WorldWideScience

Sample records for cost analysis increased

  1. [Operating cost analysis of anaesthesia: activity based costing (ABC analysis)].

    Science.gov (United States)

    Majstorović, Branislava M; Kastratović, Dragana A; Vučović, Dragan S; Milaković, Branko D; Miličić, Biljana R

    2011-01-01

    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. In order to determine the actual value of anaestesiological services, we started with the analysis of activity based costing (ABC) analysis. 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 Healthcare 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 Healthcare Insurance. 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. 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.

  2. The Hepatitis C Genotype 1 Paradox: Cost per Treatment Is Increasing, but Cost per Cure Is Decreasing

    Directory of Open Access Journals (Sweden)

    Stephen D Shafran

    2015-01-01

    Full Text Available Significant attention has been focused on the perceived increase in the cost of antiviral treatment for hepatitis C genotype 1 infection since the approval of the first direct-acting antiviral agents in 2011. Using Canadian list prices, the present analysis points out a paradox: while the cost per antiviral regimen is increasing, the cost per cure is decreasing, especially with interferon-free therapy. In a publicly funded health care system, the lowest cost per cure is a more valuable measure of value for public money than the cost per regimen.

  3. The hepatitis C genotype 1 paradox: cost per treatment is increasing, but cost per cure is decreasing.

    Science.gov (United States)

    Shafran, Stephen D

    2015-01-01

    Significant attention has been focused on the perceived increase in the cost of antiviral treatment for hepatitis C genotype 1 infection since the approval of the first direct-acting antiviral agents in 2011. Using Canadian list prices, the present analysis points out a paradox: while the cost per antiviral regimen is increasing, the cost per cure is decreasing, especially with interferon-free therapy. In a publicly funded health care system, the lowest cost per cure is a more valuable measure of value for public money than the cost per regimen.

  4. Cost benefit analysis cost effectiveness analysis

    International Nuclear Information System (INIS)

    Lombard, J.

    1986-09-01

    The comparison of various protection options in order to determine which is the best compromise between cost of protection and residual risk is the purpose of the ALARA procedure. The use of decision-aiding techniques is valuable as an aid to selection procedures. The purpose of this study is to introduce two rather simple and well known decision aiding techniques: the cost-effectiveness analysis and the cost-benefit analysis. These two techniques are relevant for the great part of ALARA decisions which need the use of a quantitative technique. The study is based on an hypothetical case of 10 protection options. Four methods are applied to the data

  5. Cost and performance analysis of physical security systems

    International Nuclear Information System (INIS)

    Hicks, M.J.; Yates, D.; Jago, W.H.; Phillips, A.W.

    1998-04-01

    Analysis of cost and performance of physical security systems can be a complex, multi-dimensional problem. There are a number of point tools that address various aspects of cost and performance analysis. Increased interest in cost tradeoffs of physical security alternatives has motivated development of an architecture called Cost and Performance Analysis (CPA), which takes a top-down approach to aligning cost and performance metrics. CPA incorporates results generated by existing physical security system performance analysis tools, and utilizes an existing cost analysis tool. The objective of this architecture is to offer comprehensive visualization of complex data to security analysts and decision-makers

  6. National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis with Policy Implications

    OpenAIRE

    Harris, Catherine R.; Osterberg, E. Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W.; McAninch, Jack W.; McCulloch, Charles E.; Breyer, Benjamin N.

    2016-01-01

    To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality.We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear ...

  7. Costs and Outcomes of Increasing Access to Bariatric Surgery: Cohort Study and Cost-Effectiveness Analysis Using Electronic Health Records.

    Science.gov (United States)

    Gulliford, Martin C; Charlton, Judith; Prevost, Toby; Booth, Helen; Fildes, Alison; Ashworth, Mark; Littlejohns, Peter; Reddy, Marcus; Khan, Omar; Rudisill, Caroline

    2017-01-01

    To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity. Outcomes were quality-adjusted life-years (QALYs) and net monetary benefits at a threshold of £30,000 per QALY. In a UK population of 250,000 adults, there may be 7,163 people with morbid obesity including 1,406 with diabetes. The immediate cost of 1,000 bariatric surgical procedures is £9.16 million, with incremental discounted lifetime health care costs of £15.26 million (95% confidence interval £15.18-£15.36 million). Patient-years with diabetes mellitus will decrease by 8,320 (range 8,123-8,502). Incremental QALYs will increase by 2,142 (range 2,032-2,256). The estimated cost per QALY gained is £7,129 (range £6,775-£7,506). Net monetary benefits will be £49.02 million (range £45.72-£52.41 million). Estimates are similar for subgroups of age, sex, and deprivation. Bariatric surgery remains cost-effective if the procedure is twice as costly, or if intervention effect declines over time. Diverse obese individuals may benefit from bariatric surgery at acceptable cost. Bariatric surgery is not cost-saving, but increased health care costs are exceeded by health benefits to obese individuals. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Cost analysis guidelines

    International Nuclear Information System (INIS)

    Strait, R.S.

    1996-01-01

    The first phase of the Depleted Uranium Hexafluoride Management Program (Program)--management strategy selection--consists of several program elements: Technology Assessment, Engineering Analysis, Cost Analysis, and preparation of an Environmental Impact Statement (EIS). Cost Analysis will estimate the life-cycle costs associated with each of the long-term management strategy alternatives for depleted uranium hexafluoride (UF6). The scope of Cost Analysis will include all major expenditures, from the planning and design stages through decontamination and decommissioning. The costs will be estimated at a scoping or preconceptual design level and are intended to assist decision makers in comparing alternatives for further consideration. They will not be absolute costs or bid-document costs. The purpose of the Cost Analysis Guidelines is to establish a consistent approach to analyzing of cost alternatives for managing Department of Energy's (DOE's) stocks of depleted uranium hexafluoride (DUF6). The component modules that make up the DUF6 management program differ substantially in operational maintenance, process-options, requirements for R and D, equipment, facilities, regulatory compliance, (O and M), and operations risk. To facilitate a consistent and equitable comparison of costs, the guidelines offer common definitions, assumptions or basis, and limitations integrated with a standard approach to the analysis. Further, the goal is to evaluate total net life-cycle costs and display them in a way that gives DOE the capability to evaluate a variety of overall DUF6 management strategies, including commercial potential. The cost estimates reflect the preconceptual level of the designs. They will be appropriate for distinguishing among management strategies

  9. BENEFIT-COST ANALYSIS IN U.S. ENVIRONMENTAL REGULATORY DECISIONS

    OpenAIRE

    Easter, K. William; Archibald, Sandra O.

    1998-01-01

    As the number and cost of environmental regulations have increased over the last thirty years, the regulated community, taxpayers, and policy makers have begun to demand that the benefits of regulations justify their costs. The use of benefit-cost analysis as an integral part of developing new regulations is increasing and the demands and expectations being placed on the method have expanded. Although benefit-cost analysis is expected to play an even greater role in environmental decision mak...

  10. National Variation in Urethroplasty Cost and Predictors of Extreme Cost: A Cost Analysis With Policy Implications.

    Science.gov (United States)

    Harris, Catherine R; Osterberg, E Charles; Sanford, Thomas; Alwaal, Amjad; Gaither, Thomas W; McAninch, Jack W; McCulloch, Charles E; Breyer, Benjamin N

    2016-08-01

    To determine which factors are associated with higher costs of urethroplasty procedure and whether these factors have been increasing over time. Identification of determinants of extreme costs may help reduce cost while maintaining quality. We conducted a retrospective analysis using the 2001-2010 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS). The HCUP-NIS captures hospital charges which we converted to cost using the HCUP cost-to-charge ratio. Log cost linear regression with sensitivity analysis was used to determine variables associated with increased costs. Extreme cost was defined as the top 20th percentile of expenditure, analyzed with logistic regression, and expressed as odds ratios (OR). A total of 2298 urethroplasties were recorded in NIS over the study period. The median (interquartile range) calculated cost was $7321 ($5677-$10,000). Patients with multiple comorbid conditions were associated with extreme costs [OR 1.56, 95% confidence interval (CI) 1.19-2.04, P = .02] compared with patients with no comorbid disease. Inpatient complications raised the odds of extreme costs (OR 3.2, CI 2.14-4.75, P costs (OR 1.78, 95% CI 1.2-2.64, P = .005). Variations in patient age, race, hospital region, bed size, teaching status, payor type, and volume of urethroplasty cases were not associated with extremes of cost. Cost variation for perioperative inpatient urethroplasty procedures is dependent on preoperative patient comorbidities, postoperative complications, and surgical complexity related to graft usage. Procedural cost and cost variation are critical for understanding which aspects of care have the greatest impact on cost. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. PLACE OF PRODUCTION COSTS SYSTEM ANALYSIS IN SYSTEM ANALYSIS

    Directory of Open Access Journals (Sweden)

    Mariia CHEREDNYCHENKO

    2016-12-01

    Full Text Available Current economic conditions require the development and implementation of an adequate system of production costs, which would ensure a steady profit growth and production volumes in a highly competitive, constantly increasing input prices and tariffs. This management system must be based on an integrated production costs system analysis (PCSA, which would provide all operating costs management subsystems necessary information to design and make better management decisions. It provides a systematic analysis of more opportunities in knowledge, creating conditions of integrity mechanism knowledge object consisting of elements that show intersystem connections, each of which has its own defined and limited objectives, relationship with the environment.

  12. 20 CFR 404.270 - Cost-of-living increases.

    Science.gov (United States)

    2010-04-01

    ... INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.270 Cost-of-living... rises in the cost of living. These automatic increases also apply to other benefit amounts, as described...

  13. Costs in Swedish Public Transport : An analysis of cost drivers and cost efficiency in public transport contracts

    OpenAIRE

    Vigren, Andreas

    2015-01-01

    During the last seven years, the total cost for Swedish public transport provision has increased by over 30 percent in real terms according to figures from the government agency Transport Analysis. A similar pattern is found if considering a longer time span. Part of the cost increase can be attributed to an increased supply, and part is due to price increases on input factors that are measured by an industry index produced by the public transport industry. The fact that about half of the cos...

  14. 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...

  15. Management of End-Stage Ankle Arthritis: Cost-Utility Analysis Using Direct and Indirect Costs.

    Science.gov (United States)

    Nwachukwu, Benedict U; McLawhorn, Alexander S; Simon, Matthew S; Hamid, Kamran S; Demetracopoulos, Constantine A; Deland, Jonathan T; Ellis, Scott J

    2015-07-15

    Total ankle replacement and ankle fusion are costly but clinically effective treatments for ankle arthritis. Prior cost-effectiveness analyses for the management of ankle arthritis have been limited by a lack of consideration of indirect costs and nonoperative management. The purpose of this study was to compare the cost-effectiveness of operative and nonoperative treatments for ankle arthritis with inclusion of direct and indirect costs in the analysis. Markov model analysis was conducted from a health-systems perspective with use of direct costs and from a societal perspective with use of direct and indirect costs. Costs were derived from the 2012 Nationwide Inpatient Sample (NIS) and expressed in 2013 U.S. dollars; effectiveness was expressed in quality-adjusted life years (QALYs). Model transition probabilities were derived from the available literature. The principal outcome measure was the incremental cost-effectiveness ratio (ICER). In the direct-cost analysis for the base case, total ankle replacement was associated with an ICER of $14,500/QALY compared with nonoperative management. When indirect costs were included, total ankle replacement was both more effective and resulted in $5900 and $800 in lifetime cost savings compared with the lifetime costs following nonoperative management and ankle fusion, respectively. At a $100,000/QALY threshold, surgical management of ankle arthritis was preferred for patients younger than ninety-six years and total ankle replacement was increasingly more cost-effective in younger patients. Total ankle replacement, ankle fusion, and nonoperative management were the preferred strategy in 83%, 12%, and 5% of the analyses, respectively; however, our model was sensitive to patient age, the direct costs of total ankle replacement, the failure rate of total ankle replacement, and the probability of arthritis after ankle fusion. Compared with nonoperative treatment for the management of end-stage ankle arthritis, total ankle

  16. 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... tier II component at the time the survivor annuity begins, all cost-of-living increases that were...

  17. Evaluation of pavement life cycle cost analysis: Review and analysis

    Directory of Open Access Journals (Sweden)

    Peyman Babashamsi

    2016-07-01

    Full Text Available The cost of road construction consists of design expenses, material extraction, construction equipment, maintenance and rehabilitation strategies, and operations over the entire service life. An economic analysis process known as Life-Cycle Cost Analysis (LCCA is used to evaluate the cost-efficiency of alternatives based on the Net Present Value (NPV concept. It is essential to evaluate the above-mentioned cost aspects in order to obtain optimum pavement life-cycle costs. However, pavement managers are often unable to consider each important element that may be required for performing future maintenance tasks. Over the last few decades, several approaches have been developed by agencies and institutions for pavement Life-Cycle Cost Analysis (LCCA. While the transportation community has increasingly been utilising LCCA as an essential practice, several organisations have even designed computer programs for their LCCA approaches in order to assist with the analysis. Current LCCA methods are analysed and LCCA software is introduced in this article. Subsequently, a list of economic indicators is provided along with their substantial components. Collecting previous literature will help highlight and study the weakest aspects so as to mitigate the shortcomings of existing LCCA methods and processes. LCCA research will become more robust if improvements are made, facilitating private industries and government agencies to accomplish their economic aims. Keywords: Life-Cycle Cost Analysis (LCCA, Pavement management, LCCA software, Net Present Value (NPV

  18. The management of aldosterone-producing adrenal adenomas--does adrenalectomy increase costs?

    Science.gov (United States)

    Reimel, Bethann; Zanocco, Kyle; Russo, Mark J; Zarnegar, Rasa; Clark, Orlo H; Allendorf, John D; Chabot, John A; Duh, Quan-Yang; Lee, James A; Sturgeon, Cord

    2010-12-01

    Most experts agree that primary hyperaldosteronism (PHA) caused by an aldosterone-producing adenoma (APA) is best treated by adrenalectomy. From a public health standpoint, the cost of treatment must be considered. We sought to compare the current guideline-based (surgical) strategy with universal pharmacologic management to determine the optimal strategy from a cost perspective. A decision analysis was performed using a Markov state transition model comparing the strategies for PHA treatment. Pharmacologic management for all patients with PHA was compared with a strategy of screening for and resecting an aldosterone-producing adenoma. Success rates were determined for treatment outcomes based on a literature review. Medicare reimbursement rates were calculated to estimate costs from a third-party payer perspective. Screening for and resecting APAs was the least costly strategy in this model. For a reference patient with 41 remaining years of life, the discounted expected cost of the surgical strategy was $27,821. The discounted expected cost of the medical strategy was $34,691. The cost of adrenalectomy would have to increase by 156% to $22,525 from $8,784 for universal pharmacologic therapy to be less costly. Screening for APA is more costly if fewer than 9.6% of PHA patients have resectable APA. Resection of APAs was the least costly treatment strategy in this decision analysis model. Copyright © 2010 Mosby, Inc. All rights reserved.

  19. A managerial accounting analysis of hospital costs.

    Science.gov (United States)

    Frank, W G

    1976-01-01

    Variance analysis, an accounting technique, is applied to an eight-component model of hospital costs to determine the contribution each component makes to cost increases. The method is illustrated by application to data on total costs from 1950 to 1973 for all U.S. nongovernmental not-for-profit short-term general hospitals. The costs of a single hospital are analyzed and compared to the group costs. The potential uses and limitations of the method as a planning and research tool are discussed.

  20. 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.

  1. 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

  2. Cost-effectiveness of increasing bisphosphonates adherence for osteoporosis in community pharmacies

    NARCIS (Netherlands)

    Van Boven, J.F.M.; Oosterhof, P.; Hiddink, E.G.; Stuurman-Bieze, A.G.G.; Postma, M.J.; Vegter, S.

    2011-01-01

    OBJECTIVES: Increasing real-life adherence to bisphosphonates therapy is important to achieve the clinical benefits of reducing fractures reported in randomized clinical trials (RCTs). The aim of this pharmacoeconomic analysis was to determine the cost-effectiveness of a pharmaceutical care

  3. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad

    2014-01-01

    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......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...

  4. Cost-effectiveness of increasing access to mammography through mobile mammography for older women.

    Science.gov (United States)

    Naeim, Arash; Keeler, Emmett; Bassett, Lawrence W; Parikh, Jay; Bastani, Roshan; Reuben, David B

    2009-02-01

    To compare the costs of mobile and stationary mammography and examine the incremental cost-effectiveness of using mobile mammography to increase screening rates. A cost-effectiveness analysis was performed using effectiveness data from a randomized clinical trial and modeling of costs associated with the mobile mammography intervention. The trial involved 60 community-based meal sites, senior centers, and clubs. Four hundred ninety-nine individuals were enrolled in the study, of whom 463 had outcome data available for analysis. Costs were calculated for stationary and mobile mammography, as well as costs due to differences in technology and film versus digital. Incremental cost-effectiveness (cost per additional screen) was modeled, and sensitivity analysis was performed by altering efficiency (throughput) and effectiveness based on subgroup data from the randomized trial. The estimated annual costs were $435,162 for a stationary unit, $539,052 for a mobile film unit, and $456, 392 for a mobile digital unit. Assuming mobile units are less efficient (50% annual volume), the cost per screen was $41 for a stationary unit, $86 for a mobile film unit, and $102 for a mobile digital unit. The incremental cost per additional screen were $207 for a mobile film unit and $264 for a mobile digital unit over a stationary unit. Although mobile mammography is a more effective way to screen older women, the absolute cost per screen of mobile units is higher, whereas the reimbursement is no different. Financial barriers may impede the widespread use of this approach.

  5. E-learning: controlling costs and increasing value.

    Science.gov (United States)

    Walsh, Kieran

    2015-04-01

    E-learning now accounts for a substantial proportion of medical education provision. This progress has required significant investment and this investment has in turn come under increasing scrutiny so that the costs of e-learning may be controlled and its returns maximised. There are multiple methods by which the costs of e-learning can be controlled and its returns maximised. This short paper reviews some of those methods that are likely to be most effective and that are likely to save costs without compromising quality. Methods might include accessing free or low-cost resources from elsewhere; create short learning resources that will work on multiple devices; using open source platforms to host content; using in-house faculty to create content; sharing resources between institutions; and promoting resources to ensure high usage. Whatever methods are used to control costs or increase value, it is most important to evaluate the impact of these methods.

  6. 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.

  7. Increasing value in plagiocephaly care: a time-driven activity-based costing pilot study.

    Science.gov (United States)

    Inverso, Gino; Lappi, Michael D; Flath-Sporn, Susan J; Heald, Ronald; Kim, David C; Meara, John G

    2015-06-01

    Process management within a health care setting is poorly understood and often leads to an incomplete understanding of the true costs of patient care. Using time-driven activity-based costing methods, we evaluated the high-volume, low-complexity diagnosis of plagiocephaly to increase value within our clinic. A total of 59 plagiocephaly patients were evaluated in phase 1 (n = 31) and phase 2 (n = 28) of this study. During phase 1, a process map was created, encompassing each of the 5 clinicians and administrative personnel delivering 23 unique activities. After analysis of the phase 1 process maps, average times as well as costs of these activities were evaluated for potential modifications in workflow. These modifications were implemented in phase 2 to determine overall impact on visit-time and costs of care. Improvements in patient education, workflow coordination, and examination room allocation were implemented during phase 2, resulting in a reduced patient visit-time of 13:25 (19.9% improvement) and an increased cost of $8.22 per patient (7.7% increase) due to changes in physician process times. However, this increased cost was directly offset by the availability of 2 additional appointments per day, potentially generating $7904 of additional annual revenue. Quantifying the impact of a 19.9% reduction in patient visit-time at an increased cost of 7.7% resulted in an increased value ratio of 1.113. This pilot study effectively demonstrates the novel use of time-driven activity-based costing in combination with the value equation as a metric for continuous process improvement programs within the health care setting.

  8. Drilling cost analysis

    International Nuclear Information System (INIS)

    Anand, A.B.

    1992-01-01

    Drilling assumes greater importance in present day uranium exploration which emphasizes to explore more areas on the basis of conceptual model than merely on surface anomalies. But drilling is as costly as it is important and consumes a major share (50% to 60%) of the exploration budget. As such the cost of drilling has great bearing on the exploration strategy as well as on the overall cost of the project. Therefore, understanding the cost analysis is very much important when planning or intensifying an exploration programme. This not only helps in controlling the current operations but also in planning the budgetary provisions for future operations. Also, if the work is entrusted to a private party, knowledge of in-house cost analysis helps in fixing the rates of drilling in different formations and areas to be drilled. Under this topic, various factors that contribute to the cost of drilling per meter as well as ways to minimize the drilling cost for better economic evaluation of mineral deposits are discussed. (author)

  9. Cost-benefit analysis on FBR cycle R and D for the world

    International Nuclear Information System (INIS)

    Kawasaki, Hirotsugu

    2006-01-01

    This analysis was estimated on the assumption that the nuclear power generation will be changed by FBR and both LWR and FBR indicate same nuclear power generation cost and the environmental load. The cost-benefit analysis results on FBR cycle R and D in the world showed that increase of power generation cost with increase of uranium fuel cost will be avoided and decrease of power generation cost by introducing FBR. The cost-benefit analysis results on FBR cycle R and D in Japan showed that about 9 billions yen will be obtained by the above two economic effects. Cost-benefit effects by introducing FBR, economic estimation method of cost-benefit effect, range and contents of cost-benefit effect on FBR R and D, preconditions of evaluation, and evaluation results are explained. (S.Y.)

  10. 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....

  11. Dietary changes needed to reach nutritional adequacy without increasing diet cost according to income: An analysis among French adults.

    Directory of Open Access Journals (Sweden)

    Matthieu Maillot

    Full Text Available To explore the dietary changes needed to achieve nutritional adequacy across income levels at constant energy and diet cost.Individual diet modelling was used to design iso-caloric, nutritionally adequate optimised diets for each observed diet in a sample of adult normo-reporters aged ≥20 years (n = 1,719 from the Individual and National Dietary Survey (INCA2, 2006-2007. Diet cost was estimated from mean national food prices (2006-2007. A first set of free-cost models explored the impact of optimisation on the variation of diet cost. A second set of iso-cost models explored the dietary changes induced by the optimisation with cost set equal to the observed one. Analyses of dietary changes were conducted by income quintiles, adjusting for energy intake, sociodemographic and socioeconomic variables, and smoking status.The cost of observed diets increased with increasing income quintiles. In free-cost models, the optimisation increased diet cost on average (+0.22 ± 1.03 euros/d and within each income quintile, with no significant difference between quintiles, but with systematic increases for observed costs lower than 3.85 euros/d. In iso-cost models, it was possible to design nutritionally adequate diets whatever the initial observed cost. On average, the optimisation at iso-cost increased fruits and vegetables (+171 g/day, starchy foods (+121 g/d, water and beverages (+91 g/d, and dairy products (+20 g/d, and decreased the other food groups (e.g. mixed dishes and salted snacks, leading to increased total diet weight (+300 g/d. Those changes were mostly similar across income quintiles, but lower-income individuals needed to introduce significantly more fruit and vegetables than higher-income ones.In France, the dietary changes needed to reach nutritional adequacy without increasing cost are similar regardless of income, but may be more difficult to implement when the budget for food is lower than 3.85 euros/d.

  12. Cost Analysis In A Multi-Mission Operations Environment

    Science.gov (United States)

    Newhouse, M.; Felton, L.; Bornas, N.; Botts, D.; Roth, K.; Ijames, G.; Montgomery, P.

    2014-01-01

    Spacecraft control centers have evolved from dedicated, single-mission or single missiontype support to multi-mission, service-oriented support for operating a variety of mission types. At the same time, available money for projects is shrinking and competition for new missions is increasing. These factors drive the need for an accurate and flexible model to support estimating service costs for new or extended missions; the cost model in turn drives the need for an accurate and efficient approach to service cost analysis. The National Aeronautics and Space Administration (NASA) Huntsville Operations Support Center (HOSC) at Marshall Space Flight Center (MSFC) provides operations services to a variety of customers around the world. HOSC customers range from launch vehicle test flights; to International Space Station (ISS) payloads; to small, short duration missions; and has included long duration flagship missions. The HOSC recently completed a detailed analysis of service costs as part of the development of a complete service cost model. The cost analysis process required the team to address a number of issues. One of the primary issues involves the difficulty of reverse engineering individual mission costs in a highly efficient multimission environment, along with a related issue of the value of detailed metrics or data to the cost model versus the cost of obtaining accurate data. Another concern is the difficulty of balancing costs between missions of different types and size and extrapolating costs to different mission types. The cost analysis also had to address issues relating to providing shared, cloud-like services in a government environment, and then assigning an uncertainty or risk factor to cost estimates that are based on current technology, but will be executed using future technology. Finally the cost analysis needed to consider how to validate the resulting cost models taking into account the non-homogeneous nature of the available cost data and the

  13. Cost analysis and cost justification of automated data processing in the clinical laboratory.

    Science.gov (United States)

    Westlake, G E

    1983-03-01

    Prospective cost analysis of alternative data processing systems can be facilitated by proper selection of the costs to be analyzed and realistic appraisal of the effect on staffing. When comparing projects with dissimilar cash flows, techniques such as analysis of net present value can be helpful in identifying financial benefits. Confidence and accuracy in prospective analyses will increase as more retrospective studies are published. Several accounts now in the literature describe long-term experience with turnkey laboratory information systems. Acknowledging the difficulty in longitudinal studies, they all report favorable effects on labor costs and recovery of lost charges. Enthusiasm is also expressed for the many intangible benefits of the systems. Several trends suggest that cost justification and cost effectiveness will be more easily demonstrated in the future. These are the rapidly decreasing cost of hardware (with corresponding reduction in service costs) and the entry into the market of additional systems designed for medium to small hospitals. The effect of broadening the sales base may be lower software prices. Finally, operational and executive data management and reporting are destined to become the premier extensions of the LIS for cost justification. Aptly applied, these facilities can promote understanding of costs, control of costs, and greater efficiency in providing laboratory services.

  14. 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.

  15. 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.

  16. The determinants of hospital cost: a cost-volume-profit analysis of health services in the occupied territories: Palestine.

    Science.gov (United States)

    Younis, Mustafa Z; Jaber, Samer; Smith, Pamela C; Hartmann, Michael; Bongyu, Moye

    2010-06-01

    The purpose of this study is to examine the unit costs of a multi-service hospital in Palestine for the period 2005-2007. We investigate the cost structure of the Rafidya Hospital located in Nablus city, for both inpatient and outpatient departments. This study uses cost-volume-profit (CVP) analysis, also known as breakeven analysis. CVP analysis requires examining total costs, along with fixed and variable costs. CVP analysis illuminates how changes in assumptions about cost behaviour and the relevant range in which those assumptions are valid affect the relationships among revenues, variable costs and fixed costs at various production levels. For the hospital of interest, we find that fixed costs account for 70% of total costs, and variable costs were 30% of total costs. Inpatient departments accounted for 86% of total costs, and outpatient departments were 14% of total costs. Results of the breakeven analysis illustrate that several departments charge sufficient fees to cover all unit costs. Results provide useful information about unit cost based on four categories: (1) unit cost per admission of each department, (2) unit cost per patient day of each department, (3) unit cost per admission with annual capital cost of each department and (4) unit cost per patient day with annual capital cost. Our results provide hospital cost information that can be used by decision-makers to provide and expand healthcare services, in an effort to increase sustainability and profitability. The use of cost analysis by administrators and regulators will improve the quality of financial information, as well as enhance the efficient use of scarce resources.

  17. 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.

  18. 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 study included data from 627 patients. Risk factors associated with increased mortality were age > 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.

  19. An analysis of nuclear power plant operating costs

    International Nuclear Information System (INIS)

    1988-01-01

    This report presents the results of a statistical analysis of nonfuel operating costs for nuclear power plants. Most studies of the economic costs of nuclear power have focused on the rapid escalation in the cost of constructing a nuclear power plant. The present analysis found that there has also been substantial escalation in real (inflation-adjusted) nonfuel operating costs. It is important to determine the factors contributing to the escalation in operating costs, not only to understand what has occurred but also to gain insights about future trends in operating costs. There are two types of nonfuel operating costs. The first is routine operating and maintenance expenditures (O and M costs), and the second is large postoperational capital expenditures, or what is typically called ''capital additions.'' O and M costs consist mainly of expenditures on labor, and according to one recently completed study, the majoriy of employees at a nuclear power plant perform maintenance activities. It is generally thought that capital additions costs consist of large maintenance expenditures needed to keep the plants operational, and to make plant modifications (backfits) required by the Nuclear Regulatory Commission (NRC). Many discussions of nuclear power plant operating costs have not considered these capital additions costs, and a major finding of the present study is that these costs are substantial. The objective of this study was to determine why nonfuel operating costs have increased over the past decade. The statistical analysis examined a number of factors that have influenced the escalation in real nonfuel operating costs and these are discussed in this report. 4 figs, 19 tabs

  20. A cost benefit analysis of outsourced laboratory services.

    Science.gov (United States)

    Bowers, J A

    1995-11-01

    As healthcare moves toward increased capitation, hospital administrators must be aware of all costs associated with patient services. This article describes the cost benefit analysis process used by northern Indiana hospital consumers during 1994-1995 to evaluate a local laboratory service outsource provider, South Bend Medical Foundation (SBMF). In an effort to meet the best interests of the community at large, three competing hospitals, medical leadership, and the local outsource provider joined forces to ensure that cost effective quality services would be provided. Laboratory utilization patterns for common DRGs were also analyzed. The team created a reconfiguration analysis to help develop benchmark figures for consideration in future contract negotiations.

  1. 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

  2. An analysis of decommissioning costs

    International Nuclear Information System (INIS)

    Teunckens, L.; Loeschhorn, U.; Yanagihara, S.; Wren, G.; Menon, S.

    1992-01-01

    Within the OECD/NEA Cooperative Programme on Decommissioning a Task Group was set up early in 1989 to identify the reasons for the large variations in decommissioning cost estimates. The Task Group gathered cost data from 12 of the 14 projects in the Programme to form the basis of their analysis. They included reactors being decommissioned to various stages as well as fuel cycle facilities. The projects were divided into groups of projects with similar characteristics ('models') to facilitate the analysis of the cost distribution in each group of projects and the cost data was progressively refined by a dialogue between the Task Group and the project managers. A comparative analysis was then performed and project specific discrepancies were identified. The Task Group's report is summarized on the results of the comparative analysis as well as the lessons learnt by the Task Group in the acquisition and analysis of cost data from international decommissioning projects. (author) 5 tabs

  3. 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....

  4. Cost benefit analysis vs. referenda

    OpenAIRE

    Martin J. Osborne; Matthew A. Turner

    2007-01-01

    We consider a planner who chooses between two possible public policies and ask whether a referendum or a cost benefit analysis leads to higher welfare. We find that a referendum leads to higher welfare than a cost benefit analyses in "common value" environments. Cost benefit analysis is better in "private value" environments.

  5. Cost-effectiveness Analysis for Technology Acquisition.

    Science.gov (United States)

    Chakravarty, A; Naware, S S

    2008-01-01

    In a developing country with limited resources, it is important to utilize the total cost visibility approach over the entire life-cycle of the technology and then analyse alternative options for acquiring technology. The present study analysed cost-effectiveness of an "In-house" magnetic resonance imaging (MRI) scan facility of a large service hospital against outsourcing possibilities. Cost per unit scan was calculated by operating costing method and break-even volume was calculated. Then life-cycle cost analysis was performed to enable total cost visibility of the MRI scan in both "In-house" and "outsourcing of facility" configuration. Finally, cost-effectiveness analysis was performed to identify the more acceptable decision option. Total cost for performing unit MRI scan was found to be Rs 3,875 for scans without contrast and Rs 4,129 with contrast. On life-cycle cost analysis, net present value (NPV) of the "In-house" configuration was found to be Rs-(4,09,06,265) while that of "outsourcing of facility" configuration was Rs-(5,70,23,315). Subsequently, cost-effectiveness analysis across eight Figures of Merit showed the "In-house" facility to be the more acceptable option for the system. Every decision for acquiring high-end technology must be subjected to life-cycle cost analysis.

  6. Above Bonneville passage and propagation cost effectiveness analysis

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. 20 CFR 404.271 - When automatic cost-of-living increases apply.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When automatic cost-of-living increases apply... AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.271 When automatic cost-of-living increases apply. Besides increases in the primary insurance amounts...

  9. Cost benefit analysis for occupational radiation exposure

    International Nuclear Information System (INIS)

    Caruthers, G.F.; Rodgers, R.C.; Donohue, J.P.; Swartz, H.M.

    1978-01-01

    In the course of system design, many decisions must be made concerning different aspects of that particular system. The design of systems and components in a nuclear power plant has the added faction of occupational exposure experienced as a result of that design. This paper will deal with the different methods available to factor occupational exposure into design decisions. The ultimate goal is to have exposures related to the design 'As Low As Reasonably Achievable' or ALARA. To do this an analysis should be performed to show that the cost of reducing exposures any further cannot be justified in a cost-benefit analysis. In this paper examples will be given that will show that it is possible to change to a design which would increase occupational exposure somewhat but would increase the benefit over the cost of the extra exposure received. It will also be shown that some changes in design or additional equipment could be justified due to a reduction in exposure while some changes could not be justified on a reduction in exposure aspect alone but are justified on a time saving aspect such as during a refueling outage. (author)

  10. Cost analysis of robotic versus laparoscopic general surgery procedures.

    Science.gov (United States)

    Higgins, Rana M; Frelich, Matthew J; Bosler, Matthew E; Gould, Jon C

    2017-01-01

    Robotic surgical systems have been used at a rapidly increasing rate in general surgery. Many of these procedures have been performed laparoscopically for years. In a surgical encounter, a significant portion of the total costs is associated with consumable supplies. Our hospital system has invested in a software program that can track the costs of consumable surgical supplies. We sought to determine the differences in cost of consumables with elective laparoscopic and robotic procedures for our health care organization. De-identified procedural cost and equipment utilization data were collected from the Surgical Profitability Compass Procedure Cost Manager System (The Advisory Board Company, Washington, DC) for our health care system for laparoscopic and robotic cholecystectomy, fundoplication, and inguinal hernia between the years 2013 and 2015. Outcomes were length of stay, case duration, and supply cost. Statistical analysis was performed using a t-test for continuous variables, and statistical significance was defined as p robotic procedures. Length of stay did not differ for fundoplication or cholecystectomy. Length of stay was greater for robotic inguinal hernia repair. Case duration was similar for cholecystectomy (84.3 robotic and 75.5 min laparoscopic, p = 0.08), but significantly longer for robotic fundoplication (197.2 robotic and 162.1 min laparoscopic, p = 0.01) and inguinal hernia repair (124.0 robotic and 84.4 min laparoscopic, p = ≪0.01). We found a significantly increased cost of general surgery procedures for our health care system when cases commonly performed laparoscopically are instead performed robotically. Our analysis is limited by the fact that we only included costs associated with consumable surgical supplies. The initial acquisition cost (over $1 million for robotic surgical system), depreciation, and service contract for the robotic and laparoscopic systems were not included in this analysis.

  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; Manns, Braden J

    2013-12-01

    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. 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. 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. 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.

  12. Health Care Analysis for the MCRMC Insurance Cost Model

    Science.gov (United States)

    2015-06-01

    incentive to reduce utilization  Subsidy to leave TRICARE and use other private health insurance  Increases in TRICARE premiums and co-pays  This...analysis develops the estimated cost of providing health care through a premium -based insurance model consistent with an employer-sponsored benefit...State  Income  Plan premium data  Contract cost data 22 May 2015 9 Agenda  Overview  Background  Data  Insurance Cost Estimate Methodology

  13. 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

  14. Cost-effectiveness Analysis with Influence Diagrams.

    Science.gov (United States)

    Arias, M; Díez, F J

    2015-01-01

    Cost-effectiveness analysis (CEA) is used increasingly in medicine to determine whether the health benefit of an intervention is worth the economic cost. Decision trees, the standard decision modeling technique for non-temporal domains, can only perform CEA for very small problems. To develop a method for CEA in problems involving several dozen variables. We explain how to build influence diagrams (IDs) that explicitly represent cost and effectiveness. We propose an algorithm for evaluating cost-effectiveness IDs directly, i.e., without expanding an equivalent decision tree. The evaluation of an ID returns a set of intervals for the willingness to pay - separated by cost-effectiveness thresholds - and, for each interval, the cost, the effectiveness, and the optimal intervention. The algorithm that evaluates the ID directly is in general much more efficient than the brute-force method, which is in turn more efficient than the expansion of an equivalent decision tree. Using OpenMarkov, an open-source software tool that implements this algorithm, we have been able to perform CEAs on several IDs whose equivalent decision trees contain millions of branches. IDs can perform CEA on large problems that cannot be analyzed with decision trees.

  15. Eliminating Residents Increases the Cost of Care.

    Science.gov (United States)

    DeMarco, Deborah M; Forster, Richard; Gakis, Thomas; Finberg, Robert W

    2017-08-01

    Academic health centers are facing a potential reduction in Medicare financing for graduate medical education (GME). Both the Medicare Payment Advisory Commission and the National Commission on Fiscal Responsibility and Reform (Deficit Commission) have suggested cutting approximately half the funding that teaching hospitals receive for indirect medical education. Because of the effort that goes into teaching trainees, who are only transient employees, hospital executives often see teaching programs as a drain on resources. In light of the possibility of a Medicare cut to GME programs, we undertook an analysis to assess the financial risk of training programs to our institution and the possibility of saving money by reducing resident positions. The chief administrative officer, in collaboration with the hospital chief financial officer, performed a financial analysis to examine the possibility of decreasing costs by reducing residency programs at the University of Massachusetts Memorial Medical Center. Despite the real costs of our training programs, the analysis demonstrated that GME programs have a positive impact on hospital finances. Reducing or eliminating GME programs would have a negative impact on our hospital's bottom line.

  16. 20 CFR 225.43 - PIA's subject to cost-of-living increases.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false PIA's subject to cost-of-living increases... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.43 PIA's subject to cost-of-living increases. The Retirement Tier I, Overall Minimum, Survivor Tier I, Employee RIB and RLS...

  17. 20 CFR 225.44 - When a cost-of-living increase is payable.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false When a cost-of-living increase is payable... RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.44 When a cost-of-living increase is payable. A cost-of-living increase is payable beginning with December of the year for...

  18. The benefits of integrating cost-benefit analysis and risk assessment

    International Nuclear Information System (INIS)

    Fisher, K.; Clarke-Whistler, K.

    1995-01-01

    It has increasingly been recognized that knowledge of risks in the absence of benefits and costs cannot dictate appropriate public policy choices. Recent evidence of this recognition includes the proposed EPA Risk Assessment and Cost-Benefit Analysis Act of 1995, a number of legislative changes in Canada and the US, and the increasing demand for field studies combining measures of impacts, risks, costs and benefits. Failure to consider relative environmental and human health risks, benefits, and costs in making public policy decisions has resulted in allocating scarce resources away from areas offering the highest levels of risk reduction and improvements in health and safety. The authors discuss the implications of not taking costs and benefits into account in addressing environmental risks, drawing on examples from both Canada and the US. The authors also present the results of their recent field work demonstrating the advantages of considering costs and benefits in making public policy and site remediation decisions, including a study on the benefits and costs of prevention, remediation and monitoring techniques applied to groundwater contamination; the benefits and costs of banning the use of chlorine; and the benefits and costs of Canada's concept of disposing of high-level nuclear waste. The authors conclude that a properly conducted Cost-Benefit Analysis can provide critical input to a Risk Assessment and can ensure that risk management decisions are efficient, cost-effective and maximize improvement to environmental and human health

  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. 20 CFR 404.273 - When are automatic cost-of-living increases effective?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false When are automatic cost-of-living increases..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.273 When are automatic cost-of-living increases effective? We make automatic cost-of-living...

  1. Urban Land Cover Mapping Accuracy Assessment - A Cost-benefit Analysis Approach

    Science.gov (United States)

    Xiao, T.

    2012-12-01

    One of the most important components in urban land cover mapping is mapping accuracy assessment. Many statistical models have been developed to help design simple schemes based on both accuracy and confidence levels. It is intuitive that an increased number of samples increases the accuracy as well as the cost of an assessment. Understanding cost and sampling size is crucial in implementing efficient and effective of field data collection. Few studies have included a cost calculation component as part of the assessment. In this study, a cost-benefit sampling analysis model was created by combining sample size design and sampling cost calculation. The sampling cost included transportation cost, field data collection cost, and laboratory data analysis cost. Simple Random Sampling (SRS) and Modified Systematic Sampling (MSS) methods were used to design sample locations and to extract land cover data in ArcGIS. High resolution land cover data layers of Denver, CO and Sacramento, CA, street networks, and parcel GIS data layers were used in this study to test and verify the model. The relationship between the cost and accuracy was used to determine the effectiveness of each sample method. The results of this study can be applied to other environmental studies that require spatial sampling.

  2. Global variation in the cost of increasing ecosystem carbon

    Science.gov (United States)

    Larjavaara, Markku; Kanninen, Markku; Gordillo, Harold; Koskinen, Joni; Kukkonen, Markus; Käyhkö, Niina; Larson, Anne M.; Wunder, Sven

    2018-01-01

    Slowing the reduction, or increasing the accumulation, of organic carbon stored in biomass and soils has been suggested as a potentially rapid and cost-effective method to reduce the rate of atmospheric carbon increase1. The costs of mitigating climate change by increasing ecosystem carbon relative to the baseline or business-as-usual scenario has been quantified in numerous studies, but results have been contradictory, as both methodological issues and substance differences cause variability2. Here we show, based on 77 standardized face-to-face interviews of local experts with the best possible knowledge of local land-use economics and sociopolitical context in ten landscapes around the globe, that the estimated cost of increasing ecosystem carbon varied vastly and was perceived to be 16-27 times cheaper in two Indonesian landscapes dominated by peatlands compared with the average of the eight other landscapes. Hence, if reducing emissions from deforestation and forest degradation (REDD+) and other land-use mitigation efforts are to be distributed evenly across forested countries, for example, for the sake of international equity, their overall effectiveness would be dramatically lower than for a cost-minimizing distribution.

  3. 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

  4. 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...

  5. 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

  6. Multiple drug cost containment policies in Michigan's Medicaid program saved money overall, although some increased costs.

    Science.gov (United States)

    Kibicho, Jennifer; Pinkerton, Steven D

    2012-04-01

    Michigan's Medicaid program implemented four cost containment policies--preferred drug lists, joint and multistate purchasing arrangements, and maximum allowable cost--during 2002-04. The goal was to control growth of drug spending for beneficiaries who were enrolled in both Medicaid and Medicare and taking antihypertensive or antihyperlipidemic prescription drugs. We analyzed the impact of each policy while holding the effect of all other policies constant. Preferred drug lists increased both preferred and generic drugs' market share and reduced daily cost--the cost per day for each prescription provided to a beneficiary. In contrast, the maximum allowable cost policy increased daily cost and was the only policy that did not generate cost savings. The joint and multistate arrangements did not affect daily cost. Despite these policy trade-offs, the cumulative effect was a 10 percent decrease in daily cost and a total cost savings of $46,195 per year. Our findings suggest that policy makers need to evaluate the impact of multiple policies aimed at restraining drug spending, and further evaluate the policy trade-offs, to ensure that scarce public dollars achieve the greatest return for money spent.

  7. Impact of increased fuel costs and inflation on the cost of desalting sea water and brackish waters

    International Nuclear Information System (INIS)

    Reed, S.A.

    1976-01-01

    The combined increases in the cost of fuel, equipment, and money during the past four years have had a marked impact on the cost of desalting saline waters. The current costs of desalting seawater by distillation and reverse osmosis and brackish waters by reverse osmosis and electrodialysis as a function of plant size and feedwater chemistry are estimated. Typically, distillation plant capital costs have increased from dollar 1 per daily gallon to dollar 3 per daily gallon for large plants (100 Mgd) and from approximately dollar 1.40 per daily gallon to approximately dollar 5 per daily gallon per plant sizes of 5 Mgd or less. Consequently, water costs are now ranging from dollar 3 to dollar 4 per 1000 gal when oil is used to generate steam. Similarly, the costs of desalting inland brackish waters using reverse osmosis or electrodialysis have increased significantly

  8. Diagnostic staging laparoscopy in gastric cancer treatment: A cost-effectiveness analysis.

    Science.gov (United States)

    Li, Kevin; Cannon, John G D; Jiang, Sam Y; Sambare, Tanmaya D; Owens, Douglas K; Bendavid, Eran; Poultsides, George A

    2018-05-01

    Accurate preoperative staging helps avert morbidity, mortality, and cost associated with non-therapeutic laparotomy in gastric cancer (GC) patients. Diagnostic staging laparoscopy (DSL) can detect metastases with high sensitivity, but its cost-effectiveness has not been previously studied. We developed a decision analysis model to assess the cost-effectiveness of preoperative DSL in GC workup. Analysis was based on a hypothetical cohort of GC patients in the U.S. for whom initial imaging shows no metastases. The cost-effectiveness of DSL was measured as cost per quality-adjusted life-year (QALY) gained. Drivers of cost-effectiveness were assessed in sensitivity analysis. Preoperative DSL required an investment of $107 012 per QALY. In sensitivity analysis, DSL became cost-effective at a threshold of $100 000/QALY when the probability of occult metastases exceeded 31.5% or when test sensitivity for metastases exceeded 86.3%. The likelihood of cost-effectiveness increased from 46% to 93% when both parameters were set at maximum reported values. The cost-effectiveness of DSL for GC patients is highly dependent on patient and test characteristics, and is more likely when DSL is used selectively where procedure yield is high, such as for locally advanced disease or in detecting peritoneal and superficial versus deep liver lesions. © 2017 Wiley Periodicals, Inc.

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

    Science.gov (United States)

    Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

    2013-01-01

    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. 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. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (Phospitalizations 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. 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. However, purely market-oriented health-care reform could also misguide future healthcare reform.

  10. Can delivery systems use cost-effectiveness analysis to reduce healthcare costs and improve value?

    Science.gov (United States)

    Savitz, Lucy A; Savitz, Samuel T

    2016-01-01

    Understanding costs and ensuring that we demonstrate value in healthcare is a foundational presumption as we transform the way we deliver and pay for healthcare in the U.S. With a focus on population health and payment reforms underway, there is increased pressure to examine cost-effectiveness in healthcare delivery. Cost-effectiveness analysis (CEA) is a type of economic analysis comparing the costs and effects (i.e. health outcomes) of two or more treatment options. The result is expressed as a ratio where the denominator is the gain in health from a measure (e.g. years of life or quality-adjusted years of life) and the numerator is the incremental cost associated with that health gain. For higher cost interventions, the lower the ratio of costs to effects, the higher the value. While CEA is not new, the approach continues to be refined with enhanced statistical techniques and standardized methods. This article describes the CEA approach and also contrasts it to optional approaches, in order for readers to fully appreciate caveats and concerns. CEA as an economic evaluation tool can be easily misused owing to inappropriate assumptions, over reliance, and misapplication. Twelve issues to be considered in using CEA results to drive healthcare delivery decision-making are summarized. Appropriately recognizing both the strengths and the limitations of CEA is necessary for informed resource allocation in achieving the maximum value for healthcare services provided.

  11. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

    With increasing concerns regarding rapidly expanding healthcare costs, cost-effectiveness analysis allows assessment of whether marginal gains from new technology are worth the increased costs. Particular methodologic issues related to cost and cost-effectiveness analysis in the area of neonatal and periviable care include how costs are estimated, such as the use of charges and whether long-term costs are included; the challenges of measuring utilities; and whether to use a maternal, neonatal, or dual perspective in such analyses. A number of studies over the past three decades have examined the costs and the cost-effectiveness of neonatal and periviable care. Broadly, while neonatal care is costly, it is also cost effective as it produces both life-years and quality-adjusted life-years (QALYs). However, as the gestational age of the neonate decreases, the costs increase and the cost-effectiveness threshold is harder to achieve. In the periviable range of gestational age (22-24 weeks of gestation), whether the care is cost effective is questionable and is dependent on the perspective. Understanding the methodology and salient issues of cost-effectiveness analysis is critical for researchers, editors, and clinicians to accurately interpret results of the growing body of cost-effectiveness studies related to the care of periviable pregnancies and neonates. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. [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.

