WorldWideScience

Sample records for cost728 evaluation study

  1. Trust No. 728 FIPATERM; Fideicomiso No. 728 FIPATERM

    Energy Technology Data Exchange (ETDEWEB)

    Comision Federal de Electricidad (CFE)

    2005-07-01

    The FIPATERM is an agency of the Administracion Publica Paraestatal, created to administer economic resources destined to programs or projects benefiting the economy or the social welfare of the country. It is a legally constituted trust and it has the aim, among others, of developing support programs for the energy saving by means of financing actions for energy diagnoses, substitution of low efficiency air conditioning equipment and refrigerators by ones of high efficiency, as well as heat insulation of house ceilings. The trust Num. 728 FIPATERM, has as its main aim, to design actions tending to the saving and efficient use of the electrical energy in benefit of the clients of Comision Federal de Electricidad (CFE), contracted in domestic tariff. In order to carry out the aims of the Trust Num. 728, the Program of Electrical Energy Saving was implemented -which for advertising purposes was denominated: Programa de Ahorro Sistematico Integral (ASI) [Spanish] El FIPATERM es un organismo de la Administracion Publica Paraestatal, creado para administrar recursos economicos destinados a programas o proyectos que beneficien la economia o el bienestar social del pais. Es un fideicomiso legalmente constituido y que tiene como fin entre otros, desarrollar programas de apoyo al ahorro de energia financiando acciones de diagnosticos energeticos, sustitucion de aparatos de aire acondicionado y refrigeradores de baja eficiencia por alta eficiencia, asi como aislamiento termico de techos de vivienda. El fideicomiso Num. 728 FIPATERM, tiene como fin principal, disenar acciones tendientes al ahorro y uso eficiente de la energia electrica en beneficio de los clientes de la Comision Federal de Electricidad (CFE), contratados en tarifa domestica. Para llevar a cabo los fines del Fideicomiso Num. 728, se implemento el Programa de Ahorro de Energia Electrica, mismo que para fines publicitarios se denomino: Programa de Ahorro Sistematico Integral (ASI)

  2. 7 CFR 58.728 - Cooking the batch.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Cooking the batch. 58.728 Section 58.728 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards... Procedures § 58.728 Cooking the batch. Each batch of cheese within the cooker, including the optional...

  3. 32 CFR 728.93 - Chart of adjuncts.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Chart of adjuncts. 728.93 Section 728.93 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Adjuncts to Medical Care § 728.93 Chart of...

  4. 32 CFR 728.13 - Application for care.

    Science.gov (United States)

    2010-07-01

    ... Duty § 728.13 Application for care. Possession of an ID card (a green colored DD 2 (with letter suffix... 32 National Defense 5 2010-07-01 2010-07-01 false Application for care. 728.13 Section 728.13 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE...

  5. 32 CFR 728.71 - Ex-service maternity care.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Ex-service maternity care. 728.71 Section 728.71... FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.71 Ex-service maternity... certified by medical authorities that the pregnancy existed prior to entry into service (EPTE), maternity...

  6. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations.

    Science.gov (United States)

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-07-06

    Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009). We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total effects and costs of interventions.

  7. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    Directory of Open Access Journals (Sweden)

    Tariq Luqman

    2010-07-01

    Full Text Available Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic evaluations report a small part of all societal costs. To determine the cost- effectiveness of an intervention it is necessary that all costs and benefits are included. The purpose of this study is to describe and quantify the difference in societal costs incorporated in economic evaluations and cost-of-illness studies on alcohol abuse. Method To investigate the economic costs attributable to alcohol in cost-of-illness studies we used the results of a recent systematic review (June 2009. We performed a PubMed search to identify economic evaluations on alcohol interventions. Only economic evaluations in which two or more interventions were compared from a societal perspective were included. The proportion of health care costs and the proportion of societal costs were estimated in both type of studies. Results The proportion of healthcare costs in cost-of-illness studies was 17% and the proportion of societal costs 83%. In economic evaluations, the proportion of healthcare costs was 57%, and the proportion of societal costs was 43%. Conclusions The costs included in economic evaluations performed from a societal perspective do not correspond with those included in cost-of-illness studies. Economic evaluations on alcohol abuse underreport true societal cost of alcohol abuse. When considering implementation of alcohol abuse interventions, policy makers should take into account that economic evaluations from the societal perspective might underestimate the total

  8. 48 CFR 728.105-1 - Advance payment bonds.

    Science.gov (United States)

    2010-10-01

    ... GENERAL CONTRACTING REQUIREMENTS BONDS AND INSURANCE Bonds 728.105-1 Advance payment bonds. (a) Generally, advance payment bonds will not be required in connection with USAID contracts containing an advance... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Advance payment bonds. 728...

  9. 32 CFR 728.33 - Nonavailability statement (DD 1251).

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Nonavailability statement (DD 1251). 728.33... Dependents of the Uniformed Services § 728.33 Nonavailability statement (DD 1251). (a) General. Per DODINST.... The following provisions are applicable to nonemergency inpatient care only. A DD 1251 is not required...

  10. 40 CFR 52.728 - Control strategy: Nitrogen dioxide. [Reserved

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 3 2010-07-01 2010-07-01 false Control strategy: Nitrogen dioxide. [Reserved] 52.728 Section 52.728 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...: Nitrogen dioxide. [Reserved] ...

  11. 32 CFR 728.42 - NATO.

    Science.gov (United States)

    2010-07-01

    ... § 728.42 NATO. (a) NATO SOFA nations. Belgium, Canada, Denmark, Federal Republic of Germany, France, Greece, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, Turkey, the United Kingdom...

  12. 32 CFR 728.51 - General provisions-the “Economy Act.”

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false General provisions-the âEconomy Act.â 728.51 Section 728.51 National Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.51 General provisions—th...

  13. 32 CFR 728.58 - Federal Aviation Agency (FAA) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Federal Aviation Agency (FAA) beneficiaries. 728... Federal Agencies § 728.58 Federal Aviation Agency (FAA) beneficiaries. (a) Beneficiaries. Air Traffic Control Specialists (ATCS) of the FAA when appropriate authorization has been furnished by the FAA...

  14. 20 CFR 404.728 - Evidence a marriage has ended.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence a marriage has ended. 404.728... DISABILITY INSURANCE (1950- ) Evidence Evidence of Age, Marriage, and Death § 404.728 Evidence a marriage has ended. (a) When evidence is needed that a marriage has ended. If you apply for benefits as the insured...

  15. 32 CFR 728.102 - Care from other than Federal sources.

    Science.gov (United States)

    2010-07-01

    ... MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Reservists-Continued Treatment, Return to Limited Duty, Separation, or Retirement for Physical Disability § 728.102 Care from... 32 National Defense 5 2010-07-01 2010-07-01 false Care from other than Federal sources. 728.102...

  16. 32 CFR 728.14 - Pay patients.

    Science.gov (United States)

    2010-07-01

    ... Defense Department of Defense (Continued) DEPARTMENT OF THE NAVY PERSONNEL MEDICAL AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Members of the Uniformed Services on Active Duty § 728.14 Pay patients. Care is provided on a reimbursable basis to: Coast Guard active duty officers...

  17. 32 CFR 728.44 - Members of security assistance training programs, foreign military sales, and their ITO...

    Science.gov (United States)

    2010-07-01

    ..., foreign military sales, and their ITO authorized dependents. 728.44 Section 728.44 National Defense... § 728.44 Members of security assistance training programs, foreign military sales, and their ITO... patient is an ITO authorized dependent), grade or rate, country of origin, diagnosis, type of elective...

  18. 32 CFR 728.12 - Extent of care.

    Science.gov (United States)

    2010-07-01

    ... § 728.12 Extent of care. Members who are away from their duty stations or are on duty where there is no... providing authorization for non-Federal care at DHHS expense. (b) Maternity episode for active duty female... facilities (once the mother has been admitted to the USMTF) from funds available for care of active duty...

  19. 32 CFR 728.73 - Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in...

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Applicants for enlistment or reenlistment in the Armed Forces, and applicants for enlistment in the reserve components. 728.73 Section 728.73 National... ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES Other Persons § 728.73 Applicants for enlistment or...

  20. The scope of costs in alcohol studies: Cost-of-illness studies differ from economic evaluations

    OpenAIRE

    van Gils, Paul F; Hamberg-van Reenen, Heleen H; van den Berg, Matthijs; Tariq, Luqman; de Wit, G Ardine

    2010-01-01

    Abstract Background Alcohol abuse results in problems on various levels in society. In terms of health, alcohol abuse is not only an important risk factor for chronic disease, but it is also related to injuries. Social harms which can be related to drinking include interpersonal problems, work problems, violent and other crimes. The scope of societal costs related to alcohol abuse in principle should be the same for both economic evaluations and cost-of-illness studies. In general, economic e...

  1. Characterization of five ECF sigma factors in the genome of Pseudomonas syringae pv. syringae B728a.

    Directory of Open Access Journals (Sweden)

    Poulami Basu Thakur

    Full Text Available Pseudomonas syringae pv. syringae B728a, a bacterial pathogen of bean, utilizes large surface populations and extracellular signaling to initiate a fundamental change from an epiphytic to a pathogenic lifestyle. Extracytoplasmic function (ECF sigma (σ factors serve as important regulatory factors in responding to various environmental signals. Bioinformatic analysis of the B728a genome revealed 10 ECF sigma factors. This study analyzed deletion mutants of five previously uncharacterized ECF sigma factor genes in B728a, including three FecI-type ECF sigma factors (ECF5, ECF6, and ECF7 and two ECF sigma factors placed in groups ECF11 and ECF18. Transcriptional profiling by qRT-PCR analysis of ECF sigma factor mutants was used to measure expression of their associated anti-sigma and outer membrane receptor proteins, and expression of genes associated with production of extracellular polysaccharides, fimbriae, glycine betaine and syringomycin. Notably, the B728aΔecf7 mutant displayed reduced swarming and had decreased expression of CupC fimbrial genes. Growth and pathogenicity assays, using a susceptible bean host, revealed that none of the tested sigma factor genes are required for in planta growth and lesion formation.

  2. 32 CFR 728.3 - General restrictions and priorities.

    Science.gov (United States)

    2010-07-01

    ... AND DENTAL CARE FOR ELIGIBLE PERSONS AT NAVY MEDICAL DEPARTMENT FACILITIES General § 728.3 General... domiciliary care. Routine dental care, other than dental prosthesis or orthodontia, may be rendered on a space...) Priorities. When care cannot be rendered to all eligible beneficiaries, the priorities in the following chart...

  3. Evaluating the Reliability, Validity, and Usefulness of Education Cost Studies

    Science.gov (United States)

    Baker, Bruce D.

    2006-01-01

    Recent studies that purport to estimate the costs of constitutionally adequate education have been described as either a "gold standard" that should guide legislative school finance policy design and judicial evaluation, or as pure "alchemy." Methods for estimating the cost of constitutionally adequate education can be roughly…

  4. Unit costs in international economic evaluations: resource costing of the Schizophrenia Outpatient Health Outcomes Study.

    Science.gov (United States)

    Urdahl, H; Knapp, M; Edgell, E T; Ghandi, G; Haro, J M

    2003-01-01

    We present unit costs corresponding to resource information collected in the Schizophrenia Outpatient Health Outcomes (SOHO) Study. The SOHO study is a 3-year, prospective, observational study of health outcomes associated with antipsychotic treatment in out-patients treated for schizophrenia. The study is being conducted across 10 European countries (Denmark, France, Germany, Greece, Ireland, Italy, the Netherlands, Portugal, Spain and the UK) and includes over 10,800 patients and over 1000 investigators. To identify the best available unit costs of hospital admissions, day care and psychiatrist out-patient visits, a tariff-based approach was used. Unit costs were obtained for nine of the 10 countries and were adjusted to 2000 price levels by consumer price indices and converted to US dollars using purchasing power parity rates (and on to Euro). The paper illustrates the need to balance the search for sound unit costs with pragmatic solutions in the costing of international economic evaluations.

  5. Direct medical cost and utility analysis of diabetics outpatient at Karanganyar public hospital

    Science.gov (United States)

    Eristina; Andayani, T. M.; Oetari, R. A.

    2017-11-01

    Diabetes Mellitus is a high cost disease, especially in long-term complication treatment. Long-term complication treatment cost was a problem for the patient, it can affect patients quality of life stated with utility value. The purpose of this study was to determine the medical cost, utility value and leverage factors of diabetics outpatient. This study was cross sectional design, data collected from retrospective medical record of the financial and pharmacy department to obtain direct medical cost, utility value taken from EQ-5D-5L questionnaire. Data analyzed by Mann-Whitney and Kruskal-Wallis test. Results of this study were IDR 433,728.00 for the direct medical cost and pharmacy as the biggest cost. EQ-5D-5L questionnaire showed the biggest proportion on each dimension were 61% no problem on mobility dimension, 89% no problems on self-care dimension, 54% slight problems on usual activities dimension, 41% moderate problems on pain/discomfort dimension and 48% moderate problems on anxiety/depresion dimension. Build upon Thailand value set, utility value was 0.833. Direct medical cost was IDR 433,728.00 with leverage factors were pattern therapy, blood glucose level and complication. Utility value was 0.833 with leverage factors were patients characteristic, therapy pattern, blood glucose level and complication.

  6. An Empirical Study of Agricultural Product Logistics Cost Control Evaluation via Fuzzy Analytic Hierarchy Process

    OpenAIRE

    Qianxia Lu; Yazhou Xiong; Ling Wei

    2015-01-01

    It is one of the core agricultural logistics cost control to establish a reasonable and effective evaluation system of agricultural logistics cost control. In this study, based on the cost basis of the value chain, an agricultural logistics cost control evaluation system is established from three levels, including the logistics costs of agricultural pre-value chain, logistics costs of agricultural mid-value chain, logistics costs of agricultural late-value chain. AHP theory and expert investi...

  7. Comparison of the complete genome sequences of Pseudomonassyringae pv. syringae B728a and pv. tomato DC3000.

    Energy Technology Data Exchange (ETDEWEB)

    Feil, Helene; Feil, William S.; Chain, Patrick; Larimer, Frank; DiBartolo, Genevieve; Copeland, Alex; Lykidis, Athanasios; Trong,Stephen; Nolan, Matt; Goltsman, Eugene; Thiel, James; Malfatti,Stephanie; Loper, Joyce E.; Lapidus, Alla; Detter, John C.; Land, Miriam; Richardson, Paul M.; Kyrpides, Nikos C.; Ivanova, Natalia; Lindow, StevenE.

    2005-04-01

    The complete genomic sequence of Pseudomonas syringaepathovar syringae B728a (Pss B728a), has been determined and is comparedwith that of Pseudomonas syringae pv. tomato DC3000 (Pst DC3000). Thesetwo pathovars of this economically important species of plant pathogenicbacteria differ in host range and apparent patterns of interaction withplants, with Pss having a more pronounced epiphytic stage of growth andhigher abiotic stress tolerance and Pst DC3000 having a more pronouncedapoplastic growth habitat. The Pss B728a genome (6.1 megabases) containsa circular chromosome and no plasmid, whereas the Pst DC3000 genome is6.5 mbp in size, composed of a circular chromosome and two plasmids.While a high degree of similarity exists between the two sequencedPseudomonads, 976 protein-encoding genes are unique to Pss B728a whencompared to Pst DC3000, including large genomic islands likely tocontribute to virulence and host specificity. Over 375 repetitiveextragenic palindromic sequences (REPs) unique to Pss B728a when comparedto Pst DC3000 are widely distributed throughout the chromosome except in14 genomic islands, which generally had lower GC content than the genomeas a whole. Content of the genomic islands vary, with one containing aprophage and another the plasmid pKLC102 of P. aeruginosa PAO1. Among the976 genes of Pss B728a with no counterpart in Pst DC3000 are thoseencoding for syringopeptin (SP), syringomycin (SR), indole acetic acidbiosynthesis, arginine degradation, and production of ice nuclei. Thegenomic comparison suggests that several unique genes for Pss B728a suchas ectoine synthase, DNA repair, and antibiotic production may contributeto epiphytic fitness and stress tolerance of this organism. Pseudomonassyringae, a member of the gamma subgroup of the Proteobacteria, is awidespread bacterial pathogen of many plant species. The species P.syringae is subdivided into approximately 50 pathovars based onpathogenicity and host range. P. syringae is capable of

  8. Biases in cost measurement for economic evaluation studies in health care.

    Science.gov (United States)

    Jacobs, P; Baladi, J F

    1996-01-01

    This paper addresses the issue of biases in cost measures which used in economic evaluation studies. The basic measure of hospital costs which is used by most investigators is unit cost. Focusing on this measure, a set of criteria which the basic measures must fulfil in order to approximate the marginal cost (MC) of a service for the relevant product, in the representative site, was identified. Then four distinct biases--a scale bias, a case mix bias, a methods bias and a site selection bias--each of which reflects the divergence of the unit cost measure from the desired MC measure, were identified. Measures are proposed for several of these biases and it is suggested how they can be corrected.

  9. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care.

    NARCIS (Netherlands)

    Schäfer, W.L.A.; Boerma, W.G.W.; Kringos, D.S.; Maeseneer, J. de; Gress, S.; Heinemann, S.; Rotar-Pavlic, D.; Seghieri, C.; Svab, I.; Berg, M.J. van den; Vainieri, M.; Westert, G.P.; Willems, S.; Groenewegen, P.P.

    2011-01-01

    Background: The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary

  10. Fresh Water Cyanobacteria Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as an Anticancer Drug Resource.

    Directory of Open Access Journals (Sweden)

    Akanksha Srivastava

    Full Text Available An increasing number of cancer patients worldwide, especially in third world countries, have raised concern to explore natural drug resources, such as the less explored fresh water filamentous cyanobacteria. Six strains of cyanobacteria (Phormidium sp. CCC727, Geitlerinema sp. CCC728, Arthrospira sp. CCC729, Phormidium sp. CCC731, Phormidium sp. CCC730, and Leptolyngbya sp. CCC732 were isolated (paddy fields and ponds in the Banaras Hindu University, campus and five strains screened for anticancer potential using human colon adenocarcinoma (HT29 and human kidney adenocarcinoma (A498 cancer cell lines. Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 were the most potent as determined by examination of morphological features and by inhibition of growth by graded concentrations of crude extracts and thin-layer chromatography (TLC eluates. Cell cycle analysis and multiplex assays using cancer biomarkers also confirmed Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as cancer drug resources. Apoptotic studies in the cells of A498 (cancer and MCF-10A (normal human epithelial exposed to crude extracts and TLC fractions revealed no significant impact on MCF-10A cells emphasizing its importance in the development of anticancer drug. Identification of biomolecules from these extracts are in progress.

  11. Fresh Water Cyanobacteria Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as an Anticancer Drug Resource.

    Science.gov (United States)

    Srivastava, Akanksha; Tiwari, Ratnakar; Srivastava, Vikas; Singh, Tej Bali; Asthana, Ravi Kumar

    2015-01-01

    An increasing number of cancer patients worldwide, especially in third world countries, have raised concern to explore natural drug resources, such as the less explored fresh water filamentous cyanobacteria. Six strains of cyanobacteria (Phormidium sp. CCC727, Geitlerinema sp. CCC728, Arthrospira sp. CCC729, Phormidium sp. CCC731, Phormidium sp. CCC730, and Leptolyngbya sp. CCC732) were isolated (paddy fields and ponds in the Banaras Hindu University, campus) and five strains screened for anticancer potential using human colon adenocarcinoma (HT29) and human kidney adenocarcinoma (A498) cancer cell lines. Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 were the most potent as determined by examination of morphological features and by inhibition of growth by graded concentrations of crude extracts and thin-layer chromatography (TLC) eluates. Cell cycle analysis and multiplex assays using cancer biomarkers also confirmed Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as cancer drug resources. Apoptotic studies in the cells of A498 (cancer) and MCF-10A (normal human epithelial) exposed to crude extracts and TLC fractions revealed no significant impact on MCF-10A cells emphasizing its importance in the development of anticancer drug. Identification of biomolecules from these extracts are in progress.

  12. Standardisation of costs: the Dutch Manual for Costing in economic evaluations.

    Science.gov (United States)

    Oostenbrink, Jan B; Koopmanschap, Marc A; Rutten, Frans F H

    2002-01-01

    The lack of a uniform costing methodology is often considered a weakness of economic evaluations that hinders the interpretation and comparison of studies. Standardisation is therefore an important topic within the methodology of economic evaluations and in national guidelines that formulate the formal requirements for studies to be considered when deciding on the reimbursement of new medical therapies. Recently, the Dutch Manual for Costing: Methods and Standard Costs for Economic Evaluations in Health Care (further referred to as "the manual") has been published, in addition to the Dutch guidelines for pharmacoeconomic research. The objectives of this article are to describe the main content of the manual and to discuss some key issues of the manual in relation to the standardisation of costs. The manual introduces a six-step procedure for costing. These steps concern: the scope of the study;the choice of cost categories;the identification of units;the measurement of resource use;the monetary valuation of units; andthe calculation of unit costs. Each step consists of a number of choices and these together define the approach taken. In addition to a description of the costing process, five key issues regarding the standardisation of costs are distinguished. These are the use of basic principles, methods for measurement and valuation, standard costs (average prices of healthcare services), standard values (values that can be used within unit cost calculations), and the reporting of outcomes. The use of the basic principles, standard values and minimal requirements for reporting outcomes, as defined in the manual, are obligatory in studies that support submissions to acquire reimbursement for new pharmaceuticals. Whether to use standard costs, and the choice of a particular method to measure or value costs, is left mainly to the investigator, depending on the specific study setting. In conclusion, several instruments are available to increase standardisation in

  13. Cost-of-illness studies.

    Science.gov (United States)

    Oderda, Gary M

    2003-01-01

    Cost-of-illness studies measure the overall economic impact of a disease on society. Such studies are important in setting public health priorities and for economic evaluation of new treatments. These studies should take the societal perspective and include both direct and indirect costs. Often indirect costs exceed direct costs. Comparison of cost-of-illness studies from different countries is difficult because of differences in population, currency, the way health care is provided, and other social and political factors.

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

    Directory of Open Access Journals (Sweden)

    Hong Xue

    2018-01-01

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

  15. Evaluating the cost-effectiveness of ecosystem-based adaptation: Kamiesberg wetlands case study

    Directory of Open Access Journals (Sweden)

    David Black

    2016-12-01

    Full Text Available Ecosystem-based adaptation (EbA is increasingly being promoted as a cost-effective means of adaptation to climate change. However, in spite of considerable international press, there is still little evidence to substantiate this claim. This study proposes a method through which the cost-effectiveness of EbA strategies can be evaluated against alternative adaptation options, and contributes to South African literature on the subject. The potential cost-effectiveness of wetland restoration is assessed as a means of securing the carrying capacity of land for pastoralist communities of the Kamiesberg communal area in South Africa under projected future climate conditions. The conventional alternatives would be to respond to increasingly dry conditions by drilling boreholes and using supplemental feed for livestock. It was assumed that the EbA interventions would occur upfront, whereas the alternatives are more likely to be implemented in reaction to droughts over a longer time period. The study found the implementation of conventional alternatives to be more cost-effective than EbA as a means to sustaining livestock stocking rates, with EbA being twice as costly. However, this is framed from the perspective of those directly affected (the landowners, and does not include the benefits to broader society.

  16. 32 CFR 728.53 - Department of Labor, Office of Workers' Compensation Programs (OWCP) beneficiaries.

    Science.gov (United States)

    2010-07-01

    ... DEPARTMENT FACILITIES Beneficiaries of Other Federal Agencies § 728.53 Department of Labor, Office of Workers... injury) incurred while engaged in: (i) Training. (ii) Flight instructions. (iii) Travel to or from... injury.) This category includes but is not limited to: (i) Civilian student employees in training at Navy...

  17. Evaluation of construction cost of pyro-partitioning plant

    International Nuclear Information System (INIS)

    Kinoshita, Kensuke; Kurata, Masateru; Inoue, Tadashi

    1999-01-01

    This study was conducted to evaluate the construction cost of a pyro-partitioning plant. The plant capacity was chosen to accommodate processing of the HLLW generated by PUREX reprocessing of 800 ton of spent LWR fuel. The block flow diagram and mass balance obtained from our previous experimental data were used to produce a detailed process-flow diagram and to design the plant. In this evaluation, the plant was estimated to cover an area of about 90 m x 70 m, and to cost $576 million for construction. This study shows that the cost of process equipments, such as reaction vessels, accountability tanks and so on, is just about 13% of total construction cost. On the other hand, the cost of process robots and the equipments for key measurement point (KMP) is major part in the cost of in-cell equipment. So it is clear that the construction cost can be reduced by reducing the number of material balance area (MBA) and KMP. (author)

  18. The Cost of Penicillin Allergy Evaluation.

    Science.gov (United States)

    Blumenthal, Kimberly G; Li, Yu; Banerji, Aleena; Yun, Brian J; Long, Aidan A; Walensky, Rochelle P

    2017-09-22

    Unverified penicillin allergy leads to adverse downstream clinical and economic sequelae. Penicillin allergy evaluation can be used to identify true, IgE-mediated allergy. To estimate the cost of penicillin allergy evaluation using time-driven activity-based costing (TDABC). We implemented TDABC throughout the care pathway for 30 outpatients presenting for penicillin allergy evaluation. The base-case evaluation included penicillin skin testing and a 1-step amoxicillin drug challenge, performed by an allergist. We varied assumptions about the provider type, clinical setting, procedure type, and personnel timing. The base-case penicillin allergy evaluation costs $220 in 2016 US dollars: $98 for personnel, $119 for consumables, and $3 for space. In sensitivity analyses, lower cost estimates were achieved when only a drug challenge was performed (ie, no skin test, $84) and a nurse practitioner provider was used ($170). Adjusting for the probability of anaphylaxis did not result in a changed estimate ($220); although other analyses led to modest changes in the TDABC estimate ($214-$246), higher estimates were identified with changing to a low-demand practice setting ($268), a 50% increase in personnel times ($269), and including clinician documentation time ($288). In a least/most costly scenario analyses, the lowest TDABC estimate was $40 and the highest was $537. Using TDABC, penicillin allergy evaluation costs $220; even with varied assumptions adjusting for operational challenges, clinical setting, and expanded testing, penicillin allergy evaluation still costs only about $540. This modest investment may be offset for patients treated with costly alternative antibiotics that also may result in adverse consequences. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Evaluation of Uniform Cost Accounting System to Fully Capture Depot Level Repair Costs.

    Science.gov (United States)

    1985-12-01

    RD-RI65 522 EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY i/I CAPTURE DEPOT LEVEL REPAIR COSTS (U) NAVAL POSTGRADUATE SCHOOL MONTEREY CA D R...8217.LECTE B ,- THESIS EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM 0TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS Jby __jDavid Richmond O’Brien lj,,, December...Include Security Classification) EVALUATION OF UNIFORM COST ACCOUNTING SYSTEM TO FULLY CAPTURE DEPOT LEVEL REPAIR COSTS 12 PERSONAL AUTHOR(S) O’Brien- David

  20. Cost of illness and economic evaluation in rare diseases.

    Science.gov (United States)

    López-Bastida, Julio; Oliva-Moreno, Juan

    2010-01-01

    Rare diseases are a major cause of morbidity and mortality in high income countries and have major repercussions on individuals and health care systems. This chapter examines the health economy of rare diseases from two different perspectives: firstly, the study of the economic impact of rare diseases (Cost of Illness studies); and, secondly, cost-effectiveness evaluation, which evaluates both the costs and results of the health care technologies applied in rare diseases. From the point of view of economics, health resource allocation is based on the principle of scarcity, as there are not - and never will be- sufficient resources for all worthy objectives. Hence, policy makers should balance costs and health outcomes. Rare diseases may well represent a significant societal burden that should rightly receive appropriate prioritisation of health care resources. As new and seemingly expensive health care technologies are developed for rare diseases, it will become increasingly important to evaluate potential and real impact of these new technologies in both dimensions: social costs and health outcomes.

  1. UPPER LIMITS ON PULSED RADIO EMISSION FROM THE 6.85 s X-RAY PULSAR XTE J0103-728 IN THE SMALL MAGELLANIC CLOUD

    International Nuclear Information System (INIS)

    Crawford, Fronefield; Devour, Brian M.; Takacs, Brian P.; Lorimer, Duncan R.; Kondratiev, Vladislav I.

    2009-01-01

    X-ray pulsations with a 6.85 s period were recently detected in the Small Magellanic Cloud (SMC) and were subsequently identified as originating from the Be/X-ray binary system XTE J0103-728. The recent localization of the source of the X-ray emission has made a targeted search for radio pulsations from this source possible. The detection of pulsed radio emission from XTE J0103-728 would make it only the second system after PSR B1259-63 that is both a Be/X-ray binary and a radio pulsar. We observed XTE J0103-728 in 2008 February with the Parkes 64 m radio telescope soon after the identification of the source of X-ray pulsations was reported in order to search for corresponding radio pulsations. We used a continuous 6.4 hr observation with a 256 MHz bandwidth centered at 1390 MHz using the center beam of the Parkes multibeam receiver. In the subsequent data analysis, which included a folding search, a Fourier search, a fast-folding algorithm search, and a single pulse search, no pulsed signals were found for trial dispersion measures (DMs) between 0 and 800 pc cm -3 . This DM range easily encompasses the expected values for sources in the SMC. We place an upper limit of ∼45 mJy kpc 2 on the luminosity of periodic radio emission from XTE J0103-728 at the epoch of our observation, and we compare this limit to a range of luminosities measured for PSR B1259-63, the only Be/X-ray binary currently known to emit radio pulses. We also compare our limit to the radio luminosities of neutron stars having similarly long spin periods to XTE J0103-728. Since the radio pulses from PSR B1259-63 are eclipsed and undetectable during the portion of the orbit near periastron, repeated additional radio search observations of XTE J0103-728 may be valuable if it is undergoing similar eclipsing and if such observations are able to sample the orbital phase of this system well.

  2. Activity-based costing evaluation of a [(18)F]-fludeoxyglucose positron emission tomography study.

    Science.gov (United States)

    Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Borght, Thierry Vander

    2009-10-01

    The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes. The cost data were obtained from the hospital administration, personnel and vendor interviews as well as from structured questionnaires. A process map separates the process in 16 patient- and non-patient-related activities, to which the detailed cost data are related. One-way sensitivity analyses shows to which degree of uncertainty the different parameters affect the individual cost and evaluate the impact of possible resource or practice changes like the acquisition of a hybrid PET/CT device, the patient throughput or the sales price of a 370MBq (18)F-FDG patient dose. The PET centre spends 73% of time in clinical activities and the resting time after injection of the tracer (42%) is the single largest departmental cost element. The tracer cost and the operational time have the most influence on cost per procedure. The analysis shows a total cost per FDG-PET ranging from 859 Euro for a BGO PET camera to 1142 Euro for a 16 slices PET-CT system, with a distribution of the resource costs in decreasing order: materials (44%), equipment (24%), wage (16%), space (6%) and hospital overhead (10%). The cost of FDG-PET is mainly influenced by the cost of the radiopharmaceutical. Therefore, the latter rather than the operational time should be reduced in order to improve its cost-effectiveness.

  3. Survey of Swiss nuclear's cost study 2016

    International Nuclear Information System (INIS)

    Alt, Stefan; Ustohalova, Veronika

    2017-01-01

    The report discusses the Swiss nuclear cost study 2016 concerning the following issues: evaluation of the aspects of the cost study: cost structure, cost classification and risk provision, additional payment liability, option of lifetime extension for Swiss nuclear power plants; specific indications on the report ''cost study 2016 (KS16) - estimation of the decommissioning cost of Swiss nuclear power plants'': decommissioning costs in Germany, France and the USA, indexing the Swiss cost estimation for decommissioning cost, impact factors on the decommissioning costs; specific indications on the report ''cost study 2016 (KS16) - estimation of the disposal cost - interim storage, transport, containers and reprocessing''; specific indications on the report ''cost studies (KS16) - estimation of disposal costs - geological deep disposal'': time scale and costs incurred, political/social risks, retrievability, comparison with other mining costs.

  4. Cost-effectiveness evaluation of an RCT in rehabilitation after lumbar spinal fusion: a low-cost, behavioural approach is cost-effective over individual exercise therapy

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Laurberg, Ida; Christensen, Finn B

    2008-01-01

    Recently, Christensen et al. reported the clinical effects of a low-cost rehabilitation program equally efficient to a relatively intensive program of individual, physiotherapist-guided exercise therapy. Yet, the low-cost approach is not fully supported as an optimal strategy until a full......-scale economic evaluation, including extra-hospital effects such as service utilization in the primary health care sector and return-to-work, is conducted. The objective of this study was to conduct such evaluation i.e. investigate the cost-effectiveness of (1) a low-cost rehabilitation regimen...... with a behavioural element and (2) a regimen of individual exercise therapy, both in comparison with usual practice, from a health economic, societal perspective. Study design was a cost-effectiveness evaluation of an RCT with a 2-year follow-up. Ninety patients having had posterolateral or circumferential fusion...

  5. Costing bias in economic evaluations.

    Science.gov (United States)

    Frappier, Julie; Tremblay, Gabriel; Charny, Mark; Cloutier, L Martin

    2015-01-01

    Determining the cost-effectiveness of healthcare interventions is key to the decision-making process in healthcare. Cost comparisons are used to demonstrate the economic value of treatment options, to evaluate the impact on the insurer budget, and are often used as a key criterion in treatment comparison and comparative effectiveness; however, little guidance is available to researchers for establishing the costing of clinical events and resource utilization. Different costing methods exist, and the choice of underlying assumptions appears to have a significant impact on the results of the costing analysis. This editorial describes the importance of the choice of the costing technique and it's potential impact on the relative cost of treatment options. This editorial also calls for a more efficient approach to healthcare intervention costing in order to ensure the use of consistent costing in the decision-making process.

  6. Cost evaluation of clinical laboratory in Taiwan's National Health System by using activity-based costing.

    Science.gov (United States)

    Su, Bin-Guang; Chen, Shao-Fen; Yeh, Shu-Hsing; Shih, Po-Wen; Lin, Ching-Chiang

    2016-11-01

    To cope with the government's policies to reduce medical costs, Taiwan's healthcare service providers are striving to survive by pursuing profit maximization through cost control. This article aimed to present the results of cost evaluation using activity-based costing performed in the laboratory in order to throw light on the differences between costs and the payment system of National Health Insurance (NHI). This study analyzed the data of costs and income of the clinical laboratory. Direct costs belong to their respective sections of the department. The department's shared costs, including public expenses and administrative assigned costs, were allocated to the department's respective sections. A simple regression equation was created to predict profit and loss, and evaluate the department's break-even point, fixed cost, and contribution margin ratio. In clinical chemistry and seroimmunology sections, the cost per test was lower than the NHI payment and their major laboratory tests had revenues with the profitability ratio of 8.7%, while the other sections had a higher cost per test than the NHI payment and their major tests were in deficit. The study found a simple linear regression model as follows: "Balance=-84,995+0.543×income (R2=0.544)". In order to avoid deficit, laboratories are suggested to increase test volumes, enhance laboratory test specialization, and become marginal scale. A hospital could integrate with regional medical institutions through alliances or OEM methods to increase volumes to reach marginal scale and reduce laboratory costs, enhancing the level and quality of laboratory medicine.

  7. Complete cost insertion in the evaluation within the energetic planning

    International Nuclear Information System (INIS)

    Reis, Lineu Belico dos; Udaeta, Miguel Edgar Morales; Carvalho, Claudio Elias

    1999-01-01

    The article discusses the environment, social and economic costs in the energetic planning. In this context, it is introduced the Complete Costs Evaluation boarding and it is presented a case study based on a kind of fertilizer produced in Sao Paulo, a Brazilian state. Quantitative and qualitative evaluation were also presented and the results were discussed

  8. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64 (Purchase...

  9. Comparative evaluation of activity-based costing and variable costing: a case study at IPEN

    International Nuclear Information System (INIS)

    Esteves, Josefina Maria da Silva SILVA

    2010-01-01

    This research aims to compare the results with the application of Activity Based Costing and Variable Costing methods in an administrative unit of the Brazilian Federal Government: the Radiopharmacy Facility of IPEN (Institute for Energy and Nuclear Research), which produces radiopharmaceuticals products and develops R and D activities. Faced with the need to adopt a more economical and managerial public administration, this research has provided information to assess which of the two costing methods proves more suitable for cost management in that unit. The research is exploratory and a single-case study. We traced about 80% of material costs by observation 'in loco' of the entire manufacturing process of technetium generator, which represents the main product in terms of production volume and revenues. The results show that the Contribution Margin Variable Costing of 29.12% is very close to the operating income of 28.86%, ahead of support activities, obtained by ABC. It is also noted that the operational result of the product does not change by using either one or another costing method. In the two costing methods the end result is 24.20%. This occurs because the production is on demand. There is no inventory of finished product because it is radioactive. The research has revealed that both methods provide useful information for the management and optimization of costs and results of processes/activities, and that the two methods, in this case, may be used in an integrated and complementary approach, enabling to use the best information content of both. (author)

  10. Productivity costs in economic evaluations: past, present, future.

    Science.gov (United States)

    Krol, Marieke; Brouwer, Werner; Rutten, Frans

    2013-07-01

    Productivity costs occur when the productivity of individuals is affected by illness, treatment, disability or premature death. The objective of this paper was to review past and current developments related to the inclusion, identification, measurement and valuation of productivity costs in economic evaluations. The main debates in the theory and practice of economic evaluations of health technologies described in this review have centred on the questions of whether and how to include productivity costs, especially productivity costs related to paid work. The past few decades have seen important progress in this area. There are important sources of productivity costs other than absenteeism (e.g. presenteeism and multiplier effects in co-workers), but their exact influence on costs remains unclear. Different measurement instruments have been developed over the years, but which instrument provides the most accurate estimates has not been established. Several valuation approaches have been proposed. While empirical research suggests that productivity costs are best included in the cost side of the cost-effectiveness ratio, the jury is still out regarding whether the human capital approach or the friction cost approach is the most appropriate valuation method to do so. Despite the progress and the substantial amount of scientific research, a consensus has not been reached on either the inclusion of productivity costs in economic evaluations or the methods used to produce productivity cost estimates. Such a lack of consensus has likely contributed to ignoring productivity costs in actual economic evaluations and is reflected in variations in national health economic guidelines. Further research is needed to lessen the controversy regarding the estimation of health-related productivity costs. More standardization would increase the comparability and credibility of economic evaluations taking a societal perspective.

  11. Comparative study of cost models for tokamak DEMO fusion reactors

    International Nuclear Information System (INIS)

    Oishi, Tetsutarou; Yamazaki, Kozo; Arimoto, Hideki; Ban, Kanae; Kondo, Takuya; Tobita, Kenji; Goto, Takuya

    2012-01-01

    Cost evaluation analysis of the tokamak-type demonstration reactor DEMO using the PEC (physics-engineering-cost) system code is underway to establish a cost evaluation model for the DEMO reactor design. As a reference case, a DEMO reactor with reference to the SSTR (steady state tokamak reactor) was designed using PEC code. The calculated total capital cost was in the same order of that proposed previously in cost evaluation studies for the SSTR. Design parameter scanning analysis and multi regression analysis illustrated the effect of parameters on the total capital cost. The capital cost was predicted to be inside the range of several thousands of M$s in this study. (author)

  12. Purposive facebook recruitment endows cost-effective nutrition education program evaluation.

    Science.gov (United States)

    Lohse, Barbara; Wamboldt, Patricia

    2013-08-15

    Recent legislation established a requirement for nutrition education in federal assistance programs to be evidence-based. Recruitment of low-income persons to participate and evaluate nutrition education activities can be challenging and costly. Facebook has been shown to be a cost-effective strategy to recruit this target audience to a nutrition program. The purpose of our study was to examine Facebook as a strategy to recruit participants, especially Supplemental Nutrition Assistance Program Education (SNAP-Ed) eligible persons, to view and evaluate an online nutrition education program intended to be offered as having some evidence base for SNAP-Ed programming. English-speaking, low-income Pennsylvania residents, 18-55 years with key profile words (eg, Supplemental Nutrition Assistance Program, Food bank), responded to a Facebook ad inviting participation in either Eating Together as a Family is Worth It (WI) or Everyone Needs Folic Acid (FA). Participants completed an online survey on food-related behaviors, viewed a nutrition education program, and completed a program evaluation. Facebook set-up functions considered were costing action, daily spending cap, and population reach. Respondents for both WI and FA evaluations were similar; the majority were white, Cost per completed evaluation was US $25.48; cost per low-income completer was US $39.92. Results were similar for the FA evaluation; 795 Facebook users clicked on the ad with 110 unique site visitors, and 73 completing the evaluation (ie, 73/795, 9.2% of ad clickers and 73/110, 66% of site visitors completed the evaluation). Cost per valid completed survey with program evaluation was US $18.88; cost per low-income completer was US $27.53. With Facebook we successfully recruited low-income Pennsylvanians to online nutrition program evaluations. Benefits using Facebook as a recruitment strategy included real-time recruitment management with lower costs and more efficiency compared to previous data from

  13. Cost effectiveness of preventive home visits to the elderly: economic evaluation alongside randomized controlled study

    DEFF Research Database (Denmark)

    Kronborg, Christian; Vass, Mikkel; Lauridsen, Jørgen

    2006-01-01

    We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person...... is able independently to transfer, walk indoors, go outdoors, walk outdoors in both pleasant and poor weather, and climb stairs. In 17 of 34 municipalities health visitors and general practitioners were offered geriatric training, which focused on early signs of disability, physical activity......,455 to 744) in 75-year-olds and 694 euro (-2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (-0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration....

  14. EVALUATION OF FORWARDER WOOD EXTRACTION COST OF OPERATION

    Directory of Open Access Journals (Sweden)

    Larissa Nunes dos Santos

    2016-03-01

    Full Text Available The objective of this study was to determine the costs of the activity of timber extraction done by forwarders until approximately 30,000 work hours. We used 7 John Deere forwarders, model 1710D with 160 kW engine power. A database provided by a forestry company located in the state of Minas Gerais was used, containing all the information necessary for calculating the operating cost of the machines and for the subsequent sensitivity analysis. The operating cost was obtained by the sum of the fixed and variable costs. For the sensitivity analysis a variation ± 20% of the most representative elements of the total cost of the machine was performed. The result obtained for the average operating cost of the forwarder was US$ 147.80 h-1. Costs for repairs and maintenance, labor, fuel, and depreciation represented approximately 90% of the total cost of the machine. A 10% reduction in their values resulted in a savings of approximately 9% in all years evaluated.

  15. Methodology for Evaluating Cost-effectiveness of Commercial Energy Code Changes

    Energy Technology Data Exchange (ETDEWEB)

    Hart, Philip R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-01-31

    This document lays out the U.S. Department of Energy’s (DOE’s) method for evaluating the cost-effectiveness of energy code proposals and editions. The evaluation is applied to provisions or editions of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 90.1 and the International Energy Conservation Code (IECC). The method follows standard life-cycle cost (LCC) economic analysis procedures. Cost-effectiveness evaluation requires three steps: 1) evaluating the energy and energy cost savings of code changes, 2) evaluating the incremental and replacement costs related to the changes, and 3) determining the cost-effectiveness of energy code changes based on those costs and savings over time.

  16. Register-based studies of healthcare costs

    DEFF Research Database (Denmark)

    Kruse, Marie; Christiansen, Terkel

    2011-01-01

    Introduction: The aim of this paper is to provide an overview and a few examples of how national registers are used in analyses of healthcare costs in Denmark. Research topics: The paper focuses on health economic analyses based on register data. For the sake of simplicity, the studies are divided...... into three main categories: economic evaluations of healthcare interventions, cost-of-illness analyses, and other analyses such as assessments of healthcare productivity. Conclusion: We examined a number of studies using register-based data on healthcare costs. Use of register-based data renders...

  17. Evaluation of the Costs of Caring for the Senile Demented Elderly: A Pilot Study.

    Science.gov (United States)

    Hu, Teh-wei; And Others

    1986-01-01

    Evaluated economic costs for nursing home patients and elderly living in their own homes. Using time records compiled by nurses or family members, the costs incurred annually in caring for a senile demented elderly person at home were estimated to average $11,735, and in a nursing home, $22,458. (Author/BL)

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

    Directory of Open Access Journals (Sweden)

    Changik Jo

    2014-12-01

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

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

    Science.gov (United States)

    2014-01-01

    Liver diseases are one of the main causes of death, and their ever-increasing prevalence is threatening to cause significant damage both to individuals and society as a whole. This damage is especially serious for the economically active population in Korea. From the societal perspective, it is therefore necessary to consider the economic impacts associated with liver diseases, and identify interventions that can reduce the burden of these diseases. The cost-of-illness study is considered to be an essential evaluation technique in health care. By measuring and comparing the economic burdens of diseases to society, such studies can help health-care decision-makers to set up and prioritize health-care policies and interventions. Using economic theories, this paper introduces various study methods that are generally applicable to most disease cases for estimating the costs of illness associated with mortality, morbidity, disability, and other disease characteristics. It also presents concepts and scopes of costs along with different cost categories from different research perspectives in cost estimations. By discussing the epidemiological and economic grounds of the cost-of-illness study, the reported results represent useful information about several evaluation techniques at an advanced level, such as cost-benefit analysis, cost-effectiveness analysis, and cost-utility analysis. PMID:25548737

  20. Practice, efficacy, and costs of thyroid nodule evaluation: a retrospective study in a Dutch university hospital

    NARCIS (Netherlands)

    Hooft, Lotty; Hoekstra, Otto S.; Boers, Maarten; van Tulder, Maurits W.; van Diest, Paul; Lips, Paul

    2004-01-01

    Fine-needle aspiration (FNA) of thyroid nodules has markedly reduced the role of thyroid scintigraphy. This is often limited to nondiagnostic or follicular (tumor) FNA classifications. In this study, we evaluated the efficacy and cost of such a strategy in a university center. From 1992-1998, 995

  1. Treatability studies performed in support of an engineering evaluation/cost analysis

    International Nuclear Information System (INIS)

    Myers, J.M.; Mueller, J.P.; Sundquist, J.A.; Moore, G.W.

    1995-01-01

    The Southern Shipbuilding Corporation (SSC) site is located on 54 acres of wooded land adjacent to Bayou Bonfouca, approximately 1.8 miles downstream of the Bayou Bonfouca National Priorities List (NPL) Superfund site in Slidell, St. Tammany Parish, Louisiana. Two one-acre, impoundments on the SSC site were used to store wastes generated from vessel cleaning. Wastes stored in the impoundments are migrating into Bayou Bonfouca, which empties into Lake Pontchartrain. In addition, the impoundments are frequently invaded by flood waters. The US EPA Emergency Response Branch (EPA-ERB) performed a site investigation which indicated that the majority of the contamination is petroleum-related and that the compounds of concern are polycyclic aromatic hydrocarbons (PARs). The wastes are generally contained with the two impoundments and surrounding soils. As part of an Engineering Evaluation/Cost Basis (EE/CA) of potential response action alternatives, four treatability studies were performed. A thermal treatment (incineration) study was performed at the EPA's Incineration Research Facility (IRF). Biodegradation remedy selection feasibility assessment was conducted on-site. A remedy screening soil washing study was also performed by TAT. A solidification/stabilization (S/S) study was conducted through EPA's Risk Reduction Engineering Laboratory (RREL) to ascertain if the PAHs could be immobilized within a solid matrix. Experimental objectives, dead methodology and conclusions for these studies are presented as they relate to potential response actions being evaluated at the SSC site

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-12-15

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

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

    International Nuclear Information System (INIS)

    Park, Byung Heung; Ko, Won Il

    2015-01-01

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

  4. Improving environmental impact and cost assessment for supplier evaluation

    Science.gov (United States)

    Beucker, Severin; Lang, Claus

    2004-02-01

    Improving a company"s environmental and financial performance necessitates the evaluation of environmental impacts deriving from the production and cost effects of corporate actions. These effects have to be made transparent and concrete targets have to be developed. Such an evaluation has to be done on a regular basis but with limited expenses. To achieve this, different instruments of environmental controlling such as LCA and environmental performance indicators have to be combined with methods from cost accounting. Within the research project CARE (Computer Aided Resource Efficiency Accounting for Medium-Sized Enterprises), the method Resource Efficiency Accounting (REA) is used to give the participating companies new insights into hidden costs and environmental effects of their production and products. The method combines process based cost accounting with environmental impact assessment methodology and offers results that can be integrated into a company"s environmental controlling system and business processes like cost accounting, supplier assessment, etc. Much of the data necessary for the combined assessment can be available within a company"s IT system and therefore can be efficiently used for the assessment process. The project CARE puts a strong focus on the use of company data and information systems for the described assessment process and offers a methodological background for the evaluation and the structuring of such data. Besides the general approach of the project CARE the paper will present results from a case study in which the described approach is used for the evaluation of suppliers.

