steady-stated calculation. The process repeats itself until the final time step. This paper describe the preliminary source term and nuclide inventory calculation of Candu single fuel channel using MCNPX, as a part of the activities to support the equilibrium core model development and decommissioning evaluation process of a Candu reactor. The aim of this study was to apply the MCNPX code for source term and nuclide inventory calculation of Candu single fuel channel. Nuclide inventories as a function of burnup will be used to model an equilibrium core for Candu reactor. The core lifetime neutron fluence obtained from the model is used to estimate radioactivity at the stage of decommisioning. In general, as expected, the actinides and fission products build up increase with increasing burnup. Despite the fact that the MCNPX code is still in development we can conclude that the code is capable of obtaining relevant results in burnup and source term calculation. It is recommended that in the future work, the calculation has to be verified on the basis of experimental data or comparison with other codes.

  11. 75 FR 9102 - Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States...

    Science.gov (United States)

    2010-03-01

    ... Part 43 Recovery of Cost of Hospital and Medical Care and Treatment Furnished by the United States..., or dental care. This change responds to the increase in medical costs since 1992, when the current... United States responsible for the furnishing of hospital, medical, surgical, or dental care. During the...

  12. On tentative decommissioning cost analysis with specific authentic cost calculations with the application of the Omega code on a case linked to the Intermediate storage facility for spent fuel in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Vasko, Marek; Daniska, Vladimir; Ondra, Frantisek; Bezak, Peter; Kristofova, Kristina; Tatransky, Peter; Zachar, Matej [DECOM Slovakia, spol. s.r.o., J. Bottu 2, SK-917 01 Trnava (Slovakia); Lindskog, Staffan [Swedish Nuclear Power Inspectorate, Stockholm (Sweden)

    2007-03-15

    The presented report is focused on tentative calculations of basic decommissioning parameters such as costs, manpower and exposure of personnel for activities of older nuclear facility decommissioning in Sweden represented by Intermediate storage facility for spent fuel in Studsvik, by means of calculation code OMEGA. This report continuously follows up two previous projects, which described methodology of cost estimates of decommissioning with an emphasis to derive cost functions for alpha contaminated material and implementation of the advanced decommissioning costing methodology for Intermediate Storage facility for Spent Fuel in Studsvik. The main purpose of the presented study is to demonstrate the trial application of the advanced costing methodology using OMEGA code for Intermediate Storage Facility for Spent Fuel in Studsvik. Basic work packages presented in report are as follows: 1. Analysis and validation input data on Intermediate Storage Facility for Spent Fuel and assemble a database suitable for standardised decommissioning cost calculations including radiological parameters, 2. Proposal of range of decommissioning calculations and define an extent of decommissioning activities, 3. Defining waste management scenarios for particular material waste streams from Intermediate Storage Facility for Spent Fuel, 4. Developing standardised cost calculation structure applied for Intermediate Storage Facility for Spent Fuel decommissioning calculation and 5. Performing tentative decommissioning calculations for Intermediate Storage Facility for Spent Fuel by OMEGA code. Calculated parameters of decommissioning are presented in structure according to Proposed Standardized List of Items for Costing Purposes. All parameters are documented and summed up in both table and graphic forms in text and Annexes. The presented report documents availability and applicability of methodology for evaluation of costs and other parameters of decommissioning in a form implemented

  13. The Per Case and Total Annual Costs of Foodborne Illness in the United States.

    Science.gov (United States)

    Minor, Travis; Lasher, Angela; Klontz, Karl; Brown, Bradley; Nardinelli, Clark; Zorn, David

    2015-06-01

    We present an economic welfare-based method to estimate the health costs associated with foodborne illness caused by known viruses, bacteria, parasites, allergens, two marine biotoxins, and unspecified agents. The method generates health costs measured in both quality-adjusted life years and in dollars. We calculate the reduction in quality-adjusted life days caused by the illness and add reductions in quality-adjusted life years from any secondary effects that are estimated to occur. For fatal cases, we calculate the life years lost due to premature death. We add direct medical expenses to the monetary costs as derived from estimates of willingness to pay to reduce health risks. In total, we estimate that foodborne illness represents an annual burden to society of approximately $36 billion, with an average identified illness estimated to reduce quality-adjusted life days by 0.84, which is monetized and included in the average cost burden per illness of $3,630. © 2014 Society for Risk Analysis.

  14. 40 CFR 1065.20 - Units of measure and overview of calculations.

    Science.gov (United States)

    2010-07-01

    ... in the following SI units: (1) For ideal gases, µmol/mol, formerly ppm (volume). (2) For all..., repeatability, linearity, or noise specification. See § 1065.1001 for the definition of tolerance. In this part...

  15. A Probability Analysis of the Generating Cost for EU-APR1400 Single Unit

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Gak Hyeon; Kim, Sung Hwan [KHNP CRI, Seoul (Korea, Republic of)

    2014-10-15

    The nuclear power plant market is expected to grow rapidly in order to address issues of global warming, reducing CO{sub 2} emissions and securing stable electricity supplies. Under these circumstances, the main primary goal of the EU-APR100 development is to ensure export competitiveness in the European countries. To this end, EU-APR1400 have been developed based one te APR1400 (Advanced Power Reactor, GEN Type) The EU-APR1400 adds many advanced design features to its predecessor, as outlined below in Table 1. In this simulation, the results of the generating cost of the EU-APR1400 single unit were determined using the probability cost analysis technique, the generating cost range was shown to be 56.16 ∼ 70.92 won/kWh.

  16. Lung stress and strain calculations in mechanically ventilated patients in the intensive care unit.

    Science.gov (United States)

    Blankman, P; Hasan, D; Bikker, I G; Gommers, D

    2016-01-01

    Stress and strain are parameters to describe respiratory mechanics during mechanical ventilation. Calculations of stress require invasive and difficult to perform esophageal pressure measurements. The hypothesis of the present study was: Can lung stress be reliably calculated based on non-invasive lung volume measurements, during a decremental Positive end-expiratory pressure (PEEP) trial in mechanically ventilated patients with different diseases? Data of 26 pressure-controlled ventilated patients admitted to the ICU with different lung conditions were retrospectively analyzed: 11 coronary artery bypass graft (CABG), 9 neurology, and 6 lung disorders. During a decremental PEEP trial (from 15 to 0 cmH2 O in three steps) end-expiratory lung volume (EELV) measurements were performed at each PEEP step, without interruption of mechanical ventilation. Strain, specific elastance, and stress were calculated for each PEEP level. Elastance was calculated as delta PEEP divided by delta PEEP volume, whereas specific elastance is elastance times the FRC. Stress was calculated as specific elastance times the strain. Global strain was divided into dynamic (tidal volume) and static (PEEP) strain. Strain calculations based on FRC showed mainly changes in static component, whereas calculations based on EELV showed changes in both the static and dynamic component of strain. Stress calculated from EELV measurements was 24.0 ± 2.7 and 13.1 ± 3.8 cmH2 O in the lung disorder group at 15 and 5 cmH2 O PEEP. For the normal lungs, the stress values were 19.2 ± 3.2 and 10.9 ± 3.3 cmH2 O, respectively. These values are comparable to earlier publications. Specific elastance calculations were comparable in patients with neurologic and lung disorders, and lower in the CABG group due to recruitment in this latter group. Stress and strain can reliably be calculated at the bedside based on non-invasive EELV measurements during a decremental PEEP trial in patients with different diseases.

  17. Primer: The DOE Wind Energy Program's Approach to Calculating Cost of Energy: July 9, 2005 - July 8, 2006

    Energy Technology Data Exchange (ETDEWEB)

    George, K.; Schweizer, T.

    2008-01-01

    This report details the methodology used by DOE to calculate levelized cost of wind energy and demonstrates the variation in COE estimates due to different financing assumptions independent of wind generation technology.

  18. Calculating Amortized Capital Costs

    Science.gov (United States)

    This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  19. Do burn patients cost more? The intensive care unit costs of burn patients compared with controls matched for length of stay and acuity.

    Science.gov (United States)

    Patil, Vikram; Dulhunty, Joel M; Udy, Andrew; Thomas, Peter; Kucharski, Geraldine; Lipman, Jeffrey

    2010-01-01

    Modern intensive care management of burn patients is resource intensive with important ramifications for funding of regional burn services. The aim of this retrospective cohort study was to determine the intensive care unit costs for burn patients compared with nonburn patients matched for length of stay and severity of illness. The patient record was reviewed to compare costs associated with expendables (medications and fluids), investigations (laboratory and radiological tests), and physiotherapy sessions in 13 burn patients and 13 nonburn controls. Medical and nursing staff costs could not be differentially determined between groups. The cost of wound dressings were estimated for burn patients. The mean daily cost of burn patients was Australian dollars (AUD) 700.74 and AUD 697.99 for nonburn controls (P = .97), with an additional AUD 1411 estimated for nursing and medical staffing. There was no significant difference in the cost of expendables or laboratory tests between the groups. The largest drug and laboratory costs in both cases and controls were attributed to the use of meropenem and intravenous antifungals (25% and 30%, respectively) and arterial blood gas analysis (31% and 27%, respectively). Analgesics, anxiolytics, and sedatives costed AUD 21.58 more per day in burn patients than in controls (P = .054). Physiotherapy costs were AUD 18.62 higher per day in burn patients (P = .028), whereas radiology costs were AUD 108.10 higher in the control group (P = .001). Burn dressings costed AUD 120.77 per day. The authors found no significant difference in the mean daily intensive care unit cost of burn patients compared with controls matched for length of stay and acuity. However, physiotherapy and dressing costs were higher in burn patients, and there was a trend to increase costs associated with analgesic/anxiolytic/sedative medications. Antimicrobials accounted for a significant proportion of pharmacy costs in both groups.

  20. Activity-based Calculation Models for the Brazilian Air Force Cellular Unit of Intendancy

    Science.gov (United States)

    2013-03-01

    during the Operation "Goal 2006", to rescue 154 crash victims of a Boeing 737 of the company Gol Air Lines in the Amazon Rainforest. The team of...responsibility of the CUI, specified in the Manual of CUI (MMA 400-3/1976), namely: a) finance; b) providing supplies, classes: I-Material of Subsistence...for troops support, according to the doctrinal definition of the Cellular Unit of Intendancy Manual (MMA400-3/1976): “The Cellular Unit of

  1. Cost and sensitivity of restricted active-space calculations of metal L-edge X-ray absorption spectra.

    Science.gov (United States)

    Pinjari, Rahul V; Delcey, Mickaël G; Guo, Meiyuan; Odelius, Michael; Lundberg, Marcus

    2016-02-15

    The restricted active-space (RAS) approach can accurately simulate metal L-edge X-ray absorption spectra of first-row transition metal complexes without the use of any fitting parameters. These characteristics provide a unique capability to identify unknown chemical species and to analyze their electronic structure. To find the best balance between cost and accuracy, the sensitivity of the simulated spectra with respect to the method variables has been tested for two models, [FeCl6 ](3-) and [Fe(CN)6 ](3-) . For these systems, the reference calculations give deviations, when compared with experiment, of ≤1 eV in peak positions, ≤30% for the relative intensity of major peaks, and ≤50% for minor peaks. When compared with these deviations, the simulated spectra are sensitive to the number of final states, the inclusion of dynamical correlation, and the ionization potential electron affinity shift, in addition to the selection of the active space. The spectra are less sensitive to the quality of the basis set and even a double-ζ basis gives reasonable results. The inclusion of dynamical correlation through second-order perturbation theory can be done efficiently using the state-specific formalism without correlating the core orbitals. Although these observations are not directly transferable to other systems, they can, together with a cost analysis, aid in the design of RAS models and help to extend the use of this powerful approach to a wider range of transition metal systems. © 2015 Wiley Periodicals, Inc.

  2. Cost-effectiveness of transfers to centers with neurological intensive care units after intracerebral hemorrhage.

    Science.gov (United States)

    Fletcher, Jeffrey J; Kotagal, Vikas; Mammoser, Aaron; Peterson, Mark; Morgenstern, Lewis B; Burke, James F

    2015-01-01

    Our aim was to estimate the cost-effectiveness of transferring patients with intracerebral hemorrhage from centers without specialized neurological intensive care units (neuro-ICUs) to centers with neuro-ICUs. Decision analytic models were developed for the lifetime horizons. Model inputs were derived from the best available data, informed by a variety of previous cost-effectiveness models of stroke. The effect of neuro-ICU care on functional outcomes was modeled in 3 scenarios. A favorable outcomes scenario was modeled based on the best observational data and compared with moderately favorable and least-favorable outcomes scenarios. Health benefits were measured in quality-adjusted life years (QALYs), and costs were estimated from a societal perspective. Costs were combined with QALYs gained to generate incremental cost-effectiveness ratios. One-way sensitivity analysis and Monte Carlo simulations were performed to test robustness of the model assumptions. Transferring patients to centers with neuro-ICUs yielded an incremental cost-effectiveness ratio for the lifetime horizon of $47,431 per QALY, $91,674 per QALY, and $380,358 per QALY for favorable, moderately favorable, and least-favorable scenarios, respectively. Models were robust at a willingness-to-pay threshold of $100,000 per QALY, with 95.5%, 75.0%, and 2.1% of simulations below the threshold for favorable, moderately favorable, and least-favorable scenarios, respectively. Transferring patients with intracerebral hemorrhage to centers with specialized neuro-ICUs is cost-effective if observational estimates of the neuro-ICU-based functional outcome distribution are accurate. If future work confirms these functional outcome distributions, then a strong societal rationale exists to build systems of care designed to transfer intracerebral hemorrhage patients to specialized neuro-ICUs. © 2014 American Heart Association, Inc.

  3. Budget-impact model for colonoscopy cost calculation and comparison between 2 litre PEG+ASC and sodium picosulphate with magnesium citrate or sodium phosphate oral bowel cleansing agents.

    Science.gov (United States)

    Gruss, H-J; Cockett, A; Leicester, R J

    2012-01-01

    With the availability of several bowel cleansing agents, physicians and hospitals performing colonoscopies will often base their choice of cleansing agent purely on acquisition cost. Therefore, an easy to use budget impact model has been developed and established as a tool to compare total colon preparation costs between different established bowel cleansing agents. The model was programmed in Excel and designed as a questionnaire evaluating information on treatment costs for a range of established bowel cleansing products. The sum of costs is based on National Health Service reference costs for bowel cleansing products. Estimations are made for savings achievable when using a 2-litre polyethylene glycol with ascorbate components solution (PEG+ASC) in place of other bowel cleansing solutions. Test data were entered into the model to confirm validity and sensitivity. The model was then applied to a set of audit cost data from a major hospital colonoscopy unit in the UK. Descriptive analysis of the test data showed that the main cost drivers in the colonoscopy process are the procedure costs and costs for bed days rather than drug acquisition costs, irrespective of the cleansing agent. Audit data from a colonoscopy unit in the UK confirmed the finding with a saving of £107,000 per year in favour of PEG+ASC when compared to sodium picosulphate with magnesium citrate solution (NaPic+MgCit). For every patient group the model calculated overall cost savings. This was irrespective of the higher drug expenditure associated with the use of PEG+ASC for bowel preparation. Savings were mainly realized through reduced costs for repeat colonoscopy procedures and associated costs, such as inpatient length of stay. The budget impact model demonstrated that the primary cost driver was the procedure cost for colonoscopy. Savings can be realized through the use of PEG+ASC despite higher drug acquisition costs relative to the comparator products. From a global hospital funding

  4. Net Costs Due to Seasonal Influenza Vaccination — United States, 2005–2009

    Science.gov (United States)

    Carias, Cristina; Reed, Carrie; Kim, Inkyu K.; Foppa, Ivo M.; Biggerstaff, Matthew; Meltzer, Martin I.; Finelli, Lyn; Swerdlow, David L.

    2015-01-01

    Background Seasonal influenza causes considerable morbidity and mortality across all age groups, and influenza vaccination was recommended in 2010 for all persons aged 6 months and above. We estimated the averted costs due to influenza vaccination, taking into account the seasonal economic burden of the disease. Methods We used recently published values for averted outcomes due to influenza vaccination for influenza seasons 2005-06, 2006-07, 2007-08, and 2008-09, and age cohorts 6 months-4 years, 5-19 years, 20-64 years, and 65 years and above. Costs were calculated according to a payer and societal perspective (in 2009 US$), and took into account medical costs and productivity losses. Results When taking into account direct medical costs (payer perspective), influenza vaccination was cost saving only for the older age group (65≥) in seasons 2005-06 and 2007-08. Using the same perspective, influenza vaccination resulted in total costs of $US 1.7 billion (95%CI: $US 0.3–4.0 billion) in 2006-07 and $US 1.8 billion (95%CI: $US 0.1–4.1 billion) in 2008-09. When taking into account a societal perspective (and including the averted lost earnings due to premature death) averted deaths in the older age group influenced the results, resulting in cost savings for all ages combined in season 07-08. Discussion Influenza vaccination was cost saving in the older age group (65≥) when taking into account productivity losses and, in some seasons, when taking into account medical costs only. Averted costs vary significantly per season; however, in seasons where the averted burden of deaths is high in the older age group, averted productivity losses due to premature death tilt overall seasonal results towards savings. Indirect vaccination effects and the possibility of diminished case severity due to influenza vaccination were not considered, thus the averted burden due to influenza vaccine may be even greater than reported. PMID:26230271

  5. Life Cycle Costing Model for Solid Waste Management

    DEFF Research Database (Denmark)

    Martinez-Sanchez, Veronica; Astrup, Thomas Fruergaard

    2014-01-01

    . Later, the costs of individual technologies can be combined to calculate the system or scenario costs. In the technology definition, each cost item is defined with a unit cost per item, which is calculated with two types of parameters: 1) economic (e.g. unit prices and depreciation periods) and 2...

  6. User guide for HCR Estimator 2.0: software to calculate cost and revenue thresholds for harvesting small-diameter ponderosa pine.

    Science.gov (United States)

    Dennis R. Becker; Debra Larson; Eini C. Lowell; Robert B. Rummer

    2008-01-01

    The HCR (Harvest Cost-Revenue) Estimator is engineering and financial analysis software used to evaluate stand-level financial thresholds for harvesting small-diameter ponderosa pine (Pinus ponderosa Dougl. ex Laws.) in the Southwest United States. The Windows-based program helps contractors and planners to identify costs associated with tree...

  7. Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    M.N. Saulez

    2007-06-01

    Full Text Available Veterinary internists need to prognosticate patients quickly and accurately in a neonatal intensive care unit (NICU. This may depend on laboratory data collected on admission, the cost of hospitalisation, length of stay (LOS and mortality rate experienced in the NICU. Therefore, we conducted a retrospective study of 62 equine neonates admitted to a NICU of a private equine referral hospital to determine the prognostic value of venous clinicopathological data collected on admission before therapy, the cost of hospitalisation, LOS and mortality rate. The WBC count, total CO2 (TCO2 and alkaline phosphatase (ALP were significantly higher (P < 0.05 and anion gap lower in survivors compared with nonsurvivors. A logistic regression model that included WBC count, hematocrit, albumin / globulin ratio, ALP, TCO2, potassium, sodium and lactate, was able to correctly predict mortality in 84 % of cases. Only anion gap proved to be an independent predictor of neonatal mortality in this study. In the study population, the overall mortality rate was 34 % with greatest mortality rates reported in the first 48 hours and again on day 6 of hospitalisation. Amongst the various clinical diagnoses, mortality was highest in foals after forced extraction during correction of dystocia. Median cost per day was higher for nonsurvivors while total cost was higher in survivors.

  8. Cost estimation of patients admitted to the intensive care unit: a case study of the Teaching University Hospital of Thessaly.

    Science.gov (United States)

    Geitona, Mary; Androutsou, Lorena; Theodoratou, Dorina

    2010-01-01

    This study aimed to estimate the cost of patients admitted to the Intensive Care Unit (ICU) of the Teaching University Hospital of Thessaly (TUHT) in 2006 and to demonstrate discrepancies between actual hospitalisation cost and social funds' reimbursement. Cost analysis was performed using a macro-costing approach, which focused on the estimation of nominal and actual cost per ICU patient. Data were derived from the annual records of resources consumed in each hospital unit and from hospital balance sheets. Sensitivity analysis was also performed by inflating nominal costs to present values. There were 312 patients admitted to the ICU. Mean actual cost per ICU patient was estimated at €16,516, whereas actual reimbursement from social funds was only €1,671. This means that reimbursement accounted for just 10% of the actual hospitalisation cost. Once nominal costs were inflated to present values, the reimbursement accounted for 25% of the actual hospitalisation cost. The major cost drivers of ICU hospitalisation were personnel costs followed by infrastructure, hotel services and pharmaceutical expenditure. These results may be limited by a lack of consideration for clinical outcomes along with a high level of aggregation in cost data. Reimbursement should be re-adjusted in order to balance public hospital deficits and make public-private mix viable. This way, intensive care capacity would increase and allow a more equitable distribution of healthcare resources.

  9. Total elbow arthroplasty in the United States: evaluation of cost, patient demographics, and complication rates

    Directory of Open Access Journals (Sweden)

    Hanbing Zhou

    2016-03-01

    Full Text Available Total elbow arthroplasty (TEA is utilized in the treatment of rheumatoid and post-traumatic elbow arthritis. TEA is a relatively low volume surgery in comparison to other types of arthroplasty and therefore little is known about current surgical utilization, patient demographics and complication rates in the United States. The purpose of our study is to evaluate the current practice trends and associated inpatient complications of TEA at academic centers in the United States. We queried the University Health Systems Consortium administrative database from 2007 to 2011 for patients who underwent an elective TEA. A descriptive analysis of demographics was performed which included patient age, sex, race, and insurance status. We also evaluated the following patient clinical benchmarks: hospital length of stay (LOS, hospital direct cost, inhospital mortality, complications, and 30-day readmission rates. Our cohort consisted of 3146 adult patients (36.5% male and 63.5% female with an average age of 58 years who underwent a total elbow arthroplasty (159 academic medical centers in the United States. The racial demographics included 2334 (74% Caucasian, 285 (9% black, 236 (7.5% Hispanic, 16 (0.5% Asian, and 283 (9% other patients. The mean LOS was 4.2±5 days and the mean total direct cost for the hospital was 16,300±4000 US Dollars per case. The overall inpatient complication rate was 3.1% and included mortality <1%, DVT (0.8%, re-operation (0.5%, and infection (0.4%. The 30-day readmission rate was 4.4%. TEA is a relatively uncommon surgery in comparison to other forms of arthroplasty but is associated with low in-patient and 30-day perioperative complication rate. Additionally, the 30-day readmission rate and overall hospital costs are comparable to the traditional total hip and knee arthroplasty surgeries.

  10. Coverage Range and Cost Comparison of Remote Antenna Unit Designs for Inbuilding Radio over Fiber Technology

    Directory of Open Access Journals (Sweden)

    Razali Ngah

    2013-09-01

    Full Text Available Future communication needs to be ubiquitous, broadband, convergent, and seamless. Radio over fiber (RoF technology is one of the most important enabler in access network for the technologies. Adoption of RoF faces bottleneck in optoelectronics, that they are still expensive, high power consumption, and limited in bandwidth. To solve the problem, transceiver in remote antenna unit (RAU is developed, i.e. electroabsorption transceiver (EAT and asymmetric FabryPerot modulator (AFPM. This paper compares their coverage range and cost in providing WCDMA and WLAN services. Needed gain of RF amplifier for supporting picocell is also discussed.

  11. Cost-Effectiveness of Ivermectin 1% Cream in Adults with Papulopustular Rosacea in the United States.

    Science.gov (United States)

    Taieb, Alain; Stein Gold, Linda; Feldman, Steven R; Dansk, Viktor; Bertranou, Evelina

    2016-06-01

    Papulopustular rosacea is a chronic skin disease involving central facial erythema in combination with papules and pustules. Papulopustular rosacea is treated with topical, systemic, or a combination of topical and systemic therapies. Currently approved topical therapies include azelaic acid gel/cream/foam twice daily (BID) and metronidazole cream/gel/lotion BID. Ivermectin 1% cream once daily (QD) is a new topical agent for the treatment of papulopustular rosacea that has been approved for the management of inflammatory lesions of rosacea and offers an alternative to current treatments. To evaluate the cost-effectiveness of ivermectin 1% cream QD compared with current topical treatments in order to understand the cost of adding ivermectin as a treatment option that would bring additional clinical benefit for adults with papulopustular rosacea in the United States. The cost-effectiveness of ivermectin 1% cream QD was compared with metronidazole 0.75% cream BID and azelaic acid 15% gel BID for adults in the United States with moderate-to-severe papulopustular rosacea using a Markov cohort state transition structure with 2 mutually exclusive health states (rosacea and no rosacea) and 5 phases. Patients could succeed or fail to respond to treatment and experience a relapse after treatment success. The model took a health care payer perspective (direct medical costs of topical and/or systemic therapy plus health care costs for physician and specialist visits) and used a 3-year time horizon. The model was run for a cohort of 1,000 patients. Costs (2014 U.S. dollars) and benefits (disease-free days and quality-adjusted life-years [QALYs]) were discounted at a rate of 3% per annum. Cost-effectiveness was determined by the incremental cost-effectiveness ratio (ICER) and measured in terms of incremental cost per QALY gained (estimated from health state utilities for patients with and without rosacea). Univariate and probabilistic sensitivity analyses (PSA) were conducted to

  12. Clinical effectiveness and cost-effectiveness of HIV pre-exposure prophylaxis in men who have sex with men: risk calculators for real-world decision-making.

    Directory of Open Access Journals (Sweden)

    Anders Chen

    Full Text Available BACKGROUND: Oral pre-exposure prophylaxis (PrEP can be clinically effective and cost-effective for HIV prevention in high-risk men who have sex with men (MSM. However, individual patients have different risk profiles, real-world populations vary, and no practical tools exist to guide clinical decisions or public health strategies. We introduce a practical model of HIV acquisition, including both a personalized risk calculator for clinical management and a cost-effectiveness calculator for population-level decisions. METHODS: We developed a decision-analytic model of PrEP for MSM. The primary clinical effectiveness and cost-effectiveness outcomes were the number needed to treat (NNT to prevent one HIV infection, and the cost per quality-adjusted life-year (QALY gained. We characterized patients according to risk factors including PrEP adherence, condom use, sexual frequency, background HIV prevalence and antiretroviral therapy use. RESULTS: With standard PrEP adherence and national epidemiologic parameters, the estimated NNT was 64 (95% uncertainty range: 26, 176 at a cost of $160,000 (cost saving, $740,000 per QALY--comparable to other published models. With high (35% HIV prevalence, the NNT was 35 (21, 57, and cost per QALY was $27,000 (cost saving, $160,000, and with high PrEP adherence, the NNT was 30 (14, 69, and cost per QALY was $3,000 (cost saving, $200,000. In contrast, for monogamous, serodiscordant relationships with partner antiretroviral therapy use, the NNT was 90 (39, 157 and cost per QALY was $280,000 ($14,000, $670,000. CONCLUSIONS: PrEP results vary widely across individuals and populations. Risk calculators may aid in patient education, clinical decision-making, and cost-effectiveness evaluation.

  13. Energy Savings and Breakeven Costs for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, Jeff [National Renewable Energy Lab. (NREL), Golden, CO (United States); Burch, Jay [National Renewable Energy Lab. (NREL), Golden, CO (United States); Merrigan, Tim [National Renewable Energy Lab. (NREL), Golden, CO (United States); Ong, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-07-01

    Heat pump water heaters (HPWHs) have recently re-emerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, NREL performed simulations of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern United States. When replacing an electric water heater, the HPWH is likely to break even in California, the southern United States, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  14. A reevaluation of the costs of heart failure and its implications for allocation of health resources in the United States.

    Science.gov (United States)

    Voigt, Jeff; Sasha John, M; Taylor, Andrew; Krucoff, Mitchell; Reynolds, Matthew R; Michael Gibson, C

    2014-05-01

    The annual cost of heart failure (HF) is estimated at $39.2 billion. This has been acknowledged to underestimate the true costs for care. The objective of this analysis is to more accurately assess these costs. Publicly available data sources were used. Cost calculations incorporated relevant factors such as Medicare hospital cost-to-charge ratios, reimbursement from both government and private insurance, and out-of-pocket expenditures. A recently published Atherosclerosis Risk in Communities (ARIC) HF scheme was used to adjust the HF classification scheme. Costs were calculated with HF as the primary diagnosis (HF in isolation, or HFI) or HF as one of the diagnoses/part of a disease milieu (HF syndrome, or HFS). Total direct costs for HF were calculated at $60.2 billion (HFI) and $115.4 billion (HFS). Indirect costs were $10.6 billion for both. Costs attributable to HF may represent a much larger burden to US health care than what is commonly referenced. These revised and increased costs have implications for policy makers.

  15. Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania

    National Research Council Canada - National Science Library

    Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

    2003-01-01

    To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use...

  16. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India.

    Science.gov (United States)

    Kumar, Parmeshwar; Jithesh, Vishwanathan; Gupta, Shakti Kumar

    2015-01-01

    Though intensive care units (ICUs) only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Fisher's two-tailed t-test. Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

  17. A preliminary design and BOP cost analysis of M-C Power`s MCFC commerical unit

    Energy Technology Data Exchange (ETDEWEB)

    Chen, T.P. [Bechtel Corp, San Francisco, CA (United States)

    1996-12-31

    M-C Power Corporation plans to introduce its molten carbonate fuel cell (MCFC) market entry unit in the year 2000 for distributed and on-site power generation. Extensive efforts have been made to analyze the cell stack manufacturing costs. The major objective of this study is to conduct a detailed analysis of BOP costs based on an initial design of the market entry unit.

  18. Arithmetic-Like Reasoning in Wild Vervet Monkeys: A Demonstration of Cost-Benefit Calculation in Foraging

    Directory of Open Access Journals (Sweden)

    Sayaka Tsutsumi

    2011-01-01

    Full Text Available Arithmetic-like reasoning has been demonstrated in various animals in captive and seminatural environments, but it is unclear whether such competence is practiced in the wild. Using a hypothetical foraging paradigm, we demonstrate that wild vervet monkeys spontaneously adjust their “foraging behavior” deploying arithmetic-like reasoning. Presented with arithmetic-like problems in artificially controlled feeding conditions, all the monkeys tested attempted to retrieve “artificial prey” according to the quantity of the remainder when the task involved one subtraction only (i.e., “2−1”, while one monkey out of four did so when it was sequentially subtracted twice (i.e., “2−1−1”. This monkey also adjusted his “foraging behavior” according to the quantity of the reminder for a task requiring stepwise mental manipulation (i.e., “(2−1−1”, though the results became less evident. This suggests that vervet monkeys are capable of spontaneously deploying mental manipulations of numerosity for cost-benefit calculation of foraging but that the extent of such capacity varies among individuals. Different foraging strategies might be deployed according to different levels of mental manipulation capacity in each individual in a given population. In addition to providing empirical data, the current study provides an easily adaptable field technique that would allow comparison across taxa and habitat using a uniform method.

  19. The influence of capacity management on the unit cost of production: a case study in a flexible plastic packaging company

    Directory of Open Access Journals (Sweden)

    Tálita Floriano Goulart Silva

    2013-08-01

    Full Text Available This article presents the relationship between capacity management and cost management in determining the unit cost. The objective was to show how the use of effective capacity decreases the unit cost of manufacturing. For this, follow these steps: 1 Knowledge and analysis of production process and PPPC; 2 Data Collection; 3 Application of the Method Cost Center; 4Verification of the relationship between the Capacity Management and Cost Management. Through the company’s accounting reports, observations and interviews, the following results was possible: knowledge of the production process and functioning of PPCP, measuring the cost of each step of the production process and the unit cost of each product. Subsequently, we compared the unit cost using the effective capacity and normal capacity. The results showed that the unit costs decrease with the use of effective capacity, while increasing the margin for each product, even with the lower sale price, thus establishing a virtuous circle: effective capacity utilization, reduced unit cost, most competitive prices and increase in the number of requests.

  20. A fuzzy inventory model with unit production cost, time depended holding cost, with-out shortages under a space constraint: a parametric geometric programming approach

    OpenAIRE

    Sahidul Islam; Wasim Akram Mandal

    2017-01-01

    In this paper, an Inventory model with unit production cost, time depended holding cost, with-out shortages is formulated and solved. We have considered here a single objective inventory model. In most real world situation, the objective and constraint function of the decision makers are imprecise in nature, hence the coefficients, indices, the objective function and constraint goals are imposed here in fuzzy environment. Geometric programming provides a powerful tool for solving a variety of...

  1. A cross-sectional study of emergency care utilization and associated costs of violent-related (assault) injuries in the United States.

    Science.gov (United States)

    Monuteaux, Michael C; Fleegler, Eric W; Lee, Lois K

    2017-11-01

    Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs. We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports. An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion. Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs. Epidemiological study, level III.

  2. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

    Energy Technology Data Exchange (ETDEWEB)

    Gibbons, John P., E-mail: john.gibbons@marybird.com [Department of Physics, Mary Bird Perkins Cancer Center, Baton Rouge, Louisiana 70809 (United States); Antolak, John A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota 55905 (United States); Followill, David S. [Department of Radiation Physics, UT M.D. Anderson Cancer Center, Houston, Texas 77030 (United States); Huq, M. Saiful [Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania 15232 (United States); Klein, Eric E. [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Lam, Kwok L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298 (United States); Roback, Donald M. [Department of Radiation Oncology, Cancer Centers of North Carolina, Raleigh, North Carolina 27607 (United States); Reid, Mark [Department of Medical Physics, Fletcher-Allen Health Care, Burlington, Vermont 05401 (United States); Khan, Faiz M. [Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota 55455 (United States)

    2014-03-15

    A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, D{sub 0}{sup ′}, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where D{sub 0}{sup ′} = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent D{sub 0}{sup ′} ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of d{sub m}, with D{sub 0}{sup ′} = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism.

  3. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71.

    Science.gov (United States)

    Gibbons, John P; Antolak, John A; Followill, David S; Huq, M Saiful; Klein, Eric E; Lam, Kwok L; Palta, Jatinder R; Roback, Donald M; Reid, Mark; Khan, Faiz M

    2014-03-01

    A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, D'0, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where D'0 = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent D'0 ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of dm, with D'0 = 1 cGy/MU, although both systems are acceptable within the current protocol. For photon beams, the formalism includes the use of blocked fields, physical or dynamic wedges, and (static) multileaf collimation. No formalism is provided for intensity modulated radiation therapy calculations, although some general considerations and a review of current calculation techniques are included. For electron beams, the formalism provides for calculations at the standard and extended SSDs using either an effective SSD or an air-gap correction factor. Example tables and problems are included to illustrate the basic concepts within the presented formalism.

