WorldWideScience

Sample records for cost saving opportunities

  1. Energy efficiency improvement and cost saving opportunities forpetroleum refineries

    Energy Technology Data Exchange (ETDEWEB)

    Worrell, Ernst; Galitsky, Christina

    2005-02-15

    The petroleum refining industry in the United States is the largest in the world, providing inputs to virtually any economic sector,including the transport sector and the chemical industry. The industry operates 146 refineries (as of January 2004) around the country,employing over 65,000 employees. The refining industry produces a mix of products with a total value exceeding $151 billion. Refineries spend typically 50 percent of cash operating costs (i.e., excluding capital costs and depreciation) on energy, making energy a major cost factor and also an important opportunity for cost reduction. Energy use is also a major source of emissions in the refinery industry making energy efficiency improvement an attractive opportunity to reduce emissions and operating costs. Voluntary government programs aim to assist industry to improve competitiveness through increased energy efficiency and reduced environmental impact. ENERGY STAR (R), a voluntary program managed by the U.S. Environmental Protection Agency, stresses the need for strong and strategic corporate energy management programs. ENERGY STAR provides energy management tools and strategies for successful corporate energy management programs. This Energy Guide describes research conducted to support ENERGY STAR and its work with the petroleum refining industry.This research provides information on potential energy efficiency opportunities for petroleum refineries. This Energy Guide introduces energy efficiency opportunities available for petroleum refineries. It begins with descriptions of the trends, structure, and production of the refining industry and the energy used in the refining and conversion processes. Specific energy savings for each energy efficiency measure based on case studies of plants and references to technical literature are provided. If available, typical payback periods are also listed. The Energy Guide draws upon the experiences with energy efficiency measures of petroleum refineries worldwide

  2. Guide to resource conservation and cost savings opportunities in the dairy processing sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-12-31

    This guide identifies and promotes opportunities for conserving energy and water, as well as reducing waste, in the dairy processing sector. The guide begins with an introduction and a profile of Ontario`s dairy processing sector, outlining the context for resource conservation and cost savings opportunities. It then outlines the rationale and the generic processes selected for careful examination of resource conservation and cost savings opportunities. Subsequent chapters describe the energy, water, and material resources commonly used in relation to the generic processes; the air, water, and solid waste residuals commonly derived from those processes; and new technologies with potential application in dairy processing. The generic processes covered in the guide are for fluid milk, cheese, ice cream and frozen products, cultured products such as yogurt, butter, and dried or evaporated products. The report ends with additional useful information for dairy processors.

  3. Guide to resource conservation and cost savings opportunities in the soap, detergents and related products sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    The soaps, detergents and related products sector is an important component of the chemical industry within Ontario, as these products are used for cleaning purposes in industrial, institutional and domestic consumer applications. This guide was prepared to assist the sector with cost savings and resource conservation. The guide highlights opportunities for resource conservation through energy and water efficiency improvements, more efficient utilisation of raw materials, and reduction of environmental releases at source. 54 figs.

  4. Immersive Environment Development for Training: Opportunities for Cooperation, Coordination, and Cost Savings

    International Nuclear Information System (INIS)

    Tackentien, J.; Hoffheins, B.; Brown, R.

    2015-01-01

    Immersive environments are increasingly demonstrating their utility for a number of nuclear safeguards, nuclear safety, and nuclear and physical security applications. Although training is an obvious use, the immersive (or sometimes called virtual) environment allows the user to ''visit'' nuclear facilities and sites that might have access restrictions because of security, high radiation or other hazards; are difficult and expensive to visit. An immersive environment can also be reconfigured to study various scenarios, processes, and other what-if situations, which can aid planning and design of new facilities or evaluate safeguards, safety and/or security measures before they are implemented. As the International Atomic Energy Agency, other international organizations, State Authorities, industry, and academia continue development and use of immersive environments and other electronic training technologies, more and more applications can be envisioned. Immersive environments are not a direct or always a desirable replacement for hands-on learning; however, the demand for electronic training media, particularly immersive environments, will grow. The resulting increase of system features and libraries presents opportunities to shorten development time frames, reduce costs and increase availability of immersive environments for a wider audience looking to balance the need for quality training with limited resources. Substantial time and cost savings can be realized by the sharing of raw assets among developers and organizations. This paper will explore potential guidelines, criteria, and mechanisms for such cooperation, including a prototype asset repository website. (author)

  5. Guide to resource conservation and cost savings opportunities in the food service sector

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    Opportunities for conserving energy and water, as well as reducing waste, within the 24,000 establishment-strong food service sector in Ontario are identified. Operators are encouraged to take advantage of these opportunities to lower their costs while conserving valuable resources at the same time. In preparing this guide, site visits were carried out at six food service facilities in Ontario. Information about how much money is generally spent on energy, water and waste management by food service operators is provided. The amount and type of waste generated by these facilities is also described. The volatility of the commercial food service market place was identified as one of the major impediments to energy conservation. It was found that most owners of the food service facilities make business decisions based on the lowest first costs, irrespective of longer-term energy efficiency and operating costs. 31 refs., 13 tabs., 9 figs., 4 appendices.

  6. [Radiology in managed care environment: opportunities for cost savings in an HMO].

    Science.gov (United States)

    Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M

    2003-09-01

    A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these

  7. Realized Cost Savings 2016

    Data.gov (United States)

    Department of Veterans Affairs — This dataset is provided as a requirement of OMB’s Integrated Data Collection (IDC) and links to VA’s Realized Cost Savings and Avoidances data in JSON format. Cost...

  8. Energy Efficiency Improvement and Cost Saving Opportunities for Breweries: An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Martin, Nathan; Worrell, Ernst; Lehman, Bryan

    2003-09-01

    Annually, breweries in the United States spend over $200 million on energy. Energy consumption is equal to 38 percent of the production costs of beer, making energy efficiency improvement an important way to reduce costs, especially in times of high energy price volatility. After a summary of the beer making process and energy use, we examine energy efficiency opportunities available for breweries. We provide specific primary energy savings for each energy efficiency measure based on case studies that have implemented the measures, as well as references to technical literature. If available, we have also listed typical payback periods. Our findings suggest that given available technology, there are still opportunities to reduce energy consumption cost-effectively in the brewing industry. Brewers value highly the quality, taste and drinkability of their beer. Brewing companies have and are expected to continue to spend capital on cost-effective energy conservation measures that meet these quality, taste and drinkability requirements. For individual plants, further research on the economics of the measures, as well as their applicability to different brewing practices, is needed to assess implementation of selected technologies.

  9. Invisible costs, visible savings.

    Science.gov (United States)

    Lefever, G

    1999-08-01

    By identifying hidden inventory costs, nurse managers can save money for the organization. Some measures include tracking and standardizing supplies, accurately evaluating patients' needs, and making informed purchasing decisions.

  10. Energy Efficiency Improvement and Cost Saving Opportunities for the Pharmaceutical Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Galitsky, Christina; Chang, Sheng-chieh; Worrell, Ernst; Masanet, Eric

    2008-03-01

    The U.S. pharmaceutical industry consumes almost $1 billion in energy annually. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. pharmaceutical industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy efficient technologies that can be implemented at the component, process, system, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. pharmaceutical industry is provided along with a description of the major process steps in the pharmaceutical manufacturing process. Expected savings in energy and energy-related costs are given for many energy efficiency measures, based on case study data from real-world applications in pharmaceutical and related facilities worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers reduce energy consumption in a cost-effective manner while meeting regulatory requirements and maintaining the quality of products manufactured. At individual plants, further research on the economics of the measures?as well as their applicability to different production practices?is needed to assess potential implementation of selected technologies.

  11. Energy Efficiency Improvement and Cost Saving Opportunities for the Glass Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Galitsky, Christina; Masanet, Eric; Graus, Wina

    2008-03-01

    The U.S. glass industry is comprised of four primary industry segments--flat glass, container glass, specialty glass, and fiberglass--which together consume $1.6 billion in energy annually. On average, energy costs in the U.S. glass industry account for around 14 percent of total glass production costs. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There is a variety of opportunities available at individual plants in the U.S. glass industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, system, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. glass industry is provided along with a description of the major process steps in glass manufacturing. Expected savings in energy and energy-related costs are given for many energy efficiency measures, based on case study data from real-world applications in glass production facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. glass industry reduce energy consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of the measures--as well on as their applicability to different production practices--is needed to assess potential implementation of selected technologies at individual plants.

  12. Energy Efficiency Improvement and Cost Saving Opportunities for the Concrete Industry

    NARCIS (Netherlands)

    Kermeli, Katerina; Worrell, E.; Masanet, Eric

    2011-01-01

    The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for about 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials

  13. Radiology in managed care environment: Opportunities for cost savings in an HMO

    International Nuclear Information System (INIS)

    Schmidt, C.; Heller, M.

    2003-01-01

    Purpose: A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. Materials and methods: We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were documented in Microsoft Excel trademark and analyzed by non-parametric tests using SPSS trademark 8.0 (Statistical Package for the Social Sciences) for Windows trademark . Results: The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. (orig.) [de

  14. Evaluation of Missed Energy Saving Opportunity Based on Illinois Home Performance Program Field Data: Homeowner Selected Upgrades Versus Cost-Optimized Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Yee, S.; Milby, M.; Baker, J.

    2014-06-01

    Expanding on previous research by PARR, this study compares measure packages installed during 800 Illinois Home Performance with ENERGY STAR(R) (IHP) residential retrofits to those recommended as cost-optimal by Building Energy Optimization (BEopt) modeling software. In previous research, cost-optimal measure packages were identified for fifteen Chicagoland single family housing archetypes, called housing groups. In the present study, 800 IHP homes are first matched to one of these fifteen housing groups, and then the average measures being installed in each housing group are modeled using BEopt to estimate energy savings. For most housing groups, the differences between recommended and installed measure packages is substantial. By comparing actual IHP retrofit measures to BEopt-recommended cost-optimal measures, missed savings opportunities are identified in some housing groups; also, valuable information is obtained regarding housing groups where IHP achieves greater savings than BEopt-modeled, cost-optimal recommendations. Additionally, a measure-level sensitivity analysis conducted for one housing group reveals which measures may be contributing the most to gas and electric savings. Overall, the study finds not only that for some housing groups, the average IHP retrofit results in more energy savings than would result from cost-optimal, BEopt recommended measure packages, but also that linking home categorization to standardized retrofit measure packages provides an opportunity to streamline the process for single family home energy retrofits and maximize both energy savings and cost-effectiveness.

  15. Evaluation of Missed Energy Saving Opportunity Based on Illinois Home Performance Program Field Data: Homeowner Selected Upgrades Versus Cost-Optimized Solutions

    Energy Technology Data Exchange (ETDEWEB)

    Yee, S. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Milby, M. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States); Baker, J. [Partnership for Advanced Residential Retrofit, Chicago, IL (United States)

    2014-06-01

    Expanding on previous research by PARR, this study compares measure packages installed during 800 Illinois Home Performance with ENERGY STAR® (IHP) residential retrofits to those recommended as cost-optimal by Building Energy Optimization (BEopt) modeling software. In previous research, cost-optimal measure packages were identified for 15 Chicagoland single family housing archetypes. In the present study, 800 IHP homes are first matched to one of these 15 housing groups, and then the average measures being installed in each housing group are modeled using BEopt to estimate energy savings. For most housing groups, the differences between recommended and installed measure packages is substantial. By comparing actual IHP retrofit measures to BEopt-recommended cost-optimal measures, missed savings opportunities are identified in some housing groups; also, valuable information is obtained regarding housing groups where IHP achieves greater savings than BEopt-modeled, cost-optimal recommendations. Additionally, a measure-level sensitivity analysis conducted for one housing group reveals which measures may be contributing the most to gas and electric savings. Overall, the study finds not only that for some housing groups, the average IHP retrofit results in more energy savings than would result from cost-optimal, BEopt recommended measure packages, but also that linking home categorization to standardized retrofit measure packages provides an opportunity to streamline the process for single family home energy retrofits and maximize both energy savings and cost effectiveness.

  16. Energy Efficiency Improvement and Cost Saving Opportunities for Cement Making. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Galitsky, Christina

    2008-01-01

    The cost of energy as part of the total production costs in the cement industry is significant, warranting attention for energy efficiency to improve the bottom line. Historically, energy intensity has declined, although more recently energy intensity seems to have stabilized with the gains. Coal and coke are currently the primary fuels for the sector, supplanting the dominance of natural gas in the 1970s. Most recently, there is a slight increase in the use of waste fuels, including tires. Between 1970 and 1999, primary physical energy intensity for cement production dropped 1 percent/year from 7.3 MBtu/short ton to 5.3 MBtu/short ton. Carbon dioxide intensity due to fuel consumption and raw material calcination dropped 16 percent, from 609 lb. C/ton of cement (0.31 tC/tonne) to 510 lb. C/ton cement (0.26 tC/tonne). Despite the historic progress, there is ample room for energy efficiency improvement. The relatively high share of wet-process plants (25 percent of clinker production in 1999 in the U.S.) suggests the existence of a considerable potential, when compared to other industrialized countries. We examined over 40 energy efficient technologies and measures and estimated energy savings, carbon dioxide savings, investment costs, and operation and maintenance costs for each of the measures. The report describes the measures and experiences of cement plants around the wold with these practices and technologies. Substantial potential for energy efficiency improvement exists in the cement industry and in individual plants. A portion of this potential will be achieved as part of (natural) modernization and expansion of existing facilities, as well as construction of new plants in particular regions. Still, a relatively large potential for improved energy management practices exists.

  17. Energy Efficiency Improvement and Cost Saving Opportunities for the U.S. Iron and Steel Industry An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Worrell, Ernst; Blinde, Paul; Neelis, Maarten; Blomen, Eliane; Masanet, Eric

    2010-10-21

    Energy is an important cost factor in the U.S iron and steel industry. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. iron and steel industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the structure, production trends, energy consumption, and greenhouse gas emissions of the iron and steel industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in the steel and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. iron and steel industry reduce energy consumption and greenhouse gas emissions in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures?and on their applicability to different production practices?is needed to assess their cost effectiveness at individual plants.

  18. Cogeneration an opportunity for industrial energy saving

    International Nuclear Information System (INIS)

    Pasha, R.A.; Butt, Z.S.

    2011-01-01

    This paper is about the cogeneration from industrial energy savings opportunities perspective. The energy crisis in these days forces industry to find ways to cope with critical situation. There are several energy savings options which if properly planned and implemented would be beneficial both for industry and community. One way of energy saving is Cogeneration i.e. Combined Heat and Power. The paper will review the basic methods, types and then discuss the suitability of these options for specific industry. It has been identified that generally process industry can get benefits of energy savings. (author)

  19. Energy efficiency improvement and cost saving opportunities for the Corn Wet Milling Industry: An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Ruth, Michael

    2003-07-01

    Corn wet milling is the most energy intensive industry within the food and kindred products group (SIC 20), using 15 percent of the energy in the entire food industry. After corn, energy is the second largest operating cost for corn wet millers in the United States. A typical corn wet milling plant in the United States spends approximately $20 to $30 million per year on energy, making energy efficiency improvement an important way to reduce costs and increase predictable earnings, especially in times of high energy-price volatility. This report shows energy efficiency opportunities available for wet corn millers. It begins with descriptions of the trends, structure and production of the corn wet milling industry and the energy used in the milling and refining process. Specific primary energy savings for each energy efficiency measure based on case studies of plants and references to technical literature are provided. If available, typical payback periods are also listed. The report draws upon the experiences of corn, wheat and other starch processing plants worldwide for energy efficiency measures. The findings suggest that given available resources and technology, there are opportunities to reduce energy consumption cost-effectively in the corn wet milling industry while maintaining the quality of the products manufactured. Further research on the economics of the measures, as well as the applicability of these to different wet milling practices, is needed to assess the feasibility of implementation of selected technologies at individual plants.

  20. Energy Efficiency Improvement and Cost Saving Opportunities for the Baking Industry: An ENERGY STAR® Guide for Plant and Energy Managers

    Energy Technology Data Exchange (ETDEWEB)

    Masanet, Eric [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Therkelsen, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Worrell, Ernst [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division

    2012-12-28

    The U.S. baking industry—defined in this Energy Guide as facilities engaged in the manufacture of commercial bakery products such as breads, rolls, frozen cakes, pies, pastries, and cookies and crackers—consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in food processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. A summary of basic, proven measures for improving plant-level water efficiency is also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. baking industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.

  1. Energy Efficiency Improvement and Cost Saving Opportunities for Cement Making An ENERGY STAR® Guide for Energy and Plant Managers

    NARCIS (Netherlands)

    Worrell, E.; Kermeli, Katerina; Galitsky, Christina

    The cost of energy as part of the total production costs in the cement industry is significant, typically at 20 to 40% of operational costs, warranting attention for energy efficiency to improve the bottom line. Historically, energy intensity has declined, although more recently energy intensity

  2. Energy Efficiency Improvement and Cost Saving Opportunities for the Vehicle Assembly Industry: An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Galitsky, Christina; Worrell, Ernst

    2008-01-01

    The motor vehicle industry in the U.S. spends about $3.6 billion on energy annually. In this report, we focus on auto assembly plants. In the U.S., over 70 assembly plants currently produce 13 million cars and trucks each year. In assembly plants, energy expenditures is a relatively small cost factor in the total production process. Still, as manufacturers face an increasingly competitive environment, energy efficiency improvements can provide a means to reduce costs without negatively affecting the yield or the quality of the product. In addition, reducing energy costs reduces the unpredictability associated with variable energy prices in today?s marketplace, which could negatively affect predictable earnings, an important element for publicly-traded companies such as those in the motor vehicle industry. In this report, we first present a summary of the motor vehicle assembly process and energy use. This is followed by a discussion of energy efficiency opportunities available for assembly plants. Where available, we provide specific primary energy savings for each energy efficiency measure based on case studies, as well as references to technical literature. If available, we have listed costs and typical payback periods. We include experiences of assembly plants worldwide with energy efficiency measures reviewed in the report. Our findings suggest that although most motor vehicle companies in the U.S. have energy management teams or programs, there are still opportunities available at individual plants to reduce energy consumption cost effectively. Further research on the economics of the measures for individual assembly plants, as part of an energy management program, is needed to assess the potential impact of selected technologies at these plants.

  3. Energy Efficiency Improvement and Cost Saving Opportunities for the Petrochemical Industry - An ENERGY STAR(R) Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Neelis, Maarten; Worrell, Ernst; Masanet, Eric

    2008-09-01

    Energy is the most important cost factor in the U.S petrochemical industry, defined in this guide as the chemical industry sectors producing large volume basic and intermediate organic chemicals as well as large volume plastics. The sector spent about $10 billion on fuels and electricity in 2004. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. petrochemical industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the petrochemical industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in the petrochemical and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. The information in this Energy Guide is intended to help energy and plant managers in the U.S. petrochemical industry reduce energy consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--and on their applicability to different production practices--is needed to assess their cost effectiveness at individual plants.

  4. Refrigeration: Introducing energy saving opportunities for business

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-04-15

    In some industries, most notably food and drink and chemicals, refrigeration accounts for a significant proportion of overall site energy costs. For instance, in the industrial handling of meat, poultry and fish, it often accounts for 50% of total energy costs. In ice-cream production the proportion is 70%. In a number of commercial sectors, refrigeration also represents a significant proportion of overall energy costs. For example: Cold storage 90%; Food supermarkets 50%; Small shops with refrigerated cabinets 70% or over; Pubs and clubs 30%. Against these high costs, even a small reduction in refrigeration energy use can offer significant cost savings, resulting in increased profits. Energy saving need not be expensive. Energy savings of up to 20% can be realised in many refrigeration plant through actions that require little or no investment. In addition, improving the efficiency and reducing the load on a refrigeration plant can improve reliability and reduce the likelihood of a breakdown. Most organisations can save energy and money on refrigeration by: More efficient equipment; Good maintenance; Housekeeping and control. This publication provides an understanding of the operation of refrigeration systems, identifies where savings can be realised and will enable readers to present an informed case on energy savings to key decision makers within their organisation. (GB)

  5. Energy Efficiency Improvement and Cost Saving Opportunities for the Dairy Processing Industry: An ENERGY STAR? Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Brush, Adrian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Masanet, Eric [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Worrell, Ernst [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2011-10-01

    The U.S. dairy processing industry—defined in this Energy Guide as facilities engaged in the conversion of raw milk to consumable dairy products—consumes around $1.5 billion worth of purchased fuels and electricity per year. Energy efficiency improvement is an important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. dairy processing industry to reduce energy consumption and greenhouse gas emissions in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. dairy processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to dairy processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in dairy processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in dairy processing, a summary of basic, proven measures for improving water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. dairy processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures—as well as on their applicability to different production practices—is needed to assess their cost effectiveness at individual plants.

  6. Energy Efficiency Improvement and Cost Saving Opportunities for the Fruit and Vegetable Processing Industry. An ENERGY STAR Guide for Energy and Plant Managers

    Energy Technology Data Exchange (ETDEWEB)

    Masanet, Eric; Masanet, Eric; Worrell, Ernst; Graus, Wina; Galitsky, Christina

    2008-01-01

    The U.S. fruit and vegetable processing industry--defined in this Energy Guide as facilities engaged in the canning, freezing, and drying or dehydrating of fruits and vegetables--consumes over $800 million worth of purchased fuels and electricity per year. Energy efficiency improvement isan important way to reduce these costs and to increase predictable earnings, especially in times of high energy price volatility. There are a variety of opportunities available at individual plants in the U.S. fruit and vegetable processing industry to reduce energy consumption in a cost-effective manner. This Energy Guide discusses energy efficiency practices and energy-efficient technologies that can be implemented at the component, process, facility, and organizational levels. A discussion of the trends, structure, and energy consumption characteristics of the U.S. fruit and vegetable processing industry is provided along with a description of the major process technologies used within the industry. Next, a wide variety of energy efficiency measures applicable to fruit and vegetable processing plants are described. Many measure descriptions include expected savings in energy and energy-related costs, based on case study data from real-world applications in fruit and vegetable processing facilities and related industries worldwide. Typical measure payback periods and references to further information in the technical literature are also provided, when available. Given the importance of water in fruit and vegetable processing, a summary of basic, proven measures for improving plant-level water efficiency are also provided. The information in this Energy Guide is intended to help energy and plant managers in the U.S. fruit and vegetable processing industry reduce energy and water consumption in a cost-effective manner while maintaining the quality of products manufactured. Further research on the economics of all measures--as well as on their applicability to different production

  7. FY 1997 cost savings report

    International Nuclear Information System (INIS)

    Sellards, J.B.

    1998-01-01

    With the end of the cold war, funding for the Environmental Management program increased rapidly as nuclear weapons production facilities were shut down, cleanup responsibilities increased, and facilities were transferred to the cleanup program. As funding for the Environmental Management (EM) program began to level off in response to Administration and Congressional efforts to balance the Federal budget, the program redoubled its efforts to increase efficiency and get more productivity out of every dollar. Cost savings and enhanced performance are an integral pair of Hanford Site operations. FY1997 was the third year of a cost savings program that was initially defined in FY 1995. The definitions and process remained virtually the same as those used in FY 1996

  8. Metaldyne. Plant-Wide Assessment at Royal Oak Finds Opportunities to Improve Manufacturing Effciency, Reduce Energy Use, and Achieve Sigificant Cost Savings

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2005-05-01

    This case study prepared for the U.S. Department of Energy's Industrial Technologies Program describes a plant-wide energy assessment conducted at the Metaldyne, Inc., forging plant in Royal Oak, Michigan. The assessment focused on reducing the plant's operating costs, inventory, and energy use. If the company were to implement all the recommendations that came out of the assessment, its total annual energy savings for electricity would be about 11.5 million kWh and annual cost savings would be $12.6 million.

  9. Metaldyne: Plant-Wide Assessment at Royal Oak Finds Opportunities to Improve Manufacturing Efficiency, Reduce Energy Use, and Achieve Significant Cost Savings

    Energy Technology Data Exchange (ETDEWEB)

    2005-05-01

    This case study prepared for the U.S. Department of Energy's Industrial Technologies Program describes a plant-wide energy assessment conducted at the Metaldyne, Inc., forging plant in Royal Oak, Michigan. The assessment focused on reducing the plant's operating costs, inventory, and energy use. If the company were to implement all the recommendations that came out of the assessment, its total annual energy savings for electricity would be about 11.5 million kWh and annual cost savings would be $12.6 million.

  10. Structured packing: an opportunity for energy savings

    International Nuclear Information System (INIS)

    Chavez T, R.H.; Guadarrama G, J.J.

    1996-01-01

    This work emphasizes the advantages about the use of structured packing. This type of packings allows by its geometry to reduce the processing time giving energy savings and throw down the production costs in several industries such as heavy water production plants, petrochemical industry and all industries involved with separation processes. There is a comparative results of energy consumption utilizing the structured vs. Raschig packings. (Author)

  11. Opportunities of energy saving in lighting systems for public buildings

    Directory of Open Access Journals (Sweden)

    Ayman Abd El-khalek

    2017-03-01

    Full Text Available The lighting system provides many options for cost-effective energy saving with low or no inconvenience. Lighting improvements are excellent investments in most public buildings, it is usually cost-effective to address because lighting improvements are often easier to make than many process upgrades.For public buildings, the easy no and low cost options to help save money and improve the energy performance are:Understand energy use.Identify optionsPrioritize actionsMake the changes and measure the savings.Continue managing energy efficiency.The challenge is to retrofit traditional lamps with LED lamps of good quality. The benefits of LED light bulbs are long-lasting, durable, cool, mercury free, more efficient, and cost effective.The light Emitting Diode (LED bulb uses a semiconductor as its light source, and is currently one of the most energy efficient and quickly developing types of bulbs for lighting. LEDs increasingly are being purchased to replace traditional bulbs. LEDs are relatively more expensive than other types of bulbs, but are very cost-effective because they use only a fraction of electricity of traditional lighting methods nd can last for longer.Benchmarking guides decision makers to policies aimed at the energy sector through better understanding of energy consumption trends nationwide, e.g.: energy price, moderating, peak demand, and encouraging sectors, low energy expansions.The “Improving Energy Efficiency Project of Lighting and Appliances” carried out energy audits and implemented opportunities of energy saving in lighting for different type of public buildings.To rationalize the use of energy by giving guidelines to consumers, the IEEL&A project prepared some brochures.This paper leads with the results of case studies as energy audits, opportunities in lighting systems, energy saving and CO2 reduction.

  12. Duration of oral antibiotic therapy for the treatment of adult acne: a retrospective analysis investigating adherence to guideline recommendations and opportunities for cost-savings.

    Science.gov (United States)

    Straight, Chelsey E; Lee, Young H; Liu, Guodong; Kirby, Joslyn S

    2015-05-01

    The duration of oral antibiotic acne therapy for adolescents compared with guidelines was recently investigated; however it was uncertain if duration of antibiotics for adult acne therapy differed. This study aimed to evaluate duration of oral antibiotics for adult acne compared with guidelines and determine possible cost-savings. This was a retrospective cohort study of MarketScan Commercial Claims and Encounters database that incorporated claims data to determine duration and costs of antibiotic treatment among adults ages 21 years and older. Of 17,448 courses, 84.5% (14,737) aligned with duration guidelines, although 12,040 (69.0%) courses did not include concomitant topical retinoid therapy. Mean savings of $592.26 per person could result if prolonged courses met guidelines. Mean (median) costs of generic and branded formulations for the most frequent course duration (90-179 days) were $103.77 ($54.27) and $1421.61 ($1462.25), respectively. Actual patient prescription adherence is uncertain and database lacks information regarding acne severity, patient physical characteristics, and clinical outcomes. The majority of oral antibiotic course durations follow guidelines, although topical retinoids are underused. Costs of antibiotic therapy were lower for shorter courses and those using generic medications; the cost-effectiveness of these modifications has not been investigated. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Cost savings through innovative technologies

    International Nuclear Information System (INIS)

    Lankford, J.M.; Jackson, J.P.

    1995-01-01

    Newly developed technologies can and already are saving money. Other technologies under development will provide solutions to problems which are currently impossible or too expensive to address, and still others will offer alternative strategies where baseline approaches are not acceptable to the public. All of these options will be considered as the nation decides what it wishes to accomplish, and fund, to clean up the nuclear weapons complex

  14. The High Cost of Saving Energy Dollars.

    Science.gov (United States)

    Rose, Patricia

    1985-01-01

    In alternative financing a private company provides the capital and expertise for improving school energy efficiency. Savings are split between the school system and the company. Options for municipal leasing, cost sharing, and shared savings are explained along with financial, procedural, and legal considerations. (MLF)

  15. Potential Logistics Cost Savings from Engine Commonality

    National Research Council Canada - National Science Library

    Henderson, Robert L; Higer, Matthew W

    2007-01-01

    The purpose of this MBA Project is to determine potential logistics cost savings the USAF and DoD could have realized through the life of the F-16 fighter aircraft had they required engine commonality...

  16. Energy Savings Potential and Research & Development Opportunities for Commercial Refrigeration

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2009-09-01

    This study documents the energy consumption of commercial refrigeration equipment (CRE) in the U.S. and evaluated the energy savings potential of various technologies and energy efficiency measures that could be applied to such equipment. The study provided an overview of CRE applications, assessed the energy-savings potential of CRE in the U.S., outline key barriers to adoption of energy-savings technologies, and recommended opportunities for advanced energy saving technology research. The study was modeled after an earlier 1996 report by Arthur D. Little, Inc., and updated key information, examined more equipment types, and outlined long-term research and development opportunities.

  17. Nuclear recycling: costs, savings, and safeguards

    International Nuclear Information System (INIS)

    Spinrad, B.I.

    1985-01-01

    This chapter discusses the economics, physical and chemical processes, and safety of nuclear fuel recycling. The spent fuel must be chemically reprocessed in order to recover uranium and plutonium. Topics considered include indifference costs, recycling in light water reactors (LWRs), plutonium in fast reactors, the choice between recycling and storage, safeguards, and weapons proliferation. It is shown that the economics of recycling nuclear fuel involves the actual costs and savings of the recycling operation in terms of money spent, made, and saved, and the impact of the recycling on the future cost of uranium

  18. Reducing hospital expenditures with the COPE (Creating Opportunities for Parent Empowerment) program for parents and premature infants: an analysis of direct healthcare neonatal intensive care unit costs and savings.

    Science.gov (United States)

    Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

    2009-01-01

    More than 500,000 premature infants are born in the United States every year. Preterm birth results in a multitude of negative adverse outcomes for children, including extended stays in the neonatal intensive care unit (NICU), developmental delays, physical and mental health/behavioral problems, increased medical utilization, and poor academic performance. In addition, parents of preterms experience a higher incidence of depression and anxiety disorders along with altered parent-infant interactions and overprotective parenting, which negatively impact their children. The costs associated with preterm birth are exorbitant. In 2005, it is estimated that preterm birth cost the United States $26.2 billion. The purpose of this study was to perform a cost analysis of the Creating Opportunities for Parent Empowerment (COPE) program for parents of premature infants, a manualized educational-behavioral intervention program comprising audiotaped information and an activity workbook that is administered to parents in 4 phases, the first phase commencing 2 to 4 days after admission to the NICU. Findings indicated that the COPE program resulted in cost savings of at least $4864 per infant. In addition to improving parent and child outcomes, routine implementation of COPE in NICUs across the United States could save the healthcare system more than $2 billion per year.

  19. Social opportunity cost of capital: empirical estimates

    Energy Technology Data Exchange (ETDEWEB)

    Townsend, S.

    1978-02-01

    This report develops estimates of the social-opportunity cost of public capital. The private and social costs of capital are found to diverge primarily because of the effects of corporate and personal income taxes. Following Harberger, the social-opportunity cost of capital is approximated by a weighted average of the returns to different classes of savers and investors where the weights are the flows of savings or investments in each class multiplied by the relevant elasticity. Estimates of these parameters are obtained and the social-opportunity cost of capital is determined to be in the range of 6.2 to 10.8%, depending upon the parameter values used. Uncertainty is found to affect the social-opportunity cost of capital in two ways. First, some allowance must be made for the chance of failure or at least of not realizing claims of a project's proponents. Second, a particular government project will change the expected variability of the returns to the government's entire portfolio of projects. In the absence of specific information about each project, the use of the economy-wide average default and risk adjustments is suggested. These are included in the empirical estimates reported. International capital markets make available private capital, the price of which is not distorted by the U.S. tax system. The inclusion of foreign sources slightly reduces the social-opportunity cost of capital. 21 references.

  20. Potential cost savings with terrestrial rabies control

    Directory of Open Access Journals (Sweden)

    Cherry Bryan

    2007-04-01

    Full Text Available Abstract Background The cost-benefit of raccoon rabies control strategies such as oral rabies vaccination (ORV are under evaluation. As an initial quantification of the potential cost savings for a control program, the collection of selected rabies cost data was pilot tested for five counties in New York State (NYS in a three-year period. Methods Rabies costs reported to NYS from the study counties were computerized and linked to a human rabies exposure database. Consolidated costs by county and year were averaged and compared. Results Reported rabies-associated costs for all rabies variants totalled $2.1 million, for human rabies postexposure prophylaxes (PEP (90.9%, animal specimen preparation/shipment to laboratory (4.7%, and pet vaccination clinics (4.4%. The proportion that may be attributed to raccoon rabies control was 37% ($784,529. Average costs associated with the raccoon variant varied across counties from $440 to $1,885 per PEP, $14 to $44 per specimen, and $0.33 to $15 per pet vaccinated. Conclusion Rabies costs vary widely by county in New York State, and were associated with human population size and methods used by counties to estimate costs. Rabies cost variability must be considered in developing estimates of possible ORV-related cost savings. Costs of PEPs and specimen preparation/shipments, as well as the costs of pet vaccination provided by this study may be valuable for development of more realistic scenarios in economic modelling of ORV costs versus benefits.

  1. Future cost savings from engineering innovations

    International Nuclear Information System (INIS)

    Roemer, R.E.; Foster, D.C.; Jacobs, S.B.

    1987-01-01

    Nuclear power plant design and operating experience in the 1970s and 1980s continues to provide feedback to the technology base. The lessons learned in these two decades, coupled with engineering innovation, will lead to improvements and cost-reductions in the plants of the 1990s. Two types of innovations related to piping are described: snubber reduction and pipe rupture elimination. A brief account of the industry experience is given for each, followed by an account of the technical methodology involved. A discussion of expected benefits, including cost savings of millions of dollars (U.S.), is provided. (author)

  2. Cost savings from extended life nuclear plants

    International Nuclear Information System (INIS)

    Forest, L.R. Jr.; Deutsch, T.R.; Schenler, W.W.

    1988-09-01

    This study assesses the costs and benefits of nuclear power plant life extension (NUPLEX) for the overall US under widely varying economic assumptions and compares these with alternative new coal- fired plants (NEWCOAL). It is found that NUPLEX saves future electricity consumers more than 3 cents/-kwh compared with NEWCOAL. The NUPLEX costs and benefits for existing individual US nuclear power plants under base-line, or most likely, assumptions are assessed to determine the effects of the basic plant design and plant age. While benefits vary widely, virtually all units would have a positive benefit from NUPLEX. The study also presents a cost-benefit analysis of the nuclear industry's planned advanced light water reactor (ALWR). It is concluded that ALWR offers electrical power at a substantially lower cost than NEWCOAL. 9 refs., 6 figs

  3. Calculating cost savings in utilization management.

    Science.gov (United States)

    MacMillan, Donna

    2014-01-01

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

  4. Radiology in managed care environment: Opportunities for cost savings in an HMO; Radiologie unter Managed-Care-Bedingungen. Einsparpotenziale aus der Sicht einer Krankenversicherung in den USA

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, C. [Universitaet Kiel (Germany). Klinik fuer Allgemeine Chirurgie und Thoraxchirurgie; Mohr, A. [University of California, San Francisco (United States). Dept. of Radiology; Universitaet Kiel (Germany). Klinik fuer Radiologische Diagnostik; Moeller, J. [Universitaet Bielefeld (Germany). Fakultaet fuer Gesundheitswissenschaften; Levin-Scherz, J. [Tufts Healthplan, Boston (United States); Heller, M. [Universitaet Kiel (Germany). Klinik fuer Radiologische Diagnostik

    2003-09-01

    Purpose: A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. Materials and methods: We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were documented in Microsoft Excel {sup trademark} and analyzed by non-parametric tests using SPSS {sup trademark} 8.0 (Statistical Package for the Social Sciences) for Windows {sup trademark}. Results: The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. (orig.) [German] Ziele

  5. Cost-saving production technologies and partial ownership

    OpenAIRE

    Juan Carlos Barcena-Ruiz; Norma Olaizola

    2007-01-01

    This work analyzes the incentives to acquire cost-saving production technologies when cross-participation exists at ownership level. We show that cross-participation reduces the incentives to adopt the cost-saving production technology.

  6. The Opportunity Cost of Capital

    Directory of Open Access Journals (Sweden)

    Ayman Chit PhD

    2015-04-01

    Full Text Available The opportunity cost of the capital invested in pharmaceutical research and development (R&D to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D.

  7. The Opportunity Cost of Capital

    Science.gov (United States)

    Chit, Ayman; Chit, Ahmad; Papadimitropoulos, Manny; Krahn, Murray; Parker, Jayson; Grootendorst, Paul

    2015-01-01

    The opportunity cost of the capital invested in pharmaceutical research and development (R&D) to bring a new drug to market makes up as much as half the total cost. However, the literature on the cost of pharmaceutical R&D is mixed on how, exactly, one should calculate this “hidden” cost. Some authors attempt to adopt models from the field of finance, whereas other prominent authors dismiss this practice as biased, arguing that it artificially inflates the R&D cost to justify higher prices for pharmaceuticals. In this article, we examine the arguments made by both sides of the debate and then explain the cost of capital concept and describe in detail how this value is calculated. Given the significant contribution of the cost of capital to the overall cost of new drug R&D, a clear understanding of the concept is critical for policy makers, investors, and those involved directly in the R&D. PMID:25933615

  8. Potential opportunities for energy savings in a Jordanian poultry company

    International Nuclear Information System (INIS)

    AlQdah, K.

    2010-01-01

    Rising concern about energy resource availability and energy prices in Jordan, cost of energy has become an issue that cannot be ignored in Jordan's industrial sector. In this study, energy auditing in a meat production factory related to poultry company was carried out. Based on the collected data and the conservation laws of energy, the performance of steam boilers, domestic hot water boilers, compressors, refrigeration systems, chillers, pumps, daily consumption of diesel and water were reviewed. The percentage of energy consumed by the refrigeration units, with respect to the total energy consumed, has been estimated. The results demonstrated a normal operation with thermal efficiency of 80.66% for the steam boiler, ability to save 18818.99 JD by installing economizer with payback period of 0.637 year and a 12.3% reduction of the energy cost achieved by reducing the blow down rate. The rate of diesel consumption was reduced by 12.87% over the last period of the study as a result of the recommendations that have been submitted to the technicians and professionals. The sum of 22223.77 JD can be saved by using heavy fuel oil instead of diesel oil. Moreover, this study demonstrated that energy saving can be considered as an ideal choice to increase profit and promote competition within the poultry industry if the company adopts all the proposals and recommendations that have been offered by this study.

  9. Estimated Incident Cost Savings in Shipping Due to Inspections

    NARCIS (Netherlands)

    S. Knapp (Sabine); G.E. Bijwaard (Govert); C. Heij (Christiaan)

    2010-01-01

    textabstractThe effectiveness of safety inspections has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper quantifies estimated cost savings based on port state control inspections and

  10. Estimated incident cost savings in shipping due to inspections

    NARCIS (Netherlands)

    Knapp, S.; Bijwaard, G.E.; Heij, C.

    2011-01-01

    The effectiveness of safety inspections of ships has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper provides a monetary quantification of the cost savings that can be attributed to port

  11. Bandwidth Study on Energy Use and Potential Energy Savings Opportunities in U.S. Petroleum Refining

    Energy Technology Data Exchange (ETDEWEB)

    Sabine Brueske, Caroline Kramer, Aaron Fisher

    2015-06-01

    Energy bandwidth studies of U.S. manufacturing sectors can serve as foundational references in framing the range (or bandwidth) of potential energy savings opportunities. This bandwidth study examines energy consumption and potential energy savings opportunities in U.S. petroleum refining. The study relies on multiple sources to estimate the energy used in nine individual process areas, representing 68% of sector-wide energy consumption. Energy savings opportunities for individual processes are based on technologies currently in use or under development; these potential savings are then extrapolated to estimate sector-wide energy savings opportunity.

  12. Bandwidth Study on Energy Use and Potential Energy Saving Opportunities in U.S. Chemical Manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Sabine Brueske, Caroline Kramer, Aaron Fisher

    2015-06-01

    Energy bandwidth studies of U.S. manufacturing sectors can serve as foundational references in framing the range (or bandwidth) of potential energy savings opportunities. This bandwidth study examines energy consumption and potential energy savings opportunities in U.S. chemical manufacturing. The study relies on multiple sources to estimate the energy used in the production of 74 individual chemicals, representing 57% of sector-wide energy consumption. Energy savings opportunities for individual chemicals and for 15 subsectors of chemicals manufacturing are based on technologies currently in use or under development; these potential savings are then extrapolated to estimate sector-wide energy savings opportunity.

  13. Reactors Save Energy, Costs for Hydrogen Production

    Science.gov (United States)

    2014-01-01

    While examining fuel-reforming technology for fuel cells onboard aircraft, Glenn Research Center partnered with Garrettsville, Ohio-based Catacel Corporation through the Glenn Alliance Technology Exchange program and a Space Act Agreement. Catacel developed a stackable structural reactor that is now employed for commercial hydrogen production and results in energy savings of about 20 percent.

  14. Energy saving and cost saving cooling; Energie und Kosten sparende Kuehlung

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, Klaus W. [Architektur- und Fachpressebuero Klaus W. Koenig, Ueberlingen (Germany)

    2012-07-01

    In the case of cost reduction, energy conservation and resource savings, rain water is an ideal medium offering more advantages in comparison to the cooling with drinking water. There are no fees for the drinking water and drainage of rain water. It is not necessary to soften rain water so that further operational costs for the treatment and drainage of waste water can be saved. The avoidance of the related material flows and necessary energy is a practiced environmental protection and climate protection.

  15. Theoretical, Methodological, and Empirical Approaches to Cost Savings: A Compendium

    Energy Technology Data Exchange (ETDEWEB)

    M Weimar

    1998-12-10

    This publication summarizes and contains the original documentation for understanding why the U.S. Department of Energy's (DOE's) privatization approach provides cost savings and the different approaches that could be used in calculating cost savings for the Tank Waste Remediation System (TWRS) Phase I contract. The initial section summarizes the approaches in the different papers. The appendices are the individual source papers which have been reviewed by individuals outside of the Pacific Northwest National Laboratory and the TWRS Program. Appendix A provides a theoretical basis for and estimate of the level of savings that can be" obtained from a fixed-priced contract with performance risk maintained by the contractor. Appendix B provides the methodology for determining cost savings when comparing a fixed-priced contractor with a Management and Operations (M&O) contractor (cost-plus contractor). Appendix C summarizes the economic model used to calculate cost savings and provides hypothetical output from preliminary calculations. Appendix D provides the summary of the approach for the DOE-Richland Operations Office (RL) estimate of the M&O contractor to perform the same work as BNFL Inc. Appendix E contains information on cost growth and per metric ton of glass costs for high-level waste at two other DOE sites, West Valley and Savannah River. Appendix F addresses a risk allocation analysis of the BNFL proposal that indicates,that the current approach is still better than the alternative.

  16. Missouri Agricultural Energy Saving Team-A Revolutionary Opportunity (MAESTRO)

    Energy Technology Data Exchange (ETDEWEB)

    McIntosh, Jane [MDA; Schumacher, Leon [University of Missouri

    2014-10-23

    The Missouri Agricultural Energy Saving Team-A Revolutionary Opportunity (MAESTRO) program brought together a team of representatives from government, academia, and private industry to enhance the availability of energy efficiency services for small livestock producers in the State of Missouri. The Missouri Department of Agriculture (MDA) managed the project via a subcontract with the University of Missouri (MU), College of Agriculture Food and Natural Resources, MU Extension, the MU College of Human Environmental Sciences, the MU College of Engineering, and the Missouri Agricultural and Small Business Development Authority (MASBDA). MU teamed with EnSave, Inc, a nationally-recognized expert in agricultural energy efficiency to assist with marketing, outreach, provision of farm energy audits and customer service. MU also teamed with independent home contractors to facilitate energy audits of the farm buildings and homes of these livestock producers. The goals of the project were to: (1) improve the environment by reducing fossil fuel emissions and reducing the total energy used on small animal farms; (2) stimulate the economy of local and regional communities by creating or retaining jobs; and (3) improve the profitability of Missouri livestock producers by reducing their energy expenditures. Historically, Missouri scientists/engineers conducted programs on energy use in agriculture, such as in equipment, grain handling and tillage practices. The MAESTRO program was the first to focus strictly on energy efficiency associated with livestock production systems in Missouri and to investigate the applicability and potential of addressing energy efficiency in animal production from a building efficiency perspective. A. Project Objectives The goal of the MAESTRO program was to strengthen the financial viability and environmental soundness of Missouri's small animal farms by helping them implement energy efficient technologies for the production facility, farm

  17. A Method for Estimating Potential Energy and Cost Savings for Cooling Existing Data Centers

    Energy Technology Data Exchange (ETDEWEB)

    Van Geet, Otto

    2017-04-24

    NREL has developed a methodology to prioritize which data center cooling systems could be upgraded for better efficiency based on estimated cost savings and economics. The best efficiency results are in cool or dry climates where 'free' economizer or evaporative cooling can provide most of the data center cooling. Locations with a high cost of energy and facilities with high power usage effectiveness (PUE) are also good candidates for data center cooling system upgrades. In one case study of a major cable provider's data centers, most of the sites studied had opportunities for cost-effective cooling system upgrades with payback period of 5 years or less. If the cable provider invested in all opportunities for upgrades with payback periods of less than 15 years, it could save 27% on annual energy costs.

  18. Users enlist consultants to calculate costs, savings

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-24

    Consultants who calculate payback provide expertise and a second opinion to back up energy managers' proposals. They can lower the costs of an energy-management investment by making complex comparisons of systems and recommending the best system for a specific application. Examples of payback calculations include simple payback for a school system, a university, and a Disneyland hotel, as well as internal rate of return for a corporate office building and a chain of clothing stores. (DCK)

  19. Energy Efficiency Improvement and Cost Saving Oportunities for the Concrete Industry

    Energy Technology Data Exchange (ETDEWEB)

    Kermeli, Katerina; Worrell, Ernst; Masanet, Eric

    2011-12-01

    The U.S. concrete industry is the main consumer of U.S.-produced cement. The manufacturing of ready mixed concrete accounts for more than 75% of the U.S. concrete production following the manufacturing of precast concrete and masonry units. The most significant expenditure is the cost of materials accounting for more than 50% of total concrete production costs - cement only accounts for nearly 24%. In 2009, energy costs of the U.S. concrete industry were over $610 million. Hence, energy efficiency improvements along with efficient use of materials without negatively affecting product quality and yield, especially in times of increased fuel and material costs, can significantly reduce production costs and increase competitiveness. The Energy Guide starts with an overview of the U.S. concrete industry’s structure and energy use, a description of the various manufacturing processes, and identification of the major energy consuming areas in the different industry segments. This is followed by a description of general and process related energy- and cost-efficiency measures applicable to the concrete industry. Specific energy and cost savings and a typical payback period are included based on literature and case studies, when available. The Energy Guide intends to provide information on cost reduction opportunities to energy and plant managers in the U.S. concrete industry. Every cost saving opportunity should be assessed carefully prior to implementation in individual plants, as the economics and the potential energy and material savings may differ.

  20. 21 Cost-Saving Measures For The Judiciary

    Directory of Open Access Journals (Sweden)

    Jessica Vapnek

    2013-02-01

    Full Text Available Courts around the world are increasingly facing budget cuts and funding shortfalls. Budget problems are particularly acute in developing countries, where courts need to increase efficiency and access to justice while also managing resource limitations. International development agencies and donors expect measurable progress to justify continued funding of judicial reform projects. Yet, as rule of law efforts in developing countries improve public perception of courts and streamline court administration, more cases may be filed. Greater use of the courts puts greater strain on court resources, triggering the need to implement cost-saving measures while maintaining effective court administration.This paper outlines 21 measures that courts can implement to reduce costs. Specific examples from developing countries are presented wherever possible, with additional examples drawn from the United States and Europe. Although this paper is intended mainly for audiences in developing countries, the issues facing those courts are similar to issues addressed through court reforms in the United States over the past 50 years. For this reason, examples of cost-saving measures from developed countries such as the United States may be directly applicable or could be used as starting points to spur further cost savings innovation in the developing world.Section I of this paper explains the context for the implementation of judicial cost-saving measures, and raises some issues for reflection. Section II sets out specific judicial cost-saving measures, dividing them into three categories: measures that address court operations; measures directed at staffing and salaries; and measures that relate to court and case management. Section III discusses ways that countries and judiciaries can generate ideas for new and innovative cost-saving mechanisms.

  1. ICU early physical rehabilitation programs: financial modeling of cost savings.

    Science.gov (United States)

    Lord, Robert K; Mayhew, Christopher R; Korupolu, Radha; Mantheiy, Earl C; Friedman, Michael A; Palmer, Jeffrey B; Needham, Dale M

    2013-03-01

    To evaluate the potential annual net cost savings of implementing an ICU early rehabilitation program. Using data from existing publications and actual experience with an early rehabilitation program in the Johns Hopkins Hospital Medical ICU, we developed a model of net financial savings/costs and presented results for ICUs with 200, 600, 900, and 2,000 annual admissions, accounting for both conservative- and best-case scenarios. Our example scenario provided a projected financial analysis of the Johns Hopkins Medical ICU early rehabilitation program, with 900 admissions per year, using actual reductions in length of stay achieved by this program. U.S.-based adult ICUs. Financial modeling of the introduction of an ICU early rehabilitation program. Net cost savings generated in our example scenario, with 900 annual admissions and actual length of stay reductions of 22% and 19% for the ICU and floor, respectively, were $817,836. Sensitivity analyses, which used conservative- and best-case scenarios for length of stay reductions and varied the per-day ICU and floor costs, across ICUs with 200-2,000 annual admissions, yielded financial projections ranging from -$87,611 (net cost) to $3,763,149 (net savings). Of the 24 scenarios included in these sensitivity analyses, 20 (83%) demonstrated net savings, with a relatively small net cost occurring in the remaining four scenarios, mostly when simultaneously combining the most conservative assumptions. A financial model, based on actual experience and published data, projects that investment in an ICU early rehabilitation program can generate net financial savings for U.S. hospitals. Even under the most conservative assumptions, the projected net cost of implementing such a program is modest relative to the substantial improvements in patient outcomes demonstrated by ICU early rehabilitation programs.

  2. A model to estimate cost-savings in diabetic foot ulcer prevention efforts.

    Science.gov (United States)

    Barshes, Neal R; Saedi, Samira; Wrobel, James; Kougias, Panos; Kundakcioglu, O Erhun; Armstrong, David G

    2017-04-01

    Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes. Clinical event and cost estimates were obtained from previously-published trials and studies. A population without previous DFU but with 17% neuropathy and 11% peripheral artery disease (PAD) prevalence was assumed. Primary prevention (PP) was defined as reducing initial DFU incidence. PP was more than 90% likely to provide cost-savings when annual prevention costs are less than $50/person and/or annual DFU incidence is reduced by at least 25%. Efforts directed at patients with diabetes who were at moderate or high risk for DFUs were very likely to provide cost-savings if DFU incidence was decreased by at least 10% and/or the cost was less than $150 per person per year. Low-cost DFU primary prevention efforts producing even small decreases in DFU incidence may provide the best opportunity for cost-savings, especially if focused on patients with neuropathy and/or PAD. Mobile phone-based reminders, self-identification of risk factors (ex. Ipswich touch test), and written brochures may be among such low-cost interventions that should be investigated for cost-savings potential. Published by Elsevier Inc.

  3. Dopamine Manipulation Affects Response Vigor Independently of Opportunity Cost.

    Science.gov (United States)

    Zénon, Alexandre; Devesse, Sophie; Olivier, Etienne

    2016-09-14

    Dopamine is known to be involved in regulating effort investment in relation to reward, and the disruption of this mechanism is thought to be central in some pathological situations such as Parkinson's disease, addiction, and depression. According to an influential model, dopamine plays this role by encoding the opportunity cost, i.e., the average value of forfeited actions, which is an important parameter to take into account when making decisions about which action to undertake and how fast to execute it. We tested this hypothesis by asking healthy human participants to perform two effort-based decision-making tasks, following either placebo or levodopa intake in a double blind within-subject protocol. In the effort-constrained task, there was a trade-off between the amount of force exerted and the time spent in executing the task, such that investing more effort decreased the opportunity cost. In the time-constrained task, the effort duration was constant, but exerting more force allowed the subject to earn more substantial reward instead of saving time. Contrary to the model predictions, we found that levodopa caused an increase in the force exerted only in the time-constrained task, in which there was no trade-off between effort and opportunity cost. In addition, a computational model showed that dopamine manipulation left the opportunity cost factor unaffected but altered the ratio between the effort cost and reinforcement value. These findings suggest that dopamine does not represent the opportunity cost but rather modulates how much effort a given reward is worth. Dopamine has been proposed in a prevalent theory to signal the average reward rate, used to estimate the cost of investing time in an action, also referred to as opportunity cost. We contrasted the effect of dopamine manipulation in healthy participants in two tasks, in which increasing response vigor (i.e., the amount of effort invested in an action) allowed either to save time or to earn more

  4. Winglets Save Billions of Dollars in Fuel Costs

    Science.gov (United States)

    2010-01-01

    The upturned ends now featured on many airplane wings are saving airlines billions of dollars in fuel costs. Called winglets, the drag-reducing technology was advanced through the research of Langley Research Center engineer Richard Whitcomb and through flight tests conducted at Dryden Flight Research Center. Seattle-based Aviation Partners Boeing -- a partnership between Aviation Partners Inc., of Seattle, and The Boeing Company, of Chicago -- manufactures Blended Winglets, a unique design featured on Boeing aircraft around the world. These winglets have saved more than 2 billion gallons of jet fuel to date, representing a cost savings of more than $4 billion and a reduction of almost 21.5 million tons in carbon dioxide emissions.