  13. Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD

    Directory of Open Access Journals (Sweden)

    Hübner, Claudia

    2015-10-01

    Full Text Available Aim: -associated diarrhea (CDAD causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.Method: A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.Results: 19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98, pharmaceuticals (€ 22.88 and laboratory (€ 17.44 are quite low.Conclusion: CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.

  14. How costly are carbon offsets : a meta-analysis of forest carbon sinks

    International Nuclear Information System (INIS)

    Van Kooten, G.C.; Eagle, A.J.; Manley, J.; Smolak, T.M.

    2004-01-01

    Carbon terrestrial sinks are one of the many proposed mitigation responses to climate change. Carbon sinks are considered to be a low-cost alternative to fuel switching and reduced fossil fuel consumption for reducing atmospheric carbon dioxide emissions. This study examined the costs of sequestering carbon in terrestrial ecosystems via forestry activities. A meta-regression analysis was used to determine which factors influence the costs of carbon sequestration via forest activities. Important concerns about how the Kyoto Protocol may be implemented were also addressed. The meta-regression analysis was used to examine 981 estimates from 55 studies on the cost of creating carbon offsets using forestry. Baseline cost estimates are US$46.62 to 260.29 per tC. Tree planting and agroforestry increases costs by more than 200 per cent. Costs are lowest when post-harvest storage of carbon in wood products is considered, or when biomass is substituted for fossil fuels in energy production. The meta-analysis also considered land use, land-use change and forestry (LULUCF) policies that increase the carbon sink functions of terrestrial ecosystems. The main motive for using sinks in the accounting process is that they avoid the use of expensive controls for the emission of carbon dioxide and other greenhouse gases. refs., tabs

  15. 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

  16. Instructional Cost Analysis: History and Present Inadequacies.

    Science.gov (United States)

    Humphrey, David A.

    The cost analysis of instruction is conducted according to principles of teaching and learning that have often become historically dated. Using today's costing systems prevents determination of whether cost effectiveness actually exists. The patterns of instruction in higher education and the systems employed for instructional cost analysis are…

  17. A cost-effectiveness and cost-utility analysis of radiosurgery vs. resection for single-brain metastases

    International Nuclear Information System (INIS)

    Mehta, Minesh; Noyes, William; Craig, Bruce; Lamond, John; Auchter, Richard; French, Molly; Johnson, Mark; Levin, Allan; Badie, Behnam; Robbins, Ian; Kinsella, Timothy

    1997-01-01

    determined. To calculate the societal or national impact of these practices, the proportion of patients potentially eligible for aggressive management was estimated and the financial impact was determined using various utilization ratios for radiosurgery and surgery. Results: Both resection and radiosurgery yielded superior survival and functional independence, compared to whole brain radiotherapy alone, with minor differences in outcome between the two modalities; resection resulted in a 1.8-fold increase in cost, compared to radiosurgery. The latter modality yielded superior cost outcomes on all measures, even when a sensitivity analysis of up to 50% was performed. A reversal estimate indicated that in order for surgery to yield equal cost effectiveness, its cost would have to decrease by 48% or median survival would have to improve by 108%. The average cost per week of survival was $310 for radiotherapy, $524 for resection plus radiation, and $270 for radiosurgery plus radiation. Conclusions: For selected patients, aggressive strategies such as resection or radiosurgery are warranted, as they result in improved median survival and functional independence. Radiosurgery appears to be the more cost-effective procedure

  18. 24 CFR 965.402 - Benefit/cost analysis.

    Science.gov (United States)

    2010-04-01

    ... 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... (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN...

  19. Fertility preservation for social indications: a cost-based decision analysis.

    Science.gov (United States)

    Hirshfeld-Cytron, Jennifer; Grobman, William A; Milad, Magdy P

    2012-03-01

    Age-related infertility remains a problem that assisted reproductive techniques (ART) have limited ability to overcome. Correspondingly, because an increasing number of women are choosing to delay childbearing, fertility preservation strategies, initially intended for patients undergoing gonadotoxic therapies, are being applied to this group of healthy women. Studies supporting the effectiveness of this practice are lacking. Decision analytic techniques. We compared the cost-effectiveness of three strategies for women planning delayed childbearing until age 40: oocyte cryopreservation at age 25, ovarian tissue cryopreservation (OTC) at age 25, and no assisted reproduction until spontaneous conception had been attempted. Not applicable. Not applicable. Cost-effectiveness, which was defined as the cost per live birth. In this analysis, the strategy of foregoing fertility preservation at age 25 and then choosing ART only after not spontaneously conceiving at age 40 was the most cost-effective option. OTC was dominated by the other strategies. Sensitivity analyses demonstrated the robustness of the model; no analysis existed in which OTC was not dominated by oocyte cryopreservation. Increasing the cost of an IVF cycle beyond $22,000 was the only situation in which oocyte cryopreservation was the most preferred strategy. Neither oocyte cryopreservation nor OTC appear to be cost-effective under current circumstances for otherwise healthy women planning delayed childbearing. This analysis should give pause to the current practice of offering fertility preservation based only on the desire for delayed childbearing. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. 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

    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...... in average direct (3,255 euro (3,703 euro) versus 4,186 euro) and total costs (10,409 euro (9,399 euro) versus 10,667 euro). The effect in group B is, however, better than in group A with no significant differences in costs. The results are insensitive to a range of assumptions regarding costs, effects...

  1. Cost analysis of in vitro fertilization.

    Science.gov (United States)

    Stern, Z; Laufer, N; Levy, R; Ben-Shushan, D; Mor-Yosef, S

    1995-08-01

    In vitro fertilization (IVF) has become a routine tool in the arsenal of infertility treatments. Assisted reproductive techniques are expensive, as reflected by the current "take home baby" rate of about 15% per cycle, implying the need for repeated attempts until success is achieved. Israel, today is facing a major change in its health care system, including the necessity to define a national package of health care benefits. The issue of infertility and whether its treatment should be part of the "health basket" is in dispute. Therefore an exact cost analysis of IVF is important. Since the cost of an IVF cycle varies dramatically between countries, we sought an exact breakdown of the different components of the costs involved in an IVF cycle and in achieving an IVF child in Israel. The key question is not how much we spend on IVF cycles but what is the cost of a successful outcome, i.e., a healthy child. This study intends to answer this question, and to give the policy makers, at various levels of the health care system, a crucial tool for their decision-making process. The cost analysis includes direct and indirect costs. The direct costs are divided into fixed costs (labor, equipment, maintenance, depreciation, and overhead) and variable costs (laboratory tests, chemicals, disposable supplies, medications, and loss of working days by the couples). The indirect costs are the costs of premature IVF babies, hospitalization of the IVF pregnant women in a high risk unit, and the cost of complications of the procedure. According to our economic analysis, an IVF cycle in Israel costs $2,560, of which fixed costs are about 50%. The cost of a "take home baby" is $19,267, including direct and indirect costs.

  2. 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.

  3. Brain Network Analysis: Separating Cost from Topology Using Cost-Integration

    Science.gov (United States)

    Ginestet, Cedric E.; Nichols, Thomas E.; Bullmore, Ed T.; Simmons, Andrew

    2011-01-01

    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. PMID:21829437

  4. 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)

  5. 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.

  6. Neuraxial blockade for external cephalic version: Cost analysis.

    Science.gov (United States)

    Yamasato, Kelly; Kaneshiro, Bliss; Salcedo, Jennifer

    2015-07-01

    Neuraxial blockade (epidural or spinal anesthesia/analgesia) with external cephalic version increases the external cephalic version success rate. Hospitals and insurers may affect access to neuraxial blockade for external cephalic version, but the costs to these institutions remain largely unstudied. The objective of this study was to perform a cost analysis of neuraxial blockade use during external cephalic version from hospital and insurance payer perspectives. Secondarily, we estimated the effect of neuraxial blockade on cesarean delivery rates. A decision-analysis model was developed using costs and probabilities occurring prenatally through the delivery hospital admission. Model inputs were derived from the literature, national databases, and local supply costs. Univariate and bivariate sensitivity analyses and Monte Carlo simulations were performed to assess model robustness. Neuraxial blockade was cost saving to both hospitals ($30 per delivery) and insurers ($539 per delivery) using baseline estimates. From both perspectives, however, the model was sensitive to multiple variables. Monte Carlo simulation indicated neuraxial blockade to be more costly in approximately 50% of scenarios. The model demonstrated that routine use of neuraxial blockade during external cephalic version, compared to no neuraxial blockade, prevented 17 cesarean deliveries for every 100 external cephalic versions attempted. Neuraxial blockade is associated with minimal hospital and insurer cost changes in the setting of external cephalic version, while reducing the cesarean delivery rate. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

  7. Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

    Science.gov (United States)

    Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

    2018-01-01

    Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

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

    Directory of Open Access Journals (Sweden)

    C. Raineri

    2015-08-01

    Full Text Available 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.

  9. Environmentally based Cost-Benefit Analysis

    International Nuclear Information System (INIS)

    Magnell, M.

    1993-11-01

    The fundamentals of the basic elements of a new comprehensive economic assessment, MILA, developed in Sweden with inspiration from the Total Cost Assessment-model are presented. The core of the MILA approach is an expanded cost and benefit inventory. But MILA also includes a complementary addition of an internal waste stream analysis, a tool for evaluation of environmental conflicts in monetary terms, an extended time horizon and direct allocation of costs and revenues to products and processes. However, MILA does not ensure profitability for environmentally sound projects. Essentially, MILA is an approach of refining investment and profitability analysis of a project, investment or product. 109 refs., 38 figs

  10. Cost-effectiveness analysis in minimally invasive spine surgery.

    Science.gov (United States)

    Al-Khouja, Lutfi T; Baron, Eli M; Johnson, J Patrick; Kim, Terrence T; Drazin, Doniel

    2014-06-01

    Medical care has been evolving with the increased influence of a value-based health care system. As a result, more emphasis is being placed on ensuring cost-effectiveness and utility in the services provided to patients. This study looks at this development in respect to minimally invasive spine surgery (MISS) costs. A literature review using PubMed, the Cost-Effectiveness Analysis (CEA) Registry, and the National Health Service Economic Evaluation Database (NHS EED) was performed. Papers were included in the study if they reported costs associated with minimally invasive spine surgery (MISS). If there was no mention of cost, CEA, cost-utility analysis (CUA), quality-adjusted life year (QALY), quality, or outcomes mentioned, then the article was excluded. Fourteen studies reporting costs associated with MISS in 12,425 patients (3675 undergoing minimally invasive procedures and 8750 undergoing open procedures) were identified through PubMed, the CEA Registry, and NHS EED. The percent cost difference between minimally invasive and open approaches ranged from 2.54% to 33.68%-all indicating cost saving with a minimally invasive surgical approach. Average length of stay (LOS) for minimally invasive surgery ranged from 0.93 days to 5.1 days compared with 1.53 days to 12 days for an open approach. All studies reporting EBL reported lower volume loss in an MISS approach (range 10-392.5 ml) than in an open approach (range 55-535.5 ml). There are currently an insufficient number of studies published reporting the costs of MISS. Of the studies published, none have followed a standardized method of reporting and analyzing cost data. Preliminary findings analyzing the 14 studies showed both cost saving and better outcomes in MISS compared with an open approach. However, more Level I CEA/CUA studies including cost/QALY evaluations with specifics of the techniques utilized need to be reported in a standardized manner to make more accurate conclusions on the cost effectiveness of

  11. Cost Accounting as a Tool for Increasing Cost Transparency in Selective Hepatic Transarterial Chemoembolization.

    Science.gov (United States)

    Ahmed, Osman; Patel, Mikin; Ward, Thomas; Sze, Daniel Y; Telischak, Kristen; Kothary, Nishita; Hofmann, Lawrence V

    2015-12-01

    To increase cost transparency and uncover potential areas for savings in patients receiving selective transarterial chemoembolization at a tertiary care academic center. The hospital cost accounting system charge master sheet for direct and total costs associated with selective transarterial chemoembolization in fiscal years 2013 and 2014 was queried for each of the four highest volume interventional radiologists at a single institution. There were 517 cases (range, 83-150 per physician) performed; direct costs incurred relating to care before, during, and after the procedure with respect to labor, supply, and equipment fees were calculated. A median of 48 activity codes were charged per selective transarterial chemoembolization from five cost centers, represented by the angiography suite, units for care before and after the procedure, pharmacy, and observation floors. The average direct cost of selective transarterial chemoembolization did not significantly differ among operators at $9,126.94, $8,768.77, $9,027.33, and $8,909.75 (P = .31). Intraprocedural costs accounted for 82.8% of total direct costs and provided the greatest degree in cost variability ($7,268.47-$7,691.27). The differences in intraprocedural expense among providers were not statistically significant (P = .09), even when separated into more specific procedure-related labor and supply costs. Cost accounting systems could effectively be interrogated as a method for calculating direct costs associated with selective transarterial chemoembolization. The greatest source of expenditure and variability in cost among providers was shown to be intraprocedural labor and supplies, although the effect did not appear to be operator dependent. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  12. Cost analysis methodology of spent fuel storage

    International Nuclear Information System (INIS)

    1994-01-01

    The report deals with the cost analysis of interim spent fuel storage; however, it is not intended either to give a detailed cost analysis or to compare the costs of the different options. This report provides a methodology for calculating the costs of different options for interim storage of the spent fuel produced in the reactor cores. Different technical features and storage options (dry and wet, away from reactor and at reactor) are considered and the factors affecting all options defined. The major cost categories are analysed. Then the net present value of each option is calculated and the levelized cost determined. Finally, a sensitivity analysis is conducted taking into account the uncertainty in the different cost estimates. Examples of current storage practices in some countries are included in the Appendices, with description of the most relevant technical and economic aspects. 16 figs, 14 tabs

  13. 20 CFR 404.275 - How is an automatic cost-of-living increase calculated?

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false How is an automatic cost-of-living increase..., SURVIVORS AND DISABILITY INSURANCE (1950- ) Computing Primary Insurance Amounts Cost-Of-Living Increases § 404.275 How is an automatic cost-of-living increase calculated? (a) Increase based on the CPI. We...

  14. 24 CFR 84.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Cost and price analysis. 84.45....45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various...

  15. 43 CFR 12.945 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Cost and price analysis. 12.945 Section 12... Requirements § 12.945 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

  16. 22 CFR 145.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cost and price analysis. 145.45 Section 145.45....45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various...

  17. QUANTIFYING BENEFITS FOR COST-BENEFIT ANALYSIS

    OpenAIRE

    Attila GYORGY; Nicoleta VINTILA; Florian GAMAN

    2014-01-01

    Cost Benefit Analysis is one of the most widely used financial tools to select future investment projects in public and private sector. This method is based on comparing costs and benefits in terms of constant prices. While costs are easier to predict and monetize, the benefits should be identified not only in direct relation with the investment, but also widening the sphere of analysis to indirect benefits experienced by the community from the neighbourhood or the whole society. During finan...

  18. 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),...

  19. Increased length of stay and costs associated with weekend admissions for failure to thrive.

    Science.gov (United States)

    Thompson, Rachel T; Bennett, William E; Finnell, S Maria E; Downs, Stephen M; Carroll, Aaron E

    2013-03-01

    To evaluate whether admission day of the week affects the length of stay (LOS) and health care costs for failure to thrive (FTT) admissions. Administrative data were obtained for all children aged <2 years (N = 23 332) with a primary admission diagnosis of FTT from 2003-2011 from 42 freestanding US hospitals. Demographic characteristics, day of admission, LOS, costs per stay, number of discharge diagnoses, primary discharge diagnoses, primary procedure code, number of radiologic and laboratory units billed during admission were obtained for each admission. Linear regression and zero-truncated Poisson regression were used for analysis. Weekend admission was significantly correlated with increased LOS and increased average cost (P < .002). This finding was also true for children with both admission and discharge diagnoses of FTT (P < .001). The number of procedures for children admitted on the weekend was not significantly different compared with children admitted on the weekdays (incident rate ratio [IRR]:1.04 [95% confidence interval (CI): 0.99-1.09]). However, weekend admissions did have more radiologic studies (IRR: 1.13 [95% CI: 1.10-1.16]) and laboratory tests (IRR: 1.39 [95% CI: 1.38-1.40]) performed. If one-half of weekend admissions in 2010 with both admission and discharge diagnoses of FTT were converted to Monday admissions, total savings in health care dollars for 2010 would be $534, 145. Scheduled FTT admissions on weekends increased LOS and health care costs compared with weekday admissions of similar levels of complexity. Reduction in planned weekend admissions for FTT could significantly reduce health care costs.

  20. 29 CFR 95.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 1 2010-07-01 2010-07-01 true Cost and price analysis. 95.45 Section 95.45 Labor Office of... Procurement Standards § 95.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

  1. Incremental ALARA cost/benefit computer analysis

    International Nuclear Information System (INIS)

    Hamby, P.

    1987-01-01

    Commonwealth Edison Company has developed and is testing an enhanced Fortran Computer Program to be used for cost/benefit analysis of Radiation Reduction Projects at its six nuclear power facilities and Corporate Technical Support Groups. This paper describes a Macro-Diven IBM Mainframe Program comprised of two different types of analyses-an Abbreviated Program with fixed costs and base values, and an extended Engineering Version for a detailed, more through and time-consuming approach. The extended engineering version breaks radiation exposure costs down into two components-Health-Related Costs and Replacement Labor Costs. According to user input, the program automatically adjust these two cost components and applies the derivation to company economic analyses such as replacement power costs, carrying charges, debt interest, and capital investment cost. The results from one of more program runs using different parameters may be compared in order to determine the most appropriate ALARA dose reduction technique. Benefits of this particular cost / benefit analysis technique includes flexibility to accommodate a wide range of user data and pre-job preparation, as well as the use of proven and standardized company economic equations

  2. Governance Based on Cost Analysis (Unit Cost Analysis for Vocational Schools

    Directory of Open Access Journals (Sweden)

    Chandra Situmeang

    2018-02-01

    Full Text Available This study aims to calculate unit cost to produce one middle-level vocational school graduate (in Indonesian terms known as "Sekolah Menengah Kejuruan” abbreviated as SMK. The calculation is required because operational grant funds (in Indonesian terms known as antuan Operasional Sekolah abbreviated as BOS are distributed so far to the same extent in all areas of Indonesia and for all majors. This is most likely less than optimal because in fact there are very basic characteristics differences including; Economic capacity of each region, the cost standard for each region, and the type of department in the school. Based on this, the researcher assumed that cost analysis should be done by considering these things as a basis to provide BOS funds tailored to specific characteristics. The data to be analyzed in this research is North Sumatra province data. This research is conducted in two stages, which in this report only completed the first phase which is a survey in North Sumatra region. Stages of survey to obtain data which then analyzed with related data such as community income, learning outcomes through the value of national examinations, tuition fee, and conditions of learning facilities. The research is funded by the ministries of research, technology and higher education through competing grant schemes for fiscal year 2017 and 2018. The result of correlation analysis between the variables shows that there is a strong relationship between the average income with average tuition paid by the community and between average tuition paid by the community with Quality Level of Education Facilities. The result of correlation analysis also shows a moderate relationship between the average tuition with learning outcomes measured through average national exam and relationship between quality level of education facilities with average national exam. While the relationship between average income with average national exam does not have a strong

  3. 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.

  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. A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

    OpenAIRE

    PETE Stefan; CARDOS Ildiko Reka

    2010-01-01

    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...

  6. Cost trend analysis of initial cancer treatment in Taiwan.

    Directory of Open Access Journals (Sweden)

    Tsai-Yun Li

    Full Text Available BACKGROUND: Despite the high cost of initial cancer care, that is, care in the first year after diagnosis, limited information is available for specific categories of cancer-related costs, especially costs for specific services. This study purposed to identify causes of change in cancer treatment costs over time and to perform trend analyses of the percentage of cancer patients who had received a specific treatment type and the mean cost of care for patients who had received that treatment. METHODOLOGY/PRINCIPAL FINDINGS: The analysis of trends in initial treatment costs focused on cancer-related surgery, chemotherapy, radiation therapy, and treatments other than active treatments. For each cancer-specific trend, slopes were calculated for regression models with 95% confidence intervals. Analyses of patients diagnosed in 2007 showed that the National Health Insurance (NHI system paid, on average, $10,780 for initial care of a gastric cancer patient and $10,681 for initial care of a lung cancer patient, which were inflation-adjusted increases of $6,234 and $5,522, respectively, over the 1996 care costs. During the same interval, the mean NHI payment for initial care for the five specific cancers increased significantly (p<0.05. Hospitalization costs comprised the largest portion of payments for all cancers. During 1996-2007, the use of chemotherapy and radiation therapy significantly increased in all cancer types (p<0.05. In 2007, NHI payments for initial care for these five cancers exceeded $12 billion, and gastric and lung cancers accounted for the largest share. CONCLUSIONS/SIGNIFICANCE: In addition to the growing number of NHI beneficiaries with cancer, treatment costs and the percentage of patients who undergo treatment are growing. Therefore, the NHI must accurately predict the economic burden of new chemotherapy agents and radiation therapies and may need to develop programs for stratifying patients according to their potential benefit

  7. 7 CFR 550.47 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost and price analysis. 550.47 Section 550.47... OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS Management of Agreements Procurement Standards § 550.47 Cost and price analysis. Some form of cost or price analysis shall...

  8. 40 CFR 35.6585 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Cost and price analysis. 35.6585... Response Actions Procurement Requirements Under A Cooperative Agreement § 35.6585 Cost and price analysis. (a) General. The recipient must conduct and document a cost or price analysis in connection with...

  9. DENINT power plant cost benefit analysis code: Analysis of methane fuelled power plant/district heating system

    International Nuclear Information System (INIS)

    Cincotti, V.; D'Andrea, A.

    1989-07-01

    The DENINT power plant cost benefit analysis code takes into consideration, not only power production costs at the generator terminals, but also, in the case of cogeneration, the costs of the fuel supply and heat and power distribution systems which depend greatly on the location of the plant. The code is able to allow comparisons of alternatives with varying annual operation hours, fuel cost increases, and different types of fossil fuels and production systems. For illustrative purposes, this paper examines two methane fired cogeneration plant/district heating alternatives

  10. Model reduction by weighted Component Cost Analysis

    Science.gov (United States)

    Kim, Jae H.; Skelton, Robert E.

    1990-01-01

    Component Cost Analysis considers any given system driven by a white noise process as an interconnection of different components, and assigns a metric called 'component cost' to each component. These component costs measure the contribution of each component to a predefined quadratic cost function. A reduced-order model of the given system may be obtained by deleting those components that have the smallest component costs. The theory of Component Cost Analysis is extended to include finite-bandwidth colored noises. The results also apply when actuators have dynamics of their own. Closed-form analytical expressions of component costs are also derived for a mechanical system described by its modal data. This is very useful to compute the modal costs of very high order systems. A numerical example for MINIMAST system is presented.

  11. ANALYSIS BENEFIT COST RATIO OF BIOCHAR IN AGRICULTURE LAND TO INCREASE INCOME HOUSEHOLD IN MERAUKE REGENCY

    Directory of Open Access Journals (Sweden)

    Maria Magdalena Diana Widiastuti

    2016-08-01

    Full Text Available Biochar has been proven to increase the availability of soil nutrient, yield productivity and farmers income. Biochar can be made from forestry/agricultural waste and do not required high technology. The objective of this study were: (1 to analyze Benefit Cost Ratio (BCR of biochar made from rice husk, (2 to compare yield productivity of paddy with biochar treatment, and (3 to analyze of paddy farming system with biochar treatment. The methodology by using BCR and productivity approach. The result showed that, firstly, the BCR of biochar from rice husks was 1.35 which indicated that biochar productivity as feasible. Secondly, the provision of biochar and fertilizer on agricultural could increase rice productivity of 4.2 ton/ha (control treatment to 5.5 ton/ha (treatment biochar + organic fertilizer and 6 ton/ha (treatment biochar + organic fertilizer + chemical fertilizers. Thirdly, the benefit cost ratio of paddy farming system for control treatment (1.54, higher than biochar+organic fertilizer treatment (1.46 and biochar+organic fertilizer+chemical fertilizer treatment.

  12. Social cost-benefit analysis and nuclear futures

    International Nuclear Information System (INIS)

    Pearce, D.W.

    1979-01-01

    The usefulness of cost-benefit analysis in making nuclear power investment decisions is considered. The essence of social cost-benefit analysis is outlined and shown to be unavoidably value-laden. As a case study six issues relevant to the decision to build on oxide fuel reprocessing plant (THORP) are examined. The potential practical value of using cost-benefit analysis as an aid to decision-making is considered for each of these issues. It is concluded that cost-benefit approach is of limited value in the nuclear power case because of its inapplicability to such issues as the liberty of the individual and nuclear weapons proliferation. (author)

  13. Cost analysis and provider satisfaction with pediatrician in triage.

    Science.gov (United States)

    Kezirian, Janice; Muhammad, Warees T; Wan, Jim Y; Godambe, Sandip A; Pershad, Jay

    2012-10-01

    The goals of this study were to (1) conduct a cost-benefit analysis, from a hospital's perspective, of using a pediatrician in triage (PIT) in the emergency department (ED) and (2) assess the impact of a physician in triage on provider satisfaction. This was a prospective, controlled trial of PIT (intervention) versus conventional registered nurse-driven triage (control), at an urban, academic, tertiary level pediatric ED, which led to a cost-benefit analysis by looking at the effect that PIT has on length of stay (LOS) and thus on ED revenue. Provider satisfaction was assessed through surveys. During the 8-week study period, a total of 6579 patients were triaged: 3242 in the PIT group and 3337 in the control group. The 2 groups were similar in age, sex, admission rate, left-without-being-seen rate, and level of acuity. The mean LOS in the PIT group was 24.3 minutes shorter than in the control group. The costs of PIT seem to be increased and are not offset by savings; the net margin (total revenue minus costs) was $42,883 per year lower in the PIT than in the control group. Sensitivity analysis showed that if the LOS were reduced by more than 98.4 minutes, the cost savings would favor PIT. Most of the physicians and nurses (67%) reported that PIT facilitated their job. Placement of a PIT during periods of peak census resulted in shorter stay and notable provider satisfaction but at an incremental cost of $42,883 per year.

  14. 14 CFR 1274.506 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost and price analysis. 1274.506 Section... WITH COMMERCIAL FIRMS Procurement Standards § 1274.506 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every...

  15. 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.

  16. 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

  17. Cost analysis of soil-depressurization techniques for indoor radon reduction

    International Nuclear Information System (INIS)

    Henschel, D.B.

    1991-01-01

    The article discusses a parametric cost analysis to evaluate active soil depressurization (ASD) systems for indoor radon reduction in houses. The analysis determined the relative importance of 14 ASD design variables and 2 operating variables on the installation and operating costs of residential ASD systems in several types of houses. Knowledge of the most important variables would enable EPA's research and development efforts to be more effectively directed at ways to reduce ASD costs and thus to increase utilization of the technology. Parameters offering the greatest potential for reductions in installation costs included three dealing with houses with poor subslab communication: (1) reducing the number of subslab depressurization pipes; (2) eliminating excavation of large subslab pits beneath the suction pipes to improve suction field extension; and (3) improving the effectiveness of premitigation subslab communication diagnostic testing in achieving simpler, less expensive ASD system designs. In addition, determining acceptable conditions for discharging ASD exhaust at grade level would reduce installation costs. Better design guidance for crawl-space submembrane depressurization (SMD) systems could reduce installation costs, if difficult membrane sealing steps and complete coverage of the crawl-space floor by the membrane can be avoided

  18. Cost-benefit analysis: reality or illusion

    International Nuclear Information System (INIS)

    Tait, G.W.C.

    1980-01-01

    The problems encountered in the application of cost-benefit analysis to the setting of acceptable radiation exposure levels are discussed, in particular the difficulty of assigning a monetary value to human life or disability, and the fact that the customary optimization of cost-benefit is not consistent with the ICRP dose limitation system, especially the ALARA principle. It is concluded that the present ICRP recommendations should remain the basis of exposure control while a carefully limited use of cost-benefit analysis may be helpful in some cases. (U.K.)

  19. Development of cost-benefit analysis system

    International Nuclear Information System (INIS)

    Shiba, Tsuyoshi; Mishima, Tetsuya; Yuyama, Tomonori; Suzuki, Atsushi

    2001-01-01

    In order to promote the FDR development, it is necessary to see various benefits brought by introduction of FBR from multiple perspectives and have a good grasp of such benefits quantitatively and an adequate R and D investment scale which corresponds with them. In this study, the structured prototype in the previous study was improved to be able to perform cost-benefit analysis. An example of improvement made in the system is addition of subroutine used for comparison between new energy and benefits brought by introduction of FBR with special emphasis on addition of logic for analyzing externality about the new energy. Other improvement examples are modification of the Conventional Year Expense Ratio method of power generation cost to Average Durable Year Cost method, addition of database function and turning input data into database, and reviewing idea on cost by the type of waste material and price of uranium. The cost-benefit analysis system was also restructured utilizing Microsoft ACCESS so that it should have a data base function. As the result of the improvement mentioned above, we expect that the improved cost-benefit analysis system will have higher generality than the system before; therefore, great deal of benefits brought by application of the system in the future is expected. (author)

  20. Nuclear power company activity based costing management analysis

    International Nuclear Information System (INIS)

    Xu Dan

    2012-01-01

    With Nuclear Energy Industry development, Nuclear Power Company has the continual promoting stress of inner management to the sustainable marketing operation development. In view of this, it is very imminence that Nuclear Power Company should promote the cost management levels and built the nuclear safety based lower cost competitive advantage. Activity based costing management (ABCM) transfer the cost management emphases from the 'product' to the 'activity' using the value chain analysis methods, cost driver analysis methods and so on. According to the analysis of the detail activities and the value chains, cancel the unnecessary activity, low down the resource consuming of the necessary activity, and manage the cost from the source, achieve the purpose of reducing cost, boosting efficiency and realizing the management value. It gets the conclusion from the detail analysis with the nuclear power company procedure and activity, and also with the selection to 'pieces analysis' of the important cost related project in the nuclear power company. The conclusion is that the activities of the nuclear power company has the obviously performance. It can use the management of ABC method. And with the management of the procedure and activity, it is helpful to realize the nuclear safety based low cost competitive advantage in the nuclear power company. (author)

  1. Analysis of costs-benefits tradeoffs of complex security systems

    International Nuclear Information System (INIS)

    Hicks, M.J.

    1996-01-01

    Essential to a systems approach to design of security systems is an analysis of the cost effectiveness of alternative designs. While the concept of analysis of costs and benefits is straightforward, implementation can be at the least tedious and, for complex designs and alternatives, can become nearly intractable without the help of structured analysis tools. PACAIT--Performance and Cost Analysis Integrated Tools--is a prototype tool. The performance side of the analysis collates and reduces data from ASSESS, and existing DOE PC-based security systems performance analysis tool. The costs side of the analysis uses ACE, an existing DOD PC-based costs analysis tool. Costs are reported over the full life-cycle of the system, that is, the costs to procure, operate, maintain and retire the system and all of its components. Results are collected in Microsoft reg-sign Excel workbooks and are readily available to analysts and decision makers in both tabular and graphical formats and at both the system and path-element levels

  2. 15 CFR 14.45 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Cost and price analysis. 14.45 Section... COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 14.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with...

  3. 45 CFR 74.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Cost and price analysis. 74.45 Section 74.45... ORGANIZATIONS, AND COMMERCIAL ORGANIZATIONS Post-Award Requirements Procurement Standards § 74.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in...

  4. 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... ORGANIZATIONS Post-Award Requirements Property Standards § 2543.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every...

  5. 49 CFR 19.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Cost and price analysis. 19.45 Section 19.45... Requirements Procurement Standards § 19.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price...

  6. 28 CFR 70.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cost and price analysis. 70.45 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.45 Cost and price analysis. Some form of cost or price analysis must be made and documented in the procurement files in connection...

  7. Performance and cost benefits analysis of double-pass solar collector with and without fins

    International Nuclear Information System (INIS)

    Fudholi, Ahmad; Sopian, Kamaruzzaman; Ruslan, Mohd Hafidz; Othman, Mohd Yusof

    2013-01-01

    Highlights: • The thermal performances and cost analysis of the double-pass solar collector with and without fins absorber were discussed. • The theoretical and experimental study on the double-pass solar air collector with and without fins absorber was conducted. • The ratio of AC/AEG or the cost benefit ratio was presented. • The double-pass solar collector with fins absorber is more cost-effective compared to without fins absorber. - Abstract: The performance and cost benefit analysis of double-pass solar collector with and without fins have been conducted. The theoretical model using steady state analysis has been developed and compared with the experimental results. The performance curves of the double-pass solar collector with and without fins, which included the effects of mass flow rate and solar intensity on the thermal efficiency of the solar collector, were obtained. Results indicated that the thermal efficiency is proportional to the solar intensity at a specific mass flow rate. The thermal efficiency increased by 9% at a solar intensity of 425–790 W/m 2 and mass flow rate of 0.09 kg/s. The theoretical and experimental analysis showed a similar trend as well as close agreement. Moreover, a cost-effectiveness model has been developed examine the cost benefit ratio of double-pass solar collector with and without fins. Evaluation of the annual cost (AC) and the annual energy gain (AEG) of the collector were also performed. The results show that the double-pass solar collector with fins is more cost-effective compared to the double-pass solar collector without fins for mass flow rate of 0.01–0.07 kg/s. Also, simulations were obtained for the double-pass solar collector with fins at Nusselt number of 5.42–36.21. The energy efficiency of collector increases with the increase of Nusselt number. The results show that by increasing the Nusselt number simultaneously would drop the outlet temperature at any solar intensity. Increase in Nusselt number

  8. Concepts of increasing productivity and reducing the processing cost of machine parts

    Directory of Open Access Journals (Sweden)

    О. С. Кленов

    2017-06-01

    Full Text Available The basic conditions to reduce the cost of processing technology and improve productivity through the use of modern cutting tools produced by leading foreign firms producing tools have been appraised from theory in the work. Theoretically, it has been found that an increase in the cost of processing varies according to extremum dependence, passing the minimum point. It is possible to reduce the minimum processing cost due to the increase of productivity using cutting edge tools, characterized by a high capacity for work in high cutting temperatures. The criterion showing the technological price cost minimum is the ratio of the expenditures on workers’ wages to the expenditures on the cutting tools, it being quite specific for various processing conditions. To analyze the possibilities of practical use of the proposed criterion, a complex of experimental researches of the technological prime cost and productivity of the processing with hard alloy cutting tools with wear-resistant coatings produced by the company «Iscar» has been carried out. It has been established that their use makes it possible by more than one half to reduce the labour consumption and overall costs as compared to the hard alloy cutting tools traditionally used in home industry. It has been shown that this effect is achieved by increasing the cutting speed and feed due to increased wear resistance and heat resistance of the «Iscar» company tools. It was established that it is much more possible to achieve low processing cost at milling than at turning. It was stated with regard to all major expenditures including the workers' wages, the cost of the cutting tools, equipment and other costs, allowing more correctly estimate the cost-effectiveness of mechanical processing. Experiments confirmed that the main condition for reducing the processing cost to its minimum value is to increase the processing performance through the use of a heat-resistant and wear-resistant cutting

  9. 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.

  10. The cost analysis of hydrogen life cycle in China

    International Nuclear Information System (INIS)

    Yao, Fei; Jia, Yuan; Mao, Zongqiang

    2010-01-01

    Currently, the increasing price of oil and the possibility of global energy crisis demand for substitutive energy to replace fossil energy. Many kinds of renewable energy have been considered, such as hydrogen, solar energy, and wind energy. Many countries including China have their own plan to support the research of hydrogen, because of its premier features. But, at present, the cost of hydrogen energy production, storage and transportation process is higher than that of fossil energy and its commercialization progress is slow. Life cycle cost analysis (LCCA) was used in this paper to evaluate the cost of hydrogen energy throughout the life cycle focused on the stratagem selection, to demonstrate the costs of every step and to discuss their relationship. Finally, the minimum cost program is as follows: natural gas steam reforming - high-pressure hydrogen bottles transported by car to hydrogen filling stations - hydrogen internal-combustion engines. (author)

  11. 20 CFR 226.13 - Cost-of-living increase in employee vested dual benefit.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost-of-living increase in employee vested... Annuity § 226.13 Cost-of-living increase in employee vested dual benefit. If the employee's annuity begins June 1, 1975 or later, a cost-of-living increase is added to the total vested dual benefit amount. This...

  12. [Advantages and cost-benefit analysis of various teleradiology scenarios].

    Science.gov (United States)

    Heckermann, D; Wetekam, V; Hundt, W; Reiser, M

    1997-04-01

    With the increasing number of users and technical improvements, there are several application scenarios of teleradiology. To perform a cost-benefit analysis, an approach is presented, which focuses on both monetary and qualitative aspects. Process-related, qualitative and quantitative evaluations are described. The prestudy compares the radiological workflow before and after the introduction of a teleradiology system. A scoring model is part of the qualitative evaluation. The quantitative study focuses on costs and savings. Amortisation and a net present value of savings versus costs can be derived using dynamic investment methods. Savings can be achieved after a short time under ideal conditions, but there is no guarantee for a reimbursement for all systems.

  13. Cost benefit analysis of power plant database integration

    International Nuclear Information System (INIS)

    Wilber, B.E.; Cimento, A.; Stuart, R.

    1988-01-01

    A cost benefit analysis of plant wide data integration allows utility management to evaluate integration and automation benefits from an economic perspective. With this evaluation, the utility can determine both the quantitative and qualitative savings that can be expected from data integration. The cost benefit analysis is then a planning tool which helps the utility to develop a focused long term implementation strategy that will yield significant near term benefits. This paper presents a flexible cost benefit analysis methodology which is both simple to use and yields accurate, verifiable results. Included in this paper is a list of parameters to consider, a procedure for performing the cost savings analysis, and samples of this procedure when applied to a utility. A case study is presented involving a specific utility where this procedure was applied. Their uses of the cost-benefit analysis are also described

  14. 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.

  15. A non-stationary cost-benefit analysis approach for extreme flood estimation to explore the nexus of 'Risk, Cost and Non-stationarity'

    Science.gov (United States)

    Qi, Wei

    2017-11-01

    Cost-benefit analysis is commonly used for engineering planning and design problems in practice. However, previous cost-benefit based design flood estimation is based on stationary assumption. This study develops a non-stationary cost-benefit based design flood estimation approach. This approach integrates a non-stationary probability distribution function into cost-benefit analysis, and influence of non-stationarity on expected total cost (including flood damage and construction costs) and design flood estimation can be quantified. To facilitate design flood selections, a 'Risk-Cost' analysis approach is developed, which reveals the nexus of extreme flood risk, expected total cost and design life periods. Two basins, with 54-year and 104-year flood data respectively, are utilized to illustrate the application. It is found that the developed approach can effectively reveal changes of expected total cost and extreme floods in different design life periods. In addition, trade-offs are found between extreme flood risk and expected total cost, which reflect increases in cost to mitigate risk. Comparing with stationary approaches which generate only one expected total cost curve and therefore only one design flood estimation, the proposed new approach generate design flood estimation intervals and the 'Risk-Cost' approach selects a design flood value from the intervals based on the trade-offs between extreme flood risk and expected total cost. This study provides a new approach towards a better understanding of the influence of non-stationarity on expected total cost and design floods, and could be beneficial to cost-benefit based non-stationary design flood estimation across the world.

  16. Nurse manager succession planning: A cost-benefit analysis.

    Science.gov (United States)

    Phillips, Tracy; Evans, Jennifer L; Tooley, Stephanie; Shirey, Maria R

    2018-03-01

    This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily. Assumptions of nursing manager succession planning cost-benefit analysis are identified and discussed. The succession planning exemplar demonstrates the integration of cost-benefit analysis principles. Comparing the costs of a formal nurse manager succession planning strategy with the status quo results in a positive cost-benefit ratio. The implementation of a formal nurse manager succession planning programme effectively reduces replacement costs and time to transition into the new role. This programme provides an internal pipeline of future leaders who will be more successful than external candidates. Using an actual cost-benefit analysis equips nurse managers with valuable evidence depicting succession planning as a viable business strategy. © 2017 John Wiley & Sons Ltd.

  17. Summit Station Skiway Cost Analysis

    Science.gov (United States)

    2016-07-01

    of fuel delivered to Summit via LC-130 at a price of $32/gal. (Lever et al. 2016), the cost for constructing and maintaining the skiway for the 2014...CRREL TR-16-9 18 The costs associated with the Twin Otter include a day rate plus an hourly mission rate, a per passenger rate, airport fees, fuel, a...ER D C/ CR RE L TR -1 6- 9 Engineering for Polar Operations, Logistics, and Research (EPOLAR) Summit Station Skiway Cost Analysis Co ld

  18. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: executive summary

    International Nuclear Information System (INIS)

    1985-04-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's Civilian Radioactive Waste Management Progrram is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 is sufficient to cover the cost of the program. This report is an input into the third evaluation of the adequacy of the fee. The total-system cost for the reference waste-management program in this analysis is estimated to be 24 to 30 billion (1984) dollars. For the sensitivity cases studied in this report, the costs could be as high as 35 billion dollars and as low as 21 billion dollars. Because factors like repository location, the quantity of waste generated, transportation-cask technology, and repository startup dates exert substantial impacts on total-system costs, there are several tradeoffs between these factors, and these tradeoffs can greatly influence the total cost of the program. The total-system cost for the reference program described in this report is higher by 3 to 5 billion dollars, or 15 to 20%, than the cost for the reference program of the TSLCC analysis of April 1984. More than two-thirds of this increase is in the cost of repository construction and operation. These repository costs have increased because of changing design concepts, different assumptions about the effort required to perform the necessary activities, and a change in the source data on which the earlier analysis was based. Development and evaluation costs have similarly increased because of a net addition to the work content. Transportation costs have increased because of different assumptions about repository locations and several characteristics of the transportation system. It is expected that the estimates of total-system costs will continue to change in response to both an evolving program strategy and better definition of the work required to achieve the program objectives

  19. Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

    Science.gov (United States)

    Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

    2013-08-01

    Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

  20. Cost and performance analysis of physical security systems

    International Nuclear Information System (INIS)

    Hicks, M.J.; Yates, D.; Jago, W.H.

    1997-01-01

    CPA - Cost and Performance Analysis - is a prototype integration of existing PC-based cost and performance analysis tools: ACEIT (Automated Cost Estimating Integrated Tools) and ASSESS (Analytic System and Software for Evaluating Safeguards and Security). ACE is an existing DOD PC-based tool that supports cost analysis over the full life cycle of a system; that is, the cost to procure, operate, maintain and retire the system and all of its components. ASSESS is an existing DOE PC-based tool for analysis of performance of physical protection systems. Through CPA, the cost and performance data are collected into Excel workbooks, making the data readily available to analysts and decision makers in both tabular and graphical formats and at both the system and subsystem levels. The structure of the cost spreadsheets incorporates an activity-based approach to cost estimation. Activity-based costing (ABC) is an accounting philosophy used by industry to trace direct and indirect costs to the products or services of a business unit. By tracing costs through security sensors and procedures and then mapping the contributions of the various sensors and procedures to system effectiveness, the CPA architecture can provide security managers with information critical for both operational and strategic decisions. The architecture, features and applications of the CPA prototype are presented. 5 refs., 3 figs

  1. Blood Transfusion During Total Ankle Arthroplasty Is Associated With Increased In-Hospital Complications and Costs.

    Science.gov (United States)

    Ewing, Michael A; Huntley, Samuel R; Baker, Dustin K; Smith, Kenneth S; Hudson, Parke W; McGwin, Gerald; Ponce, Brent A; Johnson, Michael D

    2018-04-01

    Total ankle arthroplasty (TAA) is an increasingly used, effective treatment for end-stage ankle arthritis. Although numerous studies have associated blood transfusion with complications following hip and knee arthroplasty, its effects following TAA are largely unknown. This study uses data from a large, nationally representative database to estimate the association between blood transfusion and inpatient complications and hospital costs following TAA. Using the Nationwide Inpatient Sample (NIS) database from 2004 to 2014, 25 412 patients who underwent TAA were identified, with 286 (1.1%) receiving a blood transfusion. Univariate analysis assessed patient and hospital factors associated with blood transfusion following TAA. Patients requiring blood transfusion were more likely to be female, African American, Medicare recipients, and treated in nonteaching hospitals. Average length of stay for patients following transfusion was 3.0 days longer, while average inpatient cost was increased by approximately 50%. Patients who received blood transfusion were significantly more likely to suffer from congestive heart failure, peripheral vascular disease, hypothyroidism, coagulation disorder, or anemia. Acute renal failure was significantly more common among patients receiving blood transfusion ( P < .001). Blood transfusions following TAA are infrequent and are associated with multiple medical comorbidities, increased complications, longer hospital stays, and increased overall cost. Level III: Retrospective, comparative study.

  2. Cost benefit analysis for optimization of radiation protection

    International Nuclear Information System (INIS)

    Lindell, B.

    1984-01-01

    ICRP recommends three basic principles for radiation protection. One is the justification of the source. Any use of radiation should be justified with regard to its benefit. The second is the optimization of radiation protection, i.e. all radiation exposure should be kept as low as resonably achievable. And the third principle is that there should be a limit for the radiation dose that any individual receives. Cost benefit assessment or cost benefit analysis is one tool to achieve the optimization, but the optimization is not identical with cost benefit analysis. Basically, in principle, the cost benefit analysis for the optimization of radiation protection is to find the minimum sum of the cost of protection and some cost of detriment. (Mori, K.)

  3. 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.)

  4. 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.

  5. Cost benefit analysis in diagnostic radiology: glossary and definitions

    International Nuclear Information System (INIS)

    Golder, W.

    1999-01-01

    Cost efficiency analyses in clinical radiology require the application of methods and techniques that are not yet part of the academic qualifications of the specialists. The procedures used are borrowed from economics, decision theory, applied social sciences, epidemiology and statistics. Many expressions hail from the angloamerican literature and are presently not yet germanized unequivocally. This survey is intended to present main terms of cost efficiency analysis in the English version as well as a German translation, to give a clear definition and, if necessary, explanatory notes, and to illustrate their application by means of concrete radiologic examples. The selection of the terms is based on the hierarchical models of health technology assessment resp. clinical outcome research by Fryback and Thronbury resp. Maisey and Hutton. In concrete terms, both the differences between benefit, outcomes, and utility and the differences between effectiveness, efficacy and efficiency and the differences between direct, indirect, intangible, and marginal costs are explained. True cost efficiency analysis is compared with cost effectiveness analysis, cost identification analysis, cost minimization analysis, and cost utility analysis. Applied social sciences are represented by the Medical Outcomes Study Short Form-36 and the QALY conception. From decision theory both the analysis of hypothetical alternatives and the Markov model are taken. Finally, sensitivity analysis and the procedures of combined statistical evaluation of comparable results (meta-analysis) are quoted. (orig.) [de

  6. Cost-benefit analysis and non-utilitarian ethics

    NARCIS (Netherlands)

    Lowry, R.J.; Peterson, M.B.

    2012-01-01

    Cost-benefit analysis is commonly understood to be intimately connected with utilitarianism and incompatible with other moral theories, particularly those that focus on deontological concepts such as rights. We reject this claim and argue that cost-benefit analysis can take moral rights as well as

  7. 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…

  8. Evaluation of ways and procedures to reduce construction cost and increase competition.

    Science.gov (United States)

    2009-01-01

    Construction cost inflation is affecting many state highway agencies including the Texas Department of : Transportation While some of this increase can be attributed to factors such as soaring cost of energy, : reports of large variations in cost of ...

  9. 41 CFR 105-72.505 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost and price analysis... § 105-72.505 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be...

  10. 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.

  11. 40 CFR 30.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Cost and price analysis. 30.45 Section... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

  12. 38 CFR 49.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Cost and price analysis... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

  13. 14 CFR 1260.145 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Cost and price analysis. 1260.145 Section... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

  14. 12 CFR 1206.4 - Increased costs of regulation.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Increased costs of regulation. 1206.4 Section 1206.4 Banks and Banking FEDERAL HOUSING FINANCE AGENCY ORGANIZATION AND OPERATIONS ASSESSMENTS § 1206... regulation of a Regulated Entity due to its classification as other than adequately capitalized, or as a...

