WorldWideScience

Sample records for cost savings results

  1. 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.  

  2. Saving Green on Energy Costs

    Science.gov (United States)

    Tacke, Diane L.

    2006-01-01

    In recent years, colleges and universities have begun efforts to reduce their energy costs, an initiative that can not only save an institution money, but also strengthen relationships across campus. Board leadership has been central to this endeavor in setting goals, prioritizing projects, and financing those projects. Using her experiences with…

  3. FY 1995 cost savings report

    Energy Technology Data Exchange (ETDEWEB)

    Andrews-Smith, K.L., Westinghouse Hanford

    1996-06-21

    Fiscal Year (FY) 1995 challenged us to dramatically reduce costs at Hanford. We began the year with an 8 percent reduction in our Environmental Management budget but at the same time were tasked with accomplishing additional workscope. This resulted in a Productivity Challenge whereby we took on more work at the beginning of the year than we had funding to complete. During the year, the Productivity Challenge actually grew to 23 percent because of recissions, Congressional budget reductions, and DOE Headquarters actions. We successfully met our FY 1995 Productivity Challenge through an aggressive cost reduction program that identified and eliminated unnecessary workscope and found ways to be more efficient. We reduced the size of the workforce, cut overhead expenses, eliminated paperwork, cancelled construction of new facilities, and reengineered our processes. We are proving we can get the job done better and for less money at Hanford. DOE`s drive to do it ``better, faster, cheaper`` has led us to look for more and larger partnerships with the private sector. The biggest will be privatization of Hanford`s Tank Waste Remediation System, which will turn liquid tank waste into glass logs for eventual disposal. We will also save millions of dollars and avoid the cost of replacing aging steam plants by contracting Hanford`s energy needs to a private company. Other privatization successes include the Hanford Mail Service, a spinoff of advanced technical training, low level mixed waste thermal treatment, and transfer of the Hanford Museums of Science and history to a private non-profit organization. Despite the rough roads and uncertainty we faced in FY 1995, less than 3 percent of our work fell behind schedule, while the work that was performed was completed with an 8.6 percent cost under-run. We not only met the FY 1995 productivity challenge, we also met our FY 1995-1998 savings commitments and accelerated some critical cleanup milestones. The challenges continue

  4. Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings? Comparing healthcare costs and utilization between second-line treatment options.

    Science.gov (United States)

    Hassan, Amany K; Farmer, Kevin C; Brahm, Nancy C; Keast, Shellie; Nesser, Nancy; Neas, Barbara R

    2016-12-01

    Several atypical antipsychotics (AAPs) are used as second-line agents for treatment resistant depression. AAPs can be expensive compared to other treatment options and can cause several side effects. To estimate healthcare costs and utilization of AAPs compared to other second-line agents. Observational study using Medicaid claims data (2006-2011). Subjects were depression-diagnosed adult members with at least two prescriptions of antidepressant medications followed by a second-line agent. Gamma generalized linear models (GLM) produced estimates of the difference in mean expenditures among treatment groups after adjusting for individual baseline characteristics using propensity scores. Negative binomial models produced estimates of the difference in number of hospitalizations and emergency department (ED) visits. A total of 3910 members received second-line treatment. Treatment groups were AAPs (n = 2211), augmentation agents other than AAPs (n = 1008), and antidepressant switching (n = 691). AAPs resulted in higher mean adjusted pharmacy costs and higher mean adjusted total mental health-related costs. Mean adjusted total healthcare costs and number of inpatient and ED visits were not different among treatments. The results show no evidence that AAPs used as second-line treatment for depression results in overall cost savings or lower inpatient and ED visits compared to other treatment strategies.

  5. Can Digital Pathology Result In Cost Savings? A Financial Projection For Digital Pathology Implementation At A Large Integrated Health Care Organization

    Science.gov (United States)

    Ho, Jonhan; Ahlers, Stefan M.; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L.; Kuzmishin, John A.; Montalto, Michael C.; Parwani, Anil V.

    2014-01-01

    Background: Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology “slide less” clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. Aim: As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Methods: Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. Results: When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by

  6. Can digital pathology result in cost savings? A financial projection for digital pathology implementation at a large integrated health care organization.

    Science.gov (United States)

    Ho, Jonhan; Ahlers, Stefan M; Stratman, Curtis; Aridor, Orly; Pantanowitz, Liron; Fine, Jeffrey L; Kuzmishin, John A; Montalto, Michael C; Parwani, Anil V

    2014-01-01

    Digital pathology offers potential improvements in workflow and interpretive accuracy. Although currently digital pathology is commonly used for research and education, its clinical use has been limited to niche applications such as frozen sections and remote second opinion consultations. This is mainly due to regulatory hurdles, but also to a dearth of data supporting a positive economic cost-benefit. Large scale adoption of digital pathology and the integration of digital slides into the routine anatomic/surgical pathology "slide less" clinical workflow will occur only if digital pathology will offer a quantifiable benefit, which could come in the form of more efficient and/or higher quality care. As a large academic-based health care organization expecting to adopt digital pathology for primary diagnosis upon its regulatory approval, our institution estimated potential operational cost savings offered by the implementation of an enterprise-wide digital pathology system (DPS). Projected cost savings were calculated for the first 5 years following implementation of a DPS based on operational data collected from the pathology department. Projected savings were based on two factors: (1) Productivity and lab consolidation savings; and (2) avoided treatment costs due to improvements in the accuracy of cancer diagnoses among nonsubspecialty pathologists. Detailed analyses of incremental treatment costs due to interpretive errors, resulting in either a false positive or false negative diagnosis, was performed for melanoma and breast cancer and extrapolated to 10 other common cancers. When phased in over 5-years, total cost savings based on anticipated improvements in pathology productivity and histology lab consolidation were estimated at $12.4 million for an institution with 219,000 annual accessions. The main contributing factors to these savings were gains in pathologist clinical full-time equivalent capacity impacted by improved pathologist productivity and workload

  7. 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.

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

    Science.gov (United States)

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

    2017-12-15

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

  9. 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.

  10. USAID IT Reform Cost Savings/Avoidance

    Data.gov (United States)

    US Agency for International Development — The Office of the Chief Information Officer in the Management Bureau of USAID launched initiatives designed for IT cost savings and avoidance. This dataset includes...

  11. 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...

  12. Lifestyle intervention: from cost savings to value for money.

    Science.gov (United States)

    Rappange, David R; Brouwer, Werner B F; Rutten, Frans F H; van Baal, Pieter H M

    2010-09-01

    Prevention of unhealthy lifestyles has sometimes been promoted as simultaneously reducing costs and improving public health but this will unlikely prove to be true. Additional medical costs in life years gained due to treatment of unrelated diseases may offset possible savings in related diseases, but are often ignored both in health promotion policies and in economic evaluations of life-prolonging interventions. Many national guidelines explicitly recommend excluding these costs from economic evaluations or leave inclusion up to the discretion of the analyst. This may result in too favorable estimations of cost-effectiveness, feeding the unjustified optimism among policymakers regarding lifestyle interventions as a cost-saving option. However, prevention may still be a cost-effective way to improve public health, even when it does not result in cost savings, but this should be judged taking all future costs into account and be based on the true value for money provided by lifestyle interventions.

  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. 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.

  15. Accrued Cost Savings of a Free Clinic Using Quality-Adjusted Life Years Saved and Return on Investment.

    Science.gov (United States)

    Sanders, Jim; Lacey, Marcus; Guse, Clare E

    2017-01-01

    Savings garnered through the provision of preventive services is a form of profit for health systems. Free clinics have been using this logic to demonstrate their cost-savings. The Community-Based Chronic Disease Management (CCDM) clinic treats hypertension using nurse-led teams, clinical protocols, and community-based settings. We calculated CCDM's cost-effectiveness from 2007 to 2013 using 2 metrics: Quality-adjusted life years (QALYs) saved and return on investment (ROI). QALYs were calculated using the Clinical Preventive Burden (CPB) score for hypertension care. ROI was calculated by tallying the savings from prevented heart attacks, strokes, and emergency department visits against the total operating costs. Using conservative assumptions for cost estimates, hypertension care resulted in a value of QALYs saved of $711,000 to $2,133,000 and an ROI ratio range of 0.35 to 1.20. Our study shows that when using conservative assumptions to calculate cost-savings, our free clinic did not save money. Cost-savings did occur, but the amount was modest, was less than that of cost-inputs, and was not likely captured by any single health entity. Although free clinics remain a vital health care access point for many Americans, it has yet to be demonstrated that they generate a net savings. © Copyright 2017 by the American Board of Family Medicine.

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

    Directory of Open Access Journals (Sweden)

    Baskerville Neill

    2005-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-22

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

  18. Disease prevention: saving lives or reducing health care costs?

    Directory of Open Access Journals (Sweden)

    Inge Grootjans-van Kampen

    Full Text Available BACKGROUND: Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity increases health care costs while preventing non-fatal diseases could lead to health care savings. The objective of this research is to investigate if disease prevention could result in both increased longevity and lower lifetime health care costs. METHODS: Mortality rates for Netherlands in 2009 were used to construct cause-deleted life tables. Data originating from the Dutch Costs of Illness study was incorporated in order to estimate lifetime health care costs in the absence of selected disease categories. We took into account that for most diseases health care expenditures are concentrated in the last year of life. RESULTS: Elimination of diseases that reduce life expectancy considerably increase lifetime health care costs. Exemplary are neoplasms that, when eliminated would increase both life expectancy and lifetime health care spending with roughly 5% for men and women. Costs savings are incurred when prevention has only a small effect on longevity such as in the case of mental and behavioural disorders. Diseases of the circulatory system stand out as their elimination would increase life expectancy while reducing health care spending. CONCLUSION: The stronger the negative impact of a disease on longevity, the higher health care costs would be after elimination. Successful treatment of fatal diseases leaves less room for longevity gains due to effective prevention but more room for health care savings.

  19. GSA IT Reform Cost Savings/Avoidance

    Data.gov (United States)

    General Services Administration — GSA IT provides data related to Agency IT initiatives that save or avoid expenditures. This data is provided as a requirement of OMB's Integrated Data Collection...

  20. Medication nonadherence in diabetes: longitudinal effects on costs and potential cost savings from improvement.

    Science.gov (United States)

    Egede, Leonard E; Gebregziabher, Mulugeta; Dismuke, Clara E; Lynch, Cheryl P; Axon, R Neal; Zhao, Yumin; Mauldin, Patrick D

    2012-12-01

    To examine the longitudinal effects of medication nonadherence (MNA) on key costs and estimate potential savings from increased adherence using a novel methodology that accounts for shared correlation among cost categories. Veterans with type 2 diabetes (740,195) were followed from January 2002 until death, loss to follow-up, or December 2006. A novel multivariate, generalized, linear, mixed modeling approach was used to assess the differential effect of MNA, defined as medication possession ratio (MPR) ≥0.8 on healthcare costs. A sensitivity analysis was performed to assess potential cost savings at different MNA levels using the Consumer Price Index to adjust estimates to 2012 dollar value. Mean MPR for the full sample over 5 years was 0.78, with a mean of 0.93 for the adherent group and 0.58 for the MNA group. In fully adjusted models, all annual cost categories increased ∼3% per year (P = 0.001) during the 5-year study time period. MNA was associated with a 37% lower pharmacy cost, 7% lower outpatient cost, and 41% higher inpatient cost. Based on sensitivity analyses, improving adherence in the MNA group would result in annual estimated cost savings ranging from ∼$661 million (MPR <0.6 vs. ≥0.6) to ∼$1.16 billion (MPR <1 vs. 1). Maximal incremental annual savings would occur by raising MPR from <0.8 to ≥0.8 ($204,530,778) among MNA subjects. Aggressive strategies and policies are needed to achieve optimal medication adherence in diabetes. Such approaches may further the so-called "triple aim" of achieving better health, better quality care, and lower cost.

  1. DETERMINING ENERGY SAVINGS IN BUILDINGS USING THE REDUCING COSTS METHOD

    OpenAIRE

    STAN IVAN F.E.; MIRCEA I

    2015-01-01

    The paper is structured in four parts. The first part presents the importance of thermal insulation for buildings energy economy and some insulation properties. In the second part of the paper it is described the reducing cost method to determine the energy savings. The third part of the paper includes an analysis and a comparison for an exterior wall provided with different thicknesses of insulation layer in order to determine the average savings cost. The last par...

  2. Cost Savings Analysis Guidelines for Manufacturing Technology Projects.

    Science.gov (United States)

    1985-06-28

    14 3.2.1 ’CHANGED COSTO SAMPLE PROJECT .................. .. 16 3.2.1.1 COST SAVINGS NARRATIVE ..................... 17 3.2.1.2 RECURRING COSTS...an MT project, an abbreviated format called Worksheet A is used. In such cases, all capital , operating, and implementation costs are . reflected in...not necessary to factor in the capital investment in the crystal Puller and other such implementation costs to the contractor. All such costs are

  3. 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.

  4. Potential Logistics Cost Savings from Engine Commonality

    Science.gov (United States)

    2007-12-01

    BASICS AND COST-ESTIMATING METHODOLOGY Several RAND studies detail cost methodology and spending assessments across the full range of support of both...Moore, Lorell, Mason, and Graser’s 2002 RAND Report Military Jet Engine Acquisition: Technology Basics and Cost- Estimating Methodology, pages 9 -14...9 2 2 ,016 .75$ F t W ayn e F W A 3 3 .6 7.9 3 2 0 .526 2 .326 1 .01 5 2 .8 9 2 92 .5 2 3 ,400 .00$ D ulu th D LH 4 0

  5. 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.

  6. Cost savings from performance-based maintenance contracting

    OpenAIRE

    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, cost-effective solutions that meet the performance criteria can be achieved, especially if the principle of whole-life costing is being adopted. Indirect cost savings are expected as well. It enables maintenanc...

  7. Wellness incentives in the workplace: cost savings through cost shifting to unhealthy workers.

    Science.gov (United States)

    Horwitz, Jill R; Kelly, Brenna D; DiNardo, John E

    2013-03-01

    The Affordable Care Act encourages workplace wellness programs, chiefly by promoting programs that reward employees for changing health-related behavior or improving measurable health outcomes. Recognizing the risk that unhealthy employees might be punished rather than helped by such programs, the act also forbids health-based discrimination. We reviewed results of randomized controlled trials and identified challenges for workplace wellness programs to function as the act intends. For example, research results raise doubts that employees with health risk factors, such as obesity and tobacco use, spend more on medical care than others. Such groups may not be especially promising targets for financial incentives meant to save costs through health improvement. Although there may be other valid reasons, beyond lowering costs, to institute workplace wellness programs, we found little evidence that such programs can easily save costs through health improvement without being discriminatory. Our evidence suggests that savings to employers may come from cost shifting, with the most vulnerable employees--those from lower socioeconomic strata with the most health risks--probably bearing greater costs that in effect subsidize their healthier colleagues.

  8. COST SAVING WITH ULTRASONOGRAPHY IN A DEVELOPING ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... under the Progamme of Science, Research and Development. STD 111 (Science and Technology for Development nr. TS3. - CT 94 - 0330) and Glaxo, Wellcome, Hamburg, Germany. REFERENCES. Margulis, A.R. Radiologic imaging: Changing cost, greater benefits (Whitehouse Lecture). Amer. J. Radiol.

  9. 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

  10. 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.

  11. Energy-saving wastewater treatment systems: formulation of cost functions.

    Science.gov (United States)

    Nogueira, R; Ferreira, I; Janknecht, P; Rodríguez, J J; Oliveira, P; Brito, A G

    2007-01-01

    Natural interactions between water, soil, atmosphere, plants and microorganisms include physical, chemical and biological processes with decontaminating capacities. Natural or energy-saving wastewater treatment systems utilize these processes and thereby enable a sustainable management in the field of wastewater treatment, offering low investment and operation costs, little or no energy consumption, little and low-skill labor requirements, good landscape integration and excellent feasibility for small settlements, especially when remote from centralized sewer systems. The objective of this work is the development of cost functions for investment and operation of energy-saving wastewater treatment technologies. Cost functions are essential for making cost estimations based on a very reduced number of variables. The latter are easily identified and quantified and have a direct bearing on the costs in question. The formulated investment and operation cost functions follow a power law, and the costs decrease with the increase of the population served. The different energy-saving wastewater treatment systems serving small population settlements, between 50 p.e. and 250 p.e., present associated investment costs varying from 400 Euro/p.e. to 200 Euro/p.e. and annual operation costs in the range of 70 Euro/p.e. to 20 Euro/p.e., respectively.

  12. Energy cost saving strategies in distributed power networks

    Directory of Open Access Journals (Sweden)

    Tcheukam Alain

    2016-01-01

    Full Text Available In this paper we study energy cost saving strategies in power networks in presence of prosumers. Three tips are considered: (i distributed power network architecture, (ii peak energy shaving with the integration of prosumers’ contribution, (iii Electric vehicles self-charging by means of prosumers’ production. The proposed distributed power network architecture reduces significantly the transmission costs and can reduce significantly the global energy cost up to 42 percent. Different types of prosumer who use self-charging photovoltaic systems, are able to intelligently buy energy from, or sell it, to the power grid. Therein, prosumers interact in a distributed environment during the purchase or sale of electric power using a double auction with negotiation mechanism. Using a two-step combined learning and optimization scheme, each prosumer can learn its optimal bidding strategy and forecast its energy production, consumption and storage. Our simulation results, conducted for the region of Sicily in Italy, show that the integration of prosumers can reduce peak hour costs up to 19 percent and 6 percent for eligible prosumers with electric vehicles.

  13. DETERMINING ENERGY SAVINGS IN BUILDINGS USING THE REDUCING COSTS METHOD

    Directory of Open Access Journals (Sweden)

    STAN IVAN F.E.

    2015-03-01

    Full Text Available The paper is structured in four parts. The first part presents the importance of thermal insulation for buildings energy economy and some insulation properties. In the second part of the paper it is described the reducing cost method to determine the energy savings. The third part of the paper includes an analysis and a comparison for an exterior wall provided with different thicknesses of insulation layer in order to determine the average savings cost. The last part presents conclusions and discussion.

  14. 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

    The load in mobile networks is subject to variations during the day, due to user mobility and varying network average usage. Therefore, the traditional or Distributed Radio Access Network (D-RAN) architecture, where the BaseBand processing Units (BBUs) are assigned statically to a number of cells...... using OPNET Modeler. A real case scenario is built upon the mobile traffic forecast for year 2017, a number of recommendations on traffic models and a proposed C-RAN implementation. The results achieved show that the maximum statistical multiplexing gain for user plane traffic in C-RAN architecture is 4......, 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...

  15. Energy-saving wastewater treatment systems : formulation of cost functions

    OpenAIRE

    Nogueira, R.; Ferreira, I.; Janknecht, P; Rodríguez, Juan José; de Oliveira, Pedro; A. G. Brito

    2007-01-01

    Natural interactions between water, soil, atmosphere, plants and microorganisms include physical, chemical and biological processes with decontaminating capacities. Natural or energy-saving wastewater treatment systems utilize these processes and thereby enable a sustainable management in the field of wastewater treatment, offering low investment and operation costs, little or no energy consumption, little and low-skill labor requirements, good landscape integration and excellent ...

  16. Potential cost savings from generic medicines – protecting the ...

    African Journals Online (AJOL)

    One way to do this would be to limit the costs of medicines provided for the management of chronic conditions listed in the PMBs. This study assessed the potential savings that would be achievable by substituting generics for brand name (originator) medicines listed in the chronic disease algorithms set out by the CMS.

  17. Permanent magnets in accelerators can save energy, space and cost

    DEFF Research Database (Denmark)

    Bødker, F.; Baandrup, L.O.; Hauge, N.

    2013-01-01

    Green Magnet® technology with close to zero electrical power consumption without the need for cooling water saves costs, space and natural resources. A compact dipole based on permanent magnets has been developed at Danfysik in collaboration with Sintex and Aarhus University. Our first Green Magnet...

  18. 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.

  19. 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

  20. 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.

  1. Evaluation of the Super ESPC Program: Level 2 -- Recalculated Cost Savings

    Energy Technology Data Exchange (ETDEWEB)

    Shonder, John A [ORNL; Hughes, Patrick [ORNL

    2009-04-01

    This report presents the results of Level 2 of a three-tiered evaluation of the U.S. Department of Energy Federal Energy Management Program's Super Energy Savings Performance Contract (Super ESPC) Program. Level 1 of the analysis studied all of the Super ESPC projects for which at least one Annual Measurement & Verification (M&V) Report had been produced by April 2006. For those 102 projects in aggregate, we found that the value of cost savings reported by the energy service company (ESCO) in the Annual M&V Reports was 108% of the cost savings guaranteed in the contracts. We also compared estimated energy savings (which are not guaranteed, but are the basis for the guaranteed cost savings) to the energy savings reported by the ESCO in the Annual M&V Report. In aggregate, reported energy savings were 99.8% of estimated energy savings on the basis of site energy, or 102% of estimated energy savings based on source energy. Level 2 focused on a random sample of 27 projects taken from the 102 Super ESPC projects studied in Level 1. The objectives were, for each project in the sample, to: repeat the calculations of the annual energy and cost savings in the most recent Annual M&V Report to validate the ESCO's results or correct any errors, and recalculate the value of the reported energy, water, and operations and maintenance (O&M) savings using actual utility prices paid at the project site instead of the 'contract' energy prices - the prices that are established in the project contract as those to be used by the ESCO to calculate the annual cost savings, which determine whether the guarantee has been met. Level 3 analysis will be conducted on three to five projects from the Level 2 sample that meet validity criteria for whole-building or whole-facility data analysis. This effort will verify energy and cost savings using statistical analysis of actual utility use, cost, and weather data. This approach, which can only be used for projects meeting

  2. 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.

  3. 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...... reductions between 0.5% and 2% of turnover. The main implication is that the method provides a quantitative basis for the discussion on whether or not to implement shared product architectures. This means a more fact-based approach is introduced....

  4. Speech Therapy Telepractice for Vocal Cord Dysfunction (VCD: MaineCare (Medicaid Cost Savings

    Directory of Open Access Journals (Sweden)

    Michael P. Towey

    2012-06-01

    Full Text Available This Brief Communication represents an analysis of the cost savings to MaineCare (also referred to as Medicaid directly attributable to service provided via speech therapy telepractice. Seven female (primarily adolescent MaineCare patients consecutively referred to Waldo County General Hospital (WCGH with suspected diagnosis of Vocal Cord Dysfunction (VCD were treated by speech therapy telepractice. Outcome data demonstrated a first month cost savings of $2376.72. The analysis additionally projected thousands of dollars of potential savings each month in reduced medical costs for this patient group as a result of successful treatment via speech therapy telepractice.  The study suggests that without access to speech therapy telepractice for patients with VCD, the ongoing medical costs to MaineCare will be ongoing and significant.

  5. Speech Therapy Telepractice for Vocal Cord Dysfunction (VCD): MaineCare (Medicaid) Cost Savings.

    Science.gov (United States)

    Towey, Michael P

    2012-01-01

    This Brief Communication represents an analysis of the cost savings to MaineCare (also referred to as Medicaid) directly attributable to service provided via speech therapy telepractice. Seven female (primarily adolescent) MaineCare patients consecutively referred to Waldo County General Hospital (WCGH) with suspected diagnosis of Vocal Cord Dysfunction (VCD) were treated by speech therapy telepractice. Outcome data demonstrated a first month cost savings of $2376.72. The analysis additionally projected thousands of dollars of potential savings each month in reduced medical costs for this patient group as a result of successful treatment via speech therapy telepractice. The study suggests that without access to speech therapy telepractice for patients with VCD, the medical costs to MaineCare will be ongoing and significant.

  6. 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.

  7. Dialyzer reuse: justified cost saving for south Asian region.

    Science.gov (United States)

    Dhrolia, Murtaza F; Nasir, Kiran; Imtiaz, Salman; Ahmad, Aasim

    2014-08-01

    In spite of controversies, dialyzer reuse has remained an integral part of hemodialysis because of lower cost, good overall safety record, and improved membrane biocompatibility. Reuse declined in developed countries from the beginning of this century because of mass production of hemodialyzers at favourable price with better biocompatible membrane. Abandoning dialyzer reuse became challenging in South Asian region, where more than 40% of the population live below the International Poverty Line of $1.25 per day, less than 10% of end stage renal disease patients receive renal replacement therapy, and upto 70% of those starting dialysis stop treatment due to cost within the first 3 months. Dialyzer reuse is an efficient cost-saving method that allows the use of more efficient and expensive biocompatible synthetic membranes, thereby providing high-quality dialysis to individuals living in countries with limited medical resources without compromising the safety or effectiveness of the treatment.

  8. 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.

  9. 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.

  10. Incorrect storage of medicines and potential for cost savings

    DEFF Research Database (Denmark)

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

    2017-01-01

    Objective Incorrect storage and handling of refrigerated medicines may result in destruction of medicines and financial loss for hospitals. At the Medicine Information Centre we receive and answer queries on drug-related issues. In this study we aimed to investigate and quantify savings made foll...

  11. Compressed air systems. A guidebook on energy and cost savings

    Energy Technology Data Exchange (ETDEWEB)

    1984-03-30

    This guidebook shows how energy can be saved in compressed air systems. It discusses basic compressed air systems which are typical of those found in industry and describes them and the engineering practices behind them. Energy conservation recommendations follow. These recommendations cover equipment selection, design, maintenance, and operation. Included is information which will help the reader to make economic evaluations of various engineering and equipment alternatives as they affect operations and costs. The appendices include some modern computer based approaches to predicting pressure drop for designing compressed air distribution systems. Also included is a bibliography providing leads for further and more detailed technical information on these and related subjects.

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

    DEFF Research Database (Denmark)

    Klinge Jacobsen, Henrik; Baldini, Mattia

    Energy savings are a key element in reaching ambitious climate targets and may contribute to increased productivity as well. For identification of the most attractive saving options cost curves for savings are constructed illustrating potentials of savings with associated costs. In optimisation...... modelling these cost options are then compared with the cost of producing energy and all savings with negative costs and cost below the cost of producing the energy including the associated externality costs are expected to be implemented. There are however several methodological issues associated...... 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...

  13. Costs and savings associated with implementation of a police crisis intervention team.

    Science.gov (United States)

    El-Mallakh, Peggy L; Kiran, Kranti; El-Mallakh, Rif S

    2014-06-01

    Police crisis intervention teams (CIT) have demonstrated their effectiveness in reducing injury to law enforcement personnel and citizens and the criminalization of mental illness; however, their financial effect has not been fully investigated. The objective of the study was to determine the total costs or total savings associated with implementing a CIT program in a medium-size city. The costs and savings associated with the implementation of a CIT program were analyzed in a medium-size city, Louisville, Kentucky, 9 years after the program's initiation. Costs associated with officer training, increased emergency psychiatry visits, and hospital admissions resulting from CIT activity were compared with the savings associated with diverted hospitalizations and reduced legal bookings. Based on an average of 2400 CIT calls annually, the overall costs associated with CIT per year were $2,430,128 ($146,079 for officer training, $1,768,536 for hospitalizations of patients brought in by CIT officers, $508,690 for emergency psychiatry evaluations, and $6823 for arrests). The annual savings of the CIT were $3,455,025 ($1,148,400 in deferred hospitalizations, $2,296,800 in reduced inpatient referrals from jail, and $9825 in avoided bookings and jail time). The balance is $1,024,897 in annual cost savings. The net financial effect of a CIT program is of modest benefit; however, much of this analysis was based on estimates and average length of stay. Furthermore, the costs and savings associated with officer or citizen injuries were not included because there was inadequate information about their prevalence and costs. Finally, this analysis does not take into account the nonmonetary gains of a CIT program.

  14. 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.

  15. 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

    2018-02-07

    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 period, hospice increased costs to Medicare. Medicare savings could continue with the 2016 payment rate change. Cost savings were found for all primary diagnoses analyzed except dementia.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Economic Modeling of Heart Failure Telehealth Programs: When Do They Become Cost Saving?

    Directory of Open Access Journals (Sweden)

    Sheena Xin Liu

    2016-01-01

    Full Text Available Telehealth programs for congestive heart failure have been shown to be clinically effective. This study assesses clinical and economic consequences of providing telehealth programs for CHF patients. A Markov model was developed and presented in the context of a home-based telehealth program on CHF. Incremental life expectancy, hospital admissions, and total healthcare costs were examined at periods ranging up to five years. One-way and two-way sensitivity analyses were also conducted on clinical performance parameters. The base case analysis yielded cost savings ranging from $2832 to $5499 and 0.03 to 0.04 life year gain per patient over a 1-year period. Applying telehealth solution to a low-risk cohort with no prior admission history would result in $2502 cost increase per person over the 1-year time frame with 0.01 life year gain. Sensitivity analyses demonstrated that the cost savings were most sensitive to patient risk, baseline cost of hospital admission, and the length-of-stay reduction ratio affected by the telehealth programs. In sum, telehealth programs can be cost saving for intermediate and high risk patients over a 1- to 5-year window. The results suggested the economic viability of telehealth programs for managing CHF patients and illustrated the importance of risk stratification in such programs.

  2. 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 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 of $863 was identified for PSI pricing at our institution below which PSI was less costly than SR. Similar internal cost accounting

  3. 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.

  4. 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

  5. Cost savings associated with using immunization information systems for Vaccines for Children administrative tasks.

    Science.gov (United States)

    Bartlett, Diana L; Washington, Michael L; Bryant, Amanda; Thurston, Norman; Perfili, Christine A

    2007-01-01

    Our objective was to investigate the potential cost savings of immunization information systems (IIS) in performing some administrative tasks associated with the federal Vaccines for Children (VFC) program at the state and practice levels. VFC is an entitlement program providing free vaccine to eligible children. We timed the staff of the Utah Department of Health (UDOH) and 72 private VFC practices for administrative VFC-related tasks from September 2003 through March 2004. Time measurements included time for practices to produce VFC reports and for UDOH staff to assess practice coverage levels and process VFC reports manually or via the Utah Statewide Immunization Information System (USIIS). Median cost savings to the state health department could be as much as $11 740 annually. Utah VFC practices could save up to a maximum of $446 annually per practice by using USIIS for VFC tasks. If applied to the 218 enrolled private practices statewide, this would result in a median total cost savings of $17,615 ($15,519 for reports and $2,096 for pulling medical charts).

  6. 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.

  7. Cost savings from a teledentistry model for school dental screening: an Australian health system perspective.

    Science.gov (United States)

    Estai, Mohamed; Bunt, Stuart; Kanagasingam, Yogesan; Tennant, Marc

    2017-06-05

    Objective The aim of the present study was to compare the costs of teledentistry and traditional dental screening approaches in Australian school children.Methods A cost-minimisation analysis was performed from the perspective of the oral health system, comparing the cost of dental screening in school children using a traditional visual examination approach with the cost of mid-level dental practitioners (MLDPs), such as dental therapists, screening the same cohort of children remotely using teledentistry. A model was developed to simulate the costs (over a 12-month period) of the two models of dental screening for all school children (2.7million children) aged 5-14 years across all Australian states and territories. The fixed costs and the variable costs, including staff salary, travel and accommodation costs, and cost of supply were calculated. All costs are given in Australian dollars.Results The total estimated cost of the teledentistry model was $50million. The fixed cost of teledentistry was $1million and that of staff salaries (tele-assistants, charters and their supervisors, as well as information technology support was estimated to be $49million. The estimated staff salary saved with the teledentistry model was $56million, and the estimated travel allowance and supply expenses avoided were $16million and $14million respectively; an annual reduction of $85million in total.Conclusions The present study shows that the teledentistry model of dental screening can minimise costs. The estimated savings were due primarily to the low salaries of dental therapists and the avoidance of travel and accommodation costs. Such savings could be redistributed to improve infrastructure and oral health services in rural or other underserved areas.What is known about the topic? Caries is a preventable disease, which, if it remains untreated, can cause significant morbidity requiring costly treatment. Regular dental screening and oral health education have the great potential

  8. 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

  9. 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

  10. Cost-Savings and Economic Benefits due to the Assistive Robotic Manipulator (ARM)

    NARCIS (Netherlands)

    Römer, G.R.B.E.; Stuyt, Harry J.A.; Peters, Albér

    2005-01-01

    Besides the social and personal benefits of a rehabilitation robot, the direct cost-savings and other (indirect) economic benefits, or effectiveness, are of major importance to party who pays for (or reimburses) the rehabilitation robot. This paper gives an overview of these cost-savings and, on a

  11. Direct and indirect costs and potential cost savings of laparoscopic adjustable gastric banding among obese patients with diabetes.

    Science.gov (United States)

    Finkelstein, Eric A; Allaire, Benjamin T; DiBonaventura, Marco DaCosta; Burgess, Somali M

    2011-09-01

    To estimate the time to breakeven and 5-year net costs for laparoscopic adjustable gastric banding among obese patients with diabetes taking direct and indirect costs into account. Indirect cost savings were generated by quantifying the cross-sectional relationship between medical expenditures and absenteeism and between medical expenditures and presenteeism (reduced on-the-job productivity) and simulating indirect cost savings based on these multipliers and reductions in direct medical costs available in the literature. Time to breakeven was estimated to be nine quarters with and without the inclusion of indirect costs. After 5 years, net savings increase from $26570 (±$9000) to $34160 (±$10 380) when indirect costs are included. This study presented a novel approach for incorporating indirect costs into cost-benefit analyses. Application to gastric banding revealed that inclusion of indirect costs improves the financial outlook for the procedure. (C)2011The American College of Occupational and Environmental Medicine

  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. Potential cost savings from generic medicines – protecting the ...

    African Journals Online (AJOL)

    Results: Three of the algorithms (diabetes insipidus, haemophilia and hypothyroidism) list medicines for which no generic equivalent was available at the time of the study. The median cost differential between brand and generic equivalents for the remaining 22 chronic conditions ranged from 19.5%. (for type 1 diabetes ...

  14. Cost and Benefit Tradeoffs in Using a Shade Tree for Residential Building Energy Saving

    Directory of Open Access Journals (Sweden)

    Sappinandana Akamphon

    2014-01-01

    Full Text Available Global warming and urban heat islands result in increased cooling energy consumption in buildings. Previous literature shows that planting trees to shade a building can reduce its cooling load. This work proposes a model to determine the cost effectiveness and profitability of planting a shade tree by considering both its potential to reduce cooling energy and its purchase and maintenance cost. A comparison between six selected tree species is used for illustration. Using growth rates, crown sizes, and shading coefficients, cooling energy savings from the tree shades are computed using an industrial-standard building energy simulation program, offset by costs of purchase, planting, and maintenance of these trees. The result shows that most worthwhile tree to plant should have high shading coefficient and moderate crown size to maximize shading while keeping the maintenance costs manageable.

  15. Implementation of a shared-savings program for surgical supplies decreases inventory cost.

    Science.gov (United States)

    Eiferman, Daniel; Bhakta, Ankur; Khan, Safdar

    2015-10-01

    Management of operating room inventory has substantial cost-saving opportunities if surgeons agree to standardize supplies used to perform procedures; however, there is no incentive for surgeons to participate in these decisions, because the cost-savings are realized only by the hospital, not the practitioner. In an attempt to engage surgeons with the management of the operating room supply chain, a shared-savings programs was instituted that returned 50% of money saved to the surgery divisions. Opportunities for savings in the use of biologic mesh, cranial plating systems, and neurostimulators was identified. Each item was assigned a physician champion responsible for ensuring that there was clinical equipoise between the products being used. Any cost-savings realized during the fiscal year were shared 50-50 between the hospital and the surgery divisions. The total cost-savings was $893,865 with $446,932 being shared across 15 surgery divisions. Standardization of cranial plating systems ($374,805) generated the greatest amounts of savings followed by neurostimulators ($278,404) and biologic mesh ($240,655). Aligning hospital and surgeon incentives led to dramatic cost-savings and standardization of the operative inventory used. Quality of care is not compromised by this approach, and no conflicts of interest are created. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 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.

  17. Graphic Warning Labels and the Cost Savings from Reduced Smoking among Pregnant Women.

    Science.gov (United States)

    Tauras, John A; Peck, Richard M; Cheng, Kai-Wen; Chaloupka, Frank J

    2017-02-08

    Introduction: The U.S. Food and Drug Administration (FDA) has estimated the economic impact of Graphic Warning Labels (GWLs). By omitting the impact on tobacco consumption by pregnant women, the FDA analysis underestimates the economic benefits that would occur from the proposed regulations. There is a strong link between the occurrence of low birth weight babies and smoking while pregnant. Low birth weight babies in turn generate much higher hospital costs than normal birth weight babies. This study aims to fill the gap by quantifying the national hospital cost savings from the reductions in prenatal smoking that will arise if GWLs are implemented in the U.S. Data and Methods: This study uses several data sources. It uses Natality Data from the National Vital Statistics System of the National Center for Health Statistics (NCHS) in 2013 to estimate the impact of prenatal smoking on the likelihood of having a low-birth-weight baby, controlling for socio-economic and demographic characteristics as well as medical and non-medical risk factors. Using these estimates, along with the estimates of Huang et al. (2014) regarding the effect of GWLs on smoking, we calculate the change in the number of LBW (low birth weight) babies resulting from decreased prenatal smoking due to GWLs. Using this estimated change and the estimates from Russell et al. (2007) and AHRQ (2013) on the excess hospital costs of LBW babies, we calculate cost saving that arises from reduced prenatal smoking in response of GWLs. Results and Conclusions: Our results indicated that GWLs for this population could lead to hospital cost savings of 1.2 billion to 2.0 billion dollars over a 30 year horizon.

  18. 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.

  19. 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.

  20. 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.

  1. Does remediation save lives? - on the cost of cleaning up arsenic-contaminated sites in Sweden.

    Science.gov (United States)

    Forslund, Johanna; Samakovlis, Eva; Johansson, Maria Vredin; Barregard, Lars

    2010-07-15

    Sweden has only just begun remediation of its many contaminated sites, a process that will cost an estimated SEK 60,000 million (USD 9100 million). Although the risk assessment method, carried out by the Swedish EPA, is driven by health effects, it does not consider actual exposure. Instead, the sites are assessed based on divergence from guideline values. This paper uses an environmental medicine approach that takes exposure into account to analyse how cancer risks on and near arsenic-contaminated sites are implicitly valued in the remediation process. The results show that the level of ambition is high. At 23 contaminated sites, the cost per life saved varies from SEK 287 million to SEK 1,835,000 million, despite conservative calculations that in fact probably underestimate the costs. It is concluded that if environmental health risks are to be reduced, there are probably other areas where economic resources can be used more cost-effectively.

  2. Relationship Between Timing of Multiple Retention Bonuses and the Quality of Officers Retained on the Cost Savings for the Navy

    Science.gov (United States)

    2016-12-01

    BETWEEN TIMING OF MULTIPLE RETENTION BONUSES AND THE QUALITY OF OFFICERS RETAINED ON THE COST SAVINGS FOR THE NAVY by Marley E. Cassels...RETENTION BONUSES AND THE QUALITY OF OFFICERS RETAINED ON THE COST SAVINGS FOR THE NAVY 5. FUNDING NUMBERS 6. AUTHOR(S) Marley E. Cassels 7...objectives and providing cost savings. We found that a quality auction system could provide cost savings as much as $1,850,000 or could increase costs by

  3. 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.

  4. Potential unintended pregnancies averted and cost savings associated with a revised Medicaid sterilization policy.

    Science.gov (United States)

    Borrero, Sonya; Zite, Nikki; Potter, Joseph E; Trussell, James; Smith, Kenneth

    2013-12-01

    Medicaid sterilization policy, which includes a mandatory 30-day waiting period between consent and the sterilization procedure, poses significant logistical barriers for many women who desire publicly funded sterilization. Our goal was to estimate the number of unintended pregnancies and the associated costs resulting from unfulfilled sterilization requests due to Medicaid policy barriers. We constructed a cost-effectiveness model from the health care payer perspective to determine the incremental cost over a 1-year time horizon of the current Medicaid sterilization policy compared to a hypothetical, revised policy in which women who desire a postpartum sterilization would face significantly reduced barriers. Probability estimates for potential outcomes in the model were based on published sources; costs of Medicaid-funded sterilizations and Medicaid-covered births were based on data from the Medicaid Statistical Information System and The Guttmacher Institute, respectively. With the implementation of a revised Medicaid sterilization policy, we estimated that the number of fulfilled sterilization requests would increase by 45%, from 53.3% of all women having their sterilization requests fulfilled to 77.5%. Annually, this increase could potentially lead to over 29,000 unintended pregnancies averted and $215 million saved. A revised Medicaid sterilization policy could potentially honor women's reproductive decisions, reduce the number of unintended pregnancies and save a significant amount of public funds. Compared to the current federal Medicaid sterilization policy, a hypothetical, revised policy that reduces logistical barriers for women who desire publicly funded, postpartum sterilization could potentially avert over 29,000 unintended pregnancies annually and therefore lead to cost savings of $215 million each year. © 2013.

