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Sample records for cost analysis increased

  1. Cost of bariatric surgery and factors associated with increased cost: an analysis of national inpatient sample.

    Science.gov (United States)

    Khorgami, Zhamak; Aminian, Ali; Shoar, Saeed; Andalib, Amin; Saber, Alan A; Schauer, Philip R; Brethauer, Stacy A; Sclabas, Guido M

    2017-08-01

    In the current healthcare environment, bariatric surgery centers need to be cost-effective while maintaining quality. The aim of this study was to evaluate national cost of bariatric surgery to identify the factors associated with a higher cost. A retrospective analysis of 2012-2013 Healthcare Cost and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS). We included all patients with a diagnosis of morbid obesity (ICD9 278.01) and a Diagnosis Related Group code related to procedures for obesity, who underwent Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or adjustable gastric banding (AGB) as their primary procedure. We converted "hospital charges" to "cost," using hospital specific cost-to-charge ratio. Inflation was adjusted using the annual consumer price index. Increased cost was defined as the top 20th percentile of the expenditure and its associated factors were analyzed using the logistic regression multivariate analysis. A total of 45,219 patients (20,966 RYGBs, 22,380 SGs, and 1,873 AGBs) were included. The median (interquartile range) calculated costs for RYGB, SG, and AGB were $12,543 ($9,970-$15,857), $10,531 ($8,248-$13,527), and $9,219 ($7,545-$12,106), respectively (P<.001). Robotic-assisted procedures had the highest impact on the cost (odds ratio 3.6, 95% confidence interval 3.2-4). Hospital cost of RYGB and SG increased linearly with the length of hospital stay and almost doubled after 7 days. Furthermore, multivariate analysis showed that certain co-morbidities and concurrent procedures were associated with an increased cost. Factors contributing to the cost variation of bariatric procedures include co-morbidities, robotic platform, complexity of surgery, and hospital length of stay. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  2. ANALYSIS OF THE INCREASE OF CONSTRUCTION COSTS IN URBAN REGENERATION PROJECTS

    Directory of Open Access Journals (Sweden)

    Magdalena Apollo

    2015-11-01

    Full Text Available The subject of this paper is the analysis and evaluation of the reasons for construction costs increases in urban regeneration projects. The analysis considers major refurbishments of real estates’, as well as heavy repair and modernization of the road system. For the period mentioned, the costs from works and expenditure schedules were compared with the costs of additional works, which shows the percentage cost increase in relation to initial project budget assumptions of the case study. The analysis revealed that due to difficulties in assessing technical state of inhabited buildings, the investor and potential contractor should pay special attention to the character of issues presented in this paper, taking into account an increased risk of their occurrence.

  3. Patient factors associated with increased acute care costs of hip fractures: a detailed analysis of 402 patients.

    Science.gov (United States)

    Aigner, R; Meier Fedeler, T; Eschbach, D; Hack, J; Bliemel, C; Ruchholtz, S; Bücking, B

    2016-12-01

    The aim of the present study was to identify patient factors associated with higher costs in hip fracture patients. The mean costs of a prospectively observed sample of 402 patients were 8853 €. The ASA score, Charlson comorbidity index, and fracture location were associated with increased costs. Fractures of the proximal end of the femur (hip fractures) are of increasing incidence due to demographic changes. Relevant co-morbidities often present in these patients cause high complication rates and prolonged hospital stays, thus leading to high costs of acute care. The aim of this study was to perform a precise cost analysis of the actual hospital costs of hip fractures and to identify patient factors associated with increased costs. The basis of this analysis was a prospectively observed single-center trial, which included 402 patients with fractures of the proximal end of the femur. All potential cost factors were recorded as accurately as possible for each of the 402 patients individually, and statistical analysis was performed to identify associations between pre-existing patient factors and acute care costs. The mean total acute care costs per patient were 8853 ± 5676 € with ward costs (5828 ± 4294 €) and costs for surgical treatment (1972 ± 956 €) representing the major cost factors. The ASA score, Charlson comorbidity index, and fracture location were identified as influencing the costs of acute care for hip fracture treatment. Hip fractures are associated with high acute care costs. This study underlines the necessity of sophisticated risk-adjusted payment models based on specific patient factors. Economic aspects should be an integral part of future hip fracture research due to limited health care resources.

  4. SEARCH COST REDUCTION INCREASES VARIATION IN HOTELS OCCUPANCY RATE: A THEORETICAL AND EMPIRICAL ANALYSIS

    OpenAIRE

    Marianna Succurro; Federico Boffa

    2010-01-01

    This study explores how direct online booking affects the variation in hotel bed-places occupancy rate between peak and off-peak periods, thereby contributing to three strands of literature, respectively the determinants of seasonality, the tourist information acquisition process and the impact of the internet on tourism. The empirical analysis, covering 18 countries over the 1997-2007 period, investigates the impact of an increase in the use of the internet by consumers on the seasonal varia...

  5. Effect of Increased Intensity of Physiotherapy on Patient Outcomes After Stroke: An Economic Literature Review and Cost-Effectiveness Analysis.

    Science.gov (United States)

    Chan, B

    2015-01-01

    Functional improvements have been seen in stroke patients who have received an increased intensity of physiotherapy. This requires additional costs in the form of increased physiotherapist time. The objective of this economic analysis is to determine the cost-effectiveness of increasing the intensity of physiotherapy (duration and/or frequency) during inpatient rehabilitation after stroke, from the perspective of the Ontario Ministry of Health and Long-term Care. The inputs for our economic evaluation were extracted from articles published in peer-reviewed journals and from reports from government sources or the Canadian Stroke Network. Where published data were not available, we sought expert opinion and used inputs based on the experts' estimates. The primary outcome we considered was cost per quality-adjusted life-year (QALY). We also evaluated functional strength training because of its similarities to physiotherapy. We used a 2-state Markov model to evaluate the cost-effectiveness of functional strength training and increased physiotherapy intensity for stroke inpatient rehabilitation. The model had a lifetime timeframe with a 5% annual discount rate. We then used sensitivity analyses to evaluate uncertainty in the model inputs. We found that functional strength training and higher-intensity physiotherapy resulted in lower costs and improved outcomes over a lifetime. However, our sensitivity analyses revealed high levels of uncertainty in the model inputs, and therefore in the results. There is a high level of uncertainty in this analysis due to the uncertainty in model inputs, with some of the major inputs based on expert panel consensus or expert opinion. In addition, the utility outcomes were based on a clinical study conducted in the United Kingdom (i.e., 1 study only, and not in an Ontario or Canadian setting). Functional strength training and higher-intensity physiotherapy may result in lower costs and improved health outcomes. However, these results

  6. Going for increased recycling. A social cost-benefit analysis; Inzetten op meer recycling. Een maatschappelijke kosten-batenanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Warringa, G.E.A.; De Bruyn, M.; Bijleveld, M.M.

    2013-05-15

    While the environmental benefits of scenarios geared to increased recycling have been convincingly demonstrated by previous studies, the question arises whether such scenarios bring economic benefits, too. This study therefore assesses the main economic effects of increased recycling in the Netherlands, providing data that can be used to advance policy development in this area. To address the main issue we performed a social cost-benefit analysis (SCBA), a welfare-theory-based tool that can be used to chart the full range of economic impacts ('welfare impacts') of a project or policy intervention. In doing so, a broad definition of welfare is adopted, encompassing not only financial and economic consequences, but also environmental and employment impacts and so on. Using SimaPro, all the environmental interventions inventoried (including energy consumption, transport and recycling process emissions) were assessed for each individual material flow, with impacts being expressed as far as possible in monetary terms to enable comparison. The main social costs of increased recycling are the higher costs for local authorities associated with separate waste collection. There is also reduced revenue for waste incinerators, because more waste will need to be imported from abroad. Finally, there are the policy costs of incentives for increased recycling and extra efforts to induce citizens to separate their waste. The latter costs were not quantified. Over and against these costs are positive welfare impacts. The main benefits are environmental, expressed monetarily in the present study in terms of avoided damage costs for society as a whole and avoided measures for securing government reduction targets. In addition, the separated waste has a value, reflected in lower processing costs. Increased recycling also creates new jobs, while recycling firms generate more profit than waste incinerators. Finally, there are the benefits accruing from greater innovation and

  7. Going for increased recycling. A social cost-benefit analysis; Inzetten op meer recycling. Een maatschappelijke kosten-batenanalyse

    Energy Technology Data Exchange (ETDEWEB)

    Warringa, G.E.A.; De Bruyn, M.; Bijleveld, M.M.

    2013-05-15

    While the environmental benefits of scenarios geared to increased recycling have been convincingly demonstrated by previous studies, the question arises whether such scenarios bring economic benefits, too. This study therefore assesses the main economic effects of increased recycling in the Netherlands, providing data that can be used to advance policy development in this area. To address the main issue we performed a social cost-benefit analysis (SCBA), a welfare-theory-based tool that can be used to chart the full range of economic impacts ('welfare impacts') of a project or policy intervention. In doing so, a broad definition of welfare is adopted, encompassing not only financial and economic consequences, but also environmental and employment impacts and so on. Using SimaPro, all the environmental interventions inventoried (including energy consumption, transport and recycling process emissions) were assessed for each individual material flow, with impacts being expressed as far as possible in monetary terms to enable comparison. The main social costs of increased recycling are the higher costs for local authorities associated with separate waste collection. There is also reduced revenue for waste incinerators, because more waste will need to be imported from abroad. Finally, there are the policy costs of incentives for increased recycling and extra efforts to induce citizens to separate their waste. The latter costs were not quantified. Over and against these costs are positive welfare impacts. The main benefits are environmental, expressed monetarily in the present study in terms of avoided damage costs for society as a whole and avoided measures for securing government reduction targets. In addition, the separated waste has a value, reflected in lower processing costs. Increased recycling also creates new jobs, while recycling firms generate more profit than waste incinerators. Finally, there are the benefits accruing from greater innovation and

  8. Educational Cost Analysis.

    Science.gov (United States)

    Flynn, Donald L.

    Traditional approaches to the cost analysis of educational programs involve examining annual budgets. Such approaches do not properly consider the cost of either new capital expenditures or the current value of previously purchased items. This paper presents the methodology for a new approach to educational cost analysis that identifies the actual…

  9. [Increasing cost of insulin therapy in Belgium. From a critical analysis of the situation to a search for practical solutions].

    Science.gov (United States)

    Scheen, A J

    2006-09-01

    Cost related to insulin therapy is markedly increasing in Belgium, as in other Eucopean countries. In the present paper, we will briefly analyze the main reasons for such aa increase, integrate such observation withIn the global context of diabetes management and suggest some solutions to provide best care to insulin-treated diabetic patients at a reasonable cost. The rise of the cost of insulin therapy has a multifactorial origin. It mainly results from an increase in the number of diabetic patients, a more intensive management, In both type 1 and type 2 diabetes, and a greater use of more expansive insulin analogues. It is important to analyze the increase of the cost of insulin therapy within the global burden of diabetes melitus. Only a better responsibility of all health care partners, patients, physicians, pharmaceutical companies, public health authorities, could provide solutions allowing diabetic people to profit from best treatments they should receive in order to prevent diabetic complications, by far the main cause of expenses.

  10. Comparative Cost Analysis of Increasing Registered Nursing Staff on the Labor and Delivery Unit at the National Naval Medical Center.

    Science.gov (United States)

    1991-07-01

    recognized L&D Nurses 9 the central role of the registered nurse. In its most recent Accreditation Manual for Hospitals, JCAHO requires that "a...far beyond that of a L&D Nurses 60 comparably-sized civilian instituCion . Above all else NNMC is a Navy hospital, with responsibilities far beyond...1990). Accreditation Manual for Hospitals, 1990. Chicago: Author. Klarman, H. E. (1974). Application of cost-benefit analysis to the health services and

  11. Operating cost analysis of anaesthesia: Activity based costing (ABC analysis

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    Majstorović Branislava M.

    2011-01-01

    Full Text Available Introduction. Cost of anaesthesiology represent defined measures to determine a precise profile of expenditure estimation of surgical treatment, which is important regarding planning of healthcare activities, prices and budget. Objective. In order to determine the actual value of anaestesiological services, we started with the analysis of activity based costing (ABC analysis. Methods. Retrospectively, in 2005 and 2006, we estimated the direct costs of anestesiological services (salaries, drugs, supplying materials and other: analyses and equipment. of the Institute of Anaesthesia and Resuscitation of the Clinical Centre of Serbia. The group included all anesthetized patients of both sexes and all ages. We compared direct costs with direct expenditure, “each cost object (service or unit” of the Republican Health-care Insurance. The Summary data of the Departments of Anaesthesia documented in the database of the Clinical Centre of Serbia. Numerical data were utilized and the numerical data were estimated and analyzed by computer programs Microsoft Office Excel 2003 and SPSS for Windows. We compared using the linear model of direct costs and unit costs of anaesthesiological services from the Costs List of the Republican Health-care Insurance. Results. Direct costs showed 40% of costs were spent on salaries, (32% on drugs and supplies, and 28% on other costs, such as analyses and equipment. The correlation of the direct costs of anaestesiological services showed a linear correlation with the unit costs of the Republican Healthcare Insurance. Conclusion. During surgery, costs of anaesthesia would increase by 10% the surgical treatment cost of patients. Regarding the actual costs of drugs and supplies, we do not see any possibility of costs reduction. Fixed elements of direct costs provide the possibility of rationalization of resources in anaesthesia.

  12. Benefit-cost analysis of DOE's Current Federal Program to increase hydrothermal resource utilization. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1981-12-10

    The impact of DOE's Current Federal Program on the commercialization of hydrothermal resources between 1980 and 2000 is analyzed. The hydrothermal resources of the United States and the types of DOE activities used to stimulate the development of these resources for both electric power and direct heat use are described briefly. The No Federal Program and the Current Federal Program are then described in terms of funding levels and the resultant market penetration estimates through 2000. These market penetration estimates are also compared to other geothermal utilization forecasts. The direct benefits of the Current Federal Program are next presented for electric power and direct heat use applications. An analysis of the external impacts associated with the additional hydrothermal resource development resulting from the Current Federal Program is also provided. Included are environmental effects, national security/balance-of-payments improvements, socioeconomic impacts and materials requirements. A summary of the analysis integrating the direct benefits, external impacts and DOE program costs concludes the report.

  13. Fluid overload is associated with increases in length of stay and hospital costs: pooled analysis of data from more than 600 US hospitals

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    Magee G

    2013-06-01

    Full Text Available Glenn Magee,1 Art Zbrozek21Premier Research Services, Charlotte, NC, USA; 2CSL Behring, King of Prussia, PA, USABackground: Fluid overload, including transfusion-associated circulatory overload (TACO, is a serious complication of fresh frozen plasma (FFP transfusion. The incidence of fluid overload is underreported and its economic impact is unknown. An evaluation of fluid overload cases in US hospitals was performed to assess the impact of fluid overload on length and cost of hospital stay.Study design and methods: Retrospective analysis was performed using a clinical and economic database covering >600 US hospitals. Data were collected for all inpatients discharged during 2010 who received ≥1 unit FFP during hospitalization. Incidence of fluid overload was determined through International Classification of Diagnosis (ICD-9 codes. Multivariate regression analysis was performed for primary outcome measures: hospital length of stay (LOS and total hospital costs.Results: Data were analyzed for 129,839 FFP-transfused patients, of whom 4,138 (3.2% experienced fluid overload (including TACO. Multivariate analysis, adjusting for baseline characteristics, found that increased LOS and hospital costs were independently associated with fluid overload. Patients diagnosed with fluid overload had longer mean LOS (12.9 days versus 10.0 days; P < 0.001 and higher mean hospital cost per visit ($46,644 versus $32,582; P < 0.001 compared with patients without fluid overload.Conclusion: For a population of US inpatients who received FFP during hospitalization, fluid overload was associated with a 29% increase in LOS and a $14,062 increase in hospital costs per visit. These findings suggest that the incidence of fluid overload in the general population is greater than historically reported. A substantial economic burden may be associated with fluid overload in the US.Keywords: fresh frozen plasma, fluid overload, hospital costs, hypervolemia, length of stay

  14. A lesson in business: cost-effectiveness analysis of a novel financial incentive intervention for increasing physical activity in the workplace.

    Science.gov (United States)

    Dallat, Mary Anne T; Hunter, Ruth F; Tully, Mark A; Cairns, Karen J; Kee, Frank

    2013-10-10

    Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer's perspective. Employees used a 'loyalty card' to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were £2,900/QALY and £2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer's perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable "business model" which

  15. An unsuspected cost of mate familiarity: increased loss of paternity

    OpenAIRE

    Hugh Drummond; Alejandra G Ramos; Oscar Sánchez-Macouzet; Cristina Rodríguez

    2016-01-01

    The evolution of remating and prolonged pair bonds in animals has generally been explained in terms of improved coordination and cooperation between familiar individuals, but costs of mate familiarity have rarely been considered.  To test whether this familiarity cost exists, we examined whether extrapair paternity increases with bond length in the socially monogamous blue-footed booby, Sula nebouxii, using microsatellite-based analysis of 384 broods.

  16. Variable cost of ICU care, a micro-costing analysis.

    Science.gov (United States)

    Karabatsou, Dimitra; Tsironi, Maria; Tsigou, Evdoxia; Boutzouka, Eleni; Katsoulas, Theodoros; Baltopoulos, George

    2016-08-01

    Intensive care unit (ICU) costs account for a great part of a hospital's expenses. The objective of the present study was to measure the patient-specific cost of ICU treatment, to identify the most important cost drivers in ICU and to examine the role of various contributing factors in cost configuration. A retrospective cost analysis of all ICU patients who were admitted during 2011 in a Greek General, seven-bed ICU and stayed for at least 24hours was performed, by applying bottom-up analysis. Data collected included demographics and the exact cost of every single material used for patients' care. Prices were yielded from the hospital's purchasing costs and from the national price list of the imaging and laboratory tests, which was provided by the Ministry of Health. A total of 138 patients were included. Variable cost per ICU day was €573.18. A substantial cost variation was found in the total costs obtained for individual patients (median: €3443, range: €243.70-€116,355). Medicines were responsible for more than half of the cost and antibiotics accounted for the largest part of it, followed by blood products and cardiovascular drugs. Medical cause of admission, severe illness and increased length of stay, mechanical ventilation and dialysis were the factors associated with cost escalation. ICU variable cost is patient-specific, varies according to each patient's needs and is influenced by several factors. The exact estimation of variable cost is a pre-requisite in order to control ICU expenses.

  17. An introduction to cost analysis.

    Science.gov (United States)

    Camponovo, Ernest

    2015-04-01

    This article describes the basics of cost accounting for healthcare providers and how these concepts relate to decision making in medical practice. By understanding cost accounting and cost analysis, providers can be better prepared to compete and survive in a changing healthcare environment.

  18. Cost Analysis: Methods and Realities.

    Science.gov (United States)

    Cummings, Martin M.

    1989-01-01

    Argues that librarians need to be concerned with cost analysis of library functions and services because, in the allocation of resources, decision makers will favor library managers who demonstrate understanding of the relationships between costs and productive outputs. Factors that should be included in a reliable scheme for cost accounting are…

  19. Software Cuts Homebuilding Costs, Increases Energy Efficiency

    Science.gov (United States)

    2015-01-01

    To sort out the best combinations of technologies for a crewed mission to Mars, NASA Headquarters awarded grants to MIT's Department of Aeronautics and Astronautics to develop an algorithm-based software tool that highlights the most reliable and cost-effective options. Utilizing the software, Professor Edward Crawley founded Cambridge, Massachussetts-based Ekotrope, which helps homebuilders choose cost- and energy-efficient floor plans and materials.

  20. Explaining Increases in Higher Education Costs

    Science.gov (United States)

    Archibald, Robert B.; Feldman, David H.

    2008-01-01

    The real cost of higher education per full-time equivalent student has grown substantially over the last 75 years, and the rapid rise since the early 1980s is a cause of considerable public concern. Opinion surveys consistently find that how much one has to pay for a college education is a serious national issue. In his July 1996 congressional…

  1. Does Increasing Community and Liquor Licensees’ Awareness, Police Activity, and Feedback Reduce Alcohol-Related Violent Crime? A Benefit-Cost Analysis

    Directory of Open Access Journals (Sweden)

    Dennis J. Petrie

    2013-10-01

    Full Text Available Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees’ awareness, police activity, and feedback on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

  2. Does increasing community and liquor licensees' awareness, police activity, and feedback reduce alcohol-related violent crime? A benefit-cost analysis.

    Science.gov (United States)

    Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M; Petrie, Dennis J

    2013-10-28

    Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees' awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

  3. Delayed otolaryngology referral for voice disorders increases health care costs.

    Science.gov (United States)

    Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

    2015-04-01

    Despite the accepted role of laryngoscopy in assessing patients with laryngeal/voice disorders, controversy surrounds its timing. This study sought to determine how increased time from first primary care to first otolaryngology outpatient visit affected the health care costs of patients with laryngeal/voice disorders. Retrospective analysis of a large, national administrative claims database was performed. Patients had an International Classification of Diseases, 9(th) Revision-coded diagnosis of a laryngeal/voice disorder; initially saw a primary care physician and, subsequently, an otolaryngologist as outpatients; and provided 6 months of follow-up data after the first otolaryngology evaluation. The outpatient health care costs accrued from the first primary care outpatient visit through the 6 months after the first otolaryngology outpatient visit were determined. There were 260,095 unique patients who saw a primary care physician as an outpatient for a laryngeal/voice disorder, with 8999 (3.5%) subsequently seeing an otolaryngologist and with 6 months postotolaryngology follow-up data. A generalized linear regression model revealed that, compared with patients who saw an otolaryngologist ≤1 month after the first primary care visit, patients in the >1-month and ≤3-months and >3-months time periods had relative mean cost increases of $271.34 (95% confidence interval $115.95-$426.73) and $711.38 (95% confidence interval $428.43-$993.34), respectively. Increased time from first primary care to first otolaryngology evaluation is associated with increased outpatient health care costs. Earlier otolaryngology examination may reduce health care expenditures in the evaluation and management of patients with laryngeal/voice disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. 20 CFR 228.60 - Cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost-of-living increase. 228.60 Section 228... COMPUTATION OF SURVIVOR ANNUITIES The Tier II Annuity Component § 228.60 Cost-of-living increase. The tier II annuity component of a survivor annuity under the Railroad Retirement Act is increased by 32.5 percent of...

  5. Extensive analysis of hydrogen costs

    Energy Technology Data Exchange (ETDEWEB)

    Guinea, D.M.; Martin, D.; Garcia-Alegre, M.C.; Guinea, D. [Consejo Superior de Investigaciones Cientificas, Arganda, Madrid (Spain). Inst. de Automatica Industrial; Agila, W.E. [Acciona Infraestructuras, Alcobendas, Madrid (Spain). Dept. I+D+i

    2010-07-01

    Cost is a key issue in the spreading of any technology. In this work, the cost of hydrogen is analyzed and determined, for hydrogen obtained by electrolysis. Different contributing partial costs are taken into account to calculate the hydrogen final cost, such as energy and electrolyzers taxes. Energy cost data is taken from official URLs, while electrolyzer costs are obtained from commercial companies. The analysis is accomplished under different hypothesis, and for different countries: Germany, France, Austria, Switzerland, Spain and the Canadian region of Ontario. Finally, the obtained costs are compared to those of the most used fossil fuels, both in the automotive industry (gasoline and diesel) and in the residential sector (butane, coal, town gas and wood), and the possibilities of hydrogen competing against fuels are discussed. According to this work, in the automotive industry, even neglecting subsidies, hydrogen can compete with fossil fuels. Hydrogen can also compete with gaseous domestic fuels. Electrolyzer prices were found to have the highest influence on hydrogen prices. (orig.)

  6. The cost of biologics for psoriasis is increasing

    Directory of Open Access Journals (Sweden)

    Judy Cheng

    2014-12-01

    Full Text Available Background: Biologic agents have revolutionized the management of psoriasis but at a higher cost compared with “traditional” agents. Cost must be considered when evaluating management options for psoriasis. Objective: To estimate the annual cost of treatment of psoriasis using biologic agents and assess the trend over the past decade. Methods: The cost of annual treatment paradigms for etanercept, adalimumab, and ustekinumab was estimated using the average wholesale price. Trends were assessed by calculating the percentage change in annual cost compared with the previous year. A sales-based cost of drugs was estimated using gross US sales of each drug and an estimate of the total number of patients treated based on prescription data. Results: The cost of one year of induction and maintenance treatment was highest for ustekinumab ($53,909, followed by etanercept ($46,395, and adalimumab ($39,041. The salesbased cost of drugs was greatest for ustekinumab ($25,012, then adalimumab ($6,786 and etanercept ($6,629. Sales-based cost increased at an average of 20% per year. Conclusion: The cost of biologic treatments for psoriasis has been increasing. Cost considerations in the management of psoriasis are likely to increase given the limited healthcare resources that are available.

  7. Cost analysis helps evaluate contract profitability.

    Science.gov (United States)

    Sides, R W

    2000-02-01

    A cost-accounting analysis can help group practices assess their costs of doing business and determine the profitability of managed care contracts. Group practices also can use cost accounting to develop budgets and financial benchmarks. To begin a cost analysis, group practices need to determine their revenue and cost centers. Then they can allocate their costs to each center, using an appropriate allocation basis. The next step is to calculate costs per procedure. The results can be used to evaluate operational cost efficiency as well as help negotiate managed care contracts.

  8. SOLIDWORKS COSTING ANALYSYS ON A DESIGNED PART

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    Catalin IANCU

    2016-05-01

    Full Text Available In this paperwork are presented the SolidWorks analysis steps taken for costing study of a designed part, using Costing module. There are presented the settings that have to be done for such analysis and the results shown by this software module. The costing elements that are taken into account are specific to default costing templates in SolidWorks, but can be adjusted (edited to costs specific to a given enterprise.

  9. Increasing fisheries management options with a flexible cost function

    DEFF Research Database (Denmark)

    Marchal, P.; Horwood, J.

    1998-01-01

    This study proposes a dynamic control of fisheries by fishing effort, calculated so as to optimize a novel cost function, over a long period of management, based upon an example of the exploitation of the Celtic Sea cod. This cost function is a flexible weighed compromise between: (i) minimizing......) is zero, the optimization of the cost function usually results in a non- linear divergent control, which is an artefact related to the choice of the length of the management period. (C) 1998 International Council for the Exploration of the Sea....... of fishing effort towards the agreed long-term target, a decrease in short-term yields, and an increase in long-term yields. When the weight attached to (iii) is non-zero, the optimization of the cost function provides a non-oscillatory, convergent, and near-linear control. When the weight attached to (iii...

  10. Cost-effectiveness analysis in markets with high fixed costs.

    Science.gov (United States)

    Cutler, David M; Ericson, Keith M Marzilli

    2010-01-01

    We consider how to conduct cost-effectiveness analysis when the social cost of a resource differs from the posted price. From the social perspective, the true cost of a medical intervention is the marginal cost of delivering another unit of a treatment, plus the social cost (deadweight loss) of raising the revenue to fund the treatment. We focus on pharmaceutical prices, which have high markups over marginal cost due to the monopoly power granted to pharmaceutical companies when drugs are under patent. We find that the social cost of a branded drug is approximately one-half the market price when the treatment is paid for by a public insurance plan and one-third the market price for mandated coverage by private insurance. We illustrate the importance of correctly accounting for social costs using two examples: coverage for statin drugs and approval for a drug to treat kidney cancer (sorafenib). In each case, we show that the correct social perspective for cost-effectiveness analysis would be more lenient than researcher recommendations.

  11. Costs Analysis of Iron Casts Manufacturing

    Directory of Open Access Journals (Sweden)

    S. Kukla

    2012-04-01

    Full Text Available The article presents the issues of costs analysis of iron casts manufacturing using automated foundry lines. Particular attention was paid to departmental costs, conversion costs and costs of in-plant transport. After the Pareto analysis had been carried out, it was possible to set the model area of the process and focus on improving activities related to finishing of a chosen group of casts. In order to eliminate losses, the activities realised in this domain were divided into activities with added value, activities with partially added value and activities without added value. To streamline the production flow, it was proposed to change the location of workstations related to grinding, control and machining of casts. Within the process of constant improvement of manufacturing processes, the aspect of work ergonomics at a workstation was taken into account. As a result of the undertaken actions, some activities without added value were eliminated, efficiency was increased and prime costs of manufacturing casts with regard to finishing treatment were lowered.

  12. Cost analysis methodology: Photovoltaic Manufacturing Technology Project

    Energy Technology Data Exchange (ETDEWEB)

    Whisnant, R.A. (Research Triangle Inst., Research Triangle Park, NC (United States))

    1992-09-01

    This report describes work done under Phase 1 of the Photovoltaic Manufacturing Technology (PVMaT) Project. PVMaT is a five-year project to support the translation of research and development in PV technology into the marketplace. PVMaT, conceived as a DOE/industry partnership, seeks to advanced PV manufacturing technologies, reduce PV module production costs, increase module performance, and expand US commercial production capacities. Under PVMaT, manufacturers will propose specific manufacturing process improvements that may contribute to the goals of the project, which is to lessen the cost, thus hastening entry into the larger scale, grid-connected applications. Phase 1 of the PVMaT project is to identify obstacles and problems associated with manufacturing processes. This report describes the cost analysis methodology required under Phase 1 that will allow subcontractors to be ranked and evaluated during Phase 2.

  13. Project cost analysis under risk

    Directory of Open Access Journals (Sweden)

    Florica LUBAN

    2010-12-01

    Full Text Available In this paper, an integrated approach based on Monte Carlo simulation and Six Sigma methodology is used to analyze the risk associated with a project's total cost. Monte Carlo simulation is applied to understand the variability in total cost caused by the probabilistic cost items. By Six Sigma methodology the range of variation of the project cost can be reduced by operating on the input factors with the greatest impact on total cost to cover the variation of 6 between the limits that were established in the design phase of Six Sigma.

  14. Incorporating psychological influences in probabilistic cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard; Alvaro, Mariana; Edwards, William

    2004-01-08

    Today's typical probabilistic cost analysis assumes an ''ideal'' project that is devoid of the human and organizational considerations that heavily influence the success and cost of real-world projects. In the real world ''Money Allocated Is Money Spent'' (MAIMS principle); cost underruns are rarely available to protect against cost overruns while task overruns are passed on to the total project cost. Realistic cost estimates therefore require a modified probabilistic cost analysis that simultaneously models the cost management strategy including budget allocation. Psychological influences such as overconfidence in assessing uncertainties and dependencies among cost elements and risks are other important considerations that are generally not addressed. It should then be no surprise that actual project costs often exceed the initial estimates and are delivered late and/or with a reduced scope. This paper presents a practical probabilistic cost analysis model that incorporates recent findings in human behavior and judgment under uncertainty, dependencies among cost elements, the MAIMS principle, and project management practices. Uncertain cost elements are elicited from experts using the direct fractile assessment method and fitted with three-parameter Weibull distributions. The full correlation matrix is specified in terms of two parameters that characterize correlations among cost elements in the same and in different subsystems. The analysis is readily implemented using standard Monte Carlo simulation tools such as {at}Risk and Crystal Ball{reg_sign}. The analysis of a representative design and engineering project substantiates that today's typical probabilistic cost analysis is likely to severely underestimate project cost for probability of success values of importance to contractors and procuring activities. The proposed approach provides a framework for developing a viable cost management strategy for

  15. Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2010-01-01

    The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future.......The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future....

  16. Increasing CostsPlace Primary Burden onCorporations

    Institute of Scientific and Technical Information of China (English)

    Leo Zhao

    2011-01-01

    The environment seems to be less and less optimistic for small companies in recent years.The rising raw material price and labor costs have combined to push up their export costs by 10 to 20 percent.The former factor in particular has become the greatest burden for enterprises and the most striking consequence is these enterprises' sliding competitiveness in export.“The major difficulties faced by small and medium-sized comPanies include:first is the soaring production costs due to rampant inflation of raw material prices,such as high price of crude oil,cotton and the iron ore;the second is the rising labor costs,with labor shortage and employment difficulty still severe.Labor wages in coastal regions,including Yangtze River Delta and Pearl River Delta,have been increasing sharply,” said in an interview Zhu Hongren,chief engineer of the Ministry of Industry and Information Technology,“The two parts of soaring costs have squeezed the profit m.ar”gins for small and medium-sized companies.

  17. RECTIFIED ETHANOL PRODUCTION COST ANALYSIS

    Directory of Open Access Journals (Sweden)

    Nikola J Budimir

    2011-01-01

    Full Text Available This paper deals with the impact of the most important factors of the total production costs in bioethanol production. The most influential factors are: total investment costs, price of raw materials (price of biomass, enzymes, yeast, and energy costs. Taking into account these factors, a procedure for estimation total production costs was establish. In order to gain insight into the relationship of production and selling price of bioethanol, price of bioethanol for some countries of the European Union and the United States are given.

  18. Business Cost Increases Promote Industrial Restructuring in the Yangtze River Delta

    Institute of Scientific and Technical Information of China (English)

    江静; 刘志彪

    2007-01-01

    The traditional view holds that China’s comparative advantage lies in low costs,and it is therefore imperative to reduce business costs if China intends to maintain her industrial competitiveness.In the following article,Jiang Jing and Liu Zhibiao present a rather different point of view.They consider it endogenous to increase business costs.Although they may reduce urban competitiveness to a certain extent,increased business costs exert an important"push"effect upon structural adjustment and upgrade and the growth of the regional economy due to the varying degrees of sensitivity of manufacturing industries and producer service industries to business costs.These findings have been corroborated through their analysis of business costs and industrial distribution in Yangtze River Delta cities such as Shanghai,Nanjing, Suzhou,Wuxi and Nantong.

  19. Explaining the increased health care expenditures associated with gastroesophageal reflux disease among elderly Medicare beneficiaries with chronic obstructive pulmonary disease: a cost-decomposition analysis

    Directory of Open Access Journals (Sweden)

    Ajmera M

    2014-04-01

    Full Text Available Mayank Ajmera,1 Amit D Raval,1 Chan Shen,2 Usha Sambamoorthi1 1Department of Pharmaceutical Systems and Policy, School of Pharmacy, School of Medicine, West Virginia University, Morgantown, WV, USA; 2Department of Biostatistics and Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA Objective: To estimate excess health care expenditures associated with gastroesophageal reflux disease (GERD among elderly individuals with chronic obstructive pulmonary disease (COPD and examine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors to the excess expenditures, using the Blinder-Oaxaca linear decomposition technique. Methods: This study utilized a cross-sectional, retrospective study design, using data from multiple years (2006-2009 of the Medicare Current Beneficiary Survey linked with fee-for-service Medicare claims. Presence of COPD and GERD was identified using diagnoses codes. Health care expenditures consisted of inpatient, outpatient, prescription drugs, dental, medical provider, and other services. For the analysis, t-tests were used to examine unadjusted subgroup differences in average health care expenditures by the presence of GERD. Ordinary least squares regressions on log-transformed health care expenditures were conducted to estimate the excess health care expenditures associated with GERD. The Blinder-Oaxaca linear decomposition technique was used to determine the contribution of predisposing characteristics, enabling resources, need variables, personal health care practices, and external environment factors, to excess health care expenditures associated with GERD. Results: Among elderly Medicare beneficiaries with COPD, 29.3% had co-occurring GERD. Elderly Medicare beneficiaries with COPD/GERD had 1.5 times higher ($36,793 vs $24,722 [P<0.001] expenditures than did those with COPD/no GERD. Ordinary

  20. Ethics and Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Arler, Finn

    The purpose of this research report is threefold. Firstly, the author traces the origins and justification of cost-benefit analysis in moral and political philosophy. Secondly, he explain some of the basic features of cost-benefit analysis as a planning tool in a step-bystep presentation. Thirdly......, he presents and discusses some of the main ethical difficulties related to the use of cost-benefit analysis as a planning tool....

  1. Manufacturing cost analysis of integrated photonic packages

    Science.gov (United States)

    Stirk, Charles W.; Liu, Qin; Ball, Matthew V.

    1999-04-01

    This paper analyzes the manufacturing cost of photonic system using software that combines several methods for accurate cost accounting. Activity based costing assigns al capital equipment, material and labor costs directly to the product rather than to overheads. Cost of ownership models determine the cost of using machines under different financial and utilization scenarios. Libraries of standard machines, process steps, and process sequences facilitate rapid model building and modification. Using libraries for semiconductor and photonics fabrication, along with packaging and optomechanical assembly, we construct cost models for 2D VCSEL array communication modules. The result of the analysis is that the model cost is driven mainly by the epitaxial material cost, and laser yield limits VCSEL arrays to small scale integration.

  2. Economic analysis of the cost of Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mazetas D.

    2014-04-01

    Full Text Available The cost of Intensive Care Units has the greatest impact on overall medical costs and the overall cost for the health of a country and an increasing number of studies from around the world presenting the quantification of these costs. Aim: Review of the Economic Analysis of the Cost of Intensive Care Units. Method: Search was made in the SCOPUS, MEDLINE and CINAHL databases using the key-words “Intensive Care Units (ICU”, “Cost”, “Cost Analysis”, “Health Care Costs”, “Health Resources”, “ICU resources”. The study was based on articles published in English from 2000 to 2011 investigating the Economic Analysis of the Cost of Intensive Care Units. Results: The cost of ICU is a significant percentage of gross domestic product in developed countries. Most cost analysis studies that relate to plans that include the study of staff costs, duration of stay in the ICU, the clinical situations of hospitalized patients, engineering support, medications and diagnostic tests costing scales and in relation to the diagnostic criteria. Conclusions: most studies conclude that the remuneration of staff, particularly nurses, in the ICU is the largest cost of ICU, while for the duration of stay in the ICU results are conflicting. The analysis on the cost-effectiveness of ICU can help to better apply these findings to the therapeutic context of ICU.

  3. Chapter 17. Engineering cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Higbee, Charles V.

    1998-01-01

    In the early 1970s, life cycle costing (LCC) was adopted by the federal government. LCC is a method of evaluating all the costs associated with acquisition, construction and operation of a project. LCC was designed to minimize costs of major projects, not only in consideration of acquisition and construction, but especially to emphasize the reduction of operation and maintenance costs during the project life. Authors of engineering economics texts have been very reluctant and painfully slow to explain and deal with LCC. Many authors devote less than one page to the subject. The reason for this is that LCC has several major drawbacks. The first of these is that costs over the life of the project must be estimated based on some forecast, and forecasts have proven to be highly variable and frequently inaccurate. The second problem with LCC is that some life span must be selected over which to evaluate the project, and many projects, especially renewable energy projects, are expected to have an unlimited life (they are expected to live for ever). The longer the life cycle, the more inaccurate annual costs become because of the inability to forecast accurately.

  4. Preventive health screenings and health consultations in primary care increase life expectancy without increasing costs

    DEFF Research Database (Denmark)

    Rasmussen, Susanne R; Thomsen, Janus Laust; Kilsmark, Janni

    2007-01-01

    accepted were randomized. Both intervention groups were offered a broad (multiphasic) screening including cardiovascular risk and a personal letter including screening results and advice on healthy living. Individuals in group A could contact their family physician for a normal consultation whereas group B......AIMS: The intention was to investigate whether preventive health checks and health discussions are cost effective. METHODS: In a randomized trial the authors compared two intervention groups (A and B) and one control group. In 1991 2,000 30- to 49-year-old persons were invited and those who...... were given fixed appointments for health consultations. The follow-up period was six years. Analysis was carried out on the "intention to treat" principle. Outcome parameters were life years gained, and direct and total health costs (including productivity costs), discounted by 3% annually. Costs were...

  5. Hospital costs fell as numbers of LVADs were increasing: experiences from Oslo University Hospital

    Directory of Open Access Journals (Sweden)

    Mishra Vinod

    2012-08-01

    Full Text Available Abstract Background The current study was undertaken to examine total hospital costs per patient of a consecutive implantation series of two 3rd generation Left Ventricle Assist Devices (LVAD. Further we analyzed if increased clinical experience would reduce total hospital costs and the gap between costs and the diagnosis related grouped (DRG-reimbursement. Method Cost data of 20 LVAD implantations (VentrAssist™ from 2005-2009 (period 1 were analyzed together with costs from nine patients using another LVAD (HeartWare™ from 2009-June 2011 (period 2. For each patient, total costs were calculated for three phases - the pre-LVAD implantation phase, the LVAD implantation phase and the post LVAD implant phase. Patient specific costs were obtained prospectively from patient records and included personnel resources, medication, blood products, blood chemistry and microbiology, imaging and procedure costs including operating room costs. Overhead costs were registered retrospectively and allocated to the specific patient by predefined allocation keys. Finally, patient specific costs and overhead costs were aggregated into total hospital costs for each patient. All costs were calculated in 2011-prices. We used regression analyses to analyze cost variations over time and between the different devices. Results The average total hospital cost per patient for the pre-LVAD, LVAD and post-LVAD for period 1 was $ 585, 513 (range 132, 640- 1 247, 299, and the corresponding DRG- reimbursement (2009 was $ 143, 192 . The mean LOS was 54 days (range 12- 127. For period 2 the total hospital cost per patient was $ 413, 185 (range 314, 540- 622, 664 and the corresponding DRG- reimbursement (2010 was $ 136, 963. The mean LOS was 49 days (range 31- 93. The estimates from the regression analysis showed that the total hospital costs, excluding device costs, per patient were falling as the number of treated patients increased. The estimate from the trend variable was -14

  6. Increasing nurse staffing levels in Belgian cardiac surgery centres: a cost-effective patient safety intervention?

    Science.gov (United States)

    Van den Heede, Koen; Simoens, Steven; Diya, Luwis; Lesaffre, Emmanuel; Vleugels, Arthur; Sermeus, Walter

    2010-06-01

    This paper is a report of a cost-effectiveness analysis from a hospital perspective of increased nurse staffing levels (to the level of the 75th percentile) in Belgian general cardiac postoperative nursing units. A previous study indicated that increasing nurse staffing levels in Belgian general cardiac postoperative nursing units was associated with lower mortality rates. Research is needed to compare the costs of increased nurse staffing levels with benefits of reducing mortality rates. Two types of average national costs were compared. A first calculation included the simulation of an increase in the number of nursing hours per patient day to the 75th percentile for nursing units staffed below that level. For the second calculation (the comparator) we used a 'do nothing' alternative. The most recent available data sources were used for the analysis. Results were expressed in the form of the additional costs per avoided death and the additional costs per life-year gained. The analysis used 2007 costing data. The costs of increasing nurse staffing levels to the 75th percentile in Belgian general cardiac postoperative nursing units amounted to euro1,211,022. Such nurse staffing levels would avoid an estimated number of 45.9 (95% confidence interval: 22.0-69.4) patient deaths per year and generate 458.86 (95% confidence interval: 219.93-693.79) life-years gained annually. This corresponds with incremental cost-effectiveness ratios of euro26,372 per avoided death and euro2639 per life-year gained. Increasing nurse staffing levels appears to be a cost-effective intervention as compared with other cardiovascular interventions.

  7. Can Increasing Fuel Costs Make Locally Produced Food More Competitive?

    OpenAIRE

    Grigsby, Chuck; Hellwinckel, Chad; Lambert, Dayton; Yu, Edward

    2015-01-01

    Fresh produce in the United States often travels thousands of miles in diesel operated semi-trucks before arriving to market. Under a high fuel cost scenario, the current low cost, efficient supply chain could become a high cost organizational structure for US food distribution. Rising transportation costs of food sourced from distant locations may provide competitive opportunities for small- and mid-sized local producers if transportation costs are a smaller portion of their total costs. Far...

  8. Neural basis of increased costly norm enforcement under adversity.

    Science.gov (United States)

    Wu, Yan; Yu, Hongbo; Shen, Bo; Yu, Rongjun; Zhou, Zhiheng; Zhang, Guoping; Jiang, Yushi; Zhou, Xiaolin

    2014-12-01

    Humans are willing to punish norm violations even at a substantial personal cost. Using fMRI and a variant of the ultimatum game and functional magnetic resonance imaging, we investigated how the brain differentially responds to fairness in loss and gain domains. Participants (responders) received offers from anonymous partners indicating a division of an amount of monetary gain or loss. If they accept, both get their shares according to the division; if they reject, both get nothing or lose the entire stake. We used a computational model to derive perceived fairness of offers and participant-specific inequity aversion. Behaviorally, participants were more likely to reject unfair offers in the loss (vs gain) domain. Neurally, the positive correlation between fairness and activation in ventral striatum was reduced, whereas the negative correlations between fairness and activations in dorsolateral prefrontal cortex were enhanced in the loss domain. Moreover, rejection-related dorsal striatum activation was higher in the loss domain. Furthermore, the gain-loss domain modulates costly punishment only when unfair behavior was directed toward the participants and not when it was directed toward others. These findings provide neural and computational accounts of increased costly norm enforcement under adversity and advanced our understanding of the context-dependent nature of fairness preference.

  9. Summit Station Skiway Cost Analysis

    Science.gov (United States)

    2016-07-01

    pass, depend- ing on skiway condition. Total construction time will take approximately 27–30 hours, or 4 working days. Surface maintenance ...ERDC develops innovative solutions in civil and military engineering, geospatial sciences, water resources, and environmental sciences for the...cargo loads. To explore further skiway improvement and cost saving techniques, this report reviews alternative maintenance and construction options

  10. Risk Factors Associated with Mortality and Increased Drug Costs in Nonvariceal Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Lu, Mingliang; Sun, Gang; Zhang, Xiu-li; Zhang, Xiao-mei; Liu, Qing-sen; Huang, Qi-yang; Lau, James W Y; Yang, Yun-sheng

    2015-06-01

    To determine risk factors associated with mortality and increased drug costs in patients with nonvariceal upper gastrointestinal bleeding. We retrospectively analyzed data from patients hospitalized with nonvariceal upper gastrointestinal bleeding between January 2001-December 2011. Demographic and clinical characteristics and drug costs were documented. Univariate analysis determined possible risk factors for mortality. Statistically significant variables were analyzed using a logistic regression model. Multiple linear regression analyzed factors influencing drug costs. p 60, systolic blood pressurebleeding rate is 11.20% and mortality is 5.74%. The mortality risk in patients with comorbidities was higher than in patients without comorbidities, and was higher in patients requiring blood transfusion than in patients not requiring transfusion. Rebleeding was associ-ated with mortality. Rebleeding, blood transfusion, and prolonged hospital stay were associated with increased drug costs, whereas bleeding from lesions in the esophagus and duodenum was associated with lower drug costs.

  11. Cost-benefit considerations in regulatory analysis

    Energy Technology Data Exchange (ETDEWEB)

    Mubayi, V.; Sailor, V.; Anandalingam, G.

    1995-10-01

    Justification for safety enhancements at nuclear facilities, e.g., a compulsory backfit to nuclear power plants, requires a value-impact analysis of the increase in overall public protection versus the cost of implementation. It has been customary to assess the benefits in terms of radiation dose to the public averted by the introduction of the safety enhancement. Comparison of such benefits with the costs of the enhancement then requires an estimate of the monetary value of averted dose (dollars/person rem). This report reviews available information on a variety of factors that affect this valuation and assesses the continuing validity of the figure of $1000/person-rem averted, which has been widely used as a guideline in performing value-impact analyses. Factors that bear on this valuation include the health risks of radiation doses, especially the higher risk estimates of the BEIR V committee, recent calculations of doses and offsite costs by consequence codes for hypothesized severe accidents at U.S. nuclear power plants under the NUREG-1150 program, and recent information on the economic consequences of the Chernobyl accident in the Soviet Union and estimates of risk avoidance based on the willingness-to-pay criterion. The report analyzes these factors and presents results on the dollars/person-rem ratio arising from different assumptions on the values of these factors.

  12. CERN reacts to increased costs to completion of the LHC

    CERN Document Server

    2002-01-01

    Aspects of LHC construction. The CERN Council, where the representatives of the 20 Member States of the Organization decide on scientific programmes and financial resources, held its 120th session on 14 December under the chairmanship of Prof. Maurice Bourquin (CH). CERN adjusts to the LHC Director-General, Luciano Maiani, stressed that CERN was now fully engaged in the LHC and outlined the first moves to react to the increased cost to completion of the LHC. The new accelerator is an extremely complex, high-tech project which CERN is building under very severe conditions. However, the technical challenges are solved and industrial production of accelerator elements, and installation are starting. Professor Maiani said that 2001 had been a very hard but decisive year for CERN. An important milestone had been passed during this meeting with the approval of the LHC dipole magnets contract, the last major contract for the accelerator. The new costs to completion of the LHC project are now clear. A first propos...

  13. Activity Analysis and Cost Analysis in Medical Schools.

    Science.gov (United States)

    Koehler, John E.; Slighton, Robert L.

    There is no unique answer to the question of what an ongoing program costs in medical schools. The estimates of program costs generated by classical methods of cost accounting are unsatisfactory because such accounting cannot deal with the joint production or joint cost problem. Activity analysis models aim at calculating the impact of alternative…

  14. Cost benefit analysis for climate change adaption

    NARCIS (Netherlands)

    Ierland, van E.C.; Weikard, H.P.; Wesseler, J.H.H.; Groeneveld, R.A.; Ansink, E.J.H.; Bruin, de K.; Rietveld, P.; Bockarjova, M.; Hofkes, M.; Brouwer, R.; Dekker, T.

    2012-01-01

    The focus of this programme was on the development of decision making tools based on cost benefit analysis under uncertainty, for analysing adaptation and mitigation options related to spatial planning in the Netherlands. The full programme focused on the methodological issues for cost benefit analy

  15. Cost savings associated with improving appropriate and reducing inappropriate preventive care: cost-consequences analysis

    Directory of Open Access Journals (Sweden)

    Baskerville Neill

    2005-03-01

    Full Text Available Abstract Background Outreach facilitation has been proven successful in improving the adoption of clinical preventive care guidelines in primary care practice. The net costs and savings of delivering such an intensive intervention need to be understood. We wanted to estimate the proportion of a facilitation intervention cost that is offset and the potential for savings by reducing inappropriate screening tests and increasing appropriate screening tests in 22 intervention primary care practices affecting a population of 90,283 patients. Methods A cost-consequences analysis of one successful outreach facilitation intervention was done, taking into account the estimated cost savings to the health system of reducing five inappropriate tests and increasing seven appropriate tests. Multiple data sources were used to calculate costs and cost savings to the government. The cost of the intervention and costs of performing appropriate testing were calculated. Costs averted were calculated by multiplying the number of tests not performed as a result of the intervention. Further downstream cost savings were determined by calculating the direct costs associated with the number of false positive test follow-ups avoided. Treatment costs averted as a result of increasing appropriate testing were similarly calculated. Results The total cost of the intervention over 12 months was $238,388 and the cost of increasing the delivery of appropriate care was $192,912 for a total cost of $431,300. The savings from reduction in inappropriate testing were $148,568 and from avoiding treatment costs as a result of appropriate testing were $455,464 for a total savings of $604,032. On a yearly basis the net cost saving to the government is $191,733 per year (2003 $Can equating to $3,687 per physician or $63,911 per facilitator, an estimated return on intervention investment and delivery of appropriate preventive care of 40%. Conclusion Outreach facilitation is more expensive

  16. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  17. Cost analysis of youth violence prevention.

    Science.gov (United States)

    Sharp, Adam L; Prosser, Lisa A; Walton, Maureen; Blow, Frederic C; Chermack, Stephen T; Zimmerman, Marc A; Cunningham, Rebecca

    2014-03-01

    Effective violence interventions are not widely implemented, and there is little information about the cost of violence interventions. Our goal is to report the cost of a brief intervention delivered in the emergency department that reduces violence among 14- to 18-year-olds. Primary outcomes were total costs of implementation and the cost per violent event or violence consequence averted. We used primary and secondary data sources to derive the costs to implement a brief motivational interviewing intervention and to identify the number of self-reported violent events (eg, severe peer aggression, peer victimization) or violence consequences averted. One-way and multi-way sensitivity analyses were performed. Total fixed and variable annual costs were estimated at $71,784. If implemented, 4208 violent events or consequences could be prevented, costing $17.06 per event or consequence averted. Multi-way sensitivity analysis accounting for variable intervention efficacy and different cost estimates resulted in a range of $3.63 to $54.96 per event or consequence averted. Our estimates show that the cost to prevent an episode of youth violence or its consequences is less than the cost of placing an intravenous line and should not present a significant barrier to implementation.

  18. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Lue-Ping Zhao

    Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

  19. 20 CFR 404.278 - Additional cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Additional cost-of-living increase. 404.278... DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.278 Additional cost-of-living increase. (a) General. In addition to the cost-of-living increase explained in...

  20. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad

    2014-01-01

    his report ’D3.1—Evaluation of Cost Models and Needs & Gaps Analysis’ provides an analysis of existing research related to the economics of digital curation and cost & benefit modelling. It reports upon the investigation of how well current models and tools meet stakeholders’ needs for calculating...... andcomparing financial information. Based on this evaluation, it aims to point out gaps that need to be bridged in order to increase the uptake of cost & benefit modelling and good practices that will enable costing and comparison of the costs of alternative scenarios—which in turn provides a starting point...... for amore efficient use of resources for digital curation. To facilitate and clarify the model evaluation the report first outlines a basic terminology and a generaldescription of the characteristics of cost and benefit models.The report then describes how the ten current and emerging cost and benefit...

  1. Increased set shifting costs in fasted healthy volunteers.

    Directory of Open Access Journals (Sweden)

    Heather M Bolton

    Full Text Available We investigated the impact of temporary food restriction on a set shifting task requiring participants to judge clusters of pictures against a frequently changing rule. 60 healthy female participants underwent two testing sessions: once after fasting for 16 hours and once in a satiated state. Participants also completed a battery of questionnaires (Hospital Anxiety and Depression Scale [HADS]; Persistence, Perseveration and Perfectionism Questionnaire [PPPQ-22]; and Eating Disorders Examination Questionnaire [EDE-Q6]. Set shifting costs were significantly increased after fasting; this effect was independent of self-reported mood and perseveration. Furthermore, higher levels of weight concern predicted a general performance decrement under conditions of fasting. We conclude that relatively short periods of fasting can lead to set shifting impairments. This finding may have relevance to studies of development, individual differences, and the interpretation of psychometric tests. It also could have implications for understanding the etiology and maintenance of eating disorders, in which impaired set shifting has been implicated.

  2. Cost analysis and estimating tools and techniques

    CERN Document Server

    Nussbaum, Daniel

    1990-01-01

    Changes in production processes reflect the technological advances permeat­ ing our products and services. U. S. industry is modernizing and automating. In parallel, direct labor is fading as the primary cost driver while engineering and technology related cost elements loom ever larger. Traditional, labor-based ap­ proaches to estimating costs are losing their relevance. Old methods require aug­ mentation with new estimating tools and techniques that capture the emerging environment. This volume represents one of many responses to this challenge by the cost analysis profession. The Institute of Cost Analysis (lCA) is dedicated to improving the effective­ ness of cost and price analysis and enhancing the professional competence of its members. We encourage and promote exchange of research findings and appli­ cations between the academic community and cost professionals in industry and government. The 1990 National Meeting in Los Angeles, jointly spo~sored by ICA and the National Estimating Society (NES),...

  3. Economical Feedback of Increasing Fuel Enrichment on Electricity Cost for VVER-1000

    Directory of Open Access Journals (Sweden)

    Mohammed Saad Dwiddar

    2015-08-01

    Full Text Available A methodology of evaluating the economics of the front-end nuclear fuel cycle with a price change sensitivity analysis for a VVER-1000 reactor core as a case study is presented. The effect of increasing the fuel enrichment and its corresponding reactor cycle length on the energy cost is investigated. The enrichment component was found to represent the highly expenses dynamic component affecting the economics of the front-end fuel cycle. Nevertheless, the increase of the fuel enrichment will increase the reactor cycle length, which will have a positive feedback on the electricity generation cost (cent/KWh. A long reactor operation time with a cheaper energy cost set the nuclear energy as a competitive alternative when compared with other energy sources.

