Sample records for cost analysis study

  1. Educational Cost Analysis in Action: Case Studies for Planners -- II. (United States)

    Coombs, Philip H.; Hallak, Jacques

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

  2. Educational Cost Analysis in Action: Case Studies for Planners -- III. (United States)

    Coombs, Philip H.; Hallak, Jacques

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

  3. Educational Cost Analysis in Action: Case Studies for Planners -- I. (United States)

    Coombs, Philip H.; Hallak, Jacques

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

  4. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

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


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

  5. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

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


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

  6. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

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


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

  7. Analysis of the Data From a Technical Processing Cost Study. (United States)

    Rocke, Hans Joachim

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

  8. Cost analysis of prenatal care using the activity-based costing model: a pilot study. (United States)

    Gesse, T; Golembeski, S; Potter, J


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

  9. Life support system cost study: Addendum to cost analysis of carbon dioxide concentrators (United States)

    Yakut, M. M.


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

  10. Educational Cost Analysis. (United States)

    Flynn, Donald L.

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

  11. Cost of Poor Quality Analysis for Automobile Industry: A Case Study (United States)

    Teli, S. N.; Majali, V. S.; Bhushi, U. M.; Gaikwad, L. M.; Surange, V. G.


    The high competitiveness makes the quest for production cost reduction a constant in the market, but it is necessary to reduce costs without compromising quality. When a product is in the manufacturing and this has to be scraped, we have more cost than the raw material used, it is necessary to consider the manpower and operations, thus to calculate the cost added to the product. Continuous quality improvement is a key factor in the strategy for competitiveness. Quality cost is one tool, among many others, that can help in continuous quality improvement. Properly applying quality cost techniques is critical to these efforts. Initially, a complete quality cost study could provide awareness and guidance to a steering committee on what cross-discipline teams and improvement projects should be started. The cross discipline teams also can use quality cost special studies to help in focusing efforts. In this paper cost of poor quality analysis has been done using different techniques which are currently applying in automobile industry to assess quality cost.

  12. The Real Cost of "Cosmetic Tourism" Cost Analysis Study of "Cosmetic Tourism" Complications Presenting to a Public Hospital. (United States)

    Livingston, Ryan; Berlund, Paul; Eccles-Smith, Jade; Sawhney, Raja


    "Cosmetic Tourism," the process of traveling overseas for cosmetic procedures, is an expanding global phenomenon. The model of care by which these services are delivered can limit perioperative assessment and postoperative follow-up. Our aim was to establish the number and type of complications being treated by a secondary referral hospital resulting from "cosmetic tourism" and the cost that has been incurred by the hospital in a 1-year period. Retrospective cost analysis and chart review of patients admitted to the hospital between the financial year of 2012 and 2013 were performed. Twelve "cosmetic tourism" patients presented to the hospital, requiring admission during the study period. Breast augmentation was the most common procedure and infected prosthesis was the most common complication (n = 4). Complications ranged from infection, pulmonary embolism to penile necrosis. The average cost of treating these patients was $AUD 12 597.71. The overall financial burden of the complication to the hospital was AUD$151 172.52. The "cosmetic tourism" model of care appears to be, in some cases, suboptimal for patients and their regional hospitals. In the cases presented in this study, it appears that care falls on the patient local hospital and home country to deal with the complications from their surgery abroad. This incurs a financial cost to that hospital in addition to redirecting medical resources that would otherwise be utilized for treating noncosmetic complications, without any remuneration to the local provider.

  13. A study in cost analysis of aggregate production as depending on drilling and blasting design (United States)

    Bilim, Niyazi; Çelik, Arif; Kekeç, Bilgehan


    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. Accidents at work and costs analysis: a field study in a large Italian company. (United States)

    Battaglia, Massimo; Frey, Marco; Passetti, Emilio


    Accidents at work are still a heavy burden in social and economic terms, and action to improve health and safety standards at work offers great potential gains not only to employers, but also to individuals and society as a whole. However, companies often are not interested to measure the costs of accidents even if cost information may facilitate preventive occupational health and safety management initiatives. The field study, carried out in a large Italian company, illustrates technical and organisational aspects associated with the implementation of an accident costs analysis tool. The results indicate that the implementation (and the use) of the tool requires a considerable commitment by the company, that accident costs analysis should serve to reinforce the importance of health and safety prevention and that the economic dimension of accidents is substantial. The study also suggests practical ways to facilitate the implementation and the moral acceptance of the accounting technology.

  15. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study (United States)

    Saperi, Bin Sulong; Ramli, Roszalina; Ahmed, Zafar; Muhd Nur, Amrizal; Ibrahim, Mohd Ismail; Rashdi, Muhd Fazlynizam; Nordin, Rifqah; Rahman, Normastura Abd; Yusoff, Azizah; Nazimi, Abd Jabar; Abdul Rahman, Roselinda; Abdul Razak, Noorhayati; Mohamed, Norlen


    Objective Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. PMID:28223831

  16. Including health economic analysis in pilot studies: lessons learned from a cost-utility analysis within the PROSPECTIV pilot study

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    Richéal M. Burns


    Full Text Available PurposeTo assess feasibility and health economic benefits and costs as part of a pilot study for a nurse-led, psychoeducational intervention (NPLI for prostate cancer in order to understand the potential for cost effectiveness as well as contribute to the design of a larger scale trial.MethodsMen with stable prostate cancer post-treatment were recruited from two cancer centres in the UK. Eighty-three men were randomised to the NLPI plus usual care or usual care alone (UCA (42 NLPI and 41 UCA; the NLPI plus usual care was delivered in the primary-care setting (the intervention and included an initial face-to-face consultation with a trained nurse, with follow-up tailored to individual needs. The study afforded the opportunity to undertake a short-term within pilot analysis. The primary outcome measure for the economic evaluation was quality of life, as measured by the EuroQol five dimensions questionnaire (EQ-5D (EQ-5D-5L instrument. Costs (£2014 assessed included health-service resource use, out-of-pocket expenses and losses from inability to undertake usual activities.ResultsTotal and incremental costs varied across the different scenarios assessed, with mean cost differences ranging from £173 to £346; incremental effect, as measured by the change in utility scores over the duration of follow-up, exhibited wide confidence intervals highlighting inconclusive effectiveness (95% CI: -0.0226; 0.0438. The cost per patient of delivery of the intervention would be reduced if rolled out to a larger patient cohort.ConclusionsThe NLPI is potentially cost saving depending on the scale of delivery; however, the results presented are not considered generalisable.

  17. Analysis of Environmental Costs of Mobility due to Urban Sprawl - A Modelling Study on Italian Cities

    NARCIS (Netherlands)

    Travisi, Chiara M.; Camagni, Roberto; Nijkamp, Peter


    A sound empirical and quantitative analysis on the relationship between different patterns of urban expansion and the environmental or social costs of mobility is rare, and the few studies available provide at best a qualitative discussion of these issues. Some recent tentative studies on the

  18. Comparative efficiency research (COMER): meta-analysis of cost-effectiveness studies. (United States)

    Crespo, Carlos; Monleon, Antonio; Díaz, Walter; Ríos, Martín


    The aim of this study was to create a new meta-analysis method for cost-effectiveness studies using comparative efficiency research (COMER). We built a new score named total incremental net benefit (TINB), with inverse variance weighting of incremental net benefits (INB). This permits determination of whether an alternative is cost-effective, given a specific threshold (TINB > 0 test). Before validation of the model, the structure of dependence between costs and quality-adjusted life years (QoL) was analysed using copula distributions. The goodness-of-fit of a Spanish prospective observational study (n = 498) was analysed using the Independent, Gaussian, T, Gumbel, Clayton, Frank and Placket copulas. Validation was carried out by simulating a copula distribution with log-normal distribution for costs and gamma distribution for disutilities. Hypothetical cohorts were created by varying the sample size (n: 15-500) and assuming three scenarios (1-cost-effective; 2-non-cost-effective; 3-dominant). The COMER result was compared to the theoretical result according to the incremental cost-effectiveness ratio (ICER) and the INB, assuming a margin of error of 2,000 and 500 monetary units, respectively. The Frank copula with positive dependence (-0.4279) showed a goodness-of-fit sufficient to represent costs and QoL (p-values 0.524 and 0.808). The theoretical INB was within the 95% confidence interval of the TINB, based on 15 individuals with a probability > 80% for scenarios 1 and 2, and > 90% for scenario 3. The TINB > 0 test with 15 individuals showed p-values of 0.0105 (SD: 0.0411) for scenario 1, 0.613 (SD: 0.265) for scenario 2 and < 0.0001 for scenario 3. COMER is a valid tool for combining cost-effectiveness studies and may be of use to health decision makers.

  19. The Inherent Building Energy-Cost Relationship: An Analysis of Thirty Melbourne Case Studies

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    Yu Lay Langston


    Full Text Available This study investigates the energy and cost performance of thirtyrecent buildings in Melbourne, Australia. Commonly, buildingdesign decisions are based on issues pertaining to constructioncost, and consideration of energy performance is made onlywithin the context of the initial project budget. Even where energyis elevated to more importance, operating energy is seen asthe focus and embodied energy is nearly always ignored. Forthe fi rst time, a large sample of buildings has been assembledand analysed to improve the understanding of both energy andcost performance over their full life cycle. The aim of this paperis to determine the relationship between energy and cost usingregression analysis for a range of building functional types.The conclusion is that energy and cost are strongly correlated,independent of building area, and equations are presented forfuture modelling of energy using cost as the independent variable.

  20. Comparative cost analysis of inpatient integrative medicine-Results of a pilot study. (United States)

    Ostermann, Thomas; Lauche, Romy; Cramer, Holger; Dobos, Gustav


    Costs of integrative treatment alone and in comparison with other treatment approaches have scarcely been reported in the past. This study presents results of a comparative cost analysis of an inpatient integrative medicine treatment costs. Data from 2006 for inpatients referred to a Department of Integrative Medicine in Germany were used. Case-related treatment costs were calculated, and transformed into Casemix-Indices and revenues per DRG. Costs were compared between departments at the same hospital and between different hospitals using univariate statistics and Chi-Square tests. In total 1253 inpatients (81.4% female, 61.1±14.4years) were included in the current analysis. Most patients were treated for diseases of the musculoskeletal system (57.2%), followed by diseases of the digestive system (11.4%), and diseases of the nervous system (10.4%). The department received an additional payment for most of the patients (88.0%), which led to an effective appreciation of 10.8% per case compared to the standardized Casemix-Index. In-house comparisons with other departments found the department in close vicinity to the departments of Internal medicine with regards to CMI and mean revenue, however the Patient Clinical Complexity Level was significantly lower in the Integrative medicine department. The interhospital comparison revealed comparable Casemix-Index and DRG-revenue, however the additional payment increased the mean revenue significantly. Modern integrative in-patient treatment is mostly cost-equivalent to conventional treatment. Cost effectiveness studies should be considered to further investigate the potential of integrative in patient treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Improving Library Management by Using Cost Analysis Tools: A Case Study for Cataloguing Processes

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    Lorena Siguenza-Guzman


    Full Text Available TTDABC is a relatively new costing management technique, initially developed for manufacturing processes, which is gaining attention in libraries. This is because TDABC is a fast and simple method that only requires two parameters, an estimation of time required to perform an activity and the unit cost per time of supplying capacity. A few case studies have been documented with regard to TDABC in libraries; all of them being oriented to analyse specific library activities such as inter-library loan, acquisition and circulation processes. The primary focus of this paper is to describe TDABC implementation in one of the most important library processes, namely cataloguing. In particular, original and copy cataloguing are analysed through a case study to demonstrate the applicability and usefulness of TDABC to perform cost analysis of cataloguing processes.

  2. Cost-utility analysis of stenting versus endarterectomy in the International Carotid Stenting Study. (United States)

    Morris, Stephen; Patel, Nishma V; Dobson, Joanna; Featherstone, Roland L; Richards, Toby; Luengo-Fernandez, Ramon; Rothwell, Peter M; Brown, Martin M


    The International Carotid Stenting Study was a multicenter randomized trial in which patients with symptomatic carotid artery stenosis were randomly allocated to treatment by carotid stenting or endarterectomy. Economic evidence comparing these treatments is limited and inconsistent. We compared the cost-effectiveness of stenting versus endarterectomy using International Carotid Stenting Study data. We performed a cost-utility analysis estimating mean costs and quality-adjusted life years per patient for both treatments over a five-year time horizon based on resource use data and utility values collected in the trial. Costs of managing stroke events were estimated using individual patient data from a UK population-based study (Oxford Vascular Study). Mean costs per patient (95% CI) were US$10,477 ($9669 to $11,285) in the stenting group (N = 853) and $9669 ($8835 to $10,504) in the endarterectomy group (N = 857). There were no differences in mean quality-adjusted life years per patient (3.247 (3.160 to 3.333) and 3.228 (3.150 to 3.306), respectively). There were no differences in adjusted costs between groups (mean incremental costs for stenting versus endarterectomy $736 (95% CI -$353 to $1826)) or adjusted outcomes (mean quality-adjusted life years gained -0.010 (95% CI -0.117 to 0.097)). The incremental net monetary benefit for stenting versus endarterectomy was not significantly different from zero at the maximum willingness to pay for a quality-adjusted life year commonly used in the UK. Sensitivity analyses showed little uncertainty in these findings. Economic considerations should not affect whether patients with symptomatic carotid stenosis undergo stenting or endarterectomy. © 2016 World Stroke Organization.

  3. A cost-effectiveness analysis to illustrate the impact of cost definitions on results, interpretations and comparability of pharmacoeconomic studies in the US. (United States)

    Tunis, Sandra L


    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

  4. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

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    Saperi BS


    Full Text Available Bin Sulong Saperi,1 Roszalina Ramli,2 Zafar Ahmed,1 Amrizal Muhd Nur,1 Mohd Ismail Ibrahim,3 Muhd Fazlynizam Rashdi,2 Rifqah Nordin,2 Normastura Abd Rahman,4 Azizah Yusoff,4 Abd Jabar Nazimi,2 Roselinda Abdul Rahman,4 Noorhayati Abdul Razak,4 Norlen Mohamed 5 1International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 2Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, 3Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, 4School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 5Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia Objective: Facial injury (FI may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]. The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS were performed. Results: A total of 190 patients were enrolled in the study, of whom 83 (43.7% had FI only, and 107 (56.3% had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia. Keywords: facial

  5. Cost analysis of a randomized stem cell mobilization study in multiple myeloma. (United States)

    Varmavuo, Ville; Silvennoinen, Raija; Anttila, Pekka; Säily, Marjaana; Sankelo, Marja; Putkonen, Mervi; Ahonen, Jouni; Mahlamäki, Eija; Mäntymaa, Pentti; Savolainen, Eeva-Riitta; Remes, Kari; Jantunen, Esa


    Upfront autologous stem cell transplantation (ASCT) is the standard therapy for younger multiple myeloma (MM) patients. MM patients usually undergo stem cell mobilization with cyclophosphamide (CY) followed by granulocyte colony-stimulating factor (G-CSF), or with G-CSF alone. A limited number of randomized studies are available comparing costs of different mobilization strategies. Eighty transplant-eligible patients aged up to 70 years with untreated MM were included in this prospective study. The patients were treated with RVD induction for three 21-day cycles and randomized 1:1 at inclusion into one of the two mobilization arms CY 2 g/m(2) + G-CSF [arm A] vs. G-CSF alone [arm B]. Plerixafor was given according to a specific algorithm if needed. Sixty-nine patients who received mobilization followed by blood graft collection were included in the cost analysis. The median total costs of the mobilization phase were significantly higher in arm A than in arm B (3855 € vs. 772 €, p ≤ 0.001). The cumulative median cost of the mobilization and collection phases was significantly lower in arm B than in arm A (8524 € vs. 11,622 €, p = 0.012). There was no significant difference between the arms in the total median costs of ASCT (n = 59) (34,997 € in arm A vs. 31,981 € in arm B, p = 0.118). Mobilization with G-CSF alone seems to be a preferable mobilization method for MM patients in terms of mobilization and apheresis costs. In addition, it requires less hospital resource utilization.

  6. Heliostat cost optimization study (United States)

    von Reeken, Finn; Weinrebe, Gerhard; Keck, Thomas; Balz, Markus


    This paper presents a methodology for a heliostat cost optimization study. First different variants of small, medium sized and large heliostats are designed. Then the respective costs, tracking and optical quality are determined. For the calculation of optical quality a structural model of the heliostat is programmed and analyzed using finite element software. The costs are determined based on inquiries and from experience with similar structures. Eventually the levelised electricity costs for a reference power tower plant are calculated. Before each annual simulation run the heliostat field is optimized. Calculated LCOEs are then used to identify the most suitable option(s). Finally, the conclusions and findings of this extensive cost study are used to define the concept of a new cost-efficient heliostat called `Stellio'.

  7. Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study. (United States)

    Sigurdsson, Eyjolfur; Siggeirsdottir, Kristin; Jonsson, Halldor; Gudnason, Vilmundur; Matthiasson, Thorolfur; Jonsson, Brynjolfur Y


    Total hip replacement (THR) is a common and costly procedure. The number of THR is expected to increase over the coming years. Two pathways of postoperative treatment were compared in a randomized study. Fifty patients from two hospitals were randomized into a study group (SG) of 27 patients receiving preoperative and postoperative education programs, as well as home visits from an outpatient team. A control group (CG) of 23 patients received "conventional" rehabilitation augmented by a stay at a rehabilitation center if needed. All costs for the two groups both in hospitals and after discharge were collected and analyzed. On average total costs for the SG were $8,550 and $11,952 for the CG, a 28% cost reduction. Total inpatient costs were $5,225 for the SG and $6,515 for the CG. In a regression analysis the group difference is statistically significant. Adjusting for changes in the Oxford Hip Score gives effective costs (C/E). The ratio of the SGs C/E to the CGs is 0.60. That is a cost-effectiveness gain of 40%. A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment.

  8. The cost of post-abortion care in developing countries: a comparative analysis of four studies. (United States)

    Vlassoff, Michael; Singh, Susheela; Onda, Tsuyoshi


    Over the last five years, comprehensive national surveys of the cost of post-abortion care (PAC) to national health systems have been undertaken in Ethiopia, Uganda, Rwanda and Colombia using a specially developed costing methodology-the Post-abortion Care Costing Methodology (PACCM). The objective of this study is to expand the research findings of these four studies, making use of their extensive datasets. These studies offer the most complete and consistent estimates of the cost of PAC to date, and comparing their findings not only provides generalizable implications for health policies and programs, but also allows an assessment of the PACCM methodology. We find that the labor cost component varies widely: in Ethiopia and Colombia doctors spend about 30-60% more time with PAC patients than do nurses; in Uganda and Rwanda an opposite pattern is found. Labor costs range from I$42.80 in Uganda to I$301.30 in Colombia. The cost of drugs and supplies does not vary greatly, ranging from I$79 in Colombia to I$115 in Rwanda. Capital and overhead costs are substantial amounting to 52-68% of total PAC costs. Total costs per PAC case vary from I$334 in Rwanda to I$972 in Colombia. The financial burden of PAC is considerable: the expense of treating each PAC case is equivalent to around 35% of annual per capita income in Uganda, 29% in Rwanda and 11% in Colombia. Providing modern methods of contraception to women with an unmet need would cost just a fraction of the average expenditure on PAC: one year of modern contraceptive services and supplies cost only 3-12% of the average cost of treating a PAC patient. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.


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    Catalin IANCU


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

  10. Building Energy and Cost Performance: An Analysis of Thirty Melbourne Case Studies

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    Yu Lay Langston


    Full Text Available This study investigates the energy and cost performance of thirty recent buildings in Melbourne, Australia. Commonly, building design decisions are based on issues pertaining to construction cost, and consideration of energy performance is made only within the context of the initial project budget. Even where energy is elevated to more importance, operating energy is seen as the focus and embodied energy is nearly always ignored. For the first time, a large sample of buildings has been assembled and analyzed to improve the understanding of both energy and cost performance over their full life cycle, which formed the basis of a wider doctoral study into the inherent relationship between energy and cost. The aim of this paper is to report on typical values for embodied energy, operating energy, capital cost and operating cost per square metre for a range of building functional types investigated in this research. The conclusion is that energy and cost have quite different profiles across projects, and yet the mean GJ/m2 or cost/m2 have relatively low coefficients of variation and therefore may be useful as benchmarks of typical building performance.  

  11. Cost-Benefit Analysis for Energy Management in Public Buildings: Four Italian Case Studies

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    Davide Astiaso Garcia


    Full Text Available Improving energy efficiency in public buildings is one of the main challenges for a sustainable requalification of energy issues and a consequent reduction of greenhouse gas (GHG emissions. This paper aims to provide preliminary information about economic costs and energy consumption reductions (benefits of some considered interventions in existing public buildings. Methods include an analysis of some feasible interventions in four selected public buildings. Energy efficiency improvements have been assessed for each feasible intervention. The difference of the building global energy performance index (EPgl has been assessed before and after each intervention. Economic costs of each intervention have been estimated by averaging the amount demanded by different companies for the same intervention. Results obtained show economic costs and the EPgl percentage improvement for each intervention, highlighting and allowing for the comparison of energy consumption reduction and relative economic costs. The research results come from data gathered from four public buildings, and as such they could not be used to generically identify cost-beneficial energy efficiency interventions for every context or building type. However, the data reveals useful cost based considerations for selecting energy efficiency interventions in other public buildings.

  12. Coal gasification systems engineering and analysis. Appendix D: Cost and economic studies (United States)


    The detailed cost estimate documentation for the designs prepared in this study are presented. The include: (1) Koppers-Totzek, (2) Texaco (3) Babcock and Wilcox, (4) BGC-Lurgi, and (5) Lurgi. The alternate product cost estimates include: (1) Koppers-Totzek and Texaco single product facilities (methane, methanol, gasoline, hydrogen), (2) Kopers-Totzek SNG and MBG, (3) Kopers-Totzek and Texaco SNG and MBG, and (4) Lurgi-methane and Lurgi-methane and methanol.

  13. Unit Sizing and Cost Analysis of Renewable Energy based Hybrid Power Generation System - A Case Study

    Directory of Open Access Journals (Sweden)

    Nitin AGARWAL


    Full Text Available A simulation model is developed for optimal sizing and analysis of a PV-diesel-battery based hybrid power generation system with the objectives to minimize life cycle cost and CO2 emission, while maintaining the desired system autonomy. A case study of a boy’s hostel in Moradabad district is taken for analysis purposes. It has 91 rooms with a capacity of 3 boys in each room. The decision variables included in the optimization methodology are total PV area, number of PV modules of 600 Wp, diesel generator power, fuel consumption per year and number of 24 V and 150 Ah batteries. The simulation result shows that the PV percentage of 86 % and diesel penetration of 14 % gives the most optimized solution with minimum LCC of $110,547 and average CO2 emission of 28 kg/day. The developed model has been validated by comparing its results with earlier research work.doi:10.14456/WJST.2014.24

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

    Directory of Open Access Journals (Sweden)

    Majstorović Branislava M.


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

  15. Air Force Reusable Booster System: A Quick-look, Design Focused Modeling and Cost Analysis Study (United States)

    Zapata, Edgar


    This paper presents a method and an initial analysis of the costs of a reusable booster system (RBS) as envisioned by the US Department of Defense (DoD) and numerous initiatives that form the concept of Operationally Responsive Space (ORS). This paper leverages the knowledge gained from decades of experience with the semi-reusable NASA Space Shuttle to understand how the costs of a military next generation semi-reusable space transport might behave in the real world - and how it might be made as affordable as desired. The NASA Space Shuttle had a semi-expendable booster, that being the reusable Solid Rocket MotorslBoosters (SRMlSRB) and the expendable cryogenic External Tank (ET), with a reusable cargo and crew capable orbiter. This paper will explore DoD concepts that invert this architectural arrangement, using a reusable booster plane that flies back to base soon after launch, with the in-space elements of the launch system being the expendable portions. Cost estimating in the earliest stages of any potential, large scale program has limited usefulness. As a result, the emphasis here is on developing an approach, a structure, and the basic concepts that could continue to be matured as the program gains knowledge. Where cost estimates are provided, these results by necessity carry many caveats and assumptions, and this analysis becomes more about ways in which drivers of costs for diverse scenarios can be better understood. The paper is informed throughout with a design-for-cost philosophy whereby the design and technology features of the proposed RBS (who and what, the "architecture") are taken as linked at the hip to a desire to perform a certain mission (where and when), and together these inform the cost, responsiveness, performance and sustainability (how) of the system. Concepts for developing, acquiring, producing or operating the system will be shown for their inextricable relationship to the "architecture" of the system, and how these too relate to costs

  16. An introduction to cost analysis. (United States)

    Camponovo, Ernest


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

  17. Cost Analysis: Methods and Realities. (United States)

    Cummings, Martin M.


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

  18. Multicentre study of haemodialysis costs. (United States)

    Parra Moncasi, E; Arenas Jiménez, M D; Alonso, M; Martínez, M F; Gámen Pardo, A; Rebollo, P; Ortega Montoliú, T; Martínez Terrer, T; Alvarez-Ude, F


    Previous studies to determine the cost of haemodialysis (HD) in Spain have significant limitations: they are outdated or used indirect methods. There is also a lack of analysis performed simultaneously on Public centres (PC), with direct HD services, and partially state-subsidised centres (SC). This is an important issue since the two systems coexist in Spain. To estimate the cost of HD replacement therapy for chronic renal failure in several centres. This is a prospective and publicly-funded study, which estimates the costs for 2008 using a cost accounting system with specific allocation criteria. We collected demographic and comorbidity data for each centre. Six centres participated, two PC and four SC. There were no significant differences between centres in terms of patient demographics, time on haemodialysis and the Charlson comorbidity index. The total cost per patient per year ranged between € 46, 254 and € 33,130. The cost per patient per year (excluding vascular access and hospital admission) for PC was € 42, 547 and € 39, 289 and for SC € 32 872, € 29, 786, € 35, 461 and € 35, 294 (23% more in PC than SC). Costs related to staff/patient/year and consumables/patient/year were 67% and 83% respectively, higher for PC than SC. The highest percentage cost was for staff (average 30.9%), which showed significant variability between centres, both in absolute numbers (staff cost per patient per year between € 18,151 and € 8504) and as a percentage (between 42.6 % and 25.4%). Cost variability exists among different HD centres, and this can be attributed primarily to staff and consumables costs, which is higher for PC than SC.

  19. Variable cost of ICU care, a micro-costing analysis. (United States)

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


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

  20. Fermilab Central Computing Facility: Energy conservation report and mechanical systems design optimization and cost analysis study

    Energy Technology Data Exchange (ETDEWEB)

    Krstulovich, S.F.


    This report is developed as part of the Fermilab Central Computing Facility Project Title II Design Documentation Update under the provisions of DOE Document 6430.1, Chapter XIII-21, Section 14, paragraph a. As such, it concentrates primarily on HVAC mechanical systems design optimization and cost analysis and should be considered as a supplement to the Title I Design Report date March 1986 wherein energy related issues are discussed pertaining to building envelope and orientation as well as electrical systems design.

  1. Is law enforcement of drug-impaired driving cost-efficient? An explorative study of a methodology for cost-benefit analysis. (United States)

    Veisten, Knut; Houwing, Sjoerd; Mathijssen, M P M René; Akhtar, Juned


    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.

  2. Systems cost/performance analysis (study 2.3). Volume 2, appendix A: Data base (United States)


    Data on selected payload equipments (components) which were collected for the purpose of exercising the systems cost performance model are reported in an appendix. The reader should be aware that, although most of the data are accurate, approximations based on engineering judgment and experience are used wherever actual data were unavailable. The approximations are justified by the objective of the study which was to develop a cost/performance model. Assuming that the model is successfully developed and is accepted for use by a body of users, the data base should be expanded and the approximations replaced by actual data.

  3. Answering the Call for Accountability: An Activity and Cost Analysis Case Study (United States)

    Carducci, Rozana; Kisker, Carrie B.; Chang, June; Schirmer, James


    This article summarizes the findings of a case study on the creation and application of an activity-based cost accounting model that links community college salary expenditures to mission-critical practices within academic divisions of a southern California community college. Although initially applied as a financial management tool in private…

  4. A study to evaluate prescribing pattern and cost minimization analysis of antihistamines among patients of allergy

    Directory of Open Access Journals (Sweden)

    Ayesha Vaseem


    Results: Most commonly prescribed antihistamine is cetrizine followed by levocetrizine and fexofenadine. Conclusions: This study demonstrated a significant price difference, ranging from 4% to 83.75% between the branded and generic version of given drugs. This in turn is leading to an increase in the cost of total treatment. [Int J Basic Clin Pharmacol 2016; 5(6.000: 2500-2503

  5. Heliostat cost reduction study.

    Energy Technology Data Exchange (ETDEWEB)

    Jones, Scott A.; Lumia, Ronald. (University of New Mexico, Albuquerque, NM); Davenport, Roger (Science Applications International Corporation, San Diego, CA); Thomas, Robert C. (Advanced Thermal Systems, Centennial, CO); Gorman, David (Advanced Thermal Systems, Larkspur, CO); Kolb, Gregory J.; Donnelly, Matthew W.


    Power towers are capable of producing solar-generated electricity and hydrogen on a large scale. Heliostats are the most important cost element of a solar power tower plant. Since they constitute {approx} 50% of the capital cost of the plant it is important to reduce heliostat cost as much as possible to improve the economic performance of power towers. In this study we evaluate current heliostat technology and estimate a price of $126/m{sup 2} given year-2006 materials and labor costs for a deployment of {approx}600 MW of power towers per year. This 2006 price yields electricity at $0.067/kWh and hydrogen at $3.20/kg. We propose research and development that should ultimately lead to a price as low as $90/m{sup 2}, which equates to $0.056/kWh and $2.75/kg H{sup 2}. Approximately 30 heliostat and manufacturing experts from the United States, Europe, and Australia contributed to the content of this report during two separate workshops conducted at the National Solar Thermal Test Facility.

  6. Cost analysis study of oral antidiabetic drugs available in Indian market

    Directory of Open Access Journals (Sweden)

    Nisharani B Jadhav, Manisha S Bhosale, Charles V Adhav


    Full Text Available There exists a wide range of variation in the prices of drugs marketed in India and other countries of the world. Very few studies have been conducted to reveal such price variations in the open market. Aim & Objectives: To evaluate the cost of oral anti-diabetics of different generic classes and different brand names of one compound, To evaluate the difference in cost of different brands for the same active drug by calculating percentage variation of cost. Methods: Cost of a particular drug being manufactured by different companies, in the same strength, number and dosage form was compared. The difference in the maximum and minimum price of the same drug manufactured by different pharmaceutical companies and the percentage variation in price was calculated. Results: In Single drug therapy, among sulfonylurea group of drugs, Glimepiride (1 mg shows maximum price variation of 655.38%, while Glipizide (10mg shows variation of 38.88%. In Biguanides & Thizolidinediones groups of drugs, Metformin (500 mg & Pioglitazone (15 mg show maximum price variation of 308.33% & 542% respectively. In α-glucosidases inhibitor group of drugs, Miglitol shows maximum price variation of 135.50 %. In combination therapies, Glipizide & Metformin combination shows the maximum variation up to 399.04 %. Conclusion: The average percentage price variation of different brands of the same drug manufactured in India is very wide and the appraisal and management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative personal and economic consequences

  7. Pre-operative laboratory testing: A prospective study on comparison and cost analysis

    Directory of Open Access Journals (Sweden)

    Venkatesh H Keshavan


    Full Text Available Background and Aims : Pre-operative investigations are performed before any surgical intervention under anaesthesia. Many are considered as routine. However, there are no clear guidelines regarding these in India. We aim to look at the relevance of the laboratory investigations ordered routinely and their cost implications compared with the National Institute of Clinical Excellence (NICE guidelines. Methods: This prospective study was carried out at a tertiary care hospital. A total of 163 patients scheduled for elective surgical procedures were included in this study. Neither the surgeons nor anaesthesiologists involved in the case were aware of the study. The laboratory investigations of the patients who underwent surgery were noted. All values were categorised as normal or abnormal and they were assessed as indicated or unindicated based on NICE guidelines. Results: One hundred and sixty-three patients were subjected to a total of 984 tests. Forty three patients (26% were subjected to tests as per NICE guidelines. Of the 984 tests, 515 tests were unindicated (52%. Out of the 515 unindicated tests, 7 (1.3% were abnormal. None of these seven tests required any intervention or change of anaesthetic plan. The most common unindicated tests done were cardiac echocardiography and chest X-ray (92.5% and 93% respectively. The additional cost incurred towards unindicated tests was 63% of the total cost for the tests. Conclusion: Pre-operative laboratory investigations add to cost significantly. Patient premorbid conditions and surgical grade should guide the clinician to request for the relevant laboratory tests.

  8. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M. Hoogendoorn (Martine); E.A.C. Van Woensel; R.W. Poolman (Rudolf); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)


    textabstractSummary: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost awar

  9. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study

    NARCIS (Netherlands)

    P.T.P.W. Burgers (Paul); M. Hoogendoorn (Martine); E.A.C. Van Woensel; R.W. Poolman (Rudolf); M. Bhandari (Mohit); P. Patka (Peter); E.M.M. van Lieshout (Esther)


    textabstractSummary: The aim of this study was to determine the total medical costs for treating displaced femoral neck fractures with hemi- or total hip arthroplasty in fit elderly patients. The mean total costs per patient at 2 years of follow-up were €26,399. These results contribute to cost

  10. Electrical utility generating system reliability analysis code, SYSREL. Social cost studies program

    Energy Technology Data Exchange (ETDEWEB)

    Hub, K.; Conley, L.; Buehring, W.; Rowland, B.; Stephenson, M.