  5. The Energy Smart Guide to Campus Cost Savings.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Energy Efficiency and Renewable Energy.

    Rebuild America is a program of the U.S. Department of Energy that focuses on energy-savings solutions as community solutions. It works with K-12 schools, colleges and universities, state and local governments, public and multifamily housing, and commercial buildings. This guide focuses on colleges and universities. Each chapter spells out options…

  6. Purging energy costs. [Energy savings in ammonia refrigeration system

    Energy Technology Data Exchange (ETDEWEB)

    Whitwell, Ian (Energy Technology Support Unit, Harwell (United Kingdom))

    1992-09-01

    Energy savings of over Pound 8,000 per year have been achieved by Exel Logistics, which has installed a five-point automatic purger to the evaporative condenser and receiver of the ammonia refrigeration system at its Glasgow service depot. The main features of the system are described in this article. (Author).

  7. Potential Cost Savings from Generic Medicines - Protecting the ...

    African Journals Online (AJOL)

    Background: South Africa has followed a pro-generic policy since the introduction of the National Drug Policy in 1996. ... This study assessed the potential savings that would be achievable by substituting generics for brand name (originator) medicines listed in the chronic disease algorithms set out by the Council for ...

  8. 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.

  9. 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.

  10. 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...... 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...... 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...

  11. 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

  12. 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.

  13. The SmokingPaST Framework: illustrating the impact of quit attempts, quit methods, and new smokers on smoking prevalence, years of life saved, medical costs saved, programming costs, cost effectiveness, and return on investment.

    Science.gov (United States)

    O'Donnell, Michael P; Roizen, Michael F

    2011-01-01

    Describe the specifications of the Smoking Prevalence, Savings, and Treatment (SmokingPaST) Framework and show how it can illustrate the impact of quit attempts, quit method, number of new smokers, smoking rates of immigrants and emigrants, and death rates of smokers and nonsmokers on future smoking prevalence rates, program costs, years of life saved, medical costs saved, cost effectiveness of programs, and return on investment (ROI). FRAMEWORK SPECIFICATIONS: Mathematical relationships among factors in SmokingPaST are described. Input variables include baseline smoking rates among current adults, new adults, immigrants, and emigrants; population counts for these groups; annual quit attempts; and distribution of quit methods. Assumption variables include success rate by quit method, death rates of smokers and nonsmokers, annual medical costs of smoking, costs per person for four tobacco treatment methods, age distribution of quitters, and distribution of medical cost funding by source. Output variables include year-end adult smoking rates, successful quitters, years of life saved by quitting, medical costs saved by quitting and by not hiring smokers, total costs of smoking treatment programs, cost per quitter, cost per life-year saved, distribution of medical cost savings from quitting, and ROI of treatment costs. The Framework was applied at the employer, county, state, and national levels. The SmokingPaST Framework provides a conceptually simple framework that can be applied to any population. It illustrates that significant drops in smoking rates can be achieved and significant savings in medical costs can be captured by employers as well as state and federal governments through tobacco treatment and prevention programs. Savings are especially important for reducing state and federal government deficits and enhancing job competitiveness.

  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. Cost savings associated with 10 years of road safety policies in Catalonia, Spain

    Science.gov (United States)

    Suelves, Josep M; Barbería, Eneko

    2013-01-01

    Abstract Objective To determine whether the road safety policies introduced between 2000 and 2010 in Catalonia, Spain, which aimed primarily to reduce deaths from road traffic collisions by 50% by 2010, were associated with economic benefits to society. Methods A cost analysis was performed from a societal perspective with a 10-year time horizon. It considered the costs of: hospital admissions; ambulance transport; autopsies; specialized health care; police, firefighter and roadside assistance; adapting to disability; and productivity lost due to institutionalization, death or sick leave of the injured or their caregivers; as well as material and administrative costs. Data were obtained from a Catalan hospital registry, the Catalan Traffic Service information system, insurance companies and other sources. All costs were calculated in euros (€) at 2011 values. Findings A substantial reduction in deaths from road traffic collisions was observed between 2000 and 2010. Between 2001 and 2010, with the implementation of new road safety policies, there were 26 063 fewer road traffic collisions with victims than expected, 2909 fewer deaths (57%) and 25 444 fewer hospitalizations. The estimated total cost savings were around €18 000 million. Of these, around 97% resulted from reductions in lost productivity. Of the remaining cost savings, 63% were associated with specialized health care, 15% with adapting to disability and 8.1% with hospital care. Conclusion The road safety policies implemented in Catalonia in recent years were associated with a reduction in the number of deaths and injuries from traffic collisions and with substantial economic benefits to society. PMID:23397348

  16. 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 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.

  17. Variable speed drives principles and applications for energy cost savings

    CERN Document Server

    Spitzer, David William

    2014-01-01

    Simply put, a variable speed drive is a controller that allows a motor and its associated equipment to run at different speeds depending upon automated input from an industrial process. That in turn provides the ability to provide smoother operations, and most importantly, energy savings by slowing down machinery when a process does not have to run at full speed. Long a leading book on this technology, this new edition by industry authority David William Spitzer provides insights to improving the applications of variable speed drives. Whether you have basic knowledge or advanced knowledge, you will find this book to be an extremely useful introduction to how variable speed drivers work, how they are best applied, and what to do and what to avoid when employing them as part of an overall automated industrial enterprise, all with an eye on energy savings. Inside, you will find: A basic overview of electrical, hydraulic, and instrumentation principles of variable speed drives. Coverage of the role that variabl...

  18. Energy conserved and costs saved by small and medium-size manufacturers, 1988--1989

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, F.W.

    1991-05-01

    Energy Analysis and Diagnostic Centers (EADCs) provided energy-conserving and cost saving assistance in 339 small and medium-size manufacturing plants nationwide during 1988-89. This report presents the results of what was recommended to those manufacturers, the record of what was implemented by them, and an analysis of the financial rewards gained by them. It also includes an accounting of the financial returns to the federal government, derived from taxes upon the cost savings, or incremental income, of the manufacturers who implement the EADCs` recommendations. EADCs collect implementation data within a year of the energy audit, and for these results that time period extended through 1990. The EADCs are located at accredited engineering departments of universities and staffed by faculty and students. At present there are 18 EADCs serving manufacturers in 37 states; of these, two were established as a result of the 1989 competition, and five more were chosen competitively in 1990. Most of the results in this report were generated by 11 EADCs (named in the Appendix); two others withdrew voluntarily after completing only 10 energy audits during 1988-89. Primary responsibility for selecting, training, evaluating, and managing the EADCs belongs to the Industrial Technology and Energy Management (ITEM) division of University City Science Center (UCSC). The Department of Energy`s Office of Industrial Technologies sponsors the EADC program through an agreement with UCSC.

  19. Saving on design doesn't save money, life-cycle costing studies show.

    Science.gov (United States)

    Sprague, J G

    1982-09-01

    Design and energy management decisions significantly affect both initial construction and ongoing operation costs. Because of their importance, they are examined in this article, which also provides some general background concerning construction project development and typical fees expected by architect/engineers and construction managers.

  20. Custo e economia da prática do aleitamento materno para a família Costs and savings for the family as the result of breast feeding

    Directory of Open Access Journals (Sweden)

    Maria de Fátima Moura de Araújo

    2004-06-01

    Full Text Available OBJETIVOS: comparar o custo da alimentação complementar da nutriz em relação à alimentação do bebê com substitutos do leite materno. MÉTODOS: o custo do gasto energético da lactação foi calculado com a adição de um ou dois alimentos da dieta habitual para suprir a demanda extra da lactante. Foram elaborados e calculados cardápios adicionais para a nutriz, e estimado o custo da alimentação com fórmula infantil e com leite de vaca tipo C para lactentes menores de seis meses, segundo recomendações nutricionais para essas fases da vida, para um consumo de seis meses. Determinou-se a porcentagem de salário mínimo gasto com cada tipo de alimentação. RESULTADOS: observou-se que a alimentação complementar da nutriz custa em média 8,7% do salário mínimo. Gasta-se aproximadamente 35% do salário mínimo na alimentação do bebê com fórmula infantil e 11% com leite de vaca tipo C. CONCLUSÕES: os resultados apontam que é mais barato e eficaz garantir a complementação alimentar de nutrizes carentes, para se promover a amamentação, que distribuir fórmulas ou leites, e favorecer o desmame precoce.OBJECTIVES: to compare supplementary food cost of nursing mothers related to breast feeding with breast milk substitutes. METHODS: the cost of energy spent during lactation was calculated with the addition of one or two types of food of the usual diet to supply the extra demand of a nursing baby. Menus were designed and calculated for the mothers and food cost estimated as well as the cost of baby formulas and type C cow milk for children under six months of age according to nutritional recommendations for this phase of life considering a six month consumption period. Percentage of minimum wage spent with each type of food was determined. RESULTS: supplementary food offered to mothers has an average cost of 8.7% of the minimum wage. Approximately 35% of the minimum wage is spent in feeding the baby with formulas and 11% with type

  1. 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...

  2. Disease Prevention : Saving Lives or Reducing Health Care Costs?

    NARCIS (Netherlands)

    Grootjans-van Kampen, I.; Engelfriet, P.M.; Van Baal, P.H.M.

    2014-01-01

    Background Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity increases

  3. 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,

  4. THAAD radar: examination of a cost saving initiative

    OpenAIRE

    Lewis, John W.

    1999-01-01

    Approved for public release; distribution is unlimited This thesis analyzes two acquisition reform initiatives that made Theater High Altitude Area Defense (THAAD) Radar Product Office's Best of Breed Transmit/Receive Module study a success and examines the risk involved in the pursuit of this study. The initiatives are Cost As an Independent Variable (CAIV) and commercial items in the form of dual-use technology. Analysis of the radar subsystem of THAAD reveals a major cost driver to be t...

  5. Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings.

    Science.gov (United States)

    McWilliams, Tania; Hendricks, Joyce; Twigg, Di; Wood, Fiona; Giles, Margaret

    2016-11-01

    Since 2005, the Western Australian paediatric burn unit has provided a state-wide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. To conduct a retrospective audit of avoided transfers and bed days in 2005/06-2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Over the period 2005/06-2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89million. This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. 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.

  7. Green Energy in New Construction: Maximize Energy Savings and Minimize Cost

    Science.gov (United States)

    Ventresca, Joseph

    2010-01-01

    People often use the term "green energy" to refer to alternative energy technologies. But green energy doesn't guarantee maximum energy savings at a minimum cost--a common misconception. For school business officials, green energy means getting the lowest energy bills for the lowest construction cost, which translates into maximizing green energy…

  8. 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...

  9. Disease prevention: Saving lives or reducing health care costs?

    NARCIS (Netherlands)

    I.G.-V. Kampen (Inge Grootjans-Van); P.M. Engelfriet (Peter); P.H.M. Van Baal (Pieter)

    2014-01-01

    textabstractBackground: Disease prevention has been claimed to reduce health care costs. However, preventing lethal diseases increases life expectancy and, thereby, indirectly increases the demand for health care. Previous studies have argued that on balance preventing diseases that reduce longevity

  10. 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…

  11. Pressure sores in spinal cord injury: Active intervention saves costs ...

    African Journals Online (AJOL)

    Summary. Pressure sores are a predictable consequence of poorly managed spinal cord-injured patients. Not only do pressure sores contribute to the morbidity, but also add significantly to the medical/nursing management, cost and admission stay, limiting optimal bed utilisation. This intervention study assesses the impact ...

  12. 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 accumulation (15.5% vs 2.9% of outpatients), while most DHF outpatients had hypoproteinemia (92.7% vs 81.3% of inpatients). The eight intensive care unit admissions and five deaths during this time period all occurred among inpatients. The new criteria resulted in a median cost saving of US$1.4 million to patients in 2008. The new dengue admission criteria were effective in sustainably reducing length of hospitalization, yielding considerable cost savings. A minority of DHF patients with mild symptoms recovered uneventfully through outpatient management.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-12-01

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

  14. 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.

  15. The impact of changing dental needs on cost savings from fluoridation.

    Science.gov (United States)

    Campain, A C; Mariño, R J; Wright, F A C; Harrison, D; Bailey, D L; Morgan, M V

    2010-03-01

    Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. Community water fluoridation remains a cost-effective preventive measure in Australia.

  16. 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

  17. Successful protocol for eliminating excessive urine microscopies: Quality improvement and cost savings with physician support.

    Science.gov (United States)

    Chen, Michael; Eintracht, Shaun; MacNamara, Elizabeth

    2017-01-01

    Clinical laboratories are under growing pressure to provide faster turn-around-time and maintain high quality while decreasing costs. In a setting of rising test volumes, implementation of evidence-based protocols with physician cooperation and feedback may provide frameworks and support for laboratory utilization optimization. The purpose of this study was to eliminate wasteful urine microscopy by targeting physician ordering behavior, and to ensure quality of care with physician satisfaction surveys. We evaluated how physicians use the laboratory for routine urine testing. Urinalysis requisition was redesigned with emphasis on clinical indications for testing. In collaboration with requesting physicians, restriction in reflex microscopy testing was applied with exceptions. Cost saving analysis was conducted based on test volume. After policy change, 2 physician satisfaction surveys were conducted 5year apart to address potential complaints. Over 47,000 urine microscopies have been eliminated annually, while the number of urine dipsticks and cultures remained stable. This translated into a 95% reduction in manual microscopy performed, and an estimated annual saving of $200,000. In both satisfaction surveys, 9 out of 10 physicians considered the change to have "no" or "a beneficial effect" on their clinical practice. Our laboratory did not receive any formal complaints in regards to the protocol change. By implementing changes to the way physicians order urinalysis, the number of tests can be substantially reduced. Satisfaction survey proved to be an effective tool for obtaining physician feedback, and support. The results of surveys indicated that new policy achieved significant savings without compromising on patient care. This experience has provided us with strategies on taking initiatives to further optimize utilization of laboratory tests. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Sun pipeline`s tensioned cover system saves storage costs

    Energy Technology Data Exchange (ETDEWEB)

    Blaisdell, J.R. [Sun Pipe Line Co., Detroit, MI (United States); Lydick, L. [National Seal Co., Aurora, IL (United States)

    1996-02-01

    Sun Pipe Line chose the Columbia tensioned floating cover (TFC) system from Columbia Geosystems for several reasons. First, capital costs for the TFC system are considerably lower than those for structural metal or concrete systems. Installation requires less time than fixed structures, and construction costs are about one-tenth as much. A second reason for the choice is its patented tower/tension cover design which easily accommodates fluctuating fluid levels in brine ponds, even in a rapid drawdown. When brine is pumped into the storage chambers, changes in brine ponds can be as great as ten feet. The tensioned design maintains folds of extra material on the outer perimeter of the cover above fluid level. As fluid levels fall, the curtain unfolds and adequate reservoir coverage is maintained.

  19. 25 CFR 1000.102 - How are savings that result from downsizing allocated?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false How are savings that result from downsizing allocated... Amounts § 1000.102 How are savings that result from downsizing allocated? Funds that are saved as a result of downsizing in BIA are allocated to Tribes/Consortia in the same manner as Tribal shares as...

  20. 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.

  1. Three Interventions That Reduce Childhood Obesity Are Projected To Save More Than They Cost To Implement.

    Science.gov (United States)

    Gortmaker, Steven L; Wang, Y Claire; Long, Michael W; Giles, Catherine M; Ward, Zachary J; Barrett, Jessica L; Kenney, Erica L; Sonneville, Kendrin R; Afzal, Amna Sadaf; Resch, Stephen C; Cradock, Angie L

    2015-11-01

    Policy makers seeking to reduce childhood obesity must prioritize investment in treatment and primary prevention. We estimated the cost-effectiveness of seven interventions high on the obesity policy agenda: a sugar-sweetened beverage excise tax; elimination of the tax subsidy for advertising unhealthy food to children; restaurant menu calorie labeling; nutrition standards for school meals; nutrition standards for all other food and beverages sold in schools; improved early care and education; and increased access to adolescent bariatric surgery. We used systematic reviews and a microsimulation model of national implementation of the interventions over the period 2015-25 to estimate their impact on obesity prevalence and their cost-effectiveness for reducing the body mass index of individuals. In our model, three of the seven interventions--excise tax, elimination of the tax deduction, and nutrition standards for food and beverages sold in schools outside of meals--saved more in health care costs than they cost to implement. Each of the three interventions prevented 129,000-576,000 cases of childhood obesity in 2025. Adolescent bariatric surgery had a negligible impact on obesity prevalence. Our results highlight the importance of primary prevention for policy makers aiming to reduce childhood obesity. Project HOPE—The People-to-People Health Foundation, Inc.

  2. Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Cold Climates

    Energy Technology Data Exchange (ETDEWEB)

    Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Florida Solar Energy Center (FSEC); IBACOS; National Renewable Energy Laboratory (NREL)

    2006-08-01

    The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in Cold Climates on a cost-neutral basis.

  3. Making the results of bottom-up energy savings comparable

    Directory of Open Access Journals (Sweden)

    Moser Simon

    2012-01-01

    Full Text Available The Energy Service Directive (ESD has pushed forward the issue of energy savings calculations without clarifying the methodological basis. Savings achieved in the Member States are calculated with rather non-transparent and hardly comparable Bottom-up (BU methods. This paper develops the idea of parallel evaluation tracks separating the Member States’ issue of ESD verification and comparable savings calculations. Comparability is ensured by developing a standardised BU calculation kernel for different energy efficiency improvement (EEI actions which simultaneously depicts the different calculation options in a structured way (e.g. baseline definition, system boundaries, double counting. Due to the heterogeneity of BU calculations the approach requires a central database where Member States feed in input data on BU actions according to a predefined structure. The paper demonstrates the proposed approach including a concrete example of application.

  4. Surgeon’s dilemma: should I save patient’s life at any cost?

    Directory of Open Access Journals (Sweden)

    Kamila Kocańda

    2017-12-01

    Full Text Available Every doctor practicing treatment in the field of medicine may be confronted with a serious question: should I save my patient’s life at any cost? If a doctor resigns from emergency procedures, he/she will risk the patient’s death. However, if he/she decides to proceed regardless of a Jehovah’s Witness patient’s statement of will, in which he or she refuses transfusion, he/she takes a risk of illegal medical intervention. There is neither an easy answer, nor a serious solution, thus the only way is to choose the lesser of two evils. Notwithstanding legal issues, there are still ethical problems, which result in an internal dilemma for a doctor.

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

    Science.gov (United States)

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

    2016-02-01

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

  6. Cost saving with ultrasonography in a developing country district ...

    African Journals Online (AJOL)

    Setting: 'Wad Medani Teaching Hospital, Central Sudan. Results: Local specialists referring the patients stated that an estimated 792 radiologic procedures would have been carried out to obtain the same amount of information as achieved by ultrasound. Such procedures budgeted approximately 8100 US dollars, in terms ...

  7. 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

    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 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...

  8. 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

  9. Costs, effects, and savings of screening for cystic fibrosis gene carriers

    NARCIS (Netherlands)

    Wildhagen, MF; Hilderink, HBM; Verzijl, JG; Verheij, JBGM; Kooij, L; Tijmstra, T; ten Kate, LP; Habbema, JDF

    Study objective-Evaluating the costs, effects, and savings of several strategies for cystic fibrosis (CF) gene carrier screening. Design-A general model for evaluating prenatal, preconceptional, school, and neonatal carrier screening was constructed. For prenatal and preconceptional screening, two

  10. 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

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

    Directory of Open Access Journals (Sweden)

    Aiman Roslizar

    2014-01-01

    Full Text Available 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.

  12. A Cost-Savings Analysis of a Statewide Parenting Education Program in Child Welfare

    Science.gov (United States)

    Maher, Erin J.; Corwin, Tyler W.; Hodnett, Rhenda; Faulk, Karen

    2012-01-01

    Objectives: This article presents a cost-savings analysis of the statewide implementation of an evidence-informed parenting education program. Methods: Between the years 2005 and 2008, the state of Louisiana used the Nurturing Parenting Program (NPP) to impart parenting skills to child welfare-involved families. Following these families' outcomes…

  13. Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis

    Science.gov (United States)

    Abdullah, Mohammad M. H.; Marinangeli, Christopher P. F.; Jones, Peter J. H.; Carlberg, Jared G.

    2017-01-01

    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. PMID:28737688

  14. Canadian Potential Healthcare and Societal Cost Savings from Consumption of Pulses: A Cost-Of-Illness Analysis.

    Science.gov (United States)

    Abdullah, Mohammad M H; Marinangeli, Christopher P F; Jones, Peter J H; Carlberg, Jared G

    2017-07-22

    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.

  15. 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.

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

    Science.gov (United States)

    2014-01-01

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

  17. An economic evaluation of anticipated costs and savings of a behavior change intervention to enhance medication adherence

    Directory of Open Access Journals (Sweden)

    Wiegand PN

    2008-06-01

    Full Text Available Medication adherence across disease states is generally poor. Research has focused on various methods to improve medication adherence, but there is little conclusive evidence regarding specific methods efficacy. The Transtheoretical Model for Behavior Change has been used to modify existing addictive behaviors but not in medication adherence specifically. As a behavioral component is inherently related to medication adherence, it is thought that this model may be applicable. Objective: The purpose of this research is to evaluate the costs and savings of implementing a novel behavioral intervention against the cost of poor medication adherence to determine whether further development is realistic.Methods: The basic tools required to administer this intervention were determined through primary literature review and priced by vendors supplying such materials. Diabetes Mellitus Type 2 (DM2 was used as a vehicle to establish the cost of care for long-term complications of a chronic disease. The primary literature provided information regarding the cost of care for DM2 morbidity and outpatient annual drug therapy expenditure. The total cost of the behavioral intervention components and the cost of care for DM2 morbidity were applied to a theoretical cohort of 1000 patients. By dividing this cost across 1000 patients, a per-patient cost was yielded and multiplied over a 16-year timeframe. Results: It was found that the cost to implement the behavioral intervention and resultant medication costs is USD13,574 per-patient over 16 years. The cost to treat complications of diabetes mellitus is USD 36,528 per patient over the 16 years. The total amount of healthcare dollars potentially saved by utilizing this intervention is USD 22,954 per-patient. Conclusions: It appears that the cost to implement this behavioral intervention is reasonable and permits further evaluation in other chronic conditions with notoriously poor adherence levels.

  18. Development of Compact Heat Exchangers According to the Results Study of the Regularities of Heat Exchange Enhancement Energy Saving

    Science.gov (United States)

    Vasilev, V. Ya

    2017-11-01

    The conditions for the realization of energy-saving heat exchange enhancement are experimentally determined, in which the increase in heat transfer in the investigated surface ducts is equal to the growth of aerodynamic losses. A method for determining the geometric and regime parameters of surface ducts, which determine the energy-saving regimes of heat exchange enhancement, is implemented. Energy-saving enhancement of heat transfer in the interrupted ducts and channels with ridges and valleys allows, respectively, to 2.78 and 1.40 times to reduce the heat exchange surface and the mass of the heat exchanger with the previous energy costs. The results of the research make it possible to eliminate the intuitive choice of the shape and parameters of the ducts of the heat exchanger surfaces and to ensure their operation in energy-saving regimes.

  19. 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

  20. Cost savings deliverables and criteria for the OST technology decision process

    Energy Technology Data Exchange (ETDEWEB)

    McCown, A.

    1997-04-01

    This document has been prepared to assist focus area (FA) technical and management teams in understanding the cost savings deliverables associated with a technology system during its research and development (R and D) phases. It discusses the usefulness of cost analysis in the decision-making process, and asserts that the level of confidence and data quality of a cost analysis is proportional to the maturity of the technology system`s development life cycle. Suggestions of specific investment criteria or cost savings metrics that a FA might levy on individual research projects are made but the final form of these elements should be stipulated by the FA management based on their rationale for a successful technology development project. Also, cost savings deliverables for a single FA will be more detailed than those for management of the Office of Science and Technology (OST). For example, OST management may want an analysis of the overall return on investment for each FA, while the FA program manager may want this analysis and the return on investment metrics for each technology research activity the FA supports.

  1. Cost savings of telemedicine utilization for child psychiatry in a rural Kansas community.

    Science.gov (United States)

    Spaulding, Ryan; Belz, Norbert; DeLurgio, Stephen; Williams, Arthur R

    2010-10-01

    The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents. The purpose of this study was to examine the costs of operating the Crawford County site relative to accessing services at KUMC, the likely alternative service location. The cost of travel time to parents who accompanied a dependent to either location also was estimated. Patients and parents were examined over a 6-month period in 2006. One hundred thirty-two patients received 257 telemedicine psychiatric consultations during this period. Cost estimates for using the pediatric telemedicine service were assessed for all patients; however, travel and related costs were collected from a sample of 26 patient-parent dyads. The estimated costs of services were obtained using standard cost-accounting procedures. An average cost per consultation in Crawford County was $168.61. The cost savings in travel time and other expenses to parents and patients were substantial between use of the county site and KUMC. Subtracting average savings in travel costs to patients and parents produced an average cost of a telepsychiatry consult in Crawford County of only $30.99. This study was conducted over 6 months with a small number of observations; it should be replicated over a longer study period, with more patients, and with more data that might capture marginal costs of services.

  2. What price commitment: what benefit? The cost of a saved life in a developing level I trauma center.

    Science.gov (United States)

    Rotondo, Michael F; Bard, Michael R; Sagraves, Scott G; Toschlog, Eric A; Schenarts, Paul J; Goettler, Claudia E; Newell, Mark A; Robertson, Matthew J

    2009-11-01

    In 1999, a Level I Trauma Center committed significant resources for development, recruitment of trauma surgeons, and call pay for subspecialists. Although this approach has sparked a national ethical debate, little has been published investigating efficacy. This study examines the price of commitment and outcomes at a Level I Trauma Center. Direct personnel costs including salary, call pay, and personnel expenses were analyzed against outcomes for two periods defined as PRE (1994-1999) and POST (2000-2005). Patient care costs and 1999 to 2000 transition data were excluded. Demographics, outcomes, and direct personnel costs were compared. Significant mortality reductions stratified by age and injury severity score (ISS) were used to calculate lives saved in relation to direct personnel costs. Student's t test and chi were used (significance *p gender (62.4% vs. 63.7% male), mechanism of injury (11.5% vs. 11.8% penetrating), and percent intensive care unit admissions (30.1 vs. 29.9). Significant differences were noted for ISS (10.5 +/- 9.7 vs. 11.6 +/- 10.1*), percent admissions with ISS >or=16 (18.5 vs. 27.3*), and revised trauma score (10.8 +/- 2.8 vs. 10.7 +/- 2.8*). Both the average length of stay (6.8 +/- 8.8 vs. 6.5 +/- 9.8*) and percent mortality for ISS >or=16 (23 vs. 17*) were reduced. When mortality was stratified by both age and ISS, significant reductions were noted and a total of 173 lives were saved as a result. However, direct personnel costs increased from $7.6 million to $22.7 million. When cost is allocated to lives saved; the cost of a saved life was more than $87,000. Resources for program development, including salary and call pay, significantly reduced mortality. Price of commitment: $3 million per year. The cost of a saved life: $87,000. The benefit: 173 surviving patients who would otherwise be dead.

  3. Building America Residential System Research Results. Achieving 30% Whole House Energy Savings Level in Hot-Dry and Mixed-Dry Climates

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hendron, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Eastment, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jalalzadeh-Azar, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2006-01-01

    This report summarizes Building America research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Hot-Dry/Mixed-Dry Climate Region on a cost-neutral basis.

  4. Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Mixed-Humid Climates; January 2006 - December 2006

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Hendron, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Eastment, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jalalzadeh-Azar, A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2006-12-01

    This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Mixed-Humid Climate Region on a cost-neutral basis.

  5. Carbon savings resulting from the cooling effect of green areas: A case study in Beijing

    Energy Technology Data Exchange (ETDEWEB)

    Lin Wenqi, E-mail: linwq@mail.tsinghua.edu.cn [Key Laboratory of the Ministry of Education for Urban-rural Ecological Planning and Green Architecture, School of Architecture, Tsinghua University, Beijing 100084 (China); Wu Tinghai; Zhang Chengguo [Institute of Architectural and Urban Studies, Tsinghua University, Beijing 100084 (China); Yu Ting [Key Laboratory of the Ministry of Education for Urban-rural Ecological Planning and Green Architecture, School of Architecture, Tsinghua University, Beijing 100084 (China)

    2011-08-15

    Green areas cool the climate of a city, reduce the energy consumption caused by the urban heat island (UHI) effect, and bring along carbon savings. However, the calculation of carbon savings due to the cooling effect of green areas is still not well understood. We have used a Landsat Enhanced Thematic Mapper Plus (ETM+) image of Beijing, to identify the cooled areas, compute the possible energy used to maintain the temperature differences between cooled areas and their surrounding heated areas, and calculate the carbon savings owing to the avoidance of energy use. Results show that a total amount of 14315.37 tons carbon savings was achieved in the study area and the amount was related to the biomass, the size and the shape of green areas. These results demonstrate the importance of carbon savings resulting from green areas' cooling effect. - Highlights: > We provide an integral equation for the calculation of energy conservation and carbon savings. > We show that carbon savings is partly influenced by green areas' features. > A strong correlation between biomass, size and shape of green areas and carbon savings. - An integral equation for the calculation of energy conservation and carbon savings; Showing that carbon savings is partly influenced by green areas' features.

  6. Impact of pharmacist interventions on rational prophylactic antibiotic use and cost saving in elective cesarean section.

    Science.gov (United States)

    Wang, Jingwen; Dong, Mohan; Lu, Yang; Zhao, Xian; Li, Xin; Wen, Aidong

    2015-08-01

    To assess the impact of pharmacist interventions on rational use of prophylactic antibiotics and cost saving in elective cesarean section and the economic outcomes of implementing pharmacist interventions. A pre-to-post intervention design was applied to the practices of prophylactic antibiotic use in the department of gynecology and obstetrics in a Chinese tertiary hospital. Patients admitted during a 3-month period from June to August 2012 and during that from October to December 2012 undergoing elective cesarean section were assigned to the pre-intervention and the post-intervention group, respectively. Pharmacist interventions were performed in the post-intervention group, including obstetrician education, realtime monitoring of clinical records and making recommendations to obstetricians on prophylactic antibiotic prescription based on the criteria set at the beginning of the study. Data from the two groups were then compared to evaluate the outcomes of pharmacist interventions. Cost-outcome analysis was performed to determine the economic effect of implementing pharmacist interventions in preoperative antibiotic prophylaxis. Pharmacist interventions led to significant reductions in antibiotic usage cost/patient-day (p antibiotic cost (p antibiotics (p antibiotic use to the cost of pharmacist time was 27.23 : 1 and the net cost benefit was $65,255.84. This study provides evidence that pharmacist interventions promoted rational use of prophylactic antibiotics and substantial cost saving in elective cesarean section.

  7. 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.

  8. 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.

  9. 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

  10. 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, Rémi

    2013-04-01

    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.

  11. Potential cost savings from internal/external CO{sub 2} emissions trading in the Korean electric power industry

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myunghun, E-mail: leemh@inha.ac.kr [Department of International Trade, Inha University, 253 Yonghyun-dong, Nam-gu, Incheon 402-751 (Korea, Republic of)

    2011-10-15

    Korea plans to introduce an emissions trading scheme for the controlling greenhouse gas emissions in 2015. Using Shephard's (1970) output distance function, we first estimate the shadow price of CO{sub 2} for power generators in the Korean fossil-fueled electric generation industry. Then, by assuming that each power generator is required to reduce CO{sub 2} emissions by one ton, we compute the potential cost savings from internal trading among generators within the same plant and from external trading across plants at prevailing market prices. The results indicate that, on average, the generators paid $14.63 to abate one ton of CO{sub 2} emissions in 2007. Plants realized additional gains through external trading. In particular, cost savings from trades between different fuel-fired plants were substantial. - Highlights: > We estimated the shadow price of CO{sub 2} for the Korean steam power plants. > On average, the generators paid $14.63 to abate one ton of CO{sub 2} emissions in 2007. > We computed the potential cost savings from internal trading and external trading. > Plants realized additional gains through external trading.

  12. 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.

  13. 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.

  14. 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.

  15. [Centralization of robotic surgery: better results and cost savings

    NARCIS (Netherlands)

    Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van

    2013-01-01

    In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and

  16. A cost-savings analysis of a candidate universal antiretroviral regimen.

    Science.gov (United States)

    Ripin, David; Prabhu, Vineet R

    2017-07-01

    Despite significant strides in tackling HIV/AIDS in low-income and middle-income countries (LMICs), many treatment shortcomings remain, with limited drug selection to patients emerging as a critical challenge. The potential cost-savings benefits of adopting newer drugs as near-universal first-line antiretroviral (ARV) regimens that also provide improved clinical outcomes are discussed. In the near term, a fixed-dose combination of dolutegravir (DTG or D) with tenofovir disoproxil fumarate (TDF), and either lamivudine or emtricitabine (XTC), that is, tenofovir disoproxil fumarate/XTC/DTG (TXD) (X = XTC), could represent a near-universal first-line antiretroviral regimen offering significant clinical benefit, commodity savings, and overall health system savings. In the longer term, tenofovir alafenamide fumarate (TAF) could further reduce the cost of the first-line treatment backbone, with possible clinical benefits. Relative to the current generic standard of care in first-line, currently priced at ∼USD 90 per patient per year (pppy), high-volume production of TXD could lead to price reductions of ∼USD 20 pppy, whereas high-volume production of tenofovir alafenamide fumarate/XTC/DTG (TAFXD) could offer a reduction of ∼USD 40 pppy. With TXD in the near term, and TAFXD in the longer term, patients can benefit from better tolerated and more durable treatment, and programs will benefit by simplifying patient care and reducing cost to cover more patients.

  17. Designing Rainwater Harvesting Systems Cost-Effectively in a Urban Water-Energy Saving Scheme by Using a GIS-Simulation Based Design System

    Directory of Open Access Journals (Sweden)

    Yie-Ru Chiu

    2015-11-01

    Full Text Available Current centralized urban water supply depends largely on energy consumption, creating critical water-energy challenge especially for many rapid growing Asian cities. In this context, harvesting rooftop rainwater for non-potable use has enormous potential to ease the worsening water-energy issue. For this, we propose a geographic information system (GIS-simulation-based design system (GSBDS to explore how rainwater harvesting systems (RWHSs can be systematically and cost-effectively designed as an innovative water-energy conservation scheme on a city scale. This GSBDS integrated a rainfall data base, water balance model, spatial technologies, energy-saving investigation, and economic feasibility analysis based on a case study of eight communities in the Taipei metropolitan area, Taiwan. Addressing both the temporal and spatial variations in rainfall, the GSBDS enhanced the broad application of RWHS evaluations. The results indicate that the scheme is feasible based on the optimal design when both water and energy-savings are evaluated. RWHSs were observed to be cost-effective and facilitated 21.6% domestic water-use savings, and 138.6 (kWh/year-family energy-savings. Furthermore, the cost of per unit-energy-saving is lower than that from solar PV systems in 85% of the RWHS settings. Hence, RWHSs not only enable water-savings, but are also an alternative renewable energy-saving approach that can address the water-energy dilemma caused by rapid urbanization.

  18. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Vaiopoulou, E., E-mail: vaiop@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece); Melidis, P., E-mail: pmelidis@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece); Aivasidis, A., E-mail: aavazid@env.duth.gr [Department of Environmental Engineering, Democritus University of Thrace, Vas. Sofias 12, 67 100 Xanthi (Greece)

    2011-02-28

    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{sup 3} d) and high space time yield (30-35 kg COD/m{sup 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{sub 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{sub 2} content during biogas combustion is minimized and usage of other acidifying agents is omitted.

  20. Carbon savings resulting from the cooling effect of green areas: a case study in Beijing.

    Science.gov (United States)

    Lin, Wenqi; Wu, Tinghai; Zhang, Chengguo; Yu, Ting

    2011-01-01

    Green areas cool the climate of a city, reduce the energy consumption caused by the urban heat island (UHI) effect, and bring along carbon savings. However, the calculation of carbon savings due to the cooling effect of green areas is still not well understood. We have used a Landsat Enhanced Thematic Mapper Plus (ETM+) image of Beijing, to identify the cooled areas, compute the possible energy used to maintain the temperature differences between cooled areas and their surrounding heated areas, and calculate the carbon savings owing to the avoidance of energy use. Results show that a total amount of 14315.37 tons carbon savings was achieved in the study area and the amount was related to the biomass, the size and the shape of green areas. These results demonstrate the importance of carbon savings resulting from green areas' cooling effect. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ehrenkranz Peter

    2001-01-01

    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.

  3. 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.

  4. 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.

  5. Estimation of Energy Savings Resulting From the BestPractices Program, Fiscal Year 2002

    Energy Technology Data Exchange (ETDEWEB)

    Truett, LF

    2003-09-24

    Within the U.S. Department of Energy (DOE), the Office of Energy Efficiency and Renewable Energy (EERE) has a vision of a future with clean, abundant, reliable, and affordable energy. Within EERE, the Industrial Technologies Program (ITP), formerly the Office of Industrial Technologies, works in partnership with industry to increase energy efficiency, improve environmental performance, and boost productivity. The BestPractices (BP) Program, within ITP, works directly with industries to encourage energy efficiency. The purpose of the BP Program is to improve energy utilization and management practices in the industrial sector. The program targets distinct technology areas, including pumps, process heating, steam, compressed air, motors, and insulation. This targeting is accomplished with a variety of delivery channels, such as computer software, printed publications, Internet-based resources, technical training, technical assessments, and other technical assistance. A team of program evaluators from Oak Ridge National Laboratory (ORNL) was tasked to evaluate the fiscal year 2002 (FY02) energy savings of the program. The ORNL assessment enumerates levels of program activity for technology areas across delivery channels. In addition, several mechanisms that target multiple technology areas--e.g., Plant-wide Assessments (PWAs), the ''Energy Matters'' newsletter, and special events--are also evaluated for their impacts. When possible, the assessment relies on published reports and the Industrial Assessment Center (IAC) database for estimates of energy savings that result from particular actions. Data were also provided by ORNL, Lawrence Berkeley National Laboratory (LBNL) and Project Performance Corporation (PPC), the ITP Clearinghouse at Washington State University, the National Renewable Energy Laboratory (NREL), Energetics Inc., and the Industrial Technologies Program Office. The estimated energy savings in FY02 resulting from activities of the BP

  6. 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

    silica and a transparent conductive oxide demonstrated 90% visible transmission with high thermal infrared reflectivity characteristic of conventional low-e coatings. A slightly more complex stack provided high solar infrared reflection without sacrificing visible transmission or thermal infrared reflection. Successful completion of the effort produced a prototype integrated low-e, dynamic window film with characterized energy saving potential. Cost modeling for the passive bi-layer, low-e film projects a manufacturing cost of ~$0.50/ft2 for a plant with 10M ft2/yr capacity. The novel thin film processes developed here enable high deposition rate (low cost), optical quality oxide coatings at low temperatures. When combined with engineered materials, ITN’s coating will result in low-cost, low-e films that reflect a high degree of infrared radiation without substantially reducing the visible transmission. The resultant window film will improve the U-value and achieve SHGC improvements over bare glass. The new low-e coating will be particularly attractive when combined with an electrochromic film. Low-e coating design guided by energy savings modeling allows customization of the product for different climate zones.

  7. Cost savings and clinical acceptability of an intravascular line tip culture triage policy.

    Science.gov (United States)

    Colston, J; Batchelor, B; Bowler, I C J W

    2013-05-01

    Culture of intravascular line tips is useful for the diagnosis of intravascular line-related phlebitis and bacteraemia. However, the test lacks specificity, with a low predictive value for intravascular line bacteraemia. A recent randomised study showed that predictive value could be increased and costs reduced by refrigerating intravascular lines and retrieving them for culture only if there was a bacteraemia in the seven days before or after the intravascular line was received. We studied whether a similar triage policy could be introduced into our 1400-bed National Health Service (NHS) teaching hospital in the UK. We assessed cost reduction in the laboratory and clinical acceptability. Data regarding the number of intravascular lines received, stored and cultured and blood cultures received was retrieved from the microbiology computer, for five-month periods before and after the introduction of the new triage policy. Of the 134 intravascular line tips received in the five months after the policy had been introduced, 101 (75%) were stored without retrieval and 33 were cultured. Of these, 7/134 (5%) were culture positive and three matched a concurrent blood culture. Audit showed that compliance with the policy was >98%. The estimated annual cost reduction following the introduction of the policy was £3,166.96. The policy was acceptable to clinicians. The policy was both cost saving and clinically acceptable. If the policy were adopted throughout the NHS in the UK, the annual cost saving to the service might be in the order of £300,000. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  8. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-09

    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.