  4. Incidence and Cost of Pneumonia in Older Adults with COPD in the United States

    Science.gov (United States)

    Ryan, Marian; Suaya, Jose A.; Chapman, John D.; Stason, William B.; Shepard, Donald S.; Parks Thomas, Cindy

    2013-01-01

    Objectives To estimate the incidence of pneumonia by COPD status and the excess cost of inpatient primary pneumonia in elders with COPD. Study Design A retrospective, longitudinal study using claims linked to eligibility/demographic data for a 5% sample of fee-for-service Medicare beneficiaries from 2005 through 2007. Methods Incidence rates of pneumonia were calculated for elders with and without COPD and for elders with COPD and coexistent congestive heart failure (CHF). Propensity-score matching with multivariate generalized linear regression was used to estimate the excess direct medical cost of inpatient primary pneumonia in elders with COPD as compared with elders with COPD but without a pneumonia hospitalization. Results Elders with COPD had nearly six-times the incidence of pneumonia compared with elders without COPD (167.6/1000 person-years versus 29.5/1000 person-years; RR=5.7, p pneumonia among elders with COPD was 54.2/1000 person-years compared with 7/1000 person-years for elders without COPD; RR=7.7, ppneumonia in COPD patients was $ 22,697 ($45,456 in cases vs. $ 22,759 in controls (p Pneumonia occurs more frequently in elders with COPD than without COPD. The excess direct medical cost in elders with inpatient pneumonia extends up to 24 months following the index hospitalization and represents $28,638 in 2010 dollars. PMID:24130749

  5. Water use for electricity in the United States: an analysis of reported and calculated water use information for 2008

    Science.gov (United States)

    Averyt, K.; Macknick, J.; Rogers, J.; Madden, N.; Fisher, J.; Meldrum, J.; Newmark, R.

    2013-03-01

    Water use by the electricity sector represents a significant portion of the United States water budget (41% of total freshwater withdrawals; 3% consumed). Sustainable management of water resources necessitates an accurate accounting of all water demands, including water use for generation of electricity. Since 1985, the Department of Energy (DOE) Energy Information Administration (EIA) has collected self-reported data on water consumption and withdrawals from individual power generators. These data represent the only annual collection of water consumption and withdrawals by the electricity sector. Here, we compile publically available information into a comprehensive database and then calculate water withdrawals and consumptive use for power plants in the US. In effect, we evaluate the quality of water use data reported by EIA for the year 2008. Significant differences between reported and calculated water data are evident, yet no consistent reason for the discrepancies emerges.

  6. Cost-income analysis of oral health units of health care centers in Yazd city

    Directory of Open Access Journals (Sweden)

    Hosein Fallahzadeh

    2012-01-01

    Full Text Available Background and Aims: Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness.Materials and Methods: In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers.Results: Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48.Conclusion: With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.

  7. Cost analysis and evaluation of nosocomial infections in intensive care units.

    Science.gov (United States)

    Kostakoğlu, Uğur; Saylan, Sedat; Karataş, Mevlüt; İskender, Serap; Aksoy, Firdevs; Yılmaz, Gürdal

    2016-11-17

    The purpose of this study was to evaluate nosocomial infections occurring in our hospital intensive care units (ICUs) and the risk factors for these, and to determine the effect of these infections on mortality and cost. This retrospective study was performed via infection control committee surveillance data, ICU records, and information processing data between 1 January and 31 December 2013 at the Kanuni Education and Research Hospital. A total of 309 nosocomial infections were observed in 205 out of 566 patients. The density of nosocomial infections was 25.4 in 1000 patient days. Hospitalization was prolonged, and APACHE II and Charlson comorbidity scores were high in patients developing nosocomial infections (P nosocomial infection, 170 died. Infections were determined as the cause of death in 62 (36.5%) of the nonsurviving patients with a nosocomial infection. Acinetobacter baumannii was identified in 46 (74.2%) of the patients that died from nosocomial infections. The mean cost in patients developing a nosocomial infection was 15,229.30 Turkish lira (TL), compared to 9648.00 TL in patients without a nosocomial infection (P = 0.002). Regular infection control education sessions need to be held and the number of nurses needs to be increased in order to be able to reduce this high mortality, morbidity, and cost.

  8. The economic costs of progressive supranuclear palsy and multiple system atrophy in France, Germany and the United Kingdom.

    Directory of Open Access Journals (Sweden)

    Paul McCrone

    Full Text Available Progressive supranuclear palsy (PSP and multiple system atrophy (MSA are progressive disabling neurological conditions usually fatal within 10 years of onset. Little is known about the economic costs of these conditions. This paper reports service use and costs from France, Germany and the UK and identifies patient characteristics that are associated with cost. 767 patients were recruited, and 760 included in the study, from 44 centres as part of the NNIPPS trial. Service use during the previous six months was measured at entry to the study and costs calculated. Mean six-month costs were calculated for 742 patients. Data on patient sociodemographic and clinical characteristics were recorded and used in regression models to identify predictors of service costs and unpaid care costs (i.e., care from family and friends. The mean six-month service costs of PSP were €24,491 in France, €30,643 in Germany and €25,655 in the UK. The costs for MSA were €28,924, €25,645 and €19,103 respectively. Unpaid care accounted for 68-76%. Formal and unpaid costs were significantly higher the more severe the illness, as indicated by the Parkinson's Plus Symptom scale. There was a significant inverse relationship between service and unpaid care costs.

  9. Reconfigurable AGU: An Address Generation Unit Based on Address Calculation Pattern for Low Energy and High Performance Embedded Processors

    Science.gov (United States)

    Taniguchi, Ittetsu; Raghavan, Praveen; Jayapala, Murali; Catthoor, Francky; Takeuchi, Yoshinori; Imai, Masaharu

    Low energy and high performance embedded processor is crucial in the future nomadic embedded systems design. Improvement of memory accesses, especially improvement of spatial and temporal locality is well known technique to reduce energy and increase performance. However, after transformations that improve locality, address calculation often becomes a bottleneck. In this paper, we propose novel AGU (Address Generation Unit) exploration and mapping technique based on a reconfigurable AGU model. Experimental results show that the proposed techniques help exploring AGU architectures effectively and designers can get trade-offs of real life applications for about 10 hours.

  10. Analysis of Unit Costs in a University. The Fribourg Example. Program on Institutional Management in Higher Education.

    Science.gov (United States)

    Pasquier, Jacques; Sachse, Matthias

    Costing principles are applied to a university by estimating unit costs and their component factors for the university's different inputs, activities, and outputs. The information system used is designed for Fribourg University but could be applicable to other Swiss universities and could serve Switzerland's universities policy. In general, it…

  11. Smart Grid Cost-Emission Unit Commitment via Co-Evolutionary Agents

    Directory of Open Access Journals (Sweden)

    Xiaohua Zhang

    2016-10-01

    Full Text Available In this paper, the uncertainty of wind, solar and load; smart charging and discharging of plug-in hybrid electric vehicles (PHEVs to and from various energy sources; and the coordination of wind, solar power, PHEVs and cost-emission are considered in the smart grid unit commitment (UC. First, a multi-scenario simulation is used in which a set of valid scenarios is considered for the uncertainties of wind and solar energy sources and load. Then the UC problem for the set of scenarios is decomposed into the optimization of interactive agents by multi-agent technology. Agents’ action is represented by a genetic algorithm with adaptive crossover and mutation operators. The adaptive co-evolution of agents is reached by adaptive cooperative multipliers. Finally, simulation is implemented on an example of a power system containing thermal units, a wind farm, solar power plants and PHEVs. The results show the effectiveness of the proposed method. Thermal units, wind, solar power and PHEVs are mutually complementarily by the adaptive cooperative mechanism. The adaptive multipliers’ updating strategy can save more computational time and further improve the efficiency.

  12. The economic cost of firearm-related injuries in the United States from 2006 to 2010.

    Science.gov (United States)

    Lee, Jarone; Quraishi, Sadeq A; Bhatnagar, Saurabha; Zafonte, Ross D; Masiakos, Peter T

    2014-05-01

    Estimates of the number of firearm-related injuries widely vary. Although focus has been primarily on deaths, the societal cost of caring for victims of these injuries is largely unknown. Our goal was to estimate the economic impact of nonfatal, firearm-related injuries in the United States based on recent, publically available data. We queried several national registries for hospital and emergency department (ED) discharges from 2006 to 2010 to estimate the annual incidence of firearm-related injuries. The cost of direct medical services and lost productivity from firearm-related injuries were extrapolated from recently published estimates. To identify potentially important trends, we compared the economic impact and payor mix for firearm-related injuries in 2006 with those in 2010. During the 5-year analytic period, we identified 385,769 (SE = 29,328) firearm-related ED visits resulting in 141,914 (SE = 14,243) hospital admissions, costing more than $88 billion (SE = $8.0 billion). Between 2006 and 2010, there was a decrease in the rate of hospital visits from 6.65 per 10,000 visits in 2006 to 5.76 per 10,000 visits in 2010 (P Firearm-related injuries are a major economic burden to not only the American health care system but also to American society. The incidence of these injuries has decreased slightly from 2006 to 2010, with no change in the economic burden. Research aimed at understanding the associated financial, social, health, and disability-related issues related to firearm injuries is necessary and would likely enhance our knowledge of the causes of these events, and may accelerate development of interventions and policies to decrease the staggering medical and societal cost of gun violence. Copyright © 2014 Mosby, Inc. All rights reserved.

  13. Incidence and cost of pneumonia in older adults with COPD in the United States.

    Directory of Open Access Journals (Sweden)

    Marian Ryan

    Full Text Available OBJECTIVES: To estimate the incidence of pneumonia by COPD status and the excess cost of inpatient primary pneumonia in elders with COPD. STUDY DESIGN: A retrospective, longitudinal study using claims linked to eligibility/demographic data for a 5% sample of fee-for-service Medicare beneficiaries from 2005 through 2007. METHODS: Incidence rates of pneumonia were calculated for elders with and without COPD and for elders with COPD and coexistent congestive heart failure (CHF. Propensity-score matching with multivariate generalized linear regression was used to estimate the excess direct medical cost of inpatient primary pneumonia in elders with COPD as compared with elders with COPD but without a pneumonia hospitalization. RESULTS: Elders with COPD had nearly six-times the incidence of pneumonia compared with elders without COPD (167.6/1000 person-years versus 29.5/1000 person-years; RR=5.7, p <0 .01; RR increased to 8.1 for elders with COPD and CHF compared with elders without COPD. The incidence of inpatient primary pneumonia among elders with COPD was 54.2/1000 person-years compared with 7/1000 person-years for elders without COPD; RR=7.7, p<0.01; RR increased to 11.0 for elders with COPD and CHF compared with elders without COPD. The one-year excess direct medical cost of inpatient pneumonia in COPD patients was $ 22,697 ($45,456 in cases vs. $ 22,759 in controls (p <0.01; 70.2% of this cost was accrued during the quarter of the index hospitalization. During months 13 through 24 following the index hospitalization, the excess direct medical cost was $ 5,941 ($23,215 in cases vs. $ 17,274 in controls, p<0.01. CONCLUSIONS: Pneumonia occurs more frequently in elders with COPD than without COPD. The excess direct medical cost in elders with inpatient pneumonia extends up to 24 months following the index hospitalization and represents $28,638 in 2010 dollars.

  14. 75 FR 73972 - Medicaid Program; Cost Limit for Providers Operated by Units of Government and Provisions To...

    Science.gov (United States)

    2010-11-30

    ... Integrity of Federal-State Financial Partnership AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... Units of Government and Provisions To Ensure the Integrity of Federal-State Financial Partnership'' (72... Program; Cost Limit for Providers Operated by Units of Government and Provisions To Ensure the Integrity...

  15. Economic impacts of oil spills: Spill unit costs for tankers, pipelines, refineries, and offshore facilities. [Task 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-10-15

    The impacts of oil spills -- ranging from the large, widely publicized Exxon Valdez tanker incident to smaller pipeline and refinery spills -- have been costly to both the oil industry and the public. For example, the estimated costs to Exxon of the Valdez tanker spill are on the order of $4 billion, including $2.8 billion (in 1993 dollars) for direct cleanup costs and $1.125 billion (in 1992 dollars) for settlement of damages claims caused by the spill. Application of contingent valuation costs and civil lawsuits pending in the State of Alaska could raise these costs appreciably. Even the costs of the much smaller 1991 oil spill at Texaco`s refinery near Anacortes, Washington led to costs of $8 to 9 million. As a result, inexpensive waming, response and remediation technologies could lower oil spin costs, helping both the oil industry, the associated marine industries, and the environment. One means for reducing the impact and costs of oil spills is to undertake research and development on key aspects of the oil spill prevention, warming, and response and remediation systems. To target these funds to their best use, it is important to have sound data on the nature and size of spills, their likely occurrence and their unit costs. This information could then allow scarce R&D dollars to be spent on areas and activities having the largest impact. This report is intended to provide the ``unit cost`` portion of this crucial information. The report examines the three key components of the US oil supply system, namely, tankers and barges; pipelines and refineries; and offshore production facilities. The specific purpose of the study was to establish the unit costs of oil spills. By manipulating this key information into a larger matrix that includes the size and frequency of occurrence of oil spills, it will be possible` to estimate the likely future impacts, costs, and sources of oil spills.

  16. Cost effectiveness of universal umbilical cord blood gas and lactate analysis in a tertiary level maternity unit.

    Science.gov (United States)

    White, Christopher R H; Doherty, Dorota A; Cannon, Jeffrey W; Kohan, Rolland; Newnham, John P; Pennell, Craig E

    2016-07-01

    There is an increasing body of literature supporting universal umbilical cord blood gas analysis (UCBGA) into all maternity units. A significant impediment to UCBGA's introduction is the perceived expense of the introduction and associated ongoing costs. Consequently, this study set out to conduct the first cost-effectiveness analysis of introducing universal UCBGA. Analysis was based on 42,100 consecutive deliveries ≥23 weeks of gestation at a single tertiary obstetric unit. Within 4 years of UCBGA's introduction there was a 45% reduction in term special care nursery (SCN) admissions >2499 g. Incurred costs included initial and ongoing costs associated with universal UCBGA. Averted costs were based on local diagnosis-related grouping costs for reduction in term SCN admissions. Incremental cost-effectiveness ratio (ICER) and sensitivity analysis results were reported. Under the base-case scenario, the adoption of universal UCBGA was less costly and more effective than selective UCBGA over 4 years and resulted in saving of AU$641,532 while adverting 376 SCN admissions. Sensitivity analysis showed that UCBGA was cost-effective in 51.8%, 83.3%, 99.6% and 100% of simulations in years 1, 2, 3 and 4. These conclusions were not sensitive to wide, clinically possible variations in parameter values for neonatal intensive care unit and SCN admissions, magnitude of averted SCN admissions, cumulative delivery numbers, and SCN admission costs. Universal UCBGA is associated with significant initial and ongoing costs; however, potential averted costs (due to reduced SCN admissions) exceed incurred costs in most scenarios.

  17. Feasibility and Costs of Natural Gas as a Bridge to Deep Decarbonization in the United States

    Science.gov (United States)

    Jones, A. D.; McJeon, H. C.; Muratori, M.; Shi, W.

    2015-12-01

    Achieving emissions reductions consistent with a 2 degree Celsius global warming target requires nearly complete replacement of traditional fossil fuel combustion with near-zero carbon energy technologies in the United States by 2050. There are multiple technological change pathways consistent with this deep decarbonization, including strategies that rely on renewable energy, nuclear, and carbon capture and storage (CCS) technologies. The replacement of coal-fired power plants with natural gas-fired power plants has also been suggested as a bridge strategy to achieve near-term emissions reduction targets. These gas plants, however, would need to be replaced by near-zero energy technologies or retrofitted with CCS by 2050 in order to achieve longer-term targets. Here we examine the costs and feasibility of a natural gas bridge strategy. Using the Global Change Assessment (GCAM) model, we develop multiple scenarios that each meet the recent US Intended Nationally Determined Contribution (INDC) to reduce GHG emissions by 26%-28% below its 2005 levels in 2025, as well as a deep decarbonization target of 80% emissions reductions below 1990 levels by 2050. We find that the gas bridge strategy requires that gas plants be retired on average 20 years earlier than their designed lifetime of 45 years, a potentially challenging outcome to achieve from a policy perspective. Using a more idealized model, we examine the net energy system costs of this gas bridge strategy compared to one in which near-zero energy technologies are deployed in the near tem. We explore the sensitivity of these cost results to four factors: the discount rate applied to future costs, the length (or start year) of the gas bridge, the relative capital cost of natural gas vs. near-zero energy technology, and the fuel price of natural gas. The discount rate and cost factors are found to be more important than the length of the bridge. However, we find an important interaction as well. At low discount rates

  18. Statistically rigorous calculations do not support common input and long-term synchronization of motor-unit firings.

    Science.gov (United States)

    De Luca, Carlo J; Kline, Joshua C

    2014-12-01

    Over the past four decades, various methods have been implemented to measure synchronization of motor-unit firings. In this work, we provide evidence that prior reports of the existence of universal common inputs to all motoneurons and the presence of long-term synchronization are misleading, because they did not use sufficiently rigorous statistical tests to detect synchronization. We developed a statistically based method (SigMax) for computing synchronization and tested it with data from 17,736 motor-unit pairs containing 1,035,225 firing instances from the first dorsal interosseous and vastus lateralis muscles--a data set one order of magnitude greater than that reported in previous studies. Only firing data, obtained from surface electromyographic signal decomposition with >95% accuracy, were used in the study. The data were not subjectively selected in any manner. Because of the size of our data set and the statistical rigor inherent to SigMax, we have confidence that the synchronization values that we calculated provide an improved estimate of physiologically driven synchronization. Compared with three other commonly used techniques, ours revealed three types of discrepancies that result from failing to use sufficient statistical tests necessary to detect synchronization. 1) On average, the z-score method falsely detected synchronization at 16 separate latencies in each motor-unit pair. 2) The cumulative sum method missed one out of every four synchronization identifications found by SigMax. 3) The common input assumption method identified synchronization from 100% of motor-unit pairs studied. SigMax revealed that only 50% of motor-unit pairs actually manifested synchronization. Copyright © 2014 the American Physiological Society.

  19. Valuing inter-sectoral costs and benefits of interventions in the healthcare sector: methods for obtaining unit prices.

    Science.gov (United States)

    Drost, Ruben M W A; Paulus, Aggie T G; Ruwaard, Dirk; Evers, Silvia M A A

    2017-02-01

    There is a lack of knowledge about methods for valuing health intervention-related costs and monetary benefits in the education and criminal justice sectors, also known as 'inter-sectoral costs and benefits' (ICBs). The objective of this study was to develop methods for obtaining unit prices for the valuation of ICBs. By conducting an exploratory literature study and expert interviews, several generic methods were developed. The methods' feasibility was assessed through application in the Netherlands. Results were validated in an expert meeting, which was attended by policy makers, public health experts, health economists and HTA-experts, and discussed at several international conferences and symposia. The study resulted in four methods, including the opportunity cost method (A) and valuation using available unit prices (B), self-constructed unit prices (C) or hourly labor costs (D). The methods developed can be used internationally and are valuable for the broad international field of HTA.

  20. Cost-efficient design of a quantum multiplier-accumulator unit

    Science.gov (United States)

    Babu, Hafiz Md. Hasan

    2017-01-01

    This paper proposes a cost-efficient quantum multiplier-accumulator unit. The paper also presents a fast multiplication algorithm and designs a novel quantum multiplier device based on the proposed algorithm with the optimum time complexity as multiplier is the major device of a multiplier-accumulator unit. We show that the proposed multiplication technique has time complexity O((3 log2n)+1), whereas the best known existing technique has O(n log2 n), where n is the number of qubits. In addition, our design proposes three new quantum circuits: a circuit representing a quantum full-adder, a circuit known as quantum ANDing circuit, which performs the ANDing operation and a circuit presenting quantum accumulator. Moreover, the proposed quantum multiplier-accumulator unit is the first ever quantum multiplier-accumulator circuit in the literature till now, which has reduced garbage outputs and ancillary inputs to a great extent. The comparative study shows that the proposed quantum multiplier performs better than the existing multipliers in terms of depth, quantum gates, delays, area and power with the increasing number of qubits. Moreover, we design the proposed quantum multiplier-accumulator unit, which performs better than the existing ones in terms of hardware and delay complexities, e.g., the proposed (n× n)—qubit quantum multiplier-accumulator unit requires O(n2) hardware and O(log2n) delay complexities, whereas the best known existing quantum multiplier-accumulator unit requires O(n3) hardware and O((n-1)2 +1+n) delay complexities. In addition, the proposed design achieves an improvement of 13.04, 60.08 and 27.2% for 4× 4, 7.87, 51.8 and 27.1% for 8× 8, 4.24, 52.14 and 27% for 16× 16, 2.19, 52.15 and 27.26% for 32 × 32 and 0.78, 52.18 and 27.28% for 128 × 128-qubit multiplications over the best known existing approach in terms of number of quantum gates, ancillary inputs and garbage outputs, respectively. Moreover, on average, the proposed design gains an

  1. Operating expenses for the diagnosis and treatment of peripheral vascular disease in an academic interventional radiology department: cost calculations according to a microeconomic method.

    Science.gov (United States)

    Janne d'Othée, Bertrand; Langdon, David R; Bell, Gregory K; Bettmann, Michael A

    2006-01-01

    A correct understanding of the true costs of a procedure is necessary to make informed decisions in cost-effectiveness analyses. The actual comprehensive costs of performing cardiovascular and interventional radiology (CVIR) procedures were analyzed in the present study, as opposed to charges or ratios of costs to charges (RCCs), as often used in the literature. Costs included labor, equipment, administration, facility establishment and maintenance, overhead, and consumable supplies. Cost identification was initially performed with use of an hourly rate that reflected the cost of operating the CVIR section. This was then combined with the costs of the consumable supplies used during each type of procedure. Eight types of vascular procedures were studied in 235 consecutive patients to determine mean procedure duration and supplies consumption. Costs were then compared with charges and RCCs of these procedures. The hourly rate for operating one angiography suite was 690 dollars. Average cost by procedure, including hourly rate plus consumable supplies, were: aortic arteriogram, 1,442 dollars; aortobifemoral arteriogram, 1,554 dollars; unilateral limb arteriogram, 1,307 dollars; simple iliac or femoropopliteal angioplasty, 2,119 dollars; arterial stent placement, 2,780 dollars; percutaneous thrombectomy, 1,998 dollars; arterial in situ thrombolysis, 3,133 dollars; and arteriogram after thrombolysis, 926 dollars. RCCs calculated for each procedure ranged from 0.39 (thrombectomy) to 1.92 (control arteriography during or after thrombolysis) and were lower than expected based on previous reports. The average actual costs of several common diagnostic and therapeutic procedures for peripheral vascular occlusive disease were established, allowing determination of the relative importance of different cost components. This methodology may serve as a template for future cost analyses.

  2. A cost effective model for appropriate administration of red cell units and salvaging un-transfused red cell units by using temperature sensitive indicators for blood component transportation in a hospital setting

    Directory of Open Access Journals (Sweden)

    Aseem K Tiwari

    2015-01-01

    Full Text Available Background: A rule called "30-min rule" defines that red cell unit cannot be used if it has been out of blood bank refrigerator for over 30 min. This rule is useful to guide initiation of transfusion, but is inadequate for deciding whether to reuse or discard units received-back at blood transfusion services (BTS. A simple cost-effective temperature-sensitive indicator was evaluated to decide upon reuse (cold chain was uninterrupted or discard (where cold chain was interrupted in a simulation exercise. Materials and Methods: Temperature-sensitive indicators TH-F™ that irreversibly changed color from white to red demonstrated that heat excursion has occurred and the cumulative temperature has exceeded 10°C for over 30 min, were used in outdated red cells for simulating units, which are not used and received-back. These units were also tagged with a standard temperature monitoring device, which was a re-usable credit card sized device, which would log the actual time and temperature. In few units percent hemolysis was also calculated. Results: Statistically insignificant elevation in average temperature was noted in 102 simulated units at the time of return to BTS (Δ 0.04°C, despite the fact that these units were in the transport box for over 4 h. The average supernatant hemoglobin in these units was 0.24%, much below the prescribed threshold. Conclusion: Transportation of blood in controlled conditions with temperature-sensitive indicator is a cost-effective model to save blood, a precious human resource.

  3. The net national costs of illegal immigration into the United States.

    Science.gov (United States)

    Huddle, D L

    1995-04-01

    "This article examines the major economic pros and cons of illegal immigration and answers the question: what, if any, are the public and private costs of illegal immigration in the United States? In brief, the article finds that between four and 5.4 million illegal immigrants reside here.... The article also finds that illegal immigrants and their own citizen children cost taxpayers an additional $12 to $16.2 billion annually for education, public services, and incarceration after deducting all local, state, and federal taxes paid in by them. In the private sector, illegal aliens are found to save their employers and owners of capital about $1.5 billion more than U.S. workers lose due to wage depression. The article also considers what legal and enforcement reforms would be necessary to dramatically slow the current flow of 300,000 illegals yearly and concludes that, although improvements in the system are now being proposed, the actual reforms will be insufficient to more than stem the currently rising tide of illegals due to economic instability in Mexico and the Third World." excerpt

  4. Energy Savings and Breakeven Cost for Residential Heat Pump Water Heaters in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Maguire, J.; Burch, J.; Merrigan, T.; Ong, S.

    2013-07-01

    Heat pump water heaters (HPWHs) have recently reemerged in the U.S. residential water heating market and have the potential to provide homeowners with significant energy savings. However, there are questions as to the actual performance and energy savings potential of these units, in particular in regards to the heat pump's performance in unconditioned space and the impact of the heat pump on space heating and cooling loads when it is located in conditioned space. To help answer these questions, simulations were performed of a HPWH in both conditioned and unconditioned space at over 900 locations across the continental United States and Hawaii. Simulations included a Building America benchmark home so that any interaction between the HPWH and the home's HVAC equipment could be captured. Comparisons were performed to typical gas and electric water heaters to determine the energy savings potential and cost effectiveness of a HPWH relative to these technologies. HPWHs were found to have a significant source energy savings potential when replacing typical electric water heaters, but only saved source energy relative to gas water heater in the most favorable installation locations in the southern US. When replacing an electric water heater, the HPWH is likely to break even in California, the southern US, and parts of the northeast in most situations. However, the HPWH will only break even when replacing a gas water heater in a few southern states.

  5. A low-cost off-the-shelf FGPA-based smart wireless sensing unit

    Science.gov (United States)

    Kapoor, Chetan; Graves-Abe, Troy L.; Pei, Jin-Song

    2006-03-01

    To continue with the development of a wireless sensing unit built upon an off-the-shelf FPGA development board presented by the authors at SPIE 2005, this paper outlines a further effort consisting of embedding onboard computations, simulation and validation of the FPGA-based wireless sensing unit that is able to collect, process and transmit data. This research supports the concepts of decentralized wireless sensor networks and local-based damage detection, where individual wireless sensor nodes are capable of performing intricate tasks and can eventually transmit the processed results. An FPGA-based hardware platform is thus looked upon as a major contender for performing this function in a proficient manner. Throughout this research, the principal design complexities, in terms of both hardware and software development, are kept to a minimum. Development cycle and monetary cost of the hardware are other major considerations for this research. Data processing functions including windowing, Fast Fourier Transform (FFT), peak detection, are implemented into the selected FPGA, when limitations of different design options are explored to yield a solution that optimizes the resources of the selected FPGA. Numerical simulations and laboratory validations are carried out to scrutinize the operations and flexibility of the design.

  6. The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis.

    Science.gov (United States)

    Michaelidis, Constantinos I; Fine, Michael J; Lin, Chyongchiou Jeng; Linder, Jeffrey A; Nowalk, Mary Patricia; Shields, Ryan K; Zimmerman, Richard K; Smith, Kenneth J

    2016-11-08

    Ambulatory antibiotic prescribing contributes to the development of antibiotic resistance and increases societal costs. Here, we estimate the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. In an exploratory analysis, we used published data to develop point and range estimates for the hidden societal cost of antibiotic resistance (SCAR) attributable to each ambulatory antibiotic prescription in the United States. We developed four estimation methods that focused on the antibiotic-resistance attributable costs of hospitalization, second-line inpatient antibiotic use, second-line outpatient antibiotic use, and antibiotic stewardship, then summed the estimates across all methods. The total SCAR attributable to each ambulatory antibiotic prescription was estimated to be $13 (range: $3-$95). The greatest contributor to the total SCAR was the cost of hospitalization ($9; 69 % of the total SCAR). The costs of second-line inpatient antibiotic use ($1; 8 % of the total SCAR), second-line outpatient antibiotic use ($2; 15 % of the total SCAR) and antibiotic stewardship ($1; 8 %). This apperars to be an error.; of the total SCAR) were modest contributors to the total SCAR. Assuming an average antibiotic cost of $20, the total SCAR attributable to each ambulatory antibiotic prescription would increase antibiotic costs by 65 % (range: 15-475 %) if incorporated into antibiotic costs paid by patients or payers. Each ambulatory antibiotic prescription is associated with a hidden SCAR that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.

  7. The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis

    Directory of Open Access Journals (Sweden)

    Constantinos I. Michaelidis

    2016-11-01

    Full Text Available Abstract Background Ambulatory antibiotic prescribing contributes to the development of antibiotic resistance and increases societal costs. Here, we estimate the hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States. Methods In an exploratory analysis, we used published data to develop point and range estimates for the hidden societal cost of antibiotic resistance (SCAR attributable to each ambulatory antibiotic prescription in the United States. We developed four estimation methods that focused on the antibiotic-resistance attributable costs of hospitalization, second-line inpatient antibiotic use, second-line outpatient antibiotic use, and antibiotic stewardship, then summed the estimates across all methods. Results The total SCAR attributable to each ambulatory antibiotic prescription was estimated to be $13 (range: $3–$95. The greatest contributor to the total SCAR was the cost of hospitalization ($9; 69 % of the total SCAR. The costs of second-line inpatient antibiotic use ($1; 8 % of the total SCAR, second-line outpatient antibiotic use ($2; 15 % of the total SCAR and antibiotic stewardship ($1; 8 %. This apperars to be an error.; of the total SCAR were modest contributors to the total SCAR. Assuming an average antibiotic cost of $20, the total SCAR attributable to each ambulatory antibiotic prescription would increase antibiotic costs by 65 % (range: 15–475 % if incorporated into antibiotic costs paid by patients or payers. Conclusions Each ambulatory antibiotic prescription is associated with a hidden SCAR that substantially increases the cost of an antibiotic prescription in the United States. This finding raises concerns regarding the magnitude of misalignment between individual and societal antibiotic costs.

  8. Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study

    Science.gov (United States)

    Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

    2014-01-01

    Objective To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Design Modelling study using the Sheffield Alcohol Policy Model version 2.5. Setting England 2014-15. Population Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Interventions Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45p, and 50p per unit (7.9 g/10 mL) of pure alcohol. Main outcome measures Changes in mean consumption in terms of units of alcohol, drinkers’ expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. Results The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45p minimum unit price. Below cost selling is estimated to reduce harmful drinkers’ mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health—saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45p minimum unit price is estimated to save 624 deaths and 23 700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. Conclusions The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at

  9. Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study.

    Science.gov (United States)

    Brennan, Alan; Meng, Yang; Holmes, John; Hill-McManus, Daniel; Meier, Petra S

    2014-09-30

    To evaluate the potential impact of two alcohol control policies under consideration in England: banning below cost selling of alcohol and minimum unit pricing. Modelling study using the Sheffield Alcohol Policy Model version 2.5. England 2014-15. Adults and young people aged 16 or more, including subgroups of moderate, hazardous, and harmful drinkers. Policy to ban below cost selling, which means that the selling price to consumers could not be lower than tax payable on the product, compared with policies of minimum unit pricing at £0.40 (€0.57; $0.75), 45 p, and 50 p per unit (7.9 g/10 mL) of pure alcohol. Changes in mean consumption in terms of units of alcohol, drinkers' expenditure, and reductions in deaths, illnesses, admissions to hospital, and quality adjusted life years. The proportion of the market affected is a key driver of impact, with just 0.7% of all units estimated to be sold below the duty plus value added tax threshold implied by a ban on below cost selling, compared with 23.2% of units for a 45 p minimum unit price. Below cost selling is estimated to reduce harmful drinkers' mean annual consumption by just 0.08%, around 3 units per year, compared with 3.7% or 137 units per year for a 45 p minimum unit price (an approximately 45 times greater effect). The ban on below cost selling has a small effect on population health-saving an estimated 14 deaths and 500 admissions to hospital per annum. In contrast, a 45 p minimum unit price is estimated to save 624 deaths and 23,700 hospital admissions. Most of the harm reductions (for example, 89% of estimated deaths saved per annum) are estimated to occur in the 5.3% of people who are harmful drinkers. The ban on below cost selling, implemented in the England in May 2014, is estimated to have small effects on consumption and health harm. The previously announced policy of a minimum unit price, if set at expected levels between 40 p and 50 p per unit, is estimated to have an approximately 40-50 times

  10. 42 CFR 447.206 - Cost limit for providers operated by units of government.

    Science.gov (United States)

    2010-10-01

    ... cost report (or Medicaid cost report for intermediate nursing facility care and ICFs/MR consistent with Medicare cost reporting principles, and audited financial statements that will be used in conjunction with...

  11. Does a single specialty intensive care unit make better business sense than a multi-specialty intensive care unit? A costing study in a trauma center in India

    Directory of Open Access Journals (Sweden)

    Parmeshwar Kumar

    2015-01-01

    Full Text Available Context: Though intensive care units (ICUs only account for 10% of hospital beds, they consume nearly 22% of hospital resources. Few definitive costing studies have been conducted in Indian settings that would help determine appropriate resource allocation. Aim: To evaluate and compare the cost of intensive care delivery between multi-specialty and neurosurgery ICU in an apex trauma care facility in India. Materials and Methods: The study was conducted in a polytrauma and neurosurgery ICU at a 203 bedded level IV trauma care facility in New Delhi, India from May, 2012 to June 2012. The study was cross-sectional, retrospective, and record-based. Traditional costing was used to arrive at the cost for both direct and indirect cost estimates. The cost centers included in study were building cost, equipment cost, human resources, materials and supplies, clinical and nonclinical support services, engineering maintenance cost, and biomedical waste management. Statistical Analysis: Fisher′s two-tailed t-test. Results: Total cost/bed/day for the multi-specialty ICU was Rs. 14,976.9/- and for the neurosurgery ICU was Rs. 14,306.7/-, manpower constituting nearly half of the expenditure in both ICUs. The cost center wise and overall difference in the cost among the ICUs were statistically significant. Conclusions: Quantification of expenditure in running an ICU in a trauma center would assist healthcare decision makers in better allocation of resources. Although multi-specialty ICUs are more expensive, other factors will also play a role in defining the kind of ICU that need to be designed.

  12. Break-Even Cost for Residential Solar Water Heating in the United States: Key Drivers and Sensitivities

    Energy Technology Data Exchange (ETDEWEB)

    Cassard, H.; Denholm, P.; Ong, S.