  15. 20 CFR 225.41 - How a cost-of-living increase is determined and applied.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false How a cost-of-living increase is determined... RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.41 How a cost-of-living increase is determined and applied. Depending on the condition of the social security...

  16. 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.

  17. 32 CFR 32.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Cost and price analysis. 32.45 Section 32.45... price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every procurement action. Price analysis may be accomplished in various ways...

  18. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients.

    Science.gov (United States)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W; Pols, Huibert A P; van der Cammen, Tischa J M

    2008-01-01

    Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. Within a common geriatric outpatient population, patients with a history of falls were assessed for falls risk (n = 139). Fall-risk-increasing drugs were withdrawn when appropriate (n = 75). All participants had a 2-month follow-up for fall incidents. The number of prevented falls was calculated using a loglinear regression model. The savings on health expenditures as a result of prevented injuries (estimated from a literature review) and reduced consumption of pharmaceuticals were compared with the intervention costs. After adjustment for confounders, drug withdrawal resulted in a falls risk reduction of 0.89 (95% CI 0.33, 0.98) per patient compared with the non-withdrawal group. Net cost savings were euro1691 (95% CI 662, 2181) per patient in the cohort. This resulted in a cost saving of euro491 (95% CI 465, 497) per prevented fall. Withdrawal of fall-risk-increasing drugs generates significant cost savings. Extrapolation of these findings to a national scale results in an estimated reduction of euro60 million in healthcare expenditures, that is, 15% of fall-related health costs.

  19. Cost analysis of public health influenza vaccine clinics in Ontario.

    Science.gov (United States)

    Mercer, Nicola J

    2009-01-01

    Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

  20. Cost Analysis for Large Civil Transport Rotorcraft

    Science.gov (United States)

    Coy, John J.

    2006-01-01

    This paper presents cost analysis of purchase price and DOC+I (direct operating cost plus interest) that supports NASA s study of three advanced rotorcraft concepts that could enter commercial transport service within 10 to 15 years. The components of DOC+I are maintenance, flight crew, fuel, depreciation, insurance, and finance. The cost analysis aims at VTOL (vertical takeoff and landing) and CTOL (conventional takeoff and landing) aircraft suitable for regional transport service. The resulting spreadsheet-implemented cost models are semi-empirical and based on Department of Transportation and Army data from actual operations of such aircraft. This paper describes a rationale for selecting cost tech factors without which VTOL is more costly than CTOL by a factor of 10 for maintenance cost and a factor of two for purchase price. The three VTOL designs selected for cost comparisons meet the mission requirement to fly 1,200 nautical miles at 350 knots and 30,000 ft carrying 120 passengers. The lowest cost VTOL design is a large civil tilt rotor (LCTR) aircraft. With cost tech factors applied, the LCTR is reasonably competitive with the Boeing 737-700 when operated in economy regional service following the business model of the selected baseline operation, that of Southwest Airlines.

  1. Increased costs to US pavement infrastructure from future temperature rise

    Science.gov (United States)

    Underwood, B. Shane; Guido, Zack; Gudipudi, Padmini; Feinberg, Yarden

    2017-10-01

    Roadway design aims to maximize functionality, safety, and longevity. The materials used for construction, however, are often selected on the assumption of a stationary climate. Anthropogenic climate change may therefore result in rapid infrastructure failure and, consequently, increased maintenance costs, particularly for paved roads where temperature is a key determinant for material selection. Here, we examine the economic costs of projected temperature changes on asphalt roads across the contiguous United States using an ensemble of 19 global climate models forced with RCP 4.5 and 8.5 scenarios. Over the past 20 years, stationary assumptions have resulted in incorrect material selection for 35% of 799 observed locations. With warming temperatures, maintaining the standard practice for material selection is estimated to add approximately US$13.6, US$19.0 and US$21.8 billion to pavement costs by 2010, 2040 and 2070 under RCP4.5, respectively, increasing to US$14.5, US$26.3 and US$35.8 for RCP8.5. These costs will disproportionately affect local municipalities that have fewer resources to mitigate impacts. Failing to update engineering standards of practice in light of climate change therefore significantly threatens pavement infrastructure in the United States.

  2. 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.

  3. 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…

  4. Liquidity and liquidity cost vs. bank profitability. A model analysis attempt

    OpenAIRE

    Boguslaw Guzik

    2008-01-01

    The author suggests a “model” of relations between liquidity, costs of liquidity and basic or empirical profitability. The first part of the article present the idea of the model analysis. The author makes an effort to explain the frequent empirical paradox – when an increase of liquidity is accompanied by an increase in profitability. The second part present the model analysis in more detail. The author refers to the economic and econometrical model formation. He suggests using the bank prof...

  5. Cost analysis of the US spent nuclear fuel reprocessing facility

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, E.A.; Deinert, M.R. [Department of Mechanical Engineering, University of Texas, Austin TX (United States); Cady, K.B. [Department of Theoretical and Applied Mechanics, Cornell University, Ithaca NY (United States)

    2009-09-15

    The US Department of Energy is actively seeking ways in which to delay or obviate the need for additional nuclear waste repositories beyond Yucca Mountain. All of the realistic approaches require the reprocessing of spent nuclear fuel. However, the US currently lacks the infrastructure to do this and the costs of building and operating the required facilities are poorly established. Recent studies have also suggested that there is a financial advantage to delaying the deployment of such facilities. We consider a system of government owned reprocessing plants, each with a 40 year service life, that would reprocess spent nuclear fuel generated between 2010 and 2100. Using published data for the component costs, and a social discount rate appropriate for intergenerational analyses, we establish the unit cost for reprocessing and show that it increases slightly if deployment of infrastructure is delayed by a decade. The analysis indicates that achieving higher spent fuel discharge burnup is the most important pathway to reducing the overall cost of reprocessing. The analysis also suggests that a nuclear power production fee would be a way for the US government to recover the costs in a manner that is relatively insensitive to discount and nuclear power growth rates. (author)

  6. 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...

  7. Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

    Directory of Open Access Journals (Sweden)

    Pulkki-Brännström Anni-Maria

    2012-04-01

    Full Text Available Abstract Background The World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs. LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan, but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time. Methods We modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need. Results If conventional and long-lasting bed nets have the same physical lifespan (3 years, LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price

  8. 76 FR 56413 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-09-13

    ... intends to calculate three metrics. Life-cycle cost. Simple payback period. Cash flow. Life-cycle cost... exceed costs) will be considered cost effective. The payback period and cash flow analyses provide... of LCC analysis is the summing of costs and benefits over multiple years, it requires that cash flows...

  9. 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

    2018-02-01

    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 P<0.05. This study reported an increased nutritional 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

  10. ANALYSIS BENEFIT COST RATIO OF BIOCHAR IN AGRICULTURE LAND TO INCREASE INCOME HOUSEHOLD IN MERAUKE REGENCY

    OpenAIRE

    Maria Magdalena Diana Widiastuti

    2016-01-01

    Biochar has been proven to increase the availability of soil nutrient, yield productivity and farmers income. Biochar can be made from forestry/agricultural waste and do not required high technology. The objective of this study were: (1) to analyze Benefit Cost Ratio (BCR) of biochar made from rice husk, (2) to compare yield productivity of paddy with biochar treatment, and (3) to analyze of paddy farming system with biochar treatment. The methodology by using BCR and productivity approa...

  11. A cost analysis of Colorado's 1991-92 oxygenated fuels program

    International Nuclear Information System (INIS)

    Manderino, L.A.; Bowles, S.L.

    1993-01-01

    This paper discusses the methodology used to conduct a cost analysis of Colorado's 1991-92 Oxygenated Fuels Program. This program requires the use of oxygenated fuels during the winter season in Denver and surrounding areas. The cost analysis was conducted as part of an overall cost-effectiveness study of the 1991-92 program conducted by PRC Environmental Management, Inc. (PRC). The paper, however, focuses on cost analysis and does not consider potential benefits of the program. The study analyzed costs incurred by different segments of society, including government, industry, and consumers. Because the analysis focused on a specific program year, neither past nor future costs were studied. The discussion of government costs includes the agencies interviewed and the types of costs associated with government administration and enforcement of the program. The methodology used to calculate costs to private industry is also present. The study examined the costs to fuel refineries, pipelines, and blenders, as well as fuel retailers and automobile fleet operators. Finally, the paper discusses the potential costs incurred by the consumer purchasing oxygenated fuels. Costs associated with issues such as vehicle driveability, automobile parts durability and performance, and fuel economy are also examined. A summary of all costs by category is presented along with an analysis of the major cost components. These include costs which are sensitive to specific circumstances and which may vary among programs

  12. A cost analysis: processing maple syrup products

    Science.gov (United States)

    Neil K. Huyler; Lawrence D. Garrett

    1979-01-01

    A cost analysis of processing maple sap to syrup for three fuel types, oil-, wood-, and LP gas-fired evaporators, indicates that: (1) fuel, capital, and labor are the major cost components of processing sap to syrup; (2) wood-fired evaporators show a slight cost advantage over oil- and LP gas-fired evaporators; however, as the cost of wood approaches $50 per cord, wood...

  13. Cost Analysis by Applying Time-Driven Activity Based Costing Method in Container Terminals

    OpenAIRE

    Yaşar, R. Şebnem

    2017-01-01

    Container transportation, which can also be called as “industrialization of maritime transportation”, gained significant ground in the world trade by offering numerous technical and economic advantages, and accordingly the container terminals have grown up in importance. Increased competition between container terminals puts pressure on the ports to reduce costs and increase operational productivity. To have the right cost information constitutes a prerequisite for cost reduction. Time-Driven...

  14. 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.......The second section introduces the stated preference methodology used in WARP to create weight profiles for project pool sensitivity analysis. This section includes a simple example. The third section discusses how decision makers can get a priori aid to make their pair-wise comparisons based on project pool...

  15. Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness.

    Science.gov (United States)

    Reilly, Kathryn L; Reeves, Penny; Deeming, Simon; Yoong, Sze Lin; Wolfenden, Luke; Nathan, Nicole; Wiggers, John

    2018-03-20

    No evaluations of the cost or cost effectiveness of interventions to increase school implementation of food availability policies have been reported. Government and non-government agency decisions regarding the extent of investment required to enhance school implementation of such policies are unsupported by such evidence. This study sought to i) Determine cost and cost-effectiveness of three interventions in improving school implementation of an Australian government healthy canteen policy and; ii) Determine the relative cost-effectiveness of the interventions in improving school implementation of such a policy. An analysis of the cost and cost-effectiveness of three implementation interventions of varying support intensity, relative to usual implementation support conducted during 2013-2015 was undertaken. Secondly, an indirect comparison of the trials was undertaken to determine the most cost-effective of the three strategies. The economic analysis was based on the cost of delivering the interventions by health service delivery staff to increase the proportion of schools 'adherent' with the policy. The total costs per school were $166,971, $70,926 and $75,682 for the high, medium and low intensity interventions respectively. Compared to usual support, the cost effectiveness ratios for each of the three interventions were: A$2982 (high intensity), A$2627 (medium intensity) and A$4730 (low intensity) per percent increase in proportion of schools reporting 'adherence'). Indirect comparison between the 'high' and 'medium intensity' interventions showed no statistically significant difference in cost-effectiveness. The results indicate that while the cost profiles of the interventions varied substantially, the cost-effectiveness did not. This result is valuable to policy makers seeking cost-effective solutions that can be delivered within budget.

  16. Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis.

    Science.gov (United States)

    Roghmann, Mary-Claire; Lydecker, Alison; Mody, Lona; Mullins, C Daniel; Onukwugha, Eberechukwu

    2016-08-01

    OBJECTIVE To estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes. DESIGN Cost analysis of data collected from a prospective, observational study. SETTING AND PARTICIPANTS Care activity data from 401 residents from 13 nursing homes in 2 states. METHODS Cost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups. RESULTS The average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127). CONCLUSIONS The use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities. Infect Control Hosp Epidemiol 2016;37:962-966.

  17. 78 FR 68133 - Cost-of-Living Increases and Other Determinations for 2014; Correction

    Science.gov (United States)

    2013-11-13

    ... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2013-0057] Cost-of-Living Increases and Other Determinations for 2014; Correction AGENCY: Social Security Administration. ACTION: Notice; Correction. SUMMARY..., concerning the cost-of-living increase in Social Security benefits effective December 2013. The document...

  18. Ethical objections against including life-extension costs in cost-effectiveness analysis: a consistent approach.

    Science.gov (United States)

    Gandjour, Afschin; Müller, Dirk

    2014-10-01

    One of the major ethical concerns regarding cost-effectiveness analysis in health care has been the inclusion of life-extension costs ("it is cheaper to let people die"). For this reason, many analysts have opted to rule out life-extension costs from the analysis. However, surprisingly little has been written in the health economics literature regarding this ethical concern and the resulting practice. The purpose of this work was to present a framework and potential solution for ethical objections against life-extension costs. This work found three levels of ethical concern: (i) with respect to all life-extension costs (disease-related and -unrelated); (ii) with respect to disease-unrelated costs only; and (iii) regarding disease-unrelated costs plus disease-related costs not influenced by the intervention. Excluding all life-extension costs for ethical reasons would require-for reasons of consistency-a simultaneous exclusion of savings from reducing morbidity. At the other extreme, excluding only disease-unrelated life-extension costs for ethical reasons would require-again for reasons of consistency-the exclusion of health gains due to treatment of unrelated diseases. Therefore, addressing ethical concerns regarding the inclusion of life-extension costs necessitates fundamental changes in the calculation of cost effectiveness.

  19. Can Better Outdoor Environments Lead to Cost Benefits in Assisted Living Facilities Through Increased Word-of-Mouth Referrals?

    Science.gov (United States)

    Rodiek, Susan; Boggess, May M; Lee, Chanam; Booth, Geoffrey J; Morris, Alisan

    2013-01-01

    This study explores how better outdoor environments may produce cost benefits for assisted living providers by raising occupancy levels through increased resident satisfaction and word-of-mouth referrals. Older adults who spend even minimal time outdoors may reap substantial health benefits. However, many existing outdoor areas in assisted living facilities are reportedly underutilized, in part because of design issues. Providers may be more willing to improve outdoor areas if they produce cost benefits for provider organizations. This study used data from a recent assisted living survey to assess the relationship between satisfaction with outdoor spaces, time spent outdoors, and resulting improvements in mood. A financial analysis was developed to estimate potential benefits from improved outdoor areas attributable to increased occupancy and decreased marketing costs associated with increased word-of-mouth referrals. Increasing resident satisfaction with outdoor areas (from approximately 29% to 96%) results in residents spending more time outdoors (increase of 1½ hours per week per resident) and improved psychological well-being (12% increase in feeling better). This greater overall satisfaction leads to 8% more residents willing to refer potential residents to their community. Because word-of-mouth referrals by current residents are a major factor in resident recruitment, improving outdoors areas leads to an estimated 4% increase in new residents, resulting in over $170,000 of increased revenue per year for a community of 100 residents. Improved outdoor space can provide substantial cost benefits for assisted living providers. Increasing resident well-being and satisfaction, and thereby generating additional word-of-mouth referrals, can result in higher occupancy levels. Outdoor environments, assisted living, cost benefits, resident satisfaction, occupancy levels, seniors, rental income, word-of-mouth referralPreferred Citation: Rodiek, S., Boggess, M. M., Lee

  20. Department of the Army Cost Analysis Manual

    National Research Council Canada - National Science Library

    1997-01-01

    .... The specific goal of this manual is to help the cost analyst serve the customer. This is done by providing reference material on cost analysis processes, methods, techniques, structures, and definitions...

  1. Moche CAPE Formula: Cost Analysis of Public Education.

    Science.gov (United States)

    Moche, Joanne Spiers

    The Moche Cost Analysis of Public Education (CAPE) formula was developed to identify total and per pupil costs of regular elementary education, regular secondary education, elementary special education, and secondary special education. Costs are analyzed across five components: (1) comprehensive costs (including transportation and supplemental…

  2. Cost-effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD.

    Science.gov (United States)

    Huber, Manuel B; Präger, Maximilian; Coyle, Kathryn; Coyle, Doug; Lester-George, Adam; Trapero-Bertran, Marta; Nemeth, Bertalan; Cheung, Kei Long; Stark, Renee; Vogl, Matthias; Pokhrel, Subhash; Leidl, Reiner

    2017-12-15

    To evaluate costs, effects and cost-effectiveness of increased reach of specific smoking cessation interventions in Germany. A Markov-based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health-care perspective (extended to include out-of-pocket payments) with life-time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates. Germany. Cohort of current smoking population (18+ years) in Germany. Interventions included group-based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group-based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England. EQUIPTMOD considered reach, intervention cost, number of quitters, quality-of-life years (QALYs) gained, cost-effectiveness and return on investment. The highest returns through reduction in smoking-related health-care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group-based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost-savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return-on-investment estimates. At a hypothetical willingness-to-pay threshold of only €5000, the probability of being cost-effective is approximately 75% for prospective scenario 1. Increasing the reach of group-based behavioural support, financial incentives and varenicline for smoking cessation by

  3. The Cost of Distribution System Upgrades to Accommodate Increasing Penetrations of Distributed Photovoltaic Systems on Real Feeders in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Kelsey A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Ding, Fei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mather, Barry A [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Palmintier, Bryan S [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2018-04-05

    The increasing deployment of distributed photovoltaic systems (DPV) can impact operations at the distribution level and the transmission level of the electric grid. It is important to develop and implement forward-looking approaches for calculating distribution upgrade costs that can be used to inform system planning, market and tariff design, cost allocation, and other policymaking as penetration levels of DPV increase. Using a bottom-up approach that involves iterative hosting capacity analysis, this report calculates distribution upgrade costs as a function of DPV penetration on three real feeders - two in California and one in the Northeastern United States.

  4. Bearing Procurement Analysis Method by Total Cost of Ownership Analysis and Reliability Prediction

    Science.gov (United States)

    Trusaji, Wildan; Akbar, Muhammad; Sukoyo; Irianto, Dradjad

    2018-03-01

    In making bearing procurement analysis, price and its reliability must be considered as decision criteria, since price determines the direct cost as acquisition cost and reliability of bearing determine the indirect cost such as maintenance cost. Despite the indirect cost is hard to identify and measured, it has high contribution to overall cost that will be incurred. So, the indirect cost of reliability must be considered when making bearing procurement analysis. This paper tries to explain bearing evaluation method with the total cost of ownership analysis to consider price and maintenance cost as decision criteria. Furthermore, since there is a lack of failure data when bearing evaluation phase is conducted, reliability prediction method is used to predict bearing reliability from its dynamic load rating parameter. With this method, bearing with a higher price but has higher reliability is preferable for long-term planning. But for short-term planning the cheaper one but has lower reliability is preferable. This contextuality can give rise to conflict between stakeholders. Thus, the planning horizon needs to be agreed by all stakeholder before making a procurement decision.

  5. ANALISA PERBANDINGAN BIAYA PENGGUNAAN NUTRUNNER MANUAL DAN OTOMATIS MENGGUNAKAN METODE COST & BENEFITS ANALYSIS

    Directory of Open Access Journals (Sweden)

    Ucok Mulyo Sugeng

    2017-10-01

    Full Text Available In a situation of increasingly fierce competition in every manufacturing company, PT SZI supposedly able to apply concepts and production strategies well as improve product quality. Thus the need for the selection of the right nutrunner as an investment in the assembly process. The assembly process is the part that greatly affects the quantity and quality of production in the manufacturing industry, the faster the process of assembling the more units are produced. Likewise with the production quality, the better the nutrunner is used it will be less risk of rejection unit which will incur additional costs. Nutrunner is a tool used for tightening bolts / nuts that are powered by wind energy or electricity. The different types of energy use in nutrunner that is the term naming nutrunner automatic and manual will be compared based on several aspects that will be selected which are more efficient in the production process. In search results of the comparison, cost calculation will use the application Desoutter Rightway. After known perbandinagn some aspects costs (energy costs, productivity costs, calibraton cost, maintenance cost, and quality cost then the analysis will be continued use Cost & Benefits Analysis to get some of the goals of this research, which is a long period of return on investment or breakeven on the project this nutrunner with Payback Period method. Besides the cost analysis is also used to find the value of benefits in order to determine whether the project is feasible and acceptable methods Return on Investment. After the data were analyzed using the method of cost and benefit analysis then obtained a long period of payback or breakeven for automatic nutrunner investment is 1.22 years and 14.63 months. As for the value of the benefits of 146%, this means that the project is acceptable because it provides the advantages of the total investment cost.

  6. Cost analysis of small hydroelectric power plants components and preliminary estimation of global cost

    International Nuclear Information System (INIS)

    Basta, C.; Olive, W.J.; Antunes, J.S.

    1990-01-01

    An analysis of cost for each components of Small Hydroelectric Power Plant, taking into account the real costs of these projects is shown. It also presents a global equation which allows a preliminary estimation of cost for each construction. (author)

  7. 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.

  8. A probabilistic production costing analysis of SO2 emissions reduction strategies for Ohio: emissions, costs and employment tradeoffs

    International Nuclear Information System (INIS)

    Heslin, J.S.; Hobbs, B.F.

    1991-01-01

    A new approach for state- and utility-level analysis of the cost and regional economic impacts of strategies for reducing utility SO 2 emissions is summarized and applied to Ohio. The methodology is based upon probabilistic production costing and economic input-output analysis. It is an improvement over previous approaches because it: (1) accurately models random outages of generating units, 'must-run' constraints on unit output, and the distribution of power demands; and (2) runs quickly on a microcomputer and yet considers the entire range of potential control strategies from a systems perspective. The input-output analysis considers not only the economic effects of utility fuel use and capital investment, but also those of increased electric rates. Two distinct strategies are found to be most attractive for Ohio. The first, more flexible one, consists of emissions dispatching (ED) alone to meet short run emissions reduction targets. A 75 percent reduction can then be achieved by the turn of the century by combining ED and fuel switching (FS) with flue gas desulfurization, limestone injection multistage burners, and physical coal cleaning at selected plants. The second is a scrubber-based strategy which includes ED. By the year 2000, energy conservation becomes a cost effective component of these strategies. In order to minimize compliance costs, acid rain legislation which facilitates emission trading and places regional tonnage limits on emissions is desirable

  9. Design windows and cost analysis on helical reactors

    International Nuclear Information System (INIS)

    Kozaki, Y.; Imagawa, S.; Sagara, A.

    2007-01-01

    The LHD type helical reactors are characterized by a large major radius but slender helical coil, which give us different approaches for power plants from tokamak reactors. For searching design windows of helical reactors and discussing their potential as power plants, we have developed a mass-cost estimating model linked with system design code (HeliCos), thorough studying the relationships between major plasma parameters and reactor parameters, and weight of major components. In regard to cost data we have much experience through preparing ITER construction. To compare the weight and cost of magnet systems between tokamak and helical reactors, we broke down magnet systems and cost factors, such as weights of super conducting strands, conduits, support structures, and winding unit costs, through estimating ITER cost data basis. Based on FFHR2m1 deign we considered a typical 3 GWth helical plant (LHD type) with the same magnet size, coil major radius Rc 14 m, magnetic energy 120 GJ, but increasing plasma densities. We evaluated the weight and cost of magnet systems of 3 GWth helical plant, the total magnet weights of 16,000ton and costs of 210 BYen, which are similar values of tokamak reactors (10,200 ton, 110 BYen in ITER 2002 report, and 21,900 ton, 275 BYen in ITER FDR1999). The costs of strands and winding occupy 70% of total magnet costs, and influence entire power plants economics. The design windows analysis and comparative economics studies to optimize the main reactor parameters have been carried out. Economics studies show that it is misunderstanding to consider helical coils are too large and too expensive to achieve power plants. But we should notice that the helical reactor design windows and economics are very sensitive to allowable blanket space (depend on ergodic layer conditions) and diverter configuration for decreasing heat loads. (orig.)

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

    Science.gov (United States)

    Braithwaite, R Scott; Omokaro, Cynthia; Justice, Amy C; Nucifora, Kimberly; Roberts, Mark S

    2010-02-16

    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. 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 (value services ($100,000-$300,000 per life-year or unknown), and would be increased for low-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

  11. Stochastic cost estimating in repository life-cycle cost analysis

    International Nuclear Information System (INIS)

    Tzemos, S.; Dippold, D.

    1986-01-01

    The conceptual development, the design, and the final construction and operation of a nuclear repository span many decades. Given this lengthy time frame, it is quite challenging to obtain a good approximation of the repository life-cycle cost. One can deal with this challenge by using an analytic method, the method of moments, to explicitly assess the uncertainty of the estimate. A series expansion is used to approximate the uncertainty distribution of the cost estimate. In this paper, the moment methodology is derived and is illustrated through a numerical example. The range of validity of the approximation is discussed. The method of moments is compared to the traditional stochastic cost estimating methods and found to provide more and better information on cost uncertainty. The tow methods converge to identical results as the number of convolved variables increases and approaches the range where the central limit theorem is valid

  12. Complete daVinci versus laparoscopic pyeloplasty: cost analysis.

    Science.gov (United States)

    Bhayani, Sam B; Link, Richard E; Varkarakis, John M; Kavoussi, Louis R

    2005-04-01

    Computer-assisted pyeloplasty with the daVinci system is an emerging technique to treat ureteropelvic junction (UPJ) obstruction. A relative cost analysis was performed assessing this technology in comparison with purely laparoscopic pyeloplasty. Eight patients underwent computer-assisted (daVinci) dismembered pyeloplasty (CP) via a transperitoneal four-port approach. They were compared with 13 patients who underwent purely laparoscopic pyeloplasty (LP). All patients had a primary UPJ obstruction and were matched for age, sex, and body mass index. The cost of equipment and capital depreciation for both procedures, as well as assessment of room set-up time, takedown time, and personnel were analyzed. Surgeons and nursing staff for both groups were experienced in both laparoscopy and daVinci procedures. One- and two-way financial analysis was performed to assess relative costs. The mean set-up and takedown time was 71 minutes for CP and 49 minutes for LP. The mean length of stay was 2.3 days for CP and 2.5 days for LP. The mean operating room (OR) times for CP and LP were 176 and 210 minutes, respectively. There were no complications in either group. One-way cost analysis with an economic model showed that LP is more cost effective than CP at our hospital if LP OR time is cost effective as LP. Two-way sensitivity analysis shows that in-room time must still be 500 to obtain cost equivalence for CP. Perioperative parameters for CP are encouraging. However, the costs are a clear disadvantage. In our hospital, it is more cost effective to teach and perform LP than to perform CP.

  13. 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.

  14. Cost-benefit considerations in regulatory analysis

    International Nuclear Information System (INIS)

    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

  15. Social costs of road crashes : an international analysis.

    NARCIS (Netherlands)

    Wijnen, W. & Stipdonk, H.L.

    2016-01-01

    This paper provides an international overview of the most recent estimates of the social costs of road crashes: total costs, value per casualty and breakdown in cost components. The analysis is based on publications about the national costs of road crashes of 17 countries, of which ten high income

  16. 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.

  17. Routine Pediatric Enterovirus 71 Vaccination in China: a Cost-Effectiveness Analysis.

    Science.gov (United States)

    Wu, Joseph T; Jit, Mark; Zheng, Yaming; Leung, Kathy; Xing, Weijia; Yang, Juan; Liao, Qiaohong; Cowling, Benjamin J; Yang, Bingyi; Lau, Eric H Y; Takahashi, Saki; Farrar, Jeremy J; Grenfell, Bryan T; Leung, Gabriel M; Yu, Hongjie

    2016-03-01

    China accounted for 87% (9.8 million/11.3 million) of all hand, foot, and mouth disease (HFMD) cases reported to WHO during 2010-2014. Enterovirus 71 (EV71) is responsible for most of the severe HFMD cases. Three EV71 vaccines recently demonstrated good efficacy in children aged 6-71 mo. Here we assessed the cost-effectiveness of routine pediatric EV71 vaccination in China. We characterized the economic and health burden of EV71-associated HFMD (EV71-HFMD) in China using (i) the national surveillance database, (ii) virological surveillance records from all provinces, and (iii) a caregiver survey on the household costs and health utility loss for 1,787 laboratory-confirmed pediatric cases. Using a static model parameterized with these data, we estimated the effective vaccine cost (EVC, defined as cost/efficacy or simply the cost of a 100% efficacious vaccine) below which routine pediatric vaccination would be considered cost-effective. We performed the base-case analysis from the societal perspective with a willingness-to-pay threshold of one times the gross domestic product per capita (GDPpc) and an annual discount rate of 3%. We performed uncertainty analysis by (i) accounting for the uncertainty in the risk of EV71-HFMD due to missing laboratory data in the national database, (ii) excluding productivity loss of parents and caregivers, (iii) increasing the willingness-to-pay threshold to three times GDPpc, (iv) increasing the discount rate to 6%, and (v) accounting for the proportion of EV71-HFMD cases not registered by national surveillance. In each of these scenarios, we performed probabilistic sensitivity analysis to account for parametric uncertainty in our estimates of the risk of EV71-HFMD and the expected costs and health utility loss due to EV71-HFMD. Routine pediatric EV71 vaccination would be cost-saving if the all-inclusive EVC is below US$10.6 (95% CI US$9.7-US$11.5) and would remain cost-effective if EVC is below US$17.9 (95% CI US$16.9-US$18.8) in

  18. Routine Pediatric Enterovirus 71 Vaccination in China: a Cost-Effectiveness Analysis

    Science.gov (United States)

    Leung, Kathy; Xing, Weijia; Yang, Juan; Liao, Qiaohong; Cowling, Benjamin J.; Yang, Bingyi; Lau, Eric H. Y.; Takahashi, Saki; Farrar, Jeremy J.; Grenfell, Bryan T.; Leung, Gabriel M.; Yu, Hongjie

    2016-01-01

    Background China accounted for 87% (9.8 million/11.3 million) of all hand, foot, and mouth disease (HFMD) cases reported to WHO during 2010–2014. Enterovirus 71 (EV71) is responsible for most of the severe HFMD cases. Three EV71 vaccines recently demonstrated good efficacy in children aged 6–71 mo. Here we assessed the cost-effectiveness of routine pediatric EV71 vaccination in China. Methods and Findings We characterized the economic and health burden of EV71-associated HFMD (EV71-HFMD) in China using (i) the national surveillance database, (ii) virological surveillance records from all provinces, and (iii) a caregiver survey on the household costs and health utility loss for 1,787 laboratory-confirmed pediatric cases. Using a static model parameterized with these data, we estimated the effective vaccine cost (EVC, defined as cost/efficacy or simply the cost of a 100% efficacious vaccine) below which routine pediatric vaccination would be considered cost-effective. We performed the base-case analysis from the societal perspective with a willingness-to-pay threshold of one times the gross domestic product per capita (GDPpc) and an annual discount rate of 3%. We performed uncertainty analysis by (i) accounting for the uncertainty in the risk of EV71-HFMD due to missing laboratory data in the national database, (ii) excluding productivity loss of parents and caregivers, (iii) increasing the willingness-to-pay threshold to three times GDPpc, (iv) increasing the discount rate to 6%, and (v) accounting for the proportion of EV71-HFMD cases not registered by national surveillance. In each of these scenarios, we performed probabilistic sensitivity analysis to account for parametric uncertainty in our estimates of the risk of EV71-HFMD and the expected costs and health utility loss due to EV71-HFMD. Routine pediatric EV71 vaccination would be cost-saving if the all-inclusive EVC is below US$10.6 (95% CI US$9.7–US$11.5) and would remain cost-effective if EVC is below

  19. Routine Pediatric Enterovirus 71 Vaccination in China: a Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Joseph T Wu

    2016-03-01

    Full Text Available China accounted for 87% (9.8 million/11.3 million of all hand, foot, and mouth disease (HFMD cases reported to WHO during 2010-2014. Enterovirus 71 (EV71 is responsible for most of the severe HFMD cases. Three EV71 vaccines recently demonstrated good efficacy in children aged 6-71 mo. Here we assessed the cost-effectiveness of routine pediatric EV71 vaccination in China.We characterized the economic and health burden of EV71-associated HFMD (EV71-HFMD in China using (i the national surveillance database, (ii virological surveillance records from all provinces, and (iii a caregiver survey on the household costs and health utility loss for 1,787 laboratory-confirmed pediatric cases. Using a static model parameterized with these data, we estimated the effective vaccine cost (EVC, defined as cost/efficacy or simply the cost of a 100% efficacious vaccine below which routine pediatric vaccination would be considered cost-effective. We performed the base-case analysis from the societal perspective with a willingness-to-pay threshold of one times the gross domestic product per capita (GDPpc and an annual discount rate of 3%. We performed uncertainty analysis by (i accounting for the uncertainty in the risk of EV71-HFMD due to missing laboratory data in the national database, (ii excluding productivity loss of parents and caregivers, (iii increasing the willingness-to-pay threshold to three times GDPpc, (iv increasing the discount rate to 6%, and (v accounting for the proportion of EV71-HFMD cases not registered by national surveillance. In each of these scenarios, we performed probabilistic sensitivity analysis to account for parametric uncertainty in our estimates of the risk of EV71-HFMD and the expected costs and health utility loss due to EV71-HFMD. Routine pediatric EV71 vaccination would be cost-saving if the all-inclusive EVC is below US$10.6 (95% CI US$9.7-US$11.5 and would remain cost-effective if EVC is below US$17.9 (95% CI US$16.9-US$18.8 in

  20. Dynamic analysis of hybrid energy systems under flexible operation and variable renewable generation – Part II: Dynamic cost analysis

    International Nuclear Information System (INIS)

    Garcia, Humberto E.; Mohanty, Amit; Lin, Wen-Chiao; Cherry, Robert S.

    2013-01-01

    Dynamic analysis of HES (hybrid energy systems) under flexible operation and variable renewable generation is considered in this two-part communication to better understand various challenges and opportunities associated with the high system variability arising from the integration of renewable energy into the power grid. Advanced HES solutions are investigated in which multiple forms of energy commodities, such as electricity and chemical products, may be exchanged. In particular, a comparative dynamic cost analysis is conducted in this part two of the communication to determine best HES options. The cost function includes a set of metrics for computing fixed costs, such as fixed operations and maintenance and overnight capital costs, and also variable operational costs, such as cost of operational variability, variable operations and maintenance cost, and cost of environmental impact, together with revenues. Assuming natural gas, coal, and nuclear as primary heat sources, preliminary results identify the level of renewable penetration at which a given advanced HES option (e.g., a nuclear hybrid) becomes increasingly more economical than a traditional electricity-only generation solution. Conditions are also revealed under which carbon resources may be better utilized as carbon sources for chemical production rather than as combustion material for electricity generation. - Highlights: ► Dynamic analysis of HES to investigate challenges related to renewable penetration. ► Evaluation of dynamic synergies among HES constituents on system performance. ► Comparison of traditional versus advanced HES candidates. ► Dynamic cost analysis of HES candidates to investigate their economic viability. ► Identification of conditions under which an energy commodity may be best utilized

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

    Science.gov (United States)

    Kitaysky, A.S.; Kitaiskaia, E.V.; Piatt, John 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. ?? 2003 Elsevier Science (USA). All rights reserved.

  2. [Analysis of medical cost of atlantoaxial disorders in patients receiving innovated treatment technologies].

    Science.gov (United States)

    Wu, Yunxia; Liu, Zhongjun

    2016-01-19

    To explore the effects of innovated technologies and products on improving outcomes and decreasing medical costs by analyzing a total and subtotal medical costs of patients with atlantoaxial disorders. The medical costs of 1 489 patients with atlantoaxial disorders from Peking University Third Hospital from 2005 to 2014, who received innovated technologies and products treatment were retrospectively analyzed and compared.Descriptive analysis and ANOVA were used for statistical analysis, and SPSS 19.0 was used to analyze data. From 2005 to 2014, under the situation of a general increase in medical cost by 327%, the total medical costs were stable for patients who used innovated technologies and products for treatment, fluctuating from 20 851 in 2005 to 20 878 in 2014; however, the cases of operation increased year by year, from 88 in 2005 to 163 in 2014; the average length of stay decreased from 21 in 2005 to 10 in 2014; the total cases of transfusion were 22 from 2005 to 2014; the safety, stability and feasibility of the innovated technologies and products were illustrated through the decrease of average length of stay, the reduction of bleeding and the significance of outcomes. It is illustrated that the innovated technologies and products not only decrease patients' suffering and medical costs but also are safe, stable and feasible.

  3. Joint environmental and cost efficiency analysis of electricity generation

    International Nuclear Information System (INIS)

    Welch, Eric; Barnum, Darold

    2009-01-01

    Fossil-fuel based electricity generation produces the largest proportion of human-related carbon pollution in the United States. Hence, fuel choices by steam plants are key determinants of the industry's impact on national and global greenhouse gas emissions, and key foci for climate change policy. Yet, little research has been done to examine the economic and environmental tradeoffs among the different types of fuels that are used by these plants. This paper applies a Data Envelopment Analysis procedure that incorporates the materials balance principle to estimate the allocations of coal, gas and oil inputs that minimize carbon emissions and costs. Using EIA 906 and FERC 423 data, the paper estimates cost/carbon tradeoffs facing two sets of plants: those that use coal and gas inputs, and those that use coal, gas and oil inputs. Findings for our three-input sample show that there would be a 79% increase in cost for moving from the cost-efficient point to the carbon efficient point, while there would be a 38% increase in carbon for moving from the carbon efficient point to the cost-efficient point. These conclusions indicate that, in general, the gap between efficient cost and efficient environmental production is wide, and would require substantial policy intervention, technological change or market adjustment before it could be narrowed. However, our examination of individual plants shows that what is true in general is often not true for specific plants. Some plants that are currently less efficient than those on the production frontier could produce the same amount of electricity with less carbon output and less fuel input. Additionally, many plants on the production frontier could improve both cost and carbon efficiency by changing their mixture of fossil-fuel inputs. (author)

  4. 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

  5. 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

  6. Cost analysis in interventional radiology-A tool to optimize management costs

    International Nuclear Information System (INIS)

    Clevert, D.-A.; Stickel, M.; Jung, E.M.; Reiser, M.; Rupp, N.

    2007-01-01

    Objective: The objective of the study was to analyze the methods to reduce cost in interventional radiology departments by reorganizing procurement. Materials and methods: All products used in Department of Interventional Radiology were inventoried. An ABC-analysis was completed and A-products (high-value and high turnover products) underwent a XYZ-analysis which predicted demand on the basis of ordering frequency. Then criteria for a procurement strategy for the different material categories were fixed. The net working capital (NWC) was calculated using an interest rate of 8%/year. Results: Total annual material turnover was 353,000 Euro . The value of all A-products determined by the inventory was 260,000 Euro . Changes in the A-product procurement strategy tapped a cost reduction potential of 14,500/year Euro . The resulting total saving was 17,200 Euro . Improved stores management added another 37,500 Euro. The total cost cut of 52,000 Euro is equivalent to 14.7% of annual expenses. Conclusion: A flexible procurement strategy helps to reduce the storage and capital tie-up costs of A-products in interventional radiology without affecting the quality of service provided to patients

  7. [Cost analysis of intraoperative neurophysiological monitoring (IOM)].

    Science.gov (United States)

    Kombos, T; Suess, O; Brock, M

    2002-01-01

    A number of studies demonstrate that a significant reduction of postoperative neurological deficits can be achieved by applying intraoperative neurophysiological monitoring (IOM) methods. A cost analysis of IOM is imperative considering the strained financial situation in the public health services. The calculation model presented here comprises two cost components: material and personnel. The material costs comprise consumer goods and depreciation of capital goods. The computation base was 200 IOM cases per year. Consumer goods were calculated for each IOM procedure respectively. The following constellation served as a basis for calculating personnel costs: (a) a medical technician (salary level BAT Vc) for one hour per case; (b) a resident (BAT IIa) for the entire duration of the measurement, and (c) a senior resident (BAT Ia) only for supervision. An IOM device consisting of an 8-channel preamplifier, an electrical and acoustic stimulator and special software costs 66,467 euros on the average. With an annual depreciation of 20%, the costs are 13,293 euros per year. This amounts to 66.46 euros per case for the capital goods. For reusable materials a sum of 0.75 euro; per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euro; per case were,s a sum of 0.75 euros per case was calculated. Disposable materials were calculate for each procedure respectively. Total costs of 228.02 euros per case were, calculated for surgery on the peripheral nervous system. They amount to 196.40 euros per case for spinal interventions and to 347.63 euros per case for more complex spinal operations. Operations in the cerebellopontine angle and brain stem cost 376.63 euros and 397.33 euros per case respectively. IOM costs amount to 328.03 euros per case for surgical management of an intracranial aneurysm and to 537.15 euros per case for functional interventions. Expenses run up to 833.63 euros per case for operations near the

  8. Cost-Benefit Analysis of Smart Grids Implementation

    International Nuclear Information System (INIS)

    Tomsic, Z.; Pongrasic, M.

    2014-01-01

    Paper presents guidelines for conducting the cost-benefit analysis of Smart Grid projects connected to the implementation of advanced technologies in electric power system. Restrictions of presented electric power networks are also mentioned along with solutions that are offered by advanced electric power network. From an economic point of view, the main characteristic of advanced electric power network is big investment, and benefits are seen after some time with risk of being smaller than expected. Therefore it is important to make a comprehensive analysis of those projects which consist of economic and qualitative analysis. This report relies on EPRI methodology developed in American institute for energy. The methodology is comprehensive and useful, but also simple and easy to understand. Steps of this methodology and main characteristics of methodologies which refer to EPRI methodology: methodology developed in Joint Research Center and methodologies for analysing implementation of smart meters in electricity power network are explained. Costs, benefits and categories in which they can be classified are also defined. As a part of qualitative analysis, social aspect of Smart Grid projects is described. In cost defining, special attention has to be paid to projects of integrating electricity from variable renewable energy sources into the power system because of additional costs. This work summarized categories of additional costs. In the end of this report, an overview is given of what has been done and what will be done in European Union. (author).

  9. Costs of Clostridium difficile infection in pediatric operations: A propensity score-matching analysis.

    Science.gov (United States)

    Kulaylat, Afif N; Rocourt, Dorothy V; Podany, Abigail B; Engbrecht, Brett W; Twilley, Marianne; Santos, Mary C; Cilley, Robert E; Hollenbeak, Christopher S; Dillon, Peter W

    2017-05-01

    The purpose of this analysis was to assess the burden of Clostridium difficile infection in the hospitalized pediatric surgical population and to characterize its influence on the costs of care. There were 313,664 patients age 1-18 years who underwent a general thoracic or abdominal procedure in the Kids' Inpatient Database during 2003, 2006, 2009, and 2012. Logistic regression was used to model factors associated with the development of C difficile infection. A propensity score-matching analysis was performed to evaluate the influence of C difficile infection on mortality, duration of stay, and costs in similar patient cohorts. Population weights were used to estimate the national excess burden of C difficile infection on these outcomes. The overall prevalence of C difficile infection in the sampled cohort was 0.30%, with an increasing trend of C difficile infection over time in non-children's hospitals (P difficile infection was associated with younger age, nonelective procedures, increasing comorbidities, and urban teaching hospital status (P difficile infection after operation. After propensity score matching, the mean excess duration of stay and costs attributable to C difficile infection were 5.8 days and $12,801 (P difficile infection is a relatively uncommon but costly complication after pediatric operative procedures. Given the increasing trend of C difficile infection among hospitalized surgical patients, there is substantial opportunity for reduction of inpatient burden and associated costs in this potentially preventable nosocomial infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. 76 FR 64931 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-10-19

    ...-0046] Building Energy Codes Cost Analysis AGENCY: Office of Energy Efficiency and Renewable Energy... reopening of the time period for submitting comments on the request for information on Building Energy Codes... the request for information on Building Energy Code Cost Analysis and provide docket number EERE-2011...

  11. Some Observations on Cost-Effectiveness Analysis in Education.

    Science.gov (United States)

    Geske, Terry G.

    1979-01-01

    The general nature of cost-effectiveness analysis is discussed, analytical frameworks for conducting cost-effectiveness studies are described, and some of the problems inherent in measuring educational costs and in assessing program effectiveness are addressed. (Author/IRT)

  12. 20 CFR 228.40 - Cost of living increase applicable to the tier I annuity component.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Cost of living increase applicable to the... § 228.40 Cost of living increase applicable to the tier I annuity component. The tier I annuity... the Federal Register annually. The cost-of-living increase is payable beginning with the benefit for...

  13. Climate change and electricity consumption-Witnessing increasing or decreasing use and costs?

    International Nuclear Information System (INIS)

    Pilli-Sihvola, Karoliina; Aatola, Piia; Ollikainen, Markku; Tuomenvirta, Heikki

    2010-01-01

    Climate change affects the need for heating and cooling. This paper examines the impact of gradually warming climate on the need for heating and cooling with an econometric multivariate regression model for five countries in Europe along the south-north line. The predicted changes in electricity demand are then used to analyze how climate change impacts the cost of electricity use, including carbon costs. Our main findings are, that in Central and North Europe, the decrease in heating due to climate warming, dominates and thus costs will decrease for both users of electricity and in carbon markets. In Southern Europe climate warming, and the consequential increase in cooling and electricity demand, overcomes the decreased need for heating. Therefore costs also increase. The main contributors are the role of electricity in heating and cooling, and the climatic zone.

  14. 20 CFR 225.42 - Notice of the percentage amount of a cost-of-living increase.

    Science.gov (United States)

    2010-04-01

    ... THE RAILROAD RETIREMENT ACT PRIMARY INSURANCE AMOUNT DETERMINATIONS Cost-of-Living Increases § 225.42 Notice of the percentage amount of a cost-of-living increase. The percentage amount of the cost-of-living... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Notice of the percentage amount of a cost-of...

  15. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 1, The analysis and its results

    International Nuclear Information System (INIS)

    1987-06-01

    This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 dollars) over the entire life of the system...or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

  16. 22 CFR 226.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cost and price analysis. 226.45 Section 226.45 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.45 Cost and price analysis. Some...

  17. Cost analysis of light water reactor power plants

    International Nuclear Information System (INIS)

    Mooz, W.E.

    1978-06-01

    A statistical analysis is presented of the capital costs of light water reactor (LWR) electrical power plants. The objective is twofold: to determine what factors are statistically related to capital costs and to produce a methodology for estimating these costs. The analysis in the study is based on the time and cost data that are available on U.S. nuclear power plants. Out of a total of about 60 operating plants, useful capital-cost data were available on only 39 plants. In addition, construction-time data were available on about 65 plants, and data on completed construction permit applications were available for about 132 plants. The cost data were first systematically adjusted to constant dollars. Then multivariate regression analyses were performed by using independent variables consisting of various physical and locational characteristics of the plants. The dependent variables analyzed were the time required to obtain a construction permit, the construction time, and the capital cost

  18. Impact of Cost-Sharing Increases on Continuity of Specialty Drug Use: A Quasi-Experimental Study.

    Science.gov (United States)

    Li, Pengxiang; Hu, Tianyan; Yu, Xinyan; Chahin, Salim; Dahodwala, Nabila; Blum, Marissa; Pettit, Amy R; Doshi, Jalpa A

    2017-07-24

    To examine the impact of cost-sharing increases on continuity of specialty drug use in Medicare beneficiaries with multiple sclerosis (MS) or rheumatoid arthritis (RA). Five percent Medicare claims data (2007-2010). Quasi-experimental study examining changes in specialty drug use among a group of Medicare Part D beneficiaries without low-income subsidies (non-LIS) as they transitioned from a 5 percent cost-sharing preperiod to a ≥25 percent cost-sharing postperiod, as compared to changes among a disease-matched contemporaneous control group of patients eligible for full low-income subsidies (LIS), who faced minor cost sharing (≤$6.30 copayment) in both the pre- and postperiods. Key variables were extracted from Medicare data. Relative to the LIS group, the non-LIS group had a greater increase in incidence of 30-day continuous gaps in any Part D treatment from the lower cost-sharing period to the higher cost-sharing period (MS, absolute increase = 10.1 percent, OR = 1.61, 95% CI 1.19-2.17; RA, absolute increase = 21.9 percent, OR = 2.75, 95% CI 2.15-3.51). The increase in Part D treatment gaps was not offset by increased Part B specialty drug use. Cost-sharing increases due to specialty tier-level cost sharing were associated with interruptions in MS and RA specialty drug treatments. © Health Research and Educational Trust.