  5. The evaluation of external costs from energy sources

    International Nuclear Information System (INIS)

    Lee, R.; Valette, P.; Krupnick, A.; Markandya, A.

    1994-01-01

    The paper outlines the progress of the joint EC-US Fuel Cycle study. This study seeks to provide a methodological framework for precisely the evaluation of external costs over the complete fuel cycle, from fuel extraction to decommissioning, conservation technologies, solar and wind power. (authors). 19 refs., 4 figs

  6. An Evaluation of Cost-Effectiveness of Micro Computerized ...

    African Journals Online (AJOL)

    /Integrated Set of Information System (CDS/ISIS) application software in the library and its effectiveness in performance operations was evaluated to determine the cost – effectiveness. The study population was made up of all the staff involved ...

  7. Cost evaluation of I and C upgrade approach in nuclear power plants

    International Nuclear Information System (INIS)

    Kang, Hyun-Tae; Lee, Jae-Ki

    2013-01-01

    Highlights: • Cost evaluation process for I and C system upgrade is built. • 4 cost factors affecting I and C system upgrade are described. • Additional cost incurred by a phased upgrade is calculated. • Cost for system upgrade between upgrade implementations is compared. - Abstract: Utilities have recently been debating the respective pros and cons of implementation of a multi-phase upgrade during several normal outages versus a single major upgrade implementation during a prolonged outage. We have studied these approaches and have been developing the basic design of nuclear power plants (NPPs) instrumentation and control (I and C) upgrade since early 2008. As part of this study, analyses of the NPPs I and C systems were conducted and the need for upgrading the systems was raised. One of the primary concerns regarding the system upgrade is a cost-benefit implementation, which will influence the upgrade approach. From this viewpoint, the I and C upgrade must consider economic factors such as I and C vendor cost, architecture engineering cost, installation cost, utility cost, and other transition costs such as training and procedure development. This paper presents a comparison study of economical aspects including cost evaluation between the aforementioned upgrade implementations and suggests a solution for I and C upgrade approach

  8. A prospective cohort study evaluating the cost-effectiveness of carbetocin for prevention of postpartum haemorrhage in caesarean sections.

    Science.gov (United States)

    Luni, Yasmin; Borakati, Aditya; Matah, Arti; Skeats, Katie; Eedarapalli, Padma

    2017-07-01

    Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylaxis with oxytocic medication is recommended by the WHO to prevent its occurrence. Carbetocin is a newer oxytocic, with potential to lower PPH rates, reduce the total use of oxytocic drugs and lead to financial savings. Meta-analyses have confirmed a reduction in the use of additional oxytocic medication with the use of carbetocin compared to oxytocin. However, there are few studies evaluating the costs of carbetocin prophylaxis. We carried out a prospective cohort study evaluating the financial impact of carbetocin, following its introduction at our centre for caesarean section. We collected data for 400 patients in total, making this, to our knowledge, the largest study conducted on this topic. We found a significant reduction in PPH rates and the use of additional oxytocics with projected overall financial savings of £68.93 per patient with the use of carbetocin. Impact statement It is well established that carbetocin reduces the use of secondary oxytocics compared to oxytocin alone in the active management of the third stage of labour. Evidence for reduction of post-partum haemorrhage and its cost effectiveness are more equivocal. Our study demonstrates that carbetocin also reduces post-partum haemorrhage, use of blood and blood products and midwifery recovery time in the setting of caesarean section. We have also demonstrated that despite the increased index cost of carbetocin it delivers an overall substantial cost benefit. The implications of these findings are of reduced morbidity, faster recovery and cost savings in these times of austerity in the UK. It allows more efficient labour distribution of midwives, particularly in the setting of staff shortages across the NHS. A randomised control trial in this area needs to be conducted to determine the cost benefit of carbetocin and with this and post-partum haemorrhage rates as the primary outcome measures.

  9. AEMS implementation cost study for Boeing 727

    Science.gov (United States)

    Allison, R. L.

    1977-01-01

    Costs for airline operational implementation of a NASA-developed approach energy management system (AEMS) concept, as applied to the 727 airplane, were determined. Estimated costs are provided for airplane retrofit and for installation of the required DME ground stations. Operational costs and fuel cost savings are presented in a cost-of-ownership study. The potential return on the equipment investment is evaluated using a net present value method. Scheduled 727 traffic and existing VASI, ILS, and collocated DME ground station facilities are summarized for domestic airports used by 727 operators.

  10. EVALUATION OF CORROSION COST OF CRUDE OIL PROCESSING INDUSTRY

    Directory of Open Access Journals (Sweden)

    ADESANYA A.O.

    2012-08-01

    Full Text Available Crude oil production industry as the hub of Nigeria Economy is not immune to the global financial meltdown being experienced world over which have resulted in a continual fall of oil price. This has necessitated the need to reduce cost of production. One of the major costs of production is corrosion cost, hence, its evaluation. This research work outlined the basic principles of corrosion prevention, monitoring and inspection and attempted to describe ways in which these measures may be adopted in the context of oil production. A wide range of facilities are used in crude oil production making it difficult to evaluate precisely the extent of corrosion and its cost implication. In this study, cost of corrosion per barrel was determined and the annualized value of corrosion cost was also determined using the principles of engineering economy and results analyzed using descriptive statistics. The results showed that among the corrosion prevention methods identified, the use of chemical treatment gave the highest cost contribution (81% of the total cost of prevention while coating added 19%. Cleaning pigging and cathodic protection gave no cost. The contribution of corrosion maintenance methods are 60% for repairs and 40% for replacement. Also among the corrosion monitoring and inspection identified, NDT gave the highest cost contribution of 41% of the total cost, followed by coating survey (34%. Cathodic protection survey and crude analysis gives the lowest cost contribution of 19% and 6% respectively. Corrosion control cost per barrel was found to be 77 cent/barrel. The significance of this cost was not much due to high price of crude oil in the international market. But the effect of corrosion in crude oil processing takes its toll on crude oil production (i.e. deferment.

  11. Estimating costs in the economic evaluation of medical technologies.

    Science.gov (United States)

    Luce, B R; Elixhauser, A

    1990-01-01

    The complexities and nuances of evaluating the costs associated with providing medical technologies are often underestimated by analysts engaged in economic evaluations. This article describes the theoretical underpinnings of cost estimation, emphasizing the importance of accounting for opportunity costs and marginal costs. The various types of costs that should be considered in an analysis are described; a listing of specific cost elements may provide a helpful guide to analysis. The process of identifying and estimating costs is detailed, and practical recommendations for handling the challenges of cost estimation are provided. The roles of sensitivity analysis and discounting are characterized, as are determinants of the types of costs to include in an analysis. Finally, common problems facing the analyst are enumerated with suggestions for managing these problems.

  12. Major issues associated with nuclear power generation cost and their evaluation

    International Nuclear Information System (INIS)

    Matsuo, Yuji; Shimogori, Kei; Suzuki, Atsuhiko

    2015-01-01

    This paper discusses the evaluation of power generation cost that is an important item for energy policy planning. Especially with a focus on nuclear power generation cost, it reviews what will become a focal point on evaluating power generation cost at the present point after the estimates of the 'Investigation Committee on Costs' that was organized by the government have been issued, and what will be a major factor affecting future changes in costs. This paper firstly compared several estimation results on nuclear power generation cost, and extracted/arranged controversial points and unsolved points for discussing nuclear power generation cost. In evaluating nuclear power generation cost, the comparison of capital cost and other costs can give the understanding of what can be important issues. Then, as the main issues, this paper evaluated/discussed the construction cost, operation/maintenance cost, external cost, issue of discount rate, as well as power generation costs in foreign countries and the impact of fossil fuel prices. As other issues related to power generation cost evaluation, it took up expenses for decommissioning, disposal of high-level radioactive waste, and re-processing, outlined the evaluation results by the 'Investigation Committee on Costs,' and compared them with the evaluation examples in foreign countries. These costs do not account for a large share of the entire nuclear power generation costs. The most important point for considering future energy policy is the issue of discount rate, that is, the issue of fund-raising environment for entrepreneurs. This is the factor to greatly affect the economy of future nuclear power generation. (A.O.)

  13. Activity-based costing evaluation of [18F]-fludeoxyglucose production.

    Science.gov (United States)

    Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Vander Borght, Thierry

    2008-01-01

    As healthcare expenses are escalating in many countries, the sector faces a new challenge of becoming more cost efficient. There is an urgent need for more accurate data on the costs of healthcare procedures. The cost of Positron Emission Tomography (PET) with [(18)F]-fludeoxyglucose ((18)F-FDG) studies is mainly influenced by the price of the radiopharmaceutical, which may vary throughout Europe from 300 to 500 Euro per patient dose (370 MBq). The aim of the current study is to conduct an activity-based costing (ABC) estimation of (18)F-FDG production in Europe to better identify the different cost components and to analyse their relative contribution to the total cost. Financial data were collected on capital expense and global operating costs through interviews with industry experts, PET centre managers, evaluation of prior studies, and review of expenses incurred at the University Medical Centre in Groningen (The Netherlands). After mapping the activities, we divided the cost in five categories: wage, equipment, consumables, overhead and space costs. A sensitivity analysis was performed for key cost components, including the compliance with regulatory requirements. The critical factor for profitability was throughput. Including the European regulation procedure, the cost for 370 MBq (18)F-FDG patient dose, 3 h EOS without delivery cost, ranges between 155 and 177 Euro/dose for two production runs and between 210 and 237 Euro/dose for one production run. These costs are predominantly determined by personnel and equipment costs, although the cost for quality assurance increases steadily. The ABC analysis provides significant insight into the production cost components of (18)F-FDG through different operating configurations. Reductions in equipment prices, increased availability of radiopharmaceuticals, growth in demand, and improvements in reimbursement will all contribute to the financial viability of this imaging technique.

  14. Activity-based costing evaluation of [18F]-fludeoxyglucose production

    International Nuclear Information System (INIS)

    Krug, Bruno; Pirson, Anne-Sophie; Borght, Thierry vander; Zanten, Annie van; Crott, Ralph

    2008-01-01

    As healthcare expenses are escalating in many countries, the sector faces a new challenge of becoming more cost efficient. There is an urgent need for more accurate data on the costs of healthcare procedures. The cost of Positron Emission Tomography (PET) with [ 18 F]-fludeoxyglucose ( 18 F-FDG) studies is mainly influenced by the price of the radiopharmaceutical, which may vary throughout Europe from 300 to 500 Euro per patient dose (370 MBq). The aim of the current study is to conduct an activity-based costing (ABC) estimation of 18 F-FDG production in Europe to better identify the different cost components and to analyse their relative contribution to the total cost. Financial data were collected on capital expense and global operating costs through interviews with industry experts, PET centre managers, evaluation of prior studies, and review of expenses incurred at the University Medical Centre in Groningen (The Netherlands). After mapping the activities, we divided the cost in five categories: wage, equipment, consumables, overhead and space costs. A sensitivity analysis was performed for key cost components, including the compliance with regulatory requirements. The critical factor for profitability was throughput. Including the European regulation procedure, the cost for 370 MBq 18 F-FDG patient dose, 3 h EOS without delivery cost, ranges between 155 and 177 Euro/dose for two production runs and between 210 and 237 Euro/dose for one production run. These costs are predominantly determined by personnel and equipment costs, although the cost for quality assurance increases steadily. The ABC analysis provides significant insight into the production cost components of 18 F-FDG through different operating configurations. Reductions in equipment prices, increased availability of radiopharmaceuticals, growth in demand, and improvements in reimbursement will all contribute to the financial viability of this imaging technique. (orig.)

  15. Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

    Science.gov (United States)

    Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob

    2018-06-01

    Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.

  16. SUPPLIES COSTS: AN EXPLORATORY STUDY WITH APPLICATION OF MEASUREMENT MODEL OF LOGISTICS COSTS

    Directory of Open Access Journals (Sweden)

    Ana Paula Ferreira Alves

    2013-12-01

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

  17. Evaluation of Cost Models and Needs & Gaps Analysis

    DEFF Research Database (Denmark)

    Kejser, Ulla Bøgvad

    2014-01-01

    they breakdown costs. This is followed by an in depth analysis of stakeholders’ needs for financial information derived from the 4C project stakeholder consultation.The stakeholders’ needs analysis indicated that models should:• support accounting, but more importantly they should enable budgeting• be able......his report ’D3.1—Evaluation of Cost Models and Needs & Gaps Analysis’ provides an analysis of existing research related to the economics of digital curation and cost & benefit modelling. It reports upon the investigation of how well current models and tools meet stakeholders’ needs for calculating...... andcomparing financial information. Based on this evaluation, it aims to point out gaps that need to be bridged in order to increase the uptake of cost & benefit modelling and good practices that will enable costing and comparison of the costs of alternative scenarios—which in turn provides a starting point...

  18. Heliostat cost reduction study.

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-01

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

  19. A Systematic Review of Cost-Effectiveness Studies Reporting Cost-per-DALY Averted.

    Directory of Open Access Journals (Sweden)

    Peter J Neumann

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

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

    International Nuclear Information System (INIS)

    Qu, J.; Xue, D.

    1998-01-01

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

  1. Re-evaluation of a radiation protection cost benefit analysis study in brachytherapy

    International Nuclear Information System (INIS)

    Broek, J.G. van den; Weatherburn, H.

    1994-01-01

    This study investigates changes in the NRPB advice concerning cost benefit analysis over the last 10 years by correcting all figures for inflation and applying them to a particular radiation protection example, a previously published case of the introduction of afterloading brachytherapy equipment at the Christie Hospital, Manchester. It has been shown that for this example NRPB advice at one time led to a large cost benefit, at another time led to a large cost deficit and later still it again gives a large cost benefit. Application of cost benefit analysis to decision making in radiation protection is therefore shown to be in need of further investigation and clarification. (author)

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

    Science.gov (United States)

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

    2016-04-01

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

  3. Fresh Water Cyanobacteria Geitlerinema sp. CCC728 and Arthrospira sp. CCC729 as an Anticancer Drug Resource

    OpenAIRE

    Srivastava, Akanksha; Tiwari, Ratnakar; Srivastava, Vikas; Singh, Tej Bali; Asthana, Ravi Kumar

    2015-01-01

    An increasing number of cancer patients worldwide, especially in third world countries, have raised concern to explore natural drug resources, such as the less explored fresh water filamentous cyanobacteria. Six strains of cyanobacteria (Phormidium sp. CCC727, Geitlerinema sp. CCC728, Arthrospira sp. CCC729, Phormidium sp. CCC731, Phormidium sp. CCC730, and Leptolyngbya sp. CCC732) were isolated (paddy fields and ponds in the Banaras Hindu University, campus) and five strains screened for ant...

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

    LENUS (Irish Health Repository)

    McLaughlin, Anne Marie

    2012-02-01

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

  5. Cost Evaluation of a Donation after Cardiac Death Program: How Cost per Organ Compares to Other Donor Types.

    Science.gov (United States)

    Lindemann, Jessica; Dageforde, Leigh Anne; Vachharajani, Neeta; Stahlschmidt, Emily; Brockmeier, Diane; Wellen, Jason R; Khan, Adeel; Chapman, William C; Doyle, Mb Majella

    2018-05-01

    Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. Donation after cardiac death program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected. Mean costs per donor and per organ were calculated. Cost of DCD donors that did not yield a transplantable organ were included in cost analyses resulting in total cost of the DCD program. Donation after cardiac death donor costs were compared with costs of in-hospital donation after brain death (DBD) donors. There were 289 organs transplanted from 264 DCD donors evaluated. Mean cost per DCD donor yielding transplantable organs was $9,306. However, 127 donors yielded no organs, at a mean cost of $8,794 per donor. The total cost of the DCD program was $32,020 per donor and $15,179 per organ. Mean cost for an in-hospital DBD donor was $33,546 and $9,478 per organ transplanted. Mean organ yield for DBD donors was 3.54 vs 2.21 for DCD donors (p organ 63% of the cost of a DCD organ. Mean cost per DCD donor is comparable with DBD donors, however, individual cost of DCD organs increases by almost 40% when all costs of an entire DCD program are included. Published by Elsevier Inc.

  6. Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study.

    Science.gov (United States)

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

    2018-03-03

    To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Four multinational manufacturing workplaces in Cork, Ireland. 517 randomly selected employees (18-65 years) from four workplaces. Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is considered in a cost-benefit analysis, whereby the system

  7. Assessing value in breast reconstruction: A systematic review of cost-effectiveness studies.

    Science.gov (United States)

    Sheckter, Clifford C; Matros, Evan; Momeni, Arash

    2018-03-01

    Breast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high-value care models. A systematic review of PubMed, Web of Science, and the Cost-Effectiveness Analysis Registry was conducted. Two reviewers independently evaluated all publications up until August 17, 2017. After removal of duplicates, 1996 records were screened, from which 53 studies underwent full text review. All the 13 studies included for final analysis mention an incremental cost-effectiveness ratio. Five studies evaluated the cost-effectiveness of technologies including acellular dermal matrix (ADM) in staged prosthetic reconstruction, ADM in direct-to-implant (DTI) reconstruction, preoperative computed tomography angiography in autologous reconstruction, indocyanine green dye angiography in evaluating anastomotic patency, and abdominal mesh reinforcement in abdominal tissue transfer. The remaining eight studies evaluated the cost-effectiveness of different reconstruction methods. Cost-effective strategies included free vs. pedicled abdominal tissue transfer, DTI vs. staged prosthetic reconstruction, and fascia-sparing variants of free abdominal tissue transfer. Current evidence demonstrates multiple cost-effective technologies and methods in accomplishing successful breast reconstruction. Plastic surgeons should be well informed of such economic models when engaging payers and policymakers in discussions regarding high-value breast reconstruction. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Peyman Babashamsi

    2016-07-01

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

  9. The evaluation of a hostel ward. A controlled study using modified cost-benefit analysis.

    Science.gov (United States)

    Hyde, C; Bridges, K; Goldberg, D; Lowson, K; Sterling, C; Faragher, B

    1987-12-01

    A controlled modified cost-benefit evaluation of a hostel ward caring for new long-stay patients is described and results are presented for the first two years. In some respects the residents of the hostel ward had fewer psychotic impairments than those remaining on the wards of the district general hospital, mainly because the latter seem to continue to acquire such defects, while the former have remained relatively unchanged. The hostel ward residents also develop superior domestic skills, use more facilities in the community, and are more likely to be engaged in constructive activities than controls. These advantages were not purchased at a price, since the cost of providing this form of care for these patients has cost less than care provided by the district general hospital.

  10. Evaluation of syngas production unit cost of bio-gasification facility using regression analysis techniques

    Energy Technology Data Exchange (ETDEWEB)

    Deng, Yangyang; Parajuli, Prem B.

    2011-08-10

    Evaluation of economic feasibility of a bio-gasification facility needs understanding of its unit cost under different production capacities. The objective of this study was to evaluate the unit cost of syngas production at capacities from 60 through 1800Nm 3/h using an economic model with three regression analysis techniques (simple regression, reciprocal regression, and log-log regression). The preliminary result of this study showed that reciprocal regression analysis technique had the best fit curve between per unit cost and production capacity, with sum of error squares (SES) lower than 0.001 and coefficient of determination of (R 2) 0.996. The regression analysis techniques determined the minimum unit cost of syngas production for micro-scale bio-gasification facilities of $0.052/Nm 3, under the capacity of 2,880 Nm 3/h. The results of this study suggest that to reduce cost, facilities should run at a high production capacity. In addition, the contribution of this technique could be the new categorical criterion to evaluate micro-scale bio-gasification facility from the perspective of economic analysis.

  11. IR, FT-ICR-MS studies on (1'S, 6'S)-1-cyclopropyl-7-(2,8-diazabicyclo[4.3.0] non-8-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid hydrochloride salt.

    Science.gov (United States)

    Lin, Zhiwei

    2014-01-01

    The infrared spectra of (1'S, 6'S)-1-cyclopropyl-7-(2,8-diazabicyclo[4.3.0] non-8-yl)-6-fluoro-8-methoxy-4-oxo-1,4-dihydroquinoline-3-carboxylic acid hydrochloride salt (CLF-HCl) were studied and compared with free base. Their fragmentation pathways were investigated using tandem mass spectrometric (MS/MS) techniques on Fourier-transform ion cyclotron resonance spectrum, and many characteristic fragment ions were found. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    LENUS (Irish Health Repository)

    McLaughlin, Anne Marie

    2009-12-01

    To prospectively assess the cost of patients in an adult intensive care unit (ICU) using bottom-up costing methodology and evaluate the usefulness of "severity of illness" scores in estimating ICU cost.

  13. Evaluation of Cost Leadership Strategy in Shipping Enterprises with Simulation Model

    Science.gov (United States)

    Ferfeli, Maria V.; Vaxevanou, Anthi Z.; Damianos, Sakas P.

    2009-08-01

    The present study will attempt the evaluation of cost leadership strategy that prevails in certain shipping enterprises and the creation of simulation models based on strategic model STAIR. The above model is an alternative method of strategic applications evaluation. This is held in order to be realised if the strategy of cost leadership creates competitive advantage [1] and this will be achieved via the technical simulation which appreciates the interactions between the operations of an enterprise and the decision-making strategy in conditions of uncertainty with reduction of undertaken risk.

  14. COST EVALUATION OF AUTOMATED AND MANUAL POST- CONSUMER PLASTIC BOTTLE SORTING SYSTEMS

    Science.gov (United States)

    This project evaluates, on the basis of performance and cost, two Automated BottleSort® sorting systems for post-consumer commingled plastic containers developed by Magnetic Separation Systems. This study compares the costs to sort mixed bales of post-consumer plastic at these t...

  15. Cost-effectiveness of health research study participant recruitment strategies: a systematic review.

    Science.gov (United States)

    Huynh, Lynn; Johns, Benjamin; Liu, Su-Hsun; Vedula, S Swaroop; Li, Tianjing; Puhan, Milo A

    2014-10-01

    A large fraction of the cost of conducting clinical trials is allocated to recruitment of participants. A synthesis of findings from studies that evaluate the cost and effectiveness of different recruitment strategies will inform investigators in designing cost-efficient clinical trials. To systematically identify, assess, and synthesize evidence from published comparisons of the cost and yield of strategies for recruitment of participants to health research studies. We included randomized studies in which two or more strategies for recruitment of participants had been compared. We focused our economic evaluation on studies that randomized participants to different recruitment strategies. We identified 10 randomized studies that compared recruitment strategies, including monetary incentives (cash or prize), direct contact (letters or telephone call), and medical referral strategies. Only two of the 10 studies compared strategies for recruiting participants to clinical trials. We found that allocating additional resources to recruit participants using monetary incentives or direct contact yielded between 4% and 23% additional participants compared to using neither strategy. For medical referral, recruitment of prostate cancer patients by nurses was cost-saving compared to recruitment by consultant urologists. For all underlying study designs, monetary incentives cost more than direct contact with potential participants, with a median incremental cost per recruitment ratio of Int$72 (Int$-International dollar, a theoretical unit of currency) for monetary incentive strategy compared to Int$28 for direct contact strategy. Only monetary incentives and source of referral were evaluated for recruiting participants into clinical trials. We did not review studies that presented non-monetary cost or lost opportunity cost. We did not adjust for the number of study recruitment sites or the study duration in our economic evaluation analysis. Systematic and explicit reporting of

  16. Cost-effectiveness of a complex workplace dietary intervention: an economic evaluation of the Food Choice at Work study

    Science.gov (United States)

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

    2018-01-01

    Objective To evaluate the costs, benefits and cost-effectiveness of complex workplace dietary interventions, involving nutrition education and system-level dietary modification, from the perspective of healthcare providers and employers. Design Single-study economic evaluation of a cluster-controlled trial (Food Choice at Work (FCW) study) with 1-year follow-up. Setting Four multinational manufacturing workplaces in Cork, Ireland. Participants 517 randomly selected employees (18–65 years) from four workplaces. Interventions Cost data were obtained from the FCW study. Nutrition education included individual nutrition consultations, nutrition information (traffic light menu labelling, posters, leaflets and emails) and presentations. System-level dietary modification included menu modification (restriction of fat, sugar and salt), increase in fibre, fruit discounts, strategic positioning of healthier alternatives and portion size control. The combined intervention included nutrition education and system-level dietary modification. No intervention was implemented in the control. Outcomes The primary outcome was an improvement in health-related quality of life, measured using the EuroQoL 5 Dimensions 5 Levels questionnaire. The secondary outcome measure was reduction in absenteeism, which is measured in monetary amounts. Probabilistic sensitivity analysis (Monte Carlo simulation) assessed parameter uncertainty. Results The system-level intervention dominated the education and combined interventions. When compared with the control, the incremental cost-effectiveness ratio (€101.37/quality-adjusted life-year) is less than the nationally accepted ceiling ratio, so the system-level intervention can be considered cost-effective. The cost-effectiveness acceptability curve indicates there is some decision uncertainty surrounding this, arising from uncertainty surrounding the differences in effectiveness. These results are reiterated when the secondary outcome measure is

  17. Combined Waste Form Cost Trade Study

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  18. Economic cost evaluation on the viability of offshore wind turbine farms in Nigeria

    Directory of Open Access Journals (Sweden)

    S.O. Effiom

    2016-11-01

    Full Text Available The paper presents an economic cost evaluation on the feasibility of offshore wind turbine (OWT farms development in Nigeria, using a 500 MW OWT farm as an incident study. A developed model was used to evaluate the economic cost of the OWTs at different phases of the project. Additionally, the effect of the cost drivers at the changed phases of the OWTs was studied correspondingly. Results obtained showed that over 50% of the OWT project cost emanated from CAPEX while a value less than 50% came from OPEX. However, further analysis indicates at maximum power of 4 MW a 4.95% diminution in LCOE. For comparable power rating (PR between 5⩽PR⩽6MW, a 2.7% reduction in LCOE exists. Cost stability was apparent at a growth of WTs between 300⩽WT⩽500 MW. The study also observed a decrease in LCOE for all development stages of the OWT while a decrease in the CMS detectability was considered marginal. Subsequently, it can be inferred that Nigeria has the potential for OWT farm expansion. However, the demonstrated model was appropriate for handling preliminary variations in OWT studies.

  19. Compact, rugged in-chamber transmission spectrometers (7-28 keV) for the Sandia Z facility.

    Science.gov (United States)

    Sinars, D B; Wenger, D F; Pikuz, S A; Jones, B; Geissel, M; Hansen, S B; Coverdale, C A; Ampleford, D J; Cuneo, M E; McPherson, L A; Rochau, G A

    2011-06-01

    We describe a pair of time-integrated transmission spectrometers that are designed to survey 7-28 keV (1.9 to 0.43 Å) x-ray photons produced by experiments on the Sandia Z pulsed power facility. Each spectrometer uses a quartz 10-11 crystal in a Cauchois geometry with a slit to provide spatial resolution along one dimension. The spectrometers are located in the harsh environment of the Z vacuum chamber, which necessitates that their design be compact and rugged. Example data from calibration tests and Z experiments are shown that illustrate the utility of the instruments. © 2011 American Institute of Physics

  20. QUALICOPC, a multi-country study evaluating quality, costs and equity in primary care

    Directory of Open Access Journals (Sweden)

    Van den Berg Michael J

    2011-10-01

    Full Text Available Abstract Background The QUALICOPC (Quality and Costs of Primary Care in Europe study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. The study will provide an answer to the question what strong primary care systems entail and which effects primary care systems have on the performance of health care systems. QUALICOPC is funded by the European Commission under the "Seventh Framework Programme". In this article the background and design of the QUALICOPC study is described. Methods/design QUALICOPC started in 2010 and will run until 2013. Data will be collected in 31 European countries (27 EU countries, Iceland, Norway, Switzerland and Turkey and in Australia, Israel and New Zealand. This study uses a three level approach of data collection: the system, practice and patient. Surveys will be held among general practitioners (GPs and their patients, providing evidence at the process and outcome level of primary care. These surveys aim to gain insight in the professional behaviour of GPs and the expectations and actions of their patients. An important aspect of this study is that each patient's questionnaire can be linked to their own GP's questionnaire. To gather data at the structure or national level, the study will use existing data sources such as the System of Health Accounts and the Primary Health Care Activity Monitor Europe (PHAMEU database. Analyses of the data will be performed using multilevel models. Discussion By its design, in which different data sources are combined for comprehensive analyses, QUALICOPC will advance the state of the art in primary care research and contribute to the discussion on the merit of strengthening primary care systems and to evidence based health policy development.

  1. Evaluating the administration costs of biologic drugs: development of a cost algorithm.

    Science.gov (United States)

    Tetteh, Ebenezer K; Morris, Stephen

    2014-12-01

    Biologic drugs, as with all other medical technologies, are subject to a number of regulatory, marketing, reimbursement (financing) and other demand-restricting hurdles applied by healthcare payers. One example is the routine use of cost-effectiveness analyses or health technology assessments to determine which medical technologies offer value-for-money. The manner in which these assessments are conducted suggests that, holding all else equal, the economic value of biologic drugs may be determined by how much is spent on administering these drugs or trade-offs between drug acquisition and administration costs. Yet, on the supply-side, it seems very little attention is given to how manufacturing and formulation choices affect healthcare delivery costs. This paper evaluates variations in the administration costs of biologic drugs, taking care to ensure consistent inclusion of all relevant cost resources. From this, it develops a regression-based algorithm with which manufacturers could possibly predict, during process development, how their manufacturing and formulation choices may impact on the healthcare delivery costs of their products.

  2. Cost of elective percutaneous coronary intervention in Malaysia: a multicentre cross-sectional costing study.

    Science.gov (United States)

    Lee, Kun Yun; Ong, Tiong Kiam; Low, Ee Vien; Liow, Siow Yen; Anchah, Lawrence; Hamzah, Syuhada; Liew, Houng Bang; Ali, Rosli Mohd; Ismail, Omar; Ahmad, Wan Azman Wan; Said, Mas Ayu; Dahlui, Maznah

    2017-05-28

    Limitations in the quality and access of cost data from low-income and middle-income countries constrain the implementation of economic evaluations. With the increasing prevalence of coronary artery disease in Malaysia, cost information is vital for cardiac service expansion. We aim to calculate the hospitalisation cost of percutaneous coronary intervention (PCI), using a data collection method customised to local setting of limited data availability. This is a cross-sectional costing study from the perspective of healthcare providers, using top-down approach, from January to June 2014. Cost items under each unit of analysis involved in the provision of PCI service were identified, valuated and calculated to produce unit cost estimates. Five public cardiac centres participated. All the centres provide full-fledged cardiology services. They are also the tertiary referral centres of their respective regions. The cost was calculated for elective PCI procedure in each centre. PCI conducted for urgent/emergent indication or for patients with shock and haemodynamic instability were excluded. The outcome measures of interest were the unit costs at the two units of analysis, namely cardiac ward admission and cardiac catheterisation utilisation, which made up the total hospitalisation cost. The average hospitalisation cost ranged between RM11 471 (US$3186) and RM14 465 (US$4018). PCI consumables were the dominant cost item at all centres. The centre with daycare establishment recorded the lowest admission cost and total hospitalisation cost. Comprehensive results from all centres enable comparison at the levels of cost items, unit of analysis and total costs. This generates important information on cost variations between centres, thus providing valuable guidance for service planning. Alternative procurement practices for PCI consumables may deliver cost reduction. For countries with limited data availability, costing method tailored based on country setting can be used for

  3. COST ES0602: towards a European network on chemical weather forecasting and information systems

    Directory of Open Access Journals (Sweden)

    J. Kukkonen

    2009-04-01

    Full Text Available The COST ES0602 action provides a forum for benchmarking approaches and practices in data exchange and multi-model capabilities for chemical weather forecasting and near real-time information services in Europe. The action includes approximately 30 participants from 19 countries, and its duration is from 2007 to 2011 (http://www.chemicalweather.eu/. Major efforts have been dedicated in other actions and projects to the development of infrastructures for data flow. We have therefore aimed for collaboration with ongoing actions towards developing near real-time exchange of input data for air quality forecasting. We have collected information on the operational air quality forecasting models on a regional and continental scale in a structured form, and inter-compared and evaluated the physical and chemical structure of these models. We have also constructed a European chemical weather forecasting portal that includes links to most of the available chemical weather forecasting systems in Europe. The collaboration also includes the examination of the case studies that have been organized within COST-728, in order to inter-compare and evaluate the models against experimental data. We have also constructed an operational model forecasting ensemble. Data from a representative set of regional background stations have been selected, and the operational forecasts for this set of sites will be inter-compared and evaluated. The Action has investigated, analysed and reviewed existing chemical weather information systems and services, and will provide recommendations on best practices concerning the presentation and dissemination of chemical weather information towards the public and decision makers.

  4. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance.

    Science.gov (United States)

    Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-09-01

    Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained - when only multidrug resistance costs and health care costs are included - to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. © British Journal of General Practice 2016.

  5. Cost Evaluation of Haemodialysis for End Stage Renal Disease ...

    African Journals Online (AJOL)

    Cost Evaluation of Haemodialysis for End Stage Renal Disease Patients: Experience from Benin City, Nigeria. ... Annals of Biomedical Sciences ... Objectives: To assess the costs and use of haemodialysis in a Nigerian Teaching Hospital.

  6. Estimation of the Levelised Electricity Generation Cost for a PWR-Power Plant and Preliminary Evaluation of National Participation

    International Nuclear Information System (INIS)

    Saba, G; Hainoun, A

    2008-01-01

    This work deals with the detailed economic evaluation of the Levelised discounted electricity generation costs (LDEGC) for a nuclear power plant with pressurized water reactor (PWR). The total generation costs are splited in base construction costs, supplementary costs, owner's costs, financial costs, fuel cycle costs and operation and maintenance costs. The evaluation covers also the sensitivity of the estimated energy unit cost to various factors (real annual discount rate, escalation rate, interest rate, load factor, ..) including the role of national participation, that depends upon the development of national infrastructure. For performing this study the IAEA's program package for economic bid evaluation (Bideval-3) has been employed. The program is designed to assist the user in the economic evaluation of bids for nuclear power plant (NPP). It follows the recommended method of determining the present worth value of all costs components for generated electricity unit. The performed study aims at developing national expertise in the field of bid evaluation for electric power plants with main emphasis on NPP. Additional goal is to convoying the technical and economic development of NPP technology that can help in supporting the decision maker with adequate information related to the future development of energy supply system and measures required for ensuring national energy supply security. (author)

  7. An Evaluation of the Automated Cost Estimating Integrated Tools (ACEIT) System

    Science.gov (United States)

    1989-09-01

    C~4p DTIC S ELECTE fl JAN12 19 .1R ~OF S%. B -U AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Caroline L...Ohio go 91 022 AFIT/GCA/LSQ/89S-5 AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Caroline L. Hanson Major, USAF...Department of Defense. AFIT/GCA/LSQ/89S-5 AN EVALUATION OF THE AUTOMATED COST ESTIMATING INTEGRATED TOOLS ( ACEIT ) SYSTEM THESIS Presented to the

  8. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care: an economic evaluation accounting for the cost of antimicrobial resistance

    Science.gov (United States)

    Oppong, Raymond; Smith, Richard D; Little, Paul; Verheij, Theo; Butler, Christopher C; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-01-01

    Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study sought to establish whether antibiotics (principally amoxicillin) are cost effective in patients with LRTIs, and to explore the implications of taking into account costs associated with resistance. Design and setting Multinational randomised double-blinded trial in 2060 patients with acute cough/LRTIs recruited in 12 European countries. Method A cost-utility analysis from a health system perspective with a time horizon of 28 days was conducted. The primary outcome measure was the quality-adjusted life year (QALY). Hierarchical modelling was used to estimate incremental cost-effectiveness ratios (ICERs). Results Amoxicillin was associated with an ICER of €8216 (£6540) per QALY gained when the cost of resistance was excluded. If the cost of resistance is greater than €11 (£9) per patient, then amoxicillin treatment is no longer cost effective. Including possible estimates of the cost of resistance resulted in ICERs ranging from €14 730 (£11 949) per QALY gained — when only multidrug resistance costs and health care costs are included — to €727 135 (£589 856) per QALY gained when broader societal costs are also included. Conclusion Economic evaluation of antibiotic prescribing strategies that do not include the cost of resistance may provide misleading results that could be of questionable use to policymakers. However, further work is required to estimate robust costs of resistance. PMID:27402969

  9. Life cycle cost analysis rehabilitation costs.

    Science.gov (United States)

    2015-07-01

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

  10. Evaluation of cost reduction method for manufacturing ODS ferritic claddings

    International Nuclear Information System (INIS)

    Fujiwara, Masayuki; Mizuta, Shunji; Ukai, Shigeharu

    2000-04-01

    For evaluating the fast reactor system technology, it is important to evaluate the practical feasibility of ODS ferritic claddings, which is the most promising materials to attain the goal of high coolant temperature and more than 150 GWd/t. Based on the results of their technology development, mass production process with highly economically benefit as well as manufacturing cost estimation of ODS ferritic claddings were preliminarily conducted. From the view point of future utility scale, the cost for manufacturing mother tubes has a dominant factor in the total manufacturing cost. The method to reduce the cost of mother tube manufacturing was also preliminarily investigated. (author)

  11. Cost-benefit study of different application scenarios in teleradiology

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  12. DEMONSTRATION OF FUEL CELLS TO RECOVER ENERGY FROM ANAEROBIC DIGESTER GAS - PHASE I. CONCEPTUAL DESIGN, PRELIMINARY COST, AND EVALUATION STUDY

    Science.gov (United States)

    The report discusses Phase I (a conceptual design, preliminary cost, and evaluation study) of a program to demonstrate the recovery of energy from waste methane produced by anaerobic digestion of waste water treatment sludge. The fuel cell is being used for this application becau...

  13. Exploring the relationship between costs and quality. Does the joint evaluation of costs and quality alter the rankings of Danish hospital departments?

    DEFF Research Database (Denmark)

    Hvenegaard, Anne; Nielsen Arendt, Jacob; Street, Andrew

    2011-01-01

    vascular departments, we estimate fixed effect models for costs (linear) and quality (logistic). We consider two quality measures; mortality and wound complications. To assess whether the joint evaluation of costs and quality affects the ranking of departments, we construct joint confidence regions......OBJECTIVE: The purpose is to evaluate the relationship between costs and quality and to assess whether the joint evaluation of costs and quality affects the ranking of hospital departments relative to comparison based on costs alone. METHODS: Using patient level data for 3,754 patients in six...... for each pair of departmental effects for costs and quality using a bootstrap method and rank departments according to their cost-effectiveness ratio. The findings are used to evaluate a theory of a U-shaped cost/quality relationship. RESULTS: The association between cost and quality differs depending...

  14. Energy cost of running instability evaluated with wearable trunk accelerometry.

    Science.gov (United States)

    Schütte, Kurt H; Sackey, Saint; Venter, Rachel; Vanwanseele, Benedicte

    2018-02-01

    Maintaining stability under dynamic conditions is an inherent challenge to bipedal running. This challenge may impose an energetic cost (Ec) thus hampering endurance running performance, yet the underlying mechanisms are not clear. Wireless triaxial trunk accelerometry is a simple tool that could be used to unobtrusively evaluate these mechanisms. Here, we test a cost of instability hypothesis by examining the contribution of trunk accelerometry-based measures (triaxial root mean square, step and stride regularity, and sample entropy) to interindividual variance in Ec (J/m) during treadmill running. Accelerometry and indirect calorimetry data were collected concurrently from 30 recreational runners (16 men; 14 women) running at their highest steady-state running speed (80.65 ± 5.99% V̇o 2max ). After reducing dimensionality with factor analysis, the effect of dynamic stability features on Ec was evaluated using hierarchical multiple regression analysis. Three accelerometry-based measures could explain an additional 10.4% of interindividual variance in Ec after controlling for body mass, attributed to anteroposterior stride regularity (5.2%), anteroposterior root mean square ratio (3.2%), and mediolateral sample entropy (2.0%). Our results lend support to a cost of instability hypothesis, with trunk acceleration waveform signals that are 1) more consistent between strides anteroposterioly, 2) larger in amplitude variability anteroposterioly, and 3) more complex mediolaterally and are energetically advantageous to endurance running performance. This study shows that wearable trunk accelerometry is a useful tool for understanding the Ec of running and that running stability is important for economy in recreational runners. NEW & NOTEWORTHY This study evaluates and more directly lends support to a cost of instability hypothesis between runners. Moreover, this hypothesis was tested using a minimalist setup including a single triaxial trunk mounted accelerometer

  15. Cost-benefit analysis of a Haemophilus influenzae type b meningitis prevention programme in The Philippines.

    Science.gov (United States)

    Limcangco, M R; Armour, C L; Salole, E G; Taylor, S J

    2001-01-01

    Haemophilus influenzae type b (Hib) meningitis is associated with high mortality and serious sequelae in children under 5 years of age. Vaccines which can prevent this infection are available. To evaluate the costs and benefits of a 3-dose immunisation schedule in Manila, Philippines. Government and societal perspectives. A cost-benefit analysis based on a birth cohort of 100,000 children. The state of health of the cohort with and without a Hib immunisation programme was modelled over a 5-year period. A survey of medical records of patients with Hib in Manila provided data on the extent and cost of sequelae following infection. A 3-dose Hib vaccination programme given at ages 2, 3 and 4 months. The model predicted that vaccinating children against Hib meningitis would prevent 553 cases per year in a birth cohort of 100,000, at a cost of 56,200 Philippine pesos (PHP) [$US1,605; 1998 exchange rate] per case (base case assumptions of 90% vaccine efficacy rate, 95 per 100,000 Hib incidence rate, 85% vaccination coverage). Results from the cost-benefit analyses indicated that the saving to the government would be around PHP39 million ($US1.11 million), and the saving to society would be PHP255 million ($US7.28 million). There would be a positive economic benefit for the Philippine government and for the Filipino society if a Hib vaccination programme was introduced in Manila.

  16. Program Evaluation in Cost Benefit Terms.

    Science.gov (United States)

    Tanner, C. Kenneth

    This paper advances a model, called the expected opportunity loss model, for curriculum evaluation. This decision-making technique utilizes subjective data by ranking courses according to their expected contributions to the primary objective of the total program. The model also utilizes objective data in the form of component costs, and differs…

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

    Science.gov (United States)

    Angevine, Peter D; Berven, Sigurd

    2014-10-15

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

  18. Activity-based costing evaluation of a [F-18]-fludeoxyglucose positron emission tomography study

    NARCIS (Netherlands)

    Krug, Bruno; Van Zanten, Annie; Pirson, Anne-Sophie; Crott, Ralph; Vander Borght, Thierry

    2009-01-01

    Objective: The aim of the study is to use the activity-based costing approach to give a better insight in the actual cost structure of a positron emission tomography procedure (FDG-PET) by defining the constituting components and by simulating the impact of possible resource or practice changes.

  19. The cost of crime to society: new crime-specific estimates for policy and program evaluation.

    Science.gov (United States)

    McCollister, Kathryn E; French, Michael T; Fang, Hai

    2010-04-01

    Estimating the cost to society of individual crimes is essential to the economic evaluation of many social programs, such as substance abuse treatment and community policing. A review of the crime-costing literature reveals multiple sources, including published articles and government reports, which collectively represent the alternative approaches for estimating the economic losses associated with criminal activity. Many of these sources are based upon data that are more than 10 years old, indicating a need for updated figures. This study presents a comprehensive methodology for calculating the cost to society of various criminal acts. Tangible and intangible losses are estimated using the most current data available. The selected approach, which incorporates both the cost-of-illness and the jury compensation methods, yields cost estimates for more than a dozen major crime categories, including several categories not found in previous studies. Updated crime cost estimates can help government agencies and other organizations execute more prudent policy evaluations, particularly benefit-cost analyses of substance abuse treatment or other interventions that reduce crime. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Evaluation of the Water Scarcity Energy Cost for Users

    Directory of Open Access Journals (Sweden)

    Chiara M. Fontanazza

    2013-01-01

    Full Text Available In systems experiencing water scarcity and consequent intermittent supply, users often adopt private tanks that collect water during service periods and supply users when the service is not available. The tank may be fed by gravity or by private pumping stations depending on the network pressure level. Once water resources are collected, the tank can supply users by gravity if it is located on the rooftop or by additional pumping if underground. Private tanks thus increase the energy cost of the water supply service for users by introducing several small pumping structures inside the network. The present paper aims to evaluate this users’ energy cost for different private tank configurations. A real case study was analysed, and the results showed that intermittent distribution causes inequalities not only in users’ access to water resource but also costs that users have to bear to have access to water.

  1. Quality and cost evaluation of bread produced from blends of wheat ...

    African Journals Online (AJOL)

    Background: This study was necessitated by the need to improve the nutritional quality of baked products, ensure their acceptability and the baker's profitability. Objective: The aim of the study therefore was to evaluate the quality and cost of bread produced from composite flours of wheat and partially defatted soy. Materials ...

  2. Safety and cost evaluation of nuclear waste management

    International Nuclear Information System (INIS)

    Vieno, T.; Hautojaervi, A.; Korhonen, R.

    1989-11-01

    The report introduces the results of the nuclear waste management safety and cost evaluation research carried out in the Nuclear Engineering Laboratory of the Technical Research Centre of Finland (VTT) during the years 1984-1988. The emphasis is on the description of the state-of-art of performance and cost evaluation methods. The report describes VTT's most important assessment models. Development, verification and validation of the models has largely taken place within international projects, including the Stripa, HYDROCOIN, INTRACOIN, INTRAVAL, PSACOIN and BIOMOVS projects. Furthermore, VTT's other laboratories are participating in the Natural Analogue Working Group,k the CHEMVAL project and the CoCo group. Resent safety analyses carried out in the Nuclear Engineering Laboratory include a concept feasibility study of spent fuel disposal, safety analyses for the Preliminary Safety Analysis Reports (PSAR's) of the repositories to be constructed for low and medium level operational reactor waste at the Olkiluoto and Loviisa power plants as well as safety analyses of disposal of decommissioning wastes. Appendix 1 contains a comprehensive list of the most important publications and technical reports produced. They present the content and results of the research in detail

  3. Design Study for A Low-Cost LH2 Turbopump

    Science.gov (United States)

    Japikse, David; Baines, Nicholas; Platt, Michael J.

    2000-01-01

    A preliminary design study, focusing on potential component selections and design for manufacturing and assembly (DFMAR1) analysis, is presented in this study. The investigation focused on a nominal cost liquid hydrogen turbopump suitable for a private launch class vehicle. Utilizing a "turbocharger-like" design philosophy, preliminary feasibility studies of the basic pump design class, the rotordynamic design class, and the turbine design class were conducted with associated DFMA evaluations. Reasonable cost levels and sensible levels of product assurance have been established.

  4. Risk evaluation: A cost-oriented approach

    International Nuclear Information System (INIS)

    Rogers, B.H.