    2011-02-01

    This paper examines the break-even cost for residential rooftop solar water heating (SWH) technology, defined as the point where the cost of the energy saved with a SWH system equals the cost of a conventional heating fuel purchased from the grid (either electricity or natural gas). We examine the break-even cost for the largest 1,000 electric and natural gas utilities serving residential customers in the United States as of 2008. Currently, the break-even cost of SWH in the United States varies by more than a factor of five for both electricity and natural gas, despite a much smaller variation in the amount of energy saved by the systems (a factor of approximately one and a half). The break-even price for natural gas is lower than that for electricity due to a lower fuel cost. We also consider the relationship between SWH price and solar fraction and examine the key drivers behind break-even costs. Overall, the key drivers of the break-even cost of SWH are a combination of fuel price, local incentives, and technical factors including the solar resource location, system size, and hot water draw.

  13. Direct and Indirect Costs of Chronic and Episodic Migraine in the United States: A Web-Based Survey.

    Science.gov (United States)

    Messali, Andrew; Sanderson, Joanna C; Blumenfeld, Andrew M; Goadsby, Peter J; Buse, Dawn C; Varon, Sepideh F; Stokes, Michael; Lipton, Richard B

    2016-02-01

    The objective of this study was to compare the societal direct and indirect costs of chronic and episodic migraine in the United States. Episodic and chronic migraine are distinguished by the frequency of headache-days. Chronic migraine has a greater overall impact on quality of life than does episodic migraine. Individuals with chronic migraine also use more healthcare resources (resulting in higher direct costs) and experience greater decreases in productivity (resulting in higher indirect costs) than those with episodic migraine as shown in the American Migraine Prevalence and Prevention (AMPP) Study. The International Burden of Migraine Study utilized a web-based questionnaire to elicit data on several topics related to the burden of migraine illness, including health resource utilization and productivity losses. Potential survey participants were identified by Synovate Healthcare (Chicago, IL, USA) from a pool of registered panelists from various countries. The panelists were screened online to determine eligibility and to identify individuals with migraine (episodic or chronic), based on reported symptoms. Participants from the United States were divided into episodic and chronic migraine groups, based on reported headache-day per month frequency. Direct and indirect costs were estimated by applying estimated unit costs to reported headache-related productivity losses and resource use. Costs were compared between participants with episodic and chronic migraine. Mean [standard deviation] total annual cost of headache among people with chronic migraine ($8243 [$10,646]) was over three times that of episodic migraine ($2649 [$4634], P < .001). Participants with chronic migraine had significantly greater direct medical costs ($4943 [$6382]) and indirect (lost productivity) costs ($3300 [$6907]) than did participants with episodic migraine (direct, $1705 [$3591]; indirect, $943 [$2084]) (P < .001 for each). Unlike previous findings, direct medical costs

  14. Does the Integrated Management of Childhood Illness cost more than routine care? Results from the United Republic of Tanzania.

    Science.gov (United States)

    Adam, Taghreed; Manzi, Fatuma; Schellenberg, Joanna Armstrong; Mgalula, Leslie; de Savigny, Don; Evans, David B.

    2005-01-01

    OBJECTIVE: The Integrated Management of Childhood Illness (IMCI) strategy is designed to address the five leading causes of childhood mortality, which together account for 70% of the 10 million deaths occurring among children worldwide annually. Although IMCI is associated with improved quality of care, which is a key determinant of better health outcomes, it has not yet been widely adopted, partly because it is assumed to be more expensive than routine care. Here we report the cost of IMCI compared with routine care in four districts in the United Republic of Tanzania. METHODS: Total district costs of child care were estimated from the societal perspective as the sum of child health-care costs incurred in a district at the household level, primary health-facility level and hospital level. We also included administrative and support costs incurred by national and district administrations. The incremental cost of IMCI is the difference in costs of child health-care between districts with and without IMCI, after standardization for population size. FINDINGS: The annual cost per child of caring for children less than five years old in districts with IMCI was USD 11.19, 44% lower than the cost in the districts without IMCI (USD 16.09). Much of the difference was due to higher rates of hospitalization of children less than 5 years old in the districts without IMCI. Not all of this difference can be attributed to IMCI but even when differences in hospitalization rates are excluded, the cost per child was still 6% lower in IMCI districts. CONCLUSION:IMCI was not associated with higher costs than routine child health-care in the four study districts in the United Republic of Tanzania. Given the evidence of improved quality of care in the IMCI districts, the results suggest that cost should not be a barrier to the adoption and scaling up of IMCI. PMID:15976878

  15. A Historical Analysis of Attitudes toward the Use of Calculators in Junior High and High School Math Classrooms in the United States since 1975

    Science.gov (United States)

    Banks, Sarah A.

    2011-01-01

    This thesis explored the history of calculator usage in mathematics classrooms in the United States since 1975 with a focus on the attitudes of parents, educators, and national organizations. The influence of historical events, people, organizations, research, and trends was explored in depth. Studying the changes that calculators have brought to…

  16. Mitigating climate change through afforestation: new cost estimates for the United States

    Science.gov (United States)

    Anne Sofie Elberg Nielsen; Andrew J. Plantinga; Ralph J. Alig

    2014-01-01

    We provide new cost estimates for carbon sequestration through afforestation in the U.S. We extend existing studies of carbon sequestration costs in several important ways, while ensuring the transparency of our approach. Our costs estimates have five distinguishing features: (1) we estimate costs for each county in the contiguous U.S., (2) we include afforestation of...

  17. Effect of Changes in Layout Shape on Unit Construction Cost of ...

    African Journals Online (AJOL)

    cost and overall project cost are affected by variation in plan shape narrowness and complexity (irregularity). These results will assist construction professionals, especially the cost consultants, in making more objective design decisions and in giving cost advice related to plan layout for the benefits of their clients. Samaru ...

  18. The Scales of Time, Length, Mass, Energy, and Other Fundamental Physical Quantities in the Atomic World and the Use of Atomic Units in Quantum Mechanical Calculations

    Science.gov (United States)

    Teo, Boon K.; Li, Wai-Kee

    2011-01-01

    This article is divided into two parts. In the first part, the atomic unit (au) system is introduced and the scales of time, space (length), and speed, as well as those of mass and energy, in the atomic world are discussed. In the second part, the utility of atomic units in quantum mechanical and spectroscopic calculations is illustrated with…

  19. Constructing the universal characteristic of a compressor based on the results of thermal tests of gas turbine units and using it to calculate variable operating modes

    Science.gov (United States)

    Ol'Khovskii, G. G.; Trushechkin, V. P.; Chadovskaya, I. I.

    2010-09-01

    A procedure for constructing the universal characteristic of a compressor at different positions of its inlet guide vane using experimentally obtained characteristics of the compressor and turbine, and a computer program for simulating variable operating modes of a gas turbine unit are described. Results from a comparison between calculated data and data obtained from tests of similar types of gas turbines units are presented.

  20. Do cost savings from reductions in nosocomial infections justify additional costs of single-bed rooms in intensive care units? A simulation case study.

    Science.gov (United States)

    Sadatsafavi, Hessam; Niknejad, Bahar; Zadeh, Rana; Sadatsafavi, Mohsen

    2016-02-01

    Evidence shows that single-patient rooms can play an important role in preventing cross-transmission and reducing nosocomial infections in intensive care units (ICUs). This case study investigated whether cost savings from reductions in nosocomial infections justify the additional construction and operation costs of single-bed rooms in ICUs. We conducted deterministic and probabilistic return-on-investment analyses of converting the space occupied by open-bay rooms to single-bed rooms in an exemplary ICU. We used the findings of a study of an actual ICU in which the association between the locations of patients in single-bed vs open-bay rooms with infection risk was evaluated. Despite uncertainty in the estimates of costs, infection risks, and length of stay, the cost savings from the reduction of nosocomial infections in single-bed rooms in this case substantially outweighed additional construction and operation expenses. The mean value of internal rate of return over a 5-year analysis period was 56.18% (95% credible interval, 55.34%-57.02%). This case study shows that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms by avoiding costs associated with nosocomial infections. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. VARIANTS OF DETERMINING THE MANUFACTURING COST OF A PRODUCT IN A PRODUCTION UNIT IN THE LIGHT OF BALANCE SHEET LAW

    OpenAIRE

    Marzena STROJEK‐FILUS

    2014-01-01

    The category of the manufacturing cost of a product is one of the most important ones from the point of view of proper valuation of the assets of a production unit, costs of its operations as well as pricing decisions. This article presents the problem of determining the manufacturing cost of a product in terms of balance sheet law. It has been shown that in order to determine this value various methods and options are allowed by this law, by means of which different values of manufacturing c...

  2. Research of Coalbed Methane Development Well-Type Optimization Method Based on Unit Technical Cost

    Directory of Open Access Journals (Sweden)

    Shiqun Li

    2016-08-01

    Full Text Available Coalbed Methane (CBM is a high-quality unconventional energy resource. The successful development and utilization of a CBM resource needs to consider technical feasibility and economic viability. These factors are also necessary for the improvement of production safety in coal mines, reducing carbon emission, and optimizing energy structure. Because of its unique resource characteristics, surface drilling is the prevailing development approach all over the world. Directional and horizontal wells are generally the two major well-types for CBM development. Development well-type is an important factor affecting CBM efficient development, as it is a key factor in the process of the economic and effective development of CBM resource. In this paper, a method based on Unit Technical Cost (UTC will be constructed from the perspective of economic viability, and will be used for more simple and accurate optimization of CBM. This method is used for practical well-type optimization in two major CBM development basins in China, and the application results prove that this method is scientifically accurate and feasible.

  3. Anemia, bleeding, and blood transfusion in the intensive care unit: causes, risks, costs, and new strategies.

    Science.gov (United States)

    McEvoy, Michael T; Shander, Aryeh

    2013-11-01

    The definition of anemia is controversial and varies with the sex, age, and ethnicity of the patient. Anemia afflicts half of hospitalized patients and most elderly hospitalized patients. Acute anemia in the operating room or intensive care unit is associated with increased morbidity as well as other adverse outcomes, including death. The risks of anemia are compounded by the added risks associated with transfusion of red blood cells, the most common treatment for severe anemia. The causes of anemia in hospitalized patients include iron deficiency, suppression of erythropoietin and iron transport, trauma, phlebotomy, coagulopathies, adverse effects of and reactions to medications, and stress-induced gastrointestinal bleeding. The types and causes of anemia and the increased health care utilization and costs associated with anemia and undetected internal bleeding are described. The potential benefits and risks associated with transfusion of red blood cells also are explored. Last, the strategies and new tools to help prevent anemia, allow earlier detection of internal bleeding, and avoid unnecessary blood transfusions are discussed.

  4. Unit cost analysis of training and deploying paid community health workers in three rural districts of Tanzania.

    Science.gov (United States)

    Tani, Kassimu; Exavery, Amon; Baynes, Colin D; Pemba, Senga; Hingora, Ahmed; Manzi, Fatuma; Phillips, James F; Kanté, Almamy Malick

    2016-07-08

    Tanzania, like other African countries, faces significant health workforce shortages. With advisory and partnership from Columbia University, the Ifakara Health Institute and the Tanzanian Training Centre for International Health (TTCIH) developed and implemented the Connect Project as a randomized cluster experimental trial of the childhood survival impact of recruiting, training, and deploying of a new cadre of paid community health workers (CHW), named "Wawazesha wa afya ya Jamii" (WAJA). This paper presents an estimation of the cost of training and deploying WAJA in three rural districts of Tanzania. Costing data were collected by tracking project activity expenditure records and conducting in-depth interviews of TTCIH staff who have led the training and deployment of WAJA, as well as their counterparts at Public Clinical Training Centres who have responsibility for scaling up the WAJA training program. The trial is registered with the International Standard Randomized Controlled Trial Register number ( ISRCTN96819844 ). The Connect training cost was US$ 2,489.3 per WAJA, of which 40.1 % was for meals, 20.2 % for accommodation 10.2 % for tuition fees and the remaining 29.5 % for other costs including instruction and training facilities and field allowance. A comparable training program estimated unit cost for scaling-up this training via regional/district clinical training centres would be US$ 833.5 per WAJA. Of this unit cost, 50.3 % would involve the cost of meals, 27.4 % training fees, 13.7 % for field allowances, 9 % for accommodation and medical insurance. The annual running cost of WAJA in a village will cost US$ 1.16 per capita. Costs estimated by this study are likely to be sustainable on a large scale, particularly if existing regional/district institutions are utilized for this program.

  5. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71

    Science.gov (United States)

    Gibbons, John P.; Antolak, John A.; Followill, David S.; Huq, M. Saiful; Klein, Eric E.; Lam, Kwok L.; Palta, Jatinder R.; Roback, Donald M.; Reid, Mark; Khan, Faiz M.

    2014-01-01

    A protocol is presented for the calculation of monitor units (MU) for photon and electron beams, delivered with and without beam modifiers, for constant source-surface distance (SSD) and source-axis distance (SAD) setups. This protocol was written by Task Group 71 of the Therapy Physics Committee of the American Association of Physicists in Medicine (AAPM) and has been formally approved by the AAPM for clinical use. The protocol defines the nomenclature for the dosimetric quantities used in these calculations, along with instructions for their determination and measurement. Calculations are made using the dose per MU under normalization conditions, \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′, that is determined for each user's photon and electron beams. For electron beams, the depth of normalization is taken to be the depth of maximum dose along the central axis for the same field incident on a water phantom at the same SSD, where \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′ = 1 cGy/MU. For photon beams, this task group recommends that a normalization depth of 10 cm be selected, where an energy-dependent \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$D_0^\\prime $\\end{document}D0′ ≤ 1 cGy/MU is required. This recommendation differs from the more common approach of a normalization depth of dm, with

  6. Design and calculated performance and cost of the ECAS Phase II open cycle MHD power generation system

    Science.gov (United States)

    Harris, L. P.

    1977-01-01

    A 2000 MWe MHD/steam plant for central station applications has been designed and costed as part of the Energy Conversion Alternatives Study (ECAS). This plant is fueled by Illinois No. 6 coal, rejects heat through mechanical draft wet cooling towers, and includes coal processing equipment, seed reprocessing, electrical inversion of the MHD generator output and emission controls to current EPA standards. It yields an estimated overall efficiency of 0.483 (7066 Btu/kWe-hr), a capital cost of $718 per kWe (1975 dollars), and a cost of electricity at 65% capacity factor of 32 mills per kWe-hr. If the assumed life and reliability could be achieved with these performance parameters, the MHD system should prove attractive.

  7. Modeling the Unites States government's economic cost of noise-induced hearing loss for a military population.

    Science.gov (United States)

    Tufts, Jennifer B; Weathersby, Paul K; Rodriguez, Francisco A

    2010-05-01

    The purpose of this paper is to demonstrate the feasibility and utility of developing economic cost models for noise-induced hearing loss (NIHL). First, we outline an economic model of NIHL for a population of US Navy sailors with an "industrial"-type noise exposure. Next, we describe the effect on NIHL-related cost of varying the two central model inputs--the noise-exposure level and the duration of exposure. Such an analysis can help prioritize promising areas, to which limited resources to reduce NIHL-related costs should be devoted. NIHL-related costs borne by the US government were computed on a yearly basis using a finite element approach that took into account varying levels of susceptibility to NIHL. Predicted hearing thresholds for the population were computed with ANSI S3.44-1996 and then used as the basis for the calculation of NIHL-related costs. Annual and cumulative costs were tracked. Noise-exposure level and duration were systematically varied to determine their effects on the expected lifetime NIHL-related cost of a specific US Navy sailor population. Our nominal noise-exposure case [93 dB(A) for six years] yielded a total expected lifetime cost of US $13,472 per sailor, with plausible lower and upper bounds of US $2,500 and US $26,000. Starting with the nominal case, a decrease of 50% in exposure level or duration would yield cost savings of approximately 23% and 19%, respectively. We concluded that a reduction in noise level would be more somewhat more cost-effective than the same percentage reduction in years of exposure. Our economic cost model can be used to estimate the changes in NIHL-related costs that would result from changes in noise-exposure level and/or duration for a single military population. Although the model is limited at present, suggestions are provided for adapting it to civilian populations.

  8. Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030.

    Science.gov (United States)

    Antonelli, Jodi A; Maalouf, Naim M; Pearle, Margaret S; Lotan, Yair

    2014-10-01

    The prevalence of urolithiasis and its risk factors such as obesity and diabetes have increased over time. Determine the future cost and prevalence of kidney stones using current and projected estimates for stones, obesity, diabetes, and population rates. The stone prevalence in 2000 was estimated from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010. The cost per percentage prevalence of stones in 2000, calculated using Urologic Diseases in America Project data, was used to estimate the annual cost of stones in 2030, adjusting for inflation and increases in population, stone prevalence, obesity and diabetes rates. The primary outcome was prevalence and cost of stones in 2030. The secondary outcomes were the impact of obesity and diabetes on these values, calculated using odds ratios for stones by body mass index and diabetes status. The annual cost of stone disease in 2000, adjusted for inflation to 2014 US dollars, was approximately $2.81 billion. After accounting for increases in population and stone prevalence from 2000, the estimated cost of stones in 2007 in 2014 US dollars was $3.79 billion. Future population growth alone would increase the cost of stone disease by $780 million in 2030. Based on projected estimates for 2030, obesity will independently increase stone prevalence by 0.36%, with an annual cost increase of $157 million. Diabetes will independently increase stone prevalence by 0.72%, associated with a cost increase of $308 million annually by 2030. NHANES data, however, capture patient self-assessment rather than medical diagnosis, which is a potential bias. The rising prevalence of obesity and diabetes, together with population growth, is projected to contribute to dramatic increases in the cost of urolithiasis, with an additional $1.24 billion/yr estimated by 2030. Obesity, diabetes, and population rates will contribute to an estimated $1.24 billion/yr increase in the cost of kidney stones by 2030. Copyright

  9. Impact of selection of cord blood units from the United States and swiss registries on the cost of banking operations.

    Science.gov (United States)

    Bart, Thomas; Boo, Michael; Balabanova, Snejana; Fischer, Yvonne; Nicoloso, Grazia; Foeken, Lydia; Oudshoorn, Machteld; Passweg, Jakob; Tichelli, Andre; Kindler, Vincent; Kurtzberg, Joanne; Price, Thomas; Regan, Donna; Shpall, Elizabeth J; Schwabe, Rudolf

    2013-02-01

    Over the last 2 decades, cord blood (CB) has become an important source of blood stem cells. Clinical experience has shown that CB is a viable source for blood stem cells in the field of unrelated hematopoietic blood stem cell transplantation. Studies of CB units (CBUs) stored and ordered from the US (National Marrow Donor Program (NMDP) and Swiss (Swiss Blood Stem Cells (SBSQ)) CB registries were conducted to assess whether these CBUs met the needs of transplantation patients, as evidenced by units being selected for transplantation. These data were compared to international banking and selection data (Bone Marrow Donors Worldwide (BMDW), World Marrow Donor Association (WMDA)). Further analysis was conducted on whether current CB banking practices were economically viable given the units being selected from the registries for transplant. It should be mentioned that our analysis focused on usage, deliberately omitting any information about clinical outcomes of CB transplantation. A disproportionate number of units with high total nucleated cell (TNC) counts are selected, compared to the distribution of units by TNC available. Therefore, the decision to use a low threshold for banking purposes cannot be supported by economic analysis and may limit the economic viability of future public CB banking. We suggest significantly raising the TNC level used to determine a bankable unit. A level of 125 × 10(7) TNCs, maybe even 150 × 10(7) TNCs, might be a viable banking threshold. This would improve the return on inventory investments while meeting transplantation needs based on current selection criteria.

  10. Impact of Selection of Cord Blood Units from the United States and Swiss Registries on the Cost of Banking Operations

    Science.gov (United States)

    Bart, Thomas; Boo, Michael; Balabanova, Snejana; Fischer, Yvonne; Nicoloso, Grazia; Foeken, Lydia; Oudshoorn, Machteld; Passweg, Jakob; Tichelli, Andre; Kindler, Vincent; Kurtzberg, Joanne; Price, Thomas; Regan, Donna; Shpall, Elizabeth J.; Schwabe, Rudolf

    2013-01-01

    Background Over the last 2 decades, cord blood (CB) has become an important source of blood stem cells. Clinical experience has shown that CB is a viable source for blood stem cells in the field of unrelated hematopoietic blood stem cell transplantation. Methods Studies of CB units (CBUs) stored and ordered from the US (National Marrow Donor Program (NMDP) and Swiss (Swiss Blood Stem Cells (SBSQ)) CB registries were conducted to assess whether these CBUs met the needs of transplantation patients, as evidenced by units being selected for transplantation. These data were compared to international banking and selection data (Bone Marrow Donors Worldwide (BMDW), World Marrow Donor Association (WMDA)). Further analysis was conducted on whether current CB banking practices were economically viable given the units being selected from the registries for transplant. It should be mentioned that our analysis focused on usage, deliberately omitting any information about clinical outcomes of CB transplantation. Results A disproportionate number of units with high total nucleated cell (TNC) counts are selected, compared to the distribution of units by TNC available. Therefore, the decision to use a low threshold for banking purposes cannot be supported by economic analysis and may limit the economic viability of future public CB banking. Conclusions We suggest significantly raising the TNC level used to determine a bankable unit. A level of 125 × 107 TNCs, maybe even 150 × 107 TNCs, might be a viable banking threshold. This would improve the return on inventory investments while meeting transplantation needs based on current selection criteria. PMID:23637645

  11. Low cost solar array project production process and equipment task. A Module Experimental Process System Development Unit (MEPSDU)

    Science.gov (United States)

    1981-01-01

    Technical readiness for the production of photovoltaic modules using single crystal silicon dendritic web sheet material is demonstrated by: (1) selection, design and implementation of solar cell and photovoltaic module process sequence in a Module Experimental Process System Development Unit; (2) demonstration runs; (3) passing of acceptance and qualification tests; and (4) achievement of a cost effective module.

  12. Hospital costs associated with nosocomial infections in a pediatric intensive care unit

    Directory of Open Access Journals (Sweden)

    Áurea Morillo-García

    2015-07-01

    Conclusions: NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems.

  13. Implementation of practice guidelines for antifungal therapy in a surgical intensive care unit and its impact on use and costs.

    Science.gov (United States)

    Swoboda, Stefanie; Lichtenstern, Christoph; Ober, Michael Christoff; Taylor, Lenka Alexandra; Störzinger, Dominic; Michel, André; Brobeil, Angelika; Mieth, Markus; Hofer, Stefan; Sonntag, Hans-Günther; Hoppe-Tichy, Torsten; Weigand, Markus Alexander

    2009-01-01

    Considering the complexity of diagnosis, high costs of therapy and high morbidity and mortality of systemic fungal infections, antifungal therapy of intensive care patients should follow clearly defined guidelines. We outline the impact of a standardised practice of antifungal treatment in an interdisciplinary surgical intensive care unit of a university hospital. Therapy was intended to be optimised by implementation of standardised practice guidelines supported by the clinical pharmacist. Costs for antifungal agents during a period of 18 months before and after implementation of the practice guidelines were compared, respectively. The intervention was associated with a significant decrease in use of antifungal agents. Analysis of data revealed a reduction in costs by 50%. This could substantially be attributed to the implementation of the practice guidelines. The implementation of standardised practice guidelines for antifungal therapy in intensive care units decreased the use of selected antifungal agents and resulted in substantial reduction in expenditure on antifungal agents. Copyright 2009 S. Karger AG, Basel.

  14. An estimate of the unit cost of road traffic collisions in South Africa for 1998

    CSIR Research Space (South Africa)

    Schutte, IC

    2000-03-01

    Full Text Available Road traffic collision result in both human loss and cost to the company. Government and other role players addressing this problem require reliable information on the cost of collisions to the economy. Collisions costs are also used in the economic...

  15. The average unit production cost of blood in Zimbabwe from a provider's perspective

    NARCIS (Netherlands)

    Mafirakureva, N.; Nyoni, H.; Chikwereti, R.; Khoza, S.; Mvere, D.A.; Emmanuel, J.C.; Postma, M.J.; Van Hulst, M.

    2014-01-01

    Background/Case Studies: Blood utilization and blood transfusion costs are generally perceived to be increasing at a time when healthcare budgets continue being constricted. There is a paucity of published data on the production costs of blood and the costs of blood transfusion in sub-Saharan

  16. The cost of karst subsidence and sinkhole collapse in the United States compared with other natural hazards

    Science.gov (United States)

    Weary, David J.

    2015-01-01

    Rocks with potential for karst formation are found in all 50 states. Damage due to karst subsidence and sinkhole collapse is a natural hazard of national scope. Repair of damage to buildings, highways, and other infrastructure represents a significant national cost. Sparse and incomplete data show that the average cost of karst-related damages in the United States over the last 15 years is estimated to be at least $300,000,000 per year and the actual total is probably much higher. This estimate is lower than the estimated annual costs for other natural hazards; flooding, hurricanes and cyclonic storms, tornadoes, landslides, earthquakes, or wildfires, all of which average over $1 billion per year. Very few state organizations track karst subsidence and sinkhole damage mitigation costs; none occurs at the Federal level. Many states discuss the karst hazard in their State hazard mitigation plans, but seldom include detailed reports of subsidence incidents or their mitigation costs. Most State highway departments do not differentiate karst subsidence or sinkhole collapse from other road repair costs. Amassing of these data would raise the estimated annual cost considerably. Information from insurance organizations about sinkhole damage claims and payouts is also not readily available. Currently there is no agency with a mandate for developing such data. If a more realistic estimate could be made, it would illuminate the national scope of this hazard and make comparison with costs of other natural hazards more realistic.

  17. Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs.

    Science.gov (United States)

    Sodhi, Jitender; Satpathy, Sidhartha; Sharma, D K; Lodha, Rakesh; Kapil, Arti; Wadhwa, Nitya; Gupta, Shakti Kumar

    2016-04-01

    Healthcare associated infections (HAIs) increase the length of stay in the hospital and consequently costs as reported from studies done in developed countries. The current study was undertaken to evaluate the impact of HAIs on length of stay and costs of health care in children admitted to Paediatric Intensive Care Unit (PICU) of a tertiary care hospital in north India. This prospective study was done in the seven bedded PICU of a large multi-specialty tertiary care hospital in New Delhi, India. A total of 20 children with HAI (cases) and 35 children without HAI (controls), admitted to the PICU during the study period (January 2012 to June 2012), were matched for gender, age, and average severity of illness score. Each patient's length of stay was obtained prospectively. Costs of healthcare were estimated according to traditional and time driven activity based costing methods approach. The median extra length of PICU stay for children with HAI (cases), compared with children with no HAI (controls), was seven days (IQR 3-16). The mean total costs of patients with and without HAI were ' 2,04,787 (US$ 3,413) and ' 56,587 (US$ 943), respectively and the mean difference in the total cost between cases and controls was ' 1,48,200 (95% CI 55,716 to 2,40,685, pcosts for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

  18. [Quality management (TQM) in public health-care (PHC): principles for cost-performance calculations and cost reductions with better quality].

    Science.gov (United States)

    Bergholz, W

    2008-11-01

    In many high-tech industries, quality management (QM) has enabled improvements of quality by a factor of 100 or more, in combination with significant cost reductions. Compared to this, the application of QM methods in health care is in its initial stages. It is anticipated that stringent process management, embedded in an effective QM system will lead to significant improvements in health care in general and in the German public health service in particular. Process management is an ideal platform for controlling in the health care sector, and it will significantly improve the leverage of controlling to bring down costs. Best practice sharing in industry has led to quantum leap improvements. Process management will enable best practice sharing also in the public health service, in spite of the highly diverse portfolio of services that the public health service offers in different German regions. Finally, it is emphasised that "technical" QM, e.g., on the basis of the ISO 9001 standard is not sufficient to reach excellence. It is necessary to integrate soft factors, such as patient or employee satisfaction, and leadership quality into the system. The EFQM model for excellence can serve as proven tool to reach this goal.

  19. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States.

    Science.gov (United States)

    Dagenais, Simon; Brady, O'Dane; Haldeman, Scott; Manga, Pran

    2015-10-19

    Although chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise. A systematic review was conducted using a comprehensive search strategy to uncover studies that compared health care costs for patients with any type of spine pain who received chiropractic care or care from other HCPs. Only studies conducted in the US and published in English between 1993 and 2015 were included. Health care costs were summarized for studies examining: 1. private health plans, 2. workers' compensation (WC) plans, and 3. clinical outcomes. The quality of studies in the latter group was evaluated using a Consensus on Health Economic Criteria (CHEC) list. The search uncovered 1276 citations and 25 eligible studies, including 12 from private health plans, 6 from WC plans, and 7 that examined clinical outcomes. Chiropractic care was most commonly compared to care from a medical physician, with few details about the care received. Heterogeneity was noted among studies in patient selection, definition of spine pain, scope of costs compared, study duration, and methods to estimate costs. Overall, cost comparison studies from private health plans and WC plans reported that health care costs were lower with chiropractic care. In studies that also examined clinical outcomes, there were few differences in efficacy between groups, and health care costs were higher for those receiving chiropractic care. The effects of adjusting for differences in sociodemographic, clinical, or other factors between study groups were unclear. Although cost comparison studies suggest that health care costs were generally lower among patients whose spine pain was managed with chiropractic care, the studies reviewed had many methodological limitations. Better research is needed to determine if these differences in health care costs were attributable to the

  20. Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.

    Science.gov (United States)

    Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

    2003-01-01

    To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria.

  1. Chest pain unit using thrombolysis in myocardial infarction score risk stratification: an impact on the length of stay and cost savings.

    Science.gov (United States)

    Shah, Priyank P; Gupta, Nishant; Sharma, Anurag; Bhargava, Rishi K; Bajaj, Sharad; Mittal, Vipin; Johnson, Cynthia; Shamoon, Fayez; Bikkina, Mahesh

    2012-12-01

    Despite the fact that studies have demonstrated cost-effectiveness of chest pain observation units (CPOUs) in emergency departments, they have not been widely implemented. Thrombolysis in Myocardial Infarction (TIMI) score is an easy and reliable tool, but none of the prior studies have used it for risk stratification in CPOUs. We propose to study the impact of CPOU using TIMI risk stratification model on the length of stay (LOS) and cost savings. We studied 777 patients with chest pain admitted to our hospital from July 2010 to June 2011. The patients with a TIMI score of 0 to 2 were observed for 12 hours, those with a score of 3 to 4 were observed for 20 hours, and the ones with a score >4 were deemed appropriate for admission. We calculated the cost differences between the actual admissions and the CPOU. A total of 39.1% of patients had a TIMI score of 0, 31.1% had a TIMI score of 1, 18.1% had a TIMI score of 2, 9.2% and 2.5% had TIMI scores of 3 and 4, respectively. The expected LOS based on this model was 418.5 days versus the actual LOS of 1324 days. The cost of CPOU was estimated to be $1,979,977. However, the actual cost was $3,216,809. Hence, the annual cost savings were estimated to be $1,236,832. CPOU using TIMI score is an easy and reliable risk stratification tool for patients with chest pain in the emergency department and can significantly reduce the LOS, hence saving millions of dollars in this economic crisis.

  2. The effect of major adverse renal cardiovascular event (MARCE) incidence, procedure volume, and unit cost on the hospital savings resulting from contrast media use in inpatient angioplasty.

    Science.gov (United States)

    Keuffel, Eric; McCullough, Peter A; Todoran, Thomas M; Brilakis, Emmanouil S; Palli, Swetha R; Ryan, Michael P; Gunnarsson, Candace

    2017-12-15

    To determine the net economic impact of switching from low-osmolar contrast media (LOCM) to iso-osmolar contrast media (IOCM; iodixanol) in patients undergoing inpatient coronary or peripheral angioplasty in the United States (US). A budget impact model (BIM) was developed from a hospital perspective. Nationally representative procedural and contrast media prevalence rates, along with MARCE (major adverse renal cardiovascular event) incidence and episode-related cost data were derived from Premier Hospital Data (October 2014 to September 2015). A previously estimated relative risk reduction in MARCE associated with IOCM usage (9.3%) was applied. The higher cost of IOCM was included when calculating the net impact estimates at the aggregate, hospital type, and per hospital levels. One-way (±25%) and probabilistic sensitivity analyses identified the model's most important inputs. Based on weighted analysis, 513,882 US inpatient angioplasties and 35,610 MARCE cases were estimated annually. Switching to an "IOCM only" strategy from a "LOCM only" strategy increases contrast media cost, but prevents 2,900 MARCE events. The annual budget impact was an estimated saving of $30.71 million, aggregated across all US hospitals, $6,316 per hospital, or $60 per procedure. Net savings were maintained across all univariate sensitivity analyses. While MARCE/event-free cost differential was the most important factor driving total net savings for hospitals in the Northeast and West, procedural volume was important in the Midwest and rural locations. Switching to an "IOCM only" strategy from a "LOCM only" approach yields substantial net global savings to hospitals, both at the national level and within hospital sub-groups. Hospital administrators should maintain awareness of the factors that are likely to be more influential for their hospital and recognize that purchasing on the basis of lower contrast media cost may result in higher overall costs for patients undergoing inpatient

  3. Direct medical cost of overweight and obesity in the United States: a quantitative systematic review

    Science.gov (United States)

    Tsai, Adam Gilden; Williamson, David F.; Glick, Henry A.

    2010-01-01

    Objectives To estimate per-person and aggregate direct medical costs of overweight and obesity and to examine the effect of study design factors. Methods PubMed (1968–2009), EconLit (1969–2009), and Business Source Premier (1995–2009) were searched for original studies. Results were standardized to compute the incremental cost per overweight person and per obese person, and to compute the national aggregate cost. Results A total of 33 U.S. studies met review criteria. Among the 4 highest quality studies, the 2008 per-person direct medical cost of overweight was $266 and of obesity was $1723. The aggregate national cost of overweight and obesity combined was $113.9 billion. Study design factors that affected cost estimate included: use of national samples versus more selected populations; age groups examined; inclusion of all medical costs versus obesity-related costs only; and BMI cutoffs for defining overweight and obesity. Conclusions Depending on the source of total national health care expenditures used, the direct medical cost of overweight and obesity combined is approximately 5.0% to 10% of U.S. health care spending. Future studies should include nationally representative samples, evaluate adults of all ages, report all medical costs, and use standard BMI cutoffs. PMID:20059703

  4. Cost-Effectiveness of Antibody-Based Induction Therapy in Deceased Donor Kidney Transplantation in the United States.

    Science.gov (United States)

    Gharibi, Zahra; Ayvaci, Mehmet U S; Hahsler, Michael; Giacoma, Tracy; Gaston, Robert S; Tanriover, Bekir

    2017-06-01

    Induction therapy in deceased donor kidney transplantation is costly, with wide discrepancy in utilization and a limited evidence base, particularly regarding cost-effectiveness. We linked the United States Renal Data System data set to Medicare claims to estimate cumulative costs, graft survival, and incremental cost-effectiveness ratio (ICER - cost per additional year of graft survival) within 3 years of transplantation in 19 450 deceased donor kidney transplantation recipients with Medicare as primary payer from 2000 to 2008. We divided the study cohort into high-risk (age > 60 years, panel-reactive antibody > 20%, African American race, Kidney Donor Profile Index > 50%, cold ischemia time > 24 hours) and low-risk (not having any risk factors, comprising approximately 15% of the cohort). After the elimination of dominated options, we estimated expected ICER among induction categories: no-induction, alemtuzumab, rabbit antithymocyte globulin (r-ATG), and interleukin-2 receptor-antagonist. No-induction was the least effective and most costly option in both risk groups. Depletional antibodies (r-ATG and alemtuzumab) were more cost-effective across all willingness-to-pay thresholds in the low-risk group. For the high-risk group and its subcategories, the ICER was very sensitive to the graft survival; overall both depletional antibodies were more cost-effective, mainly for higher willingness to pay threshold (US $100 000 and US $150 000). Rabbit ATG appears to achieve excellent cost-effectiveness acceptability curves (80% of the recipients) in both risk groups at US $50 000 threshold (except age > 60 years). In addition, only r-ATG was associated with graft survival benefit over no-induction category (hazard ratio, 0.91; 95% confidence interval, 0.84-0.99) in a multivariable Cox regression analysis. Antibody-based induction appears to offer substantial advantages in both cost and outcome compared with no-induction. Overall, depletional induction (preferably r

  5. CONCEPTUAL AND LEGAL FRAMEWORK FOR THE ORGANIZATION OF MANAGEMENT ACCOUNTING AND COST CALCULATION IN INDUSTRY OF MANUFACTURING DAIRY PRODUCTS

    OpenAIRE

    Cristiana Bogdanoiu

    2012-01-01

    According to the legal framework of our country, economic units are responsible for organizing the management accounting adjusted to the specific activity. Economic and social transformations after 1989 led to significant changes in financial accounting, this being in a continuous process of harmonization with the principles, rules, conventions and accounting standards in countries with developed market economy. Legal framework in our country favored and still favors notable changes in accoun...