    The system reliability code, SYSREL, is a system planning tool that can be used to assess the reliability and economic performance of alternative expansion patterns of electric utility generation systems. Given input information such as capacity, forced-outage rate, number of weeks of annual scheduled maintenance, and economic data for individual units along with the expected load characteristics, the code produces estimates of the mean time between system failures, required reserve capacity to meet a specified system-failure-frequency criterion, expected energy generation from each unit, and system energy cost. The categories of calculations performed by the code are maintenance scheduling, reliability, capacity requirement, energy production allocation, and energy cost. The code is designed to examine alternative generating units and system expansion patterns based on the constraints and general economic conditions imposed by the investigator. The computer running time to execute a study is short and many system alternatives can be examined at a relatively low cost. The report contains a technical description of the code, list of input data requirements, program listing, sample execution, and parameter studies. (auth)

  11. Cost-benefit analysis of copper recovery in remediation projects: A case study from Sweden. (United States)

    Volchko, Yevheniya; Norrman, Jenny; Rosén, Lars; Karlfeldt Fedje, Karin


    Contamination resulting from past industrial activity is a problem throughout the world and many sites are severely contaminated by metals. Advances in research in recent years have resulted in the development of technologies for recovering metal from metal-rich materials within the framework of remediation projects. Using cost-benefit analysis (CBA), and explicitly taking uncertainties into account, this paper evaluates the potential social profitability of copper recovery as part of four remediation alternatives at a Swedish site. One alternative involves delivery of copper-rich ash to a metal production company for refining. The other three alternatives involve metal leaching from materials and sale of the resulting metal sludge for its further processing at a metal production company using metallurgical methods. All the alternatives are evaluated relative to the conventional excavation and disposal method. Metal recovery from the ash, metal sludge sale, and disposal of the contaminated soil and the ash residue at the local landfill site, was found to be the best remediation alternative. However, given the present conditions, its economic potential is low relative to the conventional excavation and disposal method but higher than direct disposal of the copper-rich ash for refining. Volatile copper prices, the high cost of processing equipment, the highly uncertain cost of the metal leaching and washing process, coupled with the substantial project risks, contribute most to the uncertainties in the CBA results for the alternatives involving metal leaching prior to refining. However, investment in processing equipment within the framework of a long-term investment project, production of safe, reusable soil residue, and higher copper prices on the metal market, can make metal recovery technology socially profitable. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Accidents at Work and Costs Analysis: A Field Study in a Large Italian Company

    National Research Council Canada - National Science Library

    BATTAGLIA, Massimo; FREY, Marco; PASSETTI, Emilio


    ... to individuals and society as a whole. However, companies often are not interested to measure the costs of accidents even if cost information may facilitate preventive occupational health and safety management initiatives...

  13. Analysis of Modeling Assumptions used in Production Cost Models for Renewable Integration Studies

    Energy Technology Data Exchange (ETDEWEB)

    Stoll, Brady [National Renewable Energy Lab. (NREL), Golden, CO (United States); Brinkman, Gregory [National Renewable Energy Lab. (NREL), Golden, CO (United States); Townsend, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bloom, Aaron [National Renewable Energy Lab. (NREL), Golden, CO (United States)


    Renewable energy integration studies have been published for many different regions exploring the question of how higher penetration of renewable energy will impact the electric grid. These studies each make assumptions about the systems they are analyzing; however the effect of many of these assumptions has not been yet been examined and published. In this paper we analyze the impact of modeling assumptions in renewable integration studies, including the optimization method used (linear or mixed-integer programming) and the temporal resolution of the dispatch stage (hourly or sub-hourly). We analyze each of these assumptions on a large and a small system and determine the impact of each assumption on key metrics including the total production cost, curtailment of renewables, CO2 emissions, and generator starts and ramps. Additionally, we identified the impact on these metrics if a four-hour ahead commitment step is included before the dispatch step and the impact of retiring generators to reduce the degree to which the system is overbuilt. We find that the largest effect of these assumptions is at the unit level on starts and ramps, particularly for the temporal resolution, and saw a smaller impact at the aggregate level on system costs and emissions. For each fossil fuel generator type we measured the average capacity started, average run-time per start, and average number of ramps. Linear programming results saw up to a 20% difference in number of starts and average run time of traditional generators, and up to a 4% difference in the number of ramps, when compared to mixed-integer programming. Utilizing hourly dispatch instead of sub-hourly dispatch saw no difference in coal or gas CC units for either start metric, while gas CT units had a 5% increase in the number of starts and 2% increase in the average on-time per start. The number of ramps decreased up to 44%. The smallest effect seen was on the CO2 emissions and total production cost, with a 0.8% and 0



    Struett, Mirian Aparecida Micarelli; Souza, Antônio Artur de; Raimundini, Simone Letícia


    Brazilian hospital organizations are beginners when it comes to using managing tools. Under these circumstances, cost information becomes essential to the decision making process regarding their financial and operational management. Activity based costing is an example of such tools. Few publications describe researches on the use of this costing method in hospitals. However, there are no reports in the Brazilian hospital literature showing they have ever taken advantage of the use of this co...

  15. 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


    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.)

  16. Cost-benefit analysis for sheltered employment service programs for people with disabilities in Taiwan - a preliminary study. (United States)

    Wang, Yun-Tung; Lin, Yi-Jiun; Shu, Ching-Hsien


    The aim of this study is to do a cost-benefit analysis with monetary and non-monetary benefits for sheltered employment service programs and try to provide more evidence-based information for policy makers and practitioners to understand the outcomes of sheltered employment services. This study analyzed 3 sheltered employment service programs for people with disabilities (2006-2007) implemented by Sunshine Social Welfare Foundation in Taiwan using cost-benefit analysis (including non-monetary benefits). Three groups were analyzed, including participants in the programs, taxpayers, and society (participants and taxpayers). This study found that the net social monetary benefit was $NT29,432.07 per participant per year and the benefit cost ratio was 1.43. (In 2006-2007, $US1 = $NT32.5 averagely around.) The net monetary benefit for the participants was between $NT7,890.86 and $NT91,890.86 per participant per year. On the non-monetary benefit side, the physical health (raised 7.49%), social relationship (raised 3.36%) domains, and general quality of life (raised 2.53%) improved. However, the psychological (decreased 1.51%) and working/environment (decreased 3.85%) domains backslided. In addition, the differences between pre-test and post-test average scores of all domains were not statistically significant. This study is the first to use monetary and non-monetary cost-benefit analysis methods to analyze sheltered employment service programs for people with disabilities in Taiwan. The findings indicated that sheltered employment service programs for people with disabilities could be efficient and beneficial for the whole society and sheltered employees/clients, and also helpful for raising their quality of lives.

  17. Long- vs. short-term energy storage technologies analysis : a life-cycle cost study : a study for the DOE energy storage systems program.

    Energy Technology Data Exchange (ETDEWEB)

    Schoenung, Susan M.; Hassenzahl, William V. (, - Advanced Energy Analysis, Piedmont, CA)


    This report extends an earlier characterization of long-duration and short-duration energy storage technologies to include life-cycle cost analysis. Energy storage technologies were examined for three application categories--bulk energy storage, distributed generation, and power quality--with significant variations in discharge time and storage capacity. More than 20 different technologies were considered and figures of merit were investigated including capital cost, operation and maintenance, efficiency, parasitic losses, and replacement costs. Results are presented in terms of levelized annual cost, $/kW-yr. The cost of delivered energy, cents/kWh, is also presented for some cases. The major study variable was the duration of storage available for discharge.

  18. A retrospective study of the chemical analysis cost for the remediation of Lower East Fork Poplar Creek, Oak Ridge, Tennessee

    Energy Technology Data Exchange (ETDEWEB)

    Klatt, L.N.


    A retrospective study of the remediation of Lower East Fork Poplar Creek (LEFPC) in Oak Ridge, Tennessee was completed. The study was conducted by reviewing the public Comprehensive Environmental Response, Compensation, and Liability Act record documents associated with the remediation of LEFPC and through discussions with the project staff involved or familiar with the project. The remediation took place in two phases. The first phase involved the excavation of about 5,560 yd{sup 3} of soil at the National Oceanic and Atmospheric Administration (NOAA) locations in 1996. The second phase involved the excavation of 39,200 yd{sup 3} at another NOAA location and at the Bruner location in 1997. For the entire project (remedial investigation through cleanup), a total of 7,708 samples (1 sample for each 5.8 yd{sup 3} of soil remediated) were analyzed for mercury. The project obtained special regulatory approval to use two methods for the determination of mercury in soils that are not part of the Resource Conservation and Recovery Act SW-846 methods manual. The mercury analysis cost was $678,000, which represents 9.6% of the cleanup cost. During the cleanup phase of the project, an on-site laboratory was used. The estimated cost savings that the on-site laboratory provided fall into two categories: direct reduction of costs associated with chemical analysis and sample shipment totaling approximately $38,000, which represents a 5.3% savings relative to the estimated cost of using an off-site laboratory, and savings in the amount of $890,000 (12.5% of the $7.1 M cleanup cost), associated with expediting execution of the cleanup work by providing rapid (< 3 hours) sample result turnaround time. The manner in which the analytical services were procured for the LEFPC project suggest that the development of new chemical analysis technology must address deployment, performance, regulatory, robustness, reliability, and business appropriateness factors if the technology is to be

  19. Is treatment with ICS and LABA cost-effective for COPD? Multinational economic analysis of the TORCH study

    DEFF Research Database (Denmark)

    Briggs, A; Glick, H; Lozano-Ortega, G


    ). Regression models were fitted to survival, study medication cost, other medication cost and EQ-5D data in order to estimate total cost, number of QALYs and cost per QALY, adjusted for missing data and region. SFC had a trial-wide estimate of cost per QALY of 43,600 US dollars (USD) compared with P (95...... regions, 3-yr all-cause hospitalisation, medication and outpatient care costs were calculated. The sample was restricted to the 21 countries (n = 4,237) in which European quality of life five-dimension (EQ-5D) data were collected in order to estimate the number of quality-adjusted life years (QALYs...

  20. The cost and benefit analysis of a contaminated area remediation: case study of dose level selection

    Energy Technology Data Exchange (ETDEWEB)

    Lauria, D.C. [Instituto de Radioproteccion e Dosimetria- IRD/CNEN, Av. Salvador Allende s/n, Barra de Tijuca, Rio de Janeiro- RJ (Brazil)]. e-mail:


    In recent years there has been an increasing awareness of the radiological impact of non-nuclear industries that extract and/or process ores and minerals containing naturally occurring radioactive material (NORM). Without radiological rules, these industrial activities may result in significant radioactive contamination of installations and sites. Depending on the potential hazardous to the environment and public health, the radioactive contaminated sites may require remediation. The extent of the site cleanup is a function of the size, localization, complexity, potential risks and on possible future uses envisioned for the site. Since worker and public health, public anxiety and economics factors are involved; the selection of an appropriate dose level can be quite complicated. This paper discusses the selection of a dose level criterion to remedy a site, which was contaminated by wastes from monazite processing. The site is located in the Sao Paulo city; the most densely populated Brazilian City. In its 60,000 square meters of area, a preliminary survey showed contaminated zones covering an area of 6,500 square meters. In some places, contamination was found below the superficial layer of the soil, being the radionuclide vertical distribution not uniform. The {sup 228} Ra soil activity concentration reached values up to 33,000 Bq/kg while those for {sup 226} Ra reached values up to 6,700 Bq/kg. Based on pathway analysis model and considering both the current land use and a hypothetical residential scenario, the residual contamination levels of radionuclides in soil have been derived for dose values of 10 mSv/y (dose level for intervention), 5 mSv/y, 3 mSv/y, 1 mSv/y (dose limit for practices) and 0.3 mSv/y (dose constraint for practices). An optimized value o f annual dose of about 5 mSv/y would be a good option for intervention level, but taking into account the public concern and anxiety, the site location and size, and the remediation costs, it is suggested

  1. Complexity Management - A multiple case study analysis on control and reduction of complexity costs

    DEFF Research Database (Denmark)

    Myrodia, Anna

    of products, with features more custom-made to cover individual needs, both regarding characteristics of products and support services. This necessity leads to a considerable increase of the complexity in the company, which affects the product portfolio, production and supply chain, market segments...... product and process complexity. The possible factors for describing this correlation are identified and defined as complexity cost factors (CCFs). By identifying the CCFs this research intends to analyze the most relevant processes where the complexity and cost are directly related to the complexity...

  2. Geothermal probabilistic cost study

    Energy Technology Data Exchange (ETDEWEB)

    Orren, L.H.; Ziman, G.M.; Jones, S.C.; Lee, T.K.; Noll, R.; Wilde, L.; Sadanand, V.


    A tool is presented to quantify the risks of geothermal projects, the Geothermal Probabilistic Cost Model (GPCM). The GPCM model is used to evaluate a geothermal reservoir for a binary-cycle electric plant at Heber, California. Three institutional aspects of the geothermal risk which can shift the risk among different agents are analyzed. The leasing of geothermal land, contracting between the producer and the user of the geothermal heat, and insurance against faulty performance are examined. (MHR)

  3. An Analysis and Evaluation of Regional Cost of Education Indexes for New York State. Study #5. (United States)

    Furno, Orlando F.; Gaughan, James M.

    The proposed New York State Cost of Education Index would be a statistical measure of the price changes in the goods and services purchased by local districts. Data would be available on a regional basis. Many statistical procedures and theoretical considerations involved in constructing such an index are similar to those used for the Consumer…

  4. Absence of appropriate hospitalization cost control for patients with medical insurance: a comparative analysis study. (United States)

    Pan, Xilong; Dib, Hassan H; Zhu, Minmin; Zhang, Ying; Fan, Yang


    Expose the weak loops in the Chinese medical insurance coverage and uncover hospitals' role of over-pricing hospitalized insured patients compared with those non-insured. A multi-linear regression method was used to analyze hospitalization expense for insured and uninsured patients with uncomplicated acute appendicitis, cholecystitis, benign uterine tumors, and normal delivery. Hospitalization cost is higher among insured than uninsured patients due to longer hospitalization lengths of stay, type of disease (highest among cholecystitis patients), type of gender - females, old-aged people, and type of marital status - singles, as well as drugs expenses, surgical expenses, and other medical acts. Require a better government's supervision system over medical insurance expenses such as reforming methods of payments, building up new cost compensation mechanism, and unifying and stabilizing prices for each category of medicines.

  5. What can we do to reduce the associated costs in induction of labour of intrauterine growth restriction foetuses at term? A cost-analysis study. (United States)

    Duro-Gómez, Jorge; Garrido-Oyarzún, María Fernanda; Rodríguez-Marín, Ana Belén; de la Torre González, Antonio Jesús; Arjona-Berral, José Eduardo; Castelo-Branco, Camil


    To evaluate the costs associated with induction of labour in intrauterine growth restriction fetuses comparing different procedures. 150 pregnancies at term diagnosed with intrauterine growth restriction and indication for induction of labour were included. 24 were ripened with misoprostol 25 μg tablets, 24 with dinoprostone 10 mg vaginal insert, and 77 with Cook(®) cervical ripening balloon. To determine the costs of induction of labour, method of induction, intrapartum medication, epidural analgesia, type of delivery, and maternal and neonatal admissions were considered. Statistical analysis was performed using the G-Stat 2.0 free statistical software. ANOVA test was used for comparisons between quantitative parametric variables. Chi-squared test or Fisher test was used for qualitative variables. A value of p Costs related to maternal admissions were higher in CG (475.13 ± 146.95$) than dinoprostone group (475.13 ± 146.95$) or MG (427.97 ± 112.65$) (p = 0.03). Total costs in misoprostol group (2765.18 ± 495.38$) were lower than in the dinoprostone group (3075.774 ± 896.14$) or Cook(®) balloon group (3228.02 ± 902.06$) groups. Misoprostol for induction of labour had lower related costs than dinoprostone or Cook(®) balloon, with similar obstetrical and perinatal outcomes.

  6. Cornerstone Third Party Alternative Cost Study

    Energy Technology Data Exchange (ETDEWEB)

    Vrieling, P. Douglas [Sandia National Lab. (SNL-CA), Livermore, CA (United States)


    The attached cost analyses sheets have been developed for use in planning during the Third Party Alternative study currently underway for the Sandia CREATE project. This cost analysis builds upon the previously submitted base estimate dated June 14, 2013 and includes comparison information collected during a Market Validation exercise conducted in August/September 2013.

  7. Lean Cost Management Analysis on Food Processing Enterprise

    Directory of Open Access Journals (Sweden)

    Jing Ma


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

  8. Cost Benefit Studies. Final Report. (United States)

    Weiner, Arthur; Marson, Arthur A.

    This document applies Dr. Mehar Aurora's method for conducting cost benefit studies to the Food Manufacturing Technology-Dairy and the Food Manufacturing Technology-Canning and Freezing programs offered by the Moraine Park Technical Institute. Costs to individual students enrolled in the programs include tuition, fees, housing, travel, books,…

  9. Cost analysis helps evaluate contract profitability. (United States)

    Sides, R W


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

  10. Space biology initiative program definition review. Trade study 5: Modification of existing hardware (COTS) versus new hardware build cost analysis (United States)

    Jackson, L. Neal; Crenshaw, John, Sr.; Davidson, William L.; Blacknall, Carolyn; Bilodeau, James W.; Stoval, J. Michael; Sutton, Terry


    The JSC Life Sciences Project Division has been directly supporting NASA Headquarters, Life Sciences Division, in the preparation of data from JSC and ARC to assist in defining the Space Biology Initiative (SBI). GE Government Services and Horizon Aerospace have provided contract support for the development and integration of review data, reports, presentations, and detailed supporting data. An SBI Definition (Non-Advocate) Review at NASA Headquarters, Code B, has been scheduled for the June-July 1989 time period. In a previous NASA Headquarters review, NASA determined that additional supporting data would be beneficial to determine the potential advantages in modifying commercial off-the-shelf (COTS) hardware for some SBI hardware items. In order to meet the demands of program implementation planning with the definition review in late spring of 1989, the definition trade study analysis must be adjusted in scope and schedule to be complete for the SBI Definition (Non-Advocate) Review. The relative costs of modifying existing commercial off-the-shelf (COTS) hardware is compared to fabricating new hardware. An historical basis for new build versus modifying COTS to meet current NMI specifications for manned space flight hardware is surveyed and identified. Selected SBI hardware are identified as potential candidates for off-the-shelf modification and statistical estimates on the relative cost of modifying COTS versus new build are provided.

  11. A Two-Stage Intercontinental Ballistic Missile (ICBM) Design Optimization Study and Life Cycle Cost Analysis (United States)


    dollars. 6.5 Summary of Results - The System Performance Matriz The results of the NEMESIS systems engineering study are summarized in Table 6.12. Note...Edition. Boston , MA: PWS Engineering, 1984. 43. Hall, A.D. "Three-Dimensional Morphology of Systems Engineering." IEEE Transactions on Systems, Science and

  12. Cost-effectiveness analysis in markets with high fixed costs. (United States)

    Cutler, David M; Ericson, Keith M Marzilli


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

  13. An improved set of standards for finding cost for cost-effectiveness analysis. (United States)

    Barnett, Paul G


    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.


    Directory of Open Access Journals (Sweden)

    Murat ÖZTÜRK


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

  15. Cost-Benefit Analysis and Assessment of Ergonomic Interventions Effects: Case Study Boiler and Equipment Engineering and Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Iraj Mohammad faam


    Full Text Available Background & Objectives: In Economic and competitive world today,cost-benefit analysis is one of the most important parameters for any intervention.The purpose of thisstudy was cost-benefit analysis of ergonomic interventions effects in Boiler and Equipment Engineering and Manufacturing Company. Methods:At first all workstations of the company assessed using QEC. Thenthose earned more than 70% in QEC assessed by OWAS. By analyzing the results of these two methods, the “Haarp welding” workstation selected as the critical one. After presentation of possible solutions in specialized committee, the final solution selected and cost-benefit analysis done by CyberManS tool. Finally after implementing the intervention workstation reassessed. Findings:The results of the survey showed that the final score of assessment using QEC, OWAS and NASA-TLX before the intervention was 84.7%, 3 and 75.4, respectively and after the intervention was 47.5%, 1 and 42.7 that witnesses a significant reduction in all three methods of assessment. Also the result of cost-benefit analysis by CyberManS showed that by spending 110 million rials after 1.5 years the investment returned and profitability initiated. Conclusion:In addition to reducing the risk of musculoskeletal disorders, ergonomic interventions have financial benefits by increasing the productivity and production, reducing the compensation and the lost work days can also cause financial benefits.

  16. A cost-benefit analysis of document management strategies used at a financial institution in Zimbabwe: A case study


    Rodreck David; Patrick Ngulube; Adock Dube


    Background: Choosing a cost-effective document management approach has become a priority to many organisations, especially in view of the rapidly changing technological environment in which information is being created and managed. A literature survey indicated that document management strategies have the potential to provide some substantial cost-saving benefits if they are used judiciously.Objectives: This study investigated a commercial bank’s document management approaches in a bid to asc...

  17. Project cost analysis under risk

    Directory of Open Access Journals (Sweden)

    Florica LUBAN


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

  18. Incorporating psychological influences in probabilistic cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard; Alvaro, Mariana; Edwards, William


    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

  19. Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle


    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....

  20. Integrated analysis considered mitigation cost, damage cost and adaptation cost in Northeast Asia (United States)

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


    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

  1. Cost analysis for heavy equipment in earthfill work - An optimization of heavy equipment fleet (Case study: Jabung ring dike project) (United States)

    Arifin, Muhammad Faizal Ardhiansyah


    Earth fill work with large volumes of soil deposits will involve a lot of heavy equipment with a variety of functions and with different objectives. Where each machine will have different productivity anyway. So that in this paper discusses the calculation of the cost required to do the compacted earthfill work for embankment in accordance with the volume of work, the target date for implementation, and the number of heavy equipment needs. As the cost calculations used heavy equipment rental price per hour. In the cost analysis calculations use heavy equipment here there are several factors that we included in the calculation, are: 1.)Hauling distance; 2.)Effective hour a day; 3.)Change factor of Soil Volume; 4.)Effective Speed; 5.)Equipment efficiency factor; 6.)Equipment coefficient; 7.)Cycle Time.


    Directory of Open Access Journals (Sweden)

    Nikola J Budimir


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

  3. 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)


    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.

  4. Economic analysis of the cost of Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Mazetas D.


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

  5. 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....

  6. Cost-effectiveness analysis of corticosteroid inhaler devices in primary care asthma management: A real world observational study

    Directory of Open Access Journals (Sweden)

    Linda Kemp


    Full Text Available Linda Kemp1, John Haughney2, Neil Barnes3, Erika Sims1, Julie von Ziegenweidt1, Elizabeth V Hillyer1, Amanda J Lee4, Alison Chisholm1, David Price1,21Research in Real Life Ltd, Old Winery Business Park, Cawston, Norwich, UK; 2Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, UK; 3Department of Respiratory Medicine, London Chest Hospital, Bonner Road, London, UK; 4Medical Statistics Team, Section of Population Health, University of Aberdeen, Foresterhill, Aberdeen, UKPurpose: To evaluate and compare real world cost-effectiveness of inhaled corticosteroids (ICS administered by metered dose inhaler (MDI, breath-actuated MDI (BAI, or dry powder inhaler (DPI in asthma.Patients and methods: This retrospective database study analyzed the direct health care costs and proportion of patients (aged 5–60 years achieving asthma control over 1 year in two population groups: those starting ICS (initiation population and those receiving a first increase in ICS dose (step-up population. Asthma control was defined as no unplanned asthma visits, oral corticosteroids, or antibiotics for lower respiratory infection; outcomes were adjusted for confounding variables. Cost-effectiveness of BAI and DPI were compared with MDI.Results: For the initiation population (n = 56,347, average annual health care costs per person (adjusted results, as compared with MDIs, were £9 higher (95% CI: -1.65 to 19.71 for BAIs and £32 higher (95% CI: 19.51 to 43.66 for DPIs. The probability of BAIs being the dominant strategy (more effective and less costly than MDIs was 5% and of BAIs being more effective and more costly than MDIs was 94%. DPIs were consistently more effective and more costly than MDIs, with an incremental cost-effectiveness ratio of £1711 (95% CI: 760 to 3,576 per additional controlled patient per year. For the step-up population (n = 9169, mean total health care costs per person, (adjusted as compared with

  7. Manufacturing cost analysis of integrated photonic packages (United States)

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


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

  8. Chapter 17. Engineering cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Higbee, Charles V.


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

  9. Low cost real time interactive analysis system (United States)

    Stetina, F.


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

  10. Unsedated peroral wireless pH capsule placement vs. standard pH testing: A randomized study and cost analysis

    Directory of Open Access Journals (Sweden)

    Andrews Christopher N


    Full Text Available Abstract Background Wireless capsule pH-metry (WC is better tolerated than standard nasal pH catheter (SC, but endoscopic placement is expensive. Aims: to confirm that non-endoscopic peroral manometric placement of WC is as effective and better tolerated than SC and to perform a cost analysis of the available esophageal pH-metry methods. Methods Randomized trial at 2 centers. Patients referred for esophageal pH testing were randomly assigned to WC with unsedated peroral placement or SC after esophageal manometry (ESM. Primary outcome was overall discomfort with pH-metry. Costs of 3 different pH-metry strategies were analyzed: 1 ESM + SC, 2 ESM + WC and 3 endoscopically placed WC (EGD + WC using publicly funded health care system perspective. Results 86 patients (mean age 51 ± 2 years, 71% female were enrolled. Overall discomfort score was less in WC than in SC patients (26 ± 4 mm vs 39 ± 4 mm VAS, respectively, p = 0.012 but there were no significant group differences in throat, chest, or overall discomfort during placement. Overall failure rate was 7% in the SC group vs 12% in the WC group (p = 0.71. Per patient costs ($Canadian were $1475 for EGD + WC, $1014 for ESM + WC, and $906 for ESM + SC. Decreasing the failure rate of ESM + WC from 12% to 5% decreased the cost of ESM + WC to $991. The ESM + SC and ESM + WC strategies became equivalent when the cost of the WC device was dropped from $292 to $193. Conclusions Unsedated peroral WC insertion is better tolerated than SC pH-metry both overall and during placement. Although WC is more costly, the extra expense is partially offset when the higher patient and caregiver time costs of SC are considered. Trial registration Identifier NCT01364610

  11. Summit Station Skiway Cost Analysis (United States)


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

  12. Cost-effectiveness analysis of gemcitabine, S-1 and gemcitabine plus S-1 for treatment of advanced pancreatic cancer based on GEST study. (United States)

    Zhou, Jing; Zhao, Rongce; Wen, Feng; Zhang, Pengfei; Tang, Ruilei; Du, Zedong; He, Xiaofeng; Zhang, Jian; Li, Qiu


    Gemcitabine (GEM) alone, S-1 alone and gemcitabine plus S-1 (GS) have shown a marginal clinical benefit for the treatment of advanced pancreatic cancer. However, there is no clearly defined optimal cost-effectiveness treatment. The objective of this study was to assess the cost-effectiveness of GEM alone, S-1 alone and GS for the treatment of advanced pancreatic cancer based on GEST study for public payers. A decision model compared GEM alone, S-1 alone and GS. Primary base case data were identified using the GEST study and the literatures. Costs were estimated from West China Hospital, Sichuan University, China, and incremental cost-effectiveness ratios (ICERs) were calculated. Survival benefits were reported in quality-adjusted life-months (QALMs). Sensitive analyses were performed by varying potentially modifiable parameters of the model. The base case analysis showed that the GEM cost $21,912 and yielded survival of 6.93 QALMs, S-1 cost $19,371 and yielded survival of 7.90 QALMs and GS cost $22,943 and yielded survival of 7.46 QALMs in the entire treatment. The one-way sensitivity analyses showed that the ICER of S-1 was driven mostly by the S-1 group utility score of stable state compared with GEM, and the GEM group utility score of progressed state played a key role on the ICER of GS compared with GEM. S-1 represents an attractive cost-effective treatment for advanced pancreatic cancer, given the favorable cost per QALM and improvement in clinical efficacy, especially the limited available treatment options.

  13. Analysis and modeling of rail maintenance costs

    Directory of Open Access Journals (Sweden)

    Amir Ali Bakhshi


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

  14. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry


    Popova Viktoriya D.


    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 ...

  15. Cost Accounting and Analysis for University Libraries. (United States)

    Leimkuhler, Ferdinand F.; Cooper, Michael D.

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

  16. Suitability Analysis of Office Building Design against Maintenance Cost (Case Study of Serayu Opak River Basin Organization, Yogyakarta Province

    Directory of Open Access Journals (Sweden)

    Mario Puji Hersanto


    Full Text Available This study aims to determine the effect of building design's inaccuracy against the cost of maintenance, by taking the research in Serayu Opak River Basin Organization, Water Resources Field and Water Resources Management Center in Yogyakarta Special Region. The first step is to analyze the inaccuracy of building design based on the result of interview and observation during field survey. The second step is to analyze the cost of building maintenance. The third step is to analyze the maintenance costs used to minimize the effects of the inaccurate design of the building. The result shows the inaccuracy of building design in the form of the use of clear glass without coated glass film and the absence of heat insulator on the roof of the building cause the room to become hot. The installation of rain gutters without vertical pipes, toilet facilities in the entire building is not yet complete, inadequate accessibility for persons with disabilities, and inadequate corridor design. There is a small portion of the maintenance budget used for reducing the impact of building design's inaccuracy, so it can be concluded that the design of the building is less meet the requirements of the Government regulations.

  17. Cost/efficacy analysis of preferred Spanish AIDS study group regimens and the dual therapy with LPV/r+3TC for initial ART in HIV infected adults

    Directory of Open Access Journals (Sweden)

    Josép M Gatell


    Full Text Available Introduction: The National AIDS Plan and the Spanish AIDS study group (GESIDA panel of experts propose “preferred regimens” of antiretroviral treatment (ART as initial therapy in HIV-infected patients for 2013 [1]. All these regimens are triple therapy regimens. The Gardel Study assessed the efficacy and safety of a dual therapy (DT combination of lopinavir/ritonavir (LPV/r 400/100 mg BID+ lamivudine (3TC 150 mg BID [2]. The objective of this study is to evaluate the costs and efficiency of initiating treatment with the GESIDA “preferred regimens” and DT. Materials and Methods: Economic assessment of costs and efficiency (cost/efficacy through decision tree analysis models. Efficacy was defined as the probability of having viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance tests during the first 48 weeks. The payer perspective (Spanish National Health System was applied considering only differential direct costs: ART (official prizes, management of adverse effects, resistance tests, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was conducted, building three scenarios for each regime: base, most favourable and most unfavourable cases. Results: In the base case scenario, the cost of initiating treatment ranges from 5138 euros for DT, to 12,059 euros for tenofovir DF/emtricitabine (TDF/FTC+raltegravir (RAL. The efficacy ranges between 0.66 for abacavir (ABC/3TC+LPV/r and ABC/3TC+atazanavir (ATV/r, and 0.88 for DT. Efficiency, in terms of cost/efficacy, varies between 5817 and 13,930 euros per responder at 48 weeks, for DT and TDF/FTC+RAL respectively. DT is the most efficient regimen in the most favourable (5503 euros per responder and most unfavourable (6169 euros per responder

  18. Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study (United States)

    Smith, Megan; Lew, Jie-Bin; Walker, Robert; Moss, Sue; Kitchener, Henry; Patnick, Julietta; Canfell, Karen


    Objectives To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). Design Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. Setting English NHS Cervical Cancer Screening Programme. Interventions Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. Main outcome measures Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. Results Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost £358 222 (€440 426; $574 910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by £9388 per 1000 women treated. Conclusions Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme. PMID:23117060

  19. Activity Analysis and Cost Analysis in Medical Schools. (United States)

    Koehler, John E.; Slighton, Robert L.

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

  20. Heliostat production evaluation and cost analysis

    Energy Technology Data Exchange (ETDEWEB)

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


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

  1. Cost benefit analysis for climate change adaption

    NARCIS (Netherlands)

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


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

  2. Jail Removal Cost Study. Volume 2. (United States)

    Illinois Univ., Champaign. Community Research Center.

    This second volume of the jail removal cost study provides a detailed report of the study findings which examine the costs, experiences, and ramifications of removing children from adult jails and lockups. The foreword supplies background information and hypothetical removal cost estimates. The approach used to conduct the jail removal cost study…

  3. Green Infrastructure Siting and Cost Effectiveness Analysis (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.

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

    Directory of Open Access Journals (Sweden)

    Verena Getahun


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

  5. Cost analysis of youth violence prevention. (United States)

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


    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.

  6. Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Bjorknas study.

    Directory of Open Access Journals (Sweden)

    Sanjib Saha

    Full Text Available BACKGROUND: Lifestyle interventions affect patients' risk factors for metabolic syndrome (MeSy, a pre-stage to cardiovascular diseases, diabetes and related complications. An effective lifestyle intervention is the Swedish Björknäs intervention, a 3-year randomized controlled trial in primary care for MeSy patients. To include future disease-related cost and health consequences in a cost-effectiveness analysis, a simulation model was used to estimate the short-term (3-year and long-term (lifelong cost-effectiveness of the Björknäs study. METHODOLOGY/ PRINCIPAL FINDINGS: A Markov micro-simulation model was used to predict the cost and quality-adjusted life years (QALYs for MeSy-related diseases based on ten risk factors. Model inputs were levels of individual risk factors at baseline and at the third year. The model estimated short-term and long-term costs and QALYs for the intervention and control groups. The cost-effectiveness of the intervention was assessed using differences-in-differences approach to compare the changes between the groups in the health care and societal perspectives, using a 3% discount rate. A 95% confidence interval (CI, based on bootstrapping, and sensitivity analyses describe the uncertainty in the estimates. In the short-term, costs are predicted to increase over time in both groups, but less in the intervention group, resulting in an average cost saving/reduction of US$-700 (in 2012, US$1=six point five seven SEK and US$-500, in the societal and health care perspectives. The long-term estimate also predicts increased costs, but considerably less in the intervention group: US$-7,300 (95% CI: US$-19,700 to US$-1,000 in the societal, and US$-1,500 (95% CI: US$-5,400 to US$2,650 in the health care perspective. As intervention costs were US$211 per participant, the intervention would result in cost saving. Furthermore, in the long-term an estimated 0.46 QALYs (95% CI: 0.12 to 0.69 per participant would be gained

  7. Terminal patients in Belgian nursing homes: a cost analysis. (United States)

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


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

  8. Maintenance cost study of rotary wing aircraft (United States)


    The feasibility was studied of predicting rotary wing operation maintenance costs by using several aircraft design factors for the aircraft dynamic systems. The dynamic systems considered were engines, drives and transmissions, rotors, and flight controls. Multiple regression analysis was used to correlate aircraft design and operational factors with manhours per flight hour, and equations for each dynamic system were developed. Results of labor predictions using the equations compare favorably with actual values.

  9. A Framework for Statewide Analysis of Site Suitability, Energy Estimation, Life Cycle Costs, Financial Feasibility and Environmental Assessment of Wind Farms: A Case Study of Indiana (United States)

    Kumar, Indraneel

    In the last decade, Midwestern states including Indiana have experienced an unprecedented growth in utility scale wind energy farms. For example, by end of 2013, Indiana had 1.5 GW of wind turbines installed, which could provide electrical energy for as many as half-a-million homes. However, there is no statewide systematic framework available for the evaluation of wind farm impacts on endangered species, required necessary setbacks and proximity standards to infrastructure, and life cycle costs. This research is guided to fill that gap and it addresses the following questions. How much land is suitable for wind farm siting in Indiana given the constraints of environmental, ecological, cultural, settlement, physical infrastructure and wind resource parameters? How much wind energy can be obtained? What are the life cycle costs and economic and financial feasibility? Is wind energy production and development in a state an emission free undertaking? The framework developed in the study is applied to a case study of Indiana. A fuzzy logic based AHP (Analytic Hierarchy Process) spatial site suitability analysis for wind energy is formulated. The magnitude of wind energy that could be sited and installed comprises input for economic and financial feasibility analysis for 20-25 years life cycle of wind turbines in Indiana. Monte Carlo simulation is used to account for uncertainty and nonlinearity in various costs and price parameters. Impacts of incentives and cost variables such as production tax credits, costs of capital, and economies of scale are assessed. Further, an economic input-output (IO) based environmental assessment model is developed for wind energy, where costs from financial feasibility analysis constitute the final demand vectors. This customized model for Indiana is used to assess emissions for criteria air pollutants, hazardous air pollutants and greenhouse gases (GHG) across life cycle events of wind turbines. The findings of the case study include

  10. Cost Models: A Study in Persuasion (United States)

    Fauley, Franz E.