  4. A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

    Directory of Open Access Journals (Sweden)

    CARDOS Ildiko Reka

    2010-07-01

    Full Text Available In the last years many organizations realized that market orientation is essential to their success. Satisfying the needs of customers, offering them products and services which meet their desires and demands, customer loyalty can increase profitability for long term. After analyzing the existing journal literature in this field we would like to emphasize that managerial accounting, cost calculation methods and techniques, the analysis of costs provides relevant information when analyzing the customer’s profitability. We pay special attention on cost systems. An activity based costing approach takes customer profitability to new levels of accuracy and usefulness, provides the basis for creating, communicating and delivering value to the customers.

  5. Increase Productivity and Cost Optimization in CNC Manufacturing

    Science.gov (United States)

    Musca, Gavril; Mihalache, Andrei; Tabacaru, Lucian

    2016-11-01

    The advantage of the technological assisted design consists in easy modification of the machining technologies for obtaining machine alternation, tool changing, working parameters variation or the modification of loads to which the tools are subjected. By determining tool movement inside machining and by using tool related moving speeds needed for both positioning and manufacturing we are able to compute the required machining time for each component of the machining operation in progress. The present study describes a cost optimization model for machining operations which uses the following components: machine and its operator related cost, set-up and adjustment, unproductive costs (idle state), direct and indirect costs. By using manufacturing technologies assisted design procedures we may obtain various variants for the technological model by modifying the machining strategy, tooling, working regimes or the machine-tool that are used. Simulating those variants allows us to compare and establish the optimal manufacturing variant as well as the most productive one.

  6. Cost-benefit analysis of space technology

    Science.gov (United States)

    Hein, G. F.; Stevenson, S. M.; Sivo, J. N.

    1976-01-01

    A discussion of the implications and problems associated with the use of cost-benefit techniques is presented. Knowledge of these problems is useful in the structure of a decision making process. A methodology of cost-benefit analysis is presented for the evaluation of space technology. The use of the methodology is demonstrated with an evaluation of ion thrusters for north-south stationkeeping aboard geosynchronous communication satellites. A critique of the concept of consumers surplus for measuring benefits is also presented.

  7. Airlift deployment analysis system life cycle cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Truett, L.F.; Das, S. (Oak Ridge National Lab., TN (USA)); Worthington, J.C. (Sybase, Inc. (USA))

    1990-08-01

    The Airlift Deployment Analysis System (ADANS) is an automated system that will provide Headquarters, Military Airlift Command (HQ MAC) with planning, scheduling, and analysis tools for peacetime and contingency airlift operations. This Life Cycle Cost (LCC) analysis identifies cost factors impacting ADANS during its life cycle. This analysis lists exact costs when known and reasonable estimates of other costs. This report states costs in fiscal year (FY) dollars for costs already expended (FY86--FY89) and in FY90 dollars for projected costs. Factors that could have a substantial impact on the ADANS life cycle development and maintenance costs are noted. The development effort will conclude in FY92. This LCC analysis covers a 15-year period from FY86--FY00. The total costs of ADANS is projected to be approximately $60 million. Of this total, about 20% is for development of functional capability, about 9% for development of the cross-cutting subsystems, and about 71% for program and system support. The total Oak Ridge National Laboratory development cost for FY86--FY92 is about $27.5 million; the total cost for HQ MAC is about 32.5 million. 32 tabs.

  8. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

    Kessler, Andrew C.; Merchant, James W.; Shultz, Steven D.; Allen, Craig R.

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

  9. Making choices in health: WHO guide to cost effectiveness analysis

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

    ... . . . . . . . . . . . . . . . . . . . . . . . XXI PART ONE: METHODS COST-EFFECTIVENESS FOR GENERALIZED ANALYSIS 1. 2. What is Generalized Cost-Effectiveness Analysis? . . . . . . . . . . . . 3 Undertaking...

  10. Cost and Price Increases in Higher Education: Evidence of a Cost Disease on Higher Education Costs and Tuition Prices and the Implications for Higher Education Policy

    Science.gov (United States)

    Trombella, Jerry

    2011-01-01

    As concern over rapidly rising college costs and tuition sticker prices have increased, a variety of research has been conducted to determine potential causes. Most of this research has focused on factors unique to higher education. In contrast, cost disease theory attempts to create a comparative context to explain cost increases in higher…

  11. The Cost-Effectiveness of Using Payment to Increase Living Donor Kidneys for Transplantation

    Science.gov (United States)

    Barnieh, Lianne; Gill, John S.; Klarenbach, Scott

    2013-01-01

    Summary Background and objectives For eligible candidates, transplantation is considered the optimal treatment compared with dialysis for patients with ESRD. The growing number of patients with ESRD requires new strategies to increase the pool of potential donors. Design, setting, participants, & measurements Using decision analysis modeling, this study compared a strategy of paying living kidney donors to waitlisted recipients on dialysis with the current organ donation system. In the base case estimate, this study assumed that the number of donors would increase by 5% with a payment of $10,000. Quality of life estimates, resource use, and costs (2010 Canadian dollars) were based on the best available published data. Results Compared with the current organ donation system, a strategy of increasing the number of kidneys for transplantation by 5% by paying living donors $10,000 has an incremental cost-savings of $340 and a gain of 0.11 quality-adjusted life years. Increasing the number of kidneys for transplantation by 10% and 20% would translate into incremental cost-savings of $1640 and $4030 and incremental quality-adjusted life years gain of 0.21 and 0.39, respectively. Conclusion Although the impact is uncertain, this model suggests that a strategy of paying living donors to increase the number of kidneys available for transplantation could be cost-effective, even with a transplant rate increase of only 5%. Future work needs to examine the feasibility, legal policy, ethics, and public perception of a strategy to pay living donors. PMID:24158797

  12. An Analysis of Rocket Propulsion Testing Costs

    Science.gov (United States)

    Ramirez, Carmen; Rahman, Shamim

    2010-01-01

    The primary mission at NASA Stennis Space Center (SSC) is rocket propulsion testing. Such testing is commonly characterized as one of two types: production testing for certification and acceptance of engine hardware, and developmental testing for prototype evaluation or research and development (R&D) purposes. For programmatic reasons there is a continuing need to assess and evaluate the test costs for the various types of test campaigns that involve liquid rocket propellant test articles. Presently, in fact, there is a critical need to provide guidance on what represents a best value for testing and provide some key economic insights for decision-makers within NASA and the test customers outside the Agency. Hence, selected rocket propulsion test databases and references have been evaluated and analyzed with the intent to discover correlations of technical information and test costs that could help produce more reliable and accurate cost projections in the future. The process of searching, collecting, and validating propulsion test cost information presented some unique obstacles which then led to a set of recommendations for improvement in order to facilitate future cost information gathering and analysis. In summary, this historical account and evaluation of rocket propulsion test cost information will enhance understanding of the various kinds of project cost information; identify certain trends of interest to the aerospace testing community.

  13. Cost analysis of flood-proofing levees

    OpenAIRE

    Šuklje, Matija Jože

    2013-01-01

    In the thesis I analyzed some prices of construction works from 1950s and did a cost analysis of building a super levee. Earth and concrete dams, percolation through the core of the embankment and foundation seepage beneath the dykes are presented in details. Much attention is given to the construction and use of new types of dams such as super-levees. Furthermore, the analysis of changing prices of some construction works are presented as the costs are important in the building of levees. Th...

  14. Potential Energy Cost Savings from Increased Commercial Energy Code Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.; Zhang, Jian; Cohan, David F.

    2016-08-22

    An important question for commercial energy code compliance is: “How much energy cost savings can better compliance achieve?” This question is in sharp contrast to prior efforts that used a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. A field investigation method is being developed that goes beyond the binary approach to determine how much energy cost savings is not realized. Prototype building simulations were used to estimate the energy cost impact of varying levels of non-compliance for newly constructed office buildings in climate zone 4C. Field data collected from actual buildings on specific conditions relative to code requirements was then applied to the simulation results to find the potential lost energy savings for a single building or for a sample of buildings. This new methodology was tested on nine office buildings in climate zone 4C. The amount of additional energy cost savings they could have achieved had they complied fully with the 2012 International Energy Conservation Code is determined. This paper will present the results of the test, lessons learned, describe follow-on research that is needed to verify that the methodology is both accurate and practical, and discuss the benefits that might accrue if the method were widely adopted.

  15. Comparative analysis of the efficiencies of two low cost adsorbents ...

    African Journals Online (AJOL)

    Comparative analysis of the efficiencies of two low cost adsorbents in the removal of Cr(VI) ... African Journal of Environmental Science and Technology ... Generally, the result showed an increase in adsorption by Cr(VI) with increase in mass ...

  16. 24 CFR 965.402 - Benefit/cost analysis.

    Science.gov (United States)

    2010-04-01

    ... that the cost of debt service (interest and amortization) of the estimated installation costs plus the... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Benefit/cost analysis. 965.402...-Owned Projects § 965.402 Benefit/cost analysis. (a) A benefit/cost analysis shall be made to determine...

  17. LIFE CYCLE COST ANALYSIS OF SOLAR PONDS

    Directory of Open Access Journals (Sweden)

    Murat ÖZTÜRK

    2008-03-01

    Full Text Available Solar ponds are the systems which collect solar energy and store it for long periods of time. For effective and efficient use of these systems in the country, concepts relating economy of solar ponds which generated hot water from the sun must be known besides their physical properties. Life cycle cost analysis is a systematic analytical method that helps identify and evaluate the environmental impacts of a specific process or competing processes. In order to quantify the costs, resource consumption, and energy use, material and energy balances are performed in a cradle-to-grave manner on the operations required to transform raw materials into useful products. In this study; life cycle cost analysis of reflecting covered and non covered solar ponds are calculated for a volume of 3.5x3.5x2 cubic meters and presented. Also the energies extractable for these solar ponds in Goller Region climatic conditions are given.

  18. New antiepileptic drugs, cost-efficacy analysis

    Directory of Open Access Journals (Sweden)

    P. N. Vlasov

    2012-01-01

    Full Text Available Objective: to optimize pharmacotherapy in patients with epilepsy and to evaluate the clinical and cost-effectiveness of its therapy with the new antiepileptic drugs (AED: levetiracetam, lamotrigine, topiramate, and oxcarbazepine.Patients and methods. The study enrolled 134 patients (women, 69.03%; men, 30.97% with different types of seizures, who had previously received antiepileptic therapy. The patients visited their physician at least twice; after correcting therapy by an epileptologist, the mono- or polytherapy regimen included new AEDs. The patients' mean age was 29.8±8.7 years; disease duration was 13.01±6.7 years; mean age at onset was 16.8±8.5 years. In the groups of working and nonworking patients with different types of seizures, the authors calculated the cost of epilepsy therapy, by taking into account the use of new AEDs and the pharmacoeconomic index "cost-benefit" before and after therapy optimization.Results. When the new AEDs were incorporated into the therapy, the low incidence rate of seizures following a year averaged 75 to 92%. The index cost-effectiveness was decreased by 2—3 times in all types of seizures when the new AEDs were used despite the increased direct cost of treatment. Also, there was a significant reduction in the cost of epilepsy treatment in practically all the groups under study. The findings suggest that the index cost-efficacy directly depends on the rational choice of an AED in an adequate dose. Rational therapy with the new AEDs makes it possible to reduce not only the total cost of epilepsy treatment, but also to lower the index cost-efficacy.

  19. Increasing returns, transport costs, vertical linkages and persistent regional inequalities

    OpenAIRE

    Viego, Valentina

    2010-01-01

    Argentina presents certain stylised features in its pattern of regional development: absence of absolute convergence in geographical per capita output, stability in spatial income gaps and locational patterns of population and economic activity, strong dependence on natural resource based activities, defficiencies in truck transport system, and significant weigh of activities with high internal transport costs, among others. The article proposes a variation of the standard model of regional g...

  20. Cost Effectiveness Analysis, A DTIC Bibliography.

    Science.gov (United States)

    1980-07-01

    Model for Estimating * 0 6 DUGAS. DORIS J. Software Life Cycle Costs (ModelGuidelines for Attracting Private *4Concept). Volume 1.Capital to Corp$ of...of Category It Test Program A0-A023 442 An Econometric Analysis of aitonance Data. VOlunteer Enlistments of service AD-AO21 258 HUMPHREYS . THOMAS H

  1. Cost-utility analysis of thrombolytic therapy

    NARCIS (Netherlands)

    M.L. Simoons (Maarten); J. Vos (Jeroen); L.L. Martens (Leonardus Lambertus)

    1991-01-01

    textabstractAn analysis of the cost-effectiveness of thrombolytic therapy was performed, based on 3- to 5-year follow-up data, from 533 patients randomized to receive conventional therapy or intracoronary streptokinase. At the 3-year follow-up, mortality was 22% in the former group and 14% after thr

  2. COST-BENEFIT ANALYSIS OF EDUCATION.

    Science.gov (United States)

    MOOD, ALEXANDER M.; POWERS, RICHARD

    DIFFICULTIES ARE ENCOUNTERED WHEN COST-BENEFIT ANALYSES ARE APPLIED TO EDUCATION. THERE ARE PROBLEMS IN THE ATTEMPT TO DEFINE AN EDUCATIONAL GOAL AND IN THE ANALYSIS OF EDUCATIONAL PROCESSES. THE FEDERAL GOVERNMENT IS NOW ENGAGED IN A MULTITUDE OF PROJECTS DESIGNED TO COORDINATE RESEARCH IN EDUCATIONAL IMPROVEMENT. THIS ENTAILS CONTINUED…

  3. Cost-effectiveness analysis and innovation.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

    While cost-effectiveness (CE) analysis has provided a guide to allocating often scarce resources spent on medical technologies, less emphasis has been placed on the effect of such criteria on the behavior of innovators who make health care technologies available in the first place. A better understanding of the link between innovation and cost-effectiveness analysis is particularly important given the large role of technological change in the growth in health care spending and the growing interest of explicit use of CE thresholds in leading technology adoption in several Westernized countries. We analyze CE analysis in a standard market context, and stress that a technology's cost-effectiveness is closely related to the consumer surplus it generates. Improved CE therefore often clashes with interventions to stimulate producer surplus, such as patents. We derive the inconsistency between technology adoption based on CE analysis and economic efficiency. Indeed, static efficiency, dynamic efficiency, and improved patient health may all be induced by the cost-effectiveness of the technology being at its worst level. As producer appropriation of the social surplus of an innovation is central to the dynamic efficiency that should guide CE adoption criteria, we exemplify how appropriation can be inferred from existing CE estimates. For an illustrative sample of technologies considered, we find that the median technology has an appropriation of about 15%. To the extent that such incentives are deemed either too low or too high compared to dynamically efficient levels, CE thresholds may be appropriately raised or lowered to improve dynamic efficiency.

  4. Learning Together; part 2: training costs and health gain - a cost analysis.

    Science.gov (United States)

    Cullen, Katherine; Riches, Wendy; Macaulay, Chloe; Spicer, John

    2017-01-01

    Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options. Activity data was collected from Training Practices hosting Learning Together. A computer based model was developed to analyse the costs of the Learning Together intervention compared to usual training in a partial economic evaluation. The results of the model were used to value the health gain required to make the intervention cost effective. Data were returned for 363 patients booked into 61 clinics across 16 Training Practices. Learning Together clinics resulted in an increase in costs of £37 per clinic. Threshold analysis illustrated one child with a common illness like constipation needs to be well for two weeks, in one Practice hosting four training clinics for the clinics to be considered cost effective. Learning Together is of minimal training cost. Our threshold analysis produced a rubric that can be used locally to test cost effectiveness at a Practice or Programme level.

  5. Ectoparasites increase swimming costs in a coral reef fish.

    Science.gov (United States)

    Binning, Sandra A; Roche, Dominique G; Layton, Cayne

    2013-02-23

    Ectoparasites can reduce individual fitness by negatively affecting behavioural, morphological and physiological traits. In fishes, there are potential costs if ectoparasites decrease streamlining, thereby directly compromising swimming performance. Few studies have examined the effects of ectoparasites on fish swimming performance and none distinguish between energetic costs imposed by changes in streamlining and effects on host physiology. The bridled monocle bream (Scolopsis bilineatus) is parasitized by an isopod (Anilocra nemipteri), which attaches above the eye. We show that parasitized fish have higher standard metabolic rates (SMRs), poorer aerobic capacities and lower maximum swimming speeds than non-parasitized fish. Adding a model parasite did not affect SMR, but reduced maximum swimming speed and elevated oxygen consumption rates at high speeds to levels observed in naturally parasitized fish. This demonstrates that ectoparasites create drag effects that are important at high speeds. The higher SMR of naturally parasitized fish does, however, reveal an effect of parasitism on host physiology. This effect was easily reversed: fish whose parasite was removed 24 h earlier did not differ from unparasitized fish in any performance metrics. In sum, the main cost of this ectoparasite is probably its direct effect on streamlining, reducing swimming performance at high speeds.

  6. A cost minimisation analysis in teledermatology: model-based approach

    Directory of Open Access Journals (Sweden)

    Eminović Nina

    2010-08-01

    Full Text Available Abstract Background Although store-and-forward teledermatology is increasingly becoming popular, evidence on its effects on efficiency and costs is lacking. The aim of this study, performed in addition to a clustered randomised trial, was to investigate to what extent and under which conditions store-and-forward teledermatology can reduce costs from a societal perspective. Methods A cost minimisation study design (a model based approach was applied to compare teledermatology and conventional process costs per dermatology patient care episode. Regarding the societal perspective, total mean costs of investment, general practitioner, dermatologists, out-of-pocket expenses and employer costs were calculated. Uncertainty analysis was performed using Monte Carlo simulation with 31 distributions in the used cost model. Scenario analysis was performed using one-way and two-way sensitivity analyses with the following variables: the patient travel distance to physician and dermatologist, the duration of teleconsultation activities, and the proportion of preventable consultations. Results Total mean costs of teledermatology process were €387 (95%CI, 281 to 502.5, while the total mean costs of conventional process costs were €354.0 (95%CI, 228.0 to 484.0. The total mean difference between the processes was €32.5 (95%CI, -29.0 to 74.7. Savings by teledermatology can be achieved if the distance to a dermatologist is larger (> = 75 km or when more consultations (> = 37% can be prevented due to teledermatology. Conclusions Teledermatology, when applied to all dermatology referrals, has a probability of 0.11 of being cost saving to society. In order to achieve cost savings by teledermatology, teledermatology should be applied in only those cases with a reasonable probability that a live consultation can be prevented. Trail Registration This study is performed partially based on PERFECT D Trial (Current Controlled Trials No.ISRCTN57478950.

  7. Cost of increasing access to artemisinin combination therapy: the Cambodian experience

    Directory of Open Access Journals (Sweden)

    Socheat Duong

    2008-05-01

    Full Text Available Abstract Background Malaria-endemic countries are switching antimalarial drug policy from cheap ineffective monotherapies to artemisinin combination therapies (ACTs for the treatment of Plasmodium falciparum malaria and the global community are considering setting up a global subsidy to fund their purchase. However, in order to ensure that ACTs are correctly used and are accessible to the poor and remote communities who need them, specific interventions will be necessary and the additional costs need to be considered. Methods This paper presents an incremental cost analysis of some of these interventions in Cambodia, the first country to change national antimalarial drug policy to an ACT of artesunate and mefloquine. These costs include the cost of rapid diagnostic tests (RDTs, the cost of blister-packaging the drugs locally and the costs of increasing access to diagnosis and treatment to remote communities through malaria outreach teams (MOTs and Village Malaria Workers (VMW. Results At optimum productive capacity, the cost of blister-packaging cost under $0.20 per package but in reality was significantly more than this because of the low rate of production. The annual fixed cost (exclusive of RDTs and drugs per capita of the MOT and VMW schemes was $0.44 and $0.69 respectively. However because the VMW scheme achieved a higher rate of coverage than the MOT scheme, the cost per patient treated was substantially lower at $5.14 compared to $12.74 per falciparum malaria patient treated. The annual cost inclusive of the RDTs and drugs was $19.31 for the MOT scheme and $11.28 for the VMW scheme given similar RDT positivity rates of around 22% and good provider compliance to test results. Conclusion In addition to the cost of ACTs themselves, substantial additional investments are required in order to ensure that they reach the targeted population via appropriate delivery systems and to ensure that they are used appropriately. In addition, differences

  8. Future Capacity Procurements Under Unknown Demand and Increasing Costs

    OpenAIRE

    Apostolos Burnetas; Stephen Gilbert

    2001-01-01

    In this paper we study a situation in which a broker must manage the procurement of a short-life-cycle product. As the broker observes demand for the item, she learns about the demand process. However, as is often the case in practice, it becomes either more difficult or more expensive to procure the item as the selling season advances. Thus, the broker must trade off higher procurement costs against the benefit of making ordering decisions with better information about demand. Problems of th...

  9. Integrated analysis considered mitigation cost, damage cost and adaptation cost in Northeast Asia

    Science.gov (United States)

    Park, J. H.; Lee, D. K.; Kim, H. G.; Sung, S.; Jung, T. Y.

    2015-12-01

    Various studies show that raising the temperature as well as storms, cold snap, raining and drought caused by climate change. And variety disasters have had a damage to mankind. The world risk report(2012, The Nature Conservancy) and UNU-EHS (the United Nations University Institute for Environment and Human Security) reported that more and more people are exposed to abnormal weather such as floods, drought, earthquakes, typhoons and hurricanes over the world. In particular, the case of Korea, we influenced by various pollutants which are occurred in Northeast Asian countries, China and Japan, due to geographical meteorological characteristics. These contaminants have had a significant impact on air quality with the pollutants generated in Korea. Recently, around the world continued their effort to reduce greenhouse gas and to improve air quality in conjunction with the national or regional development goals priority. China is also working on various efforts in accordance with the international flows to cope with climate change and air pollution. In the future, effect of climate change and air quality in Korea and Northeast Asia will be change greatly according to China's growth and mitigation policies. The purpose of this study is to minimize the damage caused by climate change on the Korean peninsula through an integrated approach taking into account the mitigation and adaptation plan. This study will suggest a climate change strategy at the national level by means of a comprehensive economic analysis of the impacts and mitigation of climate change. In order to quantify the impact and damage cost caused by climate change scenarios in a regional scale, it should be priority variables selected in accordance with impact assessment of climate change. The sectoral impact assessment was carried out on the basis of selected variables and through this, to derive the methodology how to estimate damage cost and adaptation cost. And then, the methodology was applied in Korea

  10. Cost-benefit analysis of wetland restoration

    DEFF Research Database (Denmark)

    Dubgaard, Alex

    2004-01-01

    The purpose of cost-benefit analysis (CBA) is to identify value for money solutions to government policies or projects. Environmental policy appraisal is typically complicated by the fact that thre are a number of feasible solutions to a decision problem - each yielding a different mix...... of environmental services. Costs typically depend on the level of ambitions regarding the magnitude and multitude of benefits. Decision makers are therefore confronted with the questions: how can generically different benefits be measured in comparable terms and how should different levels of project costs...... be weighed against benefits? Economic valuation methods and CBA simplify the decision problem by reducing the various effects to single-valued commensurate magnitudes, which - in principle at least - facilitates the identification of a socially optimal solution. The main objective of this article...

  11. Final Report: Hydrogen Storage System Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); Houchins, Cassidy [Strategic Analysis Inc., Arlington, VA (United States); Huya-Kouadio, Jennie Moton [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel A. [Strategic Analysis Inc., Arlington, VA (United States)

    2016-09-30

    The Fuel Cell Technologies Office (FCTO) has identified hydrogen storage as a key enabling technology for advancing hydrogen and fuel cell power technologies in transportation, stationary, and portable applications. Consequently, FCTO has established targets to chart the progress of developing and demonstrating viable hydrogen storage technologies for transportation and stationary applications. This cost assessment project supports the overall FCTO goals by identifying the current technology system components, performance levels, and manufacturing/assembly techniques most likely to lead to the lowest system storage cost. Furthermore, the project forecasts the cost of these systems at a variety of annual manufacturing rates to allow comparison to the overall 2017 and “Ultimate” DOE cost targets. The cost breakdown of the system components and manufacturing steps can then be used to guide future research and development (R&D) decisions. The project was led by Strategic Analysis Inc. (SA) and aided by Rajesh Ahluwalia and Thanh Hua from Argonne National Laboratory (ANL) and Lin Simpson at the National Renewable Energy Laboratory (NREL). Since SA coordinated the project activities of all three organizations, this report includes a technical description of all project activity. This report represents a summary of contract activities and findings under SA’s five year contract to the US Department of Energy (Award No. DE-EE0005253) and constitutes the “Final Scientific Report” deliverable. Project publications and presentations are listed in the Appendix.

  12. Methodological considerations in the analysis of cost effectiveness in dentistry.

    Science.gov (United States)

    Antczak-Bouckoms, A A; Tulloch, J F; White, B A; Capilouto, E I

    1989-01-01

    Cost-effectiveness analysis is a technique applied with increasing frequency to help make rational decisions in health care resource allocation. This article reviews the ten general principles of cost-effectiveness analysis outlined by the Office of Technology Assessment of the US Congress and describes a model for such analyses used widely in medicine, but only recently applied in dentistry. The imperative for the formulation of the best current information on both the effectiveness of dental practices and their costs is made more urgent because of the now universally recognized belief that resources available to meet the demands for health care are limited. Today's environment requires critical allocation decisions within categorical health problems, across diseases, or relative to other health problems. If important health benefits or cost savings are to be realized, then these analytic approaches must become widely understood, accepted, and appropriately applied by key decision makers in the dental health sector.

  13. 77 FR 65754 - Cost-of-Living Increase and Other Determinations for 2013

    Science.gov (United States)

    2012-10-30

    ... ADMINISTRATION Cost-of-Living Increase and Other Determinations for 2013 AGENCY: Social Security Administration... cost-of-living increase in Social Security benefits effective December 2012. As a result of this... benefits) in 2013; and (5) The dollar limit on the administrative cost assessment charged to...

  14. Preventing fatal diseases increases healthcare costs: cause elimination life table approach

    NARCIS (Netherlands)

    L.G.A. Bonneux (Luc); J.J.M. Barendregt (Jan); W.J. Nusselder (Wilma); P.J. van der Maas (Paul)

    1998-01-01

    textabstractOBJECTIVES: To examine whether elimination of fatal diseases will increase healthcare costs. DESIGN: Mortality data from vital statistics combined with healthcare spending in a cause elimination life table. Costs were allocated to specific diseases through t

  15. Low cost real time interactive analysis system

    Science.gov (United States)

    Stetina, F.

    1988-01-01

    Efforts continue to develop a low cost real time interactive analysis system for the reception of satellite data. A multi-purpose ingest hardware software frame formatter was demonstrated for GOES and TIROS data and work is proceeding on extending the capability to receive GMS data. A similar system was proposed as an archival and analysis system for use with INSAT data and studies are underway to modify the system to receive the planned SeaWiFS (ocean color) data. This system was proposed as the core of a number of international programs in support of U.S. AID activities. Systems delivered or nearing final testing are listed.

  16. 78 FR 66413 - Cost-of-Living Increase and Other Determinations for 2014

    Science.gov (United States)

    2013-11-05

    ... such benefits). The dollar fee limits are subject to increase by the cost-of-living increase, with the... lower, a dollar amount that is subject to increase by the cost-of-living increase. We derive the dollar... consistent with the national average wage indexing series for 1951 through 1977 (published December 29,...

  17. Nuclear Power Plant Module, NPP-1: Nuclear Power Cost Analysis.

    Science.gov (United States)

    Whitelaw, Robert L.

    The purpose of the Nuclear Power Plant Modules, NPP-1, is to determine the total cost of electricity from a nuclear power plant in terms of all the components contributing to cost. The plan of analysis is in five parts: (1) general formulation of the cost equation; (2) capital cost and fixed charges thereon; (3) operational cost for labor,…

  18. Modelling User-Costs in Life Cycle Cost-Benefit (LCCB) analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2008-01-01

    The importance of including user's costs in Life-Cycle Cost-Benefit analysis of structures is discussed in this paper. This is especially for bridges of great importance. Repair or/and failure of a bridge will usually result in user costs greater than the repair or replacement costs of the bridge...

  19. Cost-benefit and cost-efficiency analysis of the water footprint in Spain; Analisis coste-beneficio y coste-eficiencia de la Huella Hidrica en Espana

    Energy Technology Data Exchange (ETDEWEB)

    Sotelo Navalpotro, J. A.; Sotelo Perez, M.; Garcia Quiroca, F.

    2011-07-01

    We are increasingly needing ways to secure patterns of development that be sustainable, that is, environmentally, socially and economically appropriate for us and for future generations. Sustainability indicators are a promising tool that would allow us to land the concept, supporting the way in which decisions are made. In Spain there are few experiences on the subject. This paper presents the work carried out to develop sustainability indicators. Throughout the present study shows the importance of analysis of cost-benefit and cost efficiency in the assessment of the water footprint of Spain. (Author)

  20. Rapid increase of health care utilization and cost due to benign prostatic hyperplasia in Korean men: retrospective population-based analysis using the Health Insurance Review and Assessment service data.

    Science.gov (United States)

    Son, Hwancheol; Park, Juhyun; Song, Sang Hoon; Kang, Jung Yoon; Hong, Sung Kyu; Lee, Hyun Moo; Kim, Sun-Hee; Park, Byung-Joo; Lee, Hyung-Lae; Lee, Kyung Seop

    2015-02-01

    Using the Korean public health insurance database, we analyzed patients diagnosed as benign prostatic hyperplasia (BPH) from 2004 to 2008. Age and year-specific amount and seasonal variation of hospital visits (HV), duration of treatment (DT), the total and per capita amount of insurance payment (TAIP, PCIP) were evaluated. A total of 12,088,995 HV were studied. Total HV increased 1.7 times and DT almost doubled in 2008 compared to those in 2004. HV, DT, and TAIP showed linearly increasing patterns year by year. In a time series analysis, HV increased in winter and demonstrated seasonality in a 12-month cycle. In a Poisson regression analysis, the annual variations of HV, DT, TAIP, and PCIP were different by age groups. In patients older than 40 yr, HV significantly increased 1.10-1.16 times compared to that of the previous year. DT markedly increased in their 60s and 80s patients. The rate of increase in PCIP was steeper in patients 50 yr and older than in the others.Health care utilization due to BPH was rapidly increasing in Korea and it was remarkable in the elderly population. Seasonal variation of HV demonstrated that health care utilization increased in winter.

  1. Cost Benefit Analysis of the Power Storage System Considering Outage Cost in the Deregulated Power Market

    Science.gov (United States)

    Tsuru, Hirokazu; Fujii, Yasumasa

    In this paper, the authors propose the mathematical model which derives the optimal operation strategies of an on-site power storage system through the use of stochastic dynamic programming technique. The model takes account of the variations and uncertainties of electricity market prices as well as the outage costs of power grid failures. The market price fluctuation is modeled with stochastic differential equation. The stochastic state transitions between normal and failed systems are modeled with exponential density functions. The derived optimal operation indicates that the economic value of the storage system may be increased substantially, if the avoided outage costs are explicitly taken into account. The results of the sensitivity analysis indicate that the most influential parameters are the magnitude of outage cost and the mean time to failure of power grid.

  2. 48 CFR 1552.217-74 - Option for increased quantity-cost-plus-award-fee contract.

    Science.gov (United States)

    2010-10-01

    ... quantity-cost-plus-award-fee contract. 1552.217-74 Section 1552.217-74 Federal Acquisition Regulations... Texts of Provisions and Clauses 1552.217-74 Option for increased quantity—cost-plus-award-fee contract. As prescribed in 1517.208(e), insert this contract clause in cost-plus-award-fee term contracts when...

  3. 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.

  4. Using Cost-Effectiveness Analysis to Address Health Equity Concerns.

    Science.gov (United States)

    Cookson, Richard; Mirelman, Andrew J; Griffin, Susan; Asaria, Miqdad; Dawkins, Bryony; Norheim, Ole Frithjof; Verguet, Stéphane; J Culyer, Anthony

    2017-02-01

    This articles serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. We first introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who gains and who loses from a cost-increasing health program depends on differences among people in terms of health risks, uptake, quality, adherence, capacity to benefit, and-crucially-who bears the opportunity costs of diverting scarce resources from other uses. We describe two main ways of using CEA to address health equity concerns: 1) equity impact analysis, which quantifies the distribution of costs and effects by equity-relevant variables, such as socioeconomic status, location, ethnicity, sex, and severity of illness; and 2) equity trade-off analysis, which quantifies trade-offs between improving total health and other equity objectives. One way to analyze equity trade-offs is to count the cost of fairer but less cost-effective options in terms of health forgone. Another method is to explore how much concern for equity is required to choose fairer but less cost-effective options using equity weights or parameters. We hope this article will help the health technology assessment community navigate the practical options now available for conducting equity-informative CEA that gives policymakers a better understanding of equity impacts and trade-offs.

  5. Cost analysis of the Spanish renal replacement therapy programme.

    Science.gov (United States)

    Villa, Guillermo; Rodríguez-Carmona, Ana; Fernández-Ortiz, Lucía; Cuervo, Jesús; Rebollo, Pablo; Otero, Alfonso; Arrieta, Javier

    2011-11-01

    A cost analysis of the Spanish Renal Replacement Therapy (RRT) programme in the year 2010, for end-stage renal disease (ESRD) patients, was performed from the perspective of the Public Administration. The costs associated with each RRT modality [hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (Tx)] were analysed. The Spanish ESRD incidence and prevalence figures in the year 2010 were forecasted in order to enable the calculation of an aggregate cost for each modality. Costs were mainly computed based on a review of the existing literature and of the Official Bulletins of the Spanish Autonomous Communities. Data from Oblikue Consulting eSalud health care costs database and from several Spanish public sources were also employed. In the year 2010, the forecasted incidence figures for HD, PD and Tx were 5409, 822 and 2317 patients, respectively. The forecasted prevalence figures were 22,582, 2420 and 24,761 patients, respectively. The average annual per-patient costs (incidence and prevalence) were €2651 and €37,968 (HD), €1808 and €25,826 (PD) and €38,313 and €6283 (Tx). Indirect costs amounted to €8929 (HD), €7429 (PD) and €5483 (Tx). The economic impact of the Spanish RRT programme on the Public Administration budget was estimated at ~€1829 million (indirect costs included): €1327 (HD), €109 (PD) and €393 (Tx) million. HD accounted for >70% of the aggregate costs of the Spanish RRT programme in 2010. From a costs minimization perspective, it would be preferable if the number of incident and prevalent patients in PD were increased.

  6. Cost Analysis of Ceramic Heads in Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Carnes, Keith J; Odum, Susan M; Troyer, Jennifer L; Fehring, Thomas K

    2016-11-02

    The advent of adverse local tissue reactions seen in metal-on-metal bearings, and the recent recognition of trunnionosis, have led many surgeons to recommend ceramic-on-polyethylene articulations for primary total hip arthroplasty. However, to our knowledge, there has been little research that has considered whether the increased cost of ceramic provides enough benefit over cobalt-chromium to justify its use. The primary purpose of this study was to compare the cost-effectiveness of ceramic-on-polyethylene implants and metal-on-polyethylene implants in patients undergoing total hip arthroplasty. Markov decision modeling was used to determine the ceramic-on-polyethylene implant revision rate necessary to be cost-effective compared with the revision rate of metal-on-polyethylene implants across a range of patient ages and implant costs. A different set of Markov models was used to estimate the national cost burden of choosing ceramic-on-polyethylene implants over metal-on-polyethylene implants for primary total hip arthroplasties. The Premier Research Database was used to identify 20,398 patients who in 2012 were ≥45 years of age and underwent a total hip arthroplasty with either a ceramic-on-polyethylene implant or a metal-on-polyethylene implant. The cost-effectiveness of ceramic heads is highly dependent on the cost differential between ceramic and metal femoral heads and the age of the patient. At a cost differential of $325, ceramic-on-polyethylene bearings are cost-effective for patients price premium for ceramic and the age of the patient. A wholesale switch to ceramic bearings regardless of age or cost differential may result in an economic burden to the health system. Economic and decision analysis, Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  7. Heliostat production evaluation and cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Britt, J. F.; Shulte, C. W.; Davey, H. L.

    1979-12-01

    The primary objective of this study is to provide a factory cost for the production of heliostats in terms of 1979 dollars. Factory cost is defined as the sum of all direct labor, direct material and burden expenses that are incurred in the manufacture of a heliostat, and its packaging for shipment. Transportation, installation, taxes other than plant real taxes, profit, selling expenses, and all other profit and loss items are not included. Two production volumes are considered, 25,000 heliostat units per year and 250,000 heliostat units per year. The study concluded that the factory cost to manufacture heliostats is $95.99/m/sup 2/ at 25,000 units per year and $67.95/m/sup 2/ at 250,000 units per year. The Policy Analysis Branch of the Solar Energy Research Institute estimates that this implies an installed price of $122.12/m/sup 2/ at the 25,000 unit-per-year volume.

  8. Cost Benefit Analysis of Boat Lifts

    Science.gov (United States)

    2014-09-01

    to avoid the potential of mishaps due to jumping across open water to reach both sides of the lift. With the life expectancy of a boat ramp...to jumping across open water to reach both sides of the lift. Cost Benefit Analysis of Boat Lifts 11 UNCLAS//Public | CG-926 R&DC | B. Fike...equipment from boats and craft that have been corrosion problems in the past. such as wire rope and non-stainless steel hardware. Corrosion is a function

  9. Lean Cost Management Analysis on Food Processing Enterprise

    Directory of Open Access Journals (Sweden)

    Jing Ma

    2014-06-01

    Full Text Available The aim of this study is to introduce Lean Cost Management (LCM that tries to create creating value for customers and performs whole cost management in enterprise’s entire life cycle under structure of target cost, cost sustaining and cost improvement guided by reverse thinking into food processing enterprise to construct LCM system from aspects of external value chain analysis as well as internal cost management. Dynamic pricing game model was used to provide cost improvement on food enterprise value chain so as to minimize whole cost. The target cost was divided into each part in design phase supported by cost programming, cost reduction and cost improving. Case study shows that such cost suppressing method can reduce cost of food processing enterprises and improve long-term competitiveness.

  10. 医药费用逐年增加的因素分析与对策建议%Reasons Analysis for Constant Increase of Medical Costs Year by Year and Countermeasures Suggestion

    Institute of Scientific and Technical Information of China (English)

    张超; 潘木善

    2013-01-01

    OBJECTIVE:To provide reference for constant increase of medical costs year by year returning to normal.METHODS:By analyzing the changes of hospital management direction,the approval of new drugs,pharmaceutical production,circulation and tender,the construction of hospital pharmacists team and the status quo of adverse media advertising,the factors that caused medical costs increasing year by year were discussed,and the corresponding countermeasures were put forward.RESULTS & CONCLUSIONS:Constant increase of medical cost year by year are caused by ever-expanding hospital beds,constant additions of equipment,irrational application of hospital supplies,not standardized approval of new drug (instruments),false high price of drag caused by drug tender "alienation",non-standard pharmaceutical distribution and operations,shortage of pharmacists talent caused by "focusing on medicine and ignoring pharmacy",misleading of media advertising and other factors.It is suggested that the government should clear the nature,location and purpose of medical institutions,strengthen the production,distribution and bidding of medicines and medical supplies,strengthen the pharmacist team building and enhance the supervision of media advertising to promote reasonable return of the medical costs gradually.%目的:为促使逐年增加的医药费用合理回归提供参考.方法:通过分析医院经营方向变化,新药审批与药品生产、流通、招标以及医院药师队伍建设和媒体广告的现状等,探讨引起医药费用逐年增加的因素,并提出相应对策.结果与结论:医院床位不断扩张、设备不断添置、医院耗材不合理应用、新药(械)审批不够规范、药品招标“异化”造成药价虚高、药品流通经营不规范、重医轻药造成药师队伍人才不足以及媒体广告误导等多种因素造成医药费用逐年增加.建议政府要明确医疗机构的性质、定位与宗旨,加强药品及医用耗材生产、流

  11. Increase the Performance of Companies in the Energy Sector by Implementing the Activity-Based Costing

    OpenAIRE

    Letitia-Maria Rof; Sorinel Capusneanu

    2015-01-01

    This article highlights the increasing performances as result of implementation stages of the ActivityBased Costing in the companies operating in the energy sector in Romania. There are presented some aspects of the usefulness of applying the Activity-Based Costing in the energy sector and the advantages it offers compared to traditional costing. There are also outlined the steps for applying the Activity-Based Costing and its implementation in the largest hydropower producer in Romania. The ...

  12. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region.

  13. An improved set of standards for finding cost for cost-effectiveness analysis.

    Science.gov (United States)

    Barnett, Paul G

    2009-07-01

    Guidelines have helped standardize methods of cost-effectiveness analysis, allowing different interventions to be compared and enhancing the generalizability of study findings. There is agreement that all relevant services be valued from the societal perspective using a long-term time horizon and that more exact methods be used to cost services most affected by the study intervention. Guidelines are not specific enough with respect to costing methods, however. The literature was reviewed to identify the problems associated with the 4 principal methods of cost determination. Microcosting requires direct measurement and is ordinarily reserved to cost novel interventions. Analysts should include nonwage labor cost, person-level and institutional overhead, and the cost of development, set-up activities, supplies, space, and screening. Activity-based cost systems have promise of finding accurate costs of all services provided, but are not widely adopted. Quality must be evaluated and the generalizability of cost estimates to other settings must be considered. Administrative cost estimates, chiefly cost-adjusted charges, are widely used, but the analyst must consider items excluded from the available system. Gross costing methods determine quantity of services used and employ a unit cost. If the intervention will affect the characteristics of a service, the method should not assume that the service is homogeneous. Questions are posed for future reviews of the quality of costing methods. The analyst must avoid inappropriate assumptions, especially those that bias the analysis by exclusion of costs that are affected by the intervention under study.

  14. Room Service Improves Nutritional Intake and Increases Patient Satisfaction While Decreasing Food Waste and Cost.

    Science.gov (United States)

    McCray, Sally; Maunder, Kirsty; Krikowa, Renee; MacKenzie-Shalders, Kristen

    2017-07-01

    Room service is a foodservice model that has been increasingly implemented across health care facilities in an effort to improve patient satisfaction and reduce food waste. In 2013, Mater Private Hospital Brisbane, Australia, was the first hospital in Australia to implement room service, with the aim of improving patient nutrition care and reducing costs. The aim of this study was to comprehensively evaluate the nutritional intake, plate waste, patient satisfaction, and patient meal costs of room service compared to a traditional foodservice model. A retrospective analysis of quality-assurance data audits was undertaken to assess patient nutritional intake between a facility utilizing a traditional foodservice model and a facility utilizing room service and in a pre-post study design to assess plate waste, patient satisfaction, and patient meal costs before and after the room service implementation. Audit data were collected for eligible adult inpatients in Mater Private Hospital Brisbane and Mater Hospital Brisbane, Australia, between July 2012 and May 2015. The primary outcome measures were nutritional intake, plate waste, patient satisfaction, and patient meal costs. Independent samples t-tests and χ(2) analyses were conducted between pre and post data for continuous data and categorical data, respectively. Pearson χ(2) analysis of count data for sex and reasons for plate waste for data with counts more than five was used to determine asymptotic (two-sided) significance and n-1 χ(2) used for the plate waste analysis. Significance was assessed at Pnutritional intake, improved patient satisfaction, and reduced plate waste and patient meal costs with room service compared to a traditional foodservice model. Comparison of nutritional intake between a traditional foodservice model (n=85) and room service (n=63) showed statistically significant increases with room service in both energy (1,306 kcal/day vs 1,588 kcal/day; P=0.005) and protein (52 g/day vs 66 g

  15. 78 FR 68133 - Cost-of-Living Increases and Other Determinations for 2014; Correction

    Science.gov (United States)

    2013-11-13

    ... ADMINISTRATION Cost-of-Living Increases and Other Determinations for 2014; Correction AGENCY: Social Security Administration. ACTION: Notice; Correction. SUMMARY: The Social Security Administration published a document in the Federal Register of November 5, 2013, concerning the cost-of-living increase in Social...

  16. Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

    OpenAIRE

    Li, Rui; Simmons, Katharine B.; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M.; Valencia-Prado, Miguel; Bracero, Nabal; Denise J. Jamieson; Barfield, Wanda; Moore, Cynthia A.; Mai, Cara T.; Korhonen, Lauren C.; Frey, Meghan T

    2017-01-01

    We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). The estima...

  17. Analysis and modeling of rail maintenance costs

    Directory of Open Access Journals (Sweden)

    Amir Ali Bakhshi

    2012-01-01

    Full Text Available Railroad maintenance engineering plays an important role on availability of roads and reducing the cost of railroad incidents. Rail is of the most important parts of railroad industry, which needs regular maintenance since it covers a significant part of total maintenance cost. Any attempt on optimizing total cost of maintenance could substantially reduce the cost of railroad system and it can reduce total cost of the industry. The paper presents a new method to estimate the cost of rail failure using different cost components such as cost of inspection and cost of risk associated with possible accidents. The proposed model of this paper is used for a real-world case study of railroad transportation of Tehran region and the results have been analyzed.

  18. Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs

    Science.gov (United States)

    Raineri, C.; Stivari, T. S. S.; Gameiro, A. H.

    2015-01-01

    Since lamb is a commodity, producers cannot control the price of the product they sell. Therefore, managing production costs is a necessity. We explored the study of elasticities as a tool for basing decision-making in sheep production, and aimed at investigating the composition and elasticities of lamb production costs, and their influence on the performance of the activity. A representative sheep production farm, designed in a panel meeting, was the base for calculation of lamb production cost. We then performed studies of: i) costs composition, and ii) cost elasticities for prices of inputs and for zootechnical indicators. Variable costs represented 64.15% of total cost, while 21.66% were represented by operational fixed costs, and 14.19% by the income of the factors. As for elasticities to input prices, the opportunity cost of land was the item to which production cost was more sensitive: a 1% increase in its price would cause a 0.2666% increase in lamb cost. Meanwhile, the impact of increasing any technical indicator was significantly higher than the impact of rising input prices. A 1% increase in weight at slaughter, for example, would reduce total cost in 0.91%. The greatest obstacle to economic viability of sheep production under the observed conditions is low technical efficiency. Increased production costs are more related to deficient zootechnical indexes than to high expenses. PMID:26104531

  19. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    Science.gov (United States)

    Harmon, Corey C.; Warfield, Keith R.; Rosenberg, Leigh S.

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

  20. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    Science.gov (United States)

    Harmon, Corey C.; Warfield, Keith R.; Rosenberg, Leigh S.

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

  1. THE ANALYSIS OF INFORMATICS SECURITY COSTS IN CITIZEN ORIENTED APPLICATIONS

    OpenAIRE

    Dragos Palaghita; Bogdan Vintila

    2010-01-01

    The paper highlights the analysis of informatics security costs for the citizen oriented applications. The citizen oriented informatics applications are defined. The differences brought by these when compared with the traditional applications are described. Structures of citizen oriented informatics applications are presented. A few common citizen oriented applications are discussed. The special security requirements of the citizen oriented applications are discussed. Ways of increasing the s...

  2. [Clinical cost analysis of balloon kyphoplasty--is there a possibility of cost-covering treatment?].

    Science.gov (United States)

    Chmielnicki, M; McDougall, A M; Prokop, A

    2014-06-01

    Financial pressure on hospitals has been a major issue in the health care system of the past years and the financial situation is often what decides about the future of the hospitals. Therefore today the economic feasibility of patient treatment in hospitals is more important than ever before. After the degradation of the case-based lump sum of I09D to I09F on a one and two level kyphoplasty we took that as motivation to do a cost analysis on 10 randomised cases. The average age of the patients was 75 years (m : f = 2 : 8), the average stay in hospital was 8 days (3-12 d). The analysis was done by a searching of documents in cooperation with the firm GFG-Beratungsgesellschaft mbH (Mönchengladbach, Germany). We found that the average overall cost which includes the cost of hospital stay and the expenditure on material was 7512.53 € and the average earnings of the cases was 7610,97 €, the difference and in that way the proceeds was 98.44 €. On that result performance of a one-level kyphoplasty especially after the degradation of the case-based lump sum in 2013 is possible in a cost-covering way, an increase in profit may be possible by a decrement of hospital stay. In 2014 one- and two-stage kyphoplasty once underwent a reduction of G-DRG from I09F to I09E. At the same time the cost weight of lump compensation I09E was increased by 0.071 with the result that in 2014, with an increased federal base value of 3156.82 € (in 2013 the federal base rate value was 3068.37 €), additional proceeds of 404,92 € can be realised in the field of one- and two-stage kyphoplasty compared to in 2013. On that result a one-level kyphoplasty especially after the degradation of the case-based lump sum in 2013 and in 2014 is possible in a cost-covering manner, an increase in profit may be possible by a decrement of hospital stay.

  3. Cost Accounting and Analysis for University Libraries.

    Science.gov (United States)

    Leimkuhler, Ferdinand F.; Cooper, Michael D.

    The approach to library planning studied in this report is the use of accounting models to measure library costs and implement program budgets. A cost-flow model for a university library is developed and listed with historical data from the Berkeley General Library. Various comparisons of an exploratory nature are made of the unit costs for…

  4. The Contemporary Ways to Improve the Cost Management System in Order to Increase the Competitiveness of Enterprise

    Directory of Open Access Journals (Sweden)

    Chumak Larysa F.

    2017-03-01

    Full Text Available The article is aimed at studying the current directions and ways to improve the cost management systems, allowing to increase the competitiveness of enterprise. Costs of enterprise, in any conditions of existence, are the most significant aspect of the influence on formation of economic performance, as well as obtaining the important competitive advantages, playing a special role in achieving sustainable development. Cost management system of enterprise is one of the basic elements in developing and careful substantiating the managerial decisions, therefore its continuous improvement is necessary. Improving the enterprise’s cost management system requires an integrated approach to its formation, introduction of the latest modern approaches, methods, and elaborations. Analysis of directions for improving the efficiency of cost management systems allows to define the most promising way of adapting to the practical use of the most advanced automated systems.

  5. Cost Effectiveness Analysis of Optimal Malaria Control Strategies in Kenya

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

  6. Relative value units and cost analysis, Part 3 of 4.

    Science.gov (United States)

    Glass, Kathryn P; Anderson, Jeffery R

    2002-01-01

    In recent years, the interest in relative value unit (RVU) cost analysis has been on the rise. Why all the excitement? RVU cost analysis places the knowledge, and therefore the power, in the hands of the administrator to negotiate revenues, analyze expenditures, and control costs. Cost analysis at the per (relative)-unit level allows for procedure profitability (or loss) analysis, setting internal fee schedules based on costs, contract negotiation based on RVU cost and utilization, equitable provider compensation packages based on productivity and overhead coverage, and tracking ancillary and referral utilization risks. In short, RVU cost accounting uses the Resource-Based Relative Value Scale (RBRVS) instead of stopwatches and clipboards when measuring clinical costs and activity.

  7. Integrating Evaluation into a Program for Increased Utility and Cost-Effectiveness.

    Science.gov (United States)

    Patton, Michael Quinn

    1988-01-01

    An approach toward integrating evaluation into a program at its inception is presented as a way to increase utility and cost-effectiveness. Examples illustrate that such integration, combining internal and external evaluation, is preferable to independent and separate evaluation in terms of the cost to stakeholders. (SLD)

  8. Increased cost sharing and changes in noncompliance with specialty referrals in The Netherlands.

    NARCIS (Netherlands)

    Esch, T.E.M. van; Brabers, A.E.M.; Dijk, C.E. van; Gusdorf, L.; Groenewegen, P.P.; Jong, J.D. de

    2017-01-01

    The compulsory deductible, a form of patient cost-sharing in the Netherlands, has more than doubled during the past years. There are indications that as a result, refraining from medical care has increased. We studied the relation between patient cost-sharing and refraining from medical care by

  9. Cost analysis of energy storage systems for electric utility applications

    Energy Technology Data Exchange (ETDEWEB)

    Akhil, A. [Sandia National Lab., Albuquerque, NM (United States); Swaminathan, S.; Sen, R.K. [R.K. Sen & Associates, Inc., Bethesda, MD (United States)

    1997-02-01

    Under the sponsorship of the Department of Energy, Office of Utility Technologies, the Energy Storage System Analysis and Development Department at Sandia National Laboratories (SNL) conducted a cost analysis of energy storage systems for electric utility applications. The scope of the study included the analysis of costs for existing and planned battery, SMES, and flywheel energy storage systems. The analysis also identified the potential for cost reduction of key components.

  10. Strategic cost-benefit analysis of energy policies: overview

    Energy Technology Data Exchange (ETDEWEB)

    Davitian, H; Groncki, P J; Kleeman, P; Lukachinski, J; Goettle, IV, R J; Hudson, E A

    1979-10-01

    This study describes three possible energy strategies and analyzes each in terms of its economic, environmental, and national security benefits and costs. Each strategy is represented by a specific policy. In the first, no additional programs or policies are initiated beyond those currently in effect or announced. The second is directed toward reducing the growth in energy demand, i.e., energy conservation. The third promotes increased domestic supply through accelerated development of synthetic and unconventional fuels. The analysis focuses on the evaluation and comparison of these strategy alternatives with respect to their energy, economic, and environmental consequences. The results indicate that conservation can substantially reduce import dependence and slow the growth of energy demand, with only a small macroeconomic cost and with substantial environmental benefits; the synfuels policy reduces imports by a smaller amount, does not reduce the growth in energy demand, involves substantial environmental costs and slows the rate of economic growth. These relationships could be different if the energy savings per unit cost for conservation are less than anticipated, or if the costs of synthetic fuels can be significantly lowered. Given these uncertainties, both conservation and RD and D support for synfuels should be included in future energy policy. However, between these policy alternatives, conservation appears to be the preferred strategy. The results of this study are presented in three reports (see also BNL--51127 and BNL--51128).

  11. [Cost analysis of patient blood management].

    Science.gov (United States)

    Kleinerüschkamp, A G; Zacharowski, K; Ettwein, C; Müller, M M; Geisen, C; Weber, C F; Meybohm, P

    2016-06-01

    Patient blood management (PBM) is a multidisciplinary approach focusing on the diagnosis and treatment of preoperative anaemia, the minimisation of blood loss, and the optimisation of the patient-specific anaemia reserve to improve clinical outcomes. Economic aspects of PBM have not yet been sufficiently analysed. The aim of this study is to analyse the costs associated with the clinical principles of PBM and the project costs associated with the implementation of a PBM program from an institutional perspective. Patient-related costs of materials and services were analysed at the University Hospital Frankfurt for 2013. Personnel costs of all major processes were quantified based on the time required to perform each step. Furthermore, general project costs of the implementation phase were determined. Direct costs of transfusing a single unit of red blood cells can be calculated to a minimum of €147.43. PBM-associated costs varied depending on individual patient requirements. The following costs per patient were calculated: diagnosis of preoperative anaemia €48.69-123.88; treatment of preoperative anaemia (including iron-deficiency anaemia and megaloblastic anaemia) €12.61-127.99; minimising perioperative blood loss (including point-of-care diagnostics, coagulation management and cell salvage) €3.39-1,901.81; and costs associated with the optimisation of the tolerance to anaemia (including patient monitoring and volume therapy) €28.62. General project costs associated with the implementation of PBM were €24,998.24. PBM combines various alternatives to the transfusion of red blood cells and improves clinical outcome. Costs of PBM vary from institution to institution and depend on the extent to which different aspects of PBM have been implemented. The quantification of costs associated with PBM is essential in order to assess the economic impact of PBM, and thereby, to efficiently re-allocate health care resources. Costs were determined at a single

  12. Brain network analysis: separating cost from topology using cost-integration.

    Directory of Open Access Journals (Sweden)

    Cedric E Ginestet

    Full Text Available A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i differences in weighted costs and (ii differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

  13. Cost of wound treatment to increase significantly in Denmark over the next decade

    DEFF Research Database (Denmark)

    Hjort, Anne Mette; Gottrup, F

    2010-01-01

    To demonstrate that changes in demography, life expectancy and incidence of background diseases (including type 2 diabetes mellitus) during the period 2009-2020 will significantly increase the costs of wound care in Denmark.......To demonstrate that changes in demography, life expectancy and incidence of background diseases (including type 2 diabetes mellitus) during the period 2009-2020 will significantly increase the costs of wound care in Denmark....

  14. Social cost benefit analysis and energy policy

    NARCIS (Netherlands)

    De Nooij, M.