  10. How much might a society spend on life-saving interventions at different ages while remaining cost-effective? A case study in a country with detailed data.

    Science.gov (United States)

    Kvizhinadze, Giorgi; Wilson, Nick; Nair, Nisha; McLeod, Melissa; Blakely, Tony

    2015-01-01

    We aimed to estimate the maximum intervention cost (EMIC) a society could invest in a life-saving intervention at different ages while remaining cost-effective according to a user-specified cost-effectiveness threshold. New Zealand (NZ) was used as a case study, and a health system perspective was taken. Data from NZ life tables and morbidity data from a burden of disease study were used to estimate health-adjusted life-years (HALYs) gained by a life-saving intervention. Health system costs were estimated from a national database of all publicly funded health events (hospitalizations, outpatient events, pharmaceuticals, etc.). For illustrative purposes we followed the WHO-CHOICE approach and used a cost-effectiveness threshold of the gross domestic product (GDP) per capita (NZ$45,000 or US$30,000 per HALY). We then calculated EMICs for an "ideal" life-saving intervention that fully returned survivors to the same average morbidity, mortality, and cost trajectories as the rest of their cohort. The EMIC of the "ideal" life-saving intervention varied markedly by age: NZ$1.3 million (US$880,000) for an intervention to save the life of a child, NZ$0.8 million (US$540,000) for a 50-year-old, and NZ$0.235 million (US$158,000) for an 80-year-old. These results were predictably very sensitive to the choice of discount rate and to the selected cost-effectiveness threshold. Using WHO data, we produced an online calculator to allow the performance of similar calculations for all other countries. We present an approach to estimating maximal cost-effective investment in life-saving health interventions, under various assumptions. Our online calculator allows this approach to be applied in other countries. Policymakers could use these estimates as a rapid screening tool to determine if more detailed cost-effectiveness analyses of potential life-saving interventions might be worthwhile or which proposed life-saving interventions are very unlikely to benefit from such additional

  11. Tele-Dysphagia management: an opportunity for prevention, cost-savings and advanced training.

    Science.gov (United States)

    Coyle, James

    2012-01-01

    Many patients survive severe stroke because of aggressive management in intensive care units. However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP), a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians. Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas. Tele-dysphagia management has the potential to increase patients' survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year. Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  12. Tele-Dysphagia Management: An Opportunity for Prevention, Cost-Savings and Advanced Training

    Directory of Open Access Journals (Sweden)

    James Coyle

    2012-06-01

    Full Text Available Many patients survive severe stroke because of aggressive management in intensive care units.  However, acquiring pneumonia during the post-onset phase significantly reduces both the quality and likelihood of survival. Aspiration pneumonia (AP, a relatively recent addition to the list of the pneumonias, is associated with dysphagia, a swallowing disorder that may cause aspiration of swallowed food or liquids mixed with bacterial pathogens common to saliva, or by aspiration of gastric contents due to emesis or gastroesophageal reflux. While it is within the purview of speech-language pathologists to provide evaluation, treatment, and management of dysphagia, the number of patients with dysphagia is growing faster than the number of qualified dysphagia clinicians.  Because dysphagia consultations via telepractice are feasible and relatively accessible from a technological standpoint, they offer a promising strategy to bring the expertise of distant dysphagia experts to patients in underserved areas.  Tele-dysphagia management has the potential to increase patients’ survival, enhance the expertise of primary, local clinicians, and reduce healthcare costs. Even a modest reduction in either hospital admissions for aspiration pneumonia, or in the length of stay for AP, could save the US health care system hundreds of millions of dollars each year.  Wide spread tele-dysphagia management offers significant opportunities for prevention, cost-savings and advanced training, and is therefore worthy of consideration by stakeholders in the health care system and university training programs.

  13. Cost-saving potentials using demand side management in households and electric mobility

    Energy Technology Data Exchange (ETDEWEB)

    Schinz, S.; Najib, H.; Steiner, L. [Darmstadt Univ. of Technology (Germany). Inst. for Renewable Energies

    2010-07-01

    The increasing share of renewable energies in the electricity production has an influence on the grid and on the electricity markets, where higher price fluctuations are expected. One way of integrating renewable energies is using demand side management (DSM). In this case online energy markets enable private households to participate with their loads in these markets. Especially their household appliances participate on the basis of hourly electricity prices. Thus these markets can provide DSM-services for the grid by means of aggregating household loads. To estimate the cost-savings of DSM for the purpose of reducing electricity costs in private households different gadget-models are developed and minimal costs are calculated by formulating linear optimization models. In private households especially refrigerators, freezers, washing machines, tumble- dryers and dishwashers can be considered as shiftable loads for DSM purposes. This application of DSM is examined in this paper precisely. Future developments regarding DSM are analyzed with scenarios for 2010 and 2030. The gadget-models have average specifications of gadgets in Europe and Germany. Their operation is optimized for minimal electricity cost over one year on the basis of electricity prices from the European Energy Exchange EEX in Leipzig, Germany. Finally DSM in Micro Grids is analyzed and different control options are considered to solve the voltage stability problem. (orig.)

  14. Energy and cost savings analysis of Wood Burning Boiler Plant, Fort Stewart, Georgia: Final report, Validation of ECIP Project No. 193: DOD, Energy Conservation Investment Program (ECIP)

    Energy Technology Data Exchange (ETDEWEB)

    Broders, M.A.; Miller, D.R.

    1987-08-01

    An Energy Conservation Investment Program (ECIP) project to install a 94,900 lb steam per hour wood burning boiler in the Fort Stewart Central Energy Plant was selected by the US Army for validation by the Oak Ridge National Laboratory. This ECIP project was justified on the basis of fuel cost savings and the use of a renewable energy source: wood waste, which is abundantly available at Fort Stewart, Georgia. This report documents the results of a 1-year postretrofit study designed to validate the energy and cost savings attributed to the installation of the new wood burning boiler. During the postretrofit validation study period (FY 1986), the new wood burning boiler produced approximately 90% of the steam required by the Central Energy Plant to meet the seasonal heating and cooling demands of Fort Stewart. In doing so, over 2,880,000 gal of No. 5 fuel oil (a nonrenewable energy source) was conserved. With full consideration given to the increase in electrical energy required to operate the new Wood Burning Boiler Plant addition, an annual nonrenewable energy savings of over 400,000 MBtu is projected. Based on the results of a life cycle cost analysis performed on this ECIP project, a first-year savings of over $1,200,000 is estimated. The resultant discounted savings ratio is 3.36, and the estimated simple payback period is 6.7 years. It was concluded that installation and operation of a wood burning boiler at a military installation such as Fort Stewart can result in significant cost and nonrenewable energy savings.

  15. Healthcare Expenditure and Productivity Cost Savings from Reductions in Cardiovascular Disease and Type 2 Diabetes Associated with Increased Intake of Cereal Fibre among Australian Adults: A Cost of Illness Analysis.

    Science.gov (United States)

    Fayet-Moore, Flavia; George, Alice; Cassettari, Tim; Yulin, Lev; Tuck, Kate; Pezzullo, Lynne

    2018-01-02

    An ageing population and growing prevalence of chronic diseases including cardiovascular disease (CVD) and type 2 diabetes (T2D) are putting increased pressure on healthcare expenditure in Australia. A cost of illness analysis was conducted to assess the potential savings in healthcare expenditure and productivity costs associated with lower prevalence of CVD and T2D resulting from increased intake of cereal fibre. Modelling was undertaken for three levels of increased dietary fibre intake using cereal fibre: a 10% increase in total dietary fibre; an increase to the Adequate Intake; and an increase to the Suggested Dietary Target. Total healthcare expenditure and productivity cost savings associated with reduced CVD and T2D were calculated by gender, socioeconomic status, baseline dietary fibre intake, and population uptake. Total combined annual healthcare expenditure and productivity cost savings of AUD$17.8 million-$1.6 billion for CVD and AUD$18.2 million-$1.7 billion for T2D were calculated. Total savings were generally larger among adults of lower socioeconomic status and those with lower dietary fibre intakes. Given the substantial healthcare expenditure and productivity cost savings that could be realised through increases in cereal fibre, there is cause for the development of interventions and policies that encourage an increase in cereal fibre intake in Australia.

  16. Reprocessing single-use cardiac catheters for interventional cardiology. A cost-minimization model for estimating potential saving at departmental scale and national level

    Directory of Open Access Journals (Sweden)

    Francesco Tessarolo

    2009-06-01

    Full Text Available

    Background: The utilization of single-use percutaneous catheters (SUDs is a common practice in interventional cardiology, but the increasing of cardiac interventions and the consequent economic load demand for assessing SUDs’ reuse. The study aimed at estimating the potential saving for Italian cardiology departments in the hypothesis that reprocessing and reuse of SUD is performed by guaranteeing safety and efficiency of the reconditioned device as high as the new marketed one.

    Methods: A cost-minimization model was applied from the perspective of the health national service. Input parameters for the model were settled by reviewing published data on technical, hygiene and functional properties of reprocessed electrophysiology (EP and percutaneous transluminal coronary angioplasty (PTCA catheters. Potential saving at department level was calculated as percentage of the actual expenditure for purchasing single-use devices. Two-ways sensitivity analysis was conducted on main cost drivers. Finally, saving at national level was estimated.

    Results: The revision of technical and safety data showed the feasibility of reprocessing and reuse of EP and PTCA catheters under determined constrains. Potential savings of 39%, and 12% were calculated at department level for EP and PTCA catheters, respectively. Sensitivity analysis showed saving was dependent primarily on departmental workload. Major variations in saving occurred in the range between one and 200 catheters per year. The cut-off between benefit and charges was also related to regeneration rate and maximum number of uses. The estimate of potential saving at national level ranged in the interval from €19.85M to €24.24M.

    Conclusions:When safety and efficiency is assured by certified reuse processing, substantial saving could be achieved both at departmental and national level contributing to optimize budget

  17. 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.

  18. 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.

  19. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Energy Smart Schools Team

    2001-08-06

    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.

  1. 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.

  2. 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.

  3. [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

  4. Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Marine Climates; January 2006 - December 2006

    Energy Technology Data Exchange (ETDEWEB)

    Building America Industrialized Housing Partnership (BAIHP); Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

    2006-12-01

    The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Marine Climate Region on a cost neutral basis.

  5. 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

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

    Science.gov (United States)

    Korenromp, Eline L

    2012-03-28

    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 makers and programme planners

  7. 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.

  8. Interactive internet-based clinical education: an efficient and cost-savings approach to point-of-care test training.

    Science.gov (United States)

    Knapp, Herschel; Chan, Kee; Anaya, Henry D; Goetz, Matthew B

    2011-06-01

    We successfully created and implemented an effective HIV rapid testing training and certification curriculum using traditional in-person training at multiple sites within the U.S. Department of Veterans Affairs (VA) Healthcare System. Considering the multitude of geographically remote facilities in the nationwide VA system, coupled with the expansion of HIV diagnostics, we developed an alternate training method that is affordable, efficient, and effective. Using materials initially developed for in-person HIV rapid test in-services, we used a distance learning model to offer this training via live audiovisual online technology to educate clinicians at a remote outpatient primary care VA facility. Participants' evaluation metrics showed that this form of remote education is equivalent to in-person training; additionally, HIV testing rates increased considerably in the months following this intervention. Although there is a one-time setup cost associated with this remote training protocol, there is potential cost savings associated with the point-of-care nurse manager's time productivity by using the Internet in-service learning module for teaching HIV rapid testing. If additional in-service training modules are developed into Internet-based format, there is the potential for additional cost savings. Our cost analysis demonstrates that the remote in-service method provides a more affordable and efficient alternative compared with in-person training. The online in-service provided training that was equivalent to in-person sessions based on first-hand supervisor observation, participant satisfaction surveys, and follow-up results. This method saves time and money, requires fewer personnel, and affords access to expert trainers regardless of geographic location. Further, it is generalizable to training beyond HIV rapid testing. Based on these consistent implementation successes, we plan to expand use of online training to include remote VA satellite facilities spanning

  9. 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.

  10. Reusing dialyzer in low income countries: A good cost saving tactic with complex ethics.

    Science.gov (United States)

    Dhrolia, Murtaza Fakhruddin; Imtiaz, Salman; Qureshi, Ruqaya; Ahmed, Aasim

    2017-08-01

    Despite almost universal practice of dialyzer reuse from the earliest days of haemodialysis, reusing dialyzer always remains a controversial issue and several ethical concerns have been raised. Some of the important are safety of reuse over single use, informed consent of the patient, conflict of interest on the part of physician or manufacturer, fiscal responsibility and environmental stewardship. Indeed, at the beginning of this century, there was a drastic shift of practice in favour of single use in developed countries due to availability of biocompatible haemodialyzers, at favourable price. Despite this mega shift, dialyzer reuse is still widely practised in low-income countries. Considering cost inflation and limited medical resources in such countries, dialyzer reuse may be justified as a cost-saving strategy for this part of world. However, it poses the same ethical questions to us which were a matter of debate for the western world in the 1980s and 1990s. This review of literature was planned to revisit and highlight these concerns.

  11. 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

  12. Cost-Effectiveness of a Savings-Led Economic Empowerment Intervention for AIDS-Affected Adolescents in Uganda: Implications for Scale-up in Low-Resource Communities.

    Science.gov (United States)

    Ssewamala, Fred M; Wang, Julia Shu-Huah; Neilands, Torsten B; Bermudez, Laura Gauer; Garfinkel, Irwin; Waldfogel, Jane; Brooks-Gunn, Jeanne; Kirkbride, Gwyneth

    2018-01-01

    Nearly 12 million children and adolescents in sub-Saharan Africa have lost one or both parents to AIDS. Within sub-Saharan Africa, Uganda has been greatly impacted, with an estimated 1.2 million orphaned children, nearly half of which have experienced parental loss due to the epidemic. Cost-effective and scalable interventions are needed to improve developmental outcomes for these children, most of whom are growing up in poverty. This article examines the direct impacts and cost-effectiveness of a savings-led family economic empowerment intervention, Bridges to the Future, that employed varying matched savings incentives to encourage investment in Ugandan children orphaned by AIDS. Using data from 48 primary schools in southwestern Uganda, we calculate per-person costs in each of the two treatment arms-Bridges (1:1 match savings) versus Bridges PLUS (1:2 match savings); estimate program effectiveness across outcomes of interest; and provide the ratios of per-person costs to their corresponding effectiveness. At the 24-month postintervention initiation, children in the two treatment arms showed better results in health, mental health, and education when compared to the usual care condition; however, no statistically significant differences were found between treatment arms with the exception of school attendance rates which were higher for those in Bridges PLUS. Owing to the minimal cost difference between the Bridges and Bridges PLUS arms, we did not find substantial cost-effectiveness differences across the two treatment arms. After 24 months, an economic intervention that incorporated matched savings yielded positive results on critical development outcomes for adolescents orphaned by AIDS in Uganda. The 1:1 and 1:2 match rates did not demonstrate variable levels of cost-effectiveness at 24-month follow-up, suggesting that governments intending to incorporate savings-led interventions within their social protection frameworks may not need to select a higher

  13. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children.

    Science.gov (United States)

    Bibus, Douglas M

    2016-02-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega-3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in the U.S. with 8-12 ounces of fish per week, as recommended by the Food and Drug Administration (FDA), throughout the duration of pregnancy and lactation. Based on the FDA's quantitative assessment, this may result in a net increase of IQ by 5.5 points in children and improve their early age verbal development.

  14. Economic Utility: Combinatorial Pharmacogenomics and Medication Cost Savings for Mental Health Care in a Primary Care Setting.

    Science.gov (United States)

    Brown, Lisa C; Lorenz, Raymond A; Li, James; Dechairo, Bryan M

    2017-03-01

    This study was an analysis based on a previously completed prospective study investigating medication costs of patients with mental illness guided by using the GeneSight proprietary combinatorial pharmacogenomic (PGx) test. The primary objective of this study was to determine potential cost savings of combinatorial PGx testing over the course of 1 year in patients with mental illness treated by primary care providers (PCPs) and psychiatrists who had switched or added a new psychiatric medication after patients failed to respond to monotherapy. The current evaluation details cost savings of treatment decisions congruent and incongruent with the combinatorial PGx test recommendations specific to PCPs and psychiatrists. This study was a subanalysis of a 1-year, prospective trial comparing medication costs of 2168 patients undergoing GeneSight testing. Pharmacy claims were provided by a pharmacy benefits manager, comparing medication costs 6 months before combinatorial PGx testing and followed up for 1 year after the testing. This analysis compared congruence and cost savings per patient based on the type of health care provider administering care. Using data from a large pharmacy benefits manager, we found that PCPs treat the majority of mental health patients receiving psychotropic medication prescriptions, including treatment-resistant patients. PCPs congruent with combinatorial PGx testing provided the most medication cost savings for payers and patients at $3988 per member per year (P Health care providers treating patients with mental illness can significantly reduce medication costs by following the combinatorial PGx report recommendations. PCPs, who treat the majority of patients with mental illness, reported a significant reduction in medication costs for both central nervous system and non-central nervous system drugs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-08-01

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

  16. Cost analysis of a prospective multi-site cohort study of palliative care consultation teams for adults with advanced cancer: Where do cost-savings come from?

    Science.gov (United States)

    May, Peter; Garrido, Melissa M; Cassel, J Brian; Kelley, Amy S; Meier, Diane E; Normand, Charles; Smith, Thomas J; Morrison, R Sean

    2017-04-01

    Studies report cost-savings from hospital-based palliative care consultation teams compared to usual care only, but drivers of observed differences are unclear. To analyse cost-differences associated with palliative care consultation teams using two research questions: (Q1) What is the association between early palliative care consultation team intervention, and intensity of services and length of stay, compared to usual care only? (Q2) What is the association between early palliative care consultation team intervention and day-to-day hospital costs, compared to a later intervention? Prospective multi-site cohort study (2007-2011). Patients who received a consultation were placed in the intervention group, those who did not in the comparison group. Intervention group was stratified by timing, and groups were matched using propensity scores. Adults admitted to three US hospitals with advanced cancer. Principle analytic sample contains 863 patients ( nUC = 637; nPC EARLY = 177; nPC LATE = 49) discharged alive. Cost-savings from early palliative care accrue due to both reduced length of stay and reduced intensity of treatment, with an estimated 63% of savings associated with shorter length of stay. A reduction in day-to-day costs is observable in the days immediately following initial consult but does not persist indefinitely. A comparison of early and late palliative care consultation team cost-effects shows negligible difference once the intervention is administered. Reduced length of stay is the biggest driver of cost-saving from early consultation for patients with advanced cancer. Patient- and family-centred discussions on goals of care and transition planning initiated by palliative care consultation teams may be at least as important in driving cost-savings as the reduction of unnecessary tests and pharmaceuticals identified by previous studies.

  17. 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.

  18. 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

  19. 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.

  20. Lives saved from malaria prevention in Africa - Evidence to sustain cost-effective gains

    NARCIS (Netherlands)

    E.L. Korenromp (Eline)

    2012-01-01

    textabstractLives 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

  1. 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

    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. 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. 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. 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.

  2. 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.

  3. 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.

  4. Cost and radiation savings of partial substitution of ultrasound for CT in appendicitis evaluation: a national projection.

    Science.gov (United States)

    Parker, Laurence; Nazarian, Levon N; Gingold, Eric L; Palit, Charles D; Hoey, Courtney L; Frangos, Andrea J

    2014-01-01

    The costs of an ultrasound-CT protocol and a CT-only protocol for an appendicitis evaluation are compared. For the ultrasound-CT protocol, patients with right lower quadrant abdominal pain undergo an ultrasound examination. If it is positive for appendicitis, they are sent directly to surgery, avoiding CT. A comparative effectiveness research study was conducted. The costs of imaging tests, excess surgeries, and excess surgical deaths for the ultrasound-CT protocol and the costs of imaging tests and excess cancer deaths in the CT-only protocol were estimated. Data sources were Centers for Medicare & Medicaid Services (CMS) datasets, national hospital discharge surveys, radiology information system cases, and U.S. Census Bureau life tables. A meta-analysis and sensitivity analyses were also conducted. The meta-analysis showed a positive predictive value of 92.5% for CT and 91.0% for ultrasound. Analysis of CMS files showed that utilization of CT was almost exactly 2.0 examinations (one abdominal and one pelvic) per patient and for ultrasound was almost nil. The cost of this imaging protocol was $547 per patient, whereas the cost of a limited ultrasound study would be $88 per patient. For the total U.S. population, the cost savings in imaging minus the cost of extra surgeries and extra surgical deaths is $24.9 million per year. Following model VII proposed by the Committee on the Biological Effects of Ionizing Radiation (BEIR), which is known as "BEIR VII," the avoidance of a 12.4-mSv exposure for 262,500 persons would prevent 180 excess cancer deaths. The value of the years of life lost would be $339.5 million. The sensitivity analyses indicate that the cost savings are robust. An ultrasound-CT protocol for appendicitis evaluation offers potentially large savings over the standard CT-only protocol. There are moderate savings from using a less expensive imaging technique despite extra surgeries and large savings from radiation exposure avoided.

  5. 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

  6. 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

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

  7. 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

    Sponsored by the DOE Industrial Energy Efficiency Grand Challenge program, our research team at the Georgia Institute of Technology conducted laboratory studies and confirmed the concept of making wood pulp using a dry pulping technology. This technology is a new process different from any prior pulping technology used in Kraft and CTMP pulping. Three different kinds of dry pulping methods were investigated. (a) Dry Pulping at Atmospheric Pressure: The first one is to dry and bake the pretreated woodchips in a conventional oven at atmospheric pressure without the use of a catalyst. (b) Dry Pulping at Reduced Pressure: The second method is to dry the pretreated woodchips first in a vacuum oven in the presence of anthraquinone (AQ) as a pulping catalyst, followed by baking at elevated temperature. (c) Liquid Free Chemical Pulping, LFCP. The third method is to first remove the free water of pretreated woodchips, followed by dry pulping using a conventional Kraft pulping digester with AQ and triton as additives. Method one: Experimental results indicated that Dry Pulping at Atmospheric Pressure could produce pulp with higher brightness and lower bulk than conventional Kraft pulp. However, tensile strength of the acquired pulp is much lower than traditional Kraft pulp, and their Kappa number and energy consumption are higher than conventional Kraft pulp. By fully analyzing the results, we concluded that wood fibers might be damaged during the drying process at elevated temperature. The main reason for wood fiber damage is that a long drying time was used during evaporation of water from the woodchips. This resulted in an un-uniform reaction condition on the woodchips: the outside layer of the woodchips was over reacted while inside the woodchips did not reacted at all. To solve this problem, dry pulping at reduced pressure was investigated. Method two: To achieve uniform reaction throughout the entire reaction system, the water inside the pretreated woodchips was

  8. Scope-of-practice laws for nurse practitioners limit cost savings that can be achieved in retail clinics.

    Science.gov (United States)

    Spetz, Joanne; Parente, Stephen T; Town, Robert J; Bazarko, Dawn

    2013-11-01

    Retail clinics have the potential to reduce health spending by offering convenient, low-cost access to basic health care services. Retail clinics are often staffed by nurse practitioners (NPs), whose services are regulated by state scope-of-practice regulations. By limiting NPs' work scope, restrictive regulations could affect possible cost savings. Using multistate insurance claims data from 2004-07, a period in which many retail clinics opened, we analyzed whether the cost per episode associated with the use of retail clinics was lower in states where NPs are allowed to practice independently and to prescribe independently. We also examined whether retail clinic use and scope of practice were associated with emergency department visits and hospitalizations. We found that visits to retail clinics were associated with lower costs per episode, compared to episodes of care that did not begin with a retail clinic visit, and the costs were even lower when NPs practiced independently. Eliminating restrictions on NPs' scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.

  9. 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.

  10. United States menhaden oil could save billions in U.S. health care costs and improve IQ in children

    OpenAIRE

    Bibus, Douglas M

    2016-01-01

    The United States menhaden oil annual production is sufficient to supply all of the recommended long chain Omega?3s for Americans over 55 with coronary heart disease (CHD) and pregnant and lactating women. According to a recent study, the utilization of preventable intake levels could potentially save up to $1.7 billion annually in hospital costs alone. In addition, the remaining oil could be used to support a culture of enough Atlantic salmon to provide every pregnant and lactating woman in ...

  11. Estimation of potential cost savings associated with reduced rates of cardiovascular hospitalization among atrial fibrillation/flutter patients treated with dronedarone in the ATHENA trial.

    Science.gov (United States)

    Reynolds, Matthew R; Lin, Jay; Jhaveri, Mehul; Mozaffari, Essy; Plich, Adam

    2014-01-01

    The aim of this study was to estimate, from a US payer perspective, potential cost savings resulting from the reduction in cardiovascular (CV) hospitalizations obtained with dronedarone in the ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death from any Cause in PatiENts with Atrial Fibrillation/Atrial Flutter) trial. ATHENA randomized atrial fibrillation/flutter patients to dronedarone (n=2301) or placebo (n=2327) plus standard care. Dronedarone significantly reduced first CV hospitalization/all-cause mortality over 12-30 months of follow-up. CV hospitalization costs (2008 values) from a US cohort of ATHENA-like atrial fibrillation/flutter patients with Medicare supplemental insurance (n=10,200) and diagnosis-related group costs of adverse event-related hospitalizations were applied to hospitalizations occurring in ATHENA. The impact of cost variation was assessed using Monte Carlo simulation. In ATHENA, dronedarone reduced the overall CV hospitalization rate (vs. placebo) by 29% over the first 12 months (33.36 vs. 47.19 events per 100 patients) and by 25% over the full study (51.15 vs. 68.55 events per 100 patients). Adverse event-related hospitalization rates (dronedarone vs. placebo) were low (0.48 vs. 0.21 and 0.56 vs. 0.26 events per 100 patients over 12 months and the full study, respectively). Overall hospitalization cost savings were estimated at $1329 and $1763 per patient over 12 months and the full study, respectively. Cost savings were relatively stable [mean (95% confidence interval): $1330 ($994-$1676) for the first 12 months and $1763 ($1369-$2184) for the full study] over 10,000 cycles of random variation.

  12. Saving costs through the decontamination of the packaging of unused medical supplies using hydrogen peroxide vapor.

    Science.gov (United States)

    Otter, Jonathan A; Nowakowski, Elaine; Salkeld, James A G; Duclos, Mike; Passaretti, Catherine L; Yezli, Saber; Ross, Tracy; Carroll, Karen C; Perl, Trish M

    2013-05-01

    OBJECTIVE. Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies. DESIGN. Before-after study. METHODS. A pilot study was performed in the rooms of 20 patients known to be colonized or infected with vancomycin-resistant enterococci (VRE), and a follow-up study was performed in an additional 20 rooms of patients under precautions for various MDROs in 6 high-risk units. Five pairs of supply items were selected. One item of each pair was sampled without exposure to HPV, and the other was sampled after HPV exposure. The cost of discarded supplies was calculated by examining stock lists of supplies stored on the study units. RESULTS. Seven (7%) of 100 items were contaminated with VRE in the pilot study, and 9 (9%) of 100 items were contaminated with MDROs in the follow-up study. None of the items were contaminated after exposure to HPV (P supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden. CONCLUSIONS. HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.

  13. Standardization: Hardware and Software Standardization Can Reduce Costs and Save Time

    Science.gov (United States)

    Brooks-Young, Susan

    2005-01-01

    Sadly, technical support doesn't come cheap. One money-saving strategy that's gained popularity among school technicians is equipment and software standardization. When it works, standardization can be very effective. However, standardization has its drawbacks. This article discusses the advantages and disadvantages of standardization.

  14. Energy saving by using natural energy from the shallow ground depths - many years operating results

    Science.gov (United States)

    Besler, Maciej; Skrzycki, Maciej; Cepiński, Wojciech

    2017-11-01

    We pay back more and more larger attention on solutions which saving energy produced from conventional fuels. This is possible to obtainment in significant quantities in fields in which use up the large quantities of energy. The formation the microclimate of interiors is an example of such situation. Especially in the case air conditioning, heating and mechanical ventilation. There is, however, a possibility of energy saving as well as considerable reducing the pollution coming from combustion of raw materials by utilising the natural renewable energy from the shallow ground. In the paper the results gained during several year of continuous measurement on the exchanger were presented. In summer periods an air cooling occurs 10-12 K, e. g. from +30 °C to +20 °C. In winter on the other hand, a preparatory preheating of the air is possible, e.g. from-18°C to about ± 0°C. It is then possible to obtain for the air conditioning system the total energy needed for cooling purposes at the summer periods, or up to 50% of the ventilation heat energy in winter picks.

  15. Energy saving by using natural energy from the shallow ground depths – many years operating results

    Directory of Open Access Journals (Sweden)

    Besler Maciej

    2017-01-01

    Full Text Available We pay back more and more larger attention on solutions which saving energy produced from conventional fuels. This is possible to obtainment in significant quantities in fields in which use up the large quantities of energy. The formation the microclimate of interiors is an example of such situation. Especially in the case air conditioning, heating and mechanical ventilation. There is, however, a possibility of energy saving as well as considerable reducing the pollution coming from combustion of raw materials by utilising the natural renewable energy from the shallow ground. In the paper the results gained during several year of continuous measurement on the exchanger were presented. In summer periods an air cooling occurs 10–12 K, e. g. from +30 °C to +20 °C. In winter on the other hand, a preparatory preheating of the air is possible, e.g. from-18°C to about ± 0°C. It is then possible to obtain for the air conditioning system the total energy needed for cooling purposes at the summer periods, or up to 50% of the ventilation heat energy in winter picks.

  16. 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.

  17. Assessing cost-effectiveness in obesity (ACE-obesity): an overview of the ACE approach, economic methods and cost results.

    Science.gov (United States)

    Carter, Rob; Moodie, Marj; Markwick, Alison; Magnus, Anne; Vos, Theo; Swinburn, Boyd; Haby, Michele M

    2009-11-18

    The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. The Assessing Cost Effectiveness (ACE) approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum) and when expressed as a 'cost per child' estimate (from costs per child reflected cost structure, target population and/or under-utilisation. The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost

  18. Geothermal Heat Pumps as a Cost Saving and Capital Renewal Too!

    Energy Technology Data Exchange (ETDEWEB)

    Hughes, P.J.

    1998-11-06

    An independent evaluation of the Fort Polk, Louisiana energy savings performance contract (ESPC) has verified the financial value of geothermal heat pump (GHP)-centered ESPCS to the federal government. The Department of Energy (DOE) Federal Energy Management Program (FEMP) has responded by issuing an RFP for the "National GHP-Technology-Specific Super ESPC Procurement." Federal agency sites anywhere in the nation will be able to implement GHP-centered ESPC projects as delivery orders against the awarded contracts.

  19. 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.

  20. 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.

  1. Energy saving report; Energispareredegoerelse

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-05-01

    Making the energy consumption more efficient in Denmark by means of energy saving are connected to the Danish government's overall National Growth Strategy. A reduced consumption of energy as a result of economic attractive energy saving initiatives leads to reduced energy costs and consequently an improvement of Denmark's competitive power. Furthermore, reducing the energy consumption decreases the vulnerability towards rising energy prices, and the security of supplies is increased. Finally energy conservation serves as a means of reducing environmental impact from the energy sector. Energy consumption is not damaging to the environment in itself, however, to the extent that energy consumption causes negative impact on the environment, e.g. through discharge of environmentally damaging substances generated during energy production, a reduction of the energy consumption will benefit the environment. Energy saving in itself does not lead to a decrease in CO{sub 2} emission in Denmark unless it is accompanied by an adjustment of CO{sub 2} quotas on production of electricity. The Danish Government emphasizes that the energy saving efforts are cost-effective both for the society and for the consumers. The energy saving report contains an updated projection of the Danish energy consumption and an evaluation of the impacts of the energy saving efforts. The impacts of more effective end use of energy are described, and an account of the barriers preventing the realization of a number of potential economic attractive energy saving initiatives is made. Finally the energy saving report presents a number of proposals for new energy saving initiatives. (BA)

  2. Estimating health care cost savings from an educational intervention to prevent bleeding-related complications: the outcomes impact analysis model.

    Science.gov (United States)

    Ravyn, Dana; Ravyn, Vipa; Lowney, Rob; Ferraris, Victor

    2014-01-01

    Investments in continuing medical education (CME) exceed $2 billion annually, but few studies report the economic impact of CME activities. Analysis of patient-level economic outcomes data is often not feasible. Accordingly, we developed a model to illustrate estimation of the potential economic impact associated with CME activity outcomes. Outcomes impact analysis demonstrated how costs averted from a CME symposium that promoted prevention of bleeding-related complications (BRC) and reoperation for bleeding (RFB) in cardiac and thoracic operations could be estimated. Model parameter estimates were from published studies of costs associated with BRC and RFB. Operative volume estimates came from the Society of Thoracic Surgeons workforce data. The base case predicted 3 in 10 participants preventing one BRC or RFB in 2% or 1.5% of annual operations, respectively. Probabilistic sensitivity analysis (PSA) evaluated the effect of parameter uncertainty. 92% of participants (n = 133) self-reported commitment to change, a validated measure of behavior change. For BRC, estimates for costs averted were $1,502,769 (95% confidence interval [CI], $869,860-$2,359,068) for cardiac operations and $2,715,246 (95% CI, $1,590,308-$4,217,092) for thoracic operations. For RFB, the savings estimates were $2,233,988 (95% CI, $1,223,901-$3,648,719). Our economic model demonstrates that application of CME-related learning to prevent bleeding complications may yield substantial cost savings. Model prediction of averted costs associated with CME allows estimation of the economic impact on outcomes in the absence of patient-level outcomes data related to CME activities. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  3. Assessing Cost-Effectiveness in Obesity (ACE-Obesity: an overview of the ACE approach, economic methods and cost results

    Directory of Open Access Journals (Sweden)

    Swinburn Boyd

    2009-11-01

    Full Text Available Abstract Background The aim of the ACE-Obesity study was to determine the economic credentials of interventions which aim to prevent unhealthy weight gain in children and adolescents. We have reported elsewhere on the modelled effectiveness of 13 obesity prevention interventions in children. In this paper, we report on the cost results and associated methods together with the innovative approach to priority setting that underpins the ACE-Obesity study. Methods The Assessing Cost Effectiveness (ACE approach combines technical rigour with 'due process' to facilitate evidence-based policy analysis. Technical rigour was achieved through use of standardised evaluation methods, a research team that assembles best available evidence and extensive uncertainty analysis. Cost estimates were based on pathway analysis, with resource usage estimated for the interventions and their 'current practice' comparator, as well as associated cost offsets. Due process was achieved through involvement of stakeholders, consensus decisions informed by briefing papers and 2nd stage filter analysis that captures broader factors that influence policy judgements in addition to cost-effectiveness results. The 2nd stage filters agreed by stakeholders were 'equity', 'strength of the evidence', 'feasibility of implementation', 'acceptability to stakeholders', 'sustainability' and 'potential for side-effects'. Results The intervention costs varied considerably, both in absolute terms (from cost saving [6 interventions] to in excess of AUD50m per annum and when expressed as a 'cost per child' estimate (from Conclusion The use of consistent methods enables valid comparison of potential intervention costs and cost-offsets for each of the interventions. ACE-Obesity informs policy-makers about cost-effectiveness, health impact, affordability and 2nd stage filters for important options for preventing unhealthy weight gain in children. In related articles cost-effectiveness results and

  4. Effects of a computerized provider order entry and a clinical decision support system to improve cefazolin use in surgical prophylaxis: a cost saving analysis

    Directory of Open Access Journals (Sweden)

    Okumura LM

    2016-09-01

    Full Text Available Background: Computerized Provider Order Entry (CPOE and Clinical Decision Support System (CDSS help practitioners to choose evidence-based decisions, regarding patients’ needs. Despite its use in developed countries, in Brazil, the impact of a CPOE/CDSS to improve cefazolin use in surgical prophylaxis was not assessed yet. Objective: We aimed to evaluate the impact of a CDSS to improve the use of prophylactic cefazolin and to assess the cost savings associated to inappropriate prescribing. Methods: This is a cross-sectional study that compared two different scenarios: one prior CPOE/CDSS versus after software implementation. We conducted twelve years of data analysis (3 years prior and 9 years after CDSS implementation, where main outcomes from this study included: cefazolin Defined Daily Doses/100 bed-days (DDD, crude costs and product of costs-DDD (cost-DDD/100 bed-days. We applied a Spearman rho non-parametric test to assess the reduction of cefazolin consumption through the years. Results: In twelve years, 84,383 vials of cefazolin were dispensed and represented 38.89 DDD/100 bed-days or USD 44,722.99. Surgical wards were the largest drug prescribers and comprised >95% of our studied sample. While in 2002, there were 6.31 DDD/100 bed-days, 9 years later there was a reduction to 2.15 (p<0.05. In a scenario without CDSS, the hospital would have consumed 75.72 DDD/100 bed-days, which is equivalent to USD 116 998.07. It is estimated that CDSS provided USD 50,433.39 of cost savings. Conclusion: The implementation of a CPOE/CDSS helped to improve prophylactic cefazolin use by reducing its consumption and estimated direct costs.

  5. 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.

  6. 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…

  7. 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.

  8. Palliative Care Teams’ Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities

    Science.gov (United States)

    May, Peter; Garrido, Melissa M.; Cassel, J. Brian; Kelley, Amy S.; Meier, Diane E.; Normand, Charles; Stefanis, Lee; Smith, Thomas J.; Morrison, R. Sean

    2016-01-01

    Patients with multiple serious conditions account for a high proportion of health care spending. Such spending is projected to continue to grow substantially because of increased insurance eligibility, the ever-rising cost of care, the continued use of nonbeneficial high-intensity treatments at the end of life, and demographic changes. We evaluated the impact of palliative care consultation on hospital costs for adults with advanced cancer, excluding those with dementia. We found that compared to usual care, the receipt of a palliative care consultation within two days of admission was associated with 22 percent lower costs for patients with a comorbidity score of 2–3 and with 32 percent lower costs for those with a score of 4 or higher. Earlier consultation was also found to be systematically associated with a larger cost-saving effect for all subsamples defined by multimorbidity. Given ongoing workforce shortages, targeting early specialist palliative care to hospitalized patients with advanced cancer and higher numbers of serious concurrent conditions could improve care while complementing strategies to curb the growth of health spending. PMID:26733700

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. Development of a budget-impact model to quantify potential cost savings from prescription opioids designed to deter abuse or ease of extraction.

    Science.gov (United States)

    White, Alan G; Birnbaum, Howard G; Rothman, Dov B; Katz, Nathaniel

    2009-01-01

    Prescription opioid (RxO) abuse, dependence and misuse is a significant and growing problem in the US, and is associated with a substantial economic burden. Such abuse may be reduced by theoretical formulations that minimize the possibility of abuse, dependence and misuse of RxOs by injection, snorting, crushing or chewing. As well as public health and safety benefits, use of an abuse-deterrent/resistant RxO (ADO) that may deter abuse, dependence and misuse could also generate cost savings. To estimate potential annual cost savings to US third-party payers realized from introducing a theoretical ADO. A budget-impact model (BIM) was developed to assess potential cost savings from the introduction of an ADO to third-party payers. The BIM included information on ADO attributes, costs associated with RxO abuse-related episodes, prevalence of RxO abuse and potential market share capture of the new ADO. Numbers of abuse-related episodes were calculated using a database on admissions to substance abuse treatment centres and other national surveys. Direct (medical and pharmaceutical) costs associated with RxO abuse, dependence and misuse were calculated using de-identified employer claims data (n > 6 000 000) for costs of abuse-related episodes. All cost estimates are in $US, year 2006 values. The BIM was developed for a theoretical prescription drug with therapeutic properties similar to those of controlled-release oxycodone, in a formulation that is specifically designed to resist or deter common methods of abuse, including injection, crushing, snorting and chewing. Potential cost savings to third-party payers from introducing an ADO for the US (assuming a privately insured cost structure) could range from approximately $US0.6 billion to $US1.6 billion per year depending on different possible scenarios. While savings estimates from introduction of an ADO depend on a range of assumptions, cost savings would be substantial.