    The article defines the major elements (fundamental questions, basic assumptions, anticipated costs, projected savings, and return on investment) of a cost model, discusses the function and importance of each of these elements, and illustrates the development and construction of a cost model through an analysis of a hypothetical speed reading…

  11. Cost analysis and estimating tools and techniques

    CERN Document Server

    Nussbaum, Daniel


    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),...

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

    Directory of Open Access Journals (Sweden)

    Hossam E. Hosny


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

  13. Challenges of Opportunity Cost Analysis in Planning REDD+: A Honduran Case Study of Social and Cultural Values Associated with Indigenous Forest Uses

    Directory of Open Access Journals (Sweden)

    Spencer T. Plumb


    Full Text Available The REDD Programme is predicated on the assumption that developed countries will provide sufficient funds to offset opportunity costs associated with avoiding deforestation. The role of non-market values in indigenous land management may challenge the efficacy of compensation schemes targeted at meeting opportunity costs as calculated in traditional opportunity cost analysis (OCA. Furthermore it is unclear how these economic incentives might affect social and cultural values linked to land-use norms, livelihoods, and local governance. This study explores the economic, social and cultural values of forest uses for a Miskito community in the Rio Plátano Biosphere Reserve in Honduras. Data were collected using household surveys, farm visits, and community workshops. OCA indicates potential for successful REDD+ payment schemes; however it is an inadequate method to account for subsistence and cultural opportunity costs associated with avoided deforestation. Compensation to change land-use practices may undermine governance institutions necessary to address deforestation in the region. Our results indicate that small-scale agriculture and other forest-based subsistence activities are important cultural practices for maintaining Miskito identity and forest management institutions. Recommendations are offered for using OCA to develop REDD+ projects that recognize the linkages between social and cultural values and forest management by focusing on approaches that consider a full range of economic, social and cultural opportunity costs.

  14. Management and cost analysis of cancer patients treated with G-CSF: a cohort study based on the French national healthcare insurance database. (United States)

    Tilleul, Patrick; Jacot, William; Emery, Corinne; Lafuma, Antoine; Gourmelen, Julie


    To describe the management and costs associated with G-CSF therapy in cancer patients in France. This study analyzed a representative random population sample from the French national healthcare insurance database, focusing on 1,612 patients with hematological or solid malignancies who were reimbursed in 2013 or 2014 for at least one G-CSF treatment dispensed in a retail pharmacy. Patient characteristics and treatment costs were analyzed according to the type of cancer. Then the costs and characteristics of patients associated with the use of different G-CSF products were analyzed in the sub-set of breast cancer patients. The most frequent malignancies in the database population were breast cancer (23.3%), hematological malignancies (22.2%), and lung cancer (12.4%). The reimbursed G-CSF was pegfilgrastim in 34.1% of cases, lenograstim in 26.7%, and filgrastim in 17.9%. More than one G-CSF product was reimbursed to 21.3% of patients. The total annual reimbursed health expenses per patient, according to the type of G-CSF, were €27,001, €24,511, and €20,802 for patients treated with filgrastim, lenograstim, and pegfilgrastim, respectively. Ambulatory care accounted for, respectively, 35%, 38%, and 41% of those costs. In patients with breast cancer, ambulatory care cost was €7,915 with filgrastim, €7,750 with lenograstim, and €6,989 with pegfilgrastim, and the respective cost of G-CSF was €1,733, €1,559, and €3,668. All available G-CSF products have been shown to be effective in cancer patients, and both daily G-CSFs and pegylated G-CSF are recommended in international guidelines. Nevertheless, this analysis of G-CSF reimbursement indicates that the choice of product can markedly affect the total cost of ambulatory care.

  15. Cost-minimization analysis in the treatment of spasticity in children with cerebral palsy with botulinum toxin type A: an observational, longitudinal, retrospective study

    Directory of Open Access Journals (Sweden)

    Gloria Tapias


    Full Text Available Objective: Cost-minimization analysis of onabotulinumtoxinA and abobotulinumtoxinA, taking into account the real dose administered to children with spasticity associated with dynamic equinus foot deformity due to cerebral palsy. Method: A single centre, observational, longitudinal, and retrospective study which included spastic paediatric patients aged 2-to-18-years and treated with onabotulinumtoxinA or abobotulinumtoxinA from December 1995 to October 2012, in the Paediatric Neurology Unit of a first-level Spanish hospital. A longitudinal analysis of spasticity severity was made to confirm the similar efficacy of both treatments. Cost minimization was analyzed using the dose administered and the direct costs (pharmacological and medical visits costs from the perspective of the National Health System (in euros from 2016. Results: We analyzed 895 patients with paediatric spasticity: 543 were treated only with onabotulinumtoxinA, 292 only with abobotulinumtoxinA, and 60 with both treatments. The mean doses administered were 5.44 U/kg (SD = 2.17 for onabotulinumtoxinA, and 14.73 U/kg (5.26 for abobotulinumto xinA. The total annual direct cost (pharmacological and medical visits was € 839.56 for onabotulinumtoxinA and € 631.23 for abobotulinumtoxinA, which represents a difference of € 208.34 per year in favour of treatment with abobotulinumtoxinA Conclusions: It has been demonstrated that in real clinical practice, the cost per patient and year for treatment of paediatric spasticity was lower when abobotulinumtoxinA was used.

  16. Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis. (United States)

    O'Connor, Joanne; McCaughan, Dorothy; McDaid, Catriona; Booth, Alison; Fayter, Debra; Rodriguez-Lopez, Roccio; Bowers, Roy; Dyson, Lisa; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita


    BACKGROUND Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). OBJECTIVES To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. METHODS Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review - 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium,, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis - a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis. RESULTS Qualitative study - a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients' prime desired outcome was a reduction in pain, falls or trips, with improved

  17. An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel) versus conventional paclitaxel for metastatic breast cancer patients: the COSTANza study (United States)

    Lazzaro, Carlo; Bordonaro, Roberto; Cognetti, Francesco; Fabi, Alessandra; De Placido, Sabino; Arpino, Grazia; Marchetti, Paolo; Botticelli, Andrea; Pronzato, Paolo; Martelli, Elisa


    Purpose Paclitaxel albumin (nab-paclitaxel) is a nanoparticle albumin-bound paclitaxel formulation aimed at increasing therapeutic index in metastatic breast cancer. When compared to conventional paclitaxel, nab-paclitaxel has a reported longer time to progression, higher response, lower incidence of neutropenia, no need for premedication, shorter time of administration, and in pretreated metastatic breast cancer patients, extended overall survival. This study investigates the cost-effectiveness of nab-paclitaxel versus conventional paclitaxel for pretreated metastatic breast cancer patients in Italy. Materials and methods A Markov model with progression-free, progressed, and dead states was developed to estimate costs, outcomes, and quality adjusted life years over 5 years from the Italian National Health Service viewpoint. Patients were assumed to receive nab-paclitaxel 260 mg/m2 three times weekly or conventional paclitaxel 175 mg/m2 three times weekly. Data on health care resource consumption was collected from a convenience sample of five Italian centers. Resources were valued at Euro (€) 2011. Published utility weights were applied to health states to estimate the impact of response, disease progression, and adverse events on quality adjusted life years. Three sensitivity analyses tested the robustness of the base case incremental cost-effectiveness ratio (ICER). Results and conclusion Compared to conventional paclitaxel, nab-paclitaxel gains an extra 0.165 quality adjusted life years (0.265 life years saved) and incurs additional costs of €2506 per patient treated. This translates to an ICER of €15,189 (95% confidence interval: €11,891–€28,415). One-way sensitivity analysis underscores that ICER for nab-paclitaxel remains stable despite varying taxanes cost. Threshold analysis shows that ICER for nab-paclitaxel exceeds €40,000 only if cost per mg of conventional paclitaxel is set to zero. Probabilistic sensitivity analysis highlights that nab

  18. Orthotic management of instability of the knee related to neuromuscular and central nervous system disorders: systematic review, qualitative study, survey and costing analysis. (United States)

    O'Connor, Joanne; McCaughan, Dorothy; McDaid, Catriona; Booth, Alison; Fayter, Debra; Rodriguez-Lopez, Roccio; Bowers, Roy; Dyson, Lisa; Iglesias, Cynthia P; Lalor, Simon; O'Connor, Rory J; Phillips, Margaret; Ramdharry, Gita


    Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken. Data were analysed for thematic content. A coding scheme was developed and an inductive approach was used to identify themes. Systematic review - 18 databases were searched up to November 2014: MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Cumulative Index to Nursing and Allied Health, EMBASE, PASCAL, Scopus, Science Citation Index, BIOSIS Previews, Physiotherapy Evidence Database, Recal Legacy, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Health Technology Assessment database, Cochrane Central Register of Controlled Trials, Conference Proceedings Citation Index: Science, Health Management Consortium,, International Clinical Trials Registry Platform and National Technical Information Service. Studies of adults using an orthosis for instability of the knee related to NMD or a CNS disorder were included. Data were extracted and quality was assessed by two researchers. Narrative synthesis was undertaken. Survey and costing analysis - a web survey of orthotists, physiotherapists and rehabilitation medicine physicians was undertaken. Telephone interviews with orthotists informed a costing analysis. Qualitative study - a total of 24 people participated. Potential for engagement in daily activities was of vital importance to patients; the extent to which their device enabled this was the yardstick by which it was measured. Patients' prime desired outcome was a reduction in pain, falls or trips, with improved balance and stability. Effectiveness

  19. Cost-benefit analysis of space technology (United States)

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


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

  20. Social cost benefit analysis and energy policy

    NARCIS (Netherlands)

    De Nooij, M.


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

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

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


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

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

    African Journals Online (AJOL)

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

  3. Airlift deployment analysis system life cycle cost analysis

    Energy Technology Data Exchange (ETDEWEB)

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


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

  4. Constellation Program Life-cycle Cost Analysis Model (LCAM) (United States)

    Prince, Andy; Rose, Heidi; Wood, James


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

  5. [Cost analysis of patient blood management]. (United States)

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


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

  6. Cost analysis of whole genome sequencing in German clinical practice. (United States)

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


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

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

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa


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

  8. An Analysis of Rocket Propulsion Testing Costs (United States)

    Ramirez, Carmen; Rahman, Shamim


    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.

  9. Cost analysis of flood-proofing levees


    Šuklje, Matija Jože


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

  10. Fundamental Cost Analysis of Cold Spray (United States)

    Stier, O.


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

  11. Study of cost-effectiveness and cost-utility antihypertensive drugs used in hiperdia peaked - PI


    NapoleÃo Moura Dias Neto


    Hypertension is a major cause of cardiovascular disease and study the costeffectiveness and cost-utility of anti-hypertensive drugs are rare in Brazil. This paper is a study of type pharmacoeconomic cost-effectiveness and cost-utility analysis of patients enrolled in the program HiperDia the municipality of Picos â PI in the period 20/8/2009 to 30/10/2009. We analyzed the direct costs of treatment, considering only the price of antiretroviral drugs, the effectiveness as measured by mean re...

  12. Long-term healthcare costs and functional outcomes associated with lack of remission in schizophrenia: a post-hoc analysis of a prospective observational study

    Directory of Open Access Journals (Sweden)

    Haynes Virginia S


    Full Text Available Abstract Background Little is known about the long-term outcomes for patients with schizophrenia who fail to achieve symptomatic remission. This post-hoc analysis of a 3-year study compared the costs of mental health services and functional outcomes between individuals with schizophrenia who met or did not meet cross-sectional symptom remission at study enrollment. Methods This post-hoc analysis used data from a large, 3-year prospective, non-interventional observational study of individuals treated for schizophrenia in the United States conducted between July 1997 and September 2003. At study enrollment, individuals were classified as non-remitted or remitted using the Schizophrenia Working Group Definition of symptom remission (8 core symptoms rated as mild or less. Mental health service use was measured using medical records. Costs were based on the sites’ medical information systems. Functional outcomes were measured with multiple patient-reported measures and the clinician-rated Quality of Life Scale (QLS. Symptoms were measured using the Positive and Negative Syndrome Scale (PANSS. Outcomes for non-remitted and remitted patients were compared over time using mixed effects models for repeated measures or generalized estimating equations after adjusting for multiple baseline characteristics. Results At enrollment, most of the 2,284 study participants (76.1% did not meet remission criteria. Non-remitted patients had significantly higher PANSS total scores at baseline, a lower likelihood of being Caucasian, a higher likelihood of hospitalization in the previous year, and a greater likelihood of a substance use diagnosis (all p Conclusions In this post-hoc analysis of a 3-year prospective observational study, the failure to achieve symptomatic remission at enrollment was associated with higher subsequent healthcare costs and worse functional outcomes. Further examination of outcomes for schizophrenia patients who fail to achieve remission at

  13. Cost-effectiveness analysis of darbepoetin after switch from epoetin-beta in patients on hemodialysis: an Italian single-center retrospective study

    Directory of Open Access Journals (Sweden)

    Mario Eandi


    Full Text Available Darbepoetin (DARB, a human erythropoietin with improved pharmacological parameters (longer half life and a dose-response relationship independent from the route of administration is a new treatment option for chronic nephropathy-induced anemia that in many Italian dialysis centers is substituting older erythropoietins, mainly due to greater ease of use. At current prices and at the theoretical and recommended 200:1 dose conversion factor, DARB pharmaceutical cost ranges from –9% to +17% of EPO cost. In this monocentric study, real drug consumption and related actual costs of a pre-switch semester with EPO were analysed and compared to the first two post-switch semesters with DARB therapy. Furthermore, erythropoetic response was recorded and related to drug exposition levels, in order to establish a real life EPO:DARB dose conversion factor. In this experience, the conversion factor was estimated in at least 250-280:1, depending on the method adopted for the estimation. The initial dose, chosen on the basis of the recommended conversion factor, induced an excessive erythropoietic response, which was generally followed by a dose reduction and successive titration to target desired Hb levels, generating the spiraliform dose-response curve associated with delayed feed-back mechanisms. The pharmacoeconomical analysis, conducted in the perspective of the public health service, indicated that the choice of substituting DARB for EPO in the treatment of chronic kidney failure-associated anemia is univocally convenient, the former being less costly and more effective.

  14. 24 CFR 965.402 - Benefit/cost analysis. (United States)


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

  15. NCHEMS Costing and Data Management System and the Purdue University Cost Study: A Comparison of Narrowly Defined Direct Costs. (United States)

    Eikenberry, F. L.; Gleason, W. M.

    One critical aspect of costing system methodologies is examined: the effects of average costing by course level on program unit cost. The direct costing methodologies used in two costing systems are compared. One is the internally developed Purdue University Cost Study; the other, the NCHEMS Costing and Data Management System. The comparison…

  16. Feasibility of a cost-effective, video analysis software-based mobility protocol for objective spine kinematics and gait metrics: a proof of concept study. (United States)

    Paul, Justin C; Petrizzo, Anthony; Rizzo, John-Ross; Bianco, Kristina; Maier, Stephen; Errico, Thomas J; Lafage, Virginie


    The purpose of this study was to investigate the potential of a high-throughput, easily implemented, cost-effective, video analysis software-based mobility protocol to quantify spine kinematics. This prospective cohort study of clinical biomechanics implemented 2-dimensional (2D) image processing at a tertiary-care academic institution. Ten healthy, able-bodied volunteers were recruited for 2D videography of gait and functional motion. The reliability of a 2D video analysis software program for gait and range of motion metrics was evaluated over 2 independent experimental sessions, assessing for inter-trial, inter-session, and inter-rater reliability. Healthy volunteers were evaluated for simple forward and side bending, rotation, treadmill stride length, and more complex seated-to-standing tasks. Based on established intraclass correlation coefficients, results indicated that reliability was considered good to excellent for simple forward and side bending, rotation, stride length, and more complex sit-to-standing tasks. In conclusion, a cost-effective, 2D, video analysis software-based mobility protocol represents a feasible and clinically useful approach for objective spine kinematics and gait metrics. As the complication rate of operative management in the setting of spinal deformity is weighed against functional performance and quality of life measures, an objective analysis tool in combination with an appropriate protocol will aid in clinical assessments and lead to an increased evidence base for management options and decision algorithms.

  17. Quantitative wound healing studies using a portable, low cost, handheld near-infrared optical scanner: preliminary sensitivity and specificity analysis (United States)

    Lei, Jiali; Rodriguez, Suset; Jayachandran, Maanasa; Solis, Elizabeth; Gonzalez, Stephanie; Perez-Clavijo, Francesco; Wigley, Stephen; Godavarty, Anuradha


    Lower extremity ulcers are devastating complications that are still un-recognized. To date, clinicians employ visual inspection of the wound site during its standard 4-week of healing process via monitoring of surface granulation. A novel ultra-portable near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory that can perform non-contact 2D area imaging of the wound site. From preliminary studies it was observed that the nonhealing wounds had a greater absorption contrast with respect to the normal site, unlike in the healing wounds. Currently, non-contact near-infrared (NIR) imaging studies were carried out on 22 lower extremity wounds at two podiatric clinics, and the sensitivity and specificity of the scanner evaluated. A quantitative optical biometric was developed that differentiates healing from non-healing wounds, based on the threshold values obtained during ROC analysis. In addition, optical images of the wound obtained from weekly imaging studies are also assessed to determine the ability of the device to predict wound healing consistently on a periodic basis. This can potentially impact early intervention in the treatment of lower extremity ulcers when an objective and quantitative wound healing approach is developed. Lastly, the incorporation of MATLAB graphical user interface (GUI) to automate the process of image acquisition, image processing and image analysis realizes the potential of NIROS to perform non-contact and real-time imaging on lower extremity wounds.

  18. Time and travel costs incurred by women attending antenatal tests: A costing study. (United States)

    Verhoef, Talitha I; Daley, Rebecca; Vallejo-Torres, Laura; Chitty, Lyn S; Morris, Stephen


    to estimate the costs to women, their friends and family for different antenatal tests in the Down's syndrome (DS) screening pathway. questionnaire-based costing study. eight maternity clinics across the UK. pregnant women (n=574) attending an appointment for DS screening, NIPT or invasive testing between December 2013 and September 2014. using data collected from the questionnaires we calculated the total costs to women by multiplying the time spent at the hospital and travelling to and from it by the opportunity costs of the women and accompanying person and adding travel and childcare costs. Assumptions about the value of opportunity costs were tested in one-way sensitivity analyses. The main outcome measure was the mean cost to the women and friends/family for each test (DS screening, NIPT, and invasive testing). mean costs to women and their family/friend were £33.96 per visit, of which £22.47 were time costs, £9.15 were travel costs and £2.34 were childcare costs. Costs were lowest for NIPT (£22), £32 for DS screening (£44 if combined with NIPT), and highest for invasive testing (£60). Sensitivity analysis revealed that variations around the value of leisure time opportunity costs had the largest influence on the results. there are considerable costs to women, their friends and family when attending different tests in the DS screening pathway. when assessing the cost-effectiveness of changes to this pathway, costs to women should be considered. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Cost-Effectiveness Analysis of Various Methods of Instruction in Developmental Mathematics. (United States)

    Carman, Robert A.

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

  20. Cost Effectiveness Analysis, A DTIC Bibliography. (United States)


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

  1. Cost-utility analysis of thrombolytic therapy

    NARCIS (Netherlands)

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


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




  3. Cost-effectiveness analysis and innovation. (United States)

    Jena, Anupam B; Philipson, Tomas J


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

  4. New antiepileptic drugs, cost-efficacy analysis

    Directory of Open Access Journals (Sweden)

    P. N. Vlasov


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

  5. Costs Analysis of Iron Casts Manufacturing

    Directory of Open Access Journals (Sweden)

    S. Kukla


    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.

  6. An Italian cost-effectiveness analysis of paclitaxel albumin (nab-paclitaxel versus conventional paclitaxel for metastatic breast cancer patients: the COSTANza study

    Directory of Open Access Journals (Sweden)

    Lazzaro C


    Full Text Available Carlo Lazzaro,1 Roberto Bordonaro,2 Francesco Cognetti,3 Alessandra Fabi,3 Sabino De Placido,4 Grazia Arpino,4 Paolo Marchetti,5 Andrea Botticelli,5 Paolo Pronzato,6 Elisa Martelli7 1Studio di Economia Sanitaria, Milan, Italy; 2Public Hospital Trust Garibaldi, Catania, Italy; 3Istituto dei Tumori Regina Elena, Rome, Italy; 4School of Medicine, Federico II University, Naples, Italy; 5Department of Medical Oncology, School of Medicine, Sapienza University Hospital, Rome, Italy; 6Istituto di Ricovero e Cura a Carattere Scientifico, Azienda Ospedaliera Universitaria San Martino – Isituto Scientifico Tumori, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy; 7Health Economics and Outcomes Research, Celgene Srl, Milan, Italy Purpose: Paclitaxel albumin (nab-paclitaxel is a nanoparticle albumin-bound paclitaxel formulation aimed at increasing therapeutic index in metastatic breast cancer. When compared to conventional paclitaxel, nab-paclitaxel has a reported longer time to progression, higher response, lower incidence of neutropenia, no need for premedication, shorter time of administration, and in pretreated metastatic breast cancer patients, extended overall survival. This study investigates the cost-effectiveness of nab-paclitaxel versus conventional paclitaxel for pretreated metastatic breast cancer patients in Italy. Materials and methods: A Markov model with progression-free, progressed, and dead states was developed to estimate costs, outcomes, and quality adjusted life years over 5 years from the Italian National Health Service viewpoint. Patients were assumed to receive nab-paclitaxel 260 mg/m2 three times weekly or conventional paclitaxel 175 mg/m2 three times weekly. Data on health care resource consumption was collected from a convenience sample of five Italian centers. Resources were valued at Euro (€ 2011. Published utility weights were applied to health states to estimate the impact of response, disease progression, and

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

    Directory of Open Access Journals (Sweden)

    Eminović Nina


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

  8. Cost analysis of cetuximab (Erbitux) plus radiotherapy (ERT) versus concomitant cisplatin plus radiotherapy (CRT) within an NHS oncology unit (single institution): a pilot study. (United States)

    Caroline, Brammer; Sundus, Yahya; Dawn, Dawson; Carol, Glaister; Susan, Merrick


    disease-free survival being 80% in the cisplatin arm vs 40% in the cetuximab (p = 0.097). Cetuximab is still more expensive in simple drug cost terms than cisplatin when delivered with radiotherapy taking into account costs of drugs for toxicity management and nutritional supplements but other resource implications such as inpatient admission, time spent delivering unscheduled care and cost of additional investigations to manage toxicity for patients treated with cisplatin significantly reduce differential. The study suggested significant differences in patient-reported PEG use at 6 months and in time to PEG removal in favour of the cetuximab arm. Advances in knowledge: There is paucity of randomized data on cost analysis for cisplatin vs cetuximab radiotherapy; this trial informs on the cost analysis between the two approaches.

  9. Systems cost/performance analysis (study 2.3). Volume 2, appendix A: Data base. [for unmanned spacecraft (United States)

    Campbell, B. H.


    Data are presented on selected payload equipments (components) which were collected for the purpose of exercising the systems cost/performance model. Although most of the data is accurate, approximations based on engineering judgment and experience are used wherever actual data was unavailable. The equipments are organized according to the following subsystems which use the specific components: stabilization and control, auxiliary propulsion, data processing, communication, and electrical power. The data sheet for each component states which subsystem utilizes the component, which configurations require the component, which equipment type the component is categorized as, and the data base identifier or code number assigned to the component. The data describing the component consist of the following four types: performance, safety, cost, and schedule.

  10. Cost analysis methodology: Photovoltaic Manufacturing Technology Project

    Energy Technology Data Exchange (ETDEWEB)

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


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

  11. Cost-benefit analysis of wetland restoration

    DEFF Research Database (Denmark)

    Dubgaard, Alex


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

  12. Production cost analysis of Euphorbia lathyris. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mendel, D.A.


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

  13. Analysis of costs structure of the industrial enterprise

    Directory of Open Access Journals (Sweden)

    Yuriy V. Kovtunenko


    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.

  14. Final Report: Hydrogen Storage System Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

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


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

  15. Life-cycle preferences over consumption and health: when is cost-effectiveness analysis equivalent to cost-benefit analysis? (United States)

    Bleichrodt, H; Quiggin, J


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

  16. A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted (United States)

    Neumann, Peter J.; Thorat, Teja; Zhong, Yue; Anderson, Jordan; Farquhar, Megan; Salem, Mark; Sandberg, Eileen; Saret, Cayla J.; Wilkinson, Colby; Cohen, Joshua T.


    Introduction Calculating the cost per disability-adjusted life years (DALYs) averted associated with interventions is an increasing popular means of assessing the cost-effectiveness of strategies to improve population health. However, there has been no systematic attempt to characterize the literature and its evolution. Methods We conducted a systematic review of cost-effectiveness studies reporting cost-per-DALY averted from 2000 through 2015. We developed the Global Health Cost-Effectiveness Analysis (GHCEA) Registry, a repository of English-language cost-per-DALY averted studies indexed in PubMed. To identify candidate studies, we searched PubMed for articles with titles or abstracts containing the phrases “disability-adjusted” or “DALY”. Two reviewers with training in health economics independently reviewed each article selected in our abstract review, gathering information using a standardized data collection form. We summarized descriptive characteristics on study methodology: e.g., intervention type, country of study, study funder, study perspective, along with methodological and reporting practices over two time periods: 2000–2009 and 2010–2015. We analyzed the types of costs included in analyses, the study quality on a scale from 1 (low) to 7 (high), and examined the correlation between diseases researched and the burden of disease in different world regions. Results We identified 479 cost-per-DALY averted studies published from 2000 through 2015. Studies from Sub-Saharan Africa comprised the largest portion of published studies. The disease areas most commonly studied were communicable, maternal, neonatal, and nutritional disorders (67%), followed by non-communicable diseases (28%). A high proportion of studies evaluated primary prevention strategies (59%). Pharmaceutical interventions were commonly assessed (32%) followed by immunizations (28%). Adherence to good practices for conducting and reporting cost-effectiveness analysis varied

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

    Directory of Open Access Journals (Sweden)

    Rano K. Sinuraya


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

  18. Trade study for water and waste management concepts. Task 7: Support special analysis. [cost analysis of life support systems for waste utilization during space missions (United States)


    Cost analyses and tradeoff studies are given for waste management in the Space Station, Lunar Surface Bases, and interplanetary space missions. Crew drinking water requirements are discussed and various systems to recycle water are examined. The systems were evaluated for efficiency and weight savings. The systems considered effective for urine water recovery were vapor compression, flash evaporation, and air evaporation with electrolytic pretreatment. For wash water recovery, the system of multifiltration was selected. A wet oxidation system, which can process many kinds of wastes, is also considered.


    Directory of Open Access Journals (Sweden)

    Roy G.A. Massie


    Full Text Available Background: In recent years, Indonesia government has become increasingly concerned with the issues of financing childhood vaccines and immunization programs including vaccine for typhoid  fever. The objective of the analysis is to provide alternative resources and to provide understandable data generated from the Study on Feasibility and Logistics of Vaccination School Age Children With Typhoid Vi-Vaccine in North Jakarta Indonesia. Methods: The analysis was focus on measurement of the cost for vaccinating school children with Typhoid Vi-vaccine from 18 selected primary schools in North Jakarta. The primary source of data was generated from the actual expenditures that were used in the vaccine delivery program in Indonesia. Results: The Vaccination Cost from the Study on Feasibility and Logistics of Vaccination School Age Children with Typhoid Vi-Vaccine conducted by DOMI project is not applicable for public vaccination program. The program might be feasible to be delivered only in private health sector settings.   Key words: Immunization expenditure, vaccine for typhoid fever, North Jakarta Indonesia

  20. Cost-of-illness studies: concepts, scopes, and methods

    Directory of Open Access Journals (Sweden)

    Changik Jo


    Full Text Available Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis.

  1. Analytical trade study of the STS payload environment. [design analysis and cost estimates for noise reduction devices for space shuttle orbiter payloads (United States)

    Rader, W. P.; Barrett, S.; Raratono, J.; Payne, K. R.


    The current predicted acoustic environment for the shuttle orbiter payload bay will produce random vibration environments for payload components and subsystems which potentially will result in design, weight and cost penalties if means of protecting the payloads are not developed. Results are presented of a study to develop, through design and cost effectiveness trade studies, conceptual noise suppression device designs for space shuttle payloads. The impact of noise suppression on environmental levels and associated test costs, and on test philosophy for the various payload classes is considered with the ultimate goal of reducing payload test costs. Conclusions and recommendations are presented.

  2. Power and sample size in cost-effectiveness analysis. (United States)

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


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

  3. Processing Cost Analysis for Biomass Feedstocks

    Energy Technology Data Exchange (ETDEWEB)

    Badger, P.C.


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

  4. Four-State Cost Study. Revised (United States)

    Conger, Sharmila Basu; Bell, Alli; Stanley, Jeff


    As part of Lumina Foundation's state productivity initiative in higher education, the State Higher Education Executive Officers (SHEEO) hosted a discussion of state level higher education cost studies in May 2008. After subsequent conversations with Jane Wellman, Executive Director of the Delta Cost Project, and SHEEO representatives from four…

  5. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services. (United States)

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


    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Hall, M.N., Westinghouse Hanford


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

  7. Minimum Cost Design of Distributed Energy Resources with Studying the Effect of Capital Cost and Replacement Cost

    Directory of Open Access Journals (Sweden)

    Mehdi Nafar


    Full Text Available This study presents an optimized design of HPS in a distribution system including sources like, photovoltaic array, Diesel generator and battery bank.In this research, an algorithm has been developed for evaluation and cost optimization HPS. The costs include capital cost, replacement cost, operation and maintenance cost, fuel cost and production cost for HPS and DG power during different load profile. Then an objective function with aim to minimizing of total costs has been considered. A genetic algorithm approach is employed to obtain the best cost value of HPS construction. This study tested on case study network on Mardasht city in Iran.

  8. Study of short-haul aircraft operating economics. Phase 2: An analysis of the impact of jet modernization on local service airline operating costs (United States)

    Andrastek, D. A.


    The objectives of this phase of the study were (1) to assess the 10 year operating cost trends of the local service airlines operating in the 1965 through 1974 period, (2) to glean from these trends the technological and operational parameters which were impacted most significantly by the transition to newer pure jet, short haul transports, and effected by changing fuel prices and cost of living indices, and (3) to develop, construct, and evaluate an operating cost forecasting model which would incorporate those factors which best predicted airline total operating cost behavior over that 10-year period.

  9. Nuclear Power Plant Module, NPP-1: Nuclear Power Cost Analysis. (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,…

  10. Register-based studies of healthcare costs

    DEFF Research Database (Denmark)

    Kruse, Marie; Christiansen, Terkel


    a comprehensive data material, often in the form of time series, which is very useful in health economic analyses. The disadvantage of register-based data is the use of tariffs, charges, or market prices as proxies for costs in the computation of healthcare costs.......Introduction: The aim of this paper is to provide an overview and a few examples of how national registers are used in analyses of healthcare costs in Denmark. Research topics: The paper focuses on health economic analyses based on register data. For the sake of simplicity, the studies are divided...... into three main categories: economic evaluations of healthcare interventions, cost-of-illness analyses, and other analyses such as assessments of healthcare productivity. Conclusion: We examined a number of studies using register-based data on healthcare costs. Use of register-based data renders...

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

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle


    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...

  12. Cost-benefit considerations in regulatory analysis

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  13. Cost Benefit Analysis of Boat Lifts (United States)


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

  14. Marianas Boat Fishing Cost Earnings Study 2011 (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data represent a cost-earnings study of the boat based fishing in the Mariana Archipelago fielded in 2011. Data collected include fisher classification, vessel...

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

    Directory of Open Access Journals (Sweden)

    Vandemheen Katherine


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

  16. Register-based studies of healthcare costs

    DEFF Research Database (Denmark)

    Kruse, Marie; Christiansen, Terkel


    Introduction: The aim of this paper is to provide an overview and a few examples of how national registers are used in analyses of healthcare costs in Denmark. Research topics: The paper focuses on health economic analyses based on register data. For the sake of simplicity, the studies are divide...... a comprehensive data material, often in the form of time series, which is very useful in health economic analyses. The disadvantage of register-based data is the use of tariffs, charges, or market prices as proxies for costs in the computation of healthcare costs....

  17. Cost effectiveness analysis of hemiarthroplasty and total shoulder arthroplasty. (United States)

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


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

  18. Melt analysis of mismatch amplification mutation assays (Melt-MAMA: a functional study of a cost-effective SNP genotyping assay in bacterial models.

    Directory of Open Access Journals (Sweden)

    Dawn N Birdsell

    Full Text Available Single nucleotide polymorphisms (SNPs are abundant in genomes of all species and biologically informative markers extensively used across broad scientific disciplines. Newly identified SNP markers are publicly available at an ever-increasing rate due to advancements in sequencing technologies. Efficient, cost-effective SNP genotyping methods to screen sample populations are in great demand in well-equipped laboratories, but also in developing world situations. Dual Probe TaqMan assays are robust but can be cost-prohibitive and require specialized equipment. The Mismatch Amplification Mutation Assay, coupled with melt analysis (Melt-MAMA, is flexible, efficient and cost-effective. However, Melt-MAMA traditionally suffers from high rates of assay design failures and knowledge gaps on assay robustness and sensitivity. In this study, we identified strategies that improved the success of Melt-MAMA. We examined the performance of 185 Melt-MAMAs across eight different pathogens using various optimization parameters. We evaluated the effects of genome size and %GC content on assay development. When used collectively, specific strategies markedly improved the rate of successful assays at the first design attempt from ~50% to ~80%. We observed that Melt-MAMA accurately genotypes across a broad DNA range (~100 ng to ~0.1 pg. Genomic size and %GC content influence the rate of successful assay design in an independent manner. Finally, we demonstrated the versatility of these assays by the creation of a duplex Melt-MAMA real-time PCR (two SNPs and conversion to a size-based genotyping system, which uses agarose gel electrophoresis. Melt-MAMA is comparable to Dual Probe TaqMan assays in terms of design success rate and accuracy. Although sensitivity is less robust than Dual Probe TaqMan assays, Melt-MAMA is superior in terms of cost-effectiveness, speed of development and versatility. We detail the parameters most important for the successful application of

  19. Cost of breast cancer treatment. A 4-year longitudinal study. (United States)

    Legorreta, A P; Brooks, R J; Leibowitz, A N; Solin, L J


    To determine the longitudinal cost of the treatment of patients with breast cancer. An analysis was performed of 200 women with 205 newly diagnosed breast cancers during 1989 in a health maintenance organization population (US Healthcare, Blue Bell, Pa). Medical records and claims data were analyzed for the total costs of medical care during the 4-year period after diagnosis. The costs over time were analyzed for clinical stage and use of mammography screening. The total costs of medical care during the 4-year period after diagnosis were strongly related to clinical stage at diagnosis, with higher total costs for patients with stages III to IV at diagnosis compared with patients with stages 0 to II at diagnosis. The cost for all stages of disease declined after years 1 to 2, with the exception of stage II, which increased slightly in years 3 to 4. The use of screening mammography was associated with a significant decrease in the cost of medical care during the 4-year study period. The goal of mammography screening programs should be to achieve downstaging to stages 0 to 1 to achieve reduction in breast cancer mortality and to reduce the overall consumption of health care resources for the treatment of breast cancer. These cost data should be considered within the framework of future cost-effective analysis for screening mammography programs.