    1998-01-01

    This method provides a structured and cost-oriented way to determine risks associated with loss and destruction of industrial security interests consisting of material assets and human resources. Loss and destruction are assumed to be adversary perpetrated, high-impact events in which the health and safety of people or high-value property is at risk. This concept provides a process for: (1) assessing effectiveness of all integrated protection system, which includes facility operations, safety, emergency and security systems, and (2) a qualitative prioritization scheme to determine the level of consequence relative to cost and subsequent risk. The method allows managers the flexibility to establish asset protection appropriate to programmatic requirements and priorities and to decide if funding is appropriate. The evaluation objectives are to: (1) provide for a systematic, qualitative tabletop process to estimate the potential for an undesirable event and its impact; and (2) identify ineffective protection and cost-effective solutions

  5. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

    Science.gov (United States)

    de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

    2015-02-01

    A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

  6. Cost evaluation of out-of-country care for patients with eating disorders in Ontario: a population-based study.

    Science.gov (United States)

    de Oliveira, Claire; Macdonald, Erin M; Green, Diane; Colton, Patricia; Olmsted, Marion; Bondy, Susan; Kurdyak, Paul

    2016-01-01

    Eating disorders, specifically anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified, represent a substantial burden to the health care system. Our goal was to estimate the economic burden of patients who received specialized inpatient care for an eating disorder out of country. We conducted a cost-of-illness study evaluating health care costs among patients in Ontario who received specialized inpatient care for an eating disorder out of country from 2003 to 2011, from the public third-party payer perspective. Using linked administrative databases, we estimated net costs of eating disorders for 2 patient groups: those who received specialized inpatient care both out of country and in province ( n = 160), and those who received specialized inpatient care out of country only ( n = 126). Patients approved for specialized out-of-country inpatient care were mostly girls and young women from high-income, urban neighbourhoods. Total net costs varied annually and were higher for patients treated both out of country and in province (about $11 million before 2007, $6.5 million after) than for those treated out of country alone (about $5 million and $2 million, respectively). The main cost drivers were out-of-country care and physician services. Costs associated with eating disorder care represent a substantial economic burden to the Ontario health care system. Given the high costs of out-of-country care, there may be opportunity to redirect these funds to increase capacity and expertise for eating disorder treatment within Ontario.

  7. An Evaluation of the Consumer Costs and Benefits of Energy Efficiency Resource Standards

    Science.gov (United States)

    Lessans, Mark D.

    Of the modern-day policies designed to encourage energy efficiency, one with a significant potential for impact is that of Energy Efficiency Resource Standards (EERS). EERS policies place the responsibility for meeting an efficiency target on the electric and gas utilities, typically setting requirements for annual reductions in electricity generation or gas distribution to customers as a percentage of sales. To meet these requirements, utilities typically implement demand-side management (DSM) programs, which encourage energy efficiency at the customer level through incentives and educational initiatives. In Maryland, a statewide EERS has provided for programs which save a significant amount of energy, but is ultimately falling short in meeting the targets established by the policy. This study evaluates residential DSM programs offered by Pepco, a utility in Maryland, for cost-effectiveness. However, unlike most literature on the topic, analysis focuses on the costs-benefit from the perspective of the consumer, and not the utility. The results of this study are encouraging: the majority of programs analyzed show that the cost of electricity saved, or levelized cost of saved energy (LCSE), is less expensive than the current retail cost of electricity cost in Maryland. A key goal of this study is to establish a metric for evaluating the consumer cost-effectiveness of participation in energy efficiency programs made available by EERS. In doing so, the benefits of these programs can be effectively marketed to customers, with the hope that participation will increase. By increasing consumer awareness and buy-in, the original goals set out through EERS can be realized and the policies can continue to receive support.

  8. Can cost utility evaluations inform decision making about interventions for low back pain?

    Science.gov (United States)

    Dagenais, Simon; Roffey, Darren M; Wai, Eugene K; Haldeman, Scott; Caro, Jaime

    2009-11-01

    Low back pain (LBP) is associated with high health-care utilization and lost productivity. Numerous interventions are routinely used, although few are supported by strong evidence. Cost utility analyses (CUAs) may be helpful to inform decision makers. To conduct a systematic review of CUAs of interventions for LBP. Systematic review. A search strategy combining medical subject headings and free text related to LBP and health economic evaluations was executed in MEDLINE. Cost utility analyses combined with randomized controlled trials for LBP were included. Studies that were published before 1998, non-English, decision analyses, and duplicate reports were excluded. Search results were evaluated by two reviewers, who extracted data independently related to clinical study design, economic study design, direct cost components, utility results, cost results, and CUA results. The search produced 319 citations, and of these 15 met eligibility criteria. Most were from the United Kingdom (n=8), published in the past 3 years (n=12), studied chronic LBP or radiculopathy (n=13), and had a follow-up >12 months (n=13). Combined, there were 33 study groups who received a mean 2.1 interventions, most commonly education (n=17), exercise therapy (n=13), spinal manipulation therapy (n=7), surgery (n=7), and usual care from a general practitioner (n=7). Mean baseline utility was 0.57, improving to 0.67 at follow-up; the mean difference in utility improvement between study groups was 0.04. Based on available data and converted to US dollars, the cost per quality-adjusted life year ranged from $304 to 579,527 dollars, with a median of 13,015 dollars. Few CUAs were identified for LBP, and there was heterogeneity in the interventions compared, direct cost components measured, indirect costs, other methods, and results. Reporting quality was mixed. Currently published CUAs do not provide sufficient information to assist decision makers. Future CUAs should attempt to measure all known

  9. Long-dated evaluation of the external costs of the nuclear

    International Nuclear Information System (INIS)

    Le Dars, A.; Schneider, T.

    2002-09-01

    Since the middle of the years 1990, the European Commission developed an ''ExternE'' methodology to propose an homogenous evaluation of the sanitary and environmental external costs of the various energy sectors in Europe. This document discusses the taking into account of the long-dated and analyzes the interests and the limits of the monetary evaluation, in terms of external costs, of the nuclear choice. It is organized in three chapters: 1. a presentation and a discussion on the various evaluation of the ''ExternE'' methodology; 2. a description of the available methods for the monetary evaluation of the long-dated impacts and more particularly the analysis of the monetary values actualization principle; 3. highlighted of the impacts for which the monetary evaluations exist. (A.L.B.)

  10. Bidding cost evaluation with fuzzy methods on building project in Jakarta

    Science.gov (United States)

    Susetyo, Budi; Utami, Tin Budi

    2017-11-01

    National construction companies today demanded to become more competitive to face increasingly competition. Every construction company especially the contractor must work better than ever. Ability to prepare cost of the work that represents the efficiency and effectiveness of the implementation of the work necessary to produce cost - competitive. The project is considered successful if the target meets the quality, cost and time. From the aspect of cost, the project has been designed in accordance with certain technical criteria to be taken into account based on standard costs. To ensure the cost efficiency of the bidding process carried out meet the rules of a fairly and competitive. The research objective is to formulate the proper way to compare several deals with the standard cost of the work. The fuzzy technique is used as a evaluation methods to decision making. The evaluation not merely based on the lowest prices. The methods is looking for the most valuable and reasonable prices. The comparison is conducted to determine the most cost-competitive and reasonable as the winner of the bidding.

  11. Cost-of-illness studies in chronic ulcers: a systematic review.

    Science.gov (United States)

    Chan, B; Cadarette, S; Wodchis, W; Wong, J; Mittmann, N; Krahn, M

    2017-04-01

    To systematically review the published academic literature on the cost of chronic ulcers. A literature search was conducted in MEDLINE, EMBASE, HealthSTAR, Econlit and CINAHL up to 12 May 2016 to identify potential studies for review. Cost search terms were based on validated algorithms. Clinical search terms were based on recent Cochrane reviews of interventions for chronic ulcers. Titles and abstracts were screened by two reviewers to determine eligibility for full text review. Study characteristics were summarised. The quality of reporting was evaluated using a modified cost-of-illness checklist. Mean costs were adjusted and inflated to 2015 $US and presented for different durations and perspectives. Of 2267 studies identified, 36 were eligible and included in the systematic review. Most studies presented results from the health-care public payer or hospital perspective. Many studies included hospital costs in the analysis and only reported total costs without presenting condition-specific attributable costs. The mean cost of chronic ulcers ranged from $1000 per year for patient out of pocket costs to $30,000 per episode from the health-care public payer perspective. Mean one year cost from a health-care public payer perspective was $44,200 for diabetic foot ulcer (DFU), $15,400 for pressure ulcer (PU) and $11,000 for leg ulcer (LU). There was large variability in study methods, perspectives, cost components and jurisdictions, making interpretation of costs difficult. Nevertheless, it appears that the cost for the treatment of chronic ulcers is substantial and greater attention needs to be made for preventive measures.

  12. Cost of diabetic foot in France, Spain, Italy, Germany and United Kingdom: A systematic review.

    Science.gov (United States)

    Tchero, Huidi; Kangambega, Pauline; Lin, Lucien; Mukisi-Mukaza, Martin; Brunet-Houdard, Solenne; Briatte, Christine; Retali, Gerald Reparate; Rusch, Emmanuel

    2018-04-01

    Cost estimates for diabetic foot are available for developed countries based on cost data for different years. This study aimed to provide a comparison of the cost of diabetic foot in E5 (France, Spain, Italy, Germany, and the United Kingdom) and its characteristics across different conditions. PubMed, Central and Embase databases were searched in February 2017 for English language publications. Bibliographies of relevant papers were also searched manually. Reviews and research papers from E5 regions reporting on cost of diabetic foot were included. Reported cost was converted to equivalent 2016 $ for comparison purposes. All the costs presented are mean cost per patient per year in 2016 $. Nine studies were included in the analysis. The total cost of amputation ranged from $ 15,046 in 2001 to $ 38,621 in 2005. The direct cost of amputation ranged from $ 13,842 in 2001 to $ 83,728 during 2005-2009. Indirect cost of amputation was more uniform, ranging from between $ 1,043 to $ 1,442. The direct cost of gangrene ranged from $ 3,352 in 2003 to $ 8,818 in Germany. Although, for the same year, 2003, the cost for Spain was almost double that for Germany. The total cost of an uninfected ulcer was $ 6,174 in 2002, but increased to $ 14,441 in 2005; for an infected ulcer the cost increased from $ 2,637 to $ 2,957. The different countries showed variations in the components used to calculate the cost of diabetic foot. The E5 incurs a heavy cost from diabetic foot and its complications. There is an unmet need for the identification of cost-cutting strategies, as diabetic foot costs more than major cardiac diseases. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  13. [Evaluating cost/equity in the Colombian health system, 1998-2005].

    Science.gov (United States)

    Eslava-Schmalbach, Javier; Barón, Gilberto; Gaitán-Duarte, Hernando; Alfonso, Helman; Agudelo, Carlos; Sánchez, Carolina

    2008-01-01

    An economic analysis of cost-equity (from society's viewpoint) for evaluating the impact of Law 100/93 in Colombia between 1998 and 2005. An economic analysis compared costs and equity in health in Colombia between 1998 and 2005. Data was taken from the Colombian Statistics' Administration Department ( Departamento Administrativo Nacional de Estadistica - DANE) and from national demographic and health surveys carried out in 2000 and 2005. Information regarding costs was taken from the National Health Accounts' System. Inequity in Health was considered in line with the Inequity in Health Index (IHI). Incremental and average cost-equity analysis covered three sub-periods; 1998-1999 (during which time per capita gross internal product became reduced in Colombia ), 2000-2001 (during which time total health expense became reduced) and 2001 -2005. An unstable tendency for inequity in health becoming reduced during the period was revealed. There was an inverse relationship between IHI and public health spending and a direct relationship between out-of-pocket spending on health and equity in health (Spearman, p<0.05). The second period had the best incremental cost-equity ratio. Fluctuations in IHI and marginal cost-equity during the periods being analysed suggested that health spending depended on equity in health in Colombia during the period being studied.

  14. Performance and cost evaluation of health information systems using micro-costing and discrete-event simulation.

    Science.gov (United States)

    Rejeb, Olfa; Pilet, Claire; Hamana, Sabri; Xie, Xiaolan; Durand, Thierry; Aloui, Saber; Doly, Anne; Biron, Pierre; Perrier, Lionel; Augusto, Vincent

    2018-06-01

    Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach. The methodology is applied to the consultation for cancer treatment process. Simulation scenarios are established to conclude about the impact of HIS on patient pathway. We demonstrated that although high level HIS lengthen the consultation, occupation rate of oncologists are lower and quality of service is higher (through the number of available information accessed during the consultation to formulate the diagnostic). The provided method allows also to determine the most cost-effective ICT elements to improve the care process quality while minimizing costs. The methodology is flexible enough to be applied to other health-care systems.

  15. Cost effectiveness analysis of immunotherapy in patients with grass pollen allergic rhinoconjunctivitis in Germany.

    Science.gov (United States)

    Westerhout, K Y; Verheggen, B G; Schreder, C H; Augustin, M

    2012-01-01

    An economic evaluation was conducted to assess the outcomes and costs as well as cost-effectiveness of the following grass-pollen immunotherapies: OA (Oralair; Stallergenes S.A., Antony, France) vs GRZ (Grazax; ALK-Abelló, Hørsholm, Denmark), and ALD (Alk Depot SQ; ALK-Abelló) (immunotherapy agents alongside symptomatic medication) and symptomatic treatment alone for grass pollen allergic rhinoconjunctivitis. The costs and outcomes of 3-year treatment were assessed for a period of 9 years using a Markov model. Treatment efficacy was estimated using an indirect comparison of available clinical trials with placebo as a common comparator. Estimates for immunotherapy discontinuation, occurrence of asthma, health state utilities, drug costs, resource use, and healthcare costs were derived from published sources. The analysis was conducted from the insurant's perspective including public and private health insurance payments and co-payments by insurants. Outcomes were reported as quality-adjusted life years (QALYs) and symptom-free days. The uncertainty around incremental model results was tested by means of extensive deterministic univariate and probabilistic multivariate sensitivity analyses. In the base case analysis the model predicted a cost-utility ratio of OA vs symptomatic treatment of €14,728 per QALY; incremental costs were €1356 (95%CI: €1230; €1484) and incremental QALYs 0.092 (95%CI: 0.052; 0.140). OA was the dominant strategy compared to GRZ and ALD, with estimated incremental costs of -€1142 (95%CI: -€1255; -€1038) and -€54 (95%CI: -€188; €85) and incremental QALYs of 0.015 (95%CI: -0.025; 0.056) and 0.027 (95%CI: -0.022; 0.075), respectively. At a willingness-to-pay threshold of €20,000, the probability of OA being the most cost-effective treatment was predicted to be 79%. Univariate sensitivity analyses show that incremental outcomes were moderately sensitive to changes in efficacy estimates. The main study limitation was the

  16. Method of levelized discounted costs applied in economic evaluation of nuclear power plant project

    International Nuclear Information System (INIS)

    Tian Li; Wang Yongqing; Liu Jingquan; Guo Jilin; Liu Wei

    2000-01-01

    The main methods of economic evaluation of bid which are in common use are introduced. The characteristics of levelized discounted cost method and its application are presented. The method of levelized discounted cost is applied to the cost calculation of a 200 MW nuclear heating reactor economic evaluation. The results indicate that the method of levelized discounted costs is simple, feasible and which is considered most suitable for the economic evaluation of various case. The method is suggested which is used in the national economic evaluation

  17. The cost and impact of scaling up pre-exposure prophylaxis for HIV prevention: a systematic review of cost-effectiveness modelling studies

    NARCIS (Netherlands)

    Gomez, Gabriela B.; Borquez, Annick; Case, Kelsey K.; Wheelock, Ana; Vassall, Anna; Hankins, Catherine

    2013-01-01

    Cost-effectiveness studies inform resource allocation, strategy, and policy development. However, due to their complexity, dependence on assumptions made, and inherent uncertainty, synthesising, and generalising the results can be difficult. We assess cost-effectiveness models evaluating expected

  18. The Nonmydriatic Fundus Camera in Diabetic Retinopathy Screening: A Cost-Effective Study with Evaluation for Future Large-Scale Application

    Directory of Open Access Journals (Sweden)

    Giuseppe Scarpa

    2016-01-01

    Full Text Available Aims. The study aimed to present the experience of a screening programme for early detection of diabetic retinopathy (DR using a nonmydriatic fundus camera, evaluating the feasibility in terms of validity, resources absorption, and future advantages of a potential application, in an Italian local health authority. Methods. Diabetic patients living in the town of Ponzano, Veneto Region (Northern Italy, were invited to be enrolled in the screening programme. The “no prevention strategy” with the inclusion of the estimation of blindness related costs was compared with screening costs in order to evaluate a future extensive and feasible implementation of the procedure, through a budget impact approach. Results. Out of 498 diabetic patients eligible, 80% was enrolled in the screening programme. 115 patients (34% were referred to an ophthalmologist and 9 cases required prompt treatment for either proliferative DR or macular edema. Based on the pilot data, it emerged that an extensive use of the investigated screening programme, within the Greater Treviso area, could prevent 6 cases of blindness every year, resulting in a saving of €271,543.32 (−13.71%. Conclusions. Fundus images obtained with a nonmydriatic fundus camera could be considered an effective, cost-sparing, and feasible screening tool for the early detection of DR, preventing blindness as a result of diabetes.

  19. Costs Associated With Single-Use and Conventional Sets for Distal Radius Plating.

    Science.gov (United States)

    Fugarino, Bryce; Fox, Mary Patricia; Terhoeve, Cristina; Pappas, Nicholas

    2017-11-01

    Volar plating of distal radius fractures is an increasingly common procedure. Presterilized, single-use volar plate fixation sets have been purported to increase operating room efficiency and decrease cost. The purpose of this study was to compare the actual cost of using a conventional set compared with the projected cost of using its single-use counterpart. We retrospectively analyzed 30 consecutive cases of volar plate fixation in which conventional instrument sets were used. Hardware and processing costs were calculated for the conventional sets and compared with the projected cost of using single-use sets. The mean total cost of hardware and processing for the conventional sets was $2,728, whereas the projected cost for the single-use sets was slightly higher at $2,868. Twenty-three of the 30 cases would have required additional screws not available in the single-use set. The cost of the additional screws needed to supplement the single-use set would have added an average of $282/case. Overall, the combined hardware and processing cost was lower for conventional sets in 25 of the 30 cases. Although the price of the single-use set is less than the mean charge for use of a conventional set, additional screws not available in the single-use set were required in 77% of cases and consequently rendered the conventional set cheaper in 83% of cases. Stocking the single-use sets with additional screws to reflect the most commonly used screw lengths could make these sets more cost effective in the future. Economic and decision analysis IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Multiple imputation strategies for zero-inflated cost data in economic evaluations : which method works best?

    NARCIS (Netherlands)

    MacNeil Vroomen, Janet; Eekhout, Iris; Dijkgraaf, Marcel G; van Hout, Hein; de Rooij, Sophia E; Heymans, Martijn W; Bosmans, Judith E

    2016-01-01

    Cost and effect data often have missing data because economic evaluations are frequently added onto clinical studies where cost data are rarely the primary outcome. The objective of this article was to investigate which multiple imputation strategy is most appropriate to use for missing

  1. Development and evaluation of low-cost walker with trunk support for senior citizen.

    Science.gov (United States)

    Poier, Paloma Hohmann; Godke, Francisco; Foggiatto, José Aguiomar; Ulbricht, Leandra

    2017-10-09

    Develop and evaluate a low-cost walker with trunk support for senior citizens. Two-stage descriptive study: development of a walker with trunk support and evaluation with fourth age senior citizens. Twenty-three fourth age senior citizens were selected. The evaluated criteria were the immediate influence of the walker on the static stabilometry with baropodometer and the evaluation of gait with accelerometers monitoring time and amplitude of the hip movement. There was a significant decrease in the body oscillation of senior citizens with the use of the developed walker, and there were changes in the joint amplitudes of the hip, but they were not significant. Using low-cost materials, it was possible to develop and equipment that met resistance and effectiveness requirements. The walker interfered in the balance of the senior citizens, reducing significantly the static body oscillation.

  2. The External Cost Evaluation of the Nuclear Severe Accident Using CVM

    International Nuclear Information System (INIS)

    Lee, Yong Suk; Lee, Byung Chul

    2006-01-01

    The external cost of energy can be defined as 'the cost not included in the energy market price', such as air pollution, noise, etc. Within the evaluation of the external cost of nuclear energy, the estimation of the external cost of severe accident is one of the major topics to be addressed. For the evaluation of the external cost of severe accident, the effect of risk aversion of the public against the severe accident must be addressed, because people are more concerned about low probability - high consequence events than about high probability - low consequence events having the same mean damage. It is generally recognized that there is a discrepancy between the social acceptability of the risk and the average monetary value which corresponds in principle to the compensation of the consequences for each individual of the population affected by the accident. In this paper, the CVM (Contingent Valuation Method) is used to integrate the risk aversion in the external costs of nuclear severe accidents in Korea

  3. Study on the feasibility of implementing a cost-recovery program

    International Nuclear Information System (INIS)

    1988-02-01

    The AECB does not currently have an adequate legal basis for cost recovery. The use of amendments to the AEC (Atomic Energy Control) Act or Regulations to effect cost recovery would entail too high a risk of successful legal challenge and political complications which could adversely affect the AECB's operational effectiveness. In the time frame envisaged by Treasury Board Secretariat for the AECB to collect fees, it is not practical to amend the AEC Act to make it binding on the Crown, and specifically to authorize the AECB to recover its costs. The only practical approach to providing a sound legal basis for cost recovery is through amendment of the Financial Administration Act. Studies to date have provided a basis to establish options for cost recovery which may be practical, provided that a sound legal basis is established. Studies to date have not provided a basis to evaluate the impact of any of these options on the development, application, and use of atomic energy in Canada, or on the regulatory effectiveness of the AECB. While the principle of cost-recovery has been decided by the Treasury Board, public consultations are needed to evaluate impact and to arrive at a final decision on the extent of cost recovery. Such consultations are required by the government's Regulatory Process Action Plan. Cost recovery is likely to generate a strong negative reaction from the nuclear industry, some of which may affect the ability of the AECB to implement an effective regulatory program

  4. Design and cost evaluation of generic magnetic fusion reactor using the D-D fuel cycle

    International Nuclear Information System (INIS)

    Shannon, T.E.

    1988-01-01

    A fusion reactor systems code has been developed to evaluate the economic potential of power generation from a toroidal magnetic fusion reactor using deuterium-deuterium (D-D) fuel. A method similar to that developed by J. Sheffield, of the Oak Ridge National Laboratory, for deuterium-tritium (D-T) fuel was used to model the generic aspects of magnetic fusion reactors. The results of the systems study and cost evaluation show that the cost of electricity produced by a D-D reactor is two times higher than that produced by an equivalent D-T reactor design. The significant finding of the study is that the cost ratio between the D-D and D-T systems can potentially be reduced to 1.5 by improved engineering design and even lower by better physics performance. The absolute costs for both systems at this level are close to the costs for nuclear fission and fossil fuel plants. A design for a magnet reinforced with advanced composite materials is presented as an example of an engineering improvement that could reduce the cost of electricity produced by both reactors. However, since the magnets in the D-D reactor are much larger than in the K-T reactor, the cost ratio of the two systems is significantly reduced

  5. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania.

    Science.gov (United States)

    Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; McHomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne

    2008-01-07

    The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. The costs of implementing ACT are substantial. Although drug purchases

  6. EVALUATING THE LIFE CYCLE COSTS OF PLANT ASSETS – A MULTIDIMENSIONAL VIEW

    Directory of Open Access Journals (Sweden)

    Markus Gram

    2012-11-01

    Full Text Available This paper shows the results of the task group "Asset life cycle management" of the AustrianScientific Maintenance and Asset Management Association (ÖVIA. One purpose of the researchactivities is to create a generic life cycle model for physical assets which includes all costs in everyphase of the asset life cycle. The first step is a literature review determining the most established lifecycle cost models. This is the input for discussing the completeness of such frameworks with theparticipating industrial companies. A general model is deducted from existing approaches and thedetermined costs are evaluated with respect to priority and practical relevance. The result of theevaluation shows which costs are taken into account for investment decisions. Another outcome ofthe study is the verification of importance of the proposed costs for industrial companies, especiallyfor the process industry. The derived life cycle cost framework is the basis for developing a calculationtool and subsequently, for further research in the flied of uncertainty-based methodologies forlife cycle cost analyzing of physical plant assets.

  7. Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?

    Science.gov (United States)

    Ong, Koh Jun; Soldan, Kate; Jit, Mark; Dunbar, J Kevin; Woodhall, Sarah C

    2017-02-01

    Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark). From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values. Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412. There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Performance Evaluation of Low Cost LoRa Modules in IoT Applications

    Science.gov (United States)

    Daud, Shuhaizar; Shi Yang, Teoh; Asmi Romli, Muhamad; Awang Ahmad, Zahari; Mahrom, Norfadila; Raof, Rafikha Aliana A.

    2018-03-01

    LoRa is a low power long range wireless communication platform that is designed as an efficient communication platform for small, low powered devices. This makes it very suitable for battery powered devices and IoT implementation. This paper evaluates some low cost LoRa modules available on the market and their suitability, energy efficiency and performance during operation. Two low cost LoRa transceiver from Semtech Industries, the SX1272 and SX1278 were tested for their power consumption and maximum transmission range. This study have evaluated the two LoRa solutions and found that the SX1278 have a better transmission range and uses lower energy compared to the SX1272 thus making it more suitable for embedded implementation as a data gateway.

  9. Construction of road network vulnerability evaluation index based on general travel cost

    Science.gov (United States)

    Leng, Jun-qiang; Zhai, Jing; Li, Qian-wen; Zhao, Lin

    2018-03-01

    With the development of China's economy and the continuous improvement of her urban road network, the vulnerability of the urban road network has attracted increasing attention. Based on general travel cost, this work constructs the vulnerability evaluation index for the urban road network, and evaluates the vulnerability of the urban road network from the perspective of user generalised travel cost. Firstly, the generalised travel cost model is constructed based on vehicle cost, travel time, and traveller comfort. Then, the network efficiency index is selected as an evaluation index of vulnerability: the network efficiency index is composed of the traffic volume and the generalised travel cost, which are obtained from the equilibrium state of the network. In addition, the research analyses the influence of traffic capacity decrease, road section attribute value, and location of road section, on vulnerability. Finally, the vulnerability index is used to analyse the local area network of Harbin and verify its applicability.

  10. Cost effectiveness of FDG-PET: rapid evaluation in recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Kelley, B.B.; Miles, K.A.; Keith, C.J.; Wong, D.C.; Griffiths, M.R.

    2002-01-01

    Full text: Intensive patient follow-up in assessments of the cost-effectiveness of a new imaging modality is associated with time-delays, ethical difficulties and increased costs. This study aims to evaluate the cost-effectiveness of FDG-PET in recurrent colorectal cancer using Australian data whilst avoiding intensive patient follow-up. The study population comprised patients with recurrent colorectal under consideration for resection of apparently isolated hepatic metastasis in whom demonstration of extra-hepatic tumour would preclude surgery. The results of FDG-PET in a consecutive series of 75 such patients referred to the Wesley PET centre were used to determine the range of possible values for disease prevalence and specificity, assuming the value for PET sensitivity as reported in the federal government's PET review. These values, along with the diagnostic accuracy of CT and Australian costs for procedures (PET = $ 1200), were entered into decision trees modelling a diagnostic strategy comprising CT only and an alternative strategy where patients without extra-hepatic tumour on CT also undergo FDG-PET. The cost per patient, accuracy and Incremental Cost-Accuracy Ratio (ICAR) were determined for each strategy. The PET strategy is cheaper for all possible values of disease prevalence and PET specificity ($306-328/patient) and is more cost-effective for values of disease prevalence above 0.18 or PET specificity above 0.86. At a typical disease prevalence of 0.3 (PET specificity 0.92), the ICAR for the PET strategy is $9700 versus $11,200 for CT. PET remains cost saving even if the best reported values for sensitivity of CT and worse values for PET are used, FDG-PET for recurrent colorectal cancer in Australia would be cost-saving and most probably cost-effective. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modelling study.

    Science.gov (United States)

    Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy

    2011-01-04

    to cost less than increasing male coverage but also improve the ratio of women to men diagnosed. Further evaluation of the cost effectiveness of partner notification and screening is urgently needed. The spreadsheet tool developed in this study can be easily modified for use in other settings to evaluate chlamydia control programmes.

  12. Cost-Utility of Evaluation for Posterior Vitreous Detachment and Prophylaxis of Retinal Detachment.

    Science.gov (United States)

    Yannuzzi, Nicolas A; Chang, Jonathan S; Brown, Gary C; Smiddy, William E

    2018-01-01

    To evaluate the costs and cost-utility of examination for posterior vitreous detachment (PVD) and treatment of associated pathology, and of managing various other peripheral retinal disorders to prevent retinal detachment (RD). A decision analysis model of cost-utility. There were no participants. Published retrospective data on the natural course of PVD, retinal tears, and lattice degeneration were used to quantitate the visual benefits of examination and treatment. Center for Medicare and Medicaid Services data were used to calculate associated modeled costs in a hospital/facility-based and nonfacility/ambulatory surgical center (ASC)-based setting. Published standards of utility for a given level of visual acuity were used to derive costs and quality-adjusted life years (QALYs). Cost of evaluation and treatment, utility of defined health states, QALY, and cost per QALY. The modeled cost of evaluation of a patient with PVD and treatment of associated pathology in the facility/hospital (nonfacility/ASC)-based setting was $65 to $190 ($25-$71) depending on whether a single or 2-examination protocol was used. The cost per QALY saved was $255 to $638/QALY ($100-$239/QALY). Treatment of a symptomatic horseshoe tear resulted in a net cost savings of $1749 ($1314) and improved utility, whereas treatment of an asymptomatic horseshoe tear resulted in $2981/QALY ($1436/QALY). Treatment of asymptomatic lattice degeneration in an eye in which the fellow eye had a history of RD resulted in $4414/QALY ($2187/QALY). Evaluation and management of incident acute PVD (and symptomatic horseshoe tears) offer a low cost and a favorable cost-utility (low $/QALY) as a result of the minimization of the cost and morbidity associated with the development of RD, thus justifying current practice standards. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  13. [An evaluation of costs in nephrology by means of analytical accounting system].

    Science.gov (United States)

    Hernández-Jaras, J; García Pérez, H; Pons, R; Calvo, C

    2005-01-01

    The analytical accounting is a countable technique directed to the evaluation, by means of pre-established criteria of distribution, of the internal economy of the hospital, in order to know the effectiveness and efficiency of Clinical Units. The aim of this study was to analyze the activity and costs of the Nephrology Department of General Hospital of Castellón. Activity of Hospitalization and Ambulatory Care, during 2003 was analysed. Hospitalization discharges were grouped in DGR and the costs per DGR were determinated. Total costs Hospitalisation and Ambulatory Care were 560.434,9 and 146.317,8 Euros, respectively. And the costs of one stay, one first outpatient visit and maintenance visit were 200, 63, and 31,6 Euros, respectively. Eighty per cent of the discharges were grouped in 9 DGR and DRG number 316 (Renal Failure) represented 30% of the total productivity. Costs of DGR 316 were 3.178,2 Euros and 16% represented laboratory cost and costs of diagnostic or therapeutic procedures. With introduction of analytical accounting and DGR system, the Nephrology Departments can acquire more full information on the results and costs of treatment. These techniques permits to improve the financial and economic performance.

  14. Cost evaluation of radiation vulcanization of natural rubber latex

    International Nuclear Information System (INIS)

    Makuuchi, K.

    2003-01-01

    Cost of radiation vulcanized NR latex was evaluated. The plant would be built in an existing dipping factory in an industrial area in a Southeast Asian country. One thousands dry tons of NR latex are vulcanized with a low energy electron accelerator. The electron accelerator is a self-shielding low energy type. The maximum accelerating voltage is 300 kV and the output power is 10 kW. The total construction cost of the plant is $400,000 including electron accelerator and other equipments. Costs of raw materials and utilities are $1.165 and $0.023 per one kg of product, respectively. The fixed costs of the plant consist of labor costs, labor overhead, maintenance, plant overhead, depreciation, and bank interest. It is $0.190/kg of product. The company overhead for operation including company management, R and D and insurance is $0.044/kg of product. Thus, the total production cost is estimated to be $1.422/kg of product. (author)

  15. Evaluating economic costs and benefits of climate resilient livelihood strategies

    Directory of Open Access Journals (Sweden)

    S. Liu

    2016-01-01

    Full Text Available A major challenge for international development is to assist the poorest regions to achieve development targets while taking climate change into account. Such ‘climate resilient development’ (CRD must identify and implement adaptation strategies for improving livelihoods while also being cost-effective. While the idea that climate resilience and development goals should be compatible is often discussed, empirical evaluations of the economic impacts of actual CRD investments are practically non-existent. This paper outlines a framework to evaluate economic returns to CRD and applies it in two adaptation strategies trialed in Nusa Tenggara Barat Province, eastern Indonesia. The evaluation framework is composed of three models: a household benefit cost model, a diffusion model, and a regional benefit cost model. The models draw upon the impact evaluation, technology diffusion, and risk assessment literatures, respectively. The analyzes are based on expert opinion and locally-derived information, and hence can be applied in data-poor situations typical of developing countries. Our results explore economic costs and benefits at the household and regional scale, and we identify key input variables that greatly influence the economic returns of the strategies. These variables should therefore be a focus of ongoing investment. We also discuss how the framework is more generally applicable, its limitations including challenges in accounting for less tangible social and ecosystem service benefits, potentially leading to the underestimation of impacts, and how the approach should be complemented by qualitative methods.

  16. Clinical evaluation based on cost-effectiveness

    International Nuclear Information System (INIS)

    Inoue, Takehiro; Inoue, Toshihiko

    1998-01-01

    We carried out two Phase III clinical trials using high dose rate (HDR) remote afterloading brachytherapy unit. We evaluated the clinical results based not only on the medical but also the economical standpoint. The first trial is the Phase III trial for cervical cancer treated with HDR or medium dose rate (MDR) intracavitary radiotherapy. The second one is the Phase III trial for tongue cancer treated with HDR or low dose rate (LDR) interstitial radiation. For cervical cancer, the survival rate of patients treated with HDR brachytherapy is the some as for LDR brachytherapy. The average total cost of treatment for the HDR group was 1.47 million yen, while that for the MDR group was 1.58 million yen. The average total admission days was 63. For tongue cancer, the local control rate of the HDR group is almost the same as that of the LDR groups. The average total cost for the HDR group was 780 thousand yen, and that for the LDR group was 830 thousand yen. The average total admission days was 34. According to the cost-effectiveness, HDR brachytherapy for cervical cancer has the same result as MDR, and HDR brachytherapy for tongue cancer has the same result as LDR. However, HDR can be treated without admission for patients who live near the hospital. HDR can be applied for these patients with less expense. We must be aware of not only the medical results but also the cost-effectiveness. (author)

  17. A business case evaluation of workplace engineering noise control: a net-cost model.

    Science.gov (United States)

    Lahiri, Supriya; Low, Colleen; Barry, Michael

    2011-03-01

    This article provides a convenient tool for companies to determine the costs and benefits of alternative interventions to prevent noise-induced hearing loss (NIHL). Contextualized for Singapore and in collaboration with Singapore's Ministry of Manpower, the Net-Cost model evaluates costs of intervention for equipment and labor, avoided costs of productivity losses and medical care, and productivity gains from the employer's economic perspective. To pilot this approach, four case studies are presented, with varying degrees of economic benefits to the employer, including one in which multifactor productivity is the main driver. Although compliance agencies may not require economic analysis of NIHL, given scarce resources in a market-driven economy, this tool enables stakeholders to understand and compare the costs and benefits of NIHL interventions comprehensively and helps in determining risk management strategies.

  18. Impact and Cost Evaluation of Electric Vehicle Integration on Medium Voltage Distribution Networks

    DEFF Research Database (Denmark)

    Wu, Qiuwei; Cheng, Lin; Pineau, Ulysse

    2013-01-01

    This paper presents the analysis of the impact of electric vehicle (EV) integration on medium voltage (MV) distribution networks and the cost evaluation of replacing the overloaded grid components. A number of EV charging scenarios have been studied. A 10 kV grid from the Bornholm Island...... in the city area has been used to carry out case studies. The case study results show that the secondary transformers are the bottleneck of the MV distribution networks and the increase of EV penetration leads to the overloading of secondary transformers. The cost of the transformer replacement has been...

  19. [Cost-effectiveness of percutaneous core needle breast biopsy (CNBB) versus open surgical biopsy (OSB) of nonpalpable breast lesions: metaanalysis and cost evaluation for German-speaking countries].

    Science.gov (United States)

    Gruber, R; Bernt, R; Helbich, T H

    2008-02-01

    To analyze the cost-effectiveness of percutaneous image-guided CNBB (stereotactic-/ultrasound-guided; large/vacuum-assisted) of non-palpable breast lesions vs. OSB and to compare and discuss the results reported in the literature with results for German-speaking countries. A key word search in three databases, limited to the period from 1/1994 to 12/2006 was performed. Only original papers were selected. No published articles for German-speaking countries were identified; therefore a comprehensive data collection was made. On the basis of 377 abstracts, nine studies were evaluated for final assessment. The data of German-speaking countries were compared with results reported in the literature. This study demonstrates that CNBB compared to OSB leads to reduction in cost ranging from 51-96 %. The cost reduction depends on biopsy modality and lesion type and is subject to national fluctuations. CNBB can replace a surgical procedure in 71-85 % of cases. Use of CNBB as an alternative to OSB has the potential to substantially reduce healthcare costs. The data are based almost exclusively on the North American literature. A potential cost reduction in the Netherlands and Switzerland confirms these findings. Future work must include cost evaluation studies for German-speaking countries since this is an issue with important national economic ramifications.

  20. Economic Evaluation of Decommissioning Cost of Nuclear Power Plant in the National Electricity Plan in Korea

    International Nuclear Information System (INIS)

    Lee, Man Ki; Nam, Ji Hee

    2008-01-01

    Decommissioning cost of a nuclear power plant includes the costs related with dismantling a nuclear power plant, disposal of a spent fuel and of a low/medium radioactive waste. The decommissioning cost is different from the other expenditures in that it is occurred after the reactor finishes its commercial operation. In this respect, the electricity act was enforced to secure provisions for decommissioning a nuclear power plant during its commercial operation. The purpose of this study is to provide economic evaluation and economic cost for a decommissioning when the cost of a decommissioning is provided as one of input to the national electricity plan. Therefore, this study does not deal with whether the estimated amount of a decommissioning cost is just or not. This study focuses how to transfer the estimated decommissioning cost given in the electricity act to the economic cost, which can be used in the national electricity plan

  1. Cost effectiveness of amoxicillin for lower respiratory tract infections in primary care : An economic evaluation accounting for the cost of antimicrobial resistance

    NARCIS (Netherlands)

    Oppong, Raymond; Smith, Richard D.; Little, Paul; Verheij, Theo; Butler, Christopher C.; Goossens, Herman; Coenen, Samuel; Moore, Michael; Coast, Joanna

    2016-01-01

    Background Lower respiratory tract infections (LRTIs) are a major disease burden and are often treated with antibiotics. Typically, studies evaluating the use of antibiotics focus on immediate costs of care, and do not account for the wider implications of antimicrobial resistance. Aim This study

  2. Development and Evaluation of A Novel and Cost-Effective Approach for Low-Cost NO₂ Sensor Drift Correction.

    Science.gov (United States)

    Sun, Li; Westerdahl, Dane; Ning, Zhi

    2017-08-19

    Emerging low-cost gas sensor technologies have received increasing attention in recent years for air quality measurements due to their small size and convenient deployment. However, in the diverse applications these sensors face many technological challenges, including sensor drift over long-term deployment that cannot be easily addressed using mathematical correction algorithms or machine learning methods. This study aims to develop a novel approach to auto-correct the drift of commonly used electrochemical nitrogen dioxide (NO₂) sensor with comprehensive evaluation of its application. The impact of environmental factors on the NO₂ electrochemical sensor in low-ppb concentration level measurement was evaluated in laboratory and the temperature and relative humidity correction algorithm was evaluated. An automated zeroing protocol was developed and assessed using a chemical absorbent to remove NO₂ as a means to perform zero correction in varying ambient conditions. The sensor system was operated in three different environments in which data were compared to a reference NO₂ analyzer. The results showed that the zero-calibration protocol effectively corrected the observed drift of the sensor output. This technique offers the ability to enhance the performance of low-cost sensor based systems and these findings suggest extension of the approach to improve data quality from sensors measuring other gaseous pollutants in urban air.

  3. Evaluating effectiveness and cost of community care for schizophrenic patients.

    Science.gov (United States)

    Häfner, H; an der Heiden, W

    1991-01-01

    The two main types of mental health services research are (1) the evaluation of the mental health sector within comprehensive systems of health care and (2) the evaluation of individual mental health facilities or types of care. Depending on the information systems available, the difficulties of evaluating complex systems of care can be partially obviated by using descriptive approaches. Structural quality can be assessed by structural indices, the functioning of a system by monitoring utilization, and the overall effectiveness of a national mental health care system roughly by health indicators. Causal analyses of effectiveness are practical when they are based on individual facilities or types of care, which can be studied as isolated systems on the basis of intervention and outcome variables. Reliable and reproducible results can be achieved only if a standardized intervention is used or if the intervention and its objectives are described clearly, the output indicators are defined in terms of identifiable and repeatable operations. The assets and liabilities of quasi-experimental designs and three types of naturalistic approaches will be discussed. When the cost of a new type of care is compared with the cost of traditional mental health care, the section of the population actually served out of the total of patients with comparable needs for care should be considered. Results from the authors' studies will show how the neglect of this epidemiological aspect can lead to false statements.

  4. On dealing with the pollution costs in agriculture: A case study of paddy fields

    Energy Technology Data Exchange (ETDEWEB)

    Yaqubi, Morteza, E-mail: yaqubi@pgs.usb.ac.ir [Faculty of Management and Economics, Department of Agricultural Economics, University of Sistan and Baluchestan Zahedan (Iran, Islamic Republic of); Shahraki, Javad, E-mail: j.shahraki@eco.usb.ac.ir [Faculty of Management and Economics, Department of Agricultural Economics, University of Sistan and Baluchestan Zahedan (Iran, Islamic Republic of); Sabouhi Sabouni, Mahmood, E-mail: sabouhi@ferdowsi.um.ac.ir [Department of Agricultural Economics, Ferdowsi University of Mashhad, Azadi Square, Mashhad (Iran, Islamic Republic of)

    2016-06-15

    The main purpose of this study is to evaluate marginal abatement cost of the main agricultural pollutants. In this sense, we construct three indices including Net Global Warming Potential (NGWP) and Nitrogen Surplus (NS), simulated by a biogeochemistry model, and also an Environmental Impact Quotient (EQI) for paddy fields. Then, using a Data Envelopment Analysis (DEA) model, we evaluate environmental inefficiencies and shadow values of these indices. The results show that there is still room for improvement at no extra cost just through a better input management. Besides, enormous potential for pollution reduction in the region is feasible. Moreover, in paddy cultivation, marginal abatement cost of pesticides and herbicides are much bigger than nitrogen surplus and greenhouse gasses. In addition, in the status quo, the mitigation costs are irrelevant to production decisions. Finally, to deal with the private pollution costs, market-based instruments are proved to be better than command-and-control regulation. - Highlights: • To evaluate agricultural pollution costs, a combination of two DNDC and DEA models was introduced. • The shadow values of three main agricultural pollutants in paddy fields were evaluated. • In the study area, a high potential for pollution reduction is feasible. • The pollution cost of pesticides are much bigger than nitrogen surplus and greenhouse gases. • From the farmers' viewpoint, a positive shadow value of undesirable outputs also is feasible. • To deal with the pollution costs, market-based instruments are preferred to command-and-control regulation.

  5. On dealing with the pollution costs in agriculture: A case study of paddy fields

    International Nuclear Information System (INIS)

    Yaqubi, Morteza; Shahraki, Javad; Sabouhi Sabouni, Mahmood

    2016-01-01

    The main purpose of this study is to evaluate marginal abatement cost of the main agricultural pollutants. In this sense, we construct three indices including Net Global Warming Potential (NGWP) and Nitrogen Surplus (NS), simulated by a biogeochemistry model, and also an Environmental Impact Quotient (EQI) for paddy fields. Then, using a Data Envelopment Analysis (DEA) model, we evaluate environmental inefficiencies and shadow values of these indices. The results show that there is still room for improvement at no extra cost just through a better input management. Besides, enormous potential for pollution reduction in the region is feasible. Moreover, in paddy cultivation, marginal abatement cost of pesticides and herbicides are much bigger than nitrogen surplus and greenhouse gasses. In addition, in the status quo, the mitigation costs are irrelevant to production decisions. Finally, to deal with the private pollution costs, market-based instruments are proved to be better than command-and-control regulation. - Highlights: • To evaluate agricultural pollution costs, a combination of two DNDC and DEA models was introduced. • The shadow values of three main agricultural pollutants in paddy fields were evaluated. • In the study area, a high potential for pollution reduction is feasible. • The pollution cost of pesticides are much bigger than nitrogen surplus and greenhouse gases. • From the farmers' viewpoint, a positive shadow value of undesirable outputs also is feasible. • To deal with the pollution costs, market-based instruments are preferred to command-and-control regulation.

  6. Is home-based palliative care cost-effective? An economic evaluation of the Palliative Care Extended Packages at Home (PEACH) pilot.

    Science.gov (United States)

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

    2013-12-01

    The aim of this study was to evaluate the cost-effectiveness of a home-based palliative care model relative to usual care in expediting discharge or enabling patients to remain at home. Economic evaluation of a pilot randomised controlled trial with 28 days follow-up. Mean costs and effectiveness were calculated for the Palliative Care Extended Packages at Home (PEACH) and usual care arms including: days at home; place of death; PEACH intervention costs; specialist palliative care service use; acute hospital and palliative care unit inpatient stays; and outpatient visits. PEACH mean intervention costs per patient ($3489) were largely offset by lower mean inpatient care costs ($2450) and in this arm, participants were at home for one additional day on average. Consequently, PEACH is cost-effective relative to usual care when the threshold value for one extra day at home exceeds $1068, or $2547 if only within-study days of hospital admission are costed. All estimates are high uncertainty. The results of this small pilot study point to the potential of PEACH as a cost-effective end-of-life care model relative to usual care. Findings support the feasibility of conducting a definitive, fully powered study with longer follow-up and comprehensive economic evaluation.

  7. EIA and EINP. Evaluation study

    International Nuclear Information System (INIS)

    Lande, R.W.I. van der; De Vries, E.F.

    2001-01-01

    The evaluation study on the title subjects concerns two subsidy tools in the Netherlands: the Energy Investment Rebate (EIA, abbreviated in Dutch) and the Subsidy for Energy in the non-profit sector and other special sectors (EINP, abbreviated in Dutch). The central question in the evaluation was to what extent did the EIA and EINP contribute to the original policy targets and at what costs. The evaluation has been carried out by means of a desk study, interviews, and an analysis of bottlenecks and possible solutions. [nl

  8. Compendium of cost-effectiveness evaluations of modifications for dose reduction at nuclear power plants

    International Nuclear Information System (INIS)

    Baum, J.W.; Matthews, G.R.