  14. Worker replacement and cost-benefit analysis of life-saving health care programs, a precautionary note.

    Science.gov (United States)

    Tessier, Philippe; Sultan-Taïeb, Hélène; Barnay, Thomas

    2014-04-01

    The assumption according to which ill individuals can be replaced at work that underpins the 'friction cost method' (FCM) to value productivity costs has been primarily discussed within the framework of cost-utility analysis. This paper investigates the consequences of this assumption for cost-benefit analysis (CBA). It makes three contributions. First, it provides the first analytical account of the overall consequences of ill worker replacement on social welfare and it analyzes the associated compensation effects within a CBA framework. Second, it highlights a double counting problem that arises when ill worker replacement is assumed in the CBA of life-saving health care programs. To the best of our knowledge, no satisfactory solution to this problem has yet been provided in the literature. Third, this paper suggests and discusses two original ways to address this double counting issue. One consists in adjusting value of a statistical life estimations for the well-being provided by future incomes. Another possibility lies in the estimation of marginal rates of substitution between health and wealth so as to directly monetize the value of life over and above consumption. We show that both solutions raise unresolved questions that should be addressed in future research to enable appropriate use of the FCM in CBA.

  15. 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.

  16. 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.

  17. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling

    Directory of Open Access Journals (Sweden)

    Marcello Lucchese

    2017-06-01

    Full Text Available Objective: To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years and a long-term (lifetime horizon. Methods: A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. Results: In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs. Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. Conclusion: In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis.

  18. Stereotactic Radiosurgery (SRS and Stereotactic Body Radiation Therapy (SBRT Cost-Effectiveness Results

    Directory of Open Access Journals (Sweden)

    Akash eBijlani

    2013-04-01

    Full Text Available Objective: To describe and synthesize the current stereotactic radiosurgery (SRS and stereotactic body radiation therapy (SBRT cost-effectiveness research to date across several common SRS and SBRT applications. Methods: This review was limited to comparative economic evaluations of SRS, SBRT and alternative treatments (e.g., other radiotherapy techniques or surgery. Based on PubMed searches using the terms, stereotactic, stereotactic radiosurgery, stereotactic radiotherapy, stereotactic body radiotherapy, stereotactic body radiation therapy, stereotactic ablative radiotherapy, economic evaluation, quality adjusted life year (QALY, cost, cost effectiveness, cost utility and cost analysis, published studies of cost-effectiveness and health economics were obtained. Included were articles in peer-reviewed journals that presented a comparison of costs between treatment alternatives from January 1997 to November 2012. Papers were excluded if they did not present cost calculations, therapeutic cost comparisons, or health economic endpoints. Results: Clinical outcomes and costs of SRS and SBRT were compared to other therapies for treatment of cancer in the brain, spine, lung, prostate and pancreas. Treatment outcomes for SRS and SBRT are usually superior or comparable, and cost-effective, relative to alternative techniques. Conclusion: Based on the review of current SRS and SBRT clinical and health economic literature, from a patient perspective, SRS and SBRT provide patients a clinically-effective treatment option, while from the payer and provider perspective, SRS and SBRT demonstrate cost-savings.

  19. 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

  20. Crushing leads to waste disposal savings for FUSRAP

    Energy Technology Data Exchange (ETDEWEB)

    Darby, J. [Department of Energy, Oak Ridge, TN (United States)

    1997-02-01

    In this article the author discusses the application of a rock crusher as a means of implementing cost savings in the remediation of FUSRAP sites. Transportation and offsite disposal costs are at present the biggest cost items in the remediation of FUSRAP sites. If these debris disposal problems can be handled in different manners, then remediation savings are available. Crushing can result in the ability to handle some wastes as soil disposal problems, which have different disposal regulations, thereby permitting cost savings.

  1. [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.

  2. Adding a dietitian to a Danish 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 Flintenborg

    2016-01-01

    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either w......,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...

  3. 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

  4. 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...

  5. 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

  6. 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.

  7. The costs and savings of a regional public palliative care program: the Catalan experience at 18 years.

    Science.gov (United States)

    Paz-Ruiz, Silvia; Gomez-Batiste, Xavier; Espinosa, Jose; Porta-Sales, Josep; Esperalba, Joaquim

    2009-07-01

    Conceived as a World Health Organization demonstration project for public health initiatives at the end of life, the palliative care program in Catalonia illustrates the impact that similar initiatives may have in terms of cost savings for a regional health system. In a publicly funded and freely accessible health system, decreasing the number of hospital admissions, shortening the lengths of hospital stay, diminishing the frequency of emergency room consultations, shifting the use of acute hospital beds to palliative care beds for treating advanced disease inpatients, and substantially improving the use of opioids in the community are major determinants of the palliative care program's success. These features add to the opportunity the discipline offers to improve the quality of health care at the end of life. In this article, the information gathered over an 18-year trajectory of the program is summarized. Key features of the existing financial models used while developing palliative care in Catalonia are described, and the mechanisms by which palliative care may have contributed to increase savings for the health care system in end-of-life care, from euro3,000,000 in 1995 to euro8,000,000 in 2005, are discussed.

  8. Cost Savings and Patient Experiences of a Clinic-Based, Wide-Awake Hand Surgery Program at a Military Medical Center: A Critical Analysis of the First 100 Procedures.

    Science.gov (United States)

    Rhee, Peter C; Fischer, Michelle M; Rhee, Laura S; McMillan, Ha; Johnson, Anthony E

    2017-03-01

    Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon. Cost savings analysis was performed by using the Medical Expense and Performance Reporting System, the standard cost accounting system for the MHS, to compare procedures performed in the clinic versus the operating room during the study period. A study specific questionnaire was obtained for 66 procedures to evaluate the patient's experience. For carpal tunnel release (n = 34) and A1 pulley release (n = 33), there were 85% and 70% cost savings by having the procedures performed in clinic under WALANT compared with the main operating room, respectively. During the study period, carpal tunnel release, A1 pulley release, and de Quervain release performed in the clinic instead of the operating room amounted to $393,100 in cost savings for the MHS. There were no adverse events during the WALANT procedure. A clinic-based WALANT hand surgery program at a military medical center results in considerable cost savings for the MHS. Economic/Decision Analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  9. Costs for integrating wind into the future ERCOT system with related costs for savings in CO2 emissions.

    Science.gov (United States)

    Lu, Xi; McElroy, Michael B; Sluzas, Nora A

    2011-04-01

    Wind power can make an important contribution to the goal of reducing emissions of CO2. The major problem relates to the intrinsic variability of the source and the difficulty of reconciling the supply of electricity with demand particularly at high levels of wind penetration. This challenge is explored for the case of the ERCOT system in Texas. Demand for electricity in Texas is projected to increase by approximately 60% by 2030. Considering hourly load data reported for 2006, assuming that the pattern of demand in 2030 should be similar to 2006, and adopting as a business as usual (BAU) reference an assumption that the anticipated additional electricity should be supplied by a combination of coal and gas with prices, discounted to 2007 dollars of $2 and $6 per MMBTU respectively, we conclude that the bus-bar price for electricity would increase by about 1.1 ¢/kWh at a wind penetration level of 30%, by about 3.4 ¢/kWh at a penetration level of 80%. Corresponding costs for reductions in CO2 range from $20/ton to $60/ton. A number of possibilities are discussed that could contribute to a reduction in these costs including the impact of an expanded future fleet of electrically driven vehicles.

  10. Test results and methods: residential air-to-air heat exchangers for maintaining indoor air quality and saving money

    Energy Technology Data Exchange (ETDEWEB)

    Fisk, W.J.; Roseme, G.D.; Hollowell, C.D.

    1981-02-01

    LBL has constructed a facility for testing various performance aspects of residential air-to-air heat exchangers. When used in conjunction with a mechanical ventilation system, a residential heat exchanger permits the adequate ventilation of a residence while recovering most of the energy normally lost during ventilation. By constructing or retrofitting a home so that it has low natural infiltration rates and by using a heat exchanger-ventilation system, a homeowner can save energy, reduce heating and cooling costs, and prevent the buildup of indoor-generated air contaminants. Results obtained on five different residential heat exchangers are presented. The performance criteria and the test facility are described. The performance parameters measured were heat exchanger effectiveness (a measure of heat transfer ability), airstream static pressure drop, and fan system performance. The performance of the five heat exchangers differed greatly. The ability to transfer heat ranged from 43% to 75% of the theoretical maximum. The resistance to air flow varied by a factor of two. One of the heat exchangers was highly susceptible to leakage between airstreams and one had an unstable performance. In the future, additional heat exchangers will be tested, a new test system will be used to measure cross-stream leakage, and the possibility and consequences of freeze-up within the heat exchangers will be investigated.

  11. 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.

  12. Ambulatory transradial percutaneous coronary intervention: a safe, effective, and cost-saving strategy.

    Science.gov (United States)

    Le Corvoisier, Philippe; Gellen, Barnabas; Lesault, Pierre-François; Cohen, Remy; Champagne, Stéphane; Duval, Anne-Marie; Montalescot, Gilles; Elhadad, Simon; Montagne, Olivier; Durand-Zaleski, Isabelle; Dubois-Randé, Jean-Luc; Teiger, Emmanuel

    2013-01-01

    The aim of this prospective, multicenter study was to assess the safety, feasibility, acceptance, and cost of ambulatory transradial percutaneous coronary intervention (PCI) under the conditions of everyday practice. Major advances in PCI techniques have considerably reduced the incidence of post-procedure complications. However, overnight admission still constitutes the standard of care in most interventional cardiology centers. Eligibility for ambulatory management was assessed in 370 patients with stable angina referred to three high-volume angioplasty centers. On the basis of pre-specified clinical and PCI-linked criteria, 220 patients were selected for ambulatory PCI. The study population included a substantial proportion of patients with complex procedures: 115 (52.3%) patients with multivessel coronary artery disease, 50 (22.7%) patients with multilesion procedures, and 60 (21.5%) bifurcation lesions. After 4-6 hr observation period, 213 of the 220 patients (96.8%) were cleared for discharge. The remaining seven (3.2%) patients were kept overnight for unstable angina (n = 1), atypical chest discomfort (n = 2), puncture site hematoma (n = 1), or non-cardiovascular reasons (n = 3). Within 24 hr after discharge, no patients experienced readmission, stent occlusion, recurrent ischemia, or local complications. Furthermore, 99% of patients were satisfied with ambulatory management and 85% reported no anxiety. The average non-procedural cost was lower for ambulatory PCI than conventional PCI (1,230 ± 98 Euros vs. 2,304 ± 1814 Euros, P < 10(-6)). Ambulatory PCI in patients with stable coronary artery disease is safe, effective, and well accepted by the patients. It may both significantly reduce costs and optimize hospital resource utilization. Copyright © 2012 Wiley Periodicals, Inc.

  13. 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

  14. 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.

  15. 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

    OpenAIRE

    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 re...

  16. Uncertainty in Odyssee indicators and energy savings. Development of a methodology and first results

    Energy Technology Data Exchange (ETDEWEB)

    Boonekamp, P.G.M.; Gerdes, J. [ECN Policy Studies, Petten (Netherlands); Faberi, S. [Institute of Studies for the Integration of Systems ISIS, Rome (Italy)

    2013-12-15

    The ODYSSEE database on energy efficiency indicators (www.odyssee-indicators.org) has been set up to enable the monitoring and evaluation of realised energy efficiency improvements and related energy savings. The database covers the 27 EU countries as well as Norway and Croatia. Energy indicators that relate energy consumption to a physical output (ton of steel), a performance (person-km driven per car) or the number of energy using devices (refrigerators) can show the increase in energy efficiency realised, and the amount of energy saved. By aggregating indicators, Odyssee calculates energy efficiency indices by sector and for the whole economy (so-called ODEX), in order to evaluate overall energy efficiency progress. This work contributes to the growing need for quantitative monitoring and evaluation of the impacts of energy policies and measures, both at the EU and national level, e.g. due to the Energy Service Directive. Because of the central role of Odyssee indicators in policy evaluations it becomes more important to know how reliable the Odyssee figures are, or in other words, what is the uncertainty margin for the indicator values and the related savings. This report presents a first analysis of uncertainty margins in the indicators and savings figures. The work builds on earlier work in the preceding Odyssee project with regard to the quality of input data used in Odyssee.

  17. Innovation & Risk Management Result in Energy and Life-Cycle Savings.

    Science.gov (United States)

    Anstrand, David E.; Singh, J. B.

    1999-01-01

    Examines a Pennsylvania school's successful planning, design, and bidding process for acquiring a geothermal heat pump (GHP)system whose subsequent efficiency became award-winning for environmental excellence. Charts and statistical tables describe the GHP's energy savings. Concluding comments review the lessons learned from the process. (GR)

  18. 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.

  19. 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.

  20. Resource costing for multinational neurologic clinical trials: methods and results.

    Science.gov (United States)

    Schulman, K; Burke, J; Drummond, M; Davies, L; Carlsson, P; Gruger, J; Harris, A; Lucioni, C; Gisbert, R; Llana, T; Tom, E; Bloom, B; Willke, R; Glick, H

    1998-11-01

    We present the results of a multinational resource costing study for a prospective economic evaluation of a new medical technology for treatment of subarachnoid hemorrhage within a clinical trial. The study describes a framework for the collection and analysis of international resource cost data that can contribute to a consistent and accurate intercountry estimation of cost. Of the 15 countries that participated in the clinical trial, we collected cost information in the following seven: Australia, France, Germany, the UK, Italy, Spain, and Sweden. The collection of cost data in these countries was structured through the use of worksheets to provide accurate and efficient cost reporting. We converted total average costs to average variable costs and then aggregated the data to develop study unit costs. When unit costs were unavailable, we developed an index table, based on a market-basket approach, to estimate unit costs. To estimate the cost of a given procedure, the market-basket estimation process required that cost information be available for at least one country. When cost information was unavailable in all countries for a given procedure, we estimated costs using a method based on physician-work and practice-expense resource-based relative value units. Finally, we converted study unit costs to a common currency using purchasing power parity measures. Through this costing exercise we developed a set of unit costs for patient services and per diem hospital services. We conclude by discussing the implications of our costing exercise and suggest guidelines to facilitate more effective multinational costing exercises.

  1. 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.

  2. 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.

  3. 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)

  4. Pharmaceutical Cost-Saving Strategies and their Association with Medication Adherence in a Medicare Supplement Population

    National Research Council Canada - National Science Library

    Musich, Shirley; Cheng, Yan; Wang, Shaohung S; Hommer, Cynthia E; Hawkins, Kevin; Yeh, Charlotte S

    2015-01-01

    On average, Medicare Supplement insureds take about seven unique prescription medications each year, resulting in substantial out-of-pocket drug copayments, in addition to Medicare Supplement and Part D premiums...

  5. A cost- and time-saving strategy of spraying TiO2 self-cleaning coatings in tubular substrates by air cold plasma

    Science.gov (United States)

    Zhang, Lujie; Yu, Shuang; Wang, Kaile; Zhang, Jue; Fang, Jing

    2017-11-01

    In this study, using an atmospheric pressure air plasma jet generated by a dielectric barrier structure with hollow electrodes (HEDBS), we developed an ultrafast process for spraying TiO2 self-cleaning films inside tubular substrates. Importantly, SEM images showed that the TiO2 particles were dispersed evenly in the tubular substrates. Furthermore, Raman and XRD pattern indicated the anatase structure of the HEDBS-spayed TiO2 coating after heating at 270 °C. Further results of the self cleaning test suggested that the proposed cost- and time-saving HEDBS approach with air working gas could provide a feasible way for synthesizing thin TiO2 nanofilms.

  6. Great comeback rates AHA award. Franciscan Children's develops less costly, alternative programs to save hospital.

    Science.gov (United States)

    Herreria, J

    1998-01-01

    After struggling financially for several years, Boston-based Franciscan Children's Hospital wins the coveted "Great Comeback of the Year" award. With the award, the hospital produces a PR campaign that resulted a plethora of television, print and radio stories. Officials of the Franciscan Children's Hospital announced its financial soundness and commitment to its Boston market area.

  7. 25 CFR 900.134 - At the end of a self-determination construction contract, what happens to savings on a cost...

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 2 2010-04-01 2010-04-01 false At the end of a self-determination construction contract... SERVICES CONTRACTS UNDER THE INDIAN SELF-DETERMINATION AND EDUCATION ASSISTANCE ACT Construction § 900.134 At the end of a self-determination construction contract, what happens to savings on a cost...

  8. 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)

  9. 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.

  10. Novel plan of triethylene glycol regeneration packed tower for energy and cost saving

    Energy Technology Data Exchange (ETDEWEB)

    Farahmand, Sara [Shiraz University (Iran, Islamic Republic of); Reza Jafari Nasr, Mohammad [Research Institute of Petroleum Industry (Iran, Islamic Republic of); Farahbod, Farshad [Islamic Azad University (Iran, Islamic Republic of)

    2011-06-15

    This paper analyzes the effect of structured packing internals on several important parameters such as lean triethylene glycol (TEG) concentration and benzene-toluene-xylene (BTEX) emission rates. A related mathematical model is presented which consists of non-linear differential equations of conservation of mass and energy. The role of structured packing is confirmed by the study. The injection of stripping gas improves the performance of the TEG regeneration. Using the structured packing internals could help with reaching the correct TEG concentration at lower reboiler temperature. This means that the engineers could tune the reboiler temperature to meet performance, the reboiler temperature being the main cause of TEG degradation. The results are compared with an existing regenerator filled with random packing. Temperature can also determine the effective mass and heat transfer equation under non-isothermal conditions. In this article hydrodynamic approach is used to model structured packing tower.

  11. Economic analysis of a new drug: potential savings in hospital operating costs from the use of a once-daily regimen of a parenteral cephalosporin.

    Science.gov (United States)

    Eisenberg, J M; Koffer, H; Finkler, S A

    1984-01-01

    The introduction of a new drug requires clear demonstration of its clinical efficacy and documentation of its adverse effects, but economic consequences of the new drug generally receive less attention. A new cephalosporin antibiotic, cefonicid, can be administered parenterally once daily, rather than three or four times daily, which is required for conventional cephalosporins. Methods of industrial engineering and cost accounting were used to determine the potential savings in hospital operating costs that would be available by reducing the frequency of intravenous administration of cephalosporin antibiotics. The variable cost of administering parenteral cephalosporin antibiotics averaged $2.24 per dose, $0.95 of which was attributable to labor costs and $1.28 to the costs of materials. Given present patterns of cephalosporin use, at four study hospitals the average potential savings per day for patients receiving intravenous cephalosporins ranged from $3.72 to $7.23, with a weighted mean of $5.42. Estimated national savings in hospital operating costs that would occur with use of an intravenous cephalosporin administered once daily range from $85.1 million to $115.4 million yearly.

  12. Discharge Disposition After Joint Replacement and the Potential for Cost Savings: Effect of Hospital Policies and Surgeons.

    Science.gov (United States)

    London, Daniel A; Vilensky, Seth; O'Rourke, Colin; Schill, Michelle; Woicehovich, Lynn; Froimson, Mark I

    2016-04-01

    Up to 55% of total joint arthroplasty costs come from post-acute care, with large variability dependent on a patient's discharge location. At our institution, we identified a group of surgeons using a preoperative discharge planning protocol emphasizing the merits of home discharge. We hypothesized that using the protocol would increase patients' odds for discharge home. Administrative data from 14,315 total hip and knee arthroplasties performed over a 3-year period were retrospectively analyzed to determine predictors of patient discharge location. Bayesian hierarchical logistic regression modeling was used to account for the complex multilevel structure within the data as we considered patient-, surgeon-, and hospital-level predictors. A simplified case-control data structure with logistic regression analysis was also used to better understand the impact of the preoperative discharge planning protocol. A variety of patient- and surgeon-level variables are predictive of patients being discharged home after total joint arthroplasty including a patient's length of stay, age, illness severity, and insurance, as well as surgeon's affiliation. In the case-control data, patients exposed to the rapid recovery protocol had 45% increased odds of being discharged home compared to patients not exposed to the protocol. Although patient factors are known to play a role in predicting postdischarge destination, this analysis describes additional surgeon- and hospital-level factors that predict discharge location. Exogenous factors based on how surgeons and hospital staff practice and interact with patients may impact the postdischarge decision-making process and provide a cost savings opportunity. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Telecardiology application in jordan: its impact on diagnosis and disease management, patients' quality of life, and time- and cost-savings.

    Science.gov (United States)

    Khader, Yousef Saleh; Jarrah, Mohamad Ismail; Al-Shudifat, Abde-Ellah M; Shdaifat, Amjad; Aljanabi, Husham; Al-Fakeh, Shadwan Ismeil; Turk, Elias Emil; Zayed, Khaled Ali; Al Quran, Hanadi A; Ellauzi, Ziad Mohd; Al Tahan, Mohammad

    2014-01-01

    Objectives. To assess the impact of live interactive telecardiology on diagnosis and disease management, patients' quality of life, and time- and cost-savings. Methods. All consecutive patients who attended or were referred to the teleclinics for suspected cardiac problems in two hospitals in remote areas of Jordan during the study period were included in the study. Patients were interviewed for relevant information and their quality of life was assessed during the first visit and 8 weeks after the last visit. Results. A total of 76 patients were included in this study. Final diagnosis and treatment plan were established as part of the telecardiology consultations in 71.1% and 77.3% of patients, respectively. Patients' travel was avoided for 38 (50.0%) who were managed locally. The majority of patients perceived that the visit to the telecardiology clinic results in less travel time (96.1%), less waiting time (98.1%), and lower cost (100.0%). Telecardiology consultations resulted in an improvement in the quality of life after two months of the first visit. Conclusions. Telecardiology care in remote areas of Jordan would improve the access to health care, help to reach proper diagnosis and establish the treatment plan, and improve the quality of life.

  14. Refined analysis results for multimedia network costs and profits

    DEFF Research Database (Denmark)

    Tahkokorpi, M.; Falch, Morten; Skouby, Knud Erik

    This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations......This deliverable describes the techno-economic business model developed in EURORIM WP3 and presents the refined results of the multimedia service delivery cost-profit calculations...

  15. 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.

  16. 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?

  17. Buy now, saved later? The critical impact of time-to-pandemic uncertainty on pandemic cost-effectiveness analyses.

    Science.gov (United States)

    Drake, Tom; Chalabi, Zaid; Coker, Richard

    2015-02-01

    Investment in pandemic preparedness is a long-term gamble, with the return on investment coming at an unknown point in the future. Many countries have chosen to stockpile key resources, and the number of pandemic economic evaluations has risen sharply since 2009. We assess the importance of uncertainty in time-to-pandemic (and associated discounting) in pandemic economic evaluation, a factor frequently neglected in the literature to-date. We use a probability tree model and Monte Carlo parameter sampling to consider the cost effectiveness of antiviral stockpiling in Cambodia under parameter uncertainty. Mean elasticity and mutual information (MI) are used to assess the importance of time-to-pandemic compared with other parameters. We also consider the sensitivity to choice of sampling distribution used to model time-to-pandemic uncertainty. Time-to-pandemic and discount rate are the primary drivers of sensitivity and uncertainty in pandemic cost effectiveness models. Base case cost effectiveness of antiviral stockpiling ranged between is US$112 and US$3599 per DALY averted using historical pandemic intervals for time-to-pandemic. The mean elasticities for time-to-pandemic and discount rate were greater than all other parameters. Similarly, the MI scores for time to pandemic and discount rate were greater than other parameters. Time-to-pandemic and discount rate were key drivers of uncertainty in cost-effectiveness results regardless of time-to-pandemic sampling distribution choice. Time-to-pandemic assumptions can "substantially" affect cost-effectiveness results and, in our model, is a greater contributor to uncertainty in cost-effectiveness results than any other parameter. We strongly recommend that cost-effectiveness models include probabilistic analysis of time-to-pandemic uncertainty. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  18. Household Saving in Australia

    OpenAIRE

    Richard Finlay; Fiona Price

    2014-01-01

    This paper investigates household saving behaviour in Australia, as well as the drivers behind the recent rise in the aggregate household saving ratio. Our results explaining differences in saving behaviour across households are consistent with theory and previous findings. As might be expected, households' saving ratios tend to increase with income, but decrease with wealth and gearing. Financially constrained and migrant households tend to save more than other households, all else equal. Wh...

  19. Integrated control of emission reductions, energy-saving, and cost-benefit using a multi-objective optimization technique in the pulp and paper industry.

    Science.gov (United States)

    Wen, Zongguo; Xu, Chang; Zhang, Xueying

    2015-03-17

    Reduction of water pollutant emissions and energy consumption is regarded as a key environmental objective for the pulp and paper industry. The paper develops a bottom-up model called the Industrial Water Pollutant Control and Technology Policy (IWPCTP) based on an industrial technology simulation system and multiconstraint technological optimization. Five policy scenarios covering the business as usual (BAU) scenario, the structural adjustment (SA) scenario, the cleaner technology promotion (CT) scenario, the end-treatment of pollutants (EOP) scenario, and the coupling measures (CM) scenario have been set to describe future policy measures related to the development of the pulp and paper industry from 2010-2020. The outcome of this study indicates that the energy saving amount under the CT scenario is the largest, while that under the SA scenario is the smallest. Under the CT scenario, savings by 2020 include 70 kt/year of chemical oxygen demand (COD) emission reductions and savings of 7443 kt of standard coal, 539.7 ton/year of ammonia nitrogen (NH4-N) emission reductions, and savings of 7444 kt of standard coal. Taking emission reductions, energy savings, and cost-benefit into consideration, cleaner technologies like highly efficient pulp washing, dry and wet feedstock preparation, and horizontal continuous cooking, medium and high consistency pulping and wood dry feedstock preparation are recommended.

  20. Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in the Hot-Dry and Mixed-Dry Climates

    Energy Technology Data Exchange (ETDEWEB)

    Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); Florida Solar Energy Center (FSEC); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

    2006-01-01

    The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Hot-Dry/Mixed-Dry Climate Region on a cost neutral basis.

  1. Building America Residential System Research Results: Achieving 30% Whole House Energy Savings Level in Mixed-Humid Climates; January 2006 - December 2006

    Energy Technology Data Exchange (ETDEWEB)

    Building America Industrialized Housing Partnership (BAIHP); Building Industry Research Alliance (BIRA); Building Science Consortium (BSC); Consortium for Advanced Residential Buildings (CARB); Davis Energy Group (DEG); IBACOS; National Association of Home Builders Research Center (NAHBRC); National Renewable Energy Laboratory (NREL)

    2006-12-01

    The Building America program conducts the system research required to reduce risks associated with the design and construction of homes that use an average of 30% to 90% less total energy for all residential energy uses than the Building America Research Benchmark, including research on homes that will use zero net energy on annual basis. To measure the program's progress, annual research milestones have been established for five major climate regions in the United States. The system research activities required to reach each milestone take from 3 to 5 years to complete and include research in individual test houses, studies in pre-production prototypes, and research studies with lead builders that provide early examples that the specified energy savings level can be successfully achieved on a production basis. This report summarizes research results for the 30% energy savings level and demonstrates that lead builders can successfully provide 30% homes in the Mixed-Humid Climate Region on a cost-neutral basis.

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

    Science.gov (United States)

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

    2012-12-01

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

  3. Spending to save

    DEFF Research Database (Denmark)

    Larsen, Anders

    2013-01-01

    framework and guidelines for the following EEO period, i.e. 2013-2020. This paper focuses on the net savings impact and describes the evaluation method used to determine this. Three complementary analyses are described: 1) An analysis of the additionality of the reported saving, 2) an analysis...... the energy distribution companies meet their overall saving obligation, the net savings impact are about a third of the savings reported by the obligated parties. Further it was found that while energy savings in the public and business sector have a high net impact, some subsidies given under the EEO...... are inappropriately high. The net impact in the residential sector, on the other hand, was found to be very low. The evaluation recommended that the new EEO design addresses the additionality issues in order to ensure that savings realised in the residential sector are more cost-effective from a socioeconomic...

  4. Developing a student-led health and wellbeing clinic in an underserved community: collaborative learning, health outcomes and cost savings.

    Science.gov (United States)

    Stuhlmiller, Cynthia M; Tolchard, Barry

    2015-01-01

    The University of New England (UNE), Australia decided to develop innovative placement opportunities for its increasing numbers of nursing students. Extensive community and stakeholder consultation determined that a community centre in rural New South Wales was the welcomed site of the student-led clinic because it fit the goals of the project-to increase access to health care services in an underserved area while providing service learning for students. Supported by a grant from Health Workforce Australia and in partnership with several community organisations, UNE established a student-led clinic in a disadvantaged community using an engaged scholarship approach which joins academic service learning with community based action research. The clinic was managed and run by the students, who were supervised by university staff and worked in collaboration with residents and local health and community services. Local families, many of whom were Indigenous Australians, received increased access to culturally appropriate health services. In the first year, the clinic increased from a one day per week to a three day per week service and offered over 1000 occasions of care and involved 1500 additional community members in health promotion activities. This has led to improved health outcomes for the community and cost savings to the health service estimated to be $430,000. The students learned from members of the community and community members learned from the students, in a collaborative process. Community members benefited from access to drop in help that was self-determined. The model of developing student-led community health and wellbeing clinics in underserved communities not only fulfils the local, State Government, Federal Government and international health reform agenda but it also represents good value for money. It offers free health services in a disadvantaged community, thereby improving overall health and wellbeing. The student-led clinic is an invaluable

  5. Economic Impact of Oritavancin for the Treatment of Acute Bacterial Skin and Skin Structure Infections in the Emergency Department or Observation Setting: Cost Savings Associated with Avoidable Hospitalizations.

    Science.gov (United States)

    Lodise, Thomas P; Fan, Weihong; Sulham, Katherine A

    2016-01-01

    Data indicate that acute bacterial skin and skin structure infection (ABSSSI) patients without major comorbidities can be managed effectively in the outpatient setting. Because most patients with ABSSSIs present to the emergency department, it is essential that clinicians identify candidates for outpatient treatment given the substantially higher costs associated with inpatient care. We examined the potential cost avoidance associated with shifting care from inpatient treatment with vancomycin to outpatient treatment with oritavancin for ABSSSI patients without major complications or comorbidities. A decision analytic, cost-minimization model was developed to compare costs of inpatient vancomycin versus outpatient oritavancin treatment of ABSSSI patients with few or no comorbidities (Charlson Comorbidity Index score ≤1) and no life-threatening conditions presenting to emergency department. Hospital discharge data from the Premier Research Database was used to determine the costs associated with inpatient vancomycin treatment. Mean costs for inpatient treatment with vancomycin ranged from $5973 to $9885, depending on Charlson Comorbidity Index score and presence of systemic symptoms. Switching an individual patient from inpatient vancomycin treatment to outpatient oritavancin treatment was estimated to save $1752.46 to $6475.87 per patient, depending on Charlson Comorbidity Index score, presence of systemic symptoms, and use of observation status. Assuming some patients may be admitted to the hospital after treatment with oritavancin, it is estimated that up to 38.12% of patients could be admitted while maintaining budget neutrality. This cost-minimization model indicates that use of oritavancin in the emergency department or observation setting is associated with substantial cost savings compared with inpatient treatment with vancomycin. Copyright © 2016 Elsevier HS Journals, Inc. All rights reserved.

  6. 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.

  7. 5 case studies : boiler system increases availability of hot water in CAP REIT apartment buildings while saving energy : electric-to-gas retrofit drives down energy costs and improves building performance : Novitherm heat reflector panels saves 28 per cent in heating costs for apartment building : Novitherm heat reflector panel installation with system adjustment saves 33.2 per cent in energy costs : natural gas conversion saves over $315,000 a year for condominium

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    These 5 case studies presented the details of new systems and retrofits conducted by Enbridge Gas Distribution and its partners to improve the energy efficiency of various public and residential buildings. System retrofits included the installation of boiler system installed to address tenant demands on the domestic hot water systems of properties purchased purchased by the CAP REIT organization. The comprehensive program used to address the problems included replacement of the systems with high efficiency heating boilers designed to integrate space, hot water, ramp, and pool heat. A centralized controller included setback control, trend-following processors, and the isolation of heating equipment. The second case study described an electric-to-gas conversion of a make-up air unit and boiler system at an all-electric apartment building. The system was designed to address excessive air handling and water heating costs. The gas conversion included new heating and hot water boilers, as well as a number of efficiency upgrades. The third and fourth case study described the installation of Novitherm heat reflector panels at apartment buildings in Toronto. The fifth case study described a natural gas conversion project conducted at a luxury condominium. Energy savings for all 5 projects were presented. 9 figs.

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

    Science.gov (United States)

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

    2016-02-01

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

  9. 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

  10. Adding a dietitian to a Danish 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 Flintenborg

    2016-01-01

    Background: A previous study investigated the value of adding a dietitian to a geriatric discharge Liaison-Team. The scope of this study was to explore the possible economic savings of this. Methods: Patients, 70+ and at nutritional risk, were randomized to receive discharge Liaison-Team either......,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......: 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...

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

    NARCIS (Netherlands)

    Worrell, E.|info:eu-repo/dai/nl/106856715; Kermeli, Katerina|info:eu-repo/dai/nl/411260553; 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

  12. Transferring results of occupational safety and health cost-effectiveness studies from one country to another - a case study.

    Science.gov (United States)

    Verbeek, Jos; Pulliainen, Marjo; Kankaanpää, Eila; Taimela, Simo

    2010-06-01

    There are a limited number of studies about the cost-effectiveness of occupational health and safety (OSH) interventions. Applying the results of a cost-effectiveness study from one country to another is hampered by differences in the organization of healthcare and social security. In order to find out how these problems can be overcome, we transferred the results of a Dutch occupational cost-effectiveness study to the Finnish situation and vice-versa. We recalculated incremental cost-effectiveness ratios (ICER) for the target country based on resource use in the original study and the associated costs in the target country. We also allocated the costs to the employer, the employee, and tax-payers. We found that the ICER did not differ very much from those in the original studies. However, the different healthcare funding structure led to a more unfavorable ICER for employers in the Netherlands. Both interventions represented a cost saving for tax-payers and employees. Employers had to invest euro10-54 to avert one day of sick leave. We conclude that results of cost-effectiveness studies can be transferred from one country to another, but many adjustments are needed. An extensive description of the intervention, a detailed list of resource use, allocation of costs to various parties, and detailed knowledge of the healthcare systems in the original studies are necessary to enable calculations.

  13. 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.

  14. 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.

  15. Analysis of Base Services Structure and Development of Cost-Saving Strategies to Counterattack Decreasing Funding Levels

    Science.gov (United States)

    2005-12-01

    social , ethnic , religious, age, etc.), and the individual mix of interests and economic objectives can never be exactly the same between two...41 1. Cost Benefit Analysis .........................................................................41 2. Social Cost Benefit...us salivating for more. This quality cuisine was second only to Kathy’s always phenomenal culinary masterpieces. Thank you, cutie! xviii

  16. Do changes to supply chains and procurement processes yield cost savings and improve availability of pharmaceuticals, vaccines or health products? A systematic review of evidence from low-income and middle-income countries

    Science.gov (United States)

    Atun, Rifat

    2017-01-01

    Introduction Improving health systems performance, especially in low-resource settings facing complex disease burdens, can improve population health. Specifically, the efficiency and effectiveness of supply chains and procurement processes for pharmaceuticals, vaccines and other health products has important implications for health system performance. Pharmaceuticals, vaccines and other health products make up a large share of total health expenditure in low-income and middle-income countries (LMICs), and they are critical for delivering health services. Therefore, programmes which achieve cost savings on these expenditures may help improve a health system's efficiency, whereas programmes that increase availability of health products may improve a health system's effectiveness. This systematic review investigates whether changes to supply chains and procurement processes can achieve cost savings and/or improve the availability of drugs in LMICs. Methods Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL and the Health Economic Evaluation Database to identify. Results We identified 1264 articles, of which 38 were included in our study. We found evidence that centralised procurement and tendering can achieve direct cost savings, while supply chain management programmes can reduce drug stock outs and increase drug availability for populations. Conclusions This research identifies a broad set of programmes which can improve the ways that health systems purchase and delivery health products. On the basis of this evidence, policymakers and programme managers should examine the root causes of inefficiencies in pharmaceutical supply chain and procurement processes in order to determine how best to improve health systems performance in their specific contexts. PMID:28589028

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-01

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

  18. Network unites payers, physicians, hospitals. System participants work together to improve access to care and to design cost-saving incentives.

    Science.gov (United States)

    Cassidy, J

    1993-05-01

    Through Sacred Heart Health System (SHHS), Eugene, OR, physicians, payers, and hospitals are designing a network that will integrate care and improve access by reducing healthcare costs. Together, system members design cost-saving incentives and the products the system offers the community. They promote managed care as the most efficient means to coordinate care and reduce costs. All participants share in the risks of a capitated payment system. Since the system pulled together the payers, physician groups, and hospitals, many of these entities' management functions were consolidated at the system level to avoid duplication and reduce administrative costs. Bringing in physicians was the most difficult yet important aspect of forming a successful network. Working with two physician groups in the community, the system's sponsor-the Sisters of St. Joseph of Peace, Health and Hospital Services-developed the Physician Practice Board. The board, representing 300 physicians, meets weekly and makes recommendations on issues that affect physicians. SHHS also added innovative new functions such as an integrated medical cost management and continuous quality improvement program. Another key to success is a clinically oriented information system, which will allow the system to track patients once they leave the hospital. It also will provide a better understanding of what things have an impact on outcomes and will reduce paperwork. A portion of the system's revenue is designated for initiatives to improve access. And the system recently appointed a tack force on access to explore what they can do in cooperation with others in the community.

  19. 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.

  20. Energy Saving Potential, Costs and Uncertainties in the Industry: A Case Study of the Chemical Industry in Germany

    DEFF Research Database (Denmark)

    Bühler, Fabian; Guminski, Andrej; Gruber, Anna

    2017-01-01

    ), which rank these measures according to specific implementation costs. Existing analyses, however, often do not take uncertainties in costs and potentials into account. The aim of this paper is to create a MCC of energy efficiency measures for the chemical industry in Germany, while quantifying...... to 1990. To achieve this ambitious goal, energy planners and industries alike require an overview of the existing energy efficiency measures, their technical potential as well as the costs for realizing this potential. Energy efficiency opportunities are commonly presented in marginal cost curves (MCCs......In Germany, 19.6 % of the industrial final energy consumption (FEC) can be allocated to the chemical industry. Energy efficiency measures with focus on the chemical industry could thus significantly contribute to reaching the German goal of reducing greenhouse gas emissions by 80 % in 2050 compared...

  1. 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)

  2. Household Savings

    DEFF Research Database (Denmark)

    Browning, Martin; Lusardi, Annamaria

    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...... of standard optimization techniques and focuses instead on direct consideration on saving. We provide a section on facts: who save and how much. We then discuss informally the recent decline in the U.S. saving rate and whether the theory is of much use in understanding this and other changes in aggregate...... be rationalized within a simple life cycle model. We also review a great number of studies of the consumption Euler equations. Based on our analysis of the studies cited we conclude that there is still mixed evidence that consumption is excessively sensitive to income. We also examine in depth the recent...

  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. Simplification and Saving

    Science.gov (United States)

    Beshears, John; Choi, James J.; Laibson, David; Madrian, Brigitte C.

    2012-01-01

    The daunting complexity of important financial decisions can lead to procrastination. We evaluate a low-cost intervention that substantially simplifies the retirement savings plan participation decision. Individuals received an opportunity to enroll in a retirement savings plan at a pre-selected contribution rate and asset allocation, allowing them to collapse a multidimensional problem into a binary choice between the status quo and the pre-selected alternative. The intervention increases plan enrollment rates by 10 to 20 percentage points. We find that a similar intervention can be used to increase contribution rates among employees who are already participating in a savings plan. PMID:24443619

  5. Extract BIG savings from physician preference items. Use a data-driven, team-based approach to drive down costs.

    Science.gov (United States)

    Tyson, Patricia

    2010-05-01

    As baby boomers reach retirement age, the demand for cardiac, spine and orthopedic implants is expected to escalate rapidly. Containing spending on these physician preference items (PPI) will be crucial for hospitals, which are facing reduced revenue streams due to bundled payments and other factors. Materials managers will play a lead role in devising cost-reduction strategies. They'll need to establish benchmarking data to share with physicians to build consensus on how to best cut PPI costs without sacrificing the quality of care. Follow these steps to get started.

  6. Feature Selection as a Time and Cost-Saving Approach for Land Suitability Classification (Case Study of Shavur Plain, Iran)

    NARCIS (Netherlands)

    Hamzeh, Saeid; Mokarram, Marzieh; Haratian, Azadeh; Bartholomeus, Harm; Ligtenberg, Arend; Bregt, Arnold

    2016-01-01

    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

  7. 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.