  5. Evaluation of energy and cost savings in mobile Cloud RAN

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Christiansen, Henrik Lehrmann; Berger, Michael Stübert

    2013-01-01

    , is sub optimal, comparing to a novel, cloud based architecture called Cloud Radio Access Network (C-RAN). In C-RAN a group of cells shares processing resources, and hence benefit from statistical multiplexing gain is expected. In this paper, the energy and cost savings in C-RAN are evaluated numerically...

  6. Potential Cost Savings Ideas for FAA and Users

    Science.gov (United States)

    1997-06-04

    The intent of this paper is to catalogue potential cost-savings ideas which : impact both the FAA and the aviation community. These ideas have come from : various sources including MITRE, Coopers & Lybrand (C&L), FAA studies, General : Accounting Off...

  7. Estimated incident cost savings in shipping due to inspections.

    Science.gov (United States)

    Knapp, Sabine; Bijwaard, Govert; Heij, Christiaan

    2011-07-01

    The effectiveness of safety inspections of ships has been analysed from various angles, but until now, relatively little attention has been given to translate risk reduction into incident cost savings. This paper provides a monetary quantification of the cost savings that can be attributed to port state control inspections and industry vetting inspections. The dataset consists of more than half a million ship arrivals between 2002 and 2007 and contains inspections of port state authorities in the USA and Australia and of three industry vetting regimes. The effect of inspections in reducing the risk of total loss accidents is estimated by means of duration models, in terms of the gained probability of survival. The monetary benefit of port state control inspections is estimated to range, on average, from about 70 to 190 thousand dollars, with median values ranging from about 20 to 45 thousand dollars. Industry inspections have even higher benefits, especially for tankers. The savings are in general higher for older and larger vessels, and also for vessels with undefined flag and unknown classification society. As inspection costs are relatively low in comparison to potential cost savings, the results underline the importance of determining ships with relatively high risk of total loss. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Cultural Differences in Opportunity Cost Consideration.

    Science.gov (United States)

    Zhang, Ning; Ji, Li-Jun; Li, Ye

    2017-01-01

    Two studies were conducted to investigate cultural differences in opportunity cost consideration between Chinese and Euro-Canadians. Opportunity cost is defined as the cost of a benefit that must be forgone in order to pursue a better alternative (Becker et al., 1974). In both studies, participants read about hypothetical purchase scenarios, and then decided whether they would buy a certain product. Opportunity cost consideration was measured in two ways: (1) participants' thoughts pertaining to other (nonfocal) products while making decisions; (2) participants' decisions not to buy a focal product (Study 1) or a more expensive product (Study 2). Across both indexes, we found that after controlling for individual difference variables and amount of pocket money, Chinese participants in China considered financial opportunity cost more than Euro-Canadians in Study 1. Similar results were observed in Study 2 when comparing Chinese in Canada with Euro-Canadians However, the cultural effect on opportunity cost consideration was confounded by family income in Study 2. Implications for resource management, limitations of the current research and directions for future research are discussed.

  9. Assessing the cost saving potential of shared product architectures

    DEFF Research Database (Denmark)

    Mortensen, Niels Henrik; Hansen, Christian Lindschou; Løkkegaard, Martin

    2016-01-01

    company. Experiences from the case company show it is possible to reduce the number of architectures with 60% which leads to significant reduction in direct material and labor costs. This can be achieved without compromising the market offerings of products. Experiences from the case study indicate cost......This article presents a method for calculating cost savings of shared architectures in industrial companies called Architecture Mapping and Evaluation. The main contribution is an operational method to evaluate the cost potential and evaluate the number of product architectures in an industrial...

  10. Faith community nursing: real care, real cost savings.

    Science.gov (United States)

    Yeaworth, Rosalee C; Sailors, Ronnette

    2014-01-01

    At a time when healthcare costs are increasing more than other aspects of the economy, churches are stepping up to help fill needs through congregational health ministries. Faith Community Nursing (FCN) is a rapidly growing health service in the churches of many denominations. This article documents healthcare services and financial savings provided by FCNs and health ministries, showing the critical role faith community nursing can play in containing healthcare costs.

  11. The Effect of Alternative Savings Approaches on College Aid. Opportunity and Ownership Facts. Number 15

    Science.gov (United States)

    Maag, Elaine

    2009-01-01

    To pay for college, many low- and moderate-income students and their families rely on financial aid and savings. How students and families save--and in whose name--affects both the tax consequences and the impact of savings on financial aid. Choosing the wrong way to save can raise the out-of-pocket costs of college by thousands of dollars.…

  12. Paternity leave in Sweden: costs, savings and health gains.

    Science.gov (United States)

    Månsdotter, Anna; Lindholm, Lars; Winkvist, Anna

    2007-06-01

    The initial objective is to examine the relationship between paternity leave in 1978-1979 and male mortality during 1981-2001, and the second objective is to calculate the cost-effectiveness of the 1974 parental insurance reform in Sweden. Based on a population of all Swedish couples who had their first child together in 1978 (45,801 males), the risk of death for men who took paternity leave, compared with men who did not, was estimated by odds ratios. The cost-effectiveness analysis considered costs for information, administration and production losses, minus savings due to decreased sickness leave and inpatient care, compared to health gains in life-years and quality-adjusted life-years (QALYs). It is demonstrated that fathers who took paternity leave have a statistically significant decreased death risk of 16%. Costs minus savings (discounted values) stretch from a net cost of EUR 19 million to a net saving of EUR 11 million, and the base case cost-effectiveness is EUR 8000 per QALY. The study indicates that that the right to paternity leave is a desirable reform based on commonly stated public health, economic, and feminist goals. The critical issue in future research should be to examine impact from health-related selection.

  13. Analyzing Vehicle Fuel Saving Opportunities through Intelligent Driver Feedback

    Energy Technology Data Exchange (ETDEWEB)

    Gonder, J.; Earleywine, M.; Sparks, W.

    2012-06-01

    Driving style changes, e.g., improving driver efficiency and motivating driver behavior changes, could deliver significant petroleum savings. This project examines eliminating stop-and-go driving and unnecessary idling, and also adjusting acceleration rates and cruising speeds to ideal levels to quantify fuel savings. Such extreme adjustments can result in dramatic fuel savings of over 30%, but would in reality only be achievable through automated control of vehicles and traffic flow. In real-world driving, efficient driving behaviors could reduce fuel use by 20% on aggressively driven cycles and by 5-10% on more moderately driven trips. A literature survey was conducted of driver behavior influences, and pertinent factors from on-road experiments with different driving styles were observed. This effort highlighted important driver influences such as surrounding vehicle behavior, anxiety over trying to get somewhere quickly, and the power/torque available from the vehicle. Existing feedback approaches often deliver efficiency information and instruction. Three recommendations for maximizing fuel savings from potential drive cycle improvement are: (1) leveraging applications with enhanced incentives, (2) using an approach that is easy and widely deployable to motivate drivers, and (3) utilizing connected vehicle and automation technologies to achieve large and widespread efficiency improvements.

  14. Incorrect storage of medicines and potential for cost savings

    DEFF Research Database (Denmark)

    Colberg, Lene; Schmidt-Petersen, Lone; Hansen, Merete Kock

    2017-01-01

    continue to be used, possibly with a shortened expiry date. Thus, by examining all cases of incorrect storage, the value of drugs that pharmacists advised could be used despite a broken cold chain, could be estimated. Results The Medicine Information Centre dealt with 171 cases concerning incorrect storage...... in 2013. Data show that advice from Medicine Information Centre pharmacists resulted medicine cost savings of DKK 13 million (approx. €1.7 million) in hospitals in the Capital Region for that year. Conclusions Substantial savings can be made by seeking the advice of a team of information pharmacists...

  15. Health care costs: saving in the private sector.

    Science.gov (United States)

    Robeson, F E

    1979-01-01

    Robeson offers a number of options to employers to help reduce the impact of increasing health care costs. He points out that large organizations which employ hundreds of people have considerable market power which can be exerted to contain costs. It is suggested that the risk management departments assume the responsibility for managing the effort to reduce the costs of medical care and of the health insurance programs of these organizations since that staff is experienced at evaluating premiums and negotiating with third-party payors. The article examines a number of short-run strategies for firms to pursue to contain health care costs: (1) use alternative delivery systems such as health maintenance organizations (HMOs) which have cost-cutting potential but require marketing efforts to persuade employees of their desirability; (2) contracts with third-party payors which require a second opinion (peer review), a practice which saved one labor union over $2 million from 1972 to 1976; (3) implementation of insurance coverage for less expensive outpatient care; and (4) the use of claims review. These strategies are compared in terms of four criteria: supply of demand for health services; management effort; cost; and time necessary for realized savings. Robeson concludes that development of a management plan for containing health care costs requires an extensive analysis of alternatives, organizational objectives, existing policies, and resources, and offers a table summarizing the cost-containment strategies that a firm should consider.

  16. Unveiling information on opportunity costs in REDD

    DEFF Research Database (Denmark)

    Delacote, Philip; Palmer, Charles; Bakkegaard, Riyong Kim

    2014-01-01

    Improving information about individual opportunity costs of deforestation agents has the potential to increase the efficiency of REDD when it takes the form of a payment for environmental services scheme. However, objectives pursued in REDD projects may vary across policy makers. Within a theoret......Improving information about individual opportunity costs of deforestation agents has the potential to increase the efficiency of REDD when it takes the form of a payment for environmental services scheme. However, objectives pursued in REDD projects may vary across policy makers. Within...... objectives in REDD-affected communities, having full information makes no difference to overall welfare as rents remain with agents. The amount of deforestation avoided will at least be as high as under asymmetric information. These results are illustrated with data collected on opportunity costs in Amazonas...

  17. VA Telemedicine: An Analysis of Cost and Time Savings.

    Science.gov (United States)

    Russo, Jack E; McCool, Ryan R; Davies, Louise

    2016-03-01

    The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time. All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed. Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients. Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.

  18. Saving lives and saving money: hospital-based violence intervention is cost-effective.

    Science.gov (United States)

    Juillard, Catherine; Smith, Randi; Anaya, Nancy; Garcia, Arturo; Kahn, James G; Dicker, Rochelle A

    2015-02-01

    Victims of violence are at significant risk for injury recidivism, including fatality. We previously demonstrated that our hospital-based violence intervention program (VIP) resulted in a fourfold reduction in injury recidivism, avoiding trauma care costs of $41,000 per injury. Given limited trauma center resources, assessing cost-effectiveness of interventions is fundamental to inform use of these programs in other institutions. This study examines the cost-effectiveness of hospital-based VIP. We used a decision tree and Markov disease state modeling to analyze cost utility for a hypothetical cohort of violently injured subjects, comparing VIP versus no VIP at a trauma center. Quality-adjusted life-years (QALYs) were calculated using differences in mortality and published health state utilities. Costs of trauma care and VIP were obtained from institutional data, and risk of recidivism with and without VIP were obtained from our trial. Outcomes were QALYs gained and net costs over a 5-year horizon. Sensitivity analyses examined the impact of uncertainty in input values on results. VIP results in an estimated 25.58 QALYs and net costs (program plus trauma care) of $5,892 per patient. Without VIP, these values are 25.34 and $5,923, respectively, suggesting that VIP yields substantial health benefits (24 QALYs) and savings ($4,100) if implemented for 100 individuals. In the sensitivity analysis, net QALYs gained with VIP nearly triple when the injury recidivism rate without VIP is highest. Cost-effectiveness remained robust over a range of values; $6,000 net cost savings occur when 5-year recidivism rate without VIP is at 7%. VIP costs less than having no VIP with significant gains in QALYs especially at anticipated program scale. Across a range of plausible values at which VIP would be less cost-effective (lower injury recidivism, cost of injury, and program effectiveness), VIP still results in acceptable cost per health outcome gained. VIP is effective and cost

  19. Financial Impact of Cancer Drug Wastage and Potential Cost Savings From Mitigation Strategies.

    Science.gov (United States)

    Leung, Caitlyn Y W; Cheung, Matthew C; Charbonneau, Lauren F; Prica, Anca; Ng, Pamela; Chan, Kelvin K W

    2017-07-01

    Cancer drug wastage occurs when a parenteral drug within a fixed vial is not administered fully to a patient. This study investigated the extent of drug wastage, the financial impact on the hospital budget, and the cost savings associated with current mitigation strategies. We conducted a cross-sectional study in three University of Toronto-affiliated hospitals of various sizes. We recorded the actual amount of drug wasted over a 2-week period while using current mitigation strategies. Single-dose vial cancer drugs with the highest wastage potentials were identified (14 drugs). To calculate the hypothetical drug wastage with no mitigation strategies, we determined how many vials of drugs would be needed to fill a single prescription. The total drug costs over the 2 weeks ranged from $50,257 to $716,983 in the three institutions. With existing mitigation strategies, the actual drug wastage over the 2 weeks ranged from $928 to $5,472, which was approximately 1% to 2% of the total drug costs. In the hypothetical model with no mitigation strategies implemented, the projected drug cost wastage would have been $11,232 to $149,131, which accounted for 16% to 18% of the total drug costs. As a result, the potential annual savings while using current mitigation strategies range from 15% to 17%. The financial impact of drug wastage is substantial. Mitigation strategies lead to substantial cost savings, with the opportunity to reinvest those savings. More research is needed to determine the appropriate methods to minimize risk to patients while using the cost-saving mitigation strategies.

  20. Maternal role rewards, opportunity costs and fertility.

    OpenAIRE

    Oppong C

    1982-01-01

    ILO pub-WEP pub. Working paper comprising a literature survey of interrelations between women's social role, maternity and fertility - discusses the social theory background, opportunity cost of children, economic, political, psychic and social status, role rewards, conflicts, etc. Bibliography pp. 35 to 47 and references.

  1. Maintenance cost savings - snubber elimination with limit stops

    International Nuclear Information System (INIS)

    Monette, P.; Baltus, R.; Cloud, R.L.

    1995-01-01

    ''Active'' snubbers can be replaced with ''passive'' Limit Stops using two separate strategies. One is a straightforward piping re-analysis to optimize the number of dynamics supports and replace remaining snubbers with Limit Stops. A second approach is to take implicit advantage of the margins afforded by the ASME Code Case N-411 damping ratios and simply replace snubbers one-for-one with no re-analysis. Both methods result in major maintenance cost savings and both have been received favorably by the USNRC (United States Nuclear Regulatory Commission). Approaches to maintenance cost reduction using these strategies are discussed in this paper. (Author). 11 refs., 4 figs

  2. Maintenance cost savings - snubber elimination with limit stops

    International Nuclear Information System (INIS)

    Cloud, R.L.; Taylor, W.H.

    1993-01-01

    'Active' snubbers can be replaced with 'passive' Limit Stops using two separate strategies. One is a straightforward piping re-analysis to optimize the number of dynamic supports and replace remaining snubbers with Limit Stops. A second approach is to take implicit advantage of the margins afforded by the ASME Code Case N-411 reduced damping ratios and simply replace snubbers one-for-one with no re-analysis. Both methods result in major maintenance cost savings and both have been discussed with the NRC. Approaches to maintenance cost reduction using these strategies are discussed in this paper

  3. Cost Savings for Manufacturing Lithium Batteries in a Flexible Plant

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Paul A.; Ahmed, Shabbir; Gallagher, Kevin G.; Dees, Dennis W.

    2015-06-01

    The flexible plant postulated in this study would produces types of batteries for electric-drive vehicles of the types hybrid (HEV), 10-mile range and 40-mile range plug-in hybrids (PHEV) and a 150-mile range battery-electric (EV). The annual production rate of the plant is 235,000 per year (30,000 EV batteries and 100,000 HEV batteries). The unit cost savings as calculated with the Argonne BatPaC model for this flex plant vs. dedicated plants range from 8% for the EV battery packs to 23% for the HEV packs including the battery management systems (BMS). The investment cost savings are even larger, ranging from 21% for EVs to 43% for HEVs. The costs of the 1.0-kWh HEV batteries are projected to approach $710 per unit and that of the EV batteries $228 per kWh with the most favorable cell chemistries and including the BMS. The best single indicator of the cost of producing lithium-manganate spinel/graphite batteries in a flex plant is the total cell area of the battery. For the four batteries studied, the price range is $20-24 per m2 of cell area including the cost of the BMS, averaging $21 per m2 for the entire flex plant.

  4. Maintenance cost models in deregulated power systems under opportunity costs

    International Nuclear Information System (INIS)

    Al-Arfaj, K.; Dahal, K.; Azaiez, M.N.

    2007-01-01

    In a centralized power system, the operator is responsible for scheduling maintenance. There are different types of maintenance, including corrective maintenance; predictive maintenance; preventive maintenance; and reliability-centred maintenance. The main cause of power failures is poor maintenance. As such, maintenance costs play a significant role in deregulated power systems. They include direct costs associated with material and labor costs as well as indirect costs associated with spare parts inventory, shipment, test equipment, indirect labor, opportunity costs and cost of failure. In maintenance scheduling and planning, the cost function is the only component of the objective function. This paper presented the results of a study in which different components of maintenance costs were modeled. The maintenance models were formulated as an optimization problem with single and multiple objectives and a set of constraints. The maintenance costs models could be used to schedule the maintenance activities of power generators more accurately and to identify the best maintenance strategies over a period of time as they consider failure and opportunity costs in a deregulated environment. 32 refs., 4 tabs., 4 figs

  5. O and M outsourcing saving costs for IPPs

    International Nuclear Information System (INIS)

    Byerly, K.; Mason, J.

    1997-01-01

    Over the past decade, many countries have opened their markets to independent power producers (IPPs) and expansion of utility projects. With these new found opportunities, IPPs and utilities must focus on their core business as power generators, while obtaining the most cost-effective operations and maintenance (O and M) services. Many have found that third-part O and M outsourcing is the most cost-effective and profitable way to go. (Author)

  6. Faith community nursing demonstrates good stewardship of community benefit dollars through cost savings and cost avoidance.

    Science.gov (United States)

    Brown, Ameldia R; Coppola, Patricia; Giacona, Marian; Petriches, Anne; Stockwell, Mary Ann

    2009-01-01

    Health systems seeking responsible stewardship of community benefit dollars supporting Faith Community Nursing Networks require demonstration of positive measurable health outcomes. Faith Community Nurses (FCNs) answer the call for measurable outcomes by documenting cost savings and cost avoidances to families, communities, and health systems associated with their interventions. Using a spreadsheet tool based on Medicare reimbursements and diagnostic-related groupings, 3 networks of FCNs have together shown more than 600 000 (for calendar year 2008) healthcare dollars saved by avoidance of unnecessary acute care visits and extended care placements. The cost-benefit ratio of support dollars to cost savings and cost avoidance demonstrates that support of FCNs is good stewardship of community benefit dollars.

  7. Bandwidth Study on Energy Use and Potential Energy Saving Opportunities in U.S. Pulp and Paper Manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Sabine Brueske, Caroline Kramer, Aaron Fisher

    2015-06-01

    Energy bandwidth studies of U.S. manufacturing sectors can serve as foundational references in framing the range (or bandwidth) of potential energy savings opportunities. This bandwidth study examines energy consumption and potential energy savings opportunities in U.S. pulp and paper manufacturing. The study relies on multiple sources to estimate the energy used in six individual process areas, representing 52% of sector-wide energy consumption. Energy savings opportunities for individual processes are based on technologies currently in use or under development; the potential savings are then extrapolated to estimate sector-wide energy savings opportunity

  8. Bandwidth Study on Energy Use and Potential Energy Saving Opportunities in U.S. Iron and Steel Manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Keith Jamison, Caroline Kramer, Sabine Brueske, Aaron Fisher

    2015-06-01

    Energy bandwidth studies of U.S. manufacturing sectors can serve as foundational references in framing the range (or bandwidth) of potential energy savings opportunities. This bandwidth study examines energy consumption and potential energy savings opportunities in U.S. iron and steel manufacturing. The study relies on multiple sources to estimate the energy used in six individual process areas and select subareas, representing 82% of sector-wide energy consumption. Energy savings opportunities for individual processes and subareas are based on technologies currently in use or under development; the potential savings are then extrapolated to estimate sector-wide energy savings opportunity.

  9. Autonomous hip exoskeleton saves metabolic cost of walking uphill.

    Science.gov (United States)

    Seo, Keehong; Lee, Jusuk; Park, Young Jin

    2017-07-01

    We have developed a hip joint exoskeleton to boost gait function in the elderly and rehabilitation of post-stroke patients. To quantitatively evaluate the impact of the power and mass of the exoskeleton, we measured the metabolic cost of walking on slopes of 0, 5, and 10% grade, once not wearing the exoskeleton and then wearing it. The exoskeleton reduced the metabolic cost by 13.5,15.5 and 9.8% (31.9, 51.6 and 45.6 W) at 0, 5, and 10% grade, respectively. The exoskeleton performance index was computed as 0.97, 1.24, and 1.24 at each grade, implicating that the hip exoskeleton was more effective on slopes than level ground in saving the metabolic cost.

  10. Modern methods of cost saving of the production activity in construction

    Science.gov (United States)

    Silka, Dmitriy

    2017-10-01

    Every time economy faces recession, cost saving questions acquire increased urgency. This article shows how companies of the construction industry have switched to the new kind of economic relations over recent years. It is specified that the dominant type of economic relations does not allow to quickly reorient on the necessary tools in accordance with new requirements of economic activity. Successful experience in the new environment becomes demanded. Cost saving methods, which were proven in other industries, are offered for achievement of efficiency and competitiveness of the companies. Analysis is performed on the example of the retail sphere, which, according to the authoritative analytical reviews, is extremely innovative on both local and world economic levels. At that, methods, based on the modern unprecedentedly high opportunities of communications and informational exchange took special place among offered methods.

  11. Save water to save carbon and money: developing abatement costs for expanded greenhouse gas reduction portfolios.

    Science.gov (United States)

    Stokes, Jennifer R; Hendrickson, Thomas P; Horvath, Arpad

    2014-12-02

    The water-energy nexus is of growing interest for researchers and policy makers because the two critical resources are interdependent. Their provision and consumption contribute to climate change through the release of greenhouse gases (GHGs). This research considers the potential for conserving both energy and water resources by measuring the life-cycle economic efficiency of greenhouse gas reductions through the water loss control technologies of pressure management and leak management. These costs are compared to other GHG abatement technologies: lighting, building insulation, electricity generation, and passenger transportation. Each cost is calculated using a bottom-up approach where regional and temporal variations for three different California water utilities are applied to all alternatives. The costs and abatement potential for each technology are displayed on an environmental abatement cost curve. The results reveal that water loss control can reduce GHGs at lower cost than other technologies and well below California's expected carbon trading price floor. One utility with an energy-intensive water supply could abate 135,000 Mg of GHGs between 2014 and 2035 and save--rather than spend--more than $130/Mg using the water loss control strategies evaluated. Water loss control technologies therefore should be considered in GHG abatement portfolios for utilities and policy makers.

  12. EMC Phenomena in HEP Detectors: Prevention and Cost Savings

    International Nuclear Information System (INIS)

    Arteche, F.; Rivetta, C.

    2006-01-01

    This paper addresses electromagnetic compatibility (EMC) studies applied to high-energy physics (HEP) detectors. They are focused on the quantification of the front-end electronic (FEE) sensitivity to conductive noise coupled through the input/output cables. Immunity tests performed on FEE prototypes of both the CMS hadron calorimeter and the CMS silicon tracker are presented. These tests characterize the sensitivity of the FEE to common and differential mode noise coupled through the power cables and the slow control network. Immunity tests allow evaluating the weakest areas of the system to take corrective actions before the integration of the overall detector, saving time and important costs

  13. 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

    2017-07-01

    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.

  14. Logistics opportunity costs: A mining case study

    Directory of Open Access Journals (Sweden)

    Leani van Jaarsveld

    2013-11-01

    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.

  15. Energy Savings Potential and Opportunities for High-Efficiency Electric Motors in Residential and Commercial Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Inc., Burlington, MA (United States); Sutherland, Timothy [Navigant Consulting, Inc., Burlington, MA (United States); Reis, Callie [Navigant Consulting, Inc., Burlington, MA (United States)

    2013-12-04

    This report describes the current state of motor technology and estimates opportunities for energy savings through application of more advanced technologies in a variety of residential and commercial end uses. The objectives of this report were to characterize the state and type of motor technologies used in residential and commercial appliances and equipment and to identify opportunities to reduce the energy consumption of electric motor-driven systems in the residential and commercial sectors through the use of advanced motor technologies. After analyzing the technical savings potential offered by motor upgrades and variable speed technologies, recommended actions are presented.

  16. How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money. Energy-Smart Building Choices.

    Science.gov (United States)

    Department of Energy, Washington, DC.

    This guide addresses contributions that school facility administrators and business officials can make in an effort to reduce operating costs and free up money for capital improvements. The guide explores opportunities available to utilize energy-saving strategies at any stage in a building's life, from its initial design phase through renovation.…

  17. Identifying and quantifying energy savings on fired plant using low cost modelling techniques

    International Nuclear Information System (INIS)

    Tucker, Robert; Ward, John

    2012-01-01

    Research highlights: → Furnace models based on the zone method for radiation calculation are described. → Validated steady-state and transient models have been developed. → We show how these simple models can identify the best options for saving energy. → High emissivity coatings predicted to give performance enhancement on a fired heater. → Optimal heat recovery strategies on a steel reheating furnace are predicted. -- Abstract: Combustion in fired heaters, boilers and furnaces often accounts for the major energy consumption on industrial processes. Small improvements in efficiency can result in large reductions in energy consumption, CO 2 emissions, and operating costs. This paper will describe some useful low cost modelling techniques based on the zone method to help identify energy saving opportunities on high temperature fuel-fired process plant. The zone method has for many decades, been successfully applied to small batch furnaces through to large steel-reheating furnaces, glass tanks, boilers and fired heaters on petrochemical plant. Zone models can simulate both steady-state furnace operation and more complex transient operation typical of a production environment. These models can be used to predict thermal efficiency and performance, and more importantly, to assist in identifying and predicting energy saving opportunities from such measures as: ·Improving air/fuel ratio and temperature controls. ·Improved insulation. ·Use of oxygen or oxygen enrichment. ·Air preheating via flue gas heat recovery. ·Modification to furnace geometry and hearth loading. There is also increasing interest in the application of refractory coatings for increasing surface radiation in fired plant. All of the techniques can yield savings ranging from a few percent upwards and can deliver rapid financial payback, but their evaluation often requires robust and reliable models in order to increase confidence in making financial investment decisions. This paper gives

  18. Student Attitudes Regarding Ebooks: A Survey with cost savings implications

    Directory of Open Access Journals (Sweden)

    Dennis Bialaszewski

    2013-06-01

    Full Text Available Students were surveyed regarding usage of ebooks. Findings demonstrate that their propensity to using Ebooks increases as costs decrease, Tecnological advancements have led to ebooks being more than a written text displayed in digital format as web sites provide more up to date information. Also, licensing changes such as Creative Commons allow for more data to be accessible for students allowing for more student research opportunity.

  19. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2014

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Bob S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-03-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 156 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project. For all 156 projects, there was sufficient information to compare estimated, reported, and guaranteed cost savings. For this group, the total estimated cost savings for the reporting periods addressed were $210.6 million, total reported cost savings were $215.1 million, and total guaranteed cost savings were $204.5 million. This means that on average: ESPC contractors guaranteed 97% of the estimated cost savings; projects reported achieving 102% of the estimated cost savings; and projects reported achieving 105% of the guaranteed cost savings. For 155 of the projects examined, there was sufficient information to compare estimated and reported energy savings. On the basis of site energy, estimated savings for those projects for the previous year totaled 11.938 million MMBtu, and reported savings were 12.138 million MMBtu, 101.7% of the estimated energy savings. On the basis of source energy, total estimated energy savings for the 155 projects were 19.052 million MMBtu, and reported saving were 19.516 million MMBtu, 102.4% of the estimated energy savings.

  20. Cost Savings through Innovation in Decontamination, Decommissioning, and Dismantlement

    International Nuclear Information System (INIS)

    Yancey, Neal A.

    2003-01-01

    The United States Department of Energy (DOE) continually seeks safer and more cost effective technologies for the decontamination and decommissioning (D and D) of nuclear facilities. The Deactivation and Decommissioning Focus Area (DDFA) of the DOE's Office of Science and Technology (OST) sponsored large-scale demonstration and deployment projects (LSDDPs) to help bring new technologies into the D and D programs. The Idaho National Engineering and Environmental Laboratory (INEEL) LSDDP generated a list of needs defining specific problems where improved technologies could be incorporated into ongoing D and D tasks. The needs fell into 5 major categories--characterization, dismantlement, safety, material dispositioning, and decontamination. Technologies were carefully selected that provide a large benefit for a small investment. The technologies must provide significant improvements in cost, safety, radiation exposure, waste volume reduction, or schedule savings and widely applicable throughout the DOE complex. The LSDDP project provided training for the new technologies and worked with technology suppliers to resolve any questions that arose. Since 1998, 26 technologies have been demonstrated or deployed through the LSDDP for the D and D program at the INEEL. Of the 26 demonstrated and deployed technologies, 14 were in characterization, 3 were in decontamination, 4 were in dismantlement, 3 were in safety, and 2 were in material dispositioning. To promote the use of these technologies at other sites within the DOE complex, the LSDDP team published fact sheets, videos, technology summary reports, articles in INEEL star newspaper, posters, and maintained an internet home page on the project. As a result, additional deployments have taken place at the Hanford, Mound, Fernald, Oak Ridge, Ashtabula, and West Valley. Eight of the 26 technologies evaluated were developed in foreign countries. The technologies demonstrated have been shown to be faster, less expensive, and

  1. Outside opportunities and costs incurred by others.

    Science.gov (United States)

    Roes, Frans L

    2007-07-21

    Descriptions of interactions between ants and their 'guests' serve to illustrate the thesis that Ewald's theory of the 'evolution of virulence' not only applies to interactions between micro-organisms causing infectious diseases and their hosts, but also to interactions between individuals belonging to differing species. For instance, the prediction is put forward and discussed that guests of army ants are, relative to guests of other species of ants, more often parasitic. A key variable in Ewald's theory is 'transmissibility'. It shows some resemblance to similar variables used in micro-economic theory and in Emerson's sociological Power-Dependence Relations theory. In this article, this variable is called 'outside opportunities'. In an A-B relation, an outside opportunity for A is anything which constitutes an alternative to what B can provide. It is concluded that in A-B interactions, the more outside opportunities are available to A, the more costs are incurred by B. Differences and similarities between this idea and Game Theory are discussed.

  2. Client-server computer architecture saves costs and eliminates bottlenecks

    International Nuclear Information System (INIS)

    Darukhanavala, P.P.; Davidson, M.C.; Tyler, T.N.; Blaskovich, F.T.; Smith, C.

    1992-01-01

    This paper reports that workstation, client-server architecture saved costs and eliminated bottlenecks that BP Exploration (Alaska) Inc. experienced with mainframe computer systems. In 1991, BP embarked on an ambitious project to change technical computing for its Prudhoe Bay, Endicott, and Kuparuk operations on Alaska's North Slope. This project promised substantial rewards, but also involved considerable risk. The project plan called for reservoir simulations (which historically had run on a Cray Research Inc. X-MP supercomputer in the company's Houston data center) to be run on small computer workstations. Additionally, large Prudhoe Bay, Endicott, and Kuparuk production and reservoir engineering data bases and related applications also would be moved to workstations, replacing a Digital Equipment Corp. VAX cluster in Anchorage

  3. Consistent cost curves for identification of optimal energy savings across industry and residential sectors

    DEFF Research Database (Denmark)

    Klinge Jacobsen, Henrik; Baldini, Mattia

    the costs are incurred and savings (difference in discount rates both private and social) • The issue of marginal investment in a case of replacement anyway or a full investment in the energy saving technology • Implementation costs (and probability of investment) differs across sectors • Cost saving...... with constructing and applying the cost curves in modelling: • Cost curves do not have the same cost interpretation across economic subsectors and end-use technologies (investment cost for equipment varies – including/excluding installation – adaptation costs – indirect production costs) • The time issue of when...... options are not additive - meaning that marginal energy savings from one option depends on what other options implemented We address the importance of these issues and illustrate with Danish cases how large the difference in savings cost curves can be if different methodologies are used. For example...

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

    Science.gov (United States)

    Kibicho, Jennifer; Pinkerton, Steven D

    2012-04-01

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

  5. Challenges and Opportunities To Achieve 50% Energy Savings in Homes. National Laboratory White Papers

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, Marcus V.A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-07-01

    This report summarizes the key opportunities, gaps, and barriers identified by researchers from four national laboratories (Lawrence Berkeley National Laboratory, National Renewable Energy Laboratory, Oak Ridge National Laboratory, and Pacific Northwest National Laboratory) that must be addressed to achieve the longer term 50% saving goal for Building America to ensure coordination with the Building America industry teams who are focusing their research on systems to achieve the near-term 30% savings goal. Although new construction was included, the focus of the effort was on deep energy retrofits of existing homes.

  6. Energy Savings Potential and Research, Development, & Demonstration Opportunities for Commercial Building Appliances

    Energy Technology Data Exchange (ETDEWEB)

    Zogg, Robert [Navigant Consulting, Inc., Burlington, MA (United States); Goetzler, William [Navigant Consulting, Inc., Burlington, MA (United States); Ahlfeldt, Christopher [Navigant Consulting, Inc., Burlington, MA (United States); Hiraiwa, Hirokazu [Navigant Consulting, Inc., Burlington, MA (United States); Sathe, Amul [Navigant Consulting, Inc., Burlington, MA (United States); Sutherland, Timothy [Navigant Consulting, Inc., Burlington, MA (United States)

    2009-12-01

    This study characterizes and assesses the appliances used in commercial buildings. The primary objectives of this study were to document the energy consumed by commercial appliances and identify research, development and demonstration (RD&D) opportunities for efficiency improvements, excluding product categories such as HVAC, building lighting, refrigeration equipment, and distributed generation systems. The study included equipment descriptions, characteristics of the equipment’s market, national energy consumption, estimates of technical potential for energy-saving technologies, and recommendations for U.S. Department of Energy programs that can promote energy savings in commercial appliances.

  7. Preventing Domestic Violence in Alberta: A Cost Savings Perspective

    Directory of Open Access Journals (Sweden)

    Lana Wells

    2012-06-01

    Full Text Available Recent studies show that Alberta has the fifth highest rate of police reported intimate partner violence and the second highest rate of self reported spousal violence in Canada, and despite a 2.3 percent decline over the last decade, the province’s rate of self-reported domestic violence has stubbornly remained among the highest in Canada; rates of violence against women alone are 2.3 percentage points higher than the national average. In fact, every hour of every day, a woman in Alberta will undergo some form of interpersonal violence from an ex-partner or ex-spouse. Besides the devastating toll that domestic violence has on victims and their families, the ongoing cost to Albertans is significant. In the past five years alone it is estimated that over $600 million will have been spent on the provision of a few basic health and non health supports and that the majority of this cost ($521 million is coming out of the pockets of Albertans in the form of tax dollars directed at the provision of services. Fortunately, investment in quality prevention and intervention initiatives can be very cost effective, returning as much as $20 for every dollar invested. Recent research on preventative programming in the context of domestic violence shows promising results in reducing incidents of self-reported domestic violence. The economic analysis of this preventative programming suggests that the benefits of providing the various types of programming outweighed the costs by as much as 6:1. The potential cost savings for the Alberta context are significant; the implementation of these preventative programs has been estimated to be approximately $9.6 million while generating net cost-benefits of over $54 million. Domestic violence is a persistent blight, and continues to have a significant impact on individuals and families in Alberta, but potent tools exist to fight it. This brief paper offers a cogent summary of its costs, and the benefits that could be

  8. Advertising energy saving programs: The potential environmental cost of emphasizing monetary savings.

    Science.gov (United States)

    Schwartz, Daniel; Bruine de Bruin, Wändi; Fischhoff, Baruch; Lave, Lester

    2015-06-01

    Many consumers have monetary or environmental motivations for saving energy. Indeed, saving energy produces both monetary benefits, by reducing energy bills, and environmental benefits, by reducing carbon footprints. We examined how consumers' willingness and reasons to enroll in energy-savings programs are affected by whether advertisements emphasize monetary benefits, environmental benefits, or both. From a normative perspective, having 2 noteworthy kinds of benefit should not decrease a program's attractiveness. In contrast, psychological research suggests that adding external incentives to an intrinsically motivating task may backfire. To date, however, it remains unclear whether this is the case when both extrinsic and intrinsic motivations are inherent to the task, as with energy savings, and whether removing explicit mention of extrinsic motivation will reduce its importance. We found that emphasizing a program's monetary benefits reduced participants' willingness to enroll. In addition, participants' explanations about enrollment revealed less attention to environmental concerns when programs emphasized monetary savings, even when environmental savings were also emphasized. We found equal attention to monetary motivations in all conditions, revealing an asymmetric attention to monetary and environmental motives. These results also provide practical guidance regarding the positioning of energy-saving programs: emphasize intrinsic benefits; the extrinsic ones may speak for themselves. (c) 2015 APA, all rights reserved).

  9. Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

    Science.gov (United States)

    Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

    2012-09-15

    The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

  10. Energy saving opportunity with variable speed drive in primary air-handling unit

    International Nuclear Information System (INIS)

    Li, J.S.M.

    2007-01-01

    Air conditioners used in the court buildings in Kowloon City, Hong Kong were retrofitted with variable speed drives in the primary air handling unit (PAU) in an effort to reduce energy consumption. The initial effect of this retrofit was investigated along with the feasibility of using a carbon dioxide (CO 2 ) based demand control ventilation to reduce energy consumption while optimizing indoor air quality. The air flow in most air conditioning fans is either constant or controlled by motorized inlet guide vanes. Although this controls the flow and may reduce the load on the fan, this constriction adds an energy loss, resulting in inefficient operation. Variable speed drives should be used on the PAU in order to maintain system efficiency. As the speed of the fans are reduced, the flow will decrease proportionally, while the power required by the fan will reduce the cube of the speed. Therefore, if the fresh air supply can be controlled by reducing the speed of the fan motor, then flow control would be more efficient. The energy saving associated with variable fresh air supply flow rate was evaluated along with the cost to building owners. This paper presented the results of the potential energy and cost savings associated with this retrofit, and included implementation cost and pay back period. It was estimated that about 20 per cent of power consumption and electricity costs can be saved per year, with a simple payback period of 2 years. 7 refs., 3 tabs., 3 figs

  11. Revised cost savings estimate with uncertainty for enhanced sludge washing of underground storage tank waste

    International Nuclear Information System (INIS)

    DeMuth, S.

    1998-01-01

    Enhanced Sludge Washing (ESW) has been selected to reduce the amount of sludge-based underground storage tank (UST) high-level waste at the Hanford site. During the past several years, studies have been conducted to determine the cost savings derived from the implementation of ESW. The tank waste inventory and ESW performance continues to be revised as characterization and development efforts advance. This study provides a new cost savings estimate based upon the most recent inventory and ESW performance revisions, and includes an estimate of the associated cost uncertainty. Whereas the author's previous cost savings estimates for ESW were compared against no sludge washing, this study assumes the baseline to be simple water washing which more accurately reflects the retrieval activity along. The revised ESW cost savings estimate for all UST waste at Hanford is $6.1 B ± $1.3 B within 95% confidence. This is based upon capital and operating cost savings, but does not include development costs. The development costs are assumed negligible since they should be at least an order of magnitude less than the savings. The overall cost savings uncertainty was derived from process performance uncertainties and baseline remediation cost uncertainties, as determined by the author's engineering judgment

  12. The total lifetime health cost savings of smoking cessation to society

    DEFF Research Database (Denmark)

    Rasmussen, Gitte Susanne; Prescott, Eva; Sørensen, Thorkild I A

    2005-01-01

    Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined.......Smoking cessation has major immediate and long-term health benefits. However, ex-smokers' total lifetime health costs and continuing smokers' costs remain uncompared, and hence the economic savings of smoking cessation to society have not been determined....

  13. Lives Saved Tool (LiST) costing: a module to examine costs and prioritize interventions.

    Science.gov (United States)

    Bollinger, Lori A; Sanders, Rachel; Winfrey, William; Adesina, Adebiyi

    2017-11-07

    Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST) has been used widely to calculate the impact of maternal, neonatal and child health (MNCH) interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different resource allocation strategies. It can be a useful tool for

  14. Lives Saved Tool (LiST costing: a module to examine costs and prioritize interventions

    Directory of Open Access Journals (Sweden)

    Lori A. Bollinger

    2017-11-01

    Full Text Available Abstract Background Achieving the Sustainable Development Goals will require careful allocation of resources in order to achieve the highest impact. The Lives Saved Tool (LiST has been used widely to calculate the impact of maternal, neonatal and child health (MNCH interventions for program planning and multi-country estimation in several Lancet Series commissions. As use of the LiST model increases, many have expressed a desire to cost interventions within the model, in order to support budgeting and prioritization of interventions by countries. A limited LiST costing module was introduced several years ago, but with gaps in cost types. Updates to inputs have now been added to make the module fully functional for a range of uses. Methods This paper builds on previous work that developed an initial version of the LiST costing module to provide costs for MNCH interventions using an ingredients-based costing approach. Here, we update in 2016 the previous econometric estimates from 2013 with newly-available data and also include above-facility level costs such as program management. The updated econometric estimates inform percentages of intervention-level costs for some direct costs and indirect costs. These estimates add to existing values for direct cost requirements for items such as drugs and supplies and required provider time which were already available in LiST Costing. Results Results generated by the LiST costing module include costs for each intervention, as well as disaggregated costs by intervention including drug and supply costs, labor costs, other recurrent costs, capital costs, and above-service delivery costs. These results can be combined with mortality estimates to support prioritization of interventions by countries. Conclusions The LiST costing module provides an option for countries to identify resource requirements for scaling up a maternal, neonatal, and child health program, and to examine the financial impact of different

  15. Challenges and Opportunities To Achieve 50% Energy Savings in Homes: National Laboratory White Papers

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, M. V. A.

    2011-07-01

    In 2010, researchers from four of the national laboratories involved in residential research (Lawrence Berkeley National Laboratory, National Renewable Energy Laboratory, Oak Ridge National Laboratory, and Pacific Northwest National Laboratory) were asked to prepare papers focusing on the key longer term research challenges, market barriers, and technology gaps that must be addressed to achieve the longer term 50% saving goal for Building America to ensure coordination with the Building America industry teams who are focusing their research on systems to achieve the near-term 30% savings goal. Although new construction was included, the focus of the effort was on deep energy retrofits of existing homes. This report summarizes the key opportunities, gaps, and barriers identified in the national laboratory white papers.

  16. An Audit of Repeat Testing at an Academic Medical Center: Consistency of Order Patterns With Recommendations and Potential Cost Savings.

    Science.gov (United States)

    Hueth, Kyle D; Jackson, Brian R; Schmidt, Robert L

    2018-05-31

    To evaluate the prevalence of potentially unnecessary repeat testing (PURT) and the associated economic burden for an inpatient population at a large academic medical facility. We evaluated all inpatient test orders during 2016 for PURT by comparing the intertest times to published recommendations. Potential cost savings were estimated using the Centers for Medicare & Medicaid Services maximum allowable reimbursement rate. We evaluated result positivity as a determinant of PURT through logistic regression. Of the evaluated 4,242 repeated target tests, 1,849 (44%) were identified as PURT, representing an estimated cost-savings opportunity of $37,376. Collectively, the association of result positivity and PURT was statistically significant (relative risk, 1.2; 95% confidence interval, 1.1-1.3; P < .001). PURT contributes to unnecessary health care costs. We found that a small percentage of providers account for the majority of PURT, and PURT is positively associated with result positivity.

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

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

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

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Reported Energy and Cost Savings from the DOE ESPC Program: FY 2015

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, Bob S. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-01-01

    The objective of this work was to determine the realization rate of energy and cost savings from the Department of Energy’s Energy Savings Performance Contract (ESPC) program based on information reported by the energy services companies (ESCOs) that are carrying out ESPC projects at federal sites. Information was extracted from 151 Measurement and Verification (M&V) reports to determine reported, estimated, and guaranteed cost savings and reported and estimated energy savings for the previous contract year. Because the quality of the reports varied, it was not possible to determine all of these parameters for each project.

  20. Electricity-cost savings obtained by means of nuclear plant life extension

    International Nuclear Information System (INIS)

    Forest, L.; Fletcher, T.; DuCharme, A.; Harrison, D.L.

    1987-01-01

    This study examines savings caused by nuclear-plant life extension (NUPLEX) and describes the effects of changes in assumptions on costs and technology using an approach simpler than the large economic-model simulations used in other reports. Under the simplified approach, we estimate savings at the broad national level by comparing projected costs/kWh for the typical NUPLEX plant with those for new coal-fired plants, which seem the most likely alternative in most regions. While ignoring some complications handled by the large, regionally disaggregated econometric models, the approach used in this study has advantages in sensitivity analyses. It reveals relationships between savings and basic assumptions on costs and technology in a more transparent way than in large-model simulations. We find that, absent major technological breakthroughs for present generating options, NUPLEX saves consumers money on their electric bills under most plausible economic scenarios. Using mid-range assumptions, we find that NUPLEX saves consumers a total of about dollar 180 billion spread over the period 2010-50. Under optimistic assumptions, the savings swell to over dollar 900 billion. Under extremely pessimistic assumptions, the savings actually turn negative. This wide range of estimates largely reflects the uncertainty in cost projections. Within plausible limits, higher- or lower-than-expected load growth does not affect the savings estimates. The NUPLEX construction costs stand out as the most critical unknown. If they turn out to be 50% (dollar 500 billion) above the baseline estimate savings would fall by almost 60% (dollar 105 billion). A 50% rise in nuclear fuel costs would drop baseline savings by almost 22%. A 50% increase in nuclear-plant operations-and-maintenance costs, would cut baseline savings by about 36%. These sensitivities highlight the need for continued monitoring of economic developments

  1. Potential for the Use of Energy Savings Performance Contracts to Reduce Energy Consumption and Provide Energy and Cost Savings in Non-Building Applications

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Charles; Green, Andrew S.; Dahle, Douglas; Barnett, John; Butler, Pat; Kerner, David

    2013-08-01

    The findings of this study indicate that potential exists in non-building applications to save energy and costs. This potential could save billions of federal dollars, reduce reliance on fossil fuels, increase energy independence and security, and reduce greenhouse gas emissions. The Federal Government has nearly twenty years of experience with achieving similar energy cost reductions, and letting the energy costs savings pay for themselves, by applying energy savings performance contracts (ESPC) inits buildings. Currently, the application of ESPCs is limited by statute to federal buildings. This study indicates that ESPCs can be a compatible and effective contracting tool for achieving savings in non-building applications.

  2. Opportunity Cost and the Intelligence of Economists: A Comment

    Science.gov (United States)

    Arce, Daniel G.

    2016-01-01

    In "Opportunity Cost: A Reexamination," Professor Parkin contrasts forgone physical quantities with forgone values as measures of the opportunity cost of basic economic decisions. The impetus for his study stems from an experiment conducted by Ferraro and Taylor (2005), in which professional economists could not reach a consensus over…

  3. Evidence for Opportunity Cost Neglect in the Poor

    NARCIS (Netherlands)

    Plantinga, Arnoud; Krijnen, Job M.T.; Zeelenberg, Marcel; Breugelmans, Seger M.

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an

  4. Evidence for opportunity cost neglect in the poor

    NARCIS (Netherlands)

    Plantinga, A.; Krijnen, J.M.T.; Zeelenberg, M.; Breugelmans, S.M.

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an

  5. Evidence for Opportunity Cost Neglect in the Poor.

    Science.gov (United States)

    Plantinga, Arnoud; Krijnen, Job M T; Zeelenberg, Marcel; Breugelmans, Seger M

    2018-01-01

    People often neglect opportunity costs: They do not fully take into account forgone alternatives outside of a particular choice set. Several scholars have suggested that poor people should be more likely to spontaneously consider opportunity costs, because budget constraints should lead to an increased focus on trade-offs. We did not find support for this hypothesis in five high-powered experiments (total N = 2325). The experiments used different products (both material and experiential) with both high and low prices (from $8.50 to $249.99) and different methods of reminding participants of opportunity costs. High-income and low-income participants showed an equally strong decrease in willingness to buy when reminded of opportunity costs, implying that both the rich and the poor neglect opportunity costs. © 2017 The Authors Journal of Behavioral Decision Making Published by John Wiley & Sons Ltd.

  6. Solitary pulmonary nodules: cost-savings indicated by Australian experience with FDG-PET

    International Nuclear Information System (INIS)

    Keith, C.J.; Miles, K.A.; Pitman, A.G.; Hicks, R.J.

    2002-01-01

    Full text: To date, decision tree analyses demonstrating the cost-effectiveness of PET in Australia have been constrained by the need to use overseas values for diagnostic performance and disease prevalence. This study uses Australian PET experience to estimate the cost-savings produced by incorporation of FDG-PET into diagnostic algorithms for characterisation of solitary pulmonary nodules (SPNs). Values for disease prevalence and diagnostic accuracy of PET from a combined series of 89 SPNs from the Wesley Hospital and Peter MacCallum Cancer Institute were applied to two previously published decision tree models. Procedure costs were derived from the Medicare Benefits Schedule and DRG Cost Weights for Australian public hospitals. A cost of $1200 was assigned to PET. Sensitivity analyses evaluated the effect of disease prevalence and PET cost on the cost savings produced by each strategy. The values for disease prevalence (0.54), PET sensitivity (92%) and specificity (95%) from the combined series indicated cost savings per patient of $774 and $554 for the two decision trees. PET would remain cost-saving for values of prevalence up to 0.90 and 0.76, and PET costs of $1974 and $1967, for each model respectively. FDG-PET evaluation of SPNs would produce cost-savings within Australia even with substantial variations in disease prevalence and PET costs. Copyright (2002) Blackwell Science Pty Ltd

  7. Defense Industry Restructuring: Updated Cost and Savings Information

    National Research Council Canada - National Science Library

    1998-01-01

    ...) the restructuring costs were allowable under the Federal Acquisition Regulation and (2) a DOD contracting officer determined the business combination would result in overall reduced costs to DOD or preserve a critical defense capability...

  8. Strategic design of cost savings guarantee in energy performance contracting under uncertainty

    International Nuclear Information System (INIS)

    Deng, Qianli; Jiang, Xianglin; Cui, Qingbin; Zhang, Limao

    2015-01-01

    Highlights: • A methodology is proposed to assist Energy Service Companies to maintain competitiveness in winning bids. • Uncertainties within the energy cost savings are modeled stochastically using the Monte-Carlo simulation. • A strategic energy savings guarantee design curve is derived, where all points return as appropriate guarantees. • A campus case is presented to demonstrate the applicability for finding appropriate guaranteed savings value. - Abstract: Among the key barriers to profit in Energy Performance Contracting (EPC) are uncertainties about attaining the realized energy cost savings and potential disputes over the guaranteed cost savings. In this paper, a methodology has been proposed to assist the Energy Service Company (ESCO): (1) to evaluate the risk threshold if the guarantee has already been made, and (2) to determine the guarantee design, if the guarantee has not been made yet, that not only promises the ESCO’s profitability from EPC but also maintains its competitiveness to win the bid. Uncertainties within the energy cost savings are modeled stochastically using Monte-Carlo simulation, taking both the energy price fluctuation and the facility performance variability into account. Based on that, a strategic energy savings guarantee design curve is derived, that all the points on it would return as appropriate guarantees. Finally, a campus case is presented to demonstrate the applicability for finding the appropriate guaranteed savings value. This method is also worth popularizing in similar performance-based projects

  9. Impact of a Novel Cost-Saving Pharmacy Program on Pregabalin Use and Health Care Costs.

    Science.gov (United States)

    Martin, Carolyn; Odell, Kevin; Cappelleri, Joseph C; Bancroft, Tim; Halpern, Rachel; Sadosky, Alesia

    2016-02-01

    Pharmacy cost-saving programs often aim to reduce costs for members and payers by encouraging use of lower-tier or generic medications and lower-cost sales channels. In 2010, a national U.S. health plan began a novel pharmacy program directed at reducing pharmacy expenditures for targeted medications, including pregabalin. The program provided multiple options to avoid higher cost sharing: use mail order pharmacy or switch to a lower-cost alternative medication via mail order or retail. Members who did not choose any option eventually paid the full retail cost of pregabalin. To evaluate the impact of the pharmacy program on pregabalin and alternative medication use, health care costs, and health care utilization. This retrospective analysis of claims data included adult commercial health plan members with a retail claim for pregabalin in the first 13 months of the pharmacy program (identification [ID] period: February 1, 2010-February 28, 2011). Members whose benefit plan included the pharmacy program were assigned to the program cohort; all others were assigned to the nonprogram cohort. The program cohort index date was the first retail pregabalin claim during the ID period and after the program start; the nonprogram cohort index date was the first retail pregabalin claim during the ID period. All members were continuously enrolled for 12 months pre- and post-index and had at least 1 inpatient claim or ≥ 2 ambulatory visit claims for a pregabalin-indicated condition. Cohorts were propensity score matched (PSM) 1:1 with logistic regression on demographic and pre-index characteristics, including mail order and pregabalin use, comorbidity, health care costs, and health care utilization. Pregabalin, gabapentin and other alternative medication use, health care costs, and health care utilization were measured. The program cohort was also divided into 2 groups: members who changed to gabapentin post-index and those who did not. A difference-in-differences (Di

  10. Saving Blood and Reducing Costs: Updating Blood Transfusion Practice in Lower Limb Arthroplasty

    LENUS (Irish Health Repository)

    Fenelon, C

    2018-04-01

    Our aim was to quantify blood transfusion rates in lower limb arthroplasty following the introduction of a multimodal enhanced recovery programme (ERP). We then sought to update the maximum surgical blood ordering schedule (MSBOS) and calculate cost savings achieved.