    1985-12-01

    This report summarizes available information on cost effectiveness of engineering modifications potentially valuable for dose reduction at nuclear power plants. Data were gathered from several US utilities, published literature, equipment and service suppliers, and recent technical meetings. Five simplified econometric models were employed to evaluate data and arrive at a value for cost effectiveness expressed in either (a) dollars/rem, or (b) total dollar savings calculated using a nominal value of $1000/rem. Models employed were: a basic model with no consideration given to the time value of money; two models in which discounting was used to evaluate costs and savings in terms of present values; and two models in which income taxes and revenue requirements were considered. Results from different models varied by as much as a factor of 10, and were generally lowest for the basic model and highest for the before-tax revenue requirements model. Results for 151 evaluations employing different assumptions concerning number of plants per site and outage impacts were tabulated in order of decreasing cost effectiveness. Twenty-five evaluations were identified as exceptionally cost effective since both costs and dose were saved. Forty evaluations indicated highly cost-effective changes based on costs below $1000/rem saved using results of the present-worth model that included discounting of future dose savings

  9. Hysteroscopic polypectomy prior to infertility treatment: A cost analysis and systematic review.

    Science.gov (United States)

    Mouhayar, Youssef; Yin, Ophelia; Mumford, Sunni L; Segars, James H

    2017-06-01

    The cost of fertility treatment is expensive and interventions that reduce cost can lead to greater efficiency and fewer embryos transferred. Endometrial polyps contribute to infertility and are frequently removed prior to infertility treatment. It is unclear whether polypectomy reduces fertility treatment cost and if so, the magnitude of cost reduction afforded by the procedure. The aim of this study was to determine whether performing office or operative hysteroscopic polypectomy prior to infertility treatment would be cost-effective. PubMed, Embase, and Cochrane libraries were used to identify publications reporting pregnancy rates after hysteroscopic polypectomy. Studies were required to have a polypectomy treatment group and control group of patients with polyps that were not resected. The charges of infertility treatments and polypectomy were obtained through infertility organizations and a private healthcare cost reporting website. These charges were applied to a decision tree model over the range of pregnancy rates observed in the representative studies to calculate an average cost per clinical or ongoing pregnancy. A sensitivity analysis was conducted to assess cost savings of polypectomy over a range of pregnancy rates and polypectomy costs. Pre-treatment office or operative hysteroscopic polypectomy ultimately saved €6658 ($7480) and €728 ($818), respectively, of the average cost per clinical pregnancy in women treated with four cycles of intrauterine insemination. Polypectomy prior to intrauterine insemination was cost-effective for clinical pregnancy rates greater than 30.2% for office polypectomy and 52.6% for operative polypectomy and for polypectomy price <€4414 ($4959). Office polypectomy or operative polypectomy saved €15,854 ($17,813) and €6644 ($7465), respectively, from the average cost per ongoing pregnancy for in vitro fertilization/intracytoplasmic sperm injection treated women and was cost-effective for ongoing pregnancy rates

  10. Evaluating targets and costs of treatment for secondary hyperparathyroidism in incident dialysis patients: the FARO-2 study

    Directory of Open Access Journals (Sweden)

    Roggeri DP

    2014-12-01

    Full Text Available Daniela Paola Roggeri,1 Mario Cozzolino,2 Sandro Mazzaferro,3 Diego Brancaccio,4 Ernesto Paoletti,5 Alessandro Roggeri,1 Anna Maria Costanzo,6 Umberto di Luzio Paparatti,6 Vincenzo Festa,6 Piergiorgio Messa7 1ProCure Solutions, Nembro, Bergamo, 2Department of Health Sciences, University of Milan, Milan, 3Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Rome, 4Dialysis Unit NephroCare Simone Martini, Milan, 5Department of Nephrology, San Martino Hospital, Genoa, 6AbbVie Italy, Campoverde, Latina, 7Nephrology, Dialysis and Renal Transplant, Fondazione Ca Granda IRCCS Policlinico, Milan, Italy  On behalf of the FARO Study Group Background: The aim of this analysis was to estimate biochemical parameters and the costs of treatment of secondary hyperparathyroidism (SHPT in a subpopulation of the FARO-2 study. Methods: The FARO-2 observational study aimed at evaluating the patterns of treatment for SHPT in naïve hemodialysis patients. Data related to pharmacological treatments and biochemical parameters (parathyroid hormone [PTH], calcium, phosphate were recorded at entry to hemodialysis (baseline and 6 months later (second survey. The analysis was performed from the Italian National Health Service perspective. Results: Two prominent treatment groups were identified, ie, one on oral calcitriol (n=105 and the other on intravenous paricalcitol (n=33; the intravenous calcitriol and intravenous paricalcitol + cinacalcet combination groups were not analyzed due to low patient numbers. At baseline, serum PTH levels were significantly higher in the intravenous paricalcitol group (P<0.0001. At the second survey, the intravenous paricalcitol group showed a higher percentage of patients at target for PTH than in the oral calcitriol group without changing the percentage of patients at target for phosphate. Moreover, between baseline and the second survey, intravenous paricalcitol significantly increased

  11. Assessment of external costs for transport project evaluation: Guidelines in some European countries

    Energy Technology Data Exchange (ETDEWEB)

    Petruccelli, Umberto, E-mail: umberto.petruccelli@unibas.it

    2015-09-15

    Many studies about the external costs generated by the transport system have been developed in the last twenty years. To standardize methodologies and assessment procedures to be used in the evaluation of the projects, some European countries recently have adopted specific guidelines that differ from each other in some aspects even sensibly. This paper presents a critical analysis of the British, Italian and German guidelines and is aimed at cataloguing the external cost types regarded and the assessment methods indicated as well as to highlight the differences of the results, in terms of applicability and reliability. The goal is to contribute to a European standardization process that would lead to the drafting of guidelines suited for all EU countries. - Highlights: • The analyzed guidelines agree on the methods to evaluate costs from air pollution, greenhouse gases and accidents. • They recommend respectively: dose-resp. approach; costs to reduce/permit emissions; whole direct, indirect and social costs. • For noise, DE guide indicates defensive expenditure or SP methods; IT guide, SP method; UK guide, the hedonic prices one. • For on territory impact, DE guide regards only the barrier effect; the IT one, also the soil consumption and system effects. • British guide proposes a qualitative methodology to estimate the impact on various landscapes and environments.

  12. Proton and deuteron production in neutron-induced reactions on carbon at En=42.5, 62.7, and 72.8 MeV

    International Nuclear Information System (INIS)

    Slypen, I.; Corcalciuc, V.; Meulders, J.P.

    1995-01-01

    Double-differential cross sections for proton and deuteron production in fast neutron induced reactions on carbon are reported for three incident neutron energies: 42.5, 62.7, and 72.8 MeV. Angular distributions were measured at laboratory angles between 20 degree and 160 degree. Procedures for data taking and data reduction are presented. Energy-differential cross sections and total cross sections are also reported. Experimental cross sections are compared with existing data and with theoretical calculations in the frame of the intranuclear cascade model

  13. Study to establish cost predictions for the production of Redox chemicals

    Science.gov (United States)

    Ammann, P. R.; Loreth, M.; Harvey, W. W.

    1982-01-01

    The chromium and iron chloride chemicals are significant first costs for NASA Redox energy storage systems. This study was performed to determine the lowest cost at which chromium and iron chlorides could be obtained for a complex of redox energy storage systems. In addition, since the solutions gradually become intermixed during the course of operation of Redox units, it was an objective to evaluate schemes for regeneration of the operating solutions. Three processes were evaluated for the production of chromium and iron chlorides. As a basis for the preliminary plant design and economic evaluation, it was assumed that the plant would produce about 25,000 tons of contained chromium as CrCl3 and an equivalent molar quantity of FeCl2. Preliminary plant designs, including materials and energy balances and sizing of major equipment, were prepared, and capital and operating costs were estimated.

  14. Evaluating Cost-Effectiveness of Interventions that Affect Fertility and Childbearing: How Health Effects are Measured Matters

    Science.gov (United States)

    Goldhaber-Fiebert, Jeremy D.; Brandeau, Margaret L.

    2015-01-01

    Background Current guidelines for economic evaluations of health interventions define relevant outcomes as those accruing to individuals receiving interventions. Little consensus exists on counting health impacts on current and future fertility and childbearing. Objective To characterize current practices for counting such health outcomes. Design We developed a framework characterizing health interventions with direct and/or indirect effects on fertility and childbearing and how such outcomes are reported. We identified interventions spanning the framework and performed a targeted literature review for economic evaluations of these interventions. For each article, we characterized how the potential health outcomes from each intervention were considered, focusing on QALYs associated with fertility and childbearing. Results We reviewed 108 studies, identifying seven themes: 1) Studies were heterogeneous in reporting outcomes. 2) Studies often selected outcomes for inclusion that tend to bias toward finding the intervention to be cost-effective. 3) Studies often avoided the challenges of assigning QALYs for pregnancy and fertility by instead considering cost per intermediate outcome. 4) Even for the same intervention, studies took heterogeneous approaches to outcome evaluation. 5) Studies employed multiple, competing rationales for whether and how to include fertility-related QALYs and whose QALYs to include. 6) Studies examining interventions with indirect effects on fertility typically ignored such QALYs. 7) Even recent studies had these shortcomings. Limitations The review was targeted rather than systematic. Conclusions Economic evaluations inconsistently consider QALYs from current and future fertility and childbearing in ways that frequently appear biased towards the interventions considered. As the Panel on Cost-Effectiveness in Health and Medicine updates its guidelines, making the practice of cost-effectiveness analysis more consistent is a priority. Our

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Survey of Swiss nuclear's cost study 2016; Pruefung der Kostenstudie 2016 von swissnuclear

    Energy Technology Data Exchange (ETDEWEB)

    Alt, Stefan; Ustohalova, Veronika [Oeko-Institut e.V. - Institut fuer Angewandte Oekologie, Freiburg im Breisgau (Germany)

    2017-04-26

    The report discusses the Swiss nuclear cost study 2016 concerning the following issues: evaluation of the aspects of the cost study: cost structure, cost classification and risk provision, additional payment liability, option of lifetime extension for Swiss nuclear power plants; specific indications on the report ''cost study 2016 (KS16) - estimation of the decommissioning cost of Swiss nuclear power plants'': decommissioning costs in Germany, France and the USA, indexing the Swiss cost estimation for decommissioning cost, impact factors on the decommissioning costs; specific indications on the report ''cost study 2016 (KS16) - estimation of the disposal cost - interim storage, transport, containers and reprocessing''; specific indications on the report ''cost studies (KS16) - estimation of disposal costs - geological deep disposal'': time scale and costs incurred, political/social risks, retrievability, comparison with other mining costs.

  17. Evaluation of the cost-effectiveness of evolocumab in the FOURIER study: a Canadian analysis.

    Science.gov (United States)

    Lee, Todd C; Kaouache, Mohammed; Grover, Steven A

    2018-04-03

    Evolocumab, a proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor, has been shown to reduce low-density lipoprotein levels by up to 60%. Despite the absence of a reduction in overall or cardiovascular mortality in the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial, some believe that, with longer treatment, such a benefit might eventually be realized. Our aim was to estimate the potential mortality benefit over a patient's lifetime and the cost per year of life saved (YOLS) for an average Canadian with established coronary artery disease. We also sought to estimate the price threshold at which evolocumab might be considered cost-effective for secondary prevention in Canada. We calibrated the Cardio-metabolic Model, a well-validated tool for predicting cardiovascular events and life expectancy, to the reduction in nonfatal events seen in the FOURIER trial. Assuming that long-term treatment will eventually result in mortality benefits, we estimated YOLSs and cost per YOLS with evolocumab treatment plus a statin compared to a statin alone. We then estimated the annual drug costs that would provide a 50% chance of being cost-effective at willingness-to-pay values of $50 000 and $100 000. In secondary prevention in patients similar to those in the FOURIER study, evolocumab treatment would save an average of 0.34 (95% confidence interval [CI] 0.27-0.41) life-years at a cost of $101 899 (95% CI $97 325-$106 473), yielding a cost per YOLS of $299 482. We estimate that to have a 50% probability of achieving a cost per YOLS below $50 000 and $100 000 would require annual drug costs below $1200 and $2300, respectively. At current pricing, the use of evolocumab for secondary prevention is unlikely to be cost-effective in Canada. Copyright 2018, Joule Inc. or its licensors.

  18. Cost-effectiveness of sibutramine in the LOSE Weight Study: evaluating the role of pharmacologic weight-loss therapy within a weight management program.

    Science.gov (United States)

    Malone, Daniel C; Raebel, Marsha A; Porter, Julie A; Lanty, Frances A; Conner, Douglas A; Gay, Elizabeth C; Merenich, John A; Vogel, Erin A

    2005-01-01

    the cost-effectiveness of drug therapy when used in conjunction with a weight management program (WMP) for treatment of obesity. The objective was to compare the cost-effectiveness of sibutramine (Meridia) plus a structured WMP versus only a structured WMP in both overweight and obese individuals. The core WMP was a physician-supervised, multidisciplinary program for which each enrollee paid $100 out of pocket. A cost-effectiveness analysis was performed based upon the results of a previously published randomized controlled trial conducted within a managed care organization. The target population for this study was obese or overweight persons. The perspective of the study was that of a managed care organization. The intervention consisted of subjects receiving a WMP with or without sibutramine. The primary outcomes of this study were (a) absolute change in body weight and percentage change in body weight over 12 months, (b) change in obesity-related and total medical costs from 12 months prior to enrollment through 12 months after enrollment, and (c) cost-effectiveness in terms of cost per pound of weight loss. All costs were adjusted to 2004 dollars using the respective components of the consumer price index for each medical service or medication. A total of 501 evaluable subjects were enrolled in the study, with 281 receiving sibutramine plus a structured WMP and 220 receiving only the structured WMP. The meanSD weight loss was significantly greater in the sibutramine (13.715.5 pounds, 4.8%) group than in the nondrug group (513.2 pounds, 2.2%) (P cost was a median increase of $408 for the sibutramine group compared with $31 for the nondrug group (P cost was a median $1,279 increase in the sibutramine group compared with $271 for the nondrug group (P cost by $44 per additional pound of weight loss (95% confidence interval, 42-46). Sensitivity analyses found that the results were sensitive to the price of sibutramine, whereas varying the cost of clinic visits did

  19. Private costs almost equal health care costs when intervening in mild Alzheimer's: a cohort study alongside the DAISY trial

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sørensen, Jan; Waldorff, Frans B

    2009-01-01

    BACKGROUND: Alzheimer's disease is the leading cause of dementia and affects about 25 million people worldwide. Recent studies have evaluated the effect of early interventions for dementia, but few studies have considered private time and transportation costs associated with the intervention. Thi...... in access to health care. TRIAL REGISTRATION: Current Controlled Trials ISRCTN74848736....... of counselling sessions, courses and informational packages. The typical duration of the intervention was 7 months. A micro-costing approach was applied using prospectively collected data on resource utilisation that included estimates of participant time and transportation. Precision estimates were calculated...... using a bootstrapping technique and structural uncertainty was assessed with sensitivity analysis. RESULTS: The direct intervention cost was estimated at EUR 1,070 (95% CI 1,029;1,109). The total cost (including private costs) was estimated at EUR 2,020 (95% CI 1,929;2,106) i.e. the ratio of private...

  20. A new harvest operation cost model to evaluate forest harvest layout alternatives

    Science.gov (United States)

    Mark M. Clark; Russell D. Meller; Timothy P. McDonald; Chao Chi Ting

    1997-01-01

    The authors develop a new model for harvest operation costs that can be used to evaluate stands for potential harvest. The model is based on felling, extraction, and access costs, and is unique in its consideration of the interaction between harvest area shapes and access roads. The scientists illustrate the model and evaluate the impact of stand size, volume, and road...

  1. Evaluation of a low-cost open-source gaze tracker

    DEFF Research Database (Denmark)

    San Agustin, Javier; Jensen, Henrik Tomra Skovsgaard Hegner; Møllenbach, Emilie

    2010-01-01

    This paper presents a low-cost gaze tracking system that is based on a webcam mounted close to the user's eye. The performance of the gaze tracker was evaluated in an eye-typing task using two different typing applications. Participants could type between 3.56 and 6.78 words per minute, depending...... on the typing system used. A pilot study to assess the usability of the system was also carried out in the home of a user with severe motor impairments. The user successfully typed on a wall-projected interface using his eye movements....

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

    Science.gov (United States)

    Virta, Lena; Joranger, Pål; Brox, Jens Ivar; Eriksson, Rikard

    2012-02-10

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

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

    Directory of Open Access Journals (Sweden)

    Virta Lena

    2012-02-01

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

  4. Costs of Urbanisation in Poland, Based on the Example of Wrocław

    Science.gov (United States)

    Hełdak, Maria; Płuciennik, Monika

    2017-10-01

    The paper deals with the issue of charging communes with the costs of realisation of the provisions contained in local spatial development plans. When such local spatial development plan enters into force, it leads to economic consequences. In Poland, these consequences are specified in the forecast of the financial impact, which contains a prognosis of own revenues as well as of costs incurred by the budget of the commune. The research consisted in the analysis of the costs of urbanisation of land located in Wrocław, in the southern part of the Krzyki district (Poland). This area is undeveloped to a major extent, consisting mainly of agricultural land, and its development requires the construction of technological and social infrastructure facilities. The expected costs of the realisation of local spatial development plans that are binding for the southern part of Wrocław demonstrate significant costs of the construction of sewage network and municipal roads. The planned development of residential districts is not supported by the existing infrastructure. Additionally, the development of new areas will require the city of Wrocław to take over the real properties on which public goals are planned to be realised. The estimated costs of land acquisition for the realisation of public goals amount to EUR 3 728 500.

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

    Science.gov (United States)

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

    2015-06-01

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

  6. Development of a financing model for nuclear fuel cycle cost evaluation

    International Nuclear Information System (INIS)

    Takahashi, Makoto; Yajima, Masayuki

    1984-01-01

    It is necessary to evaluate the prices of nuclear fuel pre- and post-processing in order to analyse the costs of the nuclear power generation. Those prices are directly related to the costs of construction and operation of facilities in the nuclear fuel cycle. In this report, we propose a model which evaluates financing of an undertaking that constructs and operates one of the facilities such as uranium enrichment, reprocessing or interim storage of spent fuels. The model is divided into two phases, the construction phase and the operation phase. In the construction phase, it calculates expenses during the facility construction and corresponding financings for each term. In the operation phase, the model refers to the results of the construction phase and performs calculations on profits and losses, cash-flow, and disposition to profits term by according to a certain operation schedule. Using this model, feasibility of the undertaking and effects of various pricing strategies on the nuclear fuel costs can be evaluated by simulations. (author)

  7. Preliminary nuclear decommissioning cost study

    International Nuclear Information System (INIS)

    Sissingh, R.A.P.

    1981-04-01

    The decommissioning of a nuclear power plant may involve one or more of three possible options: storage with surveillance (SWS), restricted site release (RSR), and unrestricted site use(USU). This preliminary study concentrates on the logistical, technical and cost aspects of decommissioning a multi-unit CANDU generating station using Pickering GS as the reference design. The procedure chosen for evaluation is: i) removal of the fuel and heavy water followed by decontamination prior to placing the station in SWS for thiry years; ii) complete dismantlement to achieve a USU state. The combination of SWS and USU with an interim period of surveillance allows for radioactive decay and hence less occupational exposure in achieving USU. The study excludes the conventional side of the station, assumes waste disposal repositories are available 1600 km away from the station, and uses only presently available technologies. The dismantlement of all systems except the reactor core can be accomplished using Ontario Hydro's current operating, maintenance and construction procedures. The total decommissioning period is spread out over approximately 40 years, with major activities concentrated in the first and last five years. The estimated dose would be approximately 1800 rem. Overall Pickering GS A costs would be $162,000,000 (1980 Canadian dollars)

  8. Evaluating the cost of therapy for restenosis: considerations for brachytherapy

    International Nuclear Information System (INIS)

    Weintraub, William S.

    1996-01-01

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented

  9. Evaluating the cost of therapy for restenosis: considerations for brachytherapy.

    Science.gov (United States)

    Weintraub, W S

    1996-11-01

    Costs have become increasingly important in medicine in recent years as demand for services has outstripped readily available resources. Clinical microeconomics offers an approach to understanding cost and outcomes in an environment of economic scarcity. In this article the types of costs and methods for determining cost are presented. In addition, methods for assessing outcome and outcome in relation to cost are developed. Restenosis after coronary angioplasty is a prime example of a clinical problem requiring economic evaluation. This is because it results in little serious morbidity except for recurrent chest pain, but it has serious economic consequences which occur some time after the original angioplasty. This makes the economic assessment of restenosis complicated. The application of health care microeconomic principles to brachytherapy for restenosis in the coronary arteries is presented.

  10. A Framework for Evaluating the Cost-Effectiveness of Patient Decision Aids: A Case Study Using Colorectal Cancer Screening

    Science.gov (United States)

    Cantor, Scott B.; Rajan, Tanya; Linder, Suzanne K.; Volk, Robert J.

    2017-01-01

    Objective Patient decision aids are important tools for facilitating balanced, evidence-based decision making. However, the potential of decision aids to lower health care utilization and costs is uncertain; few studies have investigated the cost-effectiveness of decision aids that change patient behavior. Using an example of a decision aid for colorectal cancer screening, we provide a framework for analyzing the cost-effectiveness of decision aids. Methods A decision-analytic model with two strategies (decision aid or no decision aid) was used to calculate expected costs in U.S. dollars and benefits measured in life-years saved (LYS). Data from a systematic review of ten studies about decision aid effectiveness was used to calculate the percentage increase in the number of people choosing screening instead of no screening. We then calculated the incremental cost per LYS with the use of the decision aid. Results The no decision aid strategy had an expected cost of $3,023 and yielded 18.19 LYS. The decision aid strategy cost $3,249 and yielded 18.20 LYS. The incremental cost-effectiveness ratio for the decision aid strategy was $36,126 per LYS. Results were sensitive to the cost of the decision aid and the percentage change in behavior caused by the decision aid. Conclusions This study provides proof-of-concept evidence for future studies examining the cost-effectiveness of decision aids. The results suggest that decision aids can be beneficial and cost-effective. PMID:25979678

  11. Cost-Effectiveness and Cost-Utility Analysis of Ingenol Mebutate Versus Diclofenac 3% and Imiquimod 5% in the Treatment of Actinic Keratosis in Spain.

    Science.gov (United States)

    Elías, I; Ortega-Joaquín, N; de la Cueva, P; Del Pozo, L J; Moreno-Ramírez, D; Boada, A; Aguilar, M; Mirada, A; Mosquera, E; Gibbons, C; Oyagüez, I

    2016-01-01

    To perform a cost-effectiveness and cost-utility analysis of ingenol mebutate in the treatment of actinic keratosis in Spain. We used an adapted Markov model to simulate outcomes in a cohort of patients (mean age, 73 years) with actinic keratosis over a 5-year period. The comparators were diclofenac 3% and imiquimod 5%. The analysis was performed from the perspective of the Spanish National Health System based on direct costs (2015 retail price plus value added tax less the mandatory discount). A panel of experts estimated resources, taking unit costs from national databases. An annual discount rate of 3% was applied. Deterministic and probabilistic sensitivity analyses were performed. The effectiveness of ingenol mebutate-with 0.192 and 0.129 more clearances gained in treatments for face and scalp lesions and trunk and extremity lesions, respectively-was superior to diclofenac's. The total costs of treatment with ingenol mebutate were lower at € 551.50 (face and scalp) and € 622.27 (trunk and extremities) than the respective costs with diclofenac (€ 849.11 and € 844.93). The incremental cost-effectiveness and cost-utility ratios showed that ingenol mebutate was a dominant strategy vs diclofenac. Ingenol mebutate also proved to be more effective than imiquimod, based on 0.535 and 0.503 additional clearances, and total costs of € 551.50 and € 527.89 for the two drugs, respectively. The resulting incremental cost-effectiveness ratio was € 728.64 per clearance gained with ingenol mebutate vs imiquimod. Ingenol mebutate was a dominant treatment option vs diclofenac and was efficient vs imiquimod (i.e., more effective at a higher cost, achieving an incremental cost-utility ratio of<€30000/quality-adjusted life-years). Copyright © 2016 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

  12. Cost evaluation of irradiation system with electron accelerator

    International Nuclear Information System (INIS)

    Kashiwagi, M.

    2003-01-01

    The features of electron beam irradiation system using electron accelerator are direct energy pour into the irradiated material, no third material mixture such as catalyst, suitable for mass production and easy operation and maintenance work available. These features can bring the various applications such as cross-linking action, graft polymerization, radical polymerization and others. The selection of electron accelerator ratings is made under consideration of quality, width and thickness of irradiated material, production amount, dose required for reaction and irradiation atmosphere. Especially in a case of irradiation of wire with high insulation material such as polyethylene, the consideration of maximum thickness toward irradiation direction is necessary to avoid the discharge (Lichtenberg discharge) by charged-up electrons inside insulation material. Therefore, the acceleration voltage should be selected to make the maximum penetration larger than maximum irradiation thickness. The actual model case of estimate the irradiation cost was selected that the irradiation object was polyethylene insulated wire up to AWG no.14, irradiation amount was 5,000 km/month, necessary dose was 200 kGy, operation time was 22 d/month and 8 h/day and actual operation efficiency was considered loss time such as bobbin changing as 80%. The selected ratings of electron accelerator were acceleration voltage of 800 kV, beam current of 100 mA and irradiation width of 180 cm with irradiation pulleys stand of 60 turns x 3 lanes. The initial total cost was estimated as 3 M$(US) and operation cost was evaluated as 215 k$(US). Therefore, the irradiation cost of wire was evaluated as 0.0036 $/m. (author)

  13. Power plant asset market evaluations: Forecasting the costs of power production

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S A; Grunsrud, G P [Aptech Engineering Services, Inc., Sunnyvale, CA (United States)

    1999-12-31

    This presentation discusses the process of evaluating and valuing power plants for sale. It describes a method to forecast the future costs at a power plant using a portion of the past fixed costs, variable energy costs, and most importantly the variable cycling-related wear-and-tear costs. The presentation then discusses how to best determine market share, expected revenues, and then to forecast plant future costs based on future expected unit cycling operations. The presentation concludes with a section on recommendations to power plant buyers or sellers on how to manage the power plant asset and how to increase its market value. (orig.) 4 refs.

  14. Power plant asset market evaluations: Forecasting the costs of power production

    Energy Technology Data Exchange (ETDEWEB)

    Lefton, S.A.; Grunsrud, G.P. [Aptech Engineering Services, Inc., Sunnyvale, CA (United States)

    1998-12-31

    This presentation discusses the process of evaluating and valuing power plants for sale. It describes a method to forecast the future costs at a power plant using a portion of the past fixed costs, variable energy costs, and most importantly the variable cycling-related wear-and-tear costs. The presentation then discusses how to best determine market share, expected revenues, and then to forecast plant future costs based on future expected unit cycling operations. The presentation concludes with a section on recommendations to power plant buyers or sellers on how to manage the power plant asset and how to increase its market value. (orig.) 4 refs.

  15. Power plant asset market evaluations: Forecasting the costs of power production

    International Nuclear Information System (INIS)

    Lefton, S.A.; Grunsrud, G.P.

    1998-01-01

    This presentation discusses the process of evaluating and valuing power plants for sale. It describes a method to forecast the future costs at a power plant using a portion of the past fixed costs, variable energy costs, and most importantly the variable cycling-related wear-and-tear costs. The presentation then discusses how to best determine market share, expected revenues, and then to forecast plant future costs based on future expected unit cycling operations. The presentation concludes with a section on recommendations to power plant buyers or sellers on how to manage the power plant asset and how to increase its market value. (orig.) 4 refs

  16. Cost-benefit evaluation in a quality control programme for conventional radiodiagnosis

    International Nuclear Information System (INIS)

    Gallini, R.; Belletti, S.; Giugni, U.

    1985-01-01

    A comparison is being made between the cost of the staff and equipment in a quality control programme of conventional radiodiagnosis and the benefit obtained in the reduction of spoilt films and in the reduction of dose to patients and workers. For over two years the programme has followed a protocol verified on about 50 X-ray tubes, 25 radiological devices and four automatic processors. The present research, based on previous data, works on a limited but representative sample of radiological X-ray tubes and accessories. The control procedures are carried out periodically to improve and make constant the efficiency of the radiological devices. An evaluation of the cost of these procedures is made. In the meantime the dose to the patients undergoing radiodiagnostic examinations is evaluated by a transmission chamber. Comparison between the values obtained before and after the control enables the benefits to be evaluated. Rejection of radiographic films is evaluated before and after the control to obtain the cost reduction. During the one year control period, there were no variations in the technical characteristics of the personnel, in the operational procedures or in the work-load. (author)

  17. Cost-effectiveness of routine computed tomography in the evaluation of idiopathic unilateral vocal fold paralysis.

    Science.gov (United States)

    Hojjat, Houmehr; Svider, Peter F; Folbe, Adam J; Raza, Syed N; Carron, Michael A; Shkoukani, Mahdi A; Merati, Albert L; Mayerhoff, Ross M

    2017-02-01

    To evaluate the cost-effectiveness of routine computed tomography (CT) in individuals with unilateral vocal fold paralysis (UVFP) STUDY DESIGN: Health Economics Decision Tree Analysis METHODS: A decision tree was constructed to determine the incremental cost-effectiveness ratio (ICER) of CT imaging in UVFP patients. Univariate sensitivity analysis was utilized to calculate what the probability of having an etiology of the paralysis discovered would have to be to make CT with contrast more cost-effective than no imaging. We used two studies examining findings in UVFP patients. The decision pathways were utilizing CT neck with intravenous contrast after diagnostic laryngoscopy versus laryngoscopy alone. The probability of detecting an etiology for UVFP and associated costs were extracted to construct the decision tree. The only incorrect diagnosis was missing a mass in the no-imaging decision branch, which rendered an effectiveness of 0. The ICER of using CT was $3,306, below most acceptable willingness-to-pay (WTP) thresholds. Additionally, univariate sensitivity analysis indicated that at the WTP threshold of $30,000, obtaining CT imaging was the most cost-effective choice when the probability of having a lesion was above 1.7%. Multivariate probabilistic sensitivity analysis with Monte Carlo simulations also showed that at the WTP of $30,000, CT scanning is more cost-effective, with 99.5% certainty. Particularly in the current healthcare environment characterized by increasing consciousness of utilization defensive medicine, economic evaluations represent evidence-based findings that can be employed to facilitate appropriate decision making and enhance physician-patient communication. This economic evaluation strongly supports obtaining CT imaging in patients with newly diagnosed UVFP. 2c. Laryngoscope, 2016 127:440-444, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania

    Directory of Open Access Journals (Sweden)

    Abdulla Salim

    2008-01-01

    Full Text Available Abstract Background The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT. However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Methods Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. Results The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita, which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD. In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. Conclusion The costs of

  19. Cost/benefit study on date disinfestation by gamma irradiation in Algeria

    International Nuclear Information System (INIS)

    Mahlous, M.

    2002-01-01

    To establish the irradiation technology, one must have a holistic approach to the technology of food irradiation in order to assure a maximum utilization rate of the facility. The assumptions in this study are based on a free standing multipurpose irradiation facility, the throughput of which is expressed in t·kGy/year, and the unit cost of the treatment in US $/t·kGy. These values may then be applied for the calculation of the treatment cost of any food commodity, according to the irradiation dose needed. The study showed that irradiation treatment of dates is profitable and that the cost of irradiation does not exceed 1.6% of the selling price of the product. Post harvest losses may be considerably reduced thanks to irradiation treatment. A comparative study between irradiation and cold storage showed that irradiation will cost 30% less than cold storage. This study is completed by an evaluation of consumer acceptance of irradiated food products. (author)

  20. New York State interim waste management cost evaluation

    International Nuclear Information System (INIS)

    Ma, M.S.; Watts, R.J.; Jorgensen, J.R.; Rochester Gas and Electric Corp., NY)

    1985-01-01

    The purpose of this study is to investigate and quantify the comparative costs associated with including or excluding Class A utility wastes at a centralized interim waste management facility in New York State. The objective of the study is to assess the unit costs and total statewide costs associated with two distinct scenarios: (1) the case where non-utility Class A LLRW is received, incinerated and stored at the centralized interim facility, and utility Class A wastes are held without incineration at respective nuclear power plant interim onsite facilities without incineration; and (2) the alternative case where both utility and non-utility Class A wastes are accepted, incinerated and stored at the centralized facility. Unit costs to waste generators are estimated for each of the two cases described. This is followed by an estimation of the statewide cost impact to the public. The cost impact represents the cost differential resulting from the exclusion of utility Class A waste from the centralized NYS interim waste management facility. The principal factors comprising the cost differential include (1) higher unit disposal fees charged to non-utility waste generators, which are passed along in the costs of products and services; and (2) costs to utilities due to construction of additional onsite storage capacity, which in turn are charged to electric rate payers

  1. Pretreatment of eucalyptus with recycled ionic liquids for low-cost biorefinery.

    Science.gov (United States)

    Xu, Jikun; Liu, Bingchuan; Hou, Huijie; Hu, Jingping

    2017-06-01

    It is urgent to develop recycled ionic liquids (ILs) as green solvents for sustainable biomass pretreatment. The goal of this study is to explore the availability and performance of reusing 1-allyl-3-methylimidazolium chloride ([amim]Cl) and 1-butyl-3-methylimidazolium acetate ([bmim]OAc) for pretreatment, structural evolution, and enzymatic hydrolysis of eucalyptus. Cellulose enzymatic digestibility slightly decreased with the increased number of pretreatment recycles. The hydrolysis efficiencies of eucalyptus pretreated via 4th recycled ILs were 54.3% for [amim]Cl and 72.8% for [bmim]OAc, which were 5.0 and 6.7-folds higher than that of untreated eucalyptus. Deteriorations of ILs were observed by the relatively lower sugar conversion and lignin removal from eucalyptus after 4th reuse. No appreciable changes in fundamental framework and thermal stability of [amim]Cl were observed even after successive pretreatments, whereas the anionic structure of [bmim]OAc was destroyed or replaced. This study suggested that the biomass pretreatment with recycled ILs was a potential alternative for low-cost biorefinery. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Design of a trial-based economic evaluation on the cost-effectiveness of employability interventions among work disabled employees or employees at risk of work disability: The CASE-study

    Directory of Open Access Journals (Sweden)

    Noben Cindy YG

    2012-01-01

    Full Text Available Abstract Background In the Netherlands, absenteeism and reduced productivity due to work disability lead to high yearly costs reaching almost 5% of the gross national product. To reduce the economic burden of sick leave and reduced productivity, different employability interventions for work-disabled employees or employees at risk of work disability have been developed. Within this study, called 'CASE-study' (Cost-effectiveness Analysis of Sustainable Employability, five different employability interventions directed at work disabled employees with divergent health complaints will be analysed on their effectiveness and cost-effectiveness. This paper describes a consistent and transparent methodological design to do so. Methods/design Per employability intervention 142 participants are needed whereof approximately 66 participants receiving the intervention will be compared with 66 participants receiving usual care. Based on the intervention-specific characteristics, a randomized control trial or a quasi-experiment with match-criteria will be conducted. Notwithstanding the study design, eligible participants will be employees aged 18 to 63, working at least 12 h per week, and at risk of work disability, or already work-disabled due to medical restrictions. The primary outcome will be the duration of sick leave. Secondary outcomes are health status and quality of life. Outcomes will be assessed at baseline and then 6, 12 and 18 months later. Economic costs will consist of healthcare costs and cost of lost production due to work disability, and will be evaluated from a societal perspective. Discussion The CASE-study is the first to conduct economic evaluations of multiple different employability interventions based on a similar methodological framework. The cost-effectiveness results for every employability intervention will be published in 2014, but the methods, strengths and weaknesses of the study protocol are discussed in this paper. To

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

    Science.gov (United States)

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

    2016-06-23

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

  4. Cost-of-illness studies in heart failure: a systematic review 2004-2016.

    Science.gov (United States)

    Lesyuk, Wladimir; Kriza, Christine; Kolominsky-Rabas, Peter

    2018-05-02

    Heart failure is a major and growing medical and economic problem worldwide as 1-2% of the healthcare budget are spent for heart failure. The prevalence of heart failure has increased over the past decades and it is expected that there will be further raise due to the higher proportion of elderly in the western societies. In this context cost-of-illness studies can significantly contribute to a better understanding of the drivers and problems which lead to the increasing costs in heart failure. The aim of this study was to perform a systematic review of published cost-of-illness studies related to heart failure to highlight the increasing cost impact of heart failure. A systematic review was conducted from 2004 to 2016 to identify cost-of-illness studies related to heart failure, searching PubMed (Medline), Cochrane, Science Direct (Embase), Scopus and CRD York Database. Of the total of 16 studies identified, 11 studies reported prevalence-based estimates, 2 studies focused on incidence-based data and 3 articles presented both types of cost data. A large variation concerning cost components and estimates can be noted. Only three studies estimated indirect costs. Most of the included studies have shown that the costs for hospital admission are the most expensive cost element. Estimates for annual prevalence-based costs for heart failure patients range from $868 for South Korea to $25,532 for Germany. The lifetime costs for heart failure patients have been estimated to $126.819 per patient. Our review highlights the considerable and growing economic burden of heart failure on the health care systems. The cost-of-illness studies included in this review show large variations in methodology used and the cost results vary consequently. High quality data from cost-of-illness studies with a robust methodology applied can inform policy makers about the major cost drivers of heart failure and can be used as the basis of further economic evaluations.

  5. A cost-effective evaluation of biomass district heating in rural communities

    International Nuclear Information System (INIS)

    Hendricks, Aaron M.; Wagner, John E.; Volk, Timothy A.; Newman, David H.; Brown, Tristan R.

    2016-01-01

    Highlights: • Develop a cost-effective model using secondary data examining delivering heat through Biomass District Heating (BDH). • Eight of ten rural villages studied could cost-effectively deliver heat through BDH below the 2013 price of heating oil. • 80% of the annual cost of BDH was attributable to capital expenses. • Erratic fuel oil prices substantially impact future feasibility. • Village level feasibility is highly-influenced by the presence of large heat demanders. - Abstract: The economic feasibility of Biomass District Heating (BDH) networks in rural villages is largely unknown. A cost-effective evaluation tool is developed to examine the feasibility of BDH in rural communities using secondary data sources. The approach is unique in that it accounts for all the major capital expenses: energy center, distribution network, and energy transfer stations, as well as biomass procurement. BDH would deliver heat below #2 fuel oil in eight of the ten rural study villages examined, saving nearly $500,000 per year in heating expenses while demanding less than 5% of the forest residues sustainably available regionally. Capital costs comprised over 80% of total costs, illuminating the importance of reaching a sufficient heat density. Reducing capital costs by 1% lowers total cost by $93,000 per year. Extending capital payment period length five years or lowering interest rates has the next highest influence decreasing delivered heat price 0.49% and 0.35% for each 1% change, respectively. This highlights that specific building heat is a strong determinant of feasibility given the relative influence of high-demanding users on the overall village heat-density. Finally, we use a stochastic analysis projecting future #2 fuel oil prices, incorporating historical variability, to determine the probability of future BDH feasibility. Although future oil prices drop below the BDH feasibility threshold, the villages retain a 22–53% probability of feasibility after

  6. Cost-effectiveness of early intervention in first-episode psychosis: economic evaluation of a randomised controlled trial (the OPUS study).

    Science.gov (United States)

    Hastrup, Lene Halling; Kronborg, Christian; Bertelsen, Mette; Jeppesen, Pia; Jorgensen, Per; Petersen, Lone; Thorup, Anne; Simonsen, Erik; Nordentoft, Merete

    2013-01-01

    Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited. To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment. An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken. The mean total costs of OPUS over 5 years (€123,683, s.e. = 8970) were not significantly different from that of standard treatment (€148,751, s.e. = 13073). At 2-year follow-up the mean Global Assessment of Functioning (GAF) score in the OPUS group (55.16, s.d. = 15.15) was significantly higher than in standard treatment group (51.13, s.d. = 15.92). However, the mean GAF did not differ significantly between the groups at 5-year follow-up (55.35 (s.d. = 18.28) and 54.16 (s.d. = 18.41), respectively). Cost-effectiveness planes based on non-parametric bootstrapping showed that OPUS was less costly and more effective in 70% of the replications. For a willingness-to-pay up to €50,000 the probability that OPUS was cost-effective was more than 80%. The incremental cost-effectiveness analysis showed that there was a high probability of OPUS being cost-effective compared with standard treatment.

  7. Cost of epilepsy: a systematic review.

    Science.gov (United States)

    Strzelczyk, Adam; Reese, Jens Peter; Dodel, Richard; Hamer, Hajo M

    2008-01-01

    The objective of this review was to overview published cost-of-illness (COI) studies of epilepsy and their methodological approaches. Epilepsy imposes a substantial burden on individuals and society as a whole. The mean prevalence of epilepsy is estimated at 0.52% in Europe, 0.68% in the US, and peaks up to 1.5% in developing countries. Estimation of the economic burden of epilepsy is of pivotal relevance to enable a rational distribution of healthcare resources. This is especially so with the introduction of the newer antiepileptic drugs (AEDs), the marketing of vagal-nerve stimulators and the resurgence of new surgical treatment options, which have the potential to considerably increase the costs of treating epilepsy.A systematic literature review was performed to identify studies that evaluated direct and indirect costs of epilepsy. Using a standardized assessment form, information on the study design, methodological framework and data sources were extracted from each publication and systematically reported. We identified 22 studies worldwide on costs of epilepsy. The majority of the studies reflected the costs of epilepsy in Europe (three studies each for the UK and Italy, one study each for Germany, the Netherlands, Switzerland, France and the EU) and the US (four studies), but studies were also available from India (two), Hong Kong, Oman, Burundi, Chile and Mexico. The studies utilized different frameworks to evaluate costs. All used a bottom-up approach; however, only 12 studies (55%) evaluated direct as well as indirect costs. The range for the mean annual direct costs lay between 40 International Dollar purchasing power parities (PPP-$) in rural Burundi and PPP-$4748 (adjusted to 2006 values) in a German epilepsy centre. Recent studies suggest AEDs are becoming the main contributor to direct costs. The mean indirect costs ranged between 12% and 85% of the total annual costs. Epilepsy is a cost-intensive disorder. A reliable comparison of the different COI

  8. Cost and Cost-Effectiveness of Donor Human Milk to Prevent Necrotizing Enterocolitis: Systematic Review.

    Science.gov (United States)

    Buckle, Abigail; Taylor, Celia

    2017-11-01

    Necrotizing enterocolitis (NEC) is a costly gastrointestinal disorder that mainly affects preterm and low-birth-weight infants and can lead to considerable morbidity and mortality. Mother's own milk is protective against NEC but is not always available. In such cases, donor human milk has also been shown to be protective (although to a lesser extent) compared with formula milk, but it is more expensive. This systematic review aimed at evaluating the cost of donor milk, the cost of treating NEC, and the cost-effectiveness of exclusive donor milk versus formula milk feeding to reduce the short-term health and treatment costs of NEC. We systematically searched five relevant databases to find studies with verifiable costs or charges of donor milk and/or treatment of NEC and any economic evaluations comparing exclusive donor milk with exclusive formula milk feeding. All search results were double screened. Seven studies with verifiable donor milk costs and 17 with verifiable NEC treatment costs were included. The types of cost or charge included varied considerably across studies, so quantitative synthesis was not attempted. Estimates of the incremental length of stay associated with NEC were ∼18 days for medical NEC and 50 days for surgical NEC. Two studies claimed to report economic evaluations but did not do so in practice. It is likely that donor milk provides short-term cost savings by reducing the incidence of NEC. Future studies should provide more details on cost components included and a full economic evaluation, including long-term outcomes, should be undertaken.

  9. A short-term cost-effectiveness study comparing robot-assisted laparoscopic and open retropubic radical prostatectomy

    DEFF Research Database (Denmark)

    Hohwü, Lena; Borre, Michael; Ehlers, Lars

    2011-01-01

    OBJECTIVE: To evaluate cost effectiveness and cost utility comparing robot-assisted laparoscopic prostatectomy (RALP) versus retropubic radical prostatectomy (RRP). METHODS: In a retrospective cohort study a total of 231 men between the age of 50 and 69 years and with clinically localised prostate....... An economic evaluation was made to estimate direct costs of the first postoperative year and an incremental cost-effectiveness ratio (ICER) per successful surgical treatment and per quality-adjusted life-year (QALY). A successful RP was defined as: no residual cancer (PSA ... high volume urology centres and utilise the full potential of each robot....

  10. Cost-benefit evaluation of systematic radiological diagnosis of congenital dislocated hip

    International Nuclear Information System (INIS)

    Faure, C.; Schmit, P.; Salvat, D.

    1984-01-01

    The interest of radiological mass screening of congential dislocated hip is still debated. We have tried to evaluate the cost-benefit ratio of radiological detection at the age of 3-4 months, taking into account the socio-economic cost and radiation risk. Assuming a frequency of this disorder of 1% the average cost of treatment of one case detected by X-ray screening at the age of 3-4 months, including the price of X-ray examinations of 99 normal babies is 23.374 FF. The average cost of treatment of a case detected at walking-age, i.e. after 9 months, is 84.230 FF. The cost-benefit ratio is 3.6. In countries where the frequency reaches 2% the cost benefit ratio is 4.57. It also appears from our study that the irradiation of the patient is much smaller when the diagnosis is made earlier. Comparing the slight irradiation delivered to normal infants by this mass screening to the heavy irradiation received by a few individuals whose treatment is started after 9 months, the calculated risk of leukemia or of genetic disorder for the whole population still favours a systematic X-ray film of the pelvis at age 3-4 months. However, if it were decided to make obligatory this mass radiological detection programme during the fourth month of life, this would necessitate a serious effort to train all radiologists to obtain adequate films with the best radiation protection. (orig.)

  11. Development and Evaluation of A Novel and Cost-Effective Approach for Low-Cost NO2 Sensor Drift Correction

    Science.gov (United States)

    Sun, Li; Westerdahl, Dane; Ning, Zhi

    2017-01-01

    Emerging low-cost gas sensor technologies have received increasing attention in recent years for air quality measurements due to their small size and convenient deployment. However, in the diverse applications these sensors face many technological challenges, including sensor drift over long-term deployment that cannot be easily addressed using mathematical correction algorithms or machine learning methods. This study aims to develop a novel approach to auto-correct the drift of commonly used electrochemical nitrogen dioxide (NO2) sensor with comprehensive evaluation of its application. The impact of environmental factors on the NO2 electrochemical sensor in low-ppb concentration level measurement was evaluated in laboratory and the temperature and relative humidity correction algorithm was evaluated. An automated zeroing protocol was developed and assessed using a chemical absorbent to remove NO2 as a means to perform zero correction in varying ambient conditions. The sensor system was operated in three different environments in which data were compared to a reference NO2 analyzer. The results showed that the zero-calibration protocol effectively corrected the observed drift of the sensor output. This technique offers the ability to enhance the performance of low-cost sensor based systems and these findings suggest extension of the approach to improve data quality from sensors measuring other gaseous pollutants in urban air. PMID:28825633

  12. Digital Image Quantitative Evaluations for Low Cost Film Digitizers Height Determination

    International Nuclear Information System (INIS)

    Khairul Anuar Mohd Salleh; Arshad Yassin; Ahmad Nasir Yusof; Noorhazleena Azaman

    2016-01-01

    Non Destructive Testing (NDT) technology contributes significant improvement to the quality of industrial products, and the integrity of equipment and plants. Introduction of powerful computers and reliable imaging technology has had significant impact on the traditional nuclear based NDT technology. Demand for faster, reliable, low cost, and flexible technology is rapidly increased. With the growing demand for more efficient digital archiving, digital image analysis, and reporting results with a low cost technology, one cannot deny the importance of having another cheaper solution. This project will apply fundamental principle of image digitization to be used in building up a low cost film digitization solution. The height of the film digitization was carefully determined by examining each digital images produced. Three (3) repetitive quantitative evaluations (Modulation Transfer Function [MTF], Characteristic Transfer Curve [CTC], and Contrast to Noise Ratio [CNR]) were performed at different condition to assist with the determination of the low cost film digitizers height. All 3 evaluations were successfully applied and the most appropriate height was successfully determined. (author)

  13. Cost effectiveness of preventing falls and improving mobility in people with Parkinson disease: protocol for an economic evaluation alongside a clinical trial

    Directory of Open Access Journals (Sweden)

    Menz Hylton B

    2008-09-01

    Full Text Available Abstract Background Cost of illness studies show that Parkinson disease (PD is costly for individuals, the healthcare system and society. The costs of PD include both direct and indirect costs associated with falls and related injuries. Methods This protocol describes a prospective economic analysis conducted alongside a randomised controlled trial (RCT. It evaluates whether physical therapy is more cost effective than usual care from the perspective of the health care system. Cost effectiveness will be evaluated using a three-way comparison of the cost per fall averted and the cost per quality adjusted life year saved across two physical therapy interventions and a control group. Conclusion This study has the potential to determine whether targetted physical therapy as an adjunct to standard care can be cost effective in reducing falls in people with PD. Trial Registration No: ACTRN12606000344594

  14. Feasibility and economic evaluation of low-cost evaporative cooling ...

    African Journals Online (AJOL)

    Feasibility and economic evaluation of low-cost evaporative cooling system in fruit and vegetables storage. ... on fruit and vegetables quality during harvesting, transportation, storage and marketing. ... The coolers were found to be effective in maintaining micro-environmental conditions for ... AJOL African Journals Online.