  8. An Investigation on the Energy Saving Potential of Electromagnetic Ballast Fluorescent Lamps

    Science.gov (United States)

    Cheong, Z. X.; Barsoum, N. N.

    2009-08-01

    Energy saving issue is a matter of great concern for industry and electrical utilities. Energy saving from fluorescent lamp system can be achieved by means of optimizing lighting level, reducing power consumption and improving the efficiency of fluorescent lamps. This paper presents an alternative energy saving control method for electromagnetic ballast fluorescent lamps. Non-linearity characteristics of fluorescent lamps and the effect of energy saving controller are taken into account in the proposed energy saving controller. The proposed energy saving controller provides energy saving feature and dimmable illuminance level control for electromagnetic ballast fluorescent lamps. In comparison to electronic ballast, integration of an energy saving controller with electromagnetic ballast results in less power consumption, less green house gas emission and longer lifespan at a much lower installation cost. Experiment results based on the proposed controller showed that 37.5% energy can be saved by reducing 15% of the AC line voltage.

  9. Counting project savings—an alternative way to monitor the results of a voluntary agreement on industrial energy savings

    NARCIS (Netherlands)

    Abeelen, Christiaan; Harmsen, Robert; Worrell, Ernst

    2016-01-01

    In 2008, the Dutch voluntary agreements on industrial energy efficiency faced fundamental changes to their monitoring methodology. Where the old method was based on measuring the improvement of energy use per unit of production, the new method focuses on the energy savings from projects implemented

  10. Cost-Utility Analysis of Bariatric Surgery in Italy: Results of Decision-Analytic Modelling.

    Science.gov (United States)

    Lucchese, Marcello; Borisenko, Oleg; Mantovani, Lorenzo Giovanni; Cortesi, Paolo Angelo; Cesana, Giancarlo; Adam, Daniel; Burdukova, Elisabeth; Lukyanov, Vasily; Di Lorenzo, Nicola

    2017-01-01

    To evaluate the cost-effectiveness of bariatric surgery in Italy from a third-party payer perspective over a medium-term (10 years) and a long-term (lifetime) horizon. A state-transition Markov model was developed, in which patients may experience surgery, post-surgery complications, diabetes mellitus type 2, cardiovascular diseases or die. Transition probabilities, costs, and utilities were obtained from the Italian and international literature. Three types of surgeries were considered: gastric bypass, sleeve gastrectomy, and adjustable gastric banding. A base-case analysis was performed for the population, the characteristics of which were obtained from surgery candidates in Italy. In the base-case analysis, over 10 years, bariatric surgery led to cost increment of EUR 2,661 and generated additional 1.1 quality-adjusted life years (QALYs). Over a lifetime, surgery led to savings of EUR 8,649, additional 0.5 life years and 3.2 QALYs. Bariatric surgery was cost-effective at 10 years with an incremental cost-effectiveness ratio of EUR 2,412/QALY and dominant over conservative management over a lifetime. In a comprehensive decision analytic model, a current mix of surgical methods for bariatric surgery was cost-effective at 10 years and cost-saving over the lifetime of the Italian patient cohort considered in this analysis. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  11. 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.

  12. Reduce microRNA RT-qPCR Assay Costs by More Than 10-fold Without Compromising Results

    DEFF Research Database (Denmark)

    Goldrick, Marianna; Busk, Peter Kamp; Lepovitz, Lance

    2013-01-01

    This white paper describes a detailed protocol for carrying out qPCR-based microRNA analysis for only ~$0.39 per assay, a cost-savings of >90% compared to commonly used alternative methods.......This white paper describes a detailed protocol for carrying out qPCR-based microRNA analysis for only ~$0.39 per assay, a cost-savings of >90% compared to commonly used alternative methods....

  13. 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.

  14. 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.

  15. 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

  16. NASA Air Force Cost Model (NAFCOM): Capabilities and Results

    Science.gov (United States)

    McAfee, Julie; Culver, George; Naderi, Mahmoud

    2011-01-01

    NAFCOM is a parametric estimating tool for space hardware. Uses cost estimating relationships (CERs) which correlate historical costs to mission characteristics to predict new project costs. It is based on historical NASA and Air Force space projects. It is intended to be used in the very early phases of a development project. NAFCOM can be used at the subsystem or component levels and estimates development and production costs. NAFCOM is applicable to various types of missions (crewed spacecraft, uncrewed spacecraft, and launch vehicles). There are two versions of the model: a government version that is restricted and a contractor releasable version.

  17. Estimates of patient costs related with population morbidity: can indirect costs affect the results?

    Science.gov (United States)

    Carreras, M; García-Goñi, M; Ibern, P; Coderch, J; Vall-Llosera, L; Inoriza, J M

    2011-08-01

    A number of health economics studies require patient cost estimates as basic information input. However, the accuracy of cost estimates remains generally unspecified. We propose to investigate how the allocation of indirect costs or overheads can affect the estimation of patient costs and lead to improvements in the analysis of patient cost estimates. Instead of focussing on the costing method, this paper will highlight observed changes in variation explained by a methodology choice. We compare four overhead allocation methods for a specific Spanish population adjusted using the Clinical Risk Groups model. Our main conclusion is that the amount of global variation explained by the risk adjustment model depends mainly on direct costs, regardless of the cost allocation methodology used. Furthermore, the variation explained can be slightly increased, depending on the cost allocation methodology, and is independent of the level of aggregation in the classification system.

  18. "Dial-an-ROI?" changing basic variables impacts cost trends in single-population pre-post ("DMAA type") savings analysis.

    Science.gov (United States)

    Juster, Iver A; Rosenberg, Stephen N; Senapati, Deeptimayee; Shah, Mayur R

    2009-02-01

    Disease management (DM) programs claim to achieve cost savings by reducing clinical adverse events. While measuring changes in adverse events is straightforward, plausibly demonstrating savings has been contentious, especially absent an external comparison population. In this situation, a single-population methodology is often used, in which the cost trend for those with no program conditions ("non-chronics"--NC) forms the expected trend for those who have at least 1 program condition ("chronics"--C). The methodology's fundamental assumption is that--absent DM--C and NC trends would be identical (or bear a constant relationship over time). We assessed this assumption by altering the values of key variables used to identify C and NC, and to calculate trend. We compared C and NC baseline trends for a 23-condition telephonic DM multiemployer program representing nearly 300,000 members. Trends were calculated for 16 combinations of values for 4 key variables: identification look-back frame (12 vs. 24 months); identification threshold (high vs. lower specificity); claims runout (3 vs. 6 months); and minimum required insurance eligibility (any 6 months vs. 12 months continuous eligibility in the measurement year). Identification was performed by annual qualification. Changes in values for the 4 key variables markedly impacted baseline C and NC trends. C trends varied between 10.1% and 13.1%; NC trends between 5.2% and 12.8%. C-NC trend differences ranged between -1.9% and +7.0%. The combination of 24 months identification look-back, high identification threshold, 6 months runout, and any-6-months eligibility gave the most convergent C and NC trends (10.4% and 10.7%). Seemingly minor changes in key variables impact C and NC trends in single-population pre-post DM savings methodologies. When a suitable comparison population is not available, at least 1 year of baseline C and NC trends should be reported-as recommended by the DMAA--and values of key variables used should be

  19. Costing injuries in South Africa: preliminary results and challenges ...

    African Journals Online (AJOL)

    The direct costs associated with the medical treatment, rehabilitation and administration of these victims run into billions of Rands which could be more productively spent on primary prevention to reduce the number of new cases and improve overall life quality. Yet, the costs of injuries in the South African public health ...

  20. Waste molasses alone displaces glucose-based medium for microalgal fermentation towards cost-saving biodiesel production.

    Science.gov (United States)

    Yan, Dong; Lu, Yue; Chen, Yi-Feng; Wu, Qingyu

    2011-06-01

    The by-product of sugar refinery-waste molasses was explored as alternative to glucose-based medium of Chlorella protothecoides in this study. Enzymatic hydrolysis is required for waste molasses suitable for algal growth. Waste molasses hydrolysate was confirmed as a sole source of full nutrients to totally replace glucose-based medium in support of rapid growth and high oil yield from algae. Under optimized conditions, the maximum algal cell density, oil content, and oil yield were respectively 70.9 g/L, 57.6%, and 40.8 g/L. The scalability of the waste molasses-fed algal system was confirmed from 0.5L flasks to 5L fermenters. The quality of biodiesel from waste molasses-fed algae was probably comparable to that from glucose-fed ones. Economic analysis indicated the cost of oil production from waste molasses-fed algae reduced by 50%. Significant cost reduction of algal biodiesel production through fermentation engineering based on the approach is expected. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients

    Directory of Open Access Journals (Sweden)

    KS Rathod

    2017-10-01

    Full Text Available Introduction Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Methods This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014. Patients who did not receive a GPIIb/IIIa inhibitor were excluded. Time to first major adverse cardiac event defined as death, non-fatal myocardial infarction, stroke or target vessel revascularization, and total hospital costs were compared between the groups. Results In all, 1741 patients received abciximab with 2122 receiving eptifibatide. Patients who received eptifibatide had higher rates of previous MI/percutaneous coronary intervention and were more likely to undergo a procedure from the radial route. Unadjusted Kaplan–Meier analysis revealed no significant difference in the 1-year event rates between patients given eptifibatide versus abciximab (p = 0.201. Age-adjusted Cox analysis demonstrated no difference in 1-year outcome between abciximab and eptifibatide (hazard ratio: 0.83; 95% confidence interval: 0.73–1.39, which persisted after multivariate adjustment (hazard ratio: 0.92; 95% confidence interval: 0.79–1.56 including the incorporation of a propensity score (hazard ratio: 0.88; 95% confidence interval: 0.71–1.44. Eptifbatide was associated with significant cost savings being 87% cheaper overall compared to abciximab (on average £650 cheaper per patient and saving approximately £950,000. Conclusion This observational data suggest that eptifibatide is associated with similar

  2. Polish households’ saving strategies

    Directory of Open Access Journals (Sweden)

    Paulina Anioła

    2013-03-01

    Full Text Available The article presents the results of households’ saving strategies types classification. A cluster analysis method, based on households’ saving portfolio, was used for classification. Six types of strategies were distinguished: low risk, conservative, very passive, very conservative, diversification and aggressive.

  3. Simultaneous bilateral anterior cruciate ligament reconstruction: Cost comparison and functional results

    Directory of Open Access Journals (Sweden)

    Matjaž Sajovic

    2014-04-01

    Full Text Available Background: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL deficiency remains controversial. The purpose was to evaluate cost and mid-term functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft.Methods: We compared the mid-term outcome of 7 patients (14 knees who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients.Results: The median duration of hospital stay was 4 nights (range 3 to 5 for the bilateral group and 2 nights (range, 1 to 4 for the control group. The duration of rehabilitation process in patients from the control group with unilateral ACL reconstruction was one week shorter (9 versus 8 weeks. In the bilateral group, the median Lysholm score was 96 (range 85–100 and in the control group, the median score was 93 (range 81–100. The median time to return to full-time work and to full sports was 9 weeks and 7 months for the simultaneous bilateral group and 8 weeks and 6 months for the unilateral group. Six patients (86 % in the bilateral group and 17 patients (81 % in the control group were still performing at their pre-injury level of activity. The Health Insurance Institute of Slovenia saves EUR 2,925 when we perform simultaneous bilateral ACL reconstruction instead of two stage ACL reconstruction.Conclusions: Mid-term clinical results suggested that simultaneous bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting with symptomatic bilateral ACL deficient knees, one stage bilateral ACL reconstruction is reproducible, cost effective, and does not compromise functional results.

  4. Food Processing Contracts: Savings for Schools.

    Science.gov (United States)

    Van Egmond-Pannell, Dorothy

    1983-01-01

    Food processing contracts between schools and food manufacturers can result in huge cost savings. Fairfax County, Virginia, is one of 30 "letter of credit" sites in a three-year study of alternatives. After one year it appears that schools can purchase more for the dollar in their local areas. (MD)

  5. Chinese hotel general managers' perspectives on energy-saving practices

    Science.gov (United States)

    Zhu, Yidan

    As hotels' concern about sustainability and budget-control is growing steadily, energy-saving issues have become one of the important management concerns hospitality industry face. By executing proper energy-saving practices, previous scholars believed that hotel operation costs can decrease dramatically. Moreover, they believed that conducting energy-saving practices may eventually help the hotel to gain other benefits such as an improved reputation and stronger competitive advantage. The energy-saving issue also has become a critical management problem for the hotel industry in China. Previous research has not investigated energy-saving in China's hotel segment. To achieve a better understanding of the importance of energy-saving, this document attempts to present some insights into China's energy-saving practices in the tourist accommodations sector. Results of the study show the Chinese general managers' attitudes toward energy-saving issues and the differences among the diverse hotel managers who responded to the study. Study results indicate that in China, most of the hotels' energy bills decrease due to the implementation of energy-saving equipments. General managers of hotels in operation for a shorter period of time are typically responsible for making decisions about energy-saving issues; older hotels are used to choosing corporate level concerning to this issue. Larger Chinese hotels generally have official energy-saving usage training sessions for employees, but smaller Chinese hotels sometimes overlook the importance of employee training. The study also found that for the Chinese hospitality industry, energy-saving practices related to electricity are the most efficient and common way to save energy, but older hotels also should pay attention to other ways of saving energy such as water conservation or heating/cooling system.

  6. Consumer-directed health plans with health savings accounts: whose skin is in the game and how do costs affect care seeking?

    Science.gov (United States)

    Reed, Mary; Graetz, Ilana; Wang, Huihui; Fung, Vicki; Newhouse, Joseph P; Hsu, John

    2012-07-01

    Employers are increasingly offering high-deductible health insurance plans with associated health savings accounts (HSAs), but there is limited information on account contributions or effects on patient care seeking. We examined HSA contributions and their source, patient-reported effects of costs on care seeking, and reports of financial burden. We conducted telephone interviews with 488 adult members of small group of employer-sponsored HSA-eligible plans within an integrated delivery system. HSA contribution sources and amounts varied with 32% receiving an employer contribution and also making their own employee contribution, 35% only receiving an employer contribution (no employee contribution), 19% only making their own contribution (no employer contribution), and 14% with no HSA contribution from either source. After adjustment for respondent characteristics, those who made their own HSA contributions in addition to their employer's contribution were significantly more likely to report that costs affected their care-seeking behavior, compared with those with only employer contributions (39% vs. 31% for emergency department and 60% vs. 49% for office visits, all Ppaid out-of-pocket for care were significantly more likely to report financial burdens than those with only employer contributions (Pemployer contributions to their HSA, but few have fully funded accounts. Those with only an employer contribution reported fewer changes in their care-seeking behavior and were less likely to report experiencing financial burdens.

  7. The PANDORA project: results of the cost of illness analysis.

    Science.gov (United States)

    Degli Esposti, E; Berto, P; Ruffo, P; Buda, S; Degli Esposti, L; Sturani, A

    2001-05-01

    To evaluate the cost of illness from hypertension for the Italian National Health System (NHS). A prospective analysis was carried out on clinical and economic data recorded in the general practitioners' (GPs) database. Twenty-one GPs working in the Ravenna area in Italy took part in the project on a voluntary basis. The study included 1047 hypertensive patients enrolled between 1 June and 31 December 1997 and continued for 365 days from the date of enrolment. The following costs were calculated: antihypertensive drugs, laboratory tests and instrumental procedures, GP visits for blood pressure control, specialist visits, casualty visits, hospitalisation due to cardiovascular problems. In the whole sample, the most relevant cost is due to antihypertensive drugs (42.7%), followed by hospital admission (28.4%), GP visits (15.1%) and tests (10.6%). The total mean cost was significantly lower in incident (no previous treatment) than in prevalent patients (already treated) (457 512 vs 725 573 Italian Lira (ITL), P < 0.05) and in older rather than in younger patients (1171 410 vs 796 452 (ITL) P < 0.05). (In the text the equivalent is given in Euros, Pounds Sterling and US dollars). Our study should be considered as preliminary, nevertheless it could represent a step towards the evaluation of the true cost of hypertension.

  8. Cost Reporting Elements and Activity Cost Tradeoffs for Defense System Software. Volume I. Study Results.

    Science.gov (United States)

    1977-05-01

    software . Specifically , only the final delivered sizes of programa were reported ; how much of the programs was new in each release was unknown...normalizing daca that will be used to establish cost estimation techniques. An initial cost estimation technique is oriented towards predicting the costs of... programaing lang- uage. It was eiptimated22 that the impact of constrained hardware resources V is approximated by: Adjusted Coding Labor — (__ o.7 X Coding

  9. Retirement plans, personal saving, and saving adequacy.

    Science.gov (United States)

    Yakoboski, P

    2000-03-01

    This Issue Brief addresses three questions raised by recent trends in personal saving: How are national savings measured and what is the meaning of the trends in measured personal saving rates, given what is included and what is not included in those measures? What is the effect of retirement saving programs--in particular, 401(k) plans and individual retirement accounts (IRAs)--on personal saving levels? What are the implications of existing saving behavior for the retirement income security of today's workers? The National Income and Product Accounts (NIPA), the most commonly referenced gauge of personal saving, is a widely misunderstood measure. One could argue that a complete measure of saving would include increases in wealth through capital gains, but NIPA does not factor accrued and realized capital gains on stocks and other assets into the saving rate. By one measure, accounting for capital gains results in an aggregate personal saving rate of 33 percent--more than double the rate of four decades ago. A major policy question is the impact of tax-qualified retirement saving plans (i.e., IRAs and 401(k) plans) on personal saving rates. Empirical analysis of this issue is extremely challenging and findings have been contradictory. These programs now represent an enormous store of retirement-earmarked wealth in tax-deferred vehicles: Combined, such tax-deferred retirement accounts currently have assets of about $4 trillion. Ninety percent of IRA contributions are now the result of "rollovers" as employees leave employer plans, like 401(k) plans. While leakage from the system remains a challenge, the majority of the assets in the system can be expected to be available to fund workers' retirements. One could argue that, from a retirement income security perspective, workers in general are better off because IRA and 401(k) programs exist. Surely, many of the dollars in these programs would have been saved even without the programs; but they would not necessarily

  10. The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity.

    Science.gov (United States)

    Laxy, Michael; Stark, Renée; Peters, Annette; Hauner, Hans; Holle, Rolf; Teuner, Christina M

    2017-08-30

    This study aims to analyse the non-linear relationship between Body Mass Index (BMI) and direct health care costs, and to quantify the resulting cost fraction attributable to obesity in Germany. Five cross-sectional surveys of cohort studies in southern Germany were pooled, resulting in data of 6757 individuals (31-96 years old). Self-reported information on health care utilisation was used to estimate direct health care costs for the year 2011. The relationship between measured BMI and annual costs was analysed using generalised additive models, and the cost fraction attributable to obesity was calculated. We found a non-linear association of BMI and health care costs with a continuously increasing slope for increasing BMI without any clear threshold. Under the consideration of the non-linear BMI-cost relationship, a shift in the BMI distribution so that the BMI of each individual is lowered by one point is associated with a 2.1% reduction of mean direct costs in the population. If obesity was eliminated, and the BMI of all obese individuals were lowered to 29.9 kg/m², this would reduce the mean direct costs by 4.0% in the population. Results show a non-linear relationship between BMI and health care costs, with very high costs for a few individuals with high BMI. This indicates that population-based interventions in combination with selective measures for very obese individuals might be the preferred strategy.

  11. The Non-Linear Relationship between BMI and Health Care Costs and the Resulting Cost Fraction Attributable to Obesity

    Directory of Open Access Journals (Sweden)

    Michael Laxy

    2017-08-01

    Full Text Available This study aims to analyse the non-linear relationship between Body Mass Index (BMI and direct health care costs, and to quantify the resulting cost fraction attributable to obesity in Germany. Five cross-sectional surveys of cohort studies in southern Germany were pooled, resulting in data of 6757 individuals (31–96 years old. Self-reported information on health care utilisation was used to estimate direct health care costs for the year 2011. The relationship between measured BMI and annual costs was analysed using generalised additive models, and the cost fraction attributable to obesity was calculated. We found a non-linear association of BMI and health care costs with a continuously increasing slope for increasing BMI without any clear threshold. Under the consideration of the non-linear BMI-cost relationship, a shift in the BMI distribution so that the BMI of each individual is lowered by one point is associated with a 2.1% reduction of mean direct costs in the population. If obesity was eliminated, and the BMI of all obese individuals were lowered to 29.9 kg/m2, this would reduce the mean direct costs by 4.0% in the population. Results show a non-linear relationship between BMI and health care costs, with very high costs for a few individuals with high BMI. This indicates that population-based interventions in combination with selective measures for very obese individuals might be the preferred strategy.

  12. Energy savings and comfort changes in buildings

    Energy Technology Data Exchange (ETDEWEB)

    Krighaar, M. [COWI (Denmark); Ivanauskas, A. [Klaipedos Energija SPAB (Lithuania)

    2000-07-01

    This article presents the results from a demonstration project on building installations in the city Klaipeda, Lithuania. The project demonstrates the energy savings and increased comfort level achieved by installation of various energy saving measures and includes a cost benefit analysis. The demonstration area consists of eight typical buildings. The outcome of the project provides a valuable basis for future decisions to be made concerning reconstruction of heating installations and enables the results and experience to be transferred to 2,500 buildings in Klaipeda and buildings in Lithuania in general. (au)

  13. Green liquor impregnation and Kraft pulping of South African Pinus Patula – “A practical approach to provide cost savings in a Kraft mill’s pulping operation”

    CSIR Research Space (South Africa)

    Johakimu, Jonas K

    2011-02-01

    Full Text Available benefits of GLP technology to the Kraft pulping industry are; providing cost savings, increased digester productivity, and mitigation of some of environmental impacts. Depending on the process economics of the pulping process of a Kraft pulp mill, GLP can...

  14. Strip Coating Metrology on Large Scale Telescope Optics: Scalable Cost Saving Preventative Maintenance with First Contact Polymer

    Science.gov (United States)

    Hamilton, J.

    2012-09-01

    Protection and cleaning of precision optical surfaces on large scale astronomical instruments has entered a new era. First surface mirrors have been restored to "like-new" condition avoiding the expense and downtime of recoating. Nearly 10 years of testing and evaluation at a variety of sites including optics at Vandenberg Air Force Base, the Canada France Hawaii Telescope (CFHT) and the W.M Keck Telescope on Mauna Kea, have yielded impressive results: restored reflectivity, no residue, insitu cleaning and better coating performance when used as a precleaner when coating. Metrology and research in our labs has resulted in these novel, commercially available polymeric stripcoatings that are applied as a liquid and subsequently peeled off the substrate as a solid film. These designer polymer solutions safely clean and protect a wide variety of nanostructured surfaces and leave the surface almost atomically clean. Contaminant removal was monitored by a variety of techniques including Reflectivity, Nomarski, Atomic Force and Scanning Electron Microscopy as well as XPS. In addition, data demonstrates that the material safely removes particulate contamination and finger oils from nanostructures such as the 300nm wide lines on diffraction gratings and similar submicron features on Si wafers. High power laser damage testing found no residue on the optical surfaces following dried film removal and YAG laser damage thresholds after cleaning on coated BK7 of 15J/cm2 at 20ns and 20Hz were unchanged. Additionally to these adhesion tunable polymer systems, nanotube and graphene doped, ESD free polymer strip coatings for surface protection, nanoreplication, cleaning and dust mitigation have also been developed. Our coatings have been successfully used on diverse surfaces like high power laser optics, the Hope Diamond in Washington DC, CCD s for the 520 megapixel Dark Energy Survey Camera being built at Fermilab and lithographically fabbed detector surfaces for the Cryogenic Dark

  15. Preliminary results of accelerated partial breast irradiation in the combination organ-saving treatment of patients with early-stage breast cancer

    Directory of Open Access Journals (Sweden)

    O. P. Trofimova

    2013-01-01

    Full Text Available Objective: to develop and introduce an accelerated partial breast irradiation procedure in patients with early-stage breast cancer after organ-saving operations using three-dimensional conformal teleradiotherapy (3D CRT and to assess the preliminary results of treat- ment.Subjects and methods: the trial enrolled 48 patients with verified T1-2N0-1micM0 stage breast cancer who received organ-saving treatment in the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, in 2008–2012. The median age of the patients was 63 years. All the patients underwent organ-saving operations with subsequent 3D CRT applied to the resected tumor bed with margins. Radiotherapy with a dose of 2.5 Gy was performed twice daily; the daily dose was 5 Gy; the course dose was 40 Gy. Indications for accelerated partial irradiation of the tumor bed were listed; the data of randomized trials were given.Results. The median follow-up was 27 months; locoregional recurrences or distant metastases were found in no patients. Late radia- tion skin and soft tissue injuries were seen in no cases. All the patients were ascertained to have early-stage grade I radiation cutane- ous injuries according to the RTOG-EORTC classification. Excellent, good, fair, and poor cosmetic results were obtained in 12 (25 %, 34 (71 %, 2 (4 %, and 0 patients, respectively.Conclusion. The developed accelerated partial breast irradiation procedure in patients with early-stage breast cancer after organ- saving operations at the median follow-up of 27 months showed good results, such as no local recurrences or distant metastases. Excel- lent and good cosmetic results were noted in 96 % of the patients.

  16. Secure savings

    Energy Technology Data Exchange (ETDEWEB)

    Dawn, Tom

    1996-09-01

    When it was installed, Dartmoor Prison`s environmental management system promised enough savings in labour and energy to pay for itself in well under five years. The system`s benefits are appreciated by staff and are thoroughly practical. (author)

  17. 77 FR 20123 - Fee Change for Paying Agents Redeeming Definitive Savings Bonds and Savings Notes

    Science.gov (United States)

    2012-04-03

    ... Fiscal Service Fee Change for Paying Agents Redeeming Definitive Savings Bonds and Savings Notes AGENCY..., the Department of the Treasury will no longer pay fees to paying agents for redeeming definitive savings bonds and savings notes. The purpose of this change is to reduce Treasury's program costs. DATES...

  18. Lives saved by Global Fund-supported HIV/AIDS, tuberculosis and malaria programs: estimation approach and results between 2003 and end-2007

    Directory of Open Access Journals (Sweden)

    Lyerla Rob

    2010-04-01

    Full Text Available Abstract Background Since 2003, the Global Fund has supported the scale-up of HIV/AIDS, tuberculosis and malaria control in low- and middle-income countries. This paper presents and discusses a methodology for estimating the lives saved through selected service deliveries reported to the Global Fund. Methods Global Fund-supported programs reported, by end-2007, 1.4 million HIV-infected persons on antiretroviral treatment (ARV, 3.3 million new smear-positive tuberculosis cases detected in DOTS (directly observed TB treatment, short course programs, and 46 million insecticide-treated mosquito nets (ITNs delivered. We estimated the corresponding lives saved using adaptations of existing epidemiological estimation models. Results By end-2007, an estimated 681,000 lives (95% uncertainty range 619,000-774,000 were saved and 1,097,000 (993,000-1,249,000 life-years gained by ARV. DOTS treatment would have saved 1.63 million lives (1.09 - 2.17 million when compared against no treatment, or 408,000 lives (265,000-551,000 when compared against non-DOTS treatment. ITN distributions in countries with stable endemic falciparum malaria were estimated to have achieved protection from malaria for 26 million of child-years at risk cumulatively, resulting in 130,000 (27,000-232,000 under-5 deaths prevented. Conclusions These results illustrate the scale of mortality effects that supported programs may have achieved in recent years, despite margins of uncertainty and covering only selected intervention components. Evidence-based evaluation of disease impact of the programs supported by the Global Fund with international and in-country partners must be strengthened using population-level data on intervention coverage and demographic outcomes, information on quality of services, and trends in disease burdens recorded in national health information systems.

  19. Energy Savings Measure Packages. Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Casey, Sean [National Renewable Energy Lab. (NREL), Golden, CO (United States); Booten, Chuck [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-11-01

    This document presents the most cost effective Energy Savings Measure Packages (ESMP) for existing mixed-fuel and all electric homes to achieve 15% and 30% savings for each BetterBuildings grantee location across the United States. These packages are optimized for minimum cost to homeowners for source energy savings given the local climate and prevalent building characteristics (i.e. foundation types). Maximum cost savings are typically found between 30% and 50% energy savings over the reference home; this typically amounts to $300 - $700/year.

  20. Cost and Cost-Effectiveness of the Mediterranean Diet: Results of a Systematic Review

    Directory of Open Access Journals (Sweden)

    Rosella Saulle

    2013-11-01

    Full Text Available The growing impact of chronic degenerative pathologies (such as cardiovascular disease, type 2 diabetes and Alzheimer’s disease requires and pushes towards the development of new preventive strategies to reduce the incidence and prevalence of these diseases. Lifestyle changes, especially related to the Mediterranean diet, have the potential to modify disease outcomes and ultimately costs related to their management. The objective of the study was to perform a systematic review of the scientific literature, to gauge the economic performance and the cost-effectiveness of the adherence to the Mediterranean diet as a prevention strategy against degenerative pathologies. We investigated the monetary costs of adopting Mediterranean dietary patterns by determining cost differences between low and high adherence. Research was conducted using the PubMed and Scopus databases. Eight articles met the pre-determined inclusion criteria and were reviewed. Quality assessment and data extraction was performed. The adherence to the Mediterranean diet has been extensively reported to be associated with a favorable health outcome and a better quality of life. The implementation of a Mediterranean dietary pattern may lead to the prevention of degenerative pathologies and to an improvement in life expectancy, a net gain in health and a reduction in total lifetime costs.

  1. Cost and Cost-Effectiveness of the Mediterranean Diet: Results of a Systematic Review

    Science.gov (United States)

    Saulle, Rosella; Semyonov, Leda; La Torre, Giuseppe

    2013-01-01

    The growing impact of chronic degenerative pathologies (such as cardiovascular disease, type 2 diabetes and Alzheimer’s disease) requires and pushes towards the development of new preventive strategies to reduce the incidence and prevalence of these diseases. Lifestyle changes, especially related to the Mediterranean diet, have the potential to modify disease outcomes and ultimately costs related to their management. The objective of the study was to perform a systematic review of the scientific literature, to gauge the economic performance and the cost-effectiveness of the adherence to the Mediterranean diet as a prevention strategy against degenerative pathologies. We investigated the monetary costs of adopting Mediterranean dietary patterns by determining cost differences between low and high adherence. Research was conducted using the PubMed and Scopus databases. Eight articles met the pre-determined inclusion criteria and were reviewed. Quality assessment and data extraction was performed. The adherence to the Mediterranean diet has been extensively reported to be associated with a favorable health outcome and a better quality of life. The implementation of a Mediterranean dietary pattern may lead to the prevention of degenerative pathologies and to an improvement in life expectancy, a net gain in health and a reduction in total lifetime costs. PMID:24253053

  2. Cost-effectiveness of internet-based cognitive behavior therapy for irritable bowel syndrome: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Paxling Björn

    2011-04-01

    Full Text Available Abstract Background Irritable Bowel Syndrome (IBS is highly prevalent and is associated with a substantial economic burden. Cognitive behavior therapy (CBT has been shown to be effective in treating IBS. The aim of this study was to evaluate the cost-effectiveness of a new treatment alternative, internet-delivered CBT based on exposure and mindfulness exercises. Methods Participants (N = 85 with IBS were recruited through self-referral and were assessed via a telephone interview and self-report measures on the internet. Participants were randomized to internet-delivered CBT or to a discussion forum. Economic data was assessed at pre-, post- and at 3-month and 1 year follow-up. Results Significant cost reductions were found for the treatment group at $16,806 per successfully treated case. The cost reductions were mainly driven by reduced work loss in the treatment group. Results were sustained at 3-month and 1 year follow-up. Conclusions Internet-delivered CBT appears to generate health gains in IBS treatment and is associated with cost-savings from a societal perspective.

  3. Monitoring peak power and cooling energy savings of shade trees and white surfaces in the Sacramento Municipal Utility District (SMUD) service area: Project design and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Akbari, H.; Bretz, S.; Hanford, J.; Rosenfeld, A.; Sailor, D.; Taha, H. [Lawrence Berkeley Lab., CA (United States); Bos, W. [Sacramento Municipal Utility District, CA (United States)

    1992-12-01

    Urban areas in warm climates create summer heat islands of daily average intensity of 3--5{degrees}C, adding to discomfort and increasing air-conditioning loads. Two important factors contributing to urban heat islands are reductions in albedo (lower overall city reflectance) and loss of vegetation (less evapotranspiration). Reducing summer heat islands by planting vegetation (shade trees) and increasing surface albedos, saves cooling energy, allows down-sizing of air conditioners, lowers air-conditioning peak demand, and reduces the emission of CO{sub 2} and other pollutants from electric power plants. The focus of this multi-year project, jointly sponsored by SMUD and the California Institute for Energy Efficiency (CIEE), was to measure the direct cooling effects of trees and white surfaces (mainly roofs) in a few buildings in Sacramento. The first-year project was to design the experiment and obtain base case data. We also obtained limited post retrofit data for some sites. This report provides an overview of the project activities during the first year at six sites. The measurement period for some of the sites was limited to September and October, which are transitional cooling months in Sacramento and hence the interpretation of results only apply to this period. In one house, recoating the dark roof with a high-albedo coating rendered air conditioning unnecessary for the month of September (possible savings of up to 10 kWh per day and 2 kW of non-coincidental peak power). Savings of 50% relative to an identical base case bungalow were achieved when a school bungalow`s roof and southeast wall were coated with a high-albedo coating during the same period. Our measured data for the vegetation sites do not indicate conclusive results because shade trees were small and the cooling period was almost over. We need to collect more data over a longer cooling season in order to demonstrate savings conclusively.

  4. Type C distal radial fractures treated with conventional AO plates: an easy and cost-saving solution in a locking plate era.

    Science.gov (United States)

    Twigt, Bas; Bemelman, Michael; Lansink, Koen; Leenen, Loek

    2013-03-01

    C-type distal radial fractures remain challenging fractures. Currently locking plates are very popular because of their length preserving, stability. A considerable drawback is the high cost. Since 2003 we have been using mini AO plates (2.7 mm) as an alternative. We analysed our results and performed a cost analysis. Retrospective analysis was performed of all patients operated upon between 2003 and 2008 for C type distal radius fractures. Reduction was achieved with mini AO plates, applied in a buttress fashion, with ligamentotaxis. Rehabilitation consisted of immediate mobilisation. Pre- and postoperative X-rays, operative results and patient charts were reviewed. Furthermore, we prospectively evaluated the functional results using VAS, DASH and Mayo wrist scores. Lastly, we assessed the implant costs and compared them to locking plates. Thirty-four patients were treated with a mean age of 49 years. Mean radial shortening improved 2 mm; dorsal and radial angulation improved 23 and 4°, respectively. At consolidation (eight weeks) the average radial shortening was 0.75 mm, a volar angulation of 3°, and 21° of radial angulation. Functional results were excellent, demonstrated by a mean VAS score less than 1, a DASH score of 12 and a Mayo wrist score of 87. Compared to locking plates, there was an overall reduction in material costs of 15,300 Euro. Our technique has excellent biomechanical stability, enabling immediate functional rehabilitation, good anatomical and functional outcome with significantly lower costs.

  5. Cost-effectiveness of defibrillator therapy or amiodarone in chronic stable heart failure: results from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT).

    Science.gov (United States)

    Mark, Daniel B; Nelson, Charlotte L; Anstrom, Kevin J; Al-Khatib, Sana M; Tsiatis, Anastasios A; Cowper, Patricia A; Clapp-Channing, Nancy E; Davidson-Ray, Linda; Poole, Jeanne E; Johnson, George; Anderson, Jill; Lee, Kerry L; Bardy, Gust H

    2006-07-11

    In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), implantable cardioverter-defibrillator (ICD) therapy significantly reduced all-cause mortality rates compared with medical therapy alone in patients with stable, moderately symptomatic heart failure, whereas amiodarone had no benefit on mortality rates. We examined long-term economic implications of these results. Medical costs were estimated by using hospital billing data and the Medicare Fee Schedule. Our base case cost-effectiveness analysis used empirical clinical and cost data to estimate the lifetime incremental cost of saving an extra life-year with ICD therapy relative to medical therapy alone. At 5 years, the amiodarone arm had a survival rate equivalent to that of the placebo arm and higher costs than the placebo arm. For ICD relative to medical therapy alone, the base case lifetime cost-effectiveness and cost-utility ratios (discounted at 3%) were dollar 38,389 per life-year saved (LYS) and dollar 41,530 per quality-adjusted LYS, respectively. A cost-effectiveness ratio < dollar 100,000 was obtained in 99% of 1000 bootstrap repetitions. The cost-effectiveness ratio was sensitive to the amount of extrapolation beyond the empirical 5-year trial data: dollar 127,503 per LYS at 5 years, dollar 88,657 per LYS at 8 years, and dollar 58,510 per LYS at 12 years. Because of a significant interaction between ICD treatment and New York Heart Association class, the cost-effectiveness ratio was dollar 29,872 per LYS for class II, whereas there was incremental cost but no incremental benefit in class III. Prophylactic use of single-lead, shock-only ICD therapy is economically attractive in patients with stable, moderately symptomatic heart failure with an ejection fraction < or = 35%, particularly those in NYHA class II, as long as the benefits of ICD therapy observed in the SCD-HeFT persist for at least 8 years.

  6. Cost-effectiveness analysis of a voucher scheme combined with obstetrical quality improvements: quasi experimental results from Uganda.

    Science.gov (United States)

    Alfonso, Y Natalia; Bishai, David; Bua, John; Mutebi, Aloysius; Mayora, Crispus; Ekirapa-Kiracho, Elizabeth

    2015-02-01

    The maternal mortality ratio (MMR) in Uganda has declined significantly during the last 20 years, but Uganda is not on track to reach the millennium development goal of reducing MMR by 75% by 2015. More evidence on the cost-effectiveness of supply- and demand-side financing programs to reduce maternal mortality could inform future strategies. This study analyses the cost-effectiveness of a voucher scheme (VS) combined with health system strengthening in rural Uganda against the status quo. The VS, implemented in 2010, provided vouchers for delivery services at public and private health facilities (HF), as well as round-trip transportation provided by private sector workers (bicycles or motorcycles generally). The VS was part of a quasi-experimental non-randomized control trial. Improvements in institutional delivery coverage (IDC) rates can be estimated using a difference-in-difference impact evaluation method and the number of maternal lives saved is modelled using the evidence-based Lives Saved Tool. Costs were estimated from primary and secondary data. Results show that the demand for births at HFs enrolled in the VS increased by 52.3 percentage points. Out of this value, conservative estimates indicate that at least 9.4 percentage points are new HF users. This 9.4% bump in IDC implies 20 deaths averted, which is equivalent to 1356 disability-adjusted-life years (DALYs) averted. Cost-effectiveness analysis comparing the status quo and VS's most conservative effectiveness estimates shows that the VS had an incremental cost-effectiveness ratio per DALY averted of US$302 and per death averted of US$20 756. Although there are limitations in the data measures, a favourable cost-effectiveness ratio persists even under extreme assumptions. Demand-side vouchers combined with supply-side financing programs can increase attended deliveries and reduce maternal mortality at a cost that is acceptable. Published by Oxford University Press in association with The London School

  7. COST 296 scientific results designed for operational use

    Directory of Open Access Journals (Sweden)

    Michael Pezzopane

    2009-06-01

    Full Text Available

    The main objective of the COST 296 Action «Mitigation of Ionospheric Effects on Radio Systems» is the establishment/

    improvement of ionospheric services by coordinating the development of specific algorithms, models,

    and tools capable of operating in a near-real-time mode.

    Key elements of these activities are contributions related to monitoring, modelling, and imaging of customer-relevant

    ionospheric quantities. COST stimulates, coordinates, and supports Europe’s goals of development and

    global cooperation by providing high quality information and knowledge of ionospheric and plasmaspheric conditions

    enabling high quality and reliable operation of radio systems.

    It also provides a platform for sharing such tools as algorithms or models, and for the joint development of advanced

    technologies. It takes advantage of many national and European service initiatives, for example DIAS

    (http://dias.space.noa.gr, SWACI (http://w3swaci.dlr.de, ESWUA (http://www.eswua.ingv.it/ingv, RWC-Warsaw

    (http://www.cbk.waw.pl/rwc, the COST Prompt Ionospheric Database http://www.wdc.rl.ac.uk/cgibin/

    digisondes/cost_database.pl, http://www.izmiran.ru/services, and others.