  11. Measured energy savings and cost-effectiveness of conservation retrofits in commercial buildings

    International Nuclear Information System (INIS)

    Greely, K.M.; Harris, J.P.; Hatcher, A.M.

    1990-01-01

    In this study, the authors examine the measured savings and cost-effectiveness of 447 commercial retrofit projects in the US, Canada, and Europe, representing over 1,700 buildings. For these projects, they examine savings and cost-effectiveness by building type and retrofit strategy, savings from individual measures, peak electric demand savings, comparisons of measured vs. predicted savings, and the persistence of savings in the years following a retrofit. Median annual site energy savings amounted to 20 kBtu/ft 2 , or 18% of whole-building usage; median retrofit cost was $0.56/ft 2 (1988 $), the median payback time was 3.1 years, and the median cost of conserved energy was $3.10/site MBtu. When examined by retrofit strategy, they found that projects with only HVAC and/or lighting retrofits had median payback times of one to three years, while those affecting the building shell, either alone or in combination with other types of measures, had payback times of five or more years. Projects in which only maintenance practices were changed typically saved 12% of their pre-retrofit consumption, often using in-house labor. Their research suggests that, despite significant savings and short payback times for the majority of projects, optimum savings are often not being achieved, due to limited owner willingness to invest in all cost-effective measures, as well as to improper retrofit installation and/or maintenance. A comprehensive understanding of energy management as a process is needed, including both inspection and commissioning of installed retrofits and ongoing tracking of energy consumption as an indicator of operating problems

  12. Cost Savings of Nuclear Power with Total Fuel Reprocessing

    International Nuclear Information System (INIS)

    Solbrig, Charles W.; Benedict, Robert W.

    2006-01-01

    The cost of fast reactor (FR) generated electricity with pyro-processing is estimated in this article. It compares favorably with other forms of energy and is shown to be less than that produced by light water reactors (LWR's). FR's use all the energy in natural uranium whereas LWR's utilize only 0.7% of it. Because of high radioactivity, pyro-processing is not open to weapon material diversion. This technology is ready now. Nuclear power has the same advantage as coal power in that it is not dependent upon a scarce foreign fuel and has the significant additional advantage of not contributing to global warming or air pollution. A jump start on new nuclear plants could rapidly allow electric furnaces to replace home heating oil furnaces and utilize high capacity batteries for hybrid automobiles: both would reduce US reliance on oil. If these were fast reactors fueled by reprocessed fuel, the spent fuel storage problem could also be solved. Costs are derived from assumptions on the LWR's and FR's five cost components: 1) Capital costs: LWR plants cost $106/MWe. FR's cost 25% more. Forty year amortization is used. 2) The annual O and M costs for both plants are 9% of the Capital Costs. 3) LWR fuel costs about 0.0035 $/kWh. Producing FR fuel from spent fuel by pyro-processing must be done in highly shielded hot cells which is costly. However, the five foot thick concrete walls have the advantage of prohibiting diversion. LWR spent fuel must be used as feedstock for the FR initial core load and first two reloads so this FR fuel costs more than LWR fuel. FR fuel costs much less for subsequent core reloads ( 6 /MWe. The annual cost for a 40 year licensed plant would be 2.5 % of this or less if interest is taken into account. All plants will eventually have to replace those components which become radiation damaged. FR's should be designed to replace parts rather than decommission. The LWR costs are estimated to be 2.65 cents/kWh. FR costs are 2.99 cents/kWh for the first

  13. Cost savings from nuclear regulatory reform: An econometric model

    International Nuclear Information System (INIS)

    Canterbery, E.R.; Johnson, B.; Reading, D.

    1996-01-01

    The nuclear-generated power touted in the 1950s as someday being open-quotes too cheap to meterclose quotes got dismissed in the 1980s as incapable of being both safe and cost effective. Today, less than 20 percent of American's electricity is nuclear-generated, no new plants are planned or on order, and some of the earliest units are scheduled for decommissioning within the next decade. Even so, interest in nuclear power has been revived by increasing energy demands, concerns about global warming, and the uncertainty surrounding oil resources in the Persian Gulf. As a long-term alternative to fossil fuels, atomic energy offers the important advantages of clean air and domestic availability of fuel. But these advantages will count for little unless and until the costs of nuclear power can be seen as reasonable. The authors premise is that the relevant costs are those of providing safe and environmentally clean electric energy. To the extent that increased costs have resulted from increasingly stringent regulations, they reflect the internalization of external costs. Indeed, the external costs of nuclear power (particularly safety and environmental protection) have been internalized to a greater degree than with most alternative fuel sources used by electric utilities. Nuclear construction costs are properly compared with those of alternative sources only after the latter are adjusted for environmental damage and endangerment, including, as examples, the costs of oil spills, of building double-hulled tankers, and of building off-shore offloading facilities. A shift to nuclear sources could reduce these costs whereas it would increase disposal costs for radioactive materials. The authors contend that a better understanding of nuclear plant construction costs is pivotal to a balanced evaluation of the merits of uranium relative to other fuel choices. 12 refs., 2 figs., 5 tabs

  14. Directions of organisational and low-cost energy saving of engineering enterprises

    Directory of Open Access Journals (Sweden)

    Dzhedzhula Viacheslav V.

    2014-01-01

    Full Text Available The article analyses directions of energy saving of industrial enterprises. Taking into account the tendency to continuous growth of cost of energy resources, introduction of measures that would allow reduction of energy consumption of enterprises is an urgent task. One of the most important obstacles in the process of introduction of energy efficient solutions are fund limits and low awareness of owners and managers of industrial enterprises. The article offers a new classification of energy saving measures: apart from traditional expense and organisation measures it introduces the low-cost measures notion. It offers to consider low-cost those measures that are realised by the enterprise by means of own funds, moreover, their repayment term is not more than one year. It offers analytical expression for identification of annual funds saving from introduction of low-cost measures. It considers the process of identification of saving of funds from introduction of some of the main low-cost measures in detail: replacement of lighting units, balancing of ventilation networks and elimination of water leakages from pipelines and water supply equipment. Based on the analysis of bibliography information the article provides a list of main measures on energy saving, which could be referred to the low-cost ones. The proposed approaches would allow paying more attention to practical aspects of realisation of the concept of energy saving in the industry.

  15. Energy-saving behavior and marginal abatement cost for household CO2 emissions

    International Nuclear Information System (INIS)

    Hamamoto, Mitsutsugu

    2013-01-01

    This paper attempts to measure consumers' perceived net benefits (or net costs) of energy-saving measures in using energy-consuming durable goods. Using the estimated net costs and the volume of CO 2 reduced by the measures, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. An analysis using the curve suggests that in order to provide households with an incentive to take actions that can lead to CO 2 emission reductions in using energy-consuming durables, a high level of carbon price is needed. In addition, a regression analysis reveals that the net benefits of the measures are larger for households that put a higher priority on energy saving, for those living in detached houses, for those with a smaller number of persons living together, and for those with less income. The result of the analysis using the MAC curve may suggest that promoting energy-saving behavior will require not only a policy to provide economic incentives but also interventions to influence psychological factors of household behavior. - Highlights: • Consumers' perceived net costs of energy-saving measures in using energy-consuming durables are measured. • Using the estimated net costs, a marginal abatement cost (MAC) curve for the average household's CO 2 emissions is produced. • A high carbon price is needed in order to provide households with an incentive to take actions for energy-savings. • Households' attributes affecting their energy-saving behavior are revealed by a regression analysis

  16. Cost savings from a telemedicine model of care in northern Queensland, Australia.

    Science.gov (United States)

    Thaker, Darshit A; Monypenny, Richard; Olver, Ian; Sabesan, Sabe

    2013-09-16

    To conduct a cost analysis of a telemedicine model for cancer care (teleoncology) in northern Queensland, Australia, compared with the usual model of care from the perspective of the Townsville and other participating hospital and health services. Retrospective cost-savings analysis; and a one-way sensitivity analysis performed to test the robustness of findings in net savings. Records of all patients managed by means of teleoncology at the Townsville Cancer Centre (TCC) and its six rural satellite centres in northern Queensland, Australia between 1 March 2007 and 30 November 2011. Costs for set-up and staffing to manage the service, and savings from avoidance of travel expenses for specialist oncologists, patients and their escorts, and for aeromedical retrievals. There were 605 teleoncology consultations with 147 patients over 56 months, at a total cost of $442 276. The cost for project establishment was $36 000, equipment/maintenance was $143 271, and staff was $261 520. The estimated travel expense avoided was $762 394; this figure included the costs of travel for patients and escorts of $658 760, aeromedical retrievals of $52 400 and travel for specialists of $47 634, as well as an estimate of accommodation costs for a proportion of patients of $3600. This resulted in a net saving of $320 118. Costs would have to increase by 72% to negate the savings. The teleoncology model of care at the TCC resulted in net savings, mainly due to avoidance of travel costs. Such savings could be redirected to enhancing rural resources and service capabilities. This teleoncology model is applicable to geographically distant areas requiring lengthy travel.

  17. Preliminary estimates of cost savings for defense high level waste vitrification options

    International Nuclear Information System (INIS)

    Merrill, R.A.; Chapman, C.C.

    1993-09-01

    The potential for realizing cost savings in the disposal of defense high-level waste through process and design modificatins has been considered. Proposed modifications range from simple changes in the canister design to development of an advanced melter capable of processing glass with a higher waste loading. Preliminary calculations estimate the total disposal cost (not including capital or operating costs) for defense high-level waste to be about $7.9 billion dollars for the reference conditions described in this paper, while projected savings resulting from the proposed process and design changes could reduce the disposal cost of defense high-level waste by up to $5.2 billion

  18. Policy Framework for Covering Preventive Services Without Cost Sharing: Saving Lives and Saving Money?

    Science.gov (United States)

    Chen, Stephanie C; Pearson, Steven D

    2016-08-01

    The US Affordable Care Act mandates that private insurers cover a list of preventive services without cost sharing. The list is determined by 4 expert committees that evaluate the overall health effect of preventive services. We analyzed the process by which the expert committees develop their recommendations. Each committee uses different criteria to evaluate preventive services and none of the committees consider cost systematically. We propose that the existing committees adopt consistent evidence review methodologies and expand the scope of preventive services reviewed and that a separate advisory committee be established to integrate economic considerations into the final selection of free preventive services. The comprehensive framework and associated criteria are intended to help policy makers in the future develop a more evidence-based, consistent, and ethically sound approach.

  19. Cost savings from performance-based maintenance contracting

    NARCIS (Netherlands)

    Straub, A.

    2009-01-01

    New procurement approaches combined with performance-based building approaches should reduce costs, but empirical qualitative and quantitative studies are lacking. Performance-based maintenance contracts give maintenance suppliers incentives to improve their way of working. Innovative,

  20. Potential Medicaid Cost Savings from Maternity Care Based..

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce...

  1. Potential Cost Savings of Contrast-Enhanced Digital Mammography.

    Science.gov (United States)

    Patel, Bhavika K; Gray, Richard J; Pockaj, Barbara A

    2017-06-01

    The purpose of this article is to discuss whether the sensitivity and specificity of contrast-enhanced digital mammography (CEDM) render it a viable diagnostic alternative to breast MRI. That CEDM couples low-energy images (comparable to the diagnostic quality of standard mammography) and subtracted contrast-enhanced mammograms make it a cost-effective modality and a realistic substitute for the more costly breast MRI.

  2. Opportunity costs of implementing forest plans

    Science.gov (United States)

    Fox, Bruce; Keller, Mary Anne; Schlosberg, Andrew J.; Vlahovich, James E.

    1989-01-01

    Intellectual concern with the National Forest Management Act of 1976 has followed a course emphasizing the planning aspects of the legislation associated with the development of forest plans. Once approved, however, forest plans must be implemented. Due to the complex nature of the ecological systems of interest, and the multiple and often conflicting desires of user clientele groups, the feasibility and costs of implementing forest plans require immediate investigation. For one timber sale on the Coconino National Forest in Arizona, forest plan constraints were applied and resulting resource outputs predicted using the terrestrial ecosystem analysis and modeling system (TEAMS), a computer-based decision support system developed at the School of Forestry, Northern Arizona University, With forest plan constraints for wildlife habitat, visual diversity, riparian area protection, and soil and slope harvesting restrictions, the maximum timber harvest obtainable was reduced 58% from the maximum obtainable without plan constraints.

  3. Opportunities and costs for preventing vertebrate extinctions.

    Science.gov (United States)

    Conde, Dalia A; Colchero, Fernando; Güneralp, Burak; Gusset, Markus; Skolnik, Ben; Parr, Michael; Byers, Onnie; Johnson, Kevin; Young, Glyn; Flesness, Nate; Possingham, Hugh; Fa, John E

    2015-03-16

    Despite an increase in policy and management responses to the global biodiversity crisis, implementation of the 20 Aichi Biodiversity Targets still shows insufficient progress [1]. These targets, strategic goals defined by the United Nations Convention on Biological Diversity (CBD), address major causes of biodiversity loss in part by establishing protected areas (Target 11) and preventing species extinctions (Target 12). To achieve this, increased interventions will be required for a large number of sites and species. The Alliance for Zero Extinction (AZE) [2], a consortium of conservation-oriented organisations that aims to protect Critically Endangered and Endangered species restricted to single sites, has identified 920 species of mammals, birds, amphibians, reptiles, conifers and reef-building corals in 588 'trigger' sites [3]. These are arguably the most irreplaceable category of important biodiversity conservation sites. Protected area coverage of AZE sites is a key indicator of progress towards Target 11 [1]. Moreover, effective conservation of AZE sites is essential to achieve Target 12, as the loss of any of these sites would certainly result in the global extinction of at least one species [2]. However, averting human-induced species extinctions within AZE sites requires enhanced planning tools to increase the chances of success [3]. Here, we assess the potential for ensuring the long-term conservation of AZE vertebrate species (157 mammals, 165 birds, 17 reptiles and 502 amphibians) by calculating a conservation opportunity index (COI) for each species. The COI encompasses a set of measurable indicators that quantify the possibility of achieving successful conservation of a species in its natural habitat (COIh) and by establishing insurance populations in zoos (COIc). Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Energy Costs of Energy Savings in Buildings: A Review

    Directory of Open Access Journals (Sweden)

    Daniel Rousse

    2012-08-01

    Full Text Available It is often claimed that the cheapest energy is the one you do not need to produce. Nevertheless, this claim could somehow be unsubstantiated. In this article, the authors try to shed some light on this issue by using the concept of energy return on investment (EROI as a yardstick. This choice brings semantic issues because in this paper the EROI is used in a different context than that of energy production. Indeed, while watts and negawatts share the same physical unit, they are not the same object, which brings some ambiguities in the interpretation of EROI. These are cleared by a refined definition of EROI and an adapted nomenclature. This review studies the research in the energy efficiency of building operation, which is one of the most investigated topics in energy efficiency. This study focuses on the impact of insulation and high efficiency windows as means to exemplify the concepts that are introduced. These results were normalized for climate, life time of the building, and construction material. In many cases, energy efficiency measures imply a very high EROI. Nevertheless, in some circumstances, this is not the case and it might be more profitable to produce the required energy than to try to save it.

  5. Rightsizing HVAC Systems to Reduce Capital Costs and Save Energy

    Science.gov (United States)

    Sebesta, James

    2010-01-01

    Nearly every institution is faced with the situation of having to reduce the cost of a construction project from time to time through a process generally referred to as "value engineering." Just the mention of those words, however, gives rise to all types of connotations, thoughts, and memories (usually negative) for those in the…

  6. Maximum potential cost-savings attributable to generic substitution ...

    African Journals Online (AJOL)

    D. Husselmann

    community. ... Conclusions: Potential economic benefits can be generated with generic substitution. ... Available online at www.sciencedirect.com ... supply of safe, cost-effective drugs of acceptable quality to all citizens of South Africa, and the rational use of drugs by .... different types of schizophrenic diagnosis) with a claim.

  7. Five Smart Ways Educators Can Save Money on Benefit Costs

    Science.gov (United States)

    McCullough, Pat

    2012-01-01

    State and local governments today face significant financial stress from the most recent recession, which makes their need to control benefit costs even greater. Revenues declined 22% from 2008 to 2009, mostly because of reduced tax income. At the same time, state and local government spending on unemployment compensation jumped 86%. It is no…

  8. Identifying Cost-Effective Residential Energy Efficiency Opportunities for the Kauai Island Utility Cooperative

    Energy Technology Data Exchange (ETDEWEB)

    Busche, S.; Hockett, S.

    2010-06-01

    This analysis is an update to the 2005 Energy Efficiency Potential Study completed by KEMA for the Kauai Island Utility Cooperative (KIUC) and identifies potential energy efficiency opportunities in the residential sector on Kauai (KEMA 2005). The Total Resource Cost (TRC) test is used to determine which of the energy efficiency measures analyzed in the KEMA report are cost effective for KIUC to include in a residential energy efficiency program. This report finds that there remains potential energy efficiency savings that could be cost-effectively incentivized through a utility residential demand-side management program on Kauai if implemented in such a way that the program costs per measure are consistent with the current residential program costs.

  9. Solar thermal technology development: Estimated market size and energy cost savings. Volume 1: Executive summary

    Science.gov (United States)

    Gates, W. R.

    1983-02-01

    Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. The fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. STT R&D is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), dependng on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest.

  10. Solar thermal technology development: Estimated market size and energy cost savings. Volume 1: Executive summary

    Science.gov (United States)

    Gates, W. R.

    1983-01-01

    Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. The fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. STT R&D is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), dependng on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest.

  11. Design of a low-cost hybrid powertrain with large fuel savings

    NARCIS (Netherlands)

    Berkel, van K.; Romers, L.H.J.; Vroemen, B.G.; Hofman, T.; Steinbuch, M.

    2010-01-01

    This paper presents a new design of a low-cost hybrid powertrain with large fuel savings. The hybrid powertrain contains only low-cost mechanical components, such as a flywheel module and a continuously variable transmission (CVT). Noelectrical motor/generator or battery is used. Based on

  12. On the assessment of marginal life saving costs for risk acceptance criteria

    DEFF Research Database (Denmark)

    Fischer, Katharina; Virguez, Edgar; Sánchez-Silva, Mauricio

    2013-01-01

    : The definition of the marginal life saving costs, the discount rate used for comparing costs and benefits that accrue at different points in time and the time horizon over which future consequences of the decision are taken into account. In the present paper these issues are discussed based on a clear...

  13. Saving Pell Grants in an Era of Cost-Cutting

    Science.gov (United States)

    Gross, Karen

    2011-01-01

    In the context of the recent efforts to arrive at a federal budget, articles abound in the popular media and trade publications debating both the value of Pell Grants and their rising cost to the U.S. government. Both pros and cons of the debate hold value. Pell Grants are what enable many low-income families to send their children to college and,…

  14. Comparing the Medicaid Retrospective Drug Utilization Review Program Cost-Savings Methods Used by State Agencies.

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

    The Medicaid Drug Utilization Review (DUR) program is a 2-phase process conducted by Medicaid state agencies. The first phase is a prospective DUR and involves electronically monitoring prescription drug claims to identify prescription-related problems, such as therapeutic duplication, contraindications, incorrect dosage, or duration of treatment. The second phase is a retrospective DUR and involves ongoing and periodic examinations of claims data to identify patterns of fraud, abuse, underutilization, drug-drug interaction, or medically unnecessary care, implementing corrective actions when needed. The Centers for Medicare & Medicaid Services requires each state to measure prescription drug cost-savings generated from its DUR programs on an annual basis, but it provides no guidance or unified methodology for doing so. To describe and synthesize the methodologies used by states to measure cost-savings using their Medicaid retrospective DUR program in federal fiscal years 2014 and 2015. For each state, the cost-savings methodologies included in the Medicaid DUR 2014 and 2015 reports were downloaded from Medicaid's website. The reports were then reviewed and synthesized. Methods described by the states were classified according to research designs often described in evaluation textbooks. In 2014, the most often used prescription drugs cost-savings estimation methodology for the Medicaid retrospective DUR program was a simple pre-post intervention method, without a comparison group (ie, 12 states). In 2015, the most common methodology used was a pre-post intervention method, with a comparison group (ie, 14 states). Comparisons of savings attributed to the program among states are still unreliable, because of a lack of a common methodology available for measuring cost-savings. There is great variation among states in the methods used to measure prescription drug utilization cost-savings. This analysis suggests that there is still room for improvement in terms of

  15. Strategy on energy saving reconstruction of distribution networks based on life cycle cost

    Science.gov (United States)

    Chen, Xiaofei; Qiu, Zejing; Xu, Zhaoyang; Xiao, Chupeng

    2017-08-01

    Because the actual distribution network reconstruction project funds are often limited, the cost-benefit model and the decision-making method are crucial for distribution network energy saving reconstruction project. From the perspective of life cycle cost (LCC), firstly the research life cycle is determined for the energy saving reconstruction of distribution networks with multi-devices. Then, a new life cycle cost-benefit model for energy-saving reconstruction of distribution network is developed, in which the modification schemes include distribution transformers replacement, lines replacement and reactive power compensation. In the operation loss cost and maintenance cost area, the operation cost model considering the influence of load season characteristics and the maintenance cost segmental model of transformers are proposed. Finally, aiming at the highest energy saving profit per LCC, a decision-making method is developed while considering financial and technical constraints as well. The model and method are applied to a real distribution network reconstruction, and the results prove that the model and method are effective.

  16. Power shopping - practical advice and cost-saving alternatives

    International Nuclear Information System (INIS)

    Anthofer, J.

    1999-01-01

    Encore Energy Solutions is a power consulting company which operates in California, Alberta and Ontario. The company manages electricity portfolios, sells risk management instruments and works with end users to lower power costs. It also helps utilities manage the evolution to a competitive energy market. In this presentation, a series of overhead viewgraphs were used to explain the roles of different players in Ontario's electric power industry, including generators, retailers, distributors, wholesale sellers, transmitters, wholesale consumers, independent market operators (IMOs), and consultants. The challenges facing municipal electric utilities regarding the wires business and retail services were also discussed. The trends in today's evolving power market were highlighted. These included price elasticity, load dispatch, granularity, long- and short-term volatility, gas prices, day/night spread, transmission tariffs, congestion and cost of capital. A graph depicting volatility term structures for electricity, natural gas and crude oil suggests that instantaneous volatility of power is almost infinite. Issues regarding risk management in terms of shareholder's portfolio values were also discussed. 17 figs

  17. Heat savings and heat generation technologies: Modelling of residential investment behaviour with local health costs

    International Nuclear Information System (INIS)

    Zvingilaite, Erika; Klinge Jacobsen, Henrik

    2015-01-01

    The trade-off between investing in energy savings and investing in individual heating technologies with high investment and low variable costs in single family houses is modelled for a number of building and consumer categories in Denmark. For each group the private economic cost of providing heating comfort is minimised. The private solution may deviate from the socio-economical optimal solution and we suggest changes to policy to incentivise the individuals to make choices more in line with the socio-economic optimal mix of energy savings and technologies. The households can combine their primary heating source with secondary heating e.g. a woodstove. This choice results in increased indoor air pollution with fine particles causing health effects. We integrate health cost due to use of woodstoves into household optimisation of heating expenditures. The results show that due to a combination of low costs of primary fuel and low environmental performance of woodstoves today, included health costs lead to decreased use of secondary heating. Overall the interdependence of heat generation technology- and heat saving-choice is significant. The total optimal level of heat savings for private consumers decrease by 66% when all have the option to shift to the technology with lowest variable costs. - Highlights: • Heat saving investment and heat technology choice are interdependent. • Health damage costs should be included in private heating choice optimisation. • Flexibility in heating technology choice reduce the optimal level of saving investments. • Models of private and socioeconomic optimal heating produce different technology mix. • Rebound effects are moderate but varies greatly among consumer categories

  18. Can home care services achieve cost savings in long-term care for older people?

    Science.gov (United States)

    Greene, V L; Ondrich, J; Laditka, S

    1998-07-01

    To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

  19. Industrial plant electrical systems: Simplicity, reliability, cost savings, redundancies

    International Nuclear Information System (INIS)

    Silvestri, A.; Tommazzolli, F.; Pavia Univ.

    1992-01-01

    This article represents a compact but complete design and construction manual for industrial plant electrical systems. It is to be used by design engineers having prior knowledge of local power supply routes and voltages and regards principally the optimum choice of internal distribution systems which can be radial or single, double ringed or with various network configurations, and with single or multiple supplies, and many or few redundancies. After giving guidelines on the choosing of these options, the manual deals with problematics relevant to suitable cable sizing. A cost benefit benefit analysis method is suggested for the choice of the number of redundancies. Recommendations are given for the choice of transformers, motorized equipment, switch boards and circuit breakers. Reference is made to Italian electrical safety and building codes

  20. Major cost savings associated with biologic dose reduction in patients with inflammatory arthritis.

    LENUS (Irish Health Repository)

    Murphy, C L

    2015-01-01

    The purpose of this study was to explore whether patients with Inflammatory Arthritis (IA) (Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Ankylosing Spondylitis (AS)) would remain in remission following a reduction in biologic dosing frequency and to calculate the cost savings associated with dose reduction. This prospective non-blinded non-randomised study commenced in 2010. Patients with Inflammatory Arthritis being treated with a biologic agent were screened for disease activity. A cohort of those in remission according to standardized disease activity indices (DAS28 < 2.6, BASDAI < 4) was offered a reduction in dosing frequency of two commonly used biologic therapies (etanercept 50 mg once per fortnight instead of weekly, adalimumab 40 mg once per month instead of fortnightly). Patients were assessed for disease activity at 3, 6, 12, 18 and 24 months following reduction in dosing frequency. Cost saving was calculated. 79 patients with inflammatory arthritis in remission were recruited. 57% had rheumatoid arthritis (n = 45), 13% psoriatic arthritis (n = 10) and 30% ankylosing spondylitis (n = 24). 57% (n = 45) were taking etanercept and 43% (n = 34) adalimumab. The percentage of patients in remission at 24 months was 56% (n = 44). This resulted in an actual saving to the state of approximately 600,000 euro over two years. This study demonstrates the reduction in biologic dosing frequency is feasible in Inflammatory Arthritis. There was a considerable cost saving at two years. The potential for major cost savings in biologic usage should be pursued further.

  1. Cost Savings From the Provision of Specific Methods of Contraception in a Publicly Funded Program

    Science.gov (United States)

    Rostovtseva, Daria P.; Brindis, Claire D.; Biggs, M. Antonia; Hulett, Denis; Darney, Philip D.

    2009-01-01

    Objectives. We examined the cost-effectiveness of contraceptive methods dispensed in 2003 to 955 000 women in Family PACT (Planning, Access, Care and Treatment), California's publicly funded family planning program. Methods. We estimated the number of pregnancies averted by each contraceptive method and compared the cost of providing each method with the savings from averted pregnancies. Results. More than half of the 178 000 averted pregnancies were attributable to oral contraceptives, one fifth to injectable methods, and one tenth each to the patch and barrier methods. The implant and intrauterine contraceptives were the most cost-effective, with cost savings of more than $7.00 for every $1.00 spent in services and supplies. Per $1.00 spent, injectable contraceptives yielded savings of $5.60; oral contraceptives, $4.07; the patch, $2.99; the vaginal ring, $2.55; barrier methods, $1.34; and emergency contraceptives, $1.43. Conclusions. All contraceptive methods were cost-effective—they saved more in public expenditures for unintended pregnancies than they cost to provide. Because no single method is clinically recommended to every woman, it is medically and fiscally advisable for public health programs to offer all contraceptive methods. PMID:18703437

  2. Natural gas cost for evaluating energy resource opportunities at Fort Stewart

    Energy Technology Data Exchange (ETDEWEB)

    Stucky, D.J.; Shankle, S.A.

    1993-01-01

    Ft. Stewart, a United States Army Forces Command (FORSCOM) installation located near Hinesville, Georgia, is currently undergoing an evaluation of its energy usage, which is being performed by Pacific Northwest Laboratory. In order to examine the energy resource opportunities (EROs) at Ft. Stewart, marginal fuel costs must be calculated. The marginal, or avoided, cost of gas service is used in conjunction with the estimated energy savings of an ERO to calculate the dollar value of those savings. In the case of natural gas, the costing becomes more complicated due to the installation of a propane-air mixing station. The propane-air station is being built under a shared energy savings (SES) contract. The building of a propane-air station allows Ft. Stewart to purchase natural gas from their local utility at an interruptible rate, which is lower than the rate for contracting natural gas on a firm basis. The propane-air station will also provide Ft. Stewart with fuel in the event that the natural gas supply is curtailed. While the propane-air station does not affect the actual cost of natural gas, it does affect the cost of services provided by gas. Because the propane-air station and the SES contract affect the cost of gas service, they must be included in the analysis. Our analysis indicates a marginal cost of gas service of 30.0 cents per therm, assuming a total propane usage by the mixing station of 42,278 gallons (38,600 therms) annually. Because the amount of propane that may be required in the event of a curtailment is small relative to the total service requirement, variations in the actual amount should not significantly affect the cost per therm.

  3. Natural gas cost for evaluating energy resource opportunities at Fort Stewart

    International Nuclear Information System (INIS)

    Stucky, D.J.; Shankle, S.A.

    1993-01-01

    Ft. Stewart, a United States Army Forces Command (FORSCOM) installation located near Hinesville, Georgia, is currently undergoing an evaluation of its energy usage, which is being performed by Pacific Northwest Laboratory. In order to examine the energy resource opportunities (EROs) at Ft. Stewart, marginal fuel costs must be calculated. The marginal, or avoided, cost of gas service is used in conjunction with the estimated energy savings of an ERO to calculate the dollar value of those savings. In the case of natural gas, the costing becomes more complicated due to the installation of a propane-air mixing station. The propane-air station is being built under a shared energy savings (SES) contract. The building of a propane-air station allows Ft. Stewart to purchase natural gas from their local utility at an interruptible rate, which is lower than the rate for contracting natural gas on a firm basis. The propane-air station will also provide Ft. Stewart with fuel in the event that the natural gas supply is curtailed. While the propane-air station does not affect the actual cost of natural gas, it does affect the cost of services provided by gas. Because the propane-air station and the SES contract affect the cost of gas service, they must be included in the analysis. Our analysis indicates a marginal cost of gas service of 30.0 cents per therm, assuming a total propane usage by the mixing station of 42,278 gallons (38,600 therms) annually. Because the amount of propane that may be required in the event of a curtailment is small relative to the total service requirement, variations in the actual amount should not significantly affect the cost per therm

  4. Offshore wind energy storage concept for cost-of-rated-power savings

    International Nuclear Information System (INIS)

    Qin, Chao; Saunders, Gordon; Loth, Eric

    2017-01-01

    Highlights: •Investigated CAES + HPT system concept for offshore wind energy; •Validated cost model for offshore wind farm including CAPEX and OPEX items; •Quantified cost-of-rated-power savings associated with CAES + HPT concept; •Estimated savings of 21.6% with CAES + HPT for a sample $2.92 billion project. -- Abstract: The size and number of off-shore wind turbines over the next decade is expected to rapidly increase due to the high wind energy potential and the ability of such farms to provide utility-scale energy. In this future, inexpensive and efficient on-site wind energy storage can be critical to address short-time (hourly) mismatches between wind supply and energy demand. This study investigates a compressed air energy storage (CAES) and hydraulic power transmission (HPT) system concept. To assess cost impact, the NREL Cost and Scaling Model was modified to improve accuracy and robustness for offshore wind farms with large turbines. Special attention was paid to the support structure, installation, electrical interface and connections, land leasing, and operations and maintenance cost items as well as specific increased/reduced costs reductions associated with CAES + HPT systems. This cost model was validated and applied to a sample $2.92 billion project Virginia Offshore case It was found that adaption of CAES + HPT can lead to a substantial savings of 21.6% of this 20-year lifetime cost by dramatically reducing capital and operating cost of the generator and power transmission components. However, there are several additional variables that can impact the off-shore energy policy and planning for this new CAES + HPT concept. Furthermore, these cost-savings are only first-order estimates based on linear mass-cost relationships, and thus detailed engineering and economic analysis are recommended.

  5. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

    Science.gov (United States)

    Prusa, Andrea-Romana; Kasper, David C; Sawers, Larry; Walter, Evelyn; Hayde, Michael; Stillwaggon, Eileen

    2017-07-01

    Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are

  6. Heat savings and heat generation technologies: Modelling of residential investment behaviour with local health costs

    DEFF Research Database (Denmark)

    Zvingilaite, Erika; Klinge Jacobsen, Henrik

    2015-01-01

    The trade-off between investing in energy savings and investing in individual heating technologies with high investment and low variable costs in single family houses is modelled for a number of building and consumer categories in Denmark. For each group the private economic cost of providing hea...... for private consumers decrease by 66% when all have the option to shift to the technology with lowest variable costs. © 2014 Elsevier Ltd. All Rights reserved......The trade-off between investing in energy savings and investing in individual heating technologies with high investment and low variable costs in single family houses is modelled for a number of building and consumer categories in Denmark. For each group the private economic cost of providing...

  7. Marginal costs of water savings from cooling system retrofits: a case study for Texas power plants

    Science.gov (United States)

    Loew, Aviva; Jaramillo, Paulina; Zhai, Haibo

    2016-10-01

    The water demands of power plant cooling systems may strain water supply and make power generation vulnerable to water scarcity. Cooling systems range in their rates of water use, capital investment, and annual costs. Using Texas as a case study, we examined the cost of retrofitting existing coal and natural gas combined-cycle (NGCC) power plants with alternative cooling systems, either wet recirculating towers or air-cooled condensers for dry cooling. We applied a power plant assessment tool to model existing power plants in terms of their key plant attributes and site-specific meteorological conditions and then estimated operation characteristics of retrofitted plants and retrofit costs. We determined the anticipated annual reductions in water withdrawals and the cost-per-gallon of water saved by retrofits in both deterministic and probabilistic forms. The results demonstrate that replacing once-through cooling at coal-fired power plants with wet recirculating towers has the lowest cost per reduced water withdrawals, on average. The average marginal cost of water withdrawal savings for dry-cooling retrofits at coal-fired plants is approximately 0.68 cents per gallon, while the marginal recirculating retrofit cost is 0.008 cents per gallon. For NGCC plants, the average marginal costs of water withdrawal savings for dry-cooling and recirculating towers are 1.78 and 0.037 cents per gallon, respectively.

  8. Building Commissioning: A Golden Opportunity for Reducing Energy Costs and Greenhouse-gas Emissions

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2009-07-16

    The aim of commissioning new buildings is to ensure that they deliver, if not exceed, the performance and energy savings promised by their design. When applied to existing buildings, commissioning identifies the almost inevitable 'drift' from where things should be and puts the building back on course. In both contexts, commissioning is a systematic, forensic approach to quality assurance, rather than a technology per se. Although commissioning has earned increased recognition in recent years - even a toehold in Wikipedia - it remains an enigmatic practice whose visibility severely lags its potential. Over the past decade, Lawrence Berkeley National Laboratory has built the world's largest compilation and meta-analysis of commissioning experience in commercial buildings. Since our last report (Mills et al. 2004) the database has grown from 224 to 643 buildings (all located in the United States, and spanning 26 states), from 30 to 100 million square feet of floorspace, and from $17 million to $43 million in commissioning expenditures. The recorded cases of new-construction commissioning took place in buildings representing $2.2 billion in total construction costs (up from 1.5 billion). The work of many more commissioning providers (18 versus 37) is represented in this study, as is more evidence of energy and peak-power savings as well as cost-effectiveness. We now translate these impacts into avoided greenhouse gases and provide new indicators of cost-effectiveness. We also draw attention to the specific challenges and opportunities for high-tech facilities such as labs, cleanrooms, data centers, and healthcare facilities. The results are compelling. We developed an array of benchmarks for characterizing project performance and cost-effectiveness. The median normalized cost to deliver commissioning was $0.30/ft2 for existing buildings and $1.16/ft2 for new construction (or 0.4% of the overall construction cost). The commissioning projects for which

  9. The Program Administrator Cost of Saved Energy for Utility Customer-Funded Energy Efficiency Programs

    Energy Technology Data Exchange (ETDEWEB)

    Billingsley, Megan A.; Hoffman, Ian M.; Stuart, Elizabeth; Schiller, Steven R.; Goldman, Charles A.; LaCommare, Kristina

    2014-03-19

    End-use energy efficiency is increasingly being relied upon as a resource for meeting electricity and natural gas utility system needs within the United States. There is a direct connection between the maturation of energy efficiency as a resource and the need for consistent, high-quality data and reporting of efficiency program costs and impacts. To support this effort, LBNL initiated the Cost of Saved Energy Project (CSE Project) and created a Demand-Side Management (DSM) Program Impacts Database to provide a resource for policy makers, regulators, and the efficiency industry as a whole. This study is the first technical report of the LBNL CSE Project and provides an overview of the project scope, approach, and initial findings, including: • Providing a proof of concept that the program-level cost and savings data can be collected, organized, and analyzed in a systematic fashion; • Presenting initial program, sector, and portfolio level results for the program administrator CSE for a recent time period (2009-2011); and • Encouraging state and regional entities to establish common reporting definitions and formats that would make the collection and comparison of CSE data more reliable. The LBNL DSM Program Impacts Database includes the program results reported to state regulators by more than 100 program administrators in 31 states, primarily for the years 2009–2011. In total, we have compiled cost and energy savings data on more than 1,700 programs over one or more program-years for a total of more than 4,000 program-years’ worth of data, providing a rich dataset for analyses. We use the information to report costs-per-unit of electricity and natural gas savings for utility customer-funded, end-use energy efficiency programs. The program administrator CSE values are presented at national, state, and regional levels by market sector (e.g., commercial, industrial, residential) and by program type (e.g., residential whole home programs, commercial new

  10. Over-Education and Its Opportunity Cost in Japan

    Science.gov (United States)

    Kucel, Aleksander; Molina, Ivette Fuentes; Raya, Josep Maria

    2016-01-01

    In this paper, we investigate the determinants of over-education in Japan and evaluate its opportunity costs for university graduates. To this end, we use the REFLEX data. Results reveal that over-education level in Japan is high and it brings an important wage penalty for Japanese workers. Large firm and high occupations point toward a…

  11. Counting the opportunity cost of abandoning the omnibus Health ...

    African Journals Online (AJOL)

    Counting the opportunity cost of abandoning the omnibus Health Professions Authority ... Twenty two years of civil war ruined the healthcare system in South Sudan. Government provides only ... This regulatory vacuum is best resolved by establishing a Health Professions Authority to set the standards, and to supervise and ...

  12. Shortened first-line TB treatment in Brazil: potential cost savings for patients and health services

    NARCIS (Netherlands)

    Trajman, Anete; Bastos, Mayara Lisboa; Belo, Marcia; Calaça, Janaína; Gaspar, Júlia; Dos Santos, Alexandre Martins; Dos Santos, Camila Martins; Brito, Raquel Trindade; Wells, William A.; Cobelens, Frank G.; Vassall, Anna; Gomez, Gabriela B.

    2016-01-01

    Shortened treatment regimens for tuberculosis are under development to improve treatment outcomes and reduce costs. We estimated potential savings from a societal perspective in Brazil following the introduction of a hypothetical four-month regimen for tuberculosis treatment. Data were gathered in

  13. Annual Energy Usage Reduction and Cost Savings of a School: End-Use Energy Analysis

    Science.gov (United States)

    Alghoul, M. A.; Bakhtyar, B.; Asim, Nilofar; Sopian, K.

    2014-01-01

    Buildings are among the largest consumers of energy. Part of the energy is wasted due to the habits of users and equipment conditions. A solution to this problem is efficient energy usage. To this end, an energy audit can be conducted to assess the energy efficiency. This study aims to analyze the energy usage of a primary school and identify the potential energy reductions and cost savings. A preliminary audit was conducted, and several energy conservation measures were proposed. The energy conservation measures, with reference to the MS1525:2007 standard, were modelled to identify the potential energy reduction and cost savings. It was found that the school's usage of electricity exceeded its need, incurring an excess expenditure of RM 2947.42. From the lighting system alone, it was found that there is a potential energy reduction of 5489.06 kWh, which gives a cost saving of RM 2282.52 via the improvement of lighting system design and its operating hours. Overall, it was found that there is a potential energy reduction and cost saving of 20.7% when the energy conservation measures are earnestly implemented. The previous energy intensity of the school was found to be 50.6 kWh/m2/year, but can theoretically be reduced to 40.19 kWh/mm2/year. PMID:25485294

  14. Cost savings and activity levels in the UKCS: a positive sum game

    International Nuclear Information System (INIS)

    Kemp, A.G.; MacDonald, Bruce

    1995-01-01

    Declining production in mature fields, relatively small sizes of new fields the fall in oil prices and the high tax takes in old fields have combined to squeeze profit margins on petroleum exploitation in the UKCS. Achieved reductions in development and operating costs can help to sustain activity levels over the next two decades. Contractors as well as oil companies and the nation generally will benefit from the substantial number of induced extra field developments achieved from cost savings of 20%. (author)

  15. Opportunities for cost reduction and improved environmental impact in the lead and lead/acid battery industries

    Science.gov (United States)

    Lewis, N.

    The opportunities for cost reduction through improved environmental performance exist in many companies, but often are not realized. This paper describes the efforts of a typical firm — Calder Industrial Materials (CIM) — that is experiencing ever-tighter environmental controls and profit erosion through the effects of new environmental legislation. At the same time, however, CIM sees opportunities to reduce its environmental burden and cut costs. As the story unfolds, readers may well discover many parallels with their own companies. It may even spur some into action, for remember, every £1000 saved requires ten times the turnover to generate the same profit.

  16. Exergy costing for energy saving in combined heating and cooling applications

    International Nuclear Information System (INIS)

    Nguyen, Chan; Veje, Christian T.; Willatzen, Morten; Andersen, Peer

    2014-01-01

    Highlights: • We investigate the basis for cost apportioning of simultaneous heating and cooling. • Two thermoeconomic methods based on energy and exergy costing is demonstrated. • The unit cost of heating and cooling for a heat pump system is found and compared. • Energy costing may obstruct efficient use of energy. • Exergy costing provides the most rational cost apportioning for energy saving. - Abstract: The aim of this study is to provide a price model that motivates energy saving for a combined district heating and cooling system. A novel analysis using two thermoeconomic methods for apportioning the costs to heating and cooling provided simultaneously by an ammonia heat pump is demonstrated. In the first method, referred to as energy costing, a conventional thermoeconomic analysis is used. Here the ammonia heat pump is subject to a thermodynamic analysis with mass and energy balance equations. In the second method referred to as exergy costing, an exergy based economic analysis is used, where exergy balance equations are used in conjunction with mass and energy balance equations. In both costing methods the thermodynamic analysis is followed by an economic analysis which includes investment and operating costs. For both methods the unit costs of heating and cooling are found and compared. The analysis shows that the two methods yield significantly different results. Rather surprisingly, it is demonstrated that the exergy costing method results in about three times higher unit cost for heating than for cooling as opposed to equal unit costs when using the energy method. Further the exergy-based cost for heating changes considerably with the heating temperature while that of cooling is much less affected

  17. Estimating the cost-savings associated with bundling maternal and child health interventions: a proposed methodology.

    Science.gov (United States)

    Adesina, Adebiyi; Bollinger, Lori A

    2013-01-01

    There is a pressing need to include cost data in the Lives Saved Tool (LiST). This paper proposes a method that combines data from both the WHO CHOosing Interventions that are Cost-Effective (CHOICE) database and the OneHealth Tool (OHT) to develop unit costs for delivering child and maternal health services, both alone and bundled. First, a translog cost function is estimated to calculate factor shares of personnel, consumables, other direct (variable or recurrent costs excluding personnel and consumables) and indirect (capital or investment) costs. Primary source facility level data from Kenya, Namibia, South Africa, Uganda, Zambia and Zimbabwe are utilized, with separate analyses for hospitals and health centres. Second, the resulting other-direct and indirect factor shares are applied to country unit costs from the WHO CHOICE unit cost database to calculate those portions of unit cost. Third, the remainder of the costs is calculated using default data from the OHT. Fourth, we calculate the effect of bundling services by assuming that a LiST intervention visit takes an average of 20 minutes when delivered alone but only incremental time in addition to the basic visit when delivered in a bundle. Personnel costs account for the greatest share of costs for both hospitals and health centres at 50% and 38%, respectively. The percentages differ between hospitals and health centres for consumables (21% versus 17%), other direct (7.5% versus 6.75%), and indirect (22% versus 23%) costs. Combining the other-direct and indirect factor shares with the WHO CHOICE database and the other costs from OHT provides a comprehensive cost estimate of LiST interventions. Finally, the cost of six recommended antenatal care (ANC) interventions is $69.76 when delivered alone, but $61.18 when delivered as a bundle, a savings of $8.58 (12.2%). This paper proposes a method for estimating a comprehensive cost of providing child and maternal health interventions by combining labor

  18. Estimating the cost of saving electricity through U.S. utility customer-funded energy efficiency programs

    International Nuclear Information System (INIS)

    Hoffman, Ian M.; Goldman, Charles A.; Rybka, Gregory; Leventis, Greg; Schwartz, Lisa; Sanstad, Alan H.; Schiller, Steven

    2017-01-01

    The program administrator and total cost of saved energy allow comparison of the cost of efficiency across utilities, states, and program types, and can identify potential performance improvements. Comparing program administrator cost with the total cost of saved energy can indicate the degree to which programs leverage investment by participants. Based on reported total costs and savings information for U.S. utility efficiency programs from 2009 to 2013, we estimate the savings-weighted average total cost of saved electricity across 20 states at $0.046 per kilowatt-hour (kW h), comparing favorably with energy supply costs and retail rates. Programs targeted on the residential market averaged $0.030 per kW h compared to $0.053 per kW h for non-residential programs. Lighting programs, with an average total cost of $0.018 per kW h, drove lower savings costs in the residential market. We provide estimates for the most common program types and find that program administrators and participants on average are splitting the costs of efficiency in half. More consistent, standardized and complete reporting on efficiency programs is needed. Differing definitions and quantification of costs, savings and savings lifetimes pose challenges for comparing program results. Reducing these uncertainties could increase confidence in efficiency as a resource among planners and policymakers. - Highlights: • The cost of saved energy allows comparisons among energy resource investments. • Findings from the most expansive collection yet of total energy efficiency program costs. • The weighted average total cost of saved electricity was $0.046 for 20 states in 2009–2013. • Averages in the residential and non-residential sectors were $0.030 and $0.053 per kW h, respectively. • Results strongly indicate need for more consistent, reliable and complete reporting on efficiency programs.

  19. Estimating the opportunity costs of bed-days.

    Science.gov (United States)

    Sandmann, Frank G; Robotham, Julie V; Deeny, Sarah R; Edmunds, W John; Jit, Mark

    2018-03-01

    Opportunity costs of bed-days are fundamental to understanding the value of healthcare systems. They greatly influence burden of disease estimations and economic evaluations involving stays in healthcare facilities. However, different estimation techniques employ assumptions that differ crucially in whether to consider the value of the second-best alternative use forgone, of any available alternative use, or the value of the actually chosen alternative. Informed by economic theory, this paper provides a taxonomic framework of methodologies for estimating the opportunity costs of resources. This taxonomy is then applied to bed-days by classifying existing approaches accordingly. We highlight differences in valuation between approaches and the perspective adopted, and we use our framework to appraise the assumptions and biases underlying the standard approaches that have been widely adopted mostly unquestioned in the past, such as the conventional use of reference costs and administrative accounting data. Drawing on these findings, we present a novel approach for estimating the opportunity costs of bed-days in terms of health forgone for the second-best patient, but expressed monetarily. This alternative approach effectively re-connects to the concept of choice and explicitly considers net benefits. It is broadly applicable across settings and for other resources besides bed-days. © 2017 The Authors Health Economics published by John Wiley & Sons Ltd.

  20. Implementing Suicide Prevention Programs: Costs and Potential Life Years Saved in Canada.

    Science.gov (United States)

    Vasiliadis, Helen-Maria; Lesage, Alain; Latimer, Eric; Seguin, Monique

    2015-09-01

    ,979 per life year saved. Suicide prevention programs such as the NAD trial are cost-effective and can result in important potential cost-savings due to averted suicide deaths and reduced life years lost. Implementation of suicide prevention programs at the population level in Canada is cost-effective. Community mental health programs aimed at increasing awareness and the treatment of depression and better follow-up of high risk individuals for suicide are associated with a minimal per capita investment. These programs can result in important potential cost-savings due to averted suicide deaths and decreased disability due to depression. Additional research should focus on whether the outcomes of multi-modal suicide programs are specific or synergistic and most effective for which population subgroups. This may help inform how best to invest resources for the highest return.

  1. Key Design Considerations When Calculating Cost Savings for Population Health Management Programs in an Observational Setting.

    Science.gov (United States)

    Murphy, Shannon M E; Hough, Douglas E; Sylvia, Martha L; Dunbar, Linda J; Frick, Kevin D

    2018-02-08

    To illustrate the impact of key quasi-experimental design elements on cost savings measurement for population health management (PHM) programs. Population health management program records and Medicaid claims and enrollment data from December 2011 through March 2016. The study uses a difference-in-difference design to compare changes in cost and utilization outcomes between program participants and propensity score-matched nonparticipants. Comparisons of measured savings are made based on (1) stable versus dynamic population enrollment and (2) all eligible versus enrolled-only participant definitions. Options for the operationalization of time are also discussed. Individual-level Medicaid administrative and claims data and PHM program records are used to match study groups on baseline risk factors and assess changes in costs and utilization. Savings estimates are statistically similar but smaller in magnitude when eliminating variability based on duration of population enrollment and when evaluating program impact on the entire target population. Measurement in calendar time, when possible, simplifies interpretability. Program evaluation design elements, including population stability and participant definitions, can influence the estimated magnitude of program savings for the payer and should be considered carefully. Time specifications can also affect interpretability and usefulness. © Health Research and Educational Trust.

  2. Patterns of Cost for Patients Dying in the Intensive Care Unit and Implications for Cost Savings of Palliative Care Interventions.

    Science.gov (United States)

    Khandelwal, Nita; Benkeser, David; Coe, Norma B; Engelberg, Ruth A; Teno, Joan M; Curtis, J Randall

    2016-11-01

    Terminal intensive care unit (ICU) stays represent an important target to increase value of care. To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. Secondary analysis of an intervention study to improve quality of care for critically ill patients. 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center. Data were linked with hospital financial records. Costs were categorized into direct fixed, direct variable, and indirect costs. Patterns of daily costs were explored using generalized estimating equations stratified by length of stay, cause of death, ICU type, and insurance status. Estimates from the literature of effects of palliative care interventions on ICU utilization were used to simulate potential cost savings under different time horizons and reimbursement models. Mean cost for a terminal ICU stay was 39.3K ± 45.1K. Direct fixed costs represented 45% of total hospital costs, direct variable costs 20%, and indirect costs 34%. Day of admission was most expensive (mean 9.6K ± 7.6K); average cost for subsequent days was 4.8K ± 3.4K and stable over time and patient characteristics. Terminal ICU stays display consistent cost patterns across patient characteristics. Savings can be realized with interventions that align care with patient preferences, helping to prevent unwanted ICU utilization at end of life. Cost modeling suggests that implications vary depending on time horizon and reimbursement models.

  3. Potential Cost Savings From Reduction of Regional Variation in Medicare Spending

    Directory of Open Access Journals (Sweden)

    Yunjie Song

    2016-04-01

    Full Text Available Potential cost savings estimated from reduction of regional variation in Medicare spending are considerable but questioned. This article evaluates the validity of the principal methods that have been used in the estimations of the potential savings. Three estimation approaches were identified. The first approach uses adjusted expenditures to calculate avoidable costs, but adjusted expenditures can be independent of avoidable costs, and measurement errors are not controlled. The second approach uses an outcome variable to replace its causal factors, and is not acceptable because the association between the outcomes and the causes is untestable. The final approach uses surveys to directly measure physician beliefs and patient preferences, but the sole study using this approach is weakened by sample selection biases and incomplete controls. A development of reliable measures and a switch of observation from clinic settings to geographic contexts could make the estimations more convincing.

  4. Will Changes to Medicare Payment Rates Alter Hospice's Cost-Saving Ability?

    Science.gov (United States)

    Taylor, Donald H; Bhavsar, Nrupen A; Bull, Janet H; Kassner, Cordt T; Olson, Andrew; Boucher, Nathan A

    2018-05-01

    On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis. All age-eligible Medicare decedents who received care and died in North Carolina in calendar years 2009 and 2010. Costs to Medicare for hospice and other healthcare services. Medicare costs were reduced from hospice election until death using both 2009-2010 and new 2016 payment structures and rates. Mean cost savings were $1,527 with actual payment rates, and would have been $2,105 with the new payment rates (p payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

  5. Vegetable output and cost savings of community gardens in San Jose, California.

    Science.gov (United States)

    Algert, Susan J; Baameur, Aziz; Renvall, Marian J

    2014-07-01

    Urban dwellers across the United States increasingly access a variety of fresh vegetables through participation in neighborhood-level community gardens. Here we document vegetable output and cost savings of community gardens in the city of San Jose, CA, to better understand the capacity of community gardens to affect food affordability in an urban setting. A convenience sample of 83 community gardeners in San Jose completed a background survey during spring and summer 2012. On average, gardeners were aged 57 years and had a monthly income of $4,900; 25% had completed college. A representative subset of 10 gardeners was recruited to weigh vegetable output of their plots using portable electronic scales at three separate garden sites. Accuracy of each portable scale was verified by comparing the weight of a sample vegetable to weights obtained using a lab scale precise to 0.2 oz. Garden yields and cost savings were tabulated overall for each plot. Results indicate that community garden practices are more similar to biointensive high-production farming, producing 0.75 lb vegetables/sq ft, rather than conventional agricultural practices, producing 0.60 lb/sq ft. Gardens produced on average 2.55 lb/plant and saved $435 per plot for the season. Results indicate that cost savings are greatest if vertical high value crops such as tomatoes and peppers are grown in community gardens, although yields depend on growing conditions, gardener's skill, availability of water, and other factors. Future research is needed to document cost savings and yields for specific crops grown in community gardens. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. The costs and potential savings of a novel telepaediatric service in Queensland

    Directory of Open Access Journals (Sweden)

    Scuffham Paul

    2007-03-01

    Full Text Available Abstract Background There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. Methods In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry. Results During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider. Conclusion Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.