  15. Accounting for external costs in a study of a Swedish district-heating system - An assessment of environmental policies

    International Nuclear Information System (INIS)

    Fahlen, E.; Ahlgren, E.O.

    2010-01-01

    Sweden has historically had strict emission control by implementation of economic policy instruments with the aim of internalising the external costs of air pollution. This study aims to evaluate how well current Swedish policy instruments reflect the environmental costs associated with heat generation in several district-heating (DH) plants in the DH system of Goeteborg. Furthermore, it aims to simulate and evaluate the operation of the DH system based on its social cost-effectiveness which takes into account the DH system's private and external costs (non-internalised environmental costs). The study shows that the economic policy instruments do not fully internalise all external costs whereas for certain technologies, the costs in terms of taxes, emission permits, environmental fees, etc. are higher than the environmental costs caused by the pollutants, given the environmental cost estimates used in the study. The simulation results show that the deviating internalisation of external costs affects the economic ranking of the different plants within the studied DH system. The estimated loss in social-cost effectiveness of the operation of the DH system of Goeteborg is noticable but relatively small if compared to the variable heat generation costs for most of the studied DH plants.

  16. Geothermal probabilistic cost study

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-08-01

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

  17. Cost evaluation of cellulase enzyme for industrial-scale cellulosic ethanol production based on rigorous Aspen Plus modeling.

    Science.gov (United States)

    Liu, Gang; Zhang, Jian; Bao, Jie

    2016-01-01

    Cost reduction on cellulase enzyme usage has been the central effort in the commercialization of fuel ethanol production from lignocellulose biomass. Therefore, establishing an accurate evaluation method on cellulase enzyme cost is crucially important to support the health development of the future biorefinery industry. Currently, the cellulase cost evaluation methods were complicated and various controversial or even conflict results were presented. To give a reliable evaluation on this important topic, a rigorous analysis based on the Aspen Plus flowsheet simulation in the commercial scale ethanol plant was proposed in this study. The minimum ethanol selling price (MESP) was used as the indicator to show the impacts of varying enzyme supply modes, enzyme prices, process parameters, as well as enzyme loading on the enzyme cost. The results reveal that the enzyme cost drives the cellulosic ethanol price below the minimum profit point when the enzyme is purchased from the current industrial enzyme market. An innovative production of cellulase enzyme such as on-site enzyme production should be explored and tested in the industrial scale to yield an economically sound enzyme supply for the future cellulosic ethanol production.

  18. Evaluation of hybrid power system alternatives: a case study

    International Nuclear Information System (INIS)

    Rosenthal, Andrew L.

    1999-01-01

    Pursuant to executive and statutory policies, the National Park Service (NPS) has been evaluating the use of photovoltaic (PV) hybrid power systems, for many of its remote, off-grid areas. This paper reports the results of a detailed technical and economic evaluation for one such area: the Needles District of Canyonlands National Park. The study evaluates the presented power systems and five alternative power generation configurations, four of which utilise PV. Projections are provided for the generator run-time and fuel use associated with each configuration as well as all initial and future costs. Included in the study are specific recommendations for energy efficiency improvements at the site. Results show that the generation systems presently in use, two full-time diesel generators, has the lowest conventional 20-year life cycle costs (LCC) of the six systems evaluated. However, when emissions costs are included (per NPS guidelines), several of the PV hybrid alternatives attain a lower LCC than the diesel-only systems. General discussion of the effects of initial versus future costs of PV hybrids as they compare with engine generator system is presented. (Author)

  19. Usability evaluation of low-cost virtual reality hand and arm rehabilitation games.

    Science.gov (United States)

    Seo, Na Jin; Arun Kumar, Jayashree; Hur, Pilwon; Crocher, Vincent; Motawar, Binal; Lakshminarayanan, Kishor

    2016-01-01

    The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients' expectations for virtual reality rehabilitation is available. This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lower-cost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements. Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user's changing functional ability, and improving usability of the motion-tracking devices. This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

  20. Techniques for Conducting Effective Concept Design and Design-to-Cost Trade Studies

    Science.gov (United States)

    Di Pietro, David A.

    2015-01-01

    Concept design plays a central role in project success as its product effectively locks the majority of system life cycle cost. Such extraordinary leverage presents a business case for conducting concept design in a credible fashion, particularly for first-of-a-kind systems that advance the state of the art and that have high design uncertainty. A key challenge, however, is to know when credible design convergence has been achieved in such systems. Using a space system example, this paper characterizes the level of convergence needed for concept design in the context of technical and programmatic resource margins available in preliminary design and highlights the importance of design and cost evaluation learning curves in determining credible convergence. It also provides techniques for selecting trade study cases that promote objective concept evaluation, help reveal unknowns, and expedite convergence within the trade space and conveys general practices for conducting effective concept design-to-cost studies.

  1. Systematic mapping review about costs and economic evaluations of skin conditions and diseases in the aged.

    Science.gov (United States)

    Lichterfeld-Kottner, Andrea; Hahnel, Elisabeth; Blume-Peytavi, Ulrike; Kottner, Jan

    2017-02-01

    Skin conditions and dermatological diseases associated with advanced age (e.g. fungal infection, dry skin and itch) receive increasingly attention in clinical practice and research. Cost and economic evaluations are important sources to inform priority setting and ressource allocation decisions in healthcare. The economics of skin conditions in aged populations has not been systematically reviewed so far. The aim of this mapping review was to summarize the economic evidence of selected skin conditions in the aged (65 + years). A mapping literature review and evidence summary was conducted. Searches were conducted in data bases Medline and Embase via OVID. Cinahl was searched using EBSCO. References lists of potential eligible studies, reviews, guidelines or other sources were screened for additional literature. For evaluation of methodological quality of full economic analyses the Consensus on Health Economic Criteria (CHEC) checklist was used. Database searches resulted in 1388 records. A total of 270 articles were read in full-text. Thirty-five publications were finally included in the data analysis reporting 38 economic analyses. Ten cost of illness analyses and 26 cost-effectiveness analyses reporting about pressure ulcers, skin tears, pressure ulcers, incontinence associated dermatitis and intertrigo/contact dermatitis/candidiasis treatment and prevention and onychomycosis testing were identified. Limited evidence indicated that low air loss beds were more cost effective than standard beds for prevention of pressure ulcers. Standardized skin care regimens seem to lower the incidence of pressure ulcers, skin tears and IAD but a cost saving effect was not always observed. Findings of this mapping review indicate that there is a paucity of high quality evidence regarding the economic impact of age-associated skin conditions and diseases. Substantial heterogeneity in terms of study design, evaluation perspective, time period, and way of cost estimation was

  2. Evaluation of activity-based costing versus resource-based relative value costing.

    Science.gov (United States)

    Berlin, Mark F; Smith, Tommy H

    2004-01-01

    Activity-based costing (ABC) and relative value units costing (RVU) are two approaches that a practice manager can use to determine the cost of physician services. Each costing approach has features that provide distinction as well as differentiation in the cost estimates that are estimated. This paper will provide cost estimates under each approach along with cost estimates under a hybrid approach that merges features from each costing approach known as the ABC-RVU costing technique. A comparison of the results will be provided.

  3. A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations.

    Science.gov (United States)

    Achana, Felix; Petrou, Stavros; Khan, Kamran; Gaye, Amadou; Modi, Neena

    2018-01-01

    A new methodological framework for assessing agreement between cost-effectiveness endpoints generated using alternative sources of data on treatment costs and effects for trial-based economic evaluations is proposed. The framework can be used to validate cost-effectiveness endpoints generated from routine data sources when comparable data is available directly from trial case report forms or from another source. We illustrate application of the framework using data from a recent trial-based economic evaluation of the probiotic Bifidobacterium breve strain BBG administered to babies less than 31 weeks of gestation. Cost-effectiveness endpoints are compared using two sources of information; trial case report forms and data extracted from the National Neonatal Research Database (NNRD), a clinical database created through collaborative efforts of UK neonatal services. Focusing on mean incremental net benefits at £30,000 per episode of sepsis averted, the study revealed no evidence of discrepancy between the data sources (two-sided p values >0.4), low probability estimates of miscoverage (ranging from 0.039 to 0.060) and concordance correlation coefficients greater than 0.86. We conclude that the NNRD could potentially serve as a reliable source of data for future trial-based economic evaluations of neonatal interventions. We also discuss the potential implications of increasing opportunity to utilize routinely available data for the conduct of trial-based economic evaluations.

  4. Preliminary evaluation of the lifecycle costs and market barriers of reflective pavements; TOPICAL

    International Nuclear Information System (INIS)

    Ting, M.; Koomey, J.G.; Pomerantz, M.

    2001-01-01

    The objective of this study is to evaluate the life cycle costs and market barriers associated with using reflective paving materials in streets and parking lots as a way to reduce the urban heat island effect. We calculated and compared the life cycle costs of conventional asphalt concrete (AC) pavements to those of other existing pavement technologies with higher reflectivity-portland cement concrete (PCC), porous pavements, resin pavements, AC pavements using light-colored chip seals, and AC pavements using light-colored asphalt emulsion additives. We found that for streets and parking lots, PCC can provide a cost-effective alternative to conventional AC when severely damaged pavements must be completely reconstructed. We also found that rehabilitating damaged AC streets and intersections with thin overlays of PCC (ultra-thin white topping) can often provide a cost-effective alternative to standard rehabilitation techniques using conventional AC. Chip sealing is a common maintenance treatment for low-volume streets which, when applied using light-colored chips, could provide a reflective pavement surface. If the incremental cost of using light-colored chips is low, this chip sealing method could also be cost-effective, but the incremental costs of light-colored chips are as of yet uncertain and expected to vary. Porous pavements were found to have higher life cycle costs than conventional AC in parking lots, but several cost-saving features of porous pavements fell outside the boundaries of this study. Resin pavements were found to be only slightly more expensive than conventional AC, but the uncertainties in the cost and performance data were large. The use of light-colored additives in asphalt emulsion seal coats for parking lot pavements was found to be significantly more expensive than conventional AC, reflecting its current niche market of decorative applications. We also proposed two additional approaches to increasing the reflectivity of conventional AC

  5. Socio-economic costs of osteoarthritis: a systematic review of cost-of-illness studies.

    Science.gov (United States)

    Puig-Junoy, Jaume; Ruiz Zamora, Alba

    2015-04-01

    The burden of illness that can be attributed to osteoarthritis is considerable and ever increasing. The aim of this systematic review is to analyze currently available data derived from cost-of-illness studies on the healthcare and non-healthcare costs of osteoarthritis. PubMed, Index Medicus Español (IME), and the Spanish Database of Health Sciences [Índice Bibliográfico Español en Ciencias de la Salud (IBECS)] were searched up to the end of April 2013. This study adhered to the PRISMA guidelines. Articles were reviewed and the study quality assessed by two independent investigators with consensus resolution of discrepancies. We identified 39 studies that investigated the socio-economic cost of osteoarthritis. Only nine studies took a social perspective. Rather than estimating the incremental cost of osteoarthritis, nine studies estimated the total cost of treating patients with osteoarthritis without a control for comorbidity. The other 30 studies determined the incremental cost with or without a control group. Only nine studies assessed a comprehensive list of healthcare resources. The annual incremental healthcare costs of generalized osteoarthritis ranged from €705 to €19,715. The annual incremental non-healthcare-related costs of generalized osteoarthritis ranged from €432 to €11,956. The study concludes that the social cost of osteoarthritis could be between 0.25% and 0.50% of a country׳s GDP. This should be considered in order to foster studies that take into account both healthcare and non-healthcare costs. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The Social Costs of Electricity Generation—Categorising Different Types of Costs and Evaluating Their Respective Relevance

    Directory of Open Access Journals (Sweden)

    Sascha Samadi

    2017-03-01

    Full Text Available Various electricity generation technologies using different primary energy sources are available. Many published studies compare the costs of these technologies. However, most of those studies only consider plant-level costs and do not fully take into account additional costs that societies may face in using these technologies. This article reviews the literature on the costs of electricity generation technologies, aiming to determine which types of costs are relevant from a societal point of view when comparing generation technologies. The paper categorises the relevant types of costs, differentiating between plant-level, system and external costs as the main categories. It discusses the relevance of each type of cost for each generation technology. The findings suggest that several low-carbon electricity generation technologies exhibit lower social costs per kWh than the currently dominant technologies using fossil fuels. More generally, the findings emphasise the importance of taking not only plant-level costs, but also system and external costs, into account when comparing electricity generation technologies from a societal point of view. The article intends to inform both policymakers and energy system modellers, the latter who may strive to include all relevant types of costs in their models.

  7. Evaluating the effect of the new incentive system for high-risk pressure ulcer patients on wound healing and cost-effectiveness: a cohort study.

    Science.gov (United States)

    Sanada, Hiromi; Nakagami, Gojiro; Mizokami, Yuko; Minami, Yukiko; Yamamoto, Aya; Oe, Makoto; Kaitani, Toshiko; Iizaka, Shinji

    2010-03-01

    To evaluate the effectiveness and cost-effectiveness of new incentive system for pressure ulcer management, which focused on skilled nurse staffing in terms of rate of healing and medical costs. A prospective cohort study included two types of groups: 39 institutions, which introduced the new incentive system, and 20 non-introduced groups (control). Sixty-seven patients suffering from severe pressure ulcers in the introduced group and 38 patients in the non-introduced group were included. Wound healing and medical costs were monitored weekly for three weeks by their skilled nurses in charge. Healing status and related medical costs. The introduced group showed significantly higher rate of healing compared with the control group at each weekly assessment. Multiple regression analysis revealed that the introduction of the new incentive system was independently associated with the faster healing rate (beta=3.44, Pcost of treating severe pressure ulcers by 1.776 billion yen per year. The new incentive system for the management of pressure ulcers, which focused on staffing with skilled nurses can improve healing rate with reduced medical cost. Copyright 2009 Elsevier Ltd. All rights reserved.

  8. Economic evaluation of a web-based tailored lifestyle intervention for adults: findings regarding cost-effectiveness and cost-utility from a randomized controlled trial.

    Science.gov (United States)

    Schulz, Daniela N; Smit, Eline S; Stanczyk, Nicola E; Kremers, Stef P J; de Vries, Hein; Evers, Silvia M A A

    2014-03-20

    Different studies have reported the effectiveness of Web-based computer-tailored lifestyle interventions, but economic evaluations of these interventions are scarce. The objective was to assess the cost-effectiveness and cost-utility of a sequential and a simultaneous Web-based computer-tailored lifestyle intervention for adults compared to a control group. The economic evaluation, conducted from a societal perspective, was part of a 2-year randomized controlled trial including 3 study groups. All groups received personalized health risk appraisals based on the guidelines for physical activity, fruit intake, vegetable intake, alcohol consumption, and smoking. Additionally, respondents in the sequential condition received personal advice about one lifestyle behavior in the first year and a second behavior in the second year; respondents in the simultaneous condition received personal advice about all unhealthy behaviors in both years. During a period of 24 months, health care use, medication use, absenteeism from work, and quality of life (EQ-5D-3L) were assessed every 3 months using Web-based questionnaires. Demographics were assessed at baseline, and lifestyle behaviors were assessed at both baseline and after 24 months. Cost-effectiveness and cost-utility analyses were performed based on the outcome measures lifestyle factor (the number of guidelines respondents adhered to) and quality of life, respectively. We accounted for uncertainty by using bootstrapping techniques and sensitivity analyses. A total of 1733 respondents were included in the analyses. From a willingness to pay of €4594 per additional guideline met, the sequential intervention (n=552) was likely to be the most cost-effective, whereas from a willingness to pay of €10,850, the simultaneous intervention (n=517) was likely to be most cost-effective. The control condition (n=664) appeared to be preferred with regard to quality of life. Both the sequential and the simultaneous lifestyle

  9. Reducing the Cost and Time to Perform a Human Factors Engineering Evaluation

    International Nuclear Information System (INIS)

    Geary, L.C. Dr.

    2003-01-01

    The Westinghouse Savannah River Company, a contractor to the Department of Energy, has developed a new software tool for automating the Human Factors Engineering design review, analysis, and evaluation processes. The set of design guidelines, used in the tool, was obtained from the United States Nuclear Regulatory Commission Nuclear Regulatory Guide, NUREG- 0700 - Human System Interface Design Review Guideline. This tool has been described at a previous IEEE Conference on Human Factors and Power Plants. The original software tool in NUREG- 0700 was used to evaluate a facility and a separate independent evaluation was performed using the new tool for the same facility. A comparison was made between the two different tools; both in results obtained and cost and time to complete the evaluation. The results demonstrate a five to ten fold reduction in time and cost to complete the evaluation using the newly developed tool while maintaining consistent evaluation results. The time to per form the review was measured in weeks using the new software tool rather than months using the existing NUREG-0700 tool. The new tool has been so successful that it was applied to two additional facilities with the same reduced time and cost savings. Plans have been made to use the new tool at other facilities in order to provide the same savings

  10. [Evaluation of financial status of public hospitals considering the updated costs of their services].

    Science.gov (United States)

    Cid P, Camilo; Bastías S, Gabriel

    2014-02-01

    In 2011 the Chilean National Health Fund (FONASA) commissioned a study to assess the costs of the 120 most relevant hospital care services with an established fee, in a large sample of public hospitals. We herein report the cost evaluation results of such study, considering the financial condition of those hospitals in the year of the study. Based on the premise that the expenses derived from the provision of institutional and appraised hospital services should be identical to the billing of hospitals to FONASA, the prices are undervalued, since they cover only 56% of billing, generating a gap between expenses and invoicing. This gap shows an important limitation of tariffs, since their prices do not cover the real costs. However not all hospitals behave in the same way. While the provision of services of some hospitals is even higher than their billing, most hospitals do not completely justify their invoicing. These assumptions would imply that, generally speaking, hospital debts are justified by the costs incurred. However, hospitals have heterogeneous financial situations that need to be analyzed carefully. In particular, nothing can be said about their relative efficiency if cost estimations are not adjusted by the complexity of patients attended and comparison groups are not defined.

  11. Uncertainty in decision models analyzing cost-effectiveness : The joint distribution of incremental costs and effectiveness evaluated with a nonparametric bootstrap method

    NARCIS (Netherlands)

    Hunink, Maria; Bult, J.R.; De Vries, J; Weinstein, MC

    1998-01-01

    Purpose. To illustrate the use of a nonparametric bootstrap method in the evaluation of uncertainty in decision models analyzing cost-effectiveness. Methods. The authors reevaluated a previously published cost-effectiveness analysis that used a Markov model comparing initial percutaneous

  12. Cervical cancer treatment costs and cost-effectiveness analysis of human papillomavirus vaccination in Vietnam: a PRIME modeling study.

    Science.gov (United States)

    Van Minh, Hoang; My, Nguyen Thi Tuyet; Jit, Mark

    2017-05-15

    Cervical cancer is currently the leading cause of cancer mortality among women in South Vietnam and the second leading cause of cancer mortality in North Vietnam. Human papillomavirus (HPV) vaccination has the potential to substantially decrease this burden. The World Health Organization (WHO) recommends that a cost-effectiveness analysis of HPV vaccination is conducted before nationwide introduction. The Papillomavirus Rapid Interface for Modeling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccine introduction. A costing study based on expert panel discussions, interviews and hospital case note reviews was conducted to explore the cost of cervical cancer care. The cost of cervical cancer treatment ranged from US$368 - 11400 depending on the type of hospital and treatment involved. Under Gavi-negotiated prices of US$4.55, HPV vaccination is likely to be very cost-effective with an incremental cost per disability-adjusted life year (DALY) averted in the range US$780 - 1120. However, under list prices for Cervarix and Gardasil in Vietnam, the incremental cost per DALY averted for HPV vaccination can exceed US$8000. HPV vaccine introduction appears to be economically attractive only if Vietnam is able to procure the vaccine at Gavi prices. This highlights the importance of initiating a nationwide vaccination programme while such prices are still available.

  13. Defense Logistics: Improved Analysis and Cost Data Needed to Evaluate the Cost-Effectiveness of Performance Based Logistics

    National Research Council Canada - National Science Library

    Solis, William M; Denman, Julia; Brumm, Harold; Dove, Matt; Echard, Jennifer; Gaskin, Chanee; Gosling, Tom; Jebo, Jennifer; Jones, Mae; Keith, Kevin; Perdue, Charles; Prybyla, Janine; Thornton, Karen

    2008-01-01

    .... GAO was asked to evaluate the extent to which DoD has used business case analyses to guide decisions related to PBL arrangements and the impact PBL arrangements have had on weapon system support costs...

  14. Cost effectiveness of MR imaging in the evaluation of focal lesions in the liver

    International Nuclear Information System (INIS)

    Cahill, P.T.; Goldberg, S.; Millerin, J.; Whalen, J.P.; Markisz, J.A.

    1986-01-01

    The authors evaluated the advantages of MR imaging over conventional imaging techniques with respect to clinical sensitivity, risk to patients, and cost-effectiveness. Patients were separated into four groups: cancer patients, those with incidental findings of liver lesions, those with questionable CT findings, and those with known hepatic hemangiomas that should be followed up. The determination of cost-effectiveness of MR imaging depended on the ability of CT to accurately distinguish between hemangiomas and metastases, as well as the cost of each examination. MR imaging at $400 per series was always cost-effective for the first three groups of patients. With a questionable rate of only 20%, MR imaging became cost-effective at an examination cost of $600. CT was cost-effective for the fourth group of patients in all instances. This analysis supports the use of MR imaging in the diagnosis of solitary liver lesions and for clinical evaluation of patients with cancer

  15. Public synthesis of the reference costs study of the electric power production

    International Nuclear Information System (INIS)

    2008-01-01

    Every 3 or 5 years, the DGEC published the reference costs study of the electric power production which evaluates, in a theoretical framework, the total cost of an electrical MWh, from different production ways. These studies bring information for the definition of the energy policy and the elaboration of the investments program. because of the great competition of the market, it was decided not to publish the absolute value of the hypothesis and the results but under indexed form. (A.L.B.)

  16. EVALUATION OF COSTS OF HARVESTER IN CUT AND PROCESSING OF EUCALYPTUS WOOD1

    Directory of Open Access Journals (Sweden)

    Larissa Nunes dos Santos

    2017-11-01

    Full Text Available ABSTRACT Before performing any financial analysis costs must be calculated. These costs should allow the planning and control over the use of the machines as well as the comparison between different investments alternatives since this is easily calculated. Generally the operating costs of forest harvesting machines are estimated until the maximum of 25,000 hours of work, and it is not possible to know whether the activity remains profitable thereafter or not. For this reason the objective of this study was to evaluate the costs from cutting activities and wood processing carried out by a forestry tractor harvester up to approximately 30,000 hours of work. Ten forest machines composed of two models of harvester (John Deere, model 1270D and 1470D were used. A spreadsheet provided by a forestry company located in the state of Minas Gerais, containing the necessary data to estimate the operating cost of the machines and subsequent achievement of the sensitivity analysis was used. The operating cost was obtained by the sum of the fixed and variable costs. For sensitivity analysis the variation ± 20% of the most representative elements of the total cost of the machine was performed. The results for the operating cost of the harvester and forwarder was U.S. $ 190.85 h-1. Costs for repairs and maintenance, labor, fuel, and depreciation represented approximately 90% of the total cost of the machine. Despite the fact that the age of the machine has a direct influence on its operating cost, the costs did not behave in a linear fashion over the years.

  17. A self-made, low-cost infrared system for evaluating the sciatic functional index in mice

    Directory of Open Access Journals (Sweden)

    Lukas Fricker

    2016-01-01

    Full Text Available The sciatic functional index (SFI is a popular parameter for peripheral nerve evaluation that relies on footprints obtained with ink and paper. Drawbacks include smearing artefacts and a lack of dynamic information during measurement. Modern applications use digitized systems that can deliver results with less analytical effort and fewer mice. However, the systems are expensive (€40,000. This study aimed to evaluate the applicability and precision of a self-made, low-cost infrared system for evaluating SFI in mice. Mice were subjected to unilateral sciatic nerve crush injury (crush group; n = 7 and sham operation (sham group; n = 4. They were evaluated on the day before surgery, the 2 nd , 4 th and 6 th days after injury, and then every day up to the 23 rd day after injury. We compared two SFI evaluation methods, i.e., conventional ink-and-paper SFI (C-SFI and our infrared system (I-SFI. Our apparatus visualized footprints with totally internally reflected infrared light (950 nm and a camera that can only detect this wavelength. Additionally we performed an analysis with the ladder beam walking test (LBWT as a reference test. I-SFI assessment reduced the standard deviation by about 33 percent, from 11.6 to 7.8, and cut the variance around the baseline to 21 percent. The system thus requires fewer measurement repetitions and fewer animals, and cuts the cost of keeping the animals. The apparatus cost €321 to build. Our results show that the process of obtaining the SFI can be made more precise via digitization with a self-made, low-cost infrared system.

  18. A self-made, low-cost infrared system for evaluating the sciatic functional index in mice.

    Science.gov (United States)

    Fricker, Lukas; Penna, Vincenzo; Lampert, Florian; Stark, G Bjoern; Witzel, Christian; Koulaxouzidis, Georgios

    2016-05-01

    The sciatic functional index (SFI) is a popular parameter for peripheral nerve evaluation that relies on footprints obtained with ink and paper. Drawbacks include smearing artefacts and a lack of dynamic information during measurement. Modern applications use digitized systems that can deliver results with less analytical effort and fewer mice. However, the systems are expensive (€40,000). This study aimed to evaluate the applicability and precision of a self-made, low-cost infrared system for evaluating SFI in mice. Mice were subjected to unilateral sciatic nerve crush injury (crush group; n = 7) and sham operation (sham group; n = 4). They were evaluated on the day before surgery, the 2(nd), 4(th) and 6(th) days after injury, and then every day up to the 23(rd) day after injury. We compared two SFI evaluation methods, i.e., conventional ink-and-paper SFI (C-SFI) and our infrared system (I-SFI). Our apparatus visualized footprints with totally internally reflected infrared light (950 nm) and a camera that can only detect this wavelength. Additionally we performed an analysis with the ladder beam walking test (LBWT) as a reference test. I-SFI assessment reduced the standard deviation by about 33 percent, from 11.6 to 7.8, and cut the variance around the baseline to 21 percent. The system thus requires fewer measurement repetitions and fewer animals, and cuts the cost of keeping the animals. The apparatus cost €321 to build. Our results show that the process of obtaining the SFI can be made more precise via digitization with a self-made, low-cost infrared system.

  19. Development and Performance Evaluation of a Low Cost Waste ...

    African Journals Online (AJOL)

    The design, development and performance evaluation of a low cost waste-water treatment plant had been carried out. The aim was to harness the usefulness of waste-waters from residential, institutional and commercial sources. The facultative lagoon method of waste-water treatment was adopted. Biological analysis of ...

  20. Screening for gastric cancer and surveillance of premalignant lesions: a systematic review of cost-effectiveness studies.

    Science.gov (United States)

    Areia, Miguel; Carvalho, Rita; Cadime, Ana Teresa; Rocha Gonçalves, Francisco; Dinis-Ribeiro, Mário

    2013-10-01

    Cost-effectiveness studies are highly dependent on the models, settings, and variables used and should be based on systematic reviews. We systematically reviewed cost-effectiveness studies that address screening for gastric cancer and/or surveillance of precancerous conditions and lesions. A systematic review of cost-effectiveness studies was performed by conducting a sensitive search in seven databases (PubMed, Scopus, Web of Science, Current Contents Connect, Centre for Reviews and Dissemination, Academic Search Complete, and CINAHL Plus), independently evaluated by two investigators. Articles were evaluated for type of study, perspective, model, intervention, incremental cost-effectiveness ratio, clinical or cost variables, and quality, according to published guidelines. From 2395 abstracts, 23 articles were included: 19 concerning population screening and 4 on following up premalignant lesions. Studies on Helicobacter pylori screening concluded that serology was cost-effective, depending on cancer incidence and endoscopy cost (incremental cost-effectiveness ratio: 6264-25,881), and eradication after endoscopic resection was also cost-effective (dominant) based on one study. Studies on imaging screening concluded that endoscopy was more cost-effective than no screening (incremental cost-effectiveness ratio: 3376-26,836). Articles on follow-up of premalignant lesions reported conflicting results (incremental cost-effectiveness ratio: 1868-72,519 for intestinal metaplasia; 18,600-39,800 for dysplasia). Quality assessment revealed a unanimous lack of a detailed systematic review and fulfillment of a median number of 23 items (20-26) of 35 possible ones. The available evidence shows that Helicobacter pylori serology or endoscopic population screening is cost-effective, while endoscopic surveillance of premalignant gastric lesions presents conflicting results. Better implementation of published guidelines and accomplishment of systematic detailed reviews are needed

  1. Cost evaluation of CO2 sequestration by aqueous mineral carbonation

    International Nuclear Information System (INIS)

    Huijgen, Wouter J.J.; Comans, Rob N.J.; Witkamp, Geert-Jan

    2007-01-01

    A cost evaluation of CO 2 sequestration by aqueous mineral carbonation has been made using either wollastonite (CaSiO 3 ) or steel slag as feedstock. First, the process was simulated to determine the properties of the streams as well as the power and heat consumption of the process equipment. Second, a basic design was made for the major process equipment, and total investment costs were estimated with the help of the publicly available literature and a factorial cost estimation method. Finally, the sequestration costs were determined on the basis of the depreciation of investments and variable and fixed operating costs. Estimated costs are 102 and 77 EUR/ton CO 2 net avoided for wollastonite and steel slag, respectively. For wollastonite, the major costs are associated with the feedstock and the electricity consumption for grinding and compression (54 and 26 EUR/ton CO 2 avoided, respectively). A sensitivity analysis showed that additional influential parameters in the sequestration costs include the liquid-to-solid ratio in the carbonation reactor and the possible value of the carbonated product. The sequestration costs for steel slag are significantly lower due to the absence of costs for the feedstock. Although various options for potential cost reduction have been identified, CO 2 sequestration by current aqueous carbonation processes seems expensive relative to other CO 2 storage technologies. The permanent and inherently safe sequestration of CO 2 by mineral carbonation may justify higher costs, but further cost reductions are required, particularly in view of (current) prices of CO 2 emission rights. Niche applications of mineral carbonation with a solid residue such as steel slag as feedstock and/or a useful carbonated product hold the best prospects for an economically feasible CO 2 sequestration process. (author)

  2. Method of evaluation of solar collector cost under fuel price change

    International Nuclear Information System (INIS)

    Klychev, Sh. I.; Sadykova, N. S.; Saifiev, A. U.; Ismanzhanov, A. I.; Samiev, M.

    2013-01-01

    When we take into account the problems of large-scale use of solar energy, the matters of economic perspectives of solar plants in the future become vital. We present the method on whose basis evaluation of the cost of solar collectors is performed taking into account the change in the fuel prices. The method is based on the approach to evaluation of the cost of energy generated by the solar plants offered previously by the authors. Assuming that the components of expenditures for production are not changed, we obtained that the cost of solar collectors will grow, at approximately the same ratio as the growth of the prices for fuel (energy). Thus, the problem of creation of the economically effective solar collectors should be solved already today, at the existing prices for materials and fuel. At present, it is assumed that competitiveness of the solar plants will increase with the growth of the fuel prices. (authors)

  3. STUDY OF THE PREPARATION OF SUGAR FROM HIGH-LIGNIN LIGNOCELLULOSE APPLYING SUBCRITICAL WATER AND ENZYMATIC HYDROLYSIS: SYNTHESIS AND CONSUMABLE COST EVALUATION

    Directory of Open Access Journals (Sweden)

    HANNY F. SANGIAN

    2015-05-01

    Full Text Available This study concern sugars hydrolyzed from the high-lignin coconut coir dust using moderate subcritical water (SCW hydrolysis at pressures 20-40 bar for 1 h and to evaluate the consumable costs driver generated. The SCW method produced two products, sugar liquid and solid (SCW-treated substrate. The solid was proceeded to prepare the sugar via enzymatic hydrolysis using pure cellulase. Yield of sugar hydrolyzed from lignocellulose by SCW technique was 0.25 gram sugar/gram cellulose +hemicellulose, or 0.09-gram sugar/gram lignocellulose at 160 °C and 40 bar. While, the maximum yield of sugar liberated enzymatically from SCW-treated solid was 0.35-gram sugar/gram cellulose+hemicellulose, or 0.13-gram sugar/gram SCW-treated solid. It was found that carbon dioxide gas was the highest cost driving in SCW hydrolysis.

  4. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities

    International Nuclear Information System (INIS)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included

  5. Adaptive salinity management in the Murray-Darling Basin: a transaction cost study

    Science.gov (United States)

    Loch, A. J.

    2017-12-01

    Transaction costs hinder or promote effective management of common good resource intertemporal externalities. Appropriate policy choices may reduce externalities and improve social welfare, and transaction cost analysis can help to evaluate policy choices. However, without measurement of relevant transaction costs such policy evaluation remains challenging. This article uses a time series dataset of salinity management program to test theory aimed at transaction cost-based policy evaluation and adaptive resource management over a period of 30 years worth of data. We identify peaks and troughs in transaction costs over time, lag-effects in program expenditure, and calculate the decay in transaction cost impacts. We conclude that Australian salinity management programs are achieving flexible institutional outcomes and effective policy arrangements with long-term benefits. Proposed changes to the program moving forward add weight to our assertions of adaptive strategies, and illustrate the value of the novel data-driven tracnsaction cost analysis approach for other jurisdictions.

  6. Benefit-cost analysis framework for evaluating inter-city transit investment.

    Science.gov (United States)

    2008-10-01

    This report describes the development and application of a benefit/cost analysis (BCA) model to support the evaluation of investment decisions for intercity bus services. The model recognizes two principle types of intercity bus benefits: benefits th...

  7. The cost effectiveness of long-acting/extended-release antipsychotics for the treatment of schizophrenia: a systematic review of economic evaluations.

    Science.gov (United States)

    Achilla, Evanthia; McCrone, Paul

    2013-04-01

    Antipsychotic medication is the mainstay of treatment in schizophrenia. Long-acting medication has potential advantages over daily medication in improving compliance and thus reducing hospitalization and relapse rates. The high acquisition and administration costs of such formulations raise the need for pharmacoeconomic evaluation. The aim of this article is to provide a comprehensive review of the available evidence on the cost effectiveness of long-acting/extended-release antipsychotic medication and critically appraise the strength of evidence reported in the studies from a methodological viewpoint. Relevant studies were identified by searching five electronic databases: PsycINFO, MEDLINE, EMBASE, the NHS Economic Evaluation Database and the Health Technology Assessment database (HTA). Search terms included, but were not limited to, 'long-acting injection', 'economic evaluation', 'cost-effectiveness' and 'cost-utility'. No limits were applied for publication dates and language. Full economic evaluations on long-acting/extended-release antipsychotics were eligible for inclusion. Observational studies and clinical trials were also checked for cost-effectiveness information. Conference abstracts and poster presentations on the cost effectiveness of long-acting antipsychotics were excluded. Thirty-two percent of identified studies met the selection criteria. Pertinent abstracts were reviewed independently by two reviewers. Relevant studies underwent data extraction by one reviewer and were checked by a second, with any discrepancies being clarified during consensus meetings. Eligible studies were assessed for methodological quality using the quality checklist for economic studies recommended by the NICE guideline on interventions in the treatment and management of schizophrenia. After applying the selection criteria, the final sample consisted of 28 studies. The majority of studies demonstrated that risperidone long-acting injection, relative to oral or other long

  8. A methodology for financial evaluation of biogas technology in India using cost functions

    International Nuclear Information System (INIS)

    Rubab, S.; Kandpal, T.C.

    1996-01-01

    A methodology for financial evaluation of biogas technology for domestic use in India using recently developed cost functions is reported. Analytical expressions for the unit cost of biogas and cost per unit of useful energy delivered by a biogas plant in combination with other suitable technologies have been developed. Net present value and discounted pay-back period have been calculated. The sensitivity of the unit cost of biogas, the cost per unit of useful energy, and the net present value with respect to a number of variables is also reported. (author)

  9. Economic evaluation of the Blanket Comparison and Selection Study

    International Nuclear Information System (INIS)

    Waganer, L.M.

    1985-01-01

    The economic impact of employing the highly ranked blankets in the Blanket Comparison and Selection Study (BCSS) was evaluated in the context of both a tokamak and a tandem mirror power reactor (TMR). The economic evaluation criterion was determined to be the cost of electricity. The influencing factors that were considered are the direct cost of the blankets and related systems; the annual cost of blanket replacement; and the performance of the blanket, heat transfer, and energy conversion systems. The technical and cost bases for comparison were those of the STARFIRE and Mirror Advanced Reactor Study conceptual design power plants. The economic evaluation results indicated that the nitrate-salt-cooled blanket concept is an economically attractive concept for either reactor type. The water-cooled, solid breeder blanket is attractive for the tokamak and somewhat less attractive for the TMR. The helium-cooled, liquidlithium breeder blanket is the least economically desirable of higher ranked concepts. The remaining self-cooled liquid-metal and the helium-cooled blanket concepts represent moderately attractive concepts from an economic standpoint. These results are not in concert with those found in the other BCSS evaluation areas (engineering feasibility, safety, and research and development (R and D) requirements). The blankets faring well economically had generally lower cost components, lower pumping power requirements, and good power production capability. On the other hand, helium- and lithium-cooled systems were preferred from the standpoints of safety, engineering feasibility, and R and D requirements

  10. Fusion reactor design studies: standard accounts for cost estimates

    International Nuclear Information System (INIS)

    Schulte, S.C.; Willke, T.L.; Young, J.R.

    1978-05-01

    The fusion reactor design studies--standard accounts for cost estimates provides a common format from which to assess the economic character of magnetically confined fusion reactor design concepts. The format will aid designers in the preparation of design concept costs estimates and also provide policymakers with a tool to assist in appraising which design concept may be economically promising. The format sets forth a categorization and accounting procedure to be used when estimating fusion reactor busbar energy cost that can be easily and consistently applied. Reasons for developing the procedure, explanations of the procedure, justifications for assumptions made in the procedure, and the applicability of the procedure are described in this document. Adherence to the format when evaluating prospective fusion reactor design concepts will result in the identification of the more promising design concepts thus enabling the fusion power alternatives with better economic potential to be quickly and efficiently developed

  11. Cost evaluation of the enslaved to breathing radiotherapy as part of support program to innovative and expensive therapies

    International Nuclear Information System (INIS)

    Remonnay, R.; Morelle, M.; Carrere, M.O.; Giraud, P.

    2009-01-01

    This study had for objective to evaluate the consequences of the implementation of the enslaved breathing on the cost of production of radiotherapy, relatively to the conformal radiotherapy without enslaved breathing (witness group) in the bronchopulmonary cancers and the breast cancers. The tariff aspect was studied. The estimation of the complete cost of the treatment enlighten the inadequacy of the pricing for innovation. (N.C.)

  12. Work productivity and activity impairment in gastroesophageal reflux disease in Korean full-time employees: a multicentre study.

    Science.gov (United States)

    Shin, Woon Geon; Kim, Heung Up; Kim, Sang Gyun; Kim, Gwang Ha; Shim, Ki-Nam; Kim, Jeong Wook; Kim, Jin Il; Kim, Jae Gyu; Kim, Jae J; Yim, Da-Hae; Park, Sue K; Park, Soo-Heon

    2012-04-01

    The costs of gastroesophageal reflux disease have not been assessed in Asia, even though the prevalence of gastroesophageal reflux disease is gradually increasing. We evaluated work presenteeism and absenteeism as indirect costs of gastroesophageal reflux disease in Korea. This was a cross-sectional and multicentre study using patient-reported outcome instruments. A total of 1009 full-time employees who visited the gastrointestinal department for any reason (281 patients with gastroesophageal reflux disease and 728 controls) were included. Main outcomes were presenteeism and absenteeism measured as work productivity loss and monetary cost per week. Absenteeism and presenteeism were significantly higher in the gastroesophageal reflux disease than the control group (1.49% vs. 0.46%, P=0.0010; 34.13% vs. 9.23%, Pgastroesophageal reflux disease than the control group (33.09% vs. 9.02%; Pgastroesophageal reflux disease group compared with the control group. Assuming average hourly wages of $14.12, the weekly burden of gastroesophageal reflux disease reached $165.07 per person. Gastroesophageal reflux disease was associated with substantial work productivity loss, mainly due to presenteeism rather than absenteeism, in Korean full-time employees. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  13. Cost-Effectiveness of a Community Pharmacist Intervention in Patients with Depression: A Randomized Controlled Trial (PRODEFAR Study)

    NARCIS (Netherlands)

    Rubio-Valera, M.; Bosmans, J.E.; Fernandez, A.; Penarrubia-Maria, M.; March, M.; Trave, P.; Bellon, J.A.; Serrano-Blanco, A.

    2013-01-01

    Background:Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist

  14. Economic costs of obesity in Thailand: a retrospective cost-of-illness study.

    Science.gov (United States)

    Pitayatienanan, Paiboon; Butchon, Rukmanee; Yothasamut, Jomkwan; Aekplakorn, Wichai; Teerawattananon, Yot; Suksomboon, Naeti; Thavorncharoensap, Montarat

    2014-04-02

    Over the last decade, the prevalence of obesity (BMI ≥ 25 kg/m2) in Thailand has been rising rapidly and consistently. Estimating the cost of obesity to society is an essential step in setting priorities for research and resource use and helping improve public awareness of the negative economic impacts of obesity. This prevalence-based, cost-of-illness study aims to estimate the economic costs of obesity in Thailand. The estimated costs in this study included health care cost, cost of productivity loss due to premature mortality, and cost of productivity loss due to hospital-related absenteeism. The Obesity-Attributable Fraction (OAF) was used to estimate the extent to which the co-morbidities were attributable to obesity. The health care cost of obesity was further estimated by multiplying the number of patients in each disease category attributable to obesity by the unit cost of treatment. The cost of productivity loss was calculated using the human capital approach. The health care cost attributable to obesity was estimated at 5,584 million baht or 1.5% of national health expenditure. The cost of productivity loss attributable to obesity was estimated at 6,558 million baht - accounting for 54% of the total cost of obesity. The cost of hospital-related absenteeism was estimated at 694 million baht, while the cost of premature mortality was estimated at 5,864 million baht. The total cost of obesity was then estimated at 12,142 million baht (725.3 million US$PPP, 16.74 baht =1 US$PPP accounting for 0.13% of Thailand's Gross Domestic Product (GDP). Obesity imposes a substantial economic burden on Thai society especially in term of health care costs. Large-scale comprehensive interventions focused on improving public awareness of the cost of and problems associated with obesity and promoting a healthy lifestyle should be regarded as a public health priority.

  15. 45 CFR 2522.540 - Do the costs of performance measurement or evaluation count towards the statutory cap on...

    Science.gov (United States)

    2010-10-01

    ... evaluation count towards the statutory cap on administrative costs? 2522.540 Section 2522.540 Public Welfare... measurement or evaluation count towards the statutory cap on administrative costs? No, the costs of performance measurement and evaluation do not count towards the statutory five percent cap on administrative...

  16. Evaluation of the costs and benefits of recycling radioactively contaminated scrap metal

    International Nuclear Information System (INIS)

    Durman, E.C.; Tsirigotis, P.; MacKinney, J.A.

    1995-01-01

    The U.S. Environmental Protection Agency (EPA) is evaluating the economic and technical issues associated with the potential recycling of radioactive scrap metals (RSM). These metals, usually only slightly contaminated, originate primarily from the decommissioning and decontamination (D and D) of federal facilities, licensees of the Nuclear Regulatory Commission, and certain unlicensed industries. EPA conducted a study entitled Analysis of the Potential Recycling of Department of Energy Radioactive Scrap Metal, September 6, 1994, for the U.S. Department of Energy (DOE) to provide information and tools to DOE for assessing DOE's problem with RSM from the D and D of their sites. EPA is now initiating an evaluation of RSM recycling to support a recycling regulation. Although the study prepared for DOE will provide a useful start for the regulatory analysis, additional information must be gathered to analyze the impacts of a recycling regulation that will apply to all potential generators of RSM. This paper summarizes cost-benefit issues related to an RSM recycling regulatory analysis, including: the quantity of potentially recyclable contaminated metals; costs of disposal at federal and private waste repositories; all potential environmental, health, and safety, and market impacts; and the potential for adverse effects on radio-sensitive industries. (author)

  17. Evaluation of trade-offs in costs and environmental impacts for returnable packaging implementation

    Science.gov (United States)

    Jarupan, Lerpong; Kamarthi, Sagar V.; Gupta, Surendra M.

    2004-02-01

    The main thrust of returnable packaging these days is to provide logistical services through transportation and distribution of products and be environmentally friendly. Returnable packaging and reverse logistics concepts have converged to mitigate the adverse effect of packaging materials entering the solid waste stream. Returnable packaging must be designed by considering the trade-offs between costs and environmental impact to satisfy manufacturers and environmentalists alike. The cost of returnable packaging entails such items as materials, manufacturing, collection, storage and disposal. Environmental impacts are explicitly linked with solid waste, air pollution, and water pollution. This paper presents a multi-criteria evaluation technique to assist decision-makers for evaluating the trade-offs in costs and environmental impact during the returnable packaging design process. The proposed evaluation technique involves a combination of multiple objective integer linear programming and analytic hierarchy process. A numerical example is used to illustrate the methodology.

  18. Bridging environmental and financial cost of dairy production: A case study of Irish agricultural policy.

    Science.gov (United States)

    Chen, Wenhao; Holden, Nicholas M

    2018-02-15

    The Irish agricultural policy 'Food Harvest 2020' is a roadmap for sectoral expansion and Irish dairy farming is expected to intensify, which could influence the environmental and economic performance of Irish milk production. Evaluating the total environmental impacts and the real cost of Irish milk production is a key step towards understanding the possibility of sustainable production. This paper addresses two main issues: aggregation of environmental impacts of Irish milk production by monetization, to understand the real cost of Irish milk production, including the environmental costs; and the effect of the agricultural policy 'Food Harvest 2020' on total cost (combining financial cost and environmental cost) of Irish milk production. This study used 2013 Irish dairy farming as a baseline, and defined 'bottom', 'target' and 'optimum' scenarios, according to the change of elementary inputs required to meet agricultural policy ambitions. The study demonstrated that the three monetization methods, Stepwise 2006, Eco-cost 2012 and EPS 2000, could be used for aggregating different environmental impacts into monetary unit, and to provide an insight for evaluating policy related to total environmental performance. The results showed that the total environmental cost of Irish milk production could be greater than the financial cost (up to €0.53/kg energy corrected milk). The dairy expansion policy with improved herbage utilization and fertilizer application could reduce financial cost and minimize the total environmental cost of per unit milk produced. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Cost-effectiveness of dryland forest restoration evaluated by spatial analysis of ecosystem services

    Science.gov (United States)

    Birch, Jennifer C.; Newton, Adrian C.; Aquino, Claudia Alvarez; Cantarello, Elena; Echeverría, Cristian; Kitzberger, Thomas; Schiappacasse, Ignacio; Garavito, Natalia Tejedor

    2010-01-01

    Although ecological restoration is widely used to combat environmental degradation, very few studies have evaluated the cost-effectiveness of this approach. We examine the potential impact of forest restoration on the value of multiple ecosystem services across four dryland areas in Latin America, by estimating the net value of ecosystem service benefits under different reforestation scenarios. The values of selected ecosystem services were mapped under each scenario, supported by the use of a spatially explicit model of forest dynamics. We explored the economic potential of a change in land use from livestock grazing to restored native forest using different discount rates and performed a cost–benefit analysis of three restoration scenarios. Results show that passive restoration is cost-effective for all study areas on the basis of the services analyzed, whereas the benefits from active restoration are generally outweighed by the relatively high costs involved. These findings were found to be relatively insensitive to discount rate but were sensitive to the market value of carbon. Substantial variation in values was recorded between study areas, demonstrating that ecosystem service values are strongly context specific. However, spatial analysis enabled localized areas of net benefits to be identified, indicating the value of this approach for identifying the relative costs and benefits of restoration interventions across a landscape. PMID:21106761

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

    Science.gov (United States)

    Bilim, Niyazi; Çelik, Arif; Kekeç, Bilgehan

    2017-10-01

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

  1. A Transparent Framework for Evaluating the Effects of DGPV on Distribution System Costs

    Energy Technology Data Exchange (ETDEWEB)

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

    2018-04-02

    Assessing the costs and benefits of distributed photovoltaic generators (DGPV) to the power system and electricity consumers is key to determining appropriate policies, tariff designs, and power system upgrades for the modern grid. We advance understanding of this topic by providing a transparent framework, terminology, and data set for evaluating distribution system upgrade costs, line losses, and interconnection costs as a function of DGPV penetration level.