  19. Health economic studies: an introduction to cost-benefit, cost-effectiveness, and cost-utility analyses.

    Science.gov (United States)

    Angevine, Peter D; Berven, Sigurd

    2014-10-15

    Narrative overview. To provide clinicians with a basic understanding of economic studies, including cost-benefit, cost-effectiveness, and cost-utility analyses. As decisions regarding public health policy, insurance reimbursement, and patient care incorporate factors other than traditional outcomes such as satisfaction or symptom resolution, health economic studies are increasingly prominent in the literature. This trend will likely continue, and it is therefore important for clinicians to have a fundamental understanding of the common types of economic studies and be able to read them critically. In this brief article, the basic concepts of economic studies and the differences between cost-benefit, cost-effectiveness, and cost-utility studies are discussed. An overview of the field of health economic analysis is presented. Cost-benefit, cost-effectiveness, and cost-utility studies all integrate cost and outcome data into a decision analysis model. These different types of studies are distinguished mainly by the way in which outcomes are valued. Obtaining accurate cost data is often difficult and can limit the generalizability of a study. With a basic understanding of health economic analysis, clinicians can be informed consumers of these important studies.

  20. Fuel cycle cost considerations of increased discharge burnups

    International Nuclear Information System (INIS)

    Scherpereel, L.R.; Frank, F.J.

    1982-01-01

    Evaluations are presented that indicate the attainment of increased discharge burnups in light water reactors will depend on economic factors particular to individual operators. In addition to pure resource conserving effects and assuming continued reliable fuel performance, a substantial economic incentive must exist to justify the longer operating times necessary to achieve higher burnups. Whether such incentive will exist or not will depend on relative price levels of all fuel cycle cost components, utility operating practices, and resolution of uncertainties associated with the back-end of the fuel cycle. It is concluded that implementation of increased burnups will continue at a graduated pace similar to past experience, rather than finding universal acceptance of particular increased levels at any particular time

  1. 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

  2. Cost-effectiveness analysis of radon remediation in schools

    International Nuclear Information System (INIS)

    Kennedy, C.A.; Gray, A.M.

    2000-01-01

    sensitivity analysis show that the ratio is particularly sensitive to assumptions of two parameters including: the average capital cost of remediation and the discount rates chosen for the life yells. The overall model presented in this study can be applied to any other area, and alternative regional parameter estimates can be substituted if these are available. As the sensitivity analysis shows, however, remediation is likely to prove cost-effective even if these parameter estimates are substantially different. These results should help to inform further discussion of policy setting for radon remediation in various settings. It provides an empirical example of the type of economic analysis encouraged by both the UK NRPB (1986) and the ICRP (1983). General information on the average costs of remediation and potential savings to the health care system will be helpful as increasing numbers of local authorities start planning remediation programmes for the schools under their care. This study also highlights the need for the evaluation of other schools remediation-based radon-induced lung cancer prevention programmes in other countries using similar methodological techniques. (author)

  3. 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

  4. A U.K. cost-benefit analysis of circles of support and accountability interventions.

    Science.gov (United States)

    Elliott, Ian A; Beech, Anthony R

    2013-06-01

    Circles of Support and Accountability (CoSA) aim to augment sex offender risk management at the point of community reentry by facilitating "Circles" of volunteers who provide support, guidance, and advice, while ensuring that the offender remains accountable for their actions. In this study, the authors provide (a) a rapid evidence assessment of the effectiveness of CoSA in reducing reoffending, and (b) a U.K. cost-benefit analysis for CoSA when compared to the criminal justice costs of reoffending. From the study analysis, the average cost of a "Circle" was estimated to be £11,303 per annum and appears to produce a 50% reduction in reoffending (sexual and nonsexual), as the estimated cost of reoffending was estimated to be £147,161 per offender, per annum. Based on a hypothetical cohort of 100 offenders--50 of whom receive CoSA and 50 of whom do not--investment in CoSA appears to provide a cost saving of £23,494 and a benefit-cost ratio of 1.04. Accounting for estimates that the full extent of the cost to society may be 5 to 10 times the tangible costs substantially increases estimated cost savings related to CoSA.

  5. Exergy costs analysis of water desalination and purification techniques by transfer functions

    International Nuclear Information System (INIS)

    Carrasquer, Beatriz; Martínez-Gracia, Amaya; Uche, Javier

    2016-01-01

    Highlights: • A procedure to estimate the unit exergy cost of water treatment techniques is provided. • Unit exergy costs of water purification and desalination are given as a function of design and operating parameters. • Unit exergy costs range from 3.3 to 6.8 in purification and from 2 to 26 in desalination. • They could be used in their preliminary design as good indicators of their energy efficiency. - Abstract: The unit exergy costs of desalination and purification, which are two alternatives commonly used for water supply and treatment, have been characterized as a function of the energy efficiency of the process by combining the Exergy Cost Analysis with Transfer Function Analysis. An equation to assess the exergy costs of these alternatives is then proposed as a quick guide to know the energy efficiency of any water treatment process under different design and operating conditions. This combination, was satisfactory applied to groundwaters and water transfers. After identifying the boundaries of the system, input and output flows are calculated in exergy values. Next, different examples are analyzed in order to propose a generic equation to assess the exergy cost of the water restoration technologies, attending to their main features. Recovery ratio, energy requirements and salts concentrations (for desalination), and plant capacity and organic matter recovery (for water purification) are introduced in the calculations as their main endogenous parameters. Values obtained for typical operation ranges of commercial plants showed that unit exergy costs of water purification ranged from 3.3 to 6.8; maximum values, as expected, were found at low plant capacities and high organic matter removal ratios. For water desalination, values varied from 2 to 7 in membrane technologies and from 10 to 26 in thermal processes. The recovery ratio and salts concentration in raw water increased the unit exergy costs in membrane techniques. In distillation processes

  6. Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis.

    Science.gov (United States)

    Cabot, Jennifer C; Lee, Cho Rok; Brunaud, Laurent; Kleiman, David A; Chung, Woong Youn; Fahey, Thomas J; Zarnegar, Rasa

    2012-12-01

    This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States. A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables. The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference. Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule. Copyright © 2012 Mosby, Inc. All rights reserved.

  7. 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

  8. The trade-off between hospital cost and quality of care. An exploratory empirical analysis.

    Science.gov (United States)

    Morey, R C; Fine, D J; Loree, S W; Retzlaff-Roberts, D L; Tsubakitani, S

    1992-08-01

    The debate concerning quality of care in hospitals, its "value" and affordability, is increasingly of concern to providers, consumers, and purchasers in the United States and elsewhere. We undertook an exploratory study to estimate the impact on hospital-wide costs if quality-of-care levels were varied. To do so, we obtained costs and service output data regarding 300 U.S. hospitals, representing approximately a 5% cross section of all hospitals operating in 1983; both inpatient and outpatient services were included. The quality-of-care measure used for the exploratory analysis was the ratio of actual deaths in the hospital for the year in question to the forecasted number of deaths for the hospital; the hospital mortality forecaster had earlier (and elsewhere) been built from analyses of 6 million discharge abstracts, and took into account each hospital's actual individual admissions, including key patient descriptors for each admission. Such adjusted death rates have increasingly been used as potential indicators of quality, with recent research lending support for the viability of that linkage. The authors then utilized the economic construct of allocative efficiency relying on "best practices" concepts and peer groupings, built using the "envelopment" philosophy of Data Envelopment Analysis and Pareto efficiency. These analytical techniques estimated the efficiently delivered costs required to meet prespecified levels of quality of care. The marginal additional cost per each death deferred in 1983 was estimated to be approximately $29,000 (in 1990 dollars) for the average efficient hospital. Also, over a feasible range, a 1% increase in the level of quality of care delivered was estimated to increase hospital cost by an average of 1.34%. This estimated elasticity of quality on cost also increased with the number of beds in the hospital.

  9. A systems engineering cost analysis capability for use in assessing nuclear waste management system cost performance

    International Nuclear Information System (INIS)

    Shay, M.R.

    1990-04-01

    The System Engineering Cost Analysis (SECA) capability has been developed by the System Integration Branch of the US Department of Energy's Office of Civilian Radioactive Waste Management for use in assessing the cost performance of alternative waste management system configurations. The SECA capability is designed to provide rapid cost estimates of the waste management system for a given operational scenario and to permit aggregate or detailed cost comparisons for alternative waste system configurations. This capability may be used as an integral part of the System Integration Modeling System (SIMS) or, with appropriate input defining a scenario, as a separate cost analysis model

  10. How (not) to Lie with Benefit-Cost Analysis

    OpenAIRE

    Scott Farrow

    2013-01-01

    Benefit-cost analysis is seen by some as a controversial activity in which the analyst can significantly bias the results. This note highlights some of the ways that analysts can "lie" in a benefit-cost analysis but more importantly, provides guidance on how not to lie and how to better inform public decisionmakers.

  11. 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

  12. Benefit-cost-risk analysis of alternatives for greater-confinement disposal of radioactive waste

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Peterson, J.M.

    1983-01-01

    Seven alternatives are included in the analysis: near-surface disposal; improved waste form; below-ground engineered structure; augered shaft; shale fracturing; shallow geologic repository; and high-level waste repository. These alternatives are representative generic facilities that span the range from low-level waste disposal practice to high-level waste disposal practice, tentatively ordered according to an expected increasing cost and/or effectiveness of confinement. They have been chosen to enable an assessment of the degree of confinement that represents an appropriate balance between public health and safety requirements and costs rather than identification of a specific preferred facility design. The objective of the analysis is to provide a comparative ranking of the alternatives on the basis of benefit-cost-risk considerations

  13. Cost analysis of the treatment of severe acute malnutrition in West Africa.

    Science.gov (United States)

    Isanaka, Sheila; Menzies, Nicolas A; Sayyad, Jessica; Ayoola, Mudasiru; Grais, Rebecca F; Doyon, Stéphane

    2017-10-01

    We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support). For each category, total costs were calculated by multiplying input quantities expended in the Médecins Sans Frontières nutrition program in Niger during a 12-month study period by 2015 input prices. All children received outpatient treatment, with 43% also receiving inpatient treatment. In this large, well-established program, the average cost per child treated was €148.86, with outpatient and inpatient treatment costs of €75.50 and €134.57 per child, respectively. Therapeutic food (44%, €32.98 per child) and personnel (35%, €26.70 per child) dominated outpatient costs, while personnel (56%, €75.47 per child) dominated in the cost of inpatient care. Sensitivity analyses suggested lowering prices of medical treatments, and therapeutic food had limited effect on total costs per child, while increasing program size and decreasing use of expatriate staff support reduced total costs per child substantially. Updated estimates of severe acute malnutrition treatment cost are substantially lower than previously published values, and important cost savings may be possible with increases in coverage/program size and integration into national health programs. These updated estimates can be used to suggest approaches to improve efficiency and inform national-level resource allocation. © 2016 John Wiley & Sons Ltd.

  14. 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.

  15. Cost benefit analysis of reactor safety systems

    International Nuclear Information System (INIS)

    Maurer, H.A.

    1984-01-01

    Cost/benefit analysis of reactor safety systems is a possibility appropriate to deal with reactor safety. The Commission of the European Communities supported a study on the cost-benefit or cost effectiveness of safety systems installed in modern PWR nuclear power plants. The following systems and their cooperation in emergency cases were in particular investigated in this study: the containment system (double containment), the leakage exhaust and control system, the annulus release exhaust system and the containment spray system. The benefit of a safety system is defined according to its contribution to the reduction of the radiological consequences for the environment after a LOCA. The analysis is so far performed in two different steps: the emergency core cooling system is considered to function properly, failure of the emergency core cooling system is assumed (with the possible consequence of core melt-down) and the results may demonstrate the evidence that striving for cost-effectiveness can produce a safer end result than the philosophy of safety at any cost. (orig.)

  16. 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.

  17. Cost-Effectiveness of Increasing Influenza Vaccination Coverage in Adults with Type 2 Diabetes in Turkey.

    Science.gov (United States)

    Akın, Levent; Macabéo, Bérengère; Caliskan, Zafer; Altinel, Serdar; Satman, Ilhan

    2016-01-01

    In Turkey, the prevalence of diabetes is high but the influenza vaccination coverage rate (VCR) is low (9.1% in 2014), despite vaccination being recommended and reimbursed. This study evaluated the cost-effectiveness of increasing the influenza VCR of adults with type 2 diabetes in Turkey to 20%. A decision-analytic model was adapted to Turkey using data derived from published sources. Direct medical costs and indirect costs due to productivity loss were included in the societal perspective. The time horizon was set at 1 year to reflect the seasonality of influenza. Increasing the VCR for adults with type 2 diabetes to 20% is predicted to avert an additional 19,777 influenza cases, 2376 hospitalizations, and 236 deaths. Associated influenza costs avoided were estimated at more than 8.3 million Turkish Lira (TRY), while the cost of vaccination would be more than TRY 8.4 million. The incremental cost-effectiveness ratio was estimated at TRY 64/quality-adjusted life years, which is below the per capita gross domestic product of TRY 21,511 and therefore very cost-effective according to World Health Organization guidelines. Factors most influencing the incremental cost-effectiveness ratio were the excess hospitalization rate, inpatient cost, vaccine effectiveness against hospitalization, and influenza attack rate. Increasing the VCR to >20% was also estimated to be very cost-effective. Increasing the VCR for adults with type 2 diabetes in Turkey to ≥20% would be very cost-effective.

  18. Environmental cost/benefit analysis for fusion power plants

    International Nuclear Information System (INIS)

    Young, J.R.

    1976-11-01

    This document presents a cost/benefit analysis of use of fusion power plants early in the 21st century. The first section describes the general formulation of the analysis. Included are the selection of the alternatives to the fusion reactor, selection of the power system cases to be compared, and a general comparison of the environmental effects of the selected alternatives. The second section compares the cumulative environmental effects from 2010 to 2040 for the primary cases of the power system with and without fusion reactors. The third section briefly illustrates the potential economic benefits if fusion reactors produce electricity at a lower unit cost than LMFBRs can. The fourth section summarizes the cost/benefit analysis

  19. Benefit-Cost Analysis of Undergraduate Education Programs: An Example Analysis of the Freshman Research Initiative.

    Science.gov (United States)

    Walcott, Rebecca L; Corso, Phaedra S; Rodenbusch, Stacia E; Dolan, Erin L

    2018-01-01

    Institutions and administrators regularly have to make difficult choices about how best to invest resources to serve students. Yet economic evaluation, or the systematic analysis of the relationship between costs and outcomes of a program or policy, is relatively uncommon in higher education. This type of evaluation can be an important tool for decision makers considering questions of resource allocation. Our purpose with this essay is to describe methods for conducting one type of economic evaluation, a benefit-cost analysis (BCA), using an example of an existing undergraduate education program, the Freshman Research Initiative (FRI) at the University of Texas Austin. Our aim is twofold: to demonstrate how to apply BCA methodologies to evaluate an education program and to conduct an economic evaluation of FRI in particular. We explain the steps of BCA, including assessment of costs and benefits, estimation of the benefit-cost ratio, and analysis of uncertainty. We conclude that the university's investment in FRI generates a positive return for students in the form of increased future earning potential. © 2018 R. L. Walcott et al. CBE—Life Sciences Education © 2018 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  20. 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...

  1. Cost effectiveness of withdrawal of fall-risk-increasing drugs in geriatric outpatients

    NARCIS (Netherlands)

    van der Velde, Nathalie; Meerding, Willen Jan; Looman, Caspar W.; Pols, Huibert A. P.; van der Cammen, Tischa J. M.

    2008-01-01

    BACKGROUND: Withdrawal of fall-risk-increasing drugs has been proven to be effective in older persons. However, given the enormous rise in healthcare costs in recent decades, the effect of such withdrawals on healthcare costs also needs to be considered. METHOD: Within a common geriatric outpatient

  2. 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...

  3. 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

  4. 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.

  5. Medical therapy v. PCI in stable coronary artery disease: a cost-effectiveness analysis.

    Science.gov (United States)

    Wijeysundera, Harindra C; Tomlinson, George; Ko, Dennis T; Dzavik, Vladimir; Krahn, Murray D

    2013-10-01

    Percutaneous coronary intervention (PCI) with either drug-eluting stents (DES) or bare metal stents (BMS) reduces angina and repeat procedures compared with optimal medical therapy alone. It remains unclear if these benefits are sufficient to offset their increased costs and small increase in adverse events. Cost utility analysis of initial medical therapy v. PCI with either BMS or DES. . Markov cohort decision model. Data Sources. Propensity-matched observational data from Ontario, Canada, for baseline event rates. Effectiveness and utility data obtained from the published literature, with costs from the Ontario Case Costing Initiative. Patients with stable coronary artery disease, confirmed after angiography, stratified by risk of restenosis based on diabetic status, lesion size, and lesion length. Time Horizon. Lifetime. Perspective. Ontario Ministry of Health and Long Term Care. Interventions. Optimal medical therapy, PCI with BMS or DES. Lifetime costs, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). of Base Case Analysis. In the overall population, medical therapy had the lowest lifetime costs at $22,952 v. $25,081 and $25,536 for BMS and DES, respectively. Medical therapy had a quality-adjusted life expectancy of 10.1 v. 10.26 QALYs for BMS, producing an ICER of $13,271/QALY. The DES strategy had a quality-adjusted life expectancy of only 10.20 QALYs and was dominated by the BMS strategy. This ranking was consistent in all groups stratified by restenosis risk, except diabetic patients with long lesions in small arteries, in whom DES was cost-effective compared with medical therapy (ICER of $18,826/QALY). Limitations. There is the possibility of residual unobserved confounding. In patients with stable coronary artery disease, an initial BMS strategy is cost-effective.

  6. Space construction system analysis. Part 2: Cost and programmatics

    Science.gov (United States)

    Vonflue, F. W.; Cooper, W.

    1980-01-01

    Cost and programmatic elements of the space construction systems analysis study are discussed. The programmatic aspects of the ETVP program define a comprehensive plan for the development of a space platform, the construction system, and the space shuttle operations/logistics requirements. The cost analysis identified significant items of cost on ETVP development, ground, and flight segments, and detailed the items of space construction equipment and operations.

  7. The Great Recession And Increased Cost Sharing In European Health Systems.

    Science.gov (United States)

    Palladino, Raffaele; Lee, John Tayu; Hone, Thomas; Filippidis, Filippos T; Millett, Christopher

    2016-07-01

    European health systems are increasingly adopting cost-sharing models, potentially increasing out-of-pocket expenditures for patients who use health care services or buy medications. Government policies that increase patient cost sharing are responding to incremental growth in cost pressures from aging populations and the need to invest in new health technologies, as well as to general constraints on public expenditures resulting from the Great Recession (2007-09). We used data from the Survey of Health, Ageing and Retirement in Europe to examine changes from 2006-07 to 2013 in out-of-pocket expenditures among people ages fifty and older in eleven European countries. Our results identify increases both in the proportion of older European citizens who incurred out-of-pocket expenditures and in mean out-of-pocket expenditures over this period. We also identified a significant increase over time in the percentage of people who incurred catastrophic health expenditures (greater than 30 percent of the household income) in the Czech Republic, Italy, and Spain. Poorer populations were less likely than those in the highest income quintile to incur an out-of-pocket expenditure and reported lower mean out-of-pocket expenditures, which suggests that measures are in place to provide poorer groups with some financial protection. These findings indicate the substantial weakening of financial protection for people ages fifty and older in European health systems after the Great Recession. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Cost Analysis of NEDU’s Helium Reclaimer.

    Science.gov (United States)

    1981-09-01

    T ITLE (and Subtitle) S . TYPE OF REPORT 6 PERIOD COVERED COST ANALYSIS OF NEDU’S HELIUM RECLAIMER . Survey 6 . PERFORMING ORG. REPORT NUMSER 7...telephone conversation). 5. Charles T. Horngren , "Introduction tu Management Accounting " Fourth Edition. 3 . .4m mmnssmmlm~ • FIGURE 1 PRESENT, FUTURE AND...FEET COST OF PERIODIC MAINTENANCE OF HELIUM ELECTRIiC COST COST OF TOTAL RECLAIMED POWER NEW COST PRESENT WORTH YEAR N PER YEAR ( S /1000 FT

  9. 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.

  10. Incorporating indirect costs into a cost-benefit analysis of laparoscopic adjustable gastric banding.

    Science.gov (United States)

    Finkelstein, Eric A; Allaire, Benjamin T; Dibonaventura, Marco Dacosta; Burgess, Somali M

    2012-01-01

    The objective of this study was to estimate the time to breakeven and 5-year net costs of laparoscopic adjustable gastric banding (LAGB) taking both direct and indirect costs and cost savings into account. Estimates of direct cost savings from LAGB were available from the literature. Although longitudinal data on indirect cost savings were not available, these estimates were generated by quantifying the relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and combining these elasticity estimates with estimates of the direct cost savings to generate total savings. These savings were then combined with the direct and indirect costs of the procedure to quantify net savings. By including indirect costs, the time to breakeven was reduced by half a year, from 16 to 14 quarters. After 5 years, net savings in medical expenditures from a gastric banding procedure were estimated to be $4970 (±$3090). Including absenteeism increased savings to $6180 (±$3550). Savings were further increased to $10,960 (±$5864) when both absenteeism and presenteeism estimates were included. This study presented a novel approach for including absenteeism and presenteeism estimates in cost-benefit analyses. Application of the approach to gastric banding among surgery-eligible obese employees revealed that the inclusion of indirect costs and cost savings improves the business case for the procedure. This approach can easily be extended to other populations and treatments. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Capital Cost Optimization for Prefabrication: A Factor Analysis Evaluation Model

    Directory of Open Access Journals (Sweden)

    Hong Xue

    2018-01-01

    Full Text Available High capital cost is a significant hindrance to the promotion of prefabrication. In order to optimize cost management and reduce capital cost, this study aims to explore the latent factors and factor analysis evaluation model. Semi-structured interviews were conducted to explore potential variables and then questionnaire survey was employed to collect professionals’ views on their effects. After data collection, exploratory factor analysis was adopted to explore the latent factors. Seven latent factors were identified, including “Management Index”, “Construction Dissipation Index”, “Productivity Index”, “Design Efficiency Index”, “Transport Dissipation Index”, “Material increment Index” and “Depreciation amortization Index”. With these latent factors, a factor analysis evaluation model (FAEM, divided into factor analysis model (FAM and comprehensive evaluation model (CEM, was established. The FAM was used to explore the effect of observed variables on the high capital cost of prefabrication, while the CEM was used to evaluate comprehensive cost management level on prefabrication projects. Case studies were conducted to verify the models. The results revealed that collaborative management had a positive effect on capital cost of prefabrication. Material increment costs and labor costs had significant impacts on production cost. This study demonstrated the potential of on-site management and standardization design to reduce capital cost. Hence, collaborative management is necessary for cost management of prefabrication. Innovation and detailed design were needed to improve cost performance. The new form of precast component factories can be explored to reduce transportation cost. Meanwhile, targeted strategies can be adopted for different prefabrication projects. The findings optimized the capital cost and improved the cost performance through providing an evaluation and optimization model, which helps managers to

  12. Cost Benefit Analysis: Bypass of Prešov city

    Directory of Open Access Journals (Sweden)

    Margorínová Martina

    2017-01-01

    Full Text Available The paper describes decision making process based on economic evaluation, i.e. Cost Benefit Analysis for motorway bypass of the Prešov city. Three variants were evaluated by means of the Highway Development and Management Tool (HDM-4. HDM-4 is a software system for evaluating options for investing in road transport infrastructure. Vehicle operating costs and travel time costs were monetized with the use of the software. The investment opportunities were evaluated in terms of Cost Benefit Analysis results, i.e. economic indicators.

  13. FORECAST: Regulatory effects cost analysis software annual

    International Nuclear Information System (INIS)

    Lopez, B.; Sciacca, F.W.

    1991-11-01

    Over the past several years the NRC has developed a generic cost methodology for the quantification of cost/economic impacts associated with a wide range of new or revised regulatory requirements. This methodology has been developed to aid the NRC in preparing Regulatory Impact Analyses (RIAs). These generic costing methods can be useful in quantifying impacts both to industry and to the NRC. The FORECAST program was developed to facilitate the use of the generic costing methodology. This PC program integrates the major cost considerations that may be required because of a regulatory change. FORECAST automates much of the calculations typically needed in an RIA and thus reduces the time and labor required to perform these analysis. More importantly, its integrated and consistent treatment of the different cost elements should help assure comprehensiveness, uniformity, and accuracy in the preparation of needed cost estimates

  14. Cost-identification analysis of total laryngectomy: an itemized approach to hospital costs.

    Science.gov (United States)

    Dedhia, Raj C; Smith, Kenneth J; Weissfeld, Joel L; Saul, Melissa I; Lee, Steve C; Myers, Eugene N; Johnson, Jonas T

    2011-02-01

    To understand the contribution of intraoperative and postoperative hospital costs to total hospital costs, examine the costs associated with specific hospital services in the postoperative period, and recognize the impact of patient factors on hospital costs. Case series with chart review. Large tertiary care teaching hospital system. Using the Pittsburgh Head and Neck Organ-Specific Database, 119 patients were identified as having total laryngectomy with bilateral selective neck dissection and primary closure from 1999 to 2009. Cost data were obtained for 112 patients. Costs include fixed and variable costs, adjusted to 2010 US dollars using the Consumer Price Index. Mean total hospital costs were $29,563 (range, $10,915 to $120,345). Operating room costs averaged 24% of total hospital costs, whereas room charges, respiratory therapy, laboratory, pharmacy, and radiology accounted for 38%, 14%, 8%, 7%, and 3%, respectively. Median length of stay was 9 days (range, 6-43), and median Charlson comorbidity index score was 8 (2-16). Patients with ≥1 day in the intensive care unit had significantly higher hospital costs ($46,831 vs $24,601, P cost differences with stratification based on previous radiation therapy ($27,598 vs $29,915 with no prior radiation, P = .62) or hospital readmission within 30 days ($29,483 vs $29,609 without readmission, P = .97). This is one of few studies in surgery and the first in otolaryngology to analyze hospital costs for a relatively standardized procedure. Further work will include cost analysis from multiple centers with investigation of global cost drivers.

  15. Streamlining: Reducing costs and increasing STS operations effectiveness

    Science.gov (United States)

    Petersburg, R. K.

    1985-01-01

    The development of streamlining as a concept, its inclusion in the space transportation system engineering and operations support (STSEOS) contract, and how it serves as an incentive to management and technical support personnel is discussed. The mechanics of encouraging and processing streamlining suggestions, reviews, feedback to submitters, recognition, and how individual employee performance evaluations are used to motivation are discussed. Several items that were implemented are mentioned. Information reported and the methodology of determining estimated dollar savings are outlined. The overall effect of this activity on the ability of the McDonnell Douglas flight preparation and mission operations team to support a rapidly increasing flight rate without a proportional increase in cost is illustrated.

  16. Vasa previa screening strategies: a decision and cost-effectiveness analysis.

    Science.gov (United States)

    Sinkey, R G; Odibo, A O

    2018-05-22

    The aim of this study is to perform a decision and cost-effectiveness analysis comparing four screening strategies for the antenatal diagnosis of vasa previa among singleton pregnancies. A decision-analytic model was constructed comparing vasa previa screening strategies. Published probabilities and costs were applied to four transvaginal screening scenarios which occurred at the time of mid-trimester ultrasound: no screening, ultrasound-indicated screening, screening pregnancies conceived by in vitro fertilization (IVF), and universal screening. Ultrasound-indicated screening was defined as performing a transvaginal ultrasound at the time of routine anatomy ultrasound in response to one of the following sonographic findings associated with an increased risk of vasa previa: low-lying placenta, marginal or velamentous cord insertion, or bilobed or succenturiate lobed placenta. The primary outcome was cost per quality adjusted life years (QALY) in U.S. dollars. The analysis was from a healthcare system perspective with a willingness to pay (WTP) threshold of $100,000 per QALY selected. One-way and multivariate sensitivity analyses (Monte-Carlo simulation) were performed. This decision-analytic model demonstrated that screening pregnancies conceived by IVF was the most cost-effective strategy with an incremental cost effectiveness ratio (ICER) of $29,186.50 / QALY. Ultrasound-indicated screening was the second most cost-effective with an ICER of $56,096.77 / QALY. These data were robust to all one-way and multivariate sensitivity analyses performed. Within our baseline assumptions, transvaginal ultrasound screening for vasa previa appears to be most cost-effective when performed among IVF pregnancies. However, both IVF and ultrasound-indicated screening strategies fall within contemporary willingness-to-pay thresholds, suggesting that both strategies may be appropriate to apply in clinical practice. This article is protected by copyright. All rights reserved. This

  17. 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.

  18. Oil and gas pipeline construction cost analysis and developing regression models for cost estimation

    Science.gov (United States)

    Thaduri, Ravi Kiran

    In this study, cost data for 180 pipelines and 136 compressor stations have been analyzed. On the basis of the distribution analysis, regression models have been developed. Material, Labor, ROW and miscellaneous costs make up the total cost of a pipeline construction. The pipelines are analyzed based on different pipeline lengths, diameter, location, pipeline volume and year of completion. In a pipeline construction, labor costs dominate the total costs with a share of about 40%. Multiple non-linear regression models are developed to estimate the component costs of pipelines for various cross-sectional areas, lengths and locations. The Compressor stations are analyzed based on the capacity, year of completion and location. Unlike the pipeline costs, material costs dominate the total costs in the construction of compressor station, with an average share of about 50.6%. Land costs have very little influence on the total costs. Similar regression models are developed to estimate the component costs of compressor station for various capacities and locations.

  19. 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. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.

  20. A cost-benefit analysis of alternatively fueled buses with special considerations for V2G technology

    International Nuclear Information System (INIS)

    Shirazi, Yosef; Carr, Edward; Knapp, Lauren

    2015-01-01

    Motivated by climate, health and economic considerations, alternatively-fueled bus fleets have emerged worldwide. Two popular alternatives are compressed natural gas (CNG) and electric vehicles. The latter provides the opportunity to generate revenue through vehicle-to-grid (V2G) services if properly equipped. This analysis conducts a robust accounting of the costs of diesel, CNG and battery-electric powertrains for school buses. Both marginal and fleet-wide scenarios are explored. Results indicate that the marginal addition of neither a small CNG nor a small V2G-enabled electric bus is cost effective at current prices. Contrary to previous findings, a small V2G-enabled electric bus increases net present costs by $7,200/seat relative to diesel for a Philadelphia, PA school district. A small CNG bus increases costs by $1,200/seat relative to diesel. This analysis is the first to quantify and include the economic implications of cold temperature extremes on electric vehicle battery operations, and the lower V2G revenues that result. Additional costs and limitations imposed by electric vehicles performing V2G are frequently overlooked in the literature and are explored here. If a variety of technical, legal, and economic challenges are overcome, a future eBus may be economical. - Highlights: • We present a robust cost-benefit analysis of various bus technologies. • Diesel is a low-cost technology at current prices. • CNG represents slightly higher costs on a marginal bus basis. • V2G-enabled electric buses are not cost-effective at current prices. • We identify frequently overlooked costs and challenges to V2G implementation.

  1. Cost-effectiveness analysis of different embryo transfer strategies in England.

    Science.gov (United States)

    Dixon, S; Faghih Nasiri, F; Ledger, W L; Lenton, E A; Duenas, A; Sutcliffe, P; Chilcott, J B

    2008-05-01

    The objective of this study was to assess the cost-effectiveness of different embryo transfer strategies for a single cycle when two embryos are available, and taking the NHS cost perspective. Cost-effectiveness model. Five in vitro fertilisation (IVF) centres in England between 2003/04 and 2004/05. Women with two embryos available for transfer in three age groups (Costs and adverse outcomes are estimated up to 5 years after the birth. Incremental cost per live birth was calculated for different embryo transfer strategies and for three separate age groups: less than 30, 30-35 and 36-39 years. Premature birth, neonatal intensive care unit admissions and days, cerebral palsy and incremental cost-effectiveness ratios. Single fresh embryo transfer (SET) plus frozen single embryo transfer (fzSET) is the more costly in terms of IVF costs, but the lower rates of multiple births mean that in terms of total costs, it is less costly than double embryo transfer (DET). Adverse events increase when moving from SET to SET+fzSET to DET. The probability of SET+fzSET being cost-effective decreases with age. When SET is included in the analysis, SET+fzSET no longer becomes a cost-effective option at any threshold value for all age groups studied. The analyses show that the choice of embryo transfer strategy is a function of four factors: the age of the mother, the relevance of the SET option, the value placed on a live birth and the relative importance placed on adverse outcomes. For each patient group, the choice of strategy is a trade-off between the value placed on a live birth and cost.

  2. Effect of increased regulation on capital costs and manual labor requirements of nuclear power plants

    International Nuclear Information System (INIS)

    Paik, S.; Schriver, W.R.

    1981-01-01

    An attempt is made to explain the impact of increasing governmental regulation on capital costs and labor requirements for constructing light water reactor (LWR) electric power plants. The principal factors contributing to these increases are: (1) market conditions and (2) increased regulation. General market conditions include additional costs attributable to price inflation of equipment, material, labor, and the increased cost of money. The central objective of this work is to estimate the impact of increasing regulation on plant costs and, conversely, on output. To do this it is necessary to isolate two opposing sets of forces which have been in operation during the period of major regulatory expansion: learning based upon plant design experience and economies of scale with increasing size (generating capacity) of newer plants. Conceptual models are specified to capture the independent effects of increasing regulation, learning, and economies of scale. Empirical results were obtained by estimating the models on data collected from industry experience during the 1967-1980 period. 23 refs

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

    Science.gov (United States)

    2010-10-01

    ... October 1, 2002, is the percentage increase projected by the hospital market basket index. (4) Target... target amount for the previous cost reporting period, updated by the market basket percentage increase... each cost reporting period, the ceiling is determined by multiplying the updated target amount, as...

  4. Cost-Benefit Analysis and the Democratic Ideal

    OpenAIRE

    Karine Nyborg; Inger Spangen

    1997-01-01

    In traditional cost-benefit analyses of public projects, every citizen’s willingness to pay for a project is given an equal weight. This is sometimes taken to imply that cost-benefit analysis is a democratic method for making public decisions, as opposed to, for example, political processes involving log-rolling and lobbying from interest groups. Politicians are frequently criticized for not putting enough emphasis on the cost-benefit analyses when making decisions. In this paper we discuss t...

  5. MEMS cost analysis from laboratory to industry

    CERN Document Server

    Freng, Ron Lawes

    2016-01-01

    The World of MEMS; Chapter 2: Basic Fabrication Processes; Chapter 3: Surface Microengineering. High Aspect Ratio Microengineering; Chapter 5: MEMS Testing; Chapter 6: MEMS Packaging. Clean Rooms, Buildings and Plant; Chapter 8: The MEMSCOST Spreadsheet; Chapter 9: Product Costs - Accelerometers. Product Costs - Microphones. MEMS Foundries. Financial Reporting and Analysis. Conclusions.

  6. 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.

  7. Standardization: using comparative maintenance costs in an economic analysis

    OpenAIRE

    Clark, Roger Nelson

    1987-01-01

    Approved for public release; distribution is unlimited This thesis investigates the use of comparative maintenance costs of functionally interchangeable equipments in similar U.S. Navy shipboard applications in an economic analysis of standardization. The economics of standardization, life-cycle costing, and the Navy 3-M System are discussed in general. An analysis of 3-M System maintenance costs for a selected equipment, diesel engines, is conducted. The potential use of comparative ma...

  8. Comparative Life-Cycle Cost Analysis Of Solar Photovoltaic Power ...

    African Journals Online (AJOL)

    Comparative Life-Cycle Cost Analysis Of Solar Photovoltaic Power System And Diesel Generator System For Remote Residential Application In Nigeria. ... like capital cost, and diesel fuel costs are varied. The results show the photovoltaic system to be more cost-effective at low-power ranges of electrical energy supply.

  9. On the transition to sustainability: an analysis of the costs of school feeding compared with the costs of primary education.

    Science.gov (United States)

    Bundy, Donald; Burbano, Carmen; Gelli, Aulo; Risley, Claire; Neeser, Kristie

    2011-09-01

    The current food, fuel, and financial crises have highlighted the importance of school feeding programs both as a social safety net for children living in poverty and food insecurity, and as part of national educational policies and plans. To examine the costs of school feeding, in terms of both the absolute cost per child and the cost per child relative to overall education expenditure and gross domestic product (GDP) in low-, middle-, and high-income countries. Data on the costs of school feeding in different countries were collected from multiple sources, including World Food Programme project data, reports from government ministries, and, where such searches failed, newspaper articles and other literature obtained from internet searches. Regression models were then used to analyze the relationships between school feeding costs, the per capita costs of primary education and GDP per capita. School feeding programs in low-income countries exhibit large variations in cost, with concomitant opportunities for cost containment. As countries get richer, however, school feeding costs become a much smaller proportion of the investment in education. The per capita costs of feeding relative to education decline nonlinearly with increasing GDP. These analyses suggest that the main reason for this decline in the relative cost of school feeding versus primary education is a greatly increased investment per child in primary education as GDP rises, but a fairly flat investment in food. The analyses also show that there appears to be a transitional discontinuity at the interface between the lower- and middle-income countries, which tends to coincide with changes in the capacity of governments to take over the management and funding of programs. Further analysis is required to define these relationships, but an initial conclusion is that supporting countries to maintain an investment in school feeding through this transition may emerge as a key role for development partners.

  10. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry

    Directory of Open Access Journals (Sweden)

    Popova Viktoriya D.

    2014-01-01

    Full Text Available 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 the generalised quantitative structure of logistics costs of Ukrainian semiconductor enterprises with various forms of ownership under conditions of a situational growth of cost value of products and reduction of profitability of production, caused by common crisis tendencies in economy. Prospects of further studies in this direction are analysis of costs in production of semiconductor products and establishment of the specific feature of their grouping and classifying from the point of view of logistics and justification of the model of assessment of cost value of products, which takes into account mutually contradictory influence of direct logistics costs and logistics management upon the final result.

  11. Fitness cost of resistance to Bt cotton linked with increased gossypol content in pink bollworm larvae.

    Directory of Open Access Journals (Sweden)

    Jennifer L Williams

    Full Text Available Fitness costs of resistance to Bacillus thuringiensis (Bt crops occur in the absence of Bt toxins, when individuals with resistance alleles are less fit than individuals without resistance alleles. As costs of Bt resistance are common, refuges of non-Bt host plants can delay resistance not only by providing susceptible individuals to mate with resistant individuals, but also by selecting against resistance. Because costs typically vary across host plants, refuges with host plants that magnify costs or make them less recessive could enhance resistance management. Limited understanding of the physiological mechanisms causing fitness costs, however, hampers attempts to increase costs. In several major cotton pests including pink bollworm (Pectinophora gossypiella, resistance to Cry1Ac cotton is associated with mutations altering cadherin proteins that bind this toxin in susceptible larvae. Here we report that the concentration of gossypol, a cotton defensive chemical, was higher in pink bollworm larvae with cadherin resistance alleles than in larvae lacking such alleles. Adding gossypol to the larval diet decreased larval weight and survival, and increased the fitness cost affecting larval growth, but not survival. Across cadherin genotypes, the cost affecting larval growth increased as the gossypol concentration of larvae increased. These results suggest that increased accumulation of plant defensive chemicals may contribute to fitness costs associated with resistance to Bt toxins.

  12. Improvement of the cost-benefit analysis algorithm for high-rise construction projects

    Directory of Open Access Journals (Sweden)

    Gafurov Andrey

    2018-01-01

    Full Text Available The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the “Project analysis scenario” flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

  13. Improvement of the cost-benefit analysis algorithm for high-rise construction projects

    Science.gov (United States)

    Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

    2018-03-01

    The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.

  14. Cost-effectiveness analysis of population-based tobacco control strategies in the prevention of cardiovascular diseases in Tanzania.

    Directory of Open Access Journals (Sweden)

    Frida Ngalesoni

    Full Text Available Tobacco consumption contributes significantly to the global burden of disease. The prevalence of smoking is estimated to be increasing in many low-income countries, including Tanzania, especially among women and youth. Even so, the implementation of tobacco control measures has been discouraging in the country. Efforts to foster investment in tobacco control are hindered by lack of evidence on what works and at what cost.We aim to estimate the cost and cost-effectiveness of population-based tobacco control strategies in the prevention of cardiovascular diseases (CVD in Tanzania.A cost-effectiveness analysis was performed using an Excel-based Markov model, from a governmental perspective. We employed an ingredient approach and step-down methodologies in the costing exercise following a government perspective. Epidemiological data and efficacy inputs were derived from the literature. We used disability-adjusted life years (DALYs averted as the outcome measure. A probabilistic sensitivity analysis was carried out with Ersatz to incorporate uncertainties in the model parameters.Our model results showed that all five tobacco control strategies were very cost-effective since they fell below the ceiling ratio of one GDP per capita suggested by the WHO. Increase in tobacco taxes was the most cost-effective strategy, while a workplace smoking ban was the least cost-effective option, with a cost-effectiveness ratio of US$5 and US$267, respectively.Even though all five interventions are deemed very cost-effective in the prevention of CVD in Tanzania, more research on budget impact analysis is required to further assess the government's ability to implement these interventions.

  15. Corruption Significantly Increases the Capital Cost of Power Plants in Developing Contexts

    Directory of Open Access Journals (Sweden)

    Kumar Biswajit Debnath

    2018-03-01

    Full Text Available Emerging economies with rapidly growing population and energy demand, own some of the most expensive power plants in the world. We hypothesized that corruption has a relationship with the capital cost of power plants in developing countries such as Bangladesh. For this study, we analyzed the capital cost of 61 operational and planned power plants in Bangladesh. Initial comparison study revealed that the mean capital cost of a power plant in Bangladesh is twice than that of the global average. Then, the statistical analysis revealed a significant correlation between corruption and the cost of power plants, indicating that higher corruption leads to greater capital cost. The high up-front cost can be a significant burden on the economy, at present and in the future, as most are financed through international loans with extended repayment terms. There is, therefore, an urgent need for the review of the procurement and due diligence process of establishing power plants, and for the implementation of a more transparent system to mitigate adverse effects of corruption on megaprojects.

  16. PPICA, Power Plant Investment Cost Analysis

    International Nuclear Information System (INIS)

    Lefevre, J.C.

    2002-01-01

    1 - Description of program or function: This software package contains two modules: - CAPITAL1 calculates investment costs from overnight costs, based on the capital structure of the utility (debt/equity ratio), return and interest rates according to the type of securities involved, and a standard-shaped curve of capital outlays during construction of a power plant. - FCRATE1 calculates the year-by-year revenue requirements to cover the capital-related charges incurred by the new investment and their economic equivalent: the levelled fixed-charge rate and capital contribution to the levelled unit power generation cost per kWh. They are proposed as an alternative to the corresponding modules CAPITAL and FCRATE, included in the LPGC (Levelled Power Generation Cost) suite of codes developed by ORNL and US-DOE. They perform the same type of analysis and provide the same results. 2 - Methods: Results output from CAPITAL1, in terms of the initial investment at startup and the fraction thereof that is allowable for tax depreciation, can be transferred automatically as data input to FCRATE1. Other user-defined data are: the project life, the time horizon of the economic analysis (which does not necessarily coincide with the project life), the plant load factor (lifetime average), the tax rate applicable to utility's income, the tax depreciation scheme and the tax charge accounting method (normalised or flow- through). The results of CAPITAL1 and FCRATE1 are expressed both in current money and in constant money of a reference year. Inflation rate and escalation rate of construction expenditures during construction period, and of fixed charges during service life are defined by the user. The discount rate is set automatically by the programme, equal to the weighted average tax-adjusted cost of money. 3 - Restrictions on the complexity of the problem: CAPITAL1 and FCRATE1 are 'alternatives', not 'substitutes', to the corresponding programs CAPITAL and FCRATE of the LPGC

  17. A Cost-Effectiveness Analysis Model for Evaluating and Planning Secondary Vocational Programs

    Science.gov (United States)

    Kim, Jin Eun

    1977-01-01

    This paper conceptualizes a cost-effectiveness analysis and describes a cost-effectiveness analysis model for secondary vocational programs. It generates three kinds of cost-effectiveness measures: program effectiveness, cost efficiency, and cost-effectiveness and/or performance ratio. (Author)

  18. Cost-effectiveness analysis of algae energy production in the EU

    International Nuclear Information System (INIS)

    Kovacevic, Vujadin; Wesseler, Justus

    2010-01-01

    Today's society relies heavily on fossil fuels as a main energy source. Global energy demand increase, energy security and climate change are the main drivers of the transition towards alternative energy sources. This paper analyses algal biodiesel production for the EU road transportation and compares it to the fossil fuels and 1st generation biofuels. A cost-effectiveness analysis was used to aggregate private and external costs and derive the social cost of each fuel. The following externalities were internalized: emissions (GHG and non-GHG), food prices impact, pesticides/fertilizers use and security of supply. Currently the social cost of producing algal biodiesel at 52.3 EUR GJ -1 is higher than rapeseed biodiesel (36.0 EUR GJ -1 ) and fossil fuels (15.8 EUR GJ -1 ). Biotechnology development, high crude oil prices and high carbon value are the key features of the scenario where algal biodiesel outcompetes all other fuels. A substantial investment into the biotechnology sector and comprehensive environmental research and policy are required to make that scenario a reality. (author)

  19. Cost-volume-profit analysis and expected benefit of health services: a study of cardiac catheterization services.

    Science.gov (United States)

    Younis, Mustafa Z; Jabr, Samer; Smith, Pamela C; Al-Hajeri, Maha; Hartmann, Michael

    2011-01-01

    Academic research investigating health care costs in the Palestinian region is limited. Therefore, this study examines the costs of the cardiac catheterization unit of one of the largest hospitals in Palestine. We focus on costs of a cardiac catheterization unit and the increasing number of deaths over the past decade in the region due to cardiovascular diseases (CVDs). We employ cost-volume-profit (CVP) analysis to determine the unit's break-even point (BEP), and investigate expected benefits (EBs) of Palestinian government subsidies to the unit. Findings indicate variable costs represent 56 percent of the hospital's total costs. Based on the three functions of the cardiac catheterization unit, results also indicate that the number of patients receiving services exceed the break-even point in each function, despite the unit receiving a government subsidy. Our findings, although based on one hospital, will permit hospital management to realize the importance of unit costs in order to make informed financial decisions. The use of break-even analysis will allow area managers to plan minimum production capacity for the organization. The economic benefits for patients and the government from the unit may encourage government officials to focus efforts on increasing future subsidies to the hospital.

  20. Effect of increasing energy cost on arm coordination in elite sprint swimmers.

    Science.gov (United States)

    Komar, J; Leprêtre, P M; Alberty, M; Vantorre, J; Fernandes, R J; Hellard, P; Chollet, D; Seifert, L

    2012-06-01

    The purpose of this study was to analyze the changes in stroke parameters, motor organization and swimming efficiency with increasing energy cost in aquatic locomotion. Seven elite sprint swimmers performed a 6×300-m incremental swimming test. Stroke parameters (speed, stroke rate and stroke length), motor organization (arm stroke phases and arm coordination index), swimming efficiency (swimming speed squared and hand speed squared) and stroke index were calculated from aerial and underwater side-view cameras. The energy cost of locomotion was assessed by measuring oxygen consumption and blood lactate. Results showed that the increase in energy cost of locomotion was correlated to an increase in the index of coordination and stroke rate, and a decrease in stroke length (pstroke index did not change significantly with the speed increments (pstroke rate were observed, along with a decrease in stroke length, stroke index and hand speed squared with each increment, revealing an adaptation to the fatigue within the 300m. Copyright © 2011 Elsevier B.V. All rights reserved.