  20. How to Appropriately Extrapolate Costs and Utilities in Cost-Effectiveness Analysis. (United States)

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


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

  1. Cost Analysis of Ceramic Heads in Primary Total Hip Arthroplasty. (United States)

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


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

  2. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar


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

  3. Cost Analysis of Poor Quality Using a Software Simulation

    Directory of Open Access Journals (Sweden)

    Jana Fabianová


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

  4. Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Sach Tracey


    Full Text Available Abstract Background Evidence demonstrates that measures are needed to optimise therapy and improve administration of medicines in care homes for older people. The aim of this study is to determine the clinical and cost effectiveness of a novel model of multi-professional medication review. Methods A cluster randomised controlled trial design, involving thirty care homes. In line with current practice in medication reviews, recruitment and consent will be sought from general practitioners and care homes, rather than individual residents. Care homes will be segmented according to size and resident mix and allocated to the intervention arm (15 homes or control arm (15 homes sequentially using minimisation. Intervention homes will receive a multi-professional medication review at baseline and at 6 months, with follow-up at 12 months. Control homes will receive usual care (support they currently receive from the National Health Service, with data collection at baseline and 12 months. The novelty of the intervention is a review of medications by a multi-disciplinary team. Primary outcome measures are number of falls and potentially inappropriate prescribing. Secondary outcome measures include medication costs, health care resource use, hospitalisations and mortality. The null hypothesis proposes no difference in primary outcomes between intervention and control patients. The primary outcome variable (number of falls will be analysed using a linear mixed model, with the intervention specified as a fixed effect and care homes included as a random effect. Analyses will be at the level of the care home. The economic evaluation will estimate the cost-effectiveness of the intervention compared to usual care from a National Health Service and personal social services perspective. The study is not measuring the impact of the intervention on professional working relationships, the medicines culture in care homes or the generic health-related quality of life of

  5. Analysis of electric vehicle's trip cost without late arrival (United States)

    Leng, Jun-Qiang; Zhao, Lin


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

  6. Life cycle cost analysis for the Plasma Arc Furnace

    Energy Technology Data Exchange (ETDEWEB)

    Barnes-Smith, P.


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

  7. 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.


    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)

  8. Parkinson Symptoms and Health Related Quality of Life as Predictors of Costs: A Longitudinal Observational Study with Linear Mixed Model Analysis.

    Directory of Open Access Journals (Sweden)

    Pablo Martinez-Martín

    Full Text Available To estimate the magnitude in which Parkinson's disease (PD symptoms and health- related quality of life (HRQoL determined PD costs over a 4-year period.Data collected during 3-month, each year, for 4 years, from the ELEP study, included sociodemographic, clinical and use of resources information. Costs were calculated yearly, as mean 3-month costs/patient and updated to Spanish €, 2012. Mixed linear models were performed to analyze total, direct and indirect costs based on symptoms and HRQoL.One-hundred and seventy four patients were included. Mean (SD age: 63 (11 years, mean (SD disease duration: 8 (6 years. Ninety-three percent were HY I, II or III (mild or moderate disease. Forty-nine percent remained in the same stage during the study period. Clinical evaluation and HRQoL scales showed relatively slight changes over time, demonstrating a stable group overall. Mean (SD PD total costs augmented 92.5%, from € 2,082.17 (€ 2,889.86 in year 1 to € 4,008.6 (€ 7,757.35 in year 4. Total, direct and indirect cost incremented 45.96%, 35.63%, and 69.69% for mild disease, respectively, whereas increased 166.52% for total, 55.68% for direct and 347.85% for indirect cost in patients with moderate PD. For severe patients, cost remained almost the same throughout the study. For each additional point in the SCOPA-Motor scale total costs increased € 75.72 (p = 0.0174; for each additional point on SCOPA-Motor and the SCOPA-COG, direct costs incremented € 49.21 (p = 0.0094 and € 44.81 (p = 0.0404, respectively; and for each extra point on the pain scale, indirect costs increased € 16.31 (p = 0.0228.PD is an expensive disease in Spain. Disease progression and severity as well as motor and cognitive dysfunctions are major drivers of costs increments. Therapeutic measures aimed at controlling progression and symptoms could help contain disease expenses.

  9. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism (United States)

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


    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.

  10. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism (United States)

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


    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.

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

    NARCIS (Netherlands)

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


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

  12. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice. (United States)

    Lääperi, A L


    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

  13. Internal Logistics System Selection with Total Cost of Ownership Analysis (United States)

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


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

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

    CERN Document Server

    Baio, Gianluca; Heath, Anna


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

  15. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management. (United States)

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


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

  16. Analysis of Cost Price and Net Profit of Paraclinic Services in Private and Public Sectors: A Case Study of Kerman City 2014

    Directory of Open Access Journals (Sweden)

    Mohammad Jafari Sirizi


    Full Text Available Introduction: Cost is becoming a growing concern for the managers of health and treatment institutes both in private and public sectors. Based on the opinions of pathology and radiology specialists and experts, one private and one public center for radiology and laboratory were selected to study in Kerman City. Method: This is a cross-sectional and applied study. The two centers were similar in frequency of their services, different tests they were conducting, and their number of personnel. Afterwards, the costs of services in both fields were determined using the activity-based costing method. This study was carried out from March 21 to September 22, 2014. The costs of services in both private and public sectors were compared to the tariffs of the Ministry of Health in 2014. Results: Laboratory results indicated that the costs in all the selected tests were higher than the tariffs and the largest difference (app. 84,930 Rls was observed in the TSH test while the smallest difference was observed in the ferritin test (11,940 Rls. However in the private sector, vitamin D and FBS tests were not profitable with differences of about 5500 and 6500 Rls, respectively. In other tests, the costs in the private sector were lower than the tariffs for the private sector. In the private sector radiology center, only the MRI services were not profitable but the other services were. The cost of MRI services in the private sector studied in this research was 190,000 Rls higher than the private sector tariffs. Conclusion: In this study, the results showed that CT scan services were the most profitable services and the price difference was about 203,000 Rls per service. However, all of the radiology services were unprofitable in the public sector and the largest price difference was seen in MRI services which was about 590,000 Rls per service.

  17. Open Latarjet versus arthroscopic Latarjet: clinical results and cost analysis. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Nacef Tazi


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

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

    Directory of Open Access Journals (Sweden)

    Mustafa Younis Ph.D.


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

  20. Relative value units and cost analysis, Part 3 of 4. (United States)

    Glass, Kathryn P; Anderson, Jeffery R


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

  1. Cost-effectiveness analysis of rotavirus vaccination in Argentina. (United States)

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


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

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

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno


    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

  3. Logistics opportunity costs: A mining case study

    Directory of Open Access Journals (Sweden)

    Leani van Jaarsveld


    Full Text Available This study highlighted the importance of determining the impact that an ineffective mode of transport has on a firm’s transportation model and costs. The main focus of this study was to determine the logistics opportunity costs of using road transport within a mining firm. A case study approach was followed, as the investigation aimed to analyse a complex problem experienced by one company and present it in an easily understandable format. From the results of this study, it was apparent that the logistics opportunity costs associated with the mode of transport was substantial. This highlighted the need for firms to revise their choice of transport mode on a regular basis, as it has a major impact not only on their transportation costs, but also on their inventory holding and carbon emissions. The results also have implications for South Africa’s only freight railway, Transnet Freight Rail, which should not only focus on expanding its existing capacity, but also on improving its customer service delivery whilst containing tariff increases.

  4. Intervention and societal costs of residential community reintegration for patients with acquired brain injury: a cost-analysis of the Brain Integration Programme

    NARCIS (Netherlands)

    Heugten, C.M. van; Geurtsen, G.J.; Derksen, R.E.; Martina, J.D.; Geurts, A.C.H.; Evers, S.M.


    OBJECTIVE: The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment. METHODS: A cost-analysis was performed identifying costs of healthcare

  5. Cost analysis of DAWT innovative wind energy systems (United States)

    Foreman, K. M.

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

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  7. 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.

  8. Cost Analysis of Non-Formal ETV Systems: A Case Study of the "Extra-Scolaire" System in the Ivory Coast. (United States)

    Klees, Steven J.

    Building on previous evaluations of the ETV systems--both formal and informal--of the Ivory Coast, this study examines the system costs of the "Extra Scolaire" (E/S) program for rural adults. Educational television is utilized through the Ivorian primary system, and battery operated televisions have been widely distributed to schools in…



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


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

  10. Cost-Utility of Group Acceptance and Commitment Therapy for Fibromyalgia Versus Recommended Drugs: An Economic Analysis Alongside a 6-Month Randomized Controlled Trial Conducted in Spain (EFFIGACT Study). (United States)

    Luciano, Juan V; D'Amico, Francesco; Feliu-Soler, Albert; McCracken, Lance M; Aguado, Jaume; Peñarrubia-María, María T; Knapp, Martin; Serrano-Blanco, Antoni; García-Campayo, Javier


    The aim of this study was to analyze the cost utility of a group-based form of acceptance and commitment therapy (GACT) in patients with fibromyalgia (FM) compared with patients receiving recommended pharmacological treatment (RPT) or on a waiting list (WL). The data were derived from a previously published study, a randomized controlled trial that focused on clinical outcomes. Health economic outcomes included health-related quality of life and health care use at baseline and at 6-month follow-up using the EuroQoL and the Client Service Receipt Inventory, respectively. Analyses included quality-adjusted life years, direct and indirect cost differences, and incremental cost effectiveness ratios. A total of 156 FM patients were randomized (51 GACT, 52 RPT, 53 WL). GACT was related to significantly less direct costs over the 6-month study period compared with both control arms (GACT €824.2 ± 1,062.7 vs RPT €1,730.7 ± 1,656.8 vs WL €2,462.7 ± 2,822.0). Lower direct costs for GACT compared with RPT were due to lower costs from primary care visits and FM-related medications. The incremental cost effectiveness ratios were dominant in the completers' analysis and remained robust in the sensitivity analyses. In conclusion, acceptance and commitment therapy appears to be a cost-effective treatment compared with RPT in patients with FM. Decision-makers have to prioritize their budget on the treatment option that is the most cost effective for the management of a specific patient group. From government as well as health care perspectives, this study shows that a GACT is more cost effective than pharmacological treatment in management of FM. Copyright © 2017 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Cost Differential Analysis--Phase 2 (United States)

    Wystrom, Dennis C.; And Others


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

  12. Department of the Army Cost Analysis Manual (United States)


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

  13. Kinetic Gait Analysis Using a Low-Cost Insole. (United States)

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


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

  14. Estimation of Social Benefits in Cost-benefit Analysis


    Beáta Fodor


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

  15. Combined Waste Form Cost Trade Study

    Energy Technology Data Exchange (ETDEWEB)

    Dirk Gombert; Steve Piet; Timothy Trickel; Joe Carter; John Vienna; Bill Ebert; Gretchen Matthern


    A new generation of aqueous nuclear fuel reprocessing, now in development under the auspices of the DOE Office of Nuclear Energy (NE), separates fuel into several fractions, thereby partitioning the wastes into groups of common chemistry. This technology advance enables development of waste management strategies that were not conceivable with simple PUREX reprocessing. Conventional wisdom suggests minimizing high level waste (HLW) volume is desirable, but logical extrapolation of this concept suggests that at some point the cost of reducing volume further will reach a point of diminishing return and may cease to be cost-effective. This report summarizes an evaluation considering three groupings of wastes in terms of cost-benefit for the reprocessing system. Internationally, the typical waste form for HLW from the PUREX process is borosilicate glass containing waste elements as oxides. Unfortunately several fission products (primarily Mo and the noble metals Ru, Rh, Pd) have limited solubility in glass, yielding relatively low waste loading, producing more glass, and greater disposal costs. Advanced separations allow matching the waste form to waste stream chemistry, allowing the disposal system to achieve more optimum waste loading with improved performance. Metals can be segregated from oxides and each can be stabilized in forms to minimize the HLW volume for repository disposal. Thus, a more efficient waste management system making the most effective use of advanced waste forms and disposal design for each waste is enabled by advanced separations and how the waste streams are combined. This trade-study was designed to juxtapose a combined waste form baseline waste treatment scheme with two options and to evaluate the cost-benefit using available data from the conceptual design studies supported by DOE-NE.

  16. Educational Benefit-Cost Analysis and the Problem of Scale. (United States)

    Welty, Gordon A.

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

  17. Cost/efficacy analysis of preferred Spanish AIDS study group regimens and the dual therapy with lopinavir/ritonavir plus lamivudine for initial ART in HIV infected adults. (United States)

    Gatell Artigas, Josep María; Arribas López, José Ramón; Lázaro Y de Mercado, Pablo; Blasco Bravo, Antonio Javier


    The National AIDS Plan and the Spanish AIDS study group (GESIDA) proposes "preferred regimens" (PR) of antiretroviral treatment (ART) as initial therapy in HIV-infected patients. In 2013, the recommended regimens were all triple therapy regimens. The Gardel Study assessed the efficacy of a dual therapy (DT) combination of lopinavir/ritonavir (LPV/r) plus lamivudine (3TC). Our objective is to evaluate the GESIDA PR and the DT regimen LPV/r+3TC cost/efficacy ratios. Decision tree models were built. probability of having viral load <50 copies/mL at week 48. ART regime cost: costs of ART, adverse effects, and drug resistance tests during the first 48 weeks. Cost/efficacy ratios varied between 5,817 and 13,930 euros per responder at 48 weeks, for the DT of LPV/r+3TC and tenofovir DF/emtricitabine+raltegravir, respectively. Taking into account the official Spanish prices of ART, the most efficient regimen was DT of LPV/r+3TC, followed by the triple therapy with non-nucleoside containing regimens. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  18. Lamb Production Costs: Analyses of Composition and Elasticities Analysis of Lamb Production Costs (United States)

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


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

  19. Cost analysis of advanced turbine blade manufacturing processes (United States)

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


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

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

    DEFF Research Database (Denmark)

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


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

  1. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink


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

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

    Directory of Open Access Journals (Sweden)

    Fernando Richartz


    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.

  3. A Cost Analysis of Space Available Travel (United States)


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

  4. Analysis of electric vehicle's trip cost allowing late arrival (United States)

    Leng, Jun-Qiang; Liu, Wei-Yi; Zhao, Lin


    In this paper, we use a car-following model to study each electric vehicle's trip cost and the total trip cost allowing late arrival. The numerical result show that the electricity cost has great effects on each commuter's trip cost and the total trip costs and that these effects are dependent on each commuter's time headway at the origin, but the electricity cost has no prominent impacts on the minimum value of total trip cost under each commuter's different time headway at the origin.

  5. Evaluating water quality investments using cost utility analysis. (United States)

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


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

  6. Bayesian Variable Selection in Cost-Effectiveness Analysis

    Directory of Open Access Journals (Sweden)

    Miguel A. Negrín


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

  7. [Cost analysis of18F-FDG PET-CT from the perspective of the Brazilian Unified National Health System as healthcare provider: a study in a public healthcare center in Rio de Janeiro, Brazil]. (United States)

    Caetano, Rosângela; Schluckebier, Luciene Fontes; Bastos, Cláudia Regina Garcia; Silva, Rondineli Mendes da; Carneiro, Michel Pontes; Silva, Jorge Wagner Esteves da; Biz, Aline Navega


    Positron emission tomography (PET) has been introduced recently in Brazil and requires costs analysis to support economic evaluation studies on its use. The current study analyzed the use of 18 F-FDG PET-CT and estimated its costs from the perspective of a public healthcare provider. The micro-costing technique was used, identifying, quantifying, and valuing all the inputs used to perform the procedure. Cost estimates considered 85 tests performed at the Brazilian National Cancer Institute from March to June 2012. Reference cases were defined as adult cancer patients, output of five tests per day, and one dose of 18 F-FDG per patient. Unit cost for the procedure was BRL 3,150.30 based on career wages under the Ministry of Science and Technology and BRL 2,927.19 based on Ministry of Health career wages. The factor with the heaviest cost impact was daily output of tests. Other factors that could impact the test's cost in public healthcare institutions were also examined.

  8. 化工物流费用分析与优化研究%The study on chemical products logistics costs analysis and optimization

    Institute of Scientific and Technical Information of China (English)



    According to the characteristics of the chemical logistics, this paper provides the design which is to reduce logistics costs from the logistics cost analysis, optimization on plan level and performance evaluation. It also gives the rules of logistics costs traceability and sharing. It points out the necessity and feasibility to choose chemical internal supply plan to optimization and gives the assessment methods to improve the rate of implementation of the plan. Based on actual business scenarios, this paper establishes index system for logistics performance evaluation.%针对化工物流的特点,阐述了从物流费用分析、物流优化与物流评价指标三方面降低物流成本的理念.给出了物流费用追溯与分摊的规则.指出了选择化工原料互供计划作为化工物流计划优化的必要性和可行性,给出了提高物流计划执行率的考核方法.依托实际业务场景,建立了物流评价指标体系.

  9. Entry costs and quality of business environment: a critical analysis

    Directory of Open Access Journals (Sweden)

    Decio Zylbersztajn


    Full Text Available Transaction costs are the costs to protect property rights. Institutions are shaped in order to control transaction costs in society. Studies have been developed to measure transaction costs both at the macro and microeconomic levels. Entry costs, i.e., the cost to start up a new business are considered a proxy for business environment quality, being also interpreted as a proxy to transaction cost measurement. This paper presents new elements in order to amplify the potential of research in business environment, particularly business entry costs. It stresses the limitation related to two theoretical points: first, the near decomposability of one complex transaction, and second, the complementarity between ex-ante and ex-post transaction costs, both related to the methodology adopted to measure business entrance costs.

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

    Directory of Open Access Journals (Sweden)



    Full Text Available Background Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs have been the main motivations to define and implement this study. Objectives The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs. Materials and Methods We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Results Total annual cost of MRI activity center (AC was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. Conclusion As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be

  11. Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique. (United States)

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


    Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system

  12. The adoption of total cost of ownership for sourcing decisions - a structural equations analysis

    NARCIS (Netherlands)

    Wouters, Marc; Anderson, James C.; Wynstra, Finn


    This study investigates the adoption of total cost of ownership (TCO) analysis to improve sourcing decisions. TCO can be seen as an application of activity based costing (ABC) that quantifies the costs that are involved in acquiring and using purchased goods or services. TCO supports purchasing deci

  13. Implementing a Cost Effectiveness Analyzer for Web-Supported Academic Instruction: A Campus Wide Analysis (United States)

    Cohen, Anat; Nachmias, Rafi


    This paper describes the implementation of a quantitative cost effectiveness analyzer for Web-supported academic instruction that was developed in Tel Aviv University during a long term study. The paper presents the cost effectiveness analysis of Tel Aviv University campus. Cost and benefit of 3,453 courses were analyzed, exemplifying campus-wide…

  14. The adoption of total cost of ownership for sourcing decisions - a structural equations analysis

    NARCIS (Netherlands)

    Wouters, Marc; Anderson, James C.; Wynstra, Finn


    This study investigates the adoption of total cost of ownership (TCO) analysis to improve sourcing decisions. TCO can be seen as an application of activity based costing (ABC) that quantifies the costs that are involved in acquiring and using purchased goods or services. TCO supports purchasing deci

  15. Life Cycle Cost Analysis of Ready Mix Concrete Plant (United States)

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


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

  16. Life Cycle Assessment and Cost Analysis of Water and ... (United States)

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

  17. Costs of Quality: Exploratory Analysis of Hidden Elements and Prioritization using Analytic Hierarchy Process

    Directory of Open Access Journals (Sweden)

    Sailaja A


    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.

  18. Cost and Training Effectiveness Analysis Performance Guide (United States)


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

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

    Energy Technology Data Exchange (ETDEWEB)


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

  20. 7 CFR 550.47 - Cost and price analysis. (United States)


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

  1. Cost Benefit Analysis of Consumer Product Safety Standards (United States)

    Smith, Betty F.; Dardis, Rachel


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

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

    Directory of Open Access Journals (Sweden)

    Omisore M. O.


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

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

    DEFF Research Database (Denmark)

    Möller, Bernd


    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....


    African Journals Online (AJOL)


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

  5. Direct costs of hypertensive patients admitted to hospital in Vietnam- a bottom-up micro-costing analysis. (United States)

    Nguyen, Thi-Phuong-Lan; Nguyen, Thi Bach Yen; Nguyen, Thanh Trung; Vinh Hac, Van; Le, Hoa H; Schuiling-Veninga, Ccm; Postma, Maarten J


    There is an economic burden associated with hypertension both worldwide and in Vietnam. In Vietnam, patients with uncontrolled high blood pressure are hospitalized for further diagnosis and initiation of treatment. Because there is no evidence on costs of inpatient care for hypertensive patients available yet to inform policy makers, health insurance and hospitals, this study aims to quantify direct costs of inpatient care for these patients in Vietnam. A retrospective study was conducted in a hospital in Vietnam. Direct costs were analyzed from the health-care provider's perspective. Hospital-based costing was performed using both bottom-up and micro-costing methods. Patients with sole essential or primary hypertension (ICD-code I10) and those comorbid with sphingolipid metabolism or other lipid storage disorders (ICD-code E75) were selected. Costs were quantified based on financial and other records of the hospital. Total cost per patient resulted from an aggregation of laboratory test costs, drug costs, inpatient-days' costs and other remaining costs, including appropriate allocation of overheads. Both mean and medians, as well as interquartile ranges (IQRs) were calculated. In addition to a base-case analysis, specific scenarios were analyzed. 230 patients were included in the study (147 cases with I10 code only and 83 cases with I10 combined with E75). Median length of hospital stay was 6 days. Median total direct costs per patient were US$65 (IQR: 37 -95). Total costs per patient were higher in the combined hypertensive and lipid population than in the sole hypertensive population at US$78 and US$53, respectively. In all scenarios, hospital inpatient days' costs were identified as the major cost driver in the total costs. Costs of hospitalization of hypertensive patients is relatively high compared to annual medication treatment at a community health station for hypertension as well as to the total health expenditure per capita in Vietnam. Given that

  6. A cost-benefit analysis of a pellet boiler with electrostatic precipitator versus conventional biomass technology: A case study of an institutional boiler in Syracuse, New York. (United States)

    Levy, Jonathan I; Biton, Leiran; Hopke, Philip K; Zhang, K Max; Rector, Lisa


    Biomass facilities have received increasing attention as a strategy to increase the use of renewable fuels and decrease greenhouse gas emissions from the electric generation and heating sectors, but these facilities can potentially increase local air pollution and associated health effects. Comparing the economic costs and public health benefits of alternative biomass fuel, heating technology, and pollution control technology options provides decision-makers with the necessary information to make optimal choices in a given location. For a case study of a combined heat and power biomass facility in Syracuse, New York, we used stack testing to estimate emissions of fine particulate matter (PM2.5) for both the deployed technology (staged combustion pellet boiler with an electrostatic precipitator) and a conventional alternative (wood chip stoker boiler with a multicyclone). We used the atmospheric dispersion model AERMOD to calculate the contribution of either fuel-technology configuration to ambient primary PM2.5 in a 10km×10km region surrounding the facility, and we quantified the incremental contribution to population mortality and morbidity. We assigned economic values to health outcomes and compared the health benefits of the lower-emitting technology with the incremental costs. In total, the incremental annualized cost of the lower-emitting pellet boiler was $190,000 greater, driven by a greater cost of the pellet fuel and pollution control technology, offset in part by reduced fuel storage costs. PM2.5 emissions were a factor of 23 lower with the pellet boiler with electrostatic precipitator, with corresponding differences in contributions to ambient primary PM2.5 concentrations. The monetary value of the public health benefits of selecting the pellet-fired boiler technology with electrostatic precipitator was $1.7 million annually, greatly exceeding the differential costs even when accounting for uncertainties. Our analyses also showed complex spatial

  7. A new approach for product cost estimation using data envelopment analysis

    Directory of Open Access Journals (Sweden)

    Adil Salam


    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.

  8. Hospitalization for pelvic inflammatory disease: a cost-effectiveness analysis. (United States)

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


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

  9. Comparing Usage and Cost- Effectiveness Analysis of English Printed and Electronic Books for University of Tehran


    Davoud Haseli; Nader Naghshineh; fatemeh Fahimnia


    Libraries operate in a competitive environment, and this is essentially needed to prove its benefits for stockholders, and continuously evaluate and compare advantages for printed and electronic resources. In these cases, economic evaluation methods such as cost- effectiveness analysis, is one of the best methods, because of a comprehensive study of the use and cost of library sources. The purpose of this study is to discovery of use and cost- effectiveness analysis of English printed and ebo...

  10. Hypergolic Propellant Destruction Evaluation Cost Benefit Analysis (United States)

    Kessel, Kurt


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

  11. Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

    Directory of Open Access Journals (Sweden)

    Virta Lena


    Full Text Available Abstract Background Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden. Methods The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model. Results 204 (103 women patients, mean age 48 (SD 11 years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16% remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389 during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third. Conclusions The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.

  12. Cost Analysis of Selected Patient Categories Within A Dermatology Department Using an ABC Approach. (United States)

    Papadaki, Šárka; Popesko, Boris


    Present trends in hospital management are facilitating the utilization of more accurate costing methods, which potentially results in superior cost-related information and improved managerial decision-making. However, the Activity-Based Costing method (ABC), which was designed for cost allocation purposes in the 1980s, is not widely used by healthcare organizations. This study analyzes costs related to selected categories of patients, those suffering from psoriasis, varicose ulcers, eczema and other conditions, within a dermatology department at a Czech regional hospital. The study was conducted in a hospital department where both inpatient and outpatient care are offered. Firstly, the diseases treated at the department were identified. Further costs were determined for each activity using ABC. The study utilized data from managerial and financial accounting, as well as data obtained through interviews with departmental staff. Using a defined cost-allocation procedure makes it possible to determine the cost of an individual patient with a given disease more accurately than via traditional costing procedures. The cost analysis focused on the differences between the costs related to individual patients within the selected diagnoses, variations between inpatient and outpatient treatments and the costs of activities performed by the dermatology department. Furthermore, comparing the costs identified through this approach and the revenue stemming from the health insurance system is an option. Activity-Based Costing is more accurate and relevant than the traditional costing method. The outputs of ABC provide an abundance of additional information for managers. The benefits of this research lie in its practically-tested outputs, resulting from calculating the costs of hospitalization, which could prove invaluable to persons involved in hospital management and decision-making. The study also defines the managerial implications of the performed cost analysis for the

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

    Directory of Open Access Journals (Sweden)

    Baskerville Neill


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

  14. Health sector costs of self-reported food allergy in Europe: a patient-based cost of illness study. (United States)

    Fox, Margaret; Mugford, Miranda; Voordouw, Jantine; Cornelisse-Vermaat, Judith; Antonides, Gerrit; de la Hoz Caballer, Belen; Cerecedo, Inma; Zamora, Javier; Rokicka, Ewa; Jewczak, Maciej; Clark, Allan B; Kowalski, Marek L; Papadopoulos, Nikos; Knulst, Anna C; Seneviratne, Suranjith; Belohlavkova, Simona; Asero, Roberto; de Blay, Frederic; Purohit, Ashok; Clausen, Michael; Flokstra de Blok, Bertine; Dubois, Anthony E; Fernandez-Rivas, Montserrat; Burney, Peter; Frewer, Lynn J; Mills, Clare E N


    Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. To investigate the health service cost for food-allergic Europeans and the relationship between severity and cost of illness. Participants recruited through EuroPrevall studies in a case-control study in four countries, and cases only in five countries, completed a validated economics questionnaire. Individuals with possible food allergy were identified by clinical history, and those with food-specific immunoglobulin E were defined as having probable allergy. Data on resource use were used to estimate total health care costs of illness. Mean costs were compared in the case-control cohorts. Regression analysis was conducted on cases from all 9 countries to assess impact of country, severity and age group. Food-allergic individuals had higher health care costs than controls. The mean annual cost of health care was international dollars (I$)2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95% confidence interval I$324-I$1530). A similar result was found for adults in each country, and for children, and was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. Food allergy is associated with higher health care costs. Severity of allergic symptoms is a key explanatory factor.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  16. Meetings with Costly Participation: An Empirical Analysis


    Turner, Matthew; Weninger, Quinn


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



    K. Jayapratha; M. Muthamizharasan


    Software Cost Estimation is one of the most important part in software development. It involves in estimating the effort and cost in terms of money to complete the software development. Software Cost Estimation is very important when lines of code for the particular project exceeds certain limit, also when the software deployed with too many bugs and uncovered requirements the project will go incomplete. Software cost estimation of a project plays a vital role in acceptance or rejection of it...

  18. Is the societal approach wide enough to include relatives? Incorporating relatives' costs and effects in a cost-effectiveness analysis. (United States)

    Davidson, Thomas; Levin, Lars-Ake


    It is important for economic evaluations in healthcare to cover all relevant information. However, many existing evaluations fall short of this goal, as they fail to include all the costs and effects for the relatives of a disabled or sick individual. The objective of this study was to analyse how relatives' costs and effects could be measured, valued and incorporated into a cost-effectiveness analysis. In this article, we discuss the theories underlying cost-effectiveness analyses in the healthcare arena; the general conclusion is that it is hard to find theoretical arguments for excluding relatives' costs and effects if a societal perspective is used. We argue that the cost of informal care should be calculated according to the opportunity cost method. To capture relatives' effects, we construct a new term, the R-QALY weight, which is defined as the effect on relatives' QALY weight of being related to a disabled or sick individual. We examine methods for measuring, valuing and incorporating the R-QALY weights. One suggested method is to estimate R-QALYs and incorporate them together with the patient's QALY in the analysis. However, there is no well established method as yet that can create R-QALY weights. One difficulty with measuring R-QALY weights using existing instruments is that these instruments are rarely focused on relative-related aspects. Even if generic quality-of-life instruments do cover some aspects relevant to relatives and caregivers, they may miss important aspects and potential altruistic preferences. A further development and validation of the existing caregiving instruments used for eliciting utility weights would therefore be beneficial for this area, as would further studies on the use of time trade-off or Standard Gamble methods for valuing R-QALY weights. Another potential method is to use the contingent valuation method to find a monetary value for all the relatives' costs and effects. Because cost-effectiveness analyses are used for

  19. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad


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

  20. Concentrated photovoltaics system costs and learning curve analysis (United States)

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


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

  1. Flat plate vs. concentrator solar photovoltaic cells - A manufacturing cost analysis (United States)

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


    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.

  2. Cost analysis of inappropriate treatments for suspected dermatomycoses

    Directory of Open Access Journals (Sweden)

    Emanuela Fiammenghi


    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

  3. Environmental costs and reverse logistics: a systemic analysis

    Directory of Open Access Journals (Sweden)

    Paula de Souza


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

  4. Cost-effectiveness analysis of sandhill crane habitat management (United States)

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


    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.

  5. Battery life-cycle cost analysis

    Energy Technology Data Exchange (ETDEWEB)

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


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

  6. Cost Analysis for Dual Source Weapon Procurement (United States)


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

  7. Development of hospital data warehouse for cost analysis of DPC based on medical costs. (United States)

    Muranaga, F; Kumamoto, I; Uto, Y


    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.

  8. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld


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

  9. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad


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

  10. Wind-To-Hydrogen Project: Electrolyzer Capital Cost Study

    Energy Technology Data Exchange (ETDEWEB)

    Saur, G.


    This study is being performed as part of the U.S. Department of Energy and Xcel Energy's Wind-to-Hydrogen Project (Wind2H2) at the National Renewable Energy Laboratory. The general aim of the project is to identify areas for improving the production of hydrogen from renewable energy sources. These areas include both technical development and cost analysis of systems that convert renewable energy to hydrogen via water electrolysis. Increased efficiency and reduced cost will bring about greater market penetration for hydrogen production and application. There are different issues for isolated versus grid-connected systems, however, and these issues must be considered. The manner in which hydrogen production is integrated in the larger energy system will determine its cost feasibility and energy efficiency.

  11. Unit cost analysis in a university hospital: an example from Srinagarind Hospital, Khon Kaen. (United States)

    Vatanasapt, V; Kosuwon, W; Pengsaa, P


    This is the first analytic study to identify the unit cost in the University Hospital using the standard method of analysis in health economics. The unit costs in the report can be used to calculate the cost of each service for any disease. The costs of the hospital administration cost center and the supportive cost center were both allocated to the patient care service center by the simultaneous allocation method. The cost of teaching personnel was excluded from the analysis because it is quite difficult to estimate and differentiate the ratio of teaching costs to service costs. The hotel cost of the inpatient ward varied from 77.81 baht to 604.7 baht per day. The unit cost per service per day is different from the charge which is presently used at Srinagarind Hospital. Some services, such as in-house transportation are not included in the charge. This study was conducted to identify the unit cost of each service. The decision to establish charges can depend partly on this data and partly on the administrator's judgement. Other factors, such as patient poverty can dictate the final decision. In any case, the hospital and health service center should identify their own unit costs to be able to plan for effective budget management.

  12. Cost Benefit Analysis: Cost Benefit Analysis for Human Effectiveness Research: Bioacoustic Protection (United States)


    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

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

    NARCIS (Netherlands)

    J. Zuidberg


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

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

    NARCIS (Netherlands)

    Zuidberg, J.


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

  15. Infrastructures and Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle


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

  16. Learning Together; part 2: training costs and health gain - a cost analysis. (United States)

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


    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.