  7. Developing Information on Energy Savings and Associated Costs and Benefits of Energy Efficient Emerging Technologies Applicable in California

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Tengfang; Slaa, Jan Willem; Sathaye, Jayant

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing carbon dioxide (CO2) emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world and in California. Successful implementation of applicable emerging technologies not only may help advance productivities, improve environmental impacts, or enhance industrial competitiveness, but also can play a significant role in climate-mitigation efforts by saving energy and reducing the associated GHG emissions. Developing new information on costs and savings benefits of energy efficient emerging technologies applicable in California market is important for policy makers as well as the industries. Therefore, provision of timely evaluation and estimation of the costs and energy savings potential of emerging technologies applicable to California is the focus of this report. The overall goal of the project is to identify and select a set of emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. Specifically, this report contains the results from performing Task 3 Technology Characterization for California Industries for the project titled Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies, sponsored by

  8. Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization

    Science.gov (United States)

    2014-05-01

    1 Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization David N. Ford...2014 4. TITLE AND SUBTITLE Potential Cost Savings with 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization 5a...Manufacturing ( 3D printing ) 2 Research Context Problem: Learning curve savings forecasted in SHIPMAIN maintenance initiative have not materialized

  9. Energy-Saving Opportunities for Manufacturing Companies, International Fact Sheet (Spanish)

    Energy Technology Data Exchange (ETDEWEB)

    2010-08-01

    This English/Spanish fact sheet describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

  10. Energy-Saving Opportunities for Manufacturing Companies (English/Portuguese Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    This English/Portuguese brochure describes the Industrial Technologies Program Save Energy Now model and provides information on tools and resources to help manufacturing facilities reduce industrial energy intensity.

  11. Development of a prediction model for the cost saving potentials in implementing the building energy efficiency rating certification

    International Nuclear Information System (INIS)

    Jeong, Jaewook; Hong, Taehoon; Ji, Changyoon; Kim, Jimin; Lee, Minhyun; Jeong, Kwangbok; Koo, Choongwan

    2017-01-01

    Highlights: • This study evaluates the building energy efficiency rating (BEER) certification. • Prediction model was developed for cost saving potentials by the BEER certification. • Prediction model was developed using LCC analysis, ROV, and Monte Carlo simulation. • Cost saving potential was predicted to be 2.78–3.77% of the construction cost. • Cost saving potential can be used for estimating the investment value of BEER. - Abstract: Building energy efficiency rating (BEER) certification is an energy performance certificates (EPCs) in South Korea. It is critical to examine the cost saving potentials of the BEER-certification in advance. This study aimed to develop a prediction model for the cost saving potentials in implementing the BEER-certification, in which the cost saving potentials included the energy cost savings of the BEER-certification and the relevant CO_2 emissions reduction as well as the additional construction cost for the BEER-certification. The prediction model was developed by using data mining, life cycle cost analysis, real option valuation, and Monte Carlo simulation. The database were established with 437 multi-family housing complexes (MFHCs), including 116 BEER-certified MFHCs and 321 non-certified MFHCs. The case study was conducted to validate the developed prediction model using 321 non-certified MFHCs, which considered 20-year life cycle. As a result, compared to the additional construction cost, the average cost saving potentials of the 1st-BEER-certified MFHCs in Groups 1, 2, and 3 were predicted to be 3.77%, 2.78%, and 2.87%, respectively. The cost saving potentials can be used as a guideline for the additional construction cost of the BEER-certification in the early design phase.

  12. An opportunity cost model of subjective effort and task performance

    Science.gov (United States)

    Kurzban, Robert; Duckworth, Angela; Kable, Joseph W.; Myers, Justus

    2013-01-01

    Why does performing certain tasks cause the aversive experience of mental effort and concomitant deterioration in task performance? One explanation posits a physical resource that is depleted over time. We propose an alternate explanation that centers on mental representations of the costs and benefits associated with task performance. Specifically, certain computational mechanisms, especially those associated with executive function, can be deployed for only a limited number of simultaneous tasks at any given moment. Consequently, the deployment of these computational mechanisms carries an opportunity cost – that is, the next-best use to which these systems might be put. We argue that the phenomenology of effort can be understood as the felt output of these cost/benefit computations. In turn, the subjective experience of effort motivates reduced deployment of these computational mechanisms in the service of the present task. These opportunity cost representations, then, together with other cost/benefit calculations, determine effort expended and, everything else equal, result in performance reductions. In making our case for this position, we review alternate explanations both for the phenomenology of effort associated with these tasks and for performance reductions over time. Likewise, we review the broad range of relevant empirical results from across subdisciplines, especially psychology and neuroscience. We hope that our proposal will help to build links among the diverse fields that have been addressing similar questions from different perspectives, and we emphasize ways in which alternate models might be empirically distinguished. PMID:24304775

  13. Cost-savings for biosimilars in the United States: a theoretical framework and budget impact case study application using filgrastim.

    Science.gov (United States)

    Grewal, Simrun; Ramsey, Scott; Balu, Sanjeev; Carlson, Josh J

    2018-05-18

    Biosimilars can directly reduce the cost of treating patients for whom a reference biologic is indicated by offering a highly similar, lower priced alternative. We examine factors related to biosimilar regulatory approval, uptake, pricing, and financing and the potential impact on drug expenditures in the U.S. We developed a framework to illustrate how key factors including regulatory policies, provider and patient perception, pricing, and payer policies impact biosimilar cost-savings. Further, we developed a budget impact cost model to estimate savings from filgrastim biosimilars under various scenarios. The model uses publicly available data on disease incidence, treatment patterns, market share, and drug prices to estimate the cost-savings over a 5-year time horizon. We estimate five-year cost savings of $256 million, of which 18% ($47 million) are from reduced patient out-of-pocket costs, 34% ($86 million) are savings to commercial payers, and 48% ($123 million) are savings for Medicare. Additional scenarios demonstrate the impact of uncertain factors, including price, uptake, and financing policies. A variety or interrelated factors influence the development, uptake, and cost-savings for Biosimilars use in the U.S. The filgrastim case is a useful example that illustrates these factors and the potential magnitude of costs savings.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

  16. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

    Directory of Open Access Journals (Sweden)

    Andrea-Romana Prusa

    2017-07-01

    Full Text Available Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario.We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years.Cost savings under a national program of prenatal screening for toxoplasma infection and

  17. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving

    Science.gov (United States)

    Prusa, Andrea-Romana; Kasper, David C.; Sawers, Larry; Walter, Evelyn; Hayde, Michael

    2017-01-01

    Background Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal findings We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance Cost savings under a national program of

  18. Using the missed opportunity tool as an application of the Lives Saved Tool (LiST) for intervention prioritization.

    Science.gov (United States)

    Tam, Yvonne; Pearson, Luwei

    2017-11-07

    The Missed Opportunity tool was developed as an application in the Lives Saved Tool (LiST) to allow users to quickly compare the relative impact of interventions. Global Financing Facility (GFF) investment cases have been identified as a potential application of the Missed Opportunity analyses in Democratic Republic of the Congo (DRC), Ethiopia, Kenya, and Tanzania, to use 'lives saved' as a normative factor to set priorities. The Missed Opportunity analysis draws on data and methods in LiST to project maternal, stillbirth, and child deaths averted based on changes in interventions' coverage. Coverage of each individual intervention in LiST was automated to be scaled up from current coverage to 90% in the next year, to simulate a scenario where almost every mother and child receive proven interventions that they need. The main outcome of the Missed Opportunity analysis is deaths averted due to each intervention. When reducing unmet need for contraception is included in the analysis, it ranks as the top missed opportunity across the four countries. When it is not included in the analysis, top interventions with the most total deaths averted are hospital-based interventions such as labor and delivery management in the CEmOC and BEmOC level, and full treatment and supportive care for premature babies, and for sepsis/pneumonia. The Missed Opportunity tool can be used to provide a quick, first look at missed opportunities in a country or geographic region, and help identify interventions for prioritization. While it is a useful advocate for evidence-based priority setting, decision makers need to consider other factors that influence decision making, and also discuss how to implement, deliver, and sustain programs to achieve high coverage.

  19. What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation

    Science.gov (United States)

    Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

    2016-01-01

    Objective This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Design Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Setting Champlain health region in Eastern Ontario, Canada. Population Primary care providers and specialists registered to use the eConsult service. Main outcome measures Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. Results A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Conclusions Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. PMID:27338880

  20. Patient level costing in Ireland: process, challenges and opportunities.

    Science.gov (United States)

    Murphy, A; McElroy, B

    2015-03-01

    In 2013, the Department of Health released their policy paper on hospital financing entitled Money Follows the Patient. A fundamental building block for the proposed financing model is patient level costing. This paper outlines the patient level costing process, identifies the opportunities and considers the challenges associated with the process in the Irish hospital setting. Methods involved a review of the existing literature which was complemented with an interview with health service staff. There are considerable challenges associated with implementing patient level costing including deficits in information and communication technologies and financial expertise as well as timeliness of coding. In addition, greater clinical input into the costing process is needed compared to traditional costing processes. However, there are long-term benefits associated with patient level costing; these include empowerment of clinical staff, improved transparency and price setting and greater fairness, especially in the treatment of outliers. These can help to achieve the Government's Health Strategy. The benefits of patient level costing need to be promoted and a commitment to investment in overcoming the challenges is required.

  1. Vaginal microbicides save money: a model of cost-effectiveness in South Africa and the USA.

    Science.gov (United States)

    Verguet, S; Walsh, J A

    2010-06-01

    To determine the hypothetical cost-effectiveness of vaginal microbicides preventing male to female HIV transmission. A mathematical epidemiological and cost-effectiveness model using data from South Africa and the USA was used. The prospective 1-year-long intervention targeted a general population of women in a city of 1,000,000 inhabitants in two very different epidemiological settings, South Africa with a male HIV prevalence of 18.80% and the USA with a male HIV prevalence of 0.72%. The base case scenario assumes a microbicide effective at 55%, used in 30% of sexual episodes at a retail price for the public sector in South Africa of US$0.51 per use and in the USA of US$2.23 per use. In South Africa, over 1 year, the intervention would prevent 1908 infections, save US$6712 per infection averted as compared with antiretroviral treatment. In the USA, it would be more costly: over 1 year, the intervention would prevent 21 infections, amounting to a net cost per infection averted of US$405,077. However, in the setting of Washington DC, with a higher HIV prevalence, the same intervention would prevent 93 infections and save US$91,176 per infection averted. Sensitivity analyses were conducted and even a microbicide with a low effectiveness of 30% would still save healthcare costs in South Africa. A microbicide intervention is likely to be very cost-effective in a country undergoing a high-level generalised epidemic such as South Africa, but is unlikely to be cost-effective in a developed country presenting epidemiological features similar to the USA unless the male HIV prevalence exceeds 2.4%.

  2. Effects of a Community-Based Fall Management Program on Medicare Cost Savings.

    Science.gov (United States)

    Ghimire, Ekta; Colligan, Erin M; Howell, Benjamin; Perlroth, Daniella; Marrufo, Grecia; Rusev, Emil; Packard, Michael

    2015-12-01

    Fall-related injuries and health risks associated with reduced mobility or physical inactivity account for significant costs to the U.S. healthcare system. The widely disseminated lay-led A Matter of Balance (MOB) program aims to help older adults reduce their risk of falling and associated activity limitations. This study examined effects of MOB participation on health service utilization and costs for Medicare beneficiaries, as a part of a larger effort to understand the value of community-based prevention and wellness programs for Medicare. A controlled retrospective cohort study was conducted in 2012-2013, using 2007-2011 MOB program data and 2006-2013 Medicare data. It investigated program effects on falls and fall-related fractures, and health service utilization and costs (standardized to 2012 dollars), of 6,136 Medicare beneficiaries enrolled in MOB from 2007 through 2011. A difference-in-differences analysis was employed to compare outcomes of MOB participants with matched controls. MOB participation was associated with total medical cost savings of $938 per person (95% CI=$379, $1,498) at 1 year. Savings per person amounted to $517 (95% CI=$265, $769) for unplanned hospitalizations; $81 for home health care (95% CI=$20, $141); and $234 (95% CI=$55, $413) for skilled nursing facility care. Changes in the incidence of falls or fall-related fractures were not detected, suggesting that cost savings accrue through other mechanisms. This study suggests that MOB and similar prevention programs have the potential to reduce Medicare costs. Further research accounting for program delivery costs would help inform the development of Medicare-covered preventive benefits. Copyright © 2015 American Journal of Preventive Medicine. All rights reserved.

  3. Assessing Potential Energy Cost Savings from Increased Energy Code Compliance in Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Hart, Philip R.; Athalye, Rahul A.; Zhang, Jian; Wang, Weimin

    2016-02-15

    The US Department of Energy’s most recent commercial energy code compliance evaluation efforts focused on determining a percent compliance rating for states to help them meet requirements under the American Recovery and Reinvestment Act (ARRA) of 2009. That approach included a checklist of code requirements, each of which was graded pass or fail. Percent compliance for any given building was simply the percent of individual requirements that passed. With its binary approach to compliance determination, the previous methodology failed to answer some important questions. In particular, how much energy cost could be saved by better compliance with the commercial energy code and what are the relative priorities of code requirements from an energy cost savings perspective? This paper explores an analytical approach and pilot study using a single building type and climate zone to answer those questions.

  4. Potential Cost-Effective Opportunities for Methane Emission Abatement

    Energy Technology Data Exchange (ETDEWEB)

    Warner, Ethan [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States); Steinberg, Daniel [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States); Hodson, Elke [U.S. Department of Energy, Washington, DC (United States); Heath, Garvin [Joint Inst. for Strategic Energy Analysis, Golden, CO (United States)

    2015-08-01

    The energy sector was responsible for approximately 84% of carbon dioxide equivalent (CO2e) greenhouse gas (GHG) emissions in the U.S. in 2012 (EPA 2014a). Methane is the second most important GHG, contributing 9% of total U.S. CO2e emissions. A large portion of those methane emissions result from energy production and use; the natural gas, coal, and oil industries produce approximately 39% of anthropogenic methane emissions in the U.S. As a result, fossil-fuel systems have been consistently identified as high priority sectors to contribute to U.S. GHG reduction goals (White House 2015). Only two studies have recently attempted to quantify the abatement potential and cost associated with the breadth of opportunities to reduce GHG emissions within natural gas, oil, and coal supply chains in the United States, namely the U.S. Environmental Protection Agency (EPA) (2013a) and ICF (2014). EPA, in its 2013 analysis, estimated the marginal cost of abatement for non-CO2 GHG emissions from the natural gas, oil, and coal supply chains for multiple regions globally, including the United States. Building on this work, ICF International (ICF) (2014) provided an update and re-analysis of the potential opportunities in U.S. natural gas and oil systems. In this report we synthesize these previously published estimates as well as incorporate additional data provided by ICF to provide a comprehensive national analysis of methane abatement opportunities and their associated costs across the natural gas, oil, and coal supply chains. Results are presented as a suite of marginal abatement cost curves (MACCs), which depict the total potential and cost of reducing emissions through different abatement measures. We report results by sector (natural gas, oil, and coal) and by supply chain segment - production, gathering and boosting, processing, transmission and storage, or distribution - to facilitate identification of which sectors and supply chain

  5. Reevaluation of Vitrified High-Level Waste Form Criteria for Potential Cost Savings at the Defense Waste Processing Facility - 13598

    Energy Technology Data Exchange (ETDEWEB)

    Ray, J.W. [Savannah River Remediation (United States); Marra, S.L.; Herman, C.C. [Savannah River National Laboratory, Savannah River Site, Aiken, SC 29808 (United States)

    2013-07-01

    At the Savannah River Site (SRS) the Defense Waste Processing Facility (DWPF) has been immobilizing SRS's radioactive high level waste (HLW) sludge into a durable borosilicate glass since 1996. Currently the DWPF has poured over 3,500 canisters, all of which are compliant with the U. S. Department of Energy's (DOE) Waste Acceptance Product Specifications for Vitrified High-Level Waste Forms (WAPS) and therefore ready to be shipped to a federal geologic repository for permanent disposal. Due to DOE petitioning to withdraw the Yucca Mountain License Application (LA) from the Nuclear Regulatory Commission (NRC) in 2010 and thus no clear disposal path for SRS canistered waste forms, there are opportunities for cost savings with future canister production at DWPF and other DOE producer sites by reevaluating high-level waste form requirements and compliance strategies and reducing/eliminating those that will not negatively impact the quality of the canistered waste form. (authors)

  6. Reevaluation Of Vitrified High-Level Waste Form Criteria For Potential Cost Savings At The Defense Waste Processing Facility

    International Nuclear Information System (INIS)

    Ray, J. W.; Marra, S. L.; Herman, C. C.

    2013-01-01

    At the Savannah River Site (SRS) the Defense Waste Processing Facility (DWPF) has been immobilizing SRS's radioactive high level waste (HLW) sludge into a durable borosilicate glass since 1996. Currently the DWPF has poured over 3,500 canisters, all of which are compliant with the U. S. Department of Energy's (DOE) Waste Acceptance Product Specifications for Vitrified High-Level Waste Forms (WAPS) and therefore ready to be shipped to a federal geologic repository for permanent disposal. Due to DOE petitioning to withdraw the Yucca Mountain License Application (LA) from the Nuclear Regulatory Commission (NRC) in 2010 and thus no clear disposal path for SRS canistered waste forms, there are opportunities for cost savings with future canister production at DWPF and other DOE producer sites by reevaluating high-level waste form requirements and compliance strategies and reducing/eliminating those that will not negatively impact the quality of the canistered waste form

  7. Energy and cost savings potential of oscillating heat pipes for waste heat recovery ventilation

    Directory of Open Access Journals (Sweden)

    Govinda Mahajan

    2017-11-01

    Full Text Available The feasibility of using finned oscillating heat pipes (OHPs for heat exchange between counter-flowing air streams in HVAC air systems (i.e., outdoor and exhaust air flows, along with the associated cost savings in typical North American climates, is investigated. For a prescribed temperature difference and volumetric flow rate of air, rudimentary design parameters for a viable OHP Heat Recovery Ventilator (OHP-HRV were determined using the ε-NTU (effectiveness-Number of Transfer Unit method. The two-phase heat transfer within the OHP-HRV is modeled via effective evaporation/condensation heat transfer coefficients, while the latent heat transfer required to initiate OHP operation via boiling and evaporation is also considered. Results suggest that an OHP-HRV can possess a reasonable pressure drop (5 kW. The proposed OHP-HRV can possess an effectiveness near 0.5 and can pre-cool/heat HVAC air by >5°C. Potential energy and cost savings associated with using an OHP-HRV were estimated for commercial building envelopes in various regions of the United States. It is found that the proposed OHP-HRV can save more than $2500 annually in cities that have continental climatic conditions, such as Chicago and Denver, and for the selected locations the average yearly cost savings per building is found to be on-the-order of $700. Overall, the OHP-HRV shows potential in effectively reducing energy consumption and the operational cost of air handling units in buildings.

  8. Societal value of generic medicines beyond cost-saving through reduced prices.

    Science.gov (United States)

    Dylst, Pieter; Vulto, Arnold; Simoens, Steven

    2015-01-01

    This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.

  9. Green Routing Fuel Saving Opportunity Assessment: A Case Study on California Large-Scale Real-World Travel Data

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Lei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holden, Jacob [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gonder, Jeffrey D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Wood, Eric W [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-07-31

    New technologies, such as connected and automated vehicles, have attracted more and more researchers for improving the energy efficiency and environmental impact of current transportation systems. The green routing strategy instructs a vehicle to select the most fuel-efficient route before the vehicle departs. It benefits the current transportation system with fuel saving opportunity through identifying the greenest route. This paper introduces an evaluation framework for estimating benefits of green routing based on large-scale, real-world travel data. The framework has the capability to quantify fuel savings by estimating the fuel consumption of actual routes and comparing to routes procured by navigation systems. A route-based fuel consumption estimation model, considering road traffic conditions, functional class, and road grade is proposed and used in the framework. An experiment using a large-scale data set from the California Household Travel Survey global positioning system trajectory data base indicates that 31% of actual routes have fuel savings potential with a cumulative estimated fuel savings of 12%.

  10. Green Routing Fuel Saving Opportunity Assessment: A Case Study on California Large-Scale Real-World Travel Data: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Lei; Holden, Jacob; Gonder, Jeff; Wood, Eric

    2017-07-13

    New technologies, such as connected and automated vehicles, have attracted more and more researchers for improving the energy efficiency and environmental impact of current transportation systems. The green routing strategy instructs a vehicle to select the most fuel-efficient route before the vehicle departs. It benefits the current transportation system with fuel saving opportunity through identifying the greenest route. This paper introduces an evaluation framework for estimating benefits of green routing based on large-scale, real-world travel data. The framework has the capability to quantify fuel savings by estimating the fuel consumption of actual routes and comparing to routes procured by navigation systems. A route-based fuel consumption estimation model, considering road traffic conditions, functional class, and road grade is proposed and used in the framework. An experiment using a large-scale data set from the California Household Travel Survey global positioning system trajectory data base indicates that 31% of actual routes have fuel savings potential with a cumulative estimated fuel savings of 12%.

  11. A Cost Estimation Analysis of U.S. Navy Ship Fuel-Savings Techniques and Technologies

    Science.gov (United States)

    2009-09-01

    Horngren , C. T., Datar, S . M., & Foster, G. (2006). Cost Accounting : A Managerial Emphasis. 12th ed. Saddle River, NJ: Pearson...COVERED Master’s Thesis 4. TITLE AND SUBTITLE A Cost Estimation Analysis of U.S. Navy Ship Fuel-Savings Techniques and Technologies 6. AUTHOR( S ...FY12 FY13 FY14 FY15 FY16 FY17 FY18 N P V   C u m   S a v i n g s   ( $ / y r / S D   s h i p s ) Time

  12. Web-based Tool Identifies and Quantifies Potential Cost Savings Measures at the Hanford Site

    International Nuclear Information System (INIS)

    Renevitz, Marisa J.; Peschong, Jon C.; Charboneau, Briant L.; Simpson, Brett C.

    2014-01-01

    The Technical Improvement system is an approachable web-based tool that is available to Hanford DOE staff, site contractors, and general support service contractors as part of the baseline optimization effort underway at the Hanford Site. Finding and implementing technical improvements are a large part of DOE's cost savings efforts. The Technical Improvement dashboard is a key tool for brainstorming and monitoring the progress of submitted baseline optimization and potential cost/schedule efficiencies. The dashboard is accessible to users over the Hanford Local Area Network (HLAN) and provides a highly visual and straightforward status to management on the ideas provided, alleviating the need for resource intensive weekly and monthly reviews

  13. Carbon and Energy Saving Financial Opportunities in the Industrial Compressed Air Sector

    Science.gov (United States)

    Vittorini, Diego; Cipollone, Roberto

    2017-08-01

    The transition towards a more sustainable energy scenario calls for both medium-to-long and short term interventions, with CO2 reduction and fossil fuel saving as main goals for all the Countries in the World. Among all others, one way to support these efforts is the setting-up of immaterial markets able to regulate, in the form of purchase and sales quotas, CO2 emissions avoided and fossil fuels not consumed. As a consequence, the upgrade of those sectors, characterized by high energy impact, is currently more than an option due to the related achievable financial advantage on the afore mentioned markets. Being responsible for about 10% electricity consumption in Industry, the compressed air sector is currently addressed as extremely appealing, when CO2 emissions and burned fossil fuels saving are in question. In the paper, once a standard is defined for compressors performances, based on data from the Compressed Air and Gas Institute and PNEUROP, the achievable energy saving is evaluated along with the effect in terms of CO2 emissions: with reference to those contexts in which mature intangible markets are established, an estimation of the financial benefit from savings sale on correspondent markets is possible, in terms of both avoided CO2 and fossil fuels not burned. The approach adopted allows to extend the analysis results to every context of interest, by applying the appropriate emission factor to the datum on compressor specific consumption.

  14. A Model of Cost Reduction and Standardization: Improved Cost Savings While Maintaining the Quality of Care.

    Science.gov (United States)

    Guzman, Michael J; Gitelis, Matthew E; Linn, John G; Ujiki, Michael B; Waskerwitz, Matthew; Umanskiy, Konstantin; Muldoon, Joseph P

    2015-11-01

    Surgeon instrument choices are influenced by training, previous experience, and established preferences. This causes variability in the cost of common operations, such as laparoscopic appendectomy. Many surgeons are unaware of the impact that this has on healthcare spending. We sought to educate surgeons on their instrument use and develop standardized strategies for operating room cost reduction. We collected the individual surgeon instrument cost for performing a laparoscopic appendectomy. Sixteen surgeons were educated about these costs and provided with cost-effective instruments and techniques. This study was conducted in a university-affiliated hospital system. Patients included those undergoing a laparoscopic appendectomy within the hospital system. Patient demographics, operating room costs, and short-term outcomes for the fiscal year before and after the education program were then compared. During fiscal year 2013, a total of 336 laparoscopic appendectomies were performed compared with 357 in 2014. Twelve surgeons had a ≥5% reduction in average cost per case. Overall, the average cost per case was reduced by 17% (p day readmissions, postoperative infections, operating time, or reoperations. This retrospective study is subject to the accuracy of the medical chart system. In addition, specific instrument costs are based on our institution contracts and vary compared with other institutions. In this study we demonstrate that operative instrument costs for laparoscopic appendectomy can be significantly reduced by informing the surgeons of their operating room costs compared with their peers and providing a low-cost standardized instrument tray. Importantly, this can be realized without any incentive or punitive measures and does not negatively impact outcomes. Additional work is needed to expand these results to more operations, hospital systems, and training programs.

  15. Achieving the 30% Goal: Energy and Cost Savings Analysis of ASHRAE Standard 90.1-2010

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A.; Rosenberg, Michael I.; Richman, Eric E.; Wang, Weimin; Xie, YuLong; Zhang, Jian; Cho, Heejin; Mendon, Vrushali V.; Athalye, Rahul A.; Liu, Bing

    2011-05-24

    This Technical Support Document presents the energy and cost savings analysis that PNNL conducted to measure the potential energy savings of 90.1-2010 relative to 90.1-2004. PNNL conducted this analysis with inputs from many other contributors and source of information. In particular, guidance and direction was provided by the Simulation Working Group under the auspices of the SSPC90.1. This report documents the approach and methodologies that PNNL developed to evaluate the energy saving achieved from use of ASHRAE/IES Standard 90.1-2010. Specifically, this report provides PNNL’s Progress Indicator process and methodology, EnergyPlus simulation framework, prototype model descriptions. This report covers the combined upgrades from 90.1-2004 to 90.1-2010, resulting in a total of 153 addenda. PNNL has reviewed and considered all 153 addenda for quantitative analysis in the Progress Indicator process. 53 of those are included in the quantitative analysis. This report provides information on the categorization of all of the addenda, a summary of the content, and deeper explanation of the impact and modeling of 53 identified addenda with quantitative savings.

  16. Potential travel cost saving in urban public-transport networks using smartphone guidance

    Science.gov (United States)

    2018-01-01

    Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers’ preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger’s choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost. PMID:29746528

  17. Potential travel cost saving in urban public-transport networks using smartphone guidance.

    Science.gov (United States)

    Song, Cuiying; Guan, Wei; Ma, Jihui

    2018-01-01

    Public transport (PT) is a key element in most major cities around the world. With the development of smartphones, available journey planning information is becoming an integral part of the PT system. Each traveler has specific preferences when undertaking a trip, and these preferences can also be reflected on the smartphone. This paper considers transit assignment in urban public-transport networks in which the passengers receive smartphone-based information containing elements that might influence the travel decisions in relation to line loads, as well as passenger benefits, and the paper discusses the transition from the current widespread choosing approach to a personalized decision-making approach based on smartphone information. The approach associated with smartphone guidance that considers passengers' preference on travel time, waiting time and transfer is proposed in the process of obtaining his/her preferred route from the potential travel routes generated by the Deep First Search (DFS) method. Two other approaches, based on the scenarios reflecting reality, include passengers with access to no real time information, and passengers that only have access to the arrival time at the platform are used as comparisons. For illustration, the same network proposed by Spiess and Florian is utilized on the experiments in an agent-based model. Two experiments are conducted respectively according to whether each passenger's choosing method is consistent. As expected, the results in the first experiment showed that the travel for consistent passengers with smartphone guidance was clearly shorter and that it can reduce travel time exceeding 15% and weighted cost exceeding 20%, and the average saved time approximated 3.88 minutes per passenger. The second experiment presented that travel cost, as well as cost savings, gradually decreased by employing smartphone guidance, and the maximum cost savings accounted for 14.2% of the total weighted cost.

  18. The need for ventilators in the developing world: An opportunity to improve care and save lives

    Directory of Open Access Journals (Sweden)

    Vijay Krishnamoorthy

    2014-06-01

    Full Text Available The drive to breathe is a fundamental human and biologic behavior, regulated by a complex system of checks and balances in the body. When respiratory mechanics are deregulated by injury, infection, coma, or a host of other conditions, the biologic equilibrium shifts into a state of respiratory failure. When this occurs, mechanical ventilation can be a life saving therapy. While commonplace in developed countries, critical care is at its infancy in many developing countries, where basic technology is often not available. Thus, while many lives are saved in developed nations through the provision of mechanical ventilation, patients in many developing nations often die from otherwise reversible causes due to lack of resources, education, and training.

  19. Time-driven activity-based costing to identify opportunities for cost reduction in pediatric appendectomy.

    Science.gov (United States)

    Yu, Yangyang R; Abbas, Paulette I; Smith, Carolyn M; Carberry, Kathleen E; Ren, Hui; Patel, Binita; Nuchtern, Jed G; Lopez, Monica E

    2016-12-01

    As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. Process maps were created using medical record time stamps. Labor capacity cost rates were calculated using national median physician salaries, weighted nurse-patient ratios, and hospital cost data. Consumable costs for supplies, pharmacy, laboratory, and food were derived from the hospital general ledger. Time-driven activity-based costing resulted in precise per-minute calculation of personnel costs. Highest costs were in the operating room ($747.07), hospital floor ($388.20), and emergency department ($296.21). Major contributors to length of stay were emergency department evaluation (270min), operating room availability (395min), and post-operative monitoring (1128min). The TDABC model led to $1712.16 in personnel costs and $1041.23 in consumable costs for a total appendicitis cost of $2753.39. Inefficiencies in healthcare delivery can be identified through TDABC. Triage-based standing delegation orders, advanced practice providers, and same day discharge protocols are proposed cost-reducing interventions to optimize value-based care for simple appendicitis. II. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Energy and cost saving results for advanced technology systems from the Cogeneration Technology Alternatives Study (CTAS)

    Science.gov (United States)

    Sagerman, G. D.; Barna, G. J.; Burns, R. K.

    1979-01-01

    An overview of the organization and methodology of the Cogeneration Technology Alternatives Study is presented. The objectives of the study were to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the future and to assess the advantages of advanced technology systems compared to those systems commercially available today. Advanced systems studied include steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics. Steam turbines, open cycle gas turbines, combined cycles, and diesel engines were also analyzed in versions typical of today's commercially available technology to provide a base against which to measure the advanced systems. Cogeneration applications in the major energy consuming manufacturing industries were considered. Results of the study in terms of plant level energy savings, annual energy cost savings and economic attractiveness are presented for the various energy conversion systems considered.

  1. Mission science value-cost savings from the Advanced Imaging Communication System (AICS)

    Science.gov (United States)

    Rice, R. F.

    1984-01-01

    An Advanced Imaging Communication System (AICS) was proposed in the mid-1970s as an alternative to the Voyager data/communication system architecture. The AICS achieved virtually error free communication with little loss in the downlink data rate by concatenating a powerful Reed-Solomon block code with the Voyager convolutionally coded, Viterbi decoded downlink channel. The clean channel allowed AICS sophisticated adaptive data compression techniques. Both Voyager and the Galileo mission have implemented AICS components, and the concatenated channel itself is heading for international standardization. An analysis that assigns a dollar value/cost savings to AICS mission performance gains is presented. A conservative value or savings of $3 million for Voyager, $4.5 million for Galileo, and as much as $7 to 9.5 million per mission for future projects such as the proposed Mariner Mar 2 series is shown.

  2. Health economic modeling of the potential cost saving effects of Neurally Adjusted Ventilator Assist.

    Science.gov (United States)

    Hjelmgren, Jonas; Bruce Wirta, Sara; Huetson, Pernilla; Myrén, Karl-Johan; Göthberg, Sylvia

    2016-02-01

    Asynchrony between patient and ventilator breaths is associated with increased duration of mechanical ventilation (MV). Neurally Adjusted Ventilatory Assist (NAVA) controls MV through an esophageal reading of diaphragm electrical activity via a nasogastric tube mounted with electrode rings. NAVA has been shown to decrease asynchrony in comparison to pressure support ventilation (PSV). The objective of this study was to conduct a health economic evaluation of NAVA compared with PSV. We developed a model based on an indirect link between improved synchrony with NAVA versus PSV and fewer days spent on MV in synchronous patients. Unit costs for MV were obtained from the Swedish intensive care unit register, and used in the model along with NAVA-specific costs. The importance of each parameter (proportion of asynchronous patients, costs, and average MV duration) for the overall results was evaluated through sensitivity analyses. Base case results showed that 21% of patients ventilated with NAVA were asynchronous versus 52% of patients receiving PSV. This equals an absolute difference of 31% and an average of 1.7 days less on MV and a total cost saving of US$7886 (including NAVA catheter costs). A breakeven analysis suggested that NAVA was cost effective compared with PSV given an absolute difference in the proportion of asynchronous patients greater than 2.5% (49.5% versus 52% asynchronous patients with NAVA and PSV, respectively). The base case results were stable to changes in parameters, such as difference in asynchrony, duration of ventilation and daily intensive care unit costs. This study showed economically favorable results for NAVA versus PSV. Our results show that only a minor decrease in the proportion of asynchronous patients with NAVA is needed for investments to pay off and generate savings. Future studies need to confirm this result by directly relating improved synchrony to the number of days on MV. © The Author(s), 2015.

  3. Clinical effectiveness and cost savings in diabetes care, supported by pharmacist counselling.

    Science.gov (United States)

    Rodriguez de Bittner, Magaly; Chirikov, Viktor V; Breunig, Ian M; Zaghab, Roxanne W; Shaya, Fadia Tohme

    To determine the effectiveness and cost savings of a real-world, continuous, pharmacist-delivered service with an employed patient population with diabetes over a 5-year period. The Patients, Pharmacists Partnerships (P 3 Program) was offered as an "opt-in" benefit to employees of 6 public and private self-insured employers in Maryland and Virginia. Care was provided in ZIP code-matched locations and at 2 employers' worksites. Six hundred two enrolled patients with type 1 and 2 diabetes were studied between July 2006 and May 2012 with an average follow-up of 2.5 years per patient. Of these patients, 162 had health plan cost and utilization data. A network of 50 trained pharmacists provided chronic disease management to patients with diabetes using a common process of care. Communications were provided to patients and physicians. Employers provided incentives for patients who opted in, including waived medication copayments and free diabetes self-monitoring supplies. The service was provided at no cost to the patient. A Web-based, electronic medical record that complied with the Health Insurance Portability and Accountability Act helped to standardize care. Quality assurance was conducted to ensure the standard of care. Glycosylated hemoglobin (A1c), blood pressure, and total health care costs (before and after enrollment). Statistically significant improvements were shown by mean decreases in A1c (-0.41%, P care costs to employers declined by $1031 per beneficiary after the cost of the program was deducted. This 66-month real-world study confirms earlier findings. Employers netted savings through improved clinical outcomes and reduced emergency and hospital utilization when comparing costs 12 months before and after enrollment. The P 3 program had positive clinical outcomes and economic outcomes. Pharmacist-provided comprehensive medication therapy management services should be included as a required element of insurance offered by employers and health insurance

  4. Assessment of Cost Savings of DOE's Return-on-Investment Program

    International Nuclear Information System (INIS)

    Yuracko, K.L.

    2000-01-01

    The US Department of Energy (DOE) Office of Pollution Prevention (EM-77) created a successful internally competed program to fund innovative projects based on projected returns. This is called the Return-on-Investment (ROI) program. EM-77 conducted a successful ROI pilot, developed and implemented sound management practices, and successfully transferred the program to several Operations Offices. Over the past 4 years sites have completed 262 ROI projects (costing $18.8 million) with claimed first-year savings of $88 million and claimed life cycle savings exceeding $300 million. EM-77 requested that Oak Ridge National Laboratory perform an independent evaluation of the site-led, DOE-HQ-funded pollution prevention (P2) ROI program to assist the Department in determining whether claimed savings are real. The approach for conducting this evaluation was to analyze a sample of P2 projects to identify actual project cost savings and other actual benefits--e.g., amount of waste avoided. To determine the projects for review, EM-77 provided a list of EM-funded projects at two Operations Offices: Oak Ridge and Richland. Sixteen projects (eight from each Operations Office) were selected at random from this list for review. Project documentation was requested from the sites, and this was followed by face-to-face interviews with project personnel. of the 16 projects selected at random, two are still awaiting implementation, and no project interview was conducted for one project. Because the purpose of this study was to review projects after they have been implemented, the two uncompleted projects were eliminated from further consideration. The remainder of this report addresses the 13 completed projects for which we received documentation and performed interviews with project personnel. Both Oak Ridge and Richland staff pointed out that because of the selection approach used, this study did not review the most successful projects at their sites

  5. Socio-economic impact of antiretroviral treatment in HIV patients. An economic review of cost savings after introduction of HAART.

    Science.gov (United States)

    Gonzalo, Teresa; García Goñi, Manuel; Muñoz-Fernández, María Angeles

    2009-01-01

    Star celebrities such as Rock Hudson, Freddie Mercury, Magic Johnson, and Isaac Asimov have unfortunately something in common: they were all victims of the HIV global pandemic. Since then HIV infection has become considered a pandemic disease, and it is regarded as a priority in healthcare worldwide. It is ranked as the first cause of death among young people in industrialized countries, and it is recognized as a public healthcare problem due to its human, social, mass media, and economic impact. Incorporation of new and highly active antiretroviral treatment, available since 1996 for HIV/AIDS treatment, has provoked a radical change in the disease pattern, as well as in the impact on patient survival and quality of life. The pharmaceutical industry's contribution, based on the research for more active new drugs, has been pivotal. Mortality rates have decreased significantly in 20 years by 50% and now AIDS is considered a chronic and controlled disease. In this review we have studied the impact of HAART treatment on infected patients, allowing them to maintain their status as active workers and the decreased absenteeism from work derived from this, contributing ultimately to overall social wealth and, thus, to economic growth. Furthermore, an analysis of the impact on healthcare costs, quality of life per year, life per year gained, cost economic savings and cost opportunity among other parameters has shown that society and governments are gaining major benefits from the inclusion of antiretroviral therapies in HIV/AIDS patients.

  6. Selected bibliography: cost and energy savings of conservation and renewable energy technologies

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-05-01

    This bibliography is a compilation of reports on the cost and energy savings of conservation and renewable energy applications throughout the United States. It is part of an overall effort to inform utilities of technological developments in conservation and renewable energy technologies and so aid utilities in their planning process to determine the most effective and economic combination of capital investments to meet customer needs. Department of Energy assessments of the applications, current costs and cost goals for the various technologies included in this bibliography are presented. These assessments are based on analyses performed by or for the respective DOE Program Offices. The results are sensitive to a number of variables and assumptions; however, the estimates presented are considered representative. These assessments are presented, followed by some conclusions regarding the potential role of the conservation and renewable energy alternative. The approach used to classify the bibliographic citations and abstracts is outlined.

  7. Energy Savings Potential and RD&D Opportunities for Commercial Building HVAC Systems

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Burlington, MA (United States); Shandross, Richard [Navigant Consulting, Burlington, MA (United States); Young, Jim [Navigant Consulting, Burlington, MA (United States); Petritchenko, Oxana [Navigant Consulting, Burlington, MA (United States); Ringo, Decker [Navigant Consulting, Burlington, MA (United States); McClive, Sam [Navigant Consulting, Burlington, MA (United States)

    2017-12-01

    The Building Technologies Office (BTO) commissioned this characterization and technology assessment of heating, ventilation, and air-conditioning (HVAC) systems for commercial buildings. The main objectives of this study: Identify a wide range of technology options in varying stages of development that could reduce commercial HVAC energy consumption; Characterize these technology options based on their technical energy-savings potential, development status, non-energy benefits, and other factors affecting end-user acceptance and the ability to compete with conventional HVAC technologies; Make specific recommendations to DOE and other stakeholders on potential research, development, and demonstration (RD&D) activities that would support further development of the most promising technology options.

  8. Maximum power point tracking: a cost saving necessity in solar energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Enslin, J H.R. [Stellenbosch Univ. (South Africa). Dept. of Electrical and Electronic Engineering

    1992-12-01

    A well engineered renewable remote energy system, utilizing the principal of Maximum Power Point Tracking (MPPT) can improve cost effectiveness, has a higher reliability and can improve the quality of life in remote areas. A high-efficient power electronic converter, for converting the output voltage of a solar panel, or wind generator, to the required DC battery bus voltage has been realized. The converter is controlled to track the maximum power point of the input source under varying input and output parameters. Maximum power point tracking for relative small systems is achieved by maximization of the output current in a battery charging regulator, using an optimized hill-climbing, inexpensive microprocessor based algorithm. Through practical field measurements it is shown that a minimum input source saving of between 15 and 25% on 3-5 kWh/day systems can easily be achieved. A total cost saving of at least 10-15% on the capital cost of these systems are achievable for relative small rating Remote Area Power Supply (RAPS) systems. The advantages at large temperature variations and high power rated systems are much higher. Other advantages include optimal sizing and system monitor and control. (author).

  9. Cost savings using a protocol approach to manage anemia in a hemodialysis unit.

    Science.gov (United States)

    Charlesworth, Emily C; Richardson, Robert M; Battistella, Marisa

    2014-01-01

    National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.

  10. Holistic impact assessment and cost savings of rainwater harvesting at the watershed scale

    Directory of Open Access Journals (Sweden)

    Santosh R. Ghimire

    2017-03-01

    Full Text Available We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S. using life cycle assessment (LCA and life cycle cost assessment. Life cycle impact assessment (LCIA categories included energy demand, fossil fuel, metals, ozone depletion, global warming, acidification, smog, blue and green water use, ecotoxicity, eutrophication, and human health effects. Building upon previous LCAs of near-optimal domestic and agricultural RWH systems in the region, we scaled functional unit LCIA scores for adoption rates of 25%, 50%, 75%, and 100% and compared these to conventional municipal water and well water systems. In addition to investigating watershed-scale impacts of RWH adoption, which few studies have addressed, potential life cycle cost savings due to reduced cumulative energy demand were scaled in each watershed for a more comprehensive analysis. The importance of managing the holistic water balance, including blue water (surface/ground water, green water (rainwater use, and annual precipitation and their relationship to RWH are also addressed. RWH contributes to water resource sustainability by offsetting surface and ground water consumption and by reducing environmental and human health impacts compared to conventional sources. A watershed-wide RWH adoption rate of 25% has a number of ecological and human health benefits including blue water use reduction ranging from 2–39 Mm3, cumulative energy savings of 12–210 TJ, and reduced global warming potential of 600–10,100 Mg CO2 eq. Potential maximum lifetime energy cost savings were estimated at $5M and $24M corresponding to domestic RWH in Greens Mill and agricultural RWH in Back Creek watersheds.

  11. Energy Savings Potential and RD&D Opportunities for Commercial Building Appliances (2015 Update)

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Burlington, MA (United States); Guernsey, Matt [Navigant Consulting, Burlington, MA (United States); Foley, Kevin [Navigant Consulting, Burlington, MA (United States); Young, Jim [Navigant Consulting, Burlington, MA (United States); Chung, Greg [Navigant Consulting, Burlington, MA (United States)

    2016-06-01

    The Department of Energy commissioned a technology characterization and assessment of appliances used in commercial buildings for cooking, cleaning, water heating, and other end-uses. The primary objectives of this study were to document the energy consumed by commercial appliances and identify research, development, and demonstration opportunities to improve energy efficiency in each end-use. This report serves as an update to a 2009 report of the same name by incorporating updated data and sources where possible and updating the available technology options that provide opportunities for efficiency improvements.

  12. Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

    Science.gov (United States)

    O'Neill, M B; Nabialek, T; Kandamany, N

    2017-08-08

    In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression, 2) perceived functional effectiveness at work, 3) psychological impact of hospital based training, and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.

  13. Opportunity Costs in Paediatric Training: The Specialist Registrars Experience.

    LENUS (Irish Health Repository)

    O’Neill, MB

    2017-08-01

    In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression2) perceived functional effectiveness at work 3) psychological impact of hospital based training and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work\\/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.

  14. Determining the Cost-Savings Threshold and Alignment Accuracy of Patient-Specific Instrumentation in Total Ankle Replacements.

    Science.gov (United States)

    Hamid, Kamran S; Matson, Andrew P; Nwachukwu, Benedict U; Scott, Daniel J; Mather, Richard C; DeOrio, James K

    2017-01-01

    Traditional intraoperative referencing for total ankle replacements (TARs) involves multiple steps and fluoroscopic guidance to determine mechanical alignment. Recent adoption of patient-specific instrumentation (PSI) allows for referencing to be determined preoperatively, resulting in less steps and potentially decreased operative time. We hypothesized that usage of PSI would result in decreased operating room time that would offset the additional cost of PSI compared with standard referencing (SR). In addition, we aimed to compare postoperative radiographic alignment between PSI and SR. Between August 2014 and September 2015, 87 patients undergoing TAR were enrolled in a prospectively collected TAR database. Patients were divided into cohorts based on PSI vs SR, and operative times were reviewed. Radiographic alignment parameters were retrospectively measured at 6 weeks postoperatively. Time-driven activity-based costing (TDABC) was used to derive direct costs. Cost vs operative time-savings were examined via 2-way sensitivity analysis to determine cost-saving thresholds for PSI applicable to a range of institution types. Cost-saving thresholds defined the price of PSI below which PSI would be cost-saving. A total of 35 PSI and 52 SR cases were evaluated with no significant differences identified in patient characteristics. Operative time from incision to completion of casting in cases without adjunct procedures was 127 minutes with PSI and 161 minutes with SR ( P cost-savings threshold range at our institution of $863 below which PSI pricing would provide net cost-savings. Two-way sensitivity analysis generated a globally applicable cost-savings threshold model based on institution-specific costs and surgeon-specific time-savings. This study demonstrated equivalent postoperative TAR alignment with PSI and SR referencing systems but with a significant decrease in operative time with PSI. Based on TDABC and associated sensitivity analysis, a cost-savings threshold

  15. The costs of the different pathways of electricity production and saving

    International Nuclear Information System (INIS)

    Dessus, B.

    2012-01-01

    The author discusses the content and methodology of a report published by the French Court of Audit on the assessment of the costs of the nuclear sector. He briefly recalls the principle adopted by the Court, i.e. the method of the economic current cost which calculates a global MWh cost on the whole operation duration of the selected production tool. The author discusses the application of this method to different electricity production and consumption sectors: ground-based wind energy, the Flamanville EPR, use of low-energy bulbs, air-air heat pumps, a refrigerator. He compares and discusses the results obtained for different electricity production sectors (EPR, ground-based wind energy, and gas combined cycle technology) and their sensitivity to adopted hypotheses. He comments the evolution of the investment cost of nuclear reactors in France, the economic current costs of offshore wind energy and small photovoltaic production. He finally discusses the economic current costs of the different ways of energy saving and their sensitivity to the adopted hypotheses

  16. Energy Savings Potential and RD&D Opportunities for Non-Vapor-Compression HVAC Technologies

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-03-01

    While vapor-compression technologies have served heating, ventilation, and air-conditioning (HVAC) needs very effectively, and have been the dominant HVAC technology for close to 100 years, the conventional refrigerants used in vapor-compression equipment contribute to global climate change when released to the atmosphere. This Building Technologies Office report: --Identifies alternatives to vapor-compression technology in residential and commercial HVAC applications --Characterizes these technologies based on their technical energy savings potential, development status, non-energy benefits, and other factors affecting end-user acceptance and their ability to compete with conventional vapor-compression systems --Makes specific research, development, and deployment (RD&D) recommendations to support further development of these technologies, should DOE choose to support non-vapor-compression technology further.

  17. Keeping ports accessible: Brazil is saving “millions” in dredging costs thanks to nuclear techniques

    International Nuclear Information System (INIS)

    Quevenco, Rodolfo

    2015-01-01

    With a coastline of over 8500 kilometres, 90 per cent of Brazil’s total exports and imports pass through its ports. Many of the country’s major ports and harbours were built over 100 years ago. Keeping shipping lanes open and enabling these ports to accommodate larger vessels with ever bigger loads requires constant dredging, often at high cost. Over the years, the use of nuclear techniques to study sediment build-up and transport across major ports and harbours (see box) has saved Brazil millions of dollars in dredging costs, said Jefferson Vianna Bandeira, a senior researcher in the Environment Department of the National Nuclear Energy Commission of Brazil. With IAEA assistance, Bandeira and a team of scientists have been using radiotracers to map sediment movements that affect Brazil’s major ports since the 1960s.

  18. School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.

    Science.gov (United States)

    Rodriguez, Eunice; Rivera, Diana Austria; Perlroth, Daniella; Becker, Edmund; Wang, Nancy Ewen; Landau, Melinda

    2013-12-01

    With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding. Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489). Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant. Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs. © 2013, American School Health Association.

  19. Mobile clinic in Massachusetts associated with cost savings from lowering blood pressure and emergency department use.

    Science.gov (United States)

    Song, Zirui; Hill, Caterina; Bennet, Jennifer; Vavasis, Anthony; Oriol, Nancy E

    2013-01-01

    Mobile health clinics are in increasingly wide use, but evidence of their clinical impact or cost-effectiveness is limited. Using a unique data set of 5,900 patients who made a total of 10,509 visits in 2010-12 to the Family Van, an urban mobile health clinic in Massachusetts, we examined the effect of screenings and counseling provided by the clinic on blood pressure. Patients who presented with high blood pressure during their initial visit experienced average reductions of 10.7 mmHg and 6.2 mmHg in systolic and diastolic blood pressure, respectively, during their follow-up visits. These changes were associated with 32.2 percent and 44.6 percent reductions in the relative risk of myocardial infarction and stroke, respectively, which we converted into savings using estimates of the incidence and costs of these conditions over thirty months. The savings from this reduction in blood pressure and patient-reported avoided emergency department visits produced a positive lower bound for the clinic's return on investment of 1.3. All other services of the clinic-those aimed at diabetes, obesity, and maternal health, for example-were excluded from this lower-bound estimate. Policy makers should consider mobile clinics as a delivery model for underserved communities with poor health status and high use of emergency departments.

  20. What are the cost savings associated with providing access to specialist care through the Champlain BASE eConsult service? A costing evaluation.

    Science.gov (United States)

    Liddy, Clare; Drosinis, Paul; Deri Armstrong, Catherine; McKellips, Fanny; Afkham, Amir; Keely, Erin

    2016-06-23

    This study estimates the costs and potential savings associated with all eConsult cases completed between 1 April 2014 and 31 March 2015. Costing evaluation from the societal perspective estimating the costs and potential savings associated with all eConsults completed during the study period. Champlain health region in Eastern Ontario, Canada. Primary care providers and specialists registered to use the eConsult service. Costs included (1) delivery costs; (2) specialist remuneration; (3) costs associated with traditional (face-to-face) referrals initiated as a result of eConsult. Potential savings included (1) costs of traditional referrals avoided; (2) indirect patient savings through avoided travel and lost wages/productivity. Net potential societal cost savings were estimated by subtracting total costs from total potential savings. A total of 3487 eConsults were completed during the study period. In 40% of eConsults, a face-to-face specialist visit was originally contemplated but avoided as result of eConsult. In 3% of eConsults, a face-to-face specialist visit was not originally contemplated but was prompted as a result of the eConsult. From the societal perspective, total costs were estimated at $207 787 and total potential savings were $246 516. eConsult led to a net societal saving of $38 729 or $11 per eConsult. Our findings demonstrate potential cost savings from the societal perspective, as patients avoided the travel costs and lost wages/productivity associated with face-to-face specialist visits. Greater savings are expected once we account for other costs such as avoided tests and visits and potential improved health outcomes associated with shorter wait times. Our findings are valuable for healthcare delivery decision-makers as they seek solutions to improve care in a patient-centred and efficient manner. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Energy saving opportunities in the refrigerated transport sector through Phase Change Materials (PCMs) application

    Science.gov (United States)

    Principi, P.; Fioretti, R.; Copertaro, B.

    2017-11-01

    Transportation of food products at controlled temperature is a critical task in the transport sector. In fact, whilst there is a need of ensuring both food quality and safety to the global population, its impact in terms of energy consumption and related CO2 emissions into the atmosphere is becoming increasingly evident. In this regard, Thermal Energy Storage (TES) using Phase Change Materials (PCMs) can be considered as a potential way of reducing the cooling load, energy consumption and related greenhouse gas emissions in refrigerated transport sector. In this paper two different PCM applications are investigated. Specifically, in the first study a PCM (35 °C melting temperature) layer was added to the external side of a refrigerated enclosure wall with the aim of managing the cooling peak (shifting and reducing) and reducing the daily energy rate. Outdoor experimental results showed that the added PCM layer helps to reduce (between 5.55% and 8.57%) and delay (between 4.30 h and 3.30 h) the peak load of incoming heat compared to the reference one. In the second study, the energy performance of a refrigerated chamber with an air heat exchanger containing PCM (5°C melting temperature) was investigated. The study purpose was to reduce the cooling energy consumption during steady state operating conditions and the rate of temperature increase throughout the course of a power failure event. Test results showed that using a PCM air heat exchanger addition, up to 16% of energy can be saved.