    2012-01-01

    Most research into the reliability of electricity supply focuses on the suppliers. Reductions in the number of power interruptions will often be possible, but also very costly. These costs will eventually be borne by the electricity users. This paper studies the value of supply security in order to

  15. Cost Differential Analysis--Phase 2

    Science.gov (United States)

    Wystrom, Dennis C.; And Others

    1974-01-01

    The cost system designed as a sub-system of the Management Information System, to record and report cost data for occupational courses funded by the Illinois Division of Vocational and Technical Education, can stand alone if necessary, providing the flexibility essential to the success of the total system. (Flow chart included.) (Author/SA)

  16. Fundamental Cost Analysis of Cold Spray

    Science.gov (United States)

    Stier, O.

    2014-01-01

    The cost structure of the cold spray (CS) process is analyzed using a generic cost model applicable to all present types of CS systems ("high pressure," "low pressure," KM™, "kinetic spraying," etc.) and kinds of application (coating, restoration, additive manufacturing, near-net forming). The cost model has originally been developed at SIEMENS and is easy to use, while being sufficiently accurate to support decisions. The dependence of the process costs on the gas stagnation properties is discussed. It is shown (i) that high pressure is generally favorable, (ii) that He-N2 blends possess economic potential, and (iii) that He recovery saves costs in high volume production, even when He-N2 blends are used. The cost model allows for the determination of the cost-optimal He concentration of the propellant gas for a given application. CS is, among others, suited to spray bond coatings on gas turbine blades and offers cost-saving potential, as shown in a case study.

  17. Department of the Army Cost Analysis Manual

    Science.gov (United States)

    2001-05-01

    SECTION I - AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) ................................................................179 SECTION II - AUTOMATED...Management & Comptroller) endorsed the Automated Cost Estimating Integrated Tools ( ACEIT ) model and since it is widely used to prepare POEs, CCAs and...CRB IPT (in ACEIT ) will be the basis for information contained in the CAB. Any remaining unresolved issues from the IPT process will be raised at the

  18. Análisis "coste-beneficio" y "coste-eficiencia" de la Huella Hídrica en España/Cost-benefit and cost-efficiency analysis of the water footprint in Spain

    National Research Council Canada - National Science Library

    José Antonio Sotelo Navalpotro; María Sotelo Pérez; Fernando García Quiroga

    2011-01-01

    ..." en la valoración de la Huella Hídrica de e spaña. Palabras clave: Indicadores, desarrollo sustentable, desarrollo económico regional, Huella Hídrica, españa, Coste-Beneficio. Cost-benefit and cost-efficiency analysis of the water footprint in Spain ABSTRACT We are increasingly needing ways to secure patterns of development that be sustainable, t...

  19. Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016

    Science.gov (United States)

    Simmons, Katharine B.; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M.; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J.; Barfield, Wanda; Moore, Cynthia A.; Mai, Cara T.; Korhonen, Lauren C.; Frey, Meghan T.; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D.

    2017-01-01

    We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus–related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus–associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs. PMID:27805547

  20. Cost-effectiveness of Increasing Access to Contraception during the Zika Virus Outbreak, Puerto Rico, 2016.

    Science.gov (United States)

    Li, Rui; Simmons, Katharine B; Bertolli, Jeanne; Rivera-Garcia, Brenda; Cox, Shanna; Romero, Lisa; Koonin, Lisa M; Valencia-Prado, Miguel; Bracero, Nabal; Jamieson, Denise J; Barfield, Wanda; Moore, Cynthia A; Mai, Cara T; Korhonen, Lauren C; Frey, Meghan T; Perez-Padilla, Janice; Torres-Muñoz, Ricardo; Grosse, Scott D

    2017-01-01

    We modeled the potential cost-effectiveness of increasing access to contraception in Puerto Rico during a Zika virus outbreak. The intervention is projected to cost an additional $33.5 million in family planning services and is likely to be cost-saving for the healthcare system overall. It could reduce Zika virus-related costs by $65.2 million ($2.8 million from less Zika virus testing and monitoring and $62.3 million from avoided costs of Zika virus-associated microcephaly [ZAM]). The estimates are influenced by the contraception methods used, the frequency of ZAM, and the lifetime incremental cost of ZAM. Accounting for unwanted pregnancies that are prevented, irrespective of Zika virus infection, an additional $40.4 million in medical costs would be avoided through the intervention. Increasing contraceptive access for women who want to delay or avoid pregnancy in Puerto Rico during a Zika virus outbreak can substantially reduce the number of cases of ZAM and healthcare costs.

  1. Reducing Nitrogen Pollution while Decreasing Farmers' Costs and Increasing Fertilizer Industry Profits.

    Science.gov (United States)

    Kanter, David R; Zhang, Xin; Mauzerall, Denise L

    2015-03-01

    Nitrogen (N) pollution is emerging as one of the most important environmental issues of the 21st Century, contributing to air and water pollution, climate change, and stratospheric ozone depletion. With agriculture being the dominant source, we tested whether it is possible to reduce agricultural N pollution in a way that benefits the environment, reduces farmers' costs, and increases fertilizer industry profitability, thereby creating a "sweet spot" for decision-makers that could significantly increase the viability of improved N management initiatives. Although studies of the economic impacts of improved N management have begun to take into account farmers and the environment, this is the first study to consider the fertilizer industry. Our "sweet spot" hypothesis is evaluated via a cost-benefit analysis of moderate and ambitious N use efficiency targets in U.S. and China corn sectors over the period 2015-2035. We use a blend of publicly available crop and energy price projections, original time-series modeling, and expert elicitation. The results present a mixed picture: although the potential for a "sweet spot" exists in both countries, it is more likely that one occurs in China due to the currently extensive overapplication of fertilizer, which creates a greater potential for farmers and the fertilizer industry to gain economically from improved N management. Nevertheless, the environmental benefits of improving N management consistently dwarf the economic impacts on farmers and the fertilizer industry in both countries, suggesting that viable policy options could include incentives to farmers and the fertilizer industry to increase their support for N management policies.

  2. Educational Benefit-Cost Analysis and the Problem of Scale.

    Science.gov (United States)

    Welty, Gordon A.

    Benefit-cost analysis consists of establishing ratios of benefits to costs for a set of project variants. The decision rule is to select that project variant where the ratio is a maximum. This paper argues that specification and estimation errors can contribute to findings for large-scale systems of benefit-cost ratios approximating zero. The…

  3. THE EFFICIENCY OF PUBLIC SERVICE OBLIGATION FOR FOOD SUBSIDY IN INDONESIA: REVIEW OF COST STRUCTURE ANALYSIS

    Directory of Open Access Journals (Sweden)

    ASRI LAKSMI RIANI

    2011-01-01

    Full Text Available The paper reviews the efficiency of food subsidy in Indonesia based on cost structure analysis. Using the comparison between cost of good of government and cost of good of National Logistics Board appointed to manage and channel the subsidy. The level of efficiency has decreased in the recent years because of increase in costs of exploitation, management cost and interest expense. It is suggested that government has to determine the cut-off point as a feasibility assessment of cost of subsidy

  4. Cost analysis of advanced turbine blade manufacturing processes

    Science.gov (United States)

    Barth, C. F.; Blake, D. E.; Stelson, T. S.

    1977-01-01

    A rigorous analysis was conducted to estimate relative manufacturing costs for high technology gas turbine blades prepared by three candidate materials process systems. The manufacturing costs for the same turbine blade configuration of directionally solidified eutectic alloy, an oxide dispersion strengthened superalloy, and a fiber reinforced superalloy were compared on a relative basis to the costs of the same blade currently in production utilizing the directional solidification process. An analytical process cost model was developed to quantitatively perform the cost comparisons. The impact of individual process yield factors on costs was also assessed as well as effects of process parameters, raw materials, labor rates and consumable items.

  5. A cost-benefit analysis of The National Map

    Science.gov (United States)

    Halsing, David L.; Theissen, Kevin; Bernknopf, Richard

    2003-01-01

    The Geography Discipline of the U.S. Geological Survey (USGS) has conducted this cost-benefit analysis (CBA) of The National Map. This analysis is an evaluation of the proposed Geography Discipline initiative to provide the Nation with a mechanism to access current and consistent digital geospatial data. This CBA is a supporting document to accompany the Exhibit 300 Capital Asset Plan and Business Case of The National Map Reengineering Program. The framework for estimating the benefits is based on expected improvements in processing information to perform any of the possible applications of spatial data. This analysis does not attempt to determine the benefits and costs of performing geospatial-data applications. Rather, it estimates the change in the differences between those benefits and costs with The National Map and the current situation without it. The estimates of total costs and benefits of The National Map were based on the projected implementation time, development and maintenance costs, rates of data inclusion and integration, expected usage levels over time, and a benefits estimation model. The National Map provides data that are current, integrated, consistent, complete, and more accessible in order to decrease the cost of implementing spatial-data applications and (or) improve the outcome of those applications. The efficiency gains in per-application improvements are greater than the cost to develop and maintain The National Map, meaning that the program would bring a positive net benefit to the Nation. The average improvement in the net benefit of performing a spatial data application was multiplied by a simulated number of application implementations across the country. The numbers of users, existing applications, and rates of application implementation increase over time as The National Map is developed and accessed by spatial data users around the country. Results from the 'most likely' estimates of model parameters and data inputs indicate that

  6. Association of antipsychotic polypharmacy with health service cost: a register-based cost analysis

    DEFF Research Database (Denmark)

    Baandrup, Lone; Lublin, Henrik Kai Francis; Nordentoft, Merete

    2012-01-01

    OBJECTIVE: To investigate the association of antipsychotic polypharmacy in schizophrenia with cost of primary and secondary health service use. METHOD: Comparative analysis of health service cost for patients prescribed antipsychotic polypharmacy versus antipsychotic monotherapy. Resource......, disease duration, psychiatric inpatient admissions, and treatment site as covariates. RESULTS: The sample consisted of 736 outpatients with a diagnosis in the schizophrenia spectrum. Antipsychotic polypharmacy was associated with significantly higher total health service costs compared with monotherapy...... (2007: 25% higher costs; 2008: 17% higher costs) when adjusting for potential confounders and risk factors. A subgroup analysis suggested that the excessive costs associated with antipsychotic polypharmacy were partly accounted for by the functional level of the patients. CONCLUSION: The results...

  7. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink

    2012-01-01

    Full Text Available Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

  8. A Cost Analysis of Space Available Travel

    Science.gov (United States)

    2014-06-14

    baggage conveyors . Therefore, the researcher has opted to not include these costs in the overall cost assessment as they would be difficult to... currently collecting the $10 fee. AMC (formerly MAC) disagreed with this fee and requested that the issue be considered by the Joint Chiefs of Staff...fee and Federal Inspection Service fee. The current charges per Space-A passenger are shown below: Table 4: Space-A Head Tax and Federal Inspection

  9. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry

    OpenAIRE

    Popova Viktoriya D.

    2014-01-01

    The goal of the article is analysis of logistics costs in production of semiconductor materials using example of two Ukrainian enterprises. The article studies influence of logistics management and logistics costs upon formation of the final cost value (price) of a commodity (service). It gives an assessment of logistics costs of Ukrainian semiconductor enterprises and establishes its structure by types of main expenditure items: material, transport, production and storehouse. It establishes ...

  10. Cost savings of reduced constipation rates attributed to increased dietary fiber intakes: a decision-analytic model.

    Science.gov (United States)

    Schmier, Jordana K; Miller, Paige E; Levine, Jessica A; Perez, Vanessa; Maki, Kevin C; Rains, Tia M; Devareddy, Latha; Sanders, Lisa M; Alexander, Dominik D

    2014-04-17

    Nearly five percent of Americans suffer from functional constipation, many of whom may benefit from increasing dietary fiber consumption. The annual constipation-related healthcare cost savings associated with increasing intakes may be considerable but have not been examined previously. The objective of the present study was to estimate the economic impact of increased dietary fiber consumption on direct medical costs associated with constipation. Literature searches were conducted to identify nationally representative input parameters for the U.S. population, which included prevalence of functional constipation; current dietary fiber intakes; proportion of the population meeting recommended intakes; and the percentage that would be expected to respond, in terms of alleviation of constipation, to a change in dietary fiber consumption. A dose-response analysis of published data was conducted to estimate the percent reduction in constipation prevalence per 1 g/day increase in dietary fiber intake. Annual direct medical costs for constipation were derived from the literature and updated to U.S. $ 2012. Sensitivity analyses explored the impact on adult vs. pediatric populations and the robustness of the model to each input parameter. The base case direct medical cost-savings was $12.7 billion annually among adults. The base case assumed that 3% of men and 6% of women currently met recommended dietary fiber intakes; each 1 g/day increase in dietary fiber intake would lead to a reduction of 1.9% in constipation prevalence; and all adults would increase their dietary fiber intake to recommended levels (mean increase of 9 g/day). Sensitivity analyses, which explored numerous alternatives, found that even if only 50% of the adult population increased dietary fiber intake by 3 g/day, annual medical costs savings exceeded $2 billion. All plausible scenarios resulted in cost savings of at least $1 billion. Increasing dietary fiber consumption is associated with

  11. Hospitalization for pelvic inflammatory disease: a cost-effectiveness analysis.

    Science.gov (United States)

    Smith, Kenneth J; Ness, Roberta B; Roberts, Mark S

    2007-02-01

    Nulliparous women are frequently hospitalized for treatment of pelvic inflammatory disease (PID). The goal of this study was to determine the economic feasibility of hospitalizing adolescents and young women for PID. The authors conducted a Markov decision model, estimating the cost-effectiveness of hospitalization compared with outpatient therapy for mild to moderate PID for adolescents and young women, calculating costs per quality-adjusted life-year (QALY) gained under various assumptions about hospitalization effects on complications. If hospitalization decreases PID complications by 10%, 20%, or 30%, the cost/QALY gained is 145,000 dollars, 67,400 dollars, or 42,400 dollars, respectively, compared with outpatient therapy. Assumptions about hospitalization effects on the development of chronic pelvic pain heavily weight the analysis; costs/QALY gained by hospitalization increase considerably if chronic pain is unaffected. Hospitalization for PID treatment to possibly preserve fertility in nulliparous young women and adolescents is unlikely to be economically reasonable even if substantial improvements in PID complication rates are assumed.

  12. Lifetime medical costs of obesity: prevention no cure for increasing health expenditure.

    Directory of Open Access Journals (Sweden)

    Pieter H M van Baal

    2008-02-01

    Full Text Available BACKGROUND: Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention. METHODS AND FINDINGS: With a simulation model, lifetime health-care costs were estimated for a cohort of obese people aged 20 y at baseline. To assess the impact of obesity, comparisons were made with similar cohorts of smokers and "healthy-living" persons (defined as nonsmokers with a body mass index between 18.5 and 25. Except for relative risk values, all input parameters of the simulation model were based on data from The Netherlands. In sensitivity analyses the effects of epidemiologic parameters and cost definitions were assessed. Until age 56 y, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position. Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions. CONCLUSIONS: Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

  13. The cost-effectiveness of increasing alcohol taxes: a modelling study

    Directory of Open Access Journals (Sweden)

    de Wit G

    2008-11-01

    Full Text Available Abstract Background Excessive alcohol use increases risks of chronic diseases such as coronary heart disease and several types of cancer, with associated losses of quality of life and life-years. Alcohol taxes can be considered as a public health instrument as they are known to be able to decrease alcohol consumption. In this paper, we estimate the cost-effectiveness of an alcohol tax increase for the entire Dutch population from a health-care perspective focusing on health benefits and health-care costs in alcohol users. Methods The chronic disease model of the National Institute for Public Health and the Environment was used to extrapolate from decreased alcohol consumption due to tax increases to effects on health-care costs, life-years gained and quality-adjusted life-years gained, A Dutch scenario in which tax increases for beer are planned, and a Swedish scenario representing one of the highest alcohol taxes in Europe, were compared with current practice in the Netherlands. To estimate cost-effectiveness ratios, yearly differences in model outcomes between intervention and current practice scenarios were discounted and added over the time horizon of 100 years to find net present values for incremental life-years gained, quality-adjusted life-years gained, and health-care costs. Results In the Swedish scenario, many more quality-adjusted life-years were gained than in the Dutch scenario, but both scenarios had almost equal incremental cost-effectiveness ratios: €5100 per quality-adjusted life-year and €5300 per quality-adjusted life-year, respectively. Conclusion Focusing on health-care costs and health consequences for drinkers, an alcohol tax increase is a cost-effective policy instrument.

  14. Strategic cost-benefit analysis of energy policies: detailed projections

    Energy Technology Data Exchange (ETDEWEB)

    Davitian, H.; Groncki, P.J.; Kleeman, P.; Lukachinski, J.

    1979-10-01

    Current US energy policy includes many programs directed toward restructuring the energy system in order to decrease US dependence on foreign supplies and to increase our reliance on plentiful and environmentally benign energy forms. However, recent events have led to renewed concern over the direction of current energy policy. This study describes three possible energy strategies and analyzes each in terms of its economic, environmental, and national security benefits and costs. Each strategy is represented by a specific policy. In the first, no additional programs or policies are initiated beyond those currently in effect or announced. The second is directed toward reducing the growth in energy demand, i.e., energy conservation. The third promotes increased domestic supply through accelerated development of synthetic and unconventional fuels. The analysis focuses on the evaluation and comparison of these strategy alternatives with respect to their energy, economic, and environmental consequences. Results indicate that conservation can substantially reduce import dependence and slow the growth of energy demand, with only a small macroeconomic cost and with substantial environmental benefits; the synfuels policy reduces imports by a smaller amount, does not reduce the growth in energy demand, involves substantial environmental costs and slows the rate of economic growth. These relationships could be different if the energy savings per unit cost for conservation are less than anticipated, or if the costs of synthetic fuels can be significantly lowered. Given these uncertainties, both conservation and RD and D support for synfuels should be included in future energy policy. However, between these policy alternatives, conservation appears to be the preferred strategy. The results of this study are presented in three reports (see also BNL--51105 and BNL--51128). 11 references, 3 figures, 61 tables.

  15. Intelligent Mobile Application for Route Finding and Transport Cost Analysis

    Directory of Open Access Journals (Sweden)

    Omisore M. O.

    2016-09-01

    Full Text Available The explosive rate of increase in number of habitats and vehicles in different areas of the developing countries like Nigeria has motivated government of such world engage in both rural and urban road construction for ease of navigation. This brings stresses in navigating such roads with public traffic hence noise pollution to the environment. For effective autonomous geo-spatial navigation service, we propose a web based model implemented as intelligent mobile application for route finding and transport cost analysis. A case study observed on data collated from different areas within Ile-Ife and its surroundings shows that the system aid users in making decision regarding transportation alternatives. This study shows how to help people living in such parts of the world reach their destinations when navigating unknown routes with reduced transportation cost

  16. Adopting a plant-based diet minimally increased food costs in WHEL Study

    Science.gov (United States)

    Hyder, Joseph A.; Thomson, Cynthia A.; Natarajan, Loki; Madlensky, Lisa; Pu, Minya; Emond, Jennifer; Kealey, Sheila; Rock, Cheryl L.; Flatt, Shirley W.; Pierce, John P.

    2017-01-01

    Objective To assess the cost of adopting a plant-based diet. Methods Breast cancer survivors randomized to dietary intervention (n=1109) or comparison (n=1145) group; baseline and 12-month data on diet and grocery costs. Results At baseline, both groups reported similar food costs and dietary intake. At 12 months, only the intervention group changed their diet (vegetable-fruit:6.3 to 8.9 serv/d.; fiber: 21.6 to 29.8 g/d; fat: 28.2 to 22.3% of E). The intervention change was associated with a significant increase of $1.22/person/week (multivariate model, p=0.027). Conclusions A major change to a plant-based diet was associated with a minimal increase in grocery costs. PMID:19296743

  17. Metabolic and respiratory costs of increasing song amplitude in zebra finches.

    Directory of Open Access Journals (Sweden)

    Sue Anne Zollinger

    Full Text Available Bird song is a widely used model in the study of animal communication and sexual selection, and several song features have been shown to reflect the quality of the singer. Recent studies have demonstrated that song amplitude may be an honest signal of current condition in males and that females prefer high amplitude songs. In addition, birds raise the amplitude of their songs to communicate in noisy environments. Although it is generally assumed that louder song should be more costly to produce, there has been little empirical evidence to support this assumption. We tested the assumption by measuring oxygen consumption and respiratory patterns in adult male zebra finches (Taeniopygia guttata singing at different amplitudes in different background noise conditions. As background noise levels increased, birds significantly increased the sound pressure level of their songs. We found that louder songs required significantly greater subsyringeal air sac pressure than quieter songs. Though increased pressure is probably achieved by increasing respiratory muscle activity, these increases did not correlate with measurable increases in oxygen consumption. In addition, we found that oxygen consumption increased in higher background noise, independent of singing behaviour. This observation supports previous research in mammals showing that high levels of environmental noise can induce physiological stress responses. While our study did not find that increasing vocal amplitude increased metabolic costs, further research is needed to determine whether there are other non-metabolic costs of singing louder or costs associated with chronic noise exposure.

  18. Cost and efficiency lead to increased value for the patient and bottom line for the practice.

    Science.gov (United States)

    Dahl, Owen J

    2009-01-01

    Understanding how much it costs to provide a service is a basic premise of any business. In addition, healthcare is in need of improved processes to provide and increase value to the patient. This can be accomplished by the application of principles called Six Sigma and Lean Management. Today's medical practice leader must be aware of the costs of doing business and be able to apply proven management principles to the processes involved in providing patient care.

  19. Flat plate vs. concentrator solar photovoltaic cells - A manufacturing cost analysis

    Science.gov (United States)

    Granon, L. A.; Coleman, M. G.

    1980-01-01

    The choice of which photovoltaic system (flat plate or concentrator) to use for utilizing solar cells to generate electricity depends mainly on the cost. A detailed, comparative manufacturing cost analysis of the two types of systems is presented. Several common assumptions, i.e., cell thickness, interest rate, power rate, factory production life, polysilicon cost, and direct labor rate are utilized in this analysis. Process sequences, cost variables, and sensitivity analyses have been studied, and results of the latter show that the most important parameters which determine manufacturing costs are concentration ratio, manufacturing volume, and cell efficiency. The total cost per watt of the flat plate solar cell is $1.45, and that of the concentrator solar cell is $1.85, the higher cost being due to the increased process complexity and material costs.

  20. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique

    Directory of Open Access Journals (Sweden)

    Bayati

    2015-09-01

    Full Text Available 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

  1. 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

  2. Analysis of Cost Growth and Cost Composition in the Defense Aerospace Industry

    Science.gov (United States)

    1988-09-01

    poor management decisions (8-87). Miller and Vollman claim that results of their 1985 survey of North American manufacturers, show that mo:3t maaagers...appreciably decreased in favor of indirect costs (32:45). Miller and Vollman explain that overhead costs have been steadily increasing as a perrentage...of total manufacturing costs for more than 100 years (22:142). Results of a survey administered by Miller and Vollman indicate that manufacturing

  3. 42 CFR 413.40 - Ceiling on the rate of increase in hospital inpatient costs.

    Science.gov (United States)

    2010-10-01

    ... reporting period subject to the ceiling if there is a significant increase in the average hourly wage for... wage survey data collected for the cost reporting period subject to the ceiling is at least 8.0 percent... 42 Public Health 2 2010-10-01 2010-10-01 false Ceiling on the rate of increase in hospital...

  4. 76 FR 66111 - Cost-of-Living Increase and Other Determinations for 2012

    Science.gov (United States)

    2011-10-25

    ... incapable of managing such benefits). The dollar fee limits are subject to increase by the cost-of-living... than 6.3 percent of the attorney's fee or, if lower, a dollar amount that is subject to increase by the... index for 2010 at a level that is consistent with the national average wage indexing series for...

  5. Counting the Costs of Acquisitions: Using Cost-Benefit Analysis in a Seminary and University Library

    Directory of Open Access Journals (Sweden)

    Verena Getahun

    2009-11-01

    Full Text Available This essay considers how cost-benefit analysis may be used in a small to mid-sized library to identify cost-savings in the acquisitions of monographs. The essay highlights parallel studies conducted at Luther Seminary Library and Bethel University Library which compared prices, discounts, and time costs across a range of vendor types to identify whether searching for the best price per item is cost-effective, and how much this strategy could save yearly in acquisitions. Both libraries found that substantial potential savings were identified through this study.

  6. Cost and Training Effectiveness Analysis Performance Guide

    Science.gov (United States)

    1980-07-23

    value is treated as a reduction in the cost of the alternative for wnioh the use of the assets is intended. The fair market value may be determined...imputed value of the facility should be used. These costs can be based on fair market value, scrap value, or alternative use. In any event, discuss this...1 MM 1 i l 1 1 SOFTIS 1X1 X XI 1 1 ’ 1 1 I Ml 1 1 1 i M 3SOFTA 1 1X 1 IX X i 1 1

  7. Educational Cost Analysis in Action: Case Studies for Planners -- II.

    Science.gov (United States)

    Coombs, Philip H.; Hallak, Jacques

    This document is the second in a series of three documents, which together contain 27 case studies on the uses of cost analysis in educational planning. The case studies are presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, or to get the best value existing…

  8. Educational Cost Analysis in Action: Case Studies for Planners -- III.

    Science.gov (United States)

    Coombs, Philip H.; Hallak, Jacques

    This document is the third in a series of three documents, which together contain 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, and to get the best value from…

  9. Educational Cost Analysis in Action: Case Studies for Planners -- I.

    Science.gov (United States)

    Coombs, Philip H.; Hallak, Jacques

    This document is the first in a series of three documents, which together contains 27 case studies on the uses of cost analysis in educational planning. The case studies have been presented to help planners and administrators see how cost analysis can be used to improve the efficiency of their educational systems, or how to get the best value from…

  10. Mirror Fusion Test Facility: Superconducting magnet system cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    1977-07-01

    At the request of Victor Karpenko, Project manager for LLL`s Mirror Fusion Test Facility, EG&G has prepared this independent cost analysis for the proposed MFTF Superconducting Magnet System. The analysis has attempted to show sufficient detail to provide adequate definition for a basis of estimating costs.

  11. 7 CFR 550.47 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ..., market prices and similar indicia, together with discounts. Cost analysis is the review and evaluation of... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost and price analysis. 550.47 Section 550.47 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE,...

  12. Cost Benefit Analysis of Consumer Product Safety Standards

    Science.gov (United States)

    Smith, Betty F.; Dardis, Rachel

    1977-01-01

    This paper investigates the role of cost-benefit analysis in evaluating consumer product safety standards and applys such analysis to an evaluation of flammability standards for children's sleepwear. (Editor)

  13. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi

    2015-06-01

    Full Text Available Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1 to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2 to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II” in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination were defined as inappropriate: (1 cortisone in a patient with at least one positive site; (2 antifungals in (a patients with all negative sites or (b ineffective antifungal treatment (in terms of drug chosen, dose or duration in those with all positive sites; or (3 antibiotics; (4 antivirals or (5 antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease

  14. Cost analysis of continuous flight auger piles construction in Egypt

    Directory of Open Access Journals (Sweden)

    Hossam E. Hosny

    2016-09-01

    Full Text Available Continuous Flight Auger (CFA piling is widely used in the Egyptian construction industry. There is a dramatic fluctuation in pricing of executing this work package within short periods as a result of unsteady changes in supply-demand equilibrium. Consequently, there is an urgent need for the use of a scientific approach in estimating construction costs. Accordingly, it is crucial to consider the different cost elements of CFA piling construction as a step to reach an accurate and realistic cost estimate to be used by contractors in tendering. This research aims to study these cost elements based on an expert judgment, site observations and statistical analysis in order to develop an effective tool to estimate the total construction cost of the CFA piles in any future project. Expert survey was performed to draw detailed information to construct a cost breakdown structure (CBS that was used as a basis for developing the proposed cost model. The developed cost model is then validated through the application on fifty two projects. Such projects were carefully selected in different sizes, purposes and locations. Then the collected data were exposed to statistical analysis techniques. An average percentage error of 4.1% was observed upon comparing the estimated costs with the actual costs of these projects. A sensitivity analysis was then performed to recognize the most effective cost factors. The developed recommended model was used by some experienced contractors in the Egyptian market who expressed their satisfaction with the model.

  15. COMPARATIVE COST AND STRENGTH ANALYSIS OF CEMENT ...

    African Journals Online (AJOL)

    2012-07-02

    Jul 2, 2012 ... ment materials which is aimed at reducing the cost of concrete production. Tests were performed ... crease shrinkage in concrete. The result of a ..... of Palm Kernel Husk Ash PKHA and Free Lime (CaO) as an admix-ture in ...

  16. Terrorism risks and cost-benefit analysis of aviation security.

    Science.gov (United States)

    Stewart, Mark G; Mueller, John

    2013-05-01

    We evaluate, for the U.S. case, the costs and benefits of three security measures designed to reduce the likelihood of a direct replication of the 9/11 terrorist attacks. To do so, we assess risk reduction, losses, and security costs in the context of the full set of security layers. The three measures evaluated are installed physical secondary barriers (IPSB) to restrict access to the hardened cockpit door during door transitions, the Federal Air Marshal Service (FAMS), and the Federal Flight Deck Officer (FFDO) Program. In the process, we examine an alternate policy measure: doubling the budget of the FFDO program to $44 million per year, installing IPSBs in all U.S. aircraft at a cost of $13.5 million per year, and reducing funding for FAMS by 75% to $300 million per year. A break-even cost-benefit analysis then finds the minimum probability of an otherwise successful attack required for the benefit of each security measures to equal its cost. We find that the IPSB is costeffective if the annual attack probability of an otherwise successful attack exceeds 0.5% or one attack every 200 years. The FFDO program is costeffective if the annual attack probability exceeds 2%. On the other hand, more than two otherwise successful attacks per year are required for FAMS to be costeffective. A policy that includes IPSBs, an increased budget for FFDOs, and a reduced budget for FAMS may be a viable policy alternative, potentially saving hundreds of millions of dollars per year with consequences for security that are, at most, negligible.

  17. Processing Cost Analysis for Biomass Feedstocks

    Energy Technology Data Exchange (ETDEWEB)

    Badger, P.C.

    2002-11-20

    The receiving, handling, storing, and processing of woody biomass feedstocks is an overlooked component of biopower systems. The purpose of this study was twofold: (1) to identify and characterize all the receiving, handling, storing, and processing steps required to make woody biomass feedstocks suitable for use in direct combustion and gasification applications, including small modular biopower (SMB) systems, and (2) to estimate the capital and operating costs at each step. Since biopower applications can be varied, a number of conversion systems and feedstocks required evaluation. In addition to limiting this study to woody biomass feedstocks, the boundaries of this study were from the power plant gate to the feedstock entry point into the conversion device. Although some power plants are sited at a source of wood waste fuel, it was assumed for this study that all wood waste would be brought to the power plant site. This study was also confined to the following three feedstocks (1) forest residues, (2) industrial mill residues, and (3) urban wood residues. Additionally, the study was confined to grate, suspension, and fluidized bed direct combustion systems; gasification systems; and SMB conversion systems. Since scale can play an important role in types of equipment, operational requirements, and capital and operational costs, this study examined these factors for the following direct combustion and gasification system size ranges: 50, 20, 5, and 1 MWe. The scope of the study also included: Specific operational issues associated with specific feedstocks (e.g., bark and problems with bridging); Opportunities for reducing handling, storage, and processing costs; How environmental restrictions can affect handling and processing costs (e.g., noise, commingling of treated wood or non-wood materials, emissions, and runoff); and Feedstock quality issues and/or requirements (e.g., moisture, particle size, presence of non-wood materials). The study found that over the

  18. Cost-effectiveness of policies aimed at increasing organ donation: the case of Chile.

    Science.gov (United States)

    Domínguez, J; Harrison, R; Atal, R; Larraín, L

    2013-01-01

    In this article we present an economic evaluation of policies aimed at increasing deceased organ donation in Chile, a developing country that has low donation rates; it had 5.4 donors per million people (pmp) in 2010. Expert opinions of leading participants in donation and transplantation were analyzed, resulting in a set of local policies aimed at increasing donation rates. Using previous results of reported cost savings of increasing kidney transplantation in Chile, we estimated the net benefits of these policies, as a function of additional donors. The main problem of the Chilean system seems to be the low capability to identify potential donors and a deficit in intensive care unit (ICU) beds. Among considered policies central to increase donation are the following: increasing human and capital resources dedicated to identifying potential donors, providing ICU beds from private centers, and developing an online information system that facilitates procurement coordination and the evaluation of performance at each hospital. Our results show that there is a linear relationship between cost savings and incremental donors pmp. For example, if these policies are capable of elevating donation rates in Chile by 6 donors pmp net estimated cost savings are approximately US $1.9 million. Likewise, considering the effect on patients' quality of life, savings would amount to around $15.0 million dollars per year. Our estimates suggest that these policies have a large cost-saving potential. In fact, considering implementation costs, cost reduction is positive after 4 additional donors pmp, and increasing afterward. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Component Commonality and Its Cost Implications - Increasing the Commonality of the Right Components

    DEFF Research Database (Denmark)

    Lyly-Yrjänäinen, Jouni; Suomala, Petri; Israelsen, Poul

    constructions was identified as the most important bottleneck for the delivery process causing many indirect costs, especially with respect to project-management-related activities. Interestingly, by eliminating the need for mechanical engineering, the context starts to approach assembly-to-order context, also......Component commonality (Labro 2004, Zhou & Gruppström 2004) can be defined as the use of the same version of a component across multiple products. It is usually seen as a means to manage costs without sacrificing product variety. However, when managing costs with component commonality, the managers...... should be able to identify rather rapidly which group of components would enable the most significant cost reductions. Unfortunately, the existing literature lacks profound discussion of how to identify the right components for increased component commonality. The objective of the paper is to discuss how...

  20. Hypergolic Propellant Destruction Evaluation Cost Benefit Analysis

    Science.gov (United States)

    Kessel, Kurt

    2010-01-01

    At space vehicle launch sites such as Vandenberg Air Force Base (VAFB), Cape Canaveral Air Force Station (CCAFS) and Kennedy Space Center (KSC), toxic vapors and hazardous liquid wastes result from the handling of commodities (hypergolic fuels and oxidizers), most notably from transfer operations where fuel and oxidizer are transferred from bulk storage tanks or transfer tankers to space launch vehicles. During commodity transfer at CCAFS and KSC, wet chemical scrubbers (typically containing four scrubbing towers) are used to neutralize fuel saturated vapors from vent systems on tanks and tanker trailers. For fuel vapors, a citric acid solution is used to scrub out most of the hydrazine. Operation of both the hypergolic fuel and oxidizer vapor scrubbers generates waste scrubber liquor. Currently, scrubber liquor from the fuel vapor scrubber is considered non-hazardous. The scrubber liquor is defined as spent citric acid scrubber solution; the solution contains complexed hydrazine I methylhydrazine and is used to neutralize nonspecification hypergolic fuel generated by CCAFS and KSC. This project is a collaborative effort between Air Force Space Command (AFSPC), Space and Missile Center (SMC), the CCAFS, and National Aeronautics and Space Administration (NASA) to evaluate microwave destruction technology for the treatment of non-specification hypergolic fuel generated at CCAFS and KSC. The project will capitalize on knowledge gained from microwave treatment work being accomplished by AFSPC and SMC at V AFB. This report focuses on the costs associated with the current non-specification hypergolic fuel neutralization process (Section 2.0) as well as the estimated costs of operating a mobile microwave unit to treat non-specification hypergolic fuel (Section 3.0), and compares the costs for each (Section 4.0).The purpose of this document is to assess the costs associated with waste hypergolic fuel. This document will report the costs associated with the current fuel

  1. Constellation Program Life-cycle Cost Analysis Model (LCAM)

    Science.gov (United States)

    Prince, Andy; Rose, Heidi; Wood, James

    2008-01-01

    The Constellation Program (CxP) is NASA's effort to replace the Space Shuttle, return humans to the moon, and prepare for a human mission to Mars. The major elements of the Constellation Lunar sortie design reference mission architecture are shown. Unlike the Apollo Program of the 1960's, affordability is a major concern of United States policy makers and NASA management. To measure Constellation affordability, a total ownership cost life-cycle parametric cost estimating capability is required. This capability is being developed by the Constellation Systems Engineering and Integration (SE&I) Directorate, and is called the Lifecycle Cost Analysis Model (LCAM). The requirements for LCAM are based on the need to have a parametric estimating capability in order to do top-level program analysis, evaluate design alternatives, and explore options for future systems. By estimating the total cost of ownership within the context of the planned Constellation budget, LCAM can provide Program and NASA management with the cost data necessary to identify the most affordable alternatives. LCAM is also a key component of the Integrated Program Model (IPM), an SE&I developed capability that combines parametric sizing tools with cost, schedule, and risk models to perform program analysis. LCAM is used in the generation of cost estimates for system level trades and analyses. It draws upon the legacy of previous architecture level cost models, such as the Exploration Systems Mission Directorate (ESMD) Architecture Cost Model (ARCOM) developed for Simulation Based Acquisition (SBA), and ATLAS. LCAM is used to support requirements and design trade studies by calculating changes in cost relative to a baseline option cost. Estimated costs are generally low fidelity to accommodate available input data and available cost estimating relationships (CERs). LCAM is capable of interfacing with the Integrated Program Model to provide the cost estimating capability for that suite of tools.

  2. Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

    Science.gov (United States)

    McGuffin, M; Merino, T; Keller, B; Pignol, J-P

    2017-03-01

    Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Is Weapon System Cost Growth Increasing? A Quantitative Assessment of Completed and Ongoing Programs

    Science.gov (United States)

    2007-01-01

    monitor was Jay Jordan, technical director of the Air Force Cost Analysis Agency. Other RAND Project AIR FORCE documents that address weapon system...Systems, Santa Monica, Calif.: RAND Corporation, MG-415-AF, 2006. As of January 15, 2007: http://www.rand.org/pubs/monographs/MG415/ Asher , Norman J

  4. Meetings with Costly Participation: An Empirical Analysis

    OpenAIRE

    Turner, Matthew; Weninger, Quinn

    2005-01-01

    Using data from the Mid-Atlantic surf clam and ocean quahog fishery, we find that firms with a preference for extreme, rather than moderate, policies are much more likely to participate in public meetings where regulation is determined. We also find that participation rates are higher for larger, closer, and more influential firms. These results; (1) improve our understanding of a very common institution for resource allocation, 'meetings with costly participation', (2) they refine our intuit...

  5. Association of increased monetary cost of dietary intake, diet quality and weight management in Spanish adults.

    Science.gov (United States)

    Schröder, Helmut; Serra-Majem, Luis; Subirana, Isaac; Izquierdo-Pulido, Maria; Fitó, Montserrat; Elosua, Roberto

    2016-03-14

    Higher monetary diet cost is associated with healthier food choices and better weight management. How changes in diet cost affect changes in diet quality and weight remains unknown. The aim of this study was to assess the impact of changes in individual monetary diet cost on changes in diet quality, measured by the modified Mediterranean diet score recommendations (MDS-rec) and by energy density (ED), as well as changes in weight and BMI. We conducted a prospective, population-based study of 2181 male and female Spaniards aged between 25 and 74 years, who were followed up to the 2009-2010 academic year. We measured weight and height and recorded dietary data using a validated FFQ. Average food cost was calculated from official Spanish government data. We fitted multivariate linear and logistic regression models. The average daily diet cost increased from 3·68(SD0.0·89)€/8·36 MJ to 4·97(SD1·16)€/8·36 MJ during the study period. This increase was significantly associated with improvement in diet quality (Δ ED and Δ MDS-rec; Pmonetary diet cost per 8·36 MJ was associated with a decrease of 0·3 kg in body weight (P=0·02) and 0·1 kg/m(2) in BMI (P=0·04). These associations were attenuated after adjusting for changes in diet quality indicators. An improvement in diet quality and better weight management were both associated with an increase in diet cost; this could be considered in food policy decisions.

  6. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

    2016-01-01

    was higher in the intervention group, but the difference was not statistically significant. The incremental CU ratio was more than (sic)400,000 per QALY gained. Conclusions: Even though the rehabilitation activities increased, the program does not appear to be cost-effective. The intervention itself...... was not costly (less than (sic)500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.......Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR...

  7. Terminal patients in Belgian nursing homes: a cost analysis.

    Science.gov (United States)

    Simoens, Steven; Kutten, Betty; Keirse, Emmanuel; Vanden Berghe, Paul; Beguin, Claire; Desmedt, Marianne; Deveugele, Myriam; Léonard, Christian; Paulus, Dominique; Menten, Johan

    2013-06-01

    Policy makers and health care payers are concerned about the costs of treating terminal patients. This study was done to measure the costs of treating terminal patients during the final month of life in a sample of Belgian nursing homes from the health care payer perspective. Also, this study compares the costs of palliative care with those of usual care. This multicenter, retrospective cohort study enrolled terminal patients from a representative sample of nursing homes. Health care costs included fixed nursing home costs, medical fees, pharmacy charges, other charges, and eventual hospitalization costs. Data sources consisted of accountancy and invoice data. The analysis calculated costs per patient during the final month of life at 2007/2008 prices. Nineteen nursing homes participated in the study, generating a total of 181 patients. Total mean nursing home costs amounted to 3,243 € per patient during the final month of life. Total mean nursing home costs per patient of 3,822 € for patients receiving usual care were higher than costs of 2,456 € for patients receiving palliative care (p = 0.068). Higher costs of usual care were driven by higher hospitalization costs (p < 0.001). This study suggests that palliative care models in nursing homes need to be supported because such care models appear to be less expensive than usual care and because such care models are likely to better reflect the needs of terminal patients.

  8. Following federal guidelines to increase nutrient consumption may lead to higher food costs for consumers.

    Science.gov (United States)

    Monsivais, Pablo; Aggarwal, Anju; Drewnowski, Adam

    2011-08-01

    The federal Dietary Guidelines for Americans, 2010, emphasized the need for Americans to consume more potassium, dietary fiber, vitamin D, and calcium, and to get fewer calories from saturated fat and added sugar. We examined the economic impact of meeting these guidelines for adults in King County, Washington. We found that increasing consumption of potassium--the most expensive of the four recommended nutrients--would add $380 per year to the average consumer's food costs. Meanwhile, each time consumers obtained 1 percent more of their daily calories from saturated fat and added sugar, their food costs significantly declined. These findings suggest that improving the American diet will require additional guidance for consumers, especially those with little budget flexibility, and new policies to increase the availability and reduce the cost of healthful foods.

  9. Concentrated photovoltaics system costs and learning curve analysis

    Science.gov (United States)

    Haysom, Joan E.; Jafarieh, Omid; Anis, Hanan; Hinzer, Karin

    2013-09-01

    An extensive set of costs in /W for the installed costs of CPV systems has been amassed from a range of public sources, including both individual company prices and market reports. Cost reductions over time are very evident, with current prices for 2012 in the range of 3.0 ± 0.7 /W and a predicted cost of 1.5 /W for 2020. Cost data is combined with deployment volumes in a learning curve analysis, providing a fitted learning rate of either 18.5% or 22.3% depending on the methodology. This learning rate is compared to that of PV modules and PV installed systems, and the influence of soft costs is discussed. Finally, if an annual growth rate of 39% is assumed for deployed volumes, then, using the learning rate of 20%, this would predict the achievement of a cost point of 1.5 /W by 2016.

  10. An analysis of glass–glass CIGS manufacturing costs

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A. W.; Fu, Ran; Woodhouse, Michael

    2016-09-01

    This article examines current cost drivers and potential avenues to reduced cost for monolithic, glass-glass Cu(In,Ga)(Se,S)2 (CIGS) modules by constructing a comprehensive bottom-up cost model. For a reference case where sputtering plus batch sulfurization after selenization (SAS) is employed, we compute a manufacturing cost of $69/m2 if the modules are made in the United States at a 1 GW/year production volume. At 14% module efficiency, this corresponds to a manufacturing cost of $0.49/WDC and a minimum sustainable price (MSP) of $0.67/WDC. We estimate that MSP could vary within +/-20% of this value given the range of quoted input prices, and existing variations in module design, manufacturing processes, and manufacturing location. Potential for reduction in manufacturing costs to below $0.40/WDC may be possible if average production module efficiencies can be increased above 17% without increasing $/m2 costs; even lower costs could be achieved if $/m2 costs could be reduced, particularly via innovations in the CIGS deposition process or balance-of-module elements. We present the impact on cost of regional factors, CIGS deposition method, device design, and price fluctuations. One metric of competitiveness-levelized cost of energy (LCOE) -- is also assessed for several U.S. locations and compared to that of standard multi-crystalline silicon (m(c-Si)) and cadmium telluride (CdTe).

  11. Increased costs reduce reciprocal helping behaviour of humans in a virtual evacuation experiment.

    Science.gov (United States)

    Bode, Nikolai W F; Miller, Jordan; O'Gorman, Rick; Codling, Edward A

    2015-11-06

    Altruistic behaviour is widespread and highly developed in humans and can also be found in some animal species. It has been suggested that altruistic tendencies can depend on costs, benefits and context. Here, we investigate the changes in the occurrence of helping behaviour in a computer-based experiment that simulates an evacuation from a building exploring the effect of varying the cost to help. Our findings illuminate a number of key mechanistic aspects of human decision-making about whether to help or not. In a novel situation where it is difficult to assess the risks associated with higher costs, we reproduce the finding that increasing costs reduce helping and find that the reduction in the frequency of helping behaviour is gradual rather than a sudden transition for a threshold cost level. Interestingly, younger and male participants were more likely to help. We provide potential explanations for this result relating to the nature of our experiment. Finally, we find no evidence that participants in our experiment plan ahead over two consecutive, inter-dependent helping opportunities when conducting cost-benefit trade-offs in spontaneous decisions. We discuss potential applications of our findings to research into decision-making during evacuations.

  12. Near-linear cost increase to reduce climate-change risk

    Energy Technology Data Exchange (ETDEWEB)

    Schaeffer, M. [Environmental Systems Analysis Group, Wageningen University and Research Centre, P.O. Box 47, 6700 AA Wageningen (Netherlands); Kram, T.; Van Vuuren, D.P. [Climate and Global Sustainability Group, Netherlands Environmental Assessment Agency, P.O. Box 303, 3720 AH Bilthoven (Netherlands); Meinshausen, M.; Hare, W.L. [Potsdam Institute for Climate Impact Research, P.O. Box 60 12 03, 14412 Potsdam (Germany); Schneider, S.H. (ed.) [Stanford University, Stanford, CA (United States)

    2008-12-30

    One approach in climate-change policy is to set normative long-term targets first and then infer the implied emissions pathways. An important example of a normative target is to limit the global-mean temperature change to a certain maximum. In general, reported cost estimates for limiting global warming often rise rapidly, even exponentially, as the scale of emission reductions from a reference level increases. This rapid rise may suggest that more ambitious policies may be prohibitively expensive. Here, we propose a probabilistic perspective, focused on the relationship between mitigation costs and the likelihood of achieving a climate target. We investigate the qualitative, functional relationship between the likelihood of achieving a normative target and the costs of climate-change mitigation. In contrast to the example of exponentially rising costs for lowering concentration levels, we show that the mitigation costs rise proportionally to the likelihood of meeting a temperature target, across a range of concentration levels. In economic terms investing in climate mitigation to increase the probability of achieving climate targets yields 'constant returns to scale', because of a counterbalancing rapid rise in the probabilities of meeting a temperature target as concentration is lowered.

  13. Military Logistics. Buying Army Spares Too Soon Creates Excess Stocks and Increases Costs

    Science.gov (United States)

    1989-08-01

    Department of Defense (DoD) response to the General Accounting Office (GAO) draft report, " MILITARY LOGISTICS : Buying Army Spares Too Soon Creates Excessive...DATED MAY 30, 1989 (GAO CODE 393294) OSD CASE 8011 " MILITARY LOGISTICS : BUYING ARM SPARES TOO SOON CREATES EXCESSIVE STOCKS AND INCREASES COSTS

  14. Component Commonality and Its Cost Implications - Increasing the Commonality of the Right Components

    DEFF Research Database (Denmark)

    Lyly-Yrjänäinen, Jouni; Suomala, Petri; Israelsen, Poul

    should be able to identify rather rapidly which group of components would enable the most significant cost reductions. Unfortunately, the existing literature lacks profound discussion of how to identify the right components for increased component commonality. The objective of the paper is to discuss how...

  15. Battery life-cycle cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Brown, D.R.; Humphreys, K.K.

    1988-07-01

    Life-cycle cost (LCC) estimates have been prepared for 17 combinations of battery or fuel-cell technologies and load-levelling, stand-alone power system, or electric vehicle applications. In addition, LCCs for gas-fired turbine, compressed-air energy storage, pumped hydro energy storage, and internal combustion engine technologies were estimated for comparative purposes. The objectives in preparing the estimates were to determine the relative economics among alternative battery systems and to compare battery systems economics with competing energy technologies.

  16. Cost Analysis for Dual Source Weapon Procurement

    Science.gov (United States)

    1983-10-01

    34,- art seems to be regrettably trueý (1981: p. 52] Current uudersta~iinq of the compatitive r~pro- curement process is meagar. it would for ixam- ple be...the- art will be organized by section, according to the following major topics: ’I. Production Rates 2. Second-Source Start-Up Cost 3. Second-Source...when capaci- , ty utilization is Low. The returns earned by contractors on DOD business are measurably lower than the returns on com- marcial business

  17. 75 FR 74123 - Office of the Commissioner; Cost-of-Living Increase and Other Determinations for 2011; Correction

    Science.gov (United States)

    2010-11-30

    ... the Change in the National Average Wage Index, But Only If There Is a Cost-of-Living Increase Certain... the national average wage index whether there is a cost-of-living increase in that year or not. These... ADMINISTRATION Office of the Commissioner; Cost-of-Living Increase and Other Determinations for 2011; Correction...

  18. Development of hospital data warehouse for cost analysis of DPC based on medical costs.

    Science.gov (United States)

    Muranaga, F; Kumamoto, I; Uto, Y

    2007-01-01

    To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignant tumors and whose DPC category was reevaluated in 2004. The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.

  19. Has increased clinical experience with methotrexate reduced the direct costs of medical management of ectopic pregnancy compared to surgery?

    Directory of Open Access Journals (Sweden)

    Westaby Daniel T

    2012-09-01

    Full Text Available Abstract Background There is a debate about the cost-efficiency of methotrexate for the management of ectopic pregnancy (EP, especially for patients presenting with serum human chorionic gonadotrophin levels of >1500 IU/L. We hypothesised that further experience with methotrexate, and increased use of guideline-based protocols, has reduced the direct costs of management with methotrexate. Methods We conducted a retrospective cost analysis on women treated for EP in a large UK teaching hospital to (1 investigate whether the cost of medical management is less expensive than surgical management for those patients eligible for both treatments and (2 to compare the cost of medical management for women with hCG concentrations 1500–3000 IU/L against those with similar hCG concentrations that elected for surgery. Three distinct treatment groups were identified: (1 those who had initial medical management with methotrexate, (2 those who were eligible for initial medical management but chose surgery (‘elected’ surgery and (3 those who initially ‘required’ surgery and did not meet the eligibility criteria for methotrexate. We calculated the costs from the point of view of the National Health Service (NHS in the UK. We summarised the cost per study group using the mean, standard deviation, median and range and, to account for the skewed nature of the data, we calculated 95% confidence intervals for differential costs using the nonparametric bootstrap method. Results Methotrexate was £1179 (CI 819–1550 per patient cheaper than surgery but there were no significant savings with methotrexate in women with hCG >1500 IU/L due to treatment failures. Conclusions Our data support an ongoing unmet economic need for better medical treatments for EP with hCG >1500 IU/L.

  20. The Validity of Cost Stickiness in Turkey: A Panel Data Analysis in Istanbul Stock Exchange (ISE

    Directory of Open Access Journals (Sweden)

    Muhsin Celik

    Full Text Available The goal of this study is to test the cost stickiness for some firms in Istanbul Stock Exchange (ISE by panel data analysis. The study is based on 2023 observations of 119 firms whose stocks were in process uninterruptedly in the period of 1995-2011 in ISE. As a result of the study, it is proven that proportional increase in sales resulted in proportional increase in costs to some extent, but proportional decrease in sales resulted in less proportional decrease in costs when compared to the case hereinabove. Thus, it is argued that the relationship between sales and costs is not linear for the firms analyzed. To put another way, cost stickiness is valid for the whole costs modeled in current term but it is valid for the costs of the sales in consecutive periods.

  1. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope......The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...

  2. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad

    2014-01-01

    his report ’D3.1—Evaluation of Cost Models and Needs & Gaps Analysis’ provides an analysis of existing research related to the economics of digital curation and cost & benefit modelling. It reports upon the investigation of how well current models and tools meet stakeholders’ needs for calculating...... for amore efficient use of resources for digital curation. To facilitate and clarify the model evaluation the report first outlines a basic terminology and a generaldescription of the characteristics of cost and benefit models.The report then describes how the ten current and emerging cost and benefit...... they breakdown costs. This is followed by an in depth analysis of stakeholders’ needs for financial information derived from the 4C project stakeholder consultation.The stakeholders’ needs analysis indicated that models should:• support accounting, but more importantly they should enable budgeting• be able...

  3. Cost analysis of whole genome sequencing in German clinical practice.

    Science.gov (United States)

    Plöthner, Marika; Frank, Martin; von der Schulenburg, J-Matthias Graf

    2017-06-01

    Whole genome sequencing (WGS) is an emerging tool in clinical diagnostics. However, little has been said about its procedure costs, owing to a dearth of related cost studies. This study helps fill this research gap by analyzing the execution costs of WGS within the setting of German clinical practice. First, to estimate costs, a sequencing process related to clinical practice was undertaken. Once relevant resources were identified, a quantification and monetary evaluation was conducted using data and information from expert interviews with clinical geneticists, and personnel at private enterprises and hospitals. This study focuses on identifying the costs associated with the standard sequencing process, and the procedure costs for a single WGS were analyzed on the basis of two sequencing platforms-namely, HiSeq 2500 and HiSeq Xten, both by Illumina, Inc. In addition, sensitivity analyses were performed to assess the influence of various uses of sequencing platforms and various coverage values on a fixed-cost degression. In the base case scenario-which features 80 % utilization and 30-times coverage-the cost of a single WGS analysis with the HiSeq 2500 was estimated at €3858.06. The cost of sequencing materials was estimated at €2848.08; related personnel costs of €396.94 and acquisition/maintenance costs (€607.39) were also found. In comparison, the cost of sequencing that uses the latest technology (i.e., HiSeq Xten) was approximately 63 % cheaper, at €1411.20. The estimated costs of WGS currently exceed the prediction of a 'US$1000 per genome', by more than a factor of 3.8. In particular, the material costs in themselves exceed this predicted cost.

  4. Cost Benefit Analysis: Cost Benefit Analysis for Human Effectiveness Research: Bioacoustic Protection

    Science.gov (United States)

    2007-11-02

    APPENDIX A. ACRONYMS ACCES Attenuating Custom Communication Earpiece System ACEIT Automated Cost estimating Integrated Tools AFSC Air Force...documented in the ACEIT cost estimating tool developed by Tecolote, Inc. The factor used was 14 percent of PMP. 1.3 System Engineering/ Program...The data source is the ASC Aeronautical Engineering Products Cost Factor Handbook which is documented in the ACEIT cost estimating tool developed

  5. Non-linear increase of respiratory diseases and their costs under severe air pollution.

    Science.gov (United States)

    Shen, Ying; Wu, Yiyun; Chen, Guangdi; Van Grinsven, Hans J M; Wang, Xiaofeng; Gu, Baojing; Lou, Xiaoming

    2017-05-01

    China is experiencing severe and persistent air pollution, with concentrations of fine particulate matters (PM2.5) reaching unprecedentedly high levels in many cities. Quantifying the detrimental effects on health and their costs derived from high PM2.5 levels is crucial because of the unsolved challenges to mitigate air pollution in the following decades. Using the daily monitoring data on PM2.5 concentrations and clinic visits, we found a non-linear increase of respiratory diseases, but not for other diseases (e.g., digestive diseases) under severe air pollution. We found an increase of respiratory diseases by 1% for each 10 μg m(-3) increase in PM2.5 when the annual average daily PM2.5 concentration was less than 50 μg m(-3); while this ratio was doubled (around 2%) with the daily PM2.5 concentration larger than 50 μg m(-3). Under severe air pollution (PM2.5 concentration >150 μg m(-3)), the respiratory diseases increased by over 50% compared to that in clean days. Children are more sensitive to the severe air pollution. The increase of clinic visits, especially for adults, was observed mainly in bigger (>500 beds) hospitals. Re-allocating medical resources (e.g., doctors) from big hospitals to community hospitals can benefit the respiratory patients due to air pollution. The total medical cost of clinic visits of respiratory diseases derived from PM2.5 pollution was estimated at 17.2-57.0 billion Yuan in 2014 in China, accounting for 0.5-1.6% of national total health expenditure. Because these medical costs only represent a small part of total health cost derived from air pollution, the reduction of associated health costs would be an important co-benefit of implementation of air pollution preventive strategies.