  2. Cost comparison of antibacterial therapies for serious infections. A New Zealand 3-hospital study.

    Science.gov (United States)

    Scott, W G; Scott, H M; Henderson, S; Inder, A; Sanders, J; Spearing, R; McArthur, C; Judson, J; Baker, B; Hicks, P; Cotterell, P

    1999-08-01

    The first aim was to identify and determine the economic costs of the regimens currently used in 3 New Zealand hospitals in the treatment of bacterial infections in haematology patients with febrile neutropenia and in intensive care patients with severe infections. The second was to develop a spreadsheet-based decision analytic model for use by hospital decision-makers as an aid in evaluating the comparative cost of drug regimens. The research utilised time and motion and microcosting techniques. The analytical perspective adopted for the study was that of a hospital administrator or clinical manager. Patients were eligible for inclusion in the study if either they were treated with the imipenem/cilastatin monotherapy, or could have been treated with this regimen. The final analysis considered 360 patient-treatment days and 8 antibacterials. Drug acquisition cost ranged from 4.52 New Zealand dollars ($NZ; 1997 values) per patient-treatment day for gentamicin to $NZ104.81 for imipenem. The cost per patient-treatment day (when other cost components such as fluid additives, giving sets and needles were added) ranged from $NZ8.75 for gentamicin to $NZ129.12 for tazobactam. Drug acquisition cost, as a percentage of total drug preparation and administration cost, ranged from 52% for gentamicin to 93% for piperacillin. Giving sets and intravenous (i.v.) fluids were found to be important cost items when they were required specifically for the treatment regimen. There was a mean monitoring rate of 0.40 at a cost of $NZ6.41 per patient-treatment day for gentamicin. It was estimated that nephrotoxicity could add between $NZ23 and $NZ43 per day to the cost of aminoglycoside treatment. Although the small sample sizes of the study mean that results should be regarded as indicative rather than conclusive, there were sufficient information to construct a working model and show how the total cost of an antibacterial regimen could be evaluated in practical terms. The important cost

  3. Cost-effectiveness of silver dressings for paediatric partial thickness burns: An economic evaluation from a randomized controlled trial.

    Science.gov (United States)

    Gee Kee, E; Stockton, K; Kimble, R M; Cuttle, L; McPhail, S M

    2017-06-01

    Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome. This study was a trial based economic evaluation (incremental cost effectiveness) conducted from a healthcare provider perspective. Ninety-six children participated in the trial investigating Acticoat™, Acticoat™ with Mepitel™ or Mepilex Ag™. Costs directly related to the management of partial thickness burns ≤10% TBSA were collected during the trial from March 2013 to July 2014 and for a one year after re-epithelialization time horizon. Incremental cost effectiveness ratios were estimated and dominance probabilities calculated from bootstrap resampling trial data. Sensitivity analyses were conducted to examine the potential effect of accounting for infrequent, but high cost, skin grafting surgical procedures. Costs (dressing, labour, analgesics, scar management) were considerably lower in the Mepilex Ag™ group (median AUD$94.45) compared to the Acticoat™ (median $244.90) and Acticoat™ with Mepitel™ (median $196.66) interventions. There was a 99% and 97% probability that Mepilex Ag™ dominated (cheaper and more effective than) Acticoat™ and Acticoat™ with Mepitel™, respectively. This pattern of dominance was consistent across raw cost and effects, after a priori adjustments, and sensitivity analyses. There was an 82% probability that Acticoat™ with Mepitel dominated Acticoat™ in the primary analysis, although this probability was sensitive to the effect of skin graft procedures. This

  4. Evaluation of potential cost reductions from improved amine-based CO2 capture systems

    International Nuclear Information System (INIS)

    Rao, Anand B.; Rubin, Edward S.; Keith, David W.; Granger Morgan, M.

    2006-01-01

    Technological innovations in CO 2 capture and storage technologies are being pursued worldwide under a variety of private and government-sponsored R and D programs. While much of this R and D is directed at novel concepts and potential breakthrough technologies, there are also substantial efforts to improve CO 2 capture technologies already in use. In this paper, we focus on amine-based CO 2 capture systems for power plants and other combustion-based applications. The current performance and cost of such systems have been documented in several recent studies. In this paper we examine the potential for future cost reductions that may result from continued process development. We used the formal methods of expert elicitation to understand what experts in this field believe about possible improvements in some of the key underlying parameters that govern the performance and cost of this technology. A dozen leading experts from North America, Europe and Asia participated in this study, providing their probabilistic judgments via a detailed questionnaire coupled with individual interviews. Judgments about detailed technical parameters were then used in an integrated power plant modeling framework (IECM-CS) developed for USDOE to evaluate the performance and costs of alternative carbon capture and sequestration technologies for fossil-fueled power plants. The experts' responses have allowed us to build a picture of how the overall performance and cost of amine-based systems might improve over the next decade or two. Results show how much the cost of CO 2 capture could be reduced via targeted R and D in key areas

  5. Evaluation on the cost-effective threshold of osteoporosis treatment on elderly women in China using discrete event simulation model.

    Science.gov (United States)

    Ni, W; Jiang, Y

    2017-02-01

    This study used a simulation model to determine the cost-effective threshold of fracture risk to treat osteoporosis among elderly Chinese women. Osteoporosis treatment is cost-effective among average-risk women who are at least 75 years old and above-average-risk women who are younger than 75 years old. Aging of the Chinese population is imposing increasing economic burden of osteoporosis. This study evaluated the cost-effectiveness of osteoporosis treatment among the senior Chinese women population. A discrete event simulation model using age-specific probabilities of hip fracture, clinical vertebral fracture, wrist fracture, humerus fracture, and other fracture; costs (2015 US dollars); and quality-adjusted life years (QALYs) was used to assess the cost-effectiveness of osteoporosis treatment. Incremental cost-effectiveness ratio (ICER) was calculated. The willingness to pay (WTP) for a QALY in China was compared with the calculated ICER to decide the cost-effectiveness. To determine the absolute 10-year hip fracture probability at which the osteoporosis treatment became cost-effective, average age-specific probabilities for all fractures were multiplied by a relative risk (RR) that was systematically varied from 0 to 10 until the WTP threshold was observed for treatment relative to no intervention. Sensitivity analyses were also performed to evaluate the impacts from WTP and annual treatment costs. In baseline analysis, simulated ICERs were higher than the WTP threshold among Chinese women younger than 75, but much lower than the WTP among the older population. Sensitivity analyses indicated that cost-effectiveness could vary due to a higher WTP threshold or a lower annual treatment cost. A 30 % increase in WTP or a 30 % reduction in annual treatment costs will make osteoporosis treatment cost-effective for Chinese women population from 55 to 85. The current study provides evidence that osteoporosis treatment is cost-effective among a subpopulation of

  6. The cost and impact of scaling up pre-exposure prophylaxis for HIV prevention: a systematic review of cost-effectiveness modelling studies.

    Directory of Open Access Journals (Sweden)

    Gabriela B Gomez

    Full Text Available Cost-effectiveness studies inform resource allocation, strategy, and policy development. However, due to their complexity, dependence on assumptions made, and inherent uncertainty, synthesising, and generalising the results can be difficult. We assess cost-effectiveness models evaluating expected health gains and costs of HIV pre-exposure prophylaxis (PrEP interventions.We conducted a systematic review comparing epidemiological and economic assumptions of cost-effectiveness studies using various modelling approaches. The following databases were searched (until January 2013: PubMed/Medline, ISI Web of Knowledge, Centre for Reviews and Dissemination databases, EconLIT, and region-specific databases. We included modelling studies reporting both cost and expected impact of a PrEP roll-out. We explored five issues: prioritisation strategies, adherence, behaviour change, toxicity, and resistance. Of 961 studies retrieved, 13 were included. Studies modelled populations (heterosexual couples, men who have sex with men, people who inject drugs in generalised and concentrated epidemics from Southern Africa (including South Africa, Ukraine, USA, and Peru. PrEP was found to have the potential to be a cost-effective addition to HIV prevention programmes in specific settings. The extent of the impact of PrEP depended upon assumptions made concerning cost, epidemic context, programme coverage, prioritisation strategies, and individual-level adherence. Delivery of PrEP to key populations at highest risk of HIV exposure appears the most cost-effective strategy. Limitations of this review include the partial geographical coverage, our inability to perform a meta-analysis, and the paucity of information available exploring trade-offs between early treatment and PrEP.Our review identifies the main considerations to address in assessing cost-effectiveness analyses of a PrEP intervention--cost, epidemic context, individual adherence level, PrEP programme coverage

  7. Cost-of-illness studies for bipolar disorder: systematic review of international studies.

    Science.gov (United States)

    Jin, Huajie; McCrone, Paul

    2015-04-01

    Bipolar disorder (BD) may result in a greater burden than all forms of cancer, Alzheimer's disease and epilepsy. Cost-of-illness (COI) studies provide useful information on the economic burden that BD imposes on a society. Furthermore, COI studies are pivotal sources of evidence used in economic evaluations. This study aims to give a general overview of COI studies for BD and to discuss methodological issues that might potentially influence results. This study also aims to provide recommendations to improve practice in this area, based on the review. A search was performed to identify COI studies of BD. The following electronic databases were searched: MEDLINE, EMBASE, PsycInfo, Cochrane Database of Systematic Reviews, HMIC and openSIGLE. The primary outcome of this review was the annual cost per BD patient. A narrative assessment of key methodological issues was also included. Based on these findings, recommendations for good practice were drafted. Fifty-four studies were included in this review. Because of the widespread methodological heterogeneity among included studies, no attempt has been made to pool results of different studies. Potential areas for methodological improvement were identified. These were: description of the disease and population, the approach to deal with comorbidities, reporting the rationale and impact for choosing different cost perspectives, and ways in which uncertainty is addressed. This review showed that numerous COI studies have been conducted for BD since 1995. However, these studies employed varying methods, which limit the comparability of findings. The recommendations provided by this review can be used by those conducting COI studies and those critiquing them, to increase the credibility and reporting of study results.

  8. Review of OECD study into 'Projected costs of generating electricity-2010 Edition'

    International Nuclear Information System (INIS)

    Khatib, Hisham

    2010-01-01

    This joint report by the International Energy Agency (IEA) and the OECD Nuclear Energy Agency (NEA) is the seventh in the long established series of studies into electricity generating costs. It presents the main results of the work carried out in 2009 for calculating the costs of generating baseload electricity. The study is quite comprehensive in covering almost all financial aspects facing investors in the electricity generating system. Therefore this study although useful, its usefulness lies in explaining methodologies, mentioning factors that affect investment and cost, educating planners and improving investment evaluation and planning methodologies, its resulting figures and cost comparisons are however controversial. Generation planning and investments are case and country specific, and should be studied correspondingly and as close as possible to the timing of decision making to take account of trends. Most likely such case specific results will differ from figures calculated in the study. Therefore we need to emphasize a key conclusion of the study which is 'that country-specific circumstances determine the LCOE'; it is this that needs to be considered and not the results represented in the study.

  9. Estimating productivity costs using the friction cost approach in practice: a systematic review.

    Science.gov (United States)

    Kigozi, Jesse; Jowett, Sue; Lewis, Martyn; Barton, Pelham; Coast, Joanna

    2016-01-01

    The choice of the most appropriate approach to valuing productivity loss has received much debate in the literature. The friction cost approach has been proposed as a more appropriate alternative to the human capital approach when valuing productivity loss, although its application remains limited. This study reviews application of the friction cost approach in health economic studies and examines how its use varies in practice across different country settings. A systematic review was performed to identify economic evaluation studies that have estimated productivity costs using the friction cost approach and published in English from 1996 to 2013. A standard template was developed and used to extract information from studies meeting the inclusion criteria. The search yielded 46 studies from 12 countries. Of these, 28 were from the Netherlands. Thirty-five studies reported the length of friction period used, with only 16 stating explicitly the source of the friction period. Nine studies reported the elasticity correction factor used. The reported friction cost approach methods used to derive productivity costs varied in quality across studies from different countries. Few health economic studies have estimated productivity costs using the friction cost approach. The estimation and reporting of productivity costs using this method appears to differ in quality by country. The review reveals gaps and lack of clarity in reporting of methods for friction cost evaluation. Generating reporting guidelines and country-specific parameters for the friction cost approach is recommended if increased application and accuracy of the method is to be realized.

  10. Report on the Savannah River Site aluminum-based spent nuclear fuel alternatives cost study

    International Nuclear Information System (INIS)

    1998-12-01

    Initial estimates of costs for the interim management and disposal of aluminum-based spent nuclear fuel (SNF) were developed during preparation of the Environmental Impact Statement (EIS) on the Nuclear Weapons Nonproliferation Policy Concerning Foreign Research Reactor Spent Nuclear Fuel. The Task Team evaluated multiple alternatives, assessing programmatic, technical, and schedule risks, and generated life-cycle cost projections for each alternative. The eight technology alternatives evaluated were: direct co-disposal; melt and dilute; reprocessing; press and dilute; glass material oxidation dissolution system (GMODS); electrometallurgical treatment; dissolve and vitrify; and plasma arc. In followup to the Business Plan that was developed to look at SNF dry storage, WSRC prepared an addendum to the cost study. This addendum estimated the costs for the modification and use of an existing (105L) reactor facility versus a greenfield approach for new facilities (for the Direct Co-Disposal and Melt and Dilute alternatives). WSRC assessed the impacts of a delay in reprocessing due to the potential reservation of H-Canyon for other missions (i.e., down blending HEU for commercial use or the conversion of plutonium to either MOX fuel or an immobilized repository disposal form). This report presents the relevant results from these WSRC cost studies, consistent with the most recent project policy, technology implementation, canyon utilization, and inventory assumptions. As this is a summary report, detailed information on the technical alternatives or the cost assumptions raised in each of the above-mentioned cost studies is not provided. A comparison table that briefly describes the bases used for the WSRC analyses is included as Appendix A

  11. Research on the Value Evaluation of Used Pure Electric Car Based on the Replacement Cost Method

    Science.gov (United States)

    Tan, zhengping; Cai, yun; Wang, yidong; Mao, pan

    2018-03-01

    In this paper, the value evaluation of the used pure electric car is carried out by the replacement cost method, which fills the blank of the value evaluation of the electric vehicle. The basic principle of using the replacement cost method, combined with the actual cost of pure electric cars, puts forward the calculation method of second-hand electric car into a new rate based on the use of AHP method to construct the weight matrix comprehensive adjustment coefficient of related factors, the improved method of value evaluation system for second-hand car

  12. Costs and Cost-Effectiveness of Plasmodium vivax Control.

    Science.gov (United States)

    White, Michael T; Yeung, Shunmay; Patouillard, Edith; Cibulskis, Richard

    2016-12-28

    The continued success of efforts to reduce the global malaria burden will require sustained funding for interventions specifically targeting Plasmodium vivax The optimal use of limited financial resources necessitates cost and cost-effectiveness analyses of strategies for diagnosing and treating P. vivax and vector control tools. Herein, we review the existing published evidence on the costs and cost-effectiveness of interventions for controlling P. vivax, identifying nine studies focused on diagnosis and treatment and seven studies focused on vector control. Although many of the results from the much more extensive P. falciparum literature can be applied to P. vivax, it is not always possible to extrapolate results from P. falciparum-specific cost-effectiveness analyses. Notably, there is a need for additional studies to evaluate the potential cost-effectiveness of radical cure with primaquine for the prevention of P. vivax relapses with glucose-6-phosphate dehydrogenase testing. © The American Society of Tropical Medicine and Hygiene.

  13. Clinical and cost effectiveness evaluation of low friction and shear garments.

    Science.gov (United States)

    Smith, G; Ingram, A

    2010-12-01

    To determine the effectiveness of Parafricta low-friction garments in reducing the incidence and prevalence of pressure ulceration and to evaluate the curative aspects of these products on pre-existing skin breakdown within a hospital setting. Patients with a Waterlow score of >15 and who were unable to reposition independently were offered the low-friction undergarments and bootees. A total of 650 patient cases were initially reviewed. Of these, 204 met the criteria for use of the products in the 3 months prior to the start of the evaluation (cohort 1) and 165 patients met the criteria during the period when the garments were used (cohort 2). Data collected included pressure ulcer incidence, location, grading, and outcome of ulcer on discharge. Locally derived costs for length of stay, wound dressings, pressure-redistributing mattresses and additional cost of the low-friction garments were applied to build a cost-effectiveness model. In patients at risk of skin breakdown there was a statistically significant reduction in the number of patients who developed pressure ulcers following use of the low-friction garments in cohort 2 when compared with cohort 1 (16% reduction; p = 0.0286). In addition, the number of patients who were ulcer free on admission but who developed ulcers and then improved or completely healed before discharge was also statistically significant (41% increase; p = 0.0065) when cohort 2 was compared with cohort 1. Fewer patients admitted with ulcers deteriorated when using the low-friction garments (21% reduction; p = 0.0012). The costs, which were calculated by comparing patient throughput for these patients, suggest that the savings associated with preventing skin breakdown outweighed the cost of the products used (base case model indicated a saving of over £63,000 per 100 at risk patients). The results support the conclusion that low-friction garment products have a role to play in the prevention of skin breakdown, and appear to be both

  14. 32 CFR 728.41 - General provisions.

    Science.gov (United States)

    2010-07-01

    ...-support due to a physical or mental incapacity that existed prior to reaching the age of 21; or (iii) Has...) Forward the request to the Chief of Naval Operations (OP-61), with a copy to the Commander, Naval Medical... financial responsibility for costs of hospitalization and travel. (2) The Chief of Naval Operations (OP-61...

  15. Evaluating external costs of human health and environmental impacts using IAEA model SIMPACTS

    International Nuclear Information System (INIS)

    Bobric, Elena; Jelev, Adrian

    2005-01-01

    SIMPACTS (Simplified Approach for Estimating Impacts and External Costs of Electricity Generation) model developed at the International Atomic Energy Agency is a powerful and convenient tool for evaluating external costs induced by different energy sources. The model was developed for industrial countries and for developing countries as well where studies of alternatives of sustainable energy policies are conducted. The SIMPACTS allow the decision making factors involved in energy policy to have reasonable estimates of environment impacts and relating costs appealing to a rather low number of input parameters. The paper aims at analyzing by means of SIMPACTS the environmental impact produced by Cernavoda NPP operation in two cases: a) the impact of the Cernavoda NPP itself; b) the impact of an hypothetical coal based power plant of the same power level and located on the Cernavoda NPP site. The SIMPACTS modules AIRPACTS and NUCPACTS were applied to assess the impacts on human health, agricultural crops and building materials from exposure to routine atmospheric emissions and as well to quantify and value the adverse effects on human health due to routine atmospheric release of radionuclides from the NPP, via radioactive waste ground disposal or resulting from accidents in nuclear facility, respectively. The conclusion of this study based on SIMPACTS model application to assess the health effects and damage cost per year is that the Cernavoda NPP presents the lower health effects and damage cost comparing with power plants of other types

  16. Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia

    Directory of Open Access Journals (Sweden)

    Ibrahim MI

    2014-03-01

    Full Text Available Background: Therapeutic drug monitoring (TDM makes use of serum drug concentrations as an adjunct to decision-making. Preliminary data in our hospital showed that approximately one-fifth of all drugs monitored by TDM service were gentamicin. Objective: In this study, we evaluated the costs associated with providing the service in patients with bronchopneumonia and treated with gentamicin. Methods: We retrospectively collected data from medical records of patients admitted to the Hospital Universiti Sains Malaysia over a 5-year period. These patients were diagnosed with bronchopneumonia and were on gentamicin as part of their treatment. Five hospitalisation costs were calculated; (i cost of laboratory and clinical investigations, (ii cost associated with each gentamicin dose, (iii fixed and operating costs of TDM service, (iv cost of providing medical care, and (v cost of hospital stay during gentamicin treatment. Results: There were 1920 patients admitted with bronchopneumonia of which 67 (3.5% had TDM service for gentamicin. Seventy-three percent (49/67 patients were eligible for final analysis. The duration of gentamicin therapy ranged from 3 to 15 days. The cost of providing one gentamicin assay was MYR25, and the average cost of TDM service for each patient was MYR104. The average total hospitalisation cost during gentamicin treatment for each patient was MYR442 (1EUR approx. MYR4.02. Conclusion: Based on the hospital perspective, in patients with bronchopneumonia and treated with gentamicin, the provision of TDM service contributes to less than 25% of the total cost of hospitalization.

  17. Rapid evaluation of the cost-effectiveness o FDG-PET in recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Miles, K.A.; Keith, C.J.; Wong, D.C.; Griffiths, M.R.

    2002-01-01

    Full text: To evaluate the cost-effectiveness of FDG-PET in recurrent colorectal cancer using Australian data whilst avoiding the time delays, costs and ethical difficulties associated with intensive patient follow-up. A decision tree sensitivity analysis was used. The study population comprised patients with recurrent colorectal under consideration for resection of apparently isolated hepatic metastasis in whom demonstration of extra-hepatic tumour would preclude surgery.The results of FDG-PET in a consecutive series of 75 such patients referred to the Wesley PET centre were used to determine the range of possible values for disease prevalence and specificity, assuming the value for PET sensitivity as reported in the federal government's PET review. These values, along with the diagnostic accuracy of CT and Australian costs for procedures (PET = $1200), were entered into decision trees modelling a diagnostic strategy comprising CT only and an alternative strategy where patients without extrahepatic tumour on CT also undergo FDG-PET. The cost per patient, accuracy and Incremental Cost-Accuracy Ratio (ICAR) were determined for each strategy. The PET strategy is cheaper for all possible values of disease prevalence and PET specificity ($306-328 / patient) and is more cost-effective for values of disease prevalence above 0.18 or PET specificity above 0.86. At a typical disease prevalence of 0.3 (PET specificity 0.92), the ICAR for the PET strategy is $9700 versus $11,200 for CT. PET remains cost saving even if the best reported values for sensitivity of CT and worse values for PET are used. FDG-PET for recurrent colorectal cancer in Australia would be cost saving and most probably cost-effective. Copyright (2002) Blackwell Science Pty Ltd

  18. Evaluation of uncertainties in benefit-cost studies of electrical power plants. II. Development and application of a procedure for quantifying environmental uncertainties of a nuclear power plant. Final report

    International Nuclear Information System (INIS)

    Sullivan, W.G.

    1977-07-01

    Steam-electric generation plants are evaluated on a benefit-cost basis. Non-economic factors in the development and application of a procedure for quantifying environmental uncertainties of a nuclear power plant are discussed. By comparing monetary costs of a particular power plant assessed in Part 1 with non-monetary values arrived at in Part 2 and using an evaluation procedure developed in this study, a proposed power plant can be selected as a preferred alternative. This procedure enables policymakers to identify the incremental advantages and disadvantages of different power plants in view of their geographic locations. The report presents the evaluation procedure on a task by task basis and shows how it can be applied to a particular power plant. Because of the lack of objective data, it draws heavily on subjectively-derived inputs of individuals who are knowledgeable about the plant being investigated. An abbreviated study at another power plant demonstrated the transferability of the general evaluation procedure. Included in the appendices are techniques for developing scoring functions and a user's manual for the Fortran IV Program

  19. Cost Benefit Studies. Final Report.

    Science.gov (United States)

    Weiner, Arthur; Marson, Arthur A.

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

  20. Evaluation of a Prototype Low-Cost, Modular, Wireless Electroencephalography (EEG) Headset Design for Widespread Application

    Science.gov (United States)

    2016-06-01

    therefore did not implement or test actual sensors or electronic components (analog-to-digital conversion, power , and the wireless transmission ...ARL-TR-7703 ● JUNE 2016 US Army Research Laboratory Evaluation of a Prototype Low-Cost, Modular, Wireless Electroencephalography...originator. ARL-TR-7703 ● JUNE 2016 US Army Research Laboratory Evaluation of a Prototype Low-Cost, Modular, Wireless

  1. Engineering evaluation/cost analysis for 100-N area waste

    International Nuclear Information System (INIS)

    Mihalik, L.A.

    1996-08-01

    The 100 Area of the Hanford Site was placed on the U.S. Environmental Protection Agency's National Priorities List (NPL) in November 1989 under the 'Comprehensive Environmental Response, Compensation, and Liability Act of 1980.' The 100 Area NPL site includes the 100-N Area, which is in the early stages of the cleanup process. To facilitate the disposal of wastes generated in preparation for cleanup, the U.S. Department of Energy, Richland Operations Office in cooperation with the Washington State Department of Ecology and the U.S. Environmental Protection Agency, has prepared this Engineering Evaluation/Cost Analysis (EE/CA). The scope of this EE/CA includes wastes from cleanout of the EDB and deactivation facilities. Volumes and costs for disposal of investigation-derived waste are also included

  2. Costs of infertility treatment: Results from an 18-month prospective cohort study

    Science.gov (United States)

    Katz, Patricia; Showstack, Jonathan; Smith, James F.; Nachtigall, Robert D.; Millstein, Susan G.; Wing, Holly; Eisenberg, Michael L.; Pasch, Lauri A.; Croughan, Mary S.; Adler, Nancy

    2010-01-01

    Objectives To examine resource use (costs) by women presenting for infertility evaluation and treatment over 18 months, regardless of treatment pursued. Design Prospective cohort study in which women were followed for 18 months. Setting Eight infertility practices. Patients 398 women recruited from infertility practices. Data collection Women completed interviews and questionnaires at baseline, and after 4, 10, and 18 months of follow-up. Medical records were abstracted after 18 months to obtain details of services used. Main outcome measures Per-person and per-successful-outcome costs Results Treatment groups were defined as highest intensity treatment use. 20% of women did not pursue cycle-based treatment; about half pursued in-vitro fertilization (IVF). Median per-person costs ranged from $1,182 for medications only, to $24,373 and $38,015 for IVF and IVF-donor egg groups, respectively. Estimates of costs of successful outcomes (delivery or ongoing pregnancy by 18 months) were higher – $61,377 for IVF, for example – reflecting treatment success rates. Within the timeframe of the study, costs were not significantly different for women who were successful and women who were not. Conclusions While individual patient costs vary, these cost estimates developed from actual patient treatment experiences may provide patients with realistic estimates to consider when initiating infertility treatment. PMID:21130988

  3. Incorporating economies of scale in the cost estimation in economic evaluation of PCV and HPV vaccination programmes in the Philippines: a game changer?

    Science.gov (United States)

    Suwanthawornkul, Thanthima; Praditsitthikorn, Naiyana; Kulpeng, Wantanee; Haasis, Manuel Alexander; Guerrero, Anna Melissa; Teerawattananon, Yot

    2018-01-01

    Many economic evaluations ignore economies of scale in their cost estimation, which means that cost parameters are assumed to have a linear relationship with the level of production. Economies of scale is the situation when the average total cost of producing a product decreases with increasing volume caused by reducing the variable costs due to more efficient operation. This study investigates the significance of applying the economies of scale concept: the saving in costs gained by an increased level of production in economic evaluation of pneumococcal conjugate vaccines (PCV) and human papillomavirus (HPV) vaccinations. The fixed and variable costs of providing partial (20% coverage) and universal (100% coverage) vaccination programs in the Philippines were estimated using various methods, including costs of conducting questionnaire survey, focus-group discussion, and analysis of secondary data. Costing parameters were utilised as inputs for the two economic evaluation models for PCV and HPV. Incremental cost-effectiveness ratios (ICERs) and 5-year budget impacts with and without applying economies of scale to the costing parameters for partial and universal coverage were compared in order to determine the effect of these different costing approaches. The program costs of the partial coverage for the two immunisation programs were not very different when applying and not applying the economies of scale concept. Nevertheless, the program costs for universal coverage were 0.26 and 0.32 times lower when applying economies of scale compared to not applying economies of scale for the pneumococcal and human papillomavirus vaccinations, respectively. ICERs varied by up to 98% for pneumococcal vaccinations, whereas the change in ICERs in the human papillomavirus vaccination depended on both the costs of cervical cancer screening and the vaccination program. This results in a significant difference in the 5-year budget impact, accounting for 30 and 40% of reduction in

  4. Cost Accounting System for fusion studies

    International Nuclear Information System (INIS)

    Hamilton, W.R.; Keeton, D.C.; Thomson, S.L.

    1985-12-01

    A Cost Accounting System that is applicable to all magnetic fusion reactor design studies has been developed. This system provides: (1) definitions of the elements of cost and methods for the combination of these elements to form a cost estimate; (2) a Code of Accounts that uses a functional arrangement for identification of the plant components; and (3) definitions and methods to analyze actual cost data so that the data can be directly reported into this Cost Accounting System. The purpose of the Cost Accounting System is to provide the structure for the development of a fusion cost data base and for the development of validated cost estimating procedures. This system has been developed through use at the Fusion Engineering Design Center (FEDC) and has been applied to different confinement concepts (tokamaks and tandem mirrors) and to different types of projects (experimental devices and commercial power plants). The use of this Cost Accounting System by all magnetic fusion projects will promote the development of a common cost data base, allow the direct comparison of cost estimates, and ultimately establish the cost credibility of the program

  5. Cost Accounting System for fusion studies

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, W.R.; Keeton, D.C.; Thomson, S.L.

    1985-12-01

    A Cost Accounting System that is applicable to all magnetic fusion reactor design studies has been developed. This system provides: (1) definitions of the elements of cost and methods for the combination of these elements to form a cost estimate; (2) a Code of Accounts that uses a functional arrangement for identification of the plant components; and (3) definitions and methods to analyze actual cost data so that the data can be directly reported into this Cost Accounting System. The purpose of the Cost Accounting System is to provide the structure for the development of a fusion cost data base and for the development of validated cost estimating procedures. This system has been developed through use at the Fusion Engineering Design Center (FEDC) and has been applied to different confinement concepts (tokamaks and tandem mirrors) and to different types of projects (experimental devices and commercial power plants). The use of this Cost Accounting System by all magnetic fusion projects will promote the development of a common cost data base, allow the direct comparison of cost estimates, and ultimately establish the cost credibility of the program.

  6. 48 CFR 247.372 - DD Form 1654, Evaluation of Transportation Cost Factors.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false DD Form 1654, Evaluation... Transportation in Supply Contracts 247.372 DD Form 1654, Evaluation of Transportation Cost Factors. Contracting personnel may use the DD Form 1654 to furnish information to the transportation office for development of...

  7. Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study

    Directory of Open Access Journals (Sweden)

    Sánchez-Lastres Juan

    2011-09-01

    Full Text Available Abstract Background The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE in Spain. Methods A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE who attended primary care (n = 18 and emergency room/hospital settings (n = 10, covering the regions of Galicia and Asturias (North-west Spain. All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Results Among the 682 enrolled children, 207 (30.4% were rotavirus positive and 170 (25% had received at least one dose of rotavirus vaccine. The mean (standard deviation indirect cost caused by an episode of AGE was estimated at 135.17 (182.70 Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8 Euros vs. 111.6 (163.5 Euros (p Conclusions Rotavirus generates a significant indirect economic burden. Our data should be considered in the decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

  8. Prospective evaluation of indirect costs due to acute rotavirus gastroenteritis in Spain: the ROTACOST study.

    Science.gov (United States)

    Bouzón-Alejandro, Marta; Redondo-Collazo, Lorenzo; Sánchez-Lastres, Juan Manuel; Martinón-Torres, Nazareth; Martinón-Sánchez, José María; Martinón-Torres, Federico

    2011-09-14

    The effect of rotavirus in developed countries is mainly economic. This study aimed to assess the indirect costs induced by rotavirus acute gastroenteritis (RVAGE) in Spain. A prospective observational study was conducted from October 2008 to June 2009. It included 682 children up to 5 years of age with acute gastroenteritis (AGE) who attended primary care (n = 18) and emergency room/hospital settings (n = 10), covering the regions of Galicia and Asturias (North-west Spain). All non-medical expenses incurred throughout the episode were recorded in detail using personal interviews and telephone contact. Among the 682 enrolled children, 207 (30.4%) were rotavirus positive and 170 (25%) had received at least one dose of rotavirus vaccine. The mean (standard deviation) indirect cost caused by an episode of AGE was estimated at 135.17 (182.70) Euros. Costs were 1.74-fold higher when AGE was caused by rotavirus compared with other etiologies: 192.7 (219.8) Euros vs. 111.6 (163.5) Euros (p purchase of material. Patients with RVAGE were admitted to hospital more frequently than those with other etiologies (47.8% vs 14%, p decision-making process of the eventual inclusion of rotavirus vaccine in the national immunization schedule of well developed countries.

  9. Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

    Science.gov (United States)

    Gomez, Gabriela B; Foster, Nicola; Brals, Daniella; Nelissen, Heleen E; Bolarinwa, Oladimeji A; Hendriks, Marleen E; Boers, Alexander C; van Eck, Diederik; Rosendaal, Nicole; Adenusi, Peju; Agbede, Kayode; Akande, Tanimola M; Boele van Hensbroek, Michael; Wit, Ferdinand W; Hankins, Catherine A; Schultsz, Constance

    2015-01-01

    While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI) in rural Nigeria. We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER) of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA) based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted) is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730). Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible interval 21

  10. Improving Maternal Care through a State-Wide Health Insurance Program: A Cost and Cost-Effectiveness Study in Rural Nigeria.

    Directory of Open Access Journals (Sweden)

    Gabriela B Gomez

    Full Text Available While the Nigerian government has made progress towards the Millennium Development Goals, further investments are needed to achieve the targets of post-2015 Sustainable Development Goals, including Universal Health Coverage. Economic evaluations of innovative interventions can help inform investment decisions in resource-constrained settings. We aim to assess the cost and cost-effectiveness of maternal care provided within the new Kwara State Health Insurance program (KSHI in rural Nigeria.We used a decision analytic model to simulate a cohort of pregnant women. The primary outcome is the incremental cost effectiveness ratio (ICER of the KSHI scenario compared to the current standard of care. Intervention cost from a healthcare provider perspective included service delivery costs and above-service level costs; these were evaluated in a participating hospital and using financial records from the managing organisations, respectively. Standard of care costs from a provider perspective were derived from the literature using an ingredient approach. We generated 95% credibility intervals around the primary outcome through probabilistic sensitivity analysis (PSA based on a Monte Carlo simulation. We conducted one-way sensitivity analyses across key model parameters and assessed the sensitivity of our results to the performance of the base case separately through a scenario analysis. Finally, we assessed the sustainability and feasibility of this program's scale up within the State's healthcare financing structure through a budget impact analysis. The KSHI scenario results in a health benefit to patients at a higher cost compared to the base case. The mean ICER (US$46.4/disability-adjusted life year averted is considered very cost-effective compared to a willingness-to-pay threshold of one gross domestic product per capita (Nigeria, US$ 2012, 2,730. Our conclusion was robust to uncertainty in parameters estimates (PSA: median US$49.1, 95% credible

  11. Comparison and Evaluation of Large-Scale and On-Site Recycling Systems for Food Waste via Life Cycle Cost Analysis

    Directory of Open Access Journals (Sweden)

    Kyoung Hee Lee

    2017-11-01

    Full Text Available The purpose of this study was to evaluate the cost-benefit of on-site food waste recycling system using Life-Cycle Cost analysis, and to compare with large-scale treatment system. For accurate evaluation, the cost-benefit analysis was conducted with respect to local governments and residents, and qualitative environmental improvement effects were quantified. As for the local governments, analysis results showed that, when large-scale treatment system was replaced with on-site recycling system, there was significant cost reduction from the initial stage depending on reduction of investment, maintenance, and food wastewater treatment costs. As for the residents, it was found that the cost incurred from using the on-site recycling system was larger than the cost of using large-scale treatment system due to the cost of producing and installing the on-site treatment facilities at the initial stage. However, analysis showed that with continuous benefits such as greenhouse gas emission reduction, compost utilization, and food wastewater reduction, cost reduction would be obtained after 6 years of operating the on-site recycling system. Therefore, it was recommended for local governments and residents to consider introducing an on-site food waste recycling system if they are to replace an old treatment system or need to establish a new one.

  12. A model study of cost estimates of decontamination and decommissioning with an emphasis to derive cost functions for alpha contaminated material using OMEGA code

    Energy Technology Data Exchange (ETDEWEB)

    Kristofova, Kristina; Daniska, Vladimir; Ondra, Frantisek; Rehak, Ivan; Vasko, Marek [DECOM SLOVAKIA spol. s.r.o., Trnava (Slovakia)

    2004-12-01

    The presented study is focused on model decommissioning cost calculations for primary circuit of A-1 nuclear power plant in Jaslovske Bohunice. In addition, the survey of advanced decommissioning costing is included together with impact analyses of contamination on particular decommissioning parameters. OMEGA code decommissioning cost calculations for primary circuit of A-1 NPP presented in the study are performed and evaluated under the following conditions: different contamination level of inner and outer surfaces; different waste management scenarios; application and non-application of pre-dismantling decontamination; different start of decommissioning: 2004, 2010, 2020, 2030, 2040; radionuclide composition of primary circuit contamination in A-1 NPP with occurrence of alpha radionuclides and fission products as a consequence of operational accident with damaged fuel cladding; radionuclide composition of primary circuit contamination in V-2 NPP in Jaslovske Bohunice as a representative NPP with an operation without accidents and therefore neither non-alpha contaminants nor fission products are included. The results of all the above mentioned conditions impacts on calculated costs, manpower, exposure and distribution of materials arisen from decommissioning are evaluated in detail within the calculation sensitivity analysis.

  13. A model study of cost estimates of decontamination and decommissioning with an emphasis to derive cost functions for alpha-contaminated material using OMEGA code

    International Nuclear Information System (INIS)

    Kristofova, Kristina; Daniska, Vladimir; Ondra, Frantisek; Rehak, Ivan; Vasko, Marek

    2004-12-01

    The presented study is focused on model decommissioning cost calculations for primary circuit of A-1 nuclear power plant in Jaslovske Bohunice. In addition, the survey of advanced decommissioning costing is included together with impact analyses of contamination on particular decommissioning parameters. OMEGA code decommissioning cost calculations for primary circuit of A-1 NPP presented in the study are performed and evaluated under the following conditions: different contamination level of inner and outer surfaces; different waste management scenarios; application and non-application of pre-dismantling decontamination; different start of decommissioning: 2004, 2010, 2020, 2030, 2040; radionuclide composition of primary circuit contamination in A-1 NPP with occurrence of alpha radionuclides and fission products as a consequence of operational accident with damaged fuel cladding; radionuclide composition of primary circuit contamination in V-2 NPP in Jaslovske Bohunice as a representative NPP with an operation without accidents and therefore neither non-alpha contaminants nor fission products are included. The results of all the above mentioned conditions impacts on calculated costs, manpower, exposure and distribution of materials arisen from decommissioning are evaluated in detail within the calculation sensitivity analysis

  14. A prospective, randomized clinical trial to assess the cost-effectiveness of a modern foam dressing versus a traditional saline gauze dressing in the treatment of stage II pressure ulcers.

    Science.gov (United States)

    Payne, Wyatt G; Posnett, John; Alvarez, Oscar; Brown-Etris, Marie; Jameson, Gayle; Wolcott, Randall; Dharma, Hussein; Hartwell, Samantha; Ochs, Diane

    2009-02-01

    Modern dressings such as hydrocolloids, gels, and foams are typically more expensive than traditional dressings such as gauze. However, if modern dressings require fewer changes, the overall cost of treatment may be lower despite the higher initial purchase price. If healing rates are comparable or better, modern dressings also may be cost-effective. A 4-week, prospective, randomized clinical trial to assess differences in treatment costs and cost-effectiveness between a modern foam dressing and saline-soaked gauze was conducted among 36 patients (22 men, 14 women, mean age 72.8 years) with a Stage II pressure ulcer (mean duration 35 weeks) at five centers in the United States. Participants were randomized to treatment with a self-adhesive polyurethane foam (n = 20) or saline-soaked gauze dressing (n = 16). No difference in time to wound closure was observed (P = 0.817). Patients in the foam group had less frequent dressing changes (P cost over the study period was lower by $466 per patient (P = 0.055) and spending on dressings was lower by $92 per patient in the foam group (P = 0.025). Cost per ulcer healed was lower by $1,517 and cost per ulcer-free day was lower by $80 for patients in the foam group. On the evidence of this study, the foam dressing is a more cost-effective treatment than saline-soaked gauze for the treatment of Stage II pressure ulcers.

  15. Energy from trash is costly says California study

    Energy Technology Data Exchange (ETDEWEB)

    1977-06-17

    An evaluation by South California Edison Company of marketing, siting, environmental, technical and economic factors for three leading waste-to-fuel systems, concludes that it is a useful fuel conservation and waste 'treatment method', but it would be costly. The systems considered are: gasification of solid waste by pyrolysis with steam or electricity production; oil production by pyrolysis; or low Btu gas production. System disposal costs range from $13 to 31/ton (1983 $) depending on system and site; the three systems appear technically feasible; air emissions are low; the capacity of such plants could be 1000 tpd with a construction cost of $50 to $70 million.

  16. Capital cost: pressurized water reactor plant. Commerical electric power cost studies

    International Nuclear Information System (INIS)

    1977-06-01

    The investment cost study for the 1139-MW(e) pressurized water reactor (PWR) central station power plant consists of two volumes. This volume includes in addition to the foreword and summary, the plant description and the detailed cost estimate

  17. Optimal search strategies for detecting cost and economic studies in EMBASE

    Directory of Open Access Journals (Sweden)

    Haynes R Brian

    2006-06-01

    Full Text Available Abstract Background Economic evaluations in the medical literature compare competing diagnosis or treatment methods for their use of resources and their expected outcomes. The best evidence currently available from research regarding both cost and economic comparisons will continue to expand as this type of information becomes more important in today's clinical practice. Researchers and clinicians need quick, reliable ways to access this information. A key source of this type of information is large bibliographic databases such as EMBASE. The objective of this study was to develop search strategies that optimize the retrieval of health costs and economics studies from EMBASE. Methods We conducted an analytic survey, comparing hand searches of journals with retrievals from EMBASE for candidate search terms and combinations. 6 research assistants read all issues of 55 journals indexed by EMBASE for the publishing year 2000. We rated all articles using purpose and quality indicators and categorized them into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized for purpose (i.e., cost and economics and other clinical topics and depending on the purpose as 'pass' or 'fail' for methodologic rigor. Candidate search strategies were developed for economic and cost studies, then run in the 55 EMBASE journals, the retrievals being compared with the hand search data. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated. Results Combinations of search terms for detecting both cost and economic studies attained levels of 100% sensitivity with specificity levels of 92.9% and 92.3% respectively. When maximizing for both sensitivity and specificity, the combination of terms for detecting cost studies (sensitivity increased 2.2% over the single term but at a slight decrease in specificity of 0.9%. The maximized combination of terms

  18. Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.

    Science.gov (United States)

    Sevick, Laura K; Ghali, Sarah; Hill, Michael D; Danthurebandara, Vishva; Lorenzetti, Diane L; Noseworthy, Tom; Spackman, Eldon; Clement, Fiona

    2017-09-01

    Rapid endovascular therapy (EVT) is an emerging treatment option for acute ischemic stroke. Several economic evaluations have been published examining the cost-effectiveness of EVT, and many international bodies are currently making adoption decisions. The objective of this study was to establish the cost-effectiveness of EVT for ischemic stroke patients and to synthesize all the publicly available economic literature. A systematic review of the published literature was conducted to identify economic evaluations and cost analyses of EVT for acute ischemic stroke patients. Systematic review best practices were followed, and study quality was assessed. Four-hundred sixty-three articles were identified from electronic databases. After deduplication, abstract review, and full-text review, 17 studies were included. Seven of the studies were cost analyses, and 10 were cost-effectiveness studies. Generally, the cost analyses reported on the cost of the approach/procedure or the hospitalization costs associated with EVT. All of the cost-effectiveness studies reported a cost per quality-adjusted life year as the primary outcomes. Studies varied in regards to the costs considered, the perspective adopted, and the time horizon used. All the studies reported a cost per quality-adjusted life year of cost and cost-effectiveness of EVT. The cost analyses suggested that although EVT was associated with higher costs, it also resulted in improved patient outcomes. From the cost-effectiveness studies, EVT seems to be good value for money when a threshold of $50 000 per quality-adjusted life year gained is adopted. © 2017 American Heart Association, Inc.

  19. Cost-effectiveness of interventions to promote physical activity: a modelling study.

    Directory of Open Access Journals (Sweden)

    Linda J Cobiac

    2009-07-01

    Full Text Available BACKGROUND: Physical inactivity is a key risk factor for chronic disease, but a growing number of people are not achieving the recommended levels of physical activity necessary for good health. Australians are no exception; despite Australia's image as a sporting nation, with success at the elite level, the majority of Australians do not get enough physical activity. There are many options for intervention, from individually tailored advice, such as counselling from a general practitioner, to population-wide approaches, such as mass media campaigns, but the most cost-effective mix of interventions is unknown. In this study we evaluate the cost-effectiveness of interventions to promote physical activity. METHODS AND FINDINGS: From evidence of intervention efficacy in the physical activity literature and evaluation of the health sector costs of intervention and disease treatment, we model the cost impacts and health outcomes of six physical activity interventions, over the lifetime of the Australian population. We then determine cost-effectiveness of each intervention against current practice for physical activity intervention in Australia and derive the optimal pathway for implementation. Based on current evidence of intervention effectiveness, the intervention programs that encourage use of pedometers (Dominant and mass media-based community campaigns (Dominant are the most cost-effective strategies to implement and are very likely to be cost-saving. The internet-based intervention program (AUS$3,000/DALY, the GP physical activity prescription program (AUS$12,000/DALY, and the program to encourage more active transport (AUS$20,000/DALY, although less likely to be cost-saving, have a high probability of being under a AUS$50,000 per DALY threshold. GP referral to an exercise physiologist (AUS$79,000/DALY is the least cost-effective option if high time and travel costs for patients in screening and consulting an exercise physiologist are considered

  20. Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

    Science.gov (United States)

    Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

    2018-01-01

    To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

  1. Economic evaluation of CISM : a pilot study

    DEFF Research Database (Denmark)

    Vogt, Joachim

    2004-01-01

    air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment......air traffic controllers, critical incident stress management, CISM, critical incidents, critical incident stress, cost-benefit-analysis, economic evaluation, efficiency, return on investment...

  2. [Evaluation of the cost of treating pressure ulcers in hospitalized patients using industrialized dressings].

    Science.gov (United States)

    Lima, Angela Cristina Beck; Guerra, Diana Mendonça

    2011-01-01

    This work evaluated wound dresses used in the Neurosurgery Department of Restauração Hospital: polyurethane, hydrogel and activated carbon wound dresses and hydrogel with alginate used for pressure ulcer care. This work aimed to identify a critical factor that increases demand and cost of wound dresses. The evaluation conducted at the Neurosurgery Department identified individuals at risk of pressure ulcer development. Sixty-two patients were evaluated and the prevalence of pressure ulcer was 22.6% according to the Braden scale. Comparative evaluation between patients that didn't receive preventive measures and others that received, showed that the average daily cost of hospitalization for the first group was 45% higher than the mean for the second group. The Wilcoxon-Mann-Withiney test compared the population at risk to develop pressure ulcer and population at low risk showing that the evaluation of Braden Scale scores between the groups presents statistically significant differences and confidence limits of 95%. Pressure ulcer is a key quality indicator in health services.It is possible to reduce costs and offer higher quality public health services by implementing a training program of nursing staff using a preventive measure protocol based on a test to evaluate risk as Braden Scale.