  1. Supply chain cost analysis of long-distance transportation of energy wood in Finland

    International Nuclear Information System (INIS)

    Tahvanainen, Timo; Anttila, Perttu

    2011-01-01

    The increasing use of bioenergy has resulted in a growing demand for long-distance transportation of energy wood. For both biofuels and traditional forest products, the importance of energy efficiency and rail use is growing. A GIS-based model for energy wood supply chains was created and used to simulate the costs for several supply chains in a study area in eastern Finland. Cost curves of ten supply chains for logging residues and full trees based on roadside, terminal and end-facility chipping were analyzed. The average procurement costs from forest to roadside storage were included. Railway transportation was compared to the most commonly used truck transportation options in long-distance transport. The potential for the development of supply chains was analyzed using a sensitivity analysis of 11 modified supply chain scenarios. For distances shorter than 60 km, truck transportation of loose residues and end-facility comminution was the most cost-competitive chain. Over longer distances, roadside chipping with chip truck transportation was the most cost-efficient option. When the transportation distance went from 135 to 165 km, depending on the fuel source, train-based transportation offered the lowest costs. The most cost-competitive alternative for long-distance transport included a combination of roadside chipping, truck transportation to the terminal and train transportation to the plant. Due to the low payload, the energy wood bundle chain with train transportation was not cost-competitive. Reduction of maximum truck weight increased the relative competitiveness of loose residue chains and train-based transportation, while reduction of fuel moisture increased competitiveness, especially of chip trucks.

  2. A cost analysis of family planning in Bangladesh.

    Science.gov (United States)

    Fiedler, J L; Day, L M

    1997-01-01

    This article presents a step-down cost analysis using secondary data sources from 26 Bangladesh non-government organizations (NGOs) providing family planning services under a US Agency for International Development-funded umbrella organization. The unit costs of the NGOs' Maternal-Child Health (MCH) clinics and community-based distribution (CBD) systems were calculated and found to be minimally different. Several simulations were conducted to investigate the impact of alternative cost-reduction measures. The more general financial analysis proved more insightful than the unit cost analysis in terms of identifying means by which to improve the efficiency of the family planning operations of these NGOs. The analysis revealed that 56 per cent of total expenditures in the two-tiered umbrella's organizational structure are incurred in management operations and overheads. Of the remaining 44 per cent of project expenditures, 39 per cent is spent on the CBD program and 5 per cent on the MCH clinics. Within the CBD program, most resources are spent providing 4 million contacts (two-thirds of the annual total) which do not involve contraceptive re-supply. The clinics devote more resources to providing MCH services than to providing family planning services. The findings suggest that significant savings could be generated by containing administrative costs, improving operational efficiency, and reducing unnecessary or redundant fieldworker contacts. The magnitude of the potential savings raises a fundamental question about the continued viability and sustainability of this supply-driven CBD strategy.

  3. Systematization of Cost Factors for Cost Management at Industrial Enterprises

    Directory of Open Access Journals (Sweden)

    N. Y.

    2017-12-01

    Full Text Available Identification and structuring of factors determining the cost level has significant importance in cost analysis and control. Cost factors need to be systematized for more effective cost management. The objective of the study is to identify and structure the factors with impact on the enterprise costs. The external and internal factors with impact on the enterprise costs in industry are highlighted. For cost management purposes, it is proposed to group the cost factors into the two categories: structural and functional. The essence of structural and functional factors is shown; a classification of functional factors is given. The effect of a structural factor such as products range (complexity is illustrated. As the factor of complexity, combined with cost analysis systems and innovative tools of analysis (ABC and XYZ methods, has been increasingly in focus of analysts, three problems are described which, once dealt with, will enable ABC method to fit into the cost management system. The importance of another structural factor of costs, technology selection, in cost management is shown. The analysis allows for the following conclusions: for purposes of current cost management, including one based on operational analysis, the output needs to be addressed as the central factor determining the cost level; in the strategic perspective, an enterprise needs to concentrate on calculating the costs for the structural alternatives that are supposed to determine its competitive position; for cost management purposes, the cost factors should be broken into two categories, structural and functional; a specific management system exists for each cost factor, which is greatly important for the positioning of an enterprise.

  4. Life cycle cost analysis rehabilitation costs.

    Science.gov (United States)

    2015-07-01

    This study evaluates data from CDOTs Cost Data books and Pavement Management Program. Cost : indices were used to normalize project data to year 2014. Data analyzed in the study was obtained from : the CDOTs Cost Data books and the Pavement Man...

  5. Analysis of nuclear-power construction costs

    International Nuclear Information System (INIS)

    Jansma, G.L.; Borcherding, J.D.

    1988-01-01

    This paper discusses the use of regression analysis for estimating construction costs. The estimate is based on an historical data base and quantification of key factors considered external to project management. This technique is not intended as a replacement for detailed cost estimates but can provide information useful to the cost-estimating process and to top management interested in evaluating project management. The focus of this paper is the nuclear-power construction industry but the technique is applicable beyond this example. The approach and critical assumptions are also useful in a public-policy situation where utility commissions are evaluating construction in prudence reviews and making comparisons to other nuclear projects. 13 references, 2 figures

  6. A cost-effectiveness analysis of adjuvant therapies for resected adenocarcinoma of the rectum

    International Nuclear Information System (INIS)

    Lee, Jason H.

    1997-01-01

    , the model projected an absolute 17% increase in eight-year survival and an additional 0.69 years of discounted life expectancy with the addition of bolus 5-FU and PRT over surgery alone. The incremental cost of this treatment was estimated as $6,100 over 8 years, for a cost-effectiveness ratio [CER] of $8,700 per year of life saved [YOLS]. In the second analysis, PVI 5-FU given with PRT cost an additional $1,466 initially, and produced an average survival benefit of 0.27 years as compared to bolus 5-FU with PRT. After 5 years, however, PVI 5-FU therapy resulted in an additional $254 in expected costs, leading to a CER of $950/YOLS. Results of the model were generally insensitive to alterations in the discount rate and the cost of adjuvant therapies. CONCLUSION: The results of this cost analysis model suggest adjuvant therapy for operable rectal carcinoma is cost-effective [less than $9,000/YOLS] over the given time horizon. Although initially more expensive, adjuvant treatment involving PVI 5-FU during PRT as compared to bolus 5-FU appears to represent a good value as future costs of recurrent disease are avoided. Longer follow-up, sensitivity analysis, and consideration of quality of life and nonmedical costs will be necessary for confirmation of these preliminary results. As additional and potentially more expensive adjuvant therapies are proposed, concerns regarding the costs of such therapies with respect to their benefits are gaining increasing attention. Models such as this permit economic analysis of investigational treatment approaches as benefits from such therapies are better clarified from ongoing cooperative group trials

  7. A practical technique for benefit-cost analysis of computer-aided design and drafting systems

    International Nuclear Information System (INIS)

    Shah, R.R.; Yan, G.

    1979-03-01

    Analysis of benefits and costs associated with the operation of Computer-Aided Design and Drafting Systems (CADDS) are needed to derive economic justification for acquiring new systems, as well as to evaluate the performance of existing installations. In practice, however, such analyses are difficult to perform since most technical and economic advantages of CADDS are ΣirreduciblesΣ, i.e. cannot be readily translated into monetary terms. In this paper, a practical technique for economic analysis of CADDS in a drawing office environment is presented. A Σworst caseΣ approach is taken since increase in productivity of existing manpower is the only benefit considered, while all foreseen costs are taken into account. Methods of estimating benefits and costs are described. The procedure for performing the analysis is illustrated by a case study based on the drawing office activities at Atomic Energy of Canada Limited. (auth)

  8. System Evaluation and Life-Cycle Cost Analysis of a Commercial-Scale High-Temperature Electrolysis Hydrogen Production Plant

    Energy Technology Data Exchange (ETDEWEB)

    Edwin A. Harvego; James E. O' Brien; Michael G. McKellar

    2012-11-01

    Results of a system evaluation and lifecycle cost analysis are presented for a commercial-scale high-temperature electrolysis (HTE) central hydrogen production plant. The plant design relies on grid electricity to power the electrolysis process and system components, and industrial natural gas to provide process heat. The HYSYS process analysis software was used to evaluate the reference central plant design capable of producing 50,000 kg/day of hydrogen. The HYSYS software performs mass and energy balances across all components to allow optimization of the design using a detailed process flow sheet and realistic operating conditions specified by the analyst. The lifecycle cost analysis was performed using the H2A analysis methodology developed by the Department of Energy (DOE) Hydrogen Program. This methodology utilizes Microsoft Excel spreadsheet analysis tools that require detailed plant performance information (obtained from HYSYS), along with financial and cost information to calculate lifecycle costs. The results of the lifecycle analyses indicate that for a 10% internal rate of return, a large central commercial-scale hydrogen production plant can produce 50,000 kg/day of hydrogen at an average cost of $2.68/kg. When the cost of carbon sequestration is taken into account, the average cost of hydrogen production increases by $0.40/kg to $3.08/kg.

  9. An analysis of energy conservation measure costs

    International Nuclear Information System (INIS)

    Jones, R.; Ellis, R.; Gellineau, D.

    1990-01-01

    This paper reports on a Denver Support Office project to evaluate cost estimation in the Institutional Conservation Program. Unit cost characteristics and cost prediction accuracy were evaluated from 1,721 Energy Conservation Measures (ECMs) and 390 Technical Assistance (TA) reports funded in the last six years. This information is especially useful to state and DOE review engineers in determining the reasonableness of future cost estimates. The estimated cost provisions for TA report grants were generally adequate to cover the actual costs. Individually, there was a tendency for TA reports to cost less than estimated by about 10%. TA report unit costs averaged $.09 to $.11 per square foot, and decreased as the building size increased. Individually, there was a tendency for ECMs to cost more than estimated by about 17%. Overall, the estimated costs of the 1,721 measures were $20.4 minion, while the actual costs were $21.4 million. This 4.6% difference indicates that, overall, ECM cost estimates have provided a reasonable basis for grant awards. There was a high variation in ECM unit costs. The data did not support speculation that there is a tendency to manipulate cost estimates to fit ECMs within the simple payback eligibility criteria of 2 to 10 years

  10. 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

  11. 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.

  12. 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...

  13. 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.

  14. [Cost analysis for navigation in knee endoprosthetics].

    Science.gov (United States)

    Cerha, O; Kirschner, S; Günther, K-P; Lützner, J

    2009-12-01

    Total knee arthroplasty (TKA) is one of the most frequent procedures in orthopaedic surgery. The outcome depends on a range of factors including alignment of the leg and the positioning of the implant in addition to patient-associated factors. Computer-assisted navigation systems can improve the restoration of a neutral leg alignment. This procedure has been established especially in Europe and North America. The additional expenses are not reimbursed in the German DRG system (Diagnosis Related Groups). In the present study a cost analysis of computer-assisted TKA compared to the conventional technique was performed. The acquisition expenses of various navigation systems (5 and 10 year depreciation), annual costs for maintenance and software updates as well as the accompanying costs per operation (consumables, additional operating time) were considered. The additional operating time was determined on the basis of a meta-analysis according to the current literature. Situations with 25, 50, 100, 200 and 500 computer-assisted TKAs per year were simulated. The amount of the incremental costs of the computer-assisted TKA depends mainly on the annual volume and the additional operating time. A relevant decrease of the incremental costs was detected between 50 and 100 procedures per year. In a model with 100 computer-assisted TKAs per year an additional operating time of 14 mins and a 10 year depreciation of the investment costs, the incremental expenses amount to 300-395 depending on the navigation system. Computer-assisted TKA is associated with additional costs. From an economical point of view an amount of more than 50 procedures per year appears to be favourable. The cost-effectiveness could be estimated if long-term results will show a reduction of revisions or a better clinical outcome.

  15. 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.

  16. Future Costs, Fixed Healthcare Budgets, and the Decision Rules of Cost-Effectiveness Analysis.

    Science.gov (United States)

    van Baal, Pieter; Meltzer, David; Brouwer, Werner

    2016-02-01

    Life-saving medical technologies result in additional demand for health care due to increased life expectancy. However, most economic evaluations do not include all medical costs that may result from this additional demand in health care and include only future costs of related illnesses. Although there has been much debate regarding the question to which extent future costs should be included from a societal perspective, the appropriate role of future medical costs in the widely adopted but more narrow healthcare perspective has been neglected. Using a theoretical model, we demonstrate that optimal decision rules for cost-effectiveness analyses assuming fixed healthcare budgets dictate that future costs of both related and unrelated medical care should be included. Practical relevance of including the costs of future unrelated medical care is illustrated using the example of transcatheter aortic valve implantation. Our findings suggest that guidelines should prescribe inclusion of these costs. Copyright © 2014 John Wiley & Sons, Ltd.

  17. A METHOD OF THE MINIMIZING OF THE TOTAL ACQUISITIONS COST WITH THE INCREASING VARIABLE DEMAND

    Directory of Open Access Journals (Sweden)

    ELEONORA IONELA FOCȘAN

    2015-12-01

    Full Text Available Over time, mankind has tried to find different ways of costs reduction. This subject which we are facing more often nowadays, has been detailed studied, without reaching a general model, and also efficient, regarding the costs reduction. Costs reduction entails a number of benefits over the entity, the most important being: increase revenue and default to the profit, increase productivity, a higher level of services / products offered to clients, and last but not least, the risk mitigation of the economic deficit. Therefore, each entity search different modes to obtain most benefits, for the company to succeed in a competitive market. This article supports the companies, trying to make known a new way of minimizing the total cost of acquisitions, by presenting some hypotheses about the increasing variable demand, proving them, and development of formulas for reducing the costs. The hypotheses presented in the model described below, can be maximally exploited to obtain new models of reducing the total cost, according to the modes of the purchase of entities which approach it.

  18. The future of nuclear power in France: an analysis of the costs of phasing-out

    International Nuclear Information System (INIS)

    Malischek, Raimund; Trüby, Johannes

    2016-01-01

    Nuclear power is an important pillar in electricity generation in France. However, the French nuclear power plant fleet is ageing, and the possibility of reducing the technology's share in power generation or even a complete phase-out has been increasingly discussed. This paper focuses on three inter-related questions: First, what are the costs of phasing-out nuclear power in France? Second, who has to bear these costs, i.e., how much of the costs will be passed on to the rest of the European power system? And third, what effect does the uncertainty regarding future nuclear policy in France have on system costs? Applying a stochastic optimization model for the European electricity system, the analysis showed that additional system costs in France of a nuclear phase-out amount up to 76 billion €_2_0_1_0. Additional costs are mostly borne by the French power system. Surprisingly, the analysis found that the costs of uncertainty are rather limited. Based on the results, it can be concluded that a commitment regarding nuclear policy reform is only mildly beneficial in terms of system cost savings. - Highlights: • Analysis of different nuclear policy and phase-out scenarios in France. • Nuclear policy uncertainty in France is treated using stochastic programming. • Costs of a nuclear phase-out in France are significant, amounting up to 76 bill €. • Costs of a phase-out are hardly passed on to the rest of the European power system. • Costs of uncertainty are low, implying little benefit of nuclear policy commitment.

  19. Cost analysis of nursing home registered nurse staffing times.

    Science.gov (United States)

    Dorr, David A; Horn, Susan D; Smout, Randall J

    2005-05-01

    To examine potential cost savings from decreased adverse resident outcomes versus additional wages of nurses when nursing homes have adequate staffing. A retrospective cost study using differences in adverse outcome rates of pressure ulcers (PUs), urinary tract infections (UTIs), and hospitalizations per resident per day from low staffing and adequate staffing nursing homes. Cost savings from reductions in these events are calculated in dollars and compared with costs of increasing nurse staffing. Eighty-two nursing homes throughout the United States. One thousand three hundred seventy-six frail elderly long-term care residents at risk of PU development. Event rates are from the National Pressure Ulcer Long-Term Care Study. Hospital costs are estimated from Medicare statistics and from charges in the Healthcare Cost and Utilization Project. UTI costs and PU costs are from cost-identification studies. Time horizon is 1 year; perspectives are societal and institutional. Analyses showed an annual net societal benefit of 3,191 dollars per resident per year in a high-risk, long-stay nursing home unit that employs sufficient nurses to achieve 30 to 40 minutes of registered nurse direct care time per resident per day versus nursing homes that have nursing time of less than 10 minutes. Sensitivity analyses revealed a robust set of estimates, with no single or paired elements reaching the cost/benefit equality threshold. Increasing nurse staffing in nursing homes may create significant societal cost savings from reduction in adverse outcomes. Challenges in increasing nurse staffing are discussed.

  20. Cranking up the heat: relationships between energetically costly song features and the increase in thorax temperature in male crickets and katydids.

    Science.gov (United States)

    Erregger, Bettina; Kovac, Helmut; Stabentheiner, Anton; Hartbauer, Manfred; Römer, Heinrich; Schmidt, Arne K D

    2017-07-15

    Sexual displays of acoustically signalling insects are used in the context of mate attraction and mate choice. While energetic investment in sound production can increase the reproductive success of the sender, this entails metabolic costs. Resource allocation to sexually selected, reproductive traits can trade off against allocation to naturally selected traits (e.g. growth, immunity) when individuals' energy budgets are limited. Estimating the magnitude of the costs invested in acoustic signalling is necessary to understand this trade-off and its influence on fitness and life history. To compare the costs associated with acoustic signalling for two ensiferan species, we simultaneously took respiratory measurements to record the rate of CO 2 production and used infrared thermography to measure the increase in thorax temperature. Furthermore, to identify what combinations of acoustic parameters were energetically costly for the sender, we recorded the calling songs of 22 different cricket and katydid species for a comparative analysis and measured their thorax temperature while they sang. Acoustic signalling was energetically costly for Mecopoda sp. and Anurogryllus muticus , requiring a 12- and 16-fold increase over resting levels in the CO 2 production rate. Moreover, calling increased thorax temperature, on average by 7.6 and 5.8°C, respectively. We found that the song intensity and effective calling rate, not simply the chirp/trill duty cycle or the pulse rate alone, were good predictors for the thorax temperature increase in males. © 2017. Published by The Company of Biologists Ltd.

  1. Cost-benefit analysis for management of low-level radioactive waste

    International Nuclear Information System (INIS)

    Jacobs, D.G.

    1979-01-01

    There are several types of cost-benefit analyses that can be used in evaluating a technical activity such as waste management. A direct comparison can be made of the benefits to be gained versus the costs to be accrued. If the balance is favorable the activity is considered to be acceptable. In many cases, however, a number of alternatives may be available requiring a comparative cost-benefit analysis so that the most favorable option is chosen. After the basic option is chosen, a further analysis is required in which additional control technologies can be considered to further reduce specific types of impact; this represents a differential cost-benefit analysis or, perhaps more properly, a study of cost-effectiveness. Also, because of the wide variety of parameters that go into a cost-benefit analysis and the range of value judgements that may be applied by different interest groups, it is likely that each additional increment of technology will have a slightly different balance point. Factors and impacts that need to be considered in management of low-level wastes will be discussed and a simplified example will be used to demonstrate the difficulties that may be encountered

  2. Cost-benefit analysis for management of low-level radioactive waste

    International Nuclear Information System (INIS)

    Jacobs, D.G.

    1977-01-01

    There are several types of cost-benefit analyses that can be used in evaluating a technical activity such as waste management. A direct comparison can be made of the benefits to be gained versus the costs to be accrued. If the balance is favorable, the activity is considered to be acceptable. In many cases, however, a number of alternatives may be available requiring a comparative cost-benefit analysis so that the most favorable option is chosen. After the basic option is chosen, a further analysis is required in which additional control technologies can be considered to further reduce specific types of impact; this represents a differential cost-benefit analysis or, perhaps more properly, a study of cost-effectiveness. Also, because of the wide variety of parameters that go into a cost-benefit analysis and the range of value judgements that may be applied by different interest groups, it is likely that each additional increment of technology will have a slightly different balance point. Factors and impacts that need to be considered in management of low-level wastes will be discussed and a simplified example will be used to demonstrate the difficulties that may be encountered

  3. The price of information: Increased inspection costs reduce the confirmation bias in visual search.

    Science.gov (United States)

    Rajsic, Jason; Wilson, Daryl E; Pratt, Jay

    2018-04-01

    In visual search, there is a confirmation bias such that attention is biased towards stimuli that match a target template, which has been attributed to covert costs of updating the templates that guide search [Rajsic, Wilson, & Pratt, 2015. Confirmation bias in visual search. Journal of Experimental Psychology: Human Perception and Performance. Advance online publication. doi:10.1037/xhp0000090]. In order to provide direct evidence for this speculation, the present study increased the cost of inspections in search by using gaze- and mouse-contingent searches, which restrict the manner in which information in search displays can be accrued, and incur additional motor costs (in the case of mouse-contingent searches). In a fourth experiment, we rhythmically mask elements in the search display to induce temporal inspection costs. Our results indicated that confirmation bias is indeed attenuated when inspection costs are increased. We conclude that confirmation bias results from the low-cost strategy of matching information to a single, concrete visual template, and that more sophisticated guidance strategies will be used when sufficiently beneficial. This demonstrates that search guidance itself comes at a cost, and that the form of guidance adopted in a given search depends on a comparison between guidance costs and the expected benefits of their implementation.

  4. Cost-effective analysis of PET application in NSCLC

    International Nuclear Information System (INIS)

    Gu Aichun; Liu Jianjun; Sun Xiaoguang; Shi Yiping; Huang Gang

    2006-01-01

    Objective: To evaluate the cost-effectiveness of PET and CT application for diagnosis of non-small cell lung cancer (NSCLC) in China. Methods: Using decision analysis method the diagnostic efficiency of PET and CT for diagnosis of NSCLC in china was analysed. And also the value of cost for accurate diagnosis (CAD), cost for accurate staging (CAS) and cost for effective therapy (CAT) was calculated. Results: (1) For the accurate diagnosis, CT was much more cost-effective than PET. (2) For the accurate staging, CT was still more cost-effective than PET. (3) For the all over diagnostic and therapeutic cost, PET was more cost-effective than CT. (4) The priority of PET to CT was for the diagnosis of stage I NSCLC. Conclusion: For the management of NSCLC patient in China, CT is more cost-effective for screening, whereas PET for clinical staging and monitoring therapeutic effect. (authors)

  5. The cost benefit analysis of implementing photovoltaic solar system in the state of Kuwait

    International Nuclear Information System (INIS)

    Ramadhan, Mohammad; Naseeb, Adel

    2011-01-01

    In addition to the high financial cost of energy resources required to meet the rising demand for electricity consumption in Kuwait, the negative environmental impact of fossil fuel is increasing. Hence, the objective of this paper is to determine the economic feasibility and viability of implementing PV solar energy in the State of Kuwait. It was found that the positive characteristics of solar radiation in Kuwait play a critical role in enhancing the feasibility of implementing solar systems. Under the present price of 5$/W and 15% efficiency, the LCOE of a 1 MW station is estimated to be around $0.20/kWh. This LCOE can be feasible only when the cost of oil is around 100$/barrel. The Cost Benefit Analysis showed that when the value of saved energy resources used in producing traditional electricity, and the cost of lowering CO 2 emissions are accounted for, the true economic cost of LCOE of a PV system will decline significantly. The preliminary economic analysis recommends the implementation of PV technology in Kuwait. (author)

  6. 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

  7. A cost-effectiveness analysis of two different antimicrobial stewardship programs.

    Science.gov (United States)

    Okumura, Lucas Miyake; Riveros, Bruno Salgado; Gomes-da-Silva, Monica Maria; Veroneze, Izelandia

    2016-01-01

    There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70), however, it was more efficient (US$ 27,549.15 vs 29,011.46). Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

  8. A cost-effectiveness analysis of two different antimicrobial stewardship programs

    Directory of Open Access Journals (Sweden)

    Lucas Miyake Okumura

    2016-05-01

    Full Text Available There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity analysis to assess model's robustness, tornado diagram and Cost-Effectiveness Acceptability Curve. Bundled Strategy was more expensive (Cost difference US$ 2119.70, however, it was more efficient (US$ 27,549.15 vs 29,011.46. Deterministic and probabilistic sensitivity analysis suggested that critical variables did not alter final Incremental Cost-Effectiveness Ratio. Bundled Strategy had higher probabilities of being cost-effective, which was endorsed by cost-effectiveness acceptability curve. As health systems claim for efficient technologies, this study conclude that Bundled Antimicrobial Stewardship Program was more cost-effective, which means that stewardship strategies with such characteristics would be of special interest in a societal and clinical perspective.

  9. 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.

  10. Social costs of road crashes: An international analysis.

    Science.gov (United States)

    Wijnen, Wim; Stipdonk, Henk

    2016-09-01

    This paper provides an international overview of the most recent estimates of the social costs of road crashes: total costs, value per casualty and breakdown in cost components. The analysis is based on publications about the national costs of road crashes of 17 countries, of which ten high income countries (HICs) and seven low and middle income countries (LMICs). Costs are expressed as a proportion of the gross domestic product (GDP). Differences between countries are described and explained. These are partly a consequence of differences in the road safety level, but there are also methodological explanations. Countries may or may not correct for underreporting of road crashes, they may or may not use the internationally recommended willingness to pay (WTP)-method for estimating human costs, and there are methodological differences regarding the calculation of some other cost components. The analysis shows that the social costs of road crashes in HICs range from 0.5% to 6.0% of the GDP with an average of 2.7%. Excluding countries that do not use a WTP- method for estimating human costs and countries that do not correct for underreporting, results in average costs of 3.3% of GDP. For LMICs that do correct for underreporting the share in GDP ranges from 1.1% to 2.9%. However, none of the LMICs included has performed a WTP study of the human costs. A major part of the costs is related to injuries: an average share of 50% for both HICs and LMICs. The average share of fatalities in the costs is 23% and 30% respectively. Prevention of injuries is thus important to bring down the socio-economic burden of road crashes. The paper shows that there are methodological differences between countries regarding cost components that are taken into account and regarding the methods used to estimate specific cost components. In order to be able to make sound comparisons of the costs of road crashes across countries, (further) harmonization of cost studies is recommended. This can be

  11. Cost analysis of one of the first outpatient wound clinics in the Netherlands.

    Science.gov (United States)

    Rondas, A A L M; Schols, J M G; Halfens, R J G; Hull, H R; Stobberingh, E E; Evers, S M A A

    2015-09-01

    To perform, from an insurance perspective, a cost analysis of one of the outpatient community wound care clinics in the Netherlands, the Knowledge Centre in Wound Care (KCWC) at Venray. This study involved a cost analysis based on an observational cohort study with a one-year pre-admission and a one-year post-admission comparison of costs. Patients were included when they first consulted the outpatient wound care clinic. Participants were all insured by the same health insurance company, Coöperatie Volksgezondheidszorg (VGZ). A standard six-step procedure for performing cost studies was used to calculate the costs. Given the skewed cost data, non-parametric bootstrapping was used to test for statistical differences. There were 172 patients included in this study. The difference in costs related to wound care between the year before and the year after initial admission to the wound clinic amounted to an average reduction of €2621 (£1873) per patient in the base case analysis. The categories 'general practitioner', 'hospital care', 'mental health care' and 'transport' scored lower, indicating lower costs, in the year after admission to the wound clinic. In this study, only the reimbursement data of patients of one health insurance company, and specifically only those made under the 2006 Dutch Health Insurance Act, were available. Because of the observational design, definitive conclusions cannot be made regarding a demonstrated reduction of costs in the year post admission. Nevertheless, this study is a first attempt of a cost analysis of an equipped outpatient wound clinic as an innovative way of responding to the increasing number of chronic wounds in the Netherlands. The calculations show that savings in wound care are possible. A possible conflict of interest should be mentioned. First author AALM Rondas, PhD student at Maastricht University, is working at the KCWC wound clinic at Venray in the Netherlands as a physician. However, the research data were

  12. 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.

  13. Tuberculosis screening of travelers to higher-incidence countries: A cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Menzies Dick

    2008-06-01

    Full Text Available Abstract Background Travelers to countries with high tuberculosis incidence can acquire infection during travel. We sought to compare four screening interventions for travelers from low-incidence countries, who visit countries with varying tuberculosis incidence. Methods Decision analysis model: We considered hypothetical cohorts of 1,000 travelers, 21 years old, visiting Mexico, the Dominican Republic, or Haiti for three months. Travelers departed from and returned to the United States or Canada; they were born in the United States, Canada, or the destination countries. The time horizon was 20 years, with 3% annual discounting of future costs and outcomes. The analysis was conducted from the health care system perspective. Screening involved tuberculin skin testing (post-travel in three strategies, with baseline pre-travel tests in two, or chest radiography post-travel (one strategy. Returning travelers with tuberculin conversion (one strategy or other evidence of latent tuberculosis (three strategies were offered treatment. The main outcome was cost (in 2005 US dollars per tuberculosis case prevented. Results For all travelers, a single post-trip tuberculin test was most cost-effective. The associated cost estimate per case prevented ranged from $21,406 for Haitian-born travelers to Haiti, to $161,196 for US-born travelers to Mexico. In all sensitivity analyses, the single post-trip tuberculin test remained most cost-effective. For US-born travelers to Haiti, this strategy was associated with cost savings for trips over 22 months. Screening was more cost-effective with increasing trip duration and infection risk, and less so with poorer treatment adherence. Conclusion A single post-trip tuberculin skin test was the most cost-effective strategy considered, for travelers from the United States or Canada. The analysis did not evaluate the use of interferon-gamma release assays, which would be most relevant for travelers who received BCG

  14. 77 FR 1743 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2012-01-11

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as specified... (Revised December 2011) Discount Rates for Cost-Effectiveness, Lease Purchase, and Related Analyses...

  15. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2011-02-11

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as specified... (Revised December 2010) DISCOUNT RATES FOR COST-EFFECTIVENESS, LEASE PURCHASE, AND RELATED ANALYSES...

  16. Special waste disposal in Austria - cost benefit analysis

    International Nuclear Information System (INIS)

    Kuntscher, H.

    1983-01-01

    The present situation of special waste disposal in Austria is summarized for radioactive and nonradioactive wastes. A cost benefit analysis for regulary collection, transport and disposal of industrial wastes, especially chemical wastes is given and the cost burden for the industry is calculated. (A.N.)

  17. Integrated thermal and nonthermal treatment technology and subsystem cost sensitivity analysis

    International Nuclear Information System (INIS)

    Harvego, L.A.; Schafer, J.J.

    1997-02-01

    The U.S. Department of Energy's (DOE) Environmental Management Office of Science and Technology (EM-50) authorized studies on alternative systems for treating contact-handled DOE mixed low-level radioactive waste (MLLW). The on-going Integrated Thermal Treatment Systems' (ITTS) and the Integrated Nonthermal Treatment Systems' (INTS) studies satisfy this request. EM-50 further authorized supporting studies including this technology and subsystem cost sensitivity analysis. This analysis identifies areas where technology development could have the greatest impact on total life cycle system costs. These areas are determined by evaluating the sensitivity of system life cycle costs relative to changes in life cycle component or phase costs, subsystem costs, contingency allowance, facility capacity, operating life, and disposal costs. For all treatment systems, the most cost sensitive life cycle phase is the operations and maintenance phase and the most cost sensitive subsystem is the receiving and inspection/preparation subsystem. These conclusions were unchanged when the sensitivity analysis was repeated on a present value basis. Opportunity exists for technology development to reduce waste receiving and inspection/preparation costs by effectively minimizing labor costs, the major cost driver, within the maintenance and operations phase of the life cycle

  18. Beyond cost-effectiveness: Using systems analysis for infectious disease preparedness.

    Science.gov (United States)

    Phelps, Charles; Madhavan, Guruprasad; Rappuoli, Rino; Colwell, Rita; Fineberg, Harvey

    2017-01-20

    Until the recent outbreaks, Ebola vaccines ranked low in decision makers' priority lists based on cost-effectiveness analysis and (or) corporate profitability. Despite a relatively small number of Ebola-related cases and deaths (compared to other causes), Ebola vaccines suddenly leapt to highest priority among international health agencies and vaccine developers. Clearly, earlier cost-effectiveness analyses badly missed some factors affecting real world decisions. Multi-criteria systems analysis can improve evaluation and prioritization of vaccine development and also of many other health policy and investment decisions. Neither cost-effectiveness nor cost-benefit analysis can capture important aspects of problems such as Ebola or the emerging threat of Zika, especially issues of inequality and disparity-issues that dominate the planning of many global health and economic organizations. Cost-benefit analysis requires assumptions about the specific value of life-an idea objectionable to many analysts and policy makers. Additionally, standard cost-effectiveness calculations cannot generally capture effects on people uninfected with Ebola for example, but nevertheless affected through such factors as contagion, herd immunity, and fear of dread disease, reduction of travel and commerce, and even the hope of disease eradication. Using SMART Vaccines, we demonstrate how systems analysis can visibly include important "other factors" and more usefully guide decision making and beneficially alter priority setting processes. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. High laboratory cost predicted per tuberculosis case diagnosed with increased case finding without a triage strategy.

    Science.gov (United States)

    Dunbar, R; Naidoo, P; Beyers, N; Langley, I

    2017-09-01

    Cape Town, South Africa. To model the effects of increased case finding and triage strategies on laboratory costs per tuberculosis (TB) case diagnosed. We used a validated operational model and published laboratory cost data. We modelled the effect of varying the proportion with TB among presumptive cases and Xpert cartridge price reductions on cost per TB case and per additional TB case diagnosed in the Xpert-based vs. smear/culture-based algorithms. In our current scenario (18.3% with TB among presumptive cases), the proportion of cases diagnosed increased by 8.7% (16.7% vs. 15.0%), and the cost per case diagnosed increased by 142% (US$121 vs. US$50). The cost per additional case diagnosed was US$986. This would increase to US$1619 if the proportion with TB among presumptive cases was 10.6%. At 25.9-30.8% of TB prevalence among presumptive cases and a 50% reduction in Xpert cartridge price, the cost per TB case diagnosed would range from US$50 to US$59 (comparable to the US$48.77 found in routine practice with smear/culture). The operational model illustrates the effect of increased case finding on laboratory costs per TB case diagnosed. Unless triage strategies are identified, the approach will not be sustainable, even if Xpert cartridge prices are reduced.

  20. Development of computer software for pavement life cycle cost analysis.

    Science.gov (United States)

    1988-01-01

    The life cycle cost analysis program (LCCA) is designed to automate and standardize life cycle costing in Virginia. It allows the user to input information necessary for the analysis, and it then completes the calculations and produces a printed copy...

  1. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2013-01-29

    ... OFFICE OF MANAGEMENT AND BUDGET Discount Rates for Cost-Effectiveness Analysis of Federal Programs... in Appendix C are to be used for cost-effectiveness analysis, including lease-purchase analysis, as...) Discount Rates for Cost-Effectiveness, Lease Purchase, and Related Analyses Effective Dates. This appendix...

  2. A Nationwide Analysis of Cost Variation for Autologous Free Flap Breast Reconstruction.

    Science.gov (United States)

    Billig, Jessica I; Lu, Yiwen; Momoh, Adeyiza O; Chung, Kevin C

    2017-11-01

    Cost variation among hospitals has been demonstrated for surgical procedures. Uncovering these differences has helped guide measures taken to reduce health care spending. To date, the fiscal consequence of hospital variation for autologous free flap breast reconstruction is unknown. To investigate factors that influence cost variation for autologous free flap breast reconstruction. A secondary cross-sectional analysis was performed using the Healthcare Cost and Utilization Project National Inpatient Sample database from 2008 to 2010. The dates of analysis were September 2016 to February 2017. The setting was a stratified sample of all US community hospitals. Participants were female patients who were diagnosed as having breast cancer or were at high risk for breast cancer and underwent autologous free flap breast reconstruction. Variables of interest included demographic data, hospital characteristics, length of stay, complications (surgical and systemic), and inpatient cost. The study used univariate and generalized linear mixed models to examine associations between patient and hospital characteristics and cost. A total of 3302 patients were included in the study, with a median age of 50 years (interquartile range, 44-57 years). The mean cost for autologous free flap breast reconstruction was $22 677 (interquartile range, $14 907-$33 391). Flap reconstructions performed at high-volume hospitals were significantly more costly than those performed at low-volume hospitals ($24 360 vs $18 918, P Logistic regression demonstrated that hospital volume correlated with increased cost (Exp[β], 1.06; 95% CI, 1.02-1.11; P = .003). Fewer surgical complications (16.4% [169 of 1029] vs 23.7% [278 of 1174], P cost variation among patients undergoing autologous free flap breast reconstruction. Experience, as measured by a hospital's volume, provides quality health care with fewer complications but is more costly. Longer length of stay contributed to regional

  3. A Comparative Cost Analysis of Picture Archiving and ...

    African Journals Online (AJOL)

    Method: An incremental cost analysis for chest radiographs,, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to ...

  4. Cost-Benefit Analysis of a Novel DC Fast-Charging Station with a Local Battery Storage for EVs

    DEFF Research Database (Denmark)

    Gjelaj, Marjan; Træholt, Chresten; Hashemi Toghroljerdi, Seyedmostafa

    2017-01-01

    and decrease the connection fees. Finally, an economic evaluation is done to evaluate the feasibility and the cost-benefit analysis (CBA) of the DCFCSs. The proposed approach considers various technical and economic issues, such as cost of installation, connection fees and life cycle cost of the batteries....... The proposed cost-benefit analysis can be used to verify the effectiveness and applicability of DCFCS in large scale....... models by increasing the size of the batteries. To satisfy EV load demand of the new EV models in urban areas the public DC Fast-Charging Station (DCFCS) is indispensable to recharge EVs rapidly. The introduction of the Battery Energy Storage within the DCFCSs is considered in this paper an alternative...

  5. The cost of electricity distribution in Italy: a quantitative analysis

    International Nuclear Information System (INIS)

    Scarpa, C.

    1998-01-01

    This paper presents a quantitative analysis of the cost of medium and low tension electricity distribution in Italy. An econometric analysis of the cost function is proposed, on the basis of data on 147 zones of the dominant firm, ENEL. Data are available only for 1996, which has forced to carry out only a cross-section OLS analysis. The econometric estimate shows the existence of significant scale economies, that the current organisational structure does not exploit. On this basis is also possible to control to what extent exogenous cost drivers affect costs. The role of numerous exogenous factors considered seems however quite limited. The area of the distribution zone and an indicator of quality are the only elements that appear significant from an economic viewpoint [it

  6. Is it time to rebalance the case mix? A portfolio analysis of direct catheterization laboratory costs over a 5-year period.

    Science.gov (United States)

    Plehn, Gunnar; Butz, Thomas; Maagh, Petra; Oernek, Ahmet; Meissner, Axel; Plehn, Natalie

    2016-11-03

    Cardiac catheterization laboratories (CLL) have continued to function as profit centers for hospitals. Due to a high percentage of material and labor costs, they are natural targets for process improvement. Our study applied a contribution margin (CBM) concept to evaluate costs and cost dynamics over a 5-year period. We retrospectively analyzed all procedures performed at a tertiary heart center between 2007 and 2011. Total variable costs, including labor time, material, and maintenance-expenses, were allocated at a global as well as a procedural level. CBM and CBM ratios were calculated by integration of individual DRG revenues. Annual case volume increased from 1288 to 1545. In parallel, overall profitability improved as indicated by a 2% increase in CBM ratio and a higher CBM generated per hour of CLL working time (4325 vs. 5892 €, p analysis of CLL costs and cost dynamics. From a health service providers view, its range of application includes global profitability analysis, portfolio evaluation, and a detailed cost analysis of specific service lines. From a healthcare payers perspective, it may help to monitor hospital activities and to provide a solid data basis in cases where inappropriate developments are suspected. The calculation principle is simple which may increase user acceptance and thus the motivation of team members.

  7. Downsizing a database platform for increased performance and decreased costs

    Energy Technology Data Exchange (ETDEWEB)

    Miller, M.M.; Tolendino, L.F.

    1993-06-01

    Technological advances in the world of microcomputers have brought forth affordable systems and powerful software than can compete with the more traditional world of minicomputers. This paper describes an effort at Sandia National Laboratories to decrease operational and maintenance costs and increase performance by moving a database system from a minicomputer to a microcomputer.

  8. Increased accuracy of cost-estimation using product configuration systems

    DEFF Research Database (Denmark)

    Rasmussen, Jeppe Bredahl; Hvam, Lars; Mortensen, Niels Henrik

    This article describes an approach for utilizing Product Configuration Systems (PCS) for quantifying project costs in project-based companies. It presents a case study demonstrating a method of quantifying costs in a way that makes it possible to configure cost- and time estimates. Piecework costs......, material costs and sub-supplier costs are used as principle cost elements and linked to structural and process elements to facilitate configuration. The cost data are used by the PCS to generate fast and accurate cost-estimates, quotations, time estimates and cost summaries. The described cost...... quantification principles have been used in a Scandinavian SME (Small and Medium-sized Enterprise) since the 90’s, but have since 2011 been adopted to be used in a configuration system. A longitudinal case study was conducted to compare cost and time-estimation accuracy before and after implementation. We...

  9. New nuclear power generation in the UK: Cost benefit analysis

    International Nuclear Information System (INIS)

    Kennedy, David

    2007-01-01

    This paper provides an economic analysis of possible nuclear new build in the UK. It compares costs and benefits of nuclear new build against conventional gas-fired generation and low carbon technologies (CCS, wind, etc.). A range of scenarios are considered to allow for uncertainty as regards nuclear and other technology costs, gas prices and carbon prices. In the base case, the analysis suggests that there is a small cost penalty for new nuclear generation relative to conventional gas-fired generation, but that this is offset by environmental and security of supply benefits. More generally nuclear new build has a positive net benefit for a range of plausible nuclear costs, gas prices and carbon prices. This supports the UK policy of developing an enabling framework for nuclear new build in a market-based context. To the extent that assumptions in the analysis are not borne out in reality (e.g. as regards nuclear cost), this is a no regrets policy, given that the market would not invest in nuclear if it is prohibitively costly. (author)

  10. Clinical process analysis and activity-based costing at a heart center.

    Science.gov (United States)

    Ridderstolpe, Lisa; Johansson, Andreas; Skau, Tommy; Rutberg, Hans; Ahlfeldt, Hans

    2002-08-01

    Cost studies, productivity, efficiency, and quality of care measures, the links between resources and patient outcomes, are fundamental issues for hospital management today. This paper describes the implementation of a model for process analysis and activity-based costing (ABC)/management at a Heart Center in Sweden as a tool for administrative cost information, strategic decision-making, quality improvement, and cost reduction. A commercial software package (QPR) containing two interrelated parts, "ProcessGuide and CostControl," was used. All processes at the Heart Center were mapped and graphically outlined. Processes and activities such as health care procedures, research, and education were identified together with their causal relationship to costs and products/services. The construction of the ABC model in CostControl was time-consuming. However, after the ABC/management system was created, it opened the way for new possibilities including process and activity analysis, simulation, and price calculations. Cost analysis showed large variations in the cost obtained for individual patients undergoing coronary artery bypass grafting (CABG) surgery. We conclude that a process-based costing system is applicable and has the potential to be useful in hospital management.

  11. Cost analysis of open radical cystectomy versus robot-assisted radical cystectomy.

    Science.gov (United States)

    Bansal, Sukhchain S; Dogra, Tara; Smith, Peter W; Amran, Maisarah; Auluck, Ishna; Bhambra, Maninder; Sura, Manraj S; Rowe, Edward; Koupparis, Anthony

    2018-03-01

    To perform a cost analysis comparing the cost of robot-assisted radical cystectomy (RARC) with open RC (ORC) in a UK tertiary referral centre and to identify the key cost drivers. Data on hospital length of stay (LOS), operative time (OT), transfusion rate, and volume and complication rate were obtained from a prospectively updated institutional database for patients undergoing RARC or ORC. A cost decision tree model was created. Sensitivity analysis was performed to find key drivers of overall cost and to find breakeven points with ORC. Monte Carlo analysis was performed to quantify the variability in the dataset. One RARC procedure costs £12 449.87, or £12 106.12 if the robot was donated via charitable funds. In comparison, one ORC procedure costs £10 474.54. RARC is 18.9% more expensive than ORC. The key cost drivers were OT, LOS, and the number of cases performed per annum. High ongoing equipment costs remain a large barrier to the cost of RARC falling. However, minimal improvements in patient quality of life would be required to offset this difference. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

  12. 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.

  13. 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.

  14. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons.

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

    Full Text Available The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group with the costs for those receiving usual care (control group.Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache.Data from 44,550 patients (67.3% females were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14-7,414.29] than in the control group (EUR 5,857.56 [5,650.98-6,064.13]; p<0.0001 with the largest differences between groups for productivity loss (homeopathy EUR 3,698.00 [3,586.48-3,809.53] vs. control EUR 3,092.84 [2,981.31-3,204.37] and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90-1,102.59] vs. control EUR 867.87 [853.52-882.21]. Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant.Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system.

  15. Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons

    Science.gov (United States)

    Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M.

    2015-01-01

    Objectives The aim of this study was to compare the health care costs for patients using additional homeopathic treatment (homeopathy group) with the costs for those receiving usual care (control group). Methods Cost data provided by a large German statutory health insurance company were retrospectively analysed from the societal perspective (primary outcome) and from the statutory health insurance perspective. Patients in both groups were matched using a propensity score matching procedure based on socio-demographic variables as well as costs, number of hospital stays and sick leave days in the previous 12 months. Total cumulative costs over 18 months were compared between the groups with an analysis of covariance (adjusted for baseline costs) across diagnoses and for six specific diagnoses (depression, migraine, allergic rhinitis, asthma, atopic dermatitis, and headache). Results Data from 44,550 patients (67.3% females) were available for analysis. From the societal perspective, total costs after 18 months were higher in the homeopathy group (adj. mean: EUR 7,207.72 [95% CI 7,001.14–7,414.29]) than in the control group (EUR 5,857.56 [5,650.98–6,064.13]; phomeopathy EUR 3,698.00 [3,586.48–3,809.53] vs. control EUR 3,092.84 [2,981.31–3,204.37]) and outpatient care costs (homeopathy EUR 1,088.25 [1,073.90–1,102.59] vs. control EUR 867.87 [853.52–882.21]). Group differences decreased over time. For all diagnoses, costs were higher in the homeopathy group than in the control group, although this difference was not always statistically significant. Conclusion Compared with usual care, additional homeopathic treatment was associated with significantly higher costs. These analyses did not confirm previously observed cost savings resulting from the use of homeopathy in the health care system. PMID:26230412

  16. An Analysis of Rocket Propulsion Testing Costs

    Science.gov (United States)

    Ramirez-Pagan, Carmen P.; Rahman, Shamim A.

    2009-01-01

    The primary mission at NASA Stennis Space Center (SSC) is rocket propulsion testing. Such testing is generally performed within two arenas: (1) Production testing for certification and acceptance, and (2) Developmental testing for prototype or experimental purposes. The customer base consists of NASA programs, DOD programs, and commercial programs. Resources in place to perform on-site testing include both civil servants and contractor personnel, hardware and software including data acquisition and control, and 6 test stands with a total of 14 test positions/cells. For several business reasons there is the need to augment understanding of the test costs for all the various types of test campaigns. Historical propulsion test data was evaluated and analyzed in many different ways with the intent to find any correlation or statistics that could help produce more reliable and accurate cost estimates and projections. The analytical efforts included timeline trends, statistical curve fitting, average cost per test, cost per test second, test cost timeline, and test cost envelopes. Further, the analytical effort includes examining the test cost from the perspective of thrust level and test article characteristics. Some of the analytical approaches did not produce evidence strong enough for further analysis. Some other analytical approaches yield promising results and are candidates for further development and focused study. Information was organized for into its elements: a Project Profile, Test Cost Timeline, and Cost Envelope. The Project Profile is a snap shot of the project life cycle on a timeline fashion, which includes various statistical analyses. The Test Cost Timeline shows the cumulative average test cost, for each project, at each month where there was test activity. The Test Cost Envelope shows a range of cost for a given number of test(s). The supporting information upon which this study was performed came from diverse sources and thus it was necessary to

  17. [Electronic versus paper-based patient records: a cost-benefit analysis].

    Science.gov (United States)

    Neubauer, A S; Priglinger, S; Ehrt, O

    2001-11-01

    The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

  18. 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 (PM 2.5 ) reaching unprecedentedly high levels in many cities. Quantifying the detrimental effects on health and their costs derived from high PM 2.5 levels is crucial because of the unsolved challenges to mitigate air pollution in the following decades. Using the daily monitoring data on PM 2.5 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 PM 2.5 when the annual average daily PM 2.5 concentration was less than 50 μg m -3 ; while this ratio was doubled (around 2%) with the daily PM 2.5 concentration larger than 50 μg m -3 . Under severe air pollution (PM 2.5 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 PM 2.5 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. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Incorporating robotic-assisted surgery for endometrial cancer staging: Analysis of morbidity and costs.