  6. Identifying airline cost economies: An econometric analysis of the factors affecting aircraft opeerating costs

    NARCIS (Netherlands)

    J. Zuidberg

    2014-01-01

    This paper provides the results of an econometric analysis of the influences of airline characteristics on the average operating costs per aircraft movement. The analysis combines a comprehensive selection of airline-output variables, airline-fleet variables, and airline-market variables. The result

  7. Identifying airline cost economies: An econometric analysis of the factors affecting aircraft opeerating costs

    NARCIS (Netherlands)

    Zuidberg, J.

    2014-01-01

    This paper provides the results of an econometric analysis of the influences of airline characteristics on the average operating costs per aircraft movement. The analysis combines a comprehensive selection of airline-output variables, airline-fleet variables, and airline-market variables. The

  8. Infrastructures and Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2012-01-01

    Design and maintenance of infrastructures using Life-Cycle Cost-Benefit analysis is discussed in this paper with special emphasis on users costs. This is for several infrastructures such as bridges, highways etc. of great importance. Repair or/and failure of infrastructures will usually result in...

  9. A Quantitative Features Analysis of Recommended No- and Low-Cost Preschool E-Books

    Science.gov (United States)

    Parette, Howard P.; Blum, Craig; Luthin, Katie

    2015-01-01

    In recent years, recommended e-books have drawn increasing attention from early childhood education professionals. This study applied a quantitative descriptive features analysis of cost (n = 70) and no-cost (n = 60) e-books recommended by the Texas Computer Education Association. While t tests revealed no statistically significant differences…

  10. A Quantitative Features Analysis of Recommended No- and Low-Cost Preschool E-Books

    Science.gov (United States)

    Parette, Howard P.; Blum, Craig; Luthin, Katie

    2015-01-01

    In recent years, recommended e-books have drawn increasing attention from early childhood education professionals. This study applied a quantitative descriptive features analysis of cost (n = 70) and no-cost (n = 60) e-books recommended by the Texas Computer Education Association. While t tests revealed no statistically significant differences…

  11. Two ideas to increase innovation and reduce pharmaceutical costs and prices.

    Science.gov (United States)

    Jayadev, Arjun; Stiglitz, Joseph

    2009-01-01

    The pharmaceutical industry is undergoing a period of uncertainty. Profits are being squeezed by increasing costs and competitive pressures, and new drug production is slowing down. This Perspective reviews two policies that could assist in realigning incentives toward genuine innovation while also keeping drug spending growth under check. Value-based pricing can incentivize genuinely new discoveries and align research and development with social welfare. Public funding of clinical trials likewise can reduce both pharmaceutical costs and prices and direct research effort in a manner that is more socially productive than the current state of affairs.

  12. Cost-benefit analysis in occupational health: A comparison of intervention scenarios for occupational asthma and rhinitis among bakery workers

    NARCIS (Netherlands)

    Meijster, T.; Duuren-Stuurman, B. van; Heederik, D.; Houba, R.; Koningsveld, E.; Warren, N.; Tielemans, E.

    2011-01-01

    Objectives: Use of cost-benefit analysis in occupational health increases insight into the intervention strategy that maximises the cost-benefit ratio. This study presents a methodological framework identifying the most important elements of a cost-benefit analysis for occupational health settings.

  13. An algorithm to generate all spanning trees of a graph in order of increasing cost

    Directory of Open Access Journals (Sweden)

    Kenneth Sörensen

    2005-08-01

    Full Text Available A minimum spanning tree of an undirected graph can be easily obtained using classical algorithms by Prim or Kruskal. A number of algorithms have been proposed to enumerate all spanning trees of an undirected graph. Good time and space complexities are the major concerns of these algorithms. Most algorithms generate spanning trees using some fundamental cut or circuit. In the generation process, the cost of the tree is not taken into consideration. This paper presents an algorithm to generate spanning trees of a graph in order of increasing cost. By generating spanning trees in order of increasing cost, new opportunities appear. In this way, it is possible to determine the second smallest or, in general, the k-th smallest spanning tree. The smallest spanning tree satisfying some additional constraints can be found by checking at each generation whether these constraints are satisfied. Our algorithm is based on an algorithm by Murty (1967, which enumerates all solutions of an assignment problem in order of increasing cost. Both time and space complexities are discussed.

  14. Environmental standards need cost/benefit analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zeltman, E.W.

    1978-02-01

    To illustrate the basic advantages of employing cost/benefit analyses in the determination of emission limits for various sources of pollution, General Electric Co. discusses the activities of the US Environmental Protection Agency in the development of new source performance standards for combustion turbines. A review of specific decisions and their consequences regarding the emission of SO/sub 2/, CO, and NO/sub x/ from gas and oil turbines shows that to ensure good regulation, regulators must consider all sides of the issue; industry, in turn, must present its case in the most technically accurate manner possible to avoid the decrease in reliability, safety, and availability of equipment that can result from too restrictive emission limits.

  15. Cost-benefit and cost-effectiveness analysis of drug therapy.

    Science.gov (United States)

    Dao, T D

    1985-04-01

    A model for cost-benefit analysis and cost-effectiveness analysis (CBA-CEA) of pharmaceutical intervention is presented, and CBA-CEA research methods reported in the literature are reviewed. The cost versus benefit and the cost effectiveness of drug therapy can be analyzed in societal as well as private terms. Since CBA measures costs and outcomes in monetary terms, it can be used to compare net benefits of all types of interventions. CEA, however, can be used only in comparing alternative interventions that can produce a similar health outcome. Research activities needed for identification of treatment protocols, alternative therapies and their respective outcomes, and resource use are described. Quantification of benefits and costs is discussed and inherent strengths and weaknesses of CBA-CEA are summarized. For the wide variety of research activities involved in CBA-CEA, the expertise of economists, physicians, clinical pharmacists and pharmacologists, epidemiologists, sociologists, and psychologists is needed. Inherent in CBA-CEA for drug therapy are judgments, either by analysts or by policy decision makers, about how to value life, pain, anxiety, and happiness and how to distribute health-care resources. When results of CBA-CEA are presented and interpreted with care, this analysis can be an important tool for policy decision makers.

  16. MECHANISMS FOR CONTROLLING ENTERPRISE COST WHILE DETERMINING ITS INVESTMENT PROSPECTS IN ORDER TO INCREASE BUSINESS RELIABILITY

    Directory of Open Access Journals (Sweden)

    R. A. Kopytov

    2011-01-01

    Full Text Available The paper considers a non-conventional approach of strategic control which is executed on the basis of integration of incompatible business platforms within the framework of the unified management system.  The system is constructed while superimposing investment prospect tool on the diagram of the running enterprise cost control on the basis of the given standards. Their determination reveals advantages of the proposed approach within the context of its influence on the enterprise management with due account of an impact of negative factors on cost losses. Their investigation within diagnostics of management system makes it possible to increase a business reliability. The results of the investigations are tested in the process of cost evaluation of a multi-profile transport enterprise. 

  17. Mastectomy Weight and Tissue Expander Volume Predict Necrosis and Increased Costs Associated with Breast Reconstruction

    Science.gov (United States)

    Yalanis, Georgia C.; Nag, Shayoni; Georgek, Jakob R.; Cooney, Carisa M.; Manahan, Michele A.; Rosson, Gedge D.

    2015-01-01

    Introduction: Impaired vascular perfusion in tissue expander (TE) breast reconstruction leads to mastectomy skin necrosis. We investigated factors and costs associated with skin necrosis in postmastectomy breast reconstruction. Methods: Retrospective review of 169 women with immediate TE placement following mastectomy between May 1, 2009 and May 31, 2013 was performed. Patient demographics, comorbidities, intraoperative, and postoperative outcomes were collected. Logistic regression analysis on individual variables was performed to determine the effects of tissue expander fill volume and mastectomy specimen weight on skin necrosis. Billing data was obtained to determine the financial burden associated with necrosis. Results: This study included 253 breast reconstructions with immediate TE placement from 169 women. Skin necrosis occurred in 20 flaps for 15 patients (8.9%). Patients with hypertension had 8 times higher odds of skin necrosis [odd ratio (OR), 8.10, P 300 cm3 had 10 times higher odds of skin necrosis (OR, 10.66, P =0.010). Volumes >400 cm3 had 15 times higher odds of skin necrosis (OR, 15.56, P = 0.002). Mastectomy specimen weight was correlated with skin necrosis. Specimens >500 g had 10 times higher odds of necrosis and specimens >1000 g had 18 times higher odds of necrosis (OR, 10.03 and OR, 18.43; P =0.003 and P Mastectomy skin necrosis was associated with a 50% increased inpatient charge. Conclusion: Mastectomy flap necrosis is associated with HTN, larger TE volumes and mastectomy specimen weights, resulting in increased inpatient charges. Conservative TE volumes should be considered for patients with hypertension and larger mastectomy specimens. PMID:26301139

  18. Generic Drugs - Decreasing Costs and Room for Increased Number of Kidney Transplantations.

    Science.gov (United States)

    Spasovski, Goce

    2015-01-01

    Kidney transplantation is the best treatment option in comparison to dialysis, although patients are obliged to receive life-long medical treatment with immunosuppressive drugs (ISDs) for prevention of the graft rejection. Such immunosuppressive treatment may be costly and associated with multiple adverse effects. Since costs are viewed as one of the major constraints for the increasing number of transplantation, the use of generic ISDs may decrease the overall cost of transplantation and raise the possibility for its further development. An ideal ISD should have the security margin between toxic and therapeutic dose, and prevent development of acute or chronic rejection of the transplanted kidney. This is particularly important for drugs with a "narrow therapeutical index" (NTI), where small differences in dose or concentration lead to dose and concentration-dependent, serious therapeutic failures and/or adverse drug reactions. The NTI generic drug is approved if within 90%-112% of the area under the curve of the original product the pharmacokinetics fulfills the strict criteria of pharmaceutical equivalence and bioequivalence. Every generic has to be proven to be bioequivalent to the innovator product, and not to other generic products because of the possible generic "drift". Thus, the generic ISDs may be economically attractive, but theoretically, they may pose a risk to transplant patients. Such risks may be reduced if a long-term clinical studies showing cost-effectiveness of generic ISDs in de novo and prevalent transplant patients for every new generic ISD are performed. In conclusion, the increased number of solid organ transplantation goes in line with the increased health care expenditure for ISDs. The generic immunosuppressants could be a possible solution if safely substituted for innovator products or other generic drug of choice. The substantial cost reduction needs to be redirected into organ donation initiatives so that more patients can benefit

  19. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

    Kidholm, Kristian; Rasmussen, Maja Kjær; Andreasen, Jan Jesper

    2016-01-01

    was not costly (less than (sic)500), and increasing the number of patients may show reduced costs of the devices and make the CTR more cost-effective. Telerehabilitation can increase participation, but the intervention, in its current form, does not appear to be cost-effective.......Background: Cardiac rehabilitation can reduce mortality of patients with cardiovascular disease, but a frequently low participation rate in rehabilitation programs has been found globally. The objective of the Teledialog study was to assess the cost-utility (CU) of a cardiac telerehabilitation (CTR......) program. The aim of the intervention was to increase the patients' participation in the CTR program. At discharge, an individualized 3-month rehabilitation plan was formulated for each patient. At home, the patients measured their own blood pressure, pulse, weight, and steps taken for 3 months. Materials...

  20. Cost Analysis of Medications Used in Upper Respiratory Tract ...

    African Journals Online (AJOL)

    Cost Analysis of Medications Used in Upper Respiratory Tract Infections and Prescribing Patterns in University Sans ... Tropical Journal of Pharmaceutical Research ... The study was done in the clinics under University Sains Malaysia. A total ...

  1. Cost-benefit analysis in decision making for diagnostic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Fabrikant, J.I.; Hilberg, A.W.

    1982-02-01

    This paper reviews certain current concepts and methods relating to benefit-risk analysis, in terms of economic costs and raidation risks to health, in relation to the benefits from diagnostic radiology in clinical medicine.

  2. Cost-effectiveness analysis of Mectizan treatment Programmes for ...

    African Journals Online (AJOL)

    Cost-effectiveness analysis of Mectizan treatment Programmes for Onchocerciasis Control: Operational Experiences in two districts of Southwestern Nigeria. ... Vol 8, No 1 (2009) >. Log in or Register to get access to full text downloads.

  3. Uncertainty Assessment in Life Cycle Cost Analysis.

    Science.gov (United States)

    1985-05-01

    of this report) Unclassified 15. DECL ASSI FICATION/ DOWNGRADING SCHEDULE 1S. DISTRIBUTION STATEMENT (of this Report) Approved for public release...data base oriented. 7. Risk Analysis and Decision Models in the Planning of Housing Projects, by Jorge A. Machado , Report No. R72-44, Structures...1979). Lewis, L., "Range Estimating -- Managing Uncertainty," AACE Bulletin, Vol. 19, No. 6, Nov/Dec 1977. Machado , J. A., "Risk Analysis and Decision

  4. Benefits and costs of increased levels of corticosterone in seabird chicks.

    Science.gov (United States)

    Kitaysky, A S; Kitaiskaia, E V; Piatt, J F; Wingfield, J C

    2003-01-01

    Seabird chicks respond to food shortages by increasing corticosterone (cort) secretion, which is probably associated with fitness benefits and costs. To examine this, we experimentally increased levels of circulating cort in captive black-legged kittiwake chicks fed ad libitum. We found that cort-implanted chicks begged more frequently and were more aggressive compared to controls. These behavioral modifications must be beneficial to chicks as they facilitate acquisition of food from the parents and might trigger brood reduction and reduced competition for food. Cort-implanted chicks also increased food intake; however, their growth rates were similar to controls. To examine the costs of chronically increased circulating levels of cort, we removed cort implants and, after a 10-day recovery period, tested cognitive abilities of young kittiwakes. We found that the ability of kittiwakes to associate a visual cue with the presence of food in a choice situation was compromised by the experimental elevation of cort during development. To examine the long-term costs of increased levels of cort, 8 months later we tested the performance of the same individuals in a spatial task requiring them to make a detour around a barrier in order to escape from an enclosure. Individuals treated with cort during development took significantly more time to solve this task compared to controls. The results of this study suggest that the adrenocortical response of a developing bird to environmental stressors is associated with both benefits (increased food intake, foraging behavior, and aggression) and costs (low growth efficiency and compromised cognitive abilities later in life). This provides an evolutionary framework for relating juvenile physiological traits to fitness of birds in subsequent life-history stages.

  5. Analysis of the Data From a Technical Processing Cost Study.

    Science.gov (United States)

    Rocke, Hans Joachim

    This study was conducted to analyze and summarize raw data obtained from a 1972 study: "Report on a Cost Study of Specific Technical Processing Activities of the California State University and College Libraries" with the hypothesis that the cost of technical processes increases as the production volume both rises above and falls below…

  6. Production cost analysis of Euphorbia lathyris. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mendel, D.A.

    1979-08-01

    The purpose of this study is to estimate costs of production for Euphorbia lathyris (hereafter referred to as Euphorbia) in commercial-scale quantities. Selection of five US locations for analysis was based on assumed climatic and cultivation requirements. The five areas are: nonirrigated areas (Southeast Kansas and Central Oklahoma, Northeast Louisiana and Central Mississippi, Southern Illinois), and irrigated areas: (San Joaquin Valley and the Imperial Valley, California and Yuma, Arizona). Cost estimates are tailored to reflect each region's requirements and capabilities. Variable costs for inputs such as cultivation, planting, fertilization, pesticide application, and harvesting include material costs, equipment ownership, operating costs, and labor. Fixed costs include land, management, and transportation of the plant material to a conversion facility. Euphorbia crop production costs, on the average, range between $215 per acre in nonirrigated areas to $500 per acre in irrigated areas. Extraction costs for conversion of Euphorbia plant material to oil are estimated at $33.76 per barrel of oil, assuming a plant capacity of 3000 dry ST/D. Estimated Euphorbia crop production costs are competitive with those of corn. Alfalfa production costs per acre are less than those of Euphorbia in the Kansas/Oklahoma and Southern Illinois site, but greater in the irrigated regions. This disparity is accounted for largely by differences in productivity and irrigation requirements.

  7. Analysis of costs structure of the industrial enterprise

    Directory of Open Access Journals (Sweden)

    Yuriy V. Kovtunenko

    2014-12-01

    Full Text Available Costs are an important factor that affects the economic activities of an industrial enterprise, because they affect the profits of the enterprise on production efficiency and competitiveness. The article aims to summarize approaches of the definition of “costs”, classification costs of the enterprise according to different characteristics and cost structure of industrial enterprises. Each scientist has his own opinion on the choice of the structure and classification of costs, which is based on his own experience and experience of other scientists. Economically justified classification of costs is an important factor for analysis and costs accounting. This paper examines the concept of “costs” in the interpretation of various authors based on research of scientists that highlight the main features of the classification of costs, give the cost structure of industrial enterprises. Based on the study it can be concluded that the standard classification of costs is not for all companies. Therefore, it is necessary to develop a classification of costs according to the main features of the company.

  8. A cost analysis of somatostatin use in the prevention of pancreatic fistula after pancreatectomy.

    Science.gov (United States)

    Anderson, R; Dunki-Jacobs, E; Burnett, N; Scoggins, C; McMasters, K; Martin, R C G

    2014-08-01

    Studies have shown that somatostatin reduces the occurrence of postoperative pancreatic fistula. However, no study to date has analyzed the cost effectiveness of this treatment. The purpose of this study was to analyze the cost effectiveness of prophylactic somatostatin use with respect to pancreatectomy. Review of prospectively collected 2002 patient hepato-pancreatico-biliary database from January 2007 to May 2012. Patients received somatostatin prophylactically at the discretion of their surgeon. Data were analyzed using univariate analysis to determine if somatostatin had an effect on imaging costs, lab costs, "other" costs, PT/OT costs, surgery costs, room and board costs, and total hospital costs. A total of 179 patients underwent pancreatectomy at a single teaching institution. Median total hospital costs were 90,673.50 (59,979-743,667) for patients who developed a postoperative pancreatic fistula versus 86,563 (39,190-463,601) for those who did not (p = 0.004). Median total hospital costs were 89,369 (39,190-743,667) for patients who were administered somatostatin versus 85,291 (40,092-463,601) for patients who did not (p = 0.821). Pancreatic fistulas significantly increase hospital costs, and somatostatin has been shown to decrease the rate of pancreatic fistula formation. Somatostatin has no significant effect on hospital costs.

  9. Analysis of the cost-effectiveness and costs rationalization of antidepressants consumption in Lithuania

    OpenAIRE

    2013-01-01

    In recent years, there has been much debate regarding the rationality of consumption and cost effectiveness of antidepressants. The economic aspects of treating depression are becoming more frequently evaluated as newer antidepressants become available and as healthcare entities attempt to address increasing costs. The aim of the research. To investigate and assess the possibilities of a more rational use of the public and private funds of the Lithuanian population in the cases of medicam...

  10. Backup Power Cost of Ownership Analysis and Incumbent Technology Comparison

    Energy Technology Data Exchange (ETDEWEB)

    Kurtz, J.; Saur, G.; Sprik, S.; Ainscough, C.

    2014-09-01

    This cost of ownership analysis identifies the factors impacting the value proposition for fuel cell backup power and presents the estimated annualized cost of ownership for fuel cell backup power systems compared with the incumbent technologies of battery and diesel generator systems. The analysis compares three different backup power technologies (diesel, battery, and fuel cell) operating in similar circumstances in four run time scenarios (8, 52, 72, and 176 hours).

  11. Space system operations and support cost analysis using Markov chains

    Science.gov (United States)

    Unal, Resit; Dean, Edwin B.; Moore, Arlene A.; Fairbairn, Robert E.

    1990-01-01

    This paper evaluates the use of Markov chain process in probabilistic life cycle cost analysis and suggests further uses of the process as a design aid tool. A methodology is developed for estimating operations and support cost and expected life for reusable space transportation systems. Application of the methodology is demonstrated for the case of a hypothetical space transportation vehicle. A sensitivity analysis is carried out to explore the effects of uncertainty in key model inputs.

  12. U.S. Department of Energy Hydrogen Storage Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Law, Karen; Rosenfeld, Jeffrey; Han, Vickie; Chan, Michael; Chiang, Helena; Leonard, Jon

    2013-03-11

    The overall objective of this project is to conduct cost analyses and estimate costs for on- and off-board hydrogen storage technologies under development by the U.S. Department of Energy (DOE) on a consistent, independent basis. This can help guide DOE and stakeholders toward the most-promising research, development and commercialization pathways for hydrogen-fueled vehicles. A specific focus of the project is to estimate hydrogen storage system cost in high-volume production scenarios relative to the DOE target that was in place when this cost analysis was initiated. This report and its results reflect work conducted by TIAX between 2004 and 2012, including recent refinements and updates. The report provides a system-level evaluation of costs and performance for four broad categories of on-board hydrogen storage: (1) reversible on-board metal hydrides (e.g., magnesium hydride, sodium alanate); (2) regenerable off-board chemical hydrogen storage materials(e.g., hydrolysis of sodium borohydride, ammonia borane); (3) high surface area sorbents (e.g., carbon-based materials); and 4) advanced physical storage (e.g., 700-bar compressed, cryo-compressed and liquid hydrogen). Additionally, the off-board efficiency and processing costs of several hydrogen storage systems were evaluated and reported, including: (1) liquid carrier, (2) sodium borohydride, (3) ammonia borane, and (4) magnesium hydride. TIAX applied a bottom-up costing methodology customized to analyze and quantify the processes used in the manufacture of hydrogen storage systems. This methodology, used in conjunction with ® software and other tools, developed costs for all major tank components, balance-of-tank, tank assembly, and system assembly. Based on this methodology, the figure below shows the projected on-board high-volume factory costs of the various analyzed hydrogen storage systems, as designed. Reductions in the key cost drivers may bring hydrogen storage system costs closer to this DOE target

  13. Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis.

    Science.gov (United States)

    Gomez, G B; Dowdy, D W; Bastos, M L; Zwerling, A; Sweeney, S; Foster, N; Trajman, A; Islam, M A; Kapiga, S; Sinanovic, E; Knight, G M; White, R G; Wells, W A; Cobelens, F G; Vassall, A

    2016-12-01

    Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered 'real world' constraints such as sub-optimal guideline adherence. From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating 'real world' constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries' GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

  14. Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis.

    Science.gov (United States)

    Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

    2016-01-01

    The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Narvy, Steven J; Ahluwalia, Avtar; Vangsness, C Thomas

    2016-01-01

    Arthroscopic rotator cuff surgery is one of the most commonly performed orthopedic surgical procedures. We conducted a study to calculate the direct cost of arthroscopic repair of rotator cuff tears confirmed by magnetic resonance imaging. Twenty-eight shoulders in 26 patients (mean age, 54.5 years) underwent primary rotator cuff repair by a single fellowship-trained arthroscopic surgeon in the outpatient surgery center of a major academic medical center. All patients had interscalene blocks placed while in the preoperative holding area. Direct costs of this cycle of care were calculated using the time-driven activity-based costing algorithm. Mean time in operating room was 148 minutes; mean time in recovery was 105 minutes. Calculated surgical cost for this process cycle was $5904.21. Among material costs, suture anchor costs were the main cost driver. Preoperative bloodwork was obtained in 23 cases, adding a mean cost of $111.04. Our findings provide important preliminary information regarding the direct economic costs of rotator cuff surgery and may be useful to hospitals and surgery centers negotiating procedural reimbursement for the increased cost of repairing complex tears.

  16. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

    Science.gov (United States)

    Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

    2009-02-01

    A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

  17. Cost of Illness and Cost Containment Analysis Using Empirical Antibiotic Therapy in Sepsis Patients in Bandung

    Directory of Open Access Journals (Sweden)

    Rano K. Sinuraya

    2012-12-01

    Full Text Available The aims of this study were to analyze cost of illness (COI and cost containment analysis using empirical antibiotic therapy in sepsis patients with respiratory infection in a hospital in Bandung. A cross sectional method was conducted retrospectively. Data were collected from medical record of inpatients sepsis patients with respiratory infections with empirical antibiotic therapy ceftazidime-levofloxacin or cefotaxime-erythromycin. Direct and indirect cost were calculated and analyzed in this study. The result showed that the average COI for patients with combination ceftazidime-levofloxaxin was 13,369,055 IDR whereas combination of cefotaxime-erythromycin was 22,250,495 IDR. In summary, the COI empirical antibiotic therapy ceftazidime-levofloxacin was lower than cefotaxime-erythromycin. Cost containment using empirical antibiotic therapy ceftazidime-levofloxacin which without reducing the service quality was 8,881,440 IDR.

  18. The Six-Food Elimination Diet for Eosinophilic Esophagitis Increases Grocery Shopping Cost and Complexity.

    Science.gov (United States)

    Asher Wolf, W; Huang, Kevin Z; Durban, Raquel; Iqbal, Zahra J; Robey, Benjamin S; Khalid, Farah J; Dellon, Evan S

    2016-12-01

    The six-food elimination diet (SFED), where dairy, wheat, eggs, soy, nuts, and seafood are avoided, is an effective treatment for eosinophilic esophagitis (EoE). Patient-related costs of this approach, however, are unknown. We aimed to assess the cost of and ease of shopping for an SFED compared to an unrestricted diet. A dietitian with expertise in EoE generated menus meeting dietary requirements for a week's worth of meals for the SFED and an unrestricted diet. We compared prices and the number of missing items for both diets at standard and specialty grocery stores. The average weekly price of the SFED at a standard supermarket was $92.54 compared to $79.84 for an unrestricted diet (p = 0.0001). A patient shopping at a standard grocery store needed a higher proportion of items from a second store compared to an unrestricted diet (32 vs. 3 %, p = 0.0001). The prices of the SFED and unrestricted diet using a specialty supermarket were comparable ($106.47 vs. $105.96, p = 0.81), as was the percentage of items requiring a trip to a second store (6 vs. 2 % items, p = 0.03). Shopping at a specialty grocery store increased weekly grocery costs by $13.93 (p = 0.04) for the SFED and $26.12 (p = 0.03) for the unrestricted diet. In conclusion, for patients shopping at standard grocery stores, the cost of an SFED is higher, and an SFED requires more items from a second store. These differences disappear at specialty grocery stores, but costs were significantly higher. This cost and logistical burden can inform patients when selecting dietary therapy.

  19. Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis?

    Science.gov (United States)

    Bleichrodt, H; Quiggin, J

    1999-12-01

    This paper studies life-cycle preferences over consumption and health status. We show that cost-effectiveness analysis is consistent with cost-benefit analysis if the lifetime utility function is additive over time, multiplicative in the utility of consumption and the utility of health status, and if the utility of consumption is constant over time. We derive the conditions under which the lifetime utility function takes this form, both under expected utility theory and under rank-dependent utility theory, which is currently the most important nonexpected utility theory. If cost-effectiveness analysis is consistent with cost-benefit analysis, it is possible to derive tractable expressions for the willingness to pay for quality-adjusted life-years (QALYs). The willingness to pay for QALYs depends on wealth, remaining life expectancy, health status, and the possibilities for intertemporal substitution of consumption.

  20. Inpatient cost analysis for treatment of myasthenia gravis.

    Science.gov (United States)

    Omorodion, Jacklyn O; Pines, Jesse M; Kaminski, Henry J

    2017-02-27

    We explore trends in U.S. inpatient costs of care over a 10-year period. We compare myasthenia gravis (MG) with multiple sclerosis (MS) and overall U.S. hospital admissions using the Agency for Healthcare Research and Quality Nationwide Inpatient Sample database for 2003-2013. Total costs of MG inpatient care rose 13-fold from 2003 to 2013. This was accounted for by a greater than sixfold increase in discharges and a greater than twofold increase in cost per discharge. The 85 years age groups experienced the greatest increases in discharges. Medicare and Medicaid use increased. Regional variations in cost were apparent. There were greater rises in the Midwestern and Southern United States, which is dissimilar to MS and all hospital admissions. There was a dramatic and disproportionate rise in the number of MG discharges, most likely because of changes in practice patterns. Muscle Nerve, 2016. © 2017 Wiley Periodicals, Inc.

  1. Bending the cost curve and increasing revenue: a family medicine model that works!

    Science.gov (United States)

    Katz, Bernard J; Needham, Mark R

    2012-12-01

    This article attempts to illustrate ways in which family physician practices are able to demonstrate high value, enhanced quality, and streamlined costs, essential components of practice sustainability. Specific examples are provided to assist practices to consider questions and information that allow for skillful engagement during contract negotiations, consider increasing practice revenues by adopting practice enhancements that make sense for the location of the practice and community needs, develop workflow analyses, and review opportunities for expense reduction.

  2. Minuteman III Cost Per Alert Hour Analysis

    Science.gov (United States)

    2012-03-22

    10 Figure 5: Bathtub Curve (Ebeling, 2009:31...maintenance visits and increase the likelihood of maintenance induced failures. Figure 5: Bathtub Curve (Ebeling, 2009:31) A concern with the...introduction of new parts is failures from burn-in. A common model for visualizing lifetime failure rates is the bathtub curve as shown in Figure 5

  3. The Cost and Value of Marketing Analysis.

    Science.gov (United States)

    Thompson, Fred

    1979-01-01

    Institutional researchers and planners are urged to adopt conceptual marketing tools to help them deal with situations where data are sparse and time is short. An easily used decision technique is described that can increase the likelihood of getting good answers to the question: How much information is enough? (Author/LBH)

  4. Analysis of the Effect of Employee Costs on Company Performance

    Directory of Open Access Journals (Sweden)

    Željko Požega

    2010-07-01

    Full Text Available The goal of every economic entity is to accomplish an optimal system of compensation management and to reach maximum returns through optimal employee investment, raising their motivation and knowledge as well as developing their abilities and skills. In order to reach this goal of maximizing company performance it is necessary to systematically approach the management of human resources within a certain economic entity and to create the fairest material and non-material reward and punishment system by using compensation management methods. This in turn will bring about a positive working atmosphere in the company, where employees will rapidly and easily adjust to changes, interact and co-operate with one another at a high level. This research, which studies the effect of employee costs on company performance, is divided into three chapters. The first chapter provides a brief theoretical overview of the importance of compensation management in human resources administration and reaching business efficiency, i.e. the different possibilities of creating a reward and punishment system in a company which aims to organise an optimal working atmosphere. The second chapter demonstrates the applied methodology and illustrates the information from different companies, which has been used in this research and analysis. The information comprises statistical data of employee costs, income, profits and losses from a sample of companies from the Republic of Croatia in 2008. The third part deals with the analysis and interpretation of the research results which show the effect of employee costs on the income and company performance, also expressed per employee. The goal of this research is to test the hypothesis that companies with higher employee cost, i.e. with higher investment in human resources, on average obtain a higher income and a higher profit per employee and are more efficient and more successful on the market. From the given hypothesis, one can

  5. Relative effects of submersion and increased pressure on respiratory mechanics, work, and energy cost of breathing.

    Science.gov (United States)

    Held, Heather E; Pendergast, David R

    2013-03-01

    Submersion and increased pressure (depth) characterize the diving environment and may independently increase demand on the respiratory system. To quantify changes in respiratory mechanics, this study employed a unique protocol and techniques to measure, in a hyperbaric chamber, inspiratory and expiratory alveolar pressures (interrupter technique), inspiratory and expiratory resistance in the airways (RawI and RawE, esophageal balloon technique), nitric oxide elimination (thought to correlate with Raw), inspiratory and expiratory mechanical power of breathing, and the total energy cost of ventilation. Eight healthy adult men underwent experiments at 1, 2.7, and 4.6 atmospheres absolute (ATA) in dry and fully submersed conditions. Subjects rested, cycled on an ergometer at 100 W, and rested while voluntarily matching their ventilation to their own exercise hyperpnea (isocapnic simulated exercise ventilation). During isocapnic simulated exercise ventilation, increased O2 uptake (above rest values) resulted from increased expired ventilation. RawI decreased with submersion (mean 43% during rest and 20% during exercise) but increased from 1 to 4.6 ATA (19% during rest and 75% during exercise), as did RawE (53% decrease with submersion during rest and 10% during exercise; 9% increase from 1 to 4.6 ATA during rest and 66% during exercise). Nitric oxide elimination did not correlate with Raw. Depth increased inspiratory mechanical power of breathing during rest (40%) and exercise (20%). Expiratory mechanical power of breathing was largely unchanged. These results suggest that the diving environment affects ventilatory mechanics primarily by increasing Raw, secondary to increased gas density. This necessitates increased alveolar pressure and increases the work and energy cost of breathing as the diver descends. These findings can inform physician assessment of diver fitness and the pulmonary risks of hyperbaric O2 therapy.

  6. Analysis of Transaction Costs in Logistics and the Methodologies for Their Information Reflection for Automotive Companies

    Directory of Open Access Journals (Sweden)

    Ol’ga Evgen’evna Kovrizhnykh

    2016-12-01

    Full Text Available Transaction costs emerge in different types of logistics activities and influence the material flow and the accompanying financial and information flows; due to this fact, the information support and assessment are important tasks for the enterprise. The paper analyzes transaction costs in logistics for automotive manufacturers; according to the analysis, the level of these costs in any functional area of “logistics supply” ranges from 1.5 to 20%. These are only the official figures of transaction costs of enterprises that do not take into consideration implicit costs. Despite the growing interest in transaction costs in logistics in the latest fifteen years, this topic is covered rather poorly in Russian literature; the definition of “transaction costs” is unclear, there is no technique of their information reflection and assessment. We have developed the methods for information reflection of transaction costs that can be used by automotive enterprises. Each enterprise will have an opportunity to choose the most suitable technique for information reflection of transaction costs or to compare the level of transaction costs when using different techniques. Application of techniques for information reflection of transaction costs allows the enterprises to increase profits by optimizing and reducing costs and using their assets more effectively, to identify possible ways to improve cost parameters of their performance, to improve their efficiency and productivity; to cut out unnecessary or duplicate activities, to optimize the number of staff involved in a particular activity

  7. Cost-Effectiveness Analysis of an Automated Medication System Implemented in a Danish Hospital Setting.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Power and sample size in cost-effectiveness analysis.

    Science.gov (United States)

    Laska, E M; Meisner, M; Siegel, C

    1999-01-01

    For resource allocation under a constrained budget, optimal decision rules for mutually exclusive programs require that the treatment with the highest incremental cost-effectiveness ratio (ICER) below a willingness-to-pay (WTP) criterion be funded. This is equivalent to determining the treatment with the smallest net health cost. The designer of a cost-effectiveness study needs to select a sample size so that the power to reject the null hypothesis, the equality of the net health costs of two treatments, is high. A recently published formula derived under normal distribution theory overstates sample-size requirements. Using net health costs, the authors present simple methods for power analysis based on conventional normal and on nonparametric statistical theory.

  9. How to Appropriately Extrapolate Costs and Utilities in Cost-Effectiveness Analysis.

    Science.gov (United States)

    Bojke, Laura; Manca, Andrea; Asaria, Miqdad; Mahon, Ronan; Ren, Shijie; Palmer, Stephen

    2017-05-03

    Costs and utilities are key inputs into any cost-effectiveness analysis. Their estimates are typically derived from individual patient-level data collected as part of clinical studies the follow-up duration of which is often too short to allow a robust quantification of the likely costs and benefits a technology will yield over the patient's entire lifetime. In the absence of long-term data, some form of temporal extrapolation-to project short-term evidence over a longer time horizon-is required. Temporal extrapolation inevitably involves assumptions regarding the behaviour of the quantities of interest beyond the time horizon supported by the clinical evidence. Unfortunately, the implications for decisions made on the basis of evidence derived following this practice and the degree of uncertainty surrounding the validity of any assumptions made are often not fully appreciated. The issue is compounded by the absence of methodological guidance concerning the extrapolation of non-time-to-event outcomes such as costs and utilities. This paper considers current approaches to predict long-term costs and utilities, highlights some of the challenges with the existing methods, and provides recommendations for future applications. It finds that, typically, economic evaluation models employ a simplistic approach to temporal extrapolation of costs and utilities. For instance, their parameters (e.g. mean) are typically assumed to be homogeneous with respect to both time and patients' characteristics. Furthermore, costs and utilities have often been modelled to follow the dynamics of the associated time-to-event outcomes. However, cost and utility estimates may be more nuanced, and it is important to ensure extrapolation is carried out appropriately for these parameters.

  10. Solid waste integrated cost analysis model: 1991 project year report

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    The purpose of the City of Houston's 1991 Solid Waste Integrated Cost Analysis Model (SWICAM) project was to continue the development of a computerized cost analysis model. This model is to provide solid waste managers with tool to evaluate the dollar cost of real or hypothetical solid waste management choices. Those choices have become complicated by the implementation of Subtitle D of the Resources Conservation and Recovery Act (RCRA) and the EPA's Integrated Approach to managing municipal solid waste;. that is, minimize generation, maximize recycling, reduce volume (incinerate), and then bury (landfill) only the remainder. Implementation of an integrated solid waste management system involving all or some of the options of recycling, waste to energy, composting, and landfilling is extremely complicated. Factors such as hauling distances, markets, and prices for recyclable, costs and benefits of transfer stations, and material recovery facilities must all be considered. A jurisdiction must determine the cost impacts of implementing a number of various possibilities for managing, handling, processing, and disposing of waste. SWICAM employs a single Lotus 123 spreadsheet to enable a jurisdiction to predict or assess the costs of its waste management system. It allows the user to select his own process flow for waste material and to manipulate the model to include as few or as many options as he or she chooses. The model will calculate the estimated cost for those choices selected. The user can then change the model to include or exclude waste stream components, until the mix of choices suits the user. Graphs can be produced as a visual communication aid in presenting the results of the cost analysis. SWICAM also allows future cost projections to be made.

  11. Cost-Sharing Rates Increase During Deep Recession: Preliminary Data From Greece.

    Science.gov (United States)

    Gouvalas, Athanasios; Igoumenidis, Michael; Theodorou, Mamas; Athanasakis, Kostas

    2016-05-28

    Measures taken over the past four years in Greece to reduce pharmaceutical expenditure have led to significant price reductions for medicines, but have also changed patient cost-sharing rates for prescription drugs. This study attempts to capture the resulting increase in patients' out-of-pocket (OOP) expenses for prescription drugs during the 2011-2014 period. The authors conducted a retrospective review of financial data derived from 39 883 prescriptions, dispensed at three randomly chosen pharmacies located in Lamia, central Greece. The study recorded an average contribution rate per prescription as follows: 11.28% for 2011 (95% CI: 10.76-11.80), 14.10% for 2012, 19.97% for 2013, and 29.08% for 2014. Correspondingly, the mean patient charge per prescription for 2011 was €6.58 (95% CI: 6.22-6.94), €8.28 for 2012, €8.35 for 2013, and €10.87 for 2014. During the 2011-2014 period, mean percentage rate of patient contribution increased by 157.75%, while average patient charge per prescription in current prices increased by 65.22%. The use of a newly introduced internal reference price (IRP) system increased the level of prescription charge at a rate of 2.41% for 2012 (100% surcharge on patients), 26.24% for 2013 (49.95% on patients and 50.04% on the appropriate health insurance funds), and 47.72% for 2014 (85.06% on patients and 14.94% on funds). Increased cost-sharing rates for prescription drugs can reduce public pharmaceutical expenditure, but international experience shows that rising OOP expenses can compromise patients' ability to pay, particularly when it comes to chronic diseases and vulnerable populations. Various suggestions could be effective in refining the cost-sharing approach by giving greater consideration to chronic patients, and to the poor and elderly.

  12. Elevated CO2 increases energetic cost and ion movement in the marine fish intestine

    Science.gov (United States)

    Heuer, Rachael M.; Grosell, Martin

    2016-01-01

    Energetic costs associated with ion and acid-base regulation in response to ocean acidification have been predicted to decrease the energy available to fish for basic life processes. However, the low cost of ion regulation (6–15% of standard metabolic rate) and inherent variation associated with whole-animal metabolic rate measurements have made it difficult to consistently demonstrate such a cost. Here we aimed to gain resolution in assessing the energetic demand associated with acid-base regulation by examining ion movement and O2 consumption rates of isolated intestinal tissue from Gulf toadfish acclimated to control or 1900 μatm CO2 (projected for year 2300). The active marine fish intestine absorbs ions from ingested seawater in exchange for HCO3− to maintain water balance. We demonstrate that CO2 exposure causes a 13% increase of intestinal HCO3− secretion that the animal does not appear to regulate. Isolated tissue from CO2-exposed toadfish also exhibited an 8% higher O2 consumption rate than tissue from controls. These findings show that compensation for CO2 leads to a seemingly maladaptive persistent base (HCO3−) loss that incurs an energetic expense at the tissue level. Sustained increases to baseline metabolic rate could lead to energetic reallocations away from other life processes at the whole-animal level. PMID:27682149

  13. Elevated CO2 increases energetic cost and ion movement in the marine fish intestine.

    Science.gov (United States)

    Heuer, Rachael M; Grosell, Martin

    2016-09-29

    Energetic costs associated with ion and acid-base regulation in response to ocean acidification have been predicted to decrease the energy available to fish for basic life processes. However, the low cost of ion regulation (6-15% of standard metabolic rate) and inherent variation associated with whole-animal metabolic rate measurements have made it difficult to consistently demonstrate such a cost. Here we aimed to gain resolution in assessing the energetic demand associated with acid-base regulation by examining ion movement and O2 consumption rates of isolated intestinal tissue from Gulf toadfish acclimated to control or 1900 μatm CO2 (projected for year 2300). The active marine fish intestine absorbs ions from ingested seawater in exchange for HCO3(-) to maintain water balance. We demonstrate that CO2 exposure causes a 13% increase of intestinal HCO3(-) secretion that the animal does not appear to regulate. Isolated tissue from CO2-exposed toadfish also exhibited an 8% higher O2 consumption rate than tissue from controls. These findings show that compensation for CO2 leads to a seemingly maladaptive persistent base (HCO3(-)) loss that incurs an energetic expense at the tissue level. Sustained increases to baseline metabolic rate could lead to energetic reallocations away from other life processes at the whole-animal level.

  14. 40 CFR 35.6585 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Procurement Requirements Under A Cooperative Agreement § 35.6585 Cost and price analysis... quantities to the general public, or on prices set by law or regulation. (2) Price analysis. In all...

  15. Marginal pricing of transmission services: An analysis of cost recovery

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Arriaga, I.J.; Rubio, F.J. [Univ. Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [IBERDROLA, Bilbao (Spain). Unidad de Planificacion Estrategica

    1995-02-01

    This paper presents an in-depth analysis of network revenues computed with marginal pricing, and in particular it investigates the reasons why marginal prices fail to recover the total incurred network costs in actual power systems. The basic theoretical results are presented and the major causes of the mismatch between network costs and marginal revenues are identified and illustrated with numerical examples, some tutorial and others of realistic size. The regulatory implications of marginal network pricing in the context of competitive electricity markets are analyzed, and suggestions are provided for the meaningful allocation of the costs of the network among its users.

  16. Life-cycle cost analysis of advanced design mixer pump

    Energy Technology Data Exchange (ETDEWEB)

    Hall, M.N., Westinghouse Hanford

    1996-07-23

    This analysis provides cost justification for the Advanced Design Mixer Pump program based on the cost benefit to the Hanford Site of 4 mixer pump systems defined in terms of the life-cycle cost.A computer model is used to estimate the total number of service hours necessary for each mixer pump to operate over the 20-year retrieval sequence period for single-shell tank waste. This study also considered the double-shell tank waste retrieved prior to the single-shell tank waste which is considered the initial retrieval.

  17. Cost analysis of ground-water supplies in the North Atlantic region, 1970

    Science.gov (United States)

    Cederstrom, Dagfin John

    1973-01-01

    The cost of municipal and industrial ground water (or, more specifically, large supplies of ground water) at the wellhead in the North Atlantic Region in 1970 generally ranged from 1.5 to 5 cents per thousand gallons. Water from crystalline rocks and shale is relatively expensive. Water from sandstone is less so. Costs of water from sands and gravels in glaciated areas and from Coastal Plain sediments range from moderate to very low. In carbonate rocks costs range from low to fairly high. The cost of ground water at the wellhead is low in areas of productive aquifers, but owing to the cost of connecting pipe, costs increase significantly in multiple-well fields. In the North Atlantic Region, development of small to moderate supplies of ground water may offer favorable cost alternatives to planners, but large supplies of ground water for delivery to one point cannot generally be developed inexpensively. Well fields in the less productive aquifers may be limited by costs to 1 or 2 million gallons a day, but in the more favorable aquifers development of several tens of millions of gallons a day may be practicable and inexpensive. Cost evaluations presented cannot be applied to any one specific well or specific site because yields of wells in any one place will depend on the local geologic and hydrologic conditions; however, with such cost adjustments as may be necessary, the methodology presented should have wide applicability. Data given show the cost of water at the wellhead based on the average yield of several wells. The cost of water delivered by a well field includes costs of connecting pipe and of wells that have the yields and spacings specified. Cost of transport of water from the well field to point of consumption and possible cost of treatment are not evaluated. In the methodology employed, costs of drilling and testing, pumping equipment, engineering for the well field, amortization at 5% percent interest, maintenance, and cost of power are considered. The

  18. Marginal pricing of transmission services. An analysis of cost recovery

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Arriaga, I.J.., Rubio, F.J. [Instituto de Investigacion Technologica, Universidad Pontificia Comillas, Madrid (Spain); Puerta, J.F.; Arceluz, J.; Marin, J. [Unidad de Planificacion Estrategica, Iberdrola, Madrid (Spain)

    1996-12-31

    The authors present an in-depth analysis of network revenues that are computed with marginal pricing, and investigate the reasons why marginal prices in actual power systems fail to recover total incurred network costs. The major causes of the failure are identified and illustrated with numerical examples. The paper analyzes the regulatory implications of marginal network pricing in the context of competitive electricity markets and provides suggestions for the meaningful allocation of network costs among users. 5 figs., 9 tabs., 8 refs.

  19. Postoperative dysphagia correlates with increased morbidity, mortality, and costs in anterior cervical fusion.

    Science.gov (United States)

    Joseph, Jacob R; Smith, Brandon W; Mummaneni, Praveen V; La Marca, Frank; Park, Paul

    2016-09-01

    Anterior cervical fusion (ACF) after discectomy and/or corpectomy is a common procedure with traditionally good patient outcomes. Though typically mild, postoperative dysphagia can result in significant patient morbidity. In this study, we examine the relationship between postoperative dysphagia and in-hospital outcomes, readmissions, and overall costs. The University HealthSystem Consortium (UHC) database was utilized to perform a retrospective cohort study of all adults who underwent a principal procedure of ACF of the anterior column (International Classification of Diseases, Ninth Revision [ICD-9] procedure code 81.02) between 2013 and 2015. Patients with a diagnosis of dysphagia (ICD-9 78720-78729) were compared to those without. Patient demographics, length of stay, in-hospital mortality, 30-day readmissions, and direct costs were recorded. A total of 49,300 patients who underwent ACF were identified. Mean age was 54.5years and 50.2% were male. Dysphagia was documented in 3,137 patients (6.4%) during their hospital stay. Patients with dysphagia had an average 2.1 comorbidities, while patients without dysphagia had 1.5 (p<0.01). Mean length of stay was 6.38days in patients with dysphagia, and 2.13days in those without (p<0.01). In-hospital mortality was 0.10% in patients without dysphagia, and 0.61% in those with dysphagia (p<0.01). Direct costs were $13,099 in patients without dysphagia, and $21,245 in those with dysphagia (p<0.01). Thirty-day readmission rate was 2.9% in patients without dysphagia, and 5.3% in those with dysphagia (p=0.01). In summary, dysphagia in patients who undergo ACF correlates with significantly increased length of stay, 30-day readmissions, and in-hospital mortality. Direct costs are similarly increased as a result.

  20. A cost-effectiveness analysis to illustrate the impact of cost definitions on results, interpretations and comparability of pharmacoeconomic studies in the US.

    Science.gov (United States)

    Tunis, Sandra L

    2009-01-01

    There is a lack of a uniform proxy for defining direct medical costs in the US. This potentially important source of variation in modelling and other types of economic studies is often overlooked. The extent to which increased expenditures for an intervention can be offset by reductions in subsequent service costs can be directly related to the choice of cost definitions. To demonstrate how different cost definitions for direct medical costs can impact results and interpretations of a cost-effectiveness analysis. The IMS-CORE Diabetes Model was used to project the lifetime (35-year) cost effectiveness in the US of one pharmacological intervention 'medication A' compared with a second 'medication B' (both unspecified) for type 2 diabetes mellitus. The complications modelled included cardiovascular disease, renal disease, eye disease and neuropathy. The model had a Markov structure with Monte Carlo simulations. Utility values were derived from the published literature. Complication costs were obtained from a retrospective database study that extracted anonymous patient-level data from (primarily private payer) adjudicated medical and pharmaceutical claims. Costs for pharmacy services, outpatient services and inpatient hospitalizations were included. Cost definitions for complications included charged, allowed and paid amounts, and for medications included both wholesale acquisition cost (WAC) and average wholesale price (AWP). Costs were reported in year 2007 values. The cost-effectiveness results differed according to the particular combination of cost definitions employed. The use of charges greatly increased costs for complications. When the analysis incorporated WAC medication prices with charged amounts for complication costs, the incremental cost-effectiveness ratio (ICER) for medication A versus medication B was $US6337 per QALY. When AWP prices were used with charged amounts, medication A became a dominant treatment strategy, i.e. lower costs with greater

  1. [Costly drugs: analysis and proposals for the Mercosur countries].

    Science.gov (United States)

    Marín, Gustavo H; Polach, María Andrea

    2011-08-01

    Determine how the Mercosur countries access, regulate, and finance costly drugs and propose joint selection and financing strategies at the subregional level. Qualitative design, using content analyses of primary and secondary sources, document reviews, interviews, focus groups, and case studies. The variables selected included: selection criteria, access, financing, and regulations in the various countries. Costly drugs were divided into those that do not alter the natural course of the disease and those with demonstrated efficacy, using the defined daily dose to compare the costs of classical treatments and those involving costly drugs. The Mercosur countries generally lack formal strategies for dealing with the demand for costly drugs, and governments and insurers wind up financing them by court order. The case studies show that there are costly drugs whose efficacy has not been established but that nonetheless generate demand. The fragmentation of procurement, international commitments with regard to intellectual property, and low negotiating power exponentially increase the price of costly drugs, putting health system finances in jeopardy. Costly drugs must be regulated and rationally selected so that only those that substantively benefit people are accepted. To finance the drugs so selected, common country strategies are needed that include such options as flexible in trade agreements, the creation of national resource funds, or joint procurement by countries to enhance their negotiating power.

  2. Cost-effectiveness analysis of computer-based assessment

    Directory of Open Access Journals (Sweden)

    Pauline Loewenberger

    2003-12-01

    Full Text Available The need for more cost-effective and pedagogically acceptable combinations of teaching and learning methods to sustain increasing student numbers means that the use of innovative methods, using technology, is accelerating. There is an expectation that economies of scale might provide greater cost-effectiveness whilst also enhancing student learning. The difficulties and complexities of these expectations are considered in this paper, which explores the challenges faced by those wishing to evaluate the costeffectiveness of computer-based assessment (CBA. The paper outlines the outcomes of a survey which attempted to gather information about the costs and benefits of CBA.

  3. Cost effectiveness analysis of hemiarthroplasty and total shoulder arthroplasty.

    Science.gov (United States)

    Mather, Richard C; Watters, Tyler S; Orlando, Lori A; Bolognesi, Michael P; Moorman, Claude T

    2010-04-01

    Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are two viable surgical treatment options for glenohumeral osteoarthritis. Recent systematic reviews and randomized trials suggest that TSA, while more costly initially, may have superior outcomes with regard to pain, function and quality of life with lower revision rates. This study compared the cost-effectiveness of TSA with HA. A Markov decision model was constructed for a cost-utility analysis of TSA compared to HA in a cohort of 64-year-old patients. Outcome probabilities and effectiveness were derived from the literature. Costs were estimated from the societal perspective using the national average Medicare reimbursement for the procedures in 2008 US dollars. Effectiveness was expressed in quality-adjusted life years (QALYs) gained. Principal outcome measures were average incremental costs, incremental effectiveness, incremental QALYs, and net health benefits. In the base case, HA resulted in a lower number of average QALYs gained at a higher average cost to society and was, therefore, dominated by the TSA strategy for the treatment of glenohumeral osteoarthritis. The cost effectiveness ratio for TSA and HA were $957/QALY and $1,194/QALY respectively. Sensitivity analysis revealed that if the utility of TSA is equal to, or revision rate lower than HA, TSA continues to be a dominant strategy. Total shoulder arthroplasty with a cemented glenoid is a cost-effective procedure, resulting in greater utility for the patient at a lower overall cost to the payer. These findings suggest that TSA is the preferred treatment for certain populations from both a patient and payer perspective. 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  4. Cost analysis of reinforced concrete slabs and columns

    OpenAIRE

    Spuś, Piotr

    2013-01-01

    The construction industry is increasingly looking for solutions that are both simple and effective and that provide cost savings, speed and flexibility of execution. Two-way slabs are a form of construction unique to reinforced concrete comparing with the other major structural materials. It is an efficient, economical, and widely used structural system. The present dissertation aims to analyze and compare costs between four types of slabs: waffle slab with recuperate molds, flat slabs wit...

  5. A cost function analysis of child health services in four districts in Malawi.

    Science.gov (United States)

    Johns, Benjamin; Munthali, Spy; Walker, Damian G; Masanjala, Winford; Bishai, David

    2013-05-10

    Recent analyses show that donor funding for child health is increasing, but little information is available on actual costs to deliver child health care services. Understanding how unit costs scale with service volume in Malawi can help planners allocate budgets as health services expand. Data on facility level inputs and outputs were collected at 24 health centres in four districts of Malawi visiting a random sample of government and a convenience sample of Christian Health Association of Malawi (CHAM) health centres. In the cost function, total outputs, quality, facility ownership, average salaries and case mix are used to predict total cost. Regression analysis identifies marginal cost as the coefficient relating cost to service volume intensity. The marginal cost per patient seen for all health centres surveyed was US$ 0.82 per additional patient visit. Average cost was US$ 7.16 (95% CI: 5.24 to 9.08) at government facilities and US$ 10.36 (95% CI: 4.92 to 15.80) at CHAM facilities per child seen for any service. The first-line anti-malarial drug accounted for over 30% of costs, on average, at government health centres. Donors directly financed 40% and 21% of costs at government and CHAM health centres, respectively. The regression models indicate higher total costs are associated with a greater number of outpatient visits but that many health centres are not providing services at optimal volume given their inputs. They also indicate that CHAM facilities have higher costs than government facilities for similar levels of utilization. We conclude by discussing ways in which efficiency may be improved at health centres. The first option, increasing the total number of patients seen, appears difficult given existing high levels of child utilization; increasing the volume of adult patients may help spread fixed and semi-fixed costs. A second option, improving the quality of services, also presents difficulties but could also usefully improve performance.

  6. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...... of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope...... sensitivity. Since pair-wise comparisons contains information on the trade-off’s acceptable to the decision maker, it is possible to calculate the shadow price of the effect compared to a given price base. The final section discusses two different approaches for the building of weight profiles...