  17. Hospitalization rates and associated cost analysis of cardiac resynchronization therapy with an implantable defibrillator and quadripolar vs. bipolar left ventricular leads: a comparative effectiveness study. (United States)

    Forleo, Giovanni B; Di Biase, Luigi; Bharmi, Rupinder; Dalal, Nirav; Panattoni, Germana; Pollastrelli, Annalisa; Tesauro, Manfredi; Santini, Luca; Natale, Andrea; Romeo, Francesco


    This study compares, from a prospective, observational, non-randomized registry, the post-implant hospitalization rates and associated healthcare resource utilization of cardiac resynchronization therapy-defibrillator (CRT-D) patients with quadripolar (QUAD) vs. bipolar (BIP) left ventricular (LV) leads. Between January 2009 and December 2012, 193 consecutive patients receiving de novo CRT-D implants with either a QUAD (n = 116) or a BIP (n = 77) LV lead were enrolled at implant and followed until July 2013 at a single-centre, university hospital. Post-implant hospitalizations related to heart failure (HF) or LV lead surgical revision and associated payer costs were identified using ICD-9-CM diagnosis and procedure codes. Italian national reimbursement rates were determined. Propensity scores were estimated using a logistic regression model based upon 11 pre-implant baseline characteristics and were used to derive a 1 : 1 matched cohort of QUAD (n = 77) and BIP (n = 77) patients. Hospitalization rates for the two groups were compared using negative binomial regression and associated payer costs were compared using non-parametric bootstrapping (×10 000) and one-sided hypothesis test. Hospitalization rates of the QUAD group [0.15/ patient (pt)-year] were lower than those of the BIP group (0.32/ pt-year); the incidence rate ratio was 0.46, P = 0.04. The hospitalization costs for the QUAD group (434 ± 128 €/pt-year) were lower than those for the BIP group (1136 ± 362 €/pt-year). The average difference was 718 €/pt-year, P = 0.016. In this comparative effectiveness assessment of well-matched groups of CRT-D patients with quadripolar and bipolar LV leads, QUAD patients experienced a lower rate of hospitalizations for HF and LV lead surgical revision, and a lower cost burden. This has important implications for LV pacing lead choice. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

  18. Coherence and health care cost--RCA actuarial study: a cost-effectiveness cohort study. (United States)

    Bedell, Woody; Kaszkin-Bettag, Marietta


    Chronic stress is among the most costly health problems in terms of direct health costs, absenteeism, disability, and performance standards. The Reformed Church in America (RCA) identified stress among its clergy as a major cause of higher-than-average health claims and implemented HeartMath (HM) to help its participants manage stress and increase physiological resilience. The 6-week HM program Revitalize You! was selected for the intervention including the emWave Personal Stress Reliever technology. From 2006 to 2007, completion of a health risk assessment (HRA) provided eligible clergy with the opportunity to participate in the HM program or a lifestyle management program (LSM). Outcomes for that year were assessed with the Stress and Well-being Survey. Of 313 participants who completed the survey, 149 completed the Revitalize You! Program, and 164 completed the LSM. Well-being, stress management, resilience, and emotional vitality were significantly improved in the HM group as compared to the LSM group. In an analysis of the claims costs data for 2007 and 2008, 144 pastors who had participated in the HM program were compared to 343 non-participants (control group). Adjusted medical costs were reduced by 3.8% for HM participants in comparison with an increase of 9.0% for the control group. For the adjusted pharmacy costs, an increase of 7.9% was found compared with an increase of 13.3% for the control group. Total 2008 savings as a result of the HM program are estimated at $585 per participant, yielding a return on investment of 1.95:1. These findings show that HM stress-reduction and coherence-building techniques can reduce health care costs.

  19. Environmental standards need cost/benefit analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zeltman, E.W.


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

  20. Cost-benefit and cost-effectiveness analysis of drug therapy. (United States)

    Dao, T D


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


    Directory of Open Access Journals (Sweden)

    CARDOS Ildiko Reka


    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.

  2. Cost variation study of antidepressant drugs

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Shukla


    Conclusions: There is wide price variation of different brands of the same generic antidepressant drug in Indian market. Cost of a drug plays an important role in treatment of depression as it follows a long course and adherence to the treatment is related with drug cost. To decrease the wide cost variation among different brands of antidepressant drugs; it is high time to generate physician awareness about impact of cost effectiveness of drug regimen and for regulation of drug prices by the concerned agencies. [Int J Basic Clin Pharmacol 2016; 5(5.000: 1816-1821

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

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

    African Journals Online (AJOL)

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

  5. Uncertainty Assessment in Life Cycle Cost Analysis. (United States)


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

  6. A Cost-Effectiveness Analysis of the Swedish Universal Parenting Program All Children in Focus.

    Directory of Open Access Journals (Sweden)

    Malin Ulfsdotter

    Full Text Available There are few health economic evaluations of parenting programs with quality-adjusted life-years (QALYs as the outcome measure. The objective of this study was, therefore, to conduct a cost-effectiveness analysis of the universal parenting program All Children in Focus (ABC. The goals were to estimate the costs of program implementation, investigate the health effects of the program, and examine its cost-effectiveness.A cost-effectiveness analysis was conducted. Costs included setup costs and operating costs. A parent proxy Visual Analog Scale was used to measure QALYs in children, whereas the General Health Questionnaire-12 was used for parents. A societal perspective was adopted, and the incremental cost-effectiveness ratio was calculated. To account for uncertainty in the estimate, the probability of cost-effectiveness was investigated, and sensitivity analyses were used to account for the uncertainty in cost data.The cost was € 326.3 per parent, of which € 53.7 represented setup costs under the assumption that group leaders on average run 10 groups, and € 272.6 was the operating costs. For health effects, the QALY gain was 0.0042 per child and 0.0027 per parent. These gains resulted in an incremental cost-effectiveness ratio for the base case of € 47 290 per gained QALY. The sensitivity analyses resulted in ratios from € 41 739 to € 55 072. With the common Swedish threshold value of € 55 000 per QALY, the probability of the ABC program being cost-effective was 50.8 percent.Our analysis of the ABC program demonstrates cost-effectiveness ratios below or just above the QALY threshold in Sweden. However, due to great uncertainty about the data, the health economic rationale for implementation should be further studied considering a longer time perspective, effects on siblings, and validated measuring techniques, before full scale implementation.

  7. Determining the economic cost of ICU treatment: a prospective "micro-costing" study.

    LENUS (Irish Health Repository)

    McLaughlin, Anne Marie


    OBJECTIVE: To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost. METHODS AND DESIGN: A prospective study costing 64 consecutive admissions over a 2-month period in a mixed medical\\/surgical ICU. RESULTS: The median daily ICU cost (interquartile range, IQR) was 2,205 euro (1,932 euro-3,073 euro), and the median total ICU cost (IQR) was 10,916 euro (4,294 euro-24,091 euro). ICU survivors had a lower median daily ICU cost at 2,164 per day, compared with 3,496 euro per day for ICU non-survivors (P = 0.08). The requirements for continuous haemodiafiltration, blood products and anti-fungal agents were associated with higher daily and overall ICU costs (P = 0.002). Each point increase in SAPS3 was associated with a 305 euro (95% CI 31 euro-579 euro) increase in total ICU cost (P = 0.029). However, SAPS3 accounted for a small proportion of the variance in this model (R (2) = 0.08), limiting its usefulness as a stand-alone predictor of cost in clinical practice. A model including haemodiafiltration, blood products and anti-fungal agents explained 54% of the variance in total ICU cost. CONCLUSION: This bottom-up costing study highlighted the considerable individual variation in costs between ICU patients and identified the major factors contributing to cost. As the requirement for expensive interventions was the main driver for ICU cost, "severity of illness" scores may not be useful as stand-alone predictors of cost in the ICU.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  9. Space system operations and support cost analysis using Markov chains (United States)

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


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

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  11. A cost analysis of somatostatin use in the prevention of pancreatic fistula after pancreatectomy. (United States)

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


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

  12. Valuation of road safety effects in cost-benefit analysis. (United States)

    Wijnen, Wim; Wesemann, Paul; de Blaeij, Arianne


    Cost-benefit analysis is a common method for evaluating the social economic impact of transport projects, and in many of these projects the saving of human lives is an issue. This implies, within the framework of cost-benefit analysis, that a monetary value should be attached to saving human lives. This paper discusses the 'Value of a Statistical Life' (VoSL), a concept that is often used for monetising safety effects, in the context of road safety. Firstly, the concept of 'willingness to pay' for road safety and its relation to the VoSL are explained. The VoSL approach will be compared to other approaches to monetise safety effects, in particular the human capital approach and 'quality adjusted life years'. Secondly, methods to estimate the VoSL and their applicability to road safety will be discussed. Thirdly, the paper reviews the VoSL estimates that have been found in scientific research and compares them with the values that are used in policy evaluations. Finally, a VoSL study in the Netherlands will be presented as a case study, and its applicability in policy evaluation will be illustrated.

  13. Review on studies for external cost of nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Heung [Korea National University of Transportation, Chungju (Korea, Republic of); Ko, Won Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)


    External cost is cost imposed on a third party when producing or consuming a good or service. Since the 1990s, the external costs of nuclear powered electricity production have been studied. Costs are a very important factor in policy decision and the external cost is considered for cost comparison on electricity production. As for nuclear fuel cycle, a chosen technology will determine the external cost. However, there has been little research on this issue. For this study, methods for external cost on nuclear power production have been surveyed and analyzed to develop an approach for evaluating external cost on nuclear fuel cycles. Before the Fukushima accident, external cost research had focused on damage costs during normal operation of a fuel cycle. However, accident cost becomes a major concern after the accident. Various considerations for external cost including accident cost have been used to different studies, and different methods have been applied corresponding to the considerations. In this study, the results of the evaluation were compared and analyzed to identify methodological applicability to the external cost estimation with nuclear fuel cycles.

  14. IAEA Safeguards: Cost/benefit analysis of commercial satellite imagery

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Christer [SSC Satellitbild AB, Kiruna (Sweden)


    A major milestone in the efforts to strengthen the Safeguards System was reached in May 1997 when the Board of Governors approved a `Model Protocol Additional to Safeguards Agreements`. The Protocol provides the legal basis necessary to enhance the Agency`s ability to detect undeclared nuclear material and activities by using information available from open sources to complement the declarations made by Member States. Commercially available high-resolution satellite data has emerged as one potential complementary open information source to support the traditional and extended Safeguard activities of IAEA. This document constitutes a first report from SSC Satellitbild giving the Agency tentative and initial estimates of the potential cost and time-savings possible with the new proposed technology. The initial cost/benefit simulation will be further finalised in the following `Implementation Blueprint` study. The general foundation and starting point for the cost/benefit calculation is to simulate a new efficient and relatively small `imagery unit` within the IAEA, capable of performing advanced image processing as a tool for various safeguards tasks. The image processing capacity is suggested to be task- and interpretation-oriented. The study was performed over a period of 1,5 weeks in late 1998, and is based upon interviews of IAEA staff, reviews of existing IAEA documentation as well as from SSC Satellitbild`s long-standing experience of satellite imagery and field missions. The cost/benefit analysis is based on a spreadsheet simulation of five potential applications of commercial satellite imagery: Reference information; Confirmation of Agency acquired and Member State supplied data; Change detection and on-going monitoring; Assessing open source information available to the Agency; Detecting undeclared activities and undeclared sites. The study confirms that the proposed concept of a relatively small `imagery unit` using high-resolution data will be a sound and

  15. Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis (United States)

    Hill, Andrew; Redd, Christopher; Gotham, Dzintars; Erbacher, Isabelle; Meldrum, Jonathan; Harada, Ryo


    Objectives The aim of this study was to estimate lowest possible treatment costs for four novel cancer drugs, hypothesising that generic manufacturing could significantly reduce treatment costs. Setting This research was carried out in a non-clinical research setting using secondary data. Participants There were no human participants in the study. Four drugs were selected for the study: bortezomib, dasatinib, everolimus and gefitinib. These medications were selected according to their clinical importance, novel pharmaceutical actions and the availability of generic price data. Primary and secondary outcome measures Target costs for treatment were to be generated for each indication for each treatment. The primary outcome measure was the target cost according to a production cost calculation algorithm. The secondary outcome measure was the target cost as the lowest available generic price; this was necessary where export data were not available to generate an estimate from our cost calculation algorithm. Other outcomes included patent expiry dates and total eligible treatment populations. Results Target prices were £411 per cycle for bortezomib, £9 per month for dasatinib, £852 per month for everolimus and £10 per month for gefitinib. Compared with current list prices in England, these target prices would represent reductions of 74–99.6%. Patent expiry dates were bortezomib 2014–22, dasatinib 2020–26, everolimus 2019–25 and gefitinib 2017. The total global eligible treatment population in 1 year is 769 736. Conclusions Our findings demonstrate that affordable drug treatment costs are possible for novel cancer drugs, suggesting that new therapeutic options can be made available to patients and doctors worldwide. Assessing treatment cost estimations alongside cost-effectiveness evaluations is an important area of future research. PMID:28110283

  16. Cost-benefit analysis of avian influenza control in Nepal. (United States)

    Karki, S; Lupiani, B; Budke, C M; Karki, N P S; Rushton, J; Ivanek, R


    Numerous outbreaks of highly pathogenic avian influenza A strain H5N1 have occurred in Nepal since 2009 despite implementation of a national programme to control the disease through surveillance and culling of infected poultry flocks. The objective of the study was to use cost-benefit analysis to compare the current control programme (CCP) with the possible alternatives of: i) no intervention (i.e., absence of control measures [ACM]) and ii) vaccinating 60% of the national poultry flock twice a year. In terms of the benefit-cost ratio, findings indicate a return of US $1.94 for every dollar spent in the CCP compared with ACM. The net present value of the CCP versus ACM, i.e., the amount of money saved by implementing the CCP rather than ACM, is US $861,507 (the benefits of CCP [prevented losses which would have occurred under ACM] minus the cost of CCP). The vaccination programme yields a return of US $2.32 for every dollar spent when compared with the CCR The net present value of vaccination versus the CCP is approximately US $12 million. Sensitivity analysis indicated thatthe findings were robust to different rates of discounting, whereas results were sensitive to the assumed market loss and the number of birds affected in the outbreaks under the ACM and vaccination options. Overall, the findings of the study indicate that the CCP is economically superior to ACM, but that vaccination could give greater economic returns and may be a better control strategy. Future research should be directed towards evaluating the financial feasibility and social acceptability of the CCP and of vaccination, with an emphasis on evaluating market reaction to the presence of H5N1 infection in the country.

  17. A cost-utility analysis of psychoanalysis versus psychoanalytic psychotherapy. (United States)

    Berghout, Caspar C; Zevalkink, Jolien; Hakkaart-van Roijen, Leona


    Despite the considerable and growing body of research about the clinical effectiveness of long-term psychoanalytic treatment, relatively little attention has been paid to economic evaluations, particularly with reference to the broader range of societal effects. In this cost-utility study, we examined the incremental cost-effectiveness ratio (ICER) of psychoanalysis versus psychoanalytic psychotherapy. Incremental costs and effects were estimated by means of cross-sectional measurements in a cohort design (psychoanalysis, n = 78; psychoanalytic psychotherapy, n = 104). Quality-adjusted life-years (QALYs) were estimated for each treatment strategy using the SF-6D. Total costs were calculated from a societal perspective (treatment costs plus other societal costs) and discounted at 4 percent. Psychoanalysis was more costly than psychoanalytic psychotherapy, but also more effective from a health-related quality of life perspective. The ICER--that is, the extra costs to gain one additional QALY by delivering psychoanalysis instead of psychoanalytic psychotherapy--was estimated at 52,384 euros per QALY gained. Our findings show that the cost-utility ratio of psychoanalysis relative to psychoanalytic psychotherapy is within an acceptable range. More research is needed to find out whether cost-utility ratios vary with different types of patients. We also encourage cost-utility analyses comparing psychoanalytic treatment to other forms of (long-term) treatment.

  18. Using Cost-Benefit Analysis to Determine Profitability of Secondary Vocational Programs. (United States)

    Navaratnam, K. K.; And Others

    A major challenge confronting vocational educators is to justify programs in economic terms. The purpose of this study was to propose and implement a cost-benefit analysis model to determine the economic outcomes of secondary vocational education programs at the local level. For the study, a cost-benefit model for secondary vocational education…

  19. Upfront plerixafor plus G-CSF versus cyclophosphamide plus G-CSF for stem cell mobilization in multiple myeloma: efficacy and cost analysis study. (United States)

    Afifi, S; Adel, N G; Devlin, S; Duck, E; Vanak, J; Landau, H; Chung, D J; Lendvai, N; Lesokhin, A; Korde, N; Reich, L; Landgren, O; Giralt, S; Hassoun, H


    Cyclophosphamide plus G-CSF (C+G-CSF) is one of the most widely used stem cell (SC) mobilization regimens for patients with multiple myeloma (MM). Plerixafor plus G-CSF (P+G-CSF) has demonstrated superior SC mobilization efficacy when compared with G-CSF alone and has been shown to rescue patients who fail mobilization with G-CSF or C+G-CSF. Despite the proven efficacy of P+G-CSF in upfront SC mobilization, its use has been limited, mostly due to concerns of high price of the drug. However, a comprehensive comparison of the efficacy and cost effectiveness of SC mobilization using C+G-CSF versus P+G-CSF is not available. In this study, we compared 111 patients receiving C+G-CSF to 112 patients receiving P+G-CSF. The use of P+G-CSF was associated with a higher success rate of SC collection defined as ⩾5 × 10(6) CD34+ cells/kg (94 versus 83%, P=0.013) and less toxicities. Thirteen patients in the C+G-CSF arm were hospitalized owing to complications while none in the P+G-CSF group. C+G-CSF was associated with higher financial burden as assessed using institutional-specific costs and charges (P<0.001) as well as using Medicare reimbursement rates (P=0.27). Higher rate of hospitalization, increased need for salvage mobilization, and increased G-CSF use account for these differences.

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

    Directory of Open Access Journals (Sweden)

    Muhsin Celik

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

  1. Renal transplantation vs hemodialysis: Cost-effectiveness analysis

    Directory of Open Access Journals (Sweden)

    Perović Saša


    Full Text Available Background/Aim. Chronic renal insufficiency (CRI, diabetes, hypertension, autosomal dominant polycystic kidney disease (ADPKD are the main reasons for starting dialysis treatment in patients having kidney function failure. At present, dialysis treatments are performed in about 4,100 patients at 46 institutions in Serbia, out of which 90% are hemodialyses. At end-stage renal disease (ESRD the only correct selection is kidney transplatation. The basic aim of the planned research was to compare ratio of costs and effects (Cost Effectiveness Analysis - CEA of hemodialysis and kidney transplantation in patients at ESRD. Methods. As the main issue of treatment in patients from both groups the life quality measured by the validated McGill Questionary, was used. The study included 150 patients totally, divided into two groups. The study group consisted of 50 patients with kidney transplantation performed at the Clinical Center of Serbia and the control group consisted of 100 patients on hemodialysis at Clinical Center of Serbia, Clinical Hospital Center Zemun, Clinical Hospital Center 'Zvezdara', Clinical Center Kragujevac and Health Center 'Studenica', Kraljevo, comparable with respect to sex, age and length of treatment with the study group. Results. Effect of kidney transplantation in relation to hemodialysis being selection of treatment is expressed in the form of incremental ratio of costs and effects (Incremental Cost-Effectiveness Ratio - ICER. It is clear from the enclosed tables that the strategy of kidney transplantation is far more profitable considering the fact that it represents saving of EUR 132,256.25 per one year of contribution Quality Adjusted Life Years (QALY within the period of 10 years. According to all aspects of live quality (physical symptoms and problems, physical well-being, psychological symptoms, existential well-being and support, difference is statistically important in favor of transplant patents. Conclusion. The costs

  2. Costing the distribution of insecticide-treated nets: a review of cost and cost-effectiveness studies to provide guidance on standardization of costing methodology

    Directory of Open Access Journals (Sweden)

    Hanson Kara


    Full Text Available Abstract Background Insecticide-treated nets (ITNs are an effective and cost-effective means of malaria control. Scaling-up coverage of ITNs is challenging. It requires substantial resources and there are a number of strategies to choose from. Information on the cost of different strategies is still scarce. To guide the choice of a delivery strategy (or combination of strategies, reliable and standardized cost information for the different options is required. Methods The electronic online database PubMed was used for a systematic search of the published English literature on costing and economic evaluations of ITN distribution programmes. The keywords used were: net, bednet, insecticide, treated, ITN, cost, effectiveness, economic and evaluation. Identified papers were analysed to determine and evaluate the costing methods used. Methods were judged against existing standards of cost analysis to arrive at proposed standards for undertaking and presenting cost analyses. Results Cost estimates were often not readily comparable or could not be adjusted to a different context. This resulted from the wide range of methods applied and measures of output chosen. Most common shortcomings were the omission of certain costs and failure to adjust financial costs to generate economic costs. Generalisability was hampered by authors not reporting quantities and prices of resources separately and not examining the sensitivity of their results to variations in underlying assumptions. Conclusion The observed shortcomings have arisen despite the abundance of literature and guidelines on costing of health care interventions. This paper provides ITN specific recommendations in the hope that these will help to standardize future cost estimates.

  3. Full cost accounting in the analysis of separated waste collection efficiency: A methodological proposal. (United States)

    D'Onza, Giuseppe; Greco, Giulio; Allegrini, Marco


    Recycling implies additional costs for separated municipal solid waste (MSW) collection. The aim of the present study is to propose and implement a management tool - the full cost accounting (FCA) method - to calculate the full collection costs of different types of waste. Our analysis aims for a better understanding of the difficulties of putting FCA into practice in the MSW sector. We propose a FCA methodology that uses standard cost and actual quantities to calculate the collection costs of separate and undifferentiated waste. Our methodology allows cost efficiency analysis and benchmarking, overcoming problems related to firm-specific accounting choices, earnings management policies and purchase policies. Our methodology allows benchmarking and variance analysis that can be used to identify the causes of off-standards performance and guide managers to deploy resources more efficiently. Our methodology can be implemented by companies lacking a sophisticated management accounting system.

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


    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.

  5. Cost-benefit analysis of multifunctional agriculture in Finland

    Directory of Open Access Journals (Sweden)



    Full Text Available This study aims at assessing the costs and benefits of multifunctional agriculture, and it is one of the very first studies using a quantitative approach to this new subject. The starting point is that if current farm subsidies are regarded as means to maintain the multifunctional characteristics of agriculture, what happens if subsidies are reduced. The effects of the decline in agricultural support on multifunctional characteristics of agriculture in Finland are estimated using the cost-benefit analysis (CBA. Only a part of the consequences can be assessed by the CBA due to lack of data on the economic value of many elements of multifunctional agriculture. Hence, the results should not be generalised too strongly, but they still provide useful information for the political decision-making. Concerning further research, we should study, inter alia, what the so-called correct level of compensation for the adequate supply of public goods would be, and what kind of means of agricultural policy are the most efficient to unambiguously enhance the multifunctional character of agriculture.

  6. Analysis of Direct Costs of Outpatient Arthroscopic Rotator Cuff Repair. (United States)

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


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

  7. A cost-effectiveness analysis of two different antimicrobial stewardship programs. (United States)

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


    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.

  8. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

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


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

  9. Ballast Water Treatment, U.S. Great Lakes Bulk Carrier Engineering and Cost Study. Volume 2: Analysis of On-Board Treatment Methods, Alternative Ballast Water Management Practices, and Implementation Costs (United States)


    citric acid monohydrate, sodium thiosulfate neutralizer Yes .05 to 32 Decreased sediment, potential corrosion increase (see Section 2.3) http...Kilograms KORDI Korea Ocean Research and Development Institute kPa Kilopascals kW Kilowatt kWh Kilowatt hour lb Pounds LCC Life cycle cost lt...flushing filter, disinfection with injected chlorine dioxide (chlorine dioxide is generated onboard from two component chemicals, sulfuric acid

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

    Energy Technology Data Exchange (ETDEWEB)


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

  11. Methodological considerations in the analysis of cost effectiveness in dentistry. (United States)

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


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

  12. A study on macroeconomic cost of CCS in Korea (United States)

    Kim, Ji-Whan; Kim, Yoon Kyung


    CCS is an important measure for mitigating the problem of World Climate Change and already several projects are entered the step of commercialization. The benefits of CCS implementation ultimately depends on the alleviation level of CO2 on earth because it is caused by the mitigation of the World Climate Change problem. Thus it is possible not to coincide at same time between starting the CCS and getting the benefits. Considering the high costs of CCS, the time mismatch between imposing the costs and getting the benefits is apt to impose some heavy burden on the individual national economy. For this reason, at the political decision-making, the policy makers should consider the macroeconomic effects. Meanwhile, Korean electricity market's supply side is comprised of competitive production and a sole distributor(public enterprise) and then electricity is supplied by a single price structure(administered pricing). Under this condition, if CCS is introduced to power setor, electric charges must be increased and production costs will go high. High production costs will have unfavourable effects on disposable income, price level, purchasing power and so on. In order to minimize these effects, policy makers have to consider the economic effects of introducing CCS. This study estimates the microscopic cost of CCS using ICCSEM 2.0 methodology made by CO2CRC and after that, the macroeconomic effects of introducing CCS is estimated on the basis of microscopic cost estimating results. The macroeconomic effects of CCS applied to Power Generation sector are estimated using macroeconometrics model and Input-Output analysis. A macroeconometrics model is an analytical tool designed to describe the operation of the national economy. This model is usually applied to examine the dynamics of aggregate quantities such as the total amount of goods and services produced, total income earned, the level of employment of productive resources, the level of prices and so forth. Introducing

  13. Power Extension Package (PEP) system definition extension, orbital service module systems analysis study. Volume 11: PEP, cost, schedules, and work breakdown structure dictionary (United States)


    Cost scheduling and funding data are presented for the reference design of the power extension package. Major schedule milestones are correlated with current Spacelab flight dates. Funding distributions provide for minimum expenditure during the first year of the project.

  14. Estimated Costs of Sporadic Gastrointestinal Illness Associated with Surface Water Recreation: A Combined Analysis of Data from NEEAR and CHEERS Studies (United States)

    BACKGROUND: The ·burden of illness can be described by addressing both incidence and illness severity attributable to water recreation. Monetized as cost. attributable disease burden estimates can be useful for environmental management decisions. OBJECTIVES: We characteriz...

  15. 40 CFR 35.6585 - Cost and price analysis. (United States)


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

  16. Vehicle Lightweighting: Mass Reduction Spectrum Analysis and Process Cost Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, Anthony [IBIS Associates, Inc., Waltham, MA (United States); Hannibal, Ted [IBIS Associates, Inc., Waltham, MA (United States); Raghunathan, Anand [Energetics Inc., Columbia, MD (United States); Ivanic, Ziga [Energetics Inc., Columbia, MD (United States); Clark, Michael [Idaho National Lab. (INL), Idaho Falls, ID (United States)


    The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. In the first two phases of this effort examined combinations of strategies aimed at achieving strategic targets of 40% and a 45% mass reduction relative to a standard North American midsize passenger sedan at an effective cost of $3.42 per pound (lb) saved. These results have been reported in the Idaho National Laboratory report INL/EXT-14-33863 entitled Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting published in March 2015. The data for these strategies were drawn from many sources, including Lotus Engineering Limited and FEV, Inc. lightweighting studies, U.S. Department of Energy-funded Vehma International of America, Inc./Ford Motor Company Multi-Material Lightweight Prototype Vehicle Demonstration Project, the Aluminum Association Transportation Group, many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  19. Sources of Weapon System Cost Growth. Analysis of 35 Major Defense Acquisition Programs (United States)


    Resource Management Program of RAND Proj- iii ect AIR FORCE. The project’s technical monitor is Jay Jordan, Techni- cal Director of the Air Force Cost...and for his long-term support of Project AIR FORCE’s acquisi- tion and cost analysis research. Richard Hartley (SAF/FMC) and Jay Jordan from the Air...Wickman (1993), Tyson, Nelson, and Utech (1992), Shaw (1982), Tyson et al. (1989), Asher and Maggelet (1984), and Drezner et al. (1993) studied cost


    Directory of Open Access Journals (Sweden)

    Maria Elena Nenni


    Full Text Available In this study the author goes through with the analysis of a cost model developed for Integrated Logistic Support (ILS activities. By means of ANOVA the evaluation of impact and interaction among cost drivers is done. The predominant importance of organizational factors compared to technical ones is definitely demonstrated. Moreover the paper provides researcher and practitioners with useful information to improve the cost model as well as for budgeting and financial planning of ILS activities.

  1. A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions


    Fitzgerald, Sarah; Kirby, Ann; Murphy, Aileen; Geaney, Fiona; Perry, Ivan J.


    Background The workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer’s perspective. Methods Cost data were obtained from a workplace dietary intervention trial, the Food Choi...

  2. A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions


    Fitzgerald, Sarah; Kirby, Ann; Murphy, Aileen; Geaney, Fiona; Perry, Ivan J.


    Background: The workplace has been identified as a priority setting to positively influence individuals’ dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer’s perspective. Methods: Cost data were obtained from a workplace dietary intervention trial, the Food Ch...

  3. Cost of dengue outbreaks: literature review and country case studies (United States)


    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  4. Antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease: a cost effectiveness analysis

    NARCIS (Netherlands)

    P. Krijnen (Pieta); C.J. Kaandorp; E.W. Steyerberg (Ewout); D. van Schaardenburg (Dirkjan); H.J. Moens; J.D.F. Habbema (Dik)


    textabstractOBJECTIVE: To assess the cost effectiveness of antibiotic prophylaxis for haematogenous bacterial arthritis in patients with joint disease. METHODS: In a decision analysis, data from a prospective study on bacterial arthritis in 4907 patients with joint dise

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

    Directory of Open Access Journals (Sweden)

    Željko Požega


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

  6. A Quantitative Features Analysis of Recommended No- and Low-Cost Preschool E-Books (United States)

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


    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…

  7. The economic costs of avoided deforestation in the developing world: A meta-analysis

    NARCIS (Netherlands)

    D.T.H. Phan; R. Brouwer; M. Davidson


    This meta-analysis aims to identify the key factors governing the economic costs of avoided deforestation in developing countries. To this end, data were collected from 32 primary studies published between 1995 and 2012, yielding 277 observations. Results show that unit costs depend significantly on

  8. Cost analysis of the treatment of severe spinal spasticity with a continuous intrathecal baclofen infusion system

    NARCIS (Netherlands)

    Postma, TJBM; Oenema, D; Terpstra, S; Bouma, J; Kuipers-Upmeijer, H; Staal, MJ; Middel, BJ

    Objective: The purpose of our study was to analyse and evaluate the costs of continuous intrathecal baclofen administration as a modality in the treatment of severe spasticity in the Netherlands. Design: A cost analysis was conducted as part of a prospective, multicentre, multidisciplinary,

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

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


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

  10. Logistics cost analysis of rice residues for second generation bioenergy production in Ghana

    DEFF Research Database (Denmark)

    Vijay Ramamurthi, Pooja; Cristina Fernandes, Maria; Nielsen, Per Sieverts;


    This study explores the techno-economic potential of rice residues as a bioenergy resource to meet Ghana’s energy demands. Major rice growing regions of Ghana have 70–90% of residues available for bioenergy production. To ensure cost-effective biomass logistics, a thorough cost analysis was made...

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

    NARCIS (Netherlands)

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


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

  12. Clinical process analysis and activity-based costing at a heart center. (United States)

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


    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.

  13. Descriptive analysis of childbirth healthcare costs in an area with high levels of immigration in Spain

    Directory of Open Access Journals (Sweden)

    Sala Maria


    Full Text Available Abstract Background The aim of this study was to estimate the cost of childbirth in a teaching hospital in Barcelona, Spain, including the costs of prenatal care, delivery and postnatal care (3 months. Costs were assessed by taking into account maternal origin and delivery type. Methods We performed a cross-sectional study of all deliveries in a teaching hospital to mothers living in its catchment area between October 2006 and September 2007. A process cost analysis based on a full cost accounting system was performed. The main information sources were the primary care program for sexual and reproductive health, and hospital care and costs records. Partial and total costs were compared according to maternal origin and delivery type. A regression model was fit to explain the total cost of the childbirth process as a function of maternal age and origin, prenatal care, delivery type, maternal and neonatal severity, and multiple delivery. Results The average cost of childbirth was 4,328€, with an average of 18.28 contacts between the mother or the newborn and the healthcare facilities. The delivery itself accounted for more than 75% of the overall cost: maternal admission accounted for 57% and neonatal admission for 20%. Prenatal care represented 18% of the overall cost and 75% of overall acts. The average overall cost was 5,815€ for cesarean sections, 4,064€ for vaginal instrumented deliveries and 3,682€ for vaginal non-instrumented deliveries (p Conclusions Neither immigration nor prenatal care were associated with a substantial difference in costs. The most important predictors of cost were delivery type and neonatal severity. Given the impact of cesarean sections on the overall cost of childbirth, attempts should be made to take into account its higher cost in the decision of performing a cesarean section.

  14. Cost Benefit Analysis of the Power Storage System Considering Outage Cost in the Deregulated Power Market (United States)

    Tsuru, Hirokazu; Fujii, Yasumasa

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

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

  16. Using Cost-Effectiveness Analysis to Address Health Equity Concerns. (United States)

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


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


    Directory of Open Access Journals (Sweden)

    Ana Paula Ferreira Alves


    Full Text Available One of the main reasons for the difficulty in adopting an integrated method of calculation of logistics costs is still a lack of adequate information about costs. The management of the supply chain and identify its costs can provide information for their managers, with regard to decision making, generating competitive advantage. Some models of calculating logistics costs are proposed by Uelze (1974, Dias (1996, Goldratt (2002, Christopher (2007, Castiglioni (2009 and Borba & Gibbon (2009, with little disclosure of the results. In this context, this study aims to evaluate the costs of supplies, applying a measurement model of logistics costs. Methodologically, the study characterized as exploratory. The model applied pointed, in original condition, that about R$ 2.5 million were being applied in the process of management of supplies, with replacement costs and storage imbalance. Upgrading the company's data, it is possible obtain a 52% reduction in costs to replace and store supplies. Thus, the cost model applied to logistical supplies showed feasibility of implementation, as well as providing information to assist in management and decision-making in logistics supply.

  18. Cost analysis of the Spanish renal replacement therapy programme. (United States)

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


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


    Directory of Open Access Journals (Sweden)



    Full Text Available Once the Lean philosophy is developed and implemented to all levels in a company, a new accounting system appears: Lean accounting. Value Stream Cost Analysis is the main and the most powerful instrument of Lean accounting. Because of the fact that VSCA allows us to identify the company’s performance at the proper time, we can rapidly intervene to make the adjustments needed. The Romanian footwear industry is competitive worldwide (14th place in the top of exporters, but in order to improve, it has to rapidly react to clients’ expectations. In the case where the companies have a production system based on Lean philosophy, the implementation of VSCA does nothing but improve the obtained results. This article presents a case study of VSCA application in footwear industry.

  20. Cost benefit analysis on different configurations of berthing structure (United States)

    Rajesh, G.; Saravanan, R.; Ravichandran, Vijaya; Parameswara Pandian, S.; Ramani Sujatha, Evangelin


    Port and harbors are essential for handling of the imports/exports of good transported through shipping. This paper discusses the different configuration of berthing structure, their design with respect to the site conditions and suitability. The analysis includes detailed load calculations conforming to the various codal provisions and design of the structure. The configuration of berthing structure considered are analyzed and designed using STAAD Pro for different combination of loads as per IS 4651. Bill of Quantities are prepared and final cost of construction is calculated. Factors affecting the construction and maintenance such as land availability, soil conditions, hydrodynamics of the site, dredging requirements, design ship size etc. are considered to finalize the configuration of the berthing structure. Result of the study shows that Diaphragm wall type of berthing structure is economic for Ennore port.