  8. Spectacle wearing in children randomised to ready-made or custom spectacles, and potential cost savings to programmes: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Morjaria, Priya; Murali, Kaushik; Evans, Jennifer; Gilbert, Clare

    2016-01-19

    Uncorrected refractive errors are the commonest cause of visual impairment in children, with myopia being the most frequent type. Myopia usually starts around 9 years of age and progresses throughout adolescence. Hyperopia usually affects younger children, and astigmatism affects all age groups. Many children have a combination of myopia and astigmatism. To correct refractive errors, the type and degree of refractive error are measured and appropriate corrective lenses prescribed and dispensed in the spectacle frame of choice. Custom spectacles (that is, with the correction specifically required for that individual) are required if astigmatism is present, and/or the refractive error differs between eyes. Spectacles without astigmatic correction and where the refractive error is the same in both eyes are straightforward to dispense. These are known as 'ready-made' spectacles. High-quality spectacles of this type can be produced in high volume at an extremely low cost. Although spectacle correction improves visual function, a high proportion of children do not wear their spectacles for a variety of reasons. The aim of this study is to compare spectacle wear at 3-4 months amongst school children aged 11 to 15 years who have significant, simple uncorrected refractive error randomised to ready-made or custom spectacles of equivalent quality, and to evaluate cost savings to programmes. The study will take place in urban and semi-urban government schools in Bangalore, India. The hypothesis is that similar proportions of children randomised to ready-made or custom spectacles will be wearing their spectacles at 3-4 months. The trial is a randomised, non-inferiority, double masked clinical trial of children with simple uncorrected refractive errors. After screening, children will be randomised to ready-made or custom spectacles. Children will choose their preferred frame design. After 3-4 months the children will be followed up to assess spectacle wear. Ready

  9. Implementation of Energy Saving Controller for Electromagnetic Ballast Fluorescent Lamps

    Science.gov (United States)

    Xiong, Zhi; Barsoum, Cheong; Barsoum, N. N.

    2010-06-01

    Fluorescent lamps have proven to be the most efficient lighting device. However, energy losses have been found in electromagnetic ballast due to high harmonic distortion and low power factor so energy is consumed unnecessarily. In today's energy demanding environment, energy efficiency of fluorescent lamps can be improved by introducing an energy saving controller in the electromagnetic ballast. The energy saving controller limits the supply voltage to an optimum level which tends to reduce the power losses in electromagnetic ballasts and fluorescent lamps. It is also anticipated that the energy saving controller has desirable characteristics of high power factor with dimmable illuminance level control. In comparison to electronic dimmable ballast, integration an energy saving controller with electromagnetic ballast fluorescent lamps results in less power consumption, dimmable illuminance control and longer life span at a much lower installation cost. Furthermore, there is no replacement cost for integrating the energy saving controller with existing electromagnetic fluorescent lamps system. In this paper, experimental works have been performed to investigate hardware implementation of the system which further supported by simulation on MATLAB Simulink. Experimental results based on the proposed energy saving controller showed that electromagnetic ballast fluorescent lamps can be dimmed without any problems down to 50% illuminance level output. In addition, experimental results show that 37.5% power consumption can be saved by reducing 15% of the supply voltage.

  10. 'Pre-endoscopy point of care test (Simtomax- IgA/IgG-Deamidated Gliadin Peptide) for coeliac disease in iron deficiency anaemia: diagnostic accuracy and a cost saving economic model'.

    Science.gov (United States)

    Lau, Michelle Shui Yee; Mooney, Peter; White, William; Appleby, Victoria; Moreea, Sulleman; Haythem, Ismail; Elias, Joshua; Bundhoo, Kiran; Corbett, Gareth; Wong, Liam; Tsai, Her Hsin; Cross, Simon; Hebden, John; Hoque, Sami; Sanders, David

    2016-09-15

    International guidelines recommend coeliac serology in iron deficiency anaemia, and duodenal biopsy for those tested positive to detect coeliac disease. However, pre-endoscopy serology is often unavailable, thus committing endoscopists to take routine duodenal biopsies. Some endoscopists consider duodenal biopsy mandatory in anaemia to exclude other pathologies. We hypothesise that using a point of care test at endoscopy could fill this gap, by providing rapid results to target anaemic patients who require biopsies, and save costs by biopsy avoidance. We therefore assessed three key aspects to this hypothesis: 1) the availability of pre-endoscopy serology in anaemia; 2) the sensitivities and cost effectiveness of pre-endoscopy coeliac screening with Simtomax in anaemia; 3) whether other anaemia-related pathologies could be missed by this targeted-biopsy approach. Group 1: pre-endoscopy serology availability was retrospectively analysed in a multicentre cohort of 934 anaemic patients at 4 UK hospitals. Group 2: the sensitivities of Simtomax, endomysial and tissue-transglutaminase antibodies were compared in 133 prospectively recruited patients with iron deficiency anaemia attending for a gastroscopy. The sensitivities were measured against duodenal histology as the reference standard in all patients. The cost effectiveness of Simtomax was calculated based on the number of biopsies that could have been avoided compared to an all-biopsy approach. Group 3: the duodenal histology of 153 patients presenting to a separate iron deficiency anaemia clinic were retrospectively reviewed. In group 1, serology was available in 361 (33.8 %) patients. In group 2, the sensitivity and negative predictive value (NPV) were 100 % and 100 % for Simtomax, 96.2 % and 98.9 % for IgA-TTG, and 84.6 % and 96.4 % for EMA respectively. In group 3, the duodenal histology found no causes for anaemia other than coeliac disease. Simtomax had excellent diagnostic accuracy in iron deficiency

  11. Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial.

    Science.gov (United States)

    Lenhard, Fabian; Ssegonja, Richard; Andersson, Erik; Feldman, Inna; Rück, Christian; Mataix-Cols, David; Serlachius, Eva

    2017-05-17

    To evaluate the cost-effectiveness of a therapist-guided internet-delivered cognitive behaviour therapy (ICBT) intervention for adolescents with obsessive-compulsive disorder (OCD) compared with untreated patients on a waitlist. Single-blinded randomised controlled trial. A research clinic within the regular child and adolescent mental health service in Stockholm, Sweden. Sixty-seven adolescents (12-17 years) with a Diagnostic and Statistical Manual of Mental Disorders Fifth Edition diagnosis of OCD. Either a 12-week, therapist-guided ICBT intervention or a wait list condition of equal duration. Cost data were collected at baseline and after treatment, including healthcare use, supportive resources, prescription drugs, prescription-free drugs, school absence and productivity loss, as well as the cost of ICBT. Health outcomes were defined as treatment responder rate and quality-adjusted life years gain. Bootstrapped mixed model analyses were conducted comparing incremental costs and health outcomes between the groups from the societal and healthcare perspectives. Compared with waitlist control, ICBT generated substantial societal cost savings averaging US$-144.98 (95% CI -159.79 to -130.16) per patient. The cost reductions were mainly driven by reduced healthcare use in the ICBT group. From the societal perspective, the probability of ICBT being cost saving compared with waitlist control was approximately 60%. From the healthcare perspective, the cost per additional responder to ICBT compared with waitlist control was approximately US$78. The results suggest that therapist-guided ICBT is a cost-effective treatment and results in societal cost savings, compared with patients who do not receive evidence-based treatment. Since, at present, most patients with OCD do not have access to evidence-based treatments, the results have important implications for the increasingly strained national and healthcare budgets. Future studies should compare the cost

  12. Drug waste minimisation and cost-containment in Medical Oncology: Two-year results of a feasibility study

    Directory of Open Access Journals (Sweden)

    Mansutti Mauro

    2008-04-01

    Full Text Available Abstract Background Cost-containment strategies are required to face the challenge of rising drug expenditures in Oncology. Drug wastage leads to economic loss, but little is known about the size of the problem in this field. Methods Starting January 2005 we introduced a day-to-day monitoring of drug wastage and an accurate assessment of its costs. An internal protocol for waste minimisation was developed, consisting of four corrective measures: 1. A rational, per pathology distribution of chemotherapy sessions over the week. 2. The use of multi-dose vials. 3. A reasonable rounding of drug dosages. 4. The selection of the most convenient vial size, depending on drug unit pricing. Results Baseline analysis focused on 29 drugs over one year. Considering their unit price and waste amount, a major impact on expense was found to be attributable to six drugs: cetuximab, docetaxel, gemcitabine, oxaliplatin, pemetrexed and trastuzumab. The economic loss due to their waste equaled 4.8% of the annual drug expenditure. After the study protocol was started, the expense due to unused drugs showed a meaningful 45% reduction throughout 2006. Conclusion Our experience confirms the economic relevance of waste minimisation and may represent a feasible model in addressing this issue. A centralised unit of drug processing, the availability of a computerised physician order entry system and an active involvement of the staff play a key role in allowing waste reduction and a consequent, substantial cost-saving.

  13. Acute peripheral joint injury: cost and effectiveness of low-field-strength MR imaging--results of randomized controlled trial.

    NARCIS (Netherlands)

    Nikken, J.J.; Oei, E.H.; Ginai, A.Z.; Krestin, G.P.; Verhaar, J.A.N.; Vugt, A.B. van; Hunink, M.G.M.

    2005-01-01

    PURPOSE: To assess prospectively if a short imaging examination performed with low-field-strength dedicated magnetic resonance (MR) imaging in addition to radiography is effective and cost saving compared with the current diagnostic imaging strategy (radiography alone) in patients with recent acute

  14. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... Download Instructions Explorer: Right-click on the link, choose "Save target as…", save file in desired location. Firefox/Chrome: Right-click on the link, choose "Save link as…", save file in desired location. ...

  15. Do changes to supply chains and procurement processes yield cost savings and improve availability of pharmaceuticals, vaccines or health products? A systematic review of evidence from low-income and middle-income countries.

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-01-01

    Improving health systems performance, especially in low-resource settings facing complex disease burdens, can improve population health. Specifically, the efficiency and effectiveness of supply chains and procurement processes for pharmaceuticals, vaccines and other health products has important implications for health system performance. Pharmaceuticals, vaccines and other health products make up a large share of total health expenditure in low-income and middle-income countries (LMICs), and they are critical for delivering health services. Therefore, programmes which achieve cost savings on these expenditures may help improve a health system's efficiency, whereas programmes that increase availability of health products may improve a health system's effectiveness. This systematic review investigates whether changes to supply chains and procurement processes can achieve cost savings and/or improve the availability of drugs in LMICs. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL and the Health Economic Evaluation Database to identify. We identified 1264 articles, of which 38 were included in our study. We found evidence that centralised procurement and tendering can achieve direct cost savings, while supply chain management programmes can reduce drug stock outs and increase drug availability for populations. This research identifies a broad set of programmes which can improve the ways that health systems purchase and delivery health products. On the basis of this evidence, policymakers and programme managers should examine the root causes of inefficiencies in pharmaceutical supply chain and procurement processes in order to determine how best to improve health systems performance in their specific contexts.

  16. The social cost of rheumatoid arthritis in Italy: the results of an estimation exercise.

    Science.gov (United States)

    Turchetti, G; Bellelli, S; Mosca, M

    2014-03-14

    The objective of this study is to estimate the mean annual social cost per adult person and the total social cost of rheumatoid arthritis (RA) in Italy. A literature review was performed by searching primary economic studies on adults in order to collect cost data of RA in Italy in the last decade. The review results were merged with data of institutional sources for estimating - following the methodological steps of the cost of illness analysis - the social cost of RA in Italy. The mean annual social cost of RA was € 13,595 per adult patient in Italy. Affecting 259,795 persons, RA determines a social cost of € 3.5 billions in Italy. Non-medical direct cost and indirect cost represent the main cost items (48% and 31%) of the total social cost of RA in Italy. Based on these results, it appears evident that the assessment of the economic burden of RA solely based on direct medical costs evaluation gives a limited view of the phenomenon.

  17. Energy and Cost Saving of a Photovoltaic-Phase Change Materials (PV-PCM System through Temperature Regulation and Performance Enhancement of Photovoltaics

    Directory of Open Access Journals (Sweden)

    Ahmad Hasan

    2014-03-01

    Full Text Available The current research seeks to maintain high photovoltaic (PV efficiency and increased operating PV life by maintaining them at a lower temperature. Solid-liquid phase change materials (PCM are integrated into PV panels to absorb excess heat by latent heat absorption mechanism and regulate PV temperature. Electrical and thermal energy efficiency analysis of PV-PCM systems is conducted to evaluate their effectiveness in two different climates. Finally costs incurred due to inclusion of PCM into PV system and the resulting benefits are discussed in this paper. The results show that such systems are financially viable in higher temperature and higher solar radiation environment.

  18. High Performance MG-System Alloys For Weight Saving Applications: First Year Results From The Green Metallurgy EU Project

    Science.gov (United States)

    D'Errico, Fabrizio; Plaza, Gerardo Garces; Hofer, Markus; Kim, Shae K.

    The GREEN METALLURGY Project, a LIFE+ project co-financed by the EU Commission, has just concluded its first year. The Project seeks to set manufacturing processes at a pre-industrial scale for nanostructured-based high-performance Mg-Zn(Y) magnesium alloys. The Project's goal is the reduction of specific energy consumed and the overall carbon-footprint produced in the cradle-to-exit gate phases. Preliminary results addressed potentialities of the upstream manufacturing process pathway. Two Mg-Zn(Y) system alloys with rapid solidifying powders have been produced and directly extruded for 100% densification. Examination of the mechanical properties showed that such materials exhibit strength and elongation comparable to several high performing aluminum alloys; 390 MPa and 440 MPa for the average UTS for two different system alloys, and 10% and 15% elongations for two system alloys. These results, together with the low-environmental impact targeted, make these novel Mg alloys competitive as lightweight high-performance materials for automotive components.

  19. Costs to Automate Demand Response - Taxonomy and Results from Field Studies and Programs

    Energy Technology Data Exchange (ETDEWEB)

    Piette, Mary A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schetrit, Oren [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cheung, Iris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Li, Becky Z [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2017-07-31

    During the past decade, the technology to automate demand response (DR) in buildings and industrial facilities has advanced significantly. Automation allows rapid, repeatable, reliable operation. This study focuses on costs for DR automation in commercial buildings with some discussion on residential buildings and industrial facilities. DR automation technology relies on numerous components, including communication systems, hardware and software gateways, standards-based messaging protocols, controls and integration platforms, and measurement and telemetry systems. This report compares cost data from several DR automation programs and pilot projects, evaluates trends in the cost per unit of DR and kilowatts (kW) available from automated systems, and applies a standard naming convention and classification or taxonomy for system elements. Median costs for the 56 installed automated DR systems studied here are about $200/kW. The deviation around this median is large with costs in some cases being an order of magnitude great or less than the median. This wide range is a result of variations in system age, size of load reduction, sophistication, and type of equipment included in cost analysis. The costs to automate fast DR systems for ancillary services are not fully analyzed in this report because additional research is needed to determine the total cost to install, operate, and maintain these systems. However, recent research suggests that they could be developed at costs similar to those of existing hot-summer DR automation systems. This report considers installation and configuration costs and does include the costs of owning and operating DR automation systems. Future analysis of the latter costs should include the costs to the building or facility manager costs as well as utility or third party program manager cost.

  20. Eptifibatide is associated with significant cost savings and similar clinical outcomes to abciximab when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction: An observational cohort study of 3863 patients.

    Science.gov (United States)

    Rathod, K S; Antoniou, S; Avari, P; Ding, N; Wright, P; Knight, C; Jain, A K; Mathur, A; Smith, E J; Weerackody, R; Wragg, A; Jones, D A

    2017-01-01

    Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014. Patients who did not receive a GPIIb/IIIa inhibitor were excluded. Time to first major adverse cardiac event defined as death, non-fatal myocardial infarction, stroke or target vessel revascularization, and total hospital costs were compared between the groups. In all, 1741 patients received abciximab with 2122 receiving eptifibatide. Patients who received eptifibatide had higher rates of previous MI/percutaneous coronary intervention and were more likely to undergo a procedure from the radial route. Unadjusted Kaplan-Meier analysis revealed no significant difference in the 1-year event rates between patients given eptifibatide versus abciximab (p = 0.201). Age-adjusted Cox analysis demonstrated no difference in 1-year outcome between abciximab and eptifibatide (hazard ratio: 0.83; 95% confidence interval: 0.73-1.39), which persisted after multivariate adjustment (hazard ratio: 0.92; 95% confidence interval: 0.79-1.56) including the incorporation of a propensity score (hazard ratio: 0.88; 95% confidence interval: 0.71-1.44). Eptifbatide was associated with significant cost savings being 87% cheaper overall compared to abciximab (on average £650 cheaper per patient and saving approximately £950,000). This observational data suggest that eptifibatide is associated with similar outcomes and significant cost savings compared to abciximab when

  1. Driver Education Saves Gas.

    Science.gov (United States)

    American Automobile Association, Falls Church, VA. Traffic Engineering and Safety Dept.

    The argument that driver education should be dropped because driver education cars use gas is shortsighted. High school driver education is an excellent vehicle for teaching concepts of energy conservation. A small investment in fuel now can result in major savings of gasoline over a student's lifetime. In addition good driver education courses…

  2. Negative predictive value and potential cost savings of acute nuclear myocardial perfusion imaging in low risk patients with suspected acute coronary syndrome: A prospective single blinded study

    Directory of Open Access Journals (Sweden)

    Björk Jonas

    2009-06-01

    Full Text Available Abstract Background Previous studies from the USA have shown that acute nuclear myocardial perfusion imaging (MPI in low risk emergency department (ED patients with suspected acute coronary syndrome (ACS can be of clinical value. The aim of this study was to evaluate the utility and hospital economics of acute MPI in Swedish ED patients with suspected ACS. Methods We included 40 patients (mean age 55 ± 2 years, 50% women who were admitted from the ED at Lund University Hospital for chest pain suspicious of ACS, and who had a normal or non-ischemic ECG and no previous myocardial infarction. All patients underwent MPI from the ED, and the results were analyzed only after patient discharge. The current diagnostic practice of admitting the included patients for observation and further evaluation was compared to a theoretical "MPI strategy", where patients with a normal MPI test would have been discharged home from the ED. Results Twenty-seven patients had normal MPI results, and none of them had ACS. MPI thus had a negative predictive value for ACS of 100%. With the MPI strategy, 2/3 of the patients would thus have been discharged from the ED, resulting in a reduction of total hospital cost by some 270 EUR and of bed occupancy by 0.8 days per investigated patient. Conclusion Our findings in a Swedish ED support the results of larger American trials that acute MPI has the potential to safely reduce the number of admissions and decrease overall costs for low-risk ED patients with suspected ACS.

  3. Utilization of agricultural residues of pineapple peels and sugarcane bagasse as cost-saving raw materials in Scenedesmus acutus for lipid accumulation and biodiesel production.

    Science.gov (United States)

    Rattanapoltee, Panida; Kaewkannetra, Pakawadee

    2014-07-01

    The aim of this study is to optimize the lipid accumulation in microalgae by using two agricultural residues of pineapple peels and sugarcane bagasse as low-cost organic carbon sources. Green microalgae Scenedesmus acutus was isolated and selected for cultivation. Effects of three initial sugar concentrations and the stage for adding sugar during cultivation on biomass and lipid production were investigated. The results clearly showed that two-stage cultivation is more suitable than one-stage. The maximum biomass concentration and productivity were obtained at 3.85 g/L and 160.42 mg/L/day when sugarcane bagasse was used. The highest lipid content and lipid yield was reached at 28.05 % and 0.93 g/L when pineapple peels were used, while in the case of sugarcane bagasse, 40.89 % and 1.24 g/L lipid content and yield were obtained. Lipid content was found in normal condition (autotrophic) at 17.71 % which was approximately 2.13-fold lower than when sugarcane bagasse was used (40.89 %). Biodiesel production via in situ transesterification was also investigated; the main fatty acids of palmitic acid and oleic acid were found. This work indicates that using agricultural residues as organic carbon sources could be able to increase lipid content and reduce the cost of biofuel production.

  4. Hand Hygiene Saves Lives

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  5. Hand Hygiene Saves Lives

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    Full Text Available ... and public health professionals. More > Hand Hygiene Saves Lives (5:10) Recommend on Facebook Tweet Share Compartir Hand Hygiene Saves Lives Hand Hygiene Saves Lives Transcript [28 KB, 2 pages] High resolution [22. ...

  6. Hand Hygiene Saves Lives

    Science.gov (United States)

    ... and public health professionals. More > Hand Hygiene Saves Lives (5:10) Recommend on Facebook Tweet Share Compartir Hand Hygiene Saves Lives Hand Hygiene Saves Lives Transcript [28 KB, 2 pages] High resolution [22. ...

  7. The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

    Science.gov (United States)

    Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

    2017-06-01

    Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

  8. Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

    NARCIS (Netherlands)

    Rozenbaum, M.H.; Mangen, M.J.; Giaquinto, C.; Wilschut, J.C.; Hak, E.; Postma, M.J.; Groot, R. de

    2011-01-01

    BACKGROUND: Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies

  9. Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

    NARCIS (Netherlands)

    Rozenbaum, M.H.; Mangen, M.J.J.; Giaquinto, C.; Wilschut, J.C.; Hak, E.; Postma, M.J.

    2011-01-01

    Background: Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies

  10. Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

    Directory of Open Access Journals (Sweden)

    Hak Eelko

    2011-06-01

    Full Text Available Abstract Background Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies showed inconsistent results for these vaccines because of lack of consensus on the impact. We aimed to investigate which factors had a major impact on cost-effectiveness and were primarily responsible for the large differences in previously estimated cost-effectiveness ratios. Methods Based on updated data on health outcomes and cost estimates, we re-assessed the cost-effectiveness of routine paediatric rotavirus vaccination within the National Immunization Program for the Netherlands. Two consensus meetings were organised with national and international experts in the field to achieve consensus and resolve potential controversies. Results It was estimated that rotavirus vaccination in the Netherlands could avert 34,214 cases of rotavirus gastroenteritis in children aged less than 5 years. Notably, 2,779 hospitalisations were averted of which 315 were extensions of existing hospital stays due to nosocomial rotavirus infection. With a threshold varying from 20K€ - 50K€ per QALY and according to the base-case scenario, the full vaccination costs per child leading to cost-effectiveness was €57.76 -€77.71. Results were sensitive to the inclusion of potential vaccine induced herd protection, QALY losses and number of deaths associated with rotavirus gastroenteritis. Conclusions Our economic analysis indicates that inclusion of rotavirus vaccination in the Dutch National Immunization Program might be cost-effective depending on the cost of the vaccine and the impact of rotavirus gastroenteritis on children's quality of life.

  11. Direct and indirect costs of COPD and its comorbidities: Results from the German COSYCONET study.

    Science.gov (United States)

    Wacker, M E; Jörres, R A; Schulz, H; Heinrich, J; Karrasch, S; Karch, A; Koch, A; Peters, A; Leidl, R; Vogelmeier, C; Holle, R

    2016-02-01

    Reliable up-to-date estimates regarding the economic impact of chronic obstructive pulmonary disease (COPD) are lacking. This study investigates COPD excess healthcare utilization, work absenteeism, and resulting costs within the German COPD cohort COSYCONET. Data from 2139 COPD patients in GOLD grade 1-4 from COSYCONET were compared with 1537 lung-healthy control subjects from the population-based KORA platform. Multiple generalized linear models analyzed the association of COPD grades with healthcare utilization, work absence, and costs from a societal perspective while adjusting for sex, age, education, smoking status, body mass index (BMI), and several comorbidities. COPD was significantly associated with excess healthcare utilization, work absence, and premature retirement. Adjusted annual excess cost of COPD in 2012 for GOLD grade 1-4 amounted to €2595 [1770-3678], €3475 [2966-4102], €5955 [5191-6843], and €8924 [7190-10,853] for direct costs, and €8621 [4104-13,857], €9871 [7692-12,777], €16,550 [13,743-20,457], and €27,658 [22,275-35,777] for indirect costs respectively. Comorbidities contributed to the primary effect of COPD on direct costs only. An additional history of cancer or stroke had the largest effect on direct costs, but the effects were smaller than those of COPD grade 3/4. COPD is associated with substantially higher costs than previously reported. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Can peer support be cost saving? An economic evaluation of RAPSID: a randomized controlled trial of peer support in diabetes compared to usual care alone in East of England communities.

    Science.gov (United States)

    Wingate, La'Marcus; Graffy, Jonathan; Holman, Daniel; Simmons, David

    2017-01-01

    Diabetes peer support, where one person with diabetes helps others, may improve diabetes management. The objective of this study was to perform a cost analysis of peer support strategies used in RAndomized controlled trial of Peer Support in type 2 Diabetes. We performed a 2×2 factorial randomized cluster controlled trial in England. People with type 2 diabetes were invited to participate as either 'peer' or 'peer support facilitator' (PSF) through postal invitation predominantly from general practice. Clusters, based on local communities, were each randomly assigned to one arm of group, 1:1, both group and 1:1 or control interventions. The intervention was delivered over 8-12 months by trained PSFs, supported by monthly meetings with a diabetes nurse. Out-of-pocket expenses/service utilization were self-reported at baseline, midpoint and on trial completion. Intervention costs were collated. Non-hospital costs used National Health Service (NHS) reference costs. Hospital payments were obtained from one local commissioning group and mean payments calculated. The analysis employed a societal perspective. Costs were evaluated at the conclusion of the trial. Participants (n=1299) were recruited across 130 clusters. The four arms were well balanced and matched (60% male, mean diabetes duration 9.5 years, mean glycated haemoglobin (HbA1c) 7.4+/-1.3%, 17% insulin treated). Implementation costs at 2013 rates were £13.84/participant/annum, participant out-of-pocket expenses for any intervention were £11.41/participant/annum and the NHS-incurred costs were reduced by £138.38/participant/annum. Savings for the 1:1, group and any intervention were £233.65, £90.52 and £113.13/participant/annum, respectively. We conclude that both 1:1 and group diabetes peer support over 8-12 months are cost saving in this setting, although much of the benefit is largely derived by differences in self-reported healthcare utilization. Long-term benefits should be investigated. ISRCTN

  13. Hand Hygiene Saves Lives

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    Full Text Available ... target as…", save file in desired location. Firefox/Chrome: Right-click on the link, choose "Save link ... target as…", save file in desired location. Firefox/Chrome: Right-click on the link, choose "Save link ...

  15. [Application of skin adhesives in head and neck surgery: analysis of cosmetic results, applicability and cost-effectiveness of cyanoacrylate-based adhesives].

    Science.gov (United States)

    Graefe, H; Wollenberg, B; Brocks, C

    2008-09-01

    In this work cyanoacrylate-based skin adhesives used in Germany for skin closure in head and neck surgery are compared with respect to ease of application, cost-effectiveness and cosmetic results. We compared 25 wounds sealed with a skin adhesive with 25 suture-sealed wounds. Bonding of surgical wounds with glue had a high level of acceptance in all patients. The tedious, time-consuming and sometimes painful postoperative removal of many sutures in patients is omitted. Patients can shower soon afterwards without additional protection as the adhesive provides a waterproof barrier. Problems of wound healing can immediately be detected through the transparent skin adhesive. Cosmetic long-term results of skin closure by adhesives are comparable to suture-sealed wounds. The adhesives available on the market differ mainly in the form of the applicator, the viscosity on application, as well as the strength after hardening. The application is easy to implement and significantly faster than conventional suturing. Apart from the cost savings of materials compared to the use of skin sutures and investment of Steri-Strips, expensive anesthesia and surgical time can also be saved.

  16. Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries

    National Research Council Canada - National Science Library

    Siapka, Mariana; Remme, Michelle; Obure, Carol Dayo; Maier, Claudia B; Dehne, Karl L; Vassall, Anna

    2014-01-01

    To synthesize the data available--on costs, efficiency and economies of scale and scope--for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale...

  17. The Sequential Self-Selection Auction Mechanism for Selective Reenlistment Bonuses: Potential Cost Savings to the U.S. Marine Corps

    National Research Council Canada - National Science Library

    Bock, Paul B

    2007-01-01

    ...). The S3AM greatly reduces the payment of economic rent. The payment of economic rent is limited because the Marine Corps would only pay Marines a monetary sum that more closely corresponds to their active duty opportunity cost...

  18. Technical Support Document: 50% Energy Savings for Small Office Buildings

    Energy Technology Data Exchange (ETDEWEB)

    Thornton, Brian A.; Wang, Weimin; Huang, Yunzhi; Lane, Michael D.; Liu, Bing

    2010-04-30

    The Technical Support Document (TSD) for 50% energy savings in small office buildings documents the analysis and results for a recommended package of energy efficiency measures (EEMs) referred to as the advanced EEMs. These are changes to a building design that will reduce energy usage. The package of advanced EEMs achieves a minimum of 50% energy savings and a construction area weighted average energy savings of 56.6% over the ANSI/ASHRAE/IESNA Standard 90.1-2004 for 16 cities which represent the full range of climate zones in the United States. The 50% goal is for site energy usage reduction. The weighted average is based on data on the building area of construction in the various climate locations. Cost-effectiveness of the EEMs is determined showing an average simple payback of 6.7 years for all 16 climate locations. An alternative set of results is provided which includes a variable air volume HVAC system that achieves at least 50% energy savings in 7 of the 16 climate zones with a construction area weighted average savings of 48.5%. Other packages of EEMs may also achieve 50% energy savings; this report does not consider all alternatives but rather presents at least one way to reach the goal. Design teams using this TSD should follow an integrated design approach and utilize additional analysis to evaluate the specific conditions of a project.

  19. Is there scope for cost savings and efficiency gains in HIV services? A systematic review of the evidence from low- and middle-income countries.

    Science.gov (United States)

    Siapka, Mariana; Remme, Michelle; Obure, Carol Dayo; Maier, Claudia B; Dehne, Karl L; Vassall, Anna

    2014-07-01

    To synthesize the data available--on costs, efficiency and economies of scale and scope--for the six basic programmes of the UNAIDS Strategic Investment Framework, to inform those planning the scale-up of human immunodeficiency virus (HIV) services in low- and middle-income countries. The relevant peer-reviewed and "grey" literature from low- and middle-income countries was systematically reviewed. Search and analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Of the 82 empirical costing and efficiency studies identified, nine provided data on economies of scale. Scale explained much of the variation in the costs of several HIV services, particularly those of targeted HIV prevention for key populations and HIV testing and treatment. There is some evidence of economies of scope from integrating HIV counselling and testing services with several other services. Cost efficiency may also be improved by reducing input prices, task shifting and improving client adherence. HIV programmes need to optimize the scale of service provision to achieve efficiency. Interventions that may enhance the potential for economies of scale include intensifying demand-creation activities, reducing the costs for service users, expanding existing programmes rather than creating new structures, and reducing attrition of existing service users. Models for integrated service delivery--which is, potentially, more efficient than the implementation of stand-alone services--should be investigated further. Further experimental evidence is required to understand how to best achieve efficiency gains in HIV programmes and assess the cost-effectiveness of each service-delivery model.

  20. Social Capital and Savings Behaviour

    DEFF Research Database (Denmark)

    Newman, Carol; Tarp, Finn; Van Den Broeck, Katleen

    We explore the extent to which social capital can play a role in imparting information about the returns to saving where potential knowledge gaps and mistrust exists. Using data from Vietnam we find strong evidence to support the hypothesis that information transmitted via reputable social...... organizations increases the proportion of liquid assets held in the form of deposits that yield a return. Our results imply that targeting information on the benefits of deposit saving through formal networks or groups would be effective in increasing the number of households that save at grassroots level....

  1. Advanced fuel cycle cost estimation model and its cost estimation results for three nuclear fuel cycles using a dynamic model in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sungki, E-mail: sgkim1@kaeri.re.kr [Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Ko, Wonil [Korea Atomic Energy Research Institute, 1045 Daedeokdaero, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Youn, Saerom; Gao, Ruxing [University of Science and Technology, 217 Gajungro, Yuseong-gu, Daejeon 305-350 (Korea, Republic of); Bang, Sungsig, E-mail: ssbang@kaist.ac.kr [Korea Advanced Institute of Science and Technology, Department of Business and Technology Management, 291 Deahak-ro, Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2015-11-15

    Highlights: • The nuclear fuel cycle cost using a new cost estimation model was analyzed. • The material flows of three nuclear fuel cycle options were calculated. • The generation cost of once-through was estimated to be 66.88 mills/kW h. • The generation cost of pyro-SFR recycling was estimated to be 78.06 mills/kW h. • The reactor cost was identified as the main cost driver of pyro-SFR recycling. - Abstract: The present study analyzes advanced nuclear fuel cycle cost estimation models such as the different discount rate model and its cost estimation results. To do so, an analysis of the nuclear fuel cycle cost of three options (direct disposal (once through), PWR–MOX (Mixed OXide fuel), and Pyro-SFR (Sodium-cooled Fast Reactor)) from the viewpoint of economic sense, focusing on the cost estimation model, was conducted using a dynamic model. From an analysis of the fuel cycle cost estimation results, it was found that some cost gap exists between the traditional same discount rate model and the advanced different discount rate model. However, this gap does not change the priority of the nuclear fuel cycle option from the viewpoint of economics. In addition, the fuel cycle costs of OT (Once-Through) and Pyro-SFR recycling based on the most likely value using a probabilistic cost estimation except for reactor costs were calculated to be 8.75 mills/kW h and 8.30 mills/kW h, respectively. Namely, the Pyro-SFR recycling option was more economical than the direct disposal option. However, if the reactor cost is considered, the economic sense in the generation cost between the two options (direct disposal vs. Pyro-SFR recycling) can be changed because of the high reactor cost of an SFR.

  2. Environmental costs resulting from the use of hard coal to electricity generation in Poland

    Science.gov (United States)

    Stala-Szlugaj, Katarzyna; Grudziński, Zbigniew

    2017-10-01

    In the world's fuel mix used for generating electricity, the most common fossil fuel is coal. In the EU, coal combustion and electricity generation entail the need to purchase emission allowances (EUA) whose purchase costs affect the costs of electricity generation significantly. The research described in the article shows how current market conditions shape the profitability of generating electricity from coal and how Clean Dark Spread (CDS) changes as a function of changes in energy and coal prices at the assumed levels of emission and prices of EUA allowances. The article compares the results of CDS calculations in two variants. Areas have been highlighted where prices of both coal and EUA allowances cause CDS to assume values at which the prices of generated electricity do not cover the costs of fuel (i) and CO2 emission allowances, cover all costs (ii), or constitute positive prices (iii), but still do not cover all fixed costs. With higher power plant efficiency, CO2 emissions are lower (0.722 t/MWh). The costs of purchasing fuel required to generate 1 MWh of electricity are also lower. In such case—even with relatively high prices of coal—a power plant can achieve profitability of electricity generation.

  3. Irbesartan is projected to be cost and life saving in a Spanish setting for treatment of patients with type 2 diabetes, hypertension, and microalbuminuria

    NARCIS (Netherlands)

    Palmer, AJ; Annemans, L; Roze, S; Lapuerta, P; Chen, R; Gabriel, S; Carita, P; Rodby, RA; de Zeeuw, D; Parving, HH; De Alvaro, F

    Objectives. The purpose of this study was to project the cumulative incidence of end-stage renal disease (ESRD), life expectancy, and costs in a Spanish setting of treating patients with diabetes, hypertension, and microalbuminuria with either standard hypertension treatment alone or standard

  4. Cost evaluation of gadoxetic acid-enhanced magnetic resonance imaging in the diagnosis of colorectal-cancer metastasis in the liver: Results from the VALUE Trial

    Energy Technology Data Exchange (ETDEWEB)

    Zech, Christoph J. [University Hospital Basel, Clinic of Radiology und Nuclear Medicine, Basel (Switzerland); Justo, Nahila; Lang, Andrea [OptumInsight, Life Sciences, Stockholm (Sweden); Ba-Ssalamah, Ahmed [Medical University of Vienna, Department of Radiology, General Hospital of Vienna (AKH), Vienna (Austria); Kim, Myeong-Jin [Yonsei University, Severance Hospital, Seoul (Korea, Republic of); Rinde, Harald [BioBridge Strategies, Binningen (Switzerland); Jonas, Eduard [Karolinska University Hospital, Department of Upper Abdominal Surgery, Stockholm (Sweden)

    2016-11-15

    To assess the costs of diagnostic workup and surgery of three strategies for patients with colorectal cancer liver-metastases (CRCLM): gadoxetic-acid-enhanced MRI (Gd-EOB-DTPA-MRI), MRI with extracellular contrast-media (ECCM-MRI) or contrast-enhanced MDCT (CE-MDCT). The within-trial cost evaluation was modelled as a decision-tree to calculate the cost of diagnosis and surgery. The model used clinical outcomes and resource utilization data from a prospective randomized multicentre study. Analyses were performed for the 354-patient safety population from eight participating countries. The diagnostic workup cost using Gd-EOB-DTPA-MRI upfront resulted in savings compared to ECCM-MRI in all countries except Thailand (difference <2 %). Compared to CE-MDCT, initial imaging with Gd-EOB-DTPA-MRI was less costly in all countries except Korea and Spain (differences 4 and 8 %, respectively). Significantly more patients in the Gd-EOB-DTPA-MRI group were eligible for surgery (39.3 % (48/122) vs. 31.0 % (36/116) and 26.7 % (31/116) for ECCM-MRI and CE-MDCT, respectively), allowing more patients to undergo potentially curative surgery, but resulting in higher treatment costs for the strategy starting with Gd-EOB-DTPA-MRI. The benefits of Gd-EOB-DTPA-MRI due to less additional imaging and similar diagnostic workup costs in the three groups suggest that Gd-EOB-DTPA-MRI should be the preferred initial imaging procedure to evaluate hepatic resectability in patients with CRCLM. (orig.)

  5. 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.

  6. [Percutaneous closure of patent ductus arteriosus: results and costs compared to surgical closure].

    Science.gov (United States)

    Vieu, T; Beaurain, S; Angel, C; Leriche, H; Petit, J; Conso, J F; Planché, C; Losay, J

    1995-10-01

    The comparison of the clinical results and costs of the two methods of closure of patient ductus arteriosus was undertaken in two comparable groups of 40 patients treated in the same period in the same hospital. After transcatheter closure there was a 9% residual shunt rate at 3 years, the 2 patients with a residual continuous murmur being operated secondarily. The only complication was severe haemolysis which regressed after transcatheter ablation of the prosthesis. After surgical closure, there were no residual shunt. Some postoperative complications were observed in 20% of cases, usually benign (ventilatory problems, dysphonia or urinary infection), but occasionally more serious (peroperative lesion of the pulmonary artery). Morbidity, inherent to the technique of closure, was very different and much less in catheter closure. The average cost (daily cost x average length of hospital stay) was much less with transcatheter closure 38,558 francs versus 11,240 francs. On the other hand, the direct cost of transcatheter closure was greater than that of surgery: 32,798 francs versus 20,903 francs, the difference being related to the actual price of the prosthesis. The authors conclude that the 3 year results of transcatheter closure of patent ductus arterious make this technique a reasonable therapeutic alternative to surgery. From the safety point of view, the two techniques are comparable bu patient confort is greater with transcatheter closure for an increase in cost of the initial procedure which should decrease in relation to the types and prices of the prosthesis used.

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

    Science.gov (United States)

    Tunis, Sandra L

    2009-01-01

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

  8. Cost management and potential savings in composting. 56th information discussion, Magdeburg, November 1997; Kostenmanagement und Einsparpotentiale bei der Kompostierung. 56. Informationsgespraech in Magdeburg im November 1997

    Energy Technology Data Exchange (ETDEWEB)

    Hangen, H.O. [comp.

    1997-12-31

    This workshop focussed on economic aspects of composting and danaerobic digestion of biological waste. Cost optimisation, methods, and ecological aspects are discussed for several facilities in the Federal Republic of Germany. (SR) [Deutsch] Thema dieses Workshops waren Wirtschaftlichkeitsbetrachtungen auf dem Sektor der Kompostierung und Vergaerung von Bioabfall. Hierbei werden die Kostenoptimierung, verschiedene Verfahren und oekologische Gesichtpunkte am Beispiel verschiedener Anlagen in der Bundesrepublik Deutschland betrachtet. (SR)

  9. ARC Code TI: Save

    Data.gov (United States)

    National Aeronautics and Space Administration — Save is a framework for implementing highly available network-accessible services. Save consists of a command-line utility and a small set of extensions for the...

  10. Comparative cost analysis of inpatient integrative medicine-Results of a pilot study.

    Science.gov (United States)

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

    2017-06-01

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

  11. Cost-effectiveness of N-terminal pro-B-type natriuretic-guided therapy in elderly heart failure patients: results from TIME-CHF (Trial of Intensified versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure).