  6. MODELS SELECTED FOR CALCULATION OF DOSES, HEALTH EFFECTS AND ECONOMIC COSTS DUE TO ACCIDENTAL RADIONUCLIDE RELEASES FROM NUCLEAR POWER PLANTS

    Energy Technology Data Exchange (ETDEWEB)

    Strenge, D L; Baker, D A; Droppo, J G; McPherson, R B; Napier, B A; Nieves, L A; Soldat, J K

    1980-05-01

    Models are described for use in site-specific environmental consequence analysis of nuclear reactor accidents of Classes 3 through 9. The models presented relate radioactivity released to resulting doses, health effects, and costs of remedial actions. Specific models are presented for the major exposure pathways of airborne releases, waterborne releases and direct irradiation from activity within the facility buildings, such as the containment. Time-dependent atmospheric dispersion parameters, crop production parameters and other variable parameters are used in the models. The environmental effects are analyzed for several accident start times during the year.

  7. Design, construction and testing of a low-cost automated (68)Gallium-labeling synthesis unit for clinical use.

    Science.gov (United States)

    Heidari, Pedram; Szretter, Alicia; Rushford, Laura E; Stevens, Maria; Collier, Lee; Sore, Judit; Hooker, Jacob; Mahmood, Umar

    2016-01-01

    The interest in (68)Gallium labeled PET probes continues to increase around the world. Widespread use in Europe and Asia has led to great interest for use at numerous sites in the US. One barrier to entry is the cost of the automated synthesis units for relatively simple labeling procedures. We describe the construction and testing of a relatively low-cost automated (68)Ga-labeling unit for human-use. We provide a guide for construction, including part lists and synthesis timelists to facilitate local implementation. Such inexpensive systems could help increase use around the globe and in the US in particular by removing one of the barriers to greater widespread availability. The developed automated synthesis unit reproducibly synthesized (68)Ga-DOTATOC with average yield of 71 ± 8% and a radiochemical purity ≥ 95% in a synthesis time of 25 ± 1 minutes. Automated product yields are comparable to that of manual synthesis. We demonstrate in-house construction and use of a low-cost automated synthesis unit for labeling of DOTATOC and similar peptides with (68)Gallium.

  8. Treatment of advanced Parkinson's disease in the United States: a cost-utility model.

    Science.gov (United States)

    Groenendaal, Huybert; Tarrants, Marcy L; Armand, Christophe

    2010-01-01

    As Parkinson's disease (PD) progresses, patients and their families experience substantial health and economic burdens. Because motor fluctuations (also called 'off-time') are linked to poor quality of life and higher healthcare costs, minimizing off-time is an effective strategy for reducing costs associated with PD. To assess the cost utility of rasagiline or entacapone as adjunctive therapies to levodopa versus levodopa/carbidopa/entacapone (LCE) versus standard levodopa monotherapy in patients with advanced PD and motor fluctuations in the US. A 2-year stochastic Markov model was utilized to examine the cost effectiveness of treatments of advanced PD. The model assumed that patients transition health status every 4 months. Transition probabilities, including uncertainties, were estimated from clinical trial data. Medical costs, daily drug costs and utility weights were obtained from published literature. Over 2 years, all therapy options showed greater effectiveness than levodopa alone. Rasagiline+levodopa and LCE were cost saving from a payor perspective, while entacapone+levodopa was cost saving from a societal perspective. Mean benefits over 2 years were 0.12 (90% credibility interval [CI] 0.07, 0.18) additional quality-adjusted life-years (QALYs) for rasagiline+levodopa, entacapone+levodopa and LCE, 5.08 (90% CI 3.87, 6.28) additional months with treatment of advanced PD patients. Results from this cost-utility model and prior adjunctive clinical data provide ongoing support for the adjunctive use of rasagiline in advanced PD patients with motor fluctuations.

  9. Lean Six Sigma to Reduce Intensive Care Unit Length of Stay and Costs in Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Trzeciak, Stephen; Mercincavage, Michael; Angelini, Cory; Cogliano, William; Damuth, Emily; Roberts, Brian W; Zanotti, Sergio; Mazzarelli, Anthony J

    Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. Before-and-after cohort study. Multidisciplinary intensive care unit (ICU) in an academic medical center. Adult patients admitted to the ICU and treated with PMV, as defined by diagnosis-related group (DRG). We implemented a clinical redesign intervention based on LSS principles. We identified eight distinct processes in preparing patients with PMV for post-acute care. Our clinical redesign included reengineering daily patient care rounds ("Lean ICU rounds") to reduce variation and waste in these processes. We compared hospital LOS and direct cost per case in patients with PMV before (2013) and after (2014) our LSS intervention. Among 259 patients with PMV (131 preintervention; 128 postintervention), median hospital LOS decreased by 24% during the intervention period (29 vs. 22 days, p < .001). Accordingly, median hospital direct cost per case decreased by 27% ($66,335 vs. $48,370, p < .001). We found that a LSS-based clinical redesign reduced hospital LOS and the costs of care for patients with PMV.

  10. A Cost-Benefit Analysis of Low-Dose Aspirin Prophylaxis for the Prevention of Preeclampsia in the United States.

    Science.gov (United States)

    Werner, Erika F; Hauspurg, Alisse K; Rouse, Dwight J

    2015-12-01

    To develop a decision model to evaluate the risks, benefits, and costs of different approaches to aspirin prophylaxis for the approximately 4 million pregnant women in the United States annually. We created a decision model to evaluate four approaches to aspirin prophylaxis in the United States: no prophylaxis, prophylaxis per American College of Obstetricians and Gynecologists (the College) recommendations, prophylaxis per U.S. Preventive Services Task Force recommendations, and universal prophylaxis. We included the costs associated with aspirin, preeclampsia, preterm birth, and potential aspirin-associated adverse effects. TreeAge Pro 2011 was used to perform the analysis. The estimated rate of preeclampsia would be 4.18% without prophylaxis compared with 4.17% with the College approach in which 0.35% (n=14,000) of women receive aspirin, 3.83% with the U.S. Preventive Services Task Force approach in which 23.5% (n=940,800) receive aspirin, and 3.81% with universal prophylaxis. Compared with no prophylaxis, the U.S. Preventive Services Task Force approach would save $377.4 million in direct medical care costs annually, and universal prophylaxis would save $365 million assuming 4 million births each year. The U.S. Preventive Services Task Force approach is the most cost-beneficial in 79% of probabilistic simulations. Assuming a willingness to pay of $100,000 per neonatal quality-adjusted life-year gained, the universal approach is the most cost-effective in more than 99% of simulations. Both the U.S. Preventive Services Task Force approach and universal prophylaxis would reduce morbidity, save lives, and lower health care costs in the United States to a much greater degree than the approach currently recommended by the College.

  11. Design and Implementation of the Intensive Care Unit Quality Management Registry: Monitoring Quality and Cost of an Adult Intensive Care Unit in a Greek State Hospital.

    Science.gov (United States)

    Kosmidis, Dimitrios; Koutsouki, Sotiria; Lampiri, Klairi; Nagy, Eva Ottilia; Papaioannou, Vasilios; Pneumatikos, Ioannis; Anastassopoulos, George

    2017-11-01

    Intensive care electronic registries have been instrumental in quality measurement, improvement, and assurance of intensive care. In this article, the development and pilot implementation of the Intensive Care Unit Quality Management Registry are described, with a particular focus on monitoring the quality and operational cost in an adult ICU at a northern Greek state hospital. A relational database was developed for a hospital ICU so that qualitative and financial data are recorded for further analysis needed for planning quality care improvement and enhanced efficiency. Key features of this database registry were low development cost, user friendliness, maximum data security, and interoperability in existing hospital information systems. The database included patient demographics, nursing and medical parameters, and quality and performance indicators as established in many national registries worldwide. Cost recording was based on a mixed approach: at patient level ("bottom-up" method) and at department level ("top-down" method). During the pilot phase of the database operation, regular monitoring of quality and cost data revealed several fields of quality excellence, while indicating room for improvement for others. Parallel recording and trending of multiple parameters showed that the database can be utilized for optimum ICU quality and cost management and also for further research purposes by nurses, physicians, and administrators.

  12. The Calculation of Rural Urban Food Price Differentials from Unit Values in Household Expenditure Surveys: A new procedure and comparison with existing methods

    OpenAIRE

    Amita Majumder; Ranjan Ray; Kompal Sinha

    2011-01-01

    While national and international statistical agencies spend much resource on calculating purchasing power parity (PPP) between countries, relatively little attention is given to PPP calculations within countries. Yet, for large and heterogeneous countries, such as the US and India, intra country PPP is as important as cross-country PPP. This is particularly true of the rural urban divide in such countries where the idea that one unit of currency has the same purchasing power in both sectors i...

  13. General Purpose Cost Distribution Model for Computer Assisted Instruction.

    Science.gov (United States)

    Voeller, Rick

    To compare the unit cost of computer-assisted instruction (CAI) programs, there must be a standard model for calculating the cost of computer services. Such cost can be classified into direct costs--expenditures made directly by the group in charge of CAI programs, and indirect costs--expenditures made by other groups in support of CAI services.…

  14. The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit.

    Science.gov (United States)

    Chen, Chia-Chi; Hsiao, Fei-Yuan; Shen, Li-Jiuan; Wu, Chien-Chih

    2017-08-01

    Medication errors may lead to adverse drug events (ADEs), which endangers patient safety and increases healthcare-related costs. The on-ward deployment of clinical pharmacists has been shown to reduce preventable ADEs, and save costs. The purpose of this study was to evaluate the ADEs prevention and cost-saving effects by clinical pharmacist deployment in a nephrology ward.This was a retrospective study, which compared the number of pharmacist interventions 1 year before and after a clinical pharmacist was deployed in a nephrology ward. The clinical pharmacist attended ward rounds, reviewed and revised all medication orders, and gave active recommendations of medication use. For intervention analysis, the numbers and types of the pharmacist's interventions in medication orders and the active recommendations were compared. For cost analysis, both estimated cost saving and avoidance were calculated and compared.The total numbers of pharmacist interventions in medication orders were 824 in 2012 (preintervention), and 1977 in 2013 (postintervention). The numbers of active recommendation were 40 in 2012, and 253 in 2013. The estimated cost savings in 2012 and 2013 were NT$52,072 and NT$144,138, respectively. The estimated cost avoidances of preventable ADEs in 2012 and 2013 were NT$3,383,700 and NT$7,342,200, respectively. The benefit/cost ratio increased from 4.29 to 9.36, and average admission days decreased by 2 days after the on-ward deployment of a clinical pharmacist.The number of pharmacist's interventions increased dramatically after her on-ward deployment. This service could reduce medication errors, preventable ADEs, and costs of both medications and potential ADEs.

  15. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States.

    Science.gov (United States)

    Chhatwal, Jagpreet; Kanwal, Fasiha; Roberts, Mark S; Dunn, Michael A

    2015-03-17

    Sofosbuvir and ledipasvir, which have recently been approved for treatment of chronic hepatitis C virus (HCV) infection, are more efficacious and safer than the old standard of care (oSOC) but are substantially more expensive. Whether and in which patients their improved efficacy justifies their increased cost is unclear. To evaluate the cost-effectiveness and budget impact of sofosbuvir and ledipasvir. Microsimulation model of the natural history of HCV infection. Published literature. Treatment-naive and treatment-experienced HCV population defined on the basis of HCV genotype, age, and fibrosis distribution in the United States. Lifetime. Third-party payer. Simulation of sofosbuvir-ledipasvir compared with the oSOC (interferon-based therapies). Quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and 5-year spending on antiviral drugs. Sofosbuvir-based therapies added 0.56 QALY relative to the oSOC at an ICER of $55 400 per additional QALY. The ICERs ranged from $9700 to $284 300 per QALY depending on the patient's status with respect to treatment history, HCV genotype, and presence of cirrhosis. At a willingness-to-pay threshold of $100 000 per QALY, sofosbuvir-based therapies were cost-effective in 83% of treatment-naive and 81% of treatment-experienced patients. Compared with the oSOC, treating eligible HCV-infected persons in the United States with the new drugs would cost an additional $65 billion in the next 5 years, whereas the resulting cost offsets would be $16 billion. Results were sensitive to drug price, drug efficacy, and quality of life after successful treatment. Data on real-world effectiveness of new antivirals are lacking. Treatment of HCV is cost-effective in most patients, but additional resources and value-based patient prioritization are needed to manage patients with HCV. National Institutes of Health.

  16. Cost Implications of New National Allocation Policy for Deceased Donor Kidneys in the United States.

    Science.gov (United States)

    Smith, Jodi M; Schnitzler, Mark A; Gustafson, Sally K; Salkowski, Nicholas J; Snyder, Jon J; Kasiske, Bertram L; Israni, Ajay K

    2016-04-01

    In December 2014, a new national deceased donor kidney allocation policy was implemented, which allocates kidneys in the top 20% of the kidney donor profile index to candidates in the top 20% of expected survival. We examined the cost implications of this policy change. A Markov model was applied to estimate differences in total lifetime cost of care and quality-adjusted life years (QALY). Under the old allocation policy, average lifetime outcomes per listed patient discounted to 2012 US dollars were US $342,799 and 5.42 QALY, yielding US $63,775 per QALY gained. Under the new policy, average lifetime cost was reduced by US $2090 and lifetime QALYs increased by 0.03. Thus, the new policy improved on the old policy by producing more QALYs at lower cost. The present value of total lifetime cost savings from the policy change is estimated to be US $271 million in the first year and US $55 million in subsequent years. The higher transplant rates and allograft survival expected for candidates in the top 20% of expected survival would decrease costs by reducing time on dialysis. Most cost savings are expected to accrue to Medicare, and most increased access to transplant is expected in private payer populations. The new allocation policy was found to be dominant over the old policy because it increases QALYs at lower cost.

  17. Cost of reactive nitrogen release from human activities to the environment in the United States

    Science.gov (United States)

    The leakage of reactive nitrogen (N) from human activities to the environment can cause human health and ecological problems. Often these harmful effects are not reflected in the costs of food, fuel, and fiber that derive from N use. Spatial analyses of economic costs and benef...

  18. United States Navy Humanitarian Assistance and Disaster Relief (HADR) Costs: A Preliminary Study

    Science.gov (United States)

    2015-08-26

    Ocean Tsunami Operations off the Coast of Sumatra ...................... 8 Table 5. Cost for Ships and Their Platforms for 2010 Haiti Earthquake ...9 Table 6. USN-Reported Incremental Costs Associated With the 2010 Haiti Earthquake Operations...Indian Ocean tsunami, 2010 earthquake in Haiti , and 2011 Tōhoku earthquake are just three instances when the USN has been a significant relief provider

  19. Cost Spreading in College Athletic Spending in the United States: Estimates and Implications

    Science.gov (United States)

    Lipford, Jody W.; Slice, Jerry K.

    2017-01-01

    With rising costs, mounting student debt, and many schools experiencing financial hardship, the higher education industry faces unwanted scrutiny from the popular media and political sector. College athletics too have come under close examination because of rising costs and internal subsidies. In this paper, we provide estimates of the per-student…

  20. Independent calculation of the monitor units and times of treatment in radiotherapy; Calculo independente das unidades monitoras e tempos de tratamento em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, Marcio Rogerio

    2005-07-01

    In this work, an independent verification system of calculations in radiotherapy was developed and applied, using Visual Basic{sup TM} programming language. The computational program performs calculations of monitor units and treatment time, based on the algorithm of manual calculation. The calculations executed for the independent system had initially been compared with the manual calculations performed by the medical physicists of the Institute of Radiotherapy of the Hospital das Clinicas da Universidade de Sao Paulo. In this step, the results found for more than two hundred fields studied were similar to those found in the literature; deviations larger than +- 1% were found only in five cases involving errors in manual calculation. The application of the independent system, in this stage, could have identified errors up to +- 2,4%. Based on these data, the system was validated for use in clinical routine. In a second step, calculations were compared with calculations realized by the treatment computerized planning system CadPIan{sup TM}. When, again, the results were similar to those published in other works allowing to obtain levels of acceptance of the discrepancies between the calculations executed for the independent system and the calculations developed from the planning system, separated by anatomical region, as recommended according by the recent literature. For beams of 6 MV, the levels of acceptance for deviations between the calculations of monitor units, separated by treatment region were the following; breast +- 1.7%, head and neck +2%; hypophysis +- 2.2%; pelvis +- 4 . 1% and thorax +- 1.5%. For beams of 15 MV, the level suggested for pelvis was of +- 4.5%. (author)

  1. The Direct Cost of Managing a Rare Disease: Assessing Medical and Pharmacy Costs Associated with Duchenne Muscular Dystrophy in the United States.

    Science.gov (United States)

    Thayer, Sarah; Bell, Christopher; McDonald, Craig M

    2017-06-01

    A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones. DMD patients were selected from a commercially insured claims database (2000-2009). Patients with claims suggestive of a non-DMD diagnosis or who were aged 30 years or older were excluded. Each DMD patient was matched by age, gender, and region to controls without DMD in a 1:10 ratio (DMD patients n = 75; controls n = 750). All-cause health care resource utilization, including emergency department, inpatient, outpatient, and physician office visits, and all-cause health care costs were examined over a minimum 1-year period. Costs were computed as total health-plan and patient-paid amounts of adjudicated medical claims (in annualized U.S. dollars). The average age of the DMD cohort was 13 years. Patients in the DMD cohort had a 10-fold increase in health care costs compared with controls ($23,005 vs. $2,277, P Therapeutics, Biomarin, and Catabasis on clinical trials regarding Duchenne muscular dystrophy clinical trial design, endpoint selection, and data analysis; Mitobridge for drug development; and Eli Lilly as part of a steering committee for clinical trials. Study concept and design were contributed primarily by Bell, along with Thayer and McDonald. Thayer collected the data, and data interpretation was performed by Thayer and Bell, along with McDonald. The manuscript was written by Thayer and Bell, along with McDonald, and revised by all the authors.

  2. Association between the unemployment rate and inpatient cost per discharge by payer in the United States, 2005-2010.

    Science.gov (United States)

    Maeda, Jared Lane K; Henke, Rachel Mosher; Marder, William D; Karaca, Zeynal; Friedman, Bernard S; Wong, Herbert S

    2014-10-13

    Several reports have linked the 2007-2009 Great Recession in the United States with a slowdown in health care spending and decreased utilization. However, little is known regarding how the recent economic downturn affected hospital costs per inpatient stay for different segments of the population. The purpose of this study was to examine the association between changes in the unemployment rate and inpatient cost per discharge for Medicare and commercial discharges. We used retrospective data at the Core Based Statistical Area (CBSA)-level from 46 states that contributed to the Healthcare Cost and Utilization Project State Inpatient Databases from 2005 to 2010. Unemployment data was derived from the American Community Survey. An instrumental variable two-stage least squares approach with fixed- or random-effects was used to examine the association between unemployment rate and inpatient cost per discharge by payer because of potential endogeneity. The marginal effect of unemployment was associated with an increase in inpatient cost per discharge for both payers. A one percentage point increase in the unemployment rate was associated with a $37 increase for commercial discharges and a $49 increase for Medicare discharges. We find evidence that the inpatient cost per discharge is countercyclical across different segments of the population. The underlying mechanisms by which unemployment affects hospital resource use however, might differ between payer groups.

  3. VARIANTS OF DETERMINING THE MANUFACTURING COST OF A PRODUCT IN A PRODUCTION UNIT IN THE LIGHT OF BALANCE SHEET LAW

    Directory of Open Access Journals (Sweden)

    Marzena STROJEK‐FILUS

    2014-01-01

    Full Text Available The category of the manufacturing cost of a product is one of the most important ones from the point of view of proper valuation of the assets of a production unit, costs of its operations as well as pricing decisions. This article presents the problem of determining the manufacturing cost of a product in terms of balance sheet law. It has been shown that in order to determine this value various methods and options are allowed by this law, by means of which different values of manufacturing cost of a product are obtained. The importance of a proper selection of an allocation key in setilement of indirect production costs has been highlighted as well as the results of using, in certain cases, approved simplifications in the balance sheet law when determining the manufacturing cost of products have been demonstrated. The problem presented in this article is crucial from the point of view of an organization and management of production as well as managerial decision‐making in a company in the area of design of products and processes.

  4. Tracking the Sun III; The Installed Cost of Photovoltaics in the United States from 1998-2009

    Energy Technology Data Exchange (ETDEWEB)

    Barbose, Galen; Darghouth, Naim; Wiser, Ryan

    2010-12-13

    Installations of solar photovoltaic (PV) systems have been growing at a rapid pace in recent years. In 2009, approximately 7,500 megawatts (MW) of PV were installed globally, up from approximately 6,000 MW in 2008, consisting primarily of grid-connected applications. With 335 MW of grid-connected PV capacity added in 2009, the United States was the world's fourth largest PV market in 2009, behind Germany, Italy, and Japan. The market for PV in the United States is driven by national, state, and local government incentives, including up-front cash rebates, production-based incentives, requirements that electricity suppliers purchase a certain amount of solar energy, and federal and state tax benefits. These programs are, in part, motivated by the popular appeal of solar energy, and by the positive attributes of PV - modest environmental impacts, avoidance of fuel price risks, coincidence with peak electrical demand, and the possible deployment of PV at the point of use. Given the relatively high cost of PV, however, a key goal of these policies is to encourage cost reductions over time. Therefore, as policy incentives have become more significant and as PV deployment has accelerated, so too has the desire to track the installed cost of PV systems over time, by system characteristics, by system location, and by component. Despite the significant year-on-year growth, however, the share of global and U.S. electricity supply met with PV remains small, and annual PV additions are currently modest in the context of the overall electric system. To address this need, Lawrence Berkeley National Laboratory initiated a report series focused on describing trends in the installed cost of grid-connected PV systems in the United States. The present report, the third in the series, describes installed cost trends from 1998 through 2009, and provides preliminary cost data for systems installed in 2010. The analysis is based on project-level cost data from approximately 78

  5. Taxes, divorce-transactions costs, economic conditions, and divorce rates: an exploratory empirical inquiry for the United States.

    Science.gov (United States)

    Cebula, R J; Belton, W J

    1995-01-01

    "This study argues that, given the tax deductibility of alimony payments in the United States, higher marginal federal income tax rates may reduce the expected transactions costs of divorce and act thereby to increase the divorce rate. After allowing for a variety of other factors, including inflation, female labor force participation, AIDS, the Vietnam War, age, the availability of legal assistance, and transfer payments, both first-differences estimates and Granger-causality tests strongly support the hypothesis." excerpt

  6. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children

    OpenAIRE

    Bibus, Douglas M

    2016-01-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega?3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in ...

  7. Healthcare cost of HER2-positive and negative breast tumors in the United States (2012-2035).

    Science.gov (United States)

    Tartari, Francesca; Santoni, Matteo; Pistelli, Mirco; Berardi, Rossana

    2017-11-01

    In this study, we estimated the current and future costs related to the use of targeted agents in patients with HER2-positive and negative advanced breast cancer (BC), aimed at identifying the subgroup associated with the higher cost in the coming years. We calculated the patient cost considering an ideal patient who received therapeutic sequences including all approved agents for HER2-positive or negative BC. The duration of treatment was estimated by the median Progression-Free Survival (PFS) reported in the phase III trials which have led to the approval of these drugs by the US Food and Drug Administration. The estimated number of BC patients in the US from 2012 to 2035 refers to data published by the World Health Organization. The per patient cost was $292,155 for HER2-positive and $224,955 for negative tumors, respectively. The total cost for HER2-positive patients was estimated for 2012 at $2,719,542,347, with an annual increase ranged from 4.3 (for 2035) to 7.7% (for 2020), leading to a total expense of $3,648,232,975 in 2035. Otherwise, the total cost for HER2-negative patients in 2012 was estimated as $8,376,028,459, with an increase of more than $2.5 billion from 2012 to 2035. The estimated cost for HER2-negative patients was $5.6 billion higher that for HER2-positive tumors, raising to $7.6 billion to 2035. Our data strongly suggest that cost-analyses should be carefully evaluated in the coming years, in particular in patients with HER2-negative tumors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Estimating tuberculosis cases and their economic costs averted in the United States over the past two decades

    Science.gov (United States)

    Castro, K. G.; Marks, S. M.; Chen, M. P.; Hill, A. N.; Becerra, J. E.; Miramontes, R.; Winston, C. A.; Navin, T. R.; Pratt, R. H.; Young, K. H.; LoBue, P. A.

    2016-01-01

    SUMMARY BACKGROUND Following a concerted public health response to the resurgence of tuberculosis (TB) in the United States in the late 1980s, annual TB incidence decreased substantially. However, no estimates exist of the number and cost savings of TB cases averted. METHODS TB cases averted in the United States during 1995–2014 were estimated: Scenario 1 used a static 1992 case rate; Scenario 2 applied the 1992 rate to foreign-born cases, and a pre-resurgence 5.1% annual decline to US-born cases; and a statistical model assessed human immunodeficiency virus and TB program indices. We applied the cost of illness to estimate the societal benefits (costs averted) in 2014 dollars. RESULTS During 1992–2014, 368 184 incident TB cases were reported, and cases decreased by two thirds during that period. In the scenarios and statistical model, TB cases averted during 1995–2014 ranged from approximately 145 000 to 319 000. The societal benefits of averted TB cases ranged from US$3.1 to US$6.7 billion, excluding deaths, and from US$6.7 to US$14.5 billion, including deaths. CONCLUSIONS Coordinated efforts in TB control and prevention in the United States yielded a remarkable number of TB cases averted and societal economic benefits. We illustrate the value of concerted action and targeted public health funding. PMID:27287646

  9. Calculation of economic viability and environmental costs of biomass from dende oil for small communities of Brazilian northeast region

    Energy Technology Data Exchange (ETDEWEB)

    Stecher, Luiza C.; Pacheco, Rafael R.; Sabundjian, Gaiane, E-mail: luizastecher@usp.br, E-mail: rafaelrade@gmail.com, E-mail: gdjian@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    The current environmental problems caused by human activity has been gaining attention in society, i.e., as it has influenced in the growth and development of the global economic. The availability of energy resources is central point to economic development and the generation of energy is responsible for a significant portion of the emissions causing the greenhouse effect nowadays. The Brazil, a developing country, still has a large number of people without access to electricity, which affects the quality of life of individuals. In this context, it should think in the sustainable economic development, so the alternative energy sources emerge as an option for power generation. Can highlight biomass as a source in the Brazilian scenario by its wide availability and variety. Therefore, the objective of this work is to estimate the economic viability of the decentralized generation of electricity based on the use of biomass from dende oil in small communities in the Brazilian Northeast considering the environmental costs involved for the source in question. The methodology is based on economic concepts and economic evaluation of environmental resources. The biomass from dende oil was adopted in this work by its characteristics and availability in the studied region. The results show that the generation of energy by biomass from dende oil, it will contribute significantly to the sustainable development of the region, already that it will bring gains environmental, social and financial to society. (author)

  10. Impacts of intra-day rescheduling of unit commitment and cross border exchange on operational costs in European power systems

    Energy Technology Data Exchange (ETDEWEB)

    Meibom, Peter [Technical Univ. of Denmark (DTU), Roskilde (Denmark). Risoe National Lab. for Sustainable Energy; Weber, Christoph [Duisburg-Essen Univ., Essen (Germany). Chair for Management Sciences and Energy Economics

    2009-07-01

    The Wilmar Planning tool was used to study market rule parameters directly influencing the functioning of the internal European electricity market. These parameters are the efficiency of the cross-border allocation mechanism (spatial dimension) and the flexibility in time that is offered by the markets (time dimension). Simulations were carried out for a European power system covering 25 countries and two target years (2020 and 2030) characterized by installed wind power capacity, electricity demand, available interconnector capacity and energy economic boundary conditions. Four model runs for each target year were carried out investigating the consequences of having different degrees of market integration between countries and having different amounts of well functioning intra-day power markets for the operation of the European power market in terms of system costs and CO{sub 2} emissions. Model results show large system cost increases connected with fixing unit commitment of slow units day-ahead, and smaller but still significant system cost increases with fixing cross-border exchange day-ahead. Cross-border exchange of reserves induced very small costs savings due to model limitations. (orig.)

  11. Vital signs: health burden and medical costs of nonfatal injuries to motor vehicle occupants - United States, 2012.

    Science.gov (United States)

    Bergen, Gwen; Peterson, Cora; Ederer, David; Florence, Curtis; Haileyesus, Tadesse; Kresnow, Marcie-jo; Xu, Likang

    2014-10-10

    Motor vehicle crashes are a leading cause of death and injury in the United States. The purpose of this study was to describe the current health burden and medical and work loss costs of nonfatal crash injuries among vehicle occupants in the United States. CDC analyzed data on emergency department (ED) visits resulting from nonfatal crash injuries among vehicle occupants in 2012 using the National Electronic Injury Surveillance System – All Injury Program (NEISS-AIP) and the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS). The number and rate of all ED visits for the treatment of crash injuries that resulted in the patient being released and the number and rate of hospitalizations for the treatment of crash injuries were estimated, as were the associated number of hospital days and lifetime medical and work loss costs. In 2012, an estimated 2,519,471 ED visits resulted from nonfatal crash injuries, with an estimated lifetime medical cost of $18.4 billion (2012 U.S. dollars). Approximately 7.5% of these visits resulted in hospitalizations that required an estimated 1,057,465 hospital days in 2012. Nonfatal crash injuries occur frequently and result in substantial costs to individuals, employers, and society. For each motor vehicle crash death in 2012, eight persons were hospitalized, and 100 were treated and released from the ED. Public health practices and laws, such as primary seat belt laws, child passenger restraint laws, ignition interlocks to prevent alcohol impaired driving, sobriety checkpoints, and graduated driver licensing systems have demonstrated effectiveness for reducing motor vehicle crashes and injuries. They might also substantially reduce associated ED visits, hospitalizations, and medical costs.

  12. A systematic review on cost effectiveness of HIV prevention interventions in the United States.

    Science.gov (United States)

    Huang, Ya-Lin A; Lasry, Arielle; Hutchinson, Angela B; Sansom, Stephanie L

    2015-04-01

    The Centers for Disease Control and Prevention (CDC) focus on funding HIV prevention interventions likely to have high impact on the HIV epidemic. In its most recent funding announcement to state and local health department grantees, CDC required that health departments allocate the majority of funds to four HIV prevention interventions: HIV testing, prevention with HIV-positives and their partners, condom distribution and policy initiatives. We conducted a systematic review of the published literature to determine the extent of the cost-effectiveness evidence for each of those interventions. We searched for US-based studies published through October 2012. The studies that qualified for inclusion contained original analyses that reported costs per quality-adjusted life-year saved, life-year saved, HIV infection averted, or new HIV diagnosis. For each study, paired reviewers performed a detailed review and data extraction. We reported the number of studies related to each intervention and summarized key cost-effectiveness findings according to intervention type. Costs were converted to 2011 US dollars. Of the 50 articles that met the inclusion criteria, 33 related to HIV testing, 15 assessed prevention with HIV-positives and partners, three reported on condom distribution, and one reported on policy initiatives. Methodologies and cost-effectiveness metrics varied across studies and interventions, making them difficult to compare. Our review provides an updated summary of the published evidence of cost effectiveness of four key HIV prevention interventions recommended by CDC. With the exception of testing-related interventions, including partner services, where economic evaluations suggest that testing often can be cost effective, more cost-effectiveness research is needed to help guide the most efficient use of HIV prevention funds.

  13. Cost Accounting In Auto Manufacturing Companies In Germany And The United States

    OpenAIRE

    Robert Jinkens; RamMohan R. Yallapragada

    2010-01-01

    Corporate accountants are mandated to prepare and distribute financial accounting reports for external U.S.ers at end of each accounting period.  However, there are no similar statutory requirements for corporate accountants to provide managers of their companies with the management accounting information necessary for decision making in their bU.S.iness operations.   Cost accounting is an important integral part of management accounting.  Product costing has always been a much debated issue ...

  14. Increasing the Cruise Range and Reducing the Capital Cost of Electric Vehicles by Integrating Auxiliary Unit with the Traction Drive

    Directory of Open Access Journals (Sweden)

    N. Satheesh Kumar

    2016-01-01

    Full Text Available Poor cruise performance of Electric Vehicles (EVs continues to be the primary reason that impends their market penetration. Adding more battery to extend the cruise range is not a viable solution as it increases the structural weight and capital cost of the EV. Simulations identified that a vehicle spends on average 15% of its total time in braking, signifying an immense potential of the utilization of regenerative braking mechanism. Based on the analysis, a 3 kW auxiliary electrical unit coupled with the traction drive during braking events increases the recoverable energy by 8.4%. In addition, the simulation revealed that, on average, the energy drawn from the battery is reduced by 3.2% when traction drive is integrated with the air-conditioning compressor (an auxiliary electrical load. A practical design solution of the integrated unit is also included in the paper. Based on the findings, it is evident that the integration of an auxiliary unit with the traction drive results in enhancing the energy capturing capacity of the regenerative braking mechanism and decreases the power consumed from the battery. Further, the integrated unit boosts other advantages such as reduced material cost, improved reliability, and a compact and lightweight design.