    Science.gov (United States)

    Bogani, Giorgio; Multinu, Francesco; Dowdy, Sean C; Cliby, William A; Wilson, Timothy O; Gostout, Bobbie S; Weaver, Amy L; Borah, Bijan J; Killian, Jill M; Bijlani, Akash; Angioni, Stefano; Mariani, Andrea

    2016-05-01

    To evaluate how the introduction of robotic-assisted surgery affects treatment-related morbidity and cost of endometrial cancer (EC) staging. We retrospectively reviewed the records of consecutive patients with stage I-III EC undergoing surgical staging between 2007 and 2012 at our institution. Costs (from surgery to 30days after surgery) were set based on the Medicare cost-to-charge ratio for each year and inflated to 2014 values. Inverse probability weighting (IPW) was used to decrease the allocation bias when comparing outcomes between surgical groups. We focused our analysis on the 251 EC patients who had robotic-assisted surgery and the 384 who had open staging. During the study period, the use of robotic-assisted surgery increased and open staging decreased (P<0.001). Correcting group imbalances by using IPW methodology, we observed that patients undergoing robotic-assisted staging had a significantly lower postoperative complication rate, lower blood transfusion rate, longer median operating time, shorter median length of stay, and lower readmission rate than patients undergoing open staging (all P<0.001). Overall 30-day costs were similar between the 2 groups, with robotic-assisted surgery having significantly higher median operating room costs ($2820 difference; P<0.001) but lower median room and board costs ($2929 difference; P<0.001) than open surgery. Increasing experience with robotic-assisted staging was significantly associated with a decrease in median operating time (P=0.002) and length of stay (P=0.003). The implementation of robotic-assisted surgery for EC staging improves patient outcomes. It provides women the benefits of minimally invasive surgery without increasing costs and potentially improves patient turnover. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 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,…

  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. Monetary evaluation of radiation detriment cost in cost/benefit analysis of protective actions after nuclear accidents

    International Nuclear Information System (INIS)

    Qu, J.; Xue, D.

    1998-01-01

    This paper discusses the monetary evaluation of radiation detriment cost in the cost/benefit analyses of countermeasures after nuclear accidents. The methods used to determine the so-called α factor in cost/benefit analysis are presented. It is pointed out that the approaches found in current literature to the consideration of individual dose in cost-benefit analyses have some limitations. To overcome those deficiencies, we introduced the concept of individual dose evaluation function in this paper. In addition, we developed a modified approach to cost-benefit analyses of protective actions after nuclear accidents. (author)

  3. Rapid, low-cost, image analysis through video processing

    International Nuclear Information System (INIS)

    Levinson, R.A.; Marrs, R.W.; Grantham, D.G.

    1976-01-01

    Remote Sensing now provides the data necessary to solve many resource problems. However, many of the complex image processing and analysis functions used in analysis of remotely-sensed data are accomplished using sophisticated image analysis equipment. High cost of this equipment places many of these techniques beyond the means of most users. A new, more economical, video system capable of performing complex image analysis has now been developed. This report describes the functions, components, and operation of that system. Processing capability of the new video image analysis system includes many of the tasks previously accomplished with optical projectors and digital computers. Video capabilities include: color separation, color addition/subtraction, contrast stretch, dark level adjustment, density analysis, edge enhancement, scale matching, image mixing (addition and subtraction), image ratioing, and construction of false-color composite images. Rapid input of non-digital image data, instantaneous processing and display, relatively low initial cost, and low operating cost gives the video system a competitive advantage over digital equipment. Complex pre-processing, pattern recognition, and statistical analyses must still be handled through digital computer systems. The video system at the University of Wyoming has undergone extensive testing, comparison to other systems, and has been used successfully in practical applications ranging from analysis of x-rays and thin sections to production of color composite ratios of multispectral imagery. Potential applications are discussed including uranium exploration, petroleum exploration, tectonic studies, geologic mapping, hydrology sedimentology and petrography, anthropology, and studies on vegetation and wildlife habitat

  4. Integrating Life-cycle Assessment into Transport Cost-benefit Analysis

    DEFF Research Database (Denmark)

    Manzo, Stefano; Salling, Kim Bang

    2016-01-01

    Traditional transport Cost-Benefit Analysis (CBA) commonly ignores the indirect environmental impacts of an infrastructure project deriving from the overall life-cycle of the different project components. Such indirect impacts are instead of key importance in order to assess the long......-term sustainability of a transport infrastructure project. In the present study we suggest to overcome this limit by combining a conventional life-cycle assessment approach with standard transport cost-benefit analysis. The suggested methodology is tested upon a case study project related to the construction of a new...... fixed link across the Roskilde fjord in Frederikssund (Denmark). The results are then compared with those from a standard CBA framework. The analysis shows that indirect environmental impacts represent a relevant share of the estimated costs of the project, clearly affecting the final project evaluation...

  5. Cost-Effectiveness Analysis of Different Genetic Testing Strategies for Lynch Syndrome in Taiwan.

    Directory of Open Access Journals (Sweden)

    Ying-Erh Chen

    Full Text Available 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

  6. Cost-utility analysis comparing laparoscopic vs open aortobifemoral bypass surgery

    Directory of Open Access Journals (Sweden)

    Krog AH

    2017-06-01

    Full Text Available Anne Helene Krog,1,2 Mehdi Sahba,3 Erik M Pettersen,4 Torbjørn Wisløff,5,6 Jon O Sundhagen,2 Syed SH Kazmi2 1Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 2Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, 3Department of Vascular Surgery, Østfold Central Hospital, Kalnes, 4Department of Vascular Surgery, Sørlandet Hospital HF, Kristiansand, 5Department of Health Management and Health Economics, University of Oslo, 6Norwegian Institute of Public Health, Oslo, Norway Objectives: Laparoscopic aortobifemoral bypass has become an established treatment option for symptomatic aortoiliac obstructive disease at dedicated centers. Minimally invasive surgical techniques like laparoscopic surgery have often been shown to reduce expenses and increase patients’ health-related quality of life. The main objective of our study was to measure quality-adjusted life years (QALYs and costs after totally laparoscopic and open aortobifemoral bypass. Patients and methods: This was a within trial analysis in a larger ongoing randomized controlled prospective multicenter trial, Norwegian Laparoscopic Aortic Surgery Trial. Fifty consecutive patients suffering from symptomatic aortoiliac occlusive disease suitable for aortobifemoral bypass surgery were randomized to either totally laparoscopic (n=25 or open surgical procedure (n=25. One patient dropped out of the study before surgery. We measured health-related quality of life using the EuroQol (EQ-5D-5L questionnaire at 4 different time points, before surgery and for 6 months during follow-up. We calculated the QALYs gained by using the area under the curve for both groups. Costs were calculated based on prices for surgical equipment, vascular prosthesis and hospital stay. Results: We found a significantly higher increase in QALYs after laparoscopic vs open aortobifemoral bypass surgery, with a difference of 0.07 QALYs, (p=0

  7. [A cost-benefit analysis of occupational disease reporting in China].

    Science.gov (United States)

    Tang, X Z; Zeng, Q; Liu, D S

    2017-03-20

    Objective: To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation. Methods: The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis. Results: The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year. Conclusion: The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.

  8. Soft-copy sonography: cost reduction sensitivity analysis in a pediatric hospital.

    Science.gov (United States)

    Don, S; Albertina, M J; Ammann, D

    1998-03-01

    Our objective was to determine whether interpreting sonograms of pediatric patients using soft-copy (computer workstation) instead of laser-printed film could reduce costs for a pediatric radiology department. We used theoretic models of growth to analyze costs. The costs of a sonographic picture archiving and communication system (three interface devices, two workstations, a network server, maintenance expenses, and storage media costs) were compared with the potential savings of eliminating film and increasing technologist efficiency or reducing the number of technologists. The model was based on historic trends and future capitation estimates that will reduce fee-for-service reimbursement. The effects of varying the study volume and reducing technologists' work hours were analyzed. By converting to soft-copy interpretation, we saved 6 min 32 sec per examination by eliminating film processing waiting time, thus reducing examination time from 30 min to 24 min. During an average day of 27 examinations, 176 min were saved. However, 33 min a day were spent retrieving prior studies from long-term storage; thus, 143 extra minutes a day were available for scanning. This improved efficiency could result in five more sonograms a day obtained by converting to soft-copy interpretation, using existing staff and equipment. Alternatively, five examinations a day would equate to one half of a full-time equivalent technologists position. Our analysis of costs considered that the hospital's anticipated growth of sonography and the depreciation of equipment during 5 years resulted in a savings of more than $606,000. Increasing the examinations by just 200 sonograms in the first year and no further growth resulted in a savings of more than $96,000. If the number of sonograms stayed constant, elimination of film printing alone resulted in a loss of approximately $157,000; reduction of one half of a full-time equivalent technologist's position would recuperate approximately $134

  9. HIV Rapid Testing in a VA Emergency Department Setting: Cost Analysis at 5 Years.

    Science.gov (United States)

    Knapp, Herschel; Chan, Kee

    2015-07-01

    To conduct a comprehensive cost-minimization analysis to comprehend the financial attributes of the first 5 years of an implementation wherein emergency department (ED) registered nurses administered HIV oral rapid tests to patients. A health science research implementation team coordinated with ED stakeholders and staff to provide training, implementation guidelines, and support to launch ED registered nurse-administered HIV oral rapid testing. Deidentified quantitative data were gathered from the electronic medical records detailing quarterly HIV rapid test rates in the ED setting spanning the first 5 years. Comprehensive cost analyses were conducted to evaluate the financial impact of this implementation. At 5 years, a total of 2,620 tests were conducted with a quarterly mean of 131 ± 81. Despite quarterly variability in testing rates, regression analysis revealed an average increase of 3.58 tests per quarter. Over the course of this implementation, Veterans Health Administration policy transitioned from written to verbal consent for HIV testing, serving to reduce the time and cost(s) associated with the testing process. Our data indicated salient health outcome benefits for patients with respect to the potential for earlier detection, and associated long-run cost savings. Copyright © 2015. Published by Elsevier Inc.

  10. IMPLEMENTATION OF ACTIVITY BASED ANALYSIS METHOD COSTING SYSTEM IN PRICING COST OF ROOMS IN HOTEL DYNASTY MAKASSAR

    Directory of Open Access Journals (Sweden)

    Muh Nur Hatta

    2017-06-01

    Full Text Available The purpose of this study is to fulfill one of the final project now where Thesis research was held in April to June, 2016. This study aims to know the differences in the calculation of the cost of the room by using a conventional system using activity-based costing (ABC system. method analysis is using descriptive method of analysis of the cost of the hotel this time, set the conventional method and then comparing the cost of a hotel room based activity based result costing. study showed that of calculating the cost of a hotel room by using activity based costing, when compared with the cost of hotel rooms used by the activity based costing Dynasty then give the results in standard rooms, deluxe, suites and family give results the calculation of which is smaller than the cost of the rooms which have been determined by the hotel management. That is, with the difference in price for a Standard room IDR. 58024.84. For a Deluxe room IDR. 175,411.58. For room Suite IDR. 99. 034,88. Family rooms and for IDR. 100,045.60. While in the room Executive Suite / Pent House Activity Based Costing calculation result is greater than the cost of the rooms which have been determined by the hotel management. That is, with the difference amounting to IDR. 368,096.17. The difference in price is due to the method of Activity Based Costing,The overhead on each product is charged to a lot of cost driver. Thus, in the Activity Based Costing method is able to allocate activity costs to each room is right by the consumption of each activity.

  11. Cost Risk Analysis Based on Perception of the Engineering Process

    Science.gov (United States)

    Dean, Edwin B.; Wood, Darrell A.; Moore, Arlene A.; Bogart, Edward H.

    1986-01-01

    In most cost estimating applications at the NASA Langley Research Center (LaRC), it is desirable to present predicted cost as a range of possible costs rather than a single predicted cost. A cost risk analysis generates a range of cost for a project and assigns a probability level to each cost value in the range. Constructing a cost risk curve requires a good estimate of the expected cost of a project. It must also include a good estimate of expected variance of the cost. Many cost risk analyses are based upon an expert's knowledge of the cost of similar projects in the past. In a common scenario, a manager or engineer, asked to estimate the cost of a project in his area of expertise, will gather historical cost data from a similar completed project. The cost of the completed project is adjusted using the perceived technical and economic differences between the two projects. This allows errors from at least three sources. The historical cost data may be in error by some unknown amount. The managers' evaluation of the new project and its similarity to the old project may be in error. The factors used to adjust the cost of the old project may not correctly reflect the differences. Some risk analyses are based on untested hypotheses about the form of the statistical distribution that underlies the distribution of possible cost. The usual problem is not just to come up with an estimate of the cost of a project, but to predict the range of values into which the cost may fall and with what level of confidence the prediction is made. Risk analysis techniques that assume the shape of the underlying cost distribution and derive the risk curve from a single estimate plus and minus some amount usually fail to take into account the actual magnitude of the uncertainty in cost due to technical factors in the project itself. This paper addresses a cost risk method that is based on parametric estimates of the technical factors involved in the project being costed. The engineering

  12. An analysis of production and costs in high-lead yarding.

    Science.gov (United States)

    Magnus E. Tennas; Robert H. Ruth; Carl M. Berntsen

    1955-01-01

    In recent years loggers and timber owners have needed better information for estimating logging costs in the Douglas-fir region. Brandstrom's comprehensive study, published in 1933 (1), has long been used as a guide in making cost estimates. But the use of new equipment and techniques and an overall increase in logging costs have made it increasingly difficult to...

  13. Comparing the Cost of Protecting Selected Lightweight Block Ciphers against Differential Power Analysis in Low-Cost FPGAs

    Directory of Open Access Journals (Sweden)

    William Diehl

    2018-04-01

    Full Text Available Lightweight block ciphers are an important topic in the Internet of Things (IoT since they provide moderate security while requiring fewer resources than the Advanced Encryption Standard (AES. Ongoing cryptographic contests and standardization efforts evaluate lightweight block ciphers on their resistance to power analysis side channel attack (SCA, and the ability to apply countermeasures. While some ciphers have been individually evaluated, a large-scale comparison of resistance to side channel attack and the formulation of absolute and relative costs of implementing countermeasures is difficult, since researchers typically use varied architectures, optimization strategies, technologies, and evaluation techniques. In this research, we leverage the Test Vector Leakage Assessment (TVLA methodology and the FOBOS SCA framework to compare FPGA implementations of AES, SIMON, SPECK, PRESENT, LED, and TWINE, using a choice of architecture targeted to optimize throughput-to-area (TP/A ratio and suitable for introducing countermeasures to Differential Power Analysis (DPA. We then apply an equivalent level of protection to the above ciphers using 3-share threshold implementations (TI and verify the improved resistance to DPA. We find that SIMON has the highest absolute TP/A ratio of protected versions, as well as the lowest relative cost of protection in terms of TP/A ratio. Additionally, PRESENT uses the least energy per bit (E/bit of all protected implementations, while AES has the lowest relative cost of protection in terms of increased E/bit.

  14. 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.

  15. 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.

    2013-01-01

    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. PMID:24169411

  16. 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.

  17. 20 CFR 404.277 - When does the frozen minimum primary insurance amount increase because of cost-of-living...

    Science.gov (United States)

    2010-04-01

    ... insurance amount increase because of cost-of-living adjustments? 404.277 Section 404.277 Employees' Benefits... Primary Insurance Amounts Cost-Of-Living Increases § 404.277 When does the frozen minimum primary insurance amount increase because of cost-of-living adjustments? (a) What is the frozen minimum primary...

  18. Better informing decision making with multiple outcomes cost-effectiveness analysis under uncertainty in cost-disutility space.

    Science.gov (United States)

    McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon

    2015-01-01

    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 multiple

  19. A cost analysis of microalgal biomass and biodiesel production in open raceways treating municipal wastewater and under optimum light wavelength.

    Science.gov (United States)

    Kang, Zion; Kim, Byung-Hyuk; Ramanan, Rishiram; Choi, Jong-Eun; Yang, Ji-Won; Oh, Hee-Mock; Kim, Hee-Sik

    2015-01-01

    Open raceway ponds are cost-efficient for mass cultivation of microalgae compared with photobioreactors. Although low-cost options like wastewater as nutrient source is studied to overcome the commercialization threshold for biodiesel production from microalgae, a cost analysis on the use of wastewater and other incremental increases in productivity has not been elucidated. We determined the effect of using wastewater and wavelength filters on microalgal productivity. Experimental results were then fitted into a model, and cost analysis was performed in comparison with control raceways. Three different microalgal strains, Chlorella vulgaris AG10032, Chlorella sp. JK2, and Scenedesmus sp. JK10, were tested for nutrient removal under different light wavelengths (blue, green, red, and white) using filters in batch cultivation. Blue wavelength showed an average of 27% higher nutrient removal and at least 42% higher chemical oxygen demand removal compared with white light. Naturally, the specific growth rate of microalgae cultivated under blue wavelength was on average 10.8% higher than white wavelength. Similarly, lipid productivity was highest in blue wavelength, at least 46.8% higher than white wavelength, whereas FAME composition revealed a mild increase in oleic and palmitic acid levels. Cost analysis reveals that raceways treating wastewater and using monochromatic wavelength would decrease costs from 2.71 to 0.73 $/kg biomass. We prove that increasing both biomass and lipid productivity is possible through cost-effective approaches, thereby accelerating the commercialization of low-value products from microalgae, like biodiesel.

  20. 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.

  1. Cost-utility analysis of varenicline, an oral smoking-cessation drug, in Japan.

    Science.gov (United States)

    Igarashi, Ataru; Takuma, Hiroki; Fukuda, Takashi; Tsutani, Kiichiro

    2009-01-01

    To conduct a cost-utility analysis of two 12-week smoking-cessation interventions in Japan: smoking-cessation counselling by a physician compared with use of varenicline, an oral smoking-cessation drug, in addition to counselling. A Markov model was constructed to analyse lifetime medical costs and QALYs from the perspective of the healthcare payer. The cycle length was 5 years. Both costs and QALYs were discounted at 3% annually. The cohort of smokers was classified by sex and age, and we assumed that smokers started smoking at the age of 20 years and received smoking-cessation therapy at the ages of 30, 40, 50, 60 or 70 years (five separate models were run). The healthcare costs and QALYs were calculated throughout the term until the age of 90 years. In the base-case analysis, success rates of varenicline plus counselling and counselling alone were assumed to be 37.9% and 25.5%, respectively, in male smokers, and 22.2% and 16.1%, respectively, in female smokers, based on a randomized controlled trial conducted in Japan. Both univariate and probabilistic sensitivity analyses were conducted. Prescribed varenicline was shown to be more effective and less costly than smoking-cessation counselling alone. Varenicline would save direct medical costs of Japanese Yen (yen)43 846 ($US381; $US1 = yen115; Oct 2007) and generate an increase of 0.094 QALYs in male smokers. In females the incremental cost-effectiveness ratio was yen346 143 per QALY gained. Varenicline is estimated to save yen23.7 billion ($US206 million) of the medical costs for tobacco-associated diseases for the whole population. Overall savings are yen9.5 billion. Sensitivity analyses suggested the robustness of the results. As with any data of this nature, there is some uncertainty in the results and further research is warranted. However, based on the results of this pharmacoeconomic evaluation, varenicline, the first non-nicotine, oral treatment developed for smoking cessation, appears to be cost

  2. Economic impact analysis for global warming: Sensitivity analysis for cost and benefit estimates

    International Nuclear Information System (INIS)

    Ierland, E.C. van; Derksen, L.

    1994-01-01

    Proper policies for the prevention or mitigation of the effects of global warming require profound analysis of the costs and benefits of alternative policy strategies. Given the uncertainty about the scientific aspects of the process of global warming, in this paper a sensitivity analysis for the impact of various estimates of costs and benefits of greenhouse gas reduction strategies is carried out to analyze the potential social and economic impacts of climate change

  3. Cost analysis of enhanced recovery after surgery in microvascular breast reconstruction.

    Science.gov (United States)

    Oh, Christine; Moriarty, James; Borah, Bijan J; Mara, Kristin C; Harmsen, William S; Saint-Cyr, Michel; Lemaine, Valerie

    2018-06-01

    Enhanced recovery after surgery (ERAS) pathways have been shown in multiple surgical specialties to decrease hospital length of stay (LOS) after surgery. ERAS in breast reconstruction has been found to decrease hospital LOS and inpatient opioid use. ERAS protocols can facilitate a patient's recovery and can potentially increase the quality of care while decreasing costs. A standardized ERAS pathway was developed through multidisciplinary collaboration. It addressed all phases of surgical care for patients undergoing free-flap breast reconstruction utilizing an abdominal donor site. In this retrospective cohort study, clinical variables associated with hospitalization costs for patients who underwent free-flap breast reconstruction with the ERAS pathway were compared with those of historical controls, termed traditional recovery after surgery (TRAS). All patients included in the study underwent surgery between September 2010 and September 2014. Predicted costs of the study groups were compared using generalized linear modeling. A total of 200 patients were analyzed: 82 in the ERAS cohort and 118 in the TRAS cohort. Clinical variables that were identified to potentially affect costs were found to have a statistically significant difference between groups and included unilateral versus bilateral procedures (p = 0.04) and the need for postoperative blood transfusion (p = 0.03). The cost regression analysis on the two cohorts was adjusted for these significant variables. Adjusted mean costs of patients with ERAS were found to be $4,576 lesser than those of the TRAS control group ($38,688 versus $43,264). Implementation of the ERAS pathway was associated with significantly decreased costs when compared to historical controls. There has been a healthcare focus toward prudent resource allocation, which dictates the need for plastic surgeons to recognize economic evaluation of clinical practice. The ERAS pathway can increase healthcare accountability by improving

  4. Cost evaluation to optimise radiation therapy implementation in different income settings: A time-driven activity-based analysis.

    Science.gov (United States)

    Van Dyk, Jacob; Zubizarreta, Eduardo; Lievens, Yolande

    2017-11-01

    With increasing recognition of growing cancer incidence globally, efficient means of expanding radiotherapy capacity is imperative, and understanding the factors impacting human and financial needs is valuable. A time-driven activity-based costing analysis was performed, using a base case of 2-machine departments, with defined cost inputs and operating parameters. Four income groups were analysed, ranging from low to high income. Scenario analyses included department size, operating hours, fractionation, treatment complexity, efficiency, and centralised versus decentralised care. The base case cost/course is US$5,368 in HICs, US$2,028 in LICs; the annual operating cost is US$4,595,000 and US$1,736,000, respectively. Economies of scale show cost/course decreasing with increasing department size, mainly related to the equipment cost and most prominent up to 3 linacs. The cost in HICs is two or three times as high as in U-MICs or LICs, respectively. Decreasing operating hours below 8h/day has a dramatic impact on the cost/course. IMRT increases the cost/course by 22%. Centralising preparatory activities has a moderate impact on the costs. The results indicate trends that are useful for optimising local and regional circumstances. This methodology can provide input into a uniform and accepted approach to evaluating the cost of radiotherapy. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  5. Life cycle cost analysis of HPVT air collector under different Indian climatic conditions

    International Nuclear Information System (INIS)

    Raman, Vivek; Tiwari, G.N.

    2008-01-01

    In this communication, a study is carried out to evaluate an annual thermal and exergy efficiency of a hybrid photovoltaic thermal (HPVT) air collector for different Indian climate conditions, of Srinagar, Mumbai, Jodhpur, New Delhi and Banglore. The study has been based on electrical, thermal and exergy output of the HPVT air collector. Further, the life cycle analysis in terms of cost/kWh has been carried out. The main focus of the study is to see the effect of interest rate, life of the HPVT air collector, subsidy, etc. on the cost/kWh HPVT air collector. A comparison is made keeping in view the energy matrices. The study reveals that (i) annual thermal and electrical efficiency decreases with increase in solar radiation and (ii) the cost/kWh is higher in case of exergy when compared with cost/kWh on the basis of thermal energy for all climate conditions. The cost/kWh for climate conditions of Jodhpur is most economical

  6. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program: Volume 2, Supporting information

    International Nuclear Information System (INIS)

    1987-06-01

    This report provides cost estimates for the fifth evaluation of the adequacy of the fee and is consistent with the program strategy and plans. The total-system cost for the reference cases in the improved-performance system is estimated at $32.1 to $38.2 billion (expressed in constant 1986 collars) over the entire life of the system, or $1.5 to $1.6 billion more than that of the authorized system (i.e., the system without an MRS facility). The current estimate of the total-system cost for the reference cases in the improved-performance system is $3.8 to $5.4 billion higher than the estimate for the same system in the 1986 TSLCC analysis. In the case with the maximum increase, nearly all of the higher cost is due to a $5.2-billion increase in the costs of development and evaluation (D and E); all other system costs are essentially unchanged. The cost difference between the improved-performance system and the authorized system is smaller than the difference estimated in last year's TSLCC analysis. Volume 2 presents the detailed results for the 1987 analysis of the total-system life cycle cost (TSLCC). It consists of four sections: Section A presents the yearly flows of waste between waste-management facilities for the 12 aggregate logistics cases that were studied; Section B presents the annual total-system costs for each of the 30 TSLCC cases by major cost category; Section C presents the annual costs for the disposal of 16,000 canisters of defense high-level waste (DHLW) by major cost category for each of the 30 TSLCC cases; and Section D presents a summary of the cost-allocation factors that were calculated to determine the defense waste share of the total-system costs

  7. PET-CT in oncological patients: analysis of informal care costs in cost-benefit assessment.

    Science.gov (United States)

    Orlacchio, Antonio; Ciarrapico, Anna Micaela; Schillaci, Orazio; Chegai, Fabrizio; Tosti, Daniela; D'Alba, Fabrizio; Guazzaroni, Manlio; Simonetti, Giovanni

    2014-04-01

    The authors analysed the impact of nonmedical costs (travel, loss of productivity) in an economic analysis of PET-CT (positron-emission tomography-computed tomography) performed with standard contrast-enhanced CT protocols (CECT). From October to November 2009, a total of 100 patients referred to our institute were administered a questionnaire to evaluate the nonmedical costs of PET-CT. In addition, the medical costs (equipment maintenance and depreciation, consumables and staff) related to PET-CT performed with CECT and PET-CT with low-dose nonenhanced CT and separate CECT were also estimated. The medical costs were 919.3 euro for PET-CT with separate CECT, and 801.3 euro for PET-CT with CECT. Therefore, savings of approximately 13% are possible. Moreover, savings in nonmedical costs can be achieved by reducing the number of hospital visits required by patients undergoing diagnostic imaging. Nonmedical costs heavily affect patients' finances as well as having an indirect impact on national health expenditure. Our results show that PET-CT performed with standard dose CECT in a single session provides benefits in terms of both medical and nonmedical costs.

  8. A cost analysis of introducing an infectious disease specialist-guided antimicrobial stewardship in an area with relatively low prevalence of antimicrobial resistance.

    Science.gov (United States)

    Lanbeck, Peter; Ragnarson Tennvall, Gunnel; Resman, Fredrik

    2016-07-27

    Antimicrobial stewardship programs have been widely introduced in hospitals as a response to increasing antimicrobial resistance. Although such programs are commonly used, the long-term effects on antimicrobial resistance as well as societal economics are uncertain. We performed a cost analysis of an antimicrobial stewardship program introduced in Malmö, Sweden in 20 weeks 2013 compared with a corresponding control period in 2012. All direct costs and opportunity costs related to the stewardship intervention were calculated for both periods. Costs during the stewardship period were directly compared to costs in the control period and extrapolated to a yearly cost. Two main analyses were performed, one including only comparable direct costs (analysis one) and one including comparable direct and opportunity costs (analysis two). An extra analysis including all comparable direct costs including costs related to length of hospital stay (analysis three) was performed, but deemed as unrepresentative. According to analysis one, the cost per year was SEK 161 990 and in analysis two the cost per year was SEK 5 113. Since the two cohorts were skewed in terms of size and of infection severity as a consequence of the program, and since short-term patient outcomes have been demonstrated to be unchanged by the intervention, the costs pertaining to patient outcomes were not included in the analysis, and we suggest that analysis two provides the most correct cost calculation. In this analysis, the main cost drivers were the physician time and nursing time. A sensitivity analysis of analysis two suggested relatively modest variation under changing assumptions. The total yearly cost of introducing an infectious disease specialist-guided, audit-based antimicrobial stewardship in a department of internal medicine, including direct costs and opportunity costs, was calculated to be as low as SEK 5 113.

  9. Carbon Emission Disclosure and the Cost of Capital: An Analysis of Malaysian Capital Market

    Directory of Open Access Journals (Sweden)

    Binti Abd Rahman Noor Raida

    2017-01-01

    Full Text Available The main purpose of this study is to examine the relationship between voluntary disclosure and cost of capital by exploring the impact of voluntary carbon emission disclosure (VCED on the firm’s weighted-average cost of capital. A carbon disclosure index is used to evaluate the quality of carbon emission disclosure in 2013 and 2014 annual reports of 247 Malaysian public listed companies. By using content analysis, the result highlights a significant increase in the level and quality of carbon emission disclosure practice from 2013 to 2014. In addition, the finding from regression analysis indicates insignificant relationship between VCED quality and weighted-average cost of capital. Overall, our findings suggest that the carbon emission disclosure is still low, as such, the quality of VCED do not have an impact on firm’s cost of capital. The results of the study allow the government to measure progress toward achieving its target to reduce carbon emission and will add weight to the call by accounting regulation body such as Malaysian Accounting Standard Board for a specific standard on carbon reporting.

  10. Economic costs attributable to smoking in Hong Kong in 2011: a possible increase from 1998.

    Science.gov (United States)

    Chen, Jing; McGhee, Sarah; Lam, Tai Hing

    2017-11-15

    Reduction in smoking prevalence does not necessarily reduce the costs of smoking as evidence shows in developed countries. We provide up-to-date estimates for direct and indirect costs attributable to smoking in Hong Kong in 2011 and compare with our 1998 estimates. We took a societal perspective to include lives and life years lost, health care costs and time lost from work in the costing. We followed guidelines on estimating costs of active smoking for those aged 35 years or above (35+) and costs due to SHS exposure for 35+, infants aged 12 months and under and children aged 15 and below. All costs are in US$. We estimated that 6154 deaths among 35+ in Hong Kong in 2011 were attributable to active smoking, an increase of 10% from 1998. Besides, 672 deaths were attributable to SHS exposure, i.e. 10% of the total 6826 smoking-attributable deaths. The estimate of productive life lost due to deaths from active smoking by those aged under 65 years in 2011 was $166 million, an increase of about 4% over the estimate in 1998. Our conservative estimate of the annual tobacco-related disease cost in 2011 was $716 million which accounted for 0.3% of GDP. If we added the value of attributable lives lost, the annual cost would be $4.7 billion. Despite the reduction in smoking prevalence, smoking-attributable disease still imposes a substantial economic burden on Hong Kong society. These findings support more stringent and effective tobacco control legislation, polices and measures. Current evidence shows reduction in smoking prevalence does not necessarily reduce the economic costs of smoking. Most studies in developed countries employed a societal perspective, including costs of productivity loss and indirect costs, but not all studies estimated costs associated with second-hand smoking (SHS). The present study estimated the total costs of smoking in Hong Kong including direct and indirect costs attributable to active smoking and to SHS exposure. Our study confirms the

  11. 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.

  12. Decision tree sensitivity analysis for cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma)

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Watanabe, Masumi; Kobayashi, Hideo; Kusano, Shoichi; Ichihara, Kiyoshi

    1998-01-01

    Decision tree analysis was used to assess cost-effectiveness of chest FDG-PET in patients with a pulmonary tumor (non-small cell carcinoma, ≤Stage IIIB), based on the data of the current decision tree. Decision tree models were constructed with two competing strategies (CT alone and CT plus chest FDG-PET) in 1,000 patient population with 71.4% prevalence. Baselines of FDG-PET sensitivity and specificity on detection of lung cancer and lymph node metastasis, and mortality and life expectancy were available from references. Chest CT plus chest FDG-PET strategy increased a total cost by 10.5% when a chest FDG-PET study costs 0.1 million yen, since it increased the number of mediastinoscopy and curative thoracotomy despite reducing the number of bronchofiberscopy to half. However, the strategy resulted in a remarkable increase by 115 patients with curable thoracotomy and decrease by 51 patients with non-curable thoracotomy. In addition, an average life expectancy increased by 0.607 year/patient, which means increase in medical cost is approximately 218,080 yen/year/patient when a chest FDG-PET study costs 0.1 million yen. In conclusion, chest CT plus chest FDG-PET strategy might not be cost-effective in Japan, but we are convinced that the strategy is useful in cost-benefit analysis. (author)

  13. Permeable treatment wall design and cost analysis

    International Nuclear Information System (INIS)

    Manz, C.; Quinn, K.

    1997-01-01

    A permeable treatment wall utilizing the funnel and gate technology has been chosen as the final remedial solution for one industrial site, and is being considered at other contaminated sites, such as a closed municipal landfill. Reactive iron gates will be utilized for treatment of chlorinated VOCs identified in the groundwater. Alternatives for the final remedial solution at each site were evaluated to achieve site closure in the most cost effective manner. This paper presents the remedial alternatives and cost analyses for each site. Several options are available at most sites for the design of a permeable treatment wall. Our analysis demonstrates that the major cost factor's for this technology are the design concept, length, thickness, location and construction methods for the reactive wall. Minimizing the amount of iron by placement in the most effective area and construction by the lowest cost method is critical to achieving a low cost alternative. These costs dictate the design of a permeable treatment wall, including selection of a variety of alternatives (e.g., a continuous wall versus a funnel and gate system, fully penetrating gates versus partially penetrating gates, etc.). Selection of the appropriate construction methods and materials for the site can reduce the overall cost of the wall

  14. Cost-benefit analysis of the ATM automatic deposit service

    Directory of Open Access Journals (Sweden)

    Ivica Županović

    2015-03-01

    Full Text Available Bankers and other financial experts have analyzed the value of automated teller machines (ATM in terms of growing consumer demand, rising costs of technology development, decreasing profitability and market share. This paper presents a step-by-step cost-benefit analysis of the ATM automatic deposit service. The first step is to determine user attitudes towards using ATM automatic deposit service by using the Technology Acceptance Model (TAM. The second step is to determine location priorities for ATMs that provide automatic deposit services using the Analytic Hierarchy Process (AHP model. The results of the previous steps enable a highly efficient application of cost-benefit analysis for evaluating costs and benefits of automatic deposit services. To understand fully the proposed procedure outside of theoretical terms, a real-world application of a case study is conducted.

  15. A comparative cost analysis of picture archiving and communications systems (PACS versus conventional radiology in the private sector

    Directory of Open Access Journals (Sweden)

    Indres Moodley

    2015-03-01

    Aim: To undertake an incremental cost analysis of PACS compared with conventional radiology to determine productivity gains, if any, at two private hospitals in Durban. Method: An incremental cost analysis for chest radiographs, computed tomography and magnetic resonance imaging brain scans with and without contrast were performed. The overall incremental cost for PACS in comparison with a conventional radiology site was determined. The net present value was also determined to evaluate the capital budgeting requirements for both systems. Results: The incremental cost of both capital and the radiology information system for installing PACS shows an expected increase. The incremental PACS image cost shows a reduction. Conclusion: The study provides a benchmark for the cost incurred when implementing PACS. It also provides a decision framework for radiology departments that plan to introduce PACS and helps to determine the feasibility of its introduction.

  16. Risk-based security cost-benefit analysis: method and example applications - 59381

    International Nuclear Information System (INIS)

    Wyss, Gregory; Hinton, John; Clem, John; Silva, Consuelo; Duran, Felicia A.

    2012-01-01

    Document available in abstract form only. Full text of publication follows: Decision makers wish to use risk-based cost-benefit analysis to prioritize security investments. However, understanding security risk requires estimating the likelihood of attack, which is extremely uncertain and depends on unquantifiable psychological factors like dissuasion and deterrence. In addition, the most common performance metric for physical security systems, probability of effectiveness at the design basis threat [P(E)], performs poorly in cost-benefit analysis. It is extremely sensitive to small changes in adversary characteristics when the threat is near a systems breaking point, but very insensitive to those changes under other conditions. This makes it difficult to prioritize investment options on the basis of P(E), especially across multiple targets or facilities. To overcome these obstacles, a Sandia National Laboratories Laboratory Directed Research and Development project has developed a risk-based security cost-benefit analysis method. This approach characterizes targets by how difficult it would be for adversaries to exploit each targets vulnerabilities to induce consequences. Adversaries generally have success criteria (e.g., adequate or desired consequences and thresholds for likelihood of success), and choose among alternative strategies that meet these criteria while considering their degree of difficulty in achieving their successful outcome. Investments reduce security risk as they reduce the severity of consequences available and/or increase the difficulty for an adversary to successfully accomplish their most advantageous attack

  17. Cost probability analysis of reprocessing spent nuclear fuel in the US

    International Nuclear Information System (INIS)

    Recktenwald, G.D.; Deinert, M.R.

    2012-01-01

    The methods by which nuclear power's radioactive signature could be reduced typically require the reprocessing of spent nuclear fuel. However, economic assessments of the costs that are associated with doing this are subject to a high degree of uncertainty. We present a probabilistic analysis of the costs to build, operate and decommission the facilities that would be required to reprocess all US spent nuclear fuel generated over a one hundred year time frame, starting from a 2010 power production rate. The analysis suggests a total life-cycle cost of 2.11 ± 0.26 mills/kWh, with a 90% and 99% confidence that the overall cost would remain below 2.45 and 2.75 mills/kWh respectively. The most significant effects on cost come from the efficiency of the reactor fleet and the growth rate of nuclear power. The analysis shows that discounting results in life-cycle costs decreasing as recycling is delayed. However the costs to store spent fuel closely counter the effect of discounting when an intergenerational discount rate is used.

  18. A perspective on electric vehicles: cost-benefit analysis and potential demand

    International Nuclear Information System (INIS)

    2011-01-01

    This report proposes some quantitative elements to assess the large scale diffusion of electric vehicles and analyse the potential demand for such vehicles. The first part proposes a cost-benefit analysis of the development of electric vehicles based on estimated costs and expected benefits by 2020. It addresses the following issues: framework and hypothesis, total cost of ownership, costs related to the deployment of a network of recharging infrastructures, assessment of external costs, and comparative cost-benefit analysis of electric vehicles. In the second part, the authors aim at identifying a potential demand for electric vehicles from the 2008 French national transport displacement survey (ENTD 2008) which provides recent data on the mobility of the French population

  19. Breath tests sustainability in hospital settings: cost analysis and reimbursement in the Italian National Health System.

    Science.gov (United States)

    Volpe, M; Scaldaferri, F; Ojetti, V; Poscia, A

    2013-01-01

    The high demand of Breath Tests (BT) in many gastroenterological conditions in time of limited resources for health care systems, generates increased interest in cost analysis from the point of view of the delivery of services to better understand how use the money to generate value. This study aims to measure the cost of C13 Urea and other most utilized breath tests in order to describe key aspects of costs and reimbursements looking at the economic sustainability for the hospital. A hospital based cost-analysis of the main breath tests commonly delivery in an ambulatory setting is performed. Mean salary for professional nurses and gastroenterologists, drugs/preparation used and disposable materials, purchase and depreciation of the instrument and the testing time was used to estimate the cost, while reimbursements are based on the 2013 Italian National Health System ambulatory pricelist. Variables that could influence the model are considered in the sensitivity analyses. The mean cost for C13--Urea, Lactulose and Lactose BT are, respectively, Euros 30,59; 45,20 and 30,29. National reimbursement often doesn't cover the cost of the analysis, especially considering the scenario with lower number of exam. On the contrary, in high performance scenario all the reimbursement could cover the cost, except for the C13 Urea BT that is high influenced by the drugs cost. However, consideration about the difference between Italian Regional Health System ambulatory pricelist are done. Our analysis shows that while national reimbursement rates cover the costs of H2 breath testing, they do not cover sufficiently C13 BT, particularly urea breath test. The real economic strength of these non invasive tests should be considered in the overall organization of inpatient and outpatient clinic, accounting for complete diagnostic pathway for each gastrointestinal disease.

  20. Cost-benefit analysis for waste segregation at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    1992-02-01

    This report presents a cost-benefit analysis for the segregation of mixed, hazardous, and nonhazardous wastes at Lawrence Livermore National Laboratory (LLNL). The cost-benefit analysis was conducted to determine if current waste segregation practices and additional candidates for waste segregation at LLNL might have the potential for significant waste source reduction and annual savings in treatment and disposal costs. In the following cost-benefit analysis, capital costs and recurring costs of waste segregation practices are compared to the economic benefits of savings in treatment and disposal costs. Indirect or overhead costs associated with these wastes are not available and have not been included. Not considered are additional benefits of waste segregation such as decreased potential for liability to LLNL for adverse environmental effects, improved worker safety, and enhanced LLNL image within the community because of environmental improvement. The economic evaluations in this report are presented on a Lab-wide basis. All hazardous wastes generated by a program are turned over to the Hazardous Waste Management (HWM) group, which is responsible for the storage, treatment, or disposal of these wastes and funded funded directly for this work

  1. Cost effectiveness analysis of indoor radon control measures

    International Nuclear Information System (INIS)

    Fujimoto, Kenzo

    1989-01-01

    The problem of radon 222 in buildings as a contributor to radiation exposure is described. Five different control methods and the dose reductions that would result from each are analysed. The annualized cost for each control measure was evaluated and the cost effectiveness of each control measure was calculated on the basis of dollars per person-sievert dose reduction. The use of unipolar ion generators for particle removal appears to be the most cost effective and the use of ceiling fans to increase air circulation the least cost effective. 3 figs., 1 tab

  2. Transaction Costs For Innovations Diffusion

    Directory of Open Access Journals (Sweden)

    Ilya A. Romanov

    2012-10-01

    Full Text Available The article deals with the analysis of transaction costs of the innovations distribution. The factors, affecting the innovations diffusion in accordance with the clusters, relations, dynamics of the distribution are disclosed. Transaction costs as a result of bounded rationality of economic entities are detected. The inevitability of transaction costs as an objective phenomenon is shown. Their dependence on the quality of economic information and information uncertainty is indicated. Correlative approach for the analysis of these costs is applied. The article justifies that the reduction of transaction costs increases the efficiency of innovations.

  3. Cost-minimization analysis: radiation treatment with and without a multi-leaf collimator

    International Nuclear Information System (INIS)

    Foroudi, Farshad; Lapsley, Helen; Manderson, Christine; Yeghiaian-Alvandi, Roland

    2000-01-01

    Purpose: To compare the costs of radiation treatment on a linear accelerator with a multileaf collimator (MLC) versus treatment on a linear accelerator without an MLC. The study was designed to determine whether the increased throughput of fields and decreased block cutting made the MLC cost effective from an institutional perspective. Methods and Materials: The number of fields, basic treatment equivalent, equivalent simple treatment visits, and blocks were prospectively collected for the four linear accelerators. Building, equipment, staffing, and service costs were all obtained in 1999 Australian dollars from the manufacturers and hospital department heads. The Joint Radiation Oncology Centre at Westmead and Nepean Hospitals, which are Australian public hospitals, runs as one unit, with the same staff, and currently operates five linear accelerators. Currently, four of the linear accelerators are used for general radiotherapy, operating for exactly the same hours; the final machine operates more limited hours and is used for specialized radiotherapy techniques and emergency cases. Results: The two machines with MLCs, on average, treated 5,169 fields each, while the two machines without MLCs treated 4,543 fields in a 3-month period, a 12% increase in throughput. The two non-MLC machines required 155 premounted trays (PMTs) in total, while the MLC machines required 17 PMTs. Linear accelerators with MLCs were demonstrably more efficient, and while their capital costs were higher, the reduction in labor costs associated with block cutting and, particularly the increased throughput, more than offset these initial costs. The total cost of a radiation field with an MLC was found to be $A101.69 compared to $A106.98 without an MLC. A multiway sensitivity analysis showed the results to be robust. The worst-case scenario was a departmental savings of $A168,000 per year; the best-case scenario was a savings of $A680,000 per year. Conclusion: Under the conditions pertaining

  4. 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.

  5. 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.

  6. Cost-effectiveness of increasing cervical cancer screening coverage in the Middle East: An example from Lebanon.

    Science.gov (United States)

    Sharma, Monisha; Seoud, Muhieddine; Kim, Jane J

    2017-01-23

    Most cervical cancer (CC) cases in Lebanon are detected at later stages and associated with high mortality. There is no national organized CC screening program so screening is opportunistic and limited to women who can pay out-of-pocket. Therefore, a small percentage of women receive repeated screenings while most are under-or never screened. We evaluated the cost-effectiveness of increasing screening coverage and extending intervals. We used an individual-based Monte Carlo model simulating HPV and CC natural history and screening. We calibrated the model to epidemiological data from Lebanon, including CC incidence and HPV type distribution. We evaluated cytology and HPV DNA screening for women aged 25-65years, varying coverage from 20 to 70% and frequency from 1 to 5years. At 20% coverage, annual cytologic screening reduced lifetime CC risk by 14% and had an incremental cost-effectiveness ratio of I$80,670/year of life saved (YLS), far exceeding Lebanon's gross domestic product (GDP) per capita (I$17,460), a commonly cited cost-effectiveness threshold. By comparison, increasing cytologic screening coverage to 50% and extending screening intervals to 3 and 5years provided greater CC reduction (26.1% and 21.4, respectively) at lower costs compared to 20% coverage with annual screening. Screening every 5years with HPV DNA testing at 50% coverage provided greater CC reductions than cytology at the same frequency (23.4%) and was cost-effective assuming a cost of I$18 per HPV test administered (I$12,210/YLS); HPV DNA testing every 4years at 50% coverage was also cost-effective at the same cost per test (I$16,340). Increasing coverage of annual cytology was not found to be cost-effective. Current practice of repeated cytology in a small percentage of women is inefficient. Increasing coverage to 50% with extended screening intervals provides greater health benefits at a reasonable cost and can more equitably distribute health gains. Novel HPV DNA strategies offer greater

  7. 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.

  8. Cost-effectiveness analysis of HPV vaccination: comparing the general population with socially vulnerable individuals.

    Science.gov (United States)

    Han, Kyu-Tae; Kim, Sun Jung; Lee, Seo Yoon; Park, Eun-Cheol

    2014-01-01

    After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

  9. Next-generation sequencing in NSCLC and melanoma patients: a cost and budget impact analysis

    Science.gov (United States)

    van Amerongen, Rosa A; Retèl, Valesca P; Coupé, Veerle MH; Nederlof, Petra M; Vogel, Maartje J; van Harten, Wim H

    2016-01-01

    Next-generation sequencing (NGS) has reached the molecular diagnostic laboratories. Although the NGS technology aims to improve the effectiveness of therapies by selecting the most promising therapy, concerns are that NGS testing is expensive and that the ‘benefits’ are not yet in relation to these costs. In this study, we give an estimation of the costs and an institutional and national budget impact of various types of NGS tests in non-small-cell lung cancer (NSCLC) and melanoma patients within The Netherlands. First, an activity-based costing (ABC) analysis has been conducted on the costs of two examples of NGS panels (small- and medium-targeted gene panel (TGP)) based on data of The Netherlands Cancer Institute (NKI). Second, we performed a budget impact analysis (BIA) to estimate the current (2015) and future (2020) budget impact of NGS on molecular diagnostics for NSCLC and melanoma patients in The Netherlands. Literature, expert opinions, and a data set of patients within the NKI (n = 172) have been included in the BIA. Based on our analysis, we expect that the NGS test cost concerns will be limited. In the current situation, NGS can indeed result in higher diagnostic test costs, which is mainly related to required additional tests besides the small TGP. However, in the future, we expect that the use of whole-genome sequencing (WGS) will increase, for which it is expected that additional tests can be (partly) avoided. Although the current clinical benefits are expected to be limited, the research potentials of NGS are already an important advantage. PMID:27899957

  10. Cost analysis of microtia treatment in the Netherlands.

    Science.gov (United States)

    Kolodzynski, M N; van Hövell Tot Westerflier, C V A; Kon, M; Breugem, C C

    2017-09-01

    Ear reconstruction for microtia is a challenging procedure. Although analyzing esthetic outcome is crucial, there is a paucity of information with regard to financial aspects of microtia reconstruction. This study was conducted to analyze the costs associated with ear reconstruction with costal cartilage in patients with microtia. Ten consecutive children with autologous ear reconstruction of a unilateral microtia were included in this analysis. All patients had completed their treatment protocol for ear reconstruction. Direct costs (admission to hospital, diagnostics, and surgery) and indirect cost (travel expenses and absence from work) were obtained retrospectively. The overall mean cumulative cost per patient was €14,753. Direct and indirect costs were €13,907 and €846, respectively. Hospital admission and surgery cover 55% and 32% of all the costs, respectively. This study analyzes the costs for autologous ear reconstruction. Hospital admission and surgery are the most important factors of the total costs. Total costs could be decreased by possibly decreasing admission days and surgical time. These data can be used for choosing and developing future treatment strategies. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Peripartum hysterectomy: an economic analysis of direct healthcare costs using routinely collected data.