  2. Opportunities for saving energy by means of cogeneration in Vegetales's Cannery of Sancti Spiritus.

    Directory of Open Access Journals (Sweden)

    Arturo Alberto Clemente Corujo

    2010-09-01

    Full Text Available This work analyzes the viability to install a system of cogeneration and to save energy at Vegetales's Cannery. The type of more convenient arrangement according to the conditions of the industry was defined. The magnitude of necessary investment, the equipment required, and also the additional quantity of diesel were determined for the correct operation of the project. It was considered the steam production and the consumptions of combustible oil and the electricity in the year 2008. As a primary motor was each engine Volvo of 3 existent generating sets. A minimal time of 4 daily hours during 300 days was calculated to work annually and they analyzed the necessary investments for expected benefits. The economic evaluation has as possitive results: a VAN of $192 646,89's and 36 %'s TIR. The cogeneration scheme more convenient is with Topping cycle. The necessary investment is about $144 000 and for having profitability it is necessary to work the same amount of hours from 6 to 10 p.m. that in the rest of a day.

  3. Impact of a University-Based Outpatient Telemedicine Program on Time Savings, Travel Costs, and Environmental Pollutants.

    Science.gov (United States)

    Dullet, Navjit W; Geraghty, Estella M; Kaufman, Taylor; Kissee, Jamie L; King, Jesse; Dharmar, Madan; Smith, Anthony C; Marcin, James P

    2017-04-01

    The objective of this study was to estimate travel-related and environmental savings resulting from the use of telemedicine for outpatient specialty consultations with a university telemedicine program. The study was designed to retrospectively analyze the telemedicine consultation database at the University of California Davis Health System (UCDHS) between July 1996 and December 2013. Travel distances and travel times were calculated between the patient home, the telemedicine clinic, and the UCDHS in-person clinic. Travel cost savings and environmental impact were calculated by determining differences in mileage reimbursement rate and emissions between those incurred in attending telemedicine appointments and those that would have been incurred if a visit to the hub site had been necessary. There were 19,246 consultations identified among 11,281 unique patients. Telemedicine visits resulted in a total travel distance savings of 5,345,602 miles, a total travel time savings of 4,708,891 minutes or 8.96 years, and a total direct travel cost savings of $2,882,056. The mean per-consultation round-trip distance savings were 278 miles, average travel time savings were 245 minutes, and average cost savings were $156. Telemedicine consultations resulted in a total emissions savings of 1969 metric tons of CO 2 , 50 metric tons of CO, 3.7 metric tons of NO x , and 5.5 metric tons of volatile organic compounds. This study demonstrates the positive impact of a health system's outpatient telemedicine program on patient travel time, patient travel costs, and environmental pollutants. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  4. Does Prevention Pay? Costs and Potential Cost-savings of School Interventions Targeting Children with Mental Health Problems.

    Science.gov (United States)

    Wellander, Lisa; Wells, Michael B; Feldman, Inna

    2016-06-01

    In Sweden, the local government is responsible for funding schools in their district. One funding initiative is for schools to provide students with mental health problems with additional support via extra teachers, personal assistants, and special education classes. There are evidence-based preventive interventions delivered in schools, which have been shown to decrease the levels of students' mental health problems. However, little is known about how much the local government currently spends on students' mental health support and if evidence-based interventions could be financially beneficial. The aim of this study was to estimate the costs of providing additional support for students' mental health problems and the potential cost-offsets, defined as reduced school-based additional support, if two evidence-based school interventions targeting children's mental health problems were implemented in routine practice. This study uses data on the additional support students with mental health problems received in schools. Data was collected from one school district for students aged 6 to 16 years. We modeled two Swedish school interventions, Comet for Teachers and Social and Emotional Training (SET), which both had evidence of reducing mental health problems. We used a cost-offset analysis framework, assuming both interventions were fully implemented throughout the whole school district. Based on the published studies, the expected effects and the costs of the interventions were calculated. We defined the cost-offsets as the amount of predicted averted additional support for students with ongoing mental health problems who might no longer require receiving services such as one-on-one time with an extra teacher, a personal assistant, or to be placed in a special education classroom. A cost-offset analysis, from a payer's perspective (the local government responsible for school financing), was conducted comparing the costs of both interventions with the potential cost-savings

  5. Advancements in valve technology and industry lessons lead to improved plant reliability and cost savings

    International Nuclear Information System (INIS)

    Sharma, V.; Kalsi, M.S.

    2005-01-01

    Plant reliability and safety hinges on the proper functioning of several valves. Recent advancements in valve technology have resulted in new analytical and test methods for evaluating and improving valve and actuator reliability. This is especially significant in critical service applications in which the economic impact of a valve failure on production, outage schedules and consequential damages far surpasses the initial equipment purchase price. This paper presents an overview of recent advances in valve technology driven by reliability concerns and cost savings objectives without comprising safety in the Nuclear Power Industry. This overview is based on over 27 years of experience in supporting US and International nuclear power utilities, and contributing to EPRI, and NSSS Owners' Groups in developing generic models/methodologies to address industry wide issues; performing design basis reviews; and implementing plant-wide valve reliability improvement programs. Various analytical prediction software and hardware solutions and training seminars are now available to implement valve programs covering power plants' lifecycle from the construction phase through life extension and power up rate. These tools and methodologies can enhance valve-engineering activities including the selection, sizing, proper application, condition monitoring, failure analysis, and condition based maintenance optimization with a focus on potential bad actors. This paper offers two such examples, the Kalsi Valve and Actuator Program (KVAP) and Check Valve Analysis and Prioritization (CVAP) [1-3, 8, 9, 11-13]. The advanced, validated torque prediction models incorporated into KVAP software for AOVs and MOVs have improved reliability of margin predictions and enabled cost savings through elimination of unwarranted equipment modifications. CVAP models provides a basis to prioritize the population of valves recommended for preventive maintenance, inspection and/or modification, allowing

  6. Opportunity cost, willingness to pay and cost benefit analysis of a community forest of Nepal

    Directory of Open Access Journals (Sweden)

    Anup KC

    2014-05-01

    Full Text Available One of the major policies in response to global climate change is reduction of green house gases emission. Community forests of Nepal are acting as major sources and sink of green house gases, in spite of providing socio-economic benefits to the user groups. There is a lack of information on whether community forests address the socio-economic disparity of user groups, and how it affects opportunity cost and willingness to pay to the forest users groups. Focusing on how the socio-economic conditions of forest users affect forest management, opportunity cost and willingness to pay; and effect of carbon trading mechanism and discounting on the cost benefit ratio, this study was carried out in one CF in western Nepal. The data collection methods included carbon stock measurement, household survey, focus group discussion and key informant interview. Study has shown that most of the forest users are in medium and poor economic classes and female involvement in forest conservation and management was remarkable. Poor people had high dependency on forest product and are most likely affected in terms of opportunity cost. Rich people were willing to pay more to sustain forest ecosystem services. Benefit cost ratio measured directly with and without discounting was 3.91 and 2.97, respectively. The findings of the present study indicate that the community forests users groups are benefitted from the current state of management. DOI: http://dx.doi.org/10.3126/ije.v3i2.10522 International Journal of the Environment Vol.3(2 2014: 108-124

  7. Costs of cardiovascular disease prevention care and scenarios for cost saving: a micro-costing study from rural Nigeria

    NARCIS (Netherlands)

    Hendriks, Marleen E.; Bolarinwa, Oladimeji A.; Nelissen, Heleen E.; Boers, Alexander C.; Gomez, Gabriela B.; Tan, Siok Swan; Redekop, William; Adenusi, Peju; Lange, Joep M. A.; Agbede, Kayode; Akande, Tanimola M.; Schultsz, Constance

    2015-01-01

    To assess the costs of cardiovascular disease (CVD) prevention care according to international guidelines, in a primary healthcare clinic in rural Nigeria, participating in a health insurance programme. A micro-costing study was conducted from a healthcare provider perspective. Activities per

  8. Energy and Energy Cost Savings Analysis of the 2015 IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Xie, YuLong [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhuge, Jing Wei [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-06-01

    As required by statute (42 USC 6833), DOE recently issued a determination that ANSI/ASHRAE/IES Standard 90.1-2013 would achieve greater energy efficiency in buildings subject to the code compared to the 2010 edition of the standard. Pacific Northwest National Laboratory (PNNL) conducted an energy savings analysis for Standard 90.1-2013 in support of its determination . While Standard 90.1 is the model energy standard for commercial and multi-family residential buildings over three floors (42 USC 6833), many states have historically adopted the International Energy Conservation Code (IECC) for both residential and commercial buildings. This report provides an assessment as to whether buildings constructed to the commercial energy efficiency provisions of the 2015 IECC would save energy and energy costs as compared to the 2012 IECC. PNNL also compared the energy performance of the 2015 IECC with the corresponding Standard 90.1-2013. The goal of this analysis is to help states and local jurisdictions make informed decisions regarding model code adoption.

  9. Energy and Energy Cost Savings Analysis of the 2015 IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Xie, YuLong [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Athalye, Rahul A. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Zhuge, Jing Wei [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Rosenberg, Michael I. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Hart, Philip R. [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Laboratory (PNNL), Richland, WA (United States)

    2015-09-01

    As required by statute (42 USC 6833), DOE recently issued a determination that ANSI/ASHRAE/IES Standard 90.1-2013 would achieve greater energy efficiency in buildings subject to the code compared to the 2010 edition of the standard. Pacific Northwest National Laboratory (PNNL) conducted an energy savings analysis for Standard 90.1-2013 in support of its determination . While Standard 90.1 is the model energy standard for commercial and multi-family residential buildings over three floors (42 USC 6833), many states have historically adopted the International Energy Conservation Code (IECC) for both residential and commercial buildings. This report provides an assessment as to whether buildings constructed to the commercial energy efficiency provisions of the 2015 IECC would save energy and energy costs as compared to the 2012 IECC. PNNL also compared the energy performance of the 2015 IECC with the corresponding Standard 90.1-2013. The goal of this analysis is to help states and local jurisdictions make informed decisions regarding model code adoption.

  10. Energy and cost savings results for advanced technology systems from the Cogeneration Technology Alternatives Study /CTAS/

    Science.gov (United States)

    Sagerman, G. D.; Barna, G. J.; Burns, R. K.

    1979-01-01

    The Cogeneration Technology Alternatives Study (CTAS), a program undertaken to identify the most attractive advanced energy conversion systems for industrial cogeneration applications in the 1985-2000 time period, is described, and preliminary results are presented. Two cogeneration options are included in the analysis: a topping application, in which fuel is input to the energy conversion system which generates electricity and waste heat from the conversion system is used to provide heat to the process, and a bottoming application, in which fuel is burned to provide high temperature process heat and waste heat from the process is used as thermal input to the energy conversion system which generates energy. Steam turbines, open and closed cycle gas turbines, combined cycles, diesel engines, Stirling engines, phosphoric acid and molten carbonate fuel cells and thermionics are examined. Expected plant level energy savings, annual energy cost savings, and other results of the economic analysis are given, and the sensitivity of these results to the assumptions concerning fuel prices, price of purchased electricity and the potential effects of regional energy use characteristics is discussed.

  11. Opportunity to Save Historical Railway Infrastructure - Adaptation and Functional Conversion of Facilities

    Science.gov (United States)

    Podwojewska, Magdalena

    2017-10-01

    After years of neglect and underinvestment, the Polish railways are now witnessing a rapid modernization of both their technical facilities and rolling stock. However, this is true only of the main railway lines connecting major urban complexes. It is worth pointing out that a great number of secondary lines, railway stations and halts still has not been covered by the transformation process. Railway facilities, warehouses and service features are in decay. Rapid technological developments have caused numerous architectural structures of historical interest and service features to fall out of use. There are historical railway facilities dating back to the late 19th or early 20th centuries, whose condition is constantly deteriorating. The only way to save these structures is to change the manner, in which they are being used, and attract new investors and operators. The adaptation of buildings may be carried out in a number of ways by following different strategies. The process depends on the structure’s current condition and significance for the railway network. The facilities which are disused as a result of technological changes in the rolling stock and infrastructure include workshops, steam locomotive bays, turntables and warehouses. Their size and location within a city make them a perfect place for commercial services, exhibitions, heritage sites, concerts and other events attracting great numbers of people. Other strategies may be used for constructions located next to railways lines, whose role has declined. Such constructions include small railway stations, warehouses, reloading and forwarding facilities, railway ramps, railway staff buildings as well as residences for railway employees. Railway stations located at large junctions can handle passenger traffic or freight loading operations. As well as acting as the only window to the world, railway stations in small towns housed all the services available in the place. At the same time, they served as

  12. Costs and longer-term savings of parenting programmes for the prevention of persistent conduct disorder: a modelling study

    Directory of Open Access Journals (Sweden)

    Beecham Jennifer

    2011-10-01

    Full Text Available Abstract Background Conduct disorders are the most common psychiatric disorders in children and may persist into adulthood in about 50% of cases. The costs to society are high and impact many public sector agencies. Parenting programmes have been shown to positively affect child behaviour, but little is known about their potential long-term cost-effectiveness. We therefore estimate the costs of and longer-term savings from evidence-based parenting programmes for the prevention of persistent conduct disorder. Methods A decision-analytic Markov model compares two scenarios: 1 a 5-year old with clinical conduct disorder receives an evidence-based parenting programme; 2 the same 5-year old does not receive the programme. Cost-savings analysis is performed by comparing the probability that conduct disorder persists over time in each scenario, adopting both a public sector and a societal perspective. If the intervention is successful in reducing persistent conduct disorder, cost savings may arise from reduced use of health services, education support, social care, voluntary agencies and from crimes averted. Results Results strongly suggest that parenting programmes reduce the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices. Conclusions Effective implementation of evidence-based parenting programmes is likely to yield cost savings to the public sector and society. More research is needed to address evidence gaps regarding the current level of provision, longer-term effectiveness and questions of implementation, engagement and equity.

  13. Establishment of windows-based load management system for electricity cost savings in competitive electricity markets

    International Nuclear Information System (INIS)

    Chung, K.H.; Kim, B.H.; Hur, D.

    2007-01-01

    For electricity markets to function in a truly competitive and efficient manner, it is not enough to focus solely on improving the efficiencies of power supply. To recognize price-responsive load as a reliability resource, the customer must be provided with price signals and an instrument to respond to these signals, preferably automatically. This paper attempts to develop the Windows-based load management system in competitive electricity markets, allowing the user to monitor the current energy consumption or billing information, to analyze the historical data, and to implement the consumption strategy for cost savings with nine possible scenarios adopted. Finally, this modeling framework will serve as a template containing the basic concepts that any load management system should address. (author)

  14. Cleaning up a salt spill : predictive modelling and monitoring natural attenuation to save remedial costs

    Energy Technology Data Exchange (ETDEWEB)

    Tsang, B.; Shaikh, A.A. [EBA Engineering Consultants Ltd., Calgary, AB (Canada)

    2006-07-01

    Predictive modelling and monitoring natural attenuation to save remedial costs in cleaning up a salt spill were discussed with reference to a site located in central Alberta, as well as a pipeline break in 2002 from a corroded pipe which resulted in a large spill of produced water and oil. Remedial alternatives and an assessment of the site were presented. This included an electromagnetic survey in 2004, groundwater flow regime, soil and groundwater quality data, vegetation survey, and predictive modelling versus observed water quality. Photos and illustrations of the site from the air were provided. A conceptual salt leaching and transport model was proposed as a solution. Model calculation results were also presented. Last, the presentation discussed some important considerations for predictive modeling and next steps for the site. These included continued monitoring, implementation of a restoration plan and engagement of stakeholders such as Alberta Environment and the site landowner. tabs., figs.

  15. Safety and cost savings of reducing adult dengue hospitalization in a tertiary care hospital in Singapore.

    Science.gov (United States)

    Lee, Linda K; Earnest, Arul; Carrasco, Luis R; Thein, Tun L; Gan, Victor C; Lee, Vernon J; Lye, David C; Leo, Yee-Sin

    2013-01-01

    Previously, most dengue cases in Singapore were hospitalized despite low incidence of dengue hemorrhagic fever (DHF) or death. To minimize hospitalization, the Communicable Disease Centre at Tan Tock Seng Hospital (TTSH) in Singapore implemented new admission criteria which included clinical, laboratory, and DHF predictive parameters in 2007. All laboratory-confirmed dengue patients seen at TTSH during 2006-2008 were retrospectively reviewed for clinical data. Disease outcome and clinical parameters were compared over the 3 years. There was a 33.0% mean decrease in inpatients after the new criteria were implemented compared with the period before (p hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

  16. Can business impact analysis play a meaningful role in planning a cost-saving programme?

    Science.gov (United States)

    Wright, Trevor

    2011-02-01

    Business continuity as it exists today would appear to have reached something of a plateau. Considering the history of the discipline, and how it has developed from 'simple' disaster recovery to its present position, it is clear that the trend has been to move from a reactive discipline to a proactive process. Following on from this broadly-accepted point, it is perhaps time to consider how the discipline may develop and what wider and deeper contribution the business continuity profession may make to add further value for our clients. In the present climate, it seems appropriate to consider how (and if) business continuity practice can make a meaningful contribution to a cost saving exercise. The public and private sectors are considered and the differences are compared.

  17. Energy-Smart Building Choices: How School Facilities Managers and Business Officials Are Reducing Operating Costs and Saving Money

    International Nuclear Information System (INIS)

    Energy Smart Schools Team

    2001-01-01

    Most K-12 schools could save 25% of their energy costs by being smart about energy. Nationwide, the savings potential is$6 billion. While improving energy use in buildings and busses, schools are likely to create better places for teaching and learning, with better lighting, temperature control, acoustics, and air quality. This brochure, targeted to school facilities managers and business officials, describes how schools can become more energy efficient

  18. CHARACTERIZING COSTS, SAVINGS AND BENEFITS OF A SELECTION OF ENERGY EFFICIENT EMERGING TECHNOLOGIES IN THE UNITED STATES

    Energy Technology Data Exchange (ETDEWEB)

    Xu, T.; Slaa, J.W.; Sathaye, J.

    2010-12-15

    Implementation and adoption of efficient end-use technologies have proven to be one of the key measures for reducing greenhouse gas (GHG) emissions throughout the industries. In many cases, implementing energy efficiency measures is among one of the most cost effective investments that the industry could make in improving efficiency and productivity while reducing CO2 emissions. Over the years, there have been incentives to use resources and energy in a cleaner and more efficient way to create industries that are sustainable and more productive. With the working of energy programs and policies on GHG inventory and regulation, understanding and managing the costs associated with mitigation measures for GHG reductions is very important for the industry and policy makers around the world. Successful implementation of emerging technologies not only can help advance productivities and competitiveness but also can play a significant role in mitigation efforts by saving energy. Providing evaluation and estimation of the costs and energy savings potential of emerging technologies is the focus of our work in this project. The overall goal of the project is to identify and select emerging and under-utilized energy-efficient technologies and practices as they are important to reduce energy consumption in industry while maintaining economic growth. This report contains the results from performing Task 2"Technology evaluation" for the project titled"Research Opportunities in Emerging and Under-Utilized Energy-Efficient Industrial Technologies," which was sponsored by California Energy Commission and managed by CIEE. The project purpose is to analyze market status, market potential, and economic viability of selected technologies applicable to the U.S. In this report, LBNL first performed re-assessments of all of the 33 emerging energy-efficient industrial technologies, including re-evaluation of the 26 technologies that were previously identified by Martin et al. (2000) and

  19. You say you want a revolution: casing drilling targets 30 per cent well-cost saving

    Energy Technology Data Exchange (ETDEWEB)

    Polczer, S.; Marsters, S.

    1999-10-01

    Casing drilling is a new method of drilling that eliminates drill strings by using standard casing to simultaneously drill and case wells. Tesco Corporation of Calgary acquired patent rights to casing drilling technology in 1995. The company now offers a conversion kit for existing drill rigs as well a new compact casing drilling rig for shallow markets. The single derrick will be rated at 1,500 meters, but initially it will be used to drill 700-800 meter gas wells in southeast Alberta. Some cost savings will be realized at these shallow depths, but the real cost saving advantages will be realized on deep holes. In the meantime, improvements are planned to the cutting structures of the under-rimming bit to increase safety and withstand higher torque loads. It will be also necessary to adapt techniques such as directional drilling and logging to the casing drilling conveyance mechanism which has been only partially successful thus far, especially in the retrieving mode. Another challenge already met, involved ensuring that casing could be run in high-compression loads without damage to connections. Despite these problems, the system attracted considerable attention with several international companies placing orders for immediate delivery. Another system, this one developed by Sperry-Sun Drilling Services and known as a 'casing while drilling' (CWD) system, is strictly a downhole assembly and is targeted for offshore use and deeper vertical holes. This system is currently being tested in two commercial operations in offshore Indonesia for Unocal Corporation. Despite numerous problems to fill casing with fluid during connections, penetration rates of 300-400 feet per hour were achieved.

  20. Review of the Fuel Saving, Life Cycle GHG Emission, and Ownership Cost Impacts of Lightweighting Vehicles with Different Powertrains.

    Science.gov (United States)

    Luk, Jason M; Kim, Hyung Chul; De Kleine, Robert; Wallington, Timothy J; MacLean, Heather L

    2017-08-01

    The literature analyzing the fuel saving, life cycle greenhouse gas (GHG) emission, and ownership cost impacts of lightweighting vehicles with different powertrains is reviewed. Vehicles with lower powertrain efficiencies have higher fuel consumption. Thus, fuel savings from lightweighting internal combustion engine vehicles can be higher than those of hybrid electric and battery electric vehicles. However, the impact of fuel savings on life cycle costs and GHG emissions depends on fuel prices, fuel carbon intensities and fuel storage requirements. Battery electric vehicle fuel savings enable reduction of battery size without sacrificing driving range. This reduces the battery production cost and mass, the latter results in further fuel savings. The carbon intensity of electricity varies widely and is a major source of uncertainty when evaluating the benefits of fuel savings. Hybrid electric vehicles use gasoline more efficiently than internal combustion engine vehicles and do not require large plug-in batteries. Therefore, the benefits of lightweighting depend on the vehicle powertrain. We discuss the value proposition of the use of lightweight materials and alternative powertrains. Future assessments of the benefits of vehicle lightweighting should capture the unique characteristics of emerging vehicle powertrains.

  1. Lives saved from malaria prevention in Africa--evidence to sustain cost-effective gains

    Directory of Open Access Journals (Sweden)

    Korenromp Eline L

    2012-03-01

    Full Text Available Abstract Lives saved have become a standard metric to express health benefits across interventions and diseases. Recent estimates of malaria-attributable under-five deaths prevented using the Lives Saved tool (LiST, extrapolating effectiveness estimates from community-randomized trials of scale-up of insecticide-treated nets (ITNs in the 1990s, confirm the substantial impact and good cost-effectiveness that ITNs have achieved in high-endemic sub-Saharan Africa. An even higher cost-effectiveness would likely have been found if the modelling had included the additional indirect mortality impact of ITNs on preventing deaths from other common child illnesses, to which malaria contributes as a risk factor. As conventional ITNs are being replaced by long-lasting insecticidal nets and scale-up is expanded to target universal coverage for full, all-age populations at risk, enhanced transmission reduction may--above certain thresholds--enhance the mortality impact beyond that observed in the trials of the 1990s. On the other hand, lives saved by ITNs might fall if improved malaria case management with artemisinin-based combination therapy averts the deaths that ITNs would otherwise prevent. Validation and updating of LiST's simple assumption of a universal, fixed coverage-to-mortality-reduction ratio will require enhanced national programme and impact monitoring and evaluation. Key indicators for time trend analysis include malaria-related mortality from population-based surveys and vital registration, vector control and treatment coverage from surveys, and parasitologically-confirmed malaria cases and deaths recorded in health facilities. Indispensable is triangulation with dynamic transmission models, fitted to long-term trend data on vector, parasite and human populations over successive phases of malaria control and elimination. Sound, locally optimized budget allocation including on monitoring and evaluation priorities will benefit much if policy

  2. How Opportunity Costs Decrease the Probability of War in an Incomplete Information Game

    OpenAIRE

    Polachek, Solomon; Xiang, Jun

    2008-01-01

    This paper shows that the opportunity costs resulting from economic interdependence decrease the equilibrium probability of war in an incomplete information game. This result is strongly consistent with existing empirical analyses of the inverse trade-conflict relationship, but is the opposite of the conclusion reached by Gartzke et al. (2001), who reject the opportunity cost argument in a game-theoretic framework. As a result of this paper's findings, one cannot dismiss the opportunity cost ...

  3. Cost-Value Analysis and the SAVE: A Work in Progress, But an Option for Localised Decision Making?

    Science.gov (United States)

    Karnon, Jonathan; Partington, Andrew

    2015-12-01

    Cost-value analysis aims to address the limitations of the quality-adjusted life-year (QALY) by incorporating the strength of public concerns for fairness in the allocation of scarce health care resources. To date, the measurement of value has focused on equity weights to reflect societal preferences for the allocation of QALY gains. Another approach is to use a non-QALY-based measure of value, such as an outcome 'equivalent to saving the life of a young person' (a SAVE). This paper assesses the feasibility and validity of using the SAVE as a measure of value for the economic evaluation of health care technologies. A web-based person trade-off (PTO) survey was designed and implemented to estimate equivalent SAVEs for outcome events associated with the progression and treatment of early-stage breast cancer. The estimated equivalent SAVEs were applied to the outputs of an existing decision analytic model for early breast cancer. The web-based PTO survey was undertaken by 1094 respondents. Validation tests showed that 68 % of eligible responses revealed consistent ordering of responses and 32 % displayed ordinal transitivity, while 37 % of respondents showing consistency and ordinal transitivity approached cardinal transitivity. Using consistent and ordinally transitive responses, the mean incremental cost per SAVE gained was £ 3.72 million. Further research is required to improve the validity of the SAVE, which may include a simpler web-based survey format or a face-to-face format to facilitate more informed responses. A validated method for estimating equivalent SAVEs is unlikely to replace the QALY as the globally preferred measure of outcome, but the SAVE may provide a useful alternative for localized decision makers with relatively small, constrained budgets-for example, in programme budgeting and marginal analysis.

  4. Supply chain collaboration and cost saving as a result of returns handling programmes in retail corporations in Poland

    Directory of Open Access Journals (Sweden)

    Anna Maria Jeszka

    2015-09-01

    Full Text Available Background: The objective is to define on the basis of the literature as well as to test empirically the main factors that affect the cost saving of many retail chains, resulting from deliberate and conscious policies as well as organized activities in the area of product returns management. Methods: Based on a survey developed for the study, standardized interviews were conducted with representatives of trade corporations in the apparel industry in Poland. The data collected were analysed statistically. Results:  The results of the statistical analysis showed that the analysed factors had a significant impact on cost saving. A company's ability to cooperate in the supply chain, limited  for the purposes of the study to the distributor - retailer relationship, is relevant to the cost savings resulting from the policies of retail corporations in the area of reverse logistics. The integration of IT systems with suppliers and customers also influences the level of cost saving, as does collaboration within a team. Conclusions: To date, studies in this field have not been conducted in Poland. A particularly important element seems to be the relationship between cooperation in the supply chain and the possible savings which this can generate. This study contributes to the growing trend of research into reverse logistics and emphasizes the role of retailers and cooperation in the supply chain.  

  5. Whole exome sequencing in neurogenetic odysseys: An effective, cost- and time-saving diagnostic approach.

    Directory of Open Access Journals (Sweden)

    Marta Córdoba

    Full Text Available Diagnostic trajectories for neurogenetic disorders frequently require the use of considerable time and resources, exposing patients and families to so-called "diagnostic odysseys". Previous studies have provided strong evidence for increased diagnostic and clinical utility of whole-exome sequencing in medical genetics. However, specific reports assessing its utility in a setting such as ours- a neurogeneticist led academic group serving in a low-income country-are rare.To assess the diagnostic yield of WES in patients suspected of having a neurogenetic condition and explore the cost-effectiveness of its implementation in a research group located in an Argentinean public hospital.This is a prospective study of the clinical utility of WES in a series of 40 consecutive patients selected from a Neurogenetic Clinic of a tertiary Hospital in Argentina. We evaluated patients retrospectively for previous diagnostic trajectories. Diagnostic yield, clinical impact on management and economic diagnostic burden were evaluated.We demonstrated the clinical utility of Whole Exome Sequencing in our patient cohort, obtaining a diagnostic yield of 40% (95% CI, 24.8%-55.2% among a diverse group of neurological disorders. The average age at the time of WES was 23 (range 3-70. The mean time elapsed from symptom onset to WES was 11 years (range 3-42. The mean cost of the diagnostic workup prior to WES was USD 1646 (USD 1439 to 1853, which is 60% higher than WES cost in our center.WES for neurogenetics proved to be an effective, cost- and time-saving approach for the molecular diagnosis of this heterogeneous and complex group of patients.

  6. Vehicle Lightweighting: 40% and 45% Weight Savings Analysis: Technical Cost Modeling for Vehicle Lightweighting

    Energy Technology Data Exchange (ETDEWEB)

    Mascarin, Anthony [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hannibal, Ted [Idaho National Lab. (INL), Idaho Falls, ID (United States); Raghunathan, Anand [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ivanic, Ziga [Idaho National Lab. (INL), Idaho Falls, ID (United States); Francfort, James [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-04-01

    The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. The strategic targets were a 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. The baseline vehicle was an average of several available vehicles in this class. Mass and cost breakdowns from several sources were used, including original equipment manufacturers’ (OEMs’) input through U.S. Department of Energy’s Vehicle Technologies Office programs and public presentations, A2Mac1 LLC’s teardown information, Lotus Engineering Limited and FEV, Inc. breakdowns in their respective lightweighting studies, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses. Information on lightweighting strategies in this analysis came from these same sources and the ongoing 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, and many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs.

  7. Cost Savings Associated with the Adoption of a Cloud Computing Data Transfer System for Trauma Patients.

    Science.gov (United States)

    Feeney, James M; Montgomery, Stephanie C; Wolf, Laura; Jayaraman, Vijay; Twohig, Michael

    2016-09-01

    Among transferred trauma patients, challenges with the transfer of radiographic studies include problems loading or viewing the studies at the receiving hospitals, and problems manipulating, reconstructing, or evalu- ating the transferred images. Cloud-based image transfer systems may address some ofthese problems. We reviewed the charts of patients trans- ferred during one year surrounding the adoption of a cloud computing data transfer system. We compared the rates of repeat imaging before (precloud) and af- ter (postcloud) the adoption of the cloud-based data transfer system. During the precloud period, 28 out of 100 patients required 90 repeat studies. With the cloud computing transfer system in place, three out of 134 patients required seven repeat films. There was a statistically significant decrease in the proportion of patients requiring repeat films (28% to 2.2%, P < .0001). Based on an annualized volume of 200 trauma patient transfers, the cost savings estimated using three methods of cost analysis, is between $30,272 and $192,453.

  8. OPPORTUNITY COST OF EDUCATIONAL HUMAN CAPITAL INVESTMENT. APPLICATION FOR THE POSITION OF BENEFICIARY-INVESTOR

    OpenAIRE

    Florea Voiculescu

    2009-01-01

    The present paper focuses on providing a model of applying the opportunitycost concept on investments in human educational capital. In the first part we haveshown that the real costs of educational capital investment does not involve direct andindirect educational costs only but also the opportunity costs, i.e. the earnings that arelost by choosing to invest in education (and not in something else). From our researchthere results the fact that the share of the opportunity cost within the tota...

  9. Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation.

    Science.gov (United States)

    Treacy, Daniel; Howard, Kirsten; Hayes, Alison; Hassett, Leanne; Schurr, Karl; Sherrington, Catherine

    2018-01-01

    Among people admitted for inpatient rehabilitation, is usual care plus standing balance circuit classes more cost-effective than usual care alone? Cost-effectiveness study embedded within a randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. 162 rehabilitation inpatients from a metropolitan hospital in Sydney, Australia. The experimental group received a 1-hour standing balance circuit class, delivered three times a week for 2 weeks, in addition to usual therapy. The circuit classes were supervised by one physiotherapist and one physiotherapy assistant for up to eight patients. The control group received usual therapy alone. Costs were estimated from routinely collected hospital use data in the 3 months after randomisation. The functional outcome measure was mobility measured at 3 months using the Short Physical Performance Battery administered by a blinded assessor. An incremental analysis was conducted and the joint probability distribution of costs and outcomes was examined using bootstrapping. The median cost savings for the intervention group was AUD4,741 (95% CI 137 to 9,372) per participant; 94% of bootstraps showed that the intervention was both effective and cost saving. Two weeks of additional standing balance circuit classes delivered in addition to usual therapy resulted in decreased healthcare costs at 3 months in hospital inpatients admitted for rehabilitation. There is a high probability that this intervention is both cost saving and effective. ACTRN12611000412932. [Treacy D, Howard K, Hayes A, Hassett L, Schurr K, Sherrington C (2018) Two weeks of additional standing balance circuit classes during inpatient rehabilitation are cost saving and effective: an economic evaluation. Journal of Physiotherapy 64: 41-47]. Copyright © 2017 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  10. Cutting costs in your own backyard: opportunities in financial services.

    Science.gov (United States)

    van Londen, Jan; Zimmerman, Paul

    2012-03-01

    Hospitals looking to reduce cost and improve performance in financial services should focus on these areas: Treasury banking services costs and fees. The possibility of a revenue-generating vendor payment solution. The accounts payable process.

  11. Development and analysis of an economizer control strategy algorithm to promote an opportunity for energy savings in air conditioning installations

    Energy Technology Data Exchange (ETDEWEB)

    Neto, Jose H.M.; Azevedo, Walter L. [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET), Belo Horizonte, MG (Brazil). Dept. de Engenharia Mecanica]. E-mail: henrique@daem.des.cefetmg.br

    2000-07-01

    This work presents an algorithm control strategy denominated enthalpy economizer. The objective of this algorithm strategy is to determine the adequate fractions of outside and return air flowrates entering a cooling coil based on the analysis of the outside, return and supply air enthalpies, rather than on the analysis of the dry bulb temperatures. The proposed algorithm predicts the actual opening position of the outside and return air dampers in order to provide the lower mixing air enthalpy. First, the psychometrics properties of the outside and return air are calculated from actual measurements of the dry and wet bulb temperatures. Then, three distinct cases are analyzed: the enthalpy of the outside air is lower than the enthalpy of the supply air (free cooling); the enthalpy of the outside air is higher than the enthalpy of the return air; the enthalpy of the outside air is lower than the enthalpy of the return air and higher than the temperature of the supply air. Different outside air conditions were selected in order to represent typical weather data of Brazilians cities, as well as typical return air conditions. It was found that the enthalpy control strategy could promote an opportunity for energy savings mainly during mild nights and wintertime periods as well as during warm afternoons and summertime periods, depending on the outside air relative humidity. The proposed algorithm works well and can be integrated in some commercial automation software to reduce energy consumption and electricity demand. (author)

  12. Analysis of benefits, opportunities, costs, and risks (BOCR) with the AHP+ANP : A critical validation

    NARCIS (Netherlands)

    Wijnmalen, D.J.D.

    2007-01-01

    This paper shows that the usual multiplicative synthesis of alternative priorities for benefits, opportunities, costs and risks, obtained from separate Analytic Hierarchy or Network models, can be ambiguous. The ratio of benefit and opportunity priorities to cost and risk priorities can be

  13. Investment opportunity : the FPL low-cost solar dry kiln

    Science.gov (United States)

    George B. Harpole

    1988-01-01

    Two equations are presented that may be used to estimate a maximum investment limit and working capital requirements for the FPL low-cost solar dry kiln systems. The equations require data for drying cycle time, green lumber cost, and kiln-dried lumber costs. Results are intended to provide a preliminary estimate.

  14. A Study on Development of a Cost Optimal and Energy Saving Building Model: Focused on Industrial Building

    Directory of Open Access Journals (Sweden)

    Hye Yeon Kim

    2016-03-01

    Full Text Available This study suggests an optimization method for the life cycle cost (LCC in an economic feasibility analysis when applying energy saving techniques in the early design stage of a building. Literature and previous studies were reviewed to select appropriate optimization and LCC analysis techniques. The energy simulation (Energy Plus and computational program (MATLAB were linked to provide an automated optimization process. From the results, it is suggested that this process could outline the cost optimization model with which it is possible to minimize the LCC. To aid in understanding the model, a case study on an industrial building was performed to outline the operations of the cost optimization model including energy savings. An energy optimization model was also presented to illustrate the need for the cost optimization model.

  15. Process control, energy recovery and cost savings in acetic acid wastewater treatment

    International Nuclear Information System (INIS)

    Vaiopoulou, E.; Melidis, P.; Aivasidis, A.

    2011-01-01

    An anaerobic fixed bed loop (AFBL) reactor was applied for treatment of acetic acid (HAc) wastewater. Two pH process control concepts were investigated; auxostatic and chemostatic control. In the auxostatic pH control, feed pump is interrupted when pH falls below a certain pH value in the bioreactor, which results in reactor operation at maximum load. Chemostatic control assures alkaline conditions by setting a certain pH value in the influent, preventing initial reactor acidification. The AFBL reactor treated HAc wastewater at low hydraulic residence time (HRT) (10-12 h), performed at high space time loads (40-45 kg COD/m 3 d) and high space time yield (30-35 kg COD/m 3 d) to achieve high COD (Chemical Oxygen Demand) removal (80%). Material and cost savings were accomplished by utilizing the microbial potential for wastewater neutralization during anaerobic treatment along with application of favourable pH-auxostatic control. NaOH requirement for neutralization was reduced by 75% and HRT was increased up to 20 h. Energy was recovered by applying costless CO 2 contained in the biogas for neutralization of alkaline wastewater. Biogas was enriched in methane by 4 times. This actually brings in more energy profits, since biogas extra heating for CO 2 content during biogas combustion is minimized and usage of other acidifying agents is omitted.

  16. A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: investigating practice gaps and potential cost-savings.

    Science.gov (United States)

    Lee, Young H; Liu, Guodong; Thiboutot, Diane M; Leslie, Douglas L; Kirby, Joslyn S

    2014-07-01

    Duration of oral antibiotic therapy in acne has not been widely studied. Recent guidelines suggest it should be limited to 3 to 6 months. We sought to compare the duration of oral antibiotic use with recent guidelines and determine the potential cost-savings related to shortened durations. This is a retrospective cohort study from the MarketScan Commercial Claims and Encounters database. Claims data were used to determine duration and costs of antibiotic therapy. The mean course duration was 129 days. The majority (93%) of courses were less than 9 months. Among the 31,634 courses, 18,280 (57.8%) did not include concomitant topical retinoid therapy. The mean (95% confidence interval) duration with and without topical retinoid use was 133 (131.5-134.7) days and 127 (125.4-127.9) days, respectively. The mean excess direct cost of antibiotic treatment for longer than 6 months was $580.99/person. Claims cannot be attributed to a specific diagnosis or provider. The database does not provide information on acne severity. Duration of antibiotic use is decreasing when compared with previous data. However, 5547 (17.53%) courses exceeded 6 months, highlighting an opportunity for reduced antibiotic use. If courses greater than 6 months were shortened to 6 months, savings would be $580.99/person. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  17. The cost of harm and savings through safety: using simulated patients for leadership decision support.

    Science.gov (United States)

    Denham, Charles R; Guilloteau, Franck R

    2012-09-01

    The ultimate objective of this program is to provide an approach to understanding and communicating health-care harm and cost to compel health-care provider leadership teams to vote "yes" to investments in patient safety initiatives, with the confidence that clinical, financial, and operational performance will be improved by such programs. Through a coordinated combination of literature evaluations, careful mapping of high impact scenarios using simulated patients and consensus review of clinical, operational, and financial factors, we confirmed value in such approaches to decision support information for hospital leadership teams to invest in patient safety projects. The study resulted in the following preliminary findings: ·Communication between hospital quality and finance departments can be much improved by direct collaborative relationships through regular meetings to help both clarify direct costs, indirect costs, and the savings of waste and harm to patients by avoidance of infections. ·Governance leaders and the professional administrative leaders should consider establishing the structures and systems necessary to act on risks and hazards as they evolve to deploy resources to areas of harm and risk. ·Quality and Infection Control Professionals can best wage their war on healthcare waste and harm by keeping abreast of the latest literature regarding the latest measures, standards, and safe practices for healthcare-acquired infections and hospital-acquired conditions. ·Regular reviews of patients with health-careYassociated infections, with direct attention to the attributable cost of treatment and how financial waste and harm to patients may be avoided, may provide hospital leaders with new insights for improvement. ·If hospitals developed their own risk scenarios to determine impact of harm and waste from hospital-acquired conditions in addition to impact scenarios for specific processes through technology and process innovations, they would have

  18. Real-time data collection technologies: Enhanced decision-making and cost savings January, 2005

    International Nuclear Information System (INIS)

    Rust, T.L.; Vu, H.Q.

    2006-01-01

    Hand-held computers, Geographic Information Systems (GIS), and wireless communication devices are rapidly replacing traditional methods for field monitoring and data collection. Although pencil and paper remain important means of data transcription, field technicians can now use Personal Digital Assistants (PDA) to record their field notes and monitoring data. As data are uploaded wirelessly from the field, decision-makers can view realtime reports and maps that identify sample locations and monitoring results. The combination of PDAs, wireless communications, and web-based GIS provides field personnel and decision-makers many benefits throughout the life cycle of a project, including improved data consistency, real-time transfer of data from field locations to centralized databases, input validation, elimination of transcription errors, and cost savings. Concerns have been expressed however, about investing in hardware, software, and training for a new technology. This paper, based on several years of experience using wireless technologies for dozens of projects, is focused specifically on two case studies. The first case study is a large lead removal site in the Midwest at which real-time data collection technologies were used throughout the project to collect thousands of data points. The second is the Hurricane Katrina/Rita emergency response requiring rapid data collection under extraordinary circumstances. At both sites, the use of real-time data collection technologies significantly improved the data management process which reduced overall costs and increased efficiency. These results could not have been achieved using traditional data collection procedures. The oral presentation will focus on the advantages and disadvantages of the real-time data collection technologies, lessons learned, and planning considerations. A live demonstration, following a typical data collection scenario in which data are collected and plotted on a GIS map in near real

  19. Army Roof Management and Improvement Opportunities

    National Research Council Canada - National Science Library

    Bailey, David

    1999-01-01

    ... - about $200 million annually. Systemic, integrated solutions offer the Army a great opportunity to save millions of dollars annually in repair and replacement costs, and to avoid incidental costs incurred due to interrupted...

  20. Savings in acute care costs if all older adults treated for fall-related injuries completed matter of balance.

    Science.gov (United States)

    Howland, Jonathan; Shankar, Kalpana Narayan; Peterson, Elizabeth W; Taylor, Alyssa A

    Falls among older adults are a common and serious public health problem. Evidence-based fall prevention programs delivered in community settings and targeting older adults living independently are increasingly deployed throughout the nation. These programs tend to be offered by public and private organizations that serve older adults, and recruitment usually occurs through direct marketing to the target population, rather than through referrals from healthcare providers. Matter of Balance , a program developed to reduce fear of falling and associated activity restriction in community-dwelling older adults, is currently being delivered in 38 of the 50 United States. In this study, we estimate the one-year medical care cost savings if older adults treated at Massachusetts hospitals for fall-related injuries were referred by healthcare providers to participate in Matter of Balance . Data from several sources were used for this study. We estimated annual cost savings in older adult falls recidivism for a hypothetical 100 patients presenting at an emergency department for a fall-related injury, assuming that all were referred to, and 50 % completed, Matter of Balance . This cost-saving estimate was subsequently expanded based on the actual number (43,931) of older adult patients presenting at, and discharged from Massachusetts emergency departments for all fall-related injuries in 2012. Cost savings were calculated for two additional participation rates: 25 % and 75 %. The return on investment (ROI), was calculated based on the percentage of return per each dollar invested. The calculated ROI for Matter of Balance was 144 %. Statewide savings ranged from $2.79 million assuming a 25 % participation rate to $8.37 million, assuming a 75 % participation rate. Referral to evidence-based falls prevention programs of older adult patients presenting at EDs with a fall-related injury could reduce subsequent falls and associated treatment costs.

  1. Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models.

    Science.gov (United States)

    Graham, Robert J; McManus, Michael L; Rodday, Angie Mae; Weidner, Ruth Ann; Parsons, Susan K

    2018-05-01

    To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data. Impact on total costs of care was then estimated based on program outcomes and nationally representative administrative data. Tertiary children's hospital. Critical Care, Anesthesia, Perioperative Extension and Home Ventilation Program enrollees. None. The program provided care for 346 patients and families over the study period. Median age at enrollment was 6 years with more than half deriving secondary respiratory failure from a primary neuromuscular disease. There were 11,960 encounters over the study period, including 1,202 home visits, 673 clinic visits, and 4,970 telephone or telemedicine encounters. Half (n = 5,853) of all encounters involved a physician and 45% included at least one care coordination activity. Overall, we estimated that program interventions were responsible for averting 556 emergency department visits and 107 hospitalizations. Conservative monetization of these alone accounted for annual savings of $1.2-2 million or $407/pt/mo net of program costs. Innovative models, such as extension of critical care services, for high-risk, high-cost patients can result in immediate cost savings. Evaluation of financial implications of comprehensive care for high-risk patients is necessary to complement clinical and patient-centered outcomes for alternative care models. When year-to-year cost variability is high and cost persistence is low, these savings can be estimated from documentation within care

  2. Estimated medical cost savings in Utah by implementation of a primary seat belt law

    Science.gov (United States)

    2010-05-01

    This report examines 2007 hospital discharge data reporting cases where the external cause of injury to : a vehicle occupant was a motor vehicle crash to predict the estimated savings to Utah if a primary seat : belt law is implemented. The savings a...

  3. Estimated medical cost savings in Nevada by implementation of a primary seat belt law

    Science.gov (United States)

    2008-09-01

    This report examines 2007 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Nevada if a primary seat belt law is implemented. The savings are...

  4. Cost-savings of community water fluoridation program; Kerman, Iran, 2016

    Directory of Open Access Journals (Sweden)

    Ali Eskandarizadeh

    2017-04-01

    CONCLUSION: This study indicates significant annual savings from CWFP; additional savings could be achieved if this program is implemented in other regions. We could also receive even more if this program is integrated with other public oral health programs such as screening school children, community dentistry and oral health education.

  5. Leisure and the Opportunity Cost of Travel Time in Recreation Demand Analysis: A Re-Examination

    OpenAIRE

    Amoako-Tuffour, Joe; Martınez-Espineira, Roberto

    2008-01-01

    Using count data models that account for zero-truncation, overdispersion, and endogenous stratification, this paper estimates the value of access to recreational parks. The focus is on the valuation of the opportunity cost of travel time within the cost of the trip and its effects on estimated consumer surplus. The fraction of hourly earnings that corresponds to the opportunity cost of travel time is endogenously estimated as a function of visitor characteristics, rather than fixed exogenousl...

  6. Rumble over jailhouse healthcare. As states broaden outsourcing to private vendors, critics question quality of care and cost savings.

    Science.gov (United States)

    Kutscher, Beth; Meyer, Harris

    2013-09-02

    The trend for states to outsource prison healthcare has met opposition from inmate advocates and legal aid groups. They fear quality of care will suffer, while others debate whether outsourcing care saves any money. Corizon, the largest U.S. private prison healthcare provider, says it definitely delivers savings. "We are the model because we've been doing capitated rates since we've been in business. Our cost per individual is significantly less than in the 'free world,' "says Corizon CEO Rich Hallworth.

  7. Opportunity cost of funding drugs for rare diseases: the cost-effectiveness of eculizumab in paroxysmal nocturnal hemoglobinuria.

    Science.gov (United States)

    Coyle, Doug; Cheung, Matthew C; Evans, Gerald A

    2014-11-01

    Both ethical and economics concerns have been raised with respect to the funding of drugs for rare diseases. This article reports both the cost-effectiveness of eculizumab for the treatment of paroxysmal nocturnal hemoglobinuria (PNH) and its associated opportunity costs. Analysis compared eculizumab plus current standard of care v. current standard of care from a publicly funded health care system perspective. A Markov model covered the major consequences of PNH and treatment. Cost-effectiveness was assessed in terms of the incremental cost per life year and per quality-adjusted life year (QALY) gained. Opportunity costs were assessed by the health gains foregone and the alternative uses for the additional resources. Eculizumab is associated with greater life years (1.13), QALYs (2.45), and costs (CAN$5.24 million). The incremental cost per life year and per QALY gained is CAN$4.62 million and CAN$2.13 million, respectively. Based on established thresholds, the opportunity cost of funding eculizumab is 102.3 discounted QALYs per patient funded. Sensitivity and subgroup analysis confirmed the robustness of the results. If the acquisition cost of eculizumab was reduced by 98.5%, it could be considered cost-effective. The nature of rare diseases means that data are often sparse for the conduct of economic evaluations. When data were limited, assumptions were made that biased results in favor of eculizumab. This study demonstrates the feasibility of conducting economic evaluations in the context of rare diseases. Eculizumab may provide substantive benefits to patients with PNH in terms of life expectancy and quality of life but at a high incremental cost and a substantial opportunity cost. Decision makers should fully consider the opportunity costs before making positive reimbursement decisions. © The Author(s) 2014.

  8. Exploiting opportunities at all cost? Entrepreneurial intent and externalities

    NARCIS (Netherlands)

    Urbig, D.; Weitzel, G.U.; Rosenkranz, S.; van Witteloostuijn, A.

    2011-01-01

    they exploit welfare-enhancing opportunities as it is assumed in several normative models? Do we need to prevent potential entrepreneurs from being destructive or are there intrinsic limits to harm others? We experimentally investigate how people with different entrepreneurial intent exploit risky

  9. Defense Headquarters: Improved Data Needed to Better Identify Streamlining and Cost Savings Opportunities by Function

    Science.gov (United States)

    2016-06-01

    2014.13 We obtained documentary and testimonial evidence from senior officials in the Office of the Deputy Chief Management Officer to determine the...reviews. OSD Organizational Delayering Initiative This review of OSD-related organizations is intended to reduce layers of management and staff. As...Defense Program IGCA Inherently Governmental / Commercial Activities ODCMO Office of the Deputy Chief Management Officer OSD Office of the

  10. Modelling the cost of community interventions to reduce child mortality in South Africa using the Lives Saved Tool (LiST).

    Science.gov (United States)

    Nkonki, Lungiswa Ll; Chola, Lumbwe L; Tugendhaft, Aviva A; Hofman, Karen K

    2017-08-28

    To estimate the costs and impact on reducing child mortality of scaling up interventions that can be delivered by community health workers at community level from a provider's perspective. In this study, we used the Lives Saved Tool (LiST), a module in the spectrum software. Within the spectrum software, LiST interacts with other modules, the AIDS Impact Module, Family Planning Module and Demography Projections Module (Dem Proj), to model the impact of more than 60 interventions that affect cause-specific mortality. DemProj Based on National South African Data. A total of nine interventions namely, breastfeeding promotion, complementary feeding, vitamin supplementation, hand washing with soap, hygienic disposal of children's stools, oral rehydration solution, oral antibiotics for the treatment of pneumonia, therapeutic feeding for wasting and treatment for moderate malnutrition. Reducing child mortality. A total of 9 interventions can prevent 8891 deaths by 2030. Hand washing with soap (21%) accounts for the highest number of deaths prevented, followed by therapeutic feeding (19%) and oral rehydration therapy (16%). The top 5 interventions account for 77% of all deaths prevented. At scale, an estimated cost of US$169.5 million (US$3 per capita) per year will be required in community health worker costs. The use of community health workers offers enormous opportunities for saving lives. These programmes require appropriate financial investments. Findings from this study show what can be achieved if concerted effort is channelled towards the identified set of life-saving interventions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Opportunity cost for early treatment of Chagas disease in Mexico.

    Directory of Open Access Journals (Sweden)

    Janine M Ramsey

    2014-04-01

    Full Text Available BACKGROUND: Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. METHODOLOGY/PRINCIPAL FINDINGS: A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. CONCLUSIONS/SIGNIFICANCE: In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  12. Opportunity cost for early treatment of Chagas disease in Mexico.

    Science.gov (United States)

    Ramsey, Janine M; Elizondo-Cano, Miguel; Sanchez-González, Gilberto; Peña-Nieves, Adriana; Figueroa-Lara, Alejandro

    2014-04-01

    Given current neglect for Chagas disease in public health programs in Mexico, future healthcare and economic development policies will need a more robust model to analyze costs and impacts of timely clinical attention of infected populations. A Markov decision model was constructed to simulate the natural history of a Chagas disease cohort in Mexico and to project the associated short and long-term clinical outcomes and corresponding costs. The lifetime cost for a timely diagnosed and treated Chagas disease patient is US$ 10,160, while the cost for an undiagnosed individual is US$ 11,877. The cost of a diagnosed and treated case increases 24-fold from early acute to indeterminate stage. The major cost component for lifetime cost was working days lost, between 44% and 75%, depending on the program scenario for timely diagnosis and treatment. In the long term, it is cheaper to diagnose and treat chagasic patients early, instead of doing nothing. This finding by itself argues for the need to shift current policy, in order to prioritize and attend this neglected disease for the benefit of social and economic development, which implies including treatment drugs in the national formularies. Present results are even more relevant, if one considers that timely diagnosis and treatment can arrest clinical progression and enhance a chronic patient's quality of life.

  13. Political economy of marine reserves: Understanding the role of opportunity costs

    Science.gov (United States)

    Smith, Martin D.; Lynham, John; Sanchirico, James N.; Wilson, James A.

    2010-01-01

    The creation of marine reserves is often controversial. For decisionmakers, trying to find compromises, an understanding of the timing, magnitude, and incidence of the costs of a reserve is critical. Understanding the costs, in turn, requires consideration of not just the direct financial costs but also the opportunity costs associated with reserves. We use a discrete choice model of commercial fishermen’s behavior to examine both the short-run and long-run opportunity costs of marine reserves. Our results can help policymakers recognize the factors influencing commercial fishermen’s responses to reserve proposals. More generally, we highlight the potential drivers behind the political economy of marine reserves. PMID:20133732

  14. Resolving the "Cost-Effective but Unaffordable" Paradox: Estimating the Health Opportunity Costs of Nonmarginal Budget Impacts.