  15. Burden of illness: direct and indirect costs among persons with hemophilia A in the United States.

    Science.gov (United States)

    Zhou, Zheng-Yi; Koerper, Marion A; Johnson, Kathleen A; Riske, Brenda; Baker, Judith R; Ullman, Megan; Curtis, Randall G; Poon, Jiat-Ling; Lou, Mimi; Nichol, Michael B

    2015-06-01

    To examine the direct and indirect costs of hemophilia care among persons with hemophilia A in the US. Observational data were obtained from HUGS-Va, a multi-center study from six federally supported hemophilia treatment centers (HTCs). Eligible individuals completed a standardized initial questionnaire and were followed regularly for 2 years to obtain information on work or school absenteeism, time spent arranging hemophilia care, and unpaid hemophilia-related support from caregivers. Data from 1-year healthcare utilization records and 2-year clotting factor dispensing records measured direct medical costs. Indirect costs were imputed using the human capital approach, which uses wages as a proxy measure of work time output. A total of 222 patients with complete data were included in the analysis. Two-thirds had severe hemophilia and the mean age was 21.1 years. The use of prophylaxis in severe hemophilia patients is associated with statistically significant reduction in the numbers of emergency department (ED) visits and bleeding episodes compared with those who were treated episodically. From the societal perspective, mild hemophilia costs $59,101 (median: $7519) annually per person, $84,363 (median: $61,837) for moderate hemophilia, $201,471 (median: $143,431) for severe hemophilia using episodic treatment, and $301,392 (median: $286,198) for severe hemophilia receiving prophylaxis. Clotting factor contributed from 54% of total costs in mild hemophilia to a maximum of 94% for patients with severe hemophilia receiving prophylaxis. Hemophilia is a costly disorder not only because of its high medical expenses, but also due to the high indirect costs incurred.

  16. Cost-effectiveness of strategies to prevent MRSA transmission and infection in an intensive care unit

    Science.gov (United States)

    Gidengil, Courtney; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M.

    2014-01-01

    Objective We created a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent MRSA transmission and infection. Design Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. Patients and setting Hypothetical cohort of 10,000 adult patients admitted to a U.S. ICU. Methods We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures (ASC); (2) ASC plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate (CHG) baths; (5) universal decolonization; (6) UCP + CHG baths; and (7) UCP + decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. Results 1,989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared to all strategies except UCP + decolonization and UCP + CHG. UCP + decolonization was more effective than universal decolonization, but would cost $2,469 per colonization averted and $9,007 per infection averted. If MRSA colonization prevalence drops from 12% to 5%, ASC plus selective decolonization becomes the least expensive strategy. Conclusions Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission. PMID:25627757

  17. Indirect Costs and Family Burden of Pediatric Crohn's Disease in the United States.

    Science.gov (United States)

    Kahn, Stacy A; Lin, Chia-Wei; Ozbay, Burak; Wang, Anthony; Chao, Jingdong; Skup, Martha

    2017-09-28

    Crohn's disease (CD) negatively impacts patient quality of life and results in greater healthcare utilization. For pediatric CD patients, the burden also extends to their caregivers. We aimed to estimate work loss and productivity costs among caregivers of pediatric CD patients. Data were from Truven MarketScan databases (2000-2012). Patients were <18 years old with ≥2 ICD-9 CD diagnostic codes. Controls were those without CD or ulcerative colitis and were matched to patients by age, Charlson Comorbidity Index, index year, and insurance plan category. Continuous enrollment was required ≥6 months before and ≥12 months after index, defined as the patient's first CD diagnosis date. Outcomes included hours of work loss and associated productivity costs of caregivers 1-year postindex. Work loss and productivity costs were compared between caregivers of patients and controls. Adjustments for unbalanced baseline factors were made using a generalized linear regression model. Each cohort included 200 study participants and their caregivers. Unadjusted annual hours of work loss after first diagnosis were 214.4 ± 171.5 and 169.6 ± 157.5 for caregivers of CD patients and controls, respectively (P = 0.007). Annual productivity costs were 27.2% ($1122) higher for caregivers of CD patients than controls, estimated at $5243 and $4,121, respectively (P = 0.004). Adjusted cost analyses yielded similar findings. Over the course of a patient's childhood, accumulated productivity losses were $24,118 for CD patients and $18,957 for control caregivers. Caregivers of pediatric CD patients have significantly higher loss in productivity costs compared with controls.

  18. Annual cost of illness and quality-adjusted life year losses in the United States due to 14 foodborne pathogens.

    Science.gov (United States)

    Hoffmann, Sandra; Batz, Michael B; Morris, J Glenn

    2012-07-01

    In this article we estimate the annual cost of illness and quality-adjusted life year (QALY) loss in the United States caused by 14 of the 31 major foodborne pathogens reported on by Scallan et al. (Emerg. Infect. Dis. 17:7-15, 2011), based on their incidence estimates of foodborne illness in the United States. These 14 pathogens account for 95 % of illnesses and hospitalizations and 98 % of deaths due to identifiable pathogens estimated by Scallan et al. We estimate that these 14 pathogens cause $14.0 billion (ranging from $4.4 billion to $33.0 billion) in cost of illness and a loss of 61,000 QALYs (ranging from 19,000 to 145,000 QALYs) per year. Roughly 90 % of this loss is caused by five pathogens: nontyphoidal Salmonella enterica ($3.3 billion; 17,000 QALYs), Campylobacter spp. ($1.7 billion; 13,300 QALYs), Listeria monocytogenes ($2.6 billion; 9,400 QALYs), Toxoplasma gondii ($3 billion; 11,000 QALYs), and norovirus ($2 billion; 5,000 QALYs). A companion article attributes losses estimated in this study to the consumption of specific categories of foods. To arrive at these estimates, for each pathogen we create disease outcome trees that characterize the symptoms, severities, durations, outcomes, and likelihoods of health states associated with that pathogen. We then estimate the cost of illness (medical costs, productivity loss, and valuation of premature mortality) for each pathogen. We also estimate QALY loss for each health state associated with a given pathogen, using the EuroQol 5D scale. Construction of disease outcome trees, outcome-specific cost of illness, and EuroQol 5D scoring are described in greater detail in a second companion article.

  19. An unit cost adjusting heuristic algorithm for the integrated planning and scheduling of a two-stage supply chain

    Directory of Open Access Journals (Sweden)

    Jianhua Wang

    2014-10-01

    Full Text Available Purpose: The stable relationship of one-supplier-one-customer is replaced by a dynamic relationship of multi-supplier-multi-customer in current market gradually, and efficient scheduling techniques are important tools of the dynamic supply chain relationship establishing process. This paper studies the optimization of the integrated planning and scheduling problem of a two-stage supply chain with multiple manufacturers and multiple retailers to obtain a minimum supply chain operating cost, whose manufacturers have different production capacities, holding and producing cost rates, transportation costs to retailers.Design/methodology/approach: As a complex task allocation and scheduling problem, this paper sets up an INLP model for it and designs a Unit Cost Adjusting (UCA heuristic algorithm that adjust the suppliers’ supplying quantity according to their unit costs step by step to solve the model.Findings: Relying on the contrasting analysis between the UCA and the Lingo solvers for optimizing many numerical experiments, results show that the INLP model and the UCA algorithm can obtain its near optimal solution of the two-stage supply chain’s planning and scheduling problem within very short CPU time.Research limitations/implications: The proposed UCA heuristic can easily help managers to optimizing the two-stage supply chain scheduling problems which doesn’t include the delivery time and batch of orders. For two-stage supply chains are the most common form of actual commercial relationships, so to make some modification and study on the UCA heuristic should be able to optimize the integrated planning and scheduling problems of a supply chain with more reality constraints.Originality/value: This research proposes an innovative UCA heuristic for optimizing the integrated planning and scheduling problem of two-stage supply chains with the constraints of suppliers’ production capacity and the orders’ delivering time, and has a great

  20. 76 FR 79678 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-22

    ... given of a proposed administrative settlement for recovery of response costs concerning the North... response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the...

  1. 76 FR 77528 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2011-12-13

    ... given of a proposed administrative settlement for recovery of response costs concerning the North... response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles, CA 90071 and at the...

  2. 77 FR 123 - Proposed CERCLA Administrative Cost Recovery Settlement; North Hollywood Operable Unit of the San...

    Science.gov (United States)

    2012-01-03

    ... proposed administrative settlement for recovery of response costs concerning the North Hollywood Operable.... The Agency's response to any comments received will be available for public inspection at the City of Los Angeles Central Library, Science and Technology Department, 630 West 5th Street, Los Angeles CA...

  3. Productivity costs of cancer mortality in the United States: 2000-2020.

    Science.gov (United States)

    Bradley, Cathy J; Yabroff, K Robin; Dahman, Bassam; Feuer, Eric J; Mariotto, Angela; Brown, Martin L

    2008-12-17

    A model that predicts the economic benefit of reduced cancer mortality provides critical information for allocating scarce resources to the interventions with the greatest benefits. We developed models using the human capital approach, which relies on earnings as a measure of productivity, to estimate the value of productivity lost as a result of cancer mortality. The base model aggregated age- and sex-specific data from four primary sources: 1) the US Bureau of the Census, 2) US death certificate data for 1999-2003, 3) cohort life tables from the Berkeley Mortality Database for 1900-2000, and 4) the Bureau of Labor Statistics Current Population Survey. In a model that included costs of caregiving and household work, data from the National Human Activity Pattern Survey and the Caregiving in the U.S. study were used. Sensitivity analyses were performed using six types of cancer assuming a 1% decline in cancer mortality rates. The values of forgone earnings for employed individuals and imputed forgone earnings for informal caregiving were then estimated for the years 2000-2020. The annual productivity cost from cancer mortality in the base model was approximately $115.8 billion in 2000; the projected value was $147.6 billion for 2020. Death from lung cancer accounted for more than 27% of productivity costs. A 1% annual reduction in lung, colorectal, breast, leukemia, pancreatic, and brain cancer mortality lowered productivity costs by $814 million per year. Including imputed earnings lost due to caregiving and household activity increased the base model total productivity cost to $232.4 billion in 2000 and to $308 billion in 2020. Investments in programs that target the cancers with high incidence and/or cancers that occur in younger, working-age individuals are likely to yield the greatest reductions in productivity losses to society.

  4. Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

    Science.gov (United States)

    Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

    2015-01-01

    OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

  5. Formulas for estimating the costs averted by sexually transmitted infection (STI prevention programs in the United States

    Directory of Open Access Journals (Sweden)

    Koski Kathryn

    2008-05-01

    Full Text Available Abstract Background Sexually transmitted infection (STI prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars, using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw(0.16(0.925(0.70($1,995, where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities.

  6. Expeditious Calculations of Electric Power Losses in 0.38–10 kV Electric Networks of Belarusian United Energy Systems

    Directory of Open Access Journals (Sweden)

    M. Fursanov

    2013-01-01

    Full Text Available An algorithmized methodology for expedi­tious calculations of technical losses in 0.38–10 kV electric networks of the Belarusian United Energy Systems has been developed on the basis of performance information which is formed by modern intellectual devices for registration and accumulation of data. The methodology allows to increase the accuracy in calculation of losses using more exact distribution of loadings between consumers of transformer substations and analyze an incremental value of  losses due to their asymmetrical connection of consumers and circuit asymmetry.

  7. Pacific Northwest National Laboratory Site Dose-per-Unit-Release Factors for Use in Calculating Radionuclide Air Emissions Potential-to-Emit Doses

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, J. Matthew; Rhoads, Kathleen

    2008-09-29

    This report documents assumptions and inputs used to prepare the dose-per-unit-release factors for the Pacific Northwest National Laboratory (PNNL) Site (including the buildings that make up the Physical Sciences Facility [PSF] as well as the Environmental Molecular Sciences Laboratory [EMSL]) calculated using the EPA-approved Clean Air Act Assessment Package 1988–Personal Computer (CAP88-PC) Version 3 software package. The dose-per-unit-release factors are used to prepare dose estimates for a maximum public receptor (MPR) in support of Radioactive Air Pollutants Notice of Construction (NOC) applications for the PNNL Site.

  8. Pacific Northwest National Laboratory Site Dose-per-Unit-Release Factors for Use in Calculating Radionuclide Air Emissions Potential-to-Emit Doses

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, J. Matthew; Rhoads, Kathleen

    2009-06-11

    This report documents assumptions and inputs used to prepare the dose-per-unit-release factors for the Pacific Northwest National Laboratory (PNNL) Site (including the buildings that make up the Physical Sciences Facility [PSF] as well as the Environmental Molecular Sciences Laboratory [EMSL]) calculated using the EPA-approved Clean Air Act Assessment Package 1988–Personal Computer (CAP88-PC) Version 3 software package. The dose-per-unit-release factors are used to prepare dose estimates for a maximum public receptor (MPR) in support of Radioactive Air Pollutants Notice of Construction (NOC) applications for the PNNL Site.

  9. Consumption and Response Output as a Function of Unit Price: Manipulation of Cost and Benefit Components

    Science.gov (United States)

    Delmendo, Xeres; Borrero, John C.; Beauchamp, Kenneth L.; Francisco, Monica T.

    2009-01-01

    We conducted preference assessments with 4 typically developing children to identify potential reinforcers and assessed the reinforcing efficacy of those stimuli. Next, we tested two predictions of economic theory: that overall consumption (reinforcers obtained) would decrease as the unit price (response requirement per reinforcer) increased and…

  10. Cost savings of unit-based pricing of household waste; the case of the Netherlands

    NARCIS (Netherlands)

    E. Dijkgraaf (Elbert); R.H.J.M. Gradus (Raymond)

    2003-01-01

    textabstractUsing a panel data set for Dutch municipalities we estimate effects for weight-based, bag-based, frequency-based and volume-based pricing of household waste collection. Unit-based pricing shows to be effective in reducing solid and compostable and increasing recyclable waste. Pricing has

  11. Cost and benefit including value of life, health and environmental damage measured in time units

    DEFF Research Database (Denmark)

    Ditlevsen, Ove Dalager; Friis-Hansen, Peter

    2009-01-01

    Key elements of the authors' work on money equivalent time allocation to costs and benefits in risk analysis are put together as an entity. This includes the data supported dimensionless analysis of an equilibrium relation between total population work time and gross domestic product leading...... to the definition of the life quality time allocation index (LQTAI). On the basis of a postulate of invariance of the LQTAI, a rule is obtained for allocating societal value in terms of time to avoid life shortening fatalities as well as serious injuries that shorten the life in good health. The excess...... of this societal value over the actual costs, used by the owner for economically optimizing an activity, motivates a simple risk accept criterion suited to be imposed on the owner by the public. An illustration is given concerning allocation of economical means for mitigation of loss of life and health on a ferry...

  12. Indirect Transportation Cost in the border crossing process: The United States–Mexico trade

    Directory of Open Access Journals (Sweden)

    Carlos Obed Figueroa Ortiz

    2015-12-01

    Full Text Available Using a Social Accounting Matrix as database, a Computable General Equilibrium model is implemented in order to estimate the Indirect Transportations Costs (ITC present in the border crossing for the U.S.–Mexico bilateral trade. Here, an “iceberg–type” transportation function is assumed to determine the amount of loss that must be faced as a result of border crossing process through the ports of entry existing between the two countries. The study period covers annual data from 1995 to 2009 allowing the analysis of the trend of these costs considering the trade liberalisation that is experienced. Results show that the ITC have experienced a decrease of 12% during the period.Test

  13. Direct and indirect costs among patients with binge-eating disorder in the United States.

    Science.gov (United States)

    Ling, You-Li; Rascati, Karen L; Pawaskar, Manjiri

    2017-05-01

    To quantify the economic burden of binge-eating disorder (BED) in terms of work productivity loss, healthcare resource utilization, and healthcare costs. Respondents of the US National Health and Wellness Survey 2013 were invited to participate in a follow-up internet survey to identify adults with BED using DSM-5 criteria. Work productivity loss, healthcare resource utilization, and direct and indirect costs were assessed for BED respondents and matched non-BED respondents using generalized linear models or two-part models as appropriate. A total of 1,720 people were included in our analysis (N = 344 with BED; N= 1,376 without BED). BED respondents had higher levels of activity impairment than non-BED respondents (41.29% vs. 23.18%, p Eat Disord 2017; 50:523-532). © 2016 Wiley Periodicals, Inc.

  14. Cost of Power Interruptions to Electricity Consumers in the UnitedStates (U.S.)

    Energy Technology Data Exchange (ETDEWEB)

    Hamachi LaCommare, Kristina; Eto, Joseph H.

    2006-02-16

    The massive electric power blackout in the northeastern U.S.and Canada on August 14-15, 2003 catalyzed discussions about modernizingthe U.S. electricity grid. Industry sources suggested that investments of$50 to $100 billion would be needed. This work seeks to better understandan important piece of information that has been missing from thesediscussions: What do power interruptions and fluctuations in powerquality (power-quality events) cost electricity consumers? We developed abottom-up approach for assessing the cost to U.S. electricity consumersof power interruptions and power-quality events (referred to collectivelyas "reliability events"). The approach can be used to help assess thepotential benefits of investments in improving the reliability of thegrid. We developed a new estimate based on publicly availableinformation, and assessed how uncertainties in these data affect thisestimate using sensitivity analysis.

  15. SOCIETAL COSTS ASSOCIATED WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION IN THE UNITED STATES.

    Science.gov (United States)

    Brown, Melissa M; Brown, Gary C; Lieske, Heidi B; Tran, Irwin; Turpcu, Adam; Colman, Shoshana

    2016-02-01

    The purpose of this study was to use a cross-sectional prevalence-based health care economic survey to ascertain the annual, incremental, societal ophthalmic costs associated with neovascular age-related macular degeneration. Consecutive patients (n = 200) with neovascular age-related macular degeneration were studied. A Control Cohort included patients with good (20/20-20/25) vision, while Study Cohort vision levels included Subcohort 1: 20/30 to 20/50, Subcohort 2: 20/60 to 20/100, Subcohort 3: 20/200 to 20/400, and Subcohort 4: 20/800 to no light perception. An interviewer-administered, standardized, written survey assessed 1) direct ophthalmic medical, 2) direct nonophthalmic medical, 3) direct nonmedical, and 4) indirect medical costs accrued due solely to neovascular age-related macular degeneration. The mean annual societal cost for the Control Cohort was $6,116 and for the Study Cohort averaged $39,910 (P age-related macular degeneration dramatically increase as vision in the better-seeing eye decreases.

  16. Spatial dispersion of housing units as an important factor influencing long-term care operational costs

    Directory of Open Access Journals (Sweden)

    Norina Szander

    2017-06-01

    Full Text Available Over 90% of seniors prefer to age in place, which is an idea supported by the European Semesters on Long-Term Care strategic plans for member states, but they do not have the necessary innovation to improve the living of the elderly in a properly built environment with sustainable financing. The spatial dispersion of housing and density in a functional area should be particularly taken into consideration by facilities’ managers and medical care institutions offering housing, healthcare and other services for the elderly in planning the built environment and other facilities for seniors because the costs of logistics (material transport, nurse workload, costs of other service providers, and transport of seniors in the case of daily programmes greatly depend on it. Using data from a care centre in a Hungarian municipality, we simulated and optimised home healthcare routing and scheduling in various scenarios of spatial dispersion and changing density of clients. We modelled the rounds of caregivers visiting seniors in homecare as a multiple travelling salesman problem, and the solutions show the necessary workforce and service time requirements. The tool that enabled us to study the outputs of scenarios might help professionals forecast and plan for coming changes in the costs of nursing services caused by the growing number of seniors that may need help in maintaining their independence as long as possible, taking into account that the density and dispersion of households are also changing.

  17. Serologic testing for syphilis in the United States: a cost-effectiveness analysis of two screening algorithms.

    Science.gov (United States)

    Owusu-Edusei, Kwame; Peterman, Thomas A; Ballard, Ronald C

    2011-01-01

    The introduction of automated treponemal enzyme immunoassays and chemiluminescence assays (EIA/CA) tests has led some laboratories in the United States to use new syphilis screening algorithms that start with a treponemal test. We compared the economic and health outcomes of this new algorithm with the standard algorithm from the perspective of the United States health system. We used a cohort decision analysis to estimate the expected costs and effects (including follow-ups and overtreatment) of the 2 algorithms from a health-care system perspective. In the standard algorithm, rapid plasma reagin (RPR) is followed (if reactive) by EIA/CA (Nontreponemal-First). In the new algorithm, EIA/CA is followed (if reactive) by RPR. If the RPR is negative, Treponema pallidum passive particle agglutination assay (TP-PA) test is used (Treponemal-First). For a cohort of 200,000 individuals (1000 current infections and 10,000 previous infections), the net costs were $1.6 m (Treponemal-First) and $1.4 m (Nontreponemal-First). The Treponemal-First option treated 118 more cases (986 vs. 868) but resulted in a substantially higher number of follow-ups (11,450 vs. 3756) and overtreatment (964 vs. 38). Treating the additional 118 cases might prevent 1 case of tertiary syphilis. The estimated cost-effectiveness ratios were $1671 (Treponemal-First) and $1621 (Nontreponemal-First) per case treated. The overtreatment was a function of the specificity of the EIA/CA and the lack of independence of EIA/CA and TP-PA. The Treponemal-First option costs slightly more and results in more unnecessary treatment.

  18. Utility-Scale Solar 2014. An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-09-01

    Other than the nine Solar Energy Generation Systems (“SEGS”) parabolic trough projects built in the 1980s, virtually no large-scale or “utility-scale” solar projects – defined here to include any groundmounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar thermal power (“CSP”) project larger than 5 MWAC – existed in the United States prior to 2007. By 2012 – just five years later – utility-scale had become the largest sector of the overall PV market in the United States, a distinction that was repeated in both 2013 and 2014 and that is expected to continue for at least the next few years. Over this same short period, CSP also experienced a bit of a renaissance in the United States, with a number of large new parabolic trough and power tower systems – some including thermal storage – achieving commercial operation. With this critical mass of new utility-scale projects now online and in some cases having operated for a number of years (generating not only electricity, but also empirical data that can be mined), the rapidly growing utility-scale sector is ripe for analysis. This report, the third edition in an ongoing annual series, meets this need through in-depth, annually updated, data-driven analysis of not just installed project costs or prices – i.e., the traditional realm of solar economics analyses – but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects in the United States. Given its current dominance in the market, utility-scale PV also dominates much of this report, though data from CPV and CSP projects are presented where appropriate.

  19. Intoxicated children at an intensive care unit: popular medicine risks, complications and costs

    OpenAIRE

    Consuelo de Rovetto; Sandra Concha

    2009-01-01

    Introduction: The Hospital Universitario del Valle (HUV) at the Pediatrics Intensive Care Unit (PICU) admits intoxicated patients, erroneously medicated by «teguas» or family members with serious aggravation of basic diseases or generating severe intoxications. Absent reports of these practices in Colombia motivated the publication of this case series Objective: To report a series of pediatric intoxication cases secondary to oral or dermatological application of varied substances by healers (...

  20. The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

    Science.gov (United States)

    Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

    2018-02-23

    To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

  1. Estimated Lifetime Medical and Work-Loss Costs of Emergency Department-Treated Nonfatal Injuries--United States, 2013.

    Science.gov (United States)

    Florence, Curtis; Haegerich, Tamara; Simon, Thomas; Zhou, Chao; Luo, Feijun

    2015-10-02

    A large number of nonfatal injuries are treated in U.S. emergency departments (EDs) every year. CDC's National Center for Health Statistics estimates that approximately 29% of all ED visits in 2010 were for injuries. To assess the economic impact of ED-treated injuries, CDC examined injury data from the National Electronic Injury Surveillance System--All Injury Program (NEISS-AIP) for 2013, as well as injury-related lifetime medical and work-loss costs from the Web-Based Injury Statistics Query and Reporting System (WISQARS). NEISS-AIP collects data from a nationally representative sample of EDs, using specific guidelines for recording the primary diagnosis and mechanism of injury. Number of injuries, crude- and age-specific injury rates, and total lifetime work-loss costs and medical costs were calculated for ED-treated injuries, stratified by sex, age groups, and intent and mechanism of injury. ED-treated injuries were further classified as those that were subsequently hospitalized or treated and released. The rate of hospitalized injuries was 950.8 per 100,000, and the rate of treated and released injuries was 8,549.8 per 100,000. Combined medical and work-loss costs for all ED-treated injuries (both hospitalized and treated and released) were $456.9 billion, or approximately 68% of the total costs of $671 billion associated with all fatal and ED-treated injuries. The substantial economic burden associated with nonfatal injuries underscores the need for effective prevention strategies.

  2. Efficiency in the United States electric industry: Transaction costs, deregulation, and governance structures

    Science.gov (United States)

    Peterson, Carl

    Transaction costs economics (TCE) posits that firms have an incentive to bypass the market mechanisms in situations where the cost of using the market is prohibitive. Vertical integration, among other governance mechanisms, can be used to minimize the transactions costs associated with the market mechanism. The study analyses different governance mechanisms, which range from complete vertical integration to the use of market mechanisms, for firms in the US electric sector. This sector has undergone tremendous change in the past decade including the introduction of retail competition in some jurisdictions. As a result of the push toward deregulation of the industry, vertically integration, while still significant in the sector, has steadily been replaced by alternative governance structures. Using a sample of 136 investor-owned electric utilities that reported data the US Federal Energy Regulatory Commission between 1996 and 2002, this study estimates firm level efficiency using Data Envelopment Analysis (DEA) and relates these estimates to governance structure and public policies. The analysis finds that vertical integration is positively related to firm efficiency, although in a non-linear fashion suggesting that hybrid governance structures tend to be associated with lower efficiency scores. In addition, while some evidence is found for negative short-term effects on firm efficiency from the choice to deregulate, this result is sensitive to DEA model choice. Further, competition in retail markets is found to be positively related to firm level efficiency, but the retreat from deregulation, which occurred after 2000, is negatively associated with firm-level efficiency. These results are important in the ongoing academic and public policy debates concerning deregulation of the electric section and indicate that vertical economies remain in the industry, but that competition has provided incentives for improving firm level efficiency.

  3. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007 - 2012; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Hand, Maureen

    2015-06-15

    This presentation provides a summary of IEA Wind Task 26 report on Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007-2012

  4. Cost effective modular unit for cleaning oil and gas field waste water

    Energy Technology Data Exchange (ETDEWEB)

    Zinberg, M.B.; Nenasheva, M.N.; Gafarov, N.A.

    1996-12-31

    Problems of environmental control involving conservation of water resources are vital for the development of giant oil and gas condensate fields near Caspian Sea (Russia) characterized by water shortages. One of the urgent tasks of oil production industry is to use all field waste water consisting of underground, processing and rain water. It was necessary to construct a new highly effective equipment which could be used in local waste water treatment. Now we have at our disposal a technology and equipment to meet the requirements to the treated water quality. Thus we have installed a modular unit of 100 m{sup 3}/a day capacity to clean waste water from oil products, suspended matter and other organic pollutants at Orenburg oil and gas condensate field, Russia. The unit provides with a full treatment of produced water and comprises a settling tank with adhesive facility, the number of sorption filters, Trofactor bioreactors and a disinfecting facility. The equipment is fitted into three boxes measuring 9 x 3.2 x 2.7 in each. The equipment is simple in design that enables to save money, time and space. Sorption filters, bioreactors as well as the Trofactor process are a part of know-how. While working on the unit construction we applied well known methods of settling and sorption. The process of mechanic cleaning is undergoing in the following succession: (1) the gravitational separation in a settling tank where the floated film oil products are constantly gathered and the sediment is periodically taken away, (2) the settled water treatment in sorption Filters of a special kind.

  5. Cost-effectiveness analysis of abobotulinumtoxinA for the treatment of cervical dystonia in the United Kingdom

    Directory of Open Access Journals (Sweden)

    Muthukumar M

    2017-04-01

    Full Text Available Madhusubramanian Muthukumar,1 Kamal Desai,1 Seye Abogunrin,2 Timothy Harrower,3 Sylvie Gabriel,4 Jerome Dinet5 1Modelling and Simulation, 2Meta Research, Evidera, London, 3Royal Devon and Exeter NHS Foundation Trust, Exeter, UK; 4Global Market Access and Pricing, 5Health Economics and Outcomes Research (Global, Ipsen Pharma, Boulogne-Billancourt, France Background: Cervical dystonia (CD involves painful involuntary contraction of the neck and shoulder muscles and abnormal posture in middle-aged adults. Botulinum neurotoxin type A (BoNT-A is effective in treating CD but little is known about its associated cost-effectiveness.Objective: To evaluate the cost-effectiveness of abobotulinumtoxinA for treating CD from the UK payer perspective.Methods: A Markov model was developed to evaluate the cost-effectiveness of abobotulinumtoxinA versus best supportive care (BSC in CD, with a lifetime horizon and health states for response, nonresponse, secondary nonresponse, and BSC in patients with CD (mean age: 53 years; 37% male. Clinical improvement measured using Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS was mapped to utility using data from a randomized trial of abobotulinumtoxinA. Health care resource use, costs, and other inputs were from the British National Formulary, Personal Social Services Research Unit, published literature, or expert opinion. Costs and outcomes were discounted at 3.5% per annum.Results: In the base case, the incremental lifetime quality-adjusted life-years (QALYs gained from abobotulinumtoxinA arm versus BSC was 0.253 per patient, whereas the incremental cost was £7,160, leading to an incremental cost-effectiveness ratio (ICER of £30,468 per QALY. One-way sensitivity analyses showed that these results were sensitive to the proportion of responders to abobotulinumtoxinA at first injection, duration between injections, the number of reinjections allowed among primary nonresponders, and any difference in

  6. Health-related quality of life and rehabilitation cost following intensive care unit stay in multiple trauma patients.

    Science.gov (United States)

    Stergiannis, Pantelis; Katsoulas, Theodoros; Fildissis, George; Intas, George; Galanis, Peter; Kosta, Natalia; Zidianakis, Vasilios; Baltopoulos, George

    2014-01-01

    The objective of this study was to assess changes in health-related quality of life (HRQOL) in multiple trauma patients due to motor vehicle crashes during a follow-up period of 2 years after discharge from an intensive care unit (ICU) and the effect of income and financial cost of rehabilitation in HRQOL. The study was a prospective observational study of multiple trauma patients from January 2009 to January 2011 who were hospitalized in a general, medical, and surgical ICU of a district hospital in Athens, Greece. Eighty-five patients with multiple traumas due to motor vehicle crashes and with an ICU stay of more than 24 hours were included in the study. HRQOL was assessed by a general questionnaire, the EuroQol 5D. Increased monthly household income and absence of traumatic brain injuries were associated with an improved EQ-VAS score. The frequency of severe problems in mobility, self-care, usual activities, pain/discomfort, and anxiety/depression decreased over time. The financial cost of rehabilitation was initially high but decreased over time. Severely injured victims of motor vehicle crashes suffer from serious problems in terms of HRQOL which is gradually improved even 2 years after hospital discharge. In addition, HRQOL is significantly related to income. Resources used for rehabilitation decrease over time, but even at 24 months, the patients still use half of the amount as compared with the cost of the first 6 months after trauma.

  7. National- and state-level impact and cost-effectiveness of nonavalent HPV vaccination in the United States.

    Science.gov (United States)

    Durham, David P; Ndeffo-Mbah, Martial L; Skrip, Laura A; Jones, Forrest K; Bauch, Chris T; Galvani, Alison P

    2016-05-03

    Every year in the United States more than 12,000 women are diagnosed with cervical cancer, a disease principally caused by human papillomavirus (HPV). Bivalent and quadrivalent HPV vaccines protect against 66% of HPV-associated cervical cancers, and a new nonavalent vaccine protects against an additional 15% of cervical cancers. However, vaccination policy varies across states, and migration between states interdependently dilutes state-specific vaccination policies. To quantify the economic and epidemiological impacts of switching to the nonavalent vaccine both for individual states and for the nation as a whole, we developed a model of HPV transmission and cervical cancer incidence that incorporates state-specific demographic dynamics, sexual behavior, and migratory patterns. At the national level, the nonavalent vaccine was shown to be cost-effective compared with the bivalent and quadrivalent vaccines at any coverage despite the greater per-dose cost of the new vaccine. Furthermore, the nonavalent vaccine remains cost-effective with up to an additional 40% coverage of the adolescent population, representing 80% of girls and 62% of boys. We find that expansion of coverage would have the greatest health impact in states with the lowest coverage because of the decreasing marginal returns of herd immunity. Our results show that if policies promoting nonavalent vaccine implementation and expansion of coverage are coordinated across multiple states, all states benefit both in health and in economic terms.

  8. SU-E-T-351: Verification of Monitor Unit Calculation for Lung Stereotactic Body Radiation Therapy Using a Secondary Independent Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Tsuruta, Y; Nakata, M; Higashimura, K [Kyoto University Hospital, Kyoto, Kyoto (Japan); Nakamura, M; Miyabe, Y; Akimoto, M; Ono, T; Mukumoto, N; Ishihara, Y; Matsuo, Y; Mizowaki, T; Hiraoka, M [Kyoto University, Graduate School of Medicine, Kyoto (Japan)

    2014-06-01

    Purpose: To compare isocenter (IC) dose between X-ray Voxel Monte Carlo (XVMC) and Acuros XB (AXB) as part of an independent verification of monitor unit (MU) calculation for lung stereotactic body radiation therapy (SBRT) using a secondary independent treatment planning system (TPS). Methods: Treatment plans of 110 lesions from 101 patients who underwent lung SBRT with Vero4DRT (Mitsubishi Heavy Industries, Ltd., Japan, and BrainLAB, Feldkirchen, Germany) were evaluated retrospectively. Dose distribution was calculated with X-ray Voxel Monte Carlo (XVMC) in iPlan 4.5.1 (BrainLAB, Feldkirchen, Germany) on averaged intensity projection images. A spatial resolution and mean variance were 2 mm and 2%, respectively. The clinical treatment plans were transferred from iPlan to Eclipse (Varian Medical Systems, Palo Alto, CA, USA), and doses were recalculated with well commissioned AXB ver. 11.0.31 while maintaining the XVMC-calculated MUs and beam arrangement. Dose calculations were made in the dose-to-medium dose reporting mode with the calculation grid size of 2.5 mm. The mean and standard deviation (SD) of the IC dose difference between XVMC and AXB were calculated. The tolerance level was defined as |mean|+2SD. Additionally, the relationship between IC dose difference and the size of planning target volume (PTV) or computed tomography (CT) value of internal target volume (ITV) was evaluated. Results: The mean±SD of the IC dose difference between XVMC and AXB was −0.32±0.73%. The tolerance level was 1.8%. Absolute IC dose differences exceeding the tolerance level were observed in 3 patients (2.8%). There were no strong correlations between IC dose difference and PTV size (R=−0.14) or CT value of ITV (R=−0.33). Conclusion: The present study suggested that independent verification of MU calculation for lung SBRT using a secondary TPS is useful.