  1. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld


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

  2. 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)


    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).

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

    Directory of Open Access Journals (Sweden)

    Burhanuddin M. A.


    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

  4. Study on safety cost and insurance degree of coal enterprises

    Energy Technology Data Exchange (ETDEWEB)

    Liang, M.; Han, C.; Yang, G. [Shandong Institute of Business and Technology, Yantai (China)


    The study confirmed the safety insurance degree of coal enterprises based on the various components of safety cost and analysed the connection between safety cost of component parts and safety insurance degree. Using Matlab software, a functional relationship was derived between mimesis curves of safety losing expenses, safety assets and management expenses, safety cost and safety insurance degree. The cost of a safety programme was forecast on the basis of this functional relationship. 3 figs., 3 tabs.

  5. [Costly drugs: analysis and proposals for the Mercosur countries]. (United States)

    Marín, Gustavo H; Polach, María Andrea


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

  6. Cost analysis of the surgical treatment of fractures of the proximal humerus: an evaluation of the determinants of cost and comparison of the institutional cost of treatment with the national tariff. (United States)

    Sabharwal, S; Carter, A W; Rashid, A; Darzi, A; Reilly, P; Gupte, C M


    The aims of this study were to estimate the cost of surgical treatment of fractures of the proximal humerus using a micro-costing methodology, contrast this cost with the national reimbursement tariff and establish the major determinants of cost. A detailed inpatient treatment pathway was constructed using semi-structured interviews with 32 members of hospital staff. Its content validity was established through a Delphi panel evaluation. Costs were calculated using time-driven activity-based costing (TDABC) and sensitivity analysis was performed to evaluate the determinants of cost The mean cost of the different surgical treatments was estimated to be £3282. Although this represented a profit of £1138 against the national tariff, hemiarthroplasty as a treatment choice resulted in a net loss of £952. Choice of implant and theatre staffing were the largest cost drivers. Operating theatre delays of more than one hour resulted in a loss of income Our findings indicate that the national tariff does not accurately represent the cost of treatment for this condition. Effective use of the operating theatre and implant discounting are likely to be more effective cost containment approaches than control of bed-day costs. This cost analysis of fractures of the proximal humerus reinforces the limitations of the national tariff within the English National Health Service, and underlines the importance of effective use of the operating theatre, as well as appropriate implant procurement where controlling costs of treatment is concerned. ©2016 The British Editorial Society of Bone & Joint Surgery.

  7. A Cost Analysis of Food Waste Composting in Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Tui Chen


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

  8. Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating. (United States)

    Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William


    Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Recombinant versus highly-purified, urinary follicle-stimulating hormone (r-FSH vs. HP-uFSH in ovulation induction: a prospective, randomized study with cost-minimization analysis

    Directory of Open Access Journals (Sweden)

    Grassi Giuseppina


    Full Text Available Abstract Background Both recombinant FSH (r-FSH and highly-purified, urinary FSH (HP-uFSH are frequently used in ovulation induction associated with timed sexual intercourse. Their effectiveness is reported to be similar, and therefore the costs of treatment represent a major issue to be considered. Although several studies about costs in IVF have been published, data obtained in low-technology infertility treatments are still scarce. Methods Two hundred and sixty infertile women (184 with unexplained infertility, 76 with CC-resistant polycystic ovary syndrome at their first treatment cycle were randomized and included in the study. Ovulation induction was accomplished by daily administration of rFSH or HP-uFSH according to a low-dose, step-up regimen aimed to obtain a monofollicular ovulation. A bi- or tri-follicular ovulation was anyway accepted, whereas hCG was withdrawn and the cycle cancelled when more than three follicles greater than or equal to 18 mm diameter were seen at ultrasound. The primary outcome measure was the cost of therapy per delivered baby, estimated according to a cost-minimization analysis. Secondary outcomes were the following: monofollicular ovulation rate, total FSH dose, cycle cancellation rate, length of the follicular phase, number of developing follicles (>12 mm diameter, endometrial thickness at hCG, incidence of twinning and ovarian hyperstimulation syndrome, delivery rate. Results The overall FSH dose needed to achieve ovulation was significantly lower with r-FSH, whereas all the other studied variables did not significantly differ with either treatments. However, a trend toward a higher delivery rate with r-FSH was observed in the whole group and also when results were considered subgrouping patients according to the indication to treatment. Conclusion Considering the significantly lower number of vials/patient and the slight (although non-significant increase in the delivery rate with r-FSH, the cost

  10. Cost-Utility Analysis of a Cardiac Telerehabilitation Program

    DEFF Research Database (Denmark)

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


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

  11. Costs analysis of a population level rabies control programme in Tamil Nadu, India. (United States)

    Abbas, Syed Shahid; Kakkar, Manish; Rogawski, Elizabeth Tacket


    The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million) and $2.2 million (Rs 119 million), respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million), $23 million (Rs 1,230 million) and $ 11 million (Rs 590 million), respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

  12. Costs analysis of a population level rabies control programme in Tamil Nadu, India.

    Directory of Open Access Journals (Sweden)

    Syed Shahid Abbas


    Full Text Available The study aimed to determine costs to the state government of implementing different interventions for controlling rabies among the entire human and animal populations of Tamil Nadu. This built upon an earlier assessment of Tamil Nadu's efforts to control rabies. Anti-rabies vaccines were made available at all health facilities. Costs were estimated for five different combinations of animal and human interventions using an activity-based costing approach from the provider perspective. Disease and population data were sourced from the state surveillance data, human census and livestock census. Program costs were extrapolated from official documents. All capital costs were depreciated to estimate annualized costs. All costs were inflated to 2012 Rupees. Sensitivity analysis was conducted across all major cost centres to assess their relative impact on program costs. It was found that the annual costs of providing Anti-rabies vaccine alone and in combination with Immunoglobulins was $0.7 million (Rs 36 million and $2.2 million (Rs 119 million, respectively. For animal sector interventions, the annualised costs of rolling out surgical sterilisation-immunization, injectable immunization and oral immunizations were estimated to be $ 44 million (Rs 2,350 million, $23 million (Rs 1,230 million and $ 11 million (Rs 590 million, respectively. Dog bite incidence, health systems coverage and cost of rabies biologicals were found to be important drivers of costs for human interventions. For the animal sector interventions, the size of dog catching team, dog population and vaccine costs were found to be driving the costs. Rabies control in Tamil Nadu seems a costly proposition the way it is currently structured. Policy makers in Tamil Nadu and other similar settings should consider the long-term financial sustainability before embarking upon a state or nation-wide rabies control programme.

  13. Operating costs and plant options analysis for the Shamokin fluidized bed boiler

    Energy Technology Data Exchange (ETDEWEB)

    Klett, M.G.; Dowdy, T.E.; Litman, R.


    This report presents the results of a study that examined the operating costs and options to improve the Shamokin Atmospheric Fluidized Bed Combustion Demonstration Plant located near Shamokin, Pennsylvania. The purpose of this study was to perform an operating cost analysis and compare the results with projected operating costs. An analysis was also made to identify possible cost savings options. Two base case scenarios were developed for this study: the first scenario assumed that the plant operated in a manner similar to operations during the extended test program; and the second scenario was concerned with two options. One option assumed upgrading the plant to achieve continuous full load operation, restarting, and used revised costs and revenues. The second assumed reconfiguring the plant for cogeneration.

  14. Cost variation study of antidepressant drugs


    Ajay Kumar Shukla; Parag Sharma


    Background: Depression and anxiety disorders are the most common mental illnesses, each affecting in excess of 10-15% of the population at some time in their lives. Approximately 10-15% of those with severe depression attempt suicide at some point of time. Thus, it is important that symptoms of depression be recognized and treated appropriately. Methods: The prices of 15 antidepressant drugs, available in 43 different formulations were analyzed. Costs of different brands of a particular ge...

  15. Health-care cost of diabetes in South India: A cost of illness study (United States)

    Akari, Sadanandam; Mateti, Uday Venkat; Kunduru, Buchi Reddy


    Objective: The objective of this study is to analyze the health-care cost by calculating the direct and indirect costs of diabetes with co-morbidities in south India. Methods: A prospective observational study was conducted at Rohini super specialty hospital (India). Patient data as well as cost details were collected from the patients for a period of 6 months. The study was approved by the hospital committee prior to the study. The diabetic patients of age >18 years, either gender were included in the study. The collected data was analyzed for the average cost incurred in treating the diabetic patients and was calculated based on the total amount spent by the patients to that of total number of patients. Findings: A total of 150 patients were enrolled during the study period. The average costs per diabetic patient with and without co-morbidities were found to be United States dollar (USD) 314.15 and USD 29.91, respectively. The average cost for those with diabetic complications was USD 125.01 for macrovascular complications, USD 90.43 for microvascular complications and USD 142.01 for other infections. Out of USD 314.15, the average total direct medical cost was USD 290.04, the average direct non-medical cost was USD 3.75 and the average total indirect cost was USD 20.34. Conclusion: Our study results revealed that more economic burden was found in male patients (USD 332.06), age group of 51-60 years (USD 353.55) and the patients bearing macrovascular complications (USD 142.01). This information can be a model for future studies of economic evaluations and outcomes research. PMID:24991617

  16. A cost-analysis of complex workplace nutrition education and environmental dietary modification interventions. (United States)

    Fitzgerald, Sarah; Kirby, Ann; Murphy, Aileen; Geaney, Fiona; Perry, Ivan J


    The workplace has been identified as a priority setting to positively influence individuals' dietary behaviours. However, a dearth of evidence exists regarding the costs of implementing and delivering workplace dietary interventions. This study aimed to conduct a cost-analysis of workplace nutrition education and environmental dietary modification interventions from an employer's perspective. Cost data were obtained from a workplace dietary intervention trial, the Food Choice at Work Study. Micro-costing methods estimated costs associated with implementing and delivering the interventions for 1 year in four multinational manufacturing workplaces in Cork, Ireland. The workplaces were allocated to one of the following groups: control, nutrition education alone, environmental dietary modification alone and nutrition education and environmental dietary modification combined. A total of 850 employees were recruited across the four workplaces. For comparison purposes, total costs were standardised for 500 employees per workplace. The combined intervention reported the highest total costs of €31,108. The nutrition education intervention reported total costs of €28,529. Total costs for the environmental dietary modification intervention were €3689. Total costs for the control workplace were zero. The average annual cost per employee was; combined intervention: €62, nutrition education: €57, environmental modification: €7 and control: €0. Nutritionist's time was the main cost contributor across all interventions, (ranging from 53 to 75% of total costs). Within multi-component interventions, the relative cost of implementing and delivering nutrition education elements is high compared to environmental modification strategies. A workplace environmental modification strategy added marginal additional cost, relative to the control. Findings will inform employers and public health policy-makers regarding the economic feasibility of implementing and scaling dietary

  17. Service contribution and cost-effectiveness of specialist registrars in NHS trusts: a survey and costing analysis. (United States)

    Dafydd, Derfel Ap; Baskaradas, Aroon; Bobdiwala, Shabnam; Anwar, Muhammad Saleem; Abrahams, Rachel; Jeremy, Levy


    Since the introduction of the European Working Time Directive, specialist registrars arguably contribute less to clinical service. The purpose of this study was to broadly quantify the service contribution of specialist registrars across a range of specialties and their value to an NHS organisation. A questionnaire-based survey of the clinical activities of specialist registrars in a large NHS trust was undertaken. Simple costing analyses of this -clinical activity were performed. Responses from 66 specialist registrars in 24 specialties showed an average of 51% overall clinical autonomy. Trainees attended an average of 2.7 outpatient clinics per week and spent 3.5 sessions a week doing ward work. Medical trainees took more referrals and attended more clinics. An analysis of costings suggested that surgical trainees might have generated around £700,000 income per year for the trust. Overall, specialist registrars make a substantial contribution to NHS clinical service and are cost-effective.

  18. Cost-Benefit Study on Nature Reserves Group in Qinling Mountains: Cost-Benefit Comparison and Analysis%秦岭自然保护区群成本效益研究(I)——成本效益比较

    Institute of Scientific and Technical Information of China (English)

    王昌海; 温亚利; 李强; 司开创; 胡崇德


    slowly and even drop. This study also measured the effectiveness of protection policy from the view of nature reserve cost and benefit. There are three purposes for this study: 1) To inform the comprehensive benefit and cost produced by biodiversity protection of QNRG from the perspective of cost-benefit analysis; 2) To analyze the cost and benefit shared by stakeholders of QNRG from the perspective of Stakeholder Theory; 3) To quantitatively analyze the development tendency of comprehensive benefits and costs in QNRG. This study can serve as an empirical base for the adjustment of biodiversity protection policies in nature reserves. In this paper, the correlation between cost and benefit of the QNRG was studied through the regress analysis with cross-sectional data. And our study may provide useful information for the forest management, particularly in investment budge, compensation and so on.

  19. Cost-minimization analysis in the treatment of spasticity in children with cerebral palsy with botulinum toxin type A: an observational, longitudinal, retrospective study. (United States)

    Tapias, Gloria; García-Romero, Mar; Crespo, Carlos; Cuesta, Maribel; Forné, Carles; Pascual-Pascual, Samuel Ignacio


    Objetivo: Estudio de minimización de costes de onabotulinumtoxinA y de abobotulinumtoxinA, teniendo en cuenta la dosis real administrada, en ninos con espasticidad asociada con la deformidad dinámica del pie equino debida a parálisis cerebral. Método: Estudio unicéntrico, observacional, longitudinal y retrospectivo que incluyó pacientes pediátricos espásticos entre 2 y 18 anos tratados con onabotulinumtoxinA o abobotulinumtoxinA, entre diciembre del 1995 y octubre del 2012, en el Servicio de Neurología Pediátrica de un hospital espanol de primer nivel. Se realizó un análisis longitudinal de la gravedad de la espasticidad para confirmar la similar efectividad de ambos tratamientos y proceder al análisis de minimización de costes que contempló las dosis infiltradas y los costes directos (costes farmacológicos y de visitas) desde la perspectiva del Sistema Nacional de Salud (euros 2016). Resultados: Se analizaron 895 pacientes con espasticidad infantil, 543 fueron tratados únicamente con onabotulinumtoxinA, 292 con abobotulinumtoxinA y 60 con ambos tratamientos. Las dosis medias infiltradas obtenidas fueron de 5,44 U/kg (DE = 2,17) para las infiltraciones con onabotulinumtoxinA y de 14,73 U/kg (5,26) para las infiltraciones con abobotulinumto xinA. El coste directo anual total (farmacológico y visitas) fue de 839,56 € para onabotulinumtoxinA y de 631,23 € para abobotulinumtoxinA, lo que supone una diferencia de 208,34 € al ano a favor del tratamiento con abobotulinumtoxinA. Conclusiones: Se ha mostrado que en práctica clínica real el coste por paciente y ano del tratamiento de la espasticidad infantil resulta más económico con la utilización de abobotulinumtoxinA.

  20. Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer. (United States)

    Lam, Simon W; Wai, Maya; Lau, Jessica E; McNamara, Michael; Earl, Marc; Udeh, Belinda


    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


    Energy Technology Data Exchange (ETDEWEB)

    Gorensek, M.; Summers, W.; Boltrunis, C.; Lahoda, E.; Allen, D.; Greyvenstein, R.


    This report documents a detailed study to determine the expected efficiency and product costs for producing hydrogen via water-splitting using energy from an advanced nuclear reactor. It was determined that the overall efficiency from nuclear heat to hydrogen is high, and the cost of hydrogen is competitive under a high energy cost scenario. It would require over 40% more nuclear energy to generate an equivalent amount of hydrogen using conventional water-cooled nuclear reactors combined with water electrolysis compared to the proposed plant design described herein. There is a great deal of interest worldwide in reducing dependence on fossil fuels, while also minimizing the impact of the energy sector on global climate change. One potential opportunity to contribute to this effort is to replace the use of fossil fuels for hydrogen production by the use of water-splitting powered by nuclear energy. Hydrogen production is required for fertilizer (e.g. ammonia) production, oil refining, synfuels production, and other important industrial applications. It is typically produced by reacting natural gas, naphtha or coal with steam, which consumes significant amounts of energy and produces carbon dioxide as a byproduct. In the future, hydrogen could also be used as a transportation fuel, replacing petroleum. New processes are being developed that would permit hydrogen to be produced from water using only heat or a combination of heat and electricity produced by advanced, high temperature nuclear reactors. The U.S. Department of Energy (DOE) is developing these processes under a program known as the Nuclear Hydrogen Initiative (NHI). The Republic of South Africa (RSA) also is interested in developing advanced high temperature nuclear reactors and related chemical processes that could produce hydrogen fuel via water-splitting. This report focuses on the analysis of a nuclear hydrogen production system that combines the Pebble Bed Modular Reactor (PBMR), under development by

  2. Logistics cost analysis of rice residues for second generation bioenergy production in Ghana. (United States)

    Vijay Ramamurthi, Pooja; Cristina Fernandes, Maria; Sieverts Nielsen, Per; Pedro Nunes, Clemente


    This study explores the techno-economic potential of rice residues as a bioenergy resource to meet Ghana's energy demands. Major rice growing regions of Ghana have 70-90% of residues available for bioenergy production. To ensure cost-effective biomass logistics, a thorough cost analysis was made for two bioenergy routes. Logistics costs for a 5 MWe straw combustion plant were 39.01, 47.52 and 47.89 USD/t for Northern, Ashanti and Volta regions respectively. Logistics cost for a 0.25 MWe husk gasification plant (with roundtrip distance 10 km) was 2.64 USD/t in all regions. Capital cost (66-72%) contributes significantly to total logistics costs of straw, however for husk logistics, staff (40%) and operation and maintenance costs (46%) dominate. Baling is the major processing logistic cost for straw, contributing to 46-48% of total costs. Scale of straw unit does not have a large impact on logistic costs. Transport distance of husks has considerable impact on logistic costs. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

    NARCIS (Netherlands)

    Koopmans, C.; Oosterhaven, J.


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

  4. 45 CFR 2543.45 - Cost and price analysis. (United States)


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

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

    African Journals Online (AJOL)

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

  6. Cost-benefit analysis of road safety measures.

    NARCIS (Netherlands)


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

  7. 40 CFR 1502.23 - Cost-benefit analysis. (United States)


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

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

    African Journals Online (AJOL)

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

  9. Evaluating Training: Return on Investment and Cost-Benefit Analysis. (United States)

    Munoz, Maria D.; Munoz, Marco A.

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

  10. A societal cost-of-illness study of hemodialysis in Lebanon. (United States)

    Rizk, Rana; Hiligsmann, Mickaël; Karavetian, Mirey; Salameh, Pascale; Evers, Silvia M A A


    Renal failure is a growing public health problem, and is mainly treated by hemodialysis. This study aims to estimate the societal costs of hemodialysis in Lebanon. This was a quantitative, cross-sectional cost-of-illness study conducted alongside the Nutrition Education for Management of Osteodystrophy trial. Costs were assessed with a prevalence-based, bottom-up approach, for the period of June-December 2011. The data of 114 patients recruited from six hospital-based units were collected through a questionnaire measuring healthcare costs, costs to patients and family, and costs in other sectors. Recall data were used for the base-case analysis. Sensitivity analyses employing various sources of resources use and costs were performed. Costs were uprated to 2015US$. Multiple linear regression was conducted to explore the predictors of societal costs. The mean 6-month societal costs were estimated at $9,258.39. The larger part was attributable to healthcare costs (91.7%), while costs to patient and family and costs in other sectors poorly contributed to the total costs (4.2% and 4.1%, respectively). In general, results were robust to sensitivity analyses. Using the maximum value for hospitalization resulted in the biggest difference (+15.5% of the base-case result). Female gender, being widowed/divorced, having hypertension comorbidity, and higher weekly time on dialysis were significantly associated with greater societal costs. Information regarding resource consumption and cost were not readily available. Rather, they were obtained from a variety of sources, with each having its own strengths and limitations. Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting

  11. Capital cost: pressurized water reactor plant. Commercial electric power cost studies

    Energy Technology Data Exchange (ETDEWEB)


    The investment cost study for the 1139 MW(e) pressurized water reactor (PWR) central station power plant consists of two volumes. This volume contains the drawings, equipment list and site description.

  12. Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA Transmission.

    Directory of Open Access Journals (Sweden)

    Michal Chowers

    Full Text Available Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia.We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel.An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600.A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country.

  13. Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) Transmission (United States)

    Chowers, Michal; Carmeli, Yehuda; Shitrit, Pnina; Elhayany, Asher; Geffen, Keren


    Introduction Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia. Methods We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel. Results An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600. Conclusions A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country. PMID:26406889

  14. An Analysis of the Cost and Cost-Effectiveness of Faculty Development for Online Teaching (United States)

    Meyer, Katrina A.


    This article presents the results of a national study of 39 higher education institutions that collected information about their cost measures used to evaluate faculty development for online teaching as well as decisions they would make to expand, keep, scale back, or eliminate various faculty development activities and contents in a…


    Directory of Open Access Journals (Sweden)



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

  16. Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland (United States)

    Sartorius, Benn; Dlamini, Xolisile; Östensson, Ellinor


    Background Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden. Materials and methods A prevalence-based cost of illness (COI) methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($). Results The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million). Costs for screening only represented 5% of the total cost ($0.9 million). Treatment of genital warts represented 6% of the total cost ($1million). Conclusion According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV

  17. New Ways Of Doing Business (NWODB) cost quantification analysis (United States)

    Hamaker, Joseph W.; Rosmait, Russell L.


    The cost of designing, producing, and operating typical aerospace flight hardware is necessarily more expensive than most other human endeavors. Because of the more stringent environment of space, hardware designed to operate there will probably always be more expensive than similar hardware which is designed for less taxing environments. It is the thesis of this study that there are very significant improvements that can be made in the cost of aerospace flight hardware.

  18. Cost Analysis of Patients with Upper Gastrointestinal Hemorrhage

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    Hakan Kocoglu


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

  19. Cost analysis of periodontitis management in public sector specialist dental clinics. (United States)

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


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

  20. GPACC program cost work breakdown structure-dictionary. General purpose aft cargo carrier study, volume 3 (United States)


    The results of detailed cost estimates and economic analysis performed on the updated Model 101 configuration of the general purpose Aft Cargo Carrier (ACC) are given. The objective of this economic analysis is to provide the National Aeronautics and Space Administration (NASA) with information on the economics of using the ACC on the Space Transportation System (STS). The detailed cost estimates for the ACC are presented by a work breakdown structure (WBS) to ensure that all elements of cost are considered in the economic analysis and related subsystem trades. Costs reported by WBS provide NASA with a basis for comparing competing designs and provide detailed cost information that can be used to forecast phase C/D planning for new projects or programs derived from preliminary conceptual design studies. The scope covers all STS and STS/ACC launch vehicle cost impacts for delivering payloads to a 160 NM low Earth orbit (LEO).

  1. DoD Cost Analysis Guidance and Procedures (United States)


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

  2. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis. (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł


    The aim of this systematic review was to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with ankylosing spondylitis. The search was conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2013 prices USD using the consumer price index and purchasing power parity. Identified studies were then analyzed to assess their possible inclusion in the meta-analysis. We identified 32 records. The average annual indirect cost per patient varies among all the identified results from US$660.95 to 45,953.87. The mean annual indirect per patient equals US$6454.76. This systematic review summarizes current data related to indirect costs generated by ankylosing spondylitis; it revealed the great economic burden of the disease for society. We observed a great variety of the considered components of indirect costs and their definitions.

  3. Practice Management Analysis Of Costs And Price Formation In Clothing Cluster - PE

    Directory of Open Access Journals (Sweden)

    Juliana Gonçalves de Araujo


    Full Text Available The aim of this study is to verify the level of use of practices related to the management of costs and price formation by the managers of the Local Productive Arrangement (APL Clothing of Pernambuco. The sample consisted of 52 companies, and the results point to a still unsatisfactory trend of cost management procedures, whereas the minority use of all the tools and adopting do informally. The significant associations found between the analysis variables were related to non-trading price of those respondents who said they adopt differentiation strategy (higher quality, and the use of costing methods by those respondents who do not adopt the low-cost strategy. It was found that those who use any funding arrangements tend not to adopt the low-cost strategy, preferring not to give up the product quality for lower costs.

  4. Control and Analysis of Costs Based On Results Account of the ABC method

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    Sorinel Capusneanu


    Full Text Available This paper presents a modality of control and cost analysis based on the results account of Activity-Based Costing method. The results account model and situations for determining deviations are presented based on the purpose, composition and classification in the existing literature. There are presented the statements for determining costs deviations resulting from their control and analysis in terms of pilot indicators, all highlighted by a case study application. The article ends with the authors' conclusions about the advantages of these syntheses accounting statements specific to ABC method and using it as a main source of rapid and accurate decision-making for the management at interentity level.


    Directory of Open Access Journals (Sweden)



    Full Text Available The judicious selection of investment projects, at the micro and macro level, with recognition of resource constraints and complementary involvement of the private sector, will lead to sustained economic growth, equitable development, poverty reduction and private sector growth. Cost-Benefit Analysis (CBA estimates and totals up the equivalent money value of the benefits and costs to the community of projects to establish whether they are worthwhile. This research enterprise proposes the study of the advantages of cost-benefit analysis and identify the several major principles that collectively describe the assumption base, objectives, analytical tasks, and merits of this important project assessment methodology.

  6. Strengthening Cost-Effectiveness Analysis for Public Health Policy. (United States)

    Russell, Louise B; Sinha, Anushua


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

  7. 地面抽采与井下抽采煤层气成本分析研究%Study on Cost Analysis of Coal Bed Methane from Surface Borehole Gas Drainage and Underground Mine Gas Drainage

    Institute of Scientific and Technical Information of China (English)



    为对比研究地面抽采煤层气成本与井下抽采瓦斯成本,以焦坪矿区下石节井田地面煤层气试验井储层测试参数和历史排采数据为基础,利用目前国际上较为先进的煤层气储层数值模拟软件CBM-SIM,对煤层气井的产能和抽采效果进行了预测分析,进而研究分析了在达到同样抽采效果的前提下,地面抽采与井下抽采煤层气的成本费用.结果显示:为了使瓦斯含量降至1 m3/t以下,地面抽采需要12.5a,成本9.09元/t;井下抽采成本16元/t,地面抽采成本远远低于井下抽采.%In order to compare and study the cost of the coal bed methane from the surface borehole gas drainage and the underground mine gas drainage,based on the reservoir measured parameters of the surface coal bed methane test well and the historical gas drainage data of Xiashijie Minefield in Jiaoping Mining Area as a base,with the application of the international advanced coal bed methane reservoir numerical simulation software CBM-SIM,a prediction analysis was conducted on the production capacity and the gas drainage effect of the coal bed methane well.On the premise of same gas drainage effect reached,the cost of the surface borehole gas drainage and underground mine gas drainage were studied and analyzed.The results showed that in order to make the gas content reduced to below 1 m3/t,the surface gas drainage would need 12.5 year,the cost would be 9.09 RMB/t.The underground mine gas drainage cost would be 16 RMB/t and the surface gas drainage cost would be far less than the underground mine gas drainage cost.

  8. Methodology for cost analysis of film-based and filmless portable chest systems (United States)

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


    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. School Cost Functions: A Meta-Regression Analysis (United States)

    Colegrave, Andrew D.; Giles, Margaret J.


    The education cost literature includes econometric studies attempting to determine economies of scale, or estimate an optimal school or district size. Not only do their results differ, but the studies use dissimilar data, techniques, and models. To derive value from these studies requires that the estimates be made comparable. One method to do…

  10. Guidelines and cost analysis for catalyst production in biocatalytic processes

    DEFF Research Database (Denmark)

    Tufvesson, Pär; Lima Ramos, Joana; Nordblad, Mathias


    be a powerful tool to guide research and development activities in order to achieve commercial potential. This study discusses the cost contribution of the biocatalyst in processes that use isolated enzymes, immobilized enzymes, or whole cells to catalyze reactions leading to the production of chemicals...... as well as the production scale are crucial for decreasing the total cost contribution of the biocatalyst. Moreover, it is clear that, based on initial process performance, the potential to reduce production costs by several orders of magnitude is possible. Guideline minimum productivities for a feasible...... process are suggested for different types of processes and products, based on typical values of biocatalyst and product costs. Such guidelines are dependent on the format of the biocatalyst (whole-cell, soluble enzyme, immobilized enzyme), as well as product market size and value. For example commodity...

  11. [Clinical cost analysis of balloon kyphoplasty--is there a possibility of cost-covering treatment?]. (United States)

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


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

  12. Cost analysis of substitutive renal therapies in children. (United States)

    Camargo, Maria Fernanda Carvalho de; Barbosa, Klenio de Souza; Fetter, Seiji Kumon; Bastos, Ana; Feltran, Luciana de Santis; Koch-Nogueira, Paulo Cesar


    End-stage renal disease is a health problem that consumes public and private resources. This study aimed to identify the cost of hemodialysis (either daily or conventional hemodialysis) and transplantation in children and adolescents. This was a retrospective cohort of pediatric patients with End-stage renal disease who underwent hemodialysis followed by kidney transplant. All costs incurred in the treatment were collected and the monthly total cost was calculated per patient and for each renal therapy. Subsequently, a dynamic panel data model was estimated. The study included 30 children who underwent hemodialysis (16 conventional/14 daily hemodialysis) followed by renal transplantation. The mean monthly outlay for hemodialysis was USD 3500 and USD 1900 for transplant. Hemodialysis costs added up to over USD 87,000 in 40 months for conventional dialysis patients and USD 131,000 in 50 months for daily dialysis patients. In turn, transplant costs in 50 months reached USD 48,000 and USD 70,000, for conventional and daily dialysis patients, respectively. For conventional dialysis patients, transplant is less costly when therapy exceeds 16 months, whereas for daily dialysis patients, the threshold is around 13 months. Transplantation is less expensive than dialysis in children, and the estimated thresholds indicate that renal transplant should be the preferred treatment for pediatric patients. Copyright © 2017. Published by Elsevier Editora Ltda.

  13. Is it really possible to build a bridge between cost-benefit analysis and cost-effectiveness analysis? (United States)

    Dolan, Paul; Edlin, Richard


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

  14. Ecological Security Pattern Analysis Based on InVEST and Least-Cost Path Model: A Case Study of Dongguan Water Village

    Directory of Open Access Journals (Sweden)

    Qian Lin


    Full Text Available The famous “world’s factory” city, Dongguan, like many other places in China, is a typical beneficiary of China’s Reform and Opening-up Policy. However, rapid urban sprawl and economic growth are at the expense of the destruction of the local environment. Therefore, it is of great importance to establish an ecological security network for sustainable development. InVEST models, effective tools to measure sensitivity and intensity of external threats to quantify habitat value, are used to calculate habitat quality of water and land. By combining structural connectivity and the Least-Cost Path model (LCP model, in which corridors are determined based on the minimum accumulative cost path between each critical point, ecological security patterns were calculated. According to the results, the northwest region of Dongguan, having a large quantity of farmlands and water and therefore many corridors and critical patches, is the most essential area in the overall security of ecological environments, which should be protected first. If developed, it should be dominated by eco-tourism and eco-agriculture. We hope that research on the ecological network, which includes critical patches and corridors formed by greenland and rivers, will lead toward better-informed proposals for local urban planning and regional sustainable development.

  15. Hospitalization costs of severe bacterial pneumonia in children: comparative analysis considering different costing methods. (United States)

    Nunes, Sheila Elke Araujo; Minamisava, Ruth; Vieira, Maria Aparecida da Silva; Itria, Alexander; Pessoa, Vicente Porfirio; Andrade, Ana Lúcia Sampaio Sgambatti de; Toscano, Cristiana Maria


    To determine and compare hospitalization costs of bacterial community-acquired pneumonia cases via different costing methods under the Brazilian Public Unified Health System perspective. Cost-of-illness study based on primary data collected from a sample of 59 children aged between 28 days and 35 months and hospitalized due to bacterial pneumonia. Direct medical and non-medical costs were considered and three costing methods employed: micro-costing based on medical record review, micro-costing based on therapeutic guidelines and gross-costing based on the Brazilian Public Unified Health System reimbursement rates. Costs estimates obtained via different methods were compared using the Friedman test. Cost estimates of inpatient cases of severe pneumonia amounted to R$ 780,70/$Int. 858.7 (medical record review), R$ 641,90/$Int. 706.90 (therapeutic guidelines) and R$ 594,80/$Int. 654.28 (Brazilian Public Unified Health System reimbursement rates). Costs estimated via micro-costing (medical record review or therapeutic guidelines) did not differ significantly (p=0.405), while estimates based on reimbursement rates were significantly lower compared to estimates based on therapeutic guidelines (pSistema Único de Saúde. Estudo de custo, com coleta de dados primários de uma amostra de 59 crianças com 28 dias a 35 meses de idade hospitalizadas por pneumonia bacteriana. Foram considerados custos diretos médicos e não médicos. Três metodologias de custeio foram utilizadas: microcusteio por revisão de prontuários, microcusteio considerando diretriz terapêutica e macrocusteio por ressarcimento do Sistema Único de Saúde. Os custos estimados pelas diferentes metodologias foram comparados utilizando o teste de Friedman. Os custos hospitalares de crianças com pneumonia grave foram R$ 780,70 ($Int. 858.7) por revisão de prontuários, R$ 641,90 ($Int. 706.90) por diretriz terapêutica e R$ 594,80 ($Int. 654.28) por ressarcimento do Sistema Único de Sa

  16. [An analysis of cost and profit of a nursing unit using performance-based costing: case of a general surgical ward in a general hospital]. (United States)

    Lim, Ji Young


    The aim of this study was to analyze net income of a surgical nursing ward in a general hospital. Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 33,269,925.0. The expense of a surgical nursing ward was 28,325,134.2. Therefore, the net income of a surgical nursing ward was won 4,944,790.8. We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

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

    Directory of Open Access Journals (Sweden)

    A. M. Oliveira Filho


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

  18. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  19. Comprehensive investigation into historical pipeline construction costs and engineering economic analysis of Alaska in-state gas pipeline (United States)

    Rui, Zhenhua

    This study analyzes historical cost data of 412 pipelines and 220 compressor stations. On the basis of this analysis, the study also evaluates the feasibility of an Alaska in-state gas pipeline using Monte Carlo simulation techniques. Analysis of pipeline construction costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary by diameter, length, volume, year, and location. Overall average learning rates for pipeline material and labor costs are 6.1% and 12.4%, respectively. Overall average cost shares for pipeline material, labor, miscellaneous, and right of way (ROW) are 31%, 40%, 23%, and 7%, respectively. Regression models are developed to estimate pipeline component costs for different lengths, cross-sectional areas, and locations. An analysis of inaccuracy in pipeline cost estimation demonstrates that the cost estimation of pipeline cost components is biased except for in the case of total costs. Overall overrun rates for pipeline material, labor, miscellaneous, ROW, and total costs are 4.9%, 22.4%, -0.9%, 9.1%, and 6.5%, respectively, and project size, capacity, diameter, location, and year of completion have different degrees of impacts on cost overruns of pipeline cost components. Analysis of compressor station costs shows that component costs, shares of cost components, and learning rates for material and labor costs vary in terms of capacity, year, and location. Average learning rates for compressor station material and labor costs are 12.1% and 7.48%, respectively. Overall average cost shares of material, labor, miscellaneous, and ROW are 50.6%, 27.2%, 21.5%, and 0.8%, respectively. Regression models are developed to estimate compressor station component costs in different capacities and locations. An investigation into inaccuracies in compressor station cost estimation demonstrates that the cost estimation for compressor stations is biased except for in the case of material costs. Overall average

  20. Why do cost-benefit studies of PACS disagree? (United States)

    van Gennip, Elisabeth M.; Ottes, Fenno P.; van Poppel, Bas M.; Andriessen, J. H. T. H.