    Science.gov (United States)

    Lomas, James; Claxton, Karl; Martin, Stephen; Soares, Marta

    2018-03-01

    Considering whether or not a proposed investment (an intervention, technology, or program of care) is affordable is really asking whether the benefits it offers are greater than its opportunity cost. To say that an investment is cost-effective but not affordable must mean that the (implicit or explicit) "threshold" used to judge cost-effectiveness does not reflect the scale and value of the opportunity costs. Existing empirical estimates of health opportunity costs are based on cross-sectional variation in expenditure and mortality outcomes by program budget categories (PBCs) and do not reflect the likely effect of nonmarginal budget impacts on health opportunity costs. The UK Department of Health regularly updates the needs-based target allocation of resources to local areas of the National Health Service (NHS), creating two subgroups of local areas (those under target allocation and those over). These data provide the opportunity to explore how the effects of changes in health care expenditure differ with available resources. We use 2008-2009 data to evaluate two econometric approaches to estimation and explore a range of criteria for accepting subgroup specific effects for differences in expenditure and outcome elasticities across the 23 PBCs. Our results indicate that health opportunity costs arising from an investment imposing net increases in expenditure are underestimated unless account is taken of likely nonmarginal effects. They also indicate the benefits (reduced health opportunity costs or increased value-based price of a technology) of being able to "smooth" these nonmarginal budget impacts by health care systems borrowing against future budgets or from manufacturers offering "mortgage" type arrangements. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. An Analysis of Alternatives for Reducing Outpatient Military Health Care Costs for Active Duty Members and their Families: Implementing a Recommended Savings Strategy Using Defense Acquisition Principles

    National Research Council Canada - National Science Library

    Jaime, Richardo; Rupert, Joshua W

    2007-01-01

    .... In efforts to reduce or contain the costs of the military health care system, this project will propose two cost savings alternatives for providing outpatient care to active duty personnel and their dependents...

  16. Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program.

    Science.gov (United States)

    Frost, Jennifer J; Sonfield, Adam; Zolna, Mia R; Finer, Lawrence B

    2014-12-01

    Policy Points: The US publicly supported family planning effort serves millions of women and men each year, and this analysis provides new estimates of its positive impact on a wide range of health outcomes and its net savings to the government. The public investment in family planning programs and providers not only helps women and couples avoid unintended pregnancy and abortion, but also helps many thousands avoid cervical cancer, HIV and other sexually transmitted infections, infertility, and preterm and low birth weight births. This investment resulted in net government savings of $13.6 billion in 2010, or $7.09 for every public dollar spent. Each year the United States' publicly supported family planning program serves millions of low-income women. Although the health impact and public-sector savings associated with this program's services extend well beyond preventing unintended pregnancy, they never have been fully quantified. Drawing on an array of survey data and published parameters, we estimated the direct national-level and state-level health benefits that accrued from providing contraceptives, tests for the human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs), Pap tests and tests for human papillomavirus (HPV), and HPV vaccinations at publicly supported family planning settings in 2010. We estimated the public cost savings attributable to these services and compared those with the cost of publicly funded family planning services in 2010 to find the net public-sector savings. We adjusted our estimates of the cost savings for unplanned births to exclude some mistimed births that would remain publicly funded if they had occurred later and to include the medical costs for births through age 5 of the child. In 2010, care provided during publicly supported family planning visits averted an estimated 2.2 million unintended pregnancies, including 287,500 closely spaced and 164,190 preterm or low birth weight (LBW) births, 99

  17. Local health care expenditure plans and their opportunity costs.

    Science.gov (United States)

    Karlsberg Schaffer, Sarah; Sussex, Jon; Devlin, Nancy; Walker, Andrew

    2015-09-01

    In the UK, approval decisions by Health Technology Assessment bodies are made using a cost per quality-adjusted life year (QALY) threshold, the value of which is based on little empirical evidence. We test the feasibility of estimating the "true" value of the threshold in NHS Scotland using information on marginal services (those planned to receive significant (dis)investment). We also explore how the NHS makes spending decisions and the role of cost per QALY evidence in this process. We identify marginal services using NHS Board-level responses to the 2012/13 Budget Scrutiny issued by the Scottish Government, supplemented with information on prioritisation processes derived from interviews with Finance Directors. We search the literature for cost-effectiveness evidence relating to marginal services. The cost-effectiveness estimates of marginal services vary hugely and thus it was not possible to obtain a reliable estimate of the threshold. This is unsurprising given the finding that cost-effectiveness evidence is rarely used to justify expenditure plans, which are driven by a range of other factors. Our results highlight the differences in objectives between HTA bodies and local health service decision makers. We also demonstrate that, even if it were desirable, the use of cost-effectiveness evidence at local level would be highly challenging without extensive investment in health economics resources. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

    Science.gov (United States)

    Gates, W. R.

    1983-02-01

    Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

  19. Solar thermal technology development: Estimated market size and energy cost savings. Volume 2: Assumptions, methodology and results

    Science.gov (United States)

    Gates, W. R.

    1983-01-01

    Estimated future energy cost savings associated with the development of cost-competitive solar thermal technologies (STT) are discussed. Analysis is restricted to STT in electric applications for 16 high-insolation/high-energy-price states. Three fuel price scenarios and three 1990 STT system costs are considered, reflecting uncertainty over future fuel prices and STT cost projections. Solar thermal technology research and development (R&D) is found to be unacceptably risky for private industry in the absence of federal support. Energy cost savings were projected to range from $0 to $10 billion (1990 values in 1981 dollars), depending on the system cost and fuel price scenario. Normal R&D investment risks are accentuated because the Organization of Petroleum Exporting Countries (OPEC) cartel can artificially manipulate oil prices and undercut growth of alternative energy sources. Federal participation in STT R&D to help capture the potential benefits of developing cost-competitive STT was found to be in the national interest. Analysis is also provided regarding two federal incentives currently in use: The Federal Business Energy Tax Credit and direct R&D funding.

  20. Cost-savings accruable to removing value added tax from antiretrovirals in the South African private health sector

    Directory of Open Access Journals (Sweden)

    Varsha Bangalee

    2017-10-01

    Full Text Available Background: Despite the important and essential role that medicines play in any society, all medicines, including those identified as essential, are uniformly subjected to 14% value added tax (VAT, regardless of their therapeutic value in the private healthcare sector of South Africa. The aim of this article is to demonstrate the potential cost-saving attained from the removal of VAT from the private sector pricing of essential medicines, using antiretroviral treatment as an example. Methods: An empirical analysis was undertaken to illustrate the potential cost-saving achieved by removing VAT from the Single Exit Price and the dispensing fee of essential medicines. This outcome was demonstrated by applying the methodology to an adult fixed dose combination 1st line antiretroviral regimen as well as to a group of 3rd line antiretroviral medicines. Results: The potential saving for the lowest priced generic and originator 1st line antiviral regimen accrued to ZAR 693.84 and ZAR 1085.04 over a year respectively. Regarding the 3rd line antiretroviral drugs, results yielded an annual saving of ZAR 1678.68 (darunavir, ZAR5741.04 (maraviroc and ZAR 159.48 (rilpivirine. Conclusions: Lobbying for the removal of VAT from the supply chain of medicines should be intensified. Policy development to monitor and recover lost government revenue through the removal of taxes should be explored.

  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.

    Science.gov (United States)

    Hunter, Wynn G; Zhang, Cecilia Z; Hesson, Ashley; Davis, J Kelly; Kirby, Christine; Williamson, Lillie D; Barnett, Jamison A; Ubel, Peter A

    2016-10-01

    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. Is Exercise Stress Testing a Cost-Saving Strategy For Risk Assessment of Pediatric Wolff-Parkinson-White Syndrome Patients?

    Science.gov (United States)

    Moltedo, Jose M.; Iyer, Ramesh V.; Forman, Howard; Fahey, John; Rosenthal, Geoffrey; Snyder, Christopher S.

    2006-01-01

    Background: In Wolff-Parkinson-White syndrome (WPW) patients the loss of pre-excitation in a single heartbeat during exercise stress testing (EST) is a predictor of low risk of sudden death. The purpose of this study was to: 1) assess the frequency of loss of pre-excitation in a single heartbeat during exercise testing, and 2) compare the cost of EST versus trans-catheter electrophysiology study (EPS) in the risk assessment of WPW patients. Methods: A retrospective review of 50 cases of patients with WPW who underwent EST was conducted including demographics, history of supraventricular tachycardia, associated congenital heart disease, maximum heart rate achieved, and loss of pre-excitation in a single heartbeat. Hospital costs of EST and EPS were compared. Results: Of the 50 patients who underwent EST, 4 (8%), lost pre-excitation in a single heartbeat during EST. No differences were found regarding gender, age at diagnosis or EST, history of supraventricular tachycardia, presence of congenital heart disease or maximal heart rate. A cost comparison, utilizing the cost data: EST ($62.75) and EPS ($5,597) found EST to be a cost-saving approach in WPW patients. With 4 patients losing pre-excitation during EST, the cost saving of EST was $22,388 for this population of WPW patients. Conclusions: A frequency of 8% loss of pre-excitation was found in a pediatric sample that underwent EST. Additionally, EST was shown to be a cost-saving strategy in risk assessment of pediatric WPW patients. PMID:21845141

  3. An Information Framework for Facilitating Cost Saving of Environmental Impacts in the Coal Mining Industry in South Africa

    Directory of Open Access Journals (Sweden)

    Mashudu D. Mbedzi

    2018-05-01

    Full Text Available Coal-mining contributes much to the economic welfare of a country. Yet it brings along a number of challenges, notably environmental impacts which include water pollution in a water scarce country such as South Africa. This research is conducted in two phases. The first phase intends to establish environmental and other challenges brought about by the coal-mining industry through a comprehensive analysis of available literature. Combatting these challenges is costly; consequently, our work investigates how established management accounting tools and techniques such as Environmental Management Accounting (EMA, Material Flow Cost Accounting (MFCA and Life Cycle Costing (LCC may facilitate cost savings for the companies involved. These techniques promote increased transparency of material usage by tracing and quantifying the flows and inventories of materials within the coal-mining industry in physical and monetary terms, hence hidden costs are elicited. The researchers postulate that an Information Framework integrating these aspects may be the way forward. To this end existing frameworks in the literature are identified. A number of research questions embodying the above aspects are defined and the objective is to define a conceptual framework to facilitate cost savings for coal-mining companies. The main contribution of this work is an information framework presented towards the end of this article. The second phase of the research will involve fieldwork in the form of a survey among stakeholders in industry to validate the conceptual framework.

  4. Supply chain collaboration and cost saving as a result of returns handling programmes in retail corporations in Poland

    OpenAIRE

    Anna Maria Jeszka

    2015-01-01

    Background: The objective is to define on the basis of the literature as well as to test empirically the main factors that affect the cost saving of many retail chains, resulting from deliberate and conscious policies as well as organized activities in the area of product returns management. Methods: Based on a survey developed for the study, standardized interviews were conducted with representatives of trade corporations in the apparel industry in Poland. The data collected were analys...

  5. Navigation API Route Fuel Saving Opportunity Assessment on Large-Scale Real-World Travel Data for Conventional Vehicles and Hybrid Electric Vehicles: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Lei [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holden, Jacob [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gonder, Jeffrey D [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-12-06

    The green routing strategy instructing a vehicle to select a fuel-efficient route benefits the current transportation system with fuel-saving opportunities. This paper introduces a navigation API route fuel-saving evaluation framework for estimating fuel advantages of alternative API routes based on large-scale, real-world travel data for conventional vehicles (CVs) and hybrid electric vehicles (HEVs). The navigation APIs, such Google Directions API, integrate traffic conditions and provide feasible alternative routes for origin-destination pairs. This paper develops two link-based fuel-consumption models stratified by link-level speed, road grade, and functional class (local/non-local), one for CVs and the other for HEVs. The link-based fuel-consumption models are built by assigning travel from a large number of GPS driving traces to the links in TomTom MultiNet as the underlying road network layer and road grade data from a U.S. Geological Survey elevation data set. Fuel consumption on a link is calculated by the proposed fuel consumption model. This paper envisions two kinds of applications: 1) identifying alternate routes that save fuel, and 2) quantifying the potential fuel savings for large amounts of travel. An experiment based on a large-scale California Household Travel Survey GPS trajectory data set is conducted. The fuel consumption and savings of CVs and HEVs are investigated. At the same time, the trade-off between fuel saving and time saving for choosing different routes is also examined for both powertrains.

  6. Opportunities and costs of tourism for a new Humanism

    Directory of Open Access Journals (Sweden)

    Bizzarri Carmen

    2016-06-01

    Full Text Available The first part of this paper describes the flow of tourism on a national and international scale, emphasizing the role that entertainment tourism and theme parks play globally. Following these preliminary remarks, the second part of the paper presents the positive and negative economic effects of leisure tourism opportunities at the European and regional level. The third part of the paper analyses the environmental aspects of tourism and entertainment tourism. It shows that sustainable tourism development can be an essential condition for the protection of natural and cultural resources. Finally, the fourth part summarizes some of the most important social issues arising from tourism activities, among them the conflict between residents and tourists on the exploitation of resources and the demonstration effect deriving from the consumption of resources. To avoid this spoliation and destruction of the destination (land and local community, the paper suggests a new Humanism based on Catholicism as a way to realize a sustainability utopia.

  7. A comparative analysis of the epidemiological impact and disease cost-savings of HPV vaccines in France

    Science.gov (United States)

    Bresse, Xavier; Adam, Marjorie; Largeron, Nathalie; Roze, Stephane; Marty, Remi

    2013-01-01

    The aim was to compare the epidemiological and economic impact of 16/18 bivalent and 6/11/16/18 quadrivalent HPV vaccination in France, considering differences in licensed outcomes, protection against non-vaccine HPV types and prevention of HPV-6/11-related diseases. The differential impact of the two vaccines was evaluated using a published model adapted to the French setting. The target population was females aged 14–23 y and the time horizon was 100 y. A total of eight different scenarios compared vaccination impact in terms of reduction in HPV-16/18-associated carcinomas (cervical, vulvar, vaginal, anal, penile and head and neck), HPV-6/11-related genital warts and recurrent respiratory papillomatosis, and incremental reduction in cervical cancer due to potential cross-protection. Quadrivalent vaccine was associated with total discounted cost savings ranging from EUR 544–1,020 million vs. EUR 177–538 million with the bivalent vaccination (100-y time horizon). Genital wart prevention thanks to quadrivalent HPV vaccination accounted for EUR 306–380 million savings (37–56% of costs saved). In contrast, the maximal assumed cross-protection against cervical cancer resulted in EUR 13–33 million savings (4%). Prevention of vulvar, vaginal and anal cancers accounted for additional EUR 71–89 million savings (13%). In France, the quadrivalent HPV vaccination would result in significant incremental epidemiological and economic benefits vs. the bivalent vaccination, driven primarily by prevention of genital. The present analysis is the first in the French setting to consider the impact of HPV vaccination on all HPV diseases and non-vaccine types. PMID:23563511

  8. Valuation of opportunity costs by rats working for rewarding electrical brain stimulation.

    Directory of Open Access Journals (Sweden)

    Rebecca Brana Solomon

    Full Text Available Pursuit of one goal typically precludes simultaneous pursuit of another. Thus, each exclusive activity entails an "opportunity cost:" the forgone benefits from the next-best activity eschewed. The present experiment estimates, in laboratory rats, the function that maps objective opportunity costs into subjective ones. In an operant chamber, rewarding electrical brain stimulation was delivered when the cumulative time a lever had been depressed reached a criterion duration. The value of the activities forgone during this duration is the opportunity cost of the electrical reward. We determined which of four functions best describes how objective opportunity costs, expressed as the required duration of lever depression, are translated into their subjective equivalents. The simplest account is the identity function, which equates subjective and objective opportunity costs. A variant of this function called the "sigmoidal-slope function," converges on the identity function at longer durations but deviates from it at shorter durations. The sigmoidal-slope function has the form of a hockey stick. The flat "blade" denotes a range over which opportunity costs are subjectively equivalent; these durations are too short to allow substitution of more beneficial activities. The blade extends into an upward-curving portion over which costs become discriminable and finally into the straight "handle," over which objective and subjective costs match. The two remaining functions are based on hyperbolic and exponential temporal discounting, respectively. The results are best described by the sigmoidal-slope function. That this is so suggests that different principles of intertemporal choice are involved in the evaluation of time spent working for a reward or waiting for its delivery. The subjective opportunity-cost function plays a key role in the evaluation and selection of goals. An accurate description of its form and parameters is essential to successful

  9. RCRA Part B permit modifications for cost savings and increased flexibility at the Rocky Flats Environmental Technology Site

    International Nuclear Information System (INIS)

    Jierree, C.; Ticknor, K.

    1996-10-01

    With shrinking budgets and downsizing, a need for streamlined compliance initiatives became evident at the Rocky Flats Environmental Technology Site (RFETS). Therefore, Rocky Mountain Remediation Services (RMRS) at the RFETS successfully and quickly modified the RFETS RCRA Part B Permit to obtain significant cost savings and increased flexibility. This 'was accomplished by requesting operations personnel to suggest changes to the Part B Permit which did not diminish overall compliance and which would be most. cost beneficial. The U.S. Department of Energy (DOE) subsequently obtained approval of those changes from the Colorado Department of Public Health and the Environment (CDPHE)

  10. Estimation of the cost savings from participation of electric vehicles in Vehicle to Grid (V2G) schemes

    OpenAIRE

    Kiaee, Mahdi; Cruden, Andrew; Sharkh, S.M.

    2015-01-01

    The storage capacity of the batteries in an electric vehicle (EV) could be utilised to store electrical energy and give it back to the grid when needed by participating in vehicle to grid (V2G) schemes. This participation could be a source of revenue for vehicle owners thus reducing the total charging cost of their EVs. A V2G simulator has been developed using MATLAB to find out the potential cost saving from participation of EVs in V2G schemes. A standard IEEE30 network has been modelled in ...

  11. Energy-saving engines reduce operating cost and environmental pollution; Energiesparmotoren senken die Betriebskosten und schonen die Umwelt

    Energy Technology Data Exchange (ETDEWEB)

    Maletz, H.; Stengel, S. [Siemens AG, Erlangen (Germany). Automatisierungs- und Antriebstechnik

    1999-07-01

    Reduction of the energy cost will make production more economical and, in consequence, gain a competitive advantage. In view of high energy cost, new international legislation and increasing energy-awareness, the new generation of energy-saving engines is gaining increasing acceptance. [German] Hohe Energiekosten schlagen im Rahmen der Betriebskosten voll zu Buche. Gelingt es, sie spuerbar zu senken, wird die Produktion letzten Endes wirtschaftlicher und wettbewerbsfaehiger. Vor dem Hintergrund hoher Energiepreise, der neuen internationalen Gesetzgebung und zunehmenden Energiebewusstseins, gewinnen Energiesparmotoren der neuen Generation zunehmend an Bedeutung. (orig.)

  12. Exploring No-Cost Opportunities for Public Sector Information Systems Energy Efficiency: A Tennessee Application

    Directory of Open Access Journals (Sweden)

    Kendra Abkowitz Brooks

    2015-11-01

    Full Text Available The Tennessee Department of Environment and Conservation (TDEC completed a pilot project within its Central Office spaces to test the utilization of computer power management (CPM technologies to implement power saving settings on state-owned, network-connected computer equipment. Currently, the State of Tennessee has no clear protocol regarding energy-conserving power settings on state-owned machines. Activation of monitor sleep modes and system standby and hibernation modes on 615 Central Office computers over an 18-month period reduced energy consumption by an estimated 8093 kWh and $526 per month, amounting to approximately $6312 in cost savings for Tennessee annually. If implemented throughout State of Tennessee executive agencies across the state, energy cost savings could amount to an estimated $323,341 annually. The research endeavored to understand both positive and negative impacts that strategic power management approaches can have on energy consumption, worker productivity, network security, and state budgets. Nearly all impacts discussed were positive. Based on successful results within TDEC Central Office spaces in Tennessee Tower, and considering the potential cost savings that could be achieved, expansion of the implementation of computer power management policies to machines in offices across the state was recommended.

  13. Estimated medical cost savings in Rhode Island by implementation of a primary seat belt law

    Science.gov (United States)

    2008-09-01

    This report examines 2006 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Rhode Island if a primary seat belt law is implemented. The savin...

  14. Estimated medical cost savings in Massachusetts by implementation of a primary seat belt law

    Science.gov (United States)

    2008-12-01

    This report examines 2006 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to Massachusetts if a primary seat belt law is implemented. The savi...

  15. Estimated medical cost savings in Vermont by implementation of a primary seat belt law

    Science.gov (United States)

    2008-09-01

    This report examines 2005 hospital discharge data reporting cases where the external cause of injury to a vehicle occupant was a motor vehicle crash to predict the estimated savings to the State of Vermont if a primary seat belt law is implemented. T...

  16. Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

    Science.gov (United States)

    Asaria, Miqdad; Grasic, Katja; Walker, Simon

    2016-02-01

    This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

  17. Cost-benefit assessment of energy efficiency investments: Accounting for future resources, savings and risks in the Australian residential sector

    International Nuclear Information System (INIS)

    Morrissey, J.; Meyrick, B.; Sivaraman, D.; Horne, R.E.; Berry, M.

    2013-01-01

    This article focuses on the impact of the discount rate on cost-benefit assessment of investment options for residential building efficiency. An integrated thermal modeling, life cycle costing approach is applied to an extensive sample of dominant house designs for Australian conditions. The relative significance of predicted thermal performance and the applied discount rate on the Present Value of energy savings from alternative investment scenarios is investigated. Costs and benefits are also evaluated at the economy-wide scale, including carbon pricing considerations, and for a test-case household faced with alternative investment options at the point of construction. The influence of the applied discount rate on produced cost-benefit calculations is investigated, as is the interaction between critical cost-benefit input parameters. Findings support that the discounting framework is the primary driver of difference in estimates about costs and benefits of higher standards of efficiency in the residential sector. Results demonstrate that agreement on a low discount rate based on sustainability principals would prioritise those projects with significant environmental benefits. - Highlights: ► High thermal efficiency is a key strategy to limit energy use in buildings. ► Integrated thermal modeling—life-cycle costing methods are applied to dominant house designs. ► The discounting framework is the primary driver of difference in observed costs. ► The selection of optimal performance investment options depends on the discount rate. ► Application of a discount rate of 3.5% or lower favours energy saving projects

  18. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

    Science.gov (United States)

    Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

    2010-04-01

    Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

  19. Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

    Directory of Open Access Journals (Sweden)

    Matthias Stoll

    Full Text Available UNLABELLED: BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. METHODS: Antiretroviral regimens (ART from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. RESULTS: During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70. Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively. Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. CONCLUSIONS: Analysis of the data of this nationwide study reflects disease-specific health services research

  20. Calculation of direct antiretroviral treatment costs and potential cost savings by using generics in the German HIV ClinSurv cohort.

    Science.gov (United States)

    Stoll, Matthias; Kollan, Christian; Bergmann, Frank; Bogner, Johannes; Faetkenheuer, Gerd; Fritzsche, Carlos; Hoeper, Kirsten; Horst, Heinz-August; van Lunzen, Jan; Plettenberg, Andreas; Reuter, Stefan; Rockstroh, Jürgen; Stellbrink, Hans-Jürgen; Hamouda, Osamah; Bartmeyer, Barbara

    2011-01-01

    BACKGROUND/AIM OF THE STUDY: The study aimed to determine the cost impacts of antiretroviral drugs by analysing a long-term follow-up of direct costs for combined antiretroviral therapy, cART, -regimens in the nationwide long-term observational multi-centre German HIV ClinSurv Cohort. The second aim was to develop potential cost saving strategies by modelling different treatment scenarios. Antiretroviral regimens (ART) from 10,190 HIV-infected patients from 11 participating ClinSurv study centres have been investigated since 1996. Biannual data cART-initiation, cART-changes, surrogate markers, clinical events and the Centre of Disease Control- (CDC)-stage of HIV disease are reported. Treatment duration was calculated on a daily basis via the documented dates for the beginning and end of each antiretroviral drug treatment. Prices were calculated for each individual regimen based on actual office sales prices of the branded pharmaceuticals distributed by the license holder including German taxes. During the 13-year follow-up period, 21,387,427 treatment days were covered. Cumulative direct costs for antiretroviral drugs of €812,877,356 were determined according to an average of €42.08 per day (€7.52 to € 217.70). Since cART is widely used in Germany, the costs for an entire regimen increased by 13.5%. Regimens are more expensive in the advanced stages of HIV disease. The potential for cost savings was calculated using non-nucleotide-reverse-transcriptase-inhibitor, NNRTI, more frequently instead of ritonavir-boosted protease inhibitor, PI/r, in first line therapy. This calculation revealed cumulative savings of 10.9% to 19.8% of daily treatment costs (50% and 90% substitution of PI/r, respectively). Substituting certain branded drugs by generic drugs showed potential cost savings of between 1.6% and 31.8%. Analysis of the data of this nationwide study reflects disease-specific health services research and will give insights into the cost impacts of

  1. Opportunity cost in the economic evaluation of da Vinci robotic assisted surgery.

    Science.gov (United States)

    Fuertes-Guiró, Fernando; Girabent-Farrés, Montserrat; Viteri-Velasco, Eduardo

    2016-04-01

    This study aims to demonstrate the importance of the opportunity cost in using da Vinci robotic surgery, assisted by a comprehensive review of the literature to determine the differences in the total cost of surgery and operative time in traditional laparoscopic surgery and da Vinci robotic surgery. We identified the studies comparing the use of traditional laparoscopic surgery with robotics during the period 2002-2012 in the electronic economic evaluation databases, and another electronic search was performed for publications by Spanish hospitals in the same period to calculate the opportunity cost. A meta-analysis of response variables considering the total cost of the intervention and surgical time was completed using the items selected in the first revision, and their differences were analyzed. We then calculated the opportunity cost represented by these time differences using the data obtained from the studies in the second review of the literature. Nine items were selected in the first review and three in the second. Traditional laparoscopic surgery has a lower cost than the da Vinci (p < 0.00001). Robotic surgery takes longer (8.0-65.5 min) than traditional surgery (p < 0.00001), and this difference represents an average opportunity cost for robot use of € 489.98, with a unit cost factor/time which varies according to the pathology dealt with, from € 8.2 to 18.7/min. The opportunity cost is a quantity that must be included in the total cost of using a surgical technology within an economic cost analysis in the context of an economic evaluation.

  2. The Quit Benefits Model: a Markov model for assessing the health benefits and health care cost savings of quitting smoking

    Directory of Open Access Journals (Sweden)

    Hurley Susan F

    2007-01-01

    Full Text Available Abstract Background In response to the lack of comprehensive information about the health and economic benefits of quitting smoking for Australians, we developed the Quit Benefits Model (QBM. Methods The QBM is a Markov model, programmed in TreeAge, that assesses the consequences of quitting in terms of cases avoided of the four most common smoking-associated diseases, deaths avoided, and quality-adjusted life-years (QALYs and health care costs saved (in Australian dollars, A$. Quitting outcomes can be assessed for males and females in 14 five year age-groups from 15–19 to 80–84 years. Exponential models, based on data from large case-control and cohort studies, were developed to estimate the decline over time after quitting in the risk of acute myocardial infarction (AMI, stroke, lung cancer, chronic obstructive pulmonary disease (COPD, and death. Australian data for the year 2001 were sourced for disease incidence and mortality and health care costs. Utility of life estimates were sourced from an international registry and a meta analysis. In this paper, outcomes are reported for simulated subjects followed up for ten years after quitting smoking. Life-years, QALYs and costs were estimated with 0%, 3% and 5% per annum discount rates. Summary results are presented for a group of 1,000 simulated quitters chosen at random from the Australian population of smokers aged between 15 and 74. Results For every 1,000 males chosen at random from the reference population who quit smoking, there is a an average saving in the first ten years following quitting of A$408,000 in health care costs associated with AMI, COPD, lung cancer and stroke, and a corresponding saving of A$328,000 for every 1,000 female quitters. The average saving per 1,000 random quitters is A$373,000. Overall 40 of these quitters will be spared a diagnosis of AMI, COPD, lung cancer and stroke in the first ten years following quitting, with an estimated saving of 47 life-years and

  3. Behavioral Economics and Physician Board Meetings: Opportunity Cost, Regret, and Their Mitigation in Orthopaedic Surgery.

    Science.gov (United States)

    Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle

    2018-01-01

    Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).

  4. Offering lung cancer screening to high-risk medicare beneficiaries saves lives and is cost-effective: an actuarial analysis.

    Science.gov (United States)

    Pyenson, Bruce S; Henschke, Claudia I; Yankelevitz, David F; Yip, Rowena; Dec, Ellynne

    2014-08-01

    By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening. To estimate the cost and cost-effectiveness (ie, cost per life-year saved) of LDCT lung cancer screening of the Medicare population at high risk for lung cancer. Medicare costs, enrollment, and demographics were used for this study; they were derived from the 2012 Centers for Medicare & Medicaid Services (CMS) beneficiary files and were forecast to 2014 based on CMS and US Census Bureau projections. Standard life and health actuarial techniques were used to calculate the cost and cost-effectiveness of lung cancer screening. The cost, incidence rates, mortality rates, and other parameters chosen by the authors were taken from actual Medicare data, and the modeled screenings are consistent with Medicare processes and procedures. Approximately 4.9 million high-risk Medicare beneficiaries would meet criteria for lung cancer screening in 2014. Without screening, Medicare patients newly diagnosed with lung cancer have an average life expectancy of approximately 3 years. Based on our analysis, the average annual cost of LDCT lung cancer screening in Medicare is estimated to be $241 per person screened. LDCT screening for lung cancer in Medicare beneficiaries aged 55 to 80 years with a history of ≥30 pack-years of smoking and who had smoked within 15 years is low cost, at approximately $1 per member per month. This assumes that 50% of these patients were screened. Such screening is also highly cost-effective, at <$19,000 per life-year saved. If all eligible Medicare

  5. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings.

    Science.gov (United States)

    Ehrenkranz, P; Lanata, C F; Penny, M E; Salazar-Lindo, E; Glass, R I

    2001-10-01

    To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384,000 cases, 64,000 clinic visits, 30,000 hospitalizations, and 1,600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal) associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

  6. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings

    Directory of Open Access Journals (Sweden)

    Peter Ehrenkranz

    2001-10-01

    Full Text Available Objective. To assess the disease burden of rotavirus diarrhea in Peru as well the need for and the potential cost savings with a rotavirus vaccine in that country. Methods. To assess the burden of rotavirus diarrhea in Peru, we reviewed published and unpublished reports where rotavirus was sought as the etiologic agent of diarrhea in children. Rotavirus detection rates obtained from these studies were combined with diarrhea incidence rates from a number of national surveys in order to estimate both the burden of rotavirus diarrhea in the country and its associated medical costs. Results. Rotavirus is a significant cause of morbidity and mortality in Peruvian children. In their first 5 years of life, an estimated 1 in 1.6 children will experience an episode of rotavirus diarrhea, 1 in 9.4 will seek medical care, 1 in 19.7 will require hospitalization, and 1 in 375 will die of the disease. Per year, this represents approximately 384 000 cases, 64 000 clinic visits, 30 000 hospitalizations, and 1 600 deaths. The annual cost of medical care alone for these children is approximately US$ 2.6 million--and that does not take into account the indirect or societal costs of the illness and the deaths. Conclusions. Rotavirus immunization provides the prospect of decreasing the morbidity and mortality from diarrhea in Peru, but a vaccine regimen would have to be relatively inexpensive, a few dollars or less per child. Future cost-effectiveness analyses should explore the total costs (medical as well as indirect or societal associated with rotavirus diarrhea. Newly licensed vaccines should be tested according to both their ability to avert deaths and their efficacy with fewer than three doses. All three of these factors could increase the cost savings associated with a rotavirus vaccine.

  7. ResStock - Targeting Energy and Cost Savings for U.S. Homes

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Eric J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-29

    The ResStock analysis tool is helping states, municipalities, utilities, and manufacturers identify which home upgrades save the most energy and money. Across the country there's a vast diversity in the age, size, construction practices, installed equipment, appliances, and resident behavior of the housing stock, not to mention the range of climates. These variations have hindered the accuracy of predicting savings for existing homes. Researchers at the National Renewable Energy Laboratory (NREL) developed ResStock. It's a versatile tool that takes a new approach to large-scale residential energy analysis by combining: large public and private data sources, statistical sampling, detailed subhourly building simulations, high-performance computing. This combination achieves unprecedented granularity and most importantly - accuracy - in modeling the diversity of the single-family housing stock.

  8. Implementation Opportunities of Green Accounting for Activity-Based Costing (ABC in Romania

    Directory of Open Access Journals (Sweden)

    Sorinel Capusneanu

    2008-01-01

    Full Text Available This article refers to implementation opportunities of green accounting for the Activity- Based Costing method. It shows why we choose Activity-Based Costing method and what must be done in this way. Green accounting observes the specific principles of the Activity-Based Costing method. It also represents the advantages and disadvantages of the green accounting into an enterprise in case of Activity-Based Costing implementation. The paper describes the stages we must follow in case of implementation of green accounting alongside Activity-Based Costing method into an enterprise.

  9. Defense Industry: Restructuring Costs Paid, Savings Realized, and Means to Ensure Benefits

    National Research Council Canada - National Science Library

    1998-01-01

    ...) the restructuring costs were allowable under the Federal Acquisition Regulation and (2) a DOD contracting officer determined that the business combination was expected to result in overall reduced costs to DOD or preserve a critical defense capability...

  10. Low-cost, highly transparent flexible low-e coating film to enable electrochromic windows with increased energy savings

    Energy Technology Data Exchange (ETDEWEB)

    Berland, Brian [ITN Energy Systems, Inc., Littleton, CO (United States); Hollingsworth, Russell [ITN Energy Systems, Inc., Littleton, CO (United States)

    2015-03-31

    Five Quads of energy are lost through windows annually in the U.S. Low-e coatings are increasingly employed to reduce the wasted energy. Most commonly, the low-e coating is an oxide material applied directly to the glass at high temperature. With over 100,000,000 existing homes, a retrofit product is crucial to achieve widespread energy savings. Low-e films, i.e. coatings on polymeric substrates, are now also available to meet this need. However, the traditional oxide materials and process is incompatible with low temperature plastics. Alternate high performing low-e films typically incorporate materials that limit visible transmission to 35% or less. Further, the cost is high. The objective of this award was to develop a retrofit, integrated low-e/electrochromic window film to dramatically reduce energy lost through windows. While field testing of state-of-the-art electrochromic (EC) windows show the energy savings are maximized if a low-e coating is used in conjunction with the EC, available low-e films have a low visible transmission (~70% or less) that limits the achievable clear state and therefore, appearance and energy savings potential. Comprehensive energy savings models were completed at Lawrence Berkeley National Lab (LBNL). A parametric approach was used to project energy usage for windows with a large range of low-e properties across all U.S. climate zones, without limiting the study to materials that had already been produced commercially or made in a lab. The model enables projection of energy savings for low-e films as well as integrated low-e/EC products. This project developed a novel low-e film, optimized for compatibility with EC windows, using low temperature, high deposition rate processes for the growth of low-e coatings on plastic films by microwave plasma enhanced chemical vapor deposition. Silica films with good density and optical properties were demonstrated at deposition rates as high as 130Å/sec. A simple bi-layer low-e stack of

  11. Mating opportunities in Sangalopsis veliterna females: Costs and benefits

    Science.gov (United States)

    Hernández Duran, Linda C.; Fajardo Medina, Gonzalo E.; Fuentes Quinter, Luz S.; Martin, Oliver

    2014-01-01

    Abstract In nature, females of several animal taxa exhibit considerable variation in their mating system, and this variation involves different balances of costs (e.g., energetic, reproductive) and benefits (e.g., increased net reproductive rate of the female, increased longevity). Many studies have focused on discovering the potential advantages and disadvantages that females could have when increasing their mating rate and the possible evolutionary consequences that may result. Butterflies and moths are an ideal study system because it is easy to determine and to manipulate experimentally their mating frequency. In this study, the effect of continuous availability of different numbers of males (1, 2, 4, 8) on female mating rate and fitness components was estimated by comparing the number of spermatophores in the corpus bursa (an estimate of the number of copulations, but not of the number males involved in these copulations), female longevity, lifetime number of laid eggs (fecundity), and proportion of hatching eggs (fertility) in the moth Sangalopsis veliterna Druce (Lepidoptera: Geometridae). The results showed that there were no significant differences in either fertility or fecundity when treatments were compared, but longevity and in some cases fecundity increased when females had several matings. Resumen En la naturaleza, hembras de varios taxa animal muestran una variación considerable en su sistema de apareamiento, esta variación involucra diferentes costos (energéticos, reproductivos, etc) y beneficios (aumento de la tasa reproductiva neta de la hembra, mayor longevidad, entre otros). En años recientes, muchos estudios se han enfocado en descubrir las potenciales ventajas y desventajas que las hembras podrían tener al aumentar su número de cópulas y las posibles consecuencias evolutivas que podrían resultar. Las mariposas y polillas son un sistema de estudio ideal, dada la facilidad para determinar y manipular experimentalmente su frecuencia de

  12. Assessment of China's energy-saving and emission-reduction accomplishments and opportunities during the 11th Five Year Plan

    International Nuclear Information System (INIS)

    Price, Lynn; Levine, Mark D.; Zhou Nan; Fridley, David; Aden, Nathaniel; Lu Hongyou; McNeil, Michael; Zheng, Nina; Qin Yining; Yowargana, Ping

    2011-01-01

    From 1980 to 2002, China experienced a 5% average annual reduction in energy consumption per unit of gross domestic product (GDP). With a dramatic reversal of this historic relationship, energy intensity increased 5% per year during 2002-2005. China's 11th Five Year Plan (FYP) set a target of reducing energy intensity by 20% by 2010. This paper assesses selected policies and programs that China has instituted to fulfill the national goal, finding that China made substantial progress and many of the energy-efficiency programs appear to be on track to meet - or in some cases exceed - their energy-saving targets. Most of the Ten Key Projects, the Top-1000 Program, and the Small Plant Closure Program will meet or surpass the 11th FYP savings goals. China's appliance standards and labeling program has become very robust. China has greatly enhanced its enforcement of new building energy standards but energy-efficiency programs for buildings retrofits, as well as the goal of adjusting China's economic structure, are failing. It is important to maintain and strengthen the existing energy-saving policies and programs that are successful while revising programs or adding new policy mechanisms to improve the programs that are not on track to achieve the stated goals. - Research highlights: → This paper assesses selected national energy efficiency policies and programs China. → The policies were established to fulfill the 11th Five Year Plan energy efficiency improvement goal. → Many of the programs appear to be on track to meet or exceed their energy-saving targets. → For the 12th Five Year Plan, it is important to maintain and strengthen energy-saving policies. → Recommendations are made for revising or adding programs based on international experience.

  13. Exergy costing for energy saving in combined heating and cooling applications

    DEFF Research Database (Denmark)

    Nguyen, Chan; Veje, Christian T.; Willatzen, Morten

    2014-01-01

    . In the first method, referred to as energy costing, a conventional thermoeconomic analysis is used. Here the ammonia heat pump is subject to a thermodynamic analysis with mass and energy balance equations. In the second method referred to as exergy costing, an exergy based economic analysis is used, where...... exergy balance equations are used in conjunction with mass and energy balance equations. In both costing methods the thermodynamic analysis is followed by an economic analysis which includes investment and operating costs. For both methods the unit costs of heating and cooling are found and compared...

  14. Cost-Sharing Contracts for Energy Saving and Emissions Reduction of a Supply Chain under the Conditions of Government Subsidies and a Carbon Tax

    Directory of Open Access Journals (Sweden)

    Yi Yuyin

    2018-03-01

    Full Text Available To study the cooperation of upstream and downstream enterprises of a supply chain in energy saving and emissions reduction, we establish a Stackelberg game model. The retailer moves first to decide a cost-sharing contract, then the manufacturer determines the energy-saving level, carbon-emission level, and wholesale price successively. In the end, the retailer determines the retail price. As a regulation, the government provides subsidies for energy-saving products, while imposing a carbon tax on the carbon emitted. The results show that (1 both the energy-saving cost-sharing (ECS and the carbon emissions reduction cost-sharing (CCS contracts are not the dominant strategy of the two parties by which they can facilitate energy savings and emissions reductions; (2 compared with single cost-sharing contracts, the bivariate cost-sharing (BCS contract for energy saving and emissions reduction is superior, although it still cannot realise prefect coordination of the supply chain; (3 government subsidy and carbon tax policies can promote the cooperation of both the upstream and downstream enterprises of the supply chain—a subsidy policy can always drive energy saving and emissions reductions, while a carbon tax policy does not always exert positive effects, as it depends on the initial level of pollution and the level of carbon tax; and (4 the subsidy policy reduces the coordination efficiency of the supply chain, while the influences of carbon tax policy upon the coordination efficiency relies on the initial carbon-emission level.

  15. Cost-benefit analysis of retrofit of high-intensity discharge factory lighting with energy-saving alternatives

    Energy Technology Data Exchange (ETDEWEB)

    Preston, D.J. [Alabama Industrial Assessment Center, The University of Alabama, 1530 W. Tremont St, Allentown, PA 18102 (United States); Woodbury, K.A. [Alabama Industrial Assessment Center, The University of Alabama, 290 Hardaway Hall, Box 870276, Tuscaloosa, AL 35487-0276 (United States)

    2013-05-15

    Due to increased concern about overall energy costs and the appearance of efficient and inexpensive lighting system alternatives, factories and plants with high-intensity discharge (HID) lighting are forced to consider retrofit with more modern, energy-efficient lighting. The decision is complicated from an economic perspective, and there is a lack of information readily available on the topic. This study provides an analysis of the replacement by retrofit of common probe-start metal halide and high-pressure sodium industrial lighting systems. Retrofit options considered include the more recent pulse-start metal halide lamps and a range of T5 high output and T8 fluorescent lamp configurations. Recent data on lighting system pricing, labor and energy costs, and time required for tasks are reported. The results generated include savings, payback period, and net present value for many retrofit options, as well as the change in energy consumption, carbon footprint, and lumen output for each retrofit. Effects of varying rate of return and daily duration of operation are considered. Based on change in lumen output, payback period, net present value, and comparison of lighting quality, one or two options are recommended from the overall retrofit options considered. A fluorescent retrofit is recommended for each of the HID initial scenarios considered. The payback period is no more than 3 years in any recommended case. The focus of this study is on the potential energy and cost savings, and some proposed solutions may, or may not, be acceptable due to lack of illuminance uniformity.

  16. Evaluation of Naval Aviation Enterprise Airspeed's Generation of Measurable Cost Savings and Reinvestment for Recapitalization of the Future Navy and Marine Corps

    National Research Council Canada - National Science Library

    Williams, Robert J

    2007-01-01

    .... Through the implementation of AIRSpeed, the NAE strives to provide the right amount of readiness at the right cost, so that money can be saved and returned to the Navy and Marine Corps to recapitalize the Fleet...

  17. Evaluation of the cost saving potential of introducing Benepali® and Flixabi® on the European and Italian markets

    Directory of Open Access Journals (Sweden)

    Cristina Negrini

    2017-10-01

    CONCLUSIONS: The introduction of Benepali® and Flixabi® has a substantial cost saving potential for the Italian and European health systems, and the budget impact is sensitive to the uptake rates of the biosimilars market.

  18. Does mitigation save? Reviewing cost-benefit analyses of disaster risk reduction

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

    The benefit-cost-ratio (BCR), used in cost-benefit analysis (CBA), is an indicator that attempts to summarize the overall value for money of a project. Disaster costs continue to rise and the demand has increased to demonstrate the economic benefit of disaster risk reduction (DRR) to policy makers. This study compiles and compares original CBA case studies reporting DRR BCRs, without restrictions as to hazard type, location, scale, or other parameters. Many results were identified supporting ...

  19. A techno-economic analysis of cost savings for retrofitting industrial aerial coolers with variable frequency drives

    International Nuclear Information System (INIS)

    Miller, Patrick; Olateju, Babatunde; Kumar, Amit

    2012-01-01

    Highlights: ► Techno-economic models were developed to assess the retrofitting of aerial coolers. ► The IRR for retrofitting with VFDs exceeds 10% for motor sizes above 20 hp. ► The IRR reaches a maximum of 220% for a cooler with fifty, 250 hp motors. ► The simple payback becomes less than 1 year for motors larger than 120 hp. ► Ambient temperature and location affects the profitability of VFD investment. - Abstract: A techno-economic model was created in order to develop curves that show the typical annual energy savings, rate of return, and payback for retrofitting aerial coolers with variable frequency drives (VFDs) for up to 50 motors, motor sizes from 4 to 186 kW (5–250 hp), and varying climate conditions. The cost savings due to installing a VFD depends on the reduction in energy used, as well as the reduction in power demand, the capital cost of the VFD, installation cost of the VFD, change in operating cost, and cost of electricity. The geographic locations examined in this report were Fort McMurray, Calgary, Vancouver, and Thunder Bay. This study found that the IRR increases rapidly with motor size, becomes greater than 10% at a motor size of approximately 15 kW, and may be as high as 220% (for the case of fifty, 186 kW motors). The IRR is sensitive to the number of fan motors retrofitted with VFDs, however the sensitivity rapidly declines as the number of motors is increased beyond five. The simple payback period becomes less than 1 year and nearly independent of number of motors and motor size for motors larger than 90 kW. Ambient temperature and geographic location affect the profitability of the investment, although the IRR only changes by approximately 4%.

  20. The cost of assisted outpatient treatment: can it save states money?

    Science.gov (United States)

    Swanson, Jeffrey W; Van Dorn, Richard A; Swartz, Marvin S; Robbins, Pamela Clark; Steadman, Henry J; McGuire, Thomas G; Monahan, John

    2013-12-01

    The authors assessed a state's net costs for assisted outpatient treatment, a controversial court-ordered program of community-based mental health services designed to improve outcomes for persons with serious mental illness and a history of repeated hospitalizations attributable to nonadherence with outpatient treatment. A comprehensive cost analysis was conducted using 36 months of observational data for 634 assisted outpatient treatment participants and 255 voluntary recipients of intensive community-based treatment in New York City and in five counties elsewhere in New York State. Administrative, budgetary, and service claims data were used to calculate and summarize costs for program administration, legal and court services, mental health and other medical treatment, and criminal justice involvement. Adjusted effects of assisted outpatient treatment and voluntary intensive services on total service costs were examined using multivariate time-series regression analysis. In the New York City sample, net costs declined 43% in the first year after assisted outpatient treatment began and an additional 13% in the second year. In the five-county sample, costs declined 49% in the first year and an additional 27% in the second year. Psychotropic drug costs increased during the first year after initiation of assisted outpatient treatment, by 40% and 44% in the city and five-county samples, respectively. Regression analyses revealed significant declines in costs associated with both assisted outpatient treatment and voluntary participation in intensive services, although the cost declines associated with assisted outpatient treatment were about twice as large as those seen for voluntary services. Assisted outpatient treatment requires a substantial investment of state resources but can reduce overall service costs for persons with serious mental illness. For those who do not qualify for assisted outpatient treatment, voluntary participation in intensive community

  1. First estimates of the potential cost and cost saving of protecting childhood hearing from damage caused by congenital CMV infection.

    Science.gov (United States)

    Williams, Eleri J; Gray, Joanne; Luck, Suzanne; Atkinson, Claire; Embleton, Nicholas D; Kadambari, Seilesh; Davis, Adrian; Griffiths, Paul; Sharland, Mike; Berrington, Janet E; Clark, Julia E

    2015-11-01

    Congenital cytomegalovirus (cCMV) is an important cause of childhood deafness, which is modifiable if diagnosed within the first month of life. Targeted screening of infants who do not pass their newborn hearing screening tests in England is a feasible approach to identify and treat cases to improve hearing outcome. To conduct a cost analysis of targeted screening and subsequent treatment for cCMV-related sensorineural hearing loss (SNHL) in an, otherwise, asymptomatic infant, from the perspective of the UK National Health Service (NHS). Using data from the newborn hearing screening programme (NHSP) in England and a recent study of targeted screening for cCMV using salivary swabs within the NHSP, we estimate the cost (in UK pounds (£)) to the NHS. The cost of screening (time, swabs and PCR), assessing, treating and following up cases is calculated. The cost per case of preventing hearing deterioration secondary to cCMV with targeted screening is calculated. The cost of identifying, assessing and treating a case of cCMV-related SNHL through targeted cCMV screening is estimated to be £6683. The cost of improving hearing outcome for an infant with cCMV-related SNHL through targeted screening and treatment is estimated at £14 202. The costs of targeted screening for cCMV using salivary swabs integrated within NHSP resulted in an estimate of cost per case that compares favourably with other screening programmes. This could be used in future studies to estimate the full economic value in terms of incremental costs and incremental health benefits. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Saving and costs of a Picture Archiving and Communication System in the Utrecht University Hospital

    NARCIS (Netherlands)

    Andriessen, J.H.T.H.; Haar Romenij, ter B.M.; Barneveld Binkhuysen, F.; Horst - Bruinsma, van der I.E.; Dwyer, S.J.; Jost, R.G.; Schneider, R.H.

    1989-01-01

    The evaluation of the Dutch PACS project comprises amongst other studies a comparison of the direct financial costs of the present conventional system and the PACSystem. This paper shows that the invest-ment costs of a PACSystem are presently substantially higher than of the present system. These

  3. Low-Cost In-Fill Installation for High-Energy-Saving, Dynamic Windows

    Science.gov (United States)

    2017-07-01

    increase 2% annually. This is consistent with national recognized energy prediction models. Electrical Labor costs: Electrical labor cost for wiring...Technology Description: ................................................................................................ 3 2.1.2 Energy Consumption ...22 Figure 15. Energy Consumption for the Calibration Period of 9/2/2015 - 9/16/2015

  4. Cost-Savings Achieved in Two Semesters through the Adoption of Open Educational Resources

    Science.gov (United States)

    Hilton, John Levi, III; Robinson, Jared; Wiley, David; Ackerman, J. Dale

    2014-01-01

    Textbooks represent a significant portion of the overall cost of higher education in the United States. The burden of these costs is typically shouldered by students, those who support them, and the taxpayers who fund the grants and student loans which pay for textbooks. Open educational resources (OER) provide students a way to receive…

  5. The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

    Directory of Open Access Journals (Sweden)

    Nhung Nghiem

    2016-05-01

    Full Text Available Abstract Background A “diet high in sodium” is the second most important dietary risk factor for health loss identified in the Global Burden of Disease Study 2013. We therefore aimed to model health gains and costs (savings of salt reduction interventions related to salt substitution and maximum levels in bread, including by ethnicity and age. We also ranked these four interventions compared to eight other modelled interventions. Methods A Markov macro-simulation model was used to estimate QALYs gained and net health system costs for four dietary sodium reduction interventions, discounted at 3 % per annum. The setting was New Zealand (NZ (2.3 million adults, aged 35+ years which has detailed individual-level administrative cost data. Results The health gain was greatest for an intervention where most (59 % of the sodium in processed foods was replaced by potassium and magnesium salts. This intervention gained 294,000 QALYs over the remaining lifetime of the cohort (95 % UI: 238,000 to 359,000; 0.13 QALY per 35+ year old. Such salt substitution also produced the highest net cost-savings of NZ$ 1.5 billion (US$ 1.0 billion (95 % UI: NZ$ 1.1 to 2.0 billion. All interventions generated relatively larger per capita QALYs for men vs women and for the indigenous Māori population vs non-Māori (e.g., 0.16 vs 0.12 QALYs per adult for the 59 % salt substitution intervention. Of relevance to workforce productivity, in the first 10 years post-intervention, 22 % of the QALY gain was among those aged <65 years (and 37 % for those aged <70. Conclusions The benefits are consistent with the international literature, with large health gains and cost savings possible from some, but not all, sodium reduction interventions. Health gain appears likely to occur among working-age adults and all interventions contributed to reducing health inequalities.

  6. Impact of five years of rotavirus vaccination in Finland - And the associated cost savings in secondary healthcare.

    Science.gov (United States)

    Leino, Tuija; Baum, Ulrike; Scott, Peter; Ollgren, Jukka; Salo, Heini

    2017-10-09

    This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme. The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999-2005) and after (2010-2014) the start of the programme among children less than five years of age. The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%-94.5%) in hospitalised RVGE and 68.5% (66.6%-70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%-96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%-9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child. The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Energy Savings Lifetimes and Persistence

    Energy Technology Data Exchange (ETDEWEB)

    Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steven R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-02-01

    This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from a national collection of costs and savings for electric efficiency programs and portfolios.

  8. Energy Savings Potential and Research, Development, & Demonstration Opportunities for Residential Building Heating, Ventilation, and Air Conditioning Systems

    Energy Technology Data Exchange (ETDEWEB)

    Goetzler, William [Navigant Consulting, Inc., Burlington, MA (United States); Zogg, Robert [Navigant Consulting, Inc., Burlington, MA (United States); Young, Jim [Navigant Consulting, Inc., Burlington, MA (United States); Schmidt, Justin [Navigant Consulting, Inc., Burlington, MA (United States)

    2012-10-01

    This report is an assessment of 135 different heating, ventilation, and air-conditioning (HVAC) technologies for U.S. residential buildings to identify and provide analysis on 19 priority technology options in various stages of development. The analyses include an estimation of technical energy-savings potential, descriptions of technical maturity, descriptions of non-energy benefits, descriptions of current barriers for market adoption, and descriptions of the technology's applicability to different building or HVAC equipment types. From these technology descriptions, are suggestions for potential research, development and demonstration (RD&D) initiatives that would support further development of the priority technology options.

  9. Energy Savings Potential and Research, Development, & Demonstration Opportunities for Commercial Building Heating, Ventilation, and Air Conditioning Systems

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-09-01

    This report covers an assessment of 182 different heating, ventilation, and air-conditioning (HVAC) technologies for U.S. commercial buildings to identify and provide analysis on 17 priority technology options in various stages of development. The analyses include an estimation of technical energy-savings potential, description of technical maturity, description of non-energy benefits, description of current barriers for market adoption, and description of the technology’s applicability to different building or HVAC equipment types. From these technology descriptions, are suggestions for potential research, development and demonstration (RD&D) initiatives that would support further development of the priority technology options.