  9. The management of the cost and utilisation of pharmaceuticals in the United Kingdom.

    Science.gov (United States)

    Burstall, M L

    1997-09-01

    The British National Health Service (NHS) provide comprehensive health services, including prescription drugs, to the entire population. Thus pharmaceuticals are seen as part of the provision of health care, not as an isolated cost element. UK expenditures on pharmaceuticals has been relatively low by European and US standards. The basic dilemma facing pharmaceutical policymakers is the need to control public spending on drugs while encouraging a successful UK pharmaceutical industry. A highly centralised policymaking apparatus has historically permitted a fairly collaborative approach with the pharmaceutical industry. Prices are not controlled directly as in some other European countries; rather, producers negotiate an allowable rate of return on all sales to the NHS. This gives producers considerable discretion to set prices for new drugs without government interference. Thus, prices are somewhat higher than in comparable European countries, but utilisation rates are among the lowest. The credit for low utilisation (and high generic substitution rates) goes to the conservative nature and medical education of British general practitioners. A general conclusion is that pharmaceutical spending has been curbed with minimal damage to the UK pharmaceutical sector.

  10. Cost of Informal Caregiving Associated with Stroke among Elderly in the United States

    Science.gov (United States)

    Joo, Heesoo; Dunet, Diane O.; Fang, Jing; Wang, Guijing

    2015-01-01

    Objectives We estimated the informal caregiving hours and costs associated with stroke. Methods We selected persons aged 65 and older in 2006 and who were also included in the 2008 follow-up survey from the Health and Retirement Study. We adapted the case-control study design by using self-reported occurrence of an initial stroke event during 2006 and 2008 to classify persons into the stroke (case) and the non-stroke (control) groups. We compared informal caregiving hours between case and control groups in 2006 (pre-stroke period for case group) and in 2008 (post-stroke period for case group) and estimated incremental informal caregiving hours attributable to stroke by applying a difference-in-differences technique to propensity-score matched populations. We used a replacement approach to estimate the economic value of informal caregiving. Results The weekly incremental informal caregiving hours attributable to stroke were 8.5 hours per patient. The economic value of informal caregiving per stroke survivor was $8,211 per year, of which $4,356 (53%) was attributable to stroke. At the national level, the annual economic burden of informal caregiving associated with stroke among elderly was estimated at $14.2 billion in 2008. Conclusions Recent changes in public health and social support policies recognize the economic burden of informal caregiving. Our estimates reinforce the high economic burden of stroke in the US and provide up-to-date information for policy development and decision-making. PMID:25305152

  11. MATHEMATICAL MODEL AND METHODOLOGY FOR CALCULATION OF MINIMIZATION ON TURNING RADIUS OF TRACTOR UNIT WITH REPLACEABLE SUPPORTING AND MANEUVERING DEVICE

    Directory of Open Access Journals (Sweden)

    P. V. Zeleniy

    2016-01-01

    Full Text Available Smooth plowing with the help of reversible plows has replaced an enclosure method of soil treatment. The method may cause a formation of back ridges or open furrows. Due to this fact turnings of a tractor unit with a minimum radius required in order to ensure shuttle movements each time in the furrow of the preceding operating stroke have become a dominant type of turnings. Non-productive shift time is directly dependent on them and it is on the average 10–12 %, and it is up to 40 % in small contour areas with short run. Large non-productive time is connected with the desire to reduce headland width at field edges, and then a turning is made in several stages while using a complicated maneuvering. Therefore, an increase in efficiency of a plowing unit by means of minimization on its turning radius and execution of turning at one stage in the shortest possible time are considered as relevant objectives. In such a case it is necessary to take into account the fact that potential capabilities of universal tractors having established time-proved designs in respect of reduction of turning radius are practically at the end. So it is expedient to solve the matter at the expense of additional removable devices that ensure transformation of tractor wheel formula at the run end in order to reorient its position. Finally high quality plowing ensured by future-oriented reversible plows will be accompanied not only by output increase per shift, but also by decrease in headland width, their compaction and abrasion due to suspension systems and increase in productivity. The developed design having a novelty which proved by an invention patent and representing an additional supporting and maneuvering device significantly minimizes all the above-mentioned disadvantages and does not require any changes in tractor production design. Investigations have been carried on the following topic: “Minimization of turning radius for universal tractors by transformation

  12. APPLICATION OF THE SPECTROMETRIC METHOD FOR CALCULATING THE DOSE RATE FOR CREATING CALIBRATION HIGHLY SENSITIVE INSTRUMENTS BASED ON SCINTILLATION DETECTION UNITS

    Directory of Open Access Journals (Sweden)

    R. V. Lukashevich

    2017-01-01

    Full Text Available Devices based on scintillation detector are highly sensitive to photon radiation and are widely used to measure the environment dose rate. Modernization of the measuring path to minimize the error in measuring the response of the detector to gamma radiation has already reached its technological ceiling and does not give the proper effect. More promising for this purpose are new methods of processing the obtained spectrometric information. The purpose of this work is the development of highly sensitive instruments based on scintillation detection units using a spectrometric method for calculating dose rate.In this paper we consider the spectrometric method of dosimetry of gamma radiation based on the transformation of the measured instrumental spectrum. Using predetermined or measured functions of the detector response to the action of gamma radiation of a given energy and flux density, a certain function of the energy G(E is determined. Using this function as the core of the integral transformation from the field to dose characteristic, it is possible to obtain the dose value directly from the current instrumentation spectrum. Applying the function G(E to the energy distribution of the fluence of photon radiation in the environment, the total dose rate can be determined without information on the distribution of radioisotopes in the environment.To determine G(E by Monte-Carlo method instrumental response function of the scintillator detector to monoenergetic photon radiation sources as well as other characteristics are calculated. Then the whole full-scale energy range is divided into energy ranges for which the function G(E is calculated using a linear interpolation.Spectrometric method for dose calculation using the function G(E, which allows the use of scintillation detection units for a wide range of dosimetry applications is considered in the article. As well as describes the method of calculating this function by using Monte-Carlo methods

  13. Updated logistic regression equations for the calculation of post-fire debris-flow likelihood in the western United States

    Science.gov (United States)

    Staley, Dennis M.; Negri, Jacquelyn A.; Kean, Jason W.; Laber, Jayme L.; Tillery, Anne C.; Youberg, Ann M.

    2016-06-30

    Wildfire can significantly alter the hydrologic response of a watershed to the extent that even modest rainstorms can generate dangerous flash floods and debris flows. To reduce public exposure to hazard, the U.S. Geological Survey produces post-fire debris-flow hazard assessments for select fires in the western United States. We use publicly available geospatial data describing basin morphology, burn severity, soil properties, and rainfall characteristics to estimate the statistical likelihood that debris flows will occur in response to a storm of a given rainfall intensity. Using an empirical database and refined geospatial analysis methods, we defined new equations for the prediction of debris-flow likelihood using logistic regression methods. We showed that the new logistic regression model outperformed previous models used to predict debris-flow likelihood.

  14. Food costs, diet quality and energy balance in the United States.

    Science.gov (United States)

    Carlson, Andrea; Frazão, Elizabeth

    2014-07-01

    The high obesity rates and poor diet quality in the United States, particularly among low income populations, are often attributed to low income, low food access, and high food prices of healthy foods. This paper discusses these associations and questions some of the metrics used to measure food prices. The paper argues that 1. On average, Americans consume diets that need improvement and there is only a very limited relationship between income and diet quality; 2. The way the food price is measured makes a difference in the perception of how expensive healthy and less healthy food is; 3. The way Americans allocate their food budgets between healthy and less healthy foods is not in line with healthy diets; and 4. At any food spending level there are households that purchase healthy (and unhealthy) diets, including budgets at or below the maximum allotment for the Supplemental Nutrition Assistance Program (SNAP) which provides a means for low-income households to purchase food. Our key finding is that healthy foods and diets are affordable, but policy makers, nutrition educators, researchers and the media need to focus on promoting this message, and providing additional guidance on making the changes for Americans to switch to a healthy and affordable diet. Published by Elsevier Inc.

  15. Data Qualification Report: Calculated Porosity and Porosity-Derived Values for Lithostratigraphic Units for use on the Yucca Mountain Project

    Energy Technology Data Exchange (ETDEWEB)

    P. Sanchez

    2001-05-30

    The qualification is being completed in accordance with the Data Qualification Plan DQP-NBS-GS-000006, Rev. 00 (CRWMS M&O 2001). The purpose of this data qualification activity is to evaluate for qualification the unqualified developed input and porosity output included in Data Tracking Number (DTN) M09910POROCALC.000. The main output of the analyses documented in DTN M09910POROCALC.000 is the calculated total porosity and effective porosity for 40 Yucca Mountain Project boreholes. The porosity data are used as input to Analysis Model Report (AMR) 10040, ''Rock Properties Model'' (MDL-NBS-GS-000004, Rev. 00), Interim Change Notice [ICN] 02 (CRWMS M&O 2000b). The output from the rock properties model is used as input to numerical physical-process modeling within the context of a relationship developed in the AMR between hydraulic conductivity, bound water and zeolitic zones for use in the unsaturated zone model. In accordance with procedure AP-3.15Q, the porosity output is not used in the direct calculation of Principal Factors for post-closure safety or disruptive events. The original source for DTN M09910POROCALC.000 is a Civilian Radioactive Waste Management System (CRWMS) Management and Operating Contractor (M&O) report, ''Combined Porosity from Geophysical Logs'' (CRWMS M&O 1999a and hereafter referred to as Rael 1999). That report recalculated porosity results for both the historical boreholes covered in Nelson (1996), and the modern boreholes reported in CRWMS M&O (1996a,b). The porosity computations in Rael (1999) are based on density-porosity mathematical relationships requiring various input parameters, including bulk density, matrix density and air and/or fluid density and volumetric water content. The main output is computed total porosity and effective porosity reported on a foot-by-foot basis for each borehole, although volumetric water content is derived from neutron data as an interim output. This qualification

  16. SU-E-T-599: The Variation of Hounsfield Unit and Relative Electron Density Determination as a Function of KVp and Its Effect On Dose Calculation Accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Ohl, A [University of Buffalo, Buffalo, NY (United States); Boer, S De [Roswell Park Cancer Institute, Buffalo, NY (United States)

    2014-06-01

    Purpose: To investigate the differences in relative electron density for different energy (kVp) settings and the effect that these differences have on dose calculations. Methods: A Nuclear Associates 76-430 Mini CT QC Phantom with materials of known relative electron densities was imaged by one multi-slice (16) and one single-slice computed tomography (CT) scanner. The Hounsfield unit (HU) was recorded for each material with energies ranging from 80 to 140 kVp and a representative relative electron density (RED) curve was created. A 5 cm thick inhomogeneity was created in the treatment planning system (TPS) image at a depth of 5 cm. The inhomogeneity was assigned HU for various materials for each kVp calibration curve. The dose was then calculated with the analytical anisotropic algorithm (AAA) at points within and below the inhomogeneity and compared using the 80 kVp beam as a baseline. Results: The differences in RED values as a function of kVp showed the largest variations of 580 and 547 HU for the Aluminum and Bone materials; the smallest differences of 0.6 and 3.0 HU were observed for the air and lung inhomogeneities. The corresponding dose calculations for the different RED values assigned to the 5 cm thick slab revealed the largest differences inside the aluminum and bone inhomogeneities of 2.2 to 6.4% and 4.3 to 7.0% respectively. The dose differences beyond these two inhomogeneities were between 0.4 to 1.6% for aluminum and 1.9 to 2.2 % for bone. For materials with lower HU the calculated dose differences were less than 1.0%. Conclusion: For high CT number materials the dose differences in the phantom calculation as high as 7.0% are significant. This result may indicate that implementing energy specific RED curves can increase dose calculation accuracy.

  17. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children.

    Science.gov (United States)

    Bibus, Douglas M

    2016-02-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega-3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in the U.S. with 8-12 ounces of fish per week, as recommended by the Food and Drug Administration (FDA), throughout the duration of pregnancy and lactation. Based on the FDA's quantitative assessment, this may result in a net increase of IQ by 5.5 points in children and improve their early age verbal development.

  18. Utility-Scale Solar 2015: An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Seel, Joachim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2016-08-17

    The utility-scale solar sector—defined here to include any ground-mounted photovoltaic (“PV”), concentrating photovoltaic (“CPV”), or concentrating solar power (“CSP”) project that is larger than 5 MWAC in capacity—has led the overall U.S. solar market in terms of installed capacity since 2012. It is expected to maintain its market-leading position for at least another five years, driven in part by December 2015’s three-year extension of the 30% federal investment tax credit (“ITC”) through 2019 (coupled with a favorable switch to a “start construction” rather than a “placed in service” eligibility requirement, and a gradual phase down of the credit to 10% by 2022). In fact, in 2016 alone, the utility-scale sector is projected to install more than twice as much new capacity as it ever has previously in a single year. This unprecedented boom makes it difficult, yet more important than ever, to stay abreast of the latest utility-scale market developments and trends. This report—the fourth edition in an ongoing annual series—is intended to help meet this need, by providing in-depth, annually updated, data-driven analysis of the utility-scale solar project fleet in the United States. Drawing on empirical project-level data from a wide range of sources, this report analyzes not just installed project costs or prices—i.e., the traditional realm of most solar economic analyses—but also operating costs, capacity factors, and power purchase agreement (“PPA”) prices from a large sample of utility-scale solar projects throughout the United States. Given its current dominance in the market, utility-scale PV also dominates much of this report, though data from CPV and CSP projects are also presented where appropriate.

  19. Treatment practices, outcomes, and costs of multidrug-resistant and extensively drug-resistant tuberculosis, United States, 2005-2007.

    Science.gov (United States)

    Marks, Suzanne M; Flood, Jennifer; Seaworth, Barbara; Hirsch-Moverman, Yael; Armstrong, Lori; Mase, Sundari; Salcedo, Katya; Oh, Peter; Graviss, Edward A; Colson, Paul W; Armitige, Lisa; Revuelta, Manuel; Sheeran, Kathryn

    2014-05-01

    To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prevention from California, New York City, and Texas during 2005-2007. At initial diagnosis, MDR TB was detected in 94% of 130 MDR TB patients and XDR TB in 80% of 5 XDR TB patients. Mutually exclusive resistance was 4% XDR, 17% pre-XDR, 24% total first-line resistance, 43% isoniazid/rifampin/rifabutin-plus-other resistance, and 13% isoniazid/rifampin/rifabutin-only resistance. Nearly three-quarters of patients were hospitalized, 78% completed treatment, and 9% died during treatment. Direct costs, mostly covered by the public sector, averaged $134,000 per MDR TB and $430,000 per XDR TB patient; in comparison, estimated cost per non-MDR TB patient is $17,000. Drug resistance was extensive, care was complex, treatment completion rates were high, and treatment was expensive.

  20. Treatment Practices, Outcomes, and Costs of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis, United States, 2005–2007

    Science.gov (United States)

    Flood, Jennifer; Seaworth, Barbara; Hirsch-Moverman, Yael; Armstrong, Lori; Mase, Sundari; Salcedo, Katya; Oh, Peter; Graviss, Edward A.; Colson, Paul W.; Armitige, Lisa; Revuelta, Manuel; Sheeran, Kathryn

    2014-01-01

    To describe factors associated with multidrug-resistant (MDR), including extensively-drug-resistant (XDR), tuberculosis (TB) in the United States, we abstracted inpatient, laboratory, and public health clinic records of a sample of MDR TB patients reported to the Centers for Disease Control and Prevention from California, New York City, and Texas during 2005–2007. At initial diagnosis, MDR TB was detected in 94% of 130 MDR TB patients and XDR TB in 80% of 5 XDR TB patients. Mutually exclusive resistance was 4% XDR, 17% pre-XDR, 24% total first-line resistance, 43% isoniazid/rifampin/rifabutin-plus-other resistance, and 13% isoniazid/rifampin/rifabutin-only resistance. Nearly three-quarters of patients were hospitalized, 78% completed treatment, and 9% died during treatment. Direct costs, mostly covered by the public sector, averaged $134,000 per MDR TB and $430,000 per XDR TB patient; in comparison, estimated cost per non-MDR TB patient is $17,000. Drug resistance was extensive, care was complex, treatment completion rates were high, and treatment was expensive. PMID:24751166

  1. Reconciling quality and cost: A case study in interventional radiology.

    Science.gov (United States)

    Zhang, Li; Domröse, Sascha; Mahnken, Andreas

    2015-10-01

    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.

  2. Cost and appropriateness of treating asthma with fixed-combination drugs in local health care units in Italy

    Science.gov (United States)

    Ruggeri, Isabella; Bragato, Donatello; Colombo, Giorgio L; Valla, Emanuela; Di Matteo, Sergio

    2012-01-01

    Background Bronchial asthma is a chronic airways disease and is considered to be one of the major health problems in the Western world. During the last decade, a significant increase in the use of β2-agonists in combination with inhaled corticosteroids has been observed. The aim of this study was to assess the appropriateness of expenditure on these agents in an asthmatic population treated in a real practice setting. Methods This study used data for a resident population of 635,906 citizens in the integrated patient database (Banca Dati Assistito) of a local health care unit (Milano 2 Azienda Sanitaria Locale) in the Lombardy region over 3 years (2007–2009). The sample included 3787–4808 patients selected from all citizens aged ≥ 18 years entitled to social security benefits, having a prescription for a corticosteroid + β2-agonist combination, and an ATC code corresponding to R03AK, divided into three groups, ie, pressurized (spray) drugs, inhaled powders, and extrafine formulations. Patients with chronic obstructive lung disease were excluded. Indicators of appropriateness were 1–3 packs per year (underdosed, inappropriate), 4–12 packs per year (presumably appropriate), and ≥13 packs per year (overtreatment, inappropriate). Results The corticosteroid + β2-agonist combination per treated asthmatic patient increased from 37% in 2007 to 45% in 2009 for the total of prescribed antiasthma drugs, and 28%–32% of patients used the drugs in an appropriate manner (4–12 packs per years). The cost of inappropriately used packs increased combination drug expenditure by about 40%, leading to inefficient use of health care resources. This trend improved during the 3-year observation period. The mean annual cost per patient was higher for powders (€223.95) and sprays (€224.83) than for extrafine formulation (€142.71). Conclusion Based on this analysis, we suggest implementation of better health care planning and more appropriate prescription practices

  3. Costo-beneficio en una unidad de cuidados intensivos neonatales The cost-benefit in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Rafael Amador Morán

    2011-06-01

    Full Text Available INTRODUCCIÓN. El Sistema Nacional de Salud de Cuba ha desarrollado un conjunto de reformas encaminadas a lograr una mayor eficiencia en la prestación de servicios, para preservar logros como la efectividad y la accesibilidad. El objetivo de esta investigación fue identificar los costos en la Unidad de Terapia Intensiva Neonatal del Hospital Ginecoobstétrico de Guanabacoa en el período de un año. MÉTODOS. Se realizó un estudio descriptivo prospectivo del período de enero a diciembre del 2009. La muestra quedo constituida por 65 recién nacidos graves y críticos. Las variables independientes estudiadas fueron: antibióticos, inmunomoduladores, fármacos vasoactivos, soluciones para hidratación, yodo, peróxido de hidrógeno, vitaminas y minerales, oxígeno, material desechable, material de oficina y medios diagnósticos. La información recogida se introdujo en una base de datos, y se procesó con el programa Epidat 3.0. RESULTADOS. Existió un costo total de 70 605,83 CU, que representó unos 2 824,23 CUC, con costo total por paciente de 74,32 CUC. El mayor gasto correspondió al uso de materiales desechables, las soluciones para hidratación y los antibióticos.INTRODUCTION. The Cuban National Health System has developed a series of reforms aimed to achieve a great efficiency in services provision to protect achievements as effectiveness and accessibility. The aim of present research was to identify the costs in the Neonatal Intensive Therapy Unit of the Gynecology and Obstetrics Hospital of Guanabacoa municipality within one year. METHODS. A prospective and descriptive study was conducted from January to December, 2009. Sample included 65 severe and critically ill newborns. The independent study variables were: antibiotics, immunological therapy, vasoactive drugs, solutions for hydration, iodine, hydrogen peroxide, vitamins and minerals, oxygen, waste material, office stationery and diagnostic means. Information capture was entered

  4. Calculation and analysis of environmental costs of the atmospheric pollution from brazilian oil refinery; Calculo e analise dos custos ambientais da poluicao atmosferica emitida por uma refinaria de petroleo brasileira

    Energy Technology Data Exchange (ETDEWEB)

    Mariano, Jacqueline [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Coordenacao dos Programas de Pos-graduacao de Engenharia (COPPE). Programa de Planejamento Energetico

    2004-07-01

    The present study presents a calculation of the environmental costs associated with the atmospheric pollution from a brazilian oil refinery and its analysis (the name of this oil refinery is confidential, for this reason it will not be mentioned). The calculation of the costs was based on a study of north-american researchers, about the environmental costs of five main atmospheric pollutants: particulate matter, sulphur oxides, nitrogen oxides, volatile organic compounds (VOC's) and carbon monoxide. The original American study offers an statistical analysis of several other American studies about environmental costs of atmospheric pollution, that present maximum, medium and minimum costs. Based on these values, the total environmental costs of the atmospheric pollution from the brazilian oil refinery were calculated, considering a fifty year operational time for the facility. The internalization of the atmospheric pollution environmental costs by the refiners is aligned with the world tendency of enforcement of the environmental limitations faced by the oil refining sector, and therefore, the adoption of a pro-active attitude is recommended by the present study. (author)

  5. SU-F-T-220: Validation of Hounsfield Unit-To-Stopping Power Ratio Calibration Used for Dose Calculation in Proton Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Polf, J; Chung, H; Langen, K [University of Maryland School of Medicine, Baltimore, MD (United States)

    2016-06-15

    Purpose: To validate the stoichiometric calibration of the Hounsfield Unit (HU) to Stopping Power Ratio (SPR) calibration used to commission a commercial treatment planning system (TPS) for proton radiotherapy dose calculation. Methods and Materials: The water equivalent thickness (WET) of several individual pig tissues (lung, fat, muscle, liver, intestine, rib, femur), mixed tissue samples (muscle/rib, ice/femur, rib/air cavity/muscle), and an intact pig head were measured with a multi-layer ionization chamber (MLIC). A CT scan of each sample was obtained and imported into a commercial TPS. The WET calculated by the TPS for each tissue sample was compared to the measured WET value to determine the accuracy of the HU-to-SPR calibration curve used by the TPS to calculate dose. Results: The WET values calculated by the TPS showed good agreement (< 2.0%) with the measured values for bone and all soft tissues except fat (3.1% difference). For the mixed tissue samples and the intact pig head measurements, the difference in the TPS and measured WET values all agreed to within 3.5%. In addition, SPR values were calculated from the measured WET of each tissue, and compared to SPR values of reference tissues from ICRU 46 used to generate the HU-to-SPR calibration for the TPS. Conclusion: For clinical scenarios where the beam passes through multiple tissue types and its path is dominated by soft tissues, we believe using an uncertainty of 3.5% of the planned beam range is acceptable to account for uncertainties in the TPS WET determination.

  6. A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool.

    Science.gov (United States)

    Hutubessy, Raymond; Levin, Ann; Wang, Susan; Morgan, Winthrop; Ally, Mariam; John, Theopista; Broutet, Nathalie

    2012-11-13

    The purpose, methods, data sources and assumptions behind the World Health Organization (WHO) Cervical Cancer Prevention and Control Costing (C4P) tool that was developed to assist low- and middle-income countries (LMICs) with planning and costing their nationwide human papillomavirus (HPV) vaccination program are presented. Tanzania is presented as a case study where the WHO C4P tool was used to cost and plan the roll-out of HPV vaccines nationwide as part of the national comprehensive cervical cancer prevention and control strategy. The WHO C4P tool focuses on estimating the incremental costs to the health system of vaccinating adolescent girls through school-, health facility- and/or outreach-based strategies. No costs to the user (school girls, parents or caregivers) are included. Both financial (or costs to the Ministry of Health) and economic costs are estimated. The cost components for service delivery include training, vaccination (health personnel time and transport, stationery for tally sheets and vaccination cards, and so on), social mobilization/IEC (information, education and communication), supervision, and monitoring and evaluation (M&E). The costs of all the resources used for HPV vaccination are totaled and shown with and without the estimated cost of the vaccine. The total cost is also divided by the number of doses administered and number of fully immunized girls (FIGs) to estimate the cost per dose and cost per FIG. Over five years (2011 to 2015), the cost of establishing an HPV vaccine program that delivers three doses of vaccine to girls at schools via phased national introduction (three regions in year 1, ten regions in year 2 and all 26 regions in years 3 to 5) in Tanzania is estimated to be US$9.2 million (excluding vaccine costs) and US$31.5 million (with vaccine) assuming a vaccine price of US$5 (GAVI 2011, formerly the Global Alliance for Vaccines and Immunizations). This is equivalent to a financial cost of US$5.77 per FIG, excluding

  7. A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool

    Directory of Open Access Journals (Sweden)

    Hutubessy Raymond

    2012-11-01

    Full Text Available Abstract Background The purpose, methods, data sources and assumptions behind the World Health Organization (WHO Cervical Cancer Prevention and Control Costing (C4P tool that was developed to assist low- and middle-income countries (LMICs with planning and costing their nationwide human papillomavirus (HPV vaccination program are presented. Tanzania is presented as a case study where the WHO C4P tool was used to cost and plan the roll-out of HPV vaccines nationwide as part of the national comprehensive cervical cancer prevention and control strategy. Methods The WHO C4P tool focuses on estimating the incremental costs to the health system of vaccinating adolescent girls through school-, health facility- and/or outreach-based strategies. No costs to the user (school girls, parents or caregivers are included. Both financial (or costs to the Ministry of Health and economic costs are estimated. The cost components for service delivery include training, vaccination (health personnel time and transport, stationery for tally sheets and vaccination cards, and so on, social mobilization/IEC (information, education and communication, supervision, and monitoring and evaluation (M&E. The costs of all the resources used for HPV vaccination are totaled and shown with and without the estimated cost of the vaccine. The total cost is also divided by the number of doses administered and number of fully immunized girls (FIGs to estimate the cost per dose and cost per FIG. Results Over five years (2011 to 2015, the cost of establishing an HPV vaccine program that delivers three doses of vaccine to girls at schools via phased national introduction (three regions in year 1, ten regions in year 2 and all 26 regions in years 3 to 5 in Tanzania is estimated to be US$9.2 million (excluding vaccine costs and US$31.5 million (with vaccine assuming a vaccine price of US$5 (GAVI 2011, formerly the Global Alliance for Vaccines and Immunizations. This is equivalent to a

  8. A case study using the United Republic of Tanzania: costing nationwide HPV vaccine delivery using the WHO Cervical Cancer Prevention and Control Costing Tool

    Science.gov (United States)

    2012-01-01

    Background The purpose, methods, data sources and assumptions behind the World Health Organization (WHO) Cervical Cancer Prevention and Control Costing (C4P) tool that was developed to assist low- and middle-income countries (LMICs) with planning and costing their nationwide human papillomavirus (HPV) vaccination program are presented. Tanzania is presented as a case study where the WHO C4P tool was used to cost and plan the roll-out of HPV vaccines nationwide as part of the national comprehensive cervical cancer prevention and control strategy. Methods The WHO C4P tool focuses on estimating the incremental costs to the health system of vaccinating adolescent girls through school-, health facility- and/or outreach-based strategies. No costs to the user (school girls, parents or caregivers) are included. Both financial (or costs to the Ministry of Health) and economic costs are estimated. The cost components for service delivery include training, vaccination (health personnel time and transport, stationery for tally sheets and vaccination cards, and so on), social mobilization/IEC (information, education and communication), supervision, and monitoring and evaluation (M&E). The costs of all the resources used for HPV vaccination are totaled and shown with and without the estimated cost of the vaccine. The total cost is also divided by the number of doses administered and number of fully immunized girls (FIGs) to estimate the cost per dose and cost per FIG. Results Over five years (2011 to 2015), the cost of establishing an HPV vaccine program that delivers three doses of vaccine to girls at schools via phased national introduction (three regions in year 1, ten regions in year 2 and all 26 regions in years 3 to 5) in Tanzania is estimated to be US$9.2 million (excluding vaccine costs) and US$31.5 million (with vaccine) assuming a vaccine price of US$5 (GAVI 2011, formerly the Global Alliance for Vaccines and Immunizations). This is equivalent to a financial cost of US

  9. Stress CMR imaging observation unit in the emergency department reduces 1-year medical care costs in patients with acute chest pain: a randomized study for comparison with inpatient care.

    Science.gov (United States)

    Miller, Chadwick D; Hwang, Wenke; Case, Doug; Hoekstra, James W; Lefebvre, Cedric; Blumstein, Howard; Hamilton, Craig A; Harper, Erin N; Hundley, W Gregory

    2011-08-01

    This study sought to compare the direct cost of medical care and clinical events during the first year after patients with intermediate risk acute chest pain were randomized to stress cardiac magnetic resonance (CMR) observation unit (OU) testing versus inpatient care. In a recent study, randomization to OU-CMR reduced median index hospitalization cost compared with the cost of inpatient care in patients presenting to the emergency department with intermediate risk acute chest pain. Emergency department patients with intermediate risk chest pain were randomized to OU-CMR (OU care, cardiac markers, stress CMR) or inpatient care (admission, care per admitting provider). This analysis reports the direct cost of cardiac-related care and clinical outcomes (myocardial infarction, revascularization, cardiovascular death) during the first year of follow-up subsequent to discharge. Consistent with health economics literature, provider cost was calculated from work-related relative value units using the Medicare conversion factor; facility charges were converted to cost using departmental-specific cost-to-charge ratios. Linear models were used to compare cost accumulation among study groups. We included 109 randomized subjects in this analysis (52 OU-CMR, 57 inpatient care). The median age was 56 years; baseline characteristics were similar in both groups. At 1 year, 6% of OU-CMR and 9% of inpatient care participants experienced a major cardiac event (p = 0.72) with 1 patient in each group experiencing a cardiac event after discharge. First-year cardiac-related costs were significantly lower for participants randomized to OU-CMR than for participants receiving inpatient care (geometric mean = $3,101 vs. $4,742 including the index visit [p = 0.004] and $29 vs. $152 following discharge [p = 0.012]). During the year following randomization, 6% of OU-CMR and 9% of inpatient care participants experienced a major cardiac event (p = 0.72). An OU-CMR strategy reduces cardiac

  10. Healthcare associated infections in Paediatric Intensive Care Unit of a tertiary care hospital in India: Hospital stay & extra costs

    Directory of Open Access Journals (Sweden)

    Jitender Sodhi

    2016-01-01

    Interpretation & conclusions: This study highlights the effect of HAI on costs for PICU patients, especially costs due to prolongation of hospital stay, and suggests the need to develop effective strategies for prevention of HAI to reduce costs of health care.

  11. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.

    Science.gov (United States)

    Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

    2015-10-01

    Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

  12. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

    Science.gov (United States)

    Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

    2015-01-01

    Background: Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. Objectives: The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). Materials and Methods: We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results: Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion: As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI

  13. Integrating the Carbon and Water Footprints’ Costs in the Water Framework Directive 2000/60/EC Full Water Cost Recovery Concept: Basic Principles Towards Their Reliable Calculation and Socially Just Allocation

    OpenAIRE

    Kanakoudis, Vasilis; Tsitsifli, Stavroula; Papadopoulou, Anastasia

    2012-01-01

    This paper presents the basic principles for the integration of the water and carbon footprints cost into the resource and environmental costs respectively, taking the suggestions set by the Water Framework Directive (WFD) 2000/60/EC one step forward. WFD states that full water cost recovery (FWCR) should be based on the estimation of the three sub-costs related: direct; environmental; and resource cost. It also strongly suggests the EU Member States develop and apply effective water pricing ...

  14. Estimating the number of persons who inject drugs in the united states by meta-analysis to calculate national rates of HIV and hepatitis C virus infections.

    Directory of Open Access Journals (Sweden)

    Amy Lansky

    Full Text Available BACKGROUND: Injection drug use provides an efficient mechanism for transmitting bloodborne viruses, including human immunodeficiency virus (HIV and hepatitis C virus (HCV. Effective targeting of resources for prevention of HIV and HCV infection among persons who inject drugs (PWID is based on knowledge of the population size and disparity in disease burden among PWID. This study estimated the number of PWID in the United States to calculate rates of HIV and HCV infection. METHODS: We conducted meta-analysis using data from 4 national probability surveys that measured lifetime (3 surveys or past-year (3 surveys injection drug use to estimate the proportion of the United States population that has injected drugs. We then applied these proportions to census data to produce population size estimates. To estimate the disease burden among PWID by calculating rates of disease we used lifetime population size estimates of PWID as denominators and estimates of HIV and HCV infection from national HIV surveillance and survey data, respectively, as numerators. We calculated rates of HIV among PWID by gender-, age-, and race/ethnicity. RESULTS: Lifetime PWID comprised 2.6% (95% confidence interval: 1.8%-3.3% of the U.S. population aged 13 years or older, representing approximately 6,612,488 PWID (range: 4,583,188-8,641,788 in 2011. The population estimate of past-year PWID was 0.30% (95% confidence interval: 0.19 %-0.41% or 774,434 PWID (range: 494,605-1,054,263. Among lifetime PWID, the 2011 HIV diagnosis rate was 55 per 100,000 PWID; the rate of persons living with a diagnosis of HIV infection in 2010 was 2,147 per 100,000 PWID; and the 2011 HCV infection rate was 43,126 per 100,000 PWID. CONCLUSION: Estimates of the number of PWID and disease rates among PWID are important for program planning and addressing health inequities.

  15. Calculation of additional costs in 2011 - for the demolition of the Swedish nuclear power plants and disposal of residues; Beraekning av merkostnader 2011 - foer rivning av de svenska kaernkraftsverken och omhaendertagande av restprodukter

    Energy Technology Data Exchange (ETDEWEB)

    Schoultz, Christian [SSM, Stockholm (Sweden); Lichtenberg, Steen [Lichtenberg and Partners ApS, Hellerup (Denmark); Borg, Lorens [Successivprincipen i Ystad AB, Ystad (Sweden)

    2011-04-15

    This report describes the SSM's estimates of future costs for the fee proposal for 2012-2014. The calculation is made according to the Financing Act and includes all additional costs until the residues from the Swedish nuclear power plants are finally stored. According to current estimates, this is assumed to be 2069. The estimation of such a long time is a major uncertainty and SSM uses, like SKB, the successive calculation method to estimate an expected value and the uncertainty of the estimate.