  7. Final Report: Hydrogen Production Pathways Cost Analysis (2013 – 2016)

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel Allan [Strategic Analysis Inc., Arlington, VA (United States); Saur, Genevieve [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-30

    This report summarizes work conducted under a three year Department of Energy (DOE) funded project to Strategic Analysis, Inc. (SA) to analyze multiple hydrogen (H2) production technologies and project their corresponding levelized production cost of H2. The analysis was conducted using the H2A Hydrogen Analysis Tool developed by the DOE and National Renewable Energy Laboratory (NREL). The project was led by SA but conducted in close collaboration with the NREL and Argonne National Laboratory (ANL). In-depth techno-economic analysis (TEA) of five different H2 production methods was conducted. These TEAs developed projections for capital costs, fuel/feedstock usage, energy usage, indirect capital costs, land usage, labor requirements, and other parameters, for each H2 production pathway, and use the resulting cost and system parameters as inputs into the H2A discounted cash flow model to project the production cost of H2 ($/kgH2). Five technologies were analyzed as part of the project and are summarized in this report: Proton Exchange Membrane technology (PEM), High temperature solid oxide electrolysis cell technology (SOEC), Dark fermentation of biomass for H2 production, H2 production via Monolithic Piston-Type Reactors with rapid swing reforming and regeneration reactions, and Reformer-Electrolyzer-Purifier (REP) technology developed by Fuel Cell Energy, Inc. (FCE).

  8. A study in cost analysis of aggregate production as depending on drilling and blasting design

    Science.gov (United States)

    Bilim, Niyazi; Çelik, Arif; Kekeç, Bilgehan

    2017-10-01

    Since aggregate production has vital importance for many engineering projects-such as construction, highway and plant-mixed concrete production-this study was undertaken to determine how the costs for such production are affected by the design of drilling and blasting processes used. Aggregates are used in the production of concrete and asphalt, which are critical resources for the construction sector. The ongoing population increase and the growth of living standards around the world drive the increasing demand for these products. As demand grows, competition has naturally arisen among producers in the industry. Competition in the market has directly affected prices, which leads to the need for new measures and cost analysis on production costs. The cost calculation is one of the most important parameters in mining activities. Aggregate production operations include drilling, blasting, secondary crushing (if necessary), loading, hauling and crushing-screening, and each of these factors affects cost. In this study, drilling and blasting design parameters (such as hole diameter, hole depth, hole distance and burden) were investigated and evaluated for their effect on the total cost of quarrying these products, based on a particular quarry selected for this research. As the result of evaluation, the parameters actually driving costs have been identified, and their effects on the cost have been determined. In addition, some suggestions are presented regarding production design which may lead to avoiding increased production costs.

  9. Labor Cost Analysis for Pome Production in Different Cultivation Modes in Hebei Province

    Institute of Scientific and Technical Information of China (English)

    Shaoyan; ZHOU; Yu; HUANG; Cui; YAO; Runhang; LU; Xingfang; LIU

    2013-01-01

    Taking the traditional fruit pear as the example, this paper analyzes labor cost for pome production in Hebei Province, based on the representative cases and the research of pome production in different cultivation modes. Firstly, it conducts cost analysis for medium-density pome production in Xinji City, focusing on the comparison of the costs for the main production labor in standard thin planting mode and dwarf close planting mode. According to the research results, labor cost has a great influence on the total production cost of pome. The methods to reduce labor cost include: adopting dwarfing rootstock close planting and intensively efficient pome cultivation method; simplifying the pruning method when matching up the shape of tree; improving soil by the methods of natural grasses and addition of organic materials, and increasing mechanized operation.

  10. A Cost Analysis of Food Waste Composting in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Tui Chen

    2016-11-01

    Full Text Available Taiwan’s Environmental Protection Administration (EPA has enacted a food waste recycling policy since 2003 as an alternative of landfill and incineration for the final disposal of municipal solid waste. Recycled food waste is currently seen as a valuable material, especially when appropriate technology is developed. This paper conducts a cost/benefit analysis based on six cases of food waste composting plants in Taiwan, finding that (1 the composting of food waste may yield the most net benefit compared to other applications of today; (2 the production cost of compost ranges from NT$ 2897–23,117/tonne; (3 the adoption of more automatic technology may reduce operation costs and, thus, a closed composting system with mechanical aeration may be more cost effective; (4 the output is a determinant of affecting production costs and private firms are more competitive in production costs than government-affiliated composting units; (5 all of the government-affiliated composting units face a negative profit and thus they are required to make use of the market value of the produced compost to achieve economic viability; and (6 a subsidy to the compost producer is needed to expand the market demand as the food waste recycled can save the disposal cost of municipal solid waste (MSW incineration.

  11. (Correcting misdiagnoses of asthma: a cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Vandemheen Katherine

    2011-05-01

    Full Text Available Abstract Background The prevalence of physician-diagnosed-asthma has risen over the past three decades and misdiagnosis of asthma is potentially common. Objective: to determine whether a secondary-screening-program to establish a correct diagnosis of asthma in those who report a physician diagnosis of asthma is cost effective. Method Randomly selected physician-diagnosed-asthmatic subjects from 8 Canadian cities were studied with an extensive diagnostic algorithm to rule-in, or rule-out, a correct diagnosis of asthma. Subjects in whom the diagnosis of asthma was excluded were followed up for 6-months and data on asthma medications and heath care utilization was obtained. Economic analysis was performed to estimate the incremental lifetime costs associated with secondary screening of previously diagnosed asthmatic subjects. Analysis was from the perspective of the Canadian healthcare system and is reported in Canadian dollars. Results Of 540 randomly selected patients with physician diagnosed asthma 150 (28%; 95%CI 19-37% did not have asthma when objectively studied. 71% of these misdiagnosed patients were on some asthma medications. Incorporating the incremental cost of secondary-screening for the diagnosis of asthma, we found that the average cost savings per 100 individuals screened was $35,141 (95%CI $4,588-$69,278. Conclusion Cost savings primarily resulted from lifetime costs of medication use averted in those who had been misdiagnosed.

  12. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar

    2012-10-01

    Full Text Available The study pertains to the optimal cost-analysis and design of a circular footing subjected to generalized loadings using sequential unconstrained minimization technique (SUMT in conjunction with Powell’s conjugate direction method for multidimensional search and quadratic interpolation method for one dimensional minimization. The cost of the footing is minimized satisfying all the structural and geotechnical engineering design considerations. As extended penalty function method has been used to convert the constrained problem into an unconstrained one, the developed technique is capable of handling both feasible and infeasible initial design vector. The net saving in cost starting from the best possible manual design ranges from 10 to 20 %. For all practical purposes, the optimum cost is independent of the initial design point. It was observed that for better convergence, the transition parameter  should be chosen at least 100 times the initial penalty parameter kr .

  13. Cost Analysis of Poor Quality Using a Software Simulation

    Directory of Open Access Journals (Sweden)

    Jana Fabianová

    2017-02-01

    Full Text Available The issues of quality, cost of poor quality and factors affecting quality are crucial to maintaining a competitiveness regarding to business activities. Use of software applications and computer simulation enables more effective quality management. Simulation tools offer incorporating the variability of more variables in experiments and evaluating their common impact on the final output. The article presents a case study focused on the possibility of using computer simulation Monte Carlo in the field of quality management. Two approaches for determining the cost of poor quality are introduced here. One from retrospective scope of view, where the cost of poor quality and production process are calculated based on historical data. The second approach uses the probabilistic characteristics of the input variables by means of simulation, and reflects as a perspective view of the costs of poor quality. Simulation output in the form of a tornado and sensitivity charts complement the risk analysis.

  14. Dynamic Cost-Contingency Management: A Method for Reducing Project Costs While Increasing the Probability of Success

    Science.gov (United States)

    2007-04-30

    with Goldratt’s observation that negative human behavior is a major cause of the project-scheduling problem. Goldratt (1997) developed the Critical...2002). Assessment of cost uncertainties for large technology projects: A methodology and an application. Interfaces 32(4), 52-66. Goldratt , E.M

  15. Cost-Sharing Rates Increase During Deep Recession: Preliminary Data From Greece

    Directory of Open Access Journals (Sweden)

    Athanasios Gouvalas

    2016-12-01

    Full Text Available Background Measures taken over the past four years in Greece to reduce pharmaceutical expenditure have led to significant price reductions for medicines, but have also changed patient cost-sharing rates for prescription drugs. This study attempts to capture the resulting increase in patients’ out-of-pocket (OOP expenses for prescription drugs during the 2011-2014 period. Methods The authors conducted a retrospective review of financial data derived from 39 883 prescriptions, dispensed at three randomly chosen pharmacies located in Lamia, central Greece. Results The study recorded an average contribution rate per prescription as follows: 11.28% for 2011 (95% CI: 10.76-11.80, 14.10% for 2012, 19.97% for 2013, and 29.08% for 2014. Correspondingly, the mean patient charge per prescription for 2011 was €6.58 (95% CI: 6.22-6.94, €8.28 for 2012, €8.35 for 2013, and €10.87 for 2014. During the 2011-2014 period, mean percentage rate of patient contribution increased by 157.75%, while average patient charge per prescription in current prices increased by 65.22%. The use of a newly introduced internal reference price (IRP system increased the level of prescription charge at a rate of 2.41% for 2012 (100% surcharge on patients, 26.24% for 2013 (49.95% on patients and 50.04% on the appropriate health insurance funds, and 47.72% for 2014 (85.06% on patients and 14.94% on funds. Conclusion Increased cost-sharing rates for prescription drugs can reduce public pharmaceutical expenditure, but international experience shows that rising OOP expenses can compromise patients’ ability to pay, particularly when it comes to chronic diseases and vulnerable populations. Various suggestions could be effective in refining the costsharing approach by giving greater consideration to chronic patients, and to the poor and elderly.

  16. Image stacking approach to increase sensitivity of fluorescence detection using a low cost complementary metal-oxide-semiconductor (CMOS) webcam.

    Science.gov (United States)

    Balsam, Joshua; Bruck, Hugh Alan; Kostov, Yordan; Rasooly, Avraham

    2012-01-01

    Optical technologies are important for biological analysis. Current biomedical optical analyses rely on high-cost, high-sensitivity optical detectors such as photomultipliers, avalanched photodiodes or cooled CCD cameras. In contrast, Webcams, mobile phones and other popular consumer electronics use lower-sensitivity, lower-cost optical components such as photodiodes or CMOS sensors. In order for consumer electronics devices, such as webcams, to be useful for biomedical analysis, they must have increased sensitivity. We combined two strategies to increase the sensitivity of CMOS-based fluorescence detector. We captured hundreds of low sensitivity images using a Webcam in video mode, instead of a single image typically used in cooled CCD devices.We then used a computational approach consisting of an image stacking algorithm to remove the noise by combining all of the images into a single image. While video mode is widely used for dynamic scene imaging (e.g. movies or time-lapse photography), it is not used to capture a single static image, which removes noise and increases sensitivity by more than thirty fold. The portable, battery-operated Webcam-based fluorometer system developed here consists of five modules: (1) a low cost CMOS Webcam to monitor light emission, (2) a plate to perform assays, (3) filters and multi-wavelength LED illuminator for fluorophore excitation, (4) a portable computer to acquire and analyze images, and (5) image stacking software for image enhancement. The samples consisted of various concentrations of fluorescein, ranging from 30 μM to 1000 μM, in a 36-well miniature plate. In the single frame mode, the fluorometer's limit-of-detection (LOD) for fluorescein is ∼1000 μM, which is relatively insensitive. However, when used in video mode combined with image stacking enhancement, the LOD is dramatically reduced to 30 μM, sensitivity which is similar to that of state-of-the-art ELISA plate photomultiplier-based readers. Numerous medical

  17. Increased disease calls for a cost-benefits review of marine reserves.

    Directory of Open Access Journals (Sweden)

    Emma C Wootton

    Full Text Available Marine reserves (or No-Take Zones are implemented to protect species and habitats, with the aim of restoring a balanced ecosystem. Although the benefits of marine reserves are commonly monitored, there is a lack of insight into the potential detriments of such highly protected waters. High population densities attained within reserves may induce negative impacts such as unfavourable trophic cascades and disease outbreaks. Hence, we investigated the health of lobster populations in the UK's Marine Conservation Zone (MCZ at Lundy Island. Comparisons were made between the fished, Refuge Zone (RZ and the un-fished, No-Take Zone (NTZ; marine reserve. We show ostensibly positive effects such as increased lobster abundance and size within the NTZ; however, we also demonstrate apparent negative effects such as increased injury and shell disease. Our findings suggest that robust cost-benefit analyses of marine reserves could improve marine reserve efficacy and subsequent management strategies.

  18. Increased disease calls for a cost-benefits review of marine reserves.

    Science.gov (United States)

    Wootton, Emma C; Woolmer, Andrew P; Vogan, Claire L; Pope, Edward C; Hamilton, Kristina M; Rowley, Andrew F

    2012-01-01

    Marine reserves (or No-Take Zones) are implemented to protect species and habitats, with the aim of restoring a balanced ecosystem. Although the benefits of marine reserves are commonly monitored, there is a lack of insight into the potential detriments of such highly protected waters. High population densities attained within reserves may induce negative impacts such as unfavourable trophic cascades and disease outbreaks. Hence, we investigated the health of lobster populations in the UK's Marine Conservation Zone (MCZ) at Lundy Island. Comparisons were made between the fished, Refuge Zone (RZ) and the un-fished, No-Take Zone (NTZ; marine reserve). We show ostensibly positive effects such as increased lobster abundance and size within the NTZ; however, we also demonstrate apparent negative effects such as increased injury and shell disease. Our findings suggest that robust cost-benefit analyses of marine reserves could improve marine reserve efficacy and subsequent management strategies.

  19. Internal Logistics System Selection with Total Cost of Ownership Analysis

    Science.gov (United States)

    Araújo, Inês; Pimentel, Carina; Godina, Radu; Matias, João C. O.

    2017-06-01

    In this paper a methodology was followed in order to support the decision-making of one industrial unit regarding its internal logistics system. The addressed factory was facing issues with their internal logistics approach. Some alternatives were pointed out and a proper total cost of ownership (TCO) analysis was developed. This analysis was taken in order to demonstrate the more cost-effective solution for the internal logistics system. This tool is more and more valued by the companies, due to their willing to reduce the costs that are associated with the way of doing business. Despite the proposal of the best choice for the internal logistics system of the enterprise, this study also intends to present some conclusions about the match between the nature of the industrial unit and the logistics systems that best fit the requirements of those.

  20. Bayesian cost-effectiveness analysis with the R package BCEA

    CERN Document Server

    Baio, Gianluca; Heath, Anna

    2017-01-01

    The book provides a description of the process of health economic evaluation and modelling for cost-effectiveness analysis, particularly from the perspective of a Bayesian statistical approach. Some relevant theory and introductory concepts are presented using practical examples and two running case studies. The book also describes in detail how to perform health economic evaluations using the R package BCEA (Bayesian Cost-Effectiveness Analysis). BCEA can be used to post-process the results of a Bayesian cost-effectiveness model and perform advanced analyses producing standardised and highly customisable outputs. It presents all the features of the package, including its many functions and their practical application, as well as its user-friendly web interface. The book is a valuable resource for statisticians and practitioners working in the field of health economics wanting to simplify and standardise their workflow, for example in the preparation of dossiers in support of marketing authorisation, or acade...

  1. Cost analysis of periodontitis management in public sector specialist dental clinics.

    Science.gov (United States)

    Mohd-Dom, Tuti; Ayob, Rasidah; Mohd-Nur, Amrizal; Abdul-Manaf, Mohd R; Ishak, Noorlin; Abdul-Muttalib, Khairiyah; Aljunid, Syed M; Ahmad-Yaziz, Yuhaniz; Abdul-Aziz, Hanizah; Kasan, Noordin; Mohd-Asari, Ahmad S

    2014-05-20

    The objective of this paper is to quantify the cost of periodontitis management at public sector specialist periodontal clinic settings and analyse the distribution of cost components. Five specialist periodontal clinics in the Ministry of Health represented the public sector in providing clinical and cost data for this study. Newly-diagnosed periodontitis patients (N = 165) were recruited and followed up for one year of specialist periodontal care. Direct and indirect costs from the societal viewpoint were included in the cost analysis. They were measured in 2012 Ringgit Malaysia (MYR) and estimated from the societal perspective using activity-based and step-down costing methods, and substantiated by clinical pathways. Cost of dental equipment, consumables and labour (average treatment time) for each procedure was measured using activity-based costing method. Meanwhile, unit cost calculations for clinic administration, utilities and maintenance used step-down approach. Patient expenditures and absence from work were recorded via diary entries. The conversion from MYR to Euro was based on the 2012 rate (1€ = MYR4). A total of 2900 procedures were provided, with an average cost of MYR 2820 (€705) per patient for the study year, and MYR 376 (€94) per outpatient visit. Out of this, 90% was contributed by provider cost and 10% by patient cost; 94% for direct cost and 4% for lost productivity. Treatment of aggressive periodontitis was significantly higher than for chronic periodontitis (t-test, P = 0.003). Higher costs were expended as disease severity increased (ANOVA, P = 0.022) and for patients requiring surgeries (ANOVA, P economic burden of periodontitis management and performing economic evaluation of the specialist periodontal programme.

  2. Analysis of Operating Costs of Subsidies in the Field of Agriculture of EU Countries

    Directory of Open Access Journals (Sweden)

    mics, University of South Bohemia, České Budějo vice, Czech RepublicJ. Svoboda

    2015-12-01

    Full Text Available The article deals with comparison of agricultural subsidies in the member states of the EU in the period 2004-2012 based on the database Farm Accountancy Data Network (FADN. During the monitored period we found a slight increase of operational subsidies with the fact that variability shows a decreasing trend. In the structure of subsidies we can see a clear transition to payments separated from production with significant differences between original member states and new member states (NMS. With the help of cluster analysis the member states were divided into groups according to their operational subsidies, total production and costs. With the use of correlation analysis we assessed the relationships between production, costs and operational subsidies re-counted per ha of utilised agricultural area. The increase of subsidies will not occur in higher cost productivity and only very slightly will it occur in the higher share of subsidized costs.

  3. Cost-effectiveness analysis of rotavirus vaccination in Argentina.

    Science.gov (United States)

    Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Hernández, Laura; Giglio, Norberto; Gentile, Ángela; Diosque, Máximo; Vizzotti, Carla

    2015-05-07

    Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. Compared to no

  4. SCGE modelling in cost-benefit analysis: the Dutch experience

    NARCIS (Netherlands)

    Koopmans, C.; Oosterhaven, J.

    2011-01-01

    Spatial computable general equilibrium (SCGE) models offer opportunities for computing wider economic effects in cost-benefit analysis (CBA) in a theoretically satisfactory way. This is important for the correct estimation of additional economic benefits and international relocation impacts. In the

  5. 45 CFR 2543.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost and price analysis. 2543.45 Section 2543.45 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT...

  6. Cost-benefit analysis of road safety measures.

    NARCIS (Netherlands)

    2008-01-01

    Traffic and transport budgets, national ones as well as regional ones, should be spent as optimally as possible. It is therefore essential to be able to make a good assessment of a variety of measures and compare them with each other. This is possible when a cost-benefit analysis is used. This

  7. 40 CFR 1502.23 - Cost-benefit analysis.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Cost-benefit analysis. 1502.23 Section 1502.23 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY ENVIRONMENTAL IMPACT STATEMENT... be when there are important qualitative considerations. In any event, an environmental...

  8. Cost-benefit analysis of replacing maize with rice husk ...

    African Journals Online (AJOL)

    Cost-benefit analysis of replacing maize with rice husk supplemented with grindazyme, nutrsea ... Log in or Register to get access to full text downloads. ... Rice husk was added at the expense of maize in the control diet and each experimental ...

  9. Evaluating Training: Return on Investment and Cost-Benefit Analysis.

    Science.gov (United States)

    Munoz, Maria D.; Munoz, Marco A.

    Training interventions can be evaluated by calculating return on investment (ROI) and cost-benefit analysis. The four-level model proposed by Kirkpatrick is the dominant evaluation model used. Calculating ROI has been a critical issue for trainers and executives, but only a few organizations have implemented the process that is considered as…

  10. Grain production versus resource and environmental costs: towards increasing sustainability of nutrient use in China.

    Science.gov (United States)

    Jiao, Xiaoqiang; Lyu, Yang; Wu, Xiaobin; Li, Haigang; Cheng, Lingyun; Zhang, Chaochun; Yuan, Lixing; Jiang, Rongfeng; Jiang, Baiwen; Rengel, Zed; Zhang, Fusuo; Davies, William J; Shen, Jianbo

    2016-09-01

    Over the past five decades, Chinese grain production has increased 4-fold, from 110 Mt in 1961 to 557 Mt in 2014, with less than 9% of the world's arable land feeding 22% of the world's population, indicating a substantial contribution to global food security. However, compared with developed economies, such as the USA and the European Union, more than half of the increased crop production in China can be attributed to a rapid increase in the consumption of chemicals, particularly fertilizers. Excessive fertilization has caused low nutrient use efficiency and high environmental costs in grain production. We analysed the key requirements underpinning increased sustainability of crop production in China, as follows: (i) enhance nutrient use efficiency and reduce nutrient losses by fertilizing roots not soil to maximize root/rhizosphere efficiency with innovative root zone nutrient management; (ii) improve crop productivity and resource use efficiency by matching the best agronomic management practices with crop improvement; and (iii) promote technology transfer of the root zone nutrient management to achieve the target of high yields and high efficiency with low environmental risks on a broad scale. Coordinating grain production and environmental protection by increasing the sustainability of nutrient use will be a key step in achieving sustainable crop production in Chinese agriculture.

  11. Cost analysis of adolescent idiopathic scoliosis surgery: early discharge decreases hospital costs much less than intraoperative variables under the control of the surgeon.

    Science.gov (United States)

    Raudenbush, Brandon L; Gurd, David P; Goodwin, Ryan C; Kuivila, Thomas E; Ballock, R Tracy

    2017-03-01

    Spinal fusion surgery for the treatment of adolescent idiopathic scoliosis (AIS) is increasing. Health systems and surgeons are decreasing hospital length of stay (LOS) to decrease costs. The purpose of this study was to review the contribution of an accelerated discharge protocol on the total cost of a single episode of care related to the surgical treatment of AIS at a single institution. A retrospective cost analysis was performed over an 18-month period, from January 2014 through June 2015, before and after the institution of an accelerated discharge program. Patients treated surgically with ICD-9 code 737.30 (Idiopathic Scoliosis) were reviewed. Itemized costs and LOS were analyzed collectively and by surgeon before and after the accelerated discharge protocol. Eighty AIS patients were treated surgically. The accelerated discharge program significantly reduced average LOS from 4.2 days in 2014 to 3.3 days during the first 6 months of 2015 (P≤0.05). There were no increases in complications. There was a 9% decrease in the total average costs per episode of care. A weighted average, a relative average change in costs, and an average cost savings per case were calculated for 12 different categories. Average Surgical Services and Nursing costs decreased during the study period while all other costs increased. The accelerated discharge program did not directly contribute significantly to this decrease in costs. Greatest cost reduction was associated with average bone graft and pedicle screw cost, with an overall 8.5% reduction in pedicle screw use and a 58% reduction in bone graft costs. Intraoperative variables under the direct control of the surgeon contribute much more to cost reduction than an accelerated discharge program for surgically treated AIS patients.

  12. A Cost Analysis of Kidney Replacement Therapy Options in Palestine

    Directory of Open Access Journals (Sweden)

    Mustafa Younis Ph.D.

    2015-03-01

    Full Text Available This study provides a cost analysis of kidney replacement therapy options in Palestine. It informs evidence-based resource allocation decisions for government-funded kidney disease services where transplant donors are limited, and some of the common modalities, i.e., peritoneal dialysis (PD and home hemodialysis (HD, are not widely available due to shortages of qualified staff, specialists, and centers to follow the patient cases, provide training, make home visits, or provide educational programs for patients. The average cost of kidney transplant was US$16 277 for the first year; the estimated cost of HD per patient averaged US$16 085 per year—nearly as much as a transplant. Consistent with prior literature and experience, while live, related kidney donors are scarce, we found that kidney transplant was more adequate and less expensive than HD. These results have direct resource allocation implications for government-funded kidney disease services under Palestinian Ministry of Health. Our findings strongly suggest that investing in sufficient qualified staff, equipment, and clinical infrastructure to replace HD services with transplantation whenever medically indicated and suitable kidney donors are available, as well as deploying PD programs and Home HD programs, will result in major overall cost savings. Our results provide a better understanding of the costs of kidney disease and will help to inform Ministry of Health and related policy makers as they develop short- and long-term strategies for the population, in terms of both cost savings and enhanced quality of life.

  13. Cost containment using cysteine HCl acidification to increase calcium/phosphate solubility in hyperalimentation solutions.

    Science.gov (United States)

    Schmidt, G L; Baumgartner, T G; Fischlschweiger, W; Sitren, H S; Thakker, K M; Cerda, J J

    1986-01-01

    The purpose of this study was to determine if (1) the calcium/phosphate insoluble product was inversely related to pH [when cysteine HC1 (CH) was added as neonatal supplementation at 0.5 mM/kg/day to hyperalimentation (HAL) solutions] and (2) the potential cost savings to the hospital. The pH of the HAL solutions was adjusted by adding various amounts of CH to the HAL solution. HAL solutions containing 27 mEq of calcium/liter and 30 mEq (15 mM) of phosphate/liter were compounded. Ten-milliliter aliquots were analyzed at 0, 12, 24, and 48 hr. All samples (n = 56) were filtered (0.22 mu), viewed with 7-10,000 X magnification scanning electron microscopy, and qualitatively analyzed with a Philips Energy Dispersive X-Ray Analysis System equipped with a SW9100 Microprocessor. Calcium/phosphate insoluble product was present in the 0-, 12-, 24-, and 48-hr samples from the CH-free solutions. The solutions containing 759 mg (4.17 mM)/liter of CH however, remained free of precipitant. This investigation demonstrated that addition of CH to HAL can foster significant cost containment (projected $82,000/yr tangible hospital savings) by the elimination of current calcium/phosphate separation procedures for neonates on parenteral nutrition.

  14. 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.

  15. Life cycle cost analysis for the Plasma Arc Furnace

    Energy Technology Data Exchange (ETDEWEB)

    Barnes-Smith, P.

    1994-03-01

    This document is a draft version. The Mixed Waste Integrated Program requested that the Systems Analysis Group investigate the cost effectiveness of using the Plasma Arc Furnace (PAF) module in place of specified thermal and final forms treatment equipment in the baseline Mixed Waste Treatment Project (MWTP) study as performed by Bechtel Corporation, September 1992. The attached estimates are based on the process equipment and facilities cost data contained in the Bechtel study. The PAF process equipment and facilities cost data were developed using independent cost estimates for the equipment list provided by SAIC, Waste Management and Technology Division, in cooperation with the Pollution Prevention and Systems Analysis Group of the Oak Ridge National Laboratory, Chemical Technology Division. In order to develop the total life cycle cost estimate comparison for this study, it was necessary to use a common base for comparison. Although it was felt that the Bechtel MWTP study did not fully reflect the optimum size for the thermal and final forms treatment equipment, it was the best available data at the time.

  16. Open Latarjet versus arthroscopic Latarjet: clinical results and cost analysis.

    Science.gov (United States)

    Randelli, P; Fossati, C; Stoppani, C; Evola, F R; De Girolamo, L

    2016-02-01

    The aim of this study was to compare the clinical results between open and arthroscopic Latarjet and perform a cost analysis of the two techniques. A systematic review of articles present in PubMed and MEDLINE was performed in accordance with PRISMA guidelines. Studies concerning post-operative outcomes following Latarjet procedures for chronic anterior shoulder instability were selected for analysis. The clinical and radiographic results as well as the costs of the open and arthroscopic techniques were evaluated. Twenty-three articles, describing a total of 1317 shoulders, met the inclusion criteria: 17 studies were related to open Latarjet, and 6 to the arthroscopic technique. Despite the heterogeneity of the evaluation scales, the clinical results seemed very satisfactory for both techniques. We detected a statistically significant difference in the percentage of bone graft healing in favour of the open technique (88.6 vs 77.6 %). Recurrent dislocation was more frequent following open surgery (3.3 % after open surgery vs 0.3 % after arthroscopy), but this finding was biased by the large difference in follow-up duration between the two techniques. The direct costs of the arthroscopic procedure were double in comparison to open surgery (€2335 vs €1040). A lack of data prevented evaluation of indirect costs and, therefore, a cost-effectiveness analysis. The open and arthroscopic Latarjet techniques showed excellent and comparable clinical results. However, the much higher direct costs of the arthroscopic procedure do not seem, at present, to be justified by a benefit to the patient. III.

  17. Price transparency for MRIs increased use of less costly providers and triggered provider competition.

    Science.gov (United States)

    Wu, Sze-jung; Sylwestrzak, Gosia; Shah, Christiane; DeVries, Andrea

    2014-08-01

    To encourage patients to select high-value providers, an insurer-initiated price transparency program that focused on elective advanced imaging procedures was implemented. Patients having at least one outpatient magnetic resonance imaging (MRI) scan in 2010 or 2012 were divided according to their membership in commercial health plans participating in the program (the intervention group) or in nonparticipating commercial health plans (the reference group) in similar US geographic regions. Patients in the intervention group were informed of price differences among available MRI facilities and given the option of selecting different providers. For those patients, the program resulted in a $220 cost reduction (18.7 percent) per test and a decrease in use of hospital-based facilities from 53 percent in 2010 to 45 percent in 2012. Price variation between hospital and nonhospital facilities for the intervention group was reduced by 30 percent after implementation. Nonparticipating members residing in intervention areas also observed price reductions, which indicates increased price competition among providers. The program significantly reduced imaging costs. This suggests that patients select lower-price facilities when informed about available alternatives.

  18. Real Option Cost Vulnerability Analysis of Electrical Infrastructure

    Science.gov (United States)

    Prime, Thomas; Knight, Phil

    2015-04-01

    Critical infrastructure such as electricity substations are vulnerable to various geo-hazards that arise from climate change. These geo-hazards range from increased vegetation growth to increased temperatures and flood inundation. Of all the identified geo-hazards, coastal flooding has the greatest impact, but to date has had a low probability of occurring. However, in the face of climate change, coastal flooding is likely to occur more often due to extreme water levels being experienced more frequently due to sea-level rise (SLR). Knowing what impact coastal flooding will have now and in the future on critical infrastructure such as electrical substations is important for long-term management. Using a flood inundation model, present day and future flood events have been simulated, from 1 in 1 year events up to 1 in 10,000 year events. The modelling makes an integrated assessment of impact by using sea-level and surge to simulate a storm tide. The geographical area the model covers is part of the Northwest UK coastline with a range of urban and rural areas. The ensemble of flood maps generated allows the identification of critical infrastructure exposed to coastal flooding. Vulnerability has be assessed using an Estimated Annual Damage (EAD) value. Sampling SLR annual probability distributions produces a projected "pathway" for SLR up to 2100. EAD is then calculated using a relationship derived from the flood model. Repeating the sampling process allows a distribution of EAD up to 2100 to be produced. These values are discounted to present day values using an appropriate discount rate. If the cost of building and maintain defences is also removed from this a Net Present Value (NPV) of building the defences can be calculated. This distribution of NPV can be used as part of a cost modelling process involving Real Options, A real option is the right but not obligation to undertake investment decisions. In terms of investment in critical infrastructure resilience this

  19. More americans living longer with cardiovascular disease will increase costs while lowering quality of life.

    Science.gov (United States)

    Pandya, Ankur; Gaziano, Thomas A; Weinstein, Milton C; Cutler, David

    2013-10-01

    In the past several decades, some risk factors for cardiovascular disease have improved, while others have worsened. For example, smoking rates have dropped and treatment rates for cardiovascular disease have increased-factors that have made the disease less fatal. At the same time, Americans' average body mass index and incidence of diabetes have increased as the population continues to live longer-factors that have made cardiovascular disease more prevalent. To assess the aggregate impact of these opposing trends, we used the nine National Health and Nutrition Examination Survey waves from 1973 to 2010 to forecast total cardiovascular disease risk and prevalence from 2015 to 2030. We found that continued improvements in cardiovascular disease treatment and declining smoking rates will not outweigh the influence of increasing population age and obesity on cardiovascular disease risk. Given an aging population, an obesity epidemic, and declining mortality from the disease, the United States should expect to see a sharp rise in the health care costs, disability, and reductions in quality of life associated with increased prevalence of cardiovascular disease. Policies that target the treatment of high blood pressure and cholesterol and the reduction of obesity will be necessary to curb the imminent spike in cardiovascular disease prevalence.

  20. Cost Analysis of Patients with Upper Gastrointestinal Hemorrhage

    Directory of Open Access Journals (Sweden)

    Hakan Kocoglu

    2016-01-01

    Full Text Available Aim: Increasing healtcare costs reveal to consider the costs of present diagnostic and treatment modalities. In this study we analysed the costs of hospitalized patients with upper gastrointestinal hemorrhage (UGIB who admitted to Sisli Hamidiye Etfal Education and Research Hospital. Material and Method: In this retrospective study, 524 UGIB patients who admitted to emergency department in 3 years were enrolled. Patients records that include gender, age, complaint at admission, history of medical drug use, presence of comorbidity, blood type, cost of hospitalization, mortality, endoscopic findings, endoscopic forrest’s classification, duration of hospitalization, number of blood transfusion were recorded. Obtained data were evaluated to determine their impact on cost of hospitalization. Results: This study was consisted of 362 male (69,1% and 162 female (30,9% patients. Mean duration of hospitalization was 6.35 ± 4.94 days, mean age was 54.70 ± 20.4 years, and mean number of transfused blood was 2.19 ± 2.25. Mortality rate was 4,2% (n = 22. Mean cost of hospitalization was 827.97 ± 747.11 Turkish Liras (TL. A statistical significance was determined between cost of hospitalization and age (p=0,001, duration of hospitalization (p=0,001, comorbidity (p<0,05, number of transfused blood (p=0,001, and hemoglobine levels at admission (p<0,05. Discussion: Predisposing drug use, presence of comorbidity, age, duration of hospitalization, number of transfused blood were determined as factors that have impact on mortality. Presence of comorbidity, number of comorbid diseases, age, number of transfused blood and hemoglobine levels at admission were determined as factors that have impact on cost of treatment. More studies are needed about duration of hospitalization and number of transfused blood in UGIB patients.

  1. Assessing the value of mepolizumab for severe eosinophilic asthma: a cost-effectiveness analysis.

    Science.gov (United States)

    Whittington, Melanie D; McQueen, R Brett; Ollendorf, Daniel A; Tice, Jeffrey A; Chapman, Richard H; Pearson, Steven D; Campbell, Jonathan D

    2017-02-01

    Adding mepolizumab to standard treatment with inhaled corticosteroids and controller medications could decrease asthma exacerbations and use of long-term oral steroids in patients with severe disease and increased eosinophils; however, mepolizumab is costly and its cost effectiveness is unknown. To estimate the cost effectiveness of mepolizumab. A Markov model was used to determine the incremental cost per quality-adjusted life year (QALY) gained for mepolizumab plus standard of care (SoC) and for SoC alone. The population, adults with severe eosinophilic asthma, was modeled for a lifetime time horizon. A responder scenario analysis was conducted to determine the cost effectiveness for a cohort able to achieve and maintain asthma control. Over a lifetime treatment horizon, 23.96 exacerbations were averted per patient receiving mepolizumab plus SoC. Avoidance of exacerbations and decrease in long-term oral steroid use resulted in more than $18,000 in cost offsets among those receiving mepolizumab, but treatment costs increased by more than $600,000. Treatment with mepolizumab plus SoC vs SoC alone resulted in a cost-effectiveness estimate of $386,000 per QALY. To achieve cost effectiveness of approximately $150,000 per QALY, mepolizumab would require a more than 60% price discount. At current pricing, treating a responder cohort yielded cost-effectiveness estimates near $160,000 per QALY. The estimated cost effectiveness of mepolizumab exceeds value thresholds. Achieving these thresholds would require significant discounts from the current list price. Alternatively, treatment limited to responders improves the cost effectiveness toward, but remains still slightly above, these thresholds. Payers interested in improving the efficiency of health care resources should consider negotiations of the mepolizumab price and ways to predict and assess the response to mepolizumab. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All

  2. DoD Cost Analysis Guidance and Procedures

    Science.gov (United States)

    1992-12-01

    Itemis 3-9 ’TABLE’S TAB P!E TIFlF IIAGF 2-1 Cost Analysis -improvemnent Group (CAIG) Tim etab Ic 2-11 De’i’en:sc Acquisition Prolgraw Life’-Cycle Cost...relationship to other systems. 1.1.3 System- Configuration. This section identifies the cquipmenleit (hardwvare and software ) work breakdown structure (W135) for...furnished commercial off-ti,: ~ (COTS) software should be addressed in thle discussion. Where Goverrnlent-fu, .’ ’.cd equipment or inron~ertx’ is

  3. Identification of Cost Indicators with Significant Economic Impact on the Total Treatment Costs of Chronic Heart Failure Patients - A Meta-Analysis.

    Science.gov (United States)

    Hameed, Ahmed S; Modre-Osprian, Robert; Schreier, Günter

    2017-01-01

    Increasing treatment costs of HF patients affect the initiation of appropriate treatment method. Divergent approaches to measure the costs of treatment and the lack of common cost indicators impede the comparison of therapy settings. In the context of the present meta-analysis, key cost indicators from the perspective of healthcare providers are to be identified, described, analyzed and quantified. This review helps narrowing down the cost indicators, which have the most significant economic impact on the total treatment costs of HF patients. Telemedical services are to be compared to standard therapy methods. The identification process was based on several steps. For the quantitative synthesis, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. An additional set of criteria was defined for the following qualitative analysis. 5 key cost indicators were identified with significant economic impact on the treatment costs of HF patients. 95% of the reported treatment costs could be captured based on the identified cost indicators.

  4. Increasing Transparency Through a Multiverse Analysis.

    Science.gov (United States)

    Steegen, Sara; Tuerlinckx, Francis; Gelman, Andrew; Vanpaemel, Wolf

    2016-09-01

    Empirical research inevitably includes constructing a data set by processing raw data into a form ready for statistical analysis. Data processing often involves choices among several reasonable options for excluding, transforming, and coding data. We suggest that instead of performing only one analysis, researchers could perform a multiverse analysis, which involves performing all analyses across the whole set of alternatively processed data sets corresponding to a large set of reasonable scenarios. Using an example focusing on the effect of fertility on religiosity and political attitudes, we show that analyzing a single data set can be misleading and propose a multiverse analysis as an alternative practice. A multiverse analysis offers an idea of how much the conclusions change because of arbitrary choices in data construction and gives pointers as to which choices are most consequential in the fragility of the result.

  5. Strengthening Cost-Effectiveness Analysis for Public Health Policy.

    Science.gov (United States)

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.

  6. Is it really possible to build a bridge between cost-benefit analysis and cost-effectiveness analysis?

    Science.gov (United States)

    Dolan, Paul; Edlin, Richard

    2002-09-01

    Cost-benefit analysis (CBA) is a recognised as the economic evaluation technique that accords most with the underlying principles of standard welfare economic theory. However, due to problems associated with the technique, economists evaluating resources allocation decisions in health care have most often used cost-effective analysis (CEA), in which health benefits are expressed in non-monetary units. As a result, attempts have been made to build a welfare economic bridge between cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA). In this paper, we develops these attempts and finds that, while assumptions can be made to facilitate a constant willingness-to-pay per unit of health outcome, these restrictions are highly unrealistic. We develop an impossibility theorem that shows it is not possible to link CBA and CEA if: (i) the axioms of expected utility theory hold; (ii) the quality-adjusted life-year (QALY) model is valid in a welfare economic sense; and (iii) illness affects the ability to enjoy consumption. We conclude that, within a welfare economic framework, it would be unwise to rely on a link between CBA and CEA in economic evaluations.

  7. Kinetic Gait Analysis Using a Low-Cost Insole.

    Science.gov (United States)

    Howell, Adam M; Kobayashi, Toshiki; Hayes, Heather A; Foreman, K Bo; Bamberg, Stacy J Morris

    2013-12-01

    Abnormal gait caused by stroke or other pathological reasons can greatly impact the life of an individual. Being able to measure and analyze that gait is often critical for rehabilitation. Motion analysis labs and many current methods of gait analysis are expensive and inaccessible to most individuals. The low-cost, wearable, and wireless insole-based gait analysis system in this study provides kinetic measurements of gait by using low-cost force sensitive resistors. This paper describes the design and fabrication of the insole and its evaluation in six control subjects and four hemiplegic stroke subjects. Subject-specific linear regression models were used to determine ground reaction force plus moments corresponding to ankle dorsiflexion/plantarflexion, knee flexion/extension, and knee abduction/adduction. Comparison with data simultaneously collected from a clinical motion analysis laboratory demonstrated that the insole results for ground reaction force and ankle moment were highly correlated (all >0.95) for all subjects, while the two knee moments were less strongly correlated (generally >0.80). This provides a means of cost-effective and efficient healthcare delivery of mobile gait analysis that can be used anywhere from large clinics to an individual's home.

  8. Comparison of Cement-Based and Polymer-Based Concrete Pipes for Analysis of Cost Assessment

    Directory of Open Access Journals (Sweden)

    Orhan Bozkurt

    2013-01-01

    Full Text Available As the variety of materials utilized in construction industry has expanded, new techniques have been used in order to optimize the quality and efficiency of output. Therefore, recent innovations taking place in the construction industry led researchers to increase the mechanical efficiency of the output more than the cost effectiveness of it. However, especially professionals experiencing in the industry look into the cost effectiveness of the work. In other words, they also want researchers to justify the innovative techniques economically. The aim of this study is to provide a comparative analysis of the cost efficiency of polymer concrete used to manufacture durable and long-lasting reinforced concrete structures.

  9. Cost analysis of DAWT innovative wind energy systems

    Science.gov (United States)

    Foreman, K. M.

    The results of a diffuser augmented wind turbine (DAWT) preliminary design study of three constructional material approaches and cost analysis of DAWT electrical energy generation are presented. Costs are estimated assuming a limited production run (100 to 500 units) of factory-built subassemblies and on-site final assembly and erection within 200 miles of regional production centers. It is concluded that with the DAWT the (busbar) cost of electricity (COE) can range between 2.0 and 3.5 cents/kW-hr for farm and REA cooperative end users, for sites with annual average wind speeds of 16 and 12 mph respectively, and 150 kW rated units. No tax credit incentives are included in these figures. For commercial end users of the same units and site characteristics, the COE ranges between 4.0 and 6.5 cents/kW-hr.

  10. Cost-effectiveness analysis in Chagas' disease vectors control interventions

    Directory of Open Access Journals (Sweden)

    A. M. Oliveira Filho

    1989-01-01

    Full Text Available After a large scale field trial performed in central Brazil envisaging the control of Chagas' disease vectors in an endemic area colonized by Triatoma infestans and T. sordida the cost-effectiveness analysis for each insecticide/formulation was performed. It considered the operational costs and the prices of insecticides and formulations, related to the activity and persistence of each one. The end point was considered to be less than 90% of domicilliary unitis (house + annexes free of infestation. The results showed good cost-effectiveness for a slow-release emulsifiable suspension (SRES based on PVA and containing malathion as active ingredient, as well as for the pyrethroids tested in this assay-cyfluthrin, cypermethrin, deltamethrin and permethrin.

  11. Stool DNA Analysis is Cost-Effective for Colorectal Cancer Surveillance in Patients With Ulcerative Colitis.

    Science.gov (United States)

    Kisiel, John B; Konijeti, Gauree G; Piscitello, Andrew J; Chandra, Tarun; Goss, Thomas F; Ahlquist, David A; Farraye, Francis A; Ananthakrishnan, Ashwin N

    2016-12-01

    Patients with chronic ulcerative colitis are at increased risk for colorectal neoplasia (CRN). Surveillance by white-light endoscopy (WLE) or chromoendoscopy may reduce risk of CRN, but these strategies are underused. Analysis of DNA from stool samples (sDNA) can detect CRN with high levels of sensitivity, but it is not clear if this approach is cost-effective. We simulated these strategies for CRN detection to determine which approach is most cost-effective. We adapted a previously published Markov model to simulate the clinical course of chronic ulcerative colitis, the incidence of cancer or dysplasia, and costs and benefits of care with 4 surveillance strategies: (1) analysis of sDNA and diagnostic chromoendoscopy for patients with positive results, (2) analysis of sDNA with diagnostic WLE for patients with positive results, (3) chromoendoscopy with targeted collection of biopsies, or (4) WLE with random collection of biopsies. Costs were based on 2014 Medicare reimbursement. The primary outcome was the incremental cost-effectiveness ratio (incremental cost/incremental difference in quality-adjusted life-years) compared with no surveillance and a willingness-to-pay threshold of $50,000. All strategies fell below the willingness-to-pay threshold at 2-year intervals. Incremental cost-effectiveness ratios were $16,362 per quality-adjusted life-year for sDNA analysis with diagnostic chromoendoscopy; $18,643 per quality-adjusted life-year for sDNA analysis with diagnostic WLE; $23,830 per quality-adjusted life-year for chromoendoscopy alone; and $27,907 per quality-adjusted life-year for WLE alone. In sensitivity analyses, sDNA analysis with diagnostic chromoendoscopy was more cost-effective than chromoendoscopy alone, up to a cost of $1135 per sDNA test. sDNA analysis remained cost-effective at all rates of compliance; when combined with diagnostic chromoendoscopy, this approach was preferred over chromoendoscopy alone, when the specificity of the sDNA test for CRN

  12. A cost for high levels of sperm competition in rodents: increased sperm DNA fragmentation.

    Science.gov (United States)

    delBarco-Trillo, Javier; García-Álvarez, Olga; Soler, Ana Josefa; Tourmente, Maximiliano; Garde, José Julián; Roldan, Eduardo R S

    2016-03-16

    Sperm competition, a prevalent evolutionary process in which the spermatozoa of two or more males compete for the fertilization of the same ovum, leads to morphological and physiological adaptations, including increases in energetic metabolism that may serve to propel sperm faster but that may have negative effects on DNA integrity. Sperm DNA damage is associated with reduced rates of fertilization, embryo and fetal loss, offspring mortality, and mutations leading to genetic disease. We tested whether high levels of sperm competition affect sperm DNA integrity. We evaluated sperm DNA integrity in 18 species of rodents that differ in their levels of sperm competition using the sperm chromatin structure assay. DNA integrity was assessed upon sperm collection, in response to incubation under capacitating or non-capacitating conditions, and after exposure to physical and chemical stressors. Sperm DNA was very resistant to physical and chemical stressors, whereas incubation in non-capacitating and capacitating conditions resulted in only a small increase in sperm DNA damage. Importantly, levels of sperm competition were positively associated with sperm DNA fragmentation across rodent species. This is the first evidence showing that high levels of sperm competition lead to an important cost in the form of increased sperm DNA damage. © 2016 The Author(s).

  13. Cost minimization analysis for combinations of sampling techniques in bronchoscopy of endobronchial lesions.

    Science.gov (United States)

    Roth, Kjetil; Hardie, Jon Andrew; Andreassen, Alf Henrik; Leh, Friedemann; Eagan, Tomas Mikal Lind

    2009-06-01

    The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques. The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions. A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyses were performed to determine threshold values. The combination of biopsy, brushing and EBNA was the most economical strategy with an average cost of Euro 893 (95% CI: 657, 1336). The cost of brushing had to be below Euro 83 and it had to increase the diagnostic yield more than 2.2%, for biopsy and brushing to be more economical than biopsy alone. The combination of biopsy, brushing and EBNA was more economical than biopsy and brushing when the cost of EBNA was below Euro 205 and the increase in diagnostic yield was above 5.2%. In the current study setting, biopsy, brushing and EBNA was the most economical combination of sampling techniques for endobronchial visible lesions.

  14. Cost-effectiveness of Bariatric Surgery: Increasing the Economic Viability of the Most Effective Treatment for Type II Diabetes Mellitus.

    Science.gov (United States)

    Warren, Jeremy A; Ewing, Joseph A; Hale, Allyson L; Blackhurst, Dawn W; Bour, Eric S; Scott, John D

    2015-08-01

    There has been considerable debate on the cost-effectiveness of bariatric surgery within larger population groups. Despite the recognition that morbid obesity and its comorbidities are best treated surgically, insurance coverage is not universally available. One of the more costly comorbidities of obesity is Type II diabetes mellitus (T2DM). We propose a model that demonstrates the cost-effectiveness of increasing the number of bariatric surgical operations performed on patients with T2DM in the United States. We applied published population cost estimates (2012) for medical care of T2DM to a retrospective cohort of morbidly obese patients in South Carolina. We compared differences in 10-year medical costs between those having bariatric surgery and controls. Resolution of T2DM in the bariatric cohort was assumed to be 40 per cent. Considering only the direct medical costs of T2DM, the 10-year aggregate cost savings compared with a control group is $2.7 million/1000 patients; the total (direct and indirect) cost savings is $5.4 million/1000 patients. When considering resolution of T2DM alone, increasing the number of bariatric operations for a given population leads to a substantial cost savings over a 10-year period. This study adds to the growing body of evidence suggesting that bariatric surgery is a cost-effective means of caring for the obese patient.

  15. [Costs analysis system; its location within a program for food, nutrition and metabolic intervention].

    Science.gov (United States)

    Fernández Hernández, Ileana Sonia; Santana Porbén, Sergio

    2015-06-01

    Every medical surgical action implies costs. Costs of medical provisions should be translated into tangible, and thus, measurable, benefits for the health status of the patient. Nutritional support therapies might increase the costs of medical provisions, but it is expected their implementation to result in lower morbidity and mortality rates as well as shortening of hospital stay, all of them leading to important savings. It is then required the assimilation of tools for costs analysis for a better management of nutritional support therapies. A proposal for the design of a hospital system (regarded anywhere in this text as SHACOST) for the analysis of the costs of interventions conducted in a patient in accordance with the guidelines included in the Metabolic, Nutrient and Food Intervention Program (referred everywhere for its Spanish acronym PRINUMA) is presented in this article. Hence, strategies are described to estimate the costs of a specified intervention. In addition, a primer on cost-effectiveness (ACE) and incremental cost-effectiveness (ACEI) analyses is shown relying on examples taken from the authors's experience in the provision of nutritional care to patients electively operated for a colorectal cancer. Finally, costs of surgical treatment of a mandibular tumor are described, followed by a discussion on how a better impact of the adopted surgical action could be achieved without considerable increases in total costs should a perioperatory nutritional support program be included. Implementation of SHACOST can provide the medical care teams with accounting tools required to assess the effectiveness of hospital nutritional support schemes, decide whether to acquire and introduce new technologies, and measure the impact of the performance of hospital forms for provision of nutritional care upon health management and perceived quality of life of the patient and their relatives.

  16. Life-cycle cost analysis of adsorption cycles for desalination

    KAUST Repository

    Thu, Kyaw

    2010-08-01

    This paper presents the thermo-economic analysis of the adsorption desalination (AD) cycle that is driven by low-temperature waste heat from exhaust of industrial processes or renewable sources. The AD cycle uses an adsorbent such as the silica gel to desalt the sea or brackish water. Based on an experimental prototype AD plant, the life-cycle cost analysis of AD plants of assorted water production capacities has been simulated and these predictions are translated into unit cost of water production. Our results show that the specific energy consumption of the AD cycle is 1.38 kWh/m3 which is the lowest ever reported. For a plant capacity of 1000 m3/d, the AD cycle offers a unit cost of $0.457/m3 as compared to more than $0.9 for the average RO plants. Besides being cost-effective, the AD cycle is also environment-friendly as it emits less CO2 emission per m3 generated, typically 85% less, by comparison to an RO process. © 2010 Desalination Publications.

  17. Cost Behavior: Mapping and Systemic Analysis of International Publications

    Directory of Open Access Journals (Sweden)

    Fernando Richartz

    2014-12-01

    Full Text Available This article has as objective mapping of scientific researches into costs behavior to identify its current scenario. The research on database provided a selection of relevant bibliographic portfolio, which had as a result 29 articles according to the research criteria defined in the study. From those, the articles from Anderson, Banker e Janakiraman (2003 were highlighted. Furthermore, Banker is considered to be the main author about costs behavior, its importance is noticed not only in the portfolio itself, but also, in its references. The most important periodic, either for its impact, or related to its number of articles publicized, is The Accounting Review. Finally, from the relationship between the most important articles about bibliometric analysis, featuring systemic analysis, the conclusion is that an important article about cost behavior has a quantitative approach (with the use of robust regression, recognize the existence of Sticky Costs (no matter which approach is in use, makes use of a variety of explanations (internal & external and add some variable or information for scientific evolution of the subject.

  18. Cost-benefit analysis for design of environmentally conscious manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Matysiak, L.M.

    1993-09-01

    In recent years, much attention has been focused on reducing the environmental impacts of products and manufacturing processes. Concerned about rising compliance costs and stringent regulatory requirements, companies are carefully evaluating the environmental impacts of their products. In response, designers, engineers, and managers are beginning to use life-cycle analysis, design for environment techniques, and environmentally conscious manufacturing (ECM) as tools to help them to not only do what is best for the environment, but also to do what is best for their company. These tools are also a useful aid in evaluating the trade-offs that may exist between different product and process alternatives. However, how does one choose the optimal solution from these various product and process alternatives? Cost versus benefit analysis is an effective tool that can be used to evaluate various manufacturing alternatives and to choose a solution that is both cost effective and environmentally compatible. Many companies are beginning to use cost benefit analyses as a means to justify product or process modifications that result in a benefit to the environment.

  19. Can broader diffusion of value-based insurance design increase benefits from US health care without increasing costs? Evidence from a computer simulation model.

    Directory of Open Access Journals (Sweden)

    R Scott Braithwaite

    2010-02-01

    Full Text Available BACKGROUND: Evidence suggests that cost sharing (i.e.,copayments and deductibles decreases health expenditures but also reduces essential care. Value-based insurance design (VBID has been proposed to encourage essential care while controlling health expenditures. Our objective was to estimate the impact of broader diffusion of VBID on US health care benefits and costs. METHODS AND FINDINGS: We used a published computer simulation of costs and life expectancy gains from US health care to estimate the impact of broader diffusion of VBID. Two scenarios were analyzed: (1 applying VBID solely to pharmacy benefits and (2 applying VBID to both pharmacy benefits and other health care services (e.g., devices. We assumed that cost sharing would be eliminated for high-value services ($300,000 per life-year. All costs are provided in 2003 US dollars. Our simulation estimated that approximately 60% of health expenditures in the US are spent on low-value services, 20% are spent on intermediate-value services, and 20% are spent on high-value services. Correspondingly, the vast majority (80% of health expenditures would have cost sharing that is impacted by VBID. With prevailing patterns of cost sharing, health care conferred 4.70 life-years at a per-capita annual expenditure of US$5,688. Broader diffusion of VBID to pharmaceuticals increased the benefit conferred by health care by 0.03 to 0.05 additional life-years, without increasing costs and without increasing out-of-pocket payments. Broader diffusion of VBID to other health care services could increase the benefit conferred by health care by 0.24 to 0.44 additional life-years, also without increasing costs and without increasing overall out-of-pocket payments. Among those without health insurance, using cost saving from VBID to subsidize insurance coverage would increase the benefit conferred by health care by 1.21 life-years, a 31% increase. CONCLUSION: Broader diffusion of VBID may amplify benefits from

  20. Cost analysis model for catalytic conversion of syngas in to light hydrocarbon gases

    Directory of Open Access Journals (Sweden)

    Yangyang Deng

    2015-05-01

    Full Text Available Bio-gasification is a new technology and considered as a more efficient way to utilize bio-energy. The economic feasibility becomes one of the greatest issues when we apply this new technology. Evaluation of economic feasibility of a bio-gasification facility needs better understanding of its production unit cost under different capacities and different working shift modes. The objective of this study was to evaluate the unit cost of biofuel products (Liquid HCs, Light HCs and Oxygenates CxHyOz under different capacities using a modeling method. The cost analysis model was developed using Visual Basic Microsoft 2008, computer programming language and mathematical equations. The modeling results showed that the unit costs of biofuel product from bio-gasification facility were significantly affected by production capacities of facilities. As the facility capacity increased from 65 to 10,000 N m3 h−1, the biofuel production unit cost of gas (Light HCs, oil (Liquid HCs, and aqueous (Oxygenates CxHyOz decreased from $38.92 per MMBTU, $30.89 per gallon and $25.74 per gallon to $2.01 per MMBTU, $1.59 per gallon, and $1.33 per gallon, respectively. The results of the sensitivity analysis showed that feedstock cost was the most sensitive cost factor on unit costs for all biofuel products at high capacity. The cost analysis model developed in this study could be used to optimize production unit costs of bio-fuel products from bio-gasification facility.