  10. The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

    Directory of Open Access Journals (Sweden)

    Annie L. Andrews

    2012-01-01

    Full Text Available Objective. To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. Methods. Using 2009 South Carolina (SC Medicaid birth cohort (n=29,316, we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. Results. Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. Conclusions. For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

  11. Ecosystem services and opportunity costs shift spatial priorities for conserving forest biodiversity.

    Directory of Open Access Journals (Sweden)

    Matthias Schröter

    Full Text Available Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone or partially restricted (partial use zone. Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2% and the non-use zone (+3.2%. Furthermore, opportunity costs increased (+6.6%, which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1% of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%.

  12. Ecosystem Services and Opportunity Costs Shift Spatial Priorities for Conserving Forest Biodiversity

    Science.gov (United States)

    Schröter, Matthias; Rusch, Graciela M.; Barton, David N.; Blumentrath, Stefan; Nordén, Björn

    2014-01-01

    Inclusion of spatially explicit information on ecosystem services in conservation planning is a fairly new practice. This study analyses how the incorporation of ecosystem services as conservation features can affect conservation of forest biodiversity and how different opportunity cost constraints can change spatial priorities for conservation. We created spatially explicit cost-effective conservation scenarios for 59 forest biodiversity features and five ecosystem services in the county of Telemark (Norway) with the help of the heuristic optimisation planning software, Marxan with Zones. We combined a mix of conservation instruments where forestry is either completely (non-use zone) or partially restricted (partial use zone). Opportunity costs were measured in terms of foregone timber harvest, an important provisioning service in Telemark. Including a number of ecosystem services shifted priority conservation sites compared to a case where only biodiversity was considered, and increased the area of both the partial (+36.2%) and the non-use zone (+3.2%). Furthermore, opportunity costs increased (+6.6%), which suggests that ecosystem services may not be a side-benefit of biodiversity conservation in this area. Opportunity cost levels were systematically changed to analyse their effect on spatial conservation priorities. Conservation of biodiversity and ecosystem services trades off against timber harvest. Currently designated nature reserves and landscape protection areas achieve a very low proportion (9.1%) of the conservation targets we set in our scenario, which illustrates the high importance given to timber production at present. A trade-off curve indicated that large marginal increases in conservation target achievement are possible when the budget for conservation is increased. Forty percent of the maximum hypothetical opportunity costs would yield an average conservation target achievement of 79%. PMID:25393951

  13. Economics of a small wind pump system based on estimated petrol and diesel cost savings from use in Northern Nigeria

    Directory of Open Access Journals (Sweden)

    C. J. Ejieji

    2013-08-01

    Full Text Available Eleven years of daily wind records were analyzed for the estimation of available wind energy for water pumping at three selected locations in Northern Nigeria, namely Jos, Kano and Sokoto. This formed the basis for investigating the economics of the use of an imported small wind pump under a deregulated energy market environment. The estimated available energy for water pumping at the installation height of 9m was 190 kwh/m2/yr for Jos, 225 kwh/m2/yr for Kano and 348 kwh/m2/yr for Sokoto. The monetary value of the available wind energy was considered as saved energy cost. The saved cost was obtained in terms of the unsubsidized cost of the petrol and diesel that an internal combustion engine (ICE would consume to produce energy equivalent to the available wind energy. At the prevailing interest and inflation rates of 21.96 % and 12.1% respectively, and unsubsidized prices of N 131.32/l and N 140.23/l for petrol and diesel respectively, investment in the wind pump was not found to be economically competitive relative to using a pump with ICE prime mover at the three locations unless the cost of the pump was subsidized. For Sokoto, the estimated subsidy for initial cost of the wind pump required for the investment to be competitive relative to the use of a pump driven by a petrol ICE was 16%. Relative to a pump driven by a diesel ICE, the required subsidy was 24%. The corresponding subsidy estimates for Kano were 48 % and 51 % respectively. For Jos, it was 56% relative to the use of a pump driven by a petrol ICE and 60 % relative to that driven by a diesel ICE. Considering the potential environmental and social and environmental benefits however, subsidy support by government for local manufacturing of the pumps was recommended since shipping cost and custom tariff constituted over 36% of the initial cost of the wind pump.

  14. Estimating the opportunity costs of activities that cause degradation in tropical dry forest: Implications for REDD +

    NARCIS (Netherlands)

    Borrego, Armonia; Skutsch, Margaret

    2014-01-01

    The viability of national REDD + programs will depend in part on whether funds generated from sales of carbon credits are sufficient to cover the opportunity costs (OC) of forgone uses of the forest. We present the results of a study in which OC were estimated in dry tropical forest, in western

  15. FIA BioSum: a tool to evaluate financial costs, opportunities and effectiveness of fuel treatments.

    Science.gov (United States)

    Jeremy Fried; Glenn. Christensen

    2004-01-01

    FIA BioSum, a tool developed by the USDA Forest Services Forest Inventory and Analysis (FIA) Program, generates reliable cost estimates, identifies opportunities and evaluates the effectiveness of fuel treatments in forested landscapes. BioSum is an analytic framework that integrates a suite of widely used computer models with a foundation of attribute-rich,...

  16. Comments on "Opportunity Cost: A Reexamination": A Case in Point of No Free Lunch

    Science.gov (United States)

    Stone, Daniel F.

    2016-01-01

    Ferraro and Taylor (2005) and Potter and Sanders (2012) have sparked a debate about the definition of opportunity cost (OC). This is, of course, ostensibly a very basic term, but Ferraro and Taylor said that most economists do not readily know its correct definition, and Potter and Sanders argued that this can be explained by the fact that there…

  17. Assessing the opportunity cost of implementing streamside management zone guidelines in eastern hardwood forests

    Science.gov (United States)

    Chris B. LeDoux

    2006-01-01

    Forest landowners, managers, loggers, land-use planners, and other decision/policy makers need to understand the opportunity cost associated with different levels of allowable management and required/voluntary protection in streamside management zones (SMZs). Four different logging technologies, two mature hardwood stands, three levels of streamside zone protection,...

  18. Dry Kraft Pulping at Ambient Pressure for Cost Effective Energy Saving and Pollution Deduction

    Energy Technology Data Exchange (ETDEWEB)

    Yulin Deng; Art Ragauskas

    2012-08-28

    evaporated first under vacuum condition at low temperature. Then, the dry woodchips were baked at high temperature (120-130 C) at atmospheric pressure. The qualities of the pulp made with this method were improved compared to that made with method one. The pulp shows higher brightness and lower bulk than Kraft pulping. The tensile strength is significantly higher than the pulp made from the first method. Although the pulp is stronger than that of TMP pulp, it is still lower than conventional Kraft fiber. Method Three: The third dry method was done in a Kraft pulping digester at elevated pressure but without free liquid in the digester. With this method, pulp that has almost the same qualities as conventional Kraft pulp could be produced. The screen yield, Kappa number, fiber brightness, pulp strength and pulp bulk are almost identical to the conventional Kraft pulp. The key advantages of this dry pulping method include ca. 55 % of cooking energy saved during the pulping process, as high as 50 wt% of NaOH saving as well as 3 wt% of Na2S saving comparing to Kraft one. By analyzing fiber properties, yields, chemical and energy consumptions, we concluded that the dry pulping method based on Liquid Free Chemical Pulping, LFCP, could be very attractive for the pulp and paper industry. More fundamental studies and scale up trials are needed to fully commercialize the technology. We expect to conduct pilot trials between 12 to 24 months of period if the DOE or industry can provide continual research funding. Based on the technology we demonstrated in this report, several pilot trial facilities in the United States will be available after small modifications. For example, the Herty Foundation in Savannah, Georgia is one of these potential locations. DOE funding for continuous study and final lead to commercialization of the technique is important.

  19. Seatbelt use to save money: Impact on hospital costs of occupants who are involved in motor vehicle crashes.

    Science.gov (United States)

    Han, Guang-Ming; Newmyer, Ashley; Qu, Ming

    2017-03-01

    Seatbelt use is the single most effective way to save lives in motor vehicle crashes (MVC). However, although safety belt laws have been enacted in many countries, seatbelt usage throughout the world remains below optimal levels, and educational interventions may be needed to further increase seatbelt use. In addition to reducing crash-related injuries and deaths, reduced medical expenditures resulting from seatbelt use are an additional benefit that could make such interventions cost-effective. Accordingly, the objective of this study was to estimate the correlation between seatbelt use and hospital costs of injuries involved in MVC. The data used in this study were from the Nebraska CODES database for motor vehicle crashes that occurred between 2004 and 2013. The hospital cost information and information about other factors were obtained by linking crash reports with hospital discharge data. A multivariable regression model was performed for the association between seatbelt use and hospital costs. Mean hospital costs were significantly lower among motor vehicle occupants using a lap-shoulder seatbelt ($2909), lap-only seatbelt ($2289), children's seatbelt ($1132), or booster ($1473) when compared with those not using any type of seatbelt ($7099). After adjusting for relevant factors, there were still significantly decreased hospital costs for motor vehicle occupants using a lap-shoulder seatbelt (84.7%), lap-only seatbelt (74.1%), shoulder-only seatbelt (40.6%), children's seatbelt (95.9%), or booster (82.8%) compared to those not using a seatbelt. Seatbelt use is significantly associated with reduced hospital costs among injured MVC occupants. The findings in this study will provide important educational information for emergency department nurses who can encourage safety belt use for vehicle occupants. Copyright © 2016. Published by Elsevier Ltd.

  20. Lost opportunity cost of surgical training in the Australian private sector.

    Science.gov (United States)

    Aitken, R James

    2012-03-01

    To meet Australia's future demands, surgical training in the private sector will be required. The aim of this study was to estimate the time and lost opportunity cost of training in the private sector. A literature search identified studies that compared the operation time required by a supervised trainee with a consultant. This time was costed using a business model. In 22 studies (34 operations), the median operation duration of a supervised trainee was 34% longer than the consultant. To complete a private training list in the same time as a consultant list, one major case would have to be dropped. A consultant's average lost opportunity cost was $1186 per list ($106,698 per year). Training in rooms and administration requirements increased this to $155,618 per year. To train 400 trainees in the private sector to college standards would require 54,000 training lists per year. The consultants' national lost opportunity cost would be $137 million per year. The average lost hospital case payment was $5894 per list, or $330 million per year nationally. The total lost opportunity cost of surgical training in the private sector would be about $467 million per year. When trainee salaries, other specialties and indirect expenses are included, the total cost will be substantially greater. It is unlikely that surgeons or hospitals will be prepared to absorb these costs. There needs to be a public debate about the funding implications of surgical training in the private sector. © 2012 The Author. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  1. Evaluating C-RAN Fronthaul Functional Splits in Terms of Network Level Energy and Cost Savings

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Popovska Avramova, Andrijana; Berger, Michael Stübert

    2016-01-01

    The placement of the complete baseband processing in a centralized pool results in high data rate requirement and inflexibility of the fronthaul network, which challenges the energy and cost effectiveness of the cloud radio access network (C-RAN). Recently, redesign of the C-RAN through functional...... split in the baseband processing chain has been proposed to overcome these challenges. This paper evaluates, by mathematical and simulation methods, different splits with respect to network level energy and cost efficiency having in the mind the expected quality of service.The proposed mathematical...... model quantifies the multiplexing gains and the trade-offs between centralization and decentralization concerning the cost of the pool, fronthaul network capacity and resource utilization. The event-based simulation captures the influence of the traffic load dynamics and traffic type variation...

  2. Cardiovascular Magnetic Resonance Imaging-Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study.

    Science.gov (United States)

    Hegde, Vinayak A; Biederman, Robert Ww; Mikolich, J Ronald

    2017-01-01

    This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

  3. Saving Money On Meds Cut your Rx costs with these tips.

    Science.gov (United States)

    Calandra, Robert

    2016-11-01

    With insurance deductibles and co-pays rising for some prescription medications and supplies, staying healthy is becoming more expensive for people with diabetes. But there are ways to trim costs without skimping on necessities. Start by being proactive and candid with your providers. Let your doctor, pharmacist, and diabetes educator know if there was an unexpected increase in your co-pay or if you need help paying for your prescriptions and supplies. They might point you toward free samples, discount coupons, and vouchers offered by pharmaceutical companies and device manufacturers. Read on for other cost- cutting tips.

  4. An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

    Science.gov (United States)

    Pyenson, Bruce S; Sander, Marcia S; Jiang, Yiding; Kahn, Howard; Mulshine, James L

    2012-04-01

    Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars. The cost per life-year saved would be below $19,000, an amount that compares favorably with screening for cervical, breast, and colorectal cancers. Our results suggest that commercial insurers should consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least fifty years old and have a smoking history of thirty pack-years or more. We also believe that payers and patients should demand screening from high-quality, low-cost providers, thus helping set an example of efficient system innovation.

  5. Estimation of avoidable skin cancers and cost-savings to government associated with regulation of the solarium industry in Australia.

    Science.gov (United States)

    Hirst, Nicholas; Gordon, Louisa; Gies, Peter; Green, Adèle C

    2009-03-01

    In Australia there is growing concern about the expanding solarium industry, and the additive effect of persons seeking exposure to artificial ultraviolet radiation (UVR) against already intense background levels of solar UVR. We estimated the numbers of potential skin cancers prevented through regulation of solaria and the associated cost-savings to the Federal Government. A lifetime decision-analytic model was created using relative risk estimates based on a meta-analysis of the literature assessing the link between skin cancer risk and solarium use. The costs were limited to those incurred by Medicare Australia, for the medical care of individuals treated for skin cancer. With stricter regulations, we estimated between 18 and 31 melanomas, 200-251 squamous cell carcinomas and associated costs of $AU 256,054 would be avoided per 100,000 persons. Our base findings were sensitive to estimates for prevalence of use, skin cancer risk and discounting rates. Continued growth in the Australian solarium industry is likely to inflate the already substantial skin cancer burden. Subject to some limitations, our study indicates that by successfully enforcing solarium regulations to prohibit use by minors and by those with fair skin colour, the Federal Government could expect favourable cost and health benefits.

  6. Crowdsourcing healthcare costs: Opportunities and challenges for patient centered price transparency.

    Science.gov (United States)

    Meisel, Zachary F; VonHoltz, Lauren A Houdek; Merchant, Raina M

    2016-03-01

    Efforts to improve health care price transparency have garnered significant attention from patients, policy makers, and health insurers. In response to increasing consumer demand, state governments, insurance plans, and health care providers are reporting health care prices. However, such data often do not provide consumers with the most salient information: their own actual out-of-pocket cost for medical care. Although untested, crowdsourcing, a mechanism for the public to help answer complex questions, represents a potential solution to the problem of opaque hospital costs. This article explores, the challenges and potential opportunities for crowdsourcing out-of-pocket costs for healthcare consumers. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

    Science.gov (United States)

    Peters, Ray DeV; Petrunka, Kelly; Khan, Shahriar; Howell-Moneta, Angela; Nelson, Geoffrey; Pancer, S Mark; Loomis, Colleen

    2016-02-01

    This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

  8. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-04-13

    Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

  9. How to save costs by reducing unnecessary testing: Lean thinking in clinical practice

    NARCIS (Netherlands)

    Vegting, I.L.; van Beneden, M.; Kramer, M.H.H.; Thijs, A.; Kostense, P.J.; Nanayakkara, P.W.B.

    2012-01-01

    Background: The burden of health care expenditure on national budgets has increased dramatically over the past decade. A pilot study in our hospital demonstrated that many unnecessary diagnostic tests were performed routinely. The aim of this study was to reduce the costs of unnecessary diagnostic

  10. Holistic impact assessment and cost savings of rainwater harvesting at the watershed scale

    Science.gov (United States)

    We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH) systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S.) using life cycle assessment (LCA) and life cycle cost assessment. Life cycle impact assessment (LCIA) categori...

  11. Modeling fuel treatment impacts on fire suppression cost savings: A review

    Science.gov (United States)

    Matthew P. Thompson; Nathaniel M. Anderson

    2015-01-01

    High up-front costs and uncertain return on investment make it difficult for land managers to economically justify large-scale fuel treatments, which remove trees and other vegetation to improve conditions for fire control, reduce the likelihood of ignition, or reduce potential damage from wildland fire if it occurs. In the short-term, revenue from harvested forest...

  12. Cost-benefit of energy saving in bioclimatic designs; Costo-beneficio del ahorro de energia en los disenos bioclimatios

    Energy Technology Data Exchange (ETDEWEB)

    Lopez P, J. Manuel A. [Doble dos soluciones de Negocios (Mexico); Morillon G, David; Rdriguez V, Luis [Universidad Autonoma de Mexico (Mexico)

    2001-06-01

    Tools and criteria for Cost-Benefit Analysis (ACB) of energy saving in bioclimatic designs (DB) are presented, for which a reference project is established. Based on the traditional design of air conditioning of a building and with the support of this one, the estimation of costs and benefits of the same building is made; but with passive systems. The tools used consider related resources such as time and money. Criteria are used such as: Present value (VP), Equivalent Annual Cost (EAC) and the Cost of the conserved Energy (CEC). The costs related to the construction, maintenance and operation of the design are taken into consideration. The differences between the design of reference and the Bioclimatic Design, established from the application of these criteria, allow evaluating the economic margin as far as operation and maintenance. Finally, the cost of the conserved energy of the bioclimatic measures is evaluated as an initiative for energy saving and calculates the present value from them in all of the period of useful life of the bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio (ACB) del ahorro de energia en los disenos bioclimaticos (DB), para lo cual se establece un proyecto de referencia. Basado en el diseno tradicional de la climatizacion de un edificio y con apoyo en este, se realiza la estimacion de costos y beneficios del mismo edificio; pero con sistema pasivos. Las herramientas usadas consideran recursos relacionados como son tiempo y dinero. Se usan criterios tales como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia conservada (CEC). Se toman en consideracion los costos relacionados con la construccion, mantenimiento y operacion del diseno. Las diferencias entre el diseno de referencia y el Diseno Bioclimatico, establecidas a partir de la aplicacion de estos criterios, permiten evaluar el margen economico en cuanto a la operacion y el mantenimiento. Finalmente, se

  13. An energy-saving opportunity in producing lubricating oil using mixed-solventin simulated Rotary Disc Contacting (RDC) extraction tower

    Energy Technology Data Exchange (ETDEWEB)

    Hatamipour, M.S.; Fakhr Hoseini, S.M.; Tavakkoli, T.; Mehrkesh, A.H. [Chemical Engineering Department, University of Isfahan, Isfahan (Iran)

    2010-05-15

    Industrial processes are the most energy consuming processes in the world. Modification of these processes helps us with controlling the consumption of energy and minimizing energy loss. Changing raw materials is one of the ways through which we can optimize industrial processes. In this paper, a new solvent mixture (furfural + a co-solvent) was used for the extraction of lubricating base oil from lube-oil cut. It was found that the energy consumption of the new solvent mixture for obtaining a product with the same quality was much lower than the original solvent. By using this new solvent mixture, the operating temperature of the top of tower was reduced by 30 K. This leads to a high reduction in energy consumption in extraction of aromatics from lube oil. At our new extraction process by means of using new solvent mixture, the maximum energy saving was 38% per cubic meter of produced raffinate. (author)

  14. Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines.

    Science.gov (United States)

    Singer, Lauren; Brown, Eric; Lanni, Thomas

    2016-08-01

    In this study, we compare the indications for re-excision, the findings of additional tumor in the re-excision specimen as they relate to margin status, and costs associated with re-excision based on recent new consensus statements. A retrospective analysis was performed on 462 patients with invasive breast carcinoma who underwent at least one lumpectomy between January 2011 and December 2013. Postoperative data was analyzed based on where additional disease was found, as it relates to the margin status of the initial lumpectomy and the additional direct costs associated with additional procedures. Of the 462 patients sampled, 149 underwent a re-excision surgery (32.2%). Four patients underwent mastectomy as their second operation. In the 40 patients with additional disease found on re-excision, 36 (90.0%) of them had a positive margin on their initial lumpectomy. None of the four mastectomy patients had residual disease. The mean cost of the initial lumpectomy for all 462 patients was $2118.01 plus an additional $1801.92 for those who underwent re-excision. A positive margin was most predictive of finding residual tumor on re-excision as would be expected. Using old criteria only 0.07% (4/61) of patients who had undergone re-excision with a 'clear' margin, had additional tumor found, at a total cost of $106,354.11. Thus, the new consensus guidelines will lead to less overall cost, at no clinical risk to patients while reducing a patient's surgical risk and essentially eliminating delays in adjuvant care. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. [Variability and opportunity costs among the surgical alternatives for breast cancer].

    Science.gov (United States)

    Angulo-Pueyo, Ester; Ridao-López, Manuel; Martínez-Lizaga, Natalia; García-Armesto, Sandra; Bernal-Delgado, Enrique

    2014-01-01

    To analyze medical practice variation in breast cancer surgery (either inpatient-based or day-case surgery), by comparing conservative surgery (CS) plus radiotherapy vs. non-conservative surgery (NCS). We also analyzed the opportunity costs associated with CS and NCS. We performed an observational study of age- and sex-standardized rates of CS and NCS, performed in 199 Spanish healthcare areas in 2008-2009. Costs were calculated by using two techniques: indirectly, by using All-Patients Diagnosis Related Groups (AP-DRG) based on hospital admissions, and directly by using full costing from the Spanish Network of Hospital Costs (SNHC) data. Standardized surgery rates for CS and NCS were 6.84 and 4.35 per 10,000 women, with variation across areas ranging from 2.95 to 3.11 per 10,000 inhabitants. In 2009, 9% of CS was performed as day-case surgery, although a third of the health care areas did not perform this type of surgery. Taking the SNHC as a reference, the cost of CS was estimated at 7,078 € and that of NCS was 6,161 €. Using AP-DRG, costs amounted to 9,036 € and 8,526 €, respectively. However, CS had lower opportunity costs than NCS when day-case surgery was performed frequently-more than 46% of cases (following SNHC estimates) or 23% of cases (following AP-DRG estimates). Day-case CS for breast cancer was found to be the best option in terms of opportunity-costs beyond a specific threshold, when both CS and NCS are elective. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  16. [Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan].

    Science.gov (United States)

    Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

    2012-01-01

    DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year.

  17. Improving the thermal integrity of new single-family detached residential buildings: Documentation for a regional database of capital costs and space conditioning load savings

    International Nuclear Information System (INIS)

    Koomey, J.G.; McMahon, J.E.; Wodley, C.

    1991-07-01

    This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole

  18. Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan

    International Nuclear Information System (INIS)

    Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

    2012-01-01

    DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year. (author)

  19. Waste Minimization Improvements Achieved Through Six Sigma Analysis Result In Significant Cost Savings

    International Nuclear Information System (INIS)

    Mousseau, Jeffrey D.; Jansen, John R.; Janke, David H.; Plowman, Catherine M.

    2003-01-01

    Improved waste minimization practices at the Department of Energy's (DOE) Idaho National Engineering and Environmental Laboratory (INEEL) are leading to a 15% reduction in the generation of hazardous and radioactive waste. Bechtel, BWXT Idaho, LLC (BBWI), the prime management and operations contractor at the INEEL, applied the Six Sigma improvement process to the INEEL Waste Minimization Program to review existing processes and define opportunities for improvement. Our Six Sigma analysis team: composed of an executive champion, process owner, a black belt and yellow belt, and technical and business team members used this statistical based process approach to analyze work processes and produced ten recommendations for improvement. Recommendations ranged from waste generator financial accountability for newly generated waste to enhanced employee recognition programs for waste minimization efforts. These improvements have now been implemented to reduce waste generation rates and are producing positive results

  20. DOD Civilian and Contractor Workforces: Additional Cost Savings Data and Efficiencies Plan are Needed

    Science.gov (United States)

    2016-10-01

    Enterprise-wide Contractor Manpower Reporting Application (ECMRA) across all its components, and which will continue to improve reporting of...costs: Not applicable yes (estimated) no (estimated) Source: GAO analysis of DOD’s February 2016 status report | GAO-17-128 aNumber of...and interviewed DOD officials. What GAO Recommends GAO previously recommended that DOD fully address ongoing section 955 requirements, such as

  1. Server Operation and Virtualization to Save Energy and Cost in Future Sustainable Computing

    Directory of Open Access Journals (Sweden)

    Jun-Ho Huh

    2018-06-01

    Full Text Available Since the introduction of the LTE (Long Term Evolution service, we have lived in a time of expanding amounts of data. The amount of data produced has increased every year with the increase of smart phone distribution in particular. Telecommunication service providers have to struggle to secure sufficient network capacity in order to maintain quick access to necessary data by consumers. Nonetheless, maintaining the maximum capacity and bandwidth at all times requires considerable cost and excessive equipment. Therefore, to solve such a problem, telecommunication service providers need to maintain an appropriate level of network capacity and to provide sustainable service to customers through a quick network development in case of shortage. So far, telecommunication service providers have bought and used the network equipment directly produced by network equipment manufacturers such as Ericsson, Nokia, Cisco, and Samsung. Since the equipment is specialized for networking, which satisfied consumers with their excellent performances, they are very costly because they are developed with advanced technologies. Moreover, it takes much time due to the purchase process wherein the telecommunication service providers place an order and the manufacturer produces and delivers. Accordingly, there are cases that require signaling and two-way data traffic as well as capacity because of the diversity of IoT devices. For these purposes, the need for NFV (Network Function Virtualization is raised. Equipment virtualization is performed so that it is operated on an x86-based compatible server instead of working on the network equipment manufacturer’s dedicated hardware. By operating in some compatible servers, it can reduce the wastage of hardware and cope with the change thanks to quick hardware development. This study proposed an efficient system of reducing cost in network server operation using such NFV technology and found that the cost was reduced by 24

  2. Using time-driven activity-based costing to identify value improvement opportunities in healthcare.

    Science.gov (United States)

    Kaplan, Robert S; Witkowski, Mary; Abbott, Megan; Guzman, Alexis Barboza; Higgins, Laurence D; Meara, John G; Padden, Erin; Shah, Apurva S; Waters, Peter; Weidemeier, Marco; Wertheimer, Sam; Feeley, Thomas W

    2014-01-01

    As healthcare providers cope with pricing pressures and increased accountability for performance, they should be rededicating themselves to improving the value they deliver to their patients: better outcomes and lower costs. Time-driven activity-based costing offers the potential for clinicians to redesign their care processes toward that end. This costing approach, however, is new to healthcare and has not yet been systematically implemented and evaluated. This article describes early time-driven activity-based costing work at several leading healthcare organizations in the United States and Europe. It identifies the opportunities they found to improve value for patients and demonstrates how this costing method can serve as the foundation for new bundled payment reimbursement approaches.

  3. The opportunity cost of family labor in the economy of the dairy production in Michoacan, Mexico

    Directory of Open Access Journals (Sweden)

    Randy Alexis Jiménez Jiménez

    2014-05-01

    Full Text Available The objective of this research is to analyze associated factors with the variation of the profit margin and the influence of the opportunity cost of family labor in the economic profit of the family dairy in the municipality of Maravatio, Michoacan. Productive economic information was obtained through the use of questionnaires, semi-structured interviews and direct observation, using the methodology of Participatory Action Research. The opportunity cost of workforce was established on the basis of the work options for the family members involved in the activity; the options were classified into three types: local, regional, and foreign, according to the location of the job opportunities. In order to determine the influence of family labor in earning, it was used a multiple regression model with inclusion of step-by-step variables. The livestock feed represented the highest index of determination of the profit margin variation with the 68 %. Family labor is one of the variables that have an adverse impact on the profitability of the production units, it represented 26% of the variation of economic gain, with a negative linear relation of -1.05 (P ≤0.001. The best labor alternatives for producers, when emigrating, show that family labor is not the productive factor allowing them to have earnings; however, the dairy activity provides productive and economic sustenance for people with a local and regional opportunity cost.

  4. Cost-Related Medication Nonadherence and Cost-Saving Behaviors Among Patients With Glaucoma Before and After the Implementation of Medicare Part D.

    Science.gov (United States)

    Blumberg, Dana M; Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; De Moraes, C Gustavo

    2015-09-01

    Understanding factors that lead to nonadherence to glaucoma treatment is important to diminish glaucoma-related disability. To determine whether the implementation of the Medicare Part D prescription drug benefit affected rates of cost-related nonadherence and cost-reduction strategies in Medicare beneficiaries with and without glaucoma and to evaluate associated risk factors for such nonadherence. Serial cross-sectional study using 2004 to 2009 Medicare Current Beneficiary Survey data linked with Medicare claims. Coding to extract data started in January 2014 and analyses were performed between September and November of 2014. Participants were all Medicare beneficiaries, including those with a glaucoma-related diagnosis in the year prior to the collection of the survey data, those with a nonglaucomatous ophthalmic diagnosis in the year prior to the collection of the survey data, and those without a recent eye care professional claim. Effect of the implementation of the Medicare Part D drug benefit. The change in cost-related nonadherence and the change in cost-reduction strategies. Between 2004 and 2009, the number of Medicare beneficiaries with glaucoma who reported taking smaller doses and skipping doses owing to cost dropped from 9.4% and 8.2% to 2.7% (P cost did not improve in the same period (3.4% in 2004 and 2.1% in 2009; P = .12). After Part D, patients with glaucoma had a decrease in several cost-reduction strategies, namely price shopping (26.2%-15.2%; P cost-related nonadherence measures were female sex, younger age, lower income (implementation of Part D, there was a decrease in the rate that beneficiaries with glaucoma reported engaging in cost-saving measures. Although there was a decline in the rate of several cost-related nonadherence behaviors, patients reporting failure to fill prescriptions owing to cost remained stable. This suggests that efforts to improve cost-related nonadherence should focus both on financial hardship and medical

  5. A cost-saving statistically based screening technique for focused sampling of a lead-contaminated site

    International Nuclear Information System (INIS)

    Moscati, A.F. Jr.; Hediger, E.M.; Rupp, M.J.

    1986-01-01

    High concentrations of lead in soils along an abandoned railroad line prompted a remedial investigation to characterize the extent of contamination across a 7-acre site. Contamination was thought to be spotty across the site reflecting its past use in battery recycling operations at discrete locations. A screening technique was employed to delineate the more highly contaminated areas by testing a statistically determined minimum number of random samples from each of seven discrete site areas. The approach not only quickly identified those site areas which would require more extensive grid sampling, but also provided a statistically defensible basis for excluding other site areas from further consideration, thus saving the cost of additional sample collection and analysis. The reduction in the number of samples collected in ''clean'' areas of the site ranged from 45 to 60%

  6. Program Potential: Estimates of Federal Energy Cost Savings from Energy Efficient Procurement

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Margaret [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fujita, K. Sydny [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-09-17

    In 2011, energy used by federal buildings cost approximately $7 billion. Reducing federal energy use could help address several important national policy goals, including: (1) increased energy security; (2) lowered emissions of greenhouse gases and other air pollutants; (3) increased return on taxpayer dollars; and (4) increased private sector innovation in energy efficient technologies. This report estimates the impact of efficient product procurement on reducing the amount of wasted energy (and, therefore, wasted money) associated with federal buildings, as well as on reducing the needless greenhouse gas emissions associated with these buildings.

  7. Monitored retrievable storage and multi-purpose canister robotic applications: Feasibility, dose savings and cost analysis

    International Nuclear Information System (INIS)

    Bennett, P.C.

    1995-01-01

    Robotic automation is examined as a possible alternative to manual spent nuclear fuel, transport cask and Multi-Purpose Canister (MPC) handling at a Monitored Retrievable Storage (MRS) facility, and as an alternative to current MPC closure and welding methods at commercial nuclear reactor sites. Automation of key operational aspects is analyzed to determine equipment requirements, through-put times and equipment costs. The economic analysis approach is described, and economic and radiation dose impacts resulting from this automation are compared to manual handling methods. (author). 5 refs, 5 figs, 3 tabs

  8. Designing Green Networks and Network Operations Saving Run-the-Engine Costs

    CERN Document Server

    Minoli, Daniel

    2011-01-01

    In recent years the confluence of socio-political trends toward environmental responsibility and the pressing need to reduce Run-the-Engine (RTE) costs has given birth to a nascent discipline of Green IT. A clear and concise introduction to green networks and green network operations, this book examines analytical measures and discusses virtualization, network computing, and web services as approaches for green data centers and networks. It identifies some strategies for green appliance and end devices and examines the methodical steps that can be taken over time to achieve a seamless migratio

  9. Minimizing opportunity costs to aquatic connectivity restoration while controlling an invasive species.

    Science.gov (United States)

    Milt, Austin W; Diebel, Matthew W; Doran, Patrick J; Ferris, Michael C; Herbert, Matthew; Khoury, Mary L; Moody, Allison T; Neeson, Thomas M; Ross, Jared; Treska, Ted; O'Hanley, Jesse R; Walter, Lisa; Wangen, Steven R; Yacobson, Eugene; McIntyre, Peter B

    2018-03-08

    Controlling invasive species is critical for conservation but can have unintended consequences for native species and divert resources away from other efforts. This dilemma occurs on a grand scale in the North American Great Lakes, where dams and culverts block tributary access to habitat of desirable fish species and are a lynchpin of long-standing efforts to limit ecological damage inflicted by the invasive, parasitic sea lamprey (Petromyzon marinus). Habitat restoration and sea-lamprey control create conflicting goals for managing aging infrastructure. We used optimization to minimize opportunity costs of habitat gains for 37 desirable migratory fishes that arose from restricting sea lamprey access (0-25% increase) when selecting barriers for removal under a limited budget (US$1-105 million). Imposing limits on sea lamprey habitat reduced gains in tributary access for desirable species by 15-50% relative to an unconstrained scenario. Additional investment to offset the effect of limiting sea-lamprey access resulted in high opportunity costs for 30 of 37 species (e.g., an additional US$20-80 million for lake sturgeon [Acipenser fulvescens]) and often required ≥5% increase in sea-lamprey access to identify barrier-removal solutions adhering to the budget and limiting access. Narrowly distributed species exhibited the highest opportunity costs but benefited more at less cost when small increases in sea-lamprey access were allowed. Our results illustrate the value of optimization in limiting opportunity costs when balancing invasion control against restoration benefits for diverse desirable species. Such trade-off analyses are essential to the restoration of connectivity within fragmented rivers without unleashing invaders. © 2018 Society for Conservation Biology.

  10. Energy and Energy Cost Savings Analysis of the IECC for Commercial Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian; Athalye, Rahul A.; Hart, Philip R.; Rosenberg, Michael I.; Xie, YuLong; Goel, Supriya; Mendon, Vrushali V.; Liu, Bing

    2013-08-30

    The purpose of this analysis is to assess the relative energy and energy cost performance of commercial buildings designed to meet the requirements found in the commercial energy efficiency provisions of the International Energy Conservation Code (IECC). Section 304(b) of the Energy Conservation and Production Act (ECPA), as amended, requires the Secretary of Energy to make a determination each time a revised version of ASHRAE Standard 90.1 is published with respect to whether the revised standard would improve energy efficiency in commercial buildings. As many states have historically adopted the IECC for both residential and commercial buildings, PNNL has evaluated the impacts of the commercial provisions of the 2006, 2009, and 2012 editions of the IECC. PNNL also compared energy performance with corresponding editions of ANSI/ASHRAE/IES Standard 90.1 to help states and local jurisdictions make informed decisions regarding model code adoption.

  11. Prime focus architectures for large space telescopes: reduce surfaces to save cost

    Science.gov (United States)

    Breckinridge, J. B.; Lillie, C. F.

    2016-07-01

    Conceptual architectures are now being developed to identify future directions for post JWST large space telescope systems to operate in the UV Optical and near IR regions of the spectrum. Here we show that the cost of optical surfaces within large aperture telescope/instrument systems can exceed $100M/reflection when expressed in terms of the aperture increase needed to over come internal absorption loss. We recommend a program in innovative optical design to minimize the number of surfaces by considering multiple functions for mirrors. An example is given using the Rowland circle imaging spectrometer systems for UV space science. With few exceptions, current space telescope architectures are based on systems optimized for ground-based astronomy. Both HST and JWST are classical "Cassegrain" telescopes derived from the ground-based tradition to co-locate the massive primary mirror and the instruments at the same end of the metrology structure. This requirement derives from the dual need to minimize observatory dome size and cost in the presence of the Earth's 1-g gravitational field. Space telescopes, however function in the zero gravity of space and the 1- g constraint is relieved to the advantage of astronomers. Here we suggest that a prime focus large aperture telescope system in space may have potentially have higher transmittance, better pointing, improved thermal and structural control, less internal polarization and broader wavelength coverage than Cassegrain telescopes. An example is given showing how UV astronomy telescopes use single optical elements for multiple functions and therefore have a minimum number of reflections.

  12. How Expensive Is Expensive Enough? Opportunities for Cost Reductions in Offshore Wind Energy Logistics

    DEFF Research Database (Denmark)

    Poulsen, Thomas; Hasager, Charlotte Bay

    2016-01-01

    This paper reveals that logistics may conservatively amount to 18% of the levelized cost of energy for offshore wind farms. This is the key finding from an extensive case study carried out within the organization of the world’s leading offshore wind farm developer and operator. The case study aimed...... to, and produced, a number of possible opportunities for offshore wind cost reductions through logistics innovation; however, within the case study company, no company-wide logistics organization existed to focus horizontally on reducing logistics costs in general. Logistics was not well defined...... within the case study company, and a logistics strategy did not exist. With full life-cycle costs of offshore wind farms still high enough to present a political challenge within the European Union in terms of legislation to ensure offshore wind diffusion beyond 2020, our research presents logistics...

  13. Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization

    Science.gov (United States)

    2014-04-30

    bäÉîÉåíÜ=^ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Potential Cost Savings for Use of 3D Printing Combined With 3D...TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and...Chair: RADM David Lewis, USN Program Executive Officer, SHIPS Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for

  14. The opportunity cost of animal based diets exceeds all food losses.

    Science.gov (United States)

    Shepon, Alon; Eshel, Gidon; Noor, Elad; Milo, Ron

    2018-04-10

    Food loss is widely recognized as undermining food security and environmental sustainability. However, consumption of resource-intensive food items instead of more efficient, equally nutritious alternatives can also be considered as an effective food loss. Here we define and quantify these opportunity food losses as the food loss associated with consuming resource-intensive animal-based items instead of plant-based alternatives which are nutritionally comparable, e.g., in terms of protein content. We consider replacements that minimize cropland use for each of the main US animal-based food categories. We find that although the characteristic conventional retail-to-consumer food losses are ≈30% for plant and animal products, the opportunity food losses of beef, pork, dairy, poultry, and eggs are 96%, 90%, 75%, 50%, and 40%, respectively. This arises because plant-based replacement diets can produce 20-fold and twofold more nutritionally similar food per cropland than beef and eggs, the most and least resource-intensive animal categories, respectively. Although conventional and opportunity food losses are both targets for improvement, the high opportunity food losses highlight the large potential savings beyond conventionally defined food losses. Concurrently replacing all animal-based items in the US diet with plant-based alternatives will add enough food to feed, in full, 350 million additional people, well above the expected benefits of eliminating all supply chain food waste. These results highlight the importance of dietary shifts to improving food availability and security. Copyright © 2018 the Author(s). Published by PNAS.

  15. Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

    Directory of Open Access Journals (Sweden)

    Elesban Kihuba

    2016-06-01

    Full Text Available Background: Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design: We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit framework to analyze the components and standards of a cost accounting system. Results: Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion: To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.

  16. Opportunities and challenges for implementing cost accounting systems in the Kenyan health system

    Science.gov (United States)

    Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K.

    2016-01-01

    Background Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. Design We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Results Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. Conclusion To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context. PMID:27357072

  17. Opportunities and challenges for implementing cost accounting systems in the Kenyan health system.

    Science.gov (United States)

    Kihuba, Elesban; Gheorghe, Adrian; Bozzani, Fiammetta; English, Mike; Griffiths, Ulla K

    2016-01-01

    Low- and middle-income countries need to sustain efficiency and equity in health financing on their way to universal health care coverage. However, systems meant to generate quality economic information are often deficient in such settings. We assessed the feasibility of streamlining cost accounting systems within the Kenyan health sector to illustrate the pragmatic challenges and opportunities. We reviewed policy documents, and conducted field observations and semi-structured interviews with key informants in the health sector. We used an adapted Human, Organization and Technology fit (HOT-fit) framework to analyze the components and standards of a cost accounting system. Among the opportunities for a viable cost accounting system, we identified a supportive broad policy environment, political will, presence of a national data reporting architecture, good implementation experience with electronic medical records systems, and the availability of patient clinical and resource use data. However, several practical issues need to be considered in the design of the system, including the lack of a framework to guide the costing process, the lack of long-term investment, the lack of appropriate incentives for ground-level staff, and a risk of overburdening the current health management information system. To facilitate the implementation of cost accounting into the health sector, the design of any proposed system needs to remain simple and attuned to the local context.

  18. Improved Process Used to Treat Aqueous Mixed Waste Results in Cost Savings and Improved Worker Safety

    International Nuclear Information System (INIS)

    Hodge, D.S.; Preuss, D.E.; Belcher, K.J.; Rock, C.M.; Bray, W.S.; Herman, J.P.

    2006-01-01

    This paper describes an improved process implemented at Argonne National Laboratory (ANL) to treat aqueous mixed waste. This waste is comprised of radioactively-contaminated corrosive liquids with heavy metals. The Aqueous Mixed Waste Treatment System (AMWTS) system components include a reaction tank and a post-treatment holding tank with ancillary piping and pumps; and a control panel with pumping/mixing controls; tank level, temperature and pH/Oxidation Reduction Potential (ORP) indicators. The process includes a neutralization step to remove the corrosive characteristic, a chromium reduction step to reduce hexavalent chromium to trivalent chromium, and a precipitation step to convert the toxic metals into an insoluble form. Once the toxic metals have precipitated, the resultant sludge is amenable to stabilization and can be reclassified as a low-level waste if the quantity of leachable toxic metals, as determined by the TCLP, is below Universal Treatment Standards (UTS). To date, six batches in eight have passed the UTS. The AMWTS is RCRA permitted and allows for the compliant treatment of mixed waste prior to final disposal at a Department of Energy (DOE) or commercial radioactive waste disposal facility. Mixed wastes eligible for treatment include corrosive liquids (pH 12.5) containing EPA-regulated toxic metals (As, Ba, Pb, Cd, Cr, Ag, Se, Hg) at concentrations greater than the RCRA Toxicity Characteristic Leaching Procedure (TCLP) limit. The system has also been used to treat corrosive wastes with small quantities of fissionable materials. The AMWTS is a significant engineered solution with many improvements over the more labor intensive on-site treatment method being performed within a ventilation hood used previously. The previously used treatment system allowed for batch sizes of only 15-20 gallons whereas the new AMWTS allows for the treatment of batches up to 75 gallons; thereby reducing batch labor and supply costs by 40-60% and reducing analytical

  19. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  20. A Time- and Cost-Saving Method of Producing Rat Polyclonal Antibodies

    International Nuclear Information System (INIS)

    Wakayama, Tomohiko; Kato, Yukio; Utsumi, Rie; Tsuji, Akira; Iseki, Shoichi

    2006-01-01

    Producing antibodies usually takes more than three months. In the present study, we introduce a faster way of producing polyclonal antibodies based on preparation of the recombinant oligopeptide as antigen followed by immunization of rats. Using this method, we produced antisera against two mouse proteins: ERGIC-53 and c-Kit. An expression vector ligated with a pair of complementary synthetic oligodeoxyribonucleotides encoding the protein was introduced into bacteria, and the recombinant oligopeptide fused with the carrier protein glutathione-S-transferase was purified. Wistar rats were immunized by injecting the emulsified antigen subcutaneously into the hind footpads, followed by a booster injection after 2 weeks. One week after the booster, the sera were collected and examined for the antibody titer by immunohistochemistry. Antisera with 1600-fold titer at the maximum were obtained for both antigens and confirmed for their specificity by Western blotting. Anti-ERGIC-53 antisera recognized acinar cells in the sublingual gland, and anti-c-Kit antisera recognized spermatogenic and Leydig cells in the testis. These antisera were applicable to fluorescent double immunostaining with mouse monoclonal or rabbit polyclonal antibodies. Consequently, this method enabled us to produce specific rat polyclonal antisera available for immunohistochemistry in less than one month at a relatively low cost

  1. OPPORTUNITY COSTS OF REWARD DELAYS AND THE DISCOUNTING OF HYPOTHETICAL MONEY AND CIGARETTES

    Science.gov (United States)

    Johnson, Patrick S.; Herrmann, Evan S.; Johnson, Matthew W.

    2015-01-01

    Humans are reported to discount delayed rewards at lower rates than nonhumans. However, nonhumans are studied in tasks that restrict reinforcement during delays, whereas humans are typically studied in tasks that do not restrict reinforcement during delays. In nonhuman tasks, the opportunity cost of restricted reinforcement during delays may increase delay discounting rates. The present within-subjects study used online crowdsourcing (Amazon Mechanical Turk, or MTurk) to assess the discounting of hypothetical delayed money (and cigarettes in smokers) under four hypothetical framing conditions differing in the availability of reinforcement during delays. At one extreme, participants were free to leave their computer without returning, and engage in any behavior during reward delays (modeling typical human tasks). At the opposite extreme, participants were required to stay at their computer and engage in little other behavior during reward delays (modeling typical nonhuman tasks). Discounting rates increased as an orderly function of opportunity cost. Results also indicated predominantly hyperbolic discounting, the “magnitude effect,” steeper discounting of cigarettes than money, and positive correlations between discounting rates of these commodities. This is the first study to test the effects of opportunity costs on discounting, and suggests that procedural differences may partially account for observed species differences in discounting. PMID:25388973

  2. Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

    Science.gov (United States)

    Tran, Anthony; Alby, Kevin; Kerr, Alan; Jones, Melissa; Gilligan, Peter H

    2015-08-01

    Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  3. Regulatory and cost barriers are likely to limit biosimilar development and expected savings in the near future.

    Science.gov (United States)

    Grabowski, Henry G; Guha, Rahul; Salgado, Maria

    2014-06-01

    In March 2010 Congress established an abbreviated Food and Drug Administration approval pathway for biosimilars-drugs that are very similar but not identical to a reference biological product and cost less. Because bringing biosimilars to the market currently requires large investments of money, fewer biosimilars are expected to enter the biologics market than has been the case with generic drugs entering the small-molecule drug market. Additionally, given the high regulatory hurdles to obtaining interchangeability-which would allow pharmacists to substitute a biosimilar for its reference product, subject to evolving state substitution laws-most biosimilars will likely compete as therapeutic alternatives instead of as therapeutic equivalents. In other words, biosimilars will need to compete with their reference product on the basis of quality; price; and manufacturer's reputation with physicians, insurers, and patient groups. Biosimilars also will face dynamic competition from new biologics in the same therapeutic class-including "biobetters," which offer incremental improvements on reference products, such as extended duration of action. The prospects for significant cost savings from the use of biosimilars appear to be limited for the next several years, but their use should increase over time because of both demand- and supply-side factors. Project HOPE—The People-to-People Health Foundation, Inc.

  4. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  5. A stitch in time saves nine. The costs of postponing action in climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Steinshamn, Stein Ivar; Kvamsdal, Sturla F; Sandal, Leif K

    2011-07-01

    The main purpose of this report is to investigate the effects of postponing implementation of a carbon tax assuming that externalities associated with climate change and global warming is real. Failing to internalize these externalities will only lead to a suboptimal situation. The model applied to investigate these externalities starts with the basic relationships, namely supply and demand for fossil fuel, and an added damage term that accounts for the externality. The objective is then to maximize the sum of consumers' and producers' surplus adjusted for the externality. This must be done subject to the dynamic constraint derived from emissions of carbon associated with extraction and consumption of fossil fuel and the natural assimilation of carbon in the atmosphere. The model is solved as a closed loop feedback policy. First the optimal emission path is calculated, and then the corresponding tax path is found. As the externality dealt with here is a pure stock externality it turns out that the optimal tax is equal to the shadow cost of the pollutant. The dynamic equation for assimilation, or natural decay, of carbon is specified using a fairly sophisticated method, namely the ensemble Kalman filter. Given the relative simplicity of the model with only one type of production and one type of pollutant, this method is supposed to give a best possible estimate of the parameters in the assimilation function.The main message in this report is that it may possibly be very expensive to postpone implementation of a carbon tax as the tax rate may have to increase by up to 30 per cent and more for each year implementation is postponed in order to recover optimality in the most pessimistic cases. In the more optimistic cases an increase of down to 0.5 per cent per year may be sufficient.(eb)

  6. A stitch in time saves nine. The costs of postponing action in climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Steinshamn, Stein Ivar; Kvamsdal, Sturla F.; Sandal, Leif K.

    2011-07-01

    The main purpose of this report is to investigate the effects of postponing implementation of a carbon tax assuming that externalities associated with climate change and global warming is real. Failing to internalize these externalities will only lead to a suboptimal situation. The model applied to investigate these externalities starts with the basic relationships, namely supply and demand for fossil fuel, and an added damage term that accounts for the externality. The objective is then to maximize the sum of consumers' and producers' surplus adjusted for the externality. This must be done subject to the dynamic constraint derived from emissions of carbon associated with extraction and consumption of fossil fuel and the natural assimilation of carbon in the atmosphere. The model is solved as a closed loop feedback policy. First the optimal emission path is calculated, and then the corresponding tax path is found. As the externality dealt with here is a pure stock externality it turns out that the optimal tax is equal to the shadow cost of the pollutant. The dynamic equation for assimilation, or natural decay, of carbon is specified using a fairly sophisticated method, namely the ensemble Kalman filter. Given the relative simplicity of the model with only one type of production and one type of pollutant, this method is supposed to give a best possible estimate of the parameters in the assimilation function.The main message in this report is that it may possibly be very expensive to postpone implementation of a carbon tax as the tax rate may have to increase by up to 30 per cent and more for each year implementation is postponed in order to recover optimality in the most pessimistic cases. In the more optimistic cases an increase of down to 0.5 per cent per year may be sufficient.(eb)

  7. Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

    Science.gov (United States)

    Hegde, Vinayak A; Biederman, Robert WW; Mikolich, J Ronald

    2017-01-01

    BACKGROUND This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. METHODS AND RESULTS Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. CONCLUSIONS Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner. PMID:28579858

  8. Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

    Directory of Open Access Journals (Sweden)

    Vinayak A Hegde

    2017-05-01

    Full Text Available Background: This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR. In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Methods and Results: Retrospective review of 361 consecutive patients (pts who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98% had diagnostic quality studies. Of the 361 pts, 350 (97% had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%. The CMR exam resulted in a new diagnosis in 69 of 361 (27% pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11% pts and prevented additional diagnostic testing in 26 (7% pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Conclusions: Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

  9. Exemplary.... Nine examples to save energy and cost by intelligent engineering; Zur Nachahmung empfohlen.... Neun Faelle, in denen mit intelligenter Technik Energie und Kosten gespart werden

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    Contents: Daylighting and energy management, light offices by daylight guidance, fresh air after demand by frequency converters, saving heating cost by intelligent control, optimized lighting systems in schools, fresh air from an external provider and compressed air monitoring in a mine. (GL)

  10. Energy Smart Guide to Campus Cost Savings: Today's Trends in Project Finance, Clean Fuel Fleets, Combined Heat& Power, Emissions Markets

    Energy Technology Data Exchange (ETDEWEB)

    2003-07-01

    The Energy Smart Guide to Campus Cost Savings covers today's trends in project finance, combined heat& power, clean fuel fleets and emissions trading. The guide is directed at campus facilities and business managers and contains general guidance, contact information and case studies from colleges and universities across the country.

  11. Compensating the opportunity cost of forest functional zoning - two alternative options for the Romanian forest policy

    Directory of Open Access Journals (Sweden)

    Marian Drăgoi,

    2010-09-01

    Full Text Available An important challenge of the environmental policy is conceivingappropriate economic instruments able to account for the positive externalities provided by forest ecosystems. This issue is extremely important for implementing the provisions of the Romanian Forest Act, which states that forest owners shall be compensated for the opportunity costs of giving up harvesting operations due to various conservation purposes. The paper presents a statistical method based on analytical assessment of the effective forgone revenues brought about by banning the harvesting operations in 96 cases, each case being a distinctive forest management plan conceived for a large forest area, i.e. a production unit. Doing so, the scale effect has been taken into account because all legal provisions referring to forest management planning systems are focused on production units, considered the basic reference elements for sustainable forest management. The multiple regression function produced by the statistical analysis was turned into a simple formula allowing for a straightforward set up of the average compensation worth being paid per year and hectare. In order to better fetch the real opportunity cost paid for each hectare of protected forest, the algorithmwas further improved in order to account for the differences in stumpage residual value. Actually, the average compensation is differentiated onto five categories of hauling distances, using the same algorithm used by the National Forest Administration for differentiating the average reservation price established at national level on the ground of full-cost method stumpage pricing system.

  12. Compensating the opportunity cost of forest functional zoning - two alternative options for the Romanian forest policy

    Directory of Open Access Journals (Sweden)

    Marian Drăgoi

    2010-06-01

    Full Text Available An important challenge of the environmental policy is conceiving appropriate economic instruments able to account for the positive externalities provided by forest ecosystems. This issue is extremely important for implementing the provisions of the Romanian Forest Act, which states that forest owners shall be compensated for the opportunity costs of giving up harvesting operations due to various conservation purposes. The paper presents a statistical method based on analytical assessment of the effective forgone revenues brought about by banning the harvesting operations in 96 cases, each case being a distinctive forest management plan conceived for a large forest area, i.e. a production unit. Doing so, the scale effect has been taken into account because all legal provisions referring to forest management planning systems are focused on production units, considered the basic reference elements for sustainable forest management. The multiple regression function produced by the statistical analysis was turned into a simple formula allowing for a straightforward set up of the average compensation worth being paid per year and hectare. In order to better fetch the real opportunity cost paid for each hectare of protected forest, the algorithm was further improved in order to account for the differences in stumpage residual value. Actually, the average compensation is differentiated onto five categories of hauling distances, using the same algorithm used by the National Forest Administration for differentiating the average reservation price established at national level on the ground of full-cost method stumpage pricing system. 