    Science.gov (United States)

    Sanders-van Wijk, Sandra; van Asselt, Antoinette D I; Rickli, Hans; Estlinbaum, Werner; Erne, Paul; Rickenbacher, Peter; Vuillomenet, Andre; Peter, Martin; Pfisterer, Matthias E; Brunner-La Rocca, Hans-Peter

    2013-02-01

    This study aimed to assess cost-effectiveness of N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided versus symptom-guided therapy in heart failure (HF) patients ≥60 years old. Cost-effectiveness of NT-proBNP guidance in HF patients is unclear. It may create additional costs with uncertain benefits. In the TIME-CHF (Trial of Intensified versus Standard Medical Therapy in Elderly Patients with Congestive Heart Failure), patients with left ventricular ejection fraction (LVEF) of ≤45% were randomized to receive intensified NT-proBNP-guided therapy or standard, symptom-guided therapy. For cost-effectiveness analysis, 467 (94%) patients (age 76 ± 7 years, 66% male) were eligible. Incremental cost-effectiveness was calculated as incremental costs per gained life-year and quality-adjusted life-year (QALY) within the 18-month trial period, as defined per protocol. NT-proBNP-guided therapy was dominant (i.e., more effective and less costly) over symptom-guided therapy, saving $2,979 USD (2.5 to 97.5% confidence interval [CI]: $8,758 to $3,265) per patient, with incremental effectiveness of +0.07 life-years and +0.05 QALYs. The probability of NT-proBNP-guided therapy being dominant was 80%, and the probability of saving 1 life-year or QALY at a cost of $50,000 was 97% and 93%, respectively. Exclusion of residence costs resulted in an incremental cost-effectiveness ratio (ICER) of $5,870 per life-year gained. Cost-effectiveness of NT-proBNP-guided therapy was most pronounced in patients CHF]; ISRCTN43596477). Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Fatalism and Savings

    OpenAIRE

    Stephen, Wu; Joel, Shapiro

    2010-01-01

    We examine the impact of fatalism, the belief that one has little or no control over future events, on the decision of whether or not to save. We develop a model that predicts that fatalism decreases savings for moderately risk averse individuals, increases savings for highly risk averse individuals, and otherwise has no impact. Furthermore, fatalism decreases effort in learning about savings and investment options. We use data from National Longitudinal Survey of Youth (NLSY) and find genera...

  13. The indirect costs of arthritis resulting from unemployment, reduced performance, and occupational changes while at work.

    Science.gov (United States)

    Li, Xin; Gignac, Monique A M; Anis, Aslam H

    2006-04-01

    The objective of this study was to assess the cost attributable to lost productivity from arthritis and the association between the degree of loss and demographic, disease-related, occupational, and psychosocial variables for people. In a prospective study, 383 employed individuals with arthritis were recruited from southwestern Ontario, Canada. Respondents completed structured questionnaires assessing demographic, disease-related, workplace, and psychosocial variables as well as employment-related transitions at 2 time points 18 months apart. Indirect costs resulting from arthritis-related absences, reduced performance, decreased work hours, job change, and work disability were estimated. A proportional odds model was used to assess the impact of the various variables on lost productivity. The average cost attributable to arthritis was CAN Dollars 11,553(Dollars CAN = 0.75 Dollars US) per person per year. The largest component of the loss was the result of reduced performance at work, which accounted for 41% (Dollars 4724) of the total loss. This was followed by wage loss resulting from stopping working or changing jobs, which comprised 37% (Dollars 4309) of the total. Another 12% (Dollars 1398) and 10% (Dollars 1121) of the loss were the result of the decrease in hours of work and absenteeism, respectively. Four variables were associated with the productivity loss: greater symptom severity (odds ratio [OR] = 1.11), low or medium control over the work schedule (OR = 0.55 and 0.60, respectively), greater workspace limitation (OR = 1.10), and higher depression (OR = 1.04). Indirect arthritis-related costs are substantial. Our results show that not only the disease itself, but also psychosocial and work-related factors affect the magnitude of the costs.

  14. Energy savings in Polish buildings

    Energy Technology Data Exchange (ETDEWEB)

    Markel, L.C.; Gula, A.; Reeves, G.

    1995-12-31

    A demonstration of low-cost insulation and weatherization techniques was a part of phase 1 of the Krakow Clean Fossil Fuels and Energy Efficient Project. The objectives were to identify a cost-effective set of measures to reduce energy used for space heating, determine how much energy could be saved, and foster widespread implementation of those measures. The demonstration project focused on 4 11-story buildings in a Krakow housing cooperative. Energy savings of over 20% were obtained. Most important, the procedures and materials implemented in the demonstration project have been adapted to Polish conditions and applied to other housing cooperatives, schools, and hospitals. Additional projects are being planned, in Krakow and other cities, under the direction of FEWE-Krakow, the Polish Energie Cities Network, and Biuro Rozwoju Krakowa.

  15. Do Health Reforms Impact Cost Consciousness of Health Care Professionals? Results from a Nation-Wide Survey in the Balkans.

    Science.gov (United States)

    Jakovljevic, Mihajlo; Vukovic, Mira; Chen, Chia-Ching; Antunovic, Mirjana; Dragojevic-Simic, Viktorija; Velickovic-Radovanovic, Radmila; Djendji, Mladenovic Siladji; Jankovic, Nikola; Rankovic, Ana; Kovacevic, Aleksandra; Antunovic, Marko; Milovanovic, Olivera; Markovic, Veroljub; Dasari, Babu N S; Yamada, Tetsuji

    2016-01-01

    Serbia, as the largest market of the Western Balkans, has entered socioeconomic transition with substantial delay compared to most of Eastern Europe. Its health system reform efforts were bold during the past 15 years, but their results were inconsistent in various areas. The two waves of global recession that hit Balkan economies ultimately reflected to the financial situation of healthcare. Serious difficulties in providing accessible medical care to the citizens became a reality. A large part of the unbearable expenses actually belongs to the overt prescription of pharmaceuticals and various laboratory and imaging diagnostic procedures requested by physicians. Therefore, a broad national survey was conducted at all levels of the healthcare system hierarchy to distinguish the ability of cost containment strategies to reshape clinician's mindsets and decision-making in practice. Assessment of healthcare professionals' judgment on economic consequences of prescribed medical interventions and evaluation of responsiveness of healthcare professionals to policy measures targeted at increasing cost-consciousness. Cross-sectional study. A nationwide cross-sectional survey was conducted through a hierarchy of medical facilities across diverse geographical regions before and after policy action, from January 2010 to April 2013. In the middle of the observed period, the National Health Insurance Fund (RFZO) adopted severe cost-containment measures. Independently, pharmacoeconomic guidelines targeted at prescribers were disseminated. Administration in large hospitals and community pharmacies was forced to restrict access to high budget-impact medical care. Economic Awareness of Healthcare Professionals Questionnaire-29 (EAHPQ-29), developed in Serbian language, was used in face-to-face interviews. The questionnaire documented clinician's attitudes on: Clinical-Decision-Making-between-Alternative-Interventions (CDMAI), Quality-of-Health-Care (QHC), and Cost

  16. Cost-effectiveness of a national exercise referral programme for primary care patients in Wales: results of a randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background A recent HTA review concluded that there was a need for RCTs of exercise referral schemes (ERS) for people with a medical diagnosis who might benefit from exercise. Overall, there is still uncertainty as to the cost-effectiveness of ERS. Evaluation of public health interventions places challenges on conventional health economics approaches. This economic evaluation of a national public health intervention addresses this issue of where ERS may be most cost effective through subgroup analysis, particularly important at a time of financial constraint. Method This economic analysis included 798 individuals aged 16 and over (55% of the randomised controlled trial (RCT) sample) with coronary heart disease risk factors and/or mild to moderate anxiety, depression or stress. Individuals were referred by health professionals in a primary care setting to a 16 week national exercise referral scheme (NERS) delivered by qualified exercise professionals in local leisure centres in Wales, UK. Health-related quality of life, health care services use, costs per participant in NERS, and willingness to pay for NERS were measured at 6 and 12 months. Results The base case analysis assumed a participation cost of £385 per person per year, with a mean difference in QALYs between the two groups of 0.027. The incremental cost-effectiveness ratio was £12,111 per QALY gained. Probabilistic sensitivity analysis demonstrated an 89% probability of NERS being cost-effective at a payer threshold of £30,000 per QALY. When participant payments of £1 and £2 per session were considered, the cost per QALY fell from £12,111 (base case) to £10,926 and £9,741, respectively. Participants with a mental health risk factor alone or in combination with a risk of chronic heart disease generated a lower ICER (£10,276) compared to participants at risk of chronic heart disease only (£13,060). Conclusions Results of cost-effectiveness analyses suggest that NERS is cost saving in fully

  17. 10 CFR 436.21 - Savings-to-investment ratio.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Savings-to-investment ratio. 436.21 Section 436.21 Energy... Procedures for Life Cycle Cost Analyses § 436.21 Savings-to-investment ratio. The savings-to-investment ratio... conservation measure. The denominator of the ratio is the present value of the net increase in investment and...

  18. Shared Savings Financing for College and University Energy Efficiency Investments.

    Science.gov (United States)

    Business Officer, 1984

    1984-01-01

    Shared savings arrangements for campus energy efficient investments are discussed. Shared savings is a term for an agreement in which a private company offers to implement an energy efficiency program, including capital improvements, in exchange for a portion of the energy cost savings. Attention is directed to: types of shared savings…

  19. Direct costs in impaired glucose regulation: results from the population-based Heinz Nixdorf Recall study

    Science.gov (United States)

    Bächle, C; Claessen, H; Andrich, S; Brüne, M; Dintsios, C M; Slomiany, U; Roggenbuck, U; Jöckel, K H; Moebus, S; Icks, A

    2016-01-01

    Objective For the first time, this population-based study sought to analyze healthcare utilization and associated costs in people with normal fasting glycemia (NFG), impaired fasting glycemia (IFG), as well as previously undetected diabetes and previously diagnosed diabetes linking data from the prospective German Heinz Nixdorf Recall (HNR) study with individual claims data from German statutory health insurances. Research design and methods A total of 1709 participants of the HNR 5-year follow-up (mean age (SD) 64.9 (7.5) years, 44.5% men) were included in the study. Age-standardized and sex-standardized healthcare utilization and associated costs (reported as € for the year 2008, perspective of the statutory health insurance) were stratified by diabetes stage defined by the participants' self-report and fasting plasma glucose values. Cost ratios (CRs) were estimated using two-part regression models, adjusting for age, sex, sociodemographic variables and comorbidity. Results The mean total direct healthcare costs for previously diagnosed diabetes, previously undetected diabetes, IFG, and NFG were €2761 (95% CI 2378 to 3268), €2210 (1483 to 4279), €2035 (1732 to 2486) and €1810 (1634 to 2035), respectively. Corresponding age-adjusted and sex-adjusted CRs were 1.53 (1.30 to 1.80), 1.16 (0.91 to 1.47), and 1.09 (0.95 to 1.25) (reference: NFG). Inpatient, outpatient and medication costs varied in order between people with IFG and those with previously undetected diabetes. Conclusions The study provides claims-based detailed cost data in well-defined glucose metabolism subgroups. CRs of individuals with IFG and previously undetected diabetes were surprisingly low. Data are important for the model-based evaluation of screening programs and interventions that are aimed either to prevent diabetes onset or to improve diabetes therapy as well. PMID:27252871

  20. Estimating the lifetime cost of childhood obesity in Germany: Results of a Markov Model.

    Science.gov (United States)

    Sonntag, D; Ali, S; Lehnert, T; Konnopka, A; Riedel-Heller, S; König, H-H

    2015-12-01

    Child obesity is a growing public health concern. Excess weight in childhood is known to be associated with a high risk of obesity and obesity-related comorbidities in adulthood. This study quantifies lifetime excess costs of overweight and obese adults in Germany taking the history of obesity in childhood into account. A two-stage Markov cohort state transition model was developed. At stage 1, the distribution of body mass index (BMI) categories was tracked from childhood (ages 3-17) to adulthood (age 17 and up). Based on these results, it was distinguished whether adults had been normal in weight or overweight/obese as child. At stage 2, age-specific and lifetime costs from age 18 onwards were simulated in two further Markov cohort models, one for each of the two BMI groups. Model parameter values were obtained from the German Interview and Examination Survey for Children and Adolescents (KiGGS), the German Microcensus 2009 and published literature. When compared with normal weight adults, lifetime excess costs are higher among adults who had been overweight or obese at any point during childhood. For 18-year-old women (men), who have been overweight/obese during their childhood (ages 3-17), undiscounted lifetime excess costs are estimated at €19,479 (€14,524), with 60% (67%) occurring beyond age 60. Discounted (3%) lifetime excess costs are considerably lower, amounting to €4262 for men and €7028 for women. Because childhood obesity determines healthcare costs occurring in adulthood, interventions preventing the persistence of child obesity and obesity-related comorbidities during adulthood could have a substantial impact on reducing the burden of the obesity epidemic. © 2015 World Obesity.

  1. On savings ratio.

    OpenAIRE

    Xiaochuan, Z.

    2011-01-01

    This paper explores the factors that affect saving and consumption behaviours, in a context where some believe that the high savings ratio of the East Asia and oil-producing countries is one major cause for the global imbalances and the crisis. The paper elaborates on the factors behind the high savings ratios in East Asia and oil producing countries and low savings ratios in the United States. It argues that the high savings in East Asia can mainly be explained by cultural and structural fac...

  2. Cost effectiveness of recycling: A systems model

    Energy Technology Data Exchange (ETDEWEB)

    Tonjes, David J., E-mail: david.tonjes@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States); Waste Reduction and Management Institute, School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794-5000 (United States); Center for Bioenergy Research and Development, Advanced Energy Research and Technology Center, Stony Brook University, 1000 Innovation Rd., Stony Brook, NY 11794-6044 (United States); Mallikarjun, Sreekanth, E-mail: sreekanth.mallikarjun@stonybrook.edu [Department of Technology and Society, College of Engineering and Applied Sciences, Stony Brook University, Stony Brook, NY 11794-3560 (United States)

    2013-11-15

    Highlights: • Curbside collection of recyclables reduces overall system costs over a range of conditions. • When avoided costs for recyclables are large, even high collection costs are supported. • When avoided costs for recyclables are not great, there are reduced opportunities for savings. • For common waste compositions, maximizing curbside recyclables collection always saves money. - Abstract: Financial analytical models of waste management systems have often found that recycling costs exceed direct benefits, and in order to economically justify recycling activities, externalities such as household expenses or environmental impacts must be invoked. Certain more empirically based studies have also found that recycling is more expensive than disposal. Other work, both through models and surveys, have found differently. Here we present an empirical systems model, largely drawn from a suburban Long Island municipality. The model accounts for changes in distribution of effort as recycling tonnages displace disposal tonnages, and the seven different cases examined all show that curbside collection programs that manage up to between 31% and 37% of the waste stream should result in overall system savings. These savings accrue partially because of assumed cost differences in tip fees for recyclables and disposed wastes, and also because recycling can result in a more efficient, cost-effective collection program. These results imply that increases in recycling are justifiable due to cost-savings alone, not on more difficult to measure factors that may not impact program budgets.

  3. Evaluation of Savings in Energy-Efficient Public Housing in the Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, A. [Washington State Univ. Extension Energy Office, Cocoa, FL (United States); Lubliner, M. [Washington State Univ. Extension Energy Office, Cocoa, FL (United States); Howard, L. [Washington State Univ. Extension Energy Office, Cocoa, FL (United States); Kunkle, R. [Washington State Univ. Extension Energy Office, Cocoa, FL (United States); Martin, E. [Washington State Univ. Extension Energy Office, Cocoa, FL (United States)

    2013-10-01

    This report presents the results of an energy performance and cost-effectiveness analysis. The Salishan phase 7 and demonstration homes were compared to Salishan phase 6 homes built to 2006 Washington State Energy Code specifications 2. Predicted annual energy savings (over Salishan phase 6) was 19% for Salishan phase 7, and between 19-24% for the demonstration homes (depending on ventilationstrategy). Approximately two-thirds of the savings are attributable to the DHP. Working with the electric utility provider, Tacoma Public Utilities, researchers conducted a billing analysis for Salishan phase 7. Median energy use for the development is 11,000 kWh; annual energy costs are $780, with a fair amount of variation dependent on size of home. Preliminary analysis of savings betweenSalishan 7 and previous phases (4 through 6) suggest savings of between 20 and 30 percent. A more comprehensive comparison between Salishan 7 and previous phases will take place in year two of this project.

  4. Evaluation of Savings in Energy-Efficient Public Housing in the Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-10-01

    This report presents the results of an energy performance and cost-effectiveness analysis. The Salishan phase 7 and demonstration homes were compared to Salishan phase 6 homes built to 2006 Washington State Energy Code specifications 2. Predicted annual energy savings (over Salishan phase 6) was 19% for Salishan phase 7, and between 19-24% for the demonstration homes (depending on ventilation strategy). Approximately two-thirds of the savings are attributable to the DHP. Working with the electric utility provider, Tacoma Public Utilities, researchers conducted a billing analysis for Salishan phase 7. Median energy use for the development is 11,000 kWh; annual energy costs are $780, with a fair amount of variation dependent on size of home. Preliminary analysis of savings between Salishan 7 and previous phases (4 through 6) suggest savings of between 20 and 30 percent. A more comprehensive comparison between Salishan 7 and previous phases will take place in year two of this project.

  5. Do hospital mergers reduce costs?

    Science.gov (United States)

    Schmitt, Matt

    2017-03-01

    Proponents of hospital consolidation claim that mergers lead to significant cost savings, but there is little systematic evidence backing these claims. For a large sample of hospital mergers between 2000 and 2010, I estimate difference-in-differences models that compare cost trends at acquired hospitals to cost trends at hospitals whose ownership did not change. I find evidence of economically and statistically significant cost reductions at acquired hospitals. On average, acquired hospitals realize cost savings between 4 and 7 percent in the years following the acquisition. These results are robust to a variety of different control strategies, and do not appear to be easily explained by post-merger changes in service and/or patient mix. I then explore several extensions of the results to examine (a) whether the acquiring hospital/system realizes cost savings post-merger and (b) if cost savings depend on the size of the acquirer and/or the geographic overlap of the merging hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Supplementary insurance as a switching cost for basic health insurance: Empirical results from the Netherlands.

    Science.gov (United States)

    Willemse-Duijmelinck, Daniëlle M I D; van de Ven, Wynand P M M; Mosca, Ilaria

    2017-10-01

    Nearly everyone with a supplementary insurance (SI) in the Netherlands takes out the voluntary SI and the mandatory basic insurance (BI) from the same health insurer. Previous studies show that many high-risks perceive SI as a switching cost for BI. Because consumers' current insurer provides them with a guaranteed renewability, SI is a switching cost if insurers apply selective underwriting to new applicants. Several changes in the Dutch health insurance market increased insurers' incentives to counteract adverse selection for SI. Tools to do so are not only selective underwriting, but also risk rating and product differentiation. If all insurers use the latter tools without selective underwriting, SI is not a switching cost for BI. We investigated to what extent insurers used these tools in the periods 2006-2009 and 2014-2015. Only a few insurers applied selective underwriting: in 2015, 86% of insurers used open enrolment for all their SI products, and the other 14% did use open enrolment for their most common SI products. As measured by our indicators, the proportion of insurers applying risk rating or product differentiation did not increase in the periods considered. Due to the fear of reputation loss insurers may have used 'less visible' tools to counteract adverse selection that are indirect forms of risk rating and product differentiation and do not result in switching costs. So, although many high-risks perceive SI as a switching cost, most insurers apply open enrolment for SI. By providing information to high-risks about their switching opportunities, the government could increase consumer choice and thereby insurers' incentives to invest in high-quality care for high-risks. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Comparison of Software Models for Energy Savings from Cool Roofs

    Energy Technology Data Exchange (ETDEWEB)

    New, Joshua Ryan [ORNL; Miller, William A [ORNL; Huang, Yu (Joe) [White Box Technologies; Levinson, Ronnen [Lawrence Berkeley National Laboratory (LBNL)

    2014-01-01

    A web-based Roof Savings Calculator (RSC) has been deployed for the United States Department of Energy as an industry-consensus tool to help building owners, manufacturers, distributors, contractors and researchers easily run complex roof and attic simulations. This tool employs modern web technologies, usability design, and national average defaults as an interface to annual simulations of hour-by-hour, whole-building performance using the world-class simulation tools DOE-2.1E and AtticSim in order to provide estimated annual energy and cost savings. In addition to cool reflective roofs, RSC simulates multiple roof and attic configurations including different roof slopes, above sheathing ventilation, radiant barriers, low-emittance roof surfaces, duct location, duct leakage rates, multiple substrate types, and insulation levels. A base case and energy-efficient alternative can be compared side-by-side to estimate monthly energy. RSC was benchmarked against field data from demonstration homes in Ft. Irwin, California; while cooling savings were similar, heating penalty varied significantly across different simulation engines. RSC results reduce cool roofing cost-effectiveness thus mitigating expected economic incentives for this countermeasure to the urban heat island effect. This paper consolidates comparison of RSC s projected energy savings to other simulation engines including DOE-2.1E, AtticSim, Micropas, and EnergyPlus, and presents preliminary analyses. RSC s algorithms for capturing radiant heat transfer and duct interaction in the attic assembly are considered major contributing factors to increased cooling savings and heating penalties. Comparison to previous simulation-based studies, analysis on the force multiplier of RSC cooling savings and heating penalties, the role of radiative heat exchange in an attic assembly, and changes made for increased accuracy of the duct model are included.

  8. Cost-effectiveness of percutaneous coronary intervention with cobalt-chromium everolimus eluting stents versus bare metal stents: Results from a patient level meta-analysis of randomized trials.

    Science.gov (United States)

    Ferko, Nicole; Ferrante, Giuseppe; Hasegawa, James T; Schikorr, Tanya; Soleas, Ireena M; Hernandez, John B; Sabaté, Manel; Kaiser, Christoph; Brugaletta, Salvatore; de la Torre Hernandez, Jose Maria; Galatius, Soeren; Cequier, Angel; Eberli, Franz; de Belder, Adam; Serruys, Patrick W; Valgimigli, Marco

    2017-05-01

    Second-generation drug eluting stents (DES) may reduce costs and improve clinical outcomes compared to first-generation DES with improved cost-effectiveness when compared to bare metal stents (BMS). We aimed to conduct an economic evaluation of a cobalt-chromium everolimus eluting stent (Co-Cr EES) compared with BMS in percutaneous coronary intervention (PCI). To conduct a cost-effectiveness analysis (CEA) of a cobalt-chromium everolimus eluting stent (Co-Cr EES) versus BMS in PCI. A Markov state transition model with a 2-year time horizon was applied from a US Medicare setting with patients undergoing PCI with Co-Cr EES or BMS. Baseline characteristics, treatment effects, and safety measures were taken from a patient level meta-analysis of 5 RCTs (n = 4,896). The base-case analysis evaluated stent-related outcomes; a secondary analysis considered the broader set of outcomes reported in the meta-analysis. The base-case and secondary analyses reported an additional 0.018 and 0.013 quality-adjusted life years (QALYs) and cost savings of $236 and $288, respectively with Co-Cr EES versus BMS. Results were robust to sensitivity analyses and were most sensitive to the price of clopidogrel. In the probabilistic sensitivity analysis, Co-Cr EES was associated with a greater than 99% chance of being cost saving or cost effective (at a cost per QALY threshold of $50,000) versus BMS. Using data from a recent patient level meta-analysis and contemporary cost data, this analysis found that PCI with Co-Cr EES is more effective and less costly than PCI with BMS. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

  9. Methods for evaluation of medical care other than credentialing. Cost, experience, and results.

    Science.gov (United States)

    Ebert, P A

    1990-08-01

    Unfortunately, the majority of studies proposed to evaluate a physician's capabilities, such as effectiveness programs, outcome research, and hospital evaluation, do not focus directly on the individual practitioner. The certifying process, although imperfect, still offers the best method of evaluation. The other evaluation methods will need additional refinement to be able to individually analyze a specific physician's performance and determine whether he or she is truly providing the highest quality care. Physicians are being asked to document the effectiveness of their clinical decision making. On the surface this seems so simple, and in some areas where the outcome is either life or death or a specific yes or no type of answer, many have the capability to come forth with some realistic documentation. However, today's society is focused on health and the perfect outcome, and many nonlife-threatening therapies are evaluated by a patient's unrealistic expectation. Thus, the same result may be interpreted differently in one geographic area or by patients with different expectations. The biggest mistake would be to believe that outcome studies can be used to reduce cost. There may be some initial reduction or delays in treatment that suggest an immediate reduction of cost, the so-called sentinel effect, but no information or evidence indicates that these effects can be expanded without actually reducing needed health care services. In fact, the delays or obstruction to entering the health-care system experienced by many individuals often lead to more costly and less effective care with suboptimal results.

  10. Low-cost EOD robot using off-the-shelf parts: revisions and performance testing results

    Science.gov (United States)

    Czop, Andrew; Hacker, Kurt; Murphy, James; Zimmerman, Todd

    2006-05-01

    With the large number of Improvised Explosive Devices (IEDs) and Unexploded Ordnance (UXO) being encountered during recent military operations, there exists a need for Explosive Ordnance Disposal (EOD) mobile robots. These robots are predominately used for surveillance and neutralization of these explosive threats from a safe distance. The nature of the mission means that these vehicles are prone to being damaged or destroyed. Current commercially available systems, although capable of performing the mission, are costly and in too short of supply to be lost or damaged in large numbers. At last year's SPIE conference the NAVEODTECHDIV proposed an alternative: a low cost, mobile robot which used commercial off-the-shelf (COTS) parts and was tailored to the types of missions that EOD soldiers commonly perform. The prototype of this low-cost robot, the RAMBOT (Readily Available Maintainable Robot), has been continuously improved over the past year. There have been significant improvements to the original design in the areas of communication, manipulation, and electronics. The result of this work is a final prototype design, which is currently undergoing extensive testing to characterize its capabilities. Some of these tests include vehicle characteristics such as vehicle speed and mobility, vehicle weight and size, as well as maximum effective communication range, susceptibility to temperature, manipulator load limitations, and battery longevity. This conference paper will present the design changes to the robot and fully report on the results from the test series conducted thus far.

  11. Using EasyMatch® to anticipate the identification of an HLA identical unrelated donor: A validated efficient time and cost saving method.

    Science.gov (United States)

    Dubois, Valérie; Detrait, Marie; Sobh, Mohamad; Morisset, Stéphane; Labussière, Hélène; Giannoli, Catherine; Nicolini, Franck; Moskovtchenko, Philippe; Mialou, Valérie; Ducastelle, Sophie; Rey, Sylvie; Thomas, Xavier; Barraco, Fiorenza; Tedone, Nathalie; Marry, Evelyne; Garnier, Federico; Bertrand, Yves; Michallet, Mauricette

    2016-11-01

    In the absence of an HLA matched familial donor, a search for an unrelated donor or cord blood unit is initiated through worldwide registries. Although a first look-up on available HLA information of donors in the "book" at BMDW (Bone Marrow Donor Worldwide) can provide a good estimation of the number of compatible donors, the variety of resolution typing levels requires confirmatory typing (CT) which are expensive and time consuming. In order to help recipient centers in their work. The French donor registry (France Greffe de Moelle/Agence de la Biomedecine) has recently developed a software program called "EasyMatch®" that uses haplotype frequencies to compute the likelihood of phenotypic match in donors according to various typing resolution levels. The goal of our study is to report a single monocentric user-experience with EasyMatch®, demonstrating that its routine use reduced the cost and the delay of the donor search in our center, allowing the definition of a new strategy to search compatible unrelated donors. The strategy was first established on a retrospective cohort of 217 recipients (185 adults and 32 children=before score) and then validated on a prospective cohort of 171 recipients (160 adults and 11 children=after score). For all patients, we calculated the delay between the registration day and the donor identification day, and the number of CT requested to the donor centre. Considering both groups, we could observe a significant decrease of the number of CT from 8 to 2 (p<0,001), and a significant decrease of the median delay to identify a suitable donor from 43 to 31days (p<0.0001). EasyMatch® estimates the number of potentially identical donors, but doesn't foresee availability of the donors. It provides us an easy tracking of mismatches, an estimation of the number of potential donors, the selection of population following ethnic origin of patients and a high prediction when probability is high or low. It affords a new approach of donor

  12. An integrated tiered service delivery model (ITSDM based on local CD4 testing demands can improve turn-around times and save costs whilst ensuring accessible and scalable CD4 services across a national programme.

    Directory of Open Access Journals (Sweden)

    Deborah K Glencross

    Full Text Available The South African National Health Laboratory Service (NHLS responded to HIV treatment initiatives with two-tiered CD4 laboratory services in 2004. Increasing programmatic burden, as more patients access anti-retroviral therapy (ART, has demanded extending CD4 services to meet increasing clinical needs. The aim of this study was to review existing services and develop a service-model that integrated laboratory-based and point-of-care testing (POCT, to extend national coverage, improve local turn-around/(TAT and contain programmatic costs.NHLS Corporate Data Warehouse CD4 data, from 60-70 laboratories and 4756 referring health facilities was reviewed for referral laboratory workload, respective referring facility volumes and related TAT, from 2009-2012.An integrated tiered service delivery model (ITSDM is proposed. Tier-1/POCT delivers CD4 testing at single health-clinics providing ART in hard-to-reach areas (350-1500 tests/day, serving ≥ 200 health-clinics. Tier-6 provides national support for standardisation, harmonization and quality across the organization.The ITSDM offers improved local TAT by extending CD4 services into rural/remote areas with new Tier-3 or Tier-2/POC-Hub services installed in existing community laboratories, most with developed infrastructure. The advantage of lower laboratory CD4 costs and use of existing infrastructure enables subsidization of delivery of more expensive POC services, into hard-to-reach districts without reasonable access to a local CD4 laboratory. Full ITSDM implementation across 5 service tiers (as opposed to widespread implementation of POC testing to extend service can facilitate sustainable 'full service coverage' across South Africa, and save>than R125 million in HIV/AIDS programmatic costs. ITSDM hierarchical parental-support also assures laboratory/POC management, equipment maintenance, quality control and on-going training between tiers.

  13. SAVED LEAVE BONUS

    CERN Multimedia

    Division des ressources humaines

    2000-01-01

    Staff members participating in the RSL programme are entitled to one additional day of saved leave for each full period of 20 days remaining in their saved leave account on 31 December 1999.Allowing some time for all concerned to make sure that their periods of leave taken in 1999 are properly registered, HR division will proceed with the crediting of the appropriate number of days in the saved leave accounts from 25 January 2000.Human Resources DivisionTel.73359

  14. Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.

    Science.gov (United States)

    Tibesku, Carsten O; Hofer, Pamela; Portegies, Wesley; Ruys, C J M; Fennema, Peter

    2013-03-01

    The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. The costs of the two approaches, PMI and standard instrumentation in TKA, were determined by the use of ABC which measures the cost of a particular procedure by determining the activities involved and adding the cost of each activity. Improvement in productivity due to increased operating room (OR) turn-around times was determined and potential additional revenue to the hospital by the efficient utilization of gained OR time was estimated. Increased efficiency in the usage of OR and utilization of surgical trays were noted with patient-specific approach. Potential revenues to the hospital were estimated with the use of PMI by efficient utilization of time saved in OR. Additional revenues of 78,240 per year were estimated considering utilization of gained OR time to perform surgeries other than TKA. The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.

  15. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... Center (EOC) 101 Emergency Operations Center CDC Laboratory Science: Mission Critical Saving Lives, Protecting People Environmental Health CDC Tracking Network Health Begins at Home Smoke- ...

  16. Control Evaluation Information System Savings

    Directory of Open Access Journals (Sweden)

    Eddy Sutedjo

    2011-05-01

    Full Text Available The purpose of this research is to evaluate the control of information system savings in the banking and to identify the weaknesses and problem happened in those saving systems. Research method used are book studies by collecting data and information needed and field studies by interview, observation, questioner, and checklist using COBIT method as a standard to assess the information system control of the company. The expected result about the evaluation result that show in the problem happened and recommendation given as the evaluation report and to give a view about the control done by the company. Conclusion took from this research that this banking company has met standards although some weaknesses still exists in the system.Index Terms - Control Information System, Savings

  17. Costs and cost-effectiveness of carotid stenting versus endarterectomy for patients at standard surgical risk: results from the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

    Science.gov (United States)

    Vilain, Katherine R; Magnuson, Elizabeth A; Li, Haiyan; Clark, Wayne M; Begg, Richard J; Sam, Albert D; Sternbergh, W Charles; Weaver, Fred A; Gray, William A; Voeks, Jenifer H; Brott, Thomas G; Cohen, David J

    2012-09-01

    The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated similar rates of the primary composite end point between carotid artery stenting (CAS) and carotid endarterectomy (CEA), although the risk of stroke was higher with CAS, and the risk of myocardial infarction was higher with CEA. Given the large number of patients who are candidates for these procedures, an understanding of their relative cost and cost-effectiveness may have important implications for health care policy and treatment guidelines. We performed a formal economic evaluation alongside the CREST trial. Costs were estimated from all trial participants over the first year of follow-up using a combination of resource use data and hospital billing data. Patient-level health use scores were obtained using data from the SF-36. We then used a Markov disease-simulation model calibrated to the CREST results to project 10-year costs and quality-adjusted life expectancy for the 2 treatment groups. Although initial procedural costs were $1025/patient higher with CAS, postprocedure costs and physician costs were lower such that total costs for the index hospitalization were similar for the CAS and CEA groups ($15 055 versus $14 816; mean difference, $239/patient; 95% CI for difference, -$297 to $775). Neither follow-up costs after discharge nor total 1-year costs differed significantly. For the CREST population, model-based projections over a 10-year time horizon demonstrated that CAS would result in a mean incremental cost of $524/patient and a reduction in quality-adjusted life expectancy of 0.008 years compared with CEA. Probabilistic sensitivity analysis demonstrated that CEA was economically attractive at an incremental cost-effectiveness threshold of $50 000/quality-adjusted life-year gained in 54% of samples, whereas CAS was economically attractive in 46%. Despite slightly lower in-trial costs and lower rates of stroke with CEA compared with CAS, projected 10-year outcomes

  18. How is the Lives Saved Tool (LiST) used in the global health community? Results of a mixed-methods LiST user study.

    Science.gov (United States)

    Stegmuller, Angela R; Self, Andrew; Litvin, Kate; Roberton, Timothy

    2017-11-07

    The Lives Saved Tool (LiST) is a computer-based model that estimates the impact of scaling up key interventions to improve maternal, newborn and child health. Initially developed to inform the Lancet Child Survival Series of 2003, the functionality and scope of LiST have been expanded greatly over the past 10 years. This study sought to "take stock" of how LiST is now being used and for what purposes. We conducted a quantitative survey of LiST users, qualitative interviews with a smaller sample of LiST users and members of the LiST team at Johns Hopkins University, and a literature review of studies involving LiST analyses. LiST is being used by donors, international organizations, governments, NGOs and academic institutions to assist program evaluation, inform strategic planning and evidenced-based decision-making, and advocate for high-impact interventions. Some organizations have integrated LiST into internal workflows and built in-house capacity for using LiST, while other organizations rely on the LiST team for support and to outsource analyses. In addition to being a popular stand-alone software, LiST is used as a calculation engine for other applications. The Lives Saved Tool has been reported to be a useful model in maternal, newborn, and child health. With continued commitment, LiST should remain as a part of the international health toolkit used to assess maternal, newborn and child health programs.

  19. Social return on investment of mutual support based housing projects: Potential for socio-economic cost savings and higher living quality

    OpenAIRE

    Borgloh, Sarah; Westerheide, Peter

    2010-01-01

    Our paper describes the results of a Social Return on Investment analysis of four new housing projects in Germany. A common characteristic of all projects is the central importance of mutual neighborly support to meet the demand for the assistance of older residents. All projects share some common architectural features and infrastructural characteristics. Furthermore, in each housing project, some form of support by social workers takes place. Using a propensity score matching approach, we c...

  20. Energy saving effects of wireless sensor networks: a case study of convenience stores in Taiwan.

    Science.gov (United States)

    Chen, Chih-Sheng; Lee, Da-Sheng

    2011-01-01

    Wireless sensor network (WSN) technology has been successfully applied to energy saving applications in many places, and plays a significant role in achieving power conservation. However, previous studies do not discuss WSN costs and cost-recovery. The application of WSNs is currently limited to research and laboratory experiments, and not mass industrial production, largely because business owners are unfamiliar with the possible favorable return and cost-recovery on WSN investments. Therefore, this paper focuses on the cost-recovery of WSNs and how to reduce air conditioning energy consumption in convenience stores. The WSN used in this study provides feedback to the gateway and adopts the predicted mean vote (PMV) and computational fluid dynamics (CFD) methods to allow customers to shop in a comfortable yet energy-saving environment. Four convenience stores in Taipei have used the proposed WSN since 2008. In 2008, the experiment was initially designed to optimize air-conditioning for energy saving, but additions to the set-up continued beyond 2008, adding the thermal comfort and crowds peak, off-peak features in 2009 to achieve human-friendly energy savings. Comparison with 2007 data, under the same comfort conditions, shows that the power savings increased by 40% (2008) and 53% (2009), respectively. The cost of the WSN equipment was 500 US dollars. Experimental results, including three years of analysis and calculations, show that the marginal energy conservation benefit of the four convenience stores achieved energy savings of up to 53%, recovering all costs in approximately 5 months. The convenience store group participating in this study was satisfied with the efficiency of energy conservation because of the short cost-recovery period.

  1. Análisis de costes y ahorros potenciales relacionados con la utilización de pruebas preoperatorias en los hospitales de Canarias Cost analysis and potential savings related to the use of preoperative tests in the hospitals of the Canary Islands [Spain

    Directory of Open Access Journals (Sweden)

    J. López-Bastida

    2003-04-01

    mejor selección y utilización de las pruebas preoperatorias.Objective: To estimate the potential cost savings that might take place in the Canary Islands Health Service (CHS through the appropriate scientific use of preoperative tests, using information obtained from five public university hospitals. Methods: A questionnaire was completed by 55 anesthesiologists, representing 60% of the total in the CHS. The questionnaire paid special attention to the most frequently used preoperative tests: chest radiograph, electrocardiogram, laboratory tests, and spirometry. The mean unit costs for the various preoperative tests were obtained from the two hospitals participating in the study. To calculate the potential cost savings derived from the appropriate use of preoperative tests, several scenarios were considered. These were characterized by different hypotheses or degrees of fulfillment of a protocol based on scientific knowledge and considered as the gold standard. Results: In the ideal scenario in which the recommended scientific protocol was fulfilled in 100% of the 16 179 patients with an American Society of Anesthesiologists (ASA grade of I-II, the economic impact would be notable, since it would free sensitive resources that could be used for other health programs. These figures could amount to approximately 1.02 million euros, without considering the cost of preoperative hospital stay. This figure could increase by up to approximately 2.13 million euros if one day of preoperative hospital stay were included and by up to 3.24 million euros if two days of preoperative hospital stay were included. Conclusions: The recent literature review and the results of the questionnaire applied in the CHS indicate that preoperative tests are of greatest benefit to patients and to society if their use is guided by scientific knowledge. In addition, resources can be freed by better selection and utilization of preoperative tests.

  2. How to Save Money by Saving Energy.

    Science.gov (United States)

    Department of Energy, Washington, DC.

    This pamphlet presents energy conservation tips to help consumers save money. Conservation measures suggested here cover topics such as: (1) insulation; (2) space heating and cooling; (3) hot water heating; (4) cooking; (5) laundry; (6) lighting; (7) electrical appliances; (8) buying or building a home; and (9) buying, maintaining and driving a…

  3. Probabilistic Robustness Analysis of Timber Structures—Results from EU COST Action E55:WG3

    DEFF Research Database (Denmark)

    Kirkegaard, Poul Henning; Sørensen, John Dalsgaard

    2011-01-01

    The present paper outlines results from Working Group 3 (WG3) in the EU COST Action E55—‘Modelling of the performance of timber structures’. The objectives of the project are related to the three main research activities: the identification and modelling of relevant load and environmental exposure...... scenarios, the improvement of knowledge concerning the behaviour of timber structural elements and the development of a generic framework for the assessment of the life-cycle vulnerability and robustness of timber structures....