  1. [Comparision of costs of secondary prevention and treatment of stroke--cost-effectiveness analysis].

    Science.gov (United States)

    Ceronja, Ivana; Sosić, Zvonko

    2011-01-01

    Cerebrovascular accident (CVA) is a serious complication of untreated arterial hypertension. The aim of this paper is to compare the cost of secondary prevention and treatment of CVA caused by untreated arterial hypertension. Cost-effectiveness analysis of diagnosis and therapy of arterial hypertension in comparison with CVA treatment. The cost of secondary prevention of CVA per patient per year in 2006. was 1.589,19 kunas, which comes to 15.107,75 kunas in thirty years of treatment (discount factor included), whereas a single CVA treatment was 17.207,54 kunas on average. In every 850 treatments of hypertension (NNT) comes a prevented CVA which is 1.350.811,5 kunas, and is therefore more expensive than a single CVA treatment. Secondary prevention has a long-term protective effect improving the patients' quality of life, inhibiting the potential post-CVA handicap and pre-retirement. Thus, the main advantage of both primary and secondary prevention is in their greater benefit for patients.

  2. Cost and Systems Analysis of Innovative Fuel Resources Concepts

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Erich [Univ. of Texas, Austin, TX (United States). Nuclear and Radiation Engineering Program; Byers, M. [Univ. of Texas, Austin, TX (United States). Nuclear and Radiation Engineering Program

    2017-05-04

    Economically recovered uranium from seawater can have a transformative effect on the way policy makers view the long-term viability of uranium based fuel cycles. Seawater uranium, even when estimated to cost more than terrestrially mined uranium, is integral in establishing an economic backstop, thus reducing uncertainty in future nuclear power costs. While a passive recovery scheme relying on a field of polymer adsorbents prepared via radiation induced grafting has long been considered the leading technology for full scale deployment, non-trivial cost and logistical barriers persist. Consequently, university partners of the nation-wide consortium for seawater uranium recovery have developed variants of this technology, each aiming to address a substantial weakness. The focus of this NEUP project is the economic impacts of the proposed variant technologies. The team at University of Alabama has pursued an adsorbent synthesis method that replaces the synthetic fiber backbone with a natural waste product. Chitin fibers suitable for ligand grafting have been prepared from shrimp shell waste. These environmental benefits could be realized at a comparable cost to the reference fiber so long as the uptake can be increased or the chemical consumption cost decreased.

  3. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

    Science.gov (United States)

    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

  4. Cost-benefit analysis of improved air quality in an office building

    DEFF Research Database (Denmark)

    Djukanovic, R.; Wargocki, Pawel; Fanger, Povl Ole

    2002-01-01

    A cost-benefit analysis of measures to improve air quality in an existing air-conditoned office building (11581 m2, 864 employees) was carried out for hot, temperate and cold climates and for two operating modes: Variable Air Volume (VAV) with economizer; and Constant Air Volume (CAV) with heat...... recovery. The annual energy cost and first cost of the HVAC system were calculat4ed using DOE 2.1E for different levels of air quality (10-50% dissatisfied). This was achieved by changing the outdoor air supply rate and the pollution loads. Previous studies have documented a 1.1% increase in office...... productivity for every 10% reduction in the proportion of occupants entering a space who are dissatisfied with the air quality. With this assumption, the annual benefit due to improved air quality was always at least 10 times higher than the increase in annual energy and maintenance costs. The payback time...

  5. Cost-benefit analysis of improved air quality in an office building

    DEFF Research Database (Denmark)

    Djukanovic, R.; Wargocki, Pawel; Fanger, Povl Ole

    2002-01-01

    productivity for every 10% reduction in the proportion of occupants entering a space who are dissatisfied with the air quality. With this assumption, the annual benefit due to improved air quality was always at least 10 times higher than the increase in annual energy and maintenance costs. The payback time......A cost-benefit analysis of measures to improve air quality in an existing air-conditoned office building (11581 m2, 864 employees) was carried out for hot, temperate and cold climates and for two operating modes: Variable Air Volume (VAV) with economizer; and Constant Air Volume (CAV) with heat...... recovery. The annual energy cost and first cost of the HVAC system were calculat4ed using DOE 2.1E for different levels of air quality (10-50% dissatisfied). This was achieved by changing the outdoor air supply rate and the pollution loads. Previous studies have documented a 1.1% increase in office...

  6. An Analysis Of Activity Based Costing Between Benefit And Cost For Its Implementation

    Directory of Open Access Journals (Sweden)

    Dadan Soekardan

    2015-08-01

    Full Text Available This research discusses how the importance of adopting activity-based costing for the company in order to carry out its business strategy. One objective is to implement activity based costing cost efficiency by cutting costs incurred for non-value added activity. But the phenomenon shows that there are still many companies organizations are not interested in adopting the activity based costing. This article also outlines the advantages and limitations in adopting activity based costing for the company.

  7. Evolution under dietary restriction increases male reproductive performance without survival cost

    Science.gov (United States)

    Canton, Cindy; Georgolopoulos, Grigorios; Maklakov, Alexei A.

    2016-01-01

    Dietary restriction (DR), a reduction in nutrient intake without malnutrition, is the most reproducible way to extend lifespan in a wide range of organisms across the tree of life, yet the evolutionary underpinnings of the DR effect on lifespan are still widely debated. The leading theory suggests that this effect is adaptive and results from reallocation of resources from reproduction to somatic maintenance, in order to survive periods of famine in nature. However, such response would cease to be adaptive when DR is chronic and animals are selected to allocate more resources to reproduction. Nevertheless, chronic DR can also increase the strength of selection resulting in the evolution of more robust genotypes. We evolved Drosophila melanogaster fruit flies on ‘DR’, ‘standard’ and ‘high’ adult diets in replicate populations with overlapping generations. After approximately 25 generations of experimental evolution, male ‘DR’ flies had higher fitness than males from ‘standard’ and ‘high’ populations. Strikingly, this increase in reproductive success did not come at a cost to survival. Our results suggest that sustained DR selects for more robust male genotypes that are overall better in converting resources into energy, which they allocate mostly to reproduction. PMID:26911958

  8. Cost-free and sustainable incentive increases healthy eating decisions during elementary school lunch.

    Science.gov (United States)

    Pittman, D W; Parker, J S; Getz, B R; Jackson, C M; Le, T-A P; Riggs, S B; Shay, J M

    2012-01-01

    We aimed to develop a cost-free and sustainable program to influence healthier eating decisions during elementary school lunch. Baseline food and beverage choices were assessed for 9 days during lunch service at two racially and economically diverse elementary schools in Spartanburg County, SC, USA. After being informed that the labeled items on the daily lunch menu represented the healthiest choice, students were allowed to ring a call bell in the cafeteria for public recognition when they chose all of the identified healthiest food and beverage items during lunch service. Using menus matched to the baseline phase, food and beverage choices were measured during a 9-day intervention phase. After 30 days, food and beverage choices were reassessed during a 3-day follow-up phase. Healthiest food & beverage choices increased 49% with >60% of students choosing non-flavored milk over flavored milk during the intervention phase. There was no difference in the success of the program between the two schools. The program continued and healthy eating decisions were significantly sustained at a 30-day follow-up assessment. Public recognition through bell ringing appears to be an effective practice to sustain increases in healthy eating decisions during elementary school lunch and warrants expansion to larger scale, longitudinal trials.

  9. Hybrid energy system cost analysis: San Nicolas Island, California

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, T.L.; McKenna, E.

    1996-07-01

    This report analyzes the local wind resource and evaluates the costs and benefits of supplementing the current diesel-powered energy system on San Nicolas Island, California (SNI), with wind turbines. In Section 2.0 the SNI site, naval operations, and current energy system are described, as are the data collection and analysis procedures. Section 3.0 summarizes the wind resource data and analyses that were presented in NREL/TP 442-20231. Sections 4.0 and 5.0 present the conceptual design and cost analysis of a hybrid wind and diesel energy system on SNI, with conclusions following in Section 6. Appendix A presents summary pages of the hybrid system spreadsheet model, and Appendix B contains input and output files for the HYBRID2 program.

  10. Evaluating water quality investments using cost utility analysis.

    Science.gov (United States)

    Hajkowicz, Stefan; Spencer, Rachel; Higgins, Andrew; Marinoni, Oswald

    2008-09-01

    This study borrows concepts from healthcare economics and uses cost utility analysis (CUA) to select an optimum portfolio of water quality enhancement projects in Perth, Western Australia. In CUA, costs are handled via standard discounted cash flow analysis, but the benefits, being intangible, are measured with a utility score. Our novel methodology combines CUA with a binary combinatorial optimisation solver, known as a 'knapsack algorithm', to identify the optimum portfolio of projects. We show how water quality projects can be selected to maximise an aggregate utility score while not exceeding a budget constraint. Our CUA model applies compromise programming (CP) to measure utility over multiple attributes in different units. CUA is shown to provide a transparent and analytically robust method to maximise benefits from water quality remediation investments under a constrained budget.

  11. Health Monitoring System Technology Assessments: Cost Benefits Analysis

    Science.gov (United States)

    Kent, Renee M.; Murphy, Dennis A.

    2000-01-01

    The subject of sensor-based structural health monitoring is very diverse and encompasses a wide range of activities including initiatives and innovations involving the development of advanced sensor, signal processing, data analysis, and actuation and control technologies. In addition, it embraces the consideration of the availability of low-cost, high-quality contributing technologies, computational utilities, and hardware and software resources that enable the operational realization of robust health monitoring technologies. This report presents a detailed analysis of the cost benefit and other logistics and operational considerations associated with the implementation and utilization of sensor-based technologies for use in aerospace structure health monitoring. The scope of this volume is to assess the economic impact, from an end-user perspective, implementation health monitoring technologies on three structures. It specifically focuses on evaluating the impact on maintaining and supporting these structures with and without health monitoring capability.

  12. Bayesian Variable Selection in Cost-Effectiveness Analysis

    Directory of Open Access Journals (Sweden)

    Miguel A. Negrín

    2010-04-01

    Full Text Available Linear regression models are often used to represent the cost and effectiveness of medical treatment. The covariates used may include sociodemographic variables, such as age, gender or race; clinical variables, such as initial health status, years of treatment or the existence of concomitant illnesses; and a binary variable indicating the treatment received. However, most studies estimate only one model, which usually includes all the covariates. This procedure ignores the question of uncertainty in model selection. In this paper, we examine four alternative Bayesian variable selection methods that have been proposed. In this analysis, we estimate the inclusion probability of each covariate in the real model conditional on the data. Variable selection can be useful for estimating incremental effectiveness and incremental cost, through Bayesian model averaging, as well as for subgroup analysis.

  13. Cholesterol-lowering diets may increase the food costs for Danish children. A cross-sectional study of food costs for Danish children with and without familial hypercholesterolaemia.

    Science.gov (United States)

    Stender, S; Skovby, F; Haraldsdóttir, J; Andresen, G R; Michaelsen, K F; Nielsen, B S; Ygil, K H

    1993-11-01

    Food costs for 30 children under dietary treatment for familial hypercholesterolaemia were compared with those of 105 other Danish children. The daily intake of macronutrients and the daily cost of the diet for each child were calculated from dietary intakes and average prices of 365 different food items. The mean +/- SE percentages of energy (E%) from fat in the diet of children with and without known familial hypercholesterolaemia were 23.6 +/- 0.8 E+ and 34.5 +/- 0.5 E%, respectively (P food wastage due to preparation and cooking. The cost per unit of energy increased with decreasing fat energy percentage of the diet for all children as one group (r = -0.37, P food costs by 10-20% for Danish children.

  14. Analysis of cost regression and post-accident absence

    Science.gov (United States)

    Wojciech, Drozd

    2017-07-01

    The article presents issues related with costs of work safety. It proves the thesis that economic aspects cannot be overlooked in effective management of occupational health and safety and that adequate expenditures on safety can bring tangible benefits to the company. Reliable analysis of this problem is essential for the description the problem of safety the work. In the article attempts to carry it out using the procedures of mathematical statistics [1, 2, 3].

  15. Estimation of Social Benefits in Cost-benefit Analysis

    OpenAIRE

    Beáta Fodor

    2012-01-01

    While examining the cost-benefit analysis related to public policy decisions in the Hungarian and international literature, this paper is looking for the answer to the question of what the methodological principles are according to which the benefit impacts can be determined. The processed Hungarian and English-language studies indicate that the theoretical-methodological questions of the determination of benefit impacts are not clear cut. The author has constructed a model that contains the ...

  16. Using functional analysis diagrams to improve product reliability and cost

    Directory of Open Access Journals (Sweden)

    Ioannis Michalakoudis

    2016-12-01

    Full Text Available Failure mode and effects analysis and value engineering are well-established methods in the manufacturing industry, commonly applied to optimize product reliability and cost, respectively. Both processes, however, require cross-functional teams to identify and evaluate the product/process functions and are resource-intensive, hence their application is mostly limited to large organizations. In this article, we present a methodology involving the concurrent execution of failure mode and effects analysis and value engineering, assisted by a set of hierarchical functional analysis diagram models, along with the outcomes of a pilot application in a UK-based manufacturing small and medium enterprise. Analysis of the results indicates that this new approach could significantly enhance the resource efficiency and effectiveness of both failure mode and effects analysis and value engineering processes.

  17. Cost-Effectiveness Analysis of Various Methods of Instruction in Developmental Mathematics.

    Science.gov (United States)

    Carman, Robert A.

    This paper examined in a critical fashion the existing applications of cost-effectiveness analysis in education, particularly the study of instructional effectiveness in the community college. Various schemes for measuring costs of instruction such as cost benefit analysis, cost-effectiveness analysis and planning programming budgeting systems…

  18. A cost benefit analysis of an enhanced seat belt enforcement program in South Africa.

    Science.gov (United States)

    Harris, G T; Olukoga, I A

    2005-04-01

    To examine whether a program to increase the wearing of seat belts in a South African urban area would be worthwhile in societal terms. A cost benefit analysis of a one year enhanced seat belt enforcement program in eThekwini (Durban) Municipality. Data were drawn from two main sources--a 1998 study of the cost of road crashes in South Africa and, given the absence of other data, a meta-analysis of the effectiveness of various types of interventions to reduce road crash casualties in the United States--and were analyzed using cost benefit analysis. A program designed to enforce greater wearing of seat belts, estimated to cost 2 million rand in one year, could be reasonably expected to increase seat belt usage rates by 16 percentage points and reduce fatalities and injuries by 9.5%. This would result in saved social costs of 13.6 million rand in the following year or a net present value of 11.6 million rand. There would also be favorable consequences for municipal finances. Investment in a program to increase seat belt wearing rates is highly profitable in societal terms.

  19. The Cost-profit Analysis of Increasing Domestic Oil Supply--Based on Reducing Oil Import Dependent Effect%我国石油供给扩张的成本-收益分析--基于降低石油进口依赖效应视角

    Institute of Scientific and Technical Information of China (English)

    陈燕; 林仲豪

    2014-01-01

    石油进口依赖给我国经济带来了巨大成本支出和经济风险,提高我国国内石油供给量是降低石油进口依赖路径之一。基于降低石油进口依赖效应,从我国国内石油供给的财富转移收益、潜在 GDP 收益和宏观经济调整收益三个角度以及从直接生产成本、环境成本和使用者成本三项成本来对提高我国国内石油供给的经济可行性进行论证,结论显示整体趋势上,提高国内石油供给的总收益大于其总成本,并且其净收益呈现上升态势,是有利可图的,这种优势在国际油价高企的时候表现得更为突出,但是收益-成本弹性却呈现下降态势,即整体上成本的相对增长幅度要快于收益的增长幅度。%Oil import dependence has brought tremendous costs and economic risk for China. Increasing China's oil supply is one way of reducing oil import dependence. Based on the reducing the oil import dependence effect, the article analyses the economic viability of increasing domestic oil supply from three points of view, that is, profits of wealth transfer, potential GDP profits and macroeconomic adjustment profits, and from another three consideration of costs, namely, direct production costs, environmental costs and user costs. The result shows that the profits of increasing our domestic oil supply are more than the costs from the overall trend, and the net profit is increasing, especially as the high oil price. But, the elasticity of profit-cost is falling, which shows the relatively growth rate of overall costs is faster than growth rate of profits.

  20. Report: Close-Out of Hotline Complaint on Unreasonable Cost Increase to the Wastewater Treatment Facility Improvements, Perkins, Oklahoma

    Science.gov (United States)

    Report #12-X-0161, December 29, 2011. We have closed a hotline complaint that project costs increased unreasonably due to American Recovery and Reinvestment Act of 2009 (Recovery Act) requirements because we found no evidence to support the complaint.

  1. Increased installation in existing hydro power plants. Potentials and costs; Oekt installasjon i eksisterende kraftverk. Potensial og kostnader

    Energy Technology Data Exchange (ETDEWEB)

    Stensby, Kjell Erik (ed.)

    2011-06-15

    This report seeks to highlight the costs associated with increased installed capacity of existing hydropower plants. Five selected power plant is further studied. Furthermore, given an overview of the technical possibilities of power expansions in Norway. (AG)

  2. Biological and chemical removal of Cr(VI) from waste water: cost and benefit analysis.

    Science.gov (United States)

    Demir, Aynur; Arisoy, Münevver

    2007-08-17

    The objective of the present study is cost and benefit analysis of biological and chemical removal of hexavalent chromium [Cr(VI)] ions. Cost and benefit analysis were done with refer to two separate studies on removal of Cr(VI), one of heavy metals with a crucial role concerning increase in environmental pollution and disturbance of ecological balance, through biological adsorption and chemical ion-exchange. Methods of biological and chemical removal were compared with regard to their cost and percentage in chrome removal. According to the result of the comparison, cost per unit in chemical removal was calculated 0.24 euros and the ratio of chrome removal was 99.68%, whereas those of biological removal were 0.14 and 59.3% euros. Therefore, it was seen that cost per unit in chemical removal and chrome removal ratio were higher than those of biological removal method. In the current study where chrome removal is seen as immeasurable benefit in terms of human health and the environment, percentages of chrome removal were taken as measurable benefit and cost per unit of the chemicals as measurable cost.

  3. Cost and effectiveness analysis on unmanned aerial vehicle (UAV) use at border security

    Science.gov (United States)

    Yilmaz, Bahadır.

    2013-06-01

    Drones and Remotely Piloted Vehicles are types of Unmanned Aerial Vehicles. UAVs began to be used with the war of Vietnam, they had a great interest when Israel used them in Bekaa Valley Operations of 1982. UAVs have been used by different countries with different aims with the help of emerging technology and investments. In this article, in the context of areas of UAV usage in national security, benefits and disadvantages of UAVs are put forward. Particularly, it has been evaluated on the basis of cost-effectiveness by focusing the use of UAV in the border security. UAVs have been studied by taking cost analysis, procurement and operational costs into consideration. Analysis of effectiveness has been done with illegal passages of people and drugs from flight times of UAVs. Although the procurement cost of the medium-level UAVs is low, its operational costs are high. For this reason, the idea of less costly alternative systems have been revealed for the border security. As the costs are reduced to acceptable level involving national security and border security in future with high-technology products in their structure, it will continue to be used in an increasing proportion.

  4. Life Cycle Cost Analysis of Ready Mix Concrete Plant

    Science.gov (United States)

    Topkar, V. M.; Duggar, A. R.; Kumar, A.; Bonde, P. P.; Girwalkar, R. S.; Gade, S. B.

    2013-11-01

    India, being a developing nation is experiencing major growth in its infrastructural sector. Concrete is the major component in construction. The requirement of good quality of concrete in large quantities can be fulfilled by ready mix concrete batching and mixing plants. The paper presents a technique of applying the value engineering tool life cycle cost analysis to a ready mix concrete plant. This will help an investor or an organization to take investment decisions regarding a ready mix concrete facility. No economic alternatives are compared in this study. A cost breakdown structure is prepared for the ready mix concrete plant. A market survey has been conducted to collect realistic costs for the ready mix concrete facility. The study establishes the cash flow for the ready mix concrete facility helpful in investment and capital generation related decisions. Transit mixers form an important component of the facility and are included in the calculations. A fleet size for transit mixers has been assumed for this purpose. The life cycle cost has been calculated for the system of the ready mix concrete plant and transit mixers.

  5. Life Cycle Assessment and Cost Analysis of Water and ...

    Science.gov (United States)

    changes in drinking and wastewater infrastructure need to incorporate a holistic view of the water service sustainability tradeoffs and potential benefits when considering shifts towards new treatment technology, decentralized systems, energy recovery and reuse of treated wastewater. The main goal of this study is to determine the influence of scale on the energy and cost performance of different transitional membrane bioreactors (MBR) in decentralized wastewater treatment (WWT) systems by performing a life cycle assessment (LCA) and cost analysis. LCA is a tool used to quantify sustainability-related metrics from a systems perspective. The study calculates the environmental and cost profiles of both aerobic MBRs (AeMBR) and anaerobic MBRs (AnMBR), which not only recover energy from waste, but also produce recycled water that can displace potable water for uses such as irrigation and toilet flushing. MBRs represent an intriguing technology to provide decentralized WWT services while maximizing resource recovery. A number of scenarios for these WWT technologies are investigated for different scale systems serving various population density and land area combinations to explore the ideal application potentials. MBR systems are examined from 0.05 million gallons per day (MGD) to 10 MGD and serve land use types from high density urban (100,000 people per square mile) to semi-rural single family (2,000 people per square mile). The LCA and cost model was built with ex

  6. Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk

    Science.gov (United States)

    Bearden, David A.; Duclos, Donald P.; Barrera, Mark J.; Mosher, Todd J.; Lao, Norman Y.

    1997-12-01

    Emerging technologies and micro-instrumentation are changing the way remote sensing spacecraft missions are developed and implemented. Government agencies responsible for procuring space systems are increasingly requesting analyses to estimate cost, performance and design impacts of advanced technology insertion for both state-of-the-art systems as well as systems to be built 5 to 10 years in the future. Numerous spacecraft technology development programs are being sponsored by Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) agencies with the goal of enhancing spacecraft performance, reducing mass, and reducing cost. However, it is often the case that technology studies, in the interest of maximizing subsystem-level performance and/or mass reduction, do not anticipate synergistic system-level effects. Furthermore, even though technical risks are often identified as one of the largest cost drivers for space systems, many cost/design processes and models ignore effects of cost risk in the interest of quick estimates. To address these issues, the Aerospace Corporation developed a concept analysis methodology and associated software tools. These tools, collectively referred to as the concept analysis and design evaluation toolkit (CADET), facilitate system architecture studies and space system conceptual designs focusing on design heritage, technology selection, and associated effects on cost, risk and performance at the system and subsystem level. CADET allows: (1) quick response to technical design and cost questions; (2) assessment of the cost and performance impacts of existing and new designs/technologies; and (3) estimation of cost uncertainties and risks. These capabilities aid mission designers in determining the configuration of remote sensing missions that meet essential requirements in a cost- effective manner. This paper discuses the development of CADET modules and their application to several remote sensing satellite

  7. Controlling Campylobacter in the chicken meat chain - Cost-effectiveness and cost-utility analysis

    NARCIS (Netherlands)

    Mangen MJJ; Havelaar AH; Nauta MJ; Koeijer AA de; Wit GA de; LEI; Animal Sciences Group; PZO; MGB

    2005-01-01

    The aim of this study was the estimation of cost-effectiveness and cost-utility of various interventions to control Campylobacter contamination of broiler meat. The relative risk, the intervention costs, the disease burden (expressed in Disability Adjusted Live Years (DALYs)) and the costs-of-illnes

  8. Routes to increasing efficiency and reducing the cost of thin-film solar panels

    NARCIS (Netherlands)

    Deelen, J. van; Barink, M.; Klerk, L.; Voorthuijzen, P.; Hovestad, A.

    2015-01-01

    Most development work in the laboratory is dedicated to efficiency enhancements at the cell level; improvements in efficiency can lead to higher cost-competitiveness of PV. However, the cost of panel manufacturing is an important aspect as well. For CIGS panels the deposition of the active layer is

  9. Lifetime medical costs of obesity : Prevention no cure for increasing health expenditure

    NARCIS (Netherlands)

    van Baal, Pieter H. M.; Polder, Johan J.; de Wit, G. Ardine; Hoogenveen, Rudolf T.; Feenstra, Talitha L.; Boshuizen, Hendriek C.; Engelfriet, Peter M.; Brouwer, Werner B. F.

    2008-01-01

    Background Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to c

  10. Cost of Health Education to Increase STD Awareness in Female Garment Workers in Bangladesh

    Science.gov (United States)

    Rianon, Nahid; Selwyn, Beatrice; Shahidullah, S. M.; Swint, J. Michael; Franzini, Luisa; Rasu, Rafia

    2009-01-01

    Risk of sexually transmitted diseases (STDs) and the need for health education in the female garment workers in Bangladesh have been emphasized in the past. Interventions were more acceptable when considered cost-effective. This preliminary study reported on the cost-effectiveness of a health education program that successfully improved knowledge…

  11. Routes to increasing efficiency and reducing the cost of thin-film solar panels

    NARCIS (Netherlands)

    Deelen, J. van; Barink, M.; Klerk, L.; Voorthuijzen, P.; Hovestad, A.

    2015-01-01

    Most development work in the laboratory is dedicated to efficiency enhancements at the cell level; improvements in efficiency can lead to higher cost-competitiveness of PV. However, the cost of panel manufacturing is an important aspect as well. For CIGS panels the deposition of the active layer is

  12. Army Corps of Engineers: Cost Increases in Flood Control Projects and Improving Communication with Nonfederal Sponsors

    Science.gov (United States)

    2013-12-01

    Expertise located in Walla Walla , Washington, which provides technical support and assistance to the districts on cost engineering issues, such as...headquarters and its cost engineering center of expertise located in Walla Walla , Washington. The Corps identified 87 new or ongoing flood control projects

  13. Reducing Enzyme Costs Increases the Market Potential of Biofuels (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2013-08-01

    Cellulosic ethanol prices depend heavily on the cost of the cellulase enzymes used to break down the biomass into fermentable sugars. To reduce these costs, NREL partnered with two leading enzyme companies, Novozymes and Genencor, to engineer new cellulase enzymes that are exceptionally good at breaking down cellulose. Genencor is now part of DuPont Industrial Biosciences.

  14. Reducing Enzyme Costs Increases the Market Potential of Biofuels (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2013-08-01

    Cellulosic ethanol prices depend heavily on the cost of the cellulase enzymes used to break down the biomass into fermentable sugars. To reduce these costs, NREL partnered with two leading enzyme companies, Novozymes and Genencor, to engineer new cellulase enzymes that are exceptionally good at breaking down cellulose. Genencor is now part of DuPont Industrial Biosciences.

  15. Army Corps of Engineers: Factors Contributing to Cost Increases and Schedule Delays in the Olmsted Locks and Dam Project

    Science.gov (United States)

    2017-02-01

    and Dam Project The following information appears as interactive content in figure 3 when viewed electronically . • 1985: Lower Ohio River...ARMY CORPS OF ENGINEERS Factors Contributing to Cost Increases and Schedule Delays in the Olmsted Locks and Dam Project ...Contributing to Cost Increases and Schedule Delays in the Olmsted Locks and Dam Project What GAO Found Reports by the U.S. Army Corps of Engineers

  16. Department of Energy Environmental Management cost infrastructure development program: Cost analysis requirements

    Energy Technology Data Exchange (ETDEWEB)

    Custer, W.R. Jr.; Messick, C.D.

    1996-03-31

    This report was prepared to support development of the Department of Energy Environmental Management cost infrastructure -- a new capability to independently estimate and analyze costs. Currently, the cost data are reported according to a structure that blends level of effort tasks with product and process oriented tasks. Also. the budgetary inputs are developed from prior year funding authorizations and from contractor-developed parametric estimates that have been adjusted to planned funding levels or appropriations. Consequently, it is difficult for headquarters and field-level activities to use actual cost data and technical requirements to independently assess the costs generated and identify trends, potential cost savings from process improvements, and cost reduction strategies.

  17. [Cost-effectiveness analysis on colorectal cancer screening program].

    Science.gov (United States)

    Huang, Q C; Ye, D; Jiang, X Y; Li, Q L; Yao, K Y; Wang, J B; Jin, M J; Chen, K

    2017-01-10

    Objective: To evaluate the cost-effectiveness of colorectal cancer screening program in different age groups from the view of health economics. Methods: The screening compliance rates, detection rates in different age groups were calculated by using the data from colorectal cancer screening program in Jiashan county, Zhejiang province. The differences in indicator among age groups were analyzed with χ(2) test or trend χ(2) test. The ratios of cost to the number of case were calculated according to cost statistics. Results: The detection rates of immunochemical fecal occult blood test (iFOBT) positivity, advanced adenoma and colorectal cancer and early stage cancer increased with age, while the early diagnosis rates were negatively associated with age. After exclusion the younger counterpart, the cost-effectiveness of individuals aged >50 years could be reduced by 15%-30%. Conclusion: From health economic perspective, it is beneficial to start colorectal cancer screening at age of 50 years to improve the efficiency of the screening.

  18. Using a Hybrid Cost-FMEA Analysis for Wind Turbine Reliability Analysis

    Directory of Open Access Journals (Sweden)

    Nacef Tazi

    2017-02-01

    Full Text Available Failure mode and effects analysis (FMEA has been proven to be an effective methodology to improve system design reliability. However, the standard approach reveals some weaknesses when applied to wind turbine systems. The conventional criticality assessment method has been criticized as having many limitations such as the weighting of severity and detection factors. In this paper, we aim to overcome these drawbacks and develop a hybrid cost-FMEA by integrating cost factors to assess the criticality, these costs vary from replacement costs to expected failure costs. Then, a quantitative comparative study is carried out to point out average failure rate, main cause of failure, expected failure costs and failure detection techniques. A special reliability analysis of gearbox and rotor-blades are presented.

  19. Cost Analysis of Different Digital Fir Filter Design Methods

    Directory of Open Access Journals (Sweden)

    Amninder Singh,

    2014-05-01

    Full Text Available FIR digital filters are widely used in the communication world. The implementation cost of filter circuit is counted by the number of multipliers & adders used, that decides the chip area. In this paper, design techniques of low pass FIR filter using the different windows are presented. The simulation is done in MATLAB. It is shown that filter designed using Hamming and Blackman windows are better than rest of the windows used. Out of two, Hamming window is better as its transition width is narrow, 0.019 than Blackman, 0.034. Further the performance analysis of Kaiser Window, Equiripple and Minimum phase filters was obtained, for same 0.04 transition width. There is a disparity in implementation cost & area. The minimum phase filter can be implemented with lesser number of filter coefficients with tolerable pass-band, stop-band ripples specifications.

  20. Free-swimming northern elephant seals have low field metabolic rates that are sensitive to an increased cost of transport

    DEFF Research Database (Denmark)

    Maresh, Jennifer L; Simmons, Samantha E; Crocker, Daniel E

    2014-01-01

    Widely ranging marine predators often adopt stereotyped, energy-saving behaviours to minimize the energetic cost of transport while maximizing energy gain. Environmental and anthropogenic disturbances can disrupt energy balance by prompting avoidance behaviours that increase transport costs......, thereby decreasing foraging efficiency. We examined the ability of 12 free-ranging, juvenile northern elephant seals (Mirounga angustirostris) to mitigate the effects of experimentally increased transport costs by modifying their behaviour and/or energy use in a compensatory manner. Under normal...... locomotion, elephant seals had low energy requirements (106.5±28.2 kJ kg−1 day−1), approaching or even falling below predictions of basal requirements. Seals responded to a small increase in locomotion costs by spending more time resting between dives (149±44 s) compared with matched control treatments (102...

  1. Environmental costs and reverse logistics: a systemic analysis

    Directory of Open Access Journals (Sweden)

    Paula de Souza

    2013-08-01

    Full Text Available This article aims to analyze the articles most relevant to the themes inherent environmental costs from the perspective of reverse logistics, identifying gaps for these two approaches through systemic analysis. In order to achieve the purpose of this article, the intervention instrument used was ProKnow-C (Knowledge Process Development - Constructivist. The application of this methodology resulted in gross bank of articles, comprising 1225 items obtained from four international databases: Science Direct, ISI Web of Science, Scopus and Wiley Online Library. The raw bank was filtered in relation to redundancy, the alignment of the title and the scientific relevance. The filtering had resulted in a set of 15 articles aligned with two axes of research. The analysis of the selected articles identified the most cited article and the author most cited, concluding that the issue environmental costs associated with reverse logistics is studied by several authors and universities. Moreover, it was found that the keyword most presented in the articles was reverse logistics. The analysis of 1117 references of the 15 articles has shown the most cited articles, as well as the most countrast journals and academic relevance of authors and their selected articles. A systemic analysis of the 15 selected articles showed that the two lines of research are related mainly to issues of environmental sustainability, competitiveness and business efficiency.

  2. The Cost Analysis of Learning at a Distance: Venezuela's Universidad Nacional Abierta.

    Science.gov (United States)

    Rumble, Greville

    1982-01-01

    Examines the cost structure and future system costs of Venezuela's Universidad Nacional Abierta, compares them with the costs of other distance universities, and discusses the cost implications of media choice, size of program, and number of students. The usefulness of cost analysis and projection for decision making is also discussed. (EAO)

  3. Analysis of electric vehicle's trip cost without late arrival

    Science.gov (United States)

    Leng, Jun-Qiang; Zhao, Lin

    2017-03-01

    In this paper, we use a car-following model to study each electric vehicle's trip cost and the corresponding total trip cost without late arrival. The numerical result show that the electricity cost has significant effects on each electric vehicle's trip cost and the corresponding total trip costs and that the effects are dependent on its time headway at the origin, but the electricity cost has no prominent effects on the minimum value of the system's total trip cost.

  4. Cost analysis of sentinel lymph node biopsy in melanoma.

    Science.gov (United States)

    Martínez-Menchón, T; Sánchez-Pedreño, P; Martínez-Escribano, J; Corbalán-Vélez, R; Martínez-Barba, E

    2015-04-01

    Sentinel lymph node biopsy (SLNB) is the most useful tool for node staging in melanoma. SLNB facilitates selective dissection of lymph nodes, that is, the performance of lymphadenectomy only in patients with sentinel nodes positive for metastasis. Our aim was to assess the cost of SLNB, given that this procedure has become the standard of care for patients with melanoma and must be performed whenever patients are to be enrolled in clinical trials. Furthermore, the literature on the economic impact of SLNB in Spain is scarce. From 2007 to 2010, we prospectively collected data for 100 patients undergoing SLNB followed by transhilar bivalving and multiple-level sectioning of the node for histology. Our estimation of the cost of the technique was based on official pricing and fee schedules for the Spanish region of Murcia. The rate of node-positive cases in our series was 20%, and the mean number of nodes biopsied was 1.96; 44% of the patients in the series had thin melanomas. The total cost was estimated at between €9486.57 and €10471.29. Histopathology accounted for a considerable portion of the cost (€5769.36). The cost of SLNB is high, consistent with amounts described for a US setting. Optimal use of SLNB will come with the increasingly appropriate selection of patients who should undergo the procedure and the standardization of a protocol for histopathologic evaluation that is both sensitive and easy to perform. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  5. The Cost-per-Product Management–Instrument for the Efficiency Increase of the Company’s Activity

    Directory of Open Access Journals (Sweden)

    Danut Rada

    2008-10-01

    Full Text Available A high-performance management supposes that the manager’s activity should rely on the practical and judicious performance of the product-focused, through the knowledge and study of the basic principles and notions in the field of the costs per product. For this purpose one should elaborate predictions of evolution and efficiency of costs per products, by means of analysis, planning and control.

  6. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

    Science.gov (United States)

    Gregório, João; Russo, Giuliano; Lapão, Luís Velez

    2016-01-01

    The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

    Kuwornu, J.K.M.; Abboah, R.; Amegashie, D.P.K.; Kuiper, W.E.

    2009-01-01

    This study analyzes the marketing costs of a pineapple producing and export firm (Bomart Farms) in Ghana. Con­ sistent with the existing literature, we categorize marketing costs into assembling, processing, and distribution costs. The assembling cost comprises of cost of crating and loading fresh

  8. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

    Kuwornu, J.K.M.; Abboah, R.; Amegashie, D.P.K.; Kuiper, W.E.

    2009-01-01

    This study analyzes the marketing costs of a pineapple producing and export firm (Bomart Farms) in Ghana. Con­ sistent with the existing literature, we categorize marketing costs into assembling, processing, and distribution costs. The assembling cost comprises of cost of crating and loading fresh f

  9. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

    Kuwornu, J.K.M.; Abboah, R.; Amegashie, D.P.K.; Kuiper, W.E.

    2009-01-01

    This study analyzes the marketing costs of a pineapple producing and export firm (Bomart Farms) in Ghana. Con­ sistent with the existing literature, we categorize marketing costs into assembling, processing, and distribution costs. The assembling cost comprises of cost of crating and loading fresh f

  10. Grid connected integrated community energy system. Phase II: final state 2 report. Cost benefit analysis, operating costs and computer simulation

    Energy Technology Data Exchange (ETDEWEB)

    1978-03-22

    A grid-connected Integrated Community Energy System (ICES) with a coal-burning power plant located on the University of Minnesota campus is planned. The cost benefit analysis performed for this ICES, the cost accounting methods used, and a computer simulation of the operation of the power plant are described. (LCL)

  11. Carbon Emissions Abatement Cost in China: Provincial Panel Data Analysis

    Directory of Open Access Journals (Sweden)

    Jianjun Wang

    2014-05-01

    Full Text Available This paper employs the quadratic directional output distance function to derive shadow prices of China’s aggregate carbon emissions at the province level between 1997 and 2010. The empirical results indicate that the national weighted average shadow price presents an “N-shape” curve across the sample period, experiencing the initial phase of growth followed by a phase of deterioration, and then a further increase. This change trend implies that the cost of carbon emissions reduction is increasing. In addition, the shadow price varies significantly across provinces, which means that China should uphold the principal of “common but differentiated responsibilities” in regional carbon emissions reduction. Generally, the shadow price of the east provinces with high economic development is markedly higher than that of the west provinces with low economic development. The OLS regression results indicate that the shadow price positively connected with the regional economic development levels. Moreover, an inflection point exists in the relation curve between the shadow price and GDP per capita, that is, the increase rate of the shadow price becomes small when the GDP per capita is less than 18.1 thousand Yuan, while it becomes large when the GDP per capita surpasses 18.1 thousand Yuan. With the economic growth, the cost of carbon emissions reduction would be significantly increased. The empirical results can provide more insight for policymakers.

  12. Cost-utility analysis of prehospital spine immobilization recommendations for penetrating trauma.

    Science.gov (United States)

    Garcia, Arturo; Liu, Terrence H; Victorino, Gregory P

    2014-02-01

    The American College of Surgeons' Committee on Trauma's recent prehospital trauma life support recommendations against prehospital spine immobilization (PHSI) after penetrating trauma are based on a low incidence of unstable spine injuries after penetrating injuries. However, given the chronic and costly nature of devastating spine injuries, the cost-utility of PHSI is unclear. Our hypothesis was that the cost-utility of PHSI in penetrating trauma precludes routine use of this prevention strategy. A Markov model based cost-utility analysis was performed from a society perspective of a hypothetical cohort of 20-year-old males presenting with penetrating trauma and transported to a US hospital. The analysis compared PHSI with observation alone. The probabilities of spine injuries, costs (US 2010 dollars), and utility of the two groups were derived from published studies and public data. Incremental effectiveness was measured in quality-adjusted life-years. Subset analyses of isolated head and neck injuries as well as sensitivity analyses were performed to assess the strength of the recommendations. Only 0.2% of penetrating trauma produced unstable spine injury, and only 7.4% of the patients with unstable spine injury who underwent spine stabilization had neurologic improvement. The total lifetime per-patient cost was $930,446 for the PHSI group versus $929,883 for the nonimmobilization group, with no difference in overall quality-adjusted life-years. Subset analysis demonstrated that PHSI for patients with isolated head or neck injuries provided equivocal benefit over nonimmobilization. PHSI was not cost-effective for patients with torso or extremity penetrating trauma. Despite increased incidence of unstable spine injures produced by penetrating head or neck injuries, the cost-benefit of PHSI in these patients is equivocal, and further studies may be needed before omitting PHSI in patients with penetrating head and neck injuries. Economic and value-based evaluation

  13. The costs, effects and cost-effectiveness of strategies to increase coverage of routine immunizations in low- and middle-income countries: systematic review of the grey literature.

    Science.gov (United States)

    Batt, Katherine; Fox-Rushby, J A; Castillo-Riquelme, Marianela

    2004-09-01

    Evidence-based reviews of published literature can be subject to several biases. Grey literature, however, can be of poor quality and expensive to access. Effective search strategies also vary by topic and are rarely known in advance. This paper complements a systematic review of the published literature on the costs and effects of expanding immunization services in developing countries. The quality of data on the effectiveness and cost-effectiveness of strategies to increase immunization coverage is shown to be similar across literatures, but the quality of information on costing is much lower in the grey literature. After excluding poorer quality studies from this review we found the quantity of available evidence almost doubled, particularly for more complex health-system interventions and cost or cost-effectiveness analyses. Interventions in the grey literature are more up to date and cover a different geographical spread. Consequently the conclusions of the published and grey literatures differ, although the number of papers is still too low to account for differences across types of interventions. We recommend that in future researchers consider using non-English keywords in their searches.

  14. Estimation of cost reduction and increase for the final disposal associated with the categorization of inert waste landfills in Japan.

    Science.gov (United States)

    Nakayama, Hirofumi; Tsuchida, Daisuke; Shimaoka, Takayuki

    2012-02-01

    This study estimates the overall cost savings that have been realized due to disposal of inert wastes in Japan because this material has been deposited in inert waste landfills (IWLs) that are designed exclusively for this purpose, instead of being co-dipsosed with organic wastes in more costly in sanitary landfills (SLs). The total realized cost savings were based on the disposed volume of inert waste and the actual disposal fees for IWLs and SLs for the period 1977-2006. The estimated reduction in expense is 4748 billion JPY for the period. On the other hand, if organic wastes had been deposited in IWLs along with inert wastes, costs would be incurred to clean up the sites because the surrounding environment may be polluted by the decomposition of the non-inert wastes and considerable efforts probably would be required to restore the polluted environment to its normal condition (this is because IWLs typically do not have a barrier system.) The potential cleanup cost was estimated to be 616 to 1226 billion JPY. These estimated costs were compared and it was found that the net reduction in expense was 3522 billion to 4122 billion JPY. Although the expense was reduced substantially, it was noted that a considerable cleanup cost would be generated. In particular, it was found that the increase in cleanup costs becomes most significant after the late 1990s.

  15. Cost analysis of prenatal care using the activity-based costing model: a pilot study.

    Science.gov (United States)

    Gesse, T; Golembeski, S; Potter, J

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care.

  16. DESCRIPTIVE STATISTICS IN COST RESEARCH: ANALYSIS OF XIV BRAZILIAN CONGRESS OF COSTS

    OpenAIRE

    Diehl, Carlos Alberto; UNISINOS; Souza, Marcos Antônio de; UNISINOS; Domingos, Laura Elaine Cabral

    2009-01-01

    The objective of this article is the study of the utilization of descriptive statistics in costs researches, specifically in those presented in XIV Brazilian Congress of Costs, carried out in 2007, in João Pessoa city (PB). Firstly one does a theoretical revision about descriptive statistic and the presentation of the Costs Congress, carried out since 1994, under the organization of the Brazilian Association of Costs. In the sequence the methodological aspects of the study are presented, clas...

  17. Low-cost thermoforming of micro fluidic analysis chips

    Science.gov (United States)

    Truckenmüller, R.; Rummler, Z.; Schaller, Th; Schomburg, W. K.

    2002-07-01

    We present a new method for the low-cost manufacture of micro fluidic devices from polymers for single use. Within a one-step or two-step process inside a hot embossing press, micro channels are thermoformed into a thin plastic film and welded on to a thicker plastic film or sheet. Sterile, hermetically sealed micro fluidic structures were fabricated from polystyrene for easy opening immediately before use. It even appears to be possible to produce micro fluidic analysis chips from polymers on a coil from which single devices are cut off for use.

  18. Low-cost commodity depth sensor comparison and accuracy analysis

    Science.gov (United States)

    Breuer, Timo; Bodensteiner, Christoph; Arens, Michael

    2014-10-01

    Low cost depth sensors have been a huge success in the field of computer vision and robotics, providing depth images even in untextured environments. The same characteristic applies to the Kinect V2, a time-of-flight camera with high lateral resolution. In order to assess advantages of the new sensor over its predecessor for standard applications, we provide an analysis of measurement noise, accuracy and other error sources with the Kinect V2. We examined the raw sensor data by using an open source driver. Further insights on the sensor design and examples of processing techniques are given to completely exploit the unrestricted access to the device.

  19. Cost-effectiveness analysis of cataract surgery with intraocular lens implantation: extracapsular cataract extraction versus phacoemulsification

    Directory of Open Access Journals (Sweden)

    Mohd R.A. Manaf

    2007-03-01

    Full Text Available A randomized single blinded clinical trial to compare the cost-effectiveness of cataract surgery between extracapsular cataract extraction (ECCE and phacoemulsification (PEA was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM from March 2000 until August 2001. The cost of a cataract surgery incurred by hospital, patients and households were calculated preoperatively, one week, two months (for both techniques and six months (for ECCE only. Effectiveness of cataract surgery was assessed using Visual Function 14 (VF-14, quality of life measurement specifically for vision. The cost analysis results from each 50 subjects of ECCE and PEA group showed that average cost for one ECCE after six months post-operation is USD 458 (± USD 72 and for PEA is USD 528 (± USD 125. VF-14 score showed a significant increased after a week, two months and six months post-operation compared to the score before operation for both techniques (p<0.001. However, there was no significant difference between them (p = 0.225. This study indicated that ECCE is more cost effective compared to PEA with cost per one unit increment of VF-14 score of USD 14 compared to USD 20 for PEA. (Med J Indones 2007; 16:25-31 Keywords: cataract, cost-effectiveness, extracapsular cataract extraction, phacoemulsification, visual function 14

  20. Life support system cost study: Addendum to cost analysis of carbon dioxide concentrators

    Science.gov (United States)

    Yakut, M. M.

    1973-01-01

    New cost data are presented for the Hydrogen-Depolarized Carbon Dioxide Concentrator (HDC), based on modifying the concentrator to delete the quick disconnect valves and filters included in the system model defined in MDC-G4631. System description, cost data and a comparison between CO2 concentrator costs are presented.

  1. Cost-benefit analysis of the Dutch nature policy: Transaction costs and land market impacts

    NARCIS (Netherlands)

    Jongeneel, R.A.; Polman, N.; Slangen, L.H.G.

    2012-01-01

    This paper analyses the financial and economic costs and benefits of the large scale National Ecological Network (NEN) nature conservation project in the Netherlands, taking into account transaction costs and land market impacts of different institutional arrangements. The net financial costs associ

  2. Cost-benefit analysis of the Dutch nature policy: Transaction costs and land market impacts

    NARCIS (Netherlands)

    Jongeneel, R.A.; Polman, N.; Slangen, L.H.G.

    2012-01-01

    This paper analyses the financial and economic costs and benefits of the large scale National Ecological Network (NEN) nature conservation project in the Netherlands, taking into account transaction costs and land market impacts of different institutional arrangements. The net financial costs associ

  3. Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

    Science.gov (United States)

    Buffalano, C.; Fogleman, S.; Gielecki, M.

    1976-01-01

    A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

  4. Integrated cost-effectiveness analysis of greenhouse gas emission abatement. The case of Finland

    Energy Technology Data Exchange (ETDEWEB)

    Lehtilae, A.; Tuhkanen, S. [VTT Energy, Espoo (Finland). Energy Systems

    1999-11-01

    In Finland greenhouse gas emissions are expected to increase during the next decades due to economic growth, particularly in the energy intensive industrial sectors. The role of these industries is very central in the national economy. The emission control according to the Kyoto Protocol will therefore be quite difficult and costly. The study analyses the cost-effectiveness of different technical options for reducing the emissions of carbon dioxide, methane, and nitrous oxide in Finland. The analysis is performed with the help of a comprehensive energy system model for Finland, which has been extended to cover all major sources of methane and nitrous oxide emissions in the energy sector, industry, waste management and agriculture. The focus being on technical options, no consideration is given to possible policy measures, emission trading or joint implementation in the study. Under the boundary conditions given for the development of the Finnish energy economy, cost-effective technical measures in the energy system include increases in the use of wood biomass, natural gas and wind energy, increases in the contribution of CHP to the power supply, and intensified energy conservation in all end-use sectors. Additional cost-effective measures are landfill gas recovery, utilisation of the combustible fraction of waste and catalytic conversion of N{sub 2}O in nitric acid production. With baseline assumptions, the direct annual costs of emission abatement are calculated to be about 2000 MFIM (330 M{epsilon}) in 2010. The marginal costs are estimated to be about 230 FIM (40 {epsilon}) per tonne of CO{sub 2}-equivalent in 2010. The cost curie derived from the analysis could be used in further analyses concerning emissions trading. (orig.) 109 refs. SIHTI Research Programme

  5. Resources and costs for microbial sequence analysis evaluated using virtual machines and cloud computing.

    Directory of Open Access Journals (Sweden)

    Samuel V Angiuoli

    Full Text Available BACKGROUND: The widespread popularity of genomic applications is threatened by the "bioinformatics bottleneck" resulting from uncertainty about the cost and infrastructure needed to meet increasing demands for next-generation sequence analysis. Cloud computing services have been discussed as potential new bioinformatics support systems but have not been evaluated thoroughly. RESULTS: We present benchmark costs and runtimes for common microbial genomics applications, including 16S rRNA analysis, microbial whole-genome shotgun (WGS sequence assembly and annotation, WGS metagenomics and large-scale BLAST. Sequence dataset types and sizes were selected to correspond to outputs typically generated by small- to midsize facilities equipped with 454 and Illumina platforms, except for WGS metagenomics where sampling of Illumina data was used. Automated analysis pipelines, as implemented in the CloVR virtual machine, were used in order to guarantee transparency, reproducibility and portability across different operating systems, including the commercial Amazon Elastic Compute Cloud (EC2, which was used to attach real dollar costs to each analysis type. We found considerable differences in computational requirements, runtimes and costs associated with different microbial genomics applications. While all 16S analyses completed on a single-CPU desktop in under three hours, microbial genome and metagenome analyses utilized multi-CPU support of up to 120 CPUs on Amazon EC2, where each analysis completed in under 24 hours for less than $60. Representative datasets were used to estimate maximum data throughput on different cluster sizes and to compare costs between EC2 and comparable local grid servers. CONCLUSIONS: Although bioinformatics requirements for microbial genomics depend on dataset characteristics and the analysis protocols applied, our results suggests that smaller sequencing facilities (up to three Roche/454 or one Illumina GAIIx sequencer invested

  6. Cost analysis in support of minimum energy standards for clothes washers and dryers

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-02

    The results of the cost analysis of energy conservation design options for laundry products are presented. The analysis was conducted using two approaches. The first, is directed toward the development of industrial engineering cost estimates of each energy conservation option. This approach results in the estimation of manufacturers costs. The second approach is directed toward determining the market price differential of energy conservation features. The results of this approach are shown. The market cost represents the cost to the consumer. It is the final cost, and therefore includes distribution costs as well as manufacturing costs.

  7. Marketplace Subsidies: Changing The 'Family Glitch' Reduces Family Health Spending But Increases Government Costs.

    Science.gov (United States)

    Buettgens, Matthew; Dubay, Lisa; Kenney, Genevieve M

    2016-07-01

    Under the Affordable Care Act, if one family member has an employer offer of single coverage deemed to be affordable-that is, costing less than 9.66 percent of family income in 2016-then all family members are ineligible for tax credits for Marketplace coverage, even if the cost of providing coverage to the whole family is greater than 9.66 percent of income. More than six million people live in such families and as a result are ineligible for premium tax credits. These families face premiums that can amount to 15.8 percent of income, or 12.0 percent after the tax advantages of employer-sponsored health coverage are factored in. We modeled the potential impact of changing the affordability test to take into account the cost of family coverage. Doing so would reduce spending on premiums from 12.0 percent to 6.3 percent of income, significantly alleviating financial burdens, but would generate little additional coverage. We estimated the additional costs to the federal government for premium tax credits and cost-sharing reductions to be between $3.7 billion and $6.5 billion in 2016.

  8. Analysis of hospital logistics and costs of the Clinical Engineering Sector in a Philanthropic Hospital

    Directory of Open Access Journals (Sweden)

    Antônio Artur de Souza

    2014-12-01

    Full Text Available Hospitals are considered complex organizations mainly due to the high cost of the health care structure employed for care. Reducing operating costs is a challenge for hospital managers. Particularly in the clinical engineering sector, adequate hospital logistics can reduce costs. In this context, the aim of the research was to analyze the activities of hospital logistics of the Clinical Engineering department at a charity hospital, focusing on cost reduction. The paper presents a case study in a large charity hospital located in the metropolitan region of Belo Horizonte, MG. The analysis focuses on the activities of hospital logistics at this hospital clinical engineering sector. The work in this sector is concentrated in the realization and implementation of equipment maintenance, to the detriment of efforts to reduce costs and increase safety for all streams managed by the sector. It was also found that there are risks of increased costs with inadequate routines: (i acquisition of new and large equipment; (ii maintenance and release schedule for use; and (iii the theft of equipment.

  9. Prevention and treatment of cardiovascular disease in Ethiopia: a cost-effectiveness analysis.

    Science.gov (United States)

    Tolla, Mieraf Taddesse; Norheim, Ole Frithjof; Memirie, Solomon Tessema; Abdisa, Senbeta Guteta; Ababulgu, Awel; Jerene, Degu; Bertram, Melanie; Strand, Kirsten; Verguet, Stéphane; Johansson, Kjell Arne

    2016-01-01

    The coverage of prevention and treatment strategies for ischemic heart disease and stroke is very low in Ethiopia. In view of Ethiopia's meager healthcare budget, it is important to identify the most cost-effective interventions for further scale-up. This paper's objective is to assess cost-effectiveness of prevention and treatment of ischemic heart disease (IHD) and stroke in an Ethiopian setting. Fifteen single interventions and sixteen intervention packages were assessed from a healthcare provider perspective. The World Health Organization's Choosing Interventions that are Cost-Effective model for cardiovascular disease was updated with available country-specific inputs, including demography, mortality and price of traded and non-traded goods. Costs and health benefits were discounted at 3 % per year. Incremental cost-effectiveness ratios are reported in US$ per disability adjusted life year (DALY) averted. Sensitivity analysis was undertaken to assess robustness of our results. Combination drug treatment for individuals having >35 % absolute risk of a CVD event in the next 10 years is the most cost-effective intervention. This intervention costs US$67 per DALY averted and about US$7 million annually. Treatment of acute myocardial infarction (AMI) (costing US$1000-US$7530 per DALY averted) and secondary prevention of IHD and stroke (costing US$1060-US$10,340 per DALY averted) become more efficient when delivered in integrated packages. At an annual willingness-to-pay (WTP) level of about US$3 million, a package consisting of aspirin, streptokinase, ACE-inhibitor and beta-blocker for AMI has the highest probability of being most cost-effective, whereas as WTP increases to > US$7 million, combination drug treatment to individuals having >35 % absolute risk stands out as the most cost-effective strategy. Cost-effectiveness ratios were relatively more sensitive to halving the effectiveness estimates as compared with doubling the price of drugs and laboratory

  10. The Economic Impact of Eradicating Peste des Petits Ruminants: A Benefit-Cost Analysis.

    Directory of Open Access Journals (Sweden)

    Bryony A Jones

    Full Text Available Peste des petits ruminants (PPR is an important cause of mortality and production loss among sheep and goats in the developing world. Despite control efforts in a number of countries, it has continued to spread across Africa and Asia, placing an increasing burden on the livelihoods of livestock keepers and on veterinary resources in affected countries. Given the similarities between PPR and rinderpest, and the lessons learned from the successful global eradication of rinderpest, the eradication of PPR seems appealing, both eliminating an important disease and improving the livelihoods of the poor in developing countries. We conducted a benefit-cost analysis to examine the economic returns from a proposed programme for the global eradication of PPR. Based on our knowledge and experience, we developed the eradication strategy and estimated its costs. The benefits of the programme were determined from (i the averted mortality costs, based on an analysis of the literature, (ii the downstream impact of reduced mortality using a social accounting matrix, and (iii the avoided control costs based on current levels of vaccination. The results of the benefit-cost analysis suggest strong economic returns from PPR eradication. Based on a 15-year programme with total discounted costs of US$2.26 billion, we estimate discounted benefits of US$76.5 billion, yielding a net benefit of US$74.2 billion. This suggests a benefit cost ratio of 33.8, and an internal rate of return (IRR of 199%. As PPR mortality rates are highly variable in different populations, we conducted a sensitivity analysis based on lower and higher mortality scenarios. All the scenarios examined indicate that investment in PPR eradication would be highly beneficial economically. Furthermore, removing one of the major constraints to small ruminant production would be of considerable benefit to many of the most vulnerable communities in Africa and Asia.