    Once the technical difficulties of PACS have been solved, the main obstacle for its introductionwill be its costs. Even though PACS is still under development, it is clear that the equipment for PACS will be much more expensive than the equipment used in the conventional situation. PACS may, however, pay itself back by allowing savings of film, space and personnel. The conclusions of some recent cost-benefit studies disagree on the costs and benefits of PACS. Some conclude that PACS would pay for itself, whereas according to others PACS would be (much) more expensive. We analyzed the latest cost-benefit studies, to find out why their outcomes diverge. The comparison of the results revealed striking differences. The calculations of the annual costs of a hospital wide PACS varied between 2 and 4 million dollars. These differences could not be explained by differences in the size of the hospitals, as indicated by the number of examinations. They were, in part, caused by the fact that the costs per piece of equipment, material or space varied per study. For instance the costs of 1 square foot of (archive) space varied from 10 to 140 per year. The variation in the given costs of the film based system, depended on the fact whether the time spent by medical personnel on film management was taken into account. The differences among these studies demonstrate clearly the need for uniform, well-defined criteria for the calculation of the costs and savings of PACS.

  1. Cost Minimization Analysis of Empiric Antibiotic Used by Sepsis Patient Respiratory Infection Source

    Directory of Open Access Journals (Sweden)

    Okky S. Purwanti


    Full Text Available Empirical antibiotics plays an important role in the therapy of sepsis. The aims of this study was to estimate and compare the cost of treating inpatient sepsis with respiratory infection, with cefotaximemetronidazole or cefotaxime-erythromycin antibiotics. Observational study of cost minimization analysis was conducted by retrospective data from 2010 until 2012. Data were collected from medical records of inpatients sepsis with respiratory infection and received empirical therapy cefotaximemetronidazole or cefotaxime-erythromycin and treatment’s pricelist from department of accounting. Direct medical cost was calculated from empirical antibiotic costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The study considered the cost from preadmission because sepsis until the patient was fully recovered of sepsis. Cefotaxime-metronidazole and cefotaxime-erythromycin are assumed to have equivalent efficacy. Patients with empirical cefotaxime-metronidazole were found have longer length of stay (25 versus 11 and average total cost of treatment was cheaper (16.641.112,04 IDR versus 21.641.678,02 IDR. The findings demonstrate that combination of empirical antibiotic of cefotaxime–metronidazole is more efficient than cefotaxime-erythromycin.

  2. Time-Driven Activity-Based Costing for Inter-Library Services: A Case Study in a University (United States)

    Pernot, Eli; Roodhooft, Filip; Van den Abbeele, Alexandra


    Although the true costs of inter-library loans (ILL) are unknown, universities increasingly rely on them to provide better library services at lower costs. Through a case study, we show how to perform a time-driven activity-based costing analysis of ILL and provide evidence of the benefits of such an analysis.

  3. Costs to Automate Demand Response - Taxonomy and Results from Field Studies and Programs

    Energy Technology Data Exchange (ETDEWEB)

    Piette, Mary A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schetrit, Oren [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cheung, Iris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Li, Becky Z [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)


    During the past decade, the technology to automate demand response (DR) in buildings and industrial facilities has advanced significantly. Automation allows rapid, repeatable, reliable operation. This study focuses on costs for DR automation in commercial buildings with some discussion on residential buildings and industrial facilities. DR automation technology relies on numerous components, including communication systems, hardware and software gateways, standards-based messaging protocols, controls and integration platforms, and measurement and telemetry systems. This report compares cost data from several DR automation programs and pilot projects, evaluates trends in the cost per unit of DR and kilowatts (kW) available from automated systems, and applies a standard naming convention and classification or taxonomy for system elements. Median costs for the 56 installed automated DR systems studied here are about $200/kW. The deviation around this median is large with costs in some cases being an order of magnitude great or less than the median. This wide range is a result of variations in system age, size of load reduction, sophistication, and type of equipment included in cost analysis. The costs to automate fast DR systems for ancillary services are not fully analyzed in this report because additional research is needed to determine the total cost to install, operate, and maintain these systems. However, recent research suggests that they could be developed at costs similar to those of existing hot-summer DR automation systems. This report considers installation and configuration costs and does include the costs of owning and operating DR automation systems. Future analysis of the latter costs should include the costs to the building or facility manager costs as well as utility or third party program manager cost.

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

    KAUST Repository

    Thu, Kyaw


    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Matysiak, L.M.


    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.

  6. [Comparision of costs of secondary prevention and treatment of stroke--cost-effectiveness analysis]. (United States)

    Ceronja, Ivana; Sosić, Zvonko


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

  7. sensitivity analysis on flexible road pavement life cycle cost model

    African Journals Online (AJOL)


    methods of assessing and managing the risk and uncertainties ... cost studies in flexible pavement delivery, it is important ... developed for the road pavement in the study area as .... vehicle counts per day of 400 of a single carriageway ..... from the Intermodal Terminal” in Sweden, which had ... Company, Malabar, Florida.

  8. A cost-benefit analysis of The National Map (United States)

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


    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

  9. Acute hospital, community, and indirect costs of stroke associated with atrial fibrillation: population-based study.

    LENUS (Irish Health Repository)

    Hannon, Niamh


    No economic data from population-based studies exist on acute or late hospital, community, and indirect costs of stroke associated with atrial fibrillation (AF-stroke). Such data are essential for policy development, service planning, and cost-effectiveness analysis of new therapeutic agents.

  10. Cost risk benefit analysis to support chemoprophylaxis policy for travellers to malaria endemic countries

    Directory of Open Access Journals (Sweden)

    Coutinho Francisco AB


    Full Text Available Abstract Background In a number of malaria endemic regions, tourists and travellers face a declining risk of travel associated malaria, in part due to successful malaria control. Many millions of visitors to these regions are recommended, via national and international policy, to use chemoprophylaxis which has a well recognized morbidity profile. To evaluate whether current malaria chemo-prophylactic policy for travellers is cost effective when adjusted for endemic transmission risk and duration of exposure. a framework, based on partial cost-benefit analysis was used Methods Using a three component model combining a probability component, a cost component and a malaria risk component, the study estimated health costs avoided through use of chemoprophylaxis and costs of disease prevention (including adverse events and pre-travel advice for visits to five popular high and low malaria endemic regions and malaria transmission risk using imported malaria cases and numbers of travellers to malarious countries. By calculating the minimal threshold malaria risk below which the economic costs of chemoprophylaxis are greater than the avoided health costs we were able to identify the point at which chemoprophylaxis would be economically rational. Results The threshold incidence at which malaria chemoprophylaxis policy becomes cost effective for UK travellers is an accumulated risk of 1.13% assuming a given set of cost parameters. The period a travellers need to remain exposed to achieve this accumulated risk varied from 30 to more than 365 days, depending on the regions intensity of malaria transmission. Conclusions The cost-benefit analysis identified that chemoprophylaxis use was not a cost-effective policy for travellers to Thailand or the Amazon region of Brazil, but was cost-effective for travel to West Africa and for those staying longer than 45 days in India and Indonesia.


    Directory of Open Access Journals (Sweden)

    Dharm Dutt


    Full Text Available Barrier paper, which is made of bleached absorbent kraft pulp, is a significant layer of decorative laminates, since it controls the see-through of brown color of saturating kraft paper and its opacifying effect usually is achieved by a heavy loading of TiO2. The TiO2, due to its very small particle size, passes between the cellulosic fibers and drains into the white water. To overcome this problem, papermakers try to use various retention aids for improving overall retention of TiO2, but agglomeration of TiO2 causes a decrease in light scattering efficiency of TiO2. During the subsequent saturation operation, the air in the voids is replaced by melamine formaldehyde, which has a refractive index close to that of cellulose. As a result, the sheet becomes translucent and poses 'see through' problem. Keeping this in view, anhydrous magnesium silicate is used as an extender with TiO2 because it effectively increases the overall filler retention, sheet brightness, opacity. The dispersed aqueous slurry of anhydrous magnesium silicate forms fine gel that entraps TiO2 in the wet web and prevents removal of fines and fillers. The addition of 25% TiO2, 7% micronized soapstone powder, 8% anhydrous magnesium silicate, 1% melamine formaldehyde, and 0.1% sodium hexameta-phosphate was found to improve the overall retention by 65.25% and to cut the manufacturing cost by US$ 546.00 per tonne of pulp without affecting the product quality.

  12. Composite propellant tank study for very low cost space transportation (United States)

    Moser, D. J.; Keith, E. L.


    A study of life-cycle cost is conducted to determine acceptable options for composite propellant tanks at low cost and weight and for use at moderate pressures. The review examines all cost issues relevant to the production, mass, applications, and reliability of the tanks for pressure-fed rockets. Specific attention is given to the manufacturing and life-cycle issues relevant to the use of composite materials in this application since composites are effective materials for liquid propellant tanks. Specific costs and parametric considerations are given for several tank candidates with 62,303-lb capacities. The mass sensitivity of the fourth stage for the concept vehicle is shown to be high, and the use of a 325-psi fourth-stage tank is shown to yield the minimum cost/lb for the stage. Wound S-glass/epoxy composites can be employed as cost-effective replacements for steel in the design of liquid-propellant tanks.


    Directory of Open Access Journals (Sweden)

    Magdalena Apollo


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

  14. Risk Costs for New Dams: Economic Analysis and Effects of Monitoring (United States)

    Paté-Cornell, M. Elisabeth; Tagaras, George


    This paper presents new developments and illustrations of the introduction of risk and costs in cost-benefit analysis for new dams. The emphasis is on a method of evaluation of the risk costs based on the structure of the local economy. Costs to agricultural property as well as residential, commercial, industrial, and public property are studied in detail. Of particular interest is the case of sequential dam failure and the evaluation of the risk costs attributable to a new dam upstream from an existing one. Three real cases are presented as illustrations of the method: the Auburn Dam, the Dickey-Lincoln School Project, and the Teton Dam, which failed in 1976. This last case provides a calibration tool for the estimation of loss ratios. For these three projects, the risk-modified benefit-cost ratios are computed to assess the effect of the risk on the economic performance of the project. The role of a warning system provided by systematic monitoring of the dam is analyzed: by reducing the risk costs, the warning system attenuates their effect on the benefit-cost ratio. The precursors, however, can be missed or misinterpreted: monitoring does not guarantee that the risks to human life can be reduced to zero. This study shows, in particular, that it is critical to consider the risk costs in the decision to build a new dam when the flood area is large and densely populated.

  15. A Study on Labor Cost of Enterprises in Shanghai

    Institute of Scientific and Technical Information of China (English)



    Increasing labor costs have become a focus of concern for enterprises and government since China's entry into the WTO. Based on recent statistics and case studies of enterprises in Shanghai, changes in labor costs in Shanghai are examined in this paper and compared with other areas around Shanghai. Some factors contributing to recent increases in laborcosts in Shanghai are analyzed. It highlights that labor costs in Shanghai will continue to increase due to the city's rapid economic development and intensive use of human capital. It points out, however, that some room still exists to reduce the labor cost, and several practical measures are suggested.

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

    Directory of Open Access Journals (Sweden)

    Dadan Soekardan


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

  17. Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach. (United States)

    Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G


    Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

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

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, T.L.; McKenna, E.


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

  19. Health Monitoring System Technology Assessments: Cost Benefits Analysis (United States)

    Kent, Renee M.; Murphy, Dennis A.


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

  20. Improving air pollution control policy in China--A perspective based on cost-benefit analysis. (United States)

    Gao, Jinglei; Yuan, Zengwei; Liu, Xuewei; Xia, Xiaoming; Huang, Xianjin; Dong, Zhanfeng


    To mitigate serious air pollution, the State Council of China promulgated the Air Pollution Prevention and Control Action Plan in 2013. To verify the feasibility and validity of industrial energy-saving and emission-reduction policies in the action plan, we conducted a cost-benefit analysis of implementing these policies in 31 provinces for the period of 2013 to 2017. We also completed a scenario analysis in this study to assess the cost-effectiveness of different measures within the energy-saving and the emission-reduction policies individually. The data were derived from field surveys, statistical yearbooks, government documents, and published literatures. The results show that total cost and total benefit are 118.39 and 748.15 billion Yuan, respectively, and the estimated benefit-cost ratio is 6.32 in the S3 scenario. For all the scenarios, these policies are cost-effective and the eastern region has higher satisfactory values. Furthermore, the end-of-pipe scenario has greater emission reduction potential than energy-saving scenario. We also found that gross domestic product and population are significantly correlated with the benefit-cost ratio value through the regression analysis of selected possible influencing factors. The sensitivity analysis demonstrates that benefit-cost ratio value is more sensitive to unit emission-reduction cost, unit subsidy, growth rate of gross domestic product, and discount rate among all the parameters. Compared with other provinces, the benefit-cost ratios of Beijing and Tianjin are more sensitive to changes of unit subsidy than unit emission-reduction cost. These findings may have significant implications for improving China's air pollution prevention policy.

  1. Incremental Cost-Effectiveness Analysis of Gestational Diabetes Mellitus Screening Strategies in Singapore. (United States)

    Chen, Pin Yu; Finkelstein, Eric A; Ng, Mor Jack; Yap, Fabian; Yeo, George S H; Rajadurai, Victor Samuel; Chong, Yap Seng; Gluckman, Peter D; Saw, Seang Mei; Kwek, Kenneth Y C; Tan, Kok Hian


    The objective of this study was to conduct an incremental cost-effectiveness analysis from the payer's perspective in Singapore of 3 gestational diabetes mellitus screening strategies: universal, targeted, or no screening. A decision tree model assessed the primary outcome: incremental cost per quality-adjusted life year (QALY) gained. Probabilities, costs, and utilities were derived from the literature, the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort study, and the KK Women's and Children's Hospital's database. Relative to targeted screening using risk factors, universal screening generates an incremental cost-effectiveness ratio (ICER) of $USD10,630/QALY gained. Sensitivity analyses show that disease prevalence rates and intervention effectiveness of glycemic management have the biggest impacts on the ICERs. Based on the model and best available data, universal screening is a cost-effective approach for reducing the complications of gestational diabetes mellitus in Singapore as compared with the targeted screening approach or no screening.

  2. Analysis of cost regression and post-accident absence (United States)

    Wojciech, Drozd


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



    Dragos Palaghita; Bogdan Vintila


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

  4. Cost-effectiveness analysis of a low-cost bubble CPAP device in providing ventilatory support for neonates in Malawi - a preliminary report. (United States)

    Chen, Ariel; Deshmukh, Ashish A; Richards-Kortum, Rebecca; Molyneux, Elizabeth; Kawaza, Kondwani; Cantor, Scott B


    A low-cost bubble continuous positive airway pressure (bCPAP) device has been shown to be an excellent clinical alternative to nasal oxygen for the care of neonates with respiratory difficulty. However, the delivery of bCPAP requires more resources than the current routine care using nasal oxygen. We performed an economic evaluation to determine the cost-effectiveness of a low-cost bCPAP device in providing ventilatory support for neonates in Malawi. We used patient-level clinical data from a previously published non-randomized controlled study. Economic data were based on the purchase price of supplies and equipment, adjusted for shelf life, as well as hospital cost data from the World Health Organization. Costs and benefits were discounted at 3%. The outcomes were measured in terms of cost, discounted life expectancy, cost/life year gained and net benefits of using bCPAP or nasal oxygen. The incremental cost-effectiveness ratio and incremental net benefits determined the value of one intervention compared to the other. Subgroup analysis on several parameters (birth weight categories, diagnosis of respiratory distress syndrome, and comorbidity of sepsis) was conducted to evaluate the effect of these parameters on the cost-effectiveness. Nasal oxygen therapy was less costly (US$29.29) than the low-cost bCPAP device ($57.78). Incremental effectiveness associated with bCPAP was 6.78 life years (LYs). In the base case analysis, the incremental cost-effectiveness ratio for bCPAP relative to nasal oxygen therapy was determined to be $4.20 (95% confidence interval, US$2.29-US$16.67) per LY gained. The results were highly sensitive for all tested subgroups, particularly for neonates with birth weight 1- cost effective. The bCPAP is a highly cost-effective strategy in providing ventilatory support for neonates in Malawi.

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

    Directory of Open Access Journals (Sweden)

    Yangyang Deng


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

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

    Directory of Open Access Journals (Sweden)

    Ioannis Michalakoudis


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

  7. Estimating the Cost of Neurosurgical Procedures in a Low-Income Setting: An Observational Economic Analysis. (United States)

    Abdelgadir, Jihad; Tran, Tu; Muhindo, Alex; Obiga, Doomwin; Mukasa, John; Ssenyonjo, Hussein; Muhumza, Michael; Kiryabwire, Joel; Haglund, Michael M; Sloan, Frank A


    There are no data on cost of neurosurgery in low-income and middle-income countries. The objective of this study was to estimate the cost of neurosurgical procedures in a low-resource setting to better inform resource allocation and health sector planning. In this observational economic analysis, microcosting was used to estimate the direct and indirect costs of neurosurgical procedures at Mulago National Referral Hospital (Kampala, Uganda). During the study period, October 2014 to September 2015, 1440 charts were reviewed. Of these patients, 434 had surgery, whereas the other 1006 were treated nonsurgically. Thirteen types of procedures were performed at the hospital. The estimated mean cost of a neurosurgical procedure was $542.14 (standard deviation [SD], $253.62). The mean cost of different procedures ranged from $291 (SD, $101) for burr hole evacuations to $1,221 (SD, $473) for excision of brain tumors. For most surgeries, overhead costs represented the largest proportion of the total cost (29%-41%). This is the first study using primary data to determine the cost of neurosurgery in a low-resource setting. Operating theater capacity is likely the binding constraint on operative volume, and thus, investing in operating theaters should achieve a higher level of efficiency. Findings from this study could be used by stakeholders and policy makers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

    Manzo, Stefano; Salling, Kim Bang


    -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....... Additionally, they can significantly modify the weight of the different components of the overall project costs – evidently becoming a significant part of the estimated construction cost. Therefore, the suggested approach guarantees a higher quality of information thus providing decision makers with a more......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...

  9. Pasireotide for the Prevention of Pancreatic Fistula Following Pancreaticoduodenectomy: A Cost-effectiveness Analysis. (United States)

    Goyert, Nik; Eeson, Gareth; Kagedan, Daniel J; Behman, Ramy; Lemke, Madeline; Hallet, Julie; Mittmann, Nicole; Law, Calvin; Karanicolas, Paul J; Coburn, Natalie G


    To determine the cost-effectiveness of perioperative administration of pasireotide for reduction of pancreatic fistula (PF). PF is a major complication following pancreaticoduodenectomy (PD), associated with significant morbidity and healthcare-related costs. Pasireotide is a novel multireceptor ligand somatostatin analogue, which has been demonstrated to reduce the incidence of PF following pancreas resection; however, the drug cost is significant. This study sought to estimate the cost-effectiveness of routine administration of pasireotide to patients undergoing PD, compared with no intervention from the perspective of the hospital system. A decision-analytic model was developed to compare costs for perioperative administration of pasireotide versus no pasireotide. The model was populated using an institutional database containing all PDs performed 2002 to 2012 at a single institution, including data regarding clinically significant PF (International Study Group on Pancreatic Fistula Grade B or C) and hospital-related inpatient costs for 90 days following PD, converted to 2014 $USD. Relative risk of PF associated with pasireotide was estimated from the published literature. Deterministic and probabilistic sensitivity analyses were performed to test robustness of the model. Mean institutional cost of index admissions was $67,417 and $31,950 for patients with and without PF, respectively. Pasireotide was the dominant strategy, associated with savings of $1685, and a mean reduction of 1.5 days length of stay. Univariate sensitivity analyses demonstrated cost-savings down to a PF rate of 5.6%, up to a relative risk of PF of 0.775, and up to a drug cost of $2817. Probabilistic sensitivity analysis showed 79% of simulations were cost saving. Pasireotide appears to be a cost-saving treatment following PD across a wide variation of clinical and cost scenarios.

  10. Technology commercialization cost model and component case study (United States)


    Fuel cells seem poised to emerge as a clean, efficient, and cost competitive source of fossil fuel based electric power and thermal energy. Sponsors of fuel cell technology development need to determine the validity and the attractiveness of a technology to the market in terms of meeting requirements and providing value which exceeds the total cost of ownership. Sponsors of fuel cell development have addressed this issue by requiring the developers to prepare projections of the future production cost of their fuel cells in commercial quantities. These projected costs, together with performance and life projections, provide a preliminary measure of the total value and cost of the product to the customer. Booz-Allen & Hamilton Inc. and Michael A. Cobb & Company have been retained in several assignments over the years to audit these cost projections. The audits have gone well beyond a simple review of the numbers. They have probed the underlying technical and financial assumptions, the sources of data on material and equipment costs, and explored issues such as the realistic manufacturing yields which can be expected in various processes. Based on the experience gained from these audits, DOE gave Booz-Allen and Michael A. Cobb & company the task to develop a criteria to be used in the execution of future fuel cell manufacturing cost studies. It was thought that such a criteria would make it easier to execute such studies in the future as well as to cause such studies to be more understandable and comparable.

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

    Demir, Aynur; Arisoy, Münevver


    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.

  12. Cost analysis of surgical treatment for pelvic organ prolapse by laparoscopic sacrocolpopexy or transvaginal mesh. (United States)

    Carracedo, D; López-Fando, L; Sánchez, M D; Jiménez, M Á; Gómez, J M; Laso, I; Rodríguez, M Á; Burgos, F J


    The objective of this study is to compare direct costs of repairing pelvic organ prolapse by laparoscopic sacrocolpopexy (LS) against vaginal mesh (VM). Our hypothesis is the correction of pelvic organ prolapse by LS has a similar cost per procedure compared to VM. We made a retrospective comparative analysis of medium cost per procedure of first 69 consecutive LS versus first 69 consecutive VM surgeries. We calculate direct cost for each procedure: structural outlays, personal, operating room occupation, hospital stay, perishable or inventory material and prosthetic material. Medium cost per procedure were calculated for each group, with a 95% confidence interval. LS group has a higher cost related to a longer length of surgery, higher operating room occupation and anesthesia; VM group has a higher cost due to longer hospital stay and more expensive prosthetic material. Globally, LS has a lower medium cost per procedure in comparison to VM (5,985.7 €±1,550.8 € vs. 6,534.3 €±1,015.5 €), although it did not achieve statistical signification. In our midst, pelvic organ prolapse surgical correction by LS has at least similar cost per procedure compared to VM. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Analysis of The Factors Influencing the Private Cost of Teacher ...

    African Journals Online (AJOL)


    was to determine the actual private unit cost of teacher education as well as the factors ... education was higher in state tertiary institutions than their federal ... project/assignment, teaching practice, study tow/excursion, textbook, stationary ... However, in order to ease the estimation process, the popular methods is to use unit.

  14. comparative cost and strength analysis of cement and aggregate ...

    African Journals Online (AJOL)


    Jul 2, 2012 ... Nigerian Journal of Technology (NIJOTECH) ... groundnut husk ash, palm oil fuel ash, bone powder ash, acha husk ash and bambara groundnut ... study suggests that; the cost of construction and concrete production can be reduced if cement .... coarse aggregate for light trafficked roads and 10% as par-.

  15. [Cost-effectiveness analysis of professional oral hygiene]. (United States)

    Olesov, E E; Shaĭmieva, N I; Kononenko, V I; Bersanov, R U; Monakova, N E


    Periodontal status and oral hygiene indexes were studied in 125 young employee of Kurchatov Institute. Oral hygiene values dynamic was assessed after professional oral hygiene in persons with unsatisfactory oral hygiene at baseline examination. When compared with the same values in the absence of professional oral hygiene procedures the results allowed calculating cost-effectiveness rate for biannual professional oral hygiene.

  16. Are Violent Delinquents Worth Treating? A Cost-Benefit Analysis (United States)

    Caldwell, Michael F.; Vitacco, Michael; Van Rybroek, Gregory J.


    This study reports on the cost benefits of an intensive treatment program for unmanageable juvenile delinquent boys, compared to the usual treatment in a secured juvenile corrections facility. A total of 101 boys who received the majority of their treatment services in a specialized program providing intensive mental health treatment were matched…


    Directory of Open Access Journals (Sweden)



    Full Text Available The analysis of the costs and of the structure of tariffs for operators in the sector of water and sewage system in Romania are a real challenge. Through this analysis we can form an overview of the costs which may involve in the service of providing clean water and the sewage and wastewater treatment. The costs is analysed both in the cost structure at the enterprise level and in comparison with the income made from the activity (supply of drinking water or treatment of wastewater. In the article we study the cost structure at the level of sector of activity and the correlation between the tariff applied to water and sewer services and size of enterprise, number of employees, wage costs, maintenance and repair costs, energy cost and other variables. The correlations results helps us to make the first steps for the realization of an equation of the cost at the level of the sector of water and sewage system. Another correlation study will be between the applied tariff and the size of the investments made with european co-financing in the framework of the SOP Environment. Through this correlation we determine if the size of the tariffs applied in this sector correlate to the size of the investments made in the SOP Environment.

  18. The value of hygiene promotion: cost-effectiveness analysis of interventions in developing countries. (United States)

    Sijbesma, Christine; Christoffers, Trea


    Hygiene promotion can greatly improve the benefits of water and sanitation programmes in developing countries at relatively limited costs. There are, however, few studies with hard data on the costs and effectiveness of individual programmes and even fewer have compared the cost-effectiveness of different promotional approaches. This article argues that objectively measured reductions of key sanitation and hygiene risks are better than DALYs for evaluating hygiene and sanitation promotion programmes. It presents a framework for the cost-effectiveness analysis of such programmes, which is used to analyse six field programmes. At costs ranging from US dollar 1.05 to US dollar 1.74 per person per year in 1999 US dollar values, they achieved (almost) complete abandonment of open defecation and considerable improvements in keeping toilets free from faecal soiling, safe disposal of child faeces, and/or washing hands with soap after defecation, before eating and after cleaning children's bottoms. However, only two studies used a quasi-experimental design (before and after studies in the intervention and - matched - control area) and only two measured costs and the degree to which results were sustained after the programme had ended. If the promotion of good sanitation and hygiene is to receive the political and managerial support it deserves, every water, sanitation and/or hygiene programme should give data on inputs, costs, processes and effects over time. More and better research that reflects the here-presented model is also needed to compare the cost-effectiveness of different promotional approaches.

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

    Energy Technology Data Exchange (ETDEWEB)


    This report presents the detailed results and assumptions for the January 1986 Total System Life Cycle Cost (TSLCC) analysis. The report is composed of three sections: Section A lists the costing assumptions which have been made about the principal waste management system parameters; Section B presents the yearly flows of waste material between system facilities for the 8 logistics cases which were studied; and Section C presents the annual total system costs for each of the 32 TSLCC cases by major cost category.

  20. Preliminary Study on Causative Factors Leading to Construction Cost Overrun

    Directory of Open Access Journals (Sweden)

    Aftab Hameed Memon


    Full Text Available Cost is the fundamental component for any construction project. However, cost overrun is observed as one of the most frequently occurring issues in construction projects worldwide and need to be studied more to alleviate this issue in the future. This trend is more severe in developing countries where these overruns sometimes exceeds 100% of the anticipated cost of the project.   Like other countries, construction industry in Malaysia is also facing a lot of challenges such as the delay to complete the project in time, the expenditure exceeding the budget, the building defects and over dependent of foreign workers. The ultimate effects of project delay also results in exceeding cost. This leads to serious need of addressing the critical issue of construction cost overrun. To avoid construction cost overrun, very first and most important step is to identify and understand the causes and factors responsible for that. Hence, this paper is aimed to identify various factors responsible for construction cost overrun. Through a comprehensive study of literature review, common factors causing cost overrun resulting in identification of 78 factors were mapped in frequency table. A questionnaire survey and interviews were carried out amongst selected experienced personnel for expert opinion to identify the significant factors causing cost overrun in Malaysia. Five respondents were selected from each of the respondents groups including client, consultant and contractor. The questionnaire responses were analyzed by average index method, which resulted in identification of 59 common factors causing construction cost overrun in Malaysia. Results show that poor design & delays in Design, unrealistic contract duration & requirements imposed, lack of experience, late delivery of materials & equipment, relationship between management & labour, delay preparation & approval of drawings, inadequate planning & scheduling, poor site management & supervision and

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  2. Cost analysis of adolescent idiopathic scoliosis surgery: early discharge decreases hospital costs much less than intraoperative variables under the control of the surgeon. (United States)

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


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

  3. Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

    Directory of Open Access Journals (Sweden)

    Mohammad M. H. Abdullah


    Full Text Available Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D and incidence of cardiovascular disease (CVD following a low glycemic index (GI or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1 estimate the proportions of individuals who are likely to consume pulses; (2 evaluate the reductions in established risk factors for T2D and CVD; (3 assess the percent reduction in incidences or complications of the diseases of interest; and (4 calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9 to Can$62.4 (95% CI $26–$98.8 and Can$31.6 (95% CI $11.1–$52 to Can$315.5 (95% CI $110.6–$520.4 million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.

  4. Low-Cost Radon Reduction Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Rose, William B. [Partnership for Advanced Residential Retrofit, Champaign, IL (United States); Francisco, Paul W. [Partnership for Advanced Residential Retrofit, Champaign, IL (United States); Merrin, Zachary [Partnership for Advanced Residential Retrofit, Champaign, IL (United States)


    The aim of the research was to conduct a primary scoping study on the impact of air sealing between the foundation and the living space on radon transport reduction across the foundation-living space floor assembly. Fifteen homes in the Champaign, Illinois area participated in the study. These homes were instrumented for hourly continuous radon measurements and simultaneous temperature and humidity the foundation was improved. However, this improved isolation did not lead to significant reductions in radon concentration in the living space. Other factors such as outdoor temperature were shown to have an impact on radon concentration.

  5. Maintenance cost study of rotary wing aircraft, phase 2 (United States)


    The Navy's maintenance and materials management data base was used in a study to determine the feasibility of predicting unscheduled maintenance costs for the dynamic systems of military rotary wing aircraft. The major operational and design variables were identified and the direct maintenance man hours per flight hour were obtained by step-wise multiple regression analysis. Five nonmilitary helicopter users were contacted to supply data on which variables were important factors in civil applications. These uses included offshore oil exploration and support, police and fire department rescue and enforcement, logging and heavy equipment movement, and U.S. Army military operations. The equations developed were highly effective in predicting unscheduled direct maintenance man hours per flying hours for military aircraft, but less effective for commercial or public service helicopters, probably because of the longer mission durations and the much higher utilization of civil users.

  6. In-Hospital Cost Analysis of Total Hip Arthroplasty: Does Surgical Approach Matter? (United States)

    Petis, Stephen M; Howard, James L; Lanting, Brent A; Marsh, Jacquelyn D; Vasarhelyi, Edward M


    The purposes of this study were to determine the impact of surgical approach on costs of total hip arthroplasty (THA) from a hospital perspective and to provide an updated cost estimation of THA. A prospective, microcosting analysis was performed on 118 patients undergoing a THA through an anterior, lateral, or posterior approach. We determined that overall costs (intraoperative costs and hospital stay) were significantly less for the anterior ($7300.22; 95% confidence interval [CI], 7064.49-7535.95) vs lateral ($7853.10; 95% CI, 7577.29-8128.91; P = .031) and anterior vs posterior approach ($8287.46; 95% CI, 7906.42-8668.51; P costs from a hospital perspective.

  7. Development of the cost-benefit analysis methodology for FR cycle research and development

    Energy Technology Data Exchange (ETDEWEB)

    Shiotani, Hiroki; Shinoda, Yoshihiko; Ono, Kiyoshi [Japan Nuclear Cycle Development Inst., Oarai, Ibaraki (Japan). Oarai Engineering Center; Yasumatsu, Naoto [Nuclear Energy System Inc., Tokyo (Japan)


    A cost-benefit analysis system for Fast Reactor (FR) cycle research and development (R and D) has been developed. The benefits derived from FR cycle research and development, which are compared with the cost for the FR cycle R and D in the system, are environmental burden reduction, risk reduction, contribution to energy security and resource import reduction, as well as power generation cost reduction. Cost-benefit analyses for a typical FR cycle R and D and the sensitivity analyses for some parameters have confirmed the validity of the system and the effects of the parameters. Different cost-benefit ratios were obtained form the analyses on the R and Ds for six FR cycle concepts in the first phase of the Feasibility Studies on commercialized FR cycle system. Those analyses showed that several-fold benefit will be derived from FR cycle R and D investment but there remains uncertainty of the parameters on future society. (author)

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

    Directory of Open Access Journals (Sweden)

    Orhan Bozkurt


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

  9. The Cost of Company Occupational Accidents: An Activity Based Analysis using the SACA Method

    DEFF Research Database (Denmark)

    Rikhardsson, Pall M.; Impgaard, Martin

    The Systematic Accident Cost Analysis (SACA) project is a research project carried out during 2001 by The Aarhus School of Business and PricewaterhouseCoopers Denmark with financial support from The Danish National Working Environment Authority. It empirically tested a method - the SACA method...... - for evaluating the visible and hidden costs of corporate occupational accidents. It also focused on whether the registration, processing and reporting of these costs could be integrated in the corporate accounting information system. The project was based on case studies in 9 Danish companies within 3 different...