  16. Sympathy for the Devil: Detailing the Effects of Planning-Unit Size, Thematic Resolution of Reef Classes, and Socioeconomic Costs on Spatial Priorities for Marine Conservation

    Science.gov (United States)

    Pressey, Robert L.; Weeks, Rebecca; Andréfouët, Serge; Moloney, James

    2016-01-01

    Spatial data characteristics have the potential to influence various aspects of prioritising biodiversity areas for systematic conservation planning. There has been some exploration of the combined effects of size of planning units and level of classification of physical environments on the pattern and extent of priority areas. However, these data characteristics have yet to be explicitly investigated in terms of their interaction with different socioeconomic cost data during the spatial prioritisation process. We quantify the individual and interacting effects of three factors—planning-unit size, thematic resolution of reef classes, and spatial variability of socioeconomic costs—on spatial priorities for marine conservation, in typical marine planning exercises that use reef classification maps as a proxy for biodiversity. We assess these factors by creating 20 unique prioritisation scenarios involving combinations of different levels of each factor. Because output data from these scenarios are analogous to ecological data, we applied ecological statistics to determine spatial similarities between reserve designs. All three factors influenced prioritisations to different extents, with cost variability having the largest influence, followed by planning-unit size and thematic resolution of reef classes. The effect of thematic resolution on spatial design depended on the variability of cost data used. In terms of incidental representation of conservation objectives derived from finer-resolution data, scenarios prioritised with uniform cost outperformed those prioritised with variable cost. Following our analyses, we make recommendations to help maximise the spatial and cost efficiency and potential effectiveness of future marine conservation plans in similar planning scenarios. We recommend that planners: employ the smallest planning-unit size practical; invest in data at the highest possible resolution; and, when planning across regional extents with the

  17. Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

    Science.gov (United States)

    Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

    2014-01-01

    Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

  18. Multi-country analysis of treatment costs for HIV/AIDS (MATCH: facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

    Directory of Open Access Journals (Sweden)

    Elya Tagar

    Full Text Available BACKGROUND: Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. METHODS & FINDINGS: In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment. CONCLUSIONS: This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

  19. Tracking the Sun IV: An Historical Summary of the Installed Cost of Photovoltaics in the United States from 1998 to 2010

    Energy Technology Data Exchange (ETDEWEB)

    Darghouth, Naim; Wiser, Ryan

    2011-09-07

    The present report describes installed cost trends for grid-connected PV projects installed from 1998 through 2010 (with some limited and preliminary results presented for projects installed in the first six months of 2011). The analysis is based on project-level cost data from approximately 116,500 residential, non-residential, and utility-sector PV systems in the United States. The inclusion of utility-sector PV is a new element in this year’s report. The combined capacity of all systems in the data sample totals 1,685 MW, equal to 79% of all grid-connected PV capacity installed in the United States through 2010 and representing one of the most comprehensive sources of installed PV cost data for the U.S. Based on this dataset, the report describes historical installed cost trends over time, and by location, market segment, technology type, and component. The report also briefly compares recent PV installed costs in the United States to those in Germany and Japan, and describes trends in customer incentives for PV installations and net installed costs after receipt of such incentives. The analysis presented here focuses on descriptive trends in the underlying data, serving primarily to summarize the data in tabular and graphical form.

  20. Trends in outcomes, complications, and hospitalization costs for hemispherectomy in the United States for the years 2000-2009.

    Science.gov (United States)

    Lin, Yimo; Harris, Dominic A; Curry, Daniel J; Lam, Sandi

    2015-01-01

    Hemispherectomy is an established surgical treatment for carefully selected pediatric patients with intractable epilepsy. Published perioperative data report low mortality rates and seizure reduction rates of 50-89%. This study investigates trends in the demographics, hospital utilization, and in-hospital complication rates of patients undergoing hemispherectomy over the past decade in the United States, using the nationally representative Kids' Inpatient Database (KID). The KID was queried for all discharges with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code for hemispherectomy in the years 2000, 2003, 2006, and 2009. The patient cohorts from these four time points were compared, analyzing differences in demographic data, insurance and payer status, total cost, length of stay, in-hospital mortality, and complications. National estimates and 95% confidence intervals are reported given the weighted sample design of KID. This study identified an estimated total of 552 hospital admissions for hemispherectomy surgery during the years studied in this cohort. The incidence of this procedure increased from 1.2/100,000 admissions in 2000 to 2.2/100,000 in 2009 (p=0.05). Mean age was 6.7 years (range 0-20). There were no significant changes in demographics (age, gender, or race), hospital descriptors (size or type), insurance type, or zip code income quartile. There was a significant increase in total cost, from $42,807 in 2003 to $57,443 in 2009 (p=0.015) (adjusted to 2009 dollars). There were no trends in postoperative complications. In-hospital mortality occurred in five subjects (0.9%). Ventricular shunt placement during hemispherectomy hospitalizations increased over time from 6.7% to 16.5% (p=0.056). Hospitals that performed two or more hemispherectomies yearly had a significantly decreased incidence of in-hospital mortality (odds ratio [OR] 0.08, p=0.04) and an increased incidence of blood transfusion

  1. The economic costs of intrapartum care in Tower Hamlets: A comparison between the cost of birth in a freestanding midwifery unit and hospital for women at low risk of obstetric complications.

    Science.gov (United States)

    Schroeder, Liz; Patel, Nishma; Keeler, Michelle; Rocca-Ihenacho, Lucia; Macfarlane, Alison J

    2017-02-01

    to compare the economic costs of intrapartum maternity care in an inner city area for 'low risk' women opting to give birth in a freestanding midwifery unit compared with those who chose birth in hospital. micro-costing of health service resources used in the intrapartum care of mothers and their babies during the period between admission and discharge, data extracted from clinical notes. the Barkantine Birth Centre, a freestanding midwifery unit and the Royal London Hospital's consultant-led obstetric unit, both run by the former Barts and the London NHS Trust in Tower Hamlets, a deprived inner city borough in east London, England, 2007-2010. maternity records of 333 women who were resident in Tower Hamlets and who satisfied the Trust's eligibility criteria for using the Birth Centre. Of these, 167 women started their intrapartum care at the Birth Centre and 166 started care at the Royal London Hospital. women who planned their birth at the Birth Centre experienced continuous intrapartum midwifery care, higher rates of spontaneous vaginal delivery, greater use of a birth pool, lower rates of epidural use, higher rates of established breastfeeding and a longer post-natal stay, compared with those who planned for care in the hospital. The total average cost per mother-baby dyad for care where mothers started their intrapartum care at the Birth Centre was £1296.23, approximately £850 per patient less than the average cost per mother and baby who received all their care at the Royal London Hospital. These costs reflect intrapartum throughput using bottom up costing per patient, from admission to discharge, including transfer, but excluding occupancy rates and the related running costs of the units. the study showed that intrapartum throughput in the Birth Centre could be considered cost-minimising when compared to hospital. Modelling the financial viability of midwifery units at a local level is important because it can inform the appropriate provision of these

  2. IEA Wind Task 26. Wind Technology, Cost, and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States: 2007–2012

    Energy Technology Data Exchange (ETDEWEB)

    Vitina, Aisma [Ea Energy Analyses, Copenhagen (Denmark); Lüers, Silke [Deutsche WindGuard, Varel (Germany); Wallasch, Anna-Kathrin [Deutsche WindGuard, Varel (Germany); Berkhout, Volker [Fraunhofer IWES, Kassel (Germany); Duffy, Aidan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Cleary, Brendan [Dublin Inst. of Technology and Dublin Energy Lab. (Ireland); Husabø, Lief I. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Weir, David E. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Lacal-Arántegui, Roberto [European Commission, Ispra (Italy). Joint Research Centre; Hand, Maureen [National Renewable Energy Lab. (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Lab. (NREL), Golden, CO (United States); Belyeu, Kathy [Belyeu Consulting, Takoma Park, MD (United States); Wiser, Ryan H [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-01

    The International Energy Agency Implementing Agreement for cooperation in Research, Development, and Deployment of Wind Energy Systems (IEA Wind) Task 26—The Cost of Wind Energy represents an international collaboration dedicated to exploring past, present and future cost of wind energy. This report provides an overview of recent trends in wind plant technology, cost, and performance in those countries that are currently represented by participating organizations in IEA Wind Task 26: Denmark, Germany, Ireland, Norway, and the United States as well as the European Union.

  3. Six climate change-related events in the United States accounted for about $14 billion in lost lives and health costs.

    Science.gov (United States)

    Knowlton, Kim; Rotkin-Ellman, Miriam; Geballe, Linda; Max, Wendy; Solomon, Gina M

    2011-11-01

    The future health costs associated with predicted climate change-related events such as hurricanes, heat waves, and floods are projected to be enormous. This article estimates the health costs associated with six climate change-related events that struck the United States between 2000 and 2009. The six case studies came from categories of climate change-related events projected to worsen with continued global warming-ozone pollution, heat waves, hurricanes, infectious disease outbreaks, river flooding, and wildfires. We estimate that the health costs exceeded $14 billion, with 95 percent due to the value of lives lost prematurely. Actual health care costs were an estimated $740 million. This reflects more than 760,000 encounters with the health care system. Our analysis provides scientists and policy makers with a methodology to use in estimating future health costs related to climate change and highlights the growing need for public health preparedness.

  4. Deterministic Assessment of Future Costs for Dismantling (FA)

    Energy Technology Data Exchange (ETDEWEB)

    Vasko, Marek [DECOM, Trnava (Slovakia)

    2012-11-01

    The main objective of the report is to provide an re-evaluation of cost calculations by OMEGA code for the Intermediate Storage for Spent Fuel in Studsvik (FA facility) using up-to-date Swedish labour cost unit factors and available up-to-date Swedish (or international) cost unit factors for consumables, materials and substances. Furthermore, evolution of other OMEGA database parameters concerning cost calculations e.g. manpower unit factors and workgroups parameters are taken into account. This report follows up former project which introduced tentative calculations of main decommissioning parameters such as costs, manpower and exposure of personnel for activities of older nuclear facility decommissioning in Sweden represented by FA Facility in Studsvik by means of calculation code OMEGA. The project demonstrated an implementation of advanced costing methodology based on PSL structure format to achieve transparent, traceable and comparable estimates even for older nuclear facilities like FA Facility in Studsvik. This former project used Slovak origin labour costs unit factors and other cost unit factors. After successful completion of this project, there was an intent of SSM to reevaluate calculations using an up-to-date Swedish labour cost data and also available Swedish consumables and materials cost data if available. Within this report re-calculations of main decommissioning parameters using available Swedish data are presented in structure according to Proposed Standardized List of Items for Costing Purposes. Calculations are made for decommissioning scenario with post-dismantling decontamination and steel radwaste melting technologies available at the site. All parameters are documented and summed up in both table and graphic forms in text and Annexes. Further, comparison of calculated results with previous calculations together with discussion is provided.

  5. Utility-Scale Solar 2016: An Empirical Analysis of Project Cost, Performance, and Pricing Trends in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark; Seel, Joachim; LaCommare, Kristina Hamachi

    2017-09-19

    The utility-scale solar sector has led the overall U.S. solar market in terms of installed capacity since 2012. In 2016, the utility-scale sector installed more than 2.5 times as much new capacity as did the residential and commercial sectors combined, and is expected to maintain its dominant position for at least another five years. This report—the fifth edition in an ongoing annual series—provides data-driven analysis of the utility-scale solar project fleet in the United States. We analyze not just installed project prices, but also operating costs, capacity factors, and power purchase agreement ("PPA") prices from a large sample of utility-scale PV and CSP projects throughout the United States. Highlights from this year's edition include the following: Installation Trends: The use of solar tracking devices dominated 2016 installations, at nearly 80% of all new capacity. In a reflection of the ongoing geographic expansion of the market beyond California and the Southwest, the median long-term average insolation level at newly built project sites declined again in 2016. While new fixed-tilt projects are now seen predominantly in less-sunny regions, tracking projects are increasingly pushing into these same regions. The median inverter loading ratio has stabilized in 2016 at 1.3 for both tracking and fixed-tilt projects. Installed Prices: Median installed PV project prices within a sizable sample have fallen by two-thirds since the 2007-2009 period, to $2.2/WAC (or $1.7/WDC) for projects completed in 2016. The lowest 20th percentile of projects within our 2016 sample were priced at or below $2.0/WAC, with the lowest-priced projects around $1.5/WAC. Overall price dispersion across the entire sample and across geographic regions decreased significantly in 2016. Operation and Maintenance (“O&M”) Costs: What limited empirical O&M cost data are publicly available suggest that PV O&M costs were in the neighborhood of $18/kWAC-year, or $8/MWh, in 2016. These

  6. Estimating Cost-effectiveness of a Multimodal Ovarian Cancer Screening Program in The United States: Secondary Analysis of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

    Science.gov (United States)

    Moss, Haley A; Berchuck, Andrew; Neely, Megan L; Myers, Evan R; Havrilesky, Laura J

    2017-12-07

    The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is the largest randomized clinical trial to evaluate screening's impact on ovarian cancer mortality, assigning women to multimodal screening (MMS) with serum cancer antigen 125 (CA-125) interpreted using a risk algorithm. If the MMS screening method is eventually shown to reduce mortality and be cost-effective, then it may be accepted by the medical community as a feasible screening tool. To estimate the cost-effectiveness of an MMS screening program in the United States. A Markov simulation model was constructed using data from UKCTOCS to compare MMS with no screening in the United States. Screening would begin at the age of 50 years for women in the general population. Published estimates of the long-term effect of MMS screening on ovarian cancer mortality and the trial's published hazard ratios were used to simulate mortality estimates up to 40 years from start of screening. Base-case costs included CA-125, ultrasound, and false-positive work-up results, in addition to a risk algorithm cost estimate of $100. The utility and costs of ovarian cancer treatment were incorporated into the model. Screening strategies varied by costs of the algorithm and treatment for advanced ovarian cancer, rates of screening compliance, ovarian cancer incidence, and extrapolation of ovarian cancer mortality. Costs, quality-adjusted life-years (QALYs), and mortality reduction of ovarian cancer screening. Multimodal screening is both more expensive and more effective in reducing ovarian cancer mortality over a lifetime than no screening. After accounting for uncertainty in the underlying parameters, screening women starting at age 50 years with MMS is cost-effective 70% of the time, when decision makers are willing to pay $150 000 per QALY. Screening reduced mortality by 15%, with an incremental cost-effectiveness ratio (ICER) ranging from $106 187 (95% CI, $97 496-$127 793) to $155 256 (95% CI

  7. Charge and Spin States in Schiff Base Metal Complexes with a Disiloxane Unit Exhibiting a Strong Noninnocent Ligand Character: Synthesis, Structure, Spectroelectrochemistry, and Theoretical Calculations.

    Science.gov (United States)

    Cazacu, Maria; Shova, Sergiu; Soroceanu, Alina; Machata, Peter; Bucinsky, Lukas; Breza, Martin; Rapta, Peter; Telser, Joshua; Krzystek, J; Arion, Vladimir B

    2015-06-15

    Mononuclear nickel(II), copper(II), and manganese(III) complexes with a noninnocent tetradentate Schiff base ligand containing a disiloxane unit were prepared in situ by reaction of 3,5-di-tert-butyl-2-hydroxybenzaldehyde with 1,3-bis(3-aminopropyl)tetramethyldisiloxane followed by addition of the appropriate metal(II) salt. The ligand H2L resulting from these reactions is a 2:1 condensation product of 3,5-di-tert-butyl-2-hydroxybenzaldehyde with 1,3-bis(3-aminopropyl)tetramethyldisiloxane. The resulting metal complexes, NiL·0.5CH2Cl2, CuL·1.5H2O, and MnL(OAc)·0.15H2O, were characterized by elemental analysis, spectroscopic methods (IR, UV-vis, X-band EPR, HFEPR, (1)H NMR), ESI mass spectrometry, and single crystal X-ray diffraction. Taking into account the well-known strong stabilizing effects of tert-butyl groups in positions 3 and 5 of the aromatic ring on phenoxyl radicals, we studied the one-electron and two-electron oxidation of the compounds using both experimental (chiefly spectroelectrochemistry) and computational (DFT) techniques. The calculated spin-density distribution and localized orbitals analysis revealed the oxidation locus and the effect of the electrochemical electron transfer on the molecular structure of the complexes, while time-dependent DFT calculations helped to explain the absorption spectra of the electrochemically generated species. Hyperfine coupling constants, g-tensors, and zero-field splitting parameters have been calculated at the DFT level of theory. Finally, the CASSCF approach has been employed to theoretically explore the zero-field splitting of the S = 2 MnL(OAc) complex for comparison purposes with the DFT and experimental HFEPR results. It is found that the D parameter sign strongly depends on the metal coordination geometry.

  8. On the contribution of external cost calculations to energy system governance: the case of a potential large-scale nuclear accident

    NARCIS (Netherlands)

    Laes, E.; Meskens, G.; van der Sluijs, J.P.

    2011-01-01

    The European Commission's ExternE Project has made major advances in the quantification of external costs of electricity. Although some impacts cannot be valued, important conclusions are possible. This paper outlines some provisional implications for energy policy. External costs are technology

  9. Further Validation of the Psychosocial Costs of Racism to Whites Scale on a Sample of University Students in the Southeastern United States

    Science.gov (United States)

    Sifford, Amy; Ng, Kok-Mun; Wang, Chuang

    2009-01-01

    We examined the factor structure of the Psychosocial Costs of Racism to Whites Scale (PCRW; Spanierman & Heppner, 2004) on 766 White American university students from the southeastern United States. Results from confirmatory factor analyses supported the 3-factor model proposed by Spanierman and Heppner (2004). The construct validity of the…

  10. Constructing Cost-Effective Crystal Structures with Table Tennis Balls and Tape That Allows Students to Assemble and Model Multiple Unit Cells

    Science.gov (United States)

    Elsworth, Catherine; Li, Barbara T. Y.; Ten, Abilio

    2017-01-01

    In this letter we present an innovative and cost-effective method of constructing crystal structures using Dual Lock fastening adhesive tape with table tennis (ping pong) balls. The use of these fasteners allows the balls to be easily assembled into layers to model various crystal structures and unit cells and then completely disassembled again.…

  11. CEEH's calculation of health costs from air pollution in the Danish Climate Commission's forecast; CEEH's beregning af sundhedsomkostninger (helbredsomkostninger) fra luftforurening i Klimakommissionens fremtidsforloeb. CEEH videnskabelig rapport no. 10

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, K.; Ystanes Foeyn, T.H.; Gregg, J.S.; Kaspersen, P.S. (Danmarks Tekniske Univ. Risoe Nationallaboratoriet for Baeredygtig Energi, Roskilde (Denmark)); Brandt, J.; Frohn, L.M. (Aarhus Univ. Institut for Miljoevidenskab, Aarhus (Denmark)); Mathiesen, B.V. (Aalborg Univ., Aalborg (Denmark))

    2011-11-15

    The Centre for Energy, Environment and Health (CEEH) has created a model system to assess the costs due to health effects from air pollution. This report assesses the health effects from the Danish Climate Commission's scenarios and is an example of how the system can be used. Calculations have been made of the health costs caused by energy consumption and production in the Danish Climate Commission's forecasts. The costs of emissions from various sectors differ, as they have different effects on health. The report shows how important it is to address health costs when evaluating and comparing the total costs in various scenarios. If health costs are included in the socio-economic assessments of the climate commission, then the annual cost decreases with approx. 2 billion DKK. To this it should be mentioned that in addition to health effects, there are other externalities (such as effects on the environment and climate) that are not normally included in the socio-economic assessments, which means that the socio-economic costs of switching to cleaner sources of energy is often overestimated. Possible effects of reduced traffic noise by converting to electric vehicles and increased exposure to wind turbine noise is also omitted, although the noise impact of dwellings especially in the cities is believed to have significance for morbidity and thus the socio-economy. (LN).

  12. Avoidable waste management costs

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, K.; Burns, M.; Priebe, S.; Robinson, P.

    1995-01-01

    This report describes the activity based costing method used to acquire variable (volume dependent or avoidable) waste management cost data for routine operations at Department of Energy (DOE) facilities. Waste volumes from environmental restoration, facility stabilization activities, and legacy waste were specifically excluded from this effort. A core team consisting of Idaho National Engineering Laboratory, Los Alamos National Laboratory, Rocky Flats Environmental Technology Site, and Oak Ridge Reservation developed and piloted the methodology, which can be used to determine avoidable waste management costs. The method developed to gather information was based on activity based costing, which is a common industrial engineering technique. Sites submitted separate flow diagrams that showed the progression of work from activity to activity for each waste type or treatability group. Each activity on a flow diagram was described in a narrative, which detailed the scope of the activity. Labor and material costs based on a unit quantity of waste being processed were then summed to generate a total cost for that flow diagram. Cross-complex values were calculated by determining a weighted average for each waste type or treatability group based on the volume generated. This study will provide DOE and contractors with a better understanding of waste management processes and their associated costs. Other potential benefits include providing cost data for sites to perform consistent cost/benefit analysis of waste minimization and pollution prevention (WMIN/PP) options identified during pollution prevention opportunity assessments and providing a means for prioritizing and allocating limited resources for WMIN/PP.

  13. Enteral nutrition improves clinical outcome and reduces costs of acute mesenteric ischaemia after recanalisation in the intensive care unit.

    Science.gov (United States)

    Yang, Shuofei; Guo, Jianming; Ni, Qihong; Chen, Jiaquan; Guo, Xiangjiang; Xue, Guanhua; Ye, Meng; Zhang, Lan

    2017-12-20

    Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88). The etiology, outcomes and complications were compared. Nutritional, immunologic, inflammatory response and mesenteric reperfusion were evaluated. Subgroup analysis and cost-assessment were performed. No significant difference of demographics and illness severity at baseline were found. The rates of TPN for ≥6 months (7.4% vs. 18.2%, P mesenteric infarction (n = 101), EN was associated with earlier bowel continuity restoration (P mesenteric flow. For recanalised AMI patients, EN starting within the first week represents a favourable alternative to TPN. A multicentre randomised controlled trial with high level of evidence is warranted in the future. Acute mesenteric ischaemia (AMI) is a catastrophic abdominal vascular emergency in the surgical intensive care unit (ICU), and the mortality of AMI remains unchanged despite significant progress of endovascular techniques. A multidisciplinary and multimodal management approach of AMI in the ICU has been recently proposed to improve patient's survival and prevent the intestinal failure. Post-recanalisation nutrition therapy may significantly improve the overall survival of AMI patients is quite underemphasised in the ICU. Definitive data comparing EN with TPN for this patient population are very lacking. This study provides the clinical data to suggest that early EN starting after ICU admission represents a favourable alternative to TPN for recanalised AMI patients. The nutrition therapy protocol in the ICU for this special cohort needs to be updated with

  14. The model for the calculation of the dispersed iron ore resource purchase cost in the world class manufacturing (WCM logistics pillar context

    Directory of Open Access Journals (Sweden)

    M. Dudek

    2014-10-01

    Full Text Available In the blast-furnace production, raw materials may account for approx. 50 % of the pig-iron manufacture costs. Therefore, any, even small, saving in the sphere of raw material purchasing will translate into the reduction in the cost of the pig-iron manufacture. The selection of appropriate supply sources and the associated raw material quality influencing the economic viability of the charge blend constitutes a multi-faceted optimization task. The paper presents a modified model for production cost estimation at the moment of making raw material purchasing, which is possible to be used in the logistics pillar of the WCM concept.

  15. Launch Vehicle Production and Operations Cost Metrics

    Science.gov (United States)

    Watson, Michael D.; Neeley, James R.; Blackburn, Ruby F.

    2014-01-01

    Traditionally, launch vehicle cost has been evaluated based on $/Kg to orbit. This metric is calculated based on assumptions not typically met by a specific mission. These assumptions include the specified orbit whether Low Earth Orbit (LEO), Geostationary Earth Orbit (GEO), or both. The metric also assumes the payload utilizes the full lift mass of the launch vehicle, which is rarely true even with secondary payloads.1,2,3 Other approaches for cost metrics have been evaluated including unit cost of the launch vehicle and an approach to consider the full program production and operations costs.4 Unit cost considers the variable cost of the vehicle and the definition of variable costs are discussed. The full program production and operation costs include both the variable costs and the manufacturing base. This metric also distinguishes operations costs from production costs, including pre-flight operational testing. Operations costs also consider the costs of flight operations, including control center operation and maintenance. Each of these 3 cost metrics show different sensitivities to various aspects of launch vehicle cost drivers. The comparison of these metrics provides the strengths and weaknesses of each yielding an assessment useful for cost metric selection for launch vehicle programs.

  16. Residential, Commercial, and Utility-Scale Photovoltaic (PV) System Prices in the United States: Current Drivers and Cost-Reduction Opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Goodrich, A.; James, T.; Woodhouse, M.

    2012-02-01

    The price of photovoltaic (PV) systems in the United States (i.e., the cost to the system owner) has dropped precipitously in recent years, led by substantial reductions in global PV module prices. However, system cost reductions are not necessarily realized or realized in a timely manner by many customers. Many reasons exist for the apparent disconnects between installation costs, component prices, and system prices; most notable is the impact of fair market value considerations on system prices. To guide policy and research and development strategy decisions, it is necessary to develop a granular perspective on the factors that underlie PV system prices and to eliminate subjective pricing parameters. This report's analysis of the overnight capital costs (cash purchase) paid for PV systems attempts to establish an objective methodology that most closely approximates the book value of PV system assets.

  17. IEA Wind Task 26. Wind Technology, Cost and Performance Trends in Denmark, Germany, Ireland, Norway, the European Union, and the United States. 2007 - 2012

    Energy Technology Data Exchange (ETDEWEB)

    Vitina, Aisma [Ea Energy Analyses, Copenhagen (Denmark); Luers, Silke [Deutsche WindGuard, Varel (Germany); Wallasch, Anna-Kathrin [Deutsche WindGuard, Varel (Germany); Berkhout, Volker [Fraunhofer IWES (Germany); Duffy, Aidan [Dublin Inst. of Technology and Dublin Energy Lab (Ireland); Cleary, Brendan [Dublin Inst. of Technology and Dublin Energy Lab (Ireland); Husabo, Leif I. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Weir, David E. [Norwegian Water Resources and Energy Directorate (NVE), Oslo (Norway); Lacal-Arantegui, Roberto [European Commission, Ispra (Italy). Joint Research Centre; Hand, M. Maureen [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Lantz, Eric [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Belyeu, Kathy [Belyeu Consulting, Tacoma Park, MD (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bolinger, Mark [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoen, Ben [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-12

    This report builds from a similar previous analysis (Schwabe et al., 2011) exploring the differences in cost of wind energy in 2008 among countries participating in IEA Wind Task 26 at that time. The levelized cost of energy (LCOE) is a widely recognized metric for understanding how technology, capital investment, operations, and financing impact the life-cycle cost of building and operating a wind plant. Schwabe et al. (2011) apply a spreadsheet-based cash flow model developed by the Energy Research Centre of the Netherlands (ECN) to estimate LCOE. This model is a detailed, discounted cash flow model used to represent the various cost structures in each of the participating countries from the perspective of a financial investor in a domestic wind energy project. This model is used for the present analysis as well, and comparisons are made for those countries who contributed to both reports, Denmark, Germany, and the United States.

  18. Cost-Benefit Analysis of Nanoparticle Albumin-Bound Paclitaxel versus Solvent-Based Paclitaxel for the Treatment of Metastatic Breast Cancer in the United States

    Science.gov (United States)

    Vichansavakul, Kittaya

    had some limitations because they were conducted from a narrow perspective such as payer and provider point of views. The studies also considered only direct costs in their analysis. In fact, conducting economic evaluations from a narrow perspective and leaving out indirect costs might undermine the true benefit of the interventions for society. A cost-benefit analysis measures all costs and benefits in monetary units. It incorporates both health outcomes gained from individuals and the value gained to society in order to maximize the usage of resources effectively. This thesis conducted a cost-benefit analysis to compare nab-paclitaxel and generic paclitaxel in treating metastatic breast cancer from a societal perspective in the United States. The results showed that nab-paclitaxel is a cost-benefit strategy regardless of the different costs and benefits due to the extra 3 years of living it provides. In all models, when nab-paclitaxel was compared to generic paclitaxel, nab-paclitaxel showed cost-benefit to society. However, the results of generic paclitaxel were dependent on the total medical costs. Performing a cost-benefit analysis of nab-paclitaxel from a societal perspective is important to understand the true benefit of interventions. Furthermore, considering both direct and indirect costs, as well as benefits, of this drug is vital because the economic profile of nab-paclitaxel would be improved.

  19. Modeling the fiscal costs and benefits of alternative treatment strategies in the United Kingdom for chronic hepatitis C.

    Science.gov (United States)

    Connolly, Mark P; Kotsopoulos, Nikos; Ustianowski, Andrew

    2018-01-01

    Hepatitis C (HCV) infection causes substantial direct health costs, but also impacts broader societal and governmental costs, such as tax revenue and social protection benefits. This study investigated the broader fiscal costs and benefits of curative interventions for chronic Hepatitis C (CHC) that allow individuals to avoid long-term HCV attributed health conditions. A prospective cohort model, assessing the long-term fiscal consequences of policy decisions, was developed for HCV infected individuals, following the generational accounting analytic framework that combines age-specific lifetime gross taxes paid and governmental transfers received (i.e. healthcare and social support costs). The analysis assessed the burden of a theoretical cohort of untreated HCV infected patients with the alternative of treating these patients with a highly efficacious curative intervention (ledipasvir/sofosbuvir [LDV/SOF]). It also compared treating patients at all fibrosis stages (Stages F0-F4) compared to late treatment (Stage F4). Based on projected lifetime work activity and taxes paid, the treated cohort paid an additional £5,900 per patient compared to the untreated cohort. Lifetime government disability costs of £97,555 and £125,359 per patient for treated cohort vs no treatment cohort were estimated, respectively. Lifetime direct healthcare costs in the treated cohort were £32,235, compared to non-treated cohort of £26,424, with an incremental healthcare costs increase of £5,901 per patient. The benefit cost ratio (BCR) of total government benefits and savings relative to government treatment costs (including LDV/SOF) ranged from 1.8-5.6. Treating patients early resulted in 77% less disability costs, 43% lower healthcare costs, and 33% higher tax revenue. The ability to cure Hepatitis C offers considerable fiscal benefits beyond direct medical costs and savings attributed to reduced disability costs, public allowances, and improved tax revenue. Changes in parameters

  20. Calculation of economic viability of alternative energy sources considering its environmental costs for small communities of Northeast Brazil; Calculo de viabilidade economica de fontes alternativas de energia considerando seus custos ambientais para pequenas comuidades da regiao nordeste brasileira

    Energy Technology Data Exchange (ETDEWEB)

    Stecher, Luiza Chourkalo

    2014-09-01

    There has been an increasing concern about current environmental issues caused by human activity, as the world searches for development. The production of electricity is an extremely relevant factor in this scenario since it is responsible for a large portion of the emissions that cause the greenhouse effect. Due to this fact, a sustainable development with alternative energy sources, which are attractive for such purpose, must be proposed, especially in places that are not supplied by the conventional electricity grid such as many communities in the Northeast Brazil. This work aims to calculate the environmental cost for the alternative sources of energy - solar, wind and biomass - during electricity generation, and to estimate the economic feasibility of those sources in small communities of Northeast Brazil, considering the avoided costs. The externalities must be properly identified and valued so the costs or benefits can be internalized and reflect accurately the economic feasibility or infeasibility of those sources. For this, the method of avoided costs was adopted for the calculation of externalities. This variable was included in the equation developed for all considered alternative energy sources. The calculations of economic feasibility were performed taking the new configurations in consideration, and the new equation was reprogrammed in the Programa de Calculo de Custos de Energias Alternativas, Solar, Eolica e Biomassa (PEASEB). The results demonstrated that the solar photovoltaic energy in isolated systems is the most feasible and broadly applicable source for small communities of Northeast Brazil. (author)

  1. High-Cost Sarcoidosis Patients in the United States: Patient Characteristics and Patterns of Health Care Resource Utilization.

    Science.gov (United States)

    Rice, J Bradford; White, Alan; Lopez, Andrea; Nelson, Winnie W

    2017-12-01

    Sarcoidosis is a multisystem inflammatory disorder characterized by the presence of noncaseating granulomas in involved organs. Prior research has found that sarcoidosis imposes a significant economic burden to U.S. payers. However, the drivers of high health care costs among sarcoidosis patients are unknown. To characterize sarcoidosis patients who were among the top 20% of total health care costs. Patients with a first diagnosis of sarcoidosis between January 1, 1998, and March 31, 2015 (index date) were selected from a deidentified privately insured administrative claims database. Study patients must have at least 12 months of continuous health plan enrollment prior to the index date. High-cost patients were those in the top 20% of total health care costs during the 12 months following the index date (follow-up period), and the remaining patients were classified as lower-cost patients. Patient characteristics, comorbidities, health care resource use, and health care costs in the study period were compared between the high-cost and lower-cost patients. Multiple logistic regression was used to assess the relationship between patient characteristics and being a high-cost sarcoidosis patient. A total of 7,173 sarcoidosis patients met the selection criteria. The 20% of patients classified as high-cost patients accounted for approximately 72% of the total health care costs in the 12-month follow-up period. Compared with lower-cost patients, high-cost patients were slightly older (50.6 vs. 49.1 years) and had a higher comorbidity burden at baseline (Charlson Comorbidity Index = 1.8 vs. 0.7). Mean annual total health care cost for high-cost sarcoidosis patients was 10 times that of their lower-cost counterparts ($73,345 vs. $7,073). Mean annual health care cost was $119,878 for patients in the 95th-99th percentile and $375,436 for patients in the top 1% of spend. High-cost patients had greater medical resource use and costs across all places of service (i.e., inpatient

  2. Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit.

    Science.gov (United States)

    Pagès, Arnaud; Iriart, Xavier; Molinier, Laurent; Georges, Bernard; Berry, Antoine; Massip, Patrice; Juillard-Condat, Blandine

    2017-12-01

    Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture. To perform a cost-effectiveness analysis of the combination of several diagnostic and therapeutic strategies to manage Candida peritonitis in non-neutropenic adult patients in ICUs. We constructed a decision tree model to evaluate the cost effectiveness. Cost and effectiveness were taken into account in a 1-year time horizon and from the French National Health Insurance perspective. Six strategies were compared: fluconazole or echinocandin as an empirical therapy, plus diagnosis by fungal culture or detection by PCR of all Candida species, or use of PCR to detect most fluconazole-resistant Candida species (i.e., Candida krusei and Candida glabrata). The use of fluconazole empirical treatment and PCR to detect all Candida species is more cost effective than using fluconazole empirical treatment without PCR (incremental cost-effectiveness ratio of €40,055/quality-adjusted life-year). Empirical treatment with echinocandin plus PCR to detect C. krusei and C. glabrata is the most effective strategy, but has an incremental cost-effectiveness ratio of €93,776/quality-adjusted life-year. If the cost of echinocandin decreases, then strategies involving PCR plus empirical echinocandin become more cost-effective. Detection by PCR of all Candida species and of most fluconazole-resistant Candida species could improve the cost-effectiveness of fluconazole and echinocandin given to non-neutropenic patients with suspected peritoneal candidiasis in ICUs. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  3. Evaluating the Economic Impact of Palliative and End-of-Life Care Interventions on Intensive Care Unit Utilization and Costs from the Hospital and Healthcare System Perspective.