  13. The French nuclear power plant reactor building containment contributions of prestressing and concrete performances in reliability improvements and cost savings

    International Nuclear Information System (INIS)

    Rouelle, P.; Roy, F.

    1998-01-01

    The Electricite de France's N4 CHOOZ B nuclear power plant, two units of the world's largest PWR model (1450 Mwe each), has earned the Electric Power International's 1997 Powerplant Award. This lead NPP for EDF's N4 series has been improved notably in terms of civil works. The presentation will focus on the Reactor Building's inner containment wall which is one of the main civil structures on a technical and safety point of view. In order to take into account the necessary evolution of the concrete technical specification such as compressive strength low creep and shrinkage, the HSC/HPC has been used on the last N4 Civaux 2 NPP. As a result of the use of this type of professional concrete, the containment withstands an higher internal pressure related to severe accident and ensures higher level of leak-tightness, thus improving the overall safety of the NPP. On that occasion, a new type of prestressing has been tested locally through 55 C 15 S tendons using a new C 1500 FE Jack. These updated civil works techniques shall allow EDF to ensure a Reactor Containment lifespan for more than 50 years. The gains in terms of reliability and cost saving of these improved techniques will be developed hereafter

  14. Cost-Saving Early Diagnosis of Functional Pain in Nonmalignant Pain: A Noninferiority Study of Diagnostic Accuracy.

    Science.gov (United States)

    Cámara, Rafael J A; Merz, Christian; Wegmann, Barbara; Stauber, Stefanie; von Känel, Roland; Egloff, Niklaus

    2016-01-01

    Objectives. We compared two index screening tests for early diagnosis of functional pain: pressure pain measurement by electronic diagnostic equipment, which is accurate but too specialized for primary health care, versus peg testing, which is cost-saving and more easily manageable but of unknown sensitivity and specificity. Early distinction of functional (altered pain perception; nervous sensitization) from neuropathic or nociceptive pain improves pain management. Methods. Clinicians blinded for the index screening tests assessed the reference standard of this noninferiority diagnostic accuracy study, namely, comprehensive medical history taking with all previous findings and treatment outcomes. All consenting patients referred to a university hospital for nonmalignant musculoskeletal pain participated. The main analysis compared the receiver operating characteristic (ROC) curves of both index screening tests. Results. The area under the ROC curve for peg testing was not inferior to that of electronic equipment: it was at least 95% as large for finger measures (two-sided p = 0.038) and at least equally as large for ear measures (two-sided p = 0.003). Conclusions. Routine diagnostic testing by peg, which is accessible for general practitioners, is at least as accurate as specialized equipment. This may shorten time-to-treatment in general practices, thereby improving the prognosis and quality of life.

  15. Medical Care Expenditures for Individuals with Prediabetes: The Potential Cost Savings in Reducing the Risk of Developing Diabetes.

    Science.gov (United States)

    Khan, Tamkeen; Tsipas, Stavros; Wozniak, Gregory

    2017-10-01

    The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with diabetes. A cohort analysis of a commercially insured population was conducted using individual-level claims data from Truven Health MarketScan ® Lab Database to identify adults with prediabetes, track whether they develop diabetes, and compare medical expenditures for those who are newly diagnosed with diabetes to those who are not. This study then illustrates how reducing the risk of developing diabetes by participation in an evidence-based lifestyle change program could yield both positive net savings on medical care expenditures and return on investment (ROI). Annual expenditures are found to be nearly one third higher for those who develop diabetes in subsequent years relative to those who do not transition from prediabetes to diabetes, with an average difference of $2671 per year. At that cost differential, the 3-year ROI for a National DPP is estimated to be as high as 42%. The results show the importance and economic benefits of participation in lifestyle intervention programs to prevent or delay the onset of type 2 diabetes.

  16. Rising Use Of Observation Care Among The Commercially Insured May Lead to Total And Out-Of-Pocket Cost Savings.

    Science.gov (United States)

    Adrion, Emily R; Kocher, Keith E; Nallamothu, Brahmajee K; Ryan, Andrew M

    2017-12-01

    Proponents of hospital-based observation care argue that it has the potential to reduce health care spending and lengths-of-stay, compared to short-stay inpatient hospitalizations. However, critics have raised concerns about the out-of-pocket spending associated with observation care. Recent reports of high out-of-pocket spending among Medicare beneficiaries have received considerable media attention and have prompted direct policy changes. Despite the potential for changed policies to indirectly affect non-Medicare patients, little is known about the use of, and spending associated with, observation care among commercially insured populations. Using multipayer commercial claims for the period 2009-13, we evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In our study period, the use of observation care increased relative to that of short-stay hospitalizations. Total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly-and at rates much higher than spending in the inpatient setting-over the study period. Despite this growth, spending on observation care is unlikely to exceed spending for short-stay hospitalizations. As observation care attracts greater attention, policy makers should be aware that Medicare policies that disincentivize observation may have unintended financial impacts on non-Medicare populations, where observation care may be cost saving.

  17. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fibre in Canada

    Directory of Open Access Journals (Sweden)

    Mohammad eAbdullah

    2015-08-01

    Full Text Available Background: Consumption of fibre-rich diets is associated with favourable impacts on type 2 diabetes (T2D and cardiovascular disease (CVD, two of the most costly ailments worldwide, however the economic value of altered fibre intakes remains poorly understood. Methods: A cost-of-illness analysis was conducted to identify the percentage of adults expected to consume fibre-rich diets in Canada, estimate fibre intakes in relation to T2D and CVD reductions, and assess the potential annual savings in healthcare costs with reductions in rates of these two epidemics. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8-$1,295.7 million in CVD costs were calculated under a scenario where cereal fibre was used to increase current intakes of dietary fibre to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fibre consumption resulted in annual CAD$2.6-$51.1 and $4.6-$92.1 million savings for T2D and CVD, respectively. Conclusions: Strategies to increase consumers’ knowledge of the recommended dietary fibre intakes, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of costs associated with T2D and CVD in Canada.

  18. Opportunity costs and local health service spending decisions: a qualitative study from Wales.

    Science.gov (United States)

    Karlsberg Schaffer, Sarah; Sussex, Jon; Hughes, Dyfrig; Devlin, Nancy

    2016-03-25

    All health care systems face the need to find the resources to meet new demands such as a new, cost-increasing health technology. In England and Wales, when a health technology is recommended by the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS) is mandated to provide the funding to accommodate it within three months of publication of the recommendation. Identifying what, in practice, is foregone when new cost-increasing technologies are introduced is important for understanding the effects of health technology assessment (HTA) decisions on the NHS or any other health care system. Our objective was to investigate how in practice local NHS commissioners in Wales accommodated financial "shocks" arising from technology appraisals (TAs) issued by NICE and from other cost pressures. Semi-structured interviews were conducted with Finance Directors and Medical Directors from all seven Local Health Boards (LHBs) in NHS Wales. These interviews covered prioritisation processes, as well as methods of financing NICE TAs and other financial shocks at each LHB. We then undertook a systematic identification of themes and topics from the information recorded. The study relates to the period October 2010 to March 2013. The financial impact of NICE TAs is generally anticipated and planned for in advance and the majority of LHBs have contingency funds available to cope with these and other financial shocks within-period. Efficiency savings (defined as reductions in costs with no assumed reductions in quality) were a source of funds for cost pressures of all kinds. Service displacements were not linkable to particular NICE TAs and there appears to be a general lack of explicit prioritisation activities. The Welsh Government has, on occasion, explicitly or implicitly acted as the funder of last resort. Services may be displaced as part of a response to the cumulative impact of all types of cost pressures, including cost-increasing health

  19. Supply chain cost improvement opportunities through streamlining cross-border operations

    Directory of Open Access Journals (Sweden)

    Jan Hendrik Havenga

    2013-09-01

    Full Text Available The Cross-Border Road Transport Agency (CBRTA in South Africa aims to encourage and facilitate trade between South Africa and its neighbouring countries. The CBRTA sponsored a study by Stellenbosch University (SU to determine the logistics cost impact of cross-border delays between South Africa and its major neighbouring trading partners, and prioritise opportunities for improvement. SU is the proprietor of both a comprehensive freight demand model and a logistics cost model for South Africa, which enable extractions and extensions of freight flows and related costs for specific purposes. Through the application of these models, the following information is identified and presented in this paper: South Africa’s most important border posts (based on traffic flows; a product profile for imports and exports through these border posts; the modal split (road and rail; the annual logistics costs incurred on the corridors feeding the border posts, as well as the additional costs incurred due to border delays. The research has proved that the streamlining of border-post operations that take a total supply chain view (i.e. of both border operations and those that could be moved from the border is beneficial.

  20. How Expensive Is Expensive Enough? Opportunities for Cost Reductions in Offshore Wind Energy Logistics

    Directory of Open Access Journals (Sweden)

    Thomas Poulsen

    2016-06-01

    Full Text Available This paper reveals that logistics may conservatively amount to 18% of the levelized cost of energy for offshore wind farms. This is the key finding from an extensive case study carried out within the organization of the world’s leading offshore wind farm developer and operator. The case study aimed to, and produced, a number of possible opportunities for offshore wind cost reductions through logistics innovation; however, within the case study company, no company-wide logistics organization existed to focus horizontally on reducing logistics costs in general. Logistics was not well defined within the case study company, and a logistics strategy did not exist. With full life-cycle costs of offshore wind farms still high enough to present a political challenge within the European Union in terms of legislation to ensure offshore wind diffusion beyond 2020, our research presents logistics as a next frontier for offshore wind constituencies. This important area of the supply chain is ripe to academically and professionally cultivate and harvest in terms of offshore wind energy cost reductions. Our paper suggests that a focused organizational approach for logistics both horizontally and vertically within the company organizations could be the way forward, coupled with a long-term legislative environment to enable the necessary investments in logistics assets and transport equipment.

  1. Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

    Energy Technology Data Exchange (ETDEWEB)

    Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-07-01

    This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

  2. Save Energy: Save Money!

    Science.gov (United States)

    Eccli, Eugene; And Others

    This publication is a collection of inexpensive energy saving tips and home improvements for home owners, particularly in low-income areas or in older homes. Section titles are: (1) Keeping Warm; (2) Getting Heat Where You Need It; (3) Using the Sun; (4) Furnaces, Stoves, and Fireplaces; (5) Insulation and Other Energy Needs; (6) Do-It-Yourself…

  3. Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

    Science.gov (United States)

    2014-01-01

    Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

  4. Ensuring Efficient Incentive and Disincentive Values for Highway Construction Projects: A Systematic Approach Balancing Road User, Agency and Contractor Acceleration Costs and Savings

    Directory of Open Access Journals (Sweden)

    Eul-Bum Lee

    2018-03-01

    Full Text Available United States State Highway Agencies (SHAs use Incentive/Disincentives (I/D to minimize negative impacts of construction on the traveling public through construction acceleration. Current I/D practices have the following short-comings: not standardized, over- or under-compensate contractors, lack of auditability result in disincentives that leave SHAs vulnerable to contractor claims and litigation and are based on agency costs/savings rather than contractor acceleration. Presented within this paper is an eleven-step I/D valuation process. The processes incorporate a US-nationwide RUC and agency cost calculation program, CA4PRS and a time-cost tradeoff I/D process. The incentive calculation used is the summation of the contractor acceleration and a reasonable contractor bonus (based on shared agency savings with an optional reduction of contractor’s own saving from schedule compression (acceleration. The process has a capability to be used both within the US and internationally with minor modifications, relies on historical costs, is simple and is auditable and repeatable. As such, it is a practical tool for optimizing I/D amounts and bridges the gap in existing literature both by its industry applicability, integrating the solution into existing SHA practices and its foundation of contractor acceleration costs.

  5. Opportunities for low-cost CO2 storage demonstration projects in China

    International Nuclear Information System (INIS)

    Meng, Kyle C.; Williams, Robert H.; Celia, Michael A.

    2007-01-01

    Several CO 2 storage demonstration projects are needed in a variety of geological formations worldwide to prove the viability of CO 2 capture and storage as a major option for climate change mitigation. China has several low-cost CO 2 sources at sites that produce NH 3 from coal via gasification. At these plants, CO 2 generated in excess of the amount needed for other purposes (e.g., urea synthesis) is vented as a relatively pure stream. These CO 2 sources would potentially be economically interesting candidates for storage demonstration projects if there are suitable storage sites nearby. In this study a survey was conducted to estimate CO 2 availability at modern Chinese coal-fed ammonia plants. Results indicate that annual quantities of available, relatively pure CO 2 per site range from 0.6 to 1.1 million tonnes. The CO 2 source assessment was complemented by analysis of possible nearby opportunities for CO 2 storage. CO 2 sources were mapped in relation to China's petroliferous sedimentary basins where prospective CO 2 storage reservoirs possibly exist. Four promising pairs of sources and sinks were identified. Project costs for storage in deep saline aquifers were estimated for each pairing ranging from $15-21/t of CO 2 . Potential enhanced oil recovery and enhanced coal bed methane recovery opportunities near each prospective source were also considered

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

    Science.gov (United States)

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

    2018-04-01

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

  7. Can the real opportunity cost stand up: displaced services, the straw man outside the room.

    Science.gov (United States)

    Eckermann, Simon; Pekarsky, Brita

    2014-04-01

    In current literature, displaced services have been suggested to provide a basis for determining a threshold value for the effects of a new technology as part of a reimbursement process when budgets are fixed. We critically examine the conditions under which displaced services would represent an economically meaningful threshold value. We first show that if we assume that the least cost-effective services are displaced to finance a new technology, then the incremental cost-effectiveness ratio (ICER) of the displaced services (d) only coincides with that related to the opportunity cost of adopting that new technology, the ICER of the most cost-effective service in expansion (n), under highly restrictive conditions-namely, complete allocative efficiency in existing provision of health care interventions. More generally, reimbursement of new technology with a fixed budget comprises two actions; adoption and financing through displacement and the effect of reimbursement is the net effect of these two actions. In order for the reimbursement process to be a pathway to allocative efficiency within a fixed budget, the net effect of the strategy of reimbursement is compared with the most cost-effective alternative strategy for reimbursement: optimal reallocation, the health gain maximizing expansion of existing services financed by the health loss minimizing contraction. The shadow price of the health effects of a new technology, βc = (1/n + 1/d - 1/m)(-1), accounts for both imperfect displacement (the ICER of the displaced service, d < m, the ICER of the least cost-effective of the existing services in contraction) and the allocative inefficiency (n < m) characteristic of health systems.

  8. Feature Selection as a Time and Cost-Saving Approach for Land Suitability Classification (Case Study of Shavur Plain, Iran

    Directory of Open Access Journals (Sweden)

    Saeid Hamzeh

    2016-10-01

    Full Text Available Land suitability classification is important in planning and managing sustainable land use. Most approaches to land suitability analysis combine a large number of land and soil parameters, and are time-consuming and costly. In this study, a potentially useful technique (combined feature selection and fuzzy-AHP method to increase the efficiency of land suitability analysis was presented. To this end, three different feature selection algorithms—random search, best search and genetic methods—were used to determine the most effective parameters for land suitability classification for the cultivation of barely in the Shavur Plain, southwest Iran. Next, land suitability classes were calculated for all methods by using the fuzzy-AHP approach. Salinity (electrical conductivity (EC, alkalinity (exchangeable sodium percentage (ESP, wetness and soil texture were selected using the random search method. Gypsum, EC, ESP, and soil texture were selected using both the best search and genetic methods. The result shows a strong agreement between the standard fuzzy-AHP methods and methods presented in this study. The values of Kappa coefficients were 0.82, 0.79 and 0.79 for the random search, best search and genetic methods, respectively, compared with the standard fuzzy-AHP method. Our results indicate that EC, ESP, soil texture and wetness are the most effective features for evaluating land suitability classification for the cultivation of barely in the study area, and uses of these parameters, together with their appropriate weights as obtained from fuzzy-AHP, can perform good results for land suitability classification. So, the combined feature selection presented and the fuzzy-AHP approach has the potential to save time and money for land suitability classification.

  9. The use of generic drugs in prevention of chronic disease is far more cost-effective than thought, and may save money.

    Science.gov (United States)

    Shrank, William H; Choudhry, Niteesh K; Liberman, Joshua N; Brennan, Troyen A

    2011-07-01

    In this article we highlight the important role that medication therapy can play in preventing disease and controlling costs. Focusing on coronary artery disease, we demonstrate that prevention, with the appropriate use of generic medications, appears far more cost-effective than previously documented, and it may even save on costs. For example, an earlier study estimated that reducing blood pressure to widely established clinical guidelines in nondiabetic patients cost an estimated $52,983 per quality-adjusted life-year if a brand-name drug was used. However, we estimate that the cost is just $7,753 per quality-adjusted life-year at generic medication prices. As the nation attempts to find strategies to improve population health without adding to the unsustainably high cost of care, policy makers should focus on ensuring that patients have access to essential generic medications.

  10. Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

    Science.gov (United States)

    Abdullah, Mohammad M. H.; Gyles, Collin L.; Marinangeli, Christopher P. F.; Carlberg, Jared G.; Jones, Peter J. H.

    2015-01-01

    Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. Methods: A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million–$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Conclusion: Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers’ general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada. PMID

  11. Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

    Science.gov (United States)

    Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

    2017-12-01

     In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

  12. In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

    Science.gov (United States)

    2014-01-01

    Background The purpose of this analysis was to determine whether in office diagnostic needle arthroscopy (Visionscope Imaging System [VSI]) can provide for improved diagnostic assessment and; more cost effective care. Methods Data on arthroscopy procedures in the US for deep seated pathology in the knee and shoulder were used (Calendar Year 2012). These procedures represent approximately 25-30% of all arthroscopic procedures performed annually. Sensitivities, specificities, positive predictive, and negative predictive values for MRI analysis of this deep seated pathology from systematic reviews and meta-analyses were used in assessing for false positive and false negative MRI findings. The costs of performing diagnostic and surgical arthroscopy procedures (using 2013 Medicare reimbursement amounts); costs associated with false negative findings; and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were then assessed. Results In patients presenting with medial meniscal pathology (ICD9CM diagnosis 836.0 over 540,000 procedures in CY 2012); use of the VSI system in place of MRI assessment (standard of care) resulted in a net cost savings to the system of $151 million. In patients presenting with rotator cuff pathology (ICD9CM 840.4 over 165,000 procedures in CY2012); use of VSI in place of MRI similarly saved $59 million. These savings were realized along with more appropriate care as; fewer patients were exposed to higher risk surgical arthroscopic procedures. Conclusions The use of an in-office arthroscopy system can: possibly save the US healthcare system money; shorten the diagnostic odyssey for patients; potentially better prepare clinicians for arthroscopic surgery (when needed) and; eliminate unnecessary outpatient arthroscopy procedures, which commonly result in surgical intervention. PMID:24885678

  13. The future of fully automated vehicles : opportunities for vehicle- and ride-sharing, with cost and emissions savings.

    Science.gov (United States)

    2014-08-01

    Fully automated or autonomous vehicles (AVs) hold great promise for the future of transportation. By 2020 : Google, auto manufacturers and other technology providers intend to introduce self-driving cars to the public with : either limited or fully a...

  14. Aging infrastructure creates opportunities for cost-efficient restoration of aquatic ecosystem connectivity.

    Science.gov (United States)

    Neeson, Thomas M; Moody, Allison T; O'Hanley, Jesse R; Diebel, Matthew; Doran, Patrick J; Ferris, Michael C; Colling, Timothy; McIntyre, Peter B

    2018-06-09

    A hallmark of industrialization is the construction of dams for water management and roads for transportation, leading to fragmentation of aquatic ecosystems. Many nations are striving to address both maintenance backlogs and mitigation of environmental impacts as their infrastructure ages. Here, we test whether accounting for road repair needs could offer opportunities to boost conservation efficiency by piggybacking connectivity restoration projects on infrastructure maintenance. Using optimization models to align fish passage restoration sites with likely road repair priorities, we find potential increases in conservation return-on-investment ranging from 17% to 25%. Importantly, these gains occur without compromising infrastructure or conservation priorities; simply communicating openly about objectives and candidate sites enables greater accomplishment at current funding levels. Society embraces both reliable roads and thriving fisheries, so overcoming this coordination challenge should be feasible. Given deferred maintenance crises for many types of infrastructure, there could be widespread opportunities to enhance the cost effectiveness of conservation investments by coordinating with infrastructure renewal efforts. © 2018 by the Ecological Society of America.

  15. Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost.

    Science.gov (United States)

    Kim, Byungjoon B J; Delbridge, Theodore R; Kendrick, Dawn B

    2017-07-10

    Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system. The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value A new streaming scheme of patients' flow may improve the performance of fast track system.

  16. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Directory of Open Access Journals (Sweden)

    Jörg Tomeczkowski

    Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  17. Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

    Science.gov (United States)

    Tomeczkowski, Jörg; Stern, Sean; Müller, Alfred; von Heymann, Christian

    2013-01-01

    Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO) compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategy)during elective hip and knee replacement surgery. Individual patients (N = 50,000) were simulated based on data from controlled trials, the German DRG institute (InEK) and various publications and entered into a stochastic model (Monte-Carlo) of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit), pneumonia treatment (€5,000), and length of stay (€300/day). Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

  18. 20 Years Experience with using Low Cost Launch Opportunities for 20 Small Satellite Missions

    Science.gov (United States)

    Meerman, Maarten; Sweeting, Martin, , Sir

    To realise the full potential of modern low cost mini-micro-nano-satellite missions, regular and affordable launch opportunities are required. It is simply not economic to launch individual satellites of 5-300kg on single dedicated launchers costing typically 15-20M per launch. Whilst there have been periodic 'piggy-back' launches of small satellites on US launchers since the 1960's, these have been infrequent and often experienced significant delays due the vagaries of the main (paying!) payload. In 1989, Arianespace provided a critical catalyst to the microsatellite community when it imaginatively developed the ASAP platform on Ariane-4 providing, for the first time, a standard interface and affordable launch contracts for small payloads up to 50kg. During the 1990's, some 20 small satellites have been successfully launched on the Ariane-4 ASAP ring for international customers carrying out a range of operational, technology demonstration and training missions. However, most of these microsatellite missions seek low Earth orbit and especially sun-synchronous orbits, but the number of primary missions into these orbit has declined since 1996 and with it the availability of useful low cost launch opportunities for microsatellites. Whilst Ariane-5 has an enhanced capacity ASAP, it has yet to be widely used due both to the infrequent launches, higher costs, and the GTO orbit required by the majority of customers. China, Japan and India have also provided occasional secondary launches for small payloads, but not yet on a regular basis. Fortunately, the growing interest and demand for microsatellite missions coincided with the emergence of regular, low cost launch opportunities from the former Soviet Union (FSU) - both as secondary 'piggy-back' missions or as multiple microsatellite payloads on converted military ICBMs. Indeed, the FSU now supplies the only affordable means of launching minisatellites (200-500kg) into LEO as dedicated missions on converted missiles as

  19. Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

    Science.gov (United States)

    Baldini, Christopher G; Culley, Eric J

    2011-01-01

    A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

  20. RESULTS FROM THE U.S. DOE 2006 SAVE ENERGY NOW ASSESSMENT INITIATIVE: DOE's Partnership with U.S. Industry to Reduce Energy Consumption, Energy Costs, and Carbon Dioxide Emissions

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Gemmer, Bob [U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy; Scheihing, Paul [U.S. Department of Energy, Industrial Technologies Program; Quinn, James [U.S. Department of Energy

    2007-09-01

    nation's largest manufacturing plants--those that consume a total of 1 trillion British thermal units (Btu) or more annually. The approximately 6800 U.S. facilities that fall into this category collectively account for about 53% of all energy consumed by industry in the United States. The 2006 Save Energy Now energy assessments departed from earlier DOE plant assessments by concentrating solely on steam and process heating systems, which are estimated to account for approximately 74% of all natural gas use for manufacturing. The assessments also integrated a strong training component designed to teach industrial plant personnel how to use DOE's steam or process heating opportunity assessment software tools. This approach had the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to independently replicate the assessment process at the company's other facilities. The Save Energy Now initiative also included provisions to help plants that applied for but did not qualify for assessments (based on the 1 trillion Btu criterion). Services offered to these plants included (1) an assessment by one of DOE's 26 university-based Industrial Assessment Centers (IACs), (2) a telephone consultation with a systems expert at the DOE's Energy Efficiency and Renewable Energy Information Center, or (3) other technical materials and services available through ITP (e.g., the Save Energy Now CD). By the end of 2006, DOE had completed all 200 of the promised assessments, identifying potential natural gas savings of more than 50 trillion Btu and energy cost savings of about $500 million. These savings, if fully implemented, could reduce CO2 emissions by 4.04 million metric tons annually. These results, along with the fact that a large percentage of U.S. energy is used by a relatively small number of very large plants, clearly suggest that assessments are an expedient and cost-effective way to

  1. Cost savings and enhanced hospice enrollment with a home-based palliative care program implemented as a hospice-private payer partnership.

    Science.gov (United States)

    Kerr, Christopher W; Donohue, Kathleen A; Tangeman, John C; Serehali, Amin M; Knodel, Sarah M; Grant, Pei C; Luczkiewicz, Debra L; Mylotte, Kathleen; Marien, Melanie J

    2014-12-01

    In the United States, 5% of the population is responsible for nearly half of all health care expenditures, with a large concentration of spending driven by individuals with expensive chronic conditions in their last year of life. Outpatient palliative care under the Medicare Hospice Benefit excludes a large proportion of the chronically ill and there is widespread recognition that innovative strategies must be developed to meet the needs of the seriously ill while reducing costs. This study aimed to evaluate the impact of a home-based palliative care program, implemented through a hospice-private payer partnership, on health care costs and utilization. This was a prospective, observational database study where insurance enrollment and claims data were analyzed. The study population consisted of Home Connections (HC) program patients enrolled between January 1, 2010 and December 31, 2012 who subsequently expired (n=149) and who were also Independent Health members. A control group (n=537) was derived using propensity-score matching. The primary outcome variable was overall costs within the last year of life. Costs were also examined at six months, three months, one month, and two weeks. Inpatient, outpatient, ancillary, professional, and pharmacy costs were compared between the two groups. Medical service utilization and hospice enrollment and length of stay were also evaluated. Cost savings were apparent in the last three months of life—$6,804 per member per month (PMPM) cost for palliative care participants versus $10,712 for usual care. During the last two weeks of life, total allowed PMPM was $6,674 versus $13,846 for usual care. Enhanced hospice entry (70% versus 25%) and longer length of stay in hospice (median 34 versus 9 days) were observed. Palliative care programs partnered with community hospice providers may achieve cost savings while helping provide care across the continuum.

  2. Opportunistic maintenance considering non-homogenous opportunity arrivals and stochastic opportunity durations

    International Nuclear Information System (INIS)

    Truong Ba, H.; Cholette, M.E.; Borghesani, P.; Zhou, Y.; Ma, L.

    2017-01-01

    Many systems and manufacturing processes undergo intermittent operation due to external factors (e.g. weather, low market prices), offering opportunities to conduct maintenance with reduced production losses. Making use of appropriate opportunities can thus lead to significant reduction in the total cost of maintenance and improvement in productivity. In this paper, an opportunistic maintenance (OM) model is developed considering two critical properties of real world opportunities: (i) non-homogeneous opportunity arrivals and (ii) stochastic opportunity duration. The model enables exploiting downtime cost savings from “partial” opportunities (stops shorter than the required maintenance time) thus extending the potential benefit of OM. The criteria for accepting maintenance opportunities are found by minimizing the single-cycle total cost. A closed form expression of the single-cycle total cost is derived for a given PM/OM policy and then a Genetic Algorithm is used to solve the optimization problem. Numerical results are presented to assess the benefit of opportunistic maintenance and the marginal benefit of considering partial opportunities. Results indicate that significant savings can be achieved by considering OM. Moreover, it is shown that the novel consideration of partial opportunities significantly increase the benefit of OM. - Highlights: • Opportunistic and time-based preventive maintenance jointly optimized. • Non-homogeneous opportunity arrivals and stochastic durations considered. • “Partial” opportunities considered for the first time. • Opportunity duration thresholds used as a decision criterion. • Numerical study conducted to evaluate benefit of optimized policy.

  3. Cost-Benefit of the energy saving in the bioclimatic designs; Costo-Beneficio del ahorro de energia en los disenos bioclimaticos

    Energy Technology Data Exchange (ETDEWEB)

    Lopez P, J. Manuel A. [Doble Dos Soluciones de Negocios, S.A. de C.V., Mexico, D.F. (Mexico); Morillon G, David; Rodriguez V, Luis [Instituto de Ingenieria de la UNAM, Mexico, D.F. (Mexico)

    1999-07-01

    Tools and criteria for the Cost-Benefit analysis from the energy saving in bioclimatic designs (BD) are presented, for which, a reference project is established and the costs and benefits of energy saving in BD with base in that project are evaluated. A case study is presented taking as reference the traditional design of the air conditioning of a building and with this base the estimation of cost-benefit of the same building is made, but with passive systems. The tools used are those that allow to consider related resources such as time and money; in that sense, are used criteria such as: Present value (PV), Equivalent Annual Cost (EAC) and the Cost of the Conserved Energy (CCE). The costs related to the construction, maintenance and operation of the design are taken into account. The differences between the reference design and the BD, established from the application of these criteria, allow to evaluate the economic margin of the BD as far as operation and maintenance is concerned. Finally the CCE of the bioclimatic measures is evaluated as an initiative of energy saving and the present value is calculated of the energy saving in the entire useful life of a bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio del ahorro de energia en disenos bioclimaticos (DB), para lo cual, se establece un proyecto de referencia y se evaluan los costos y beneficios del ahorro de energia en DB con base en ese proyecto. Se presenta el estudio de un caso tomando como referencia el dise tradicional de la climatizacion de un edificio y con base en este, se realiza la estimacion de costos y beneficios del mismo edificio, pero con sistemas pasivos. Las herramientas usadas, son aquellas que permiten considerar recursos relacionados como son tiempo y dinero; en ese sentido, se usan criterios como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia Conservada (CEC). Se toman en consideracion los costos relacionados

  4. Improved Safety and Cost Savings from Reductions in Cast-Saw Burns After Simulation-Based Education for Orthopaedic Surgery Residents.

    Science.gov (United States)

    Bae, Donald S; Lynch, Hayley; Jamieson, Katherine; Yu-Moe, C Winnie; Roussin, Christopher

    2017-09-06

    The purpose of this investigation was to characterize the clinical efficacy and cost-effectiveness of simulation training aimed at reducing cast-saw injuries. Third-year orthopaedic residents underwent simulation-based instruction on distal radial fracture reduction, casting, and cast removal using an oscillating saw. The analysis compared incidences of cast-saw injuries and associated costs before and after the implementation of the simulation curriculum. Actual and potential costs associated with cast-saw injuries included wound care, extra clinical visits, and potential total payment (indemnity and expense payments). Curriculum costs were calculated through time-derived, activity-based accounting methods. The researchers compared the costs of cast-saw injuries and the simulation curriculum to determine overall savings and return on investment. In the 2.5 years prior to simulation, cast-saw injuries occurred in approximately 4.3 per 100 casts cut by orthopaedic residents. For the 2.5-year period post-simulation, the injury rate decreased significantly to approximately 0.7 per 100 casts cut (p = 0.002). The total cost to implement the casting simulation was $2,465.31 per 6-month resident rotation. On the basis of historical data related to cast-saw burns (n = 6), total payments ranged from $2,995 to $25,000 per claim. The anticipated savings from averted cast-saw injuries and associated medicolegal payments in the 2.5 years post-simulation was $27,131, representing an 11-to-1 return on investment. Simulation-based training for orthopaedic surgical residents was effective in reducing cast-saw injuries and had a high theoretical return on investment. These results support further investment in simulation-based training as cost-effective means of improving patient safety and clinical outcomes. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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

    Science.gov (United States)

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

    2010-12-01

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

  6. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L

    2012-02-01

    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  7. Water Saving and Cost Analysis of Large-Scale Implementation of Domestic Rain Water Harvesting in Minor Mediterranean Islands

    Directory of Open Access Journals (Sweden)

    Alberto Campisano

    2017-11-01

    Full Text Available This paper describes a novel methodology to evaluate the benefits of large-scale installation of domestic Rain Water Harvesting (RWH systems in multi-story buildings. The methodology was specifically developed for application to small settlements of the minor Mediterranean islands characterized by sharp fluctuations in precipitation and water demands between winter and summer periods. The methodology is based on the combined use of regressive models for water saving evaluation and of geospatial analysis tools for semi-automatic collection of spatial information at the building/household level. An application to the old town of Lipari (Aeolian islands showed potential for high yearly water savings (between 30% and 50%, with return on investment in less than 15 years for about 50% of the installed RWH systems.

  8. The Opportunity Cost of Labor for Valuing Mangrove Restoration in Mahakam Delta, Indonesia

    Directory of Open Access Journals (Sweden)

    Heru Susilo

    2017-11-01

    Full Text Available Worldwide, damage to mangroves is alarming. Restoration is required to recover mangrove ecosystems, and communities’ involvement is a primary factor to reduce the threat to mangroves. Their participation might be interpreted as the appropriate decision concerning conservation and utilization of mangroves. Using a contingent valuation approach, this study assesses mangroves’ values to local communities through their willingness to contribute labor to obtain monetary value. Results showed that the opportunity cost of time was valued at IDR 398.76 thousand (US$29.99 a month or IDR 4.79 million (US$359.90 per year. A total annual benefit of mangrove restoration using the wage rate of time (WRT is IDR 143 billion (US$10.77 million per year. Accessing such information is crucial to making the appropriate decisions about conservation of mangroves within the context of developing countries that have poor coastal communities and low incomes. Tobit regression determined that five variables affect willingness to provide labor time and WRT significantly for mangrove restoration. These findings can support decision-makers with the relevant information for assessing a mangrove restoration project.

  9. Household Savings

    DEFF Research Database (Denmark)

    Browning, Martin; Lusardi, Annamaria

    suggested in the informal saving literature can be captured in the standard optimizing model. Particular attention is given to recent work on the precautionary motive and its implications for saving and consumption behavior. We also discuss the "behavioral" or "psychological" approach that eschews the use......In this survey, we review the recent theoretical and empirical literature on household saving and consumption. The discussion is structured around a list of motives for saving and how well the standard theory captures these motives. We show that almost all of the motives for saving that have been...

  10. Formosa Plastics Corporation: Plant-Wide Assessment of Texas Plant Identifies Opportunities for Improving Process Efficiency and Reducing Energy Costs

    Energy Technology Data Exchange (ETDEWEB)

    None

    2005-01-01

    At Formosa Plastics Corporation's plant in Point Comfort, Texas, a plant-wide assessment team analyzed process energy requirements, reviewed new technologies for applicability, and found ways to improve the plant's energy efficiency. The assessment team identified the energy requirements of each process and compared actual energy consumption with theoretical process requirements. The team estimated that total annual energy savings would be about 115,000 MBtu for natural gas and nearly 14 million kWh for electricity if the plant makes several improvements, which include upgrading the gas compressor impeller, improving the vent blower system, and recovering steam condensate for reuse. Total annual cost savings could be $1.5 million. The U.S. Department of Energy's Industrial Technologies Program cosponsored this assessment.

  11. Energy, Pollutant Emissions and Other Negative Externality Savings from Curbing Individual Motorized Transportation (IMT: A Low Cost, Low Technology Scenario Analysis in Brazilian Urban Areas

    Directory of Open Access Journals (Sweden)

    Ursula Maruyama

    2012-03-01

    Full Text Available This article examines the inefficient use of resources in the Brazilian transportation system. The energy use growth and external cost generation in this essential economic sector are considerable, and the trend is towards an increasing problem in the coming years. The continued expansion of Brazilian cities and the increase in demand for mobility is a result of a substantial growth in the number of road transport users, as increased earnings enable lower income groups to acquire and use individual motorized means of transport. The aim of this paper is to estimate the potential gains from reducing individual motorized transport by the year 2020. This investigation concludes that in a conservationist scenario, by prioritizing low cost, low technology public policies—which include operation of Bus Rapid Transit systems, walking and cycling facilities and congestion charges, among others—it should be possible to save over USD 30 billion and USD 26 billion in external transportation and infrastructure costs, respectively, up to 2020. In addition, these public policies can save more than 35 million Tons of Oil Equivalents in energy consumption and avoid almost 4,000 thousand tons of local pollution emissions and 37,500 thousand tons of GHG emissions in the same period.

  12. Trends in Opportunity Costs of U.S. Postsecondary Education: A National HRD and Human Capital Theory Analysis

    Science.gov (United States)

    Cornacchione, Edgard; Daugherty, Jenny L.

    2013-01-01

    The purpose of this study was to explore opportunity costs of postsecondary education in the U.S. in the past three decades (1975-2005), as a measure to support investment decisions at national levels and as experienced by individuals deciding on pursuing further education. Based on human capital theory and inspired by a set of studies aiming at…

  13. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method.Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  14. Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

    Science.gov (United States)

    Serxner, Seth; Alberti, Angela; Weinberger, Sarah

    2012-01-01

    To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

  15. Opportunities and new business models : transaction cost and property rights perspectives on entrepreneurship

    OpenAIRE

    Stieglitz, Nils; Foss, Nicolai Juul

    2009-01-01

    Entrepreneurs in a competitive economy face three fundamental problems. They need to search for and discover a business opportunity (Kirzner, 1973), evaluate it (Knight, 1921), and then seize the opportunity to reap entrepreneurial profits (Schumpeter, 1911) (Langlois, 2007). The problem that we address is how the ability to exploit business opportunities is influenced by entrepreneurial search and the economic organization of entrepreneurship (Arrow, 1962; Lippman & Rumelt, 2003;...

  16. Potential cost savings by minimisation of blood sample delays on care decision making in urgent care services

    Directory of Open Access Journals (Sweden)

    David M.S. Bodansky

    2017-08-01

    Conclusion: Sample rejection rate is high and is associated with increased in-hospital stay and cost. Blood sampling technique impacts on rejection rates. Reduction in sample rejection rates in emergency care areas in acute hospitals has the potential to impact on patient flow and reduce cost.

  17. Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

    Science.gov (United States)

    Howe, Lynn

    2008-06-01

    This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

  18. "Poverty is the big thing": exploring financial, transportation, and opportunity costs associated with fistula management and repair in Nigeria and Uganda.

    Science.gov (United States)

    Keya, Kaji Tamanna; Sripad, Pooja; Nwala, Emmanuel; Warren, Charlotte E

    2018-06-01

    Women living with obstetric fistula often live in poverty and in remote areas far from hospitals offering surgical repair. These women and their families face a range of costs while accessing fistula repair, some of which include: management of their condition, lost productivity and time, and transport to facilities. This study explores, through women's, communities', and providers' perspectives, the financial, transport, and opportunity cost barriers and enabling factors for seeking repair services. A qualitative approach was applied in Kano and Ebonyi in Nigeria and Hoima and Masaka in Uganda. Between June and December 2015, the study team conducted in-depth interviews (IDIs) with women affected by fistula (n = 52) - including those awaiting repair, living with fistula, and after repair, and their spouses and other family members (n = 17), along with health service providers involved in fistula repair and counseling (n = 38). Focus group discussions (FGDs) with male and female community stakeholders (n = 8) and post-repair clients (n = 6) were also conducted. Women's experiences indicate the obstetric fistula results in a combined set of costs associated with delivery, repair, transportation, lost income, and companion expenses that are often limiting. Medical and non-medical ancillary costs such as food, medications, and water are not borne evenly among all fistula care centers or camps due to funding shortages. In Uganda, experienced transport costs indicate that women spend Ugandan Shilling (UGX) 10,000 to 90,000 (US$3.00-US$25.00) for two people for a single trip to a camp (client and her caregiver), while Nigerian women (Kano) spent Naira 250 to 2000 (US$0.80-US$6.41) for transportation. Factors that influence women's and families' ability to cover costs of fistula care access include education and vocational skills, community savings mechanisms, available resources in repair centers, client counseling, and subsidized care and

  19. The effect of handover location on trauma theatre start time: An estimated cost saving of £131 000 per year.

    Science.gov (United States)

    Nahas, Sam; Ali, Adam; Majid, Kiran; Joseph, Roshan; Huber, Chris; Babu, Victor

    2018-02-08

    The National Health Service was estimated to be in £2.45 billion deficit in 2015 to 2016. Trauma theatre utilization and efficiency has never been so important as it is estimated to cost £15/minute. Structured questionnaires were given to 23 members of staff at our Trust who are actively involved in the organization or delivery of orthopaedic trauma lists at least once per week. This was used to identify key factors that may improve theatre efficiency. Following focus group evaluation, the location of the preoperative theatre meeting was changed, with all staff involved being required to attend this. Our primary outcome measure was mean theatre start time (time of arrival in the anaesthetic room) during the 1 month immediately preceding the change and the month following the change. Theatre start time was improved on average 24 minutes (1 month premeeting and postmeeting change). This equates to a saving of £360 per day, or £131 040 per year. Changing the trauma meeting location to a venue adjacent to the trauma theatre can improve theatre start times, theatre efficiency, and therefore result in significant cost savings. Copyright © 2018 John Wiley & Sons, Ltd.

  20. Guide to protect climate. Saving energy and cost, protecting climate; Der Klima-Knigge. Energie sparen, Kosten senken, Klima schuetzen

    Energy Technology Data Exchange (ETDEWEB)

    Griesshammer, Rainer

    2008-07-01

    As a climate protector you mustn't seat in the darkness. The author shows by much humour and esprit how simple it is to save energy. Who is willing to persue his every day tips, must not miss comfort and lowers even carbon dioxide emission. This is good for the environment and fills up the own purse. (orig./GL) [German] Als Klimaschuetzer braucht man nicht im Dunkeln zu sitzen. Mit viel Humor und Esprit zeigt Griesshammer, wie einfach Energie sparen sein kann. Wer seine Alltagstipps befolgt, muss auf keinen Komfort verzichten und mindert trotzdem den CO2-Ausstoss. Das nutzt der Umwelt und fuellt den eigenen Geldbeutel auf. (orig./GL)

  1. New environment-friendly and cost-saving fertiliser recommendation system for supporting sustainable agriculture in Hungary and beyond

    Directory of Open Access Journals (Sweden)

    Nándor FODOR

    2011-07-01

    Full Text Available In the current economic situation the former, intensive fertiliser recommendation system is unfit to help Hungarian farmers in their fertilising practice. The aim of the new system has been to apply the lowest possible NPK rates required to achieve safe and high yields as well as allowing minimal agricultural NP losses to surface and subsurface waters. The new system was developed by using the correlations revealed by analyzing the results of long-term fertilisation experiments set up in Hungary between 1960 and 2000. Several field experiments as well as comparative analyses confirmed the correctness of the basic principles as well as of the methods of calculating fertiliser rates of the new system. An estimated amount of 3,200,000 € was saved for the Hungarian farmers in 2007 alone by giving recommendations for more than 160,000 ha arable land applying the new system.

  2. Integrated economic and life cycle assessment of thermochemical production of bioethanol to reduce production cost by exploiting excess of greenhouse gas savings

    International Nuclear Information System (INIS)

    Reyes Valle, C.; Villanueva Perales, A.L.; Vidal-Barrero, F.; Ollero, P.

    2015-01-01

    Highlights: • Assessment of economics and sustainability of thermochemical ethanol production. • Exploitation of excess CO 2 saving by either importing fossil energy or CO 2 trading. • Significant increase in alcohol production by replacing biomass with natural gas. • CO 2 emission trading is not cost-competitive versus import of fossil energy. • Lowest ethanol production cost for partial oxidation as reforming technology. - Abstract: In this work, two options are investigated to enhance the economics of the catalytic production of bioethanol from biomass gasification by exploiting the excess of CO 2 emission saving: (i) to import fossil energy, in the form of natural gas and electricity or (ii) to trade CO 2 emissions. To this end, an integrated life cycle and economic assessment is carried out for four process configurations, each using a different light hydrocarbon reforming technology: partial oxidation, steam methane reforming, tar reforming and autothermal reforming. The results show that for all process configurations the production of bioethanol and other alcohols significantly increases when natural gas displaces biomass, maintaining the total energy content of the feedstock. The economic advantage of the partial substitution of biomass by natural gas depends on their prices and this is explored by carrying out a sensitivity analysis, taking historical prices into account. It is also concluded that the trade of CO 2 emissions is not cost-competitive compared to the import of natural gas if the CO 2 emission price remains within historical European prices. The CO 2 emission price would have to double or even quadruple the highest CO 2 historical price for CO 2 emission trading to be a cost-competitive option

  3. Potential cost savings in waste incineration in grate furnaces; Kosteneinsparpotentiale bei der Verbrennung von Abfaellen in Rostfeuerungsanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, C; Beckmann, R [Fraunhofer Inst. fuer Umwelt-, Sicherheits- und Energietechnik UMSICHT, Oberhausen (Germany). Abt. Abfall- und Kreislaufwirtschaft

    1998-09-01

    Shortage of public puts increased cost pressure on thermal treatment of waste. The specific operating cost of current projects is around 200 DM/t. The contribution outlines parameters that can help to reduce the operating and investment cost. This includes economic as well as technical parameters that directly influence plant operation. The analyses were carried out using the UMSICHT-owned calculation program GLOBUS which permits the conservative determination of the cost-determining plant cost as a function of sensitive influencing parameters. (orig./SR) [Deutsch] Nicht zuletzt aufgrund leerer oeffentlicher Kassen hat in den letzten Jahren ein Umdenken stattgefunden, das durch die Forderung nach umweltvertraeglichen Entsorgungsverfahren bei gleichzeitig moderaten Abfallgebuehren gepraegt ist. Somit hat fuer die thermische Abfallbehandlung der Kostendruck stark zugenommen. Fuer aktuelle Projekte werden spezifische Betriebskosten von etwa 200 DM/t erreicht. Der vorliegende Beitrag zeigt kostenwirksame Einflussgroessen auf, durch die eine Reduzierung der Betriebs- und Investitionskosten ermoeglicht wird. Dazu gehoeren sowohl abfallwirtschaftlicher Parameter als auch technische Groessen, die einen direkten Einfluss auf den Betrieb der Anlage besitzen. Die Analysen wurden mit dem UMSICHT-eigenen Kalkulationsprogramm GLOBUS durchgefuehrt, das die belastbare Ermittlung der fuer die Kostenseite bestimmenden Apparatekosten in Abhaengigkeit sensitiver Einflussgroessen erlaubt. (orig./SR)

  4. Net savings

    International Nuclear Information System (INIS)

    Roche, P.

    2001-01-01

    The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study was

  5. Net savings

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2001-02-01

    The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study

  6. Status and opportunities associated with product costing strategies in wood component manufacturing

    Science.gov (United States)

    Adrienn Andersch; Urs Buehlmann; Jan Wiedenbeck; Steve Lawser

    2013-01-01

    Product costing systems are critically important for businesses because they help reduce costs, price products at competitive prices, and enable strategic decisionmaking. This article reports the results of a survey designed to collect information about practices used by the North American hardwood dimension and components industry to calculate the cost of their...

  7. Adding A Dietician to the Liaison-Team after Discharge of Geriatric Patients at Nutritional Risk May Save Health Care Costs

    DEFF Research Database (Denmark)

    Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher

    2016-01-01

    with (intervention group, IG) or without a dietitian (control group, CG). The IG received three home visits by the dietitian during a 12-week period. Data included in the economic analysis was time spent by the dietitian, use of oral nutritional supplements (ONS) and number of hospitalization days. Results......: Of the 71 included patients, 34 were in the IG, 30 patients received all three dietitian visits. Cumulated number of hospitalization days was 172 in the IG and 415 in the CG. Use of ONS was 48 % in the IG and 17% in the CG (P=0.001). Estimated cost for the dietitian and ONS combined in the IG was €9......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

  8. Household opportunity costs of protecting and developing forest lands in Son La and Hoa Binh Provinces, Vietnam

    Directory of Open Access Journals (Sweden)

    Le Ngoc Lan

    2016-09-01

    Full Text Available Vietnam has pilot-tested a payment for forest environmental services (PFES program in an effort to restore and protect forest areas, some of which have been severely degraded by the excessive cutting of trees by small-scale farmers planting annual crops on steep, sloping lands. The pilot program implemented in southern Vietnam seems to be successful, yet the program in northern Vietnam has not produced the desired rates of planting and maintaining forest areas. The reasons for these mixed results include differences in socio-economic characteristics and also the production and marketing opportunities available to rural households in the project areas. To gain insight regarding program participation, we examine the household-level opportunity costs of planting and ­maintaining small plots of forest trees in northern Vietnam. We find that small-scale farmers in Hoa Binh Province, with limited financial resources, prefer the annual revenue stream provided by crops such as maize and cassava, rather than waiting for 7 years to obtain revenue from a forest planting. Farmers in Son La Province, with limited access to markets, prefer annual crops because they are not able to sell bamboo shoots and other forest products harvested from their small plots. In both provinces, the payments offered for planting and maintaining forest trees are smaller than the opportunity costs of planting and harvesting annual crops. Thus, most households likely would choose not to participate in the PFES program, at current payment rates, if given the opportunity to decline.

  9. Reducing Idle Power Consumption in Office Spaces Saves U.S. Navy in Energy Costs (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2014-04-01

    As part of a two-year project to demonstrate energy efficiency measures, renewable energy generation, and energy systems integration, the National Renewable Energy Laboratory (NREL) has identified advanced plug load controls as a promising technology for reducing energy use and related costs in the U.S. Navy's Naval Facilities Engineering Command (NAVFAC) office spaces.

  10. Compendium of GAO’s Views on the Cost Saving Proposals of the Grace Commission. Volume 2. Individual Issue Analyses

    Science.gov (United States)

    1985-02-19

    fashion , linking it to other management processes such as budgeting and operational planning. III. GAO ASSESSMENT OF IMPLEMENTATION AUTHORITY...research which private industy is able to conduct on its own. Past GAO work has illustrated the costs of duplica- tion. A 1982 GAO report on UMTA...could be increased approximately $4.9 million, over 3 years, if the average concessioner franchise fee were increased from 2 to 4 percent of gross

  11. Emergency planning. Can the cost of remedial actions be compared to the value of the health effects they save

    International Nuclear Information System (INIS)

    Frittelli, L.; Tamburrano, A.

    1981-01-01

    When an accidental release of radioactive material occurs the exposure of the people concerned can be reduced only by remedial actions, applied to individuals (evacuation) or their environment (e.g. by land interdiction, by impoundment of contaminated products). The adoption of remedial actions should be based on a balance between the damage they cause and the reduction in health effects they can achieve. In this paper a 'cost-effectiveness' analysis is attempted by comparing the costs of remedial actions with the monetary value of the collective dose avoided by them. Remedial actions are undertaken to prevent non-stochastic effects in the exposed population and to limit stochastic effects therein. The damage caused by the remedial actions is evaluated by taking into account the loss of value of interdicted property, the costs for decontaminating land and structures, the loss of income of evacuated people. The options in remedial actions (interdiction, decontamination, goods removal) which minimize the total costs are supposed to be adopted at every location. The collective effective dose equivalent avoided by the remedial actions is computed by taking into account the external exposure from the cloud and from the contaminated ground, and the internal exposure from material inhaled from the passing cloud or inhaled from matter resuspended after deposition on the ground. The extent of the resulting total damage (both economic and health aspects) is partly determined by the intervention level chosen for defining the time and space features of remedial actions. As a result, the total damage has a lower value for an intervention level of about 0.1 Sv for large and medium releases from a nuclear power plant in a not very highly developed site. For a contained release no value of the intervention level optimizes the balance between health and economic consequences. (author)

  12. Ownership, competition, and the adoption of new technologies and cost-saving practices in a fixed-price environment.

    Science.gov (United States)

    Hirth, R A; Chernew, M E; Orzol, S M

    2000-01-01

    Advances in medical technology have been implicated as the primary cause of rising health care expenditures. It is not yet known whether the increasing prevalence of managed care mechanisms, particularly capitation, will change substantially incentives for acquiring and using cost-increasing innovations. We examined the decisions of dialysis units (a set of providers that has faced capitation and real decreases in payment for several decades) with respect to use of cost-increasing technologies that enhance quality of care, cost-cutting practices that reduce quality of care, and amenities desired by patients that are unrelated to quality of care. We found that the dialysis payment system does not appear to have blocked access to a number of new, quality-enhancing technologies that were developed in the 1980s. However, facilities made adjustments along other valuable margins to facilitate adoption of these technologies; use of new technologies varied with numerous facility, regulatory, and case-mix characteristics including ownership, chain membership, size, market competition, and certificate of need programs. Interestingly, the trade-offs made by for-profit and nonprofit facilities when faced with fixed prices appeared quite different. For-profits tended to deliver lower technical quality of care but more amenities, while nonprofits favored technical quality of care over amenities. Our findings may have implications for the response of other types of health care providers to capitation and increasing economic constraints.

  13. Impact of political costs on company benefits in the institutions with high free cash flow and low growth opportunity: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Mohammad Pasandidehfar

    2015-11-01

    Full Text Available The political costs, bonuses paid to managers, how to use the growth opportunities obtained and their effects on the profitability of companies are the issues that have always been a major of corporations’ concerns. Company exposure to political decisions, its costs and effects on the company's cash flow is very important. Hence, understanding the relationship between variables in a company and how they influence on each other helps management decisions for better opportunities and reduction in political costs, increase cash flow and ultimately increase the profitability of the firms. This survey studies the relationship between the impact of political costs on companies with high free cash flow and low growth opportunity. In this survey, company's assets, sales, income and number of employees are estimated. Then the indexes related to these costs are evaluated based on the tax component, the cost of the sports, personnel costs and relationships among them. Pearson correlation coefficient, regression coefficients and analysis of variance have been used to examine the hypotheses of the survey. The results show that the political cost, high free cash flow and low growth opportunity had negative correlations with each other. In other words, there was a negative relationship between profit and political costs in companies with high free cash flow and low growth opportunity. Moreover, high free cash flow and low growth opportunities had significant effect on the relationship between political costs and benefits in companies listed in Tehran Stock Exchange.