  11. The Economic Impact of Eradicating Peste des Petits Ruminants: A Benefit-Cost Analysis.

    Science.gov (United States)

    Jones, Bryony A; Rich, Karl M; Mariner, Jeffrey C; Anderson, John; Jeggo, Martyn; Thevasagayam, Sam; Cai, Yi; Peters, Andrew R; Roeder, Peter

    2016-01-01

    Peste des petits ruminants (PPR) is an important cause of mortality and production loss among sheep and goats in the developing world. Despite control efforts in a number of countries, it has continued to spread across Africa and Asia, placing an increasing burden on the livelihoods of livestock keepers and on veterinary resources in affected countries. Given the similarities between PPR and rinderpest, and the lessons learned from the successful global eradication of rinderpest, the eradication of PPR seems appealing, both eliminating an important disease and improving the livelihoods of the poor in developing countries. We conducted a benefit-cost analysis to examine the economic returns from a proposed programme for the global eradication of PPR. Based on our knowledge and experience, we developed the eradication strategy and estimated its costs. The benefits of the programme were determined from (i) the averted mortality costs, based on an analysis of the literature, (ii) the downstream impact of reduced mortality using a social accounting matrix, and (iii) the avoided control costs based on current levels of vaccination. The results of the benefit-cost analysis suggest strong economic returns from PPR eradication. Based on a 15-year programme with total discounted costs of US$2.26 billion, we estimate discounted benefits of US$76.5 billion, yielding a net benefit of US$74.2 billion. This suggests a benefit cost ratio of 33.8, and an internal rate of return (IRR) of 199%. As PPR mortality rates are highly variable in different populations, we conducted a sensitivity analysis based on lower and higher mortality scenarios. All the scenarios examined indicate that investment in PPR eradication would be highly beneficial economically. Furthermore, removing one of the major constraints to small ruminant production would be of considerable benefit to many of the most vulnerable communities in Africa and Asia.

  12. The net cost of biofuels in Thailand. An economic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Bell, David R.; Kamens, Richard [University of North Carolina at Chapel Hill, North Carolina (United States); Silalertruksa, Thapat; Gheewala, Shabbir H. [The Joint Graduate School of Energy and Environment, King Mongkut' s University of Technology Thonburi, Bangkok (Thailand); Center for Energy Technology and Environment, Ministry of Education (Thailand)

    2011-02-15

    Biofuels are expected to represent a growing portion of liquid fuel consumption in Thailand due to environmental and social considerations in conjunction with policy goals supporting their domestic production and consumption. This paper reviews the economic costs associated with biofuel policy implementation in Thailand in the short term target year of 2011. Internal (production) and external (environmental, social, etc.) costs and benefits are evaluated, and, where possible, monetized. Domestic production of biofuel is calculated to be 9.5 billion THB (317 million USD) more expensive than importing the equivalent amount of petroleum. The environmental benefits from GHG savings as well as losses due to increased ground level ozone formation and government expenditure to support the biofuel industry yield a total 'net cost' of 8.6 billion THB or 121 THB (4.04 USD) per capita for the year 2011. This result is contextualized with the (non-monetized) consideration that although biofuels are somewhat more expensive in the short term, their domestic production allows virtually all of the money to stay within the Thai economy as opposed to being sent abroad. This fact, coupled with significant uncertainty in future petroleum prices, could strongly influence the direction of Thai policy with respect to biofuels. (author)

  13. Aagesta-BR3 Decommissioning Cost. Comparison and Benchmarking Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Varley, Geoff [NAC International, Henley on Thames (United Kingdom)

    2002-11-01

    25 is equipment. The BR3 work packages described in this report add up to something like 83,000 labour hours plus about MSEK 13 of investments and consumables costs. At Swedish average team labour rates 83,000 hours would equate to about MSEK 52. Adding the investment cost of MSEK 13 gives a total of about MSEK 65. This of course is quite close to the Aagesta figure but it would be wrong to draw immediate, firm conclusions based on these data. Such a comparison should take into account, inter alia: The number and relative sizes of the equipment decontaminated and dismantled at Aagesta and BR3. The assumed productivity in the Aagesta estimate compared to the actual BR3 figures. The physical scale of the Aagesta reactor is somewhat larger than the BR3 reactor, so all other things being equal, one might expect the Aagesta decommissioning cost estimate to be higher than for BR3. Aagesta has better access overall, which should help to constrain costs. The productivity ratio for workers at BR3 on average was high - generally 80 per cent or more, so this is unlikely to be exceeded at Aagesta and might not be equalled, which would tend to push the Aagesta cost up relative to the BR3 situation. There is an additional question of the possible extra work performed at BR3 due to the R and D nature of the project. The BR3 data analysed has tried to strip away any such 'extra' work but nevertheless there may be some residual effect on the final numbers. Analysis and comparison of individual work packages has raised several conclusions, as follows: The constructed cost for Aagesta using BR3 benchmark data is encouragingly close to the Aagesta estimate value but it is not clear that the way of deriving the Aagesta estimate for decontamination was entirely rigorous. The reliability of the Aagesta estimate on these grounds therefore might reasonably be questioned. A significant discrepancy between the BR3 and Aagesta cases appears to exist in respect of the volumes of waste

  14. An analysis of the cost of incomplete abortion to the public health ...

    African Journals Online (AJOL)

    abortions.....1 In this analysis we estimate the cost of treatment for all incomplete ... include all 'hotel' functions of care, administrative overheads, rent ..... with existing medical technology.13 The costs reported in this analysis represent ...

  15. REVASCULARIZATION FOR FEMOROPOPLITEAL DISEASE - A DECISION AND COST-EFFECTIVENESS ANALYSIS

    NARCIS (Netherlands)

    HUNINK, MGM; WONG, JB; DONALDSON, MC; MEYEROVITZ, MF; DEVRIES, J; HARRINGTON, DP

    1995-01-01

    Objective.-To evaluate the relative benefits and cost-effectiveness of revascularization for femoropopliteal disease using percutaneous transluminal angioplasty or bypass surgery. Design.-Decision analysis using a multistate transition simulation model (Markov process) and cost-effectiveness analysi

  16. A stochastic analysis of tractor overturn costs on catfish farms.

    Science.gov (United States)

    Ibendahl, G A; Stephens, W B; Myers, M L

    2012-10-01

    An area of health and safety risk in agriculture that can be especially dangerous is catfish farming. One of the potential sources of injuries on catfish farms is tractor overturns that often result in crushing injuries. There is likely a higher probability of tractor overturns on a catfish farm than on a traditional crop farm due to the conditions that prevail on catfish farms. A catfish farm requires tractor movement near pond levees and water, and these levees have steep banks. Many of the activities on a catfish farm, such as mowing, feeding, and pond maintenance, require operating a tractor near a pond levee. Rollover protection structures (ROPS) on tractors can help to minimize the injuries caused by tractor overturns. ROPS do not lessen the probability of overturns, but ROPS mitigate the expected injury severity and lower the associated costs of an overturn. Despite the benefits of ROPS, not every tractor is so equipped. Some earlier work indicated that the cost to retrofit older tractors might outweigh the expected benefits. This article uses stochastic (i.e., randomly determined) analysis to determine if risk-averse farmers are more likely than risk-neutral farmers to retrofit tractors with ROPS. For this analysis, a distribution function of injury costs should an overturn occur was developed for both ROPS and non-ROPS tractors, and a Monte Carlo simulation was conducted. Results indicate that many risk-averse producers would be willing to retrofit older tractors with ROPS. However producers who are risk-neutral probably will not retrofit. These results might explain why not all tractors have been retrofitted despite the long-term availability of retrofit kits.

  17. Cost-benefit analysis of avian influenza control in Nepal.

    Science.gov (United States)

    Karki, S; Lupiani, B; Budke, C M; Karki, N P S; Rushton, J; Ivanek, R

    2015-12-01

    Numerous outbreaks of highly pathogenic avian influenza A strain H5N1 have occurred in Nepal since 2009 despite implementation of a national programme to control the disease through surveillance and culling of infected poultry flocks. The objective of the study was to use cost-benefit analysis to compare the current control programme (CCP) with the possible alternatives of: i) no intervention (i.e., absence of control measures [ACM]) and ii) vaccinating 60% of the national poultry flock twice a year. In terms of the benefit-cost ratio, findings indicate a return of US $1.94 for every dollar spent in the CCP compared with ACM. The net present value of the CCP versus ACM, i.e., the amount of money saved by implementing the CCP rather than ACM, is US $861,507 (the benefits of CCP [prevented losses which would have occurred under ACM] minus the cost of CCP). The vaccination programme yields a return of US $2.32 for every dollar spent when compared with the CCR The net present value of vaccination versus the CCP is approximately US $12 million. Sensitivity analysis indicated thatthe findings were robust to different rates of discounting, whereas results were sensitive to the assumed market loss and the number of birds affected in the outbreaks under the ACM and vaccination options. Overall, the findings of the study indicate that the CCP is economically superior to ACM, but that vaccination could give greater economic returns and may be a better control strategy. Future research should be directed towards evaluating the financial feasibility and social acceptability of the CCP and of vaccination, with an emphasis on evaluating market reaction to the presence of H5N1 infection in the country.

  18. Valuation of road safety effects in cost-benefit analysis.

    Science.gov (United States)

    Wijnen, Wim; Wesemann, Paul; de Blaeij, Arianne

    2009-11-01

    Cost-benefit analysis is a common method for evaluating the social economic impact of transport projects, and in many of these projects the saving of human lives is an issue. This implies, within the framework of cost-benefit analysis, that a monetary value should be attached to saving human lives. This paper discusses the 'Value of a Statistical Life' (VoSL), a concept that is often used for monetising safety effects, in the context of road safety. Firstly, the concept of 'willingness to pay' for road safety and its relation to the VoSL are explained. The VoSL approach will be compared to other approaches to monetise safety effects, in particular the human capital approach and 'quality adjusted life years'. Secondly, methods to estimate the VoSL and their applicability to road safety will be discussed. Thirdly, the paper reviews the VoSL estimates that have been found in scientific research and compares them with the values that are used in policy evaluations. Finally, a VoSL study in the Netherlands will be presented as a case study, and its applicability in policy evaluation will be illustrated.

  19. Changing the Curation Equation: A Data Lifecycle Approach to Lowering Costs and Increasing Value

    Science.gov (United States)

    Myers, J.; Hedstrom, M.; Plale, B. A.; Kumar, P.; McDonald, R.; Kooper, R.; Marini, L.; Kouper, I.; Chandrasekar, K.

    2013-12-01

    What if everything that researchers know about their data, and everything their applications know, were directly available to curators? What if all the information that data consumers discover and infer about data were also available? What if curation and preservation activities occurred incrementally, during research projects instead of after they end, and could be leveraged to make it easier to manage research data from the moment of its creation? These are questions that the Sustainable Environments - Actionable Data (SEAD) project, funded as part of the National Science Foundation's DataNet partnership, was designed to answer. Data curation is challenging, but it is made more difficult by the historical separation of data production, data use, and formal curation activities across organizations, locations, and applications, and across time. Modern computing and networking technologies allow a much different approach in which data and metadata can easily flow between these activities throughout the data lifecycle, and in which heterogeneous and evolving data and metadata can be managed. Sustainability research, SEAD's initial focus area, is a clear example of an area where the nature of the research (cross-disciplinary, integrating heterogeneous data from independent sources, small teams, rapid evolution of sensing and analysis techniques) and the barriers and costs inherent in traditional methods have limited adoption of existing curation tools and techniques, to the detriment of overall scientific progress. To explore these ideas and create a sustainable curation capability for communities such as sustainability research, the SEAD team has developed and is now deploying an interacting set of open source data services that demonstrate this approach. These services provide end-to-end support for management of data during research projects; publication of that data into long-term archives; and integration of it into community networks of publications, research

  20. IAEA Safeguards: Cost/benefit analysis of commercial satellite imagery

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Christer [SSC Satellitbild AB, Kiruna (Sweden)

    1999-03-01

    A major milestone in the efforts to strengthen the Safeguards System was reached in May 1997 when the Board of Governors approved a `Model Protocol Additional to Safeguards Agreements`. The Protocol provides the legal basis necessary to enhance the Agency`s ability to detect undeclared nuclear material and activities by using information available from open sources to complement the declarations made by Member States. Commercially available high-resolution satellite data has emerged as one potential complementary open information source to support the traditional and extended Safeguard activities of IAEA. This document constitutes a first report from SSC Satellitbild giving the Agency tentative and initial estimates of the potential cost and time-savings possible with the new proposed technology. The initial cost/benefit simulation will be further finalised in the following `Implementation Blueprint` study. The general foundation and starting point for the cost/benefit calculation is to simulate a new efficient and relatively small `imagery unit` within the IAEA, capable of performing advanced image processing as a tool for various safeguards tasks. The image processing capacity is suggested to be task- and interpretation-oriented. The study was performed over a period of 1,5 weeks in late 1998, and is based upon interviews of IAEA staff, reviews of existing IAEA documentation as well as from SSC Satellitbild`s long-standing experience of satellite imagery and field missions. The cost/benefit analysis is based on a spreadsheet simulation of five potential applications of commercial satellite imagery: Reference information; Confirmation of Agency acquired and Member State supplied data; Change detection and on-going monitoring; Assessing open source information available to the Agency; Detecting undeclared activities and undeclared sites. The study confirms that the proposed concept of a relatively small `imagery unit` using high-resolution data will be a sound and

  1. 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.

  2. Cost-benefit analysis of the introduction and implementation of a Terminology Management System

    DEFF Research Database (Denmark)

    Grinsted, Annelise

    2008-01-01

    if language is not an obvious distinctive competence, i.e. a strategic element to be incorporated into products so as to increase the penetration into the desired markets. For communicators it is clear that terminology work is useful and necessary - in this relation both quality and price would be clear...... distinctive competences. However, management in private and public organizations (most often) requires concrete figures and numbers to document the arguments before allocating resources. Cost/benefit-analysis supports the arguments through a comparison between benefits and costs of a given new initiative...

  3. Medical Malpractice: Insurance Costs Increased but Varied among Physicians and Hospitals. Report to Congressional Requesters.

    Science.gov (United States)

    General Accounting Office, Washington, DC. Div. of Human Resources.

    This report concerns the medical malpractice situation in the United States and contains information on the cost of malpractice insurance for physicians and hospitals. The report contains an executive summary and four chapters. Chapter 1 reviews the background of the problem and the objectives, scope, and methodology of the report. Chapter 2…

  4. Increasing maternal age at first pregnancy planning: Health outcomes and associated costs

    NARCIS (Netherlands)

    M. Tromp (Miranda); A.C. Ravelli (Anita); J.B. Reitsma (Johannes); G.J. Bonsel (Gouke); B.W.J. Mol (Ben)

    2011-01-01

    textabstractObjectives: To describe the consequences in terms of health outcomes, care and associated healthcare costs for three hypothetical cohorts of women planning their first pregnancy at a fixed, different age. Design: Decision model based on data from perinatal registries and the literature.

  5. Report: EPA Needs to Improve Internal Controls to Increase Cost Recovery

    Science.gov (United States)

    Report #09-P-0144, April 27, 2009. Within a sample of removal actions we reviewed, EPA collected from responsible parties approximately 11 percent ($31.4 of $294.5 million) of the Federal Government’s costs for conducting the removal actions.

  6. Adoption of Angiomax at Christus Santa Rosa Medical Center decreases costs and increases satisfaction.

    Science.gov (United States)

    Starin, Elvira

    2005-01-01

    Angiomax allows for easier post-percutaneous coronary intervention care and enhanced throughput and has become the gold standard of care in our institution. This article describes how Angiomax was brought into our hospital; the rationale and science to support its use; and the resulting patient and staff satisfaction, improved throughput, and cost savings.

  7. Near-linear cost increase to reduce climate-change risk

    NARCIS (Netherlands)

    Schaeffer, M.; Kram, T.; Meinshausen, M.; Vuuren, van D.P.; Hare, W.L.

    2008-01-01

    One approach in climate-change policy is to set normative long-term targets first and then infer the implied emissions pathways. An important example of a normative target is to limit the global-mean temperature change to a certain maximum. In general, reported cost estimates for limiting global war

  8. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study.

    Science.gov (United States)

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y

    2008-09-01

    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  9. Renal transplantation vs hemodialysis: Cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Perović Saša

    2009-01-01

    Full Text Available Background/Aim. Chronic renal insufficiency (CRI, diabetes, hypertension, autosomal dominant polycystic kidney disease (ADPKD are the main reasons for starting dialysis treatment in patients having kidney function failure. At present, dialysis treatments are performed in about 4,100 patients at 46 institutions in Serbia, out of which 90% are hemodialyses. At end-stage renal disease (ESRD the only correct selection is kidney transplatation. The basic aim of the planned research was to compare ratio of costs and effects (Cost Effectiveness Analysis - CEA of hemodialysis and kidney transplantation in patients at ESRD. Methods. As the main issue of treatment in patients from both groups the life quality measured by the validated McGill Questionary, was used. The study included 150 patients totally, divided into two groups. The study group consisted of 50 patients with kidney transplantation performed at the Clinical Center of Serbia and the control group consisted of 100 patients on hemodialysis at Clinical Center of Serbia, Clinical Hospital Center Zemun, Clinical Hospital Center 'Zvezdara', Clinical Center Kragujevac and Health Center 'Studenica', Kraljevo, comparable with respect to sex, age and length of treatment with the study group. Results. Effect of kidney transplantation in relation to hemodialysis being selection of treatment is expressed in the form of incremental ratio of costs and effects (Incremental Cost-Effectiveness Ratio - ICER. It is clear from the enclosed tables that the strategy of kidney transplantation is far more profitable considering the fact that it represents saving of EUR 132,256.25 per one year of contribution Quality Adjusted Life Years (QALY within the period of 10 years. According to all aspects of live quality (physical symptoms and problems, physical well-being, psychological symptoms, existential well-being and support, difference is statistically important in favor of transplant patents. Conclusion. The costs

  10. Medical Cost Analysis of the Osteoporotic Hip Fractures

    Directory of Open Access Journals (Sweden)

    Savaş Çamur

    2015-12-01

    Full Text Available Objective: Osteoporotic hip fractures decrease the life expectancy for 20% about 20-50% of the patients become permanently dependent in terms of walking for the rest of their life. Life expectancy is increasing in Turkey in the last 20 years. We investigated the impact of osteoporotic hip fractures which increase the morbidity and mortality on the national economy. Materials and Methods: A total of 81 patients admitted to our emergency department with the diagnosis of femur intertrochanteric fracture and femoral neck fracture between 2008 and 2012 were included in this study. We retrospectively evaluated the medical records and the medical costs of these patients from hospital information management system. Results: Of the 81 patients 32 (39.6% males and 49 (60.4% females meeting the inclusion criteria were included in this study. The mean age was 80.1 years (range, 61-103. Twenty-three (27.5% patients had femoral neck fracture and 58 (72.5% patients had intertrochanteric femur fracture. The mean length of hospital stay was 13.4 days in intertrochanteric femur fracture and 15.5 days in femoral neck fracture; average of the total days of hospitalization of all patients was 13.9 days. The average treatment cost per patient was 5,912.36 TL for intertrochanteric fractures, 5,753.00 TL for neck fractures, and 5,863.09 TL for the whole patient population. Conclusion: Hip fracture is a substantial cause of morbidity and mortality in elderly. Taking preventive measures before the fracture occurs may help to prevent this problem which has a high cost treatment and which is a substantial burden for the national economy.

  11. Analysis of the evolution of direct costs of antiretroviral delivery in Argentina

    Directory of Open Access Journals (Sweden)

    E Bissio

    2012-11-01

    Full Text Available Background: In Argentina, antiretroviral treatment (ART is covered by the State for all the persons who do not have health insurances, who represent 70% of all HIV infected patients in the country. Since 1992, the Direction of Aids (Ministry of Health buys and delivers ART, treatments for opportunistic infections and reagents to diagnose and follow-up HIV infection. Nevertheless, until now, an analysis of the evolution of the costs of the drugs acquired by the Direction of Aids has not been performed. The aim of this study was to analyze the direct costs of ART for the Direction of Aids in Argentina since 2006, and evaluate progression over time. Methods: The expenditure on ART and drugs for opportunistic infections was obtained. All values (in pesos were converted to dollars. The cost of ART per patient per year was calculated. Changes in cost were determined for the total and per patient expenditures, and the reasons for the changes analyzed. Results: Total expenditure for ART (in uS dollars went from 33.7 million in 2006 to 75 million in 2011 (123% increase. The number of patients on ART covered by the Aids Direction increased from 23228 in 2006 to 33279 (43% by the end of 2011. The cost (u$s of ART per person per year was: *06*: 1449; *07*: 1645; *08*: 1516; *09*: 1543; *10*: 1968; *11*: 2255. This represents a 56% increase from 2006 to 2011, though this change was uneven through the years. This was driven mainly by a decrease from 07 to 08, due to lack of acquisition of ART for political reasons; and a very steep increase in 09-10 due to incorporation of more expensive drugs such as tenofovir/emtricitabine, raltegravir and maraviroc. Conclusions: Annual cost of ART per person in Argentina has been increasing considerably in the last years. Even though this cost is much lower than those informed by some European countries (Italy: u$ 7500[1]; UK: u$ 9000[2], Germany: u$ 18000; it is one of the highest in Latin-America, where median cost is u

  12. 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.

  13. Cost analysis of a novel HIV testing strategy in community pharmacies and retail clinics.

    Science.gov (United States)

    Lecher, Shirley Lee; Shrestha, Ram K; Botts, Linda W; Alvarez, Jorge; Moore, James H; Thomas, Vasavi; Weidle, Paul J

    2015-01-01

    To document the cost of implementing point-of-care (POC) human immunodeficiency virus (HIV) rapid testing in busy community pharmacies and retail clinics. Providing HIV testing services in community pharmacies and retail clinics is an innovative way to expand HIV testing. The cost of implementing POC HIV rapid testing in a busy retail environment needs to be documented to provide program and policy leaders with adequate information for planning and budgeting. Cost analysis from a pilot project that provided confidential POC HIV rapid testing services in community pharmacies and retail clinics. The pharmacy sites were operated under several different ownership structures (for-profit, nonprofit, sole proprietorship, corporation, public, and private) in urban and rural areas. We included data from the initial six sites that participated in the project. We collected the time spent by pharmacy and retail clinic staff for pretest and posttest counseling in an activity log for time-in-motion for each interaction. Pharmacists and retail clinic staff. HIV rapid testing. The total cost was calculated to include costs of test kits, control kits, shipping, test supplies, training, reporting, program administration, and advertising. The six sites trained 22 staff to implement HIV testing. A total of 939 HIV rapid tests were conducted over a median time of 12 months, of which 17 were reactive. Median pretest counseling time was 2 minutes. Median posttest counseling time was 2 minutes for clients with a nonreactive test and 10 minutes for clients with a reactive test. The average cost per person tested was an estimated $47.21. When we considered only recurrent costs, the average cost per person tested was $32.17. Providing POC HIV rapid testing services required a modest amount of staff time and costs that are comparable to other services offered in these settings. HIV testing in pharmacies and retail clinics can provide an additional alternative venue for increasing the

  14. Analysis of electric vehicle's trip cost allowing late arrival

    Science.gov (United States)

    Leng, Jun-Qiang; Liu, Wei-Yi; Zhao, Lin

    2017-05-01

    In this paper, we use a car-following model to study each electric vehicle's trip cost and the total trip cost allowing late arrival. The numerical result show that the electricity cost has great effects on each commuter's trip cost and the total trip costs and that these effects are dependent on each commuter's time headway at the origin, but the electricity cost has no prominent impacts on the minimum value of total trip cost under each commuter's different time headway at the origin.

  15. Activity cost analysis: a tool to cost medical services and improve quality of care.

    Science.gov (United States)

    Udpa, S

    2001-01-01

    This paper suggests an activity-based cost (ABC) system as the appropriate cost accounting system to measure and control costs under the microstatistical episode of care (EOC) paradigm suggested by D. W. Emery (1999). ABC systems work well in such an environment because they focus on activities performed to provide services in the delivery of care. Thus, under an ABC system it is not only possible to accurately cost episodes of care but also to more effectively monitor and improve the quality of care. Under the ABC system, costs are first traced to activities and then traced from the activities to units of episodic care using cost drivers based on the consumption of activity resources.

  16. Entry costs and quality of business environment: a critical analysis

    Directory of Open Access Journals (Sweden)

    Decio Zylbersztajn

    2010-10-01

    Full Text Available Transaction costs are the costs to protect property rights. Institutions are shaped in order to control transaction costs in society. Studies have been developed to measure transaction costs both at the macro and microeconomic levels. Entry costs, i.e., the cost to start up a new business are considered a proxy for business environment quality, being also interpreted as a proxy to transaction cost measurement. This paper presents new elements in order to amplify the potential of research in business environment, particularly business entry costs. It stresses the limitation related to two theoretical points: first, the near decomposability of one complex transaction, and second, the complementarity between ex-ante and ex-post transaction costs, both related to the methodology adopted to measure business entrance costs.

  17. Army Initial Acquisition Training: An Analysis of Costs and Benefits

    Science.gov (United States)

    2015-12-01

    civilian university and the vast differences in Graduate Management Admission Test ( GMAT ) scores, total program cost, total credit hours, and cost per...on location Average GMAT Score Program Tuition in State Total Credit Hours Total Cost In State Total Cost Per Credit Hour Cost Per Credit...common qualitative measure of student aptitude. The GMAT 38 is the most readily available measure most business schools use as a qualitative predictor

  18. Cost estimation and analysis using the Sherpa Automated Mine Cost Engineering System

    Energy Technology Data Exchange (ETDEWEB)

    Stebbins, P.E. [Western Mine Engineering, Spokane, WA (United States)

    1993-09-01

    The Sherpa Automated Mine Cost Engineering System is a menu-driven software package designed to estimate capital and operating costs for proposed surface mining operations. The program is engineering (as opposed to statistically) based, meaning that all equipment, manpower, and supply requirements are determined from deposit geology, project design and mine production information using standard engineering techniques. These requirements are used in conjunction with equipment, supply, and labor cost databases internal to the program to estimate all associated costs. Because virtually all on-site cost parameters are interrelated within the program, Sherpa provides an efficient means of examining the impact of changes in the equipment mix on total capital and operating costs. If any aspect of the operation is changed, Sherpa immediately adjusts all related aspects as necessary. For instance, if the user wishes to examine the cost ramifications of selecting larger trucks, the program not only considers truck purchase and operation costs, it also automatically and immediately adjusts excavator requirements, operator and mechanic needs, repair facility size, haul road construction and maintenance costs, and ancillary equipment specifications.

  19. Increasing durability and lowering the overall cost of wave energy converters using Ultra High Performance Concrete

    DEFF Research Database (Denmark)

    Jepsen, Michael S.; Damkilde, Lars; Hansen, Niels A.

    2013-01-01

    Lowering the overall cost of wave energy converters is a necessity for creating a feasible solution to renewable energy. The design of wave energy converters is in general based on traditional steel design methods. In the design of steel structures subjected to significant dynamical loading...... and a harsh environment issues such fatigue resistance and durability are of major concern. The welded joints in steel structures significantly reduce the fatigue resistance and give a low utilization ratio of the steel material. Furthermore is coating of all exposed steel surfaces a necessity to secure...... as primary material in the design of wave energy converters is a feasible and promising solution, which reduce the overall cost of the structure significantly. This will be illustrated by means of a feasibility study carried out on the Wavestar project, where special attention is pointed at the arm and float...

  20. Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Wang, Weimin [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-02-15

    The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energy code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.

  1. Direct costs of hypertensive patients admitted to hospital in Vietnam- a bottom-up micro-costing analysis.

    Science.gov (United States)

    Nguyen, Thi-Phuong-Lan; Nguyen, Thi Bach Yen; Nguyen, Thanh Trung; Vinh Hac, Van; Le, Hoa H; Schuiling-Veninga, Ccm; Postma, Maarten J

    2014-10-28

    There is an economic burden associated with hypertension both worldwide and in Vietnam. In Vietnam, patients with uncontrolled high blood pressure are hospitalized for further diagnosis and initiation of treatment. Because there is no evidence on costs of inpatient care for hypertensive patients available yet to inform policy makers, health insurance and hospitals, this study aims to quantify direct costs of inpatient care for these patients in Vietnam. A retrospective study was conducted in a hospital in Vietnam. Direct costs were analyzed from the health-care provider's perspective. Hospital-based costing was performed using both bottom-up and micro-costing methods. Patients with sole essential or primary hypertension (ICD-code I10) and those comorbid with sphingolipid metabolism or other lipid storage disorders (ICD-code E75) were selected. Costs were quantified based on financial and other records of the hospital. Total cost per patient resulted from an aggregation of laboratory test costs, drug costs, inpatient-days' costs and other remaining costs, including appropriate allocation of overheads. Both mean and medians, as well as interquartile ranges (IQRs) were calculated. In addition to a base-case analysis, specific scenarios were analyzed. 230 patients were included in the study (147 cases with I10 code only and 83 cases with I10 combined with E75). Median length of hospital stay was 6 days. Median total direct costs per patient were US$65 (IQR: 37 -95). Total costs per patient were higher in the combined hypertensive and lipid population than in the sole hypertensive population at US$78 and US$53, respectively. In all scenarios, hospital inpatient days' costs were identified as the major cost driver in the total costs. Costs of hospitalization of hypertensive patients is relatively high compared to annual medication treatment at a community health station for hypertension as well as to the total health expenditure per capita in Vietnam. Given that

  2. A framework and review of customer outage costs: Integration and analysis of electric utility outage cost surveys

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, Leora; Sullivan, Michael; Van Liere, Kent; Katz, Aaron; Eto, Joseph

    2003-11-01

    A clear understanding of the monetary value that customers place on reliability and the factors that give rise to higher and lower values is an essential tool in determining investment in the grid. The recent National Transmission Grid Study recognizes the need for this information as one of growing importance for both public and private decision makers. In response, the U.S. Department of Energy has undertaken this study, as a first step toward addressing the current absence of consistent data needed to support better estimates of the economic value of electricity reliability. Twenty-four studies, conducted by eight electric utilities between 1989 and 2002 representing residential and commercial/industrial (small, medium and large) customer groups, were chosen for analysis. The studies cover virtually all of the Southeast, most of the western United States, including California, rural Washington and Oregon, and the Midwest south and east of Chicago. All variables were standardized to a consistent metric and dollar amounts were adjusted to the 2002 CPI. The data were then incorporated into a meta-database in which each outage scenario (e.g., the lost of electric service for one hour on a weekday summer afternoon) is treated as an independent case or record both to permit comparisons between outage characteristics and to increase the statistical power of analysis results. Unadjusted average outage costs and Tobit models that estimate customer damage functions are presented. The customer damage functions express customer outage costs for a given outage scenario and customer class as a function of location, time of day, consumption, and business type. One can use the damage functions to calculate outage costs for specific customer types. For example, using the customer damage functions, the cost experienced by an ''average'' customer resulting from a 1 hour summer afternoon outage is estimated to be approximately $3 for a residential customer, $1

  3. Increased Patient Cost-Sharing, Weak US Economy, and Poor Health Habits: Implications for Employers and Insurers.

    Science.gov (United States)

    Haren, Melinda C; McConnell, Kirk; Shinn, Arthur F

    2009-04-01

    Many healthcare stakeholders, including insurers and employers, agree that growth in healthcare costs is inevitable. But the current trend toward further cost-shifting to employees and other health plan members is unsustainable. In 2008, the Zitter Group conducted a large national study on the relationship between insurers and employers, to understand how these 2 healthcare stakeholders interact in the creation of health benefit design. The survey results were previously summarized and discussed in the February/March 2009 issue of this journal. The present article aims to assess the implications of those results in the context of the growing tendency to increase patient cost-sharing, a weak US economy, and poor health habits. Increasing cost-sharing is a blunt instrument: although it may reduce utilization of frivolous services, it may also result in individuals forgoing medically necessary care. Increases in deductibles will lead to an overall decrease in optimal care-seeking behavior as families juggle healthcare costs with a weak economy and stagnating wages.

  4. Risk-Cost Estimation of On-Site Wastewater Treatment System Failures Using Extreme Value Analysis.

    Science.gov (United States)

    Kohler, Laura E; Silverstein, JoAnn; Rajagopalan, Balaji

    2017-05-01

      Owner resistance to increasing regulation of on-site wastewater treatment systems (OWTS), including obligatory inspections and upgrades, moratoriums and cease-and-desist orders in communities around the U.S. demonstrate the challenges associated with managing risks of inadequate performance of owner-operated wastewater treatment systems. As a result, determining appropriate and enforceable performance measures in an industry with little history of these requirements is challenging. To better support such measures, we develop a statistical method to predict lifetime failure risks, expressed as costs, in order to identify operational factors associated with costly repairs and replacement. A binomial logistic regression is used to fit data from public records of reported OWTS failures, in Boulder County, Colorado, which has 14 300 OWTS to determine the probability that an OWTS will be in a low- or high-risk category for lifetime repair and replacement costs. High-performing or low risk OWTS with repairs and replacements below the threshold of $9000 over a 40-year life are associated with more frequent inspections and upgrades following home additions. OWTS with a high risk of exceeding the repair cost threshold of $18 000 are further analyzed in a variation of extreme value analysis (EVA), Points Over Threshold (POT) where the distribution of risk-cost exceedance values are represented by a generalized Pareto distribution. The resulting threshold cost exceedance estimates for OWTS in the high-risk category over a 40-year expected life ranged from $18 000 to $44 000.

  5. Telerehabilitation after total knee replacement in Italy: cost-effectiveness and cost-utility analysis of a mixed telerehabilitation-standard rehabilitation programme compared with usual care

    Science.gov (United States)

    Fusco, Francesco; Turchetti, Giuseppe

    2016-01-01

    Objectives To assess cost-effectiveness and cost utility of telerehabilitation (TR) versus standard rehabilitation (SR) after total knee replacement (TKR). Design Markov decision modelling of cost-effectiveness and cost-utility analysis based on patient-level and secondary data sources employing Italian National Health Service (NHS; Ita-NHS) and Society perspectives. Setting Primary care units (PCUs) in Italy. Participants Patients discharged after TKR. Interventions Mixed SR-TR service (10 face-to-face sessions and 10 telesessions) versus SR (20 face-to-face sessions) Primary and secondary outcome measures The incremental cost per additional knee flexion range of motion (ROM) and per QALY gained by SR-TR compared with SR. Second, we considered the probability of being cost-effective and the probability of being more effective and less expensive. Results TR appears to be the cost-effective in the base case and in all of the considered scenarios, but is no longer more effective and less expensive if transportation costs are excluded. Comparing SR-TR with SR, the incremental cost-effectiveness ratio (ICER) adopting the Ita-NHS perspective for the base case was −€117/ROM gained. The cost-effectiveness probability for SR-TR was 0.98 (ceiling ratio: €50/ROM), while the joint probability of being more effective and less expensive was 0.87. Assuming that TR would increase health-related quality of life (HRQOL) utilities by 2.5%, the ICER adopting Ita-NHS perspective is −€960/QALY (cost-effectiveness probability: 1; ceiling ratio: €30 000/QALY). All the performed sensitivity analyses did not change the conclusions, but if transportation costs were excluded, the probability for SR-TR of being more clinically effective and less expensive reduced to 0.56. Conclusions The analysis suggested SR-TR to be cost-effective, even less expensive and more effective if the PCUs provide ambulance transportations. However, the uncertainty related to TR costs, HRQOL and long

  6. THE COMPARATIVE COST-EFFICACY ANALYSIS OF VARIOUS ANTIHYPERTENSIVE THERAPIES

    Directory of Open Access Journals (Sweden)

    S. V. Malchikova

    2016-01-01

    Full Text Available Aim. To perform the comparative cost-efficacy analysis of various antihypertensive therapies in hypertensives patients.Material and methods. 140 hypertensive patients with history of ineffective antihypertensive therapy were randomized in to 4 groups, 35 patients in each one. Patients of Group A received indapamide retard plus perindopril; group B - indapamide retard plus amlodipine; group C - amlodipine plus lisinopril; group D - amlodipine plus bisoprolol. The Russian version of general questionnaire MOS-SF-36 was applied for quality of a life estimated. Endothelium function was evaluated with B-mode ultrasonography (Acuson 128 ХР/10. Albuminuria level was detected by immunoturbometric method (Integra-700, Roche.Results. The drug combination B had the least cost. The drug combination C was the most effective. The drug combination C was the most economically rational. The drug combination A was the least economically rational for BP reduction. However the drug combination A was comparable with drug combination C in effects on quality of life and on endothelium function, and it was the most economically rational for albuminuria reduction.Conclusion. Indapamide retard plus perindopril combination is the most economically rational in patients with target-organ lesions (nephropathy. Lisinopril plus amlodipine combination is economically rational in patients without target-organ lesions. 

  7. Vehicle Lightweighting: Mass Reduction Spectrum Analysis and Process Cost Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, Anthony [IBIS Associates, Inc., Waltham, MA (United States); Hannibal, Ted [IBIS Associates, Inc., Waltham, MA (United States); Raghunathan, Anand [Energetics Inc., Columbia, MD (United States); Ivanic, Ziga [Energetics Inc., Columbia, MD (United States); Clark, Michael [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-03-01

    The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. In the first two phases of this effort examined combinations of strategies aimed at achieving strategic targets of 40% and a 45% mass reduction relative to a standard North American midsize passenger sedan at an effective cost of $3.42 per pound (lb) saved. These results have been reported in the Idaho National Laboratory report INL/EXT-14-33863 entitled Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting published in March 2015. The data for these strategies were drawn from many sources, including Lotus Engineering Limited and FEV, Inc. lightweighting studies, U.S. Department of Energy-funded Vehma International of America, Inc./Ford Motor Company Multi-Material Lightweight Prototype Vehicle Demonstration Project, the Aluminum Association Transportation Group, many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses.

  8. Cost-benefit analysis of multifunctional agriculture in Finland

    Directory of Open Access Journals (Sweden)

    T. YRJÖLÄ

    2008-12-01

    Full Text Available This study aims at assessing the costs and benefits of multifunctional agriculture, and it is one of the very first studies using a quantitative approach to this new subject. The starting point is that if current farm subsidies are regarded as means to maintain the multifunctional characteristics of agriculture, what happens if subsidies are reduced. The effects of the decline in agricultural support on multifunctional characteristics of agriculture in Finland are estimated using the cost-benefit analysis (CBA. Only a part of the consequences can be assessed by the CBA due to lack of data on the economic value of many elements of multifunctional agriculture. Hence, the results should not be generalised too strongly, but they still provide useful information for the political decision-making. Concerning further research, we should study, inter alia, what the so-called correct level of compensation for the adequate supply of public goods would be, and what kind of means of agricultural policy are the most efficient to unambiguously enhance the multifunctional character of agriculture.

  9. Cost benefit analysis for remediation of a nuclear industry landfill

    Energy Technology Data Exchange (ETDEWEB)

    Parker, Tom; Hardisty, Paul [WorleyParsons Komex, Bristol (United Kingdom); Dennis, Frank; Liddiard, Mark; McClelland, Paul [UKAEA, Dounreay (United Kingdom)

    2006-09-15

    An old landfill site, licensed to receive inert construction waste, is situated on the top of hard rock cliffs adjacent to the sea at the Dounreay nuclear facility in Scotland. During restoration and investigation work at the landfill, radioactively contaminated material and asbestos was identified. UKAEA subsequently investigated the feasibility of remediating the landfill with the aim of removing any remaining radioactive or otherwise-contaminated material. The cost of landfill remediation would be considerable, making Cost Benefit Analysis (CBA) an ideal tool for assessing remediation options. The overall conclusion of the CBA, from a remedial decision making point of view, is that the remediation objective for the landfill should be to reduce any impacts to the current receptors through a comprehensive pathway control scheme. This would be considerably less expensive than even a limited source removal approach. Aggressive source removal objectives are not likely to be economic, even under the most conservative assumptions. A natural monitored attenuation approach will not be economic. All remediation options are considered assuming compliance with the existing regulatory requirements to monitor and cap the landfill before and after closure.

  10. Is the societal approach wide enough to include relatives? Incorporating relatives' costs and effects in a cost-effectiveness analysis.

    Science.gov (United States)

    Davidson, Thomas; Levin, Lars-Ake

    2010-01-01

    It is important for economic evaluations in healthcare to cover all relevant information. However, many existing evaluations fall short of this goal, as they fail to include all the costs and effects for the relatives of a disabled or sick individual. The objective of this study was to analyse how relatives' costs and effects could be measured, valued and incorporated into a cost-effectiveness analysis. In this article, we discuss the theories underlying cost-effectiveness analyses in the healthcare arena; the general conclusion is that it is hard to find theoretical arguments for excluding relatives' costs and effects if a societal perspective is used. We argue that the cost of informal care should be calculated according to the opportunity cost method. To capture relatives' effects, we construct a new term, the R-QALY weight, which is defined as the effect on relatives' QALY weight of being related to a disabled or sick individual. We examine methods for measuring, valuing and incorporating the R-QALY weights. One suggested method is to estimate R-QALYs and incorporate them together with the patient's QALY in the analysis. However, there is no well established method as yet that can create R-QALY weights. One difficulty with measuring R-QALY weights using existing instruments is that these instruments are rarely focused on relative-related aspects. Even if generic quality-of-life instruments do cover some aspects relevant to relatives and caregivers, they may miss important aspects and potential altruistic preferences. A further development and validation of the existing caregiving instruments used for eliciting utility weights would therefore be beneficial for this area, as would further studies on the use of time trade-off or Standard Gamble methods for valuing R-QALY weights. Another potential method is to use the contingent valuation method to find a monetary value for all the relatives' costs and effects. Because cost-effectiveness analyses are used for

  11. Primary Prevention of Pediatric Abusive Head Trauma: A Cost Audit and Cost-Utility Analysis

    Science.gov (United States)

    Friedman, Joshua; Reed, Peter; Sharplin, Peter; Kelly, Patrick

    2012-01-01

    Objectives: To obtain comprehensive, reliable data on the direct cost of pediatric abusive head trauma in New Zealand, and to use this data to evaluate the possible cost-benefit of a national primary prevention program. Methods: A 5 year cohort of infants with abusive head trauma admitted to hospital in Auckland, New Zealand was reviewed. We…

  12. Cost-efficacy analysis of hormonal treatments for advanced prostate cancer

    Directory of Open Access Journals (Sweden)

    Sergio Iannazzo

    2008-09-01

    Full Text Available Introduction: prostatic cancer is the second more frequent cancer in Italy (after lung cancer and is the third cancer-related death cause. Age is the principal risk factor and, given the ageing process undergoing in the Italian population, it seems clear that the public sanitary expenditure to treat the disease is bound to increase, arising the need to perform pharmacoeconomic evaluations of the therapeutic strategies available. Methods: we performed a cost/utility analysis, through a Markov model, of several hormonal therapies in patients with advanced prostate cancer who underwent radical prostatectomy, from the biochemical recurrence to death. Nine androgen suppression therapies were considered: orchiectomy, two nonsteroidal antiandrogens (NSAA, four luteinizing hormone-releasing hormone (LHRH agonists, cyproterone acetate and the association of a NSAA and a LHRH (BAT. In the simulation the androgen suppression therapies were started at the PSA recurrence and never stopped until death. The model used the Italian NHS prospective and a time horizon corresponding to patient’s lifetime. Drug costs were calculated for each therapy, considering the less costly brand. Results: all the considered therapies produced a life expectancy (LE of about 12 life years (LYs with a small variability ranging from 12.3 LYs for BAT (the most effective to 11.37 LYs for NSAA-flutamide (the least effective. Quality adjusted life expectancy ranged from 9.98 QALYs for BAT to 9.28 QALYs for NSAA-flutamide. The average cost per patient presented a more enhanced variability, from 12,538 Euro for orchiectomy to 59,496 Euro for NSAA-bicalutamide. Among all the alternatives orchiectomy resulted the most cost/effective alternative with a cost/utility ratio of about 1,300 Euro/QALY. In the LHRH-agonists class leuprorelin was the most cost/effective with about 2,200 Euro/QALY. A one-way sensitivity analysis showed a substantial stability of the results. Conclusions: BAT

  13. Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis

    Science.gov (United States)

    Hill, Andrew; Redd, Christopher; Gotham, Dzintars; Erbacher, Isabelle; Meldrum, Jonathan; Harada, Ryo

    2017-01-01

    Objectives The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. Setting This research was carried out in a non-clinical research setting using secondary data. Participants There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data. Primary and secondary outcome measures Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations. Results Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74–99.6%. Patent expiry dates were bortezomib 2014–22, dasatinib 2020–26, everolimus 2019–25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736. Conclusions Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research. PMID:28110283

  14. Cost-benefit Analysis of Chestnut Production in Xingtai County

    Institute of Scientific and Technical Information of China (English)

    Yuji; JIN

    2014-01-01

    On the basis of market demand survey of chestnut,this article carries out cost-benefit analysis of the chestnut production in Xingtai County,to understand the profitability and payback period of local chestnut production.It points out that chestnut production has a high rate of return on investment,and chestnut can be promoted on a large scale in Xingtai County.However,there are still some problems in the production and marketing of chestnut in Xingtai County,such as low level of technology,extensive management,low level of organization,market imperfections and weak brand consciousness.Based on these problems,corresponding recommendations are put forth.

  15. Cost benefit analysis of 20 mph zones in London.

    Science.gov (United States)

    Steinbach, Rebecca; Cairns, John; Grundy, Chris; Edwards, Phil

    2013-06-01

    Evidence suggests that 20 mph zones are an effective intervention to reduce casualties from road traffic crashes in urban areas. This analysis compares the costs of construction of the 20 mph zone intervention in high and low casualty areas in London to the value of casualties avoided over 5 and 10 year time horizons. Probabilistic sensitivity analyses were conducted to quantify uncertainty in the results associated with model parameters. Results indicate a net present value (NPV) of £18 947 (90% credible limits -£75 252 to £82 021 2005 prices) after 5 years and £67 306 (£-29 157 to £137 890) after 10 years when 20 mph zones are implemented in areas with one or more casualty per kilometre of road. Simulations from our model suggest that the 'threshold of casualties' where NPVs become positive using a 10 year time horizon is 0.7 casualties per kilometre.

  16. VALUE STREAM COST ANALYSIS IN THE ROMANIAN FOOTWEAR INDUSTRY

    Directory of Open Access Journals (Sweden)

    Dimi OFILEANU

    2015-06-01

    Full Text Available Once the Lean philosophy is developed and implemented to all levels in a company, a new accounting system appears: Lean accounting. Value Stream Cost Analysis is the main and the most powerful instrument of Lean accounting. Because of the fact that VSCA allows us to identify the company’s performance at the proper time, we can rapidly intervene to make the adjustments needed. The Romanian footwear industry is competitive worldwide (14th place in the top of exporters, but in order to improve, it has to rapidly react to clients’ expectations. In the case where the companies have a production system based on Lean philosophy, the implementation of VSCA does nothing but improve the obtained results. This article presents a case study of VSCA application in footwear industry.

  17. Cost benefit analysis on different configurations of berthing structure

    Science.gov (United States)

    Rajesh, G.; Saravanan, R.; Ravichandran, Vijaya; Parameswara Pandian, S.; Ramani Sujatha, Evangelin

    2017-07-01

    Port and harbors are essential for handling of the imports/exports of good transported through shipping. This paper discusses the different configuration of berthing structure, their design with respect to the site conditions and suitability. The analysis includes detailed load calculations conforming to the various codal provisions and design of the structure. The configuration of berthing structure considered are analyzed and designed using STAAD Pro for different combination of loads as per IS 4651. Bill of Quantities are prepared and final cost of construction is calculated. Factors affecting the construction and maintenance such as land availability, soil conditions, hydrodynamics of the site, dredging requirements, design ship size etc. are considered to finalize the configuration of the berthing structure. Result of the study shows that Diaphragm wall type of berthing structure is economic for Ennore port.

  18. HYBRID SULFUR PROCESS REFERENCE DESIGN AND COST ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    Gorensek, M.; Summers, W.; Boltrunis, C.; Lahoda, E.; Allen, D.; Greyvenstein, R.

    2009-05-12

    This report documents a detailed study to determine the expected efficiency and product costs for producing hydrogen via water-splitting using energy from an advanced nuclear reactor. It was determined that the overall efficiency from nuclear heat to hydrogen is high, and the cost of hydrogen is competitive under a high energy cost scenario. It would require over 40% more nuclear energy to generate an equivalent amount of hydrogen using conventional water-cooled nuclear reactors combined with water electrolysis compared to the proposed plant design described herein. There is a great deal of interest worldwide in reducing dependence on fossil fuels, while also minimizing the impact of the energy sector on global climate change. One potential opportunity to contribute to this effort is to replace the use of fossil fuels for hydrogen production by the use of water-splitting powered by nuclear energy. Hydrogen production is required for fertilizer (e.g. ammonia) production, oil refining, synfuels production, and other important industrial applications. It is typically produced by reacting natural gas, naphtha or coal with steam, which consumes significant amounts of energy and produces carbon dioxide as a byproduct. In the future, hydrogen could also be used as a transportation fuel, replacing petroleum. New processes are being developed that would permit hydrogen to be produced from water using only heat or a combination of heat and electricity produced by advanced, high temperature nuclear reactors. The U.S. Department of Energy (DOE) is developing these processes under a program known as the Nuclear Hydrogen Initiative (NHI). The Republic of South Africa (RSA) also is interested in developing advanced high temperature nuclear reactors and related chemical processes that could produce hydrogen fuel via water-splitting. This report focuses on the analysis of a nuclear hydrogen production system that combines the Pebble Bed Modular Reactor (PBMR), under development by

  19. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    Science.gov (United States)

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  20. Cost-effectiveness analysis of interventions for migraine in four low- and middle-income countries.

    Science.gov (United States)

    Linde, Mattias; Steiner, Timothy J; Chisholm, Dan

    2015-02-18

    Evidence of the cost and effects of interventions for reducing the global burden of migraine remains scarce. Our objective was to estimate the population-level cost-effectiveness of evidence-based migraine interventions and their contributions towards reducing current burden in low- and middle-income countries. Using a standard WHO approach to cost-effectiveness analysis (CHOICE), we modelled core set intervention strategies for migraine, taking account of coverage and efficacy as well as non-adherence. The setting was primary health care including pharmacies. We modelled 26 intervention strategies implemented during 10 years. These included first-line acute and prophylactic drugs, and the expected consequences of adding consumer-education and provider-training. Total population-level costs and effectiveness (healthy life years [HLY] gained) were combined to form average and incremental cost-effectiveness ratios. We executed runs of the model for the general populations of China, India, Russia and Zambia. Of the strategies considered, acute treatment of attacks with acetylsalicylic acid (ASA) was by far the most cost-effective and generated a HLY for less than US$ 100. Adding educational actions increased annual costs by 1-2 US cents per capita of the population. Cost-effectiveness ratios then became slightly less favourable but still less than US$ 100 per HLY gained for ASA. An incremental cost of > US$ 10,000 would have to be paid per extra HLY by adding a triptan in a stepped-care treatment paradigm. For prophylaxis, amitriptyline was more cost-effective than propranolol or topiramate. Self-management with simple analgesics was by far the most cost-effective strategy for migraine treatment in low- and middle-income countries and represents a highly efficient use of health resources. Consumer education and provider training are expected to accelerate progress towards desired levels of coverage and adherence, cost relatively little to implement, and can

  1. Cost analysis of concepts for a demand oriented biogas supply for flexible power generation.

    Science.gov (United States)

    Hahn, Henning; Ganagin, Waldemar; Hartmann, Kilian; Wachendorf, Michael

    2014-10-01

    With the share of intermittent renewable energies within the electricity system rising, balancing services from dispatchable power plants are of increasing importance. Highlighting the importance of the need to keeping fuel costs for flexible power generation to a minimum, the study aims to identify favourable biogas plant configurations, supplying biogas on demand. A cost analysis of five configurations based on biogas storing and flexible biogas production concepts has been carried out. Results show that additional flexibility costs for a biogas supply of 8h per day range between 2€ and 11€MWh(-1) and for a 72h period without biogas demand from 9€ to 19€MWh(-1). While biogas storage concepts were identified as favourable short term supply configurations, flexible biogas production concepts profit from reduced storage requirements at plants with large biogas production capacities or for periods of several hours without biogas demand.

  2. A Cost-Effectiveness Analysis of the First Federally Funded Antismoking Campaign

    Science.gov (United States)

    Xu, Xin; Alexander, Robert L.; Simpson, Sean A.; Goates, Scott; Nonnemaker, James M.; Davis, Kevin C.; McAfee, Tim

    2015-01-01

    Background In 2012, CDC launched the first federally funded national mass media antismoking campaign. The Tips From Former Smokers (Tips) campaign resulted in a 12% relative increase in population-level quit attempts. Purpose Cost-effectiveness analysis was conducted in 2013 to evaluate Tips from a funding agency’s perspective. Methods Estimates of sustained cessations; premature deaths averted; undiscounted life years (LYs) saved; and quality-adjusted life years (QALYs) gained by Tips were estimated. Results Tips saved about 179,099 QALYs and prevented 17,109 premature deaths in the U.S. With the campaign cost of roughly $48 million, Tips spent approximately $480 per quitter, $2,819 per premature death averted, $393 per LY saved, and $268 per QALY gained. Conclusions Tips was not only successful at reducing smoking-attributable morbidity and mortality but also was a highly cost-effective mass media intervention. PMID:25498550

  3. Comparative cost analysis of inpatient integrative medicine-Results of a pilot study.

    Science.gov (United States)

    Ostermann, Thomas; Lauche, Romy; Cramer, Holger; Dobos, Gustav

    2017-06-01

    Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs. Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests. In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly. Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. A direct healthcare cost analysis of the cryopreserved versus fresh transfer policy at the blastocyst stage.

    Science.gov (United States)

    Papaleo, Enrico; Pagliardini, Luca; Vanni, Valeria Stella; Delprato, Diana; Rubino, Patrizia; Candiani, Massimo; Viganò, Paola

    2017-01-01

    A cost analysis covering direct healthcare costs relating to IVF freeze-all policy was conducted. Normal- and high- responder patients treated with a freeze-all policy (n = 63) compared with fresh transfer IVF (n = 189) matched by age, body mass index, duration and cause of infertility, predictive factors for IVF (number of oocytes used for fertilization) and study period, according to a 1:3 ratio were included. Total costs per patient (€6952 versus €6863) and mean costs per live birth were similar between the freeze-all strategy (€13,101, 95% CI 10,686 to 17,041) and fresh transfer IVF (€15,279, 95% CI 13,212 to 18,030). A mean per live birth cost-saving of €2178 (95% CI -1810 to 6165) resulted in a freeze-all strategy owing to fewer embryo transfer procedures (1.29 ± 0.5 versus 1.41 ± 0.7); differences were not significant. Sensitivity analysis revealed that the freeze-all strategy remained cost-effective until the live birth rate is either higher or only slightly lower (≥-0.59%) in the freeze-all group compared with fresh cycles. A freeze-all policy does not increase costs compared with fresh transfer, owing to negligible additional expenses, i.e. vitrification, endometrial priming and monitoring, against fewer embryo transfer procedures required to achieve pregnancy. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Does the environmental gain of switching to the healthy New Nordic Diet outweigh the increased consumer cost?