  3. Cost/benefit evaluation of electrofibrous air filters

    International Nuclear Information System (INIS)

    Bergman, W.; Kuhl, W.; Biermann, A.; Lum, B.

    1986-01-01

    Experimental electric air filters based on the principle of superimposing an electric field over conventional fibrous air filters have been developed. The different experimental electric filters described in this report include prefilters for use in glove boxes and in ventilation systems, re-circulating air filters, electric HEPA filters, and high efficiency, high temperature air filters. In each case the large improvement in filter efficiency that occurs when a mechanical filter is electrified is demonstrated. Also a significant increase in the particle loading capacity of filters in many of our evaluations is demonstrated. Both laboratory and field test results are presented. This paper also demonstrates that the performance of all of our electric filter designs, except one, can be matched by conventional mechanical air filters and usually at a lower cost. The one exception is the high temperature, high efficiency electric air filter. In that case there is no mechanical filter media that can match the performance of the electric air filter. Our findings show that electric air filters are only cost effective compared to mechanical air filters when the performance of the mechanical air filter cannot be further improved by mechanical means. (author)

  4. Electrification Futures Study: End-Use Electric Technology Cost and Performance Projections through 2050

    Energy Technology Data Exchange (ETDEWEB)

    Vimmerstedt, Laura J. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Jadun, Paige [National Renewable Energy Lab. (NREL), Golden, CO (United States); McMillan, Colin A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Steinberg, Daniel C. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Muratori, Matteo [National Renewable Energy Lab. (NREL), Golden, CO (United States); Mai, Trieu T. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2018-01-02

    This report provides projected cost and performance assumptions for electric technologies considered in the Electrification Futures Study, a detailed and comprehensive analysis of the effects of widespread electrification of end-use service demands in all major economic sectors - transportation, residential and commercial buildings, and industry - for the contiguous United States through 2050. Using extensive literature searches and expert assessment, the authors identify slow, moderate, and rapid technology advancement sensitivities on technology cost and performance, and they offer a comparative analysis of levelized cost metrics as a reference indicator of total costs. The identification and characterization of these end-use service demand technologies is fundamental to the Electrification Futures Study. This report, the larger Electrification Futures Study, and the associated data and methodologies may be useful to planners and analysts in evaluating the potential role of electrification in an uncertain future. The report could be broadly applicable for other analysts and researchers who wish to assess electrification and electric technologies.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  6. A comprehensive economic evaluation of integrated desalination systems using fossil fuelled and nuclear energies and including their environmental costs

    International Nuclear Information System (INIS)

    Nisan, S.; Benzarti, N.

    2008-01-01

    Seawater desalination is now widely accepted as an attractive alternative source of freshwater for domestic and industrial uses. Despite the considerable progress made in the relevant technologies desalination, however, remains an energy intensive process in which the energy cost is the paramount factor. This Study is a first of a kind in that we have integrated the environmental costs into the power and desalination costs. The study has focused on the seawater desalination cost evaluation of the following systems. It is supposed that they will be operating in the co-generation mode (Simultaneous production of electrical power and desalted water) in 2015: Fossil fuelled based systems such as the coal and oil fired plants and the gas turbine combined cycle plant, coupled to MED, and RO; Pressurised water reactors such as the PWR-900 and the AP-600, coupled to MED, and RO; High temperature reactors such as the GT-MHR, the PBMR, coupled to MED, with the utilisation of virtually free waste-heat provided by these reactors. The study is made in real site-specific conditions of a site In Southern Europe. Sensitivity studies for different parameters such as the fossil fuel prices, interest and discount rates, power costs etc., have also been undertaken. The results obtained are then used to evaluate the financial interest of selected integrated desalination systems in terms of a detailed cash flow analysis, providing the net present values, pay back periods and the internal rate of returns. Analysis of the results shows that among the fossil fuelled systems the power and desalination costs by circulating fluidized bed coal fired plant would be the lowest with current coal prices. Those by oil fired plants would be highest. In all cases, integrated nuclear energy systems would lead to considerably lower power and water costs than the corresponding coal based systems. When external costs for different energies are internalized in power and water costs, the relative cost

  7. Risk management study for the Hanford Site facilities: Risk reduction cost comparison for the retired Hanford Site facilities. Volume 4

    Energy Technology Data Exchange (ETDEWEB)

    Coles, G.A.; Egge, R.G.; Senger, E.; Shultz, M.W.; Taylor, W.E.

    1994-02-01

    This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km{sup 2} Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This cost-comparison evaluation (1) determines relative costs for reducing risk to acceptable levels; (2) compares the cost of reducing risk using different risk-reduction options; and (3) compares the cost of reducing risks at different facilities. The result is an identification of the cost effective risk-reduction measures. Supporting information required to develop costs of the various risk-reduction options also is included.

  8. Study of China's coal supply cost

    International Nuclear Information System (INIS)

    Schneider, K.

    1998-01-01

    The Department of Primary Industries and Energy is funding a joint research project between ABARE and the Energy Research Institute of China's State Planning Commission, China's leading organisation undertaking policy-related energy sector research. Together, the two organisations will analyse the economic costs and impacts of moving large quantities of coal from China's northern coal fields to, power stations in the rapidly growing south-eastern coastal provinces. The study will also compare the true economic costs of using domestic coal - including the costs of subsidies on coal production and transport - with the costs of using imported coal. ABARE will use its dynamic model, MEGABARE, to undertake ky parts of the study, taking into account the complex linkages between sectors in an economy and between different economies

  9. Studies in Software Cost Model Behavior: Do We Really Understand Cost Model Performance?

    Science.gov (United States)

    Lum, Karen; Hihn, Jairus; Menzies, Tim

    2006-01-01

    While there exists extensive literature on software cost estimation techniques, industry practice continues to rely upon standard regression-based algorithms. These software effort models are typically calibrated or tuned to local conditions using local data. This paper cautions that current approaches to model calibration often produce sub-optimal models because of the large variance problem inherent in cost data and by including far more effort multipliers than the data supports. Building optimal models requires that a wider range of models be considered while correctly calibrating these models requires rejection rules that prune variables and records and use multiple criteria for evaluating model performance. The main contribution of this paper is to document a standard method that integrates formal model identification, estimation, and validation. It also documents what we call the large variance problem that is a leading cause of cost model brittleness or instability.

  10. Evaluation of the Total Cost of Ownership of Fuel Cell-Powered Material Handling Equipment

    Energy Technology Data Exchange (ETDEWEB)

    Ramsden, T.

    2013-04-01

    This report discusses an analysis of the total cost of ownership of fuel cell-powered and traditional battery-powered material handling equipment (MHE, or more typically 'forklifts'). A number of fuel cell MHE deployments have received funding support from the federal government. Using data from these government co-funded deployments, DOE's National Renewable Energy Laboratory (NREL) has been evaluating the performance of fuel cells in material handling applications. NREL has assessed the total cost of ownership of fuel cell MHE and compared it to the cost of ownership of traditional battery-powered MHE. As part of its cost of ownership assessment, NREL looked at a range of costs associated with MHE operation, including the capital costs of battery and fuel cell systems, the cost of supporting infrastructure, maintenance costs, warehouse space costs, and labor costs. Considering all these costs, NREL found that fuel cell MHE can have a lower overall cost of ownership than comparable battery-powered MHE.

  11. Resource utilization and costs associated with the diagnostic evaluation of nonrefluxing primary hydronephrosis in infants.

    Science.gov (United States)

    Akhavan, Ardavan; Shnorhavorian, Margarett; Garrison, Louis P; Merguerian, Paul A

    2014-09-01

    Long-term evaluation of postnatal nonrefluxing primary hydronephrosis presents a dilemma for urologists since most cases resolve without surgery. We report longitudinal resource utilization and costs associated with diagnostic evaluation of infants with isolated primary nonrefluxing hydronephrosis to determine the costs associated with diagnosing a surgical case, and we assess the implications using a cost-consequences analysis. A retrospective chart review was used to capture resource utilization for all patients younger than 6 months with hydronephrosis evaluated at our institution during a 5-year period. Infants with confounding urological diagnoses were excluded. Payer and societal perspectives were used. Costs were estimated from resource utilization, including radiographic imaging and clinical encounter types. Data were collected from first clinic visit until surgery or resolution or 3 years, whichever was shortest. Of 165 included patients surgical rates for hydronephrosis were 0% for grade I, 5% for grade II, 21% for grade III and 74% for grade IV. Median respective costs of identifying a single surgical case per increasing hydronephrosis grade 0 to IV were infinite, $37,600, $11,741 and $2,124 (p hydronephrosis is significantly more productive in terms of identifying patients requiring surgery vs evaluation of patients with lower grade disease. In patients with grades I and II hydronephrosis a more abbreviated diagnostic strategy than the current standard of care may be warranted. For the population in this analysis we project that a less intensive approach could save about 24% of costs. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. An Integrated Modeling Approach to Evaluate and Optimize Data Center Sustainability, Dependability and Cost

    Directory of Open Access Journals (Sweden)

    Gustavo Callou

    2014-01-01

    Full Text Available Data centers have evolved dramatically in recent years, due to the advent of social networking services, e-commerce and cloud computing. The conflicting requirements are the high availability levels demanded against the low sustainability impact and cost values. The approaches that evaluate and optimize these requirements are essential to support designers of data center architectures. Our work aims to propose an integrated approach to estimate and optimize these issues with the support of the developed environment, Mercury. Mercury is a tool for dependability, performance and energy flow evaluation. The tool supports reliability block diagrams (RBD, stochastic Petri nets (SPNs, continuous-time Markov chains (CTMC and energy flow (EFM models. The EFM verifies the energy flow on data center architectures, taking into account the energy efficiency and power capacity that each device can provide (assuming power systems or extract (considering cooling components. The EFM also estimates the sustainability impact and cost issues of data center architectures. Additionally, a methodology is also considered to support the modeling, evaluation and optimization processes. Two case studies are presented to illustrate the adopted methodology on data center power systems.

  13. Evaluation of the Overall Costs for the Croatian Repository: Varying Site, Design and Financial Parameters

    International Nuclear Information System (INIS)

    Kucar-Dragicevic, S.; Subasic, D.; Lebegner, J.

    2000-01-01

    Preliminary preparations for the construction of a LILW repository in Croatia included a number of activities and projects related to the siting process, safety assessment, disposal technology and repository design, and public acceptance issues. Costs evaluations have always been a part of the developing project documentation. However, only the estimates of the facility construction and equipment acquisition costs had been included, while other costs associated with the project development and management have not been considered up to now. For the first time the infrastructure status at the potential sites has been evaluated, and the costs of the repository operations as well as the post-closure management has been estimated. Cost parameters have been considered from both technical and fiscal points of view, comparing their relative influence on the overall repository costs. Assessment of the total project costs in eight cases for the four preferential sites and two repository designs gave a clearer picture of the development and management costs differences for the considered options. Without considerations of the operational and post-operational repository management expenses, the total project costs appear to have been heavily underestimated. Also, while the construction costs for the tunnel and the surface type repositories are significantly different, this influence of the repository type on the total project costs becomes far less important when the later phases management expenses are added. Finally, the role of fiscal parameters may further diminish the site and technology impacts on the overall costs. (author)

  14. FBI fingerprint identification automation study. AIDS 3 evaluation report. Volume 4: Economic feasibility

    Science.gov (United States)

    Mulhall, B. D. L.

    1980-01-01

    The results of the economic analysis of the AIDS 3 system design are presented. AIDS 3 evaluated a set of economic feasibility measures including life cycle cost, implementation cost, annual operating expenditures and annual capital expenditures. The economic feasibility of AIDS 3 was determined by comparing the evaluated measures with the same measures, where applicable, evaluated for the current system. A set of future work load scenarios was constructed using JPL's environmental evaluation study of the fingerprint identification system. AIDS 3 and the current system were evaluated for each of the economic feasibility measures for each of the work load scenarios. They were compared for a set of performance measures, including response time and accuracy, and for a set of cost/benefit ratios, including cost per transaction and cost per technical search. Benefit measures related to the economic feasibility of the system are also presented, including the required number of employees and the required employee skill mix.

  15. Development of geological disposal system; localization of element cost data and cost evaluation on the HLW repository

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Sik; Kim, Kil Jung; Yang, Young Jin; Kim, Sung Chun [KOPEC, Taejeon (Korea)

    2002-03-01

    To estimate Total Life Cycle Cost (TSLCC) for Korea HLW Repository through localization of element cost data, we review and re-organize each basic element cost data for reference repository system, localize various element cost and finally estimate TSLCC considering economic parameters. As results of the study, TSLCC is estimated as 17,167,689 million won, which includes costs for site preparation, surface facilities, underground facilities and management/integration. Since HLW repository Project is an early stage of pre-conceptual design at present, the information of design and project information are not enough to perform cost estimate and cost localization for the Project. However, project cost structure is re-organized based on the local condition and Total System Life Cycle Cost is estimated using the previous cost data gathered from construction experience of the local nuclear power plant. Project results can be used as basic reference data to assume total construction cost for the local HLW repository and should be revised to more reliable cost data with incorporating detail project design information into the cost estimate in a future. 20 refs. (Author)

  16. Evaluation of the use of low-cost GPS receivers in the autonomous guidance of agricultural tractors

    Energy Technology Data Exchange (ETDEWEB)

    Alonso-Garcia, S.; Gomez-Gil, J.; Arribas, J. I.

    2011-07-01

    This paper evaluates the use of low-cost global positioning system (GPS) receivers in the autonomous guidance of agricultural tractors. An autonomous guidance system was installed in a 6400 John Deere agricultural tractor. A low cost GPS receiver was used as positioning sensor. Three different control laws were implemented in order to evaluate the autonomous guidance of the tractor with the low-cost receiver. The guidance was experimentally tested with the tracking of straight trajectories and with the step response. The total guidance error was obtained from the receiver accuracy and from the guidance error. For the evaluation of the receivers accuracy, positioning data from several low cost receivers were recorded and analyzed. For the evaluation of the guidance error, tests were performed with each control law at three different speeds. The conclusions obtained were that relative accuracy of low-cost receivers decreases with the time; that for an interval lower than 15 min, the error usually remains below 1 m; that all the control laws have a similar behavior and it is conditioned by the control law adjustment; that automatic guidance with low cost receivers is possible with speeds that went up to 9 km h{sup -}1; and finally, that the total error in the guidance is mainly determined by the receivers accuracy. (Author) 46 refs.

  17. Handling time in economic evaluation studies.

    Science.gov (United States)

    Permsuwan, Unchalee; Guntawongwan, Kansinee; Buddhawongsa, Piyaluk

    2014-05-01

    The discount rates and time horizons used in a health technology assessment (HTA) can have a significant impact on the results, and thus the prioritization of technologies. Therefore, it is important that clear guidance be provided on the appropriate discount rates for cost and health effect and appropriate time horizons. In this paper we conduct a review of relevant case studies and guidelines and provide guidance for all researchers conducting economic evaluations of health technologies in the Thai context. A uniform discount rate of 3% is recommended for both costs and health effects in base case analyses. A sensitivity analysis should also be conducted, with a discount range of 0-6%. For technologies where the effects are likely to sustain for at least 30y ears, a rate of 4% for costs and 2% for health effects is recommended. The time horizon should be long enough to capture the full costs and effects of the programs.

  18. Cost Evaluation of CO2 Sequestration by Aqueous Mineral Carbonation

    NARCIS (Netherlands)

    Huijgen, W.J.J.; Comans, R.N.J.; Witkamp, G.J.

    2007-01-01

    A cost evaluation of CO2 sequestration by aqueous mineral carbonation has been made using either wollastonite (CaSiO3) or steel slag as feedstock. First, the process was simulated to determine the properties of the streams as well as the power and heat consumption of the process equipment. Second, a

  19. High performance APCS conceptual design and evaluation scoping study

    International Nuclear Information System (INIS)

    Soelberg, N.; Liekhus, K.; Chambers, A.; Anderson, G.

    1998-02-01

    This Air Pollution Control System (APCS) Conceptual Design and Evaluation study was conducted to evaluate a high-performance (APC) system for minimizing air emissions from mixed waste thermal treatment systems. Seven variations of high-performance APCS designs were conceptualized using several design objectives. One of the system designs was selected for detailed process simulation using ASPEN PLUS to determine material and energy balances and evaluate performance. Installed system capital costs were also estimated. Sensitivity studies were conducted to evaluate the incremental cost and benefit of added carbon adsorber beds for mercury control, specific catalytic reduction for NO x control, and offgas retention tanks for holding the offgas until sample analysis is conducted to verify that the offgas meets emission limits. Results show that the high-performance dry-wet APCS can easily meet all expected emission limits except for possibly mercury. The capability to achieve high levels of mercury control (potentially necessary for thermally treating some DOE mixed streams) could not be validated using current performance data for mercury control technologies. The engineering approach and ASPEN PLUS modeling tool developed and used in this study identified APC equipment and system performance, size, cost, and other issues that are not yet resolved. These issues need to be addressed in feasibility studies and conceptual designs for new facilities or for determining how to modify existing facilities to meet expected emission limits. The ASPEN PLUS process simulation with current and refined input assumptions and calculations can be used to provide system performance information for decision-making, identifying best options, estimating costs, reducing the potential for emission violations, providing information needed for waste flow analysis, incorporating new APCS technologies in existing designs, or performing facility design and permitting activities

  20. Cost-of-illness studies and cost-effectiveness analyses in anxiety disorders: a systematic review.

    Science.gov (United States)

    Konnopka, Alexander; Leichsenring, Falk; Leibing, Eric; König, Hans-Helmut

    2009-04-01

    To review cost-of-illness studies (COI) and cost-effectiveness analyses (CEA) conducted for anxiety disorders. Based on a database search in Pubmed, PsychINFO and NHS EED, studies were classified according to various criteria. Cost data were inflated and converted to 2005 US-$ purchasing power parities (PPP). We finally identified 20 COI and 11 CEA of which most concentrated on panic disorder (PD) and generalized anxiety disorder (GAD). Differing inclusion of cost categories limited comparability of COI. PD and GAD tended to show higher direct costs per case, but lower direct cost per inhabitant than social and specific phobias. Different measures of effectiveness severely limited comparability of CEA. Overall CEA analysed 26 therapeutic or interventional strategies mostly compared to standard treatment, 8 of them resulting in lower better effectiveness and costs than the comparator. Anxiety disorders cause considerable costs. More research on phobias, more standardised inclusion of cost categories in COI and a wider use of comparable effectiveness measures (like QALYs) in CEA is needed.

  1. GMOs in animal agriculture: time to consider both costs and benefits in regulatory evaluations.

    Science.gov (United States)

    Van Eenennaam, Alison L

    2013-09-25

    In 2012, genetically engineered (GE) crops were grown by 17.3 million farmers on over 170 million hectares. Over 70% of harvested GE biomass is fed to food producing animals, making them the major consumers of GE crops for the past 15 plus years. Prior to commercialization, GE crops go through an extensive regulatory evaluation. Over one hundred regulatory submissions have shown compositional equivalence, and comparable levels of safety, between GE crops and their conventional counterparts. One component of regulatory compliance is whole GE food/feed animal feeding studies. Both regulatory studies and independent peer-reviewed studies have shown that GE crops can be safely used in animal feed, and rDNA fragments have never been detected in products (e.g. milk, meat, eggs) derived from animals that consumed GE feed. Despite the fact that the scientific weight of evidence from these hundreds of studies have not revealed unique risks associated with GE feed, some groups are calling for more animal feeding studies, including long-term rodent studies and studies in target livestock species for the approval of GE crops. It is an opportune time to review the results of such studies as have been done to date to evaluate the value of the additional information obtained. Requiring long-term and target animal feeding studies would sharply increase regulatory compliance costs and prolong the regulatory process associated with the commercialization of GE crops. Such costs may impede the development of feed crops with enhanced nutritional characteristics and durability, particularly in the local varieties in small and poor developing countries. More generally it is time for regulatory evaluations to more explicitly consider both the reasonable and unique risks and benefits associated with the use of both GE plants and animals in agricultural systems, and weigh them against those associated with existing systems, and those of regulatory inaction. This would represent a shift away

  2. Cost-effectiveness of high-efficiency appliances in the U.S. residential sector: A case study

    International Nuclear Information System (INIS)

    McNeil, Michael A.; Bojda, Nicholas

    2012-01-01

    This paper presents an analysis of the cost-effectiveness of high-efficiency appliances in the U.S. residential sector using cost and efficiency data developed as part of the regulatory process of the U.S. Department of Energy's Appliances and Commercial Equipment Standards Program. These data are presented as a case study in the development of an ‘efficiency technology database’ which can be expanded and published as a resource to other researchers and policy makers seeking scenarios that optimize efficiency policies and forecast their likely impacts on energy demand and greenhouse gas emissions. The use of this data to evaluate cost-effectiveness according to a variety of metrics is demonstrated using the example of one refrigerator–freezer product class. Cost-effectiveness is then evaluated in terms of cost of conserved energy for refrigerators, room air conditioners, water heaters, cooking equipment, central air conditioners and gas furnaces. The resulting potential of cost-effective improvement ranges from 1% to 53% of energy savings, with a typical potential of 15–20%. - Highlights: ► We determined the potential for cost-effective efficiency for residential appliances. ► We cover 6 appliance groups using cost of conserved energy as a metric for cost-effectiveness. ► Data are source from the DOE's Appliance and Commercial Equipment Standards Program. ► Between 15% and 20% additional cost-effective efficiency improvement is possible.

  3. Evaluation of depreciation costs in replacement investments of nuclear power plants

    International Nuclear Information System (INIS)

    Nakada, Shoji; Takashima, Ryuta; Nagano, Koji; Kimura, Hiroshi; Madarame, Haruki

    2010-01-01

    Replacement of nuclear power plants has the possibility of affecting the management of electric power suppliers. Therefore, in the nuclear policy, a depreciation method as an equalization method, which means that part of the investment cost is accumulated as an allowance, and after the start of operation, the depreciation cost in the replacement project is equalized, has been introduced in Japan. In this paper, we evaluate the replacement of nuclear power plants by taking into account the uncertainty of operating costs and the depreciation cost in order to examine the effect of the depreciation method on the decision criteria of the replacement.We found that the equalization method is elective for inducing the acceleration of the replacement. Furthermore, we show the relationship between the uncertainty and the depreciation method. It turns out that as uncertainty increases, the difference in investment threshold between the equalization method and the existing depreciation method decreases, and that in option value increases. (author)

  4. LIFE Cost of Electricity, Capital and Operating Costs

    International Nuclear Information System (INIS)

    Anklam, T.

    2011-01-01

    Successful commercialization of fusion energy requires economic viability as well as technical and scientific feasibility. To assess economic viability, we have conducted a pre-conceptual level evaluation of LIFE economics. Unit costs are estimated from a combination of bottom-up costs estimates, working with representative vendors, and scaled results from previous studies of fission and fusion plants. An integrated process model of a LIFE power plant was developed to integrate and optimize unit costs and calculate top level metrics such as cost of electricity and power plant capital cost. The scope of this activity was the entire power plant site. Separately, a development program to deliver the required specialized equipment has been assembled. Results show that LIFE power plant cost of electricity and plant capital cost compare favorably to estimates for new-build LWR's, coal and gas - particularly if indicative costs of carbon capture and sequestration are accounted for.

  5. Incorporating economies of scale in the cost estimation in economic evaluation of PCV and HPV vaccination programmes in the Philippines: a game changer?

    Directory of Open Access Journals (Sweden)

    Thanthima Suwanthawornkul

    2018-02-01

    Full Text Available Abstract Background Many economic evaluations ignore economies of scale in their cost estimation, which means that cost parameters are assumed to have a linear relationship with the level of production. Economies of scale is the situation when the average total cost of producing a product decreases with increasing volume caused by reducing the variable costs due to more efficient operation. This study investigates the significance of applying the economies of scale concept: the saving in costs gained by an increased level of production in economic evaluation of pneumococcal conjugate vaccines (PCV and human papillomavirus (HPV vaccinations. Methods The fixed and variable costs of providing partial (20% coverage and universal (100% coverage vaccination programs in the Philippines were estimated using various methods, including costs of conducting questionnaire survey, focus-group discussion, and analysis of secondary data. Costing parameters were utilised as inputs for the two economic evaluation models for PCV and HPV. Incremental cost-effectiveness ratios (ICERs and 5-year budget impacts with and without applying economies of scale to the costing parameters for partial and universal coverage were compared in order to determine the effect of these different costing approaches. Results The program costs of the partial coverage for the two immunisation programs were not very different when applying and not applying the economies of scale concept. Nevertheless, the program costs for universal coverage were 0.26 and 0.32 times lower when applying economies of scale compared to not applying economies of scale for the pneumococcal and human papillomavirus vaccinations, respectively. ICERs varied by up to 98% for pneumococcal vaccinations, whereas the change in ICERs in the human papillomavirus vaccination depended on both the costs of cervical cancer screening and the vaccination program. This results in a significant difference in the 5-year budget

  6. Evaluating the cost effectiveness of environmental projects: Case studies in aerospace and defense

    Science.gov (United States)

    Shunk, James F.

    1995-01-01

    Using the replacement technology of high pressure waterjet decoating systems as an example, a simple methodology is presented for developing a cost effectiveness model. The model uses a four-step process to formulate an economic justification designed for presentation to decision makers as an assessment of the value of the replacement technology over conventional methods. Three case studies from major U.S. and international airlines are used to illustrate the methodology and resulting model. Tax and depreciation impacts are also presented as potential additions to the model.

  7. The longitudinal study of turnover and the cost of turnover in EMS

    Science.gov (United States)

    Patterson, P. Daniel; Jones, Cheryl B.; Hubble, Michael W.; Carr, Matthew; Weaver, Matthew D.; Engberg, John; Castle, Nicholas

    2010-01-01

    provide estimates of two key workforce measures – turnover rates and costs – where previously none have existed. Local EMS directors and policymakers at all levels of government may find the results and study methodology useful towards designing and evaluating programs targeting the EMS workforce. PMID:20199235

  8. 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.

  9. Cost Analysis of Prenatal Care Using the Activity-Based Costing Model: A Pilot Study

    Science.gov (United States)

    Gesse, Theresa; Golembeski, Susan; Potter, Jonell

    1999-01-01

    The cost of prenatal care in a private nurse-midwifery practice was examined using the activity-based costing system. Findings suggest that the activities of the nurse-midwife (the health care provider) constitute the major cost driver of this practice and that the model of care and associated, time-related activities influence the cost. This pilot study information will be used in the development of a comparative study of prenatal care, client education, and self care. PMID:22945985

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

    Science.gov (United States)

    Gesse, T; Golembeski, S; Potter, J

    1999-01-01

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

  11. Cost Evaluation of a Government-Conducted Oral Cholera Vaccination Campaign-Haiti, 2013.

    Science.gov (United States)

    Routh, Janell A; Sreenivasan, Nandini; Adhikari, Bishwa B; Andrecy, Lesly L; Bernateau, Margarette; Abimbola, Taiwo; Njau, Joseph; Jackson, Ernsley; Juin, Stanley; Francois, Jeannot; Tohme, Rania A; Meltzer, Martin I; Katz, Mark A; Mintz, Eric D

    2017-10-01

    The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government's first vaccine campaign implemented in August-September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed-our analyses suggested that approximately 2.5-6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.

  12. The impact of NHS based primary care complementary therapy services on health outcomes and NHS costs: a review of service audits and evaluations

    Directory of Open Access Journals (Sweden)

    Wye Lesley

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.

  13. ON TRAVERSABILITY COST EVALUATION FROM PROPRIOCEPTIVE SENSING FOR A CRAWLING ROBOT

    Directory of Open Access Journals (Sweden)

    Jakub Mrva

    2015-12-01

    Full Text Available Traversability characteristics of the robot working environment are crucial in planning an efficient path for a robot operating in rough unstructured areas. In the literature, approaches to wheeled or tracked robots can be found, but a relatively little attention is given to walking multi-legged robots. Moreover, the existing approaches for terrain traversability assessment seem to be focused on gathering key features from a terrain model acquired from range data or camera image and only occasionally supplemented with proprioceptive sensing that expresses the interaction of the robot with the terrain. This paper addresses the problem of traversability cost evaluation based on proprioceptive sensing for a hexapod walking robot while optimizing different criteria. We present several methods of evaluating the robot-terrain interaction that can be used as a cost function for an assessment of the robot motion that can be utilized in high-level path-planning algorithms.

  14. The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study.

    Science.gov (United States)

    Zarkin, Gary A; Bray, Jeremy W; Aldridge, Arnie; Mills, Michael; Cisler, Ron A; Couper, David; McKay, James R; O'Malley, Stephanie

    2010-05-01

    The COMBINE (combined pharmacotherapies and behavioral intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the effect of alcohol interventions on broader social costs and outcomes. To estimate the sum of treatment costs plus the costs of health care utilization, arrests, and motor vehicle accidents for the 9 treatments in COMBINE 3 years postrandomization. A cost study based on a randomized controlled clinical trial. : The study involved 786 participants 3 years postrandomization. Multivariate results show no significant differences in mean costs between any of the treatment arms as compared with medical management (MM) + placebo for the 3-year postrandomization sample. The median costs of MM + acamprosate, MM + naltrexone, MM + acamprosate + naltrexone, and MM + acamprosate + combined behavioral intervention were significantly lower than the median cost for MM + placebo. The results show that social cost savings are generated relative to MM + placebo by 3 years postrandomization, and the magnitude of these cost savings is greater than the costs of the COMBINE treatment received 3 years prior. Our study suggests that several alcohol treatments may indeed lead to reduced median social costs associated with health care, arrests, and motor vehicle accidents.

  15. Economic evaluation studies in nuclear medicine. A methodological review of the literature

    International Nuclear Information System (INIS)

    Gambhir, S.S.; Schwimmer, J.

    2000-01-01

    The growing need for evaluation of the utility of new nuclear medicine technologies has spawned a few economic studies ranging from preliminary indications of cost savings to complete decision analysis models incorporating costs and quality of life. The objective of the current study was to evaluate the methodological quality of economic analyses of nuclear medicine procedures which targeted cost-effectiveness or cost-utility issues published in the medical literature during the years 1985-1999. A computerized literature search was used to identify original investigations from the medical literature which included an economic analysis of a nuclear medicine procedure. Each economic analysis article was evaluated by two independent reviewers for adherence to ten accepted methodological criteria. Of the 29 articles meeting the search criteria, only six (21%) conformed to all ten methodological criteria. Published economic analyses of nuclear medicine procedures usually do not meet accepted methodological standards and could be significantly improved to achieve overall better quality relative to similar analyses in the literature from other medical fields. Continued improvement in the number and quality of economic studies is critically needed for the future competitiveness of nuclear medicine studies

  16. Risk-adjusted capitation based on the Diagnostic Cost Group Model: an empirical evaluation with health survey information

    NARCIS (Netherlands)

    L.M. Lamers (Leida)

    1999-01-01

    textabstractOBJECTIVE: To evaluate the predictive accuracy of the Diagnostic Cost Group (DCG) model using health survey information. DATA SOURCES/STUDY SETTING: Longitudinal data collected for a sample of members of a Dutch sickness fund. In the Netherlands the sickness

  17. Nanoparticle risk management and cost evaluation: a general framework

    Science.gov (United States)

    Fleury, Dominique; Bomfim, João A. S.; Metz, Sébastien; Bouillard, Jacques X.; Brignon, Jean-Marc

    2011-07-01

    Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

  18. Nanoparticle risk management and cost evaluation: a general framework

    International Nuclear Information System (INIS)

    Fleury, Dominique; Metz, Sebastien; Bouillard, Jacques X; Brignon, Jean-Marc; Bomfim, Joao A S

    2011-01-01

    Industrial production of nano-objects has been growing fast during the last decade and a wide range of products containing nanoparticles (NPs) is proposed to the public in various markets (automotive, electronics, textiles...). The issues encountered in monitoring the presence of nano-objects in any media cause a major difficulty for controlling the risk associated to the production stage. It is therefore very difficult to assess the efficiency of prevention and mitigation solutions, which potentially leads to overestimate the level of the protection barriers that are recommended. The extra costs in adding nano-objects to the process, especially that of nanosafety, must be estimated and optimized to ensure the competitiveness of the future production lines and associated products. The risk management and cost evaluation methods presented herein have been designed for application in a pilot production line of injection-moulded nanocomposites.

  19. Economic evaluation of closure cap barrier materials study

    Energy Technology Data Exchange (ETDEWEB)

    Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

    1993-09-01

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

  20. Economic evaluation of closure cap barrier materials study

    International Nuclear Information System (INIS)

    Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

    1993-09-01

    Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

  1. Cost-benefit and extended cost-effectiveness analysis of a comprehensive adolescent pregnancy prevention program in Zambia: study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Mori, Amani Thomas; Kampata, Linda; Musonda, Patrick; Johansson, Kjell Arne; Robberstad, Bjarne; Sandøy, Ingvild

    2017-12-19

    Early marriages, pregnancies and births are the major cause of school drop-out among adolescent girls in sub-Saharan Africa. Birth complications are also one of the leading causes of death among adolescent girls. This paper outlines a protocol for a cost-benefit analysis (CBA) and an extended cost-effectiveness analysis (ECEA) of a comprehensive adolescent pregnancy prevention program in Zambia. It aims to estimate the expected costs, monetary and non-monetary benefits associated with health-related and non-health outcomes, as well as their distribution across populations with different standards of living. The study will be conducted alongside a cluster-randomized controlled trial, which is testing the hypothesis that economic support with or without community dialogue is an effective strategy for reducing adolescent childbearing rates. The CBA will estimate net benefits by comparing total costs with monetary benefits of health-related and non-health outcomes for each intervention package. The ECEA will estimate the costs of the intervention packages per unit health and non-health gain stratified by the standards of living. Cost data include program implementation costs, healthcare costs (i.e. costs associated with adolescent pregnancy and birth complications such as low birth weight, pre-term birth, eclampsia, medical abortion procedures and post-abortion complications) and costs of education and participation in community and youth club meetings. Monetary benefits are returns to education and averted healthcare costs. For the ECEA, health gains include reduced rate of adolescent childbirths and non-health gains include averted out-of-pocket expenditure and financial risk protection. The economic evaluations will be conducted from program and societal perspectives. While the planned intervention is both comprehensive and expensive, it has the potential to produce substantial short-term and long-term health and non-health benefits. These benefits should be

  2. Validated Feasibility Study of Integrally Stiffened Metallic Fuselage Panels for Reducing Manufacturing Costs

    Science.gov (United States)

    Pettit, R. G.; Wang, J. J.; Toh, C.

    2000-01-01

    The continual need to reduce airframe cost and the emergence of high speed machining and other manufacturing technologies has brought about a renewed interest in large-scale integral structures for aircraft applications. Applications have been inhibited, however, because of the need to demonstrate damage tolerance, and by cost and manufacturing risks associated with the size and complexity of the parts. The Integral Airframe Structures (IAS) Program identified a feasible integrally stiffened fuselage concept and evaluated performance and manufacturing cost compared to conventional designs. An integral skin/stiffener concept was produced both by plate hog-out and near-net extrusion. Alloys evaluated included 7050-T7451 plate, 7050-T74511 extrusion, 6013-T6511 extrusion, and 7475-T7351 plate. Mechanical properties, structural details, and joint performance were evaluated as well as repair, static compression, and two-bay crack residual strength panels. Crack turning behavior was characterized through panel tests and improved methods for predicting crack turning were developed. Manufacturing cost was evaluated using COSTRAN. A hybrid design, made from high-speed machined extruded frames that are mechanically fastened to high-speed machined plate skin/stringer panels, was identified as the most cost-effective manufacturing solution. Recurring labor and material costs of the hybrid design are up to 61 percent less than the current technology baseline.

  3. Early‐Stage Capital Cost Estimation of Biorefinery Processes: A Comparative Study of Heuristic Techniques

    Science.gov (United States)

    Couturier, Jean‐Luc; Kokossis, Antonis; Dubois, Jean‐Luc

    2016-01-01

    Abstract Biorefineries offer a promising alternative to fossil‐based processing industries and have undergone rapid development in recent years. Limited financial resources and stringent company budgets necessitate quick capital estimation of pioneering biorefinery projects at the early stages of their conception to screen process alternatives, decide on project viability, and allocate resources to the most promising cases. Biorefineries are capital‐intensive projects that involve state‐of‐the‐art technologies for which there is no prior experience or sufficient historical data. This work reviews existing rapid cost estimation practices, which can be used by researchers with no previous cost estimating experience. It also comprises a comparative study of six cost methods on three well‐documented biorefinery processes to evaluate their accuracy and precision. The results illustrate discrepancies among the methods because their extrapolation on biorefinery data often violates inherent assumptions. This study recommends the most appropriate rapid cost methods and urges the development of an improved early‐stage capital cost estimation tool suitable for biorefinery processes. PMID:27484398

  4. Cost and resource utilization associated with use of computed tomography to evaluate chest pain in the emergency department: the Rule Out Myocardial Infarction using Computer Assisted Tomography (ROMICAT) study.

    Science.gov (United States)

    Hulten, Edward; Goehler, Alexander; Bittencourt, Marcio Sommer; Bamberg, Fabian; Schlett, Christopher L; Truong, Quynh A; Nichols, John; Nasir, Khurram; Rogers, Ian S; Gazelle, Scott G; Nagurney, John T; Hoffmann, Udo; Blankstein, Ron

    2013-09-01

    Coronary computed tomographic angiography (cCTA) allows rapid, noninvasive exclusion of obstructive coronary artery disease (CAD). However, concern exists whether implementation of cCTA in the assessment of patients presenting to the emergency department with acute chest pain will lead to increased downstream testing and costs compared with alternative strategies. Our aim was to compare observed actual costs of usual care (UC) with projected costs of a strategy including early cCTA in the evaluation of patients with acute chest pain in the Rule Out Myocardial Infarction Using Computer Assisted Tomography I (ROMICAT I) study. We compared cost and hospital length of stay of UC observed among 368 patients enrolled in the ROMICAT I study with projected costs of management based on cCTA. Costs of UC were determined by an electronic cost accounting system. Notably, UC was not influenced by cCTA results because patients and caregivers were blinded to the cCTA results. Costs after early implementation of cCTA were estimated assuming changes in management based on cCTA findings of the presence and severity of CAD. Sensitivity analysis was used to test the influence of key variables on both outcomes and costs. We determined that in comparison with UC, cCTA-guided triage, whereby patients with no CAD are discharged, could reduce total hospital costs by 23% (Pcost increases such that when the prevalence of ≥ 50% stenosis is >28% to 33%, the use of cCTA becomes more costly than UC. cCTA may be a cost-saving tool in acute chest pain populations that have a prevalence of potentially obstructive CAD cost would be anticipated in populations with higher prevalence of disease.

  5. Econometric Analysis of Marketing Costs: A Case Study

    NARCIS (Netherlands)

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

    2009-01-01

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

  6. CHARACTERIZATION AND EVALUATION OF TIME-DRIVEN ACTIVITY BASED COSTING BASED ON ABC’S DEVELOPMENT

    DEFF Research Database (Denmark)

    Israelsen, Poul; Kristensen, Thomas Borup

    2014-01-01

    The paper provides a description of the development of Activity Based Costing (ABC) in four variants. This is used to characterize and evaluated the changes made in Time-Driven ABC (TDABC). It is found that TDABC in some cases reaches back to cost calculations prior to ABC (e.g. homogenous...

  7. Cost-benefit study of school nursing services.

    Science.gov (United States)

    Wang, Li Yan; Vernon-Smiley, Mary; Gapinski, Mary Ann; Desisto, Marie; Maughan, Erin; Sheetz, Anne

    2014-07-01

    In recent years, across the United States, many school districts have cut on-site delivery of health services by eliminating or reducing services provided by qualified school nurses. Providing cost-benefit information will help policy makers and decision makers better understand the value of school nursing services. To conduct a case study of the Massachusetts Essential School Health Services (ESHS) program to demonstrate the cost-benefit of school health services delivered by full-time registered nurses. Standard cost-benefit analysis methods were used to estimate the costs and benefits of the ESHS program compared with a scenario involving no school nursing service. Data from the ESHS program report and other published studies were used. A total of 477 163 students in 933 Massachusetts ESHS schools in 78 school districts received school health services during the 2009-2010 school year. School health services provided by full-time registered nurses. Costs of nurse staffing and medical supplies incurred by 78 ESHS districts during the 2009-2010 school year were measured as program costs. Program benefits were measured as savings in medical procedure costs, teachers' productivity loss costs associated with addressing student health issues, and parents' productivity loss costs associated with student early dismissal and medication administration. Net benefits and benefit-cost ratio were calculated. All costs and benefits were in 2009 US dollars. During the 2009-2010 school year, at a cost of $79.0 million, the ESHS program prevented an estimated $20.0 million in medical care costs, $28.1 million in parents' productivity loss, and $129.1 million in teachers' productivity loss. As a result, the program generated a net benefit of $98.2 million to society. For every dollar invested in the program, society would gain $2.20. Eighty-nine percent of simulation trials resulted in a net benefit. The results of this study demonstrated that school nursing services provided in

  8. Biosimilar medicines and cost-effectiveness

    Directory of Open Access Journals (Sweden)

    Steven Simoens

    2011-02-01

    Full Text Available Steven SimoensResearch Centre for Pharmaceutical Care and Pharmaco-economics, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Leuven, BelgiumAbstract: Given that biosimilars are agents that are similar but not identical to the reference biopharmaceutical, this study aims to introduce and describe specific issues related to the economic evaluation of biosimilars by focusing on the relative costs, relative effectiveness, and cost-effectiveness of biosimilars. Economic evaluation assesses the cost-effectiveness of a medicine by comparing the costs and outcomes of a medicine with those of a relevant comparator. The assessment of cost-effectiveness of a biosimilar is complicated by the fact that evidence needed to obtain marketing authorization from a registration authority does not always correspond to the data requirements of a reimbursement authority. In particular, this relates to the availability of adequately powered equivalence or noninferiority studies, the need for comparative data about the effectiveness in a real-world setting rather than the efficacy in a structured setting, and the use of health outcome measures instead of surrogate endpoints. As a biosimilar is likely to be less expensive than the comparator (eg, the reference biopharmaceutical, the assessment of the cost-effectiveness of a biosimilar depends on the relative effectiveness. If appropriately designed and powered clinical studies demonstrate equivalent effectiveness between a biosimilar and the comparator, then a cost-minimization analysis identifies the least expensive medicine. If there are differences in the effectiveness of a biosimilar and the comparator, other techniques of economic evaluation need to be employed, such as cost-effectiveness analysis or cost-utility analysis. Given that there may be uncertainty surrounding the long-term safety (ie, risk of immunogenicity and rare adverse events and effectiveness of a biosimilar, the cost

  9. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment – a review

    Directory of Open Access Journals (Sweden)

    Hasford Joerg

    2009-03-01

    Full Text Available Abstract Background Blood pressure lowering drugs are usually evaluated in short term trials determining the absolute blood pressure reduction during trough and the duration of the antihypertensive effect after single or multiple dosing. A lack of persistence with treatment has however been shown to be linked to a worse cardiovascular prognosis. This review explores the blood pressure reduction and persistence with treatment of antihypertensive drugs and the cost consequences of poor persistence with pharmaceutical interventions in arterial hypertension. Methods We have searched the literature for data on blood pressure lowering effects of different antihypertensive drug classes and agents, on persistence with treatment, and on related costs. Persistence was measured as patients' medication possession rate. Results are presented in the form of a systematic review. Results Angiotensin II receptor blocker (ARBs have a competitive blood pressure lowering efficacy compared with ACE-inhibitors (ACEi and calcium channel blockers (CCBs, beta-blockers (BBs and diuretics. 8 studies describing the persistence with treatment were identified. Patients were more persistent on ARBs than on ACEi and CCBs, BBs and diuretics. Thus the product of blood pressure lowering and persistence was higher on ARBs than on any other drug class. Although the price per tablet of more recently developed drugs (ACEi, ARBs is higher than that of older ones (diuretics and BBs, the newer drugs result in a more favourable cost to effect ratio when direct drug costs and indirect costs are also considered. Conclusion To evaluate drugs for the treatment of hypertension several key variables including the blood pressure lowering effect, side effects, compliance/persistence with treatment, as well as drug costs and direct and indirect costs of medical care have to be considered. ARBs, while nominally more expensive when drug costs are considered only, provide substantial cost savings

  10. Evaluating the effect of ration composition on income over feed cost and milk yield.

    Science.gov (United States)

    Buza, M H; Holden, L A; White, R A; Ishler, V A

    2014-05-01

    Feed is generally the greatest expense for milk production. With volatility in feed and milk markets, income over feed cost (IOFC) is a more advantageous measure of profit than simply feed cost per cow. The objective of this study was to evaluate the effects of ration cost and ingredient composition on IOFC and milk yield. The Pennsylvania State Extension Dairy Team IOFC tool (http://extension.psu.edu/animals/dairy/business-management/financial-tools/income-over-feed-cost/introduction-to-iofc) was used to collect data from 95 Pennsylvania lactating dairy cow herds from 2009 to 2012 and to determine the IOFC per cow per day. The data collected included average milk yield, milk income, purchased feed cost, ration ingredients, ingredient cost per ton, and amount of each ingredient fed. Feed costs for home-raised feeds for each ration were based on market values rather than on-farm cost. Actual costs were used for purchased feed for each ration. Mean lactating herd size was 170 ± 10.5 and daily milk yield per cow was 31.7 ± 0.19 kg. The mean IOFC was $7.71 ± $1.01 cost per cow, ranging from -$0.33 in March 2009 to $16.60 in September 2011. Data were analyzed using a one-way ANOVA in SPSS (IBM Corp., Armonk, NY). Values were grouped by quartiles and analyzed with all years combined as well as by individual year. Purchased feed cost per cow per day averaged $3.16 ± $1.07 for 2009 to 2012. For 2009 to 2012 combined, milk yield and IOFC did not differ with purchased feed cost. Intermediate levels (quartiles 2 and 3) of forage cost per cow per day between $1.45 and $1.97 per cow per day resulted in the greatest average IOFC of $8.19 and the greatest average milk yield of 32.3 kg. Total feed costs in the fourth quartile ($6.27 or more per cow per day) resulted in the highest IOFC. Thus, minimizing feed cost per cow per day did not maximize IOFC. In 2010, the IOFC was highest at $8.09 for dairies that fed 1 or more commodity by-products. Results of the study indicated

  11. A decision-making framework for total ownership cost management of complex systems: A Delphi study

    Science.gov (United States)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  12. [Bayesian approach for the cost-effectiveness evaluation of healthcare technologies].

    Science.gov (United States)

    Berchialla, Paola; Gregori, Dario; Brunello, Franco; Veltri, Andrea; Petrinco, Michele; Pagano, Eva

    2009-01-01

    The development of Bayesian statistical methods for the assessment of the cost-effectiveness of health care technologies is reviewed. Although many studies adopt a frequentist approach, several authors have advocated the use of Bayesian methods in health economics. Emphasis has been placed on the advantages of the Bayesian approach, which include: (i) the ability to make more intuitive and meaningful inferences; (ii) the ability to tackle complex problems, such as allowing for the inclusion of patients who generate no cost, thanks to the availability of powerful computational algorithms; (iii) the importance of a full use of quantitative and structural prior information to produce realistic inferences. Much literature comparing the cost-effectiveness of two treatments is based on the incremental cost-effectiveness ratio. However, new methods are arising with the purpose of decision making. These methods are based on a net benefits approach. In the present context, the cost-effectiveness acceptability curves have been pointed out to be intrinsically Bayesian in their formulation. They plot the probability of a positive net benefit against the threshold cost of a unit increase in efficacy.A case study is presented in order to illustrate the Bayesian statistics in the cost-effectiveness analysis. Emphasis is placed on the cost-effectiveness acceptability curves. Advantages and disadvantages of the method described in this paper have been compared to frequentist methods and discussed.

  13. Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation.