  4. Simple, cost effective & result oriented framework for supplier performance measurement in sports goods manufacturing industry

    Directory of Open Access Journals (Sweden)

    2011-09-01

    Full Text Available The emergences of global markets have increased competition worldwide. For the Sports Goods Manufacturing Industry which is considered to be an intensive supplier base industry with limited resources to sustain in what is already a very competitive market there is a need for the entire supply chain viz. raw material and machinery suppliers and manufacturers to measure their supplier's performance to reduce business risks and revenue losses. How to design & execute a simple, cost effective & result oriented Framework for Supplier Performance Measurement for sports goods manufacturing small - medium enterprises is the main aim of this research paper.

  5. Psychological determinants of household saving behaviour

    OpenAIRE

    Nyhus, Ellen Katrine

    2002-01-01

    This dissertation reports the results of a study that examined the impact of psychological variables on household saving and borrowing behaviour. Understanding saving behaviour is important for policy makers and financial institutions, but a comprehensive explanatory model that can explain individual differences in saving does not yet exist. The aim of this research has been to contribute towards the construction of such a model. The study was designed to answer four research q...

  6. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... As…", save file in desired location. About CDC-TV CDC-TV videos cover a variety of health, ... As…", save file in desired location. About CDC-TV CDC-TV videos cover a variety of health, ...

  7. Potential energy savings

    DEFF Research Database (Denmark)

    Schultz, Jørgen Munthe

    1996-01-01

    This chapter describes the chosen methods for estimating the potential energy savings if ordinary window glazing is exchanged with aerogel glazing as well as commercial low-energy glazings.......This chapter describes the chosen methods for estimating the potential energy savings if ordinary window glazing is exchanged with aerogel glazing as well as commercial low-energy glazings....

  8. Plugging into Energy Savings.

    Science.gov (United States)

    Harrigan, Merrilee

    1999-01-01

    The nonprofit Alliance to Save Energy has been helping schools reduce energy consumption through a combination of retrofits, classroom instruction, and behavior. Lists eight small steps to big energy savings, among them: involve the whole school, stop leaks, turn off computers, and recycle. (MLF)

  9. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... Download Linked File As…", save file in desired location. About CDC-TV CDC-TV videos cover a variety of health, safety and preparedness ... Download Linked File As…", save file in desired location. About CDC-TV CDC-TV videos cover a variety of health, safety and preparedness ...

  10. Energy Savings Analysis of the Proposed Revision of the Washington D.C. Non-Residential Energy Code

    Energy Technology Data Exchange (ETDEWEB)

    Rosenberg, Michael I.; Athalye, Rahul A.; Hart, Philip R.

    2017-12-01

    This report presents the results of an assessment of savings for the proposed Washington D.C. energy code relative to ASHRAE Standard 90.1-2010. It includes annual and life cycle savings for site energy, source energy, energy cost, and carbon dioxide emissions that would result from adoption and enforcement of the proposed code for newly constructed buildings in Washington D.C. over a five year period.

  11. Costs of Peri-Procedural Complications in Patients Treated with Transcatheter Aortic Valve Replacement: Results from the PARTNER Trial

    Science.gov (United States)

    Arnold, Suzanne V.; Lei, Yang; Reynolds, Matthew R.; Magnuson, Elizabeth A.; Suri, Rakesh M.; Tuzcu, E. Murat; Petersen, John L.; Douglas, Pamela S.; Svensson, Lars G.; Gada, Hemal; Thourani, Vinod H.; Kodali, Susheel K.; Mack, Michael J.; Leon, Martin B.; Cohen, David J.

    2014-01-01

    Background In patients with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) improves survival compared with nonsurgical therapy but with higher in-hospital and lifetime costs. Complications associated with TAVR may decrease with greater experience and improved devices, thereby reducing the overall cost of the procedure. Therefore, we sought to estimate the impact of peri-procedural complications on in-hospital costs and length of stay of TAVR. Methods and Results Using detailed cost data from 406 TAVR patients enrolled in the PARTNER I trial, we developed multivariable models to estimate the incremental cost and length of stay associated with specific peri-procedural complications. Attributable costs and length of stay for each complication were calculated by multiplying the independent cost of each event by its frequency in the treatment group. Mean cost for the initial hospitalization was $79,619 ± 40,570 ($50,891 excluding the valve); 49% of patients had ≥1 complication. Seven complications were independently associated with increased hospital costs, with major bleeding, arrhythmia and death accounting for the largest attributable cost per patient. Renal failure and the need for repeat TAVR, although less frequent, were also associated with substantial incremental and attributable costs. Overall, complications accounted for $12,475/patient in initial hospital costs and 2.4 days of hospitalization. Conclusion In the PARTNER trial, peri-procedural complications were frequent, costly, and accounted for approximately 25% of non-implant related hospital costs. Avoidance of complications should improve the cost-effectiveness of TAVR for inoperable and high-risk patients, but reductions in the cost of uncomplicated TAVR will also be necessary for optimal efficiency. PMID:25336467

  12. Reconciling quality and cost: A case study in interventional radiology.

    Science.gov (United States)

    Zhang, Li; Domröse, Sascha; Mahnken, Andreas

    2015-10-01

    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.

  13. Energy saving opportunities of energy efficient air nozzles

    Science.gov (United States)

    Slootmaekers, Tim; Slaets, Peter; Bartsoen, Tom; Malfait, Lieven; Vanierschot, Maarten

    2015-12-01

    Compressed air is a common energy medium. The production of compressed air itself is not a very efficient process. Avoiding any unnecessary losses of air can lead to large reductions in electricity consumption. Since blowing applications are one of the main domains were compressed-air is used, any reduction in the mass flow needed for operation can lead to significant energy savings. In this paper the normal volumetric flow rate and generated impact force are compared between a stepped nozzle and a so called energy saving nozzle which allows extra air from the surroundings to be entrained. These two different nozzle geometries are used in industrial blowing applications. Until now there was no study available which compares the impact forces and volumetric flow rates for these types of nozzles. The flow field of the two nozzles was calculated by CFD simulations. The impact forces and volumetric flow rates are calculated out of this flow field. Each nozzle was simulated with three different input pressures. The nozzles were simulated with an input pressure of 3, 4 and 5 barg. The energy saving nozzle consumes only 1 % less volumetric flow rate then the stepped nozzle at the same inlet pressure. The replacement of a stepped nozzle with an energy saving nozzle will not immediately result in a decrease in input volumetric flow rate. The pressure at the inlet of the energy saving nozzle has to be reduced as well. After reducing the input pressure the energy saving nozzle generates the same impact force than the stepped nozzle. Hereby a decrease of 4.5 % in input volumetric flow rate was possible. The energy cost will decrease with 4.5 % as well because the normal volumetric flow rate is directly proportional to the energy cost. The replacement of a stepped nozzle with an energy saving nozzle while maintaining the same inlet pressure is only useful when the impact force from the stepped nozzle is not sufficient. The energy saving nozzle can generate 5.6 % more impact

  14. Aging, Saving, and Public Pensions in Japan

    OpenAIRE

    Horioka, Charles Yuji; Suzuki, Wataru; Hatta, Tatsuo

    2007-01-01

    We analyze the impact of population aging on Japan's household saving rate and on its public pension system and the impact of that system on Japan's household saving rate and obtain the following results: first, the age structure of Japan's population can explain the level of, and past and future trends in, its household saving rate; second, the rapid aging of Japan's population is causing Japan's household saving rate to decline and this decline can be expected to continue; third, the pay-as...

  15. Actions and results of the management of energy saving of the CONDUMEX group; Acciones y resultados de la gerencia de ahorro de energia de grupo CONDUMEX

    Energy Technology Data Exchange (ETDEWEB)

    Sashida Key, Carlos; Jimenez Huerta, Arturo; Alavez Alcazar, Moises [Grupo Condumex, Industrias IEM, S.A. de C.V., Mexico, D.F. (Mexico)

    1999-07-01

    The purpose of this paper is to expose some practical cases that have been developed through the Energy Saving Management of GRUPO CONDUMEX, in different areas such as systems related to water, steam, electricity and compressed air. This experience has been compiled of diagnoses and actions that have been carried out in the companies inside and outside GRUPO CONDUMEX, and of systems with the purpose of making efficient the use of fuels and getting close to the energy indexes that are handled in other International companies of the same manufacture branch. [Spanish] Este trabajo tiene por objeto exponer algunos casos practicos que se han desarrollado a traves de la Gerencia de Ahorro de Energia de GRUPO CONDUMEX, en distintas areas tales como sistemas relacionados con agua, vapor, electricidad y aire comprimido. Esta experiencia ha sido recopilada de diagnosticos y acciones que se han llevado a cabo en las empresas dentro y fuera de GRUPO CONDUMEX, y de sistemas con la finalidad de eficientar el uso de los energeticos y acercarnos a los indices energeticos que se manejan en otras empresas internacionales del mismo ramo de fabricacion.

  16. Results from portable and of low cost equipment developed for detection of milk adulterations

    Directory of Open Access Journals (Sweden)

    Wesley William Gonçalves NASCIMENTO

    Full Text Available Abstract This work presents the results of a device, MilkTech, developed to detect milk tampering, based on electrical measurements. The device indicates possible frauds by water, sodium chloride, caustic soda, ethyl alcohol and sodium bicarbonate. The advantages in relation to traditional methods are portability, low cost and detection of mixed frauds. The experiments were conducted in dairy plants at Governador Valadares, in Brazil. The results were compared with cryoscopy and chloride tests. It is demonstrated there is high correlation between MilkTech and Cryoscopy. For instance, the detection limit of the equipment for water addition with the set of analyzed data was 0.78% with precision of 1.1%. Adulterations with sodium chloride, caustic soda, ethyl alcohol and sodium bicarbonate are detected qualitatively, even when added with water, and MilkTech indicates “SUSPECT” milk.

  17. Cost-Effectiveness and Cost-Utility Analysis of Spinal Cord Stimulation in Patients With Failed Back Surgery Syndrome: Results From the PRECISE Study.

    Science.gov (United States)

    Zucco, Furio; Ciampichini, Roberta; Lavano, Angelo; Costantini, Amedeo; De Rose, Marisa; Poli, Paolo; Fortini, Gianpaolo; Demartini, Laura; De Simone, Enrico; Menardo, Valentino; Cisotto, Piero; Meglio, Mario; Scalone, Luciana; Mantovani, Lorenzo G

    2015-06-01

    To assess the cost-effectiveness and cost-utility of Spinal Cord Stimulation (SCS) in patients with failed back surgery syndrome (FBSS) refractory to conventional medical management (CMM). We conducted an observational, multicenter, longitudinal ambispective study, where patients with predominant leg pain refractory to CMM expecting to receive SCS+CMM were recruited in 9 Italian centers and followed up to 24 months after SCS. We collected data on clinical status (pain intensity, disability), Health-Related Quality-of-Life (HRQoL) and on direct and indirect costs before (pre-SCS) and after (post-SCS) the SCS intervention. Costs were quantified in € 2009, adopting the National Health Service's (NHS), patient and societal perspectives. Benefits and costs pre-SCS versus post-SCS were compared to estimate the incremental cost-effectiveness and cost utility ratios. 80 patients (40% male, mean age 58 years) were recruited. Between baseline and 24 months post-SCS, clinical outcomes and HRQoL significantly improved. The EQ-5D utility index increased from 0.421 to 0.630 (p costs increased from €6600 (pre-SCS) to €13,200 (post-SCS) per patient per year. Accordingly, the cost-utility acceptability curve suggested that if decision makers' willingness to pay per Quality-Adjusted-Life-Years (QALYs) was €60,000, SCS implantation would be cost-effective in 80% and 85% of cases, according to the NHS's and societal point of views, respectively. Our results suggest that in clinical practice, SCS+CMM treatment of FBSS patients refractory to CMM provides good value for money. Further research is encouraged in the form of larger, long-term studies. © 2015 International Neuromodulation Society.

  18. Savings account for health care costs

    Science.gov (United States)

    ... who are self-employed and employees of small businesses (less than 50 employees), and their spouses. The ... J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of ...

  19. Realized Cost Savings and Avoidance Decisions

    Data.gov (United States)

    National Aeronautics and Space Administration — The OMB Office of the Chief Information Officer (OFCIO) has a long-standing practice of making information about Federal IT available to the public through various...

  20. Novel surface measurement system reading cost savings

    Energy Technology Data Exchange (ETDEWEB)

    Sword, M.

    1996-05-01

    A new state-of-the-art data acquisition system for the oil and natural gas industries is being marketed by OPSCO`92 Industries Ltd. The unit is portable, it measures surface data which is calibrated to bottom-hole conditions and designed to measure temperature and pressure information without the necessity of sending testing equipment downhole. The Surface Data System (SDS) uses silicon-crystal technology, is mounted in a suitcase size carrying case, and runs off a 12-volt battery enclosure which can be backed up by a small solar panel. The first generation system can handle 16 different channels of information input on a laptop computer. Pressure, pressure differential, temperature, frequency and pulse signals for flow meter measurements are handled by standard sensors. Areas of application include build-up and fall-off tests, pipeline evaluation, pre-frac tests, underbalanced drilling and gas well evaluation. 1 fig., 1 photo.

  1. EFFECTIVE SAVINGS IN PRODUCTION TIMES AND COST

    African Journals Online (AJOL)

    ES OBE

    e-mail:mcedeson@yahoo.com) ... into consideration their workshop temperatures for particular work-piece based, of course, on the .... the lamination in polyester resin of two car body components: (1) two sides of a car fender and (2) the floor ...

  2. EFFECTIVE SAVINGS IN PRODUCTION TIMES AND COST

    African Journals Online (AJOL)

    ES OBE

    time periods. 2.EXPERIMENTAL PROCEDURE. Materials. The following experiments were conducted in polyester resin matrix. (containing. 65% styrene) using hydroquinone as inhibitor; dimethyl aniline as accelerator and benzoyle peroxide as catalyst (see tables 1-6). Test Method. Six different tests were conducted each ...

  3. COST SAVING WITH ULTRASONOGRAPHY IN A DEVELOPING ...

    African Journals Online (AJOL)

    1999-05-05

    ) to the University of Gezira and this was placed in the Radiology Department in October 1986. Details of the ultrasound service in operation since then have been published previously(6). Eight hundred and sixty three ...

  4. EFFECTIVE SAVINGS IN PRODUCTION TIMES AND COST

    African Journals Online (AJOL)

    ES OBE

    controlling arm in production [4]. A minute error in the accelerator-to-resin percentage quantity required to achieve this purpose can ... tremendous wastes by way of down-time periods during handlay-up processes where applications of a second coat of resin would have to wait for the already applied coat to cure, And, in ...

  5. Tankering Fuel: A Cost Saving Initiative

    Science.gov (United States)

    2011-05-01

    Dakota US ANG NORTHCOM Hill AFB KHIF AF Utah US AFMC NORTHCOM Holloman AFB KHMN AF New Mexico US ACC NORTHCOM Holy Corp DESC Idaho US NULL NORTHCOM...NEWPORT NEWS WILLIAMSBURG INTL KPHF VA 3.587035 NIAGARA FALLS INTL KIAG NY 3.4684 NIAGARA FALLS INTL KIAG NY 3.4684 NINOY AQUINO INTL (COL JESUS A...3.653219 ST PETERSBURG CLEARWATER INTL KPIE FL 3.723219 ST. CROIX/HENRY E. ROHLSEN APT TISX OS 4.2308 ST. THOMAS /CYRIL E. KING APT TIST OS 3.9667

  6. Pittsburgh as a High Risk Population: The Potential Savings of a Personalized Dental Care Plan.

    Science.gov (United States)

    Ng, Andrew J; Vieira, Alexandre R

    2016-01-01

    Objectives. Little evidence exists for the current standard of two annual preventative care visits. The purpose of this study was investigate this claim by modeling the potential savings of implementing a personalized care plan for high risk individuals in the Pittsburgh region. Methods. Using radiographs from 39 patients in the University of Pittsburgh Dental Registry and DNA Repository database, two models were created to analyse the direct savings of implementing a more aggressive preventative treatment plan and to view the longitudinal cost of increased annual yearly visits. Results. There is a significant decrease (p < 0.001) between original and modeled treatment cost when treatment severity is reduced. In addition, there is a significant decrease in adult lifetime treatment cost (p < 0.001) for up to four annual visits. Conclusions. Patients in high risk populations may see significant cost benefits in treatment cost when a personalized care plan, or higher annual preventative care visits, is implemented.

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

    Science.gov (United States)

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

    2017-12-15

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

  8. Energy savings in Danish residential building stock

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Svendsen, Svend

    2006-01-01

    A large potential for energy savings exists in the Danish residential building stock due to the fact that 75% of the buildings were constructed before 1979 when the first important demands for energy performance of building were introduced. It is also a fact that many buildings in Denmark face...... comprehensive renovations in the coming years and in connection with this renovation process energy saving measures can be implemented relatively inexpensive and cost effective. This opportunity should be used to insure the buildings in the future as far as energy consumption is concerned. This paper gives...... buildings representing the residential building stock and based on these calculations an assessment of the energy-saving potential is performed. A profitable savings potential of energy used for space heating of about 80% is identified over 45 years (until 2050) within the residential building stock...

  9. The actual and potential costs of meningitis surveillance in the African meningitis belt: Results from Chad and Niger.

    Science.gov (United States)

    Irurzun-Lopez, Maite; Erondu, Ngozi A; Djibo, Ali; Griffiths, Ulla; Stuart, James M; Fernandez, Katya; Ronveaux, Olivier; Le Gargasson, Jean-Bernard; Gessner, Bradford D; Colombini, Anaïs

    2016-02-17

    The introduction of serogroup A meningococcal conjugate vaccine in the African meningitis belt required strengthened surveillance to assess long-term vaccine impact. The costs of implementing this strengthening had not been assessed. The ingredients approach was used to retrospectively determine bacterial meningitis surveillance costs in Chad and Niger in 2012. Resource use and unit cost data were collected through interviews with staff at health facilities, laboratories, government offices and international partners, and by reviewing financial reports. Sample costs were extrapolated to national level and costs of upgrading to desired standards were estimated. Case-based surveillance had been implemented in all 12 surveyed hospitals and 29 of 33 surveyed clinics in Niger, compared to six out of 21 clinics surveyed in Chad. Lumbar punctures were performed in 100% of hospitals and clinics in Niger, compared to 52% of the clinics in Chad. The total costs of meningitis surveillance were US$ 1,951,562 in Niger and US$ 338,056 in Chad, with costs per capita of US$ 0.12 and US$ 0.03, respectively. Laboratory investigation was the largest cost component per surveillance functions, comprising 51% of the total costs in Niger and 40% in Chad. Personnel resources comprised the biggest expense type: 37% of total costs in Niger and 26% in Chad. The estimated annual, incremental costs of upgrading current systems to desired standards were US$ 183,299 in Niger and US$ 605,912 in Chad, which are 9% and 143% of present costs, respectively. Niger's more robust meningitis surveillance system costs four times more per capita than the system in Chad. Since Chad spends less per capita, fewer activities are performed, which weakens detection and analysis of cases. Countries in the meningitis belt are diverse, and can use these results to assess local costs for adapting surveillance systems to monitor vaccine impact. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Model for Determining Geographical Distribution of Heat Saving Potentials in Danish Building Stock

    DEFF Research Database (Denmark)

    Petrovic, Stefan; Karlsson, Kenneth Bernard

    2014-01-01

    . A highly detailed model for determining heat demand, possible heat savings and associated costs in the Danish building stock is presented. Both scheduled and energy-saving renovations until year 2030 have been analyzed. The highly detailed GIS-based heat atlas for Denmark is used as a container for storing...... data about physical properties for 2.5 million buildings in Denmark. Consequently, the results of the analysis can be represented on a single building level. Under the assumption that buildings with the most profitable heat savings are renovated first, the consequences of heat savings for the economy...... and energy system have been quantified and geographically referenced. The possibilities for further improvements of the model and the application to other geographical regions have been discussed....

  11. The design and application of shared savings programs: lessons from early adopters.

    Science.gov (United States)

    Weissman, Joel S; Bailit, Michael; D'Andrea, Guy; Rosenthal, Meredith B

    2012-09-01

    Different forms of physician payment result in different levels of financial risk for health care payers and providers, and can affect clinical decision making and the cost of care. Shared savings programs reward providers for holding spending below specific targets, thus introducing a level of financial accountability not present in strictly volume-based payment models, such as fee-for-service. Here we examine the design and application of shared savings formulas across a range of actual programs. We also present a more detailed description of one particular shared savings program-the Massachusetts Patient-Centered Medical Home Initiative-focusing on key trade-offs between payers and providers that eventually led to agreement on specific aspects of the program. We conclude with principles for the design of future shared savings arrangements and consideration of issues that will confront decision makers as these efforts mature and expand.

  12. Risk transfer via energy savings insurance

    Energy Technology Data Exchange (ETDEWEB)

    Mills, Evan

    2001-10-01

    Among the key barriers to investment in energy efficiency improvements are uncertainties about attaining projected energy savings and apprehension about potential disputes over these savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building commissioning), financial risk transfer techniques are less developed in the energy management arena than in other more mature segments of the economy. Energy Savings Insurance (ESI) - formal insurance of predicted energy savings - is one method of transferring financial risks away from the facility owner or energy services contractor. ESI offers a number of significant advantages over other forms of financial risk transfer, e.g. savings guarantees or performance bonds. ESI providers manage risk via pre-construction design review as well as post-construction commissioning and measurement and verification of savings. We found that the two mos t common criticisms of ESI - excessive pricing and onerous exclusions - are not born out in practice. In fact, if properly applied, ESI can potentially reduce the net cost of energy savings projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Debt service can also be ensured by matching loan payments to projected energy savings while designing the insurance mechanism so that payments are made by the insurer in the event of a savings shortfall. We estimate the U.S. ESI market potential of $875 million/year in premium income. From an energy-policy perspective, ESI offers a number of potential benefits: ESI transfers performance risk from the balance sheet of the entity implementing the energy savings project, thereby freeing up capital otherwise needed to ''self-insure'' the savings. ESI reduces barriers to market entry of smaller energy services firms who do not have sufficiently strong balance

  13. Ringkøbing-Skjern energy atlas for analysis of heat saving potentials in building stock

    DEFF Research Database (Denmark)

    Petrovic, Stefan; Karlsson, Kenneth Bernard

    2016-01-01

    such drastic change of municipality's energy system. For that purpose, GIS-based Ringkøbing-Skjern Energy Atlas has been developed. The present paper utilises Ringkøbing-Skjern Energy Atlas together with the Heating Model to calculate potentials and costs of heat saving measures.The results show......Ringkøbing-Skjern municipality aims to be 100% self-sufficient in renewable energy supply starting from 2020. It is expected that the building sector will contribute by reducing energy demand by 25-50%.Technical, economic, environmental and geographical aspects need to be considered when analysing...... that the reduction of heating demand by 25% and 35% can be achieved at the annuitized full cost lower than 1.7 and 2 DKK/kWh, respectively. The results also show that significant heat saving potential lies in farmhouses and detached houses as well as in buildings built before 1950. Over 75% of very cheap heat saving...

  14. Hand Hygiene Saves Lives

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    Full Text Available ... prepared for different audiences including, children, parents, and public health professionals. More > Hand Hygiene Saves Lives (5:10) ... prepared for different audiences including, children, parents, and public health professionals. More > File Formats Help: How do I ...

  15. Hand Hygiene Saves Lives

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    Full Text Available ... is not supported by your browser. For this reason, some items on this page will be unavailable. ... CDC Laboratory Science: Mission Critical Saving Lives, Protecting People Environmental Health CDC Tracking Network Health Begins at ...

  16. Hand Hygiene Saves Lives

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    Full Text Available ... 101 Emergency Operations Center CDC Laboratory Science: Mission Critical Saving Lives, Protecting People Environmental Health CDC Tracking ... Cultures Are Our Source of Health (:30) Systems Thinking The Value of Systems Thinking (10:09) Systems ...

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    Full Text Available ... Obesity Epidemic Outbreaks CDC: Protecting Americans through Global Health Ebola and Contact Tracing Global Disease Detectives in ... Science: Mission Critical Saving Lives, Protecting People Environmental Health CDC Tracking Network Health Begins at Home Smoke- ...

  1. Hand Hygiene Saves Lives

    Medline Plus

    Full Text Available ... hospital while being treated for something else. The best way to help prevent infection is to practice proper hand hygiene. Hand Hygiene Saves Lives shows how patients can play an active role in reminding healthcare ...

  2. Hand Hygiene Saves Lives

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    Full Text Available ... Please Parents Want To Do What′s Best The Obesity Epidemic Outbreaks CDC: Protecting Americans through Global Health ... best way to help prevent infection is to practice proper hand hygiene. Hand Hygiene Saves Lives shows ...

  3. Latin American Clinical Epidemiology Network Series - Paper 4: Economic evaluation of Kangaroo Mother Care: cost utility analysis of results from a randomized controlled trial conducted in Bogotá.

    Science.gov (United States)

    Ruiz, Juan Gabriel; Charpak, Nathalie; Castillo, Mario; Bernal, Astrid; Ríos, John; Trujillo, Tammy; Córdoba, María Adelaida

    2017-06-01

    Although kangaroo mother care (KMC) has been shown to be safe and effective in randomized controlled trials (RCTs), there are no published complete economic evaluations including the three components of the full intervention. A cost utility analysis performed on the results of an RCT conducted in Bogotá, Colombia between 1993 and 1996. Hospital and ambulatory costs were estimated by microcosting in a sample of preterm infants from a University Hospital in Bogotá in 2011 and at a KMC clinic in the same period. Utility scores were assigned by experts by means of (1) direct ordering and scoring discrete health states and (2) constructing a multi-attribute utility function. Ninety-five percent confidence intervals (CIs) for the incremental cost-utility ratios (ICURs) were computed by the Fiellers theorem method. One-way sensitivity analysis on price estimates for valuing costs was performed. ICUR at 1 year of corrected age was $ -1,546 per extra quality-adjusted life year gained using the KMC method (95% CI $ -7,963 to $ 4,910). In Bogotá, the use of KMC is dominant: more effective and cost-saving. Although results from an economic analysis should not be extrapolated to different systems and communities, this dominant result suggests that KMC could be cost-effective in similar low and middle income countries settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Frailty and healthcare costs-longitudinal results of a prospective cohort study.

    Science.gov (United States)

    Hajek, André; Bock, Jens-Oliver; Saum, Kai-Uwe; Matschinger, Herbert; Brenner, Hermann; Holleczek, Bernd; Haefeli, Walter E; Heider, Dirk; König, Hans-Helmut

    2017-09-21

    to investigate how frailty and frailty symptoms affect healthcare costs in older age longitudinally. data were gathered from a prospective cohort study in Saarland, Germany (two waves with 3-year interval, n = 1,636 aged 57-84 years at baseline). Frailty was assessed by the five Fried frailty criteria. Frailty was defined as having at least three criteria, the presence of 1-2 criteria as 'pre-frail'. Healthcare costs were quantified based on self-reported healthcare use in the sectors of inpatient treatment, outpatient treatment, professional nursing care and informal care as well as the provision of pharmaceuticals, medical supplies and dental prostheses. while the onset of pre-frailty did not increase (log) total healthcare costs after adjusting for potential confounders including comorbidity, progression from non-frailty to frailty was associated with an increase in total healthcare costs (for example, costs increased by ~54 and 101% if 3 and 4 or 5 symptoms were present, respectively). This association of frailty onset with increased healthcare costs was in particular observed in the inpatient sector and for informal nursing care. Among the frailty symptoms, the onset of exhaustion was associated with an increase in total healthcare costs, whereas changes in slowness, weakness, weight loss and low-physical activity were not significantly associated with an increase in total healthcare costs. our data stress the economic relevance of frailty in late life. Postponing or reducing frailty might be fruitful in order to reduce healthcare costs.

  5. Health care costs associated with gestational diabetes mellitus among high-risk women – results from a randomised trial

    Directory of Open Access Journals (Sweden)

    Kolu Päivi

    2012-07-01

    Full Text Available Abstract Background The costs of gestational diabetes mellitus (GDM screening have been frequently reported, but total GDM-related health care costs compared to the health care costs of women without GDM have not been reported. The aim of this study was to analyse GDM-related health care costs among women with an elevated risk of GDM. Methods The study was based on a cluster-randomised GDM prevention trial (N = 848 carried out at maternity clinics, combined with data from the Finnish Medical Birth Register and Care Registers for Social Welfare and Health Care. Costs of outpatient visits to primary and secondary care, cost of inpatient hospital care before and after delivery, the use of insulin, delivery costs and babies’ stay in the neonatal intensive care unit were analysed. Women who developed GDM were compared to those who were not diagnosed with GDM. Results Total mean health care costs adjusted for age, body mass index and education were 25.1% higher among women diagnosed with GDM (€6,432 vs. €5,143, p  Conclusions A confirmed GDM diagnosis was associated with a significant increase in total health care costs. Effective lifestyle counselling by primary health care providers may offer a means of reducing the high costs of secondary care.

  6. Assessing the agricultural costs of climate change: Combining results from crop and economic models

    Science.gov (United States)

    Howitt, R. E.

    2016-12-01

    Any perturbation to a resource system used by humans elicits both technical and behavioral changes. For agricultural production, economic criteria and their associated models are usually good predictors of human behavior in agricultural production. Estimation of the agricultural costs of climate change requires careful downscaling of global climate models to the level of agricultural regions. Plant growth models for the dominant crops are required to accurately show the full range of trade-offs and adaptation mechanisms needed to minimize the cost of climate change. Faced with the shifts in the fundamental resource base of agriculture, human behavior can either exacerbate or offset the impact of climate change on agriculture. In addition, agriculture can be an important source of increased carbon sequestration. However the effectiveness and timing of this sequestration depends on agricultural practices and farmer behavior. Plant growth models and economic models have been shown to interact in two broad fashions. First there is the direct embedding of a parametric representation plant growth simulations in the economic model production function. A second and more general approach is to have plant growth and crop process models interact with economic models as they are simulated. The development of more general wrapper programs that transfer information between models rapidly and efficiently will encourage this approach. However, this method does introduce complications in terms of matching up disparate scales both in time and space between models. Another characteristic behavioral response of agricultural production is the distinction between the intensive margin which considers the quantity of resource, for example fertilizer, used for a given crop, and the extensive margin of adjustment that measures how farmers will adjust their crop proportions in response to climate change. Ideally economic models will measure the response to both these margins of adjustment

  7. Results from the NASA Spacecraft Fault Management Workshop: Cost Drivers for Deep Space Missions

    Science.gov (United States)

    Newhouse, Marilyn E.; McDougal, John; Barley, Bryan; Stephens Karen; Fesq, Lorraine M.

    2010-01-01

    Fault Management, the detection of and response to in-flight anomalies, is a critical aspect of deep-space missions. Fault management capabilities are commonly distributed across flight and ground subsystems, impacting hardware, software, and mission operations designs. The National Aeronautics and Space Administration (NASA) Discovery & New Frontiers (D&NF) Program Office at Marshall Space Flight Center (MSFC) recently studied cost overruns and schedule delays for five missions. The goal was to identify the underlying causes for the overruns and delays, and to develop practical mitigations to assist the D&NF projects in identifying potential risks and controlling the associated impacts to proposed mission costs and schedules. The study found that four out of the five missions studied had significant overruns due to underestimating the complexity and support requirements for fault management. As a result of this and other recent experiences, the NASA Science Mission Directorate (SMD) Planetary Science Division (PSD) commissioned a workshop to bring together invited participants across government, industry, and academia to assess the state of the art in fault management practice and research, identify current and potential issues, and make recommendations for addressing these issues. The workshop was held in New Orleans in April of 2008. The workshop concluded that fault management is not being limited by technology, but rather by a lack of emphasis and discipline in both the engineering and programmatic dimensions. Some of the areas cited in the findings include different, conflicting, and changing institutional goals and risk postures; unclear ownership of end-to-end fault management engineering; inadequate understanding of the impact of mission-level requirements on fault management complexity; and practices, processes, and tools that have not kept pace with the increasing complexity of mission requirements and spacecraft systems. This paper summarizes the

  8. Cost Benefit Analysis Modeling Tool for Electric vs. ICE Airport Ground Support Equipment – Development and Results

    Energy Technology Data Exchange (ETDEWEB)

    James Francfort; Kevin Morrow; Dimitri Hochard

    2007-02-01

    This report documents efforts to develop a computer tool for modeling the economic payback for comparative airport ground support equipment (GSE) that are propelled by either electric motors or gasoline and diesel engines. The types of GSE modeled are pushback tractors, baggage tractors, and belt loaders. The GSE modeling tool includes an emissions module that estimates the amount of tailpipe emissions saved by replacing internal combustion engine GSE with electric GSE. This report contains modeling assumptions, methodology, a user’s manual, and modeling results. The model was developed based on the operations of two airlines at four United States airports.

  9. Economic assessment of different mulches in conventional and water-saving rice production systems.

    Science.gov (United States)

    Jabran, Khawar; Hussain, Mubshar; Fahad, Shah; Farooq, Muhammad; Bajwa, Ali Ahsan; Alharrby, Hesham; Nasim, Wajid

    2016-05-01

    Water-saving rice production systems including alternate wetting and drying (AWD) and aerobic rice (AR) are being increasingly adopted by growers due to global water crises. Application of natural and artificial mulches may further improve water economy of water-saving rice production systems. Conventionally flooded rice (CFR) system has been rarely compared with AWD and AR in terms of economic returns. In this 2-year field study, we compared CFR with AWD and AR (with and without straw and plastic mulches) for the cost of production and economic benefits. Results indicated that CFR had a higher production cost than AWD and AR. However, application of mulches increased the cost of production of AWD and AR production systems where plastic mulch was expensive than straw mulch. Although the mulching increased the cost of production for AWD and AR, the gross income of these systems was also improved significantly. The gross income from mulched plots of AWD and AR was higher than non-mulched plots of the same systems. In conclusion, AWD and AR effectively reduce cost of production by economizing the water use. However, the use of natural and artificial mulches in such water-saving environments further increased the economic returns. The maximized economic returns by using straw mulch in water-saving rice production systems definitely have pragmatic implications for sustainable agriculture.

  10. Potential savings of harmonising hospital and community formularies for chronic disease medications initiated in hospital.

    Directory of Open Access Journals (Sweden)

    Lauren Lapointe-Shaw

    Full Text Available Hospitals in Canada manage their formularies independently, yet many inpatients are discharged on medications which will be purchased through publicly-funded programs. We sought to determine how much public money could be saved on chronic medications if hospitals promoted the initiation of agents with the lowest outpatient formulary prices.We used administrative databases for the province of Ontario to identify patients initiated on a proton pump inhibitor (PPI, angiotensin-converting enzyme (ACE inhibitor or angiotensin receptor blocker (ARB following hospital admission from April 1(st 2008-March 31(st 2009. We assessed the cost to the Ontario Drug Benefit Program (ODB over the year following initiation and determined the cost savings if prescriptions were substituted with the least expensive agent in each class.The cost for filling all PPI, ACE inhibitor and ARB prescriptions was $ 2.48 million, $968 thousand and $325 thousand respectively. Substituting the least expensive agent could have saved $1.16 million (47% for PPIs, $162 thousand (17% for ACE inhibitors and $14 thousand (4% for ARBs over the year following discharge.In a setting where outpatient prescriptions are publicly funded, harmonising outpatient formularies with inpatient therapeutic substitution resulted in modest cost savings and may be one way to control rising pharmaceutical costs.

  11. Heat savings in buildings in a 100% renewable heat and power system in Denmark with different shares of district heating

    DEFF Research Database (Denmark)

    Zvingilaite, Erika; Balyk, Olexandr

    2014-01-01

    . A further expansion of district heating network in Denmark is assessed and penetration of heat savings is analysed in this context.If all heat saving measures, included in the model, are implemented, heat demand in Danish buildings in 2050 could be reduced by around 40%. Results show that it is cost...... levels of heat savings, which can be implemented by reducing heat transmission losses through building elements and by installing ventilation systems with heat recovery, in different future Danish heat and power system scenarios. Today almost 50% of heat demand in Denmark is covered by district heating...

  12. Delaware's Wellness Program: Motivating Employees Improves Health and Saves Money.

    Science.gov (United States)

    Davis, Jennifer J J

    2008-09-01

    Every year, employers around the country evaluate their company benefits package in the hopes of finding a solution to the ever-rising cost of health insurance premiums. For many business executives, the only logical choice is to pass along those costs to the employee. As an employer, our goal in Delaware has always been to come up with innovative solutions to drive down the cost of health insurance premiums while encouraging our employees to take responsibility for their own health and wellness by living a healthy and active lifestyle, and provide them with the necessary tools. The DelaWELL program (N = 68,000) was launched in 2007, after being tested in initial (N = 100) and expanded (N = 1500) pilot programs from 2004 to 2006 in which 3 similar groups were compared before and after the pilot. Employee health risk assessment, education, and incentives provided employees the necessary tools we had assumed would help them make healthier lifestyle choices. In the first pilot, fewer emergency department visits and lower blood pressure levels resulted in direct savings of more than $62,000. In the expanded pilot, in all 3 groups blood pressure was significantly reduced (P employees participating in DelaWELL had a combined weight loss of 5162 lb. Decision makers in the State of Delaware have come up with an innovative solution to controlling costs while offering employees an attractive benefits package. The savings from its employee benefit program have allowed the state to pass along the savings to employees by maintaining employee-paid health insurance contributions at the same level for the past 3 years. DelaWELL has already confirmed our motto, "Although it may seem an unusual business investment to pay for healthcare before the need arises, in Delaware we concluded that this makes perfect sense." This promising approach to improving health and reducing healthcare costs could potentially be applied to other employer groups.

  13. Do You Automate? Saving Time and Dollars

    Science.gov (United States)

    Carmichael, Christine H.

    2010-01-01

    An automated workforce management strategy can help schools save jobs, improve the job satisfaction of teachers and staff, and free up precious budget dollars for investments in critical learning resources. Automated workforce management systems can help schools control labor costs, minimize compliance risk, and improve employee satisfaction.…

  14. Shared services centers can drive significant savings.

    Science.gov (United States)

    McDowell, Jim

    2011-06-01

    A study of more than 30 U.S. integrated delivery systems (IDSs) found that implementing effective shared services centers can drive significant cost savings in human resources, accounts payable, and procurement. Many IDSs have not adopted effective shared services strategies. Implementing administrative shared services involves low risk and a relatively low start-up investment.

  15. Cost-effectiveness of treating acute coronary syndrome patients with ticagrelor for 12 months: results from the PLATO study.

    Science.gov (United States)

    Nikolic, Elisabet; Janzon, Magnus; Hauch, Ole; Wallentin, Lars; Henriksson, Martin

    2013-01-01

    The efficacy and safety of ticagrelor vs. clopidogrel in patients with acute coronary syndromes (ACS) are well documented in the PLATelet inhibition and patient Outcomes trial (PLATO). The aim of this study was to assess the long-term cost-effectiveness of treating ACS patients for 12 months with ticagrelor compared with generic clopidogrel. Event rates, health-care costs, and health-related quality of life during 12 months of therapy with either ticagrelor or generic clopidogrel were estimated from PLATO. Beyond 12 months, quality-adjusted survival and costs were estimated conditional on whether a non-fatal myocardial infarction (MI), a non-fatal stroke, or no MI or stroke occurred during the 12 months of therapy. Lifetime costs, life expectancy, and quality-adjusted life years (QALYs) were estimated for both treatment strategies. Incremental cost-effectiveness ratios were presented from a health-care perspective in 2010 Euros (€) applying unit costs and life tables from a Swedish setting in the base-case analysis. Treatment with ticagrelor was associated with increased health-care costs of €362 and a QALY gain of 0.13 compared with generic clopidogrel, yielding a cost per QALY gained with ticagrelor of €2753. The cost per life year gained was €2372. The results were consistent in major subgroups. Sensitivity analyses showed a cost per QALY gained with ticagrelor of ∼€7300 under certain scenarios. Based on clinical and health-economic evidence from the PLATO study, treating ACS patients with ticagrelor for 12 months is associated with a cost per QALY below generally accepted thresholds for cost-effectiveness. ClinicalTrials.gov Identifier: NCT00391872.

  16. Camp Pendleton Saves 91% in Parking Lot Lighting

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-01-01

    Case study describes how Camp Pendleton Marine Corps Base replaced high-pressure sodium (HPS) fixtures in one parking lot with high-efficiency induction fixtures for 91% savings in energy use and $5,700 in cost savings annually. This parking lot is estimated to have a simple payback of 2.9 years. Sitewide up-grades yielded annual savings of 1 million kWh.

  17. The effect of online gambling on gambling problems and