    DEFF Research Database (Denmark)

    Saxe, Henrik; Jensen, Jørgen Dejgård

    2014-01-01

    important environmental impacts by 16-22%, mainly caused by reduced meat content. The surcharge to consumers of the ADD-to-NND diet-shift was €216/capita/year. In monetary terms, the savings related to the environmental impact of the diet-shift were €151/capita/year. 70% of the increased consumer cost...

  6. COST ANALYSIS OF THE PSYCHOLOGICAL EFFECTS OF WASTE DISPOSAL

    Directory of Open Access Journals (Sweden)

    S. A. Oke, K. O. Awofeso

    2006-01-01

    Full Text Available This paper quantifies the cost involved due to the psychological effect of waste disposal. The major costs are quantified as management and personnel costs. Management costs refer to those associated with awareness, recovery and recycling, taskforce and experimental. On the other hand, personnel costs are related to tax and health. The approach utilized is the algebraic sum of these component costs, since dimensional consistency of the formulation is observed. The results obtained indicate that the framework presented could beneficially add to the tool kit of the environmental decision makers. This would make it possible to generate scenarios that would give the decision maker adequate information before decisions are made. The implication of this research is that intuitive decision-making on cost is replaced with scientific backed up decision making. The idea proposed in this work is new since it provides a unique way of measuring cost of the effects of waste disposal on the stakeholders in the system.

  7. A utility/cost analysis of breast cancer risk prediction algorithms

    Science.gov (United States)

    Abbey, Craig K.; Wu, Yirong; Burnside, Elizabeth S.; Wunderlich, Adam; Samuelson, Frank W.; Boone, John M.

    2016-03-01

    Breast cancer risk prediction algorithms are used to identify subpopulations that are at increased risk for developing breast cancer. They can be based on many different sources of data such as demographics, relatives with cancer, gene expression, and various phenotypic features such as breast density. Women who are identified as high risk may undergo a more extensive (and expensive) screening process that includes MRI or ultrasound imaging in addition to the standard full-field digital mammography (FFDM) exam. Given that there are many ways that risk prediction may be accomplished, it is of interest to evaluate them in terms of expected cost, which includes the costs of diagnostic outcomes. In this work we perform an expected-cost analysis of risk prediction algorithms that is based on a published model that includes the costs associated with diagnostic outcomes (true-positive, false-positive, etc.). We assume the existence of a standard screening method and an enhanced screening method with higher scan cost, higher sensitivity, and lower specificity. We then assess expected cost of using a risk prediction algorithm to determine who gets the enhanced screening method under the strong assumption that risk and diagnostic performance are independent. We find that if risk prediction leads to a high enough positive predictive value, it will be cost-effective regardless of the size of the subpopulation. Furthermore, in terms of the hit-rate and false-alarm rate of the of the risk prediction algorithm, iso-cost contours are lines with slope determined by properties of the available diagnostic systems for screening.

  8. Cost-benefit analysis of climate change dynamics. Uncertainties and the value of information

    Energy Technology Data Exchange (ETDEWEB)

    Rable, A. [Centre Energetique et Procedes, Ecole des Mines, Paris (France); Van der Zwaan, B.C.C. [ECN Policy Studies, Petten (Netherlands)

    2009-10-15

    damage costs are three times larger or smaller than the estimate, the total social cost of global climate change increases by less than 20% above its minimum at the true optimal emission level. Because of the enormous magnitude of the total costs involved with climate change (mitigation), however, even a small relative error implies large additional expenses in absolute terms. To evaluate the benefit of reducing cost uncertainties, we plot the cost penalty as function of the uncertainty in relative damage and abatement costs, expressed as geometric standard deviation and standard deviation respectively. If continued externality analysis reduces the geometric standard deviation of relative damage cost estimates from 5 to 4, the benefit is 0.05% of the present value G{sub tot} of total gross word product over 150 years (about USD 3.9 x 10{sup 15}), and if further research reduces the standard deviation of relative abatement costs from 1 to 0.5, the benefit is 0.03% of G{sub tot}.

  9. Cost Analysis Method for Estimating Dynamic Reserve Considering Uncertainties in Supply and Demand

    Directory of Open Access Journals (Sweden)

    Kyung-bin Kwon

    2016-10-01

    Full Text Available The use of appropriate hourly reserve margins can maintain power system security by balancing supply and demand in the presence of errors in the forecast demand, generation outages, or errors in the forecast of wind power generation. Because the cost of unit commitment increases with larger reserve margins, cost analysis to determine the most economical reserve margin is an important issue in power system operation. Here, we define the “short-term reliability of balance” and describe a method to determine the reserve margin based on the short-term reliability of balance. We describe a case study, in which we calculate the reserve margin using this method with various standards of short-term reliability of balance. A cost analysis is then performed to determine the most economic standard, and a comparison between our method and a conventional method is carried out. The results show that our method with an economic short-term reliability of balance enables more reliable and efficient operation of the power system. Moreover, with an hourly reserve margin, we show that an increase in wind power generation can result in a significant decrease in the operating cost, which makes wind power generation economically viable.

  10. Analysis of quality costs - A critical element in CIM

    Science.gov (United States)

    Unal, Resit; Dean, Edwin B.

    1990-01-01

    Computer integrated manufacturing (CIM) is a cohesive database of manufacturing information, providing an opportunity to track quality costs and measure progress toward their reduction. This paper presents the quality cost concept as an approach to identify, measure and reduce quality costs while improving quality within CIM. The effect of advanced failure prevention methodologies, such as continuous process improvement and the quality engineering methods of Taguchi, on quality and cost, is discussed.

  11. Analysis of Appraising Agricultural Intangible Asset Value by Cost Method

    OpenAIRE

    Li, Xiao-Juan

    2010-01-01

    On the basis of describing the connotation of agricultural intangible asset and cost method, the technical ideas of appraising by cost method are introduced. The article analyzes the advantages (simple appraisal principle and easy to understand and grasp; overall consideration of various factors related to appraisal result value) and disadvantages (high appraisal cost; difficult to appraise and grasp various appraisal factors) of appraising by cost method. The article also summarizes the prec...

  12. Guidelines for cost control and analysis of cost-type research and development contracts

    Science.gov (United States)

    Sibbers, C. W.

    1981-01-01

    The cost information which should be obtained from a contractor(s) on a major, cost type research and development contract(s), and the analyses and effective use of these data are discussed. Specific type(s) of information which should be required, methods for analyzing such information, and methods for effectively using the results of such analyses to enhance NASA contract and project management are included. The material presented is based primarily on the principal methods which have been effectively used in the management of major cost type research and development contracts.

  13. Are Public-Private Partnerships an Appropriate Governance Structure for Power Plants? A Transaction Cost Analysis

    Science.gov (United States)

    Ho, S. Ping; Hsu, Yaowen

    2015-04-01

    In order to meet the requirements of the rapid economic growth, many countries demand an increasing number of power plants to meet the increasing electricity usage. Since high capital requirements of power plants present a big issue for these countries, PPPs have been considered an alternative to provide power plant infrastructure. In particular, in emerging or developing countries, PPPs may be the fastest way to provide the infrastructure needed. However, while PPPs are a promising alternative to providing various types of infrastructure, many failed power plant PPP projects have made it evident that PPPs, under certain situations, can be very costly or even a wrong choice of governance structure. While the higher efficiency due to better pooling of resources is greatly emphasized in Public-Private Partnerships (PPPs), the embedded transaction inefficiencies are often understated or even ignored. Through the lens of Transaction Cost Economics (TCE), this paper aims to answer why and when PPPs may become a costly governance structure for power plants. Specifically, we develop a TCE-based theory of PPPs as a governance structure. This theory suggests that three major opportunism problems embedded in infrastructure PPPs are possible to cause substantial transaction costs and render PPPs a costly governance structure. The three main opportunism problems are principal-principal problem, firm's hold-up problem, and government-led hold-up problem. Moreover, project and institutional characteristics that may lead to opportunism problems are identified. Based on these characteristics, an opportunism-focused transaction cost analysis (OTCA) for PPPs as a governance structure is proposed to supplement the current practice of PPP feasibility analysis. As a part of theory development, a case study of PPP power plants is performed to evaluate the proposed theory and to illustrate how the proposed OTCA can be applied in practice. Policies and administration strategies for power

  14. DVT surveillance program in the ICU: analysis of cost-effectiveness.

    Directory of Open Access Journals (Sweden)

    Ajai K Malhotra

    Full Text Available BACKGROUND: Venous Thrombo-embolism (VTE--Deep venous thrombosis (DVT and/or pulmonary embolism (PE--in traumatized patients causes significant morbidity and mortality. The current study evaluates the effectiveness of DVT surveillance in reducing PE, and performs a cost-effectiveness analysis. METHODS: All traumatized patients admitted to the adult ICU underwent twice weekly DVT surveillance by bilateral lower extremity venous Duplex examination (48-month surveillance period--SP. The rates of DVT and PE were recorded and compared to the rates observed in the 36-month pre-surveillance period (PSP. All patients in both periods received mechanical and pharmacologic prophylaxis unless contraindicated. Total costs--diagnostic, therapeutic and surveillance--for both periods were recorded and the incremental cost for each Quality Adjusted Life Year (QALY gained was calculated. RESULTS: 4234 patients were eligible (PSP--1422 and SP--2812. Rate of DVT in SP (2.8% was significantly higher than in PSP (1.3% - p<0.05, and rate of PE in SP (0.7% was significantly lower than that in PSP (1.5% - p<0.05. Logistic regression demonstrated that surveillance was an independent predictor of increased DVT detection (OR: 2.53 - CI: 1.462-4.378 and decreased PE incidence (OR: 0.487 - CI: 0.262-0.904. The incremental cost was $509,091/life saved in the base case, translating to $29,102/QALY gained. A sensitivity analysis over four of the parameters used in the model indicated that the incremental cost ranged from $18,661 to $48,821/QALY gained. CONCLUSIONS: Surveillance of traumatized ICU patients increases DVT detection and reduces PE incidence. Costs in terms of QALY gained compares favorably with other interventions accepted by society.

  15. Increasing the Benefit from Cost-Minimizing Loads via Centralized Adjustments

    Directory of Open Access Journals (Sweden)

    Antti Alahäivälä

    2016-11-01

    Full Text Available Several demand response (DR strategies rely on real-time pricing and selfish local optimization, which may not result in optimal electricity consumption patterns from the viewpoint of an energy supplier or a power system. Thus, this paper proposes a strategy enabling centralized adjustments to cost-minimize consumers’ load. By employing the strategy, an aggregator is able to alter electricity consumption in order to remove power imbalances and to participate in the balancing power market (BPM. In this paper, we focus on direct electric space heating (DESH loads that aim to minimize their heating cost locally. The consumers and an aggregator agree about an indoor temperature band, within which the aggregator is allowed to alter the temperature, and thus the electricity consumption. Centrally, the aggregator procures its electricity demand from a day-ahead (DA market by utilizing the allowed temperature band and employs the band later in real-time (RT operation for the balancing of its own imbalances or regulating power in the BPM.

  16. Cost Analysis of Outsourcing An Air Force Supply Squadron

    Science.gov (United States)

    2006-12-01

    56 5. Transaction Cost Economics.............................................................57 6. Improving Efficiency... Transaction Cost Economics and A-76: A Framework for Defense Managers. Naval Postgraduate School, 2002. Monterey, California. 66 Christopher Lonsdale...Naval Postgraduate School, 2004. Monterey, California. 74 Craig A. Powell. Transaction Cost Economics and A-76: A Framework for Defense Managers. Naval

  17. 75 FR 33987 - Disposing of Unneeded Federal Real Estate Increasing Sales Proceeds, Cutting Operating Costs, and...

    Science.gov (United States)

    2010-06-16

    ... Documents#0;#0; ] Memorandum of June 10, 2010 Disposing of Unneeded Federal Real Estate-- Increasing Sales... year 2012, yielded from increased proceeds from the sale of assets and reduced operating, maintenance... footprint by capitalizing on innovative technologies to increase efficiencies. However, during that same...

  18. A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy.

    Science.gov (United States)

    Berghout, Caspar C; Zevalkink, Jolien; Hakkaart-van Roijen, Leona

    2010-01-01

    Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER--that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy--was estimated at 52,384 euros per QALY gained. Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

  19. Development of Production PVD-AIN Buffer Layer System and Processes to Reduce Epitaxy Costs and Increase LED Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    Cerio, Frank

    2013-09-14

    The DOE has set aggressive goals for solid state lighting (SSL) adoption, which require manufacturing and quality improvements for virtually all process steps leading to an LED luminaire product. The goals pertinent to this proposed project are to reduce the cost and improve the quality of the epitaxial growth processes used to build LED structures. The objectives outlined in this proposal focus on achieving cost reduction and performance improvements over state-of-the-art, using technologies that are low in cost and amenable to high efficiency manufacturing. The objectives of the outlined proposal focus on cost reductions in epitaxial growth by reducing epitaxy layer thickness and hetero-epitaxial strain, and by enabling the use of larger, less expensive silicon substrates and would be accomplished through the introduction of a high productivity reactive sputtering system and an effective sputtered aluminum-nitride (AlN) buffer/nucleation layer process. Success of the proposed project could enable efficient adoption of GaN on-silicon (GaN/Si) epitaxial technology on 150mm silicon substrates. The reduction in epitaxy cost per cm{sup 2} using 150mm GaN-on-Si technology derives from (1) a reduction in cost of ownership and increase in throughput for the buffer deposition process via the elimination of MOCVD buffer layers and other throughput and CoO enhancements, (2) improvement in brightness through reductions in defect density, (3) reduction in substrate cost through the replacement of sapphire with silicon, and (4) reduction in non-ESD yield loss through reductions in wafer bow and temperature variation. The adoption of 150mm GaN/Si processing will also facilitate significant cost reductions in subsequent wafer fabrication manufacturing costs. There were three phases to this project. These three phases overlap in order to aggressively facilitate a commercially available production GaN/Si capability. In Phase I of the project, the repeatability of the performance

  20. Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan.

    Science.gov (United States)

    Chen, Ying-Erh; Kao, Sung-Shuo; Chung, Ren-Hua

    2016-01-01

    Patients with Lynch syndrome (LS) have a significantly increased risk of developing colorectal cancer (CRC) and other cancers. Genetic screening for LS among patients with newly diagnosed CRC aims to identify mutations in the disease-causing genes (i.e., the DNA mismatch repair genes) in the patients, to offer genetic testing for relatives of the patients with the mutations, and then to provide early prevention for the relatives with the mutations. Several genetic tests are available for LS, such as DNA sequencing for MMR genes and tumor testing using microsatellite instability and immunohistochemical analyses. Cost-effectiveness analyses of different genetic testing strategies for LS have been performed in several studies from different countries such as the US and Germany. However, a cost-effectiveness analysis for the testing has not yet been performed in Taiwan. In this study, we evaluated the cost-effectiveness of four genetic testing strategies for LS described in previous studies, while population-specific parameters, such as the mutation rates of the DNA mismatch repair genes and treatment costs for CRC in Taiwan, were used. The incremental cost-effectiveness ratios based on discounted life years gained due to genetic screening were calculated for the strategies relative to no screening and to the previous strategy. Using the World Health Organization standard, which was defined based on Taiwan's Gross Domestic Product per capita, the strategy based on immunohistochemistry as a genetic test followed by BRAF mutation testing was considered to be highly cost-effective relative to no screening. Our probabilistic sensitivity analysis results also suggest that the strategy has a probability of 0.939 of being cost-effective relative to no screening based on the commonly used threshold of $50,000 to determine cost-effectiveness. To the best of our knowledge, this is the first cost-effectiveness analysis for evaluating different genetic testing strategies for LS in

  1. Is reproduction costly? No increase of oxidative damage in breeding bank voles.

    Science.gov (United States)

    Ołdakowski, Łukasz; Piotrowska, Zaneta; Chrzaácik, Katarzyna M; Sadowska, Edyta T; Koteja, Paweł; Taylor, Jan R E

    2012-06-01

    According to life-history theory, investment in reproduction is associated with costs, which should appear as decreased survival to the next reproduction or lower future reproductive success. It has been suggested that oxidative stress may be the proximate mechanism of these trade-offs. Despite numerous studies of the defense against reactive oxygen species (ROS) during reproduction, very little is known about the damage caused by ROS to the tissues of wild breeding animals. We measured oxidative damage to lipids and proteins in breeding bank vole (Myodes glareolus) females after rearing one and two litters, and in non-breeding females. We used bank voles from lines selected for high maximum aerobic metabolic rates (which also had high resting metabolic rates and food intake) and non-selected control lines. The oxidative damage was determined in heart, kidneys and skeletal muscles by measuring the concentration of thiobarbituric acid-reactive substances, as markers of lipid peroxidation, and carbonyl groups in proteins, as markers of protein oxidation. Surprisingly, we found that the oxidative damage to lipids in kidneys and muscles was actually lower in breeding than in non-breeding voles, and it did not differ between animals from the selected and control lines. Thus, contrary to our predictions, females that bred suffered lower levels of oxidative stress than those that did not reproduce. Elevated production of antioxidant enzymes and the protective role of sex hormones may explain the results. The results of the present study do not support the hypothesis that oxidative damage to tissues is the proximate mechanism of reproduction costs.

  2. Cost-Effectiveness Analysis of Infrapopliteal Drug-Eluting Stents

    Energy Technology Data Exchange (ETDEWEB)

    Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr; Karnabatidis, Dimitris; Diamantopoulos, Athanasios; Spiliopoulos, Stavros; Siablis, Dimitris [Patras University Hospital, Department of Interventional Radiology, School of Medicine (Greece)

    2013-02-15

    IntroductionThere are no cost-utility data about below-the-knee placement of drug-eluting stents. The authors determined the cost-effectiveness of infrapopliteal drug-eluting stents for critical limb ischemia (CLI) treatment. The event-free individual survival outcomes defined by the absence of any major events, including death, major amputation, and target limb repeat procedures, were reconstructed on the basis of two published infrapopliteal series. The first included spot Bail-out use of Sirolimus-eluting stents versus bare metal stents after suboptimal balloon angioplasty (Bail-out SES).The second was full-lesion Primary Everolimus-eluting stenting versus plain balloon angioplasty and bail-out bare metal stenting as necessary (primary EES). The number-needed-to-treat (NNT) to avoid one major event and incremental cost-effectiveness ratios (ICERs) were calculated for a 3-year postprocedural period for both strategies. Overall event-free survival was significantly improved in both strategies (hazard ratio (HR) [confidence interval (CI)]: 0.68 [0.41-1.12] in Bail-out SES and HR [CI]: 0.53 [0.29-0.99] in Primary EES). Event-free survival gain per patient was 0.89 (range, 0.11-3.0) years in Bail-out SES with an NNT of 4.6 (CI: 2.5-25.6) and a corresponding ICER of 6,518 Euro-Sign (range 1,685-10,112 Euro-Sign ). Survival gain was 0.91 (range 0.25-3.0) years in Primary EES with an NNT of 2.7 (CI: 1.7-5.8) and an ICER of 11,581 Euro-Sign (range, 4,945-21,428 Euro-Sign ) per event-free life-year gained. Two-way sensitivity analysis showed that stented lesion length >10 cm and/or DES list price >1000 Euro-Sign were associated with the least economically favorable scenario in both strategies. Both strategies of bail-out SES and primary EES placement in the infrapopliteal arteries for CLI treatment exhibit single-digit NNT and relatively low corresponding ICERs.

  3. Better informing decision making with multiple outcomes cost-effectiveness analysis under uncertainty in cost-disutility space.

    Directory of Open Access Journals (Sweden)

    Nikki McCaffrey

    Full Text Available Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses-where outcomes are considered separately, with their joint relationship under uncertainty ignored-lead to incorrect inference regarding preferred strategies.The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison.Multiple outcomes CEA of a home-based palliative care model (PEACH relative to usual care is undertaken in cost disutility (CDU space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL.Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home (1 exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home, with a 51.6% chance of PEACH being cost-effective.Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding transparent and robust joint comparison of costs and

  4. Simulation-Based Approach to Operating Costs Analysis of Freight Trucking

    Directory of Open Access Journals (Sweden)

    Ozernova Natalja

    2015-12-01

    Full Text Available The article is devoted to the problem of costs uncertainty in road freight transportation services. The article introduces the statistical approach, based on Monte Carlo simulation on spreadsheets, to the analysis of operating costs. The developed model gives an opportunity to estimate operating freight trucking costs under different configuration of cost factors. Important conclusions can be made after running simulations regarding sensitivity to different factors, optimal decisions and variability of operating costs.

  5. Automated Sequence Selection and Cost Calculation for Maintenance and Rehabilitation in Highway Life-Cycle Cost Analysis (LCCA

    Directory of Open Access Journals (Sweden)

    Changmo Kim

    2015-03-01

    Full Text Available Life-Cycle Cost Analysis (LCCA for highway projects is an analytical technique that uses economic principles to evaluate long-term alternative investment options, especially for comparing the values of alternative pavement design structures and construction strategies. Several approaches and software have been adopted to undertake LCCA by many transportation agencies in the United States over the last decade. In 2007, the California Department of Transportation (Caltrans adopted RealCost, the LCCA software, developed by the U.S. Federal Highway Administration (FHWA. The California implementation incorporates major user interface enhancements and customization. This paper introduces the Caltrans LCCA procedure and describes the functions and improvements of the enhanced California version of RealCost software (RealCost 2.5CA. Automated functions were developed to select efficient and adequate sequences for future maintenance and rehabilitation (M&R for comparing alternatives. The graphical user interface integrates service life, maintenance frequency, and agency cost of each maintenance activity with given project constraints, such as climate region, final pavement surface, and design life. The automated cost calculation modules estimate future M&R costs based on each construction scope and pavement type. The main focus of the California LCCA enhancement is to improve the efficiency of LCCA procedures with automatic data selection and computations. The RealCost 2.5CA program has been adopted as an official LCCA tool to comply with regulatory requirements for California state highway projects. Utilization of this California-customized LCCA software helps Caltrans to achieve substantial economic benefits (agency cost and road user cost savings for highway projects.

  6. Cost effectiveness analysis of strategies for tuberculosis control in developing countries

    NARCIS (Netherlands)

    K. Floyd (Katherine); C. Dye; R.M.P.M. Baltussen (Rob)

    2005-01-01

    textabstractOBJECTIVE: To assess the costs and health effects of tuberculosis control interventions in Africa and South East Asia in the context of the millennium development goals. DESIGN: Cost effectiveness analysis based on an epidemiological model. SETTING: Analyses undertaken

  7. Cost utility analysis of sildenafil compared with papaverine-phentolamine injections

    NARCIS (Netherlands)

    E.A. Stolk (Elly); M. Caffa; E.J. Meuleman; F.F.H. Rutten (Frans); J.J. van Busschbach (Jan)

    2000-01-01

    textabstractOBJECTIVE: To compare the cost effectiveness of sildenafil and papaverine-phentolamine injections for treating erectile dysfunction. DESIGN: Cost utility analysis comparing treatment with sildenafil (allowing a switch to injection therapy) and treatment with

  8. Determination of the potential for utilising combined heat and power and of the target reduction of CO{sub 2} emissions, inclusive of cost analysis (increased use of combined heat and power); Ermittlung der Potenziale fuer die Anwendung der Kraft-Waerme-Kopplung und der erzielbaren Minderung der CO{sub 2}-Emissionen einschliesslich Bewertung der Kosten (Verstaerkte Nutzung der Kraft-Waerme-Kopplung)

    Energy Technology Data Exchange (ETDEWEB)

    Horn, Manfred; Ziesing, Hans-Joachim [Deutsches Inst. fuer Wirtschaftsforschung, Berlin (Germany); Matthes, Felix Christian; Harthan, Ralph [Oeko Institut e.V., Berlin (Germany); Menzler, Gerald [VIK Verband der Industriellen Energie- und Kraftwirtschaft e.V., Essen (Germany)

    2007-07-15

    The report provides a statistical overview of CHP utilisation up to now in Germany, analyses the general economic and political conditions with a view to evaluating the competitiveness of CHP, discusses the effectiveness of the German CHP Act with respect to its contribution to meeting emissions-related goals, analyses the cost-effectiveness of investments in different types of new CHP installations, addresses mid- and longer term potential as well as impediments to the utilisation of CHP installations, presents model simulations of how CHP is expected to develop in the context of economic conditions subject to various general political conditions and makes recommendations with an eye to additional requirements and opportunities to support CHP, against the background of the findings of the analysis. (orig.)

  9. Use of cost-effectiveness analysis to determine inventory size for a national cord blood bank.

    Science.gov (United States)

    Howard, David H; Meltzer, David; Kollman, Craig; Maiers, Martin; Logan, Brent; Gragert, Loren; Setterholm, Michelle; Horowitz, Mary M

    2008-01-01

    Transplantation with stem cells from stored umbilical cord blood units is an alternative to living unrelated bone marrow transplantation. The larger the inventory of stored cord units, the greater the likelihood that transplant candidates will match to a unit, but storing units is costly. The authors present the results of a study, commissioned by the Institute of Medicine, as part of a report on the establishment of a national cord blood bank, examining the optimal inventory level. They emphasize the unique challenges of undertaking cost-effectiveness analysis in this field and the contribution of the analysis to policy. The authors estimate the likelihood that transplant candidates will match to a living unrelated marrow donor or a cord blood unit as a function of cord blood inventory and then calculate the life-years gained for each transplant type by match level using historical data. They develop a model of the cord blood inventory level to estimate total costs as a function of the number of stored units. The cost per life-year gained associated with increasing inventory from 50,000 to 100,000 units is $44,000 to $86,000 and from 100,000 to 150,000 units is $64,000 to $153,000, depending on the assumption about the degree to which survival rates for cord transplants vary by match quality. Expanding the cord blood inventory above current levels is cost-effective by conventional standards. The analysis helped shape the Institute of Medicine's report, but it is difficult to determine the extent to which the analysis influenced subsequent congressional legislation.

  10. 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.

  11. Using discrete choice experiments within a cost-benefit analysis framework: some considerations.

    Science.gov (United States)

    McIntosh, Emma

    2006-01-01

    A great advantage of the stated preference discrete choice experiment (SPDCE) approach to economic evaluation methodology is its immense flexibility within applied cost-benefit analyses (CBAs). However, while the use of SPDCEs in healthcare has increased markedly in recent years there has been a distinct lack of equivalent CBAs in healthcare using such SPDCE-derived valuations. This article outlines specific issues and some practical suggestions for consideration relevant to the development of CBAs using SPDCE-derived benefits. The article shows that SPDCE-derived CBA can adopt recent developments in cost-effectiveness methodology including the cost-effectiveness plane, appropriate consideration of uncertainty, the net-benefit framework and probabilistic sensitivity analysis methods, while maintaining the theoretical advantage of the SPDCE approach. The concept of a cost-benefit plane is no different in principle to the cost-effectiveness plane and can be a useful tool for reporting and presenting the results of CBAs.However, there are many challenging issues to address for the advancement of CBA methodology using SPCDEs within healthcare. Particular areas for development include the importance of accounting for uncertainty in SPDCE-derived willingness-to-pay values, the methodology of SPDCEs in clinical trial settings and economic models, measurement issues pertinent to using SPDCEs specifically in healthcare, and the importance of issues such as consideration of the dynamic nature of healthcare and the resulting impact this has on the validity of attribute definitions and context.

  12. Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods.

    Science.gov (United States)

    Nunes, Sheila Elke Araujo; Minamisava, Ruth; Vieira, Maria Aparecida da Silva; Itria, Alexander; Pessoa, Vicente Porfirio; Andrade, Ana Lúcia Sampaio Sgambatti de; Toscano, Cristiana Maria

    2017-01-01

    To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective. Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test. Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (pSistema Único de Saúde. Estudo de custo, com coleta de dados primários de uma amostra de 59 crianças com 28 dias a 35 meses de idade hospitalizadas por pneumonia bacteriana. Foram considerados custos diretos médicos e não médicos. Três metodologias de custeio foram utilizadas: microcusteio por revisão de prontuários, microcusteio considerando diretriz terapêutica e macrocusteio por ressarcimento do Sistema Único de Saúde. Os custos estimados pelas diferentes metodologias foram comparados utilizando o teste de Friedman. Os custos hospitalares de crianças com pneumonia grave foram R$ 780,70 ($Int. 858.7) por revisão de prontuários, R$ 641,90 ($Int. 706.90) por diretriz terapêutica e R$ 594,80 ($Int. 654.28) por ressarcimento do Sistema Único de Sa

  13. Cost-Effective Consolidation of Fine Aluminum Scrap for Increased Remelting Effieciency

    Energy Technology Data Exchange (ETDEWEB)

    William Van Geertruyden

    2005-09-22

    The main objective of this research was to develop a new re-melting process for fine or light gauge aluminum scrap products that exhibits dramatic improvements in energy efficiency. Light gauge aluminum scrap in the form of chips, turnings, and borings has historically been underutilized in the aluminum recycling process due to its high surface area to volume ratio resulting in low melt recovery. Laboratory scale consolidation experiments were performed using loose aluminum powder as a modeling material as well as shredded aluminum wire scrap. The processing parameters necessary to create consolidated aluminum material were determined. Additionally, re-melting experiments using consolidated and unconsolidated aluminum powder confirmed the hypothesis that metal recovery using consolidated material will significantly improve by as much as 20%. Based on this research, it is estimated that approximately 495 billion Btu/year can be saved by implementation of this technology in one domestic aluminum rolling plant alone. The energy savings are realized by substituting aluminum scrap for primary aluminum, which requires large amounts of energy to produce. While there will be an initial capital investment, companies will benefit from the reduction of dependence on primary aluminum thus saving considerable costs. Additionally, the technology will allow companies to maintain in-house alloy scrap, rather than purchasing from other vendors and eliminate the need to discard the light gauge scrap to landfills.

  14. Costs of Quality: Exploratory Analysis of Hidden Elements and Prioritization using Analytic Hierarchy Process

    Directory of Open Access Journals (Sweden)

    Sailaja A

    2015-02-01

    Full Text Available Cost of Quality analysis is emerged as an effective tool for the industrial managers for pinpointing the deficiencies in the system as well as for identifying the improvement areas by highlighting the cost reduction opportunities. However , this analysis will be fully effective only if it is further extended to identify the cost incurred in ensuring quality in all areas of the supply chain including the hidden costs and costs of missed out opportunities. Most of the hidden elements of quality costs are difficult to track and not accounted by the traditional accounting tools. An exploratory analysis is made in this research to identify the hidden elements of quality costs in manufacturing industry. Further, the identified cost elements are classified into various groups for better analysis and, finally, prioritized to identify the vital few among them. Analytic Hierarchy Process (AHP technique which is one of the most popular Multi Criteria Decision Method (MCDM and Pareto analysis were used in this study for prioritizing the hidden quality cost elements based on their degree of impact on overall cost of quality. By this analysis, the key cost elements which are to be addressed to reduce the overall cost of quality are identified.

  15. Incremental cost analysis of advanced concept CAES systems

    Energy Technology Data Exchange (ETDEWEB)

    Knutsen, C.A.

    1979-09-01

    The costs of compressed air energy storage (CAES) systems using thermal energy storage (TES) are compared to the costs of CAES systems without TES and simple cycle gas turbine systems. Comparisons are made in terms of the system energy costs levelized over the operating life of the systems. These are in 1985 price levels which is the assumed first year of operation for the systems.

  16. Activity-based Management of Logistic Costs in a Manufacturing Company: A Case of Increased Visibility of Logistics Costs in a Slovenian Paper Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Julijana Krajnc

    2012-01-01

    Full Text Available Both the transparent reporting of logistics costs and the related accounting of their cost drivers present a significant factor for the successful management of material flows and the related logistics activities in production companies. These costs, which are mainly reported as part of overhead (indirect costs in such companies, usually remain hidden or are not explicitly visible when the traditional method of accounting is applied. The aim of this research is to create a model of activity-based accounting of logistics costs in a production company, and to test its efficiency in the disclosure of logistics costs compared with traditional cost accounting. The application of the model in a production company shows that an activity-based approach discloses as much as 108% more logistics costs at the level of a group of products than the traditional cost-accounting approach. Further, detailed information on logistics costs obtained in this way enables their more efficient management. Key words: logistics costs; activity-based costing; cost allocation; cost visibility; cost management

  17. Analysis of Appraising Agricultural Intangible Asset Value by Cost Method

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    On the basis of describing the connotation of agricultural intangible asset and cost method,the technical ideas of appraising by cost method are introduced.The article analyzes the advantages(simple appraisal principle and easy to understand and grasp;overall consideration of various factors related to appraisal result value) and disadvantages(high appraisal cost;difficult to appraise and grasp various appraisal factors) of appraising by cost method.The article also summarizes the precondition of appraising by cost method:it is applicable to appraise the agricultural intangible asset which can be reproduced and afresh developed.Based on the cognition of agricultural intangible asset and the relevant rules of Ministry of Finance on appraisal of intangible asset by using cost method,the model of appraising agricultural intangible asset by cost method is constructed.That is:agricultural intangible asset value = replacement cost of agricultural intangible asset ×newness rate + opportunity cost of agricultural intangible asset.Determine and analyze parameters of the model,in order to offer references for appraisers to appraise agricultural intangible asset value more reasonably.

  18. Development of a Five-Day Basic Microsurgery Simulation Training Course: A Cost Analysis

    Directory of Open Access Journals (Sweden)

    Masha Singh

    2014-05-01

    Full Text Available The widespread use of microsurgery in numerous surgical fields has increased the need for basic microsurgical training outside of the operating room. The traditional start of microsurgical training has been in undertaking a 5-day basic microsurgery course. In an era characterised by financial constraints in academic and healthcare institutions as well as increasing emphasis on patient safety, there has been a shift in microsurgery training to simulation environments. This paper reviews the stepwise framework of microsurgical skill acquisition providing a cost analysis of basic microsurgery courses in order to aid planning and dissemination of microsurgical training worldwide.

  19. Cost-benefit analysis of road safety measures: applicability and controversies.

    Science.gov (United States)

    Elvik, R

    2001-01-01

    This paper discusses the applicability of cost-benefit analysis as an aid to policy making for road safety measures. A framework for assessing the applicability of cost-benefit analysis is developed. Five main types of criticism of cost-benefit analysis are identified: 1. rejecting the basic principles of cost-benefit analysis as not applicable to road safety, 2. excluding some types of issues from the scope of calculation of costs and benefits, 3. setting policy objectives that are not amenable to cost-benefit analysis, 4. rejecting the need for maintaining a separation between policy objectives and policy programmes as required for cost-benefit analysis, and 5. rejecting, or denying the possibility of ever obtaining, acceptably valid and reliable economic valuations of the consequences of alternative policy programmes. It is concluded that rejecting the basic principles of cost-benefit analysis is a difficult position to defend, since these principles are simply a re-statement in economic terms of very general principles of rational choice. These principles are part of the normative basis of all formal techniques designed to aid policy making as well as the democratic system of government. Everybody, including those who advocate the use of cost-benefit analysis, agree that some issues are unsuitable for cost-benefit analysis, in particular those that involve basic human rights and fairness in distribution. There may, however, be disagreement with respect to the perception of a specific policy issue in terms of whether it is mainly about rights and fairness or mainly about the effective use of policy instruments to solve a social problem. Politicians may be tempted to set policy objectives that are ill suited for cost-benefit analysis, but this does not imply that cost-benefit analysis makes unreasonable assumptions. Perhaps the most important issue for the applicability of cost-benefit analysis is whether people in general have sufficiently well ordered

  20. Impact of total knee replacement practice: cost effectiveness analysis of data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Ferket, Bart S; Feldman, Zachary; Zhou, Jing; Oei, Edwin H; Bierma-Zeinstra, Sita M A; Mazumdar, Madhu

    2017-03-28

    Objectives To evaluate the impact of total knee replacement on quality of life in people with knee osteoarthritis and to estimate associated differences in lifetime costs and quality adjusted life years (QALYs) according to use by level of symptoms.Design Marginal structural modeling and cost effectiveness analysis based on lifetime predictions for total knee replacement and death from population based cohort data.Setting Data from two studies-Osteoarthritis Initiative (OAI) and the Multicenter Osteoarthritis Study (MOST)-within the US health system.Participants 4498 participants with or at high risk for knee osteoarthritis aged 45-79 from the OAI with no previous knee replacement (confirmed by baseline radiography) followed up for nine years. Validation cohort comprised 2907 patients from MOST with two year follow-up.Intervention Scenarios ranging from current practice, defined as total knee replacement practice as performed in the OAI (with procedural rates estimated by a prediction model), to practice limited to patients with severe symptoms to no surgery.Main outcome measures Generic (SF-12) and osteoarthritis specific quality of life measured over 96 months, model based QALYs, costs, and incremental cost effectiveness ratios over a lifetime horizon.Results In the OAI, total knee replacement showed improvements in quality of life with small absolute changes when averaged across levels of confounding variables: 1.70 (95% uncertainty interval 0.26 to 3.57) for SF-12 physical component summary (PCS); -10.69 (-13.39 to -8.01) for Western Ontario and McMaster Universities arthritis index (WOMAC); and 9.16 (6.35 to 12.49) for knee injury and osteoarthritis outcome score (KOOS) quality of life subscale. These improvements became larger with decreasing functional status at baseline. Provision of total knee replacement to patients with SF-12 PCS scores osteoarthritis from the MOST cohort and were robust against various scenarios including increased rates of total

  1. Increased photosynthesis offsets costs of allocation to sapwood in an arid environment

    Energy Technology Data Exchange (ETDEWEB)

    Carey, E.V.; DeLucia, E.H. [Univ. of Illinois, Urbana, IL (United States). Dept. of Plant Biology; Callaway, R.M. [Univ. of Montana, Missoula, MT (United States). Div. of Biological Sciences

    1998-10-01

    The authors assessed the effect that varying patterns of biomass allocation had on growth of ponderosa pine (Pinus ponderosa) growing in the desert climate of the Great Basin and the montane climate of the eastern Sierra Nevada. Prior work established that desert trees have lower leaf:sapwood area ratios than montane trees and proportionally greater stem respiration. Sapwood:leaf mass ratios are also greater and increase more as a function stem diameter in desert than in montane trees. The authors hypothesized that this increased allocation of carbon to stem sapwood and stem respiration in large trees could decrease growth rates in the desert compared to the montane environment, in addition to any growth reduction imposed by drought on physiology and growth processes. Trees of all diameters (dbh) in the desert environment had lower relative growth rates (RGRs) than montane trees. However, growth rates of desert and montane trees declined similarly with increasing dbh and did not reflect diverging sapwood:leaf mass ratios. Alternatively, the authors hypothesized that desert trees may increase rates of photosynthetic carbon accumulation with diameter, thereby compensating for increased sapwood respiration. Leaf nitrogen (N) concentration and stable-carbon isotope composition ({delta}{sup 13}C) were measured to examine size-dependent and seasonally integrated photosynthetic capacity within desert and montane environments. Nitrogen concentration was correlated with photosynthetic capacity.

  2. Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis.

    Science.gov (United States)

    Veisten, Knut; Houwing, Sjoerd; Mathijssen, M P M René; Akhtar, Juned

    2013-03-01

    Road users driving under the influence of psychoactive substances may be at much higher relative risk (RR) in road traffic than the average driver. Legislation banning blood alcohol concentrations above certain threshold levels combined with roadside breath-testing of alcohol have been in lieu for decades in many countries, but new legislation and testing of drivers for drug use have recently been implemented in some countries. In this article we present a methodology for cost-benefit analysis (CBA) of increased law enforcement of roadside drug screening. This is an analysis of the profitability for society, where costs of control are weighed against the reduction in injuries expected from fewer drugged drivers on the roads. We specify assumptions regarding costs and the effect of the specificity of the drug screening device, and quantify a deterrence effect related to sensitivity of the device yielding the benefit estimates. Three European countries with different current enforcement levels were studied, yielding benefit-cost ratios in the approximate range of 0.5-5 for a tripling of current levels of enforcement, with costs of about 4000 EUR per convicted and in the range of 1.5 and 13 million EUR per prevented fatality. The applied methodology for CBA has involved a simplistic behavioural response to enforcement increase and control efficiency. Although this methodology should be developed further, it is clearly indicated that the cost-efficiency of increased law enforcement of drug driving offences is dependent on the baseline situation of drug-use in traffic and on the current level of enforcement, as well as the RR and prevalence of drugs in road traffic. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. [Statistical Process Control (SPC) can help prevent treatment errors without increasing costs in radiotherapy].

    Science.gov (United States)

    Govindarajan, R; Llueguera, E; Melero, A; Molero, J; Soler, N; Rueda, C; Paradinas, C

    2010-01-01

    Statistical Process Control (SPC) was applied to monitor patient set-up in radiotherapy and, when the measured set-up error values indicated a loss of process stability, its root cause was identified and eliminated to prevent set-up errors. Set up errors were measured for medial-lateral (ml), cranial-caudal (cc) and anterior-posterior (ap) dimensions and then the upper control limits were calculated. Once the control limits were known and the range variability was acceptable, treatment set-up errors were monitored using sub-groups of 3 patients, three times each shift. These values were plotted on a control chart in real time. Control limit values showed that the existing variation was acceptable. Set-up errors, measured and plotted on a X chart, helped monitor the set-up process stability and, if and when the stability was lost, treatment was interrupted, the particular cause responsible for the non-random pattern was identified and corrective action was taken before proceeding with the treatment. SPC protocol focuses on controlling the variability due to assignable cause instead of focusing on patient-to-patient variability which normally does not exist. Compared to weekly sampling of set-up error in each and every patient, which may only ensure that just those sampled sessions were set-up correctly, the SPC method enables set-up error prevention in all treatment sessions for all patients and, at the same time, reduces the control costs. Copyright © 2009 SECA. Published by Elsevier Espana. All rights reserved.

  4. Low-cost activation analysis at small research reactors

    CERN Document Server

    Westphal, G P; Lemmel, H; Niedermaier, M R; Joestl, K; Schröder, P; Böck, H H; Schachner, H; Klapfer, E

    2003-01-01

    A software implementation of a loss-free counting multichannel analyzer, storing immediately into the multimegabyte memory of a low-cost 486 or Pentium type PC, enables the real-time control of a rabbit system as well as the collection of up to 1000 pairs of simultaneously recorded loss-corrected and non-corrected spectra of 16 k channels each, in a true sequence without time gaps in between, at throughput rates of up to 200 kc/s. Intended for activation analysis of short-lived isomeric transitions, the system renders possible peak to background optimizations and separations of lines with different half-lives without an a priori knowledge of sample composition by summing up appropriate numbers of spectra over appropriate intervals of time. By automatically adapting the noise filtering time to individual pulse intervals, the Preloaded Digital Filter (PLDF) combines low- to medium-rate resolutions comparable to those of high-quality Gaussian amplifiers with throughput rates of up to 100 kc/s, and high-rate reso...

  5. Cost benefit analysis of policy measures in the transport sector

    Energy Technology Data Exchange (ETDEWEB)

    Buus Kristensen, N. [COWI (Denmark)

    1996-12-01

    The Government has introduced a national target for the reduction of CO{sub 2} emissions from the transport sector, which aims to stabilize emissions at the 1988 level, by the year 2005. This target was first formalized in the Government`s 1990 transport action plan, and later repeated in `Traffic 2005`, published in December 1993. The latter document also makes reference to six strategies, which the Government proposed in order to attain the national target. The majority of the transport policy measures will impact on CO{sub 2} emissions from the sector, even if they are targeted at different objectives, e.g. road safety, air pollution, time savings, etc. A long-list of potential measures, which might be adopted with the primary purpose is to reduce CO{sub 2} emissions, has been identified from the six overall strategies. The measures identified have been subjected to detailed analyses, to ascertain all the potential impacts. The main emphasis has been on clarifying the potential efficacy of each of the measures in reducing CO{sub 2} emissions, and the social costs in a wide sense. The analysis assumes that each policy measure is implemented separately. A methodology is developed that presents the respective consequences in commensurate terms. Similar calculations are undertaken for two different combinations of policy measures. (EG)

  6. Does the environmental gain of switching to the healthy New Nordic Diet outweigh the increased consumer cost?

    DEFF Research Database (Denmark)

    Saxe, Henrik; Jensen, Jørgen Dejgård

    2014-01-01

    The new Nordic diet (NND) was designed by gastronomic, nutritional and environmental specialists to be a palatable, healthy and sustainable diet containing 30%-40% less meat than the average Danish diet (ADD), ≥ 75% organics, and more locally grown wholegrain products, nuts, fruit and vegetables....... In this study, the NND was based on economic modelling to represent a “realistic NND bought by Danish consumers”. The objective was to investigate whether the ADD-to-NND diet-shift has environmental consequences that outweigh the increased consumer cost of the diet-shift. The diet-shift reduced the three most...... important environmental impacts by 16%-22%, mainly caused by reduced meat content. The surcharge to consumers of the ADD-to-NND diet-shift was €216/capita/year. In monetary terms, the savings related to the environmental impact of the diet-shift were €151/capita/year. 70% of the increased consumer cost...

  7. Does the environmental gain of switching to the healthy New Nordic Diet outweigh the increased consumer cost?

    DEFF Research Database (Denmark)

    Saxe, Henrik; Jensen, Jørgen Dejgård

    2014-01-01

    The New Nordic Diet (NND) was designed by gastronomic, nutritional and environmental specialists to be a palatable, healthy and sustainable diet containing 30-40% less meat than the Average Danish Diet (ADD), ≥75% organics, and more locally grown wholegrain products, nuts, fruit and vegetables....... In this study, the NND was based on economic modelling to represent a “realistic NND bought by Danish consumers”. The objective was to investigate whether the ADD-to-NND diet-shift has environmental consequences that outweigh the increased consumer cost of the diet-shift. The diet-shift reduced the three most...... important environmental impacts by 16-22%, mainly caused by reduced meat content. The surcharge to consumers of the ADD-to-NND diet-shift was €216/capita/year. In monetary terms, the savings related to the environmental impact of the diet-shift were €151/capita/year. 70% of the increased consumer cost...

  8. Does the Environmental Gain of Switching to the Healthy New Nordic Diet Outweigh the Increased Consumer Cost?

    DEFF Research Database (Denmark)

    Saxe, Henrik; Jensen, Jørgen Dejgard

    2014-01-01

    The new Nordic diet (NND) was designed by gastronomic, nutritional and environmental specialists to be a palatable, healthy and sustainable diet containing 30%-40% less meat than the average Danish diet (ADD), ≥ 75% organics, and more locally grown wholegrain products, nuts, fruit and vegetables....... In this study, the NND was based on economic modelling to represent a “realistic NND bought by Danish consumers”. The objective was to investigate whether the ADD-to-NND diet-shift has environmental consequences that outweigh the increased consumer cost of the diet-shift. The diet-shift reduced the three most...... important environmental impacts by 16%-22%, mainly caused by reduced meat content. The surcharge to consumers of the ADD-to-NND diet-shift was €216/capita/year. In monetary terms, the savings related to the environmental impact of the diet-shift were €151/capita/year. 70% of the increased consumer cost...

  9. A new approach for product cost estimation using data envelopment analysis

    Directory of Open Access Journals (Sweden)

    Adil Salam

    2012-10-01

    Full Text Available Cost estimation of new products has always been difficult as only few design, manufacturing and operational features will be known. In these situations, parametric or non-parametric methods are commonly used to estimate the cost of a product given the corresponding cost drivers. The parametric models use priori determined cost function where the parameters of the function are evaluated from historical data. Non-parametric methods, on the other hand, attempt to fit curves to the historic data without predetermined function. In both methods, it is assumed that the historic data used in the analysis is a true representation of the relation between the cost drivers and the corresponding costs. However, because of efficiency variations of the manufacturers and suppliers, changes in supplier selections, market fluctuations, and several other reasons, certain costs in the historic data may be too high whereas other costs may represent better deals for their corresponding cost drivers. Thus, it may be important to rank the historic data and identify benchmarks and estimate the target costs of the product based on these benchmarks. In this paper, a novel adaptation of cost drivers and cost data is introduced in order to use data envelopment analysis for the purpose of ranking cost data and identify benchmarks, and then estimate the target costs of a new product based on these benchmarks. An illustrative case study has been presented for the cost estimation of landing gears of an aircraft manufactured by an aerospace company located in Montreal, CANADA.

  10. An Analysis of the Cost and Cost-Effectiveness of Faculty Development for Online Teaching

    Science.gov (United States)

    Meyer, Katrina A.

    2014-01-01

    This article presents the results of a national study of 39 higher education institutions that collected information about their cost measures used to evaluate faculty development for online teaching as well as decisions they would make to expand, keep, scale back, or eliminate various faculty development activities and contents in a…

  11. Evaluation and Cost Analysis of National Health Policy of Thalassaemia Screening in West-Azerbaijan Province of Iran

    Science.gov (United States)

    Ahmadnezhad, Elham; Sepehrvand, Nariman; Jahani, Farshid Fayyaz; Hatami, Sanaz; Kargar, Catauon; Mirmohammadkhani, Majid; Bazargan-Hejazi, Shahrzad

    2012-01-01

    Background: Thalassaemia is one of the most common Mendelian disorders in Mediterranean area. Iran has about 26,000 Thalassaemic patients, so it is one of the most affected countries. The aim of this study was to evaluate the screening program and cost analysis of Thalassaemia prevention program in West-Azerbaijan province of Iran. Methods: This study evaluated the efficacy of Health system's Thalassaemia prevention program with a sensitivity analysis for its costs. The second five years of the program was evaluated. The economic burden of Thalassaemia is determined by the birth prevalence of the affected infants and the cost that is accrued to treat the infected individuals and was compared with the total cost of screening the couples for thalassemia trait. Results: The average incidence rate of major Thalassaemia was 19.8 per 100,000 live births and mean coverage rate of program was 74%. The rate of canceling the marriage among carrier couples was 53%. Cost analysis showed that the cost of screening and prenatal diagnosis program was much lower than the cost of treatment in potential thalassaemic patients. Conclusions: The prevention program of Thalassaemia including a premarital and pre-natal screening in west Azerbaijan province is demonstrated to be cost-effective. Taking some actions in order to increase the coverage of pre-marital screening, providing pre-natal diagnosis in private and public sector, complete insurance coverage for the high-risk couples to perform the investigations more easily, were recommended. PMID:23112894

  12. Evaluation and cost analysis of national health policy of thalassaemia screening in west-azerbaijan province of iran.

    Science.gov (United States)

    Ahmadnezhad, Elham; Sepehrvand, Nariman; Jahani, Farshid Fayyaz; Hatami, Sanaz; Kargar, Catauon; Mirmohammadkhani, Majid; Bazargan-Hejazi, Shahrzad

    2012-10-01

    Thalassaemia is one of the most common Mendelian disorders in Mediterranean area. Iran has about 26,000 Thalassaemic patients, so it is one of the most affected countries. The aim of this study was to evaluate the screening program and cost analysis of Thalassaemia prevention program in West-Azerbaijan province of Iran. This study evaluated the efficacy of Health system's Thalassaemia prevention program with a sensitivity analysis for its costs. The second five years of the program was evaluated. The economic burden of Thalassaemia is determined by the birth prevalence of the affected infants and the cost that is accrued to treat the infected individuals and was compared with the total cost of screening the couples for thalassemia trait. The average incidence rate of major Thalassaemia was 19.8 per 100,000 live births and mean coverage rate of program was 74%. The rate of canceling the marriage among carrier couples was 53%. Cost analysis showed that the cost of screening and prenatal diagnosis program was much lower than the cost of treatment in potential thalassaemic patients. The prevention program of Thalassaemia including a premarital and pre-natal screening in west Azerbaijan province is demonstrated to be cost-effective. Taking some actions in order to increase the coverage of pre-marital screening, providing pre-natal diagnosis in private and public sector, complete insurance coverage for the high-risk couples to perform the investigations more easily, were recommended.

  13. Increasing Learning and Reducing Costs through Technology: The University of Alabama Story

    Science.gov (United States)

    Witkowsky, Kathy

    2008-01-01

    Long known as a college-football powerhouse, the University of Alabama (UA) is now considered a model for institutions seeking to maintain or boost their academic quality even as enrollments increase and budgets are squeezed. According to Carol Twigg, president of the National Center for Academic Transformation (NCAT), which has been a significant…

  14. Increasing Learning and Reducing Costs through Technology: The University of Alabama Story

    Science.gov (United States)

    Witkowsky, Kathy

    2008-01-01

    Long known as a college-football powerhouse, the University of Alabama (UA) is now considered a model for institutions seeking to maintain or boost their academic quality even as enrollments increase and budgets are squeezed. According to Carol Twigg, president of the National Center for Academic Transformation (NCAT), which has been a significant…

  15. Increasing Water Use Efficiency Comes at a Cost for Norway Spruce

    Directory of Open Access Journals (Sweden)

    Tanja G M Sanders

    2016-11-01

    Full Text Available Intrinsic water use efficiency (WUEi in trees is an indication of the ratio of carbon assimilation to the rate of transpiration. It is generally assumed that it is a response to water availability. In agricultural research, the question of drought tolerance by increased WUEi has been well studied. In general, the increase is a trade-off for productivity and is therefore not desired. For forest trees, this question is less clearly understood. Using stable carbon isotopes derived from tree rings combined with productivity as the product of the annual growth increment and annual density measurements, we compared the change in WUEi over a 15 year period. While WUEi increased over this period, the productivity decreased, causing an opposing trend. The gradient of the correlation between WUEi and productivity varies between provenances and sites. Counterintuitively, the populations at the drier site showed low WUEi values at the beginning of the investigation. Slopes vary with the provenance from Poland showing the least decline in productivity. In general, we found that a decline in productivity aligned with an increase in WUEi.

  16. Intervention and societal costs of residential community reintegration for patients with acquired brain injury: a cost-analysis of the Brain Integration Programme

    NARCIS (Netherlands)

    Heugten, C.M. van; Geurtsen, G.J.; Derksen, R.E.; Martina, J.D.; Geurts, A.C.H.; Evers, S.M.

    2011-01-01

    OBJECTIVE: The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment. METHODS: A cost-analysis was performed identifying costs of healthcare

  17. Cost analysis of youth clinic network in Estonia

    NARCIS (Netherlands)

    Kempers, J.P.

    2015-01-01

    BACKGROUND: Youth-friendly sexual and reproductive health (YFSRH) services for young people have high priority in many countries. Yet, little is known about the actual cost of delivering YFSRH services. This article analyses costs of a fully scaled up national youth clinic network (YCN) in Estonia.

  18. Cost-Effectiveness Analysis of Family Planning Services Offered by ...

    African Journals Online (AJOL)

    USER

    Keywords: Mobile clinics; Staic clinic; Family planning; Cost-effectiveness. Résumé ... revealed surprisingly low use of mobile clinic services ... provider point of view. Cost data ..... this is an even more attractive strategy than tying free IUDs to ...

  19. Predicting travel time variability for cost-benefit analysis

    NARCIS (Netherlands)

    Peer, S.; Koopmans, C.; Verhoef, E.T.

    2010-01-01

    Unreliable travel times cause substantial costs to travelers. Nevertheless, they are not taken into account in many cost-benefit-analyses (CBA), or only in very rough ways. This paper aims at providing simple rules on how variability can be predicted, based on travel time data from Dutch highways.

  20. Appendix W. Cost Analysis in Teacher Education Programs.

    Science.gov (United States)

    Sell, G. Roger; And Others

    This paper is an introduction to the basic cost-related tools available to management for planning, evaluating, and organizing resources for the purpose of achieving objectives within a teacher education preparation program. Three tools are presented in separate sections. Part I on the cost accounting tool for identifying, categorizing, and…