    Science.gov (United States)

    Cambiano, Valentina; Miners, Alec; Dunn, David; McCormack, Sheena; Ong, Koh Jun; Gill, O Noel; Nardone, Anthony; Desai, Monica; Field, Nigel; Hart, Graham; Delpech, Valerie; Cairns, Gus; Rodger, Alison; Phillips, Andrew N

    2018-01-01

    In the UK, HIV incidence among men who have sex with men (MSM) has remained high for several years, despite widespread use of antiretroviral therapy and high rates of virological suppression. Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in preventing further infections in MSM, but its cost-effectiveness is uncertain. In this modelling study and economic evaluation, we calibrated a dynamic, individual-based stochastic model, the HIV Synthesis Model, to multiple data sources (surveillance data provided by Public Health England and data from a large, nationally representative survey, Natsal-3) on HIV among MSM in the UK. We did a probabilistic sensitivity analysis (sampling 22 key parameters) along with a range of univariate sensitivity analyses to evaluate the introduction of a PrEP programme with sexual event-based use of emtricitabine and tenofovir for MSM who had condomless anal sexual intercourse in the previous 3 months, a negative HIV test at baseline, and a negative HIV test in the preceding year. The main model outcomes were the number of HIV infections, quality-adjusted life-years (QALYs), and costs. Introduction of such a PrEP programme, with around 4000 MSM initiated on PrEP by the end of the first year and almost 40 000 by the end of the 15th year, would result in a total cost saving (£1·0 billion discounted), avert 25% of HIV infections (42% of which would be directly because of PrEP), and lead to a gain of 40 000 discounted QALYs over an 80-year time horizon. This result was particularly sensitive to the time horizon chosen, the cost of antiretroviral drugs (for treatment and PrEP), and the underlying trend in condomless sex. This analysis suggests that the introduction of a PrEP programme for MSM in the UK is cost-effective and possibly cost-saving in the long term. A reduction in the cost of antiretroviral drugs (including the drugs used for PrEP) would substantially shorten the time for cost savings to be realised

  14. Routeing of power lines through least-cost path analysis and multicriteria evaluation to minimise environmental impacts

    International Nuclear Information System (INIS)

    Bagli, Stefano; Geneletti, Davide; Orsi, Francesco

    2011-01-01

    Least-cost path analysis (LCPA) allows designers to find the 'cheapest' way to connect two locations within a cost surface, which can be computed by combining multiple criteria, and therefore by accounting for different issues (environmental impact, economic investment, etc.). This procedure can be easily implemented with modern Geographic Information System (GIS) technologies, and consequently it has been widely employed to support planning and design of different types of linear infrastructures, ranging from roads to pipelines. This paper presents an approach based on the integration of multicriteria evaluation (MCE) and LCPA to identify the most suitable route for a 132 kV power line. Criteria such as cost, visibility, population density, and ecosystem naturalness were used for the analysis. Firstly, spatial MCE and LCPA were combined to generate cost surfaces, and to identify alternative paths. Subsequently, MCE was used to compare the alternatives, and rank them according to their overall suitability. Finally, a sensitivity analysis allowed the stability of the results to be tested and the most critical factors of the evaluation to be detected. The study found that small changes in the location of the power line start and end points can result in significantly different paths, and consequently impact levels. This suggested that planners should always consider alternative potential locations of terminals in order to identify the best path. Furthermore, it was shown that the use of different weight scenarios may help making the model adaptable to varying environmental and social contexts. The approach was tested on a real-world case study in north-eastern Italy.

  15. Cost and quality of life of overlooked eye care needs of children

    Directory of Open Access Journals (Sweden)

    Malvankar-Mehta MS

    2018-02-01

    Full Text Available Monali S Malvankar-Mehta,1,2 Ryan Wilson,3 Erik Leci,3 Kelly Hatch,4 Sapna Sharan1 1Department of Ophthalmology, Ivey Eye Institute, St. Joseph’s Hospital, 2Department of Epidemiology and Biostatistics, 3Schulich School of Medicine and Dentistry, 4Allyn & Betty Taylor Library, Natural Sciences Centre, The University of Western Ontario, London, ON, Canada Background: The objective of this research was to conduct a systematic review and cost analysis to summarize, from the Ministry of Health perspective, the costs families might incur because of their child’s prescription for refractive errors and amblyopia correction.Methods: Databases including MEDLINE, Embase, BIOSIS, CINAHL, HEED, ISI Web of Science, and the Cochrane Library as well as the gray literature were searched. Systematic review was conducted using EPPI-Reviewer 4. Percentage difference in cost of glasses and patches per patient per various diagnoses were computed. The cost of glasses and patches was projected over a 5-year time horizon. Cost-utility analysis was performed.Results: In total, 302 records were retrieved from multiple databases and an additional 48 records were identified through gray literature search. From these, a total of 14 studies (10,388 subjects were eligible for quantitative analysis. The cost of glasses increased significantly for congenital cataract patients to US$1,820, esotropia patients to US$840, myopes to US$411, amblyopes (mixed to US$916, anisometropes to US$521, and patients with strabismus to US$728 over a 5-year period making them unaffordable for low-income families. Incremental cost of glasses of congenital cataract patients with delayed treatment was computed to be US$1,690 per health utility gained. Incremental cost of glasses for high refractive error was US$93 per health utility gained in non-compliant children. For amblyopia patients, incremental cost of glasses per quality-adjusted life years gained was US$3,638.Conclusion: Cost of

  16. Project CHAMP, 1986-1987. OEA Evaluation Report.

    Science.gov (United States)

    Cabrera, Eulalia; And Others

    In its fourth year, Project CHAMP (Chinese Achievement and Mastery Program) provided instruction in English as a second language (ESL), native language arts, mathematics, science, and social studies to 728 limited-English-speaking Chinese immigrant students in grades nine through twelve at three schools. Content-area classes were taught in English…

  17. Costing the lifecycle of networked learning: documenting the costs from conception to evaluation

    Directory of Open Access Journals (Sweden)

    Paul Bacsich

    2000-12-01

    Full Text Available Analysing the costs of new learning technologies within the educational sector is currently a neglected area, yet the issue of how to spend money effectively in this context is a question that must be answered. This question is made especially pertinent with the current expansion of information technology into higher and further education. To know the costeffectiveness of these initiatives, it is first necessary to gain some comprehension of the costs involved. This must be done in a way that is comprehensible to everyone in academia. A recently completed research study undertaken by the authors addressed these problems.

  18. The costs of power outages: A case study from Cyprus

    International Nuclear Information System (INIS)

    Zachariadis, Theodoros; Poullikkas, Andreas

    2012-01-01

    We study the costs of electricity disruptions in Cyprus, which suffered severe power shortages in summer 2011 after an explosion that destroyed 60% of its power generating capacity. We employ both economic and engineering approaches to assess these costs. Among other calculations, we provide estimates of the value of lost load by economic sector and the hourly value of electricity by season and type of day. The results of two economic methods employed to assess welfare losses differ largely, indicating that the assessment of outage costs is associated with many uncertainties. Our calculations show that the emergency actions taken by national energy authorities in response to that accident, though not necessarily optimal, have generally been appropriate and in line with international best practices: the additional costs incurred due to these measures are lower than the economic losses avoided thanks to these actions. Preferential treatment of specific consumer types in the case of repeated power outages remains an open policy question. - Highlights: ► We evaluate the response of energy authorities to a sudden electricity crisis. ► We combine two top-down economic methods and a bottom-up engineering approach. ► We estimate the value of lost electricity by hour, day type and season. ► The response of energy authorities turned out to be effective. ► Costs of emergency actions were lower than the economic losses avoided.

  19. Development and Evaluation of an iPad App for Measuring the Cost of a Nutritious Diet.

    Science.gov (United States)

    Palermo, Claire; Perera-Schulz, Dharani; Kannan, Anitha; Truby, Helen; Shiell, Alan; Emilda, Sindhu; Quenette, Steve

    2014-12-04

    Monitoring food costs informs governments of the affordability of healthy diets. Many countries have adopted a standardized healthy food basket. The Victorian Healthy Food Basket contains 44 food items necessary to meet the nutritional requirements of four different Australian family types for a fortnight. The aim of this study was to describe the development of a new iPad app as core to the implementation of the Victorian Healthy Food Basket. The app significantly automates the data collection. We evaluate if the new technology enhanced the quality and efficacy of the research. Time taken for data collection and entry was recorded. Semi-structured evaluative interviews were conducted with five field workers during the pilot of the iPad app. Field workers were familiar with previous manual data collection methods. Qualitative process evaluation data was summarized against key evaluation questions. Field workers reported that using the iPad for data collection resulted in increased data accuracy, time savings, and efficient data management, and was preferred over manual collection. Portable digital devices may be considered to improve and extend data collection in the field of food cost monitoring.

  20. A systematic review of cost-effectiveness studies of prevention and treatment for eating disorders.

    Science.gov (United States)

    Le, Long Khanh-Dao; Hay, Phillipa; Mihalopoulos, Cathrine

    2018-04-01

    Eating disorders are serious mental disorders and are associated with substantial economic and social burden. The aim of this study is to undertake a systematic review of the cost-effectiveness studies of both preventive and treatment interventions for eating disorder. Electronic databases (including the Cochrane Controlled Trial Register, MEDLINE, PsycINFO, Academic Search Complete, Global Health, CINAHL complete, Health Business Elite, Econlit, Health Policy Reference Center and ERIC) were searched for published cost-effectiveness studies of eating disorder prevention and treatment including papers published up to January 2017. The quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. In all, 13 studies met the review inclusion criteria as full cost-effectiveness studies and 8 were published since 2011. The studies included three modelled and one trial-based study focused on prevention, two trial-based and one modelled study for anorexia nervosa treatment and three trial-based studies for bulimia nervosa treatment. The remaining studies targeted binge-eating disorder or non-specific eating disorder treatment. The average percent of CHEERS checklist items reported was 71% (standard deviation 21%). Eating disorder interventions were mainly cost-saving or more effective and more costly compared to comparators; however, some results did not reach statistical significance. In the two studies that achieved 100% CHEERS checklist, one study reported that a cognitive dissonance intervention might be cost-effective for prevention of anorexia nervosa and bulimia nervosa with a 90% participation rate and the second study supported lisdexamfetamine to be cost-effective in the treatment of binge-eating disorder. Insufficient evidence for long-term cost-effectiveness (e.g. over 2 years) was found. Cost-effectiveness studies in eating disorder appear to be increasing in number over the last 6 years. Findings

  1. Assessing the effectiveness and cost-effectiveness of audit and feedback on physician’s prescribing indicators: study protocol of a randomized controlled trial with economic evaluation

    Science.gov (United States)

    2012-01-01

    Background Physician prescribing is the most frequent medical intervention with a highest impact on healthcare costs and outcomes. Therefore improving and promoting rational drug use is a great interest. We aimed to assess the effectiveness and cost-effectiveness of two forms of conducting prescribing audit and feedback interventions and a printed educational material intervention in improving physician prescribing. Method/design A four-arm randomized trial with economic evaluation will be conducted in Tehran. Three interventions (routine feedback, revised feedback, and printed educational material) and a no intervention control arm will be compared. Physicians working in outpatient practices are randomly allocated to one of the four arms using stratified randomized sampling. The interventions are developed based on a review of literature, physician interviews, current experiences in Iran and with theoretical insights from the Theory of Planned Behavior. Effects of the interventions on improving antibiotics and corticosteroids prescribing will be assessed in regression analyses. Cost data will be assessed from a health care provider’s perspective and incremental cost-effectiveness ratios will be calculated. Discussion This study will determine the effectiveness and cost-effectiveness of three interventions and allow us to determine the most effective interventions in improving prescribing pattern. If the interventions are cost-effective, they will likely be applied nationwide. Trial registration Iranian Registry of Clinical Trials Registration Number: IRCT201106086740N1Pharmaceutical Sciences Research Center of TUMS Ethics Committee Registration Number: 90-02-27-07 PMID:23351564

  2. Commerical electric power cost studies. Capital cost addendum multi-unit coal and nuclear stations

    International Nuclear Information System (INIS)

    1977-09-01

    This report is the culmination of a study performed to develop designs and associated capital cost estimates for multi-unit nuclear and coal commercial electric power stations, and to determine the distribution of these costs among the individual units. This report addresses six different types of 2400 MWe (nominal) multi-unit stations as follows: Two Unit PWR Station-1139 MWe Each, Two Unit BWR Station-1190 MWe Each, Two Unit High Sulfur Coal-Fired Station-1232 MWe Each, Two Unit Low Sulfur Coal-Fired Station-1243 MWe Each, Three Unit High Sulfur Coal-Fired Station-794 MWe Each, Three Unit Low Sulfur Coal-Fired Station-801 MWe Each. Recent capital cost studies performed for ERDA/NRC of single unit nuclear and coal stations are used as the basis for developing the designs and costs of the multi-unit stations. This report includes the major study groundrules, a summary of single and multi-unit stations total base cost estimates, details of cost estimates at the three digit account level and plot plan drawings for each multi-unit station identified

  3. Economic evaluation of the breast cancer screening programme in the Basque Country: retrospective cost-effectiveness and budget impact analysis.

    Science.gov (United States)

    Arrospide, Arantzazu; Rue, Montserrat; van Ravesteyn, Nicolien T; Comas, Merce; Soto-Gordoa, Myriam; Sarriugarte, Garbiñe; Mar, Javier

    2016-06-01

    Breast cancer screening in the Basque Country has shown 20 % reduction of the number of BC deaths and an acceptable overdiagnosis level (4 % of screen detected BC). The aim of this study was to evaluate the breast cancer early detection programme in the Basque Country in terms of retrospective cost-effectiveness and budget impact from 1996 to 2011. A discrete event simulation model was built to reproduce the natural history of breast cancer (BC). We estimated for lifetime follow-up the total cost of BC (screening, diagnosis and treatment), as well as quality-adjusted life years (QALY), for women invited to participate in the evaluated programme during the 15-year period in the actual screening scenario and in a hypothetical unscreened scenario. An incremental cost-effectiveness ratio was calculated with the use of aggregated costs. Besides, annual costs were considered for budget impact analysis. Both population level and single-cohort analysis were performed. A probabilistic sensitivity analysis was applied to assess the impact of parameters uncertainty. The actual screening programme involved a cost of 1,127 million euros and provided 6.7 million QALYs over the lifetime of the target population, resulting in a gain of 8,666 QALYs for an additional cost of 36.4 million euros, compared with the unscreened scenario. Thus, the incremental cost-effectiveness ratio was 4,214€/QALY. All the model runs in the probabilistic sensitivity analysis resulted in an incremental cost-effectiveness ratio lower than 10,000€/QALY. The screening programme involved an increase of the annual budget of the Basque Health Service by 5.2 million euros from year 2000 onwards. The BC screening programme in the Basque Country proved to be cost-effective during the evaluated period and determined an affordable budget impact. These results confirm the epidemiological benefits related to the centralised screening system and support the continuation of the programme.

  4. Time and travel costs incurred by women attending antenatal tests: A costing study.

    Science.gov (United States)

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

    2016-09-01

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

  5. Evaluation of Cost and Effectiveness of Decontamination Scenarios on External Radiation Exposure in Fukushima

    Energy Technology Data Exchange (ETDEWEB)

    Yasutaka, T.; Naito, W. [National Institute of Advanced Industrial Science and Technology (Japan)

    2014-07-01

    Despite the enormous cost associated with radiation decontamination, almost no quantitative assessment has been performed on the relationship between the potential reduction in long-term radiation exposure and the costs of the various decontamination strategies considered for the decontamination areas in Fukushima. In order to establish effective and pragmatic decontamination strategies for use in the radiation contaminated areas in Fukushima, a holistic approach for assessing decontamination strategies, their costs, and long-term external radiation doses is needed. The objective of the present study is to evaluate the cost and effectiveness of decontamination scenarios in the decontamination areas in Fukushima in regard to external radiation exposure. The choice of decontamination strategies in the decontamination areas should be based on a comprehensive analysis of multiple attributes such as radiological, economic, and socio-psychological attributes. The cost and effectiveness of the different decontamination strategies is not sole determinant of the decontamination strategies of the special decontamination area but is one of the most important attributes when making the policy decision. In the current study, we focus on radiological and economic attributes in determining decontamination strategies. A geographical information system (GIS) was used to relate the predicted external dose in the affected areas to the number of potential inhabitants and the land use in the areas. A comprehensive review of the costs of various decontamination methods was conducted as part of the analysis. The results indicate that aerial decontamination in the special decontamination areas in Fukushima would be effective for reducing the air dose rate to the target level in a short period of time in some but not all of the areas. In a standard scenario, the analysis of cost suggests that decontamination costs of decontamination in Fukushima was estimated to be up to approximately 5

  6. Economic evaluation, human immunodeficiency virus infection and screening: a review and critical appraisal of economic studies.

    Science.gov (United States)

    Dibosa-Osadolor, Onome; Roberts, Tracy

    2010-07-01

    The aim of this study was to review, systematically and critically, evidence used to derive estimates of cost-effectiveness of human immunodeficiency virus (HIV) screening. A systematic review was conducted. Searched were three main electronic bibliographic databases from 1993 to 2008 using key words including HIV, mass screening, HAART, economic evaluation, cost-effectiveness analysis, modeling. We included studies of sexually transmitted HIV infection in both sexes, including studies comparing diagnostic testing protocols and partner notification. Outcomes included were cases of HIV infection detected, deterioration to the AIDS state, secondary transmission of HIV, the quality-adjusted life-years/survival, costs, and cost-effectiveness of HIV screening. Eighty-four papers were identified; ten of which were formal economic evaluations, one cost study, three effectiveness studies, and three systematic reviews of HIV prevention programs. The predominant assertion was that HIV screening is cost-effective; methodological problems, such as the preponderance of static models which are inappropriate for infectious diseases, varying perspectives from which the studies were analyzed, and arbitrary threshold incremental cost-effectiveness ratio levels, limited the validity of these findings, and their usefulness in informing health policy decisions. The majority of published economic evaluations are based on inappropriate static models. This flaw renders the results of these studies as inconclusive and the purported cost-effectiveness of HIV screening debatable. The results of this review could form a basis for consideration of further research and analysis by health economists into the cost-effectiveness of HIV screening.

  7. Study protocol: Cost-effectiveness of transmural nutritional support in malnourished elderly patients in comparison with usual care

    Directory of Open Access Journals (Sweden)

    van Bokhorst-de van der Schueren Marian AE

    2010-02-01

    Full Text Available Abstract Background Malnutrition is a common consequence of disease in older patients. Both in hospital setting and in community setting oral nutritional support has proven to be effective. However, cost-effectiveness studies are scarce. Therefore, the aim of our study is to investigate the effectiveness and cost-effectiveness of transmural nutritional support in malnourished elderly patients, starting at hospital admission until three months after discharge. Methods This study is a randomized controlled trial. Patients are included at hospital admission and followed until three months after discharge. Patients are eligible to be included when they are ≥ 60 years old and malnourished according to the following objective standards: Body Mass Index (BMI in kg/m2 Conclusion In this randomized controlled trial we will evaluate the effect of transmural nutritional support in malnourished elderly patients after hospital discharge, compared to usual care. Primary endpoints of the study are changes in activities of daily living, body weight, body composition, quality of life, and muscle strength. An economic evaluation will be performed to evaluate the cost-effectiveness of the intervention in comparison with usual care. Trial registration Netherlands Trial Register (ISRCTN29617677, registered 14-Sep-2005

  8. The costs and cost-effectiveness of a school-based comprehensive intervention study on childhood obesity in China.

    Directory of Open Access Journals (Sweden)

    Liping Meng

    Full Text Available The dramatic rise of overweight and obesity among Chinese children has greatly affected the social economic development. However, no information on the cost-effectiveness of interventions in China is available. The objective of this study is to evaluate the cost and the cost-effectiveness of a comprehensive intervention program for childhood obesity. We hypothesized the integrated intervention which combined nutrition education and physical activity (PA is more cost-effective than the same intensity of single intervention.And Findings: A multi-center randomized controlled trial conducted in six large cities during 2009-2010. A total of 8301 primary school students were categorized into five groups and followed one academic year. Nutrition intervention, PA intervention and their shared common control group were located in Beijing. The combined intervention and its' control group were located in other 5 cities. In nutrition education group, 'nutrition and health classes' were given 6 times for the students, 2 times for the parents and 4 times for the teachers and health workers. "Happy 10" was carried out twice per day in PA group. The comprehensive intervention was a combination of nutrition and PA interventions. BMI and BAZ increment was 0.65 kg/m(2 (SE 0.09 and 0.01 (SE 0.11 in the combined intervention, respectively, significantly lower than that in its' control group (0.82 ± 0.09 for BMI, 0.10 ± 0.11 for BAZ. No significant difference were found neither in BMI nor in BAZ change between the PA intervention and its' control, which is the same case in the nutrition intervention. The single intervention has a relative lower intervention costs compared with the combined intervention. Labor costs in Guangzhou, Shanghai and Jinan was higher compared to other cities. The cost-effectiveness ratio was $120.3 for BMI and $249.3 for BAZ in combined intervention, respectively.The school-based integrated obesity intervention program was cost

  9. Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: Results of an economic evaluation alongside a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Oostdam Nicolette

    2012-07-01

    Full Text Available Abstract Background The prevalence of gestational diabetes mellitus (GDM is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is cost-effective from a societal perspective as compared to standard care. Methods A randomised controlled trial (RCT and simultaneous economic evaluation of the FitFor2 program were conducted. Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62 or to standard care (n = 59. The exercise program consisted of two sessions of aerobic and strengthening exercises per week. Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight. Quality of life was measured using the EuroQol 5-D and quality-adjusted life-years (QALYs were calculated. Resource utilization and sick leave data were collected by questionnaires. Data were analysed according to the intention-to-treat principle. Missing data were imputed using multiple imputations. Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost-effectiveness ratios. Results There were no statistically significant differences in any outcome measure. During pregnancy, total health care costs and costs of productivity losses were statistically non-significant (mean difference €1308; 95%CI €-229 - €3204. The cost-effectiveness analyses showed that the exercise program was not cost-effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs. Conclusion The twice-weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost-effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of

  10. Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: results of an economic evaluation alongside a randomised controlled trial.

    Science.gov (United States)

    Oostdam, Nicolette; Bosmans, Judith; Wouters, Maurice G A J; Eekhoff, Elisabeth M W; van Mechelen, Willem; van Poppel, Mireille N M

    2012-07-04

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM and the risks associated with GDM lead to increased health care costs and losses in productivity. The objective of this study is to evaluate whether the FitFor2 exercise program during pregnancy is cost-effective from a societal perspective as compared to standard care. A randomised controlled trial (RCT) and simultaneous economic evaluation of the FitFor2 program were conducted. Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62) or to standard care (n = 59). The exercise program consisted of two sessions of aerobic and strengthening exercises per week. Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight. Quality of life was measured using the EuroQol 5-D and quality-adjusted life-years (QALYs) were calculated. Resource utilization and sick leave data were collected by questionnaires. Data were analysed according to the intention-to-treat principle. Missing data were imputed using multiple imputations. Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost-effectiveness ratios. There were no statistically significant differences in any outcome measure. During pregnancy, total health care costs and costs of productivity losses were statistically non-significant (mean difference €1308; 95%CI €-229 - €3204). The cost-effectiveness analyses showed that the exercise program was not cost-effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs. The twice-weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost-effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of GDM cannot be recommended. NTR1139.

  11. [Cost-Effectiveness and Cost-Utility Analyses of Antireflux Medicine].

    Science.gov (United States)

    Gockel, Ines; Lange, Undine Gabriele; Schürmann, Olaf; Jansen-Winkeln, Boris; Sibbel, Rainer; Lyros, Orestis; von Dercks, Nikolaus

    2018-04-12

    Laparoscopic antireflux surgery and medical therapy with proton pump inhibitors are gold standards of gastroesophageal reflux treatment. On account of limited resources and increasing healthcare needs and costs, in this analysis, not only optimal medical results, but also superiority in health economics of these 2 methods are evaluated. We performed an electronic literature survey in MEDLINE, PubMed, Cochrane Library, ISRCTN (International Standard Randomization Controlled Trial Number) as well as in the NHS Economic Evaluation Database, including studies published until 1/2017. Only studies considering the effect size of QALY (Quality-Adjusted Life Years) (with respect to different quality of life-scores) as primary outcome comparing laparoscopic fundoplication and medical therapy were included. Criteria of comparison were ICER (Incremental Cost-Effectiveness Ratio) and ICUR (Incremental Cost-Utility Ratio). Superiority of the respective treatment option for each publication was worked out. In total, 18 comparative studies were identified in the current literature with respect to above-mentioned search terms, qualifying for the defined inclusion criteria. Six studies were finally selected for analyses. Out of 6 publications, 3 showed superiority of laparoscopic fundoplication over long-term medical management based on current cost-effectiveness data. Limitations were related to different time intervals, levels of evidence of studies and underlying resources/costs of analyses, healthcare systems and applied quality of life instruments. Future prospective, randomized trials should examine this comparison in greater detail. Additionally, there is a large potential for further research in the health economics assessment of early diagnosis and prevention measures of reflux disease and Barrett's esophagus/carcinoma. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Reducing Operating Room Costs Through Real-Time Cost Information Feedback: A Pilot Study.

    Science.gov (United States)

    Tabib, Christian H; Bahler, Clinton D; Hardacker, Thomas J; Ball, Kevin M; Sundaram, Chandru P

    2015-08-01

    To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor nephrectomy. Before the beginning of this project, costs pertaining to the 20 most recent cases were analyzed. Items were identified from previous cases as modifiable for replacement or omission. Timely feedback of total OR costs and cost of each item used was provided to the surgeon after each case, and costs were analyzed. A cost analysis of the robot-assisted partial nephrectomy before the washout period indicates expenditures of $5243.04 per case. Ten recommended modifiable items were found to have an average per case cost of $1229.33 representing 23.4% of the total cost. A postwashout period cost analysis found the total OR cost decreased by $899.67 (17.2%) because of changes directly related to the modifiable items. Therefore, 73.2% of the possible identified savings was realized. The same stepwise approach was applied to laparoscopic donor nephrectomies. The average total cost per case before the washout period was $3530.05 with $457.54 attributed to modifiable items. After the washout period, modifiable items costs were reduced by $289.73 (8.0%). No complications occurred in the donor nephrectomy cases while one postoperative complication occurred in the partial nephrectomy group. Providing surgeons with feedback related to OR costs may lead to a change in surgeon behavior and decreased overall costs. Further studies are needed to show equivalence in patient outcomes.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-01-01

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

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  15. A review of costing methodologies in critical care studies.

    Science.gov (United States)

    Pines, Jesse M; Fager, Samuel S; Milzman, David P

    2002-09-01

    Clinical decision making in critical care has traditionally been based on clinical outcome measures such as mortality and morbidity. Over the past few decades, however, increasing competition in the health care marketplace has made it necessary to consider costs when making clinical and managerial decisions in critical care. Sophisticated costing methodologies have been developed to aid this decision-making process. We performed a narrative review of published costing studies in critical care during the past 6 years. A total of 282 articles were found, of which 68 met our search criteria. They involved a mean of 508 patients (range, 20-13,907). A total of 92.6% of the studies (63 of 68) used traditional cost analysis, whereas the remaining 7.4% (5 of 68) used cost-effectiveness analysis. None (0 of 68) used cost-benefit analysis or cost-utility analysis. A total of 36.7% (25 of 68) used hospital charges as a surrogate for actual costs. Of the 43 articles that actually counted costs, 37.2% (16 of 43) counted physician costs, 27.9% (12 of 43) counted facility costs, 34.9% (15 of 43) counted nursing costs, 9.3% (4 of 43) counted societal costs, and 90.7% (39 of 43) counted laboratory, equipment, and pharmacy costs. Our conclusion is that despite considerable progress in costing methodologies, critical care studies have not adequately implemented these techniques. Given the importance of financial implications in medicine, it would be prudent for critical care studies to use these more advanced techniques. Copyright 2002, Elsevier Science (USA). All rights reserved.

  16. Reliability and cost evaluation of small isolated power systems containing photovoltaic and wind energy

    Science.gov (United States)

    Karki, Rajesh

    Renewable energy application in electric power systems is growing rapidly worldwide due to enhanced public concerns for adverse environmental impacts and escalation in energy costs associated with the use of conventional energy sources. Photovoltaics and wind energy sources are being increasingly recognized as cost effective generation sources. A comprehensive evaluation of reliability and cost is required to analyze the actual benefits of utilizing these energy sources. The reliability aspects of utilizing renewable energy sources have largely been ignored in the past due the relatively insignificant contribution of these sources in major power systems, and consequently due to the lack of appropriate techniques. Renewable energy sources have the potential to play a significant role in the electrical energy requirements of small isolated power systems which are primarily supplied by costly diesel fuel. A relatively high renewable energy penetration can significantly reduce the system fuel costs but can also have considerable impact on the system reliability. Small isolated systems routinely plan their generating facilities using deterministic adequacy methods that cannot incorporate the highly erratic behavior of renewable energy sources. The utilization of a single probabilistic risk index has not been generally accepted in small isolated system evaluation despite its utilization in most large power utilities. Deterministic and probabilistic techniques are combined in this thesis using a system well-being approach to provide useful adequacy indices for small isolated systems that include renewable energy. This thesis presents an evaluation model for small isolated systems containing renewable energy sources by integrating simulation models that generate appropriate atmospheric data, evaluate chronological renewable power outputs and combine total available energy and load to provide useful system indices. A software tool SIPSREL+ has been developed which generates

  17. Regulatory cost-risk study

    International Nuclear Information System (INIS)

    1983-04-01

    This study is intended to provide some quantitative perspective by selecting certain examples of criteria for which estimates of risks and costs can be obtained, and the balance of the various risks, (i.e., internal versus external risks), can be put into perspective. 35 refs., 39 tabs

  18. A systematic review of cost-effectiveness studies comparing conventional, biological and surgical interventions for inflammatory bowel disease.

    Science.gov (United States)

    Pillai, Nadia; Dusheiko, Mark; Burnand, Bernard; Pittet, Valérie

    2017-01-01

    Inflammatory bowel disease (IBD) is a chronic disease placing a large health and economic burden on health systems worldwide. The treatment landscape is complex with multiple strategies to induce and maintain remission while avoiding long-term complications. The extent to which rising treatment costs, due to expensive biologic agents, are offset by improved outcomes and fewer hospitalisations and surgeries needs to be evaluated. This systematic review aimed to assess the cost-effectiveness of treatment strategies for IBD. A systematic literature search was performed in March 2017 to identify economic evaluations of pharmacological and surgical interventions, for adults diagnosed with Crohn's disease (CD) or ulcerative colitis (UC). Costs and incremental cost-effectiveness ratios (ICERs) were adjusted to reflect 2015 purchasing power parity (PPP). Risk of bias assessments and a narrative synthesis of individual study findings are presented. Forty-nine articles were included; 24 on CD and 25 on UC. Infliximab and adalimumab induction and maintenance treatments were cost-effective compared to standard care in patients with moderate or severe CD; however, in patients with conventional-drug refractory CD, fistulising CD and for maintenance of surgically-induced remission ICERs were above acceptable cost-effectiveness thresholds. In mild UC, induction of remission using high dose mesalazine was dominant compared to standard dose. In UC refractory to conventional treatments, infliximab and adalimumab induction and maintenance treatment were not cost-effective compared to standard care; however, ICERs for treatment with vedolizumab and surgery were favourable. We found that, in general, while biologic agents helped improve outcomes, they incurred high costs and therefore were not cost-effective, particularly for use as maintenance therapy. The cost-effectiveness of biologic agents may improve as market prices fall and with the introduction of biosimilars. Future research

  19. Evaluation of the external costs of energy production in the Helsinki metropolitan area

    International Nuclear Information System (INIS)

    Otterstroem, T.

    1995-01-01

    The aim of the research is to evaluate the external costs of energy production at Helsinki metropolitan area (Helsinki, Espoo, Vantaa). The previously developed valorization method for effects on population centres is adjusted. All the main health, material and environmental effects will be taken into account in the research. The effects of emissions of the energy production of the Helsinki metropolitan area on concentrations of the impurities in the air and through them on human and environment will be evaluated. The estimates will be based on the relativistic fuels consumption and the emission data of Helsinki metropolitan area. Life-cycle reasoning will be applied so that the emissions of the main components of the fuels used in the metropolitan area will be included in the estimation. The cost-effectiveness of the investments will be estimated by comparing the environmental investments of energy boards with the external costs. The methods of this work can be applied to estimation of the profitability of energy production plants from the point of view of national economy also elsewhere in the country

  20. Evaluating Drug Cost per Response with SGLT2 Inhibitors in Patients with Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Lopez, Janice M S; Macomson, Brian; Ektare, Varun; Patel, Dipen; Botteman, Marc

    2015-09-01

    The sodium-glucose cotransporter 2 (SGLT2) inhibitors, which include canagliflozin, dapagliflozin, and empagliflozin, represent a new class of antihyperglycemic agents. Few studies have assessed their cost per response, with "cost per response" being the total cost of a select drug, divided by the resulting change in glycated hemoglobin (HbA1c) levels. To examine the drug cost of SGLT2 inhibitors per a reduction in placebo-adjusted 1% HbA1c in patients with type 2 diabetes mellitus who received treatment during 26 weeks with canagliflozin, dapagliflozin, or empagliflozin. The drug cost per response for each of the 3 agents individually was assessed based on data from a subset of clinical trials discussed in the prescribing information for each drug that were all placebo-controlled studies evaluating each drug as monotherapy, dual therapy (combined with metformin), and triple therapy (combined with metformin and a sulfonylurea) in patients with uncontrolled, type 2 diabetes mellitus. The US 2015 wholesale acquisition cost for each drug was used to calculate each drug's treatment costs over 26 weeks. The average cost per response for each drug was defined as the prescription drug cost of each SGLT2 inhibitor, divided by the average, placebo-adjusted HbA1c reduction at 26 weeks. The drug cost per unit dose was the same for canagliflozin (100 mg or 300 mg), dapagliflozin (5 mg or 10 mg), and empagliflozin (10 mg or 25 mg), at $11.43. The drug cost per placebo-adjusted 1% HbA1c reduction varied by agent and by dose, as a result of the differences in the treatment responses for each of the 3 drugs. The costs per response for canagliflozin 100 mg as monotherapy, dual therapy, and triple therapy regimens ranged from $2286 to $3355, and for canagliflozin 300 mg, from $1793 to $2702. The costs per response for dapagliflozin 5 mg as monotherapy and dual therapy (triple therapy was not available at the time of the study) ranged from $4161 to $5201; the cost for dapagliflozin

  1. Modeling the cost-benefit of nerve conduction studies in pre-employment screening for carpal tunnel syndrome.

    Science.gov (United States)

    Evanoff, Bradley; Kymes, Steve

    2010-06-01

    The aim of this study was to evaluate the costs associated with pre-employment nerve conduction testing as a screening tool for carpal tunnel syndrome (CTS) in the workplace. We used a Markov decision analysis model to compare the costs associated with a strategy of screening all prospective employees for CTS and not hiring those with abnormal nerve conduction, versus a strategy of not screening for CTS. The variables included in our model included employee turnover rate, the incidence of CTS, the prevalence of median nerve conduction abnormalities, the relative risk of developing CTS conferred by abnormal nerve conduction screening, the costs of pre-employment screening, and the worker's compensation costs to the employer for each case of CTS. In our base case, total employer costs for CTS from the perspective of the employer (cost of screening plus costs for workers' compensation associated with CTS) were higher when screening was used. Median costs per employee position over five years were US$503 for the screening strategy versus US$200 for a no-screening strategy. A sensitivity analysis showed that a strategy of screening was cost-beneficial from the perspective of the employer only under a few circumstances. Using Monte Carlo simulation varying all parameters, we found a 30% probability that screening would be cost-beneficial. A strategy of pre-employment screening for CTS should be carefully evaluated for yield and social consequences before being implemented. Our model suggests such screening is not appropriate for most employers.

  2. Concise method for evaluating the probability distribution of the marginal cost of power generation

    International Nuclear Information System (INIS)

    Zhang, S.H.; Li, Y.Z.

    2000-01-01

    In the developing electricity market, many questions on electricity pricing and the risk modelling of forward contracts require the evaluation of the expected value and probability distribution of the short-run marginal cost of power generation at any given time. A concise forecasting method is provided, which is consistent with the definitions of marginal costs and the techniques of probabilistic production costing. The method embodies clear physical concepts, so that it can be easily understood theoretically and computationally realised. A numerical example has been used to test the proposed method. (author)

  3. Cost estimating for CERCLA remedial alternatives a unit cost methodology

    International Nuclear Information System (INIS)

    Brettin, R.W.; Carr, D.J.; Janke, R.J.

    1995-06-01

    The United States Environmental Protection Agency (EPA) Guidance for Conducting Remedial Investigations and Feasibility Studies Under CERCLA, Interim Final, dated October 1988 (EPA 1988) requires a detailed analysis be conducted of the most promising remedial alternatives against several evaluation criteria, including cost. To complete the detailed analysis, order-of-magnitude cost estimates (having an accuracy of +50 percent to -30 percent) must be developed for each remedial alternative. This paper presents a methodology for developing cost estimates of remedial alternatives comprised of various technology and process options with a wide range of estimated contaminated media quantities. In addition, the cost estimating methodology provides flexibility for incorporating revisions to remedial alternatives and achieves the desired range of accuracy. It is important to note that the cost estimating methodology presented here was developed as a concurrent path to the development of contaminated media quantity estimates. This methodology can be initiated before contaminated media quantities are estimated. As a result, this methodology is useful in developing cost estimates for use in screening and evaluating remedial technologies and process options. However, remedial alternative cost estimates cannot be prepared without the contaminated media quantity estimates. In the conduct of the feasibility study for Operable Unit 5 at the Fernald Environmental Management Project (FEMP), fourteen remedial alternatives were retained for detailed analysis. Each remedial alternative was composed of combinations of remedial technologies and processes which were earlier determined to be best suited for addressing the media-specific contaminants found at the FEMP site, and achieving desired remedial action objectives

  4. Regulatory cost-risk study

    Energy Technology Data Exchange (ETDEWEB)

    1983-04-01

    This study is intended to provide some quantitative perspective by selecting certain examples of criteria for which estimates of risks and costs can be obtained, and the balance of the various risks, (i.e., internal versus external risks), can be put into perspective. 35 refs., 39 tabs. (JDB)

  5. The Cost of Joint Replacement: Comparing Two Approaches to Evaluating Costs of Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Palsis, John A; Brehmer, Thomas S; Pellegrini, Vincent D; Drew, Jacob M; Sachs, Barton L

    2018-02-21

    In an era of mandatory bundled payments for total joint replacement, accurate analysis of the cost of procedures is essential for orthopaedic surgeons and their institutions to maintain viable practices. The purpose of this study was to compare traditional accounting and time-driven activity-based costing (TDABC) methods for estimating the total costs of total hip and knee arthroplasty care cycles. We calculated the overall costs of elective primary total hip and total knee replacement care cycles at our academic medical center using traditional and TDABC accounting methods. We compared the methods with respect to the overall costs of hip and knee replacement and the costs for each major cost category. The traditional accounting method resulted in higher cost estimates. The total cost per hip replacement was $22,076 (2014 USD) using traditional accounting and was $12,957 using TDABC. The total cost per knee replacement was $29,488 using traditional accounting and was $16,981 using TDABC. With respect to cost categories, estimates using traditional accounting were greater for hip and knee replacement, respectively, by $3,432 and $5,486 for personnel, by $3,398 and $3,664 for space and equipment, and by $2,289 and $3,357 for indirect costs. Implants and consumables were derived from the actual hospital purchase price; accordingly, both methods produced equivalent results. Substantial cost differences exist between accounting methods. The focus of TDABC only on resources used directly by the patient contrasts with the allocation of all operating costs, including all indirect costs and unused capacity, with traditional accounting. We expect that the true costs of hip and knee replacement care cycles are likely somewhere between estimates derived from traditional accounting methods and TDABC. TDABC offers patient-level granular cost information that better serves in the redesign of care pathways and may lead to more strategic resource-allocation decisions to optimize

  6. An Analysis of the IOM Cost Study

    Science.gov (United States)

    Schwartz, Michael A.

    1976-01-01

    During the 1972-73 academic year, the National Institute of Medicine (IOM) undertook a study of the cost of education of those health professionals supported through federal capitation grants. The methodology of the study is described and the patterns of costs of pharmacy education are compared with those in another profession. (LBH)

  7. A cost comparison study of open pit mining vs. in situ assisted gravity drainage

    International Nuclear Information System (INIS)

    McIntosh, J.; Luhning, R.W.

    1991-01-01

    The twin-well steam assisted gravity drainage (SAGD) process has resulted in breakthrough technology to access previously uneconomical deep-seated oil sands reserves in Alberta, and to provide a very cost-effective and environmentally acceptable method for extracting bitumen from reserves having a minimum of 30 m overburden. In the evaluation of new or improved bitumen recovery technologies for its new North Mine, Syncrude Canada has recognized that SAGD was a potential alternate to the current open pit mining and hot water extraction process. A study was conducted to compare and evaluate bitumen recovery by the two schemes at the North Mine site, scheduled to begin operations in 1996, for the reserves under Syncrude's tailings pond, and at a new grassroots area. Study description and analysis of results are presented for the grassroots case. The assumptions and mining/recovery processes used for the mining or SAGD method are detailed and the advantages and drawbacks of each scheme are noted. Results show that the SAGD unit supply costs are projected to be proportionately lower than the corresponding open pit mining/hot water extraction (OP/X) cost, using a 20-y project life. A sensitivity analysis indicates that the SAGD process is more sensitive to natural gas costs, while the OP/X scheme is more sensitive to power costs. The SAGD process is much less labor-intensive than OP/X and has obvious advantages in terms of tailings disposal and post-mining reclamation. In addition, the underground nature of SAGD operation eliminates adverse effects of the weather on working conditions. 11 figs

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  9. UNEP greenhouse gas abatement costing studies

    International Nuclear Information System (INIS)

    Morthorst, P.E.; Grohnheit, P.E.

    1992-04-01

    The project initiated by the United Nations Environment Programme aims to clarify some economic issues involved in greenhouse gas limitation by carrying out comparative studies of various nations. The programme should contribute to the establishment of a consistent methodological framework for making cost assessments of greenhouse gas abatement and help to support countries in the process of establishing national and international agreements on actions to combat climate change. The publication gives a survey of Danish energy demand and supply, emissions and current energy policy issues and reviews existing studies of carbon dioxide reductions. This includes the overall national environmental policy and the plan of action for the transport sector. Conclusions are that there seems to be a long-term potential for significant reduction of CO 2 emission by 10-15% by 2010 with no additional costs, a 50% reduction will cost DKK 25-50 per kg reduced CO 2 . The most promising options include increased use of cogeneration of heat and electricity, and electricity conservation in households, services and in industry. Economic growth is forecast as ca. 2.7% and energy prices for oil products should increase by ca. 4.8%. A 40% reduction of CO 2 emission in the year 2005 would increase costs by 1-2%, and a reduction of two thirds of present emission should be possible at no additional cost compared to the reference cases. There is general agreement that a reduction of carbon dioxide emission of 15-30% by 2005-10 should involve no additional costs to society. (AB) (11 refs.)

  10. Economic costs of social phobia: a population-based study.

    Science.gov (United States)

    Acarturk, C; Smit, Filip; de Graaf, R; van Straten, A; Ten Have, M; Cuijpers, P

    2009-06-01

    Information about the economic costs of social phobia is scant. In this study, we examine the economic costs of social phobia and subthreshold social phobia. Data were derived from the Netherlands Mental Health Survey and Incidence Study (NEMESIS) which is a population-based prospective study (n=4,789). Costs related to health service uptake, patients' out-of-pocket expenses, and costs arising from production losses were calculated for the reference year 2003. The costs for people with social phobia were compared with the costs for people with no mental disorder. The annual per capita total costs of social phobia were euro 11,952 (95% CI=7,891-16,013) which is significantly higher than the total costs for people with no mental disorder, euro 2957 (95% CI=2690-3224). When adjusting for mental and somatic co-morbidity, the costs decreased to euro 6,100 (95% CI=2681-9519), or 136 million euro per year per 1 million inhabitants, which was still significantly higher than the costs for people with no mental disorder. The costs of subthreshold social phobia were also significantly higher than the costs for people without any mental disorder, at euro 4,687 (95% CI=2557-6816). The costs presented here are conservative lower estimates because we only included costs related to mental health services. The economic costs associated with social phobia are substantial, and those of subthreshold social phobia approach those of the full-blown disorder.

  11. Cost study of dermal substitutes and topical negative pressure in the surgical treatment of burns.

    Science.gov (United States)

    Hop, M Jenda; Bloemen, Monica C T; van Baar, Margriet E; Nieuwenhuis, Marianne K; van Zuijlen, Paul P M; Polinder, Suzanne; Middelkoop, Esther

    2014-05-01

    A recently performed randomised controlled trial investigated the clinical effectiveness of dermal substitutes (DS) and split skin grafts (SSG) in combination with topical negative pressure (TNP) in the surgical treatment of burn wounds. In the current study, medical and non-medical costs were investigated, to comprehensively assess the benefits of this new treatment. The primary outcome was mean total costs of the four treatment strategies: SSG with or without DS, and with or without TNP. Costs were studied from a societal perspective. Findings were evaluated in light of the clinical effects on scar elasticity. Eighty-six patients were included. Twelve months post-operatively, highest elasticity was measured in scars treated with DS and TNP (p=0.027). The initial cost price of treatment with DS and TNP was €2912 compared to treatment with SSG alone €1703 (ptreatment contributed maximal 7% to the total costs and total costs varied widely within and between groups, but were not significantly different. Therefore, in the selection of the most optimal type of surgical intervention, cost considerations should not play an important role. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  12. The value of psychological treatment for borderline personality disorder: Systematic review and cost offset analysis of economic evaluations

    Science.gov (United States)

    Meuldijk, Denise; McCarthy, Alexandra; Bourke, Marianne E.; Grenyer, Brin F. S.

    2017-01-01

    Aim Borderline Personality Disorder (BPD) is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update. Methods Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $) using purchasing power parities. Results We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392) was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found. Discussion Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread

  13. The value of psychological treatment for borderline personality disorder: Systematic review and cost offset analysis of economic evaluations.

    Directory of Open Access Journals (Sweden)

    Denise Meuldijk

    Full Text Available Borderline Personality Disorder (BPD is a common mental health condition with high patterns of service utilisation of inpatient and community treatment. Over the past five years there has been significant growth in research with economic data, making this systematic review a timely update.Empirical studies written in English or German, published up to December 2015, and cited in major electronic databases were examined using the PRISMA systematic review method. Papers were included that had one of the following: data related to cost of BPD to society, the individual, the carer or families; cost benefits of interventions. Reported cost data were inflated to the year 2015 and converted into US- dollars (USD $ using purchasing power parities.We identified 30 economic evaluations providing cost data related to interventions for BPD across 134,136 patients. The methodological quality was good, almost all studies fulfilled ≥ 50% of the quality criteria. The mean cost saving for treating BPD with evidence-based psychotherapy across studies was USD $2,987.82 per patient per year. A further mean weighted reduction of USD $1,551 per patient per year (range $83 - $29,392 was found compared to treatment as usual. Evidence-based psychological treatment was both less expensive as well as more effective, despite considerable differences in health cost arrangements between individual studies and countries. Where it was able to be calculated, a significant difference in cost-savings between different types of evidence-based psychotherapies was found.Individuals with BPD consistently demonstrate high patterns of service utilization and therefore high costs. The findings of this review present a strong argument in favour of prioritizing BPD treatments in reimbursement decisions, both for the affected individual and the family. The provision of evidence based treatment, irrespective of the type of psychological treatment, may lead to widespread reductions in

  14. Logistics opportunity costs: A mining case study

    Directory of Open Access Journals (Sweden)

    Leani van Jaarsveld

    2013-11-01

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

  15. Comparisons of hypertension-related costs from multinational clinical studies.

    Science.gov (United States)

    Mullins, C Daniel; Sikirica, Mirko; Seneviratne, Viran; Ahn, Jeonghoon; Akhras, Kasem S

    2004-01-01

    This study identifies and compares the individual cost components of hospital and ambulatory services that manage the care of hypertensive patients in eight countries: the US, the UK, France, Spain, Germany, Italy