    Science.gov (United States)

    Achana, F A; Fleming, K M; Tata, L J; Sultan, A A; Petrou, S

    2017-10-03

    To estimate resource use and costs associated with peripartum hysterectomy for the English National Health Service. Analysis of linked Clinical Practice Research Datalink and Hospital Episodes Statistics (CPRD-HES) data. Women undergoing peripartum hysterectomy between 1997 and 2013 and matched controls. Inverse probability weighted generalised estimating equations were used to model the non-linear trend in healthcare service use and costs over time, accounting for missing data, adjusting for maternal age, body mass index, delivery year, smoking and socio-economic indicators. Primary care, hospital outpatient and inpatient attendances and costs (UK 2015 prices). The study sample included 1362 women (192 cases and 1170 controls) who gave birth between 1997 and 2013; 1088 (153 cases and 935 controls) of these were deliveries between 2003 and 2013 when all categories of hospital resource use were available. Based on the 2003-2013 delivery cohort, peripartum hysterectomy was associated with a mean adjusted additional total cost of £5380 (95% CI £4436-6687) and a cost ratio of 1.76 (95% CI 1.61-1.98) over 5 years of follow up compared with controls. Inpatient costs, mostly incurred during the first year following surgery, accounted for 78% excluding or 92% including delivery-related costs. Peripartum hysterectomy is associated with increased healthcare costs driven largely by increased post-surgery hospitalisation rates. To reduce healthcare costs and improve outcomes for women who undergo hysterectomy, interventions that reduce avoidable repeat hospitalisations following surgery such as providing active follow up, treatment and support in the community should be considered. A large amount of NHS data on peripartum hysterectomy suggests active community follow up could reduce costs, #HealthEconomics. © 2017 Royal College of Obstetricians and Gynaecologists.

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

    Science.gov (United States)

    Merry, Matthew; Boulware, David R

    2016-06-15

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

  13. 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.

  14. 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.

  15. A cost-effectiveness analysis of hormone replacement therapy in the menopause.

    Science.gov (United States)

    Cheung, A P; Wren, B G

    1992-03-02

    To evaluate the cost-effectiveness of hormone replacement therapy in the menopause with particular reference to osteoporotic fracture and myocardial infarction. The multiple-decrement form of the life table was the mathematical model used to follow women of age 50 through their lifetime under the "no hormone replacement" and "hormone replacement" assumptions. Standard demographic and health economic techniques were used to calculate the corresponding lifetime differences in direct health care costs (net costs in dollars) and health effects ("net effectiveness" in terms of life expectancy and quality, in "quality-adjusted life-years"). This was then expressed as a cost-effectiveness ratio or the cost ($) per quality-adjusted life-year (QALY) for each of the chosen hormone replacement regimens. All women of age 50 in New South Wales, Australia (n = 27,021). The analysis showed that the lifetime net increments in direct medical care costs were largely contributed by hormone drug and consultation costs. Hormone replacement was associated with increased quality-adjusted life expectancy, a large percentage of which was attributed to a relief of menopausal symptoms. Cost-effectiveness ratios ranged from under 10,000 to over a million dollars per QALY. Factors associated with improved cost-effectiveness were prolonged treatment duration, the presence of menopausal symptoms, minimum progestogen side effects (in the case of oestrogen with progestogen regimens), oestrogen use after hysterectomy and the inclusion of cardiac benefits in addition to fracture prevention. Hormone replacement therapy for symptomatic women is cost-effective when factors that enhance its efficiency are considered. Short-term treatment of asymptomatic women for prevention of osteoporotic fractures and myocardial infarction is an inefficient use of health resources. Cost-effectiveness of hormone replacement in asymptomatic women is dependent on the magnitude of cardiac benefits associated with hormone

  16. Cost-effectiveness analysis: what it really means for transfusion medicine decision making.

    Science.gov (United States)

    Custer, Brian; Hoch, Jeffrey S

    2009-01-01

    Some have suggested that "blood is different," and the role for cost-effectiveness is thus circumscribed. In this article, the authors start by reviewing key concepts in health economics and economic analysis methods. Examples are drawn from published blood safety studies. After explaining the underlying reasoning behind cost-effectiveness analysis, the authors point out how economic thinking is evident in some aspects of transfusion medicine. Some cost-effectiveness study results for blood safety are discussed to provide context, followed by consideration of prominent decisions that have been made in transfusion medicine field. In the last section, the authors conjecture as to why in some cases cost-effectiveness analysis appears to have greater impact than in others, noting the terrible price that is paid in mortality and morbidity when cost-effectiveness analysis is ignored. In this context, the implications of opportunity cost are discussed, and it is noted that opportunity cost should not be viewed as benefits forgone by concentrating on one aspect of blood safety and instead should be viewed as our societal willingness to misallocate resources to achieve less health for the same cost.

  17. Costs and benefits of railway urban logistics: a prospective social cost benefit analysis

    OpenAIRE

    Gonzalez-Feliu, Jesus

    2014-01-01

    This paper presents a general framework to assess urban rail logistics suitability via a socio-economic cost benefit analysis. Firstly, we propose an overview on the basic notions of CBA and SCBA. Secondly, we identify and present the main types of costs and benefits or railway urban logistics services and the related final delivery services using low emission road vehicles to serve customers where the rail systems cannot. Thirdly, as an example of application, we propose to assess a scenario...

  18. Integrated cost-effectiveness analysis of agri-environmental measures for water quality.

    Science.gov (United States)

    Balana, Bedru B; Jackson-Blake, Leah; Martin-Ortega, Julia; Dunn, Sarah

    2015-09-15

    This paper presents an application of integrated methodological approach for identifying cost-effective combinations of agri-environmental measures to achieve water quality targets. The methodological approach involves linking hydro-chemical modelling with economic costs of mitigation measures. The utility of the approach was explored for the River Dee catchment in North East Scotland, examining the cost-effectiveness of mitigation measures for nitrogen (N) and phosphorus (P) pollutants. In-stream nitrate concentration was modelled using the STREAM-N and phosphorus using INCA-P model. Both models were first run for baseline conditions and then their effectiveness for changes in land management was simulated. Costs were based on farm income foregone, capital and operational expenditures. The costs and effects data were integrated using 'Risk Solver Platform' optimization in excel to produce the most cost-effective combination of measures by which target nutrient reductions could be attained at a minimum economic cost. The analysis identified different combination of measures as most cost-effective for the two pollutants. An important aspect of this paper is integration of model-based effectiveness estimates with economic cost of measures for cost-effectiveness analysis of land and water management options. The methodological approach developed is not limited to the two pollutants and the selected agri-environmental measures considered in the paper; the approach can be adapted to the cost-effectiveness analysis of any catchment-scale environmental management options. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Cost-effectiveness analysis of a state funded programme for control of severe asthma

    Directory of Open Access Journals (Sweden)

    Loureiro Sebastião

    2007-05-01

    Full Text Available Abstract Background Asthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce. Methods 81 patients with severe asthma (12–75 years joining a programme in a reference clinic providing free asthma medication were asked retrospectively about costs and events in the previous 12 months. During 12 months after joining the programme, information on direct and indirect costs, asthma control by lung function, symptoms and quality of life were collected. The information obtained was used to estimate cost-effectiveness of the intervention as compared to usual public health asthma management. Sensitivity analysis was conducted. Results 64 patients concluded the study. During the 12-months follow-up within the programme, patients had 5 fewer days of hospitalization and 68 fewer visits to emergency/non scheduled medical visits per year, on average. Asthma control scores improved by 50% and quality of life by 74%. The annual saving in public resources was US$387 per patient. Family annual income increased US$512, and family costs were reduced by US$733. Conclusion A programme for control of severe asthma in a developing country can reduce morbidity, improve quality of life and save resources from the health system and patients families.

  20. Life-cycle private-cost-based competitiveness analysis of electric vehicles in China considering the intangible cost of traffic policies

    International Nuclear Information System (INIS)

    Diao, Qinghua; Sun, Wei; Yuan, Xinmei; Li, Lili; Zheng, Zhi

    2016-01-01

    Highlights: • LCCs of BEVs and CVs are compared, considering the effects of traffic policy. • BEVs are economically competitive with both national and local subsidies. • Traffic policies have a significant impact on the competitiveness of BEVs. • The promotion of electric vehicles should prioritize mega-cities. - Abstract: Electric vehicles produce zero tailpipe emissions during operation and have thus been considered a most promising method for providing mobility while reducing the greenhouse gas emissions of the transportation sector in the future. The life-cycle cost of electric vehicles has been widely studied to evaluate their competitiveness compared to conventional vehicles. However, the competitiveness of electric vehicles is highly dependent on government promotion policies, and the effects of non-economic incentive policies are currently difficult to include in life-cycle cost analysis. These non-economic effects are usually measured by the intangible cost. Traffic policies represent typical non-economic incentive policies. In China, electric vehicles are exempted from purchase restrictions (license plate control policy) and driving restrictions; thus, the intangible cost of traffic policies has significant effects on the comparison of electric vehicles and conventional vehicles. In this paper, from the consumers’ perspective, the intangible cost of purchase and driving restrictions is modeled and expressed in monetary terms; then, the impact of these non-economic incentive policies are compared with subsidies and other costs of vehicles. Thus, a more comprehensive comparison between electric and conventional vehicles can be provided. Using three selected typical battery electric vehicles and three correspondingly similarly sized conventional vehicles in China, the private life-cycle costs of battery electric vehicles and conventional vehicles are calculated and compared, a parametric variation analysis is performed, and the effects of economic

  1. 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

  2. Analysis of Cost of Rework on Time and Cost Performance of Building Construction Projects in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Emmanuel Chidiebere Eze

    2018-01-01

    Full Text Available Rework is a menace that leads to undesired and unnecessary loss of efforts, it degrades project cost and schedule performance of construction projects, both at design and construction phases. This study therefore, analyzed the impact of cost of rework on time and cost performance of building construction projects in Nigerian, using selected commercial building project within the country’s capital. A pro forma was adopted for gathering data on rework cost, project cost and time of selected building projects, while structured questionnaire was used to collect information on the likely measures for reducing rework incidences from construction professionals that were involved in the delivery of the identified projects. Regression analysis, relative importance index and Kruskal-Walis test were employed for data analysis. The study revealed a significant relationship between the cost of rework and initial and final project cost of delivering commercial buildings, as an average of 3.53% impact on the initial project cost, 46.60% contribution to cost overrun, and p-value of 0.000 was observed on all assessed projects. For the project delivery time, a significant relationship between the cost of rework and initial and final project duration, as an average of 7.35% impact on the initial delivery time, extra 19 days and p-value of 0.000 was observed on all assessed projects. Team building and education, management commitment, employee involvement, were some of the best possible measures to minimized rework problems.

  3. Cost analysis and cost determinants in a European inflammatory bowel disease inception cohort with 10 years of follow-up evaluation.

    Science.gov (United States)

    Odes, Selwyn; Vardi, Hillel; Friger, Michael; Wolters, Frank; Russel, Maurice G; Riis, Lene; Munkholm, Pia; Politi, Patrizia; Tsianos, Epameinondas; Clofent, Juan; Vermeire, Severine; Monteiro, Estela; Mouzas, Iannis; Fornaciari, Giovanni; Sijbrandij, Jildou; Limonard, Charles; Van Zeijl, Gilbert; O'morain, Colm; Moum, Bjørn; Vatn, Morten; Stockbrugger, Reinhold

    2006-09-01

    Economic analysis in chronic diseases is a prerequisite for planning a proper distribution of health care resources. We aimed to determine the cost of inflammatory bowel disease, a lifetime illness with considerable morbidity. We studied 1321 patients from an inception cohort in 8 European countries and Israel over 10 years. Data on consumption of resources were obtained retrospectively. The cost of health care was calculated from the use of resources and their median prices. Data were analyzed using regression models based on the generalized estimating equations approach. The mean annual total expenditure on health care was 1871 Euro/patient-year for inflammatory bowel disease, 1524 Euro/patient-year for ulcerative colitis, and 2548 Euro/patient-year for Crohn's disease (P < .001). The most expensive resources were medical and surgical hospitalizations, together accounting for 63% of the cost in Crohn's disease and 45% in ulcerative colitis. Total and hospitalization costs were much higher in the first year after diagnosis than in subsequent years. Differences in medical and surgical hospitalizations were the primary cause of substantial intercountry variations of cost; the mean cost of health care was 3705 Euro/patient-year in Denmark and 888 Euro/patient-year in Norway. The outlay for mesalamine, a costly medication with extensive use, was greater than for all other drugs combined. Patient age at diagnosis and sex did not affect costs. In this multinational, population-based, time-dependent characterization of the health care cost of inflammatory bowel disease, increased expenditure was driven largely by country, diagnosis, hospitalization, and follow-up year.

  4. 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.

  5. Life cycle cost analysis of wind power considering stochastic uncertainties

    International Nuclear Information System (INIS)

    Li, Chiao-Ting; Peng, Huei; Sun, Jing

    2014-01-01

    This paper presents a long-term cost analysis of wind power and compares its competitiveness to non-renewable generating technologies. The analysis considers several important attributes related to wind intermittency that are sometimes ignored in traditional generation planning or LCOE (levelized cost of energy) studies, including the need for more nameplate capacity due to intermittency, hourly fluctuations in wind outputs and cost for reserves. The competitiveness of wind power is assessed by evaluating four scenarios: 1) adding natural gas generating capacity to the power grid; 2) adding coal generating capacity to the power grid; 3) adding wind capacity to the power grid; and, 4) adding wind capacity and energy storage to the power grid where an energy storage device is used to cover wind intermittency. A case study in the state of Michigan is presented to demonstrate the use of the proposed methodology, in which a time horizon from 2010 to 2040 is considered. The results show that wind energy will still be more expensive than natural gas power plants in the next three decades, but will be cheaper than coal capacities if wind intermittency is mitigated. Furthermore, if the costs of carbon emissions and environmental externalities are considered, wind generation will be a competitive option for grid capacity expansion. - Highlights: • The competitiveness of wind power is analyzed via life cycle cost analysis. • Wind intermittency and reserve costs are explicitly considered in the analysis. • Results show that wind is still more expensive than natural gas power plants. • Wind can be cheaper than coal capacities if wind intermittency is mitigated. • Wind will be competitive if costs of carbon emissions are considered

  6. 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 ...

  7. 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.

  8. The Rise and Fall in Out-of-Pocket Costs in Australia: An Analysis of the Strengthening Medicare Reforms.

    Science.gov (United States)

    Wong, Chun Yee; Greene, Jessica; Dolja-Gore, Xenia; van Gool, Kees

    2017-08-01

    After a period of steady decline, out-of-pocket (OOP) costs for general practitioner (GP) consultations in Australia began increasing in the mid-1990s. Following the rising community concerns about the increasing costs, the Australian Government introduced the Strengthening Medicare reforms in 2004 and 2005, which included a targeted incentive for GPs to charge zero OOP costs for consultations provided to children and concession cardholders (older adults and the poor), as well as an increase in the reimbursement for all GP visits. This paper examines the impact of those reforms using longitudinal survey and administrative data from a large national sample of women. The findings suggest that the reforms were effective in reducing OOP costs by an average of $A0.40 per visit. Decreases in OOP costs, however, were not evenly distributed. Those with higher pre-reform OOP costs had the biggest reductions in OOP costs, as did those with concession cards. However, results also reveal increases in OOP costs for most people without a concession card. The analysis suggests that there has been considerable heterogeneity in GP responses to the reforms, which has led to substantial changes in the fees charged by doctors and, as a result, the OOP costs incurred by different population groups. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Cost Per Flying Hour Analysis of the C-141

    Science.gov (United States)

    1997-09-01

    Government Printing Office, 1996. Horngren , Charles T. Cost Accounting : A Managerial Emphasis (Eighth Edition). New Jersey: Prentice Hall, 1994. Hough...standard accounting techniques. This analysis of AMC’s current costs and their applicability to the price charged to the customer shall be the focus of... Horngren et al.,1994:864). There are three generally recognized methods of determining a transfer price (Arnstein and Gilabert, 1980:189). Cost based

  10. Exergy costs analysis of groundwater use and water transfers

    International Nuclear Information System (INIS)

    Carrasquer, Beatriz; Uche, Javier; Martínez-Gracia, Amaya

    2016-01-01

    Highlights: • A methodology to estimate the unit exergy cost of water supply alternatives is provided. • Two alternatives (water transfers and groundwaters) are defined. • The unit exergy costs are given as a function of design and operating parameters. • Unit exergy cost of groundwaters go from 1.01 to 2.67 and from 1 to 4.06 in water transfers. • Unit exergy costs are calculated and contrasted for the medium course of the Ebro. - Abstract: In the search for new alternatives to meet the water demands, it is interesting to analyze the cost of using alternatives different from those such as desalination and pumping. The exergy cost analysis can be a useful tool to estimate costs of those alternatives as a function of its energy efficiency and its relative abundance with respect to existing resources in their surroundings. This study proposes a methodology for assessing the costs of groundwaters and water transfers from surplus basins within the exergy perspective. An equation to assess the exergy costs of these alternatives is proposed. System boundaries are first identified to the assessment of input and output currents to the system in exergy values for the design and certain operating conditions. Next, an equation to assess water supply costs depending on design and operational parameters is proposed, from the analysis of different examples. Pumping efficiency, altitude gap and flow among other features are introduced in the calculations as those characteristics parameters. In the developed examples, unit exergy costs of groundwaters go from 1.01 to 2.67, and from 1 to 4.06 in case of water transfers. Maximum values, as expected within this perspective, are found at high pumped/transferred flows and high pumping levels and/or low pumping efficiency if pumping is required.

  11. Workshop in economics - the problem of climate change benefit-cost analysis

    International Nuclear Information System (INIS)

    Kosobud, R.F.

    1992-01-01

    Could benefit-cost analysis play a larger role in the discussion of policies to deal with the greenhouse effect? The paper also investigates the causes of this lack of influence. Selected forms of benefit-cost research are probed, particularly the critical discussions raised by this type of research, in an effort to suggest where the chances of greater acceptance lie. The paper begins by discussing the search for an appropriate policy: optimal, targeted, or incremental. It then describes the work being done in specifying and estimating climate change damage relationships. A consideration of the work being done in specifying and estimating abatement (both mitigation and adaptation) cost relationships follows. Finally, the paper ends with an examination of the search for the appropriate policy instrument. International and methodological concerns cut across these areas and are discussed in each section. This paper concludes that there seem to be a number of reasons that benefit-cost results play only a limited role in policy development. There is some evidence that the growing interest in market-based approaches to climate change policy and to other environmental control matters is a sign of increased acceptance. Suggestions about research directions are made throughout this paper

  12. The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis.

    Science.gov (United States)

    Chun, June Sang; Har, Alix; Lim, Hyun-Pil; Lim, Hoi-Jeong

    2016-02-01

    This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10(th) year after the treatment, and more cost-effective regardless of the WTP from 20(th) year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10(th) year after the prosthodontic treatment, more than 35,000 won at the 20(th) year after prosthodontic treatment. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10(th) year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.

  13. Cost and performance analysis of physical protection systems - a case study

    International Nuclear Information System (INIS)

    Hicks, M.J.; Snell, M.S.; Sandoval, J.S.; Potter, C.S.

    1998-01-01

    Design and analysis of physical protection systems requires (1) identification of mission critical assets; (2) identification of potential threats that might undermine mission capability; (3) identification of the consequences of loss of mission-critical assets (e.g., time and cost to recover required capability and impact on operational readiness); and (4) analysis of the effectiveness of physical protection elements. CPA -- Cost and Performance Analysis -- addresses the fourth of these four issues. CPA is a methodology that joins Activity Based Cost estimation with performance-based analysis of physical protection systems. CPA offers system managers an approach that supports both tactical decision making and strategic planning. Current exploratory applications of the CPA methodology address analysis of alternative conceptual designs. Hypothetical data is used to illustrate this process

  14. 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.

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

    DEFF Research Database (Denmark)

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

    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...... 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...... 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...

  16. A Sensitivity Analysis of Timing and Costs of Greenhouse Gas Emission Reductions

    International Nuclear Information System (INIS)

    Gerlagh, R.; Van der Zwaan, B.

    2004-01-01

    This paper analyses the optimal timing and macro-economic costs of carbon emission reductions that mitigate the global average atmospheric temperature increase. We use a macro-economic model in which there are two competing energy sources, fossil-fuelled and non-fossil-fuelled. Technological change is represented endogenously through learning curves, and niche markets exist implying positive demand for the relatively expensive non-fossil-fuelled energy source. Under these conditions, with a temperature increase constraint of 2C, early abatement is found to be optimal, and, compared to the results of many existing top-down models, the costs of this strategy prove to be low. We perform an extensive sensitivity analysis of our results regarding the uncertainties that dominate various economic and technological modeling parameters. Uncertainties in the learning rate and the elasticity of substitution between the two different energy sources most significantly affect the robustness of our findings

  17. Cost and Cost-Effectiveness of a Demand Creation Intervention to Increase Uptake of Voluntary Medical Male Circumcision in Tanzania: Spending More to Spend Less.

    Science.gov (United States)

    Torres-Rueda, Sergio; Wambura, Mwita; Weiss, Helen A; Plotkin, Marya; Kripke, Katharine; Chilongani, Joseph; Mahler, Hally; Kuringe, Evodius; Makokha, Maende; Hellar, Augustino; Schutte, Carl; Kazaura, Kokuhumbya J; Simbeye, Daimon; Mshana, Gerry; Larke, Natasha; Lija, Gissenge; Changalucha, John; Vassall, Anna; Hayes, Richard; Grund, Jonathan M; Terris-Prestholt, Fern

    2018-03-19

    Although voluntary medical male circumcision (VMMC) reduces the risk of HIV acquisition, demand for services is lower among men in most at-risk age groups (ages 20-34 years). A randomised controlled trial was conducted to assess the effectiveness of locally-tailored demand creation activities (including mass media, community mobilisation and targeted service delivery) in increasing uptake of campaign-delivered VMMC among men aged 20-34 years. We conducted an economic evaluation to understand the intervention's cost and cost-effectiveness. Tanzania (Njombe and Tabora regions). Cost data were collected on surgery, demand creation activities and monitoring and supervision related to VMMC implementation across clusters in both trial arms, as well as start-up activities for the intervention arm. The Decision Makers' Program Planning Tool was used to estimate the number of HIV infections averted and related cost savings given total VMMCs per cluster. Disability-adjusted life years were calculated and used to estimate incremental cost-effectiveness ratios. Client load was higher in the intervention arms than in the control arms: 4394 v. 2901, respectively, in Tabora and 1797 v. 1025 in Njombe. Despite additional costs of tailored demand creation, demand increased more than proportionally: mean costs per VMMC in the intervention arms were $62 in Tabora and $130 in Njombe, and in the control arms $70 and $191, respectively. More infections were averted in the intervention arm than in the control arm in Tabora (123 v. 67, respectively) and in Njombe (164 v. 102, respectively). The intervention dominated the control as it was both less costly and more effective. Cost-savings were observed in both regions stemming from the antiretroviral treatment costs averted as a result of the VMMCs performed. Spending more to address local preferences as a way to increase uptake of VMMC can be cost-saving.This is an open access article distributed under the terms of the Creative Commons

  18. Better Informing Decision Making with Multiple Outcomes Cost-Effectiveness Analysis under Uncertainty in Cost-Disutility Space

    Science.gov (United States)

    McCaffrey, Nikki; Agar, Meera; Harlum, Janeane; Karnon, Jonathon; Currow, David; Eckermann, Simon

    2015-01-01

    Introduction 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. Objective 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. Methods 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. Results 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. Conclusion Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding

  19. Cost-utility analysis of antihypertensive medications in Nigeria: a decision analysis

    Directory of Open Access Journals (Sweden)

    Ekwunife Obinna Ikechukwu

    2013-01-01

    Full Text Available Abstract Background Many drugs are available for control of hypertension and its sequels in Nigeria but some are not affordable for majority of the populace. This serious pharmacoeconomic question has to be answered by the nation’s health economists. The objective of this study was to evaluate the cost-effectiveness of drugs from 4 classes of antihypertensive medications commonly used in Nigeria in management of hypertension without compelling indication to use a particular antihypertensive drug. Methods The study employed decision analytic modeling. Interventions were obtained from a meta-analysis. The Markov process model calculated clinical outcomes and costs during a life cycle of 30 years of 1000 hypertensive patients stratified by 3 cardiovascular risk groups, under the alternative intervention scenarios. Quality adjusted life year (QALY was used to quantify clinical outcome. The average cost of treatment for the 1000 patient was tracked over the Markov cycle model of the alternative interventions and results were presented in 2010 US Dollars. Probabilistic cost-effectiveness analysis was performed using Monte Carlo simulation, and results presented as cost-effectiveness acceptability frontiers. Expected value of perfect information (EVPI and expected value of parameter perfect information (EVPPI analyses were also conducted for the hypothetical population. Results Thiazide diuretic was the most cost-effective option across the 3 cardiovascular risk groups. Calcium channel blocker was the second best for Moderate risk and high risk with a willingness to pay of at least 2000$/QALY. The result was robust since it was insensitive to the parameters alteration. Conclusions The result of this study showed that thiazide diuretic followed by calcium channel blocker could be a feasible strategy in order to ensure that patients in Nigeria with hypertension are better controlled.

  20. Baseline Assessment of the Department of the Army Cost Estimating and Analysis (CE/A) and Cost Management (CM) Capabilities

    National Research Council Canada - National Science Library

    Doyle, Michael C

    2005-01-01

    .../A) and cost management (CM) capabilities. In particular, it supports the Deputy Assistant Secretary of the Army- Cost AND Economics' mission to provide DA with cost, performance and economic analysis in the form of expertise, models, data...

  1. Resistance delaying strategies on UK sheep farms: A cost benefit analysis.

    Science.gov (United States)

    Learmount, Jane; Glover, Mike J; Taylor, Mike A

    2018-04-30

    UK guidelines for the sustainable control of parasites in sheep (SCOPS) were formulated with the primary aim of delaying development of anthelmintic resistance (AR) on UK sheep farms. Promoting their use requires the engagement and commitment of stakeholders. An important driver for behavioural change in sheep farmers is evidence of economic benefits. A recent evaluation of SCOPS guidance in practice demonstrated a significant reduction in anthelmintic use, suggesting economic benefits through a direct reduction in product and labour costs. However, in order to maintain production, a range of alternative control strategies are advised, resulting in additional costs to farmers and so a full cost benefit analysis of best practice management was undertaken. We allocated financial values to the management recommendations described in the SCOPS technical manual. Benefits were calculated using data for production variables and anthelmintic use measured during studies to evaluate the effect of SCOPS recommendations on 16 UK sheep farms and from other published work. As SCOPS control is not prescriptive and a range of different diagnostics are available, best and worst case scenarios were presented, comparing the cheapest methods (e.g. egg counts without larval culture) and management situations (e.g closed flocks not requiring quarantine treatments) with the most laborious and expensive. Simulations were run for farms with a small, medium or large flock (300; 1000; 1900 ewes) as well as comparing scenarios with and without potential production benefits from using effective wormers. Analysis demonstrated a moderate cost for all farms under both scenarios when production benefits were not included. A cost benefit was demonstrated for medium and large farms when production benefits were included and the benefit could be perceived as significant in the case of the large farms for the best case scenario (>£5000 per annum). Despite a significant potential reduction in

  2. Department of Defenses 2015 Retirement Plan Cost Analysis

    Science.gov (United States)

    2016-06-01

    PLAN COST ANALYSIS ABSTRACT The new military retirement system is advertised to significantly reduce the Department of Defense’s (DOD...200 words) The new military retirement system is advertised to significantly reduce the Department of Defense’s (DOD) monetary outlays over the...determine how changing the value of the following planning assumptions in the MCRMC report will impact the estimated cost savings of this new plan through

  3. Analysis of nuclear power plant construction costs

    International Nuclear Information System (INIS)

    1986-01-01

    The objective of this report is to present the results of a statistical analysis of nuclear power plant construction costs and lead-times (where lead-time is defined as the duration of the construction period), using a sample of units that entered construction during the 1966-1977 period. For more than a decade, analysts have been attempting to understand the reasons for the divergence between predicted and actual construction costs and lead-times. More importantly, it is rapidly being recognized that the future of the nuclear power industry rests precariously on an improvement in the cost and lead-time situation. Thus, it is important to study the historical information on completed plants, not only to understand what has occurred to also to improve the ability to evaluate the economics of future plants. This requires an examination of the factors that have affected both the realized costs and lead-times and the expectations about these factors that have been formed during the construction process. 5 figs., 22 tabs

  4. Analysis of nuclear power plant construction costs

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    The objective of this report is to present the results of a statistical analysis of nuclear power plant construction costs and lead-times (where lead-time is defined as the duration of the construction period), using a sample of units that entered construction during the 1966-1977 period. For more than a decade, analysts have been attempting to understand the reasons for the divergence between predicted and actual construction costs and lead-times. More importantly, it is rapidly being recognized that the future of the nuclear power industry rests precariously on an improvement in the cost and lead-time situation. Thus, it is important to study the historical information on completed plants, not only to understand what has occurred to also to improve the ability to evaluate the economics of future plants. This requires an examination of the factors that have affected both the realized costs and lead-times and the expectations about these factors that have been formed during the construction process. 5 figs., 22 tabs.

  5. A cost-benefit analysis for materials management information systems.

    Science.gov (United States)

    Slapak-Iacobelli, L; Wilde, A H

    1993-02-01

    The cost-benefit analysis provided the system planners with valuable information that served many purposes. It answered the following questions: Why was the CCF undertaking this project? What were the alternatives? How much was it going to cost? And what was the expected outcome? The process of developing cost-benefit the document kept the project team focused. It also motivated them to involve additional individuals from materials management and accounts payable in its development. A byproduct of this involvement was buy-in and commitment to the project by everyone in these areas. Consequently, the project became a team effort championed by many and not just one. We were also able to introduce two new information system processes: 1) a management review process with goals and anticipated results, and 2) a quality assurance process that ensured the CCF had a better product in the end. The cost-benefit analysis provided a planning tool that assisted in successful implementation of an integrated materials management information system.

  6. Characterization and Deployment Studies and Cost Analysis of Seawater Uranium Recovered by a Polymeric Adsorbent System

    International Nuclear Information System (INIS)

    Schneider, Erich; Gill, Gary

    2014-01-01

    Conclusions: • The cost and EROI analysis suggest a number of R&D directions aimed at high-leverage contributors to the U production cost or reducing uncertainty: • Capacity, durability and stability are the key cost drivers: – Complementary R&D areas include design of selective and durable ligands and adsorbents, as well as gentler U stripping procedures. • Experimentation is defining minimum requirements for cost driving chemicals and improve recyclability or identify substitutes for the most costly; • Novel elution strategies have great potential to increase durability and reusability; • Textile physical properties (fiber diameter, shape, surface area to volume ratio) continue to be optimized to improve performance and fabrication cost; • Marine tests and kinetics modeling continue to improve our understanding of the time, temperature and flow velocity dependence of adsorption rate

  7. The health care cost analysis for VZP clients during their last year of life

    OpenAIRE

    Jirsová, Karolína

    2017-01-01

    The health care cost analysis for VZP clients during their last year of life Abstract Objective of this thesis is a health care cost analysis for VZP clients, who died in 2014. An analysis of cost has been approached from a few different aspects, but mainly by segmentation of health care providers and chapters of diagnosis by ICD-10. Following analysis has been also processed in this thesis - the analysis of average health care costs of one day in life and the regional analysis of average hea...

  8. Methodology for cost analysis of film-based and filmless portable chest systems

    Science.gov (United States)

    Melson, David L.; Gauvain, Karen M.; Beardslee, Brian M.; Kraitsik, Michael J.; Burton, Larry; Blaine, G. James; Brink, Gary S.

    1996-05-01

    Many studies analyzing the costs of film-based and filmless radiology have focused on multi- modality, hospital-wide solutions. Yet due to the enormous cost of converting an entire large radiology department or hospital to a filmless environment all at once, institutions often choose to eliminate film one area at a time. Narrowing the focus of cost-analysis may be useful in making such decisions. This presentation will outline a methodology for analyzing the cost per exam of film-based and filmless solutions for providing portable chest exams to Intensive Care Units (ICUs). The methodology, unlike most in the literature, is based on parallel data collection from existing filmless and film-based ICUs, and is currently being utilized at our institution. Direct costs, taken from the perspective of the hospital, for portable computed radiography chest exams in one filmless and two film-based ICUs are identified. The major cost components are labor, equipment, materials, and storage. Methods for gathering and analyzing each of the cost components are discussed, including FTE-based and time-based labor analysis, incorporation of equipment depreciation, lease, and maintenance costs, and estimation of materials costs. Extrapolation of data from three ICUs to model hypothetical, hospital-wide film-based and filmless ICU imaging systems is described. Performance of sensitivity analysis on the filmless model to assess the impact of anticipated reductions in specific labor, equipment, and archiving costs is detailed. A number of indirect costs, which are not explicitly included in the analysis, are identified and discussed.

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

    Science.gov (United States)

    2001-07-21

    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

  10. The System Cost Model: A tool for life cycle cost and risk analysis

    International Nuclear Information System (INIS)

    Hsu, K.; Lundeen, A.; Shropshire, D.; Sherick, M.

    1996-01-01

    In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors began development of the System Cost Model (SCM) application. The SCM estimates life cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, and transuranic waste. The SCM uses parametric cost functions to estimate life cycle costs for various treatment, storage, and disposal modules which reflect planned and existing waste management facilities at DOE installations. In addition, SCM can model new TSD facilities based on capacity needs over the program life cycle. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction, operations and maintenance, and decommissioning these waste management facilities. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. A complement to the SCM is the System Cost Model-Risk (SCM-R) model, which provides relative Environmental, Safety, and Health (ES and H) risk information. A relative ES and H risk basis has been developed and applied by LITCO at the INEL. The risk basis is now being automated in the SCM-R to facilitate rapid risk analysis of system alternatives. The added risk functionality will allow combined cost and risk evaluation of EM alternatives

  11. Analysis of Private Cost of Education in a Selected Nigerian University

    African Journals Online (AJOL)

    Analysis of Private Cost of Education in a Selected Nigerian University. ... Journal of Research in National Development. Journal Home ... The results revealed that there was a gap between the average institutional unit cost and private cost.

  12. An empirical analysis of the cost of rearing dairy heifers from birth to first calving and the time taken to repay these costs.

    Science.gov (United States)

    Boulton, A C; Rushton, J; Wathes, D C

    2017-08-01

    Rearing quality dairy heifers is essential to maintain herds by replacing culled cows. Information on the key factors influencing the cost of rearing under different management systems is, however, limited and many farmers are unaware of their true costs. This study determined the cost of rearing heifers from birth to first calving in Great Britain including the cost of mortality, investigated the main factors influencing these costs across differing farming systems and estimated how long it took heifers to repay the cost of rearing on individual farms. Primary data on heifer management from birth to calving was collected through a survey of 101 dairy farms during 2013. Univariate followed by multivariable linear regression was used to analyse the influence of farm factors and key rearing events on costs. An Excel spreadsheet model was developed to determine the time it took for heifers to repay the rearing cost. The mean±SD ages at weaning, conception and calving were 62±13, 509±60 and 784±60 days. The mean total cost of rearing was £1819±387/heifer with a mean daily cost of £2.31±0.41. This included the opportunity cost of the heifer and the mean cost of mortality, which ranged from £103.49 to £146.19/surviving heifer. The multivariable model predicted an increase in mean cost of rearing of £2.87 for each extra day of age at first calving and a decrease in mean cost of £6.06 for each percentile increase in time spent at grass. The model also predicted a decrease in the mean cost of rearing in autumn and spring calving herds of £273.20 and £288.56, respectively, compared with that in all-year-round calving herds. Farms with herd sizes⩾100 had lower mean costs of between £301.75 and £407.83 compared with farms with economic analysis suggest that management decisions on key reproduction events and grazing policy significantly influence the cost of rearing and the time it takes for heifers to start making a profit for the farm.

  13. Thoracoabdominal computed tomography in trauma patients: a cost-consequences analysis

    NARCIS (Netherlands)

    Vugt, R. van; Kool, D.R.; Brink, M.; Dekker, H.M.; Deunk, J.; Edwards, M.J.R.

    2014-01-01

    BACKGROUND: CT is increasingly used during the initial evaluation of blunt trauma patients. In this era of increasing cost-awareness, the pros and cons of CT have to be assessed. OBJECTIVES: This study was performed to evaluate cost-consequences of different diagnostic algorithms that use

  14. 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.

  15. A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

    Science.gov (United States)

    Liu, C Carrie; Rudmik, Luke

    2016-10-01

    The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

  16. Hospital Merger Increased Medicare and Medicaid Payments for Capital Costs.

    Science.gov (United States)

    1983-12-22

    15 provisions relating to depreciation and appraisals, i.e., the very subjects addressed by the draft report, expressly incorporate GAAP . For example...the historical cost for depreciation purposes of "owned" assets and, as stated be- fore, (see p. 54) places limitations on the use of GAAP for es...increased because of the acquisition by a net amount of about $55 million attributable to changes in interest, depreciation , and home office expenses. A

  17. 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.

  18. A Retrospective Analysis of Precision Medicine Outcomes in Patients With Advanced Cancer Reveals Improved Progression-Free Survival Without Increased Health Care Costs.

    Science.gov (United States)

    Haslem, Derrick S; Van Norman, S Burke; Fulde, Gail; Knighton, Andrew J; Belnap, Tom; Butler, Allison M; Rhagunath, Sharanya; Newman, David; Gilbert, Heather; Tudor, Brian P; Lin, Karen; Stone, Gary R; Loughmiller, David L; Mishra, Pravin J; Srivastava, Rajendu; Ford, James M; Nadauld, Lincoln D

    2017-02-01

    The advent of genomic diagnostic technologies such as next-generation sequencing has recently enabled the use of genomic information to guide targeted treatment in patients with cancer, an approach known as precision medicine. However, clinical outcomes, including survival and the cost of health care associated with precision cancer medicine, have been challenging to measure and remain largely unreported. We conducted a matched cohort study of 72 patients with metastatic cancer of diverse subtypes in the setting of a large, integrated health care delivery system. We analyzed the outcomes of 36 patients who received genomic testing and targeted therapy (precision cancer medicine) between July 1, 2013, and January 31, 2015, compared with 36 historical control patients who received standard chemotherapy (n = 29) or best supportive care (n = 7). The average progression-free survival was 22.9 weeks for the precision medicine group and 12.0 weeks for the control group ( P = .002) with a hazard ratio of 0.47 (95% CI, 0.29 to 0.75) when matching on age, sex, histologic diagnosis, and previous lines of treatment. In a subset analysis of patients who received all care within the Intermountain Healthcare system (n = 44), per patient charges per week were $4,665 in the precision treatment group and $5,000 in the control group ( P = .126). These findings suggest that precision cancer medicine may improve survival for patients with refractory cancer without increasing health care costs. Although the results of this study warrant further validation, this precision medicine approach may be a viable option for patients with advanced cancer.

  19. Geographical cost-supply analysis forest biomass for distributed generation in Denmark

    DEFF Research Database (Denmark)

    Möller, Bernd

    2004-01-01

    The article presents a study which uses geographical information system (GIS) to perform cost-supply analysis of wood chips resources for energy production.......The article presents a study which uses geographical information system (GIS) to perform cost-supply analysis of wood chips resources for energy production....

  20. Ablation - breakthrough technology to reduce uranium mining cost and increase resources

    International Nuclear Information System (INIS)

    Scriven, D.

    2014-01-01

    Ablation Technologies, LLC has developed and patented a revolutionary mining technology termed “ablation”. Ablation is a process using only mechanical forces to upgrade sandstone uranium ores. Uranium bearing sandstone orebodies are formed from a uranium enriched solution flowing through an aquifer until it reached some type of a “red/ox” zone forcing the uranium and other heavy metals to come out of solution. The precipitate forms a thin coating on the sand grains and fills the interstitial space between the sand grains but does no penetrate the sand grains. The ablation process knocks the precipitate off the sand grains using the forces of abrasion, elastic compression and rebounding, much like a mud coated tennis ball will sheds the mud when bounced off the ground, and to some extent, sonic waves. This produces a product which collectively is exactly the same as the ore going in but with all the individual components separated. This allows for disgressionary separation, the most important of which is screening. The uranium and heavy metals report to the finer fractions of the material, typically less than 250 mesh. The larger fractions contain less than five percent of the uranium but 90 to 95 percent of the mass. The advantages of making an enriched ore are numerous: • Reduce haulage costs from 90 to 95 percent. • Reduce milling costs by reducing material handling costs, acid consumption and tailings disposal costs. • In addition to reducing overall mining and milling costs, the overall recovery of the recourse is increased because the ablation process is so inexpensive, if the material has to be mined it will be ablated and screened. This basically means ore control is significantly reduced, cutoff grade goes to practically zero and overall resource recovery is significantly increased. • Environmentally, the two major advantages are reduced tailings requirements at the mill site and cleaner waste dumps at the mine site. This paper will show

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

    International Nuclear Information System (INIS)

    Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan

    2015-01-01

    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. 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

  3. An analysis of electric utility embedded power supply costs

    International Nuclear Information System (INIS)

    Kahal, M.; Brown, D.

    1998-01-01

    There is little doubt that for the vast majority of electric utilities the embedded costs of power supply exceed market prices, giving rise to the stranded cost problem. Beyond that simple generalization, there are a number of crucial questions, which this study attempts to answer. What are the regional patterns of embedded cost differences? To what extent is the cost problem attributable to nuclear power? How does the cost of purchased power compare to the cost of utility self-generation? What is the breakdown of utility embedded generation costs between operating costs - which are potentially avoidable--and ownership costs, which by definition are ''sunk'' and therefore not avoidable? How will embedded generation costs and market prices compare over time? These are the crucial questions for states as they address retail-restructuring proposal. This study presents an analysis of generation costs, which addresses these key questions. A computerized costing model was developed and applied using FERC Form 1 data for 1995. The model analyzed embedded power supply costs (i.e.; self-generation plus purchased power) for two groups of investor-owned utilities, 49 non-nuclear vs. 63 nuclear. These two subsamples represent substantially the entire US investor-owned electric utility industry. For each utility, embedded cost is estimated both at busbar and at meter

  4. Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova

    Science.gov (United States)

    2014-01-01

    Background Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Methods Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Results Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. Conclusions The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result

  5. Cost analysis and exploratory cost-effectiveness of youth-friendly sexual and reproductive health services in the Republic of Moldova.

    Science.gov (United States)

    Kempers, Jari; Ketting, Evert; Lesco, Galina

    2014-07-21

    Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of four well performing youth-friendly health centres (YFHC) in Moldova. This study assesses: (1) what were the costs of YFHSs at centre level, (2) how much would scaling-up to a national good quality YFHS programme cost, and (3) was the programme potentially cost-effective? Four well performing YFHCs were selected for the study. YFHS costs were analysed per centre, funding source, service and person reached. The costing results were extrapolated to estimate cost of a good quality national YFHS programme in Moldova. A threshold analysis was carried out to estimate the required impact level for the YFHSs to break-even (become cost saving). Average annual cost of a well performing YFHC was USD 26,000 in 2011. 58% was financed by the National Health Insurance Company and the rest by external donors (42%). Personnel salaries were the largest expense category (47%). The annual implementation costs of a good quality YFHSs in all 38 YFHCs of Moldova were estimated to be USD 1.0 million. The results of the threshold analysis indicate that the annual break-even impact points in a YFHC for: 1) STI services would be >364 averted STIs, 2) early pregnancy and contraceptive services >178 averted unwanted pregnancies, and 3) HIV services only >0.65 averted new HIV infections. The costing results highlight the following: 1) significant additional resources would be required for implementation of a good quality national YFHS programme, 2) the four well performing YFHCs rely heavily on external funding (42%), 3) which raises questions about financial sustainability of the programme. At the same time results of the threshold analysis are encouraging. The result suggest that, together the three SRH

  6. Cost-benefit analysis of a socio-technical intervention in a Brazilian footwear company.

    Science.gov (United States)

    Guimarães, L B de M; Ribeiro, J L D; Renner, J S

    2012-09-01

    This article presents a costs-benefits analysis of a macroergonomic intervention in a Brazilian footwear company. Comparing results of a pilot line (composed by 100 multiskilled workers organized in teams) with eight traditional lines (still working in a one human being/one task model) the intervention showed to be worth pursuing since achieved gains were higher than intervention costs: there was a reduction in human resource costs (80% reduction in industrial accidents, 100% reduction in work-related musculoskeletal disorders or WMSD, medical consultations and turnover, and a 45.65% reduction in absenteeism) and production improvement (productivity increased in 3% and production waste decrease to less than 1%). The net intervention value of the intervention was around U$ 430,000 with a benefit-to-cost ratio of 7.2. Moreover, employees who worked in the pilot line understood that their quality of work life improved, compensating the anxiety brought up by the radical changes implemented. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  7. Cost and cost-effectiveness analysis of a community mobilisation intervention to reduce intimate partner violence in Kampala, Uganda.

    Science.gov (United States)

    Michaels-Igbokwe, Christine; Abramsky, Tanya; Devries, Karen; Michau, Lori; Musuya, Tina; Watts, Charlotte

    2016-02-29

    Intimate partner violence (IPV) poses a major public health concern. To date there are few rigorous economic evaluations of interventions aimed at preventing IPV in low-income settings. This study provides a cost and cost effectiveness analysis of SASA!, a community mobilisation intervention to change social norms and prevent IPV. An economic evaluation alongside a cluster randomised controlled trial. Both financial and economic costs were collected retrospectively from the provider's perspective to generate total and unit cost estimates over four years of intervention programming. Univariate sensitivity analysis is conducted to estimate the impact of uncertainty in cost and outcome measures on results. The total cost of developing the SASA! Activist Kit is estimated as US$138,598. Total intervention costs over four years are estimated as US$553,252. The annual cost of supporting 351 activists to conduct SASA! activities was approximately US$389 per activist and the average cost per person reached in intervention communities was US$21 over the full course of the intervention, or US$5 annually. The primary trial outcome was past year experience of physical IPV with an estimated 1201 cases averted (90% CI: 97-2307 cases averted). The estimated cost per case of past year IPV averted was US$460. This study provides the first economic evaluation of a community mobilisation intervention aimed at preventing IPV. SASA! unit costs compare favourably with gender transformative interventions and support services for survivors of IPV. ClinicalTrials.gov # NCT00790959.

  8. Life cycle cost estimation and systems analysis of Waste Management Facilities

    International Nuclear Information System (INIS)

    Shropshire, D.; Feizollahi, F.