  10. Development of synthetic flood damage curve by explicit costs analysis (United States)

    Martina, Mario; Molinari, Daniela; Dottori, Francesco; Scorzini, Annarita


    Damage modelling is a key component in flood risk assessments. A conventional approach for estimating direct flood damages is the use of depth-damage functions. However, at present, there are few studies that describe in detail the parameters involved in the models and the hypotheses used for the development of these functions based on synthetic approaches and/or actual flood damage data. In this work a synthetic approach was adopted for the development of a damage model for residential buildings. The approach follows the loss assessment procedure usually applied by the insurance loss adjusters. Required information consisted of all those variables that are necessary to define hazard characteristics at building location, compute the exposure value of the building and the replacement costs of its components. In detail, the model requires four input tables. The hazard module includes the variables describing the features of the flood event at building location (e.g. water depth outside the building, water depth inside the basement, maximum velocity of the flood, duration of the event, contaminant and sediment load). The exposure module includes both extensive variables (e.g. foot print area, number of floors) and "vulnerability" variables, where the latter affect damage estimation in two different ways: by changing the replacement value/unit prices of the building and its components (e.g. the finishing level, building type) or by modifying the function(s) describing damage mechanisms (e.g. building structure, plant distribution). The replacement values table and the unit-price table include respectively the replacement value of the building and the unitary replacement costs of the different building components (e.g. doors and pavement replacement per square meter). The final output of the model is represented by different sets of damage functions describing all the building components (e.g. plasters, plants), depending on hazard, exposure and vulnerability

  11. Terrorism risks and cost-benefit analysis of aviation security. (United States)

    Stewart, Mark G; Mueller, John


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

  12. Performance and cost analysis of all-optical switching: OBS and OCS

    Directory of Open Access Journals (Sweden)

    Ekularn Dhavarudha


    Full Text Available This paper presents a study of performance and cost analysis of optical circuit switching (OCS and optical burstswitching (OBS by proposing the clear images of their node architectures and cost formulations. Then, we apply servicelevel agreement (SLA of the high quality of service application in the terms of network blocking probability and averagenetwork delay to demonstrate OCS and OBS performances, their investment costs, and network dimensioning methodology.Applying SLA to our studies can illustrate the impact of contention resolution and blocking resolution schemes to theperformances and costs of OBS and OCS, accordingly. The simulations illustrate that OBS applying WC gives the bestperformance among all architectures deploying the same offered bandwidth. The investigations also show that WC is a majortechnique contributing high performance gain to both OCS and OBS. Especially for OBS, WC is an important scheme allowingOBS high data grooming property as its performance gain contributing to OBS is much higher than those of OCS. For thecost analysis, OCS is the most economic among all architectures. BA provides the most cost effectiveness among all OBScontention resolution schemes. Lastly, FDL is the least cost effective scheme as it gives little performance enhancement butadds more cost to the network.

  13. Methodology for conceptual remote sensing spacecraft technology: insertion analysis balancing performance, cost, and risk (United States)

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


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

  14. Cost Analysis of Different Digital Fir Filter Design Methods

    Directory of Open Access Journals (Sweden)

    Amninder Singh,


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

  15. Low-cost Radon Reduction Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Rose, William B. [Univ. of Illinois, Urbana-Champaign, IL (United States); Francisco, Paul W. [Univ. of Illinois, Urbana-Champaign, IL (United States); Merrin, Zachary [Univ. of Illinois, Urbana-Champaign, IL (United States)


    The U.S. Department of Energy's Building America research team Partnership for Advanced Residential Retrofits conducted a primary scoping study on the impact of air sealing between the foundation and the living space on radon transport reduction across the foundation and living space floor assembly. Fifteen homes in the Champaign, Illinois, area participated in the study. These homes were instrumented for hourly continuous radon measurements and simultaneous temperature and humidity measurements. Blower door and zone pressure diagnostics were conducted at each house. The treatments consisted of using air-sealing foams at the underside of the floor that separated the living space from the foundation and providing duct sealing on the ductwork that is situated in the foundation area. The hypothesis was that air sealing the floor system that separated the foundation from the living space should better isolate the living space from the foundation; this isolation should lead to less radon entering the living space from the foundation. If the hypothesis had been proven, retrofit energy-efficiency programs may have chosen to adopt these isolation methods for enhanced radon protection to the living space.

  16. Cost minimization analysis for combinations of sampling techniques in bronchoscopy of endobronchial lesions. (United States)

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


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

  17. Total Ownership Cost Reduction Case Study: AEGIS Radar Phase Shifters

    National Research Council Canada - National Science Library

    Bridger, Wray W; Ruiz, Mark D


    The goal of this research is to provide a case study that captures the production and design processes and program management solutions used to reduce total ownership costs of AEGIS Radar Phase Shifters...

  18. Rising Price of Opioid OD Antidote Could Cost Lives: Study (United States)

    ... fullstory_162410.html Rising Price of Opioid OD Antidote Could Cost Lives: Study Investigators identify strategies for ... called attention to skyrocketing prices for the lifesaving antidote, noting: Hospira (a Pfizer Inc. company) charges $142 ...

  19. The Cost Analysis of Learning at a Distance: Venezuela's Universidad Nacional Abierta. (United States)

    Rumble, Greville


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

  20. Time-driven activity based costing: a comparative study with the activity based costing

    Directory of Open Access Journals (Sweden)

    Marina Battistella Luna


    Full Text Available The activity-based costing (ABC emerged in the 1980s to meet the new necessities of cost information facing companies, the result of continuous changes in the business environment. In the 2000s, a new costing method, known as time-driven activity-based costing (TDABC was introduced in order to simplify the ABC. This paper compares these methods in order to provide information to assist managers to decide which of these methods better suits the reality of their companies. Therefore, they were analyzed based on information obtained through a systematic search in the Scopus and Web of Knowledge databases, as well as papers from the annals of the Congresso Brasileiro de Custos, Congresso de Controladoria e Contabilidade da USP and Encontro Nacional de Engenharia de Produção (considering scientific papers published between 2004 and 2016. From this analysis, in most cases it was concluded that TDABC is a simpler and more practical option than ABC. However, it was also apparent that managers, before choosing a particular method, must verify whether the conditions that enable its applicability exist.

  1. What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits. (United States)

    Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A


    More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median duration, 68 s). We identified 4 strategies to lower costs without changing the care plan. They were, in order of overall frequency: 1) changing logistics of care, 2) facilitating co-pay assistance, 3) providing free samples, and 4) changing/adding insurance plans. We also identified 4 strategies to reduce costs by changing the care plan: 1) switching to lower-cost alternative therapy/diagnostic, 2) switching from brand name to generic, 3) changing dosage/frequency, and 4) stopping/withholding interventions. Strategies were relatively consistent across health conditions, except for switching to a lower-cost alternative (more common in breast oncology) and providing free samples (more common in depression). Focus on 3 conditions with potentially high out-of-pocket costs. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. © The Author(s) 2016.

  2. Cost analysis of awake versus asleep deep brain stimulation: a single academic health center experience. (United States)

    Jacob, R Lorie; Geddes, Jonah; McCartney, Shirley; Burchiel, Kim J


    OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial data for patients receiving a neurostimulator lead implant (from the first quarter of 2009 to the second quarter of 2014) were collected and analyzed. Inpatient charges included those associated with International Classification of Diseases, Ninth Revision (ICD-9) procedure code 0293 (implantation or replacement of intracranial neurostimulator lead). Outpatient charges included all preoperative charges ≤ 30 days prior to implant and all postoperative charges ≤ 30 days after implant. The cost of care based on reported charges and a cost-to-charge ratio was estimated. The UHC database was queried (January 2011 to March 2014) with the same ICD-9 code. Procedure cost data across like hospitals (27 UHC hospitals) conducting similar DBS procedures were compared. RESULTS Two hundred eleven DBS procedures (53 awake and 158 asleep) were performed at a single US academic health center during the study period. The average patient age ( ± SD) was 65 ± 9 years old and 39% of patients were female. The most common primary diagnosis was Parkinson's disease (61.1%) followed by essential and other forms of tremor (36%). Overall average DBS procedure cost was $39,152 ± $5340. Asleep DBS cost $38,850 ± $4830, which was not significantly different than the awake DBS cost of $40,052 ± $6604. The standard deviation for asleep DBS was significantly lower (p ≤ 0.05). In 2013, the median cost for a neurostimulator implant lead was $34,052 at UHC-affiliated hospitals that performed at least 5 procedures a year. At Oregon Health & Science University, the median cost was $17,150 and the observed single academic health center cost for a neurostimulator lead implant was

  3. Life-cycle cost analysis of conventional and fuel cell/battery powered urban passenger vehicles (United States)


    This Final Report summarizes the work on the life cycle cost (LCC) analysis of conventional and fuel cell/battery powered urban passenger vehicles. The purpose of the work is to support the Division in making sound economic comparisons between conventional and fuel cell/battery powered buses, passenger vans, and cars for strategic analysis of programmatic R&D goals. The LCC analysis can indicate whether paying a relatively high initial capital cost for advanced technology with low operating and/or environmental costs is advantageous over paying a lower initial cost for conventional technology with higher operating and/or environmental costs. While minimizing life cycle cost is an important consideration, it does not always result in technology penetration in the marketplace. The LCC analysis model developed under this contract facilitates consideration of all perspectives. Over 100 studies have been acquired and analyzed for their applicability. Drawing on prior work by JPL and Los Alamos National Laboratory as primary sources, specific analytical relationships and cost/performance data relevant to fuel cell/battery and intemal combustion engine (ICE) powered vehicles were selected for development of an LCC analysis model. The completed LCC model is structured around twelve integrated modules. Comparative analysis is made between conventional gasoline and diesel vehicles and fuel cell/battery vehicles using either phosphoric acid fuel cells or proton-exchange membrane fuel cells. In all, seven base vehicle configuration cases with a total of 21 vehicle class/powertrain/fuel combinations are analyzed. The LCC model represents a significant advance in comparative economic analysis of conventional and fuel cell/battery powered vehicle technologies embodying several unique features which were not included in prior models.

  4. Cost-of-Illness Studies: A Review of Current Methods


    Ebere Akobundu; Jing Ju; Lisa Blatt; C Daniel Mullins


    The number of cost-of-illness (COI) studies has expanded considerably over time. One outcome of this growth is that the reported COI estimates are inconsistent across studies, thereby raising concerns over the validity of the estimates and methods. Several factors have been identified in the literature as reasons for the observed variation in COI estimates. To date, the variation in the methods used to calculate costs has not been examined in great detail even though the variations in methods...

  5. Analysis of cost data in a cluster-randomized, controlled trial: comparison of methods

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Ørnbøl, Eva; Rosendal, Marianne

    studies have used non-valid analysis of skewed data. We propose two different methods to compare mean cost in two groups. Firstly, we use a non-parametric bootstrap method where the re-sampling takes place on two levels in order to take into account the cluster effect. Secondly, we proceed with a log......  We consider health care data from a cluster-randomized intervention study in primary care to test whether the average health care costs among study patients differ between the two groups. The problems of analysing cost data are that most data are severely skewed. Median instead of mean...... is commonly used for skewed distributions. For health care data, however, we need to recover the total cost in a given patient population. Thus, we focus, on making inferences on population means. Furthermore, a problem of clustered data is added as data related to patients in primary care are organized...

  6. Cost-effectiveness of health research study participant recruitment strategies: a systematic review. (United States)

    Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A


    A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

  7. Burden of epilepsy: a prevalence-based cost of illness study of direct, indirect and intangible costs for epilepsy. (United States)

    Gao, Lan; Xia, Li; Pan, Song-Qing; Xiong, Tao; Li, Shu-Chuen


    We aimed to gauge the burden of epilepsy in China from a societal perspective by estimating the direct, indirect and intangible costs. Patients with epilepsy and controls were enrolled from two tertiary hospitals in China. Patients were asked to complete a Cost-of-Illness (COI), Willingness-to-Pay (WTP) questionnaires, two utility elicitation instruments and Mini Mental State Examination (MMSE). Healthy controls only completed WTP questionnaire, and utility instruments. Univariate analyses were performed to investigate the differences in cost on the basis of different variables, while multivariate analysis was undertaken to explore the predictors of cost/cost component. In total, 141 epilepsy patients and 323 healthy controls were recruited. The median total cost, direct cost and indirect cost due to epilepsy were US$949.29, 501.34 and 276.72, respectively. Particularly, cost of anti-epileptic drugs (AEDs) (US$394.53) followed by cost of investigations (US$59.34), cost of inpatient and outpatient care (US$9.62) accounted for the majority of the direct medical costs. While patients' (US$103.77) and caregivers' productivity costs (US$103.77) constituted the major component of indirect cost. The intangible costs in terms of WTP value (US$266.07 vs. 88.22) and utility (EQ-5D, 0.828 vs. 0.923; QWB-SA, 0.657 vs. 0.802) were both substantially higher compared to the healthy subjects. Epilepsy is a cost intensive disease in China. According to the prognostic groups, drug-resistant epilepsy generated the highest total cost whereas patients in seizure remission had the lowest cost. AED is the most costly component of direct medical cost probably due to 83% of patients being treated by new generation of AEDs. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. System Cost Analysis for an Interior Permanent Magnet Motor

    Energy Technology Data Exchange (ETDEWEB)

    Peter Campbell


    The objective of this program is to provide an assessment of the cost structure for an interior permanent magnet ('IPM') motor which is designed to meet the 2010 FreedomCAR specification. The program is to evaluate the range of viable permanent magnet materials for an IPM motor, including sintered and bonded grades of rare earth magnets. The study considers the benefits of key processing steps, alternative magnet shapes and their assembly methods into the rotor (including magnetization), and any mechanical stress or temperature limits. The motor's costs are estimated for an annual production quantity of 200,000 units, and are broken out into such major components as magnetic raw materials, processing and manufacturing. But this is essentially a feasibility study of the motor's electromagnetic design, and is not intended to include mechanical or thermal studies as would be done to work up a selected design for production.

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

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Yangyang; Parajuli, Prem B.


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

  10. Cost analysis of NOx control alternatives for stationary gas turbines

    Energy Technology Data Exchange (ETDEWEB)

    Bill Major


    The use of stationary gas turbines for power generation has been growing rapidly with continuing trends predicted well into the future. Factors that are contributing to this growth include advances in turbine technology, operating and siting flexibility and low capital cost. Restructuring of the electric utility industry will provide new opportunities for on-site generation. In a competitive market, it maybe more cost effective to install small distributed generation units (like gas turbines) within the grid rather than constructing large power plants in remote locations with extensive transmission and distribution systems. For the customer, on-site generation will provide added reliability and leverage over the cost of purchased power One of the key issues that is addressed in virtually every gas turbine application is emissions, particularly NO{sub x} emissions. Decades of research and development have significantly reduced the NO{sub x} levels emitted from gas turbines from uncontrolled levels. Emission control technologies are continuing to evolve with older technologies being gradually phased-out while new technologies are being developed and commercialized. The objective of this study is to determine and compare the cost of NO{sub x} control technologies for three size ranges of stationary gas turbines: 5 MW, 25 MW and 150 MW. The purpose of the comparison is to evaluate the cost effectiveness and impact of each control technology as a function of turbine size. The NO{sub x} control technologies evaluated in this study include: Lean premix combustion, also known as dry low NO{sub x} (DLN) combustion; Catalytic combustion; Water/steam injection; Selective catalytic reduction (SCR)--low temperature, conventional, high temperature; and SCONO{sub x}{trademark}.

  11. Pressure ulcer dressings in critical patients: a cost analysis

    Directory of Open Access Journals (Sweden)

    Dinara Raquel Araújo Silva

    Full Text Available Abstract OBJECTIVE To assess the direct cost of dressings in pressure ulcer treatment. METHOD This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL were converted into U.S. dollars at the exchange rate of USD 0.26/BRL. Univariate and bivariate analyses were conducted. RESULTS The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002, with a mean of USD 11.9 (±7.4. The most common topical treatments used were essential fatty acids and papain. CONCLUSION Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management.

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

    Energy Technology Data Exchange (ETDEWEB)


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

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

    Yilmaz, Bahadır.


    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.

  14. Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

    Directory of Open Access Journals (Sweden)

    Carlos R. Maia


    Full Text Available Objective:To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD with methylphenidate immediate-release (MPH-IR in children and adolescents from Brazil.Method:A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY, and costs reported in 2014 international dollars (I$. The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years.Results:Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530 as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy.Discussion:MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy.Trial registration number:NCT01705613.

  15. [Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013]. (United States)

    Blasco, Antonio Javier; Llibre, Josep M; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; López, Juan Carlos; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Santamaría, Juan Miguel; Tuset, Montserrat; Zamora, Laura; Lázaro, Pablo; Gatell, Josep M


    The GESIDA and National AIDS Plan panel of experts have proposed "preferred regimens" of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2013. The objective of this study is to evaluate the costs and effectiveness of initiating treatment with these "preferred regimens". An economic assessment of costs and effectiveness (cost/effectiveness) was performed using decision tree analysis models. Effectiveness was defined as the probability of having viral load <50copies/mL at week48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance analyses) during the first 48weeks. The perspective of the analysis is that of the National Health System was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, resistance studies, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was performed, constructing three scenarios for each regimen: baseline, most favourable, and most unfavourable cases. In the baseline case scenario, the cost of initiating treatment ranges from 6,747euros for TDF/FTC+NVP to 12,059euros for TDF/FTC+RAL. The effectiveness ranges between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.87 for TDF/FTC+RAL and ABC/3TC+RAL. Effectiveness, in terms of cost/effectiveness, varies between 8,396euros and 13,930euros per responder at 48weeks, for TDF/FTC/RPV and TDF/FTC+RAL, respectively. Taking ART at official prices, the most effective regimen was TDF/FTC/RPV, followed by the rest of non-nucleoside containing regimens. The sensitivity analysis confirms the robustness of these findings. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  16. A decision-making framework for total ownership cost management of complex systems: A Delphi study (United States)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  17. Cost Analysis of Internet vs. Print Interventions for Physical Activity Promotion (United States)

    Lewis, Beth A.; Williams, David M.; Neighbors, Charles J.; Jakicic, John M.; Marcus, Bess H.


    Objective The objective of this study was to compare the costs associated with Internet and print-based physical activity interventions. Method The costs associated with delivering tailored print and Internet-based interventions were estimated from a randomized controlled physical activity trial (n=167). The estimates were based on research assistant time sampling surveys, web development invoices, and other tracking procedures. Results Web-development costs for the Internet intervention were $109,564. Taken together with the website hosting fees and staff costs, the cost per participant per month was $122.52 The cost of the print intervention was $35.81 per participant per month. However, in a break-even analysis, the Internet intervention became more cost-efficient, relative to the print intervention, when the total number of participants exceeded 352. Conclusions Relative to print-based interventions, Internet-based interventions may be a more cost efficient way to reach a large number of sedentary individuals. PMID:20401164

  18. Low-cost thermoforming of micro fluidic analysis chips (United States)

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


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

  19. Low-cost commodity depth sensor comparison and accuracy analysis (United States)

    Breuer, Timo; Bodensteiner, Christoph; Arens, Michael


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

  20. Cost-of-illness studies : a review of current methods. (United States)

    Akobundu, Ebere; Ju, Jing; Blatt, Lisa; Mullins, C Daniel


    The number of cost-of-illness (COI) studies has expanded considerably over time. One outcome of this growth is that the reported COI estimates are inconsistent across studies, thereby raising concerns over the validity of the estimates and methods. Several factors have been identified in the literature as reasons for the observed variation in COI estimates. To date, the variation in the methods used to calculate costs has not been examined in great detail even though the variations in methods are a major driver of variation in COI estimates. The objective of this review was to document the variation in the methodologies employed in COI studies and to highlight the benefits and limitations of these methods. The review of COI studies was implemented following a four-step procedure: (i) a structured literature search of MEDLINE, JSTOR and EconLit; (ii) a review of abstracts using pre-defined inclusion and exclusion criteria; (iii) a full-text review using pre-defined inclusion and exclusion criteria; and (iv) classification of articles according to the methods used to calculate costs. This review identified four COI estimation methods (Sum_All Medical, Sum_Diagnosis Specific, Matched Control and Regression) that were used in categorising articles. Also, six components of direct medical costs and five components of indirect/non-medical costs were identified and used in categorising articles.365 full-length articles were reflected in the current review following the structured literature search. The top five cost components were emergency room/inpatient hospital costs, outpatient physician costs, drug costs, productivity losses and laboratory costs. The dominant method, Sum_Diagnosis Specific, was a total costing approach that restricted the summation of medical expenditures to those related to a diagnosis of the disease of interest. There was considerable variation in the methods used within disease subcategories. In several disease subcategories (e.g. asthma, dementia

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

    NARCIS (Netherlands)

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


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

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

    NARCIS (Netherlands)

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


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

  3. Medicare long-term CPAP coverage policy: a cost-utility analysis. (United States)

    Billings, Martha E; Kapur, Vishesh K


    CPAP is an effective treatment for OSA that may reduce health care utilization and costs. Medicare currently reimburses the costs of long-term CPAP therapy only if the patient is adherent during a 90-day trial. If not, Medicare requires a repeat polysomnogram (PSG) and another trial which seems empirically not cost-effective. We modeled the cost-effectiveness of current Medicare policy compared to an alternative policy (clinic-only) without the adherence criterion and repeat PSG. Cost-utility and cost-effectiveness analysis. U.S. Medicare Population. N/A. N/A. We created a decision tree modeling (1) clinic only follow-up vs. (2) current Medicare policy. Costs were assigned based on Medicare reimbursement rates in 2012. Sensitivity analyses were conducted to test our assumptions. We estimated cumulative costs, overall adherence, and QALY gained for a 5-year time horizon from the perspective of Medicare as the payer. Current Medicare policy is more costly than the clinic-only policy but has higher net adherence and improved utility. Current Medicare policy compared to clinic-only policy costs $30,544 more per QALY. Current CMS policy promotes early identification of those more likely to adhere to CPAP therapy by requiring strict adherence standards. The policy effect is to deny coverage to those unlikely to use CPAP long-term and prevent wasted resources. Future studies are needed to measure long-term adherence in an elderly population with and without current adherence requirements to verify the cost-effectiveness of a policy change.

  4. Manufacturing cost reductions and ecoefficiency: a relationship based on a case study

    Directory of Open Access Journals (Sweden)

    Rosangela Maria Vanalle


    Full Text Available In the search for higher profits or competitiveness, firms have frequently used structured procedures to reduce their costs and expenses. However, the environmental consequences associated to those processes have hardly been considered. Hence, the central purpose of this paper is to show that it is possible to obtain relevant environmental gains even not considering the environmental issues as part of the operational cost reduction efforts. This particular point was verified through a single case study where value analysis was used to obtain manufacturing cost reductions in a company belonging to the Brazilian textile sector. Even not considering environmental aspects as part of the value analysis procedures, when the cost reduction actions were implemented it was possible to confirm that they also brought significant improvements to the environmental conditions, which were measured by the firm ecoefficiency levels before and after the cost reduction implementations. Normal 0 21 false false false PT-BR X-NONE X-NONE

  5. Analysis of the management costs of municipal wastes; Analyse des couts de gestion des dechets municipaux

    Energy Technology Data Exchange (ETDEWEB)

    Cagnot, J.F.; Monier, V.; Hugues, N.


    This document presents the results of the study carried out from March 1997 to September 1998 and relative to the costs generated by the management of domestic wastes. The study comprises 3 parts: the elaboration of a method of evaluation of management costs, the analysis of management costs in todays situation and in the regulatory context of the year 2002, and the elaboration of tools for the application of the method. The following aspects are presented successively: 1 - the objectives, methodology and limitations of the analysis; 2 - the costs of the municipal wastes management in the regulatory context of 2002: presentation of the configurations studied, costs, comparison with the 1997 situation as observed on sites; 3 - factors that influence the success of a good management of municipal wastes: selective collecting, dimensioning of equipments with respect to capacities, local or centralized management, energy and materials valorization of products from incineration plants, materials recycling; 4 - impact of local conditions of programs application: costs, influence of the type of accommodation in the selective collecting, public information. (J.S.)

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

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


    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.

  7. Cost analysis in support of minimum energy standards for clothes washers and dryers

    Energy Technology Data Exchange (ETDEWEB)


    The results of the cost analysis of energy conservation design options for laundry products are presented. The analysis was conducted using two approaches. The first, is directed toward the development of industrial engineering cost estimates of each energy conservation option. This approach results in the estimation of manufacturers costs. The second approach is directed toward determining the market price differential of energy conservation features. The results of this approach are shown. The market cost represents the cost to the consumer. It is the final cost, and therefore includes distribution costs as well as manufacturing costs.

  8. Application of Data Envelopment Analysis to Measure Cost, Revenue and Profit Efficiency

    Directory of Open Access Journals (Sweden)

    Kristína Kočišová


    Full Text Available The literature analysing efficiency of financial institutions has enveloped rapidly over the last years. Most studies have focused on the input side analysing input technical and cost efficiency. Only few studies have examined the output side evaluating output technical and revenue efficiency. We know that both sides are relevant when evaluating efficiency of financial institutions. Therefore the primary purpose of this paper is to review a number of approaches for efficiency measurement. In particular, the concepts of cost, revenue and profit functions are discussed. We apply Data Envelopment Analysis (DEA to a sample of Slovak and Czech commercial banks during years 2009–2013 comparing the efficiencies by either minimizing cost or maximizing revenue and profit. The results showed that the level of average revenue efficiency was the highest and the average profit efficiency was the lowest one. As can be seen the Czech banks were more cost, revenue and profit efficient than Slovak ones during the whole analysed period.

  9. Cost of pneumococcal infections and cost-effectiveness analysis of pneumococcal vaccination at risk adults and elderly in Turkey. (United States)

    Akin, Levent; Kaya, Mehmet; Altinel, Serdar; Durand, Laure


    Pneumococcal infections have a substantial burden in Turkey, particularly in the elderly (> 60 years) and at-risk adults (18-59 years). VCR are low at approximately 2%. The first aim of this study was the evaluation of the burden of pneumococcal infections (pneumonia and bacteremia) from a public payer perspective in elderly and at-risk adults. The second aim was the evaluation of cost effectiveness of implementing a large PPV program in these populations. A decision tree model was employed using demographic and epidemiological input obtained from Turkish official sources and international literature. Vaccination was assumed to protect for 5 years with 60% and 50% effectiveness against BPP in elderly and at-risk adults respectively. Vaccination effectiveness of 21% against NBPP was assumed for both populations. Costs input were obtained from a previous study conducted between 2002 and 2008 in a public university hospital in Ankara, Turkey. Univariate sensitivity analyses and Monte-Carlo simulations were performed. The vaccination program was cost effective and cost saving compared to no vaccination, pneumococcal vaccination with 60% coverage led to a mean of 4,695 LYG in the elderly and 2,134 LYG in at-risk adults with 40% coverage. Mean incremental savings reached 45.4 million YTL in the elderly and 21.8 million YTL in at-risk adults. This analysis suggests that pneumococcal vaccination of elderly and at-risk adults is associated with a positive return on investment from a public payer perspective and supports the continued recommendation of pneumococcal vaccines, as well as their full funding in Turkey.

  10. Cost-utility analysis of prehospital spine immobilization recommendations for penetrating trauma. (United States)

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


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

  11. Cost minimization analysis of different growth hormone pen devices based on time-and-motion simulations

    Directory of Open Access Journals (Sweden)

    Kim Jaewhan


    Full Text Available Abstract Background Numerous pen devices are available to administer recombinant Human Growth Hormone (rhGH, and both patients and health plans have varying issues to consider when selecting a particular product and device for daily use. Therefore, the present study utilized multi-dimensional product analysis to assess potential time involvement, required weekly administration steps, and utilization costs relative to daily rhGH administration. Methods Study objectives were to conduct 1 Time-and-Motion (TM simulations in a randomized block design that allowed time and steps comparisons related to rhGH preparation, administration and storage, and 2 a Cost Minimization Analysis (CMA relative to opportunity and supply costs. Nurses naïve to rhGH administration and devices were recruited to evaluate four rhGH pen devices (2 in liquid form, 2 requiring reconstitution via TM simulations. Five videotaped and timed trials for each product were evaluated based on: 1 Learning (initial use instructions, 2 Preparation (arrange device for use, 3 Administration (actual simulation manikin injection, and 4 Storage (maintain product viability between doses, in addition to assessment of steps required for weekly use. The CMA applied micro-costing techniques related to opportunity costs for caregivers (categorized as wages, non-drug medical supplies, and drug product costs. Results Norditropin® NordiFlex and Norditropin® NordiPen (NNF and NNP, Novo Nordisk, Inc., Bagsværd, Denmark took less weekly Total Time (p ® Pen (GTP, Pfizer, Inc, New York, New York or HumatroPen® (HTP, Eli Lilly and Company, Indianapolis, Indiana. Time savings were directly related to differences in new package Preparation times (NNF (1.35 minutes, NNP (2.48 minutes GTP (4.11 minutes, HTP (8.64 minutes, p Conclusions Time-and-motion simulation data used to support a micro-cost analysis demonstrated that the pen device with the greater time demand has highest net costs.

  12. Estimating study costs for use in VOI, a study of dutch publicly funded drug related research

    NARCIS (Netherlands)

    Van Asselt, A.D.; Ramaekers, B.L.; Corro Ramos, I.; Joore, M.A.; Al, M.J.; Lesman-Leegte, I.; Postma, M.J.; Vemer, P.; Feenstra, T.F.


    Objectives: To perform value of information (VOI) analyses, an estimate of research costs is needed. However, reference values for such costs are not available. This study aimed to analyze empirical data on research budgets and, by means of a cost tool, provide an overview of costs of several types

  13. Aagesta-BR3 Decommissioning Cost. Comparison and Benchmarking Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Varley, Geoff [NAC International, Henley on Thames (United Kingdom)


    25 is equipment. The BR3 work packages described in this report add up to something like 83,000 labour hours plus about MSEK 13 of investments and consumables costs. At Swedish average team labour rates 83,000 hours would equate to about MSEK 52. Adding the investment cost of MSEK 13 gives a total of about MSEK 65. This of course is quite close to the Aagesta figure but it would be wrong to draw immediate, firm conclusions based on these data. Such a comparison should take into account, inter alia: The number and relative sizes of the equipment decontaminated and dismantled at Aagesta and BR3. The assumed productivity in the Aagesta estimate compared to the actual BR3 figures. The physical scale of the Aagesta reactor is somewhat larger than the BR3 reactor, so all other things being equal, one might expect the Aagesta decommissioning cost estimate to be higher than for BR3. Aagesta has better access overall, which should help to constrain costs. The productivity ratio for workers at BR3 on average was high - generally 80 per cent or more, so this is unlikely to be exceeded at Aagesta and might not be equalled, which would tend to push the Aagesta cost up relative to the BR3 situation. There is an additional question of the possible extra work performed at BR3 due to the R and D nature of the project. The BR3 data analysed has tried to strip away any such 'extra' work but nevertheless there may be some residual effect on the final numbers. Analysis and comparison of individual work packages has raised several conclusions, as follows: The constructed cost for Aagesta using BR3 benchmark data is encouragingly close to the Aagesta estimate value but it is not clear that the way of deriving the Aagesta estimate for decontamination was entirely rigorous. The reliability of the Aagesta estimate on these grounds therefore might reasonably be questioned. A significant discrepancy between the BR3 and Aagesta cases appears to exist in respect of the volumes of waste

  14. Research Costs Investigated: A Study Into the Budgets of Dutch Publicly Funded Drug-Related Research. (United States)

    van Asselt, Thea; Ramaekers, Bram; Corro Ramos, Isaac; Joore, Manuela; Al, Maiwenn; Lesman-Leegte, Ivonne; Postma, Maarten; Vemer, Pepijn; Feenstra, Talitha


    The costs of performing research are an important input in value of information (VOI) analyses but are difficult to assess. The aim of this study was to investigate the costs of research, serving two purposes: (1) estimating research costs for use in VOI analyses; and (2) developing a costing tool to support reviewers of grant proposals in assessing whether the proposed budget is realistic. For granted study proposals from the Netherlands Organization for Health Research and Development (ZonMw), type of study, potential cost drivers, proposed budget, and general characteristics were extracted. Regression analysis was conducted in an attempt to generate a 'predicted budget' for certain combinations of cost drivers, for implementation in the costing tool. Of 133 drug-related research grant proposals, 74 were included for complete data extraction. Because an association between cost drivers and budgets was not confirmed, we could not generate a predicted budget based on regression analysis, but only historic reference budgets given certain study characteristics. The costing tool was designed accordingly, i.e. with given selection criteria the tool returns the range of budgets in comparable studies. This range can be used in VOI analysis to estimate whether the expected net benefit of sampling will be positive to decide upon the net value of future research. The absence of association between study characteristics and budgets may indicate inconsistencies in the budgeting or granting process. Nonetheless, the tool generates useful information on historical budgets, and the option to formally relate VOI to budgets. To our knowledge, this is the first attempt at creating such a tool, which can be complemented with new studies being granted, enlarging the underlying database and keeping estimates up to date.

  15. Cost-benefit analysis of telehealth in pre-hospital care. (United States)

    Langabeer, James R; Champagne-Langabeer, Tiffany; Alqusairi, Diaa; Kim, Junghyun; Jackson, Adria; Persse, David; Gonzalez, Michael


    Objective There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. Methods Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention. The intervention consisted of telehealth-based consultation between the 911 patient and an EMS physician, to evaluate and triage the necessity for patient transport to a hospital emergency department (ED). Patients with non-urgent, primary care-related conditions were then scheduled and transported by alternative means to an affiliated primary care clinic. We measured CBA as both total cost savings and cost per ED visit averted, in US Dollars ($USD). Results In total, 5570 patients were treated over the first full 12 months with a telehealth-enabled care model. We found a 6.7% absolute reduction in potentially medically unnecessary ED visits, and a 44-minute reduction in total ambulance back-in-service times. The average cost for a telehealth patient was $167, which was a statistically significantly $103 less than the control group ( p cost savings from the societal perspective, or $2468 cost savings per ED visit averted (benefit). Conclusion Patient care enabled by telehealth in a pre-hospital environment, is a more cost effective alternative compared to the traditional EMS 'treat and transport to ED' model.

  16. A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

    DEFF Research Database (Denmark)

    Clark, J F; Mealing, S J; Scott, D A


    includes the long-term sequelae of impaired renal function and urinary tract infection (UTI). SETTING: Analysis based on a UK perspective. METHODS: A probabilistic Markov decision model was constructed, to compare lifetime costs and quality-adjusted life years, taking renal and UTI health states......STUDY DESIGN: Cost-effectiveness analysisObjective:To establish a model to investigate the cost effectiveness for people with spinal cord injury (SCI), from a lifetime perspective, for the usage of two different single-use catheter designs: hydrophilic-coated (HC) and uncoated (UC). The model...... into consideration, as well as other catheter-related events. UTI event rates for the primary data set were based on data from hospital settings to ensure controlled and accurate reporting. A sensitivity analysis was applied to evaluate best- and worst-case scenarios. RESULTS: The model predicts that a 36-year...

  17. An analysis of the cost of incomplete abortion to the public health ...

    African Journals Online (AJOL)

    abortions.....1 In this analysis we estimate the cost of treatment for all incomplete ... include all 'hotel' functions of care, administrative overheads, rent ..... with existing medical technology.13 The costs reported in this analysis represent ...


    NARCIS (Netherlands)



    Objective.-To evaluate the relative benefits and cost-effectiveness of revascularization for femoropopliteal disease using percutaneous transluminal angioplasty or bypass surgery. Design.-Decision analysis using a multistate transition simulation model (Markov process) and cost-effectiveness