    Science.gov (United States)

    Khandelwal, Nita; Brumback, Lyndia C; Halpern, Scott D; Coe, Norma B; Brumback, Babette; Curtis, J Randall

    2017-12-01

    Purpose of report: Understanding the impact of palliative care interventions on intensive care unit (ICU) costs and utilization is critical for demonstrating the value of palliative care. Performing these economic assessments, however, can be challenging. The purpose of this special report is to highlight and discuss important considerations when assessing ICU utilization and costs from the hospital perspective, with the goal of providing recommendations on methods to consider for future analyses. ICU length of stay (LOS) and associated costs of care are common and important outcome measures, but must be analyzed properly to yield valid conclusions. There is significant variation in costs by day of stay in the ICU with only modest differences between an ICU day at the end of a stay and the first day on the acute care floor; this variation must be appropriately accounted for analytically. Furthermore, reporting direct variable costs, in addition to total ICU costs, is needed to understand short-term and long-term impact of a reduction in LOS. Importantly, incentives for the hospital to realize savings vary depending on reimbursement policies. ICU utilization and costs are common outcomes in studies evaluating palliative care interventions. Accurate estimation and interpretation are key to understanding the economic implications of palliative care interventions.

  4. The Cost of Health Service Waste Management of (HSWM: A Case Study of Intensive Care Unit of Infectious Diseases at a Public Hospital in São Paulo.

    Directory of Open Access Journals (Sweden)

    Chennyfer Dobbins Paes da Rosa

    2015-08-01

    Full Text Available The Health Service Waste Management is a set of technical and legal procedures for waste management in any type of health facilities. It is known about the limited resources, so reducing environmental costs can contribute to the management of hospital costs. The objective was to estimate the cost of the phases of HSWM to the Intensive Care Unit for public service. Data collecting was done through a script of questions and observations on site at the Emilio Ribas Infectious Diseases Institute in Sao Paulo. The ABC costing method was used. The most costly step was wrapping (40.68%, followed by segregation (40.17%, which is justified by both being associated with health workers’ salaries. The daily cost of the management of health care waste from segregation to final disposal in the ICU was R$ 4,288.81 a day, being R$ 314.80/bed-patient/day. To know the cost of an activity allows for the analysis of strategies for price negotiation. Health care waste is little remembered when pricing a daily ICU, many managers believe this value to be irrelevant; but< if not measured, it may bring losses to the institution.

  5. Calculation of additional costs in 2010 - for the demolition of the Swedish nuclear power plants and disposal of residues; Beraekning av merkostnader 2010 - foer rivning av de svenska kaernkraftsverken och omhaendertagande av restprodukter

    Energy Technology Data Exchange (ETDEWEB)

    Brewitz, Erica; Schoultz, Christian; Wetzel, Carina

    2010-09-15

    This report describes the SSM's calculation of additional costs for fee proposal for 2012-2014. The calculation is made pursuant to the Financing Act and includes all additional costs until the residue from the Swedish nuclear power plants is disposed of. According to current calculations, this should be done in 2069. Estimates of such a long time means a great deal of uncertainty and SSM uses, like SKB, the successive calculation method to estimate an expected value and tax association uncertainty. As a starting point for analysis, the SSM has made estimates of the future costs broken down into paragraphs in paragraph 2 Financing Act. The estimates were made after discussions within the organization and representatives of relevant external organizations. Assuming a total annual cost per worker of 1.24 million gave these estimates a total cost of over three billion. It should be emphasized that this sum is only a starting point for analysis and applies in particular circumstances. These circumstances critically reviewed the analysis and the reasonableness of assessments made by a analysis group. The analysis took place for 2.5 days in spring 2010. The analysis group consisted of 17 people including nine from the SSM. Lores Borg and Steen Lichtenberg were moderators. Via a brainstorming process, the analysis group presented a number of uncertainties and made a three-part assessment of their impact on the overall results (minimum, most likely and maximum). The result of the analysis: average in the 2010 monetary value was assessed to 4.24 billion Swedish crowns with a standard deviation of 920 million Swedish crowns. These values are undiscounted

  6. Determination of MEPRS Direct Care Costs for Selected Ambulatory Professional Services and a Comparison to Similar CHAMPUS Care Costs for the United States Army, Health Services Command Hospitals.

    Science.gov (United States)

    1991-06-05

    author obtained the MEPRS Permanent Computation Results ( PCOM ) file. This file summarizes the raw data located on the Permanent Input Data (PIND...file. The PCOM steps down MEPRS data and DETERMINATION AND COMPARISON OF COSTS 21 determines expense allocations for the MEPRS accounts. SAS data sets...were again developed for each of the eight specialties selected from the TCSDP. Three expense fields exist in the PCOM and were transferred into a

  7. [Costs of the influenza pandemic for the public health services - calculations based on the model of the metropolitan region Frankfurt am Main].

    Science.gov (United States)

    Gottschalk, R; Bellinger, O; Stadthagen, S; Götsch, U; Cress, M; Diel, R

    2011-11-01

    The influenza pandemic of 2009 has been the biggest challenge to the public health services in post-war Germany. This study investigates the impact on the overall costs for the public health authorities of the metropolitan region Frankfurt am Main which arose in the context of the pandemic as well as the specific costs of the implementation and realisation of the vaccination campaign during the pandemic. In 2009 the incremental costs for the Health Protection Authority of the City of Frankfurt am Main for the prevention and logistics caused by this pandemic amounted to € 223,537.91, whereas costs which could be directly attributed to the vaccination campaign (vaccine not included amounted to only a fraction thereof (€ 45,401.48). The per-capita costs for vaccinated citizens were € 10.66.  These results clearly demonstrate the importance of adequate financial resources for the public health authorities to cope with infectious disease outbreaks and future pandemics. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Propuesta de metodología para el cálculo del costo del No Mantenimiento // Methodology proposal for the calculation of the non maintenance cost.

    Directory of Open Access Journals (Sweden)

    O. Fabelo-García

    2009-01-01

    Full Text Available Si tan importante es el control de los costos del mantenimiento, es también el determinar loscostos provocados por acciones deficientes en el mismo por cualquier causa que este lo provoque,a fin de ser considerado en los análisis de la gestión del mantenimiento y por consecuencia en lagestión empresarial.En la revisión de la literatura sobre este último tema, no se ha encontrado un método que permitaal menos controlar estos costos, por lo que en este trabajo se analizarán una serie de elementos,con el objetivo de determinar los costos que están asociados al no mantenimiento y a partir deellos, evaluar el comportamiento del mismo.Palabras claves: mantenimiento, costo._____________________________________________________________________________AbstractThe cost control of maintenance is as important as the determination of the costs caused byinadequate maintenance actions. These should be considered in the maintenance managementanalysis, and consequently in business management.Reviewing literature related to the topic is clear that it hasn’t been found a method that allows, atleast, to control these costs. That’s why, in this research some elements will be analysed todetermine the costs associated to the non maintenance, and from that point on, to evaluate theirbehaviour.Key words: Maintenance, cost

  9. Comparison of alterations in frequency and cost of antibiotic use in neonatal and pediatric intensive care units of a hospital following protocol to an education and research hospital

    Directory of Open Access Journals (Sweden)

    Mustafa Dogan

    2015-04-01

    Full Text Available AiM: The objective of this study is to show the alterations in frequency and cost of antibiotic use in neonatal and pediatric intensive care units of a state hospital after it started to service as an education and research hospital. We also aimed to raise an awareness related to rational antibiotic use. METHODS: The surveillance of antibiotic use and comparison of costs were evaluated in 392 patients in between August 2013-January 2014. The rate and cost of antibiotic use during last 90 days before the protocol of state hospital to research and education hospital and the first 90 days after protocol were evaluated. Antibiotics were assessed according to the treatment protocols of the Committee of Rational Drug Use, Infection Control Committee and Antibiotic Control Committee. Antibiotics were provided from administrative system and the data related to costs were obtained from Ministry of Health and Ministry of Finance. The demographic data and the data related to indication for admission to intensive care units, antibiotic dosages and pathogens causing infections were also obtained. For statistical analysis, SPSS program was used and descriptive analysis were made. In comparison of the groups, Mann Whitney U and chi-square tests were used. The data were evaluated within a 95% confidence interval. RESULTS: In first and second period, 143 patients were hospitalized for 3.18+/-1.13 days and 105 patients were hospitalized for 2.69+/-4.14 days in pediatric intensive care unit(PICU; 79 patients were hospitalized for 17.29+/-3.61 days and 65 patients stayed for 21.29+/-3.29 days in neonatal intensive care unit(NICU, respectively. In the first and second period, cost of antibiotics in PICU was found 341.81+/-744.49 (med:14.91 and 585.35+/-796.62 (med:256.44 (p=0.02 Turkish Liras (TL; in NICU 137.92+/-178.78 (med:14.59 and 247.40+/-370.13(med:19.23 (p=0.76 TL respectively. CONCLUSiON: In the second period, in PICU, duration of hospitalization was found

  10. EURISOL-DS multi-MW target unit: Neutronics performance and shielding assessment, dose rate and material activation calculations for the MAFF configuration

    CERN Document Server

    Romanets, Y; Kadi, Y; Luis, R; Goncalves, I F; Tecchio, L; Kharoua, C; Vaz, P; Ene, D; David, J C; Rocca, R; Negoita, F

    2010-01-01

    One of the objectives of the EURISOL (EURopean Isotope Separation On-Line Radioactive Ion Beam) Design Study consisted of providing a safe and reliable facility layout and design for the following operational parameters and characteristics: (a) a 4 MW proton beam of 1 GeV energy impinging on a mercury target (the converter); (b) high neutron fluxes (similar to 3 x 10(16) neutrons/s) generated by spallation reactions of the protons impinging in the converter and (c) fission rate on fissile U-235 targets in excess of 10(15) fissions/s. In this work, the state-of-the-art Monte Carlo codes MCNPX (Pelowitz, 2005) and FLUKA (Vlachoudis, 2009; Ferrari et al., 2008) were used to characterize the neutronics performance and to perform the shielding assessment (Herrera-Martinez and Kadi, 2006; Cornell, 2003) of the EURISOLTarget Unit and to provide estimations of dose rate and activation of different components, in view of the radiation safety assessment of the facility. Dosimetry and activation calculations were perfor...

  11. Indirect costs in chronic obstructive pulmonary disease: a review of the economic burden on employers and individuals in the United States.

    Science.gov (United States)

    Patel, Jeetvan G; Nagar, Saurabh P; Dalal, Anand A

    2014-01-01

    To review and summarize existing literature on the indirect burden of chronic obstructive pulmonary disease (COPD) in the US. Medline, Scopus, and OvidSP databases were searched using defined search terms to identify relevant studies. Eligible studies were published in English between January 2000 and April 2012 and calculated the indirect burden of COPD in a US population in terms of prevalence, incidence or costs of productivity loss, disability, morbidity, or mortality. Of 53 studies identified, eleven met eligibility criteria, with data years spanning 1987-2009. Estimates of workforce participation range from 56% to 69% among individuals with COPD and from 65% to 77% among individuals without COPD. Approximately 13%-18% of those with COPD are limited in the amount or type of work they can do and one-third or more experience general activity limitation. Estimates of restricted activity days range from 27-63 days per year. Estimates of mean annual sick leave and/or disability days among employed individuals with COPD range from 1.3-19.4 days. Estimates of bed confinement range from 13-32 days per year. Estimated mean annual indirect costs were $893-$2,234/person (US dollars) with COPD ($1,521-$3,348 in 2010 [US dollars]) and varied with the population studied, specific cost outcomes, and economic inputs. In studies that assessed total (direct and indirect) costs, indirect costs accounted for 27%-61% of total costs, depending on the population studied. COPD is associated with substantial indirect costs. The disease places a burden on employers in terms of lost productivity and associated costs and on individuals in terms of lost income related to absenteeism, activity limitation, and disability. Consideration of indirect as well as direct costs is necessary to gain a more complete view of the societal burden of COPD.

  12. Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit.

    Science.gov (United States)

    Axente, Carmen; Licker, Monica; Moldovan, Roxana; Hogea, Elena; Muntean, Delia; Horhat, Florin; Bedreag, Ovidiu; Sandesc, Dorel; Papurica, Marius; Dugaesescu, Dorina; Voicu, Mirela; Baditoiu, Luminita

    2017-05-22

    Due to the vulnerable nature of its patients, the wide use of invasive devices and broad-spectrum antimicrobials used, the intensive care unit (ICU) is often called the epicentre of infections. In the present study, we quantified the burden of hospital acquired pathology in a Romanian university hospital ICU, represented by antimicrobial agents consumption, costs and local resistance patterns, in order to identify multimodal interventional strategies. Between 1(st) January 2012 and 31(st) December 2013, a prospective study was conducted in the largest ICU of Western Romania. The study group was divided into four sub-samples: patients who only received prophylactic antibiotherapy, those with community-acquired infections, patients who developed hospital acquired infections and patients with community acquired infections complicated by hospital-acquired infections. The statistical analysis was performed using the EpiInfo version 3.5.4 and SPSS version 20. A total of 1596 subjects were enrolled in the study and the recorded consumption of antimicrobial agents was 1172.40 DDD/ 1000 patient-days. The presence of hospital acquired infections doubled the length of stay (6.70 days for patients with community-acquired infections versus 16.06/14.08 days for those with hospital-acquired infections), the number of antimicrobial treatment days (5.47 in sub-sample II versus 11.18/12.13 in sub-samples III/IV) and they increased by 4 times compared to uninfected patients. The perioperative prophylactic antibiotic treatment had an average length duration of 2.78 while the empirical antimicrobial therapy was 3.96 days in sample II and 4.75/4.85 days for the patients with hospital-acquired infections. The incidence density of resistant strains was 8.27/1000 patient-days for methicilin resistant Staphylococcus aureus, 7.88 for extended spectrum β-lactamase producing Klebsiella pneumoniae and 4.68/1000 patient-days for multidrug resistant Acinetobacter baumannii. Some of the most

  13. The Social Cost of Trading: Measuring the Increased Damages from Sulfur Dioxide Trading in the United States

    Science.gov (United States)

    Henry, David D., III; Muller, Nicholas Z.; Mendelsohn, Robert O.

    2011-01-01

    The sulfur dioxide (SO[subscript 2]) cap and trade program established in the 1990 Clean Air Act Amendments is celebrated for reducing abatement costs ($0.7 to $2.1 billion per year) by allowing emissions allowances to be traded. Unfortunately, places with high marginal costs also tend to have high marginal damages. Ton-for-ton trading reduces…

  14. A Cost-Effectiveness Analysis of First Trimester Non-Invasive Prenatal Screening for Fetal Trisomies in the United States.

    Directory of Open Access Journals (Sweden)

    Brandon S Walker

    Full Text Available Non-invasive prenatal testing (NIPT is a relatively new technology for diagnosis of fetal aneuploidies. NIPT is more accurate than conventional maternal serum screening (MSS but is also more costly. Contingent NIPT may provide a cost-effective alternative to universal NIPT screening. Contingent screening used a two-stage process in which risk is assessed by MSS in the first stage and, based on a risk cutoff, high-risk pregnancies are referred for NIPT. The objective of this study was to (1 determine the optimum MSS risk cutoff for contingent NIPT and (2 compare the cost effectiveness of optimized contingent NIPT to universal NIPT and conventional MSS.Decision-analytic model using micro-simulation and probabilistic sensitivity analysis. We evaluated cost effectiveness from three perspectives: societal, governmental, and payer.From a societal perspective, universal NIPT dominated both contingent NIPT and MSS. From a government and payer perspective, contingent NIPT dominated MSS. Compared to contingent NIPT, adopting a universal NIPT would cost $203,088 for each additional case detected from a government perspective and $263,922 for each additional case detected from a payer perspective.From a societal perspective, universal NIPT is a cost-effective alternative to MSS and contingent NIPT. When viewed from narrower perspectives, contingent NIPT is less costly than universal NIPT and provides a cost-effective alternative to MSS.

  15. A Cost-Effectiveness Analysis of First Trimester Non-Invasive Prenatal Screening for Fetal Trisomies in the United States

    Science.gov (United States)

    Walker, Brandon S.; Nelson, Richard E.; Jackson, Brian R.; Grenache, David G.; Ashwood, Edward R.; Schmidt, Robert L.

    2015-01-01

    Background Non-invasive prenatal testing (NIPT) is a relatively new technology for diagnosis of fetal aneuploidies. NIPT is more accurate than conventional maternal serum screening (MSS) but is also more costly. Contingent NIPT may provide a cost-effective alternative to universal NIPT screening. Contingent screening used a two-stage process in which risk is assessed by MSS in the first stage and, based on a risk cutoff, high-risk pregnancies are referred for NIPT. The objective of this study was to (1) determine the optimum MSS risk cutoff for contingent NIPT and (2) compare the cost effectiveness of optimized contingent NIPT to universal NIPT and conventional MSS. Study Design Decision-analytic model using micro-simulation and probabilistic sensitivity analysis. We evaluated cost effectiveness from three perspectives: societal, governmental, and payer. Results From a societal perspective, universal NIPT dominated both contingent NIPT and MSS. From a government and payer perspective, contingent NIPT dominated MSS. Compared to contingent NIPT, adopting a universal NIPT would cost $203,088 for each additional case detected from a government perspective and $263,922 for each additional case detected from a payer perspective. Conclusions From a societal perspective, universal NIPT is a cost-effective alternative to MSS and contingent NIPT. When viewed from narrower perspectives, contingent NIPT is less costly than universal NIPT and provides a cost-effective alternative to MSS. PMID:26133556

  16. Management of acute kidney injury in the intensive care unit: a cost-effectiveness analysis of daily vs alternate-day hemodialysis.

    Science.gov (United States)

    Desai, Amar A; Baras, Jacqueline; Berk, Benjamin B; Nakajima, Aya; Garber, Alan M; Owens, Douglas; Chertow, Glenn M

    2008-09-08

    Although evidence suggests that a higher hemodialysis dose and/or frequency may be associated with improved outcomes, the cost-effectiveness of a daily hemodialysis strategy for critically ill patients with acute kidney injury (AKI) is unknown. We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of daily hemodialysis, compared with alternate-day hemodialysis, for patients with AKI in the intensive care unit (ICU). We employed a societal perspective with a lifetime analytic time horizon. We modeled the efficacy of daily hemodialysis as a reduction in the relative risk of death on the basis of data reported in the 2004 clinical trial published by Schiffl et al. We performed 1- and 2-way sensitivity analyses across cost, efficacy, and utility input variables. The main outcome measure was cost per quality-adjusted life-year (QALY). In the base case for a 60-year-old man, daily hemodialysis was projected to add 2.14 QALYs and $10,924 in cost. We found that the cost-effectiveness of daily hemodialysis compared with alternate-day hemodialysis was $5084 per QALY gained. The incremental cost-effectiveness ratio became less favorable (>$50,000 per QALY gained) when the maintenance hemodialysis rate of the daily hemodialysis group was varied to more than 27% and when the difference in 14-day postdischarge mortality between the alternatives was varied to less than 0.5%. Daily hemodialysis is a cost-effective strategy compared with alternate-day hemodialysis for patients with severe AKI in the ICU.

  17. Integrating the Carbon and Water Footprints’ Costs in the Water Framework Directive 2000/60/EC Full Water Cost Recovery Concept: Basic Principles Towards Their Reliable Calculation and Socially Just Allocation

    Directory of Open Access Journals (Sweden)

    Anastasia Papadopoulou

    2012-01-01

    Full Text Available This paper presents the basic principles for the integration of the water and carbon footprints cost into the resource and environmental costs respectively, taking the suggestions set by the Water Framework Directive (WFD 2000/60/EC one step forward. WFD states that full water cost recovery (FWCR should be based on the estimation of the three sub-costs related: direct; environmental; and resource cost. It also strongly suggests the EU Member States develop and apply effective water pricing policies to achieve FWCR. These policies must be socially just to avoid any social injustice phenomena. This is a very delicate task to handle, especially within the fragile economic conditions that the EU is facing today. Water losses play a crucial role for the FWC estimation. Water losses should not be neglected since they are one of the major “water uses” in any water supply network. A methodology is suggested to reduce water losses and the related Non Revenue Water (NRW index. An Expert Decision Support System is proposed to assess the FWC incorporating the Water and Carbon Footprint costs.

  18. Cost-Effectiveness of Home Energy Retrofits in Pre-Code Vintage Homes in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Fairey, P.; Parker, D.

    2012-11-01

    This analytical study examines the opportunities for cost-effective energy efficiency and renewable energy retrofits in residential archetypes constructed prior to 1980 (Pre-Code) in fourteen U.S. cities. These fourteen cities are representative of each of the International Energy Conservation Code (IECC) climate zones in the contiguous U.S. The analysis is conducted using an in-house version of EnergyGauge USA v.2.8.05 named CostOpt that has been programmed to perform iterative, incremental economic optimization on a large list of residential energy efficiency and renewable energy retrofit measures. The principle objectives of the study are as follows: to determine the opportunities for cost effective source energy reductions in this large cohort of existing residential building stock as a function of local climate and energy costs; and to examine how retrofit financing alternatives impact the source energy reductions that are cost effectively achievable.

  19. The estimated economic burden of genital herpes in the United States. An analysis using two costing approaches

    Directory of Open Access Journals (Sweden)

    Fisman David N

    2001-06-01

    Full Text Available Abstract Background Only limited data exist on the costs of genital herpes (GH in the USA. We estimated the economic burden of GH in the USA using two different costing approaches. Methods The first approach was a cross-sectional survey of a sample of primary and secondary care physicians, analyzing health care resource utilization. The second approach was based on the analysis of a large administrative claims data set. Both approaches were used to generate the number of patients with symptomatic GH seeking medical treatment, the average medical expenditures and estimated national costs. Costs were valued from a societal and a third party payer's perspective in 1996 US dollars. Results In the cross-sectional study, based on an estimated 3.1 million symptomatic episodes per year in the USA, the annual direct medical costs were estimated at a maximum of $984 million. Of these costs, 49.7% were caused by drug expenditures, 47.7% by outpatient medical care and 2.6% by hospital costs. Indirect costs accounted for further $214 million. The analysis of 1,565 GH cases from the claims database yielded a minimum national estimate of $283 million direct medical costs. Conclusions GH appears to be an important public health problem from the health economic point of view. The observed difference in direct medical costs may be explained with the influence of compliance to treatment and possible undersampling of subpopulations in the claims data set. The present study demonstrates the validity of using different approaches in estimating the economic burden of a specific disease to the health care system.

  20. Economical analysis and study on a solar desalination unit

    DEFF Research Database (Denmark)

    Based on the calculation of the single-factor impact values of the parameters of a triple tower-type solar desalination unit on the cost of fresh water production by utilizing a single-factor analyzing method, the influences of the cost of solar heating system, the cost of hot water tank, the cos...

  1. Cost-Effectiveness of Helicopter Versus Ground Emergency Medical Services for Trauma Scene Transport in the United States

    Science.gov (United States)

    Delgado, M. Kit; Staudenmayer, Kristan L.; Wang, N. Ewen; Spain, David A.; Weir, Sharada; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

    2014-01-01

    Objective We determined the minimum mortality reduction that helicopter emergency medical services (HEMS) should provide relative to ground EMS for the scene transport of trauma victims to offset higher costs, inherent transport risks, and inevitable overtriage of minor injury patients. Methods We developed a decision-analytic model to compare the costs and outcomes of helicopter versus ground EMS transport to a trauma center from a societal perspective over a patient's lifetime. We determined the mortality reduction needed to make helicopter transport cost less than $100,000 and $50,000 per quality adjusted life year (QALY) gained compared to ground EMS. Model inputs were derived from the National Study on the Costs and Outcomes of Trauma (NSCOT), National Trauma Data Bank, Medicare reimbursements, and literature. We assessed robustness with probabilistic sensitivity analyses. Results HEMS must provide a minimum of a 17% relative risk reduction in mortality (1.6 lives saved/100 patients with the mean characteristics of the NSCOT cohort) to cost less than $100,000 per QALY gained and a reduction of at least 33% (3.7 lives saved/100 patients) to cost less than $50,000 per QALY. HEMS becomes more cost-effective with significant reductions in minor injury patients triaged to air transport or if long-term disability outcomes are improved. Conclusions HEMS needs to provide at least a 17% mortality reduction or a measurable improvement in long-term disability to compare favorably to other interventions considered cost-effective. Given current evidence, it is not clear that HEMS achieves this mortality or disability reduction. Reducing overtriage of minor injury patients to HEMS would improve its cost-effectiveness. PMID:23582619

  2. Evaluating the costs of glycemic response with canagliflozin versus dapagliflozin and empagliflozin as add-on to metformin in patients with type 2 diabetes mellitus in the United Arab Emirates.

    Science.gov (United States)

    Schubert, Agata; Buchholt, Anders T; El Khoury, Antoine C; Kamal, Ahmed; Taieb, Vanessa

    2017-06-01

    This study evaluates the cost of achieving glycemic control with three sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin, dapagliflozin, and empagliflozin, in patients with type 2 diabetes mellitus (T2DM) from the payer perspective in the United Arab Emirates (UAE). A systematic literature review identified randomized controlled trials of antihyperglycemic agents as add-on to metformin in patients with T2DM of 26 ± 4 weeks in duration, published by 10 September 2014. A Bayesian network-meta analysis (NMA) compared HbA1c changes with canagliflozin 100 and 300 mg versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg. The cost associated with a 1% placebo-adjusted HbA1c reduction with each SGLT2 inhibitor as add-on to metformin was calculated based on NMA results and UAE drug costs. In the NMA, canagliflozin 100 and 300 mg were associated with HbA1c reductions (-0.67% and -0.79%) compared with dapagliflozin 10 mg (-0.41%) and empagliflozin 10 and 25 mg (-0.57% and -0.64%). Probabilities of canagliflozin 100 mg performing better were 79%, 60%, and 53% versus dapagliflozin 10 mg and empagliflozin 10 and 25 mg, respectively; probabilities for canagliflozin 300 mg performing better were 88%, 72%, and 65%, respectively. The cost per 1%-point reduction in HbA1c was projected to be lower with canagliflozin 100 and 300 mg ($448 and $422) compared with dapagliflozin 10 mg ($785) and empagliflozin 10 and 25 mg ($527 and $563). Canagliflozin may provide a greater glycemic response at a lower effective cost than dapagliflozin or empagliflozin for patients with T2DM inadequately controlled with metformin from the payer perspective in the UAE.

  3. Low cost solar array project: Experimental process system development unit for producing semiconductor-grade silicon using silane-to-silicon process

    Science.gov (United States)

    1980-01-01

    The design, fabrication, and installation of an experimental process system development unit (EPSDU) were analyzed. Supporting research and development were performed to provide an information data base usable for the EPSDU and for technological design and economical analysis for potential scale-up of the process. Iterative economic analyses were conducted for the estimated product cost for the production of semiconductor grade silicon in a facility capable of producing 1000-MT/Yr.

  4. Implementation Costs of an Enhanced Recovery After Surgery Program in the United States: A Financial Model and Sensitivity Analysis Based on Experiences at a Quaternary Academic Medical Center.

    Science.gov (United States)

    Stone, Alexander B; Grant, Michael C; Pio Roda, Claro; Hobson, Deborah; Pawlik, Timothy; Wu, Christopher L; Wick, Elizabeth C

    2016-03-01

    Despite positive results from several international Enhanced Recovery After Surgery (ERAS) protocols, the United States has been slow to adopt ERAS protocols, in part due to concern regarding the expenses of such a program. We sought to evaluate the potential annual net cost savings of implementing a US-based ERAS program. Using data from existing publications and experience with an ERAS program, a model of net financial costs was developed for surgical groups of escalating numbers of annual cases. Our example scenario provided a financial analysis of the implementation of an ERAS program at a United States academic institution based on data from the ERAS Program for Colorectal Surgery at The Johns Hopkins Hospital. Based on available data from the United States, ERAS programs lead to reductions in lengths of hospital stay that range from 0.7 to 2.7 days and substantial direct cost savings. Using example data from a quaternary hospital, the considerable cost of $552,783 associated with implementation of an ERAS program was offset by even greater savings in the first year of nearly $948,500, yielding a net savings of $395,717. Sensitivity analysis across several caseload and direct cost scenarios yielded similar savings in 20 of the 27 projections. Enhanced Recovery After Surgery protocols have repeatedly led to reduction in length of hospital stay and improved surgical outcomes. A financial model, based on published data and experience, projects that investment in an ERAS program can also lead to net financial savings for US hospitals. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Assessment of activity-based pyroprocess costs for an engineering-scale facility in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sung Ki; Ko, Won Il [Nuclear Fuel Cycle Analysis Department, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Bang, Sung Sig [Dept. of Business and Technology Management, Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2015-12-15

    This study set the pyroprocess facility at an engineering scale as a cost object, and presented the cost consumed during the unit processes of the pyroprocess. For the cost calculation, the activity based costing (ABC) method was used instead of the engineering cost estimation method, which calculates the cost based on the conceptual design of the pyroprocess facility. The calculation results demonstrate that the pyroprocess facility's unit process cost is $194/kgHM for pretreatment, $298/kgHM for electrochemical reduction, $226/kgHM for electrorefining, and $299/kgHM for electrowinning. An analysis demonstrated that the share of each unit process cost among the total pyroprocess cost is as follows: 19% for pretreatment, 29% for electrochemical reduction, 22% for electrorefining, and 30% for electrowinning. The total unit cost of the pyroprocess was calculated at $1,017/kgHM. In the end, electrochemical reduction and the electrowinning process took up most of the cost, and the individual costs for these two processes was found to be similar. This is because significant raw material cost is required for the electrochemical reduction process, which uses platinum as an anode electrode. In addition, significant raw material costs are required, such as for Li3PO4, which is used a lot during the salt purification process.

  6. Assessment of activity-based pyroprocess costs for an engineering-scale facility in Korea

    Directory of Open Access Journals (Sweden)

    Sungki Kim

    2015-12-01

    Full Text Available This study set the pyroprocess facility at an engineering scale as a cost object, and presented the cost consumed during the unit processes of the pyroprocess. For the cost calculation, the activity based costing (ABC method was used instead of the engineering cost estimation method, which calculates the cost based on the conceptual design of the pyroprocess facility. The calculation results demonstrate that the pyroprocess facility's unit process cost is $194/kgHM for pretreatment, $298/kgHM for electrochemical reduction, $226/kgHM for electrorefining, and $299/kgHM for electrowinning. An analysis demonstrated that the share of each unit process cost among the total pyroprocess cost is as follows: 19% for pretreatment, 29% for electrochemical reduction, 22% for electrorefining, and 30% for electrowinning. The total unit cost of the pyroprocess was calculated at $1,017/kgHM. In the end, electrochemical reduction and the electrowinning process took up most of the cost, and the individual costs for these two processes was found to be similar. This is because significant raw material cost is required for the electrochemical reduction process, which uses platinum as an anode electrode. In addition, significant raw material costs are required, such as for Li3PO4, which is used a lot during the salt purification process.

  7. A Compact Energy Harvesting System for Outdoor Wireless Sensor Nodes Based on a Low-Cost In Situ Photovoltaic Panel Characterization-Modelling Unit.

    Science.gov (United States)

    Antolín, Diego; Medrano, Nicolás; Calvo, Belén; Martínez, Pedro A

    2017-08-04

    This paper presents a low-cost high-efficiency solar energy harvesting system to power outdoor wireless sensor nodes. It is based on a Voltage Open Circuit (VOC) algorithm that estimates the open-circuit voltage by means of a multilayer perceptron neural network model trained using local experimental characterization data, which are acquired through a novel low cost characterization system incorporated into the deployed node. Both units-characterization and modelling-are controlled by the same low-cost microcontroller, providing a complete solution which can be understood as a virtual pilot cell, with identical characteristics to those of the specific small solar cell installed on the sensor node, that besides allows an easy adaptation to changes in the actual environmental conditions, panel aging, etc. Experimental comparison to a classical pilot panel based VOC algorithm show better efficiency under the same tested conditions.

  8. The association of willingness-to-pay and patient attributes: a cost-volume-profit analysis of cardiac catheter unit services in Ramallah Hospital, Palestine.

    Science.gov (United States)

    Jabr, Samer F K; Younis, Mustafa Mike Z; Forgione, Dana A

    2009-01-01

    The purpose of this study is to examine the association of willingness-to-pay and patient attributes in relation to the multi-service cost-volume-profit structure of a cardiac catheter unit in Ramallah Hospital. This article contributes to the literature by providing primary evidence on patient willingness-to-pay, by identifying the specific break-even parameters of three hospital cardiac catheter unit service types (diagnosis, balloon, and pacemaker), and by demonstrating the cross-subsidization of patient income groups that is inherent in the existing hospital rate structure. Our results provide information useful for (1) evidence-based policy making with respect to hospital rate setting and cross-subsidies of patient income groups; (2) the advancement of hospital management, by demonstrating the estimated variable and fixed cost parameters and the impact of patient revenue mix on the profitability of cardiac catheter unit services; and (3) the advancement of theory, by documenting the relationship of patient demand and the cost of supply in a multi-patient-group, multi-service hospital setting.

  9. The burden of nosocomial infection in the intensive care unit: Effects on organ failure, mortality and costs. A nested case-control study.

    Science.gov (United States)

    Sánchez-Velázquez, Luis D; Ponce de León Rosales, Samuel; Rangel Frausto, M Sigfrido

    2006-04-01

    Nosocomial infections increase mortality and costs in the intensive care units; however, few studies have addressed organ failure that developed in infected patients and their overall costs. The goal of this study was to measure the frequency of organ failure in nosocomial infection and the mortality and costs of these in critical care areas. This was a nested 1:2 case-control study in a cohort of all consecutively hospitalized patients comparing those with and without nosocomial infections over a year in an institutional intensive care unit (ICU). Those patients who acquired an infection during hospitalization were considered cases. Controls were matched by hospital stay at least as long as the cases' time acquisition of nosocomial infection, age +/-5 years and APACHE II +/-5 points. Forty-three patients developed at least one nosocomial infection event (cases). The matching success was about 94%. Higher frequency and duration of organ failures was observed in the cases, as well as the number of devices and procedures (p nosocomial infection acquired in the ICU was 12,155 dollars. Nosocomial infection acquired in the ICU increases length of stay, frequency and duration of organ failures, mortality, and costs.

  10. Treatment patterns and costs of care for patients with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin in the United States: A retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Shelagh M Szabo

    Full Text Available Although brentuximab vedotin (BV has changed the management of patients with relapsed or refractory Hodgkin lymphoma (RRHL, little information is available on routine clinical practice. We identified treatment patterns and costs of care among RRHL patients in the United States (US treated with BV.A retrospective observational study of adults initiating BV for RRHL from 2011-2015, with ≥6 months of data prior to and following BV initiation, was conducted. Treatments were classified based on dispensations and chemotherapy administration. Median total and monthly costs were estimated based on all-cause healthcare resource use in 2015 US dollars (USD.The cohort comprised 289 patients (59% male; mean age at diagnosis, 42 years with a mean follow-up of 250 weeks. Eleven percent had BV salvage therapy prior to ASCT, and 32% had BV for a relapse post-ASCT. 43% received treatment post-BV, most commonly allogeneic stem cell transplant (SCT and bendamustine (both 10.2%. Median (IQR total costs from BV initiation to censoring were 294,790 (142,110-483,360 USD; and were highest among those treated with BV prior to ASCT (up to 421,900 [300,940-778,970] USD. Median monthly costs were almost 20,000 USD per month, and up to 25,000 USD per month among those with BV and ASCT. Medications were the greatest driver of median monthly costs.Median total all-caus