    1995-01-01

    This paper presents general conclusions from application of a system cost analysis method developed by the United States Department of Energy (DOE), Waste Management Division (WM), Waste Management Facilities Costs Information (WMFCI) program. The WMFCI method has been used to assess the DOE complex-wide management of radioactive, hazardous, and mixed wastes. The Idaho Engineering Laboratory, along with its subcontractor Morrison Knudsen Corporation, has been responsible for developing and applying the WMFCI cost analysis method. The cost analyses are based on system planning level life-cycle costs. The costs for life-cycle waste management activities estimated by WMFCI range from bench-scale testing and developmental work needed to design and construct a facility, facility permitting and startup, operation and maintenance, to the final decontamination, decommissioning, and closure of the facility. For DOE complex-wide assessments, cost estimates have been developed at the treatment, storage, and disposal module level and rolled up for each DOE installation. Discussions include conclusions reached by studies covering complex-wide consolidation of treatment, storage, and disposal facilities, system cost modeling, system costs sensitivity, system cost optimization, and the integration of WM waste with the environmental restoration and decontamination and decommissioning secondary wastes

  9. Cost Model for Digital Preservation: Cost of Digital Migration

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad; Nielsen, Anders Bo; Thirifays, Alex

    2011-01-01

    The Danish Ministry of Culture has funded a project to set up a model for costing preservation of digital materials held by national cultural heritage institutions. The overall objective of the project was to increase cost effectiveness of digital preservation activities and to provide a basis...... for comparing and estimating future cost requirements for digital preservation. In this study we describe an activity-based costing methodology for digital preservation based on the Open Archice Information System (OAIS) Reference Model. Within this framework, which we denote the Cost Model for Digital...... Preservation (CMDP), the focus is on costing the functional entity Preservation Planning from the OAIS and digital migration activities. In order to estimate these costs we have identified cost-critical activities by analysing the functions in the OAIS model and the flows between them. The analysis has been...

  10. A Costing Analysis for Decision Making Grid Model in Failure-Based Maintenance

    Directory of Open Access Journals (Sweden)

    Burhanuddin M. A.

    2011-01-01

    Full Text Available Background. In current economic downturn, industries have to set good control on production cost, to maintain their profit margin. Maintenance department as an imperative unit in industries should attain all maintenance data, process information instantaneously, and subsequently transform it into a useful decision. Then act on the alternative to reduce production cost. Decision Making Grid model is used to identify strategies for maintenance decision. However, the model has limitation as it consider two factors only, that is, downtime and frequency of failures. We consider third factor, cost, in this study for failure-based maintenance. The objective of this paper is to introduce the formulae to estimate maintenance cost. Methods. Fish bone analysis conducted with Ishikawa model and Decision Making Grid methods are used in this study to reveal some underlying risk factors that delay failure-based maintenance. The goal of the study is to estimate the risk factor that is, repair cost to fit in the Decision Making Grid model. Decision Making grid model consider two variables, frequency of failure and downtime in the analysis. This paper introduces third variable, repair cost for Decision Making Grid model. This approaches give better result to categorize the machines, reduce cost, and boost the earning for the manufacturing plant. Results. We collected data from one of the food processing factories in Malaysia. From our empirical result, Machine C, Machine D, Machine F, and Machine I must be in the Decision Making Grid model even though their frequency of failures and downtime are less than Machine B and Machine N, based on the costing analysis. The case study and experimental results show that the cost analysis in Decision Making Grid model gives more promising strategies in failure-based maintenance. Conclusions. The improvement of Decision Making Grid model for decision analysis with costing analysis is our contribution in this paper for

  11. 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.

  12. Climate-based policies may increase life-cycle social costs of vehicle fleet operation

    International Nuclear Information System (INIS)

    Emery, Isaac; Mbonimpa, Eric; Thal, Alfred E.

    2017-01-01

    Sustainability guidelines and regulations in the United States often focus exclusively on carbon or petroleum reductions. Though some of these policies have resulted in substantial progress toward their goals, the effects of these efforts on other social and environmental externalities are often ignored. In this study, we examine the life-cycle air pollutant emissions for alternative fuel and vehicle purchase scenarios at a military installation near a typical urban area in the United States (U.S.). We find that scenarios which minimize petroleum use or greenhouse gas emissions do not concomitantly minimize criteria air pollutant emissions. We also employ social cost methodologies to quantify economic externalities due to climate change and health-related air pollutant impacts. Accounting for the social costs of climate change and air pollution from vehicle use reveals that criteria air pollutants may have a greater total impact than greenhouse gas emissions in locations similar to the urban area examined in this study. Use of first-generation biofuels, particularly corn grain ethanol, may reduce net petroleum use at the cost of increased total health impacts. More comprehensive policies may be needed to ensure that sustainability policies result in a net benefit to society. - Highlights: • U.S. energy and transportation policies focus on petroleum use and greenhouse gases. • Use of corn ethanol at a military base in Ohio, U.S. increases total social costs vs. gasoline. • Renewable electricity provides cost-effective climate and health protection. • DOD strategy to improve energy security may damage Americans' health. • More inclusive policies needed to protect health and climate.

  13. Manufacturing Cost Analysis for YSZ-Based FlexCells at Pilot and Full Scale Production Scales

    Energy Technology Data Exchange (ETDEWEB)

    Scott Swartz; Lora Thrun; Robin Kimbrell; Kellie Chenault

    2011-05-01

    Significant reductions in cell costs must be achieved in order to realize the full commercial potential of megawatt-scale SOFC power systems. The FlexCell designed by NexTech Materials is a scalable SOFC technology that offers particular advantages over competitive technologies. In this updated topical report, NexTech analyzes its FlexCell design and fabrication process to establish manufacturing costs at both pilot scale (10 MW/year) and full-scale (250 MW/year) production levels and benchmarks this against estimated anode supported cell costs at the 250 MW scale. This analysis will show that even with conservative assumptions for yield, materials usage, and cell power density, a cost of $35 per kilowatt can be achieved at high volume. Through advancements in cell size and membrane thickness, NexTech has identified paths for achieving cell manufacturing costs as low as $27 per kilowatt for its FlexCell technology. Also in this report, NexTech analyzes the impact of raw material costs on cell cost, showing the significant increases that result if target raw material costs cannot be achieved at this volume.

  14. 76 FR 66111 - Cost-of-Living Increase and Other Determinations for 2012

    Science.gov (United States)

    2011-10-25

    ... visit our Internet site, Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2011-0075] Cost-of-Living Increase and Other Determinations for 2012 AGENCY: Social Security Administration. ACTION: Notice. SUMMARY: Under title II of the...

  15. 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).

  16. Smarter elder care? A cost-effectiveness analysis of implementing technology in elder care.

    Science.gov (United States)

    Aanesen, Margrethe; Lotherington, Ann Therese; Olsen, Frank

    2011-09-01

    Whereas in most sectors, technology has taken over trivial and labour consuming tasks, this transformation has been delayed in the healthcare sector. Although appropriate technology is available, there is general resistance to substituting 'warm' hands with 'cold' technology. In the future, this may change as the number of elderly people increases relative to the people in the work force. In combination with an increasing demand for healthcare services, there are calls for efforts to increase productivity in the sector. Based on experience data from previous studies on information and communication technology efforts in the healthcare sector, we quantitatively assess the use of smart house technology and video visits in home care. Having identified healthcare providers, hospitals and relatives as the main affected groups, we show that smart house technology is cost-effective, even if only relatives gain from it. Video visits, which have higher implementation costs, demand effects on both relatives and health care providers in order to be a cost-effective tool in home care. As the analysis is purely quantitative, these results need to be complemented with qualitative effects and with more thorough discussions of the ethical, medical and legal aspects of the use of technology in home care.

  17. Digital vs conventional radiography: cost and revenue analysis

    International Nuclear Information System (INIS)

    Dalla Palma, L.; Cuttin, R.; Rimondini, A.; Grisi, G.

    1999-01-01

    The objective of this study was to analyse and compare the operating and investment costs of two radiographic systems, a conventional and a digital one, and to evaluate the cost/revenue ratio of the two systems. The radiological activity over 1 year for chest and skeletal exams was evaluated: 13,401 chest and 7,124 skeletal exams were considered. The following parameters of variable costs were evaluated: the difference between variable proportional costs of the two technologies, the effective variable cost of any size film, including the chemicals, and for different sizes of digital film, variable costs of chest plus skeletal exams performed with the two techniques. Afterwards the economical effect was considered taking into account depreciation during a time of utilization ranging between 8 and 4 years. In the second part of the analysis the total cost and the revenues of the two technologies were determined. The comparison between the digital and conventional systems has shown the following aspects: 1. Digital radiography system has a much higher investment cost in comparison with the conventional one. 2. Operating costs of digital equipment are higher or lower depending on the film size used. Evaluating chest X-ray we reach a breakeven point after 1 year and 10,000 exams only if displayed over 8 x 10-in. film and after 30,000 if displayed over a 11 x 14-in. film. 3. The total cost (variable cost, technology cost, labour cost) of digital technology is lower than that of the conventional system by 20 % on average using 8 x 10-in. film size. 4. Digital technology also allows lesser film waste and lesser film per exam (orig.)

  18. Proposals for software analysis of cost effectiveness and cost-benefit for optimisation of radiation protection

    International Nuclear Information System (INIS)

    Schieber, C.; Lombard, J.; Lefaure, C.

    1990-06-01

    The objective of this report is to present the principles of decision making software for radiation protection option, applying ALARA principle. The choice of optimum options is performed by applying the models of cost effectiveness and cost-benefit. Options of radiation protection are described by two indicators: a simple economic indicator: cost of radiation protection; and dosimetry indicator: collective dose related to protection. For both analyses the software enables sensitivity analysis. It would be possible to complete the software by integrating a module which would take into account combinations of two options since they are not independent

  19. Cost-effectiveness in the management of Dupuytren's contracture. A Canadian cost-utility analysis of current and future management strategies.

    Science.gov (United States)

    Baltzer, H; Binhammer, P A

    2013-08-01

    In Canada, Dupuytren's contracture is managed with partial fasciectomy or percutaneous needle aponeurotomy (PNA). Injectable collagenase will soon be available. The optimal management of Dupuytren's contracture is controversial and trade-offs exist between the different methods. Using a cost-utility analysis approach, our aim was to identify the most cost-effective form of treatment for managing Dupuytren's contracture it and the threshold at which collagenase is cost-effective. We developed an expected-value decision analysis model for Dupuytren's contracture affecting a single finger, comparing the cost-effectiveness of fasciectomy, aponeurotomy and collagenase from a societal perspective. Cost-effectiveness, one-way sensitivity and variability analyses were performed using standard thresholds for cost effective treatment ($50 000 to $100 000/QALY gained). Percutaneous needle aponeurotomy was the preferred strategy for managing contractures affecting a single finger. The cost-effectiveness of primary aponeurotomy improved when repeated to treat recurrence. Fasciectomy was not cost-effective. Collagenase was cost-effective relative to and preferred over aponeurotomy at $875 and $470 per course of treatment, respectively. In summary, our model supports the trend towards non-surgical interventions for managing Dupuytren's contracture affecting a single finger. Injectable collagenase will only be feasible in our publicly funded healthcare system if it costs significantly less than current United States pricing.

  20. Human cost as a factor used in the cost-benefit analysis

    Directory of Open Access Journals (Sweden)

    Karol RÁSTOČNÝ

    2008-01-01

    Full Text Available Cost-benefit analysis (CBA is a prescriptive technique that is performed for the purpose of informing policy makers about what they ought to do. The paper discusses the problem of assigning a monetary value to human life (lifesaving or quality of life as an important factor used in the CBA. Presented ideas come from the project SELCAT solved within the 6th Frame Program.

  1. Analysis of the production and transaction costs of forest carbon offset projects in the USA.

    Science.gov (United States)

    Galik, Christopher S; Cooley, David M; Baker, Justin S

    2012-12-15

    Forest carbon offset project implementation costs, comprised of both production and transaction costs, could present an important barrier to private landowner participation in carbon offset markets. These costs likewise represent a largely undocumented component of forest carbon offset potential. Using a custom spreadsheet model and accounting tool, this study examines the implementation costs of different forest offset project types operating in different forest types under different accounting and sampling methodologies. Sensitivity results are summarized concisely through response surface regression analysis to illustrate the relative effect of project-specific variables on total implementation costs. Results suggest that transaction costs may represent a relatively small percentage of total project implementation costs - generally less than 25% of the total. Results also show that carbon accounting methods, specifically the method used to establish project baseline, may be among the most important factors in driving implementation costs on a per-ton-of-carbon-sequestered basis, dramatically increasing variability in both transaction and production costs. This suggests that accounting could be a large driver in the financial viability of forest offset projects, with transaction costs likely being of largest concern to those projects at the margin. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Cost analysis of alternate management schemes in early stage testicular seminoma

    International Nuclear Information System (INIS)

    Sharda, Navneet N.; Kinsella, Timothy J.; Ritter, Mark A.

    1995-01-01

    Purpose: Optimal management of early stage testicular seminoma remains uncertain. Standard therapy includes inguinal orchidectomy followed by irradiation of the pelvic and para-aortic nodes. Due to the excellent survival rates (<4% seminoma specific mortality as per the Princess Margaret, Institute Goustave-Roussy experience), the option of observation following orchidectomy has been proposed, with no diminution in absolute survival noted since salvage chemotherapy is effective in the treatment of early systemic relapse. However, the intensity of follow-up required if observation is chosen will likely add an increased medical cost burden which needs to be balanced against the cost of standard treatment using radiation therapy. We have therefore performed a cost comparison between these two management strategies in order to define any differences. Methods and Materials: All costs reported are adjusted to 1994 dollars and analysis is begun immediately post-orchidectomy. The cost of observation was calculated assuming a 15% relapse rate (10%-20%) over seven years of follow-up. The follow-up schedule was assumed identical to that commonly reported in the literature (Princess Margaret, Institute Gustave-Roussy, Royal Marsden), consisting of periodic CXR, CT abd/pelvis, tumor markers and examinations. Chemotherapy costs associated with treatment of recurrences were generated from the inpatient hospital charges and physician billing of five patients who received three cycles of a standard United States regimen consisting of bleomycin, etoposide and cis-platinum in 1994. On average, four days of hospitalization were required. Radiological costs were also calculated from the actual patient billing records in 1994 and incremented at a rate of 3%/year over the length of proposed follow-up. Costs of irradiation and subsequent standard follow-up were similarly generated from the hospital charges and physician billing of five patients treated postoperatively. A 4% recurrence

  3. Cost-benefit analysis of reforming Israel's electricity industry

    International Nuclear Information System (INIS)

    Tishler, A.; Newman, J.; Spekterman, I.; Woo, C.K.

    2006-01-01

    In June 2003, the Israeli government decided to reform the Israeli electricity industry, which is currently dominated by Israel electric corporation (IEC), a government-owned vertically integrated electric utility. The first step of the planned reform will be taken in 2006, when IEC will be functionally separated into generation, transmission, local distribution, and customer services. Immediately thereafter will be the second step, which by 2012 will result in the deregulation and privatization of the wholesale generation and customer services. Transmission and distribution (T and D) services will remain regulated but will be available to all T and D users under mandatory open access. This paper summarizes a cost-benefit analysis of the government's reform plan. Relative to a regulated regime, the government's plan, even if carried out flawlessly, may only yield a small net benefit. However, it entails a large increase in electricity producer profit and government tax receipt, at the expense of electricity consumers. A less-than-perfect transition to competition can easily wipe out the potential gain of the government plan. Market reform experience to date shows that electricity market reform can easily fail, and the factors for success do not exist in Israel. Since the outcome of a failing reform can be disastrous, it will be imprudent to implement the government's plan in 2006, when the current electricity law expires. Hence, we recommend performance-based regulation for the period of 2006-2010. Subject to an updated cost-benefit analysis, possible decentralization, privatization and competition may follow

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

    CERN Multimedia

    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...

  5. Cost-benefit analysis of FBR program

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S [Japan Energy Economic Research Inst., Tokyo

    1975-07-01

    In several countries of the world, both financial and human resources are being invested to the development of fast breeder reactors. Quantitative determination of the benefit which will be expected as the reqard to these efforts of research and development - this is the purpose of the present study. It is cost-benefit analysis. The instances of this analysis are given, namely the work in The Institute of Energy Economics in Japan, and also the one by U.S.AEC. The effect of the development of fast breeder reactors is evaluated in this way ; and problems in the analysis method are indicated. These two works in Japan and the U.S. were performed before the so-called oil crisis.

  6. Palbociclib in hormone receptor positive advanced breast cancer: A cost-utility analysis.

    Science.gov (United States)

    Raphael, J; Helou, J; Pritchard, K I; Naimark, D M

    2017-11-01

    The addition of palbociclib to letrozole improves progression-free survival in the first-line treatment of hormone receptor positive advanced breast cancer (ABC). This study assesses the cost-utility of palbociclib from the Canadian healthcare payer perspective. A probabilistic discrete event simulation (DES) model was developed and parameterised with data from the PALOMA 1 and 2 trials and other sources. The incremental cost per quality-adjusted life-month (QALM) gained for palbociclib was calculated. A time horizon of 15 years was used in the base case with costs and effectiveness discounted at 5% annually. Time-to- progression and time-to-death were derived from a Weibull and exponential distribution. Expected costs were based on Ontario fees and other sources. Probabilistic sensitivity analyses were conducted to account for parameter uncertainty. Compared to letrozole, the addition of palbociclib provided an additional 14.7 QALM at an incremental cost of $161,508. The resulting incremental cost-effectiveness ratio was $10,999/QALM gained. Assuming a willingness-to-pay (WTP) of $4167/QALM, the probability of palbociclib to be cost-effective was 0%. Cost-effectiveness acceptability curves derived from a probabilistic sensitivity analysis showed that at a WTP of $11,000/QALM gained, the probability of palbociclib to be cost-effective was 50%. The addition of palbociclib to letrozole is unlikely to be cost-effective for the treatment of ABC from a Canadian healthcare perspective with its current price. While ABC patients derive a meaningful clinical benefit from palbociclib, considerations should be given to increase the WTP threshold and reduce the drug pricing, to render this strategy more affordable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Cost-utility analysis of the National truth campaign to prevent youth smoking.

    Science.gov (United States)

    Holtgrave, David R; Wunderink, Katherine A; Vallone, Donna M; Healton, Cheryl G

    2009-05-01

    In 2005, the American Journal of Public Health published an article that indicated that 22% of the overall decline in youth smoking that occurred between 1999 and 2002 was directly attributable to the truth social marketing campaign launched in 2000. A remaining key question about the truth campaign is whether the economic investment in the program can be justified by the public health outcomes; that question is examined here. Standard methods of cost and cost-utility analysis were employed in accordance with the U.S. Panel on Cost-Effectiveness in Health and Medicine; a societal perspective was employed. During 2000-2002, expenditures totaled just over $324 million to develop, deliver, evaluate, and litigate the truth campaign. The base-case cost-utility analysis result indicates that the campaign was cost saving; it is estimated that the campaign recouped its costs and that just under $1.9 billion in medical costs was averted for society. Sensitivity analysis indicated that the basic determination of cost effectiveness for this campaign is robust to substantial variation in input parameters. This study suggests that the truth campaign not only markedly improved the public's health but did so in an economically efficient manner.

  8. The application of cost-benefit analysis to the radiological protection of the public

    International Nuclear Information System (INIS)

    1980-03-01

    The subject of this document is the quantification of the potential harm caused to the general public by ionising radiation in normal operating circumstances. The object is to enable the health detriment from a practice involving exposure to ionising radiation to be directly compared with the costs of keeping the ensuing doses as low as reasonably achievable. Chapter headings include: development of radiological protection criteria; principles underlying the valuation of harm from radiation exposure; risk evaluation approach to costing of detriment; monetary valuations; distribution of costs and risk in time. Appendices cover the following: cost benefit analysis (principles); recommendations of ICRP on the use of cost benefit analysis; life valuation studies (review); application of cost benefit analysis to the value of the man sievert. (U.K.)

  9. A cost-benefit analysis of spent fuel management

    International Nuclear Information System (INIS)

    Lamorlette, G.

    2001-01-01

    The back end of the fuel cycle is an area of economic risk for utilities having nuclear power plants to generate electricity. A cost-benefit analysis is a method by which utilities can evaluate advantages and drawbacks of alternative back end fuel cycle strategies. The present paper analyzes how spent fuel management can influence the risks and costs incurred by a utility over the lifetime of its power plants and recommends a recycling strategy. (author)

  10. A Cost Analysis of School-Based Lifestyle Interventions.

    Science.gov (United States)

    Oosterhoff, Marije; Bosma, Hans; van Schayck, Onno C P; Joore, Manuela A

    2018-05-31

    A uniform approach for costing school-based lifestyle interventions is currently lacking. The objective of this study was to develop a template for costing primary school-based lifestyle interventions and apply this to the costing of the "Healthy Primary School of the Future" (HPSF) and the "Physical Activity School" (PAS), which aim to improve physical activity and dietary behaviors. Cost-effectiveness studies were reviewed to identify the cost items. Societal costs were reflected by summing up the education, household and leisure, labor and social security, and health perspectives. Cost inputs for HPSF and PAS were obtained for the first year after implementation. In a scenario analysis, the costs were explored for a hypothetical steady state. From a societal perspective, the per child costs were €2.7/$3.3 (HPSF) and €- 0.3/$- 0.4 (PAS) per day during the first year after implementation, and €1.0/$1.2 and €- 1.3/$- 1.6 in a steady state, respectively (2016 prices). The highest costs were incurred by the education perspective (first year: €8.7/$10.6 (HPSF) and €4.0/$4.9 (PAS); steady state: €6.1/$7.4 (HPSF) and €2.1/$2.6 (PAS)), whereas most of the cost offsets were received by the household and leisure perspective (first year: €- 6.0/$- 7.3 (HPSF) and €- 4.4/$- 5.4 (PAS); steady state: €- 5.0/$- 6.1 (HPSF) and €- 3.4/$- 4.1 (PAS)). The template proved helpful for costing HPSF and PAS from various stakeholder perspectives. The costs for the education sector were fully (PAS) and almost fully (HPSF) compensated by the savings within the household sector. Whether the additional costs of HPSF over PAS represent value for money will depend on their relative effectiveness.

  11. Chronic Hepatitis C-Related Cirrhosis Hospitalization Cost Analysis in Bulgaria

    Directory of Open Access Journals (Sweden)

    Maria Dimitrova

    2017-08-01

    Full Text Available ObjectiveHCV infection is a leading cause of chronic liver disease with long-term complications—extensive fibrosis, cirrhosis, and hepatocellular carcinoma. The objective of this study is to perform cost analysis of therapy of patients with chronic HCV-related cirrhosis hospitalized in the University Hospital “Queen Joanna-ISUL” for 3-year period (2012–2014.MethodsIt is a prospective, real life observational study of 297 patients with chronic HCV infection and cirrhosis monitored in the University Hospital “Queen Joanna-ISUL” for 3-year period. Data on demographic, clinical characteristics, and health-care resources utilization (hospitalizations, highly specialized interventions, and pharmacotherapy were collected. Micro-costing approach was applied to evaluate the total direct medical costs. The points of view are that of the National Health Insurance Fund (NHIF, hospital and the patients. Collected cost data are from the NHIF and hospitals tariffs, patients, and from the positive dug list for medicines prices. Descriptive statistics, chi-squared test, Kruskal–Wallis, and Friedman tests were used for statistical processing.Results76% of patients were male. 93% were diagnosed in grade Child-Pugh A and B. 97% reported complications, and almost all developed esophageal varices. During the 3 years observational period, patients did not change the critical clinical values for Child-Pugh status and therefore the group was considered as homogenous. 847 hospitalizations were recorded for 3 years period with average length of stay 17 days. The mortality rate of 6.90% was extremely high. The total direct medical costs for the observed cohort of patients for 3-year period accounted for 1,290,533 BGN (€659,839 with an average cost per patient 4,577 BGN (€2,340. Statistically significant correlation was observed between the total cost per patient from the different payers’ perspective and the Child-Pugh cirrhosis score

  12. BIM cost analysis of transport infrastructure projects

    Science.gov (United States)

    Volkov, Andrey; Chelyshkov, Pavel; Grossman, Y.; Khromenkova, A.

    2017-10-01

    The article describes the method of analysis of the energy costs of transport infrastructure objects using BIM software. The paper consideres several options of orientation of a building using SketchUp and IES VE software programs. These options allow to choose the best direction of the building facades. Particular attention is given to a distribution of a temperature field in a cross-section of the wall according to the calculation made in the ELCUT software. The issues related to calculation of solar radiation penetration into a building and selection of translucent structures are considered in the paper. The article presents data on building codes relating to the transport sector, on the basis of which the calculations were made. The author emphasizes that BIM-programs should be implemented and used in order to optimize a thermal behavior of a building and increase its energy efficiency using climatic data.

  13. 75 FR 65696 - Cost-of-Living Increase and Other Determinations for 2011

    Science.gov (United States)

    2010-10-26

    ... eligibility or claiming benefits, call 1-800-772-1213, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION Office of the Commissioner [Docket No. SSA-2010-0054] Cost-of-Living Increase and Other Determinations for 2011 AGENCY: Social Security Administration. ACTION: Notice...

  14. Increased care demand and medical costs after falls in nursing homes: A Delphi study.

    Science.gov (United States)

    Sterke, Carolyn Shanty; Panneman, Martien J; Erasmus, Vicki; Polinder, Suzanne; van Beeck, Ed F

    2018-04-21

    To estimate the increased care demand and medical costs caused by falls in nursing homes. There is compelling evidence that falls in nursing homes are preventable. However, proper implementation of evidence-based guidelines to prevent falls is often hindered by insufficient management support, staff time and funding. A three-round Delphi study. A panel of 41 experts, all working in nursing homes in the Netherlands, received three online questionnaires to estimate the extra hours of care needed during the first year after the fall. This was estimated for ten falls categories with different levels of injury severity, in three scenarios, that is a best-case, a typical-case and a worst-case scenario. We calculated the costs of falls by multiplying the mean amount of extra hours that the participants spent on the care for a resident after a fall with their hourly wages. In case of a noninjurious fall, the extra time spent on the faller is on average almost 5 hr, expressed in euros that add to € 193. The extra staff time and costs of falls increased with increasing severity of injury. In the case of a fracture of the lower limb, the extra staff time increased to 132 hr, expressed in euros that is € 4,604. In the worst-case scenario of a fracture of the lower limb, the extra staff time increased to 284 hr, expressed in euros that is € 10,170. Falls in nursing homes result in a great deal of extra staff time spent on care, with extra costs varying between € 193 for a noninjurious fall and € 10,170 for serious falls. This study could aid decision-making on investing in appropriate implementation of falls prevention interventions in nursing homes. © 2018 John Wiley & Sons Ltd.

  15. 34 CFR 75.232 - The cost analysis; basis for grant amount.

    Science.gov (United States)

    2010-07-01

    ... Secretary sets the amount of a new grant, the Secretary does a cost analysis of the project. The Secretary... objectives of the project with reasonable efficiency and economy under the budget in the application... 34 Education 1 2010-07-01 2010-07-01 false The cost analysis; basis for grant amount. 75.232...

  16. Prevalence and Cost Analysis of Complex Regional Pain Syndrome (CRPS): A Role for Neuromodulation.

    Science.gov (United States)

    Elsamadicy, Aladine A; Yang, Siyun; Sergesketter, Amanda R; Ashraf, Bilal; Charalambous, Lefko; Kemeny, Hanna; Ejikeme, Tiffany; Ren, Xinru; Pagadala, Promila; Parente, Beth; Xie, Jichun; Lad, Shivanand P

    2017-09-29

    The diagnosis and treatment of complex regional pain syndrome (CRPS) is challenging and there is a paucity of data describing its overall cost burden and quantifying its impact on the US healthcare system. The aim of this study was to assess the prevalence and healthcare utilization costs associated with CRPS. A retrospective longitudinal study was performed using the Truven MarketScan® database to identify patients with a new indexed diagnosis of CRPS (Type I, II, or both) from 2001 to 2012. We collected total, outpatient, and pain prescription costs three years prior to CRPS diagnosis (baseline), at year of CRPS diagnosis, and eight-year post-CRPS diagnosis. A longitudinal multivariate analysis was used to model the estimated total and pain prescription cost ratios comparing patients diagnosed before and after CRPS. We included 35,316 patients with a newly indexed diagnosis of CRPS (Type I: n = 18,703, Type II: n = 14,599, Unspecified: n = 2014). Baseline characteristics were similar between the CRPS cohorts. Compared to two- and three-year baseline costs, one-year prior to diagnosis for all CRPS patients yielded the highest interquartile median [IQR] costs: total costs $7904[$3469, $16,084]; outpatient costs $6706[$3119, $12,715]; and pain prescription costs $1862[$147, $7649]. At the year of CRPS diagnosis, the median [IQR] costs were significantly higher than baseline costs: total costs $8508[$3943, $16,666]; outpatient costs $7251[$3527, $13,568]; and pain prescription costs $2077[$140, $8856]. Over the eight-year period after CRPS diagnosis, costs between all the years were similar, ranging from the highest (one-year) to lowest (seven-years), $4845 to $3888. The median total cumulative cost 8-years after CRPS diagnosis was $43,026 and $12,037 for pain prescription costs. [Correction added on 06 November 2017 after first online publication: the preceding sentence has been updated to demonstrate the median cumulative cost in replacement of the

  17. Cost Analysis of Channeled, Distal Chip Laryngoscope for In-office Laryngopharyngeal Biopsies.

    Science.gov (United States)

    Marcus, Sonya; Timen, Micah; Dion, Gregory R; Fritz, Mark A; Branski, Ryan C; Amin, Milan R

    2018-02-19

    Given that financial considerations play an increasingly prominent role in clinical decision-making, we sought (1) to determine the cost-effectiveness of in-office biopsy for the patient, the provider, and the health-care system, and (2) to determine the diagnostic accuracy of in-office biopsy. Retrospective, financial analyses were performed. Patients who underwent in-office (Current Procedural Terminology Code 31576) or operative biopsy (CPT Code 31535) for laryngopharyngeal lesions were included. Two financial analyses were performed: (1) the average cost of operating room (OR) versus in-office biopsy was calculated, and (2) a break-even analysis was calculated to determine the cost-effectiveness of in-office biopsy for the provider. In addition, the diagnostic accuracy of in-office biopsies and need for additional biopsies or procedures was recorded. Of the 48 patients included in the current study, 28 underwent in-office biopsy. A pathologic sample was obtained in 26 of 28 (92.9%) biopsies performed in the office. Of these patients, 16 avoided subsequent OR procedures. The average per patient cost was $7000 and $11,000 for in-office and OR biopsy, respectively. Break-even analysis demonstrated that the provider could achieve a profit 2 years after purchase of the necessary equipment. In-office laryngopharyngeal biopsies are accurate and, overall, more cost-effective than OR biopsies. Purchase of the channeled, distal chip laryngoscope and biopsy forceps to perform in-office biopsies can be profitable for a provider with a videolaryngoscopy tower. In-office biopsy should be considered the initial diagnostic tool for suspected laryngopharyngeal malignancies noted on videolaryngoscopy. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. The costs and cost-effectiveness of an integrated sepsis treatment protocol.

    Science.gov (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

    2008-04-01

    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

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

    International Nuclear Information System (INIS)

    Matysiak, L.M.

    1993-01-01

    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

  20. 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.

  1. 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.

  2. Low-Cost Behavioral Nudges Increase Medicaid Take-Up Among Eligible Residents Of Oregon.

    Science.gov (United States)

    Wright, Bill J; Garcia-Alexander, Ginny; Weller, Margarette A; Baicker, Katherine

    2017-05-01

    Efforts to reduce the ranks of the uninsured hinge on take-up of available programs and subsidies, but take-up of even free insurance is often less than complete. The evidence of the effectiveness of policies aiming to increase take-up is limited. We used a randomized controlled design to evaluate the impact of improved communication and behaviorally informed "nudges" designed to increase Medicaid take-up among eligible populations. Fielding randomized interventions in two different study populations in Oregon, we found that even very low-cost interventions substantially increased enrollment. Effects were larger in a population whose members had already expressed interest in obtaining coverage, but the effects were more persistent in low-income populations whose members were already enrolled in other state assistance programs but had not expressed interest in health insurance. The effects were similar across different demographic groups. Our results suggest that improving the design of enrollment processes and using low-cost mass-outreach efforts have the potential to substantially increase insurance coverage of vulnerable populations. Project HOPE—The People-to-People Health Foundation, Inc.

  3. Cost analysis of iliac stenting performed in the operating room and the catheterization lab: A case-control study.

    Science.gov (United States)

    Kim, Sooyeon; Kramer, Sage P; Dugan, Adam J; Minion, David J; Gurley, John C; Davenport, Daniel L; Ferraris, Victor A; Saha, Sibu P

    2016-12-01

    Iliac arterial stenting is performed both in the operating room (OR) and the catheterization lab (CL). To date, no analysis has compared resource utilization between these locations. Consecutive patients (n = 105) treated at a single center were retrospectively analyzed. Patients included adults with chronic, symptomatic iliac artery stenosis with a minimum Rutherford classification (RC) of 3, treated with stents. Exclusion criteria were prior stenting, acute ischemia, or major concomitant procedures. Immediate and two-year outcomes were observed. Patient demographics, perioperative details, physician billings, and hospital costs were recorded. Multivariable regression was used to adjust costs by patient and perioperative cost drivers. Fifty-one procedures (49%) were performed in the OR and 54 (51%) in the CL. Mean age was 57, and 44% were female. Severe cases were more often performed in the OR (RC ≥ 4; 42% vs. 11%, P costs (P costs (P costs but was associated with increased professional fees. Same-stay (5%) and post-discharge reintervention (33%) did not vary by location. The OR was associated with increased length of stay, more ICU admissions, and increased total costs. However, OR patients had more severe disease and therefore often required more aggressive intervention. After controlling for these differences, procedure venue per se was not associated with increased costs, but OR cases incurred increased professional fees due to dual-provider charges. Given the similar clinical results between venues, it seems reasonable to perform most stenting in the CL or utilize conscious sedation in the OR. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  4. Cost-effectiveness analysis of introducing malaria diagnostic testing in drug shops

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Clarke, Siân E.; Lal, Sham

    2017-01-01

    Background Private sector drug shops are an important source of malaria treatment in Africa, yet diagnosis without parasitological testing is common among these providers. Accurate rapid diagnostic tests for malaria (mRDTs) require limited training and present an opportunity to increase access...... to correct diagnosis. The present study was a cost-effectiveness analysis of the introduction of mRDTs in Ugandan drug shops. Methods Drug shop vendors were trained to perform and sell subsidised mRDTs and artemisinin-based combination therapies (ACTs) in the intervention arm while vendors offered ACTs...... following presumptive diagnosis of malaria in the control arm. The effect on the proportion of customers with fever ‘appropriately treated of malaria with ACT’ was captured during a randomised trial in drug shops in Mukono District, Uganda. Health sector costs included: training of drug shop vendors...

  5. Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali.

    Science.gov (United States)

    Maccario, Roberta; Rouhani, Saba; Drake, Tom; Nagy, Annie; Bamadio, Modibo; Diarra, Seybou; Djanken, Souleymane; Roschnik, Natalie; Clarke, Siân E; Sacko, Moussa; Brooker, Simon; Thuilliez, Josselin

    2017-06-12

    The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali. Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

  6. Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali

    Directory of Open Access Journals (Sweden)

    Roberta Maccario

    2017-06-01

    Full Text Available Abstract Background The expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN, and Intermittent Parasite Clearance in schools (IPCs in southern Mali. Methods Costs were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children. A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed. Results The economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41 with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%, $5.53 (53.3% and $2.72 (26.2% per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child. Conclusions A comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.

  7. A cost-effectiveness analysis of typhoid fever vaccines in US military personnel.

    Science.gov (United States)

    Warren, T A; Finder, S F; Brier, K L; Ries, A J; Weber, M P; Miller, M R; Potyk, R P; Reeves, C S; Moran, E L; Tornow, J J

    1996-11-01

    Typhoid fever has been a problem for military personnel throughout history. A cost-effectiveness analysis of typhoid fever vaccines from the perspective of the US military was performed. Currently 3 vaccine preparations are available in the US: an oral live Type 21A whole cell vaccine; a single-dose parenteral, cell subunit vaccine; and a 2-dose parenteral heat-phenol killed, whole cell vaccine. This analysis assumed all vaccinees were US military personnel. Two pharmacoeconomic models were developed, one for personnel who have not yet been deployed, and the other for personnel who are deployed to an area endemic for typhoid fever. Drug acquisition, administration, adverse effect and lost work costs, as well as the costs associated with typhoid fever, were included in this analysis. Unique military issues, typhoid fever attack rates, vaccine efficacy, and compliance with each vaccine's dosage regimen were included in this analysis. A sensitivity analysis was performed to test the robustness of the models. Typhoid fever immunisation is not cost-effective for US military personnel unless they are considered imminently deployable or are deployed. The most cost-effective vaccine for US military personnel is the single-dose, cell subunit parenteral vaccine.

  8. 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

  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. Development of a method for efficient cost-effective screening of Aspergillus niger mutants having increased production of glucoamylase.

    Science.gov (United States)

    Zhu, Xudong; Arman, Bessembayev; Chu, Ju; Wang, Yonghong; Zhuang, Yingping

    2017-05-01

    To develop an efficient cost-effective screening process to improve production of glucoamylase in Aspergillus niger. The cultivation of A. niger was achieved with well-dispersed morphology in 48-deep-well microtiter plates, which increased the throughput of the samples compared to traditional flask cultivation. There was a close negative correlation between glucoamylase and its pH of the fermentation broth. A novel high-throughput analysis method using Methyl Orange was developed. When compared to the conventional analysis method using 4-nitrophenyl α-D-glucopyranoside as substrate, a correlation coefficient of 0.96 by statistical analysis was obtained. Using this novel screening method, we acquired a strain with an activity of 2.2 × 10 3  U ml -1 , a 70% higher yield of glucoamylase than its parent strain.

  11. Increasing coal-fired power generation efficiency to reduce electric cost and environmental emissions

    International Nuclear Information System (INIS)

    Torrens, I.M.; Stenzel, W.C.

    1997-01-01

    New generating capacity required globally between 1993 and 2010 is estimated to be around 1500 GW, of which some two-thirds will be outside the OECD, and some 40 % in the Asian non-OECD countries. Coal is likely to account for a substantial fraction of this new generation. Today's state-of-the-art supercritical coal-fired power plant has a conversion efficiency of some 42-45 %. The capital cost increase associated with the supercritical or ultra-supercritical pulverized coal power plant compared to a conventional subcritical plant is small to negligible. The increased efficiency associated with the supercritical plant leads to an actual reduction in the total cost of electricity generated in cents/kWh, relative to a conventional plant. Despite this, the power sector continues to build subcritical plants and has no near term plans to increase the efficiency of power plants in the projects it is developing. Advanced clean coal technologies such as integrated gasification combined cycle and pressurized fluidized bed combustion will be selected for independent power projects only in very specific circumstances. Advanced clean coal plants can be operated reliably and with superior performance, and specifically that their present estimated capital costs can be reduced substantially to a point where they are competitive with state-of-the-art pulverized coal technologies. (R.P.)

  12. 77 FR 65754 - Cost-of-Living Increase and Other Determinations for 2013

    Science.gov (United States)

    2012-10-30

    ... eligibility or claiming benefits, call 1-800-772-1213, or visit our Internet site, Social Security Online, at... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2012-0054] Cost-of-Living Increase and Other Determinations for 2013 AGENCY: Social Security Administration. ACTION: Notice. SUMMARY: Under title II of the...

  13. Re-evaluation of a radiation protection cost benefit analysis study in brachytherapy

    International Nuclear Information System (INIS)

    Broek, J.G. van den; Weatherburn, H.

    1994-01-01

    This study investigates changes in the NRPB advice concerning cost benefit analysis over the last 10 years by correcting all figures for inflation and applying them to a particular radiation protection example, a previously published case of the introduction of afterloading brachytherapy equipment at the Christie Hospital, Manchester. It has been shown that for this example NRPB advice at one time led to a large cost benefit, at another time led to a large cost deficit and later still it again gives a large cost benefit. Application of cost benefit analysis to decision making in radiation protection is therefore shown to be in need of further investigation and clarification. (author)

  14. Intervention and societal costs of residential community reintegration for patients with acquired brain injury: a cost-analysis of the Brain Integration Programme.

    Science.gov (United States)

    van Heugten, Caroline M; Geurtsen, Gert J; Derksen, R Elze; Martina, Juan D; Geurts, Alexander C H; Evers, Silvia M A A

    2011-06-01

    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. A cost-analysis was performed identifying costs of healthcare, informal care, and productivity losses. The costs in the year before the Brain Integration Programme (BIP) were compared with the costs in the year after the BIP using the following cost categories: care consumption, caregiver support, productivity losses. Dutch guidelines were used for cost valuation. Thirty-three cases participated (72% response). Mean age was 29.8 years, 59% traumatic brain injury. The BIP costs were €68,400. The informal care and productivity losses reduced significantly after BIP (p costs per patient were €48,449. After BIP these costs were €39,773; a significant reduction (p costs after the BIP advocates the allocation of resources and, from an economic perspective, favours reimbursement of the BIP costs by healthcare insurance companies. However, this cost-analysis is limited as it does not relate costs to clinical effectiveness. :

  15. THE ANALYSIS OF FINANCIAL EQUILIBRIUM THROUGH THE COST OF THE INVESTED CAPITAL

    Directory of Open Access Journals (Sweden)

    MELANIA ELENA MICULEAC

    2016-10-01

    Full Text Available The financial equilibrium of a company can be analyzed through the cost of the invested capital. It is the most pragmatic approach of the financial equilibrium analysis because it takes into account the cost of invested resources, their capacity to account return. I suggest a model to approach the analysis of the balanced average cost of the invested capital using the method of chain substitutions. I reached the conclusion that the main consequence of changes in the balanced average cost of the capital is on the company’s value.

  16. Increased lower limb muscle coactivation reduces gait performance and increases metabolic cost in patients with hereditary spastic paraparesis.

    Science.gov (United States)

    Rinaldi, Martina; Ranavolo, Alberto; Conforto, Silvia; Martino, Giovanni; Draicchio, Francesco; Conte, Carmela; Varrecchia, Tiwana; Bini, Fabiano; Casali, Carlo; Pierelli, Francesco; Serrao, Mariano

    2017-10-01

    The aim of this study was to investigate the lower limb muscle coactivation and its relationship with muscles spasticity, gait performance, and metabolic cost in patients with hereditary spastic paraparesis. Kinematic, kinetic, electromyographic and energetic parameters of 23 patients and 23 controls were evaluated by computerized gait analysis system. We computed ankle and knee antagonist muscle coactivation indexes throughout the gait cycle and during the subphases of gait. Energy consumption and energy recovery were measured as well. In addition to the correlation analysis between coactivation indexes and clinical variables, correlations between coactivation indexes and time-distance, kinematic, kinetic, and energetic parameters were estimated. Increased coactivity indexes of both knee and ankle muscles throughout the gait cycle and during the subphases of gait were observed in patients compared with controls. Energetic parameters were significantly higher in patients than in controls. Both knee and ankle muscle coactivation indexes were positively correlated with knee and ankle spasticity (Ashworth score), respectively. Knee and ankle muscle coactivation indexes were both positively correlated with energy consumption and both negatively correlated with energy recovery. Positive correlations between the Ashworth score and lower limb muscle coactivation suggest that abnormal lower limb muscle coactivation in patients with hereditary spastic paraparesis reflects a primary deficit linked to lower limb spasticity. Furthermore, these abnormalities influence the energetic mechanisms during walking. Identifying excessive muscle coactivation may be helpful in individuating the rehabilitative treatments and designing specific orthosis to restrain spasticity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Cost-effectiveness analysis for a tele-based health coaching program for chronic disease in primary care.

    Science.gov (United States)

    Oksman, Erja; Linna, Miika; Hörhammer, Iiris; Lammintakanen, Johanna; Talja, Martti

    2017-02-15

    The burden of chronic disease and multimorbidity is rapidly increasing. Self-management support interventions are effective in reduce cost, especially when targeted at a single disease group; however, economical evidence of such complex interventions remains scarce. The objective of this study was to evaluate a cost-effectiveness analysis of a tele-based health-coaching intervention among patients with type 2 diabetes (T2D), coronary artery disease (CAD) and congestive heart failure (CHF). A total of 1570 patients were blindly randomized to intervention (n = 970) and control (n = 470) groups. The intervention group received monthly individual health coaching by telephone from a specially trained nurse for 12-months in addition to routine social and healthcare. Patients in the control group received routine social and health care. Quality of life was assessed at the beginning of the intervention and follow-up measurements were made after 12 months health coaching. The cost included all direct health-care costs supplemented with home care and nursing home-care costs in social care. Utility was based on a Health Related Quality of Life (HRQoL) measurement (15D instrument), and cost effectiveness was assessed using incremental cost-effectiveness ratios (ICERs). The cost-effectiveness of health coaching was highest in the T2D group (ICER €20,000 per Quality-Adjusted Life Years [QALY]). The ICER for the CAD group was more modest (€40,278 per QALY), and in the CHF group, costs increased with no marked effect on QoL. Probabilistic sensitivity analysis indicated that at the societal willingness to pay threshold of €50,000 per QALY, the probability of health coaching being cost effective was 55% in the whole study group. The cost effectiveness of health coaching may vary substantially across patient groups, and thus interventions should be targeted at selected subgroups of chronically ill. Based on the results of this study, health coaching improved the QoL of

  18. Outline of cost-benefit analysis and a case study

    Science.gov (United States)

    Kellizy, A.

    1978-01-01

    The methodology of cost-benefit analysis is reviewed and a case study involving solar cell technology is presented. Emphasis is placed on simplifying the technique in order to permit a technical person not trained in economics to undertake a cost-benefit study comparing alternative approaches to a given problem. The role of economic analysis in management decision making is discussed. In simplifying the methodology it was necessary to restrict the scope and applicability of this report. Additional considerations and constraints are outlined. Examples are worked out to demonstrate the principles. A computer program which performs the computational aspects appears in the appendix.

  19. COST BENEFIT ANALYSIS OF A DG INTEGRATED SYSTEM: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ch. V. S. S. SAILAJA

    2017-09-01

    Full Text Available Distributed Generation is capable of meeting the load of the consumers partially or completely. Depending on the type of DG involved it can be operated in interconnected mode and islanded mode. The availability of numerous alternatives present for the DG technologies and large initial investments necessitates a detailed cost benefit analysis for the implementation of DG technologies. In this work an attempt has been made to study the costs involved in implementing the DG technologies. A practical system having two kinds of distributed generation i.e., Diesel Generator and solar photovoltaic system for its back up purpose is considered. A detailed cost analysis of the two DG technologies is carried out.

  20. Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer.

    Science.gov (United States)

    Lam, Simon W; Wai, Maya; Lau, Jessica E; McNamara, Michael; Earl, Marc; Udeh, Belinda

    2017-01-01

    Gastric cancer is the fifth most common malignancy and second leading cause of cancer-related mortality. Chemotherapy options for patients who fail first-line treatment are limited. Thus the objective of this study was to assess the cost-effectiveness of second-line treatment options for patients with advanced or metastatic gastric cancer. Cost-effectiveness analysis using a Markov model to compare the cost-effectiveness of six possible second-line treatment options for patients with advanced gastric cancer who have failed previous chemotherapy: irinotecan, docetaxel, paclitaxel, ramucirumab, paclitaxel plus ramucirumab, and palliative care. The model was performed from a third-party payer's perspective to compare lifetime costs and health benefits associated with studied second-line therapies. Costs included only relevant direct medical costs. The model assumed chemotherapy cycle lengths of 30 days and a maximum number of 24 cycles. Systematic review of literature was performed to identify clinical data sources and utility and cost data. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. The primary outcome measure for this analysis was the ICER between different therapies, where the incremental cost was divided by the number of QALYs saved. The ICER was compared with a willingness-to-pay (WTP) threshold that was set at $50,000/QALY gained, and an exploratory analysis using $160,000/QALY gained was also used. The model's robustness was tested by using 1-way sensitivity analyses and a 10,000 Monte Carlo simulation probabilistic sensitivity analysis (PSA). Irinotecan had the lowest lifetime cost and was associated with a QALY gain of 0.35 year. Docetaxel, ramucirumab alone, and palliative care were dominated strategies. Paclitaxel and the combination of paclitaxel plus ramucirumab led to higher QALYs gained, at an incremental cost of $86,815 and $1,056,125 per QALY gained, respectively. Based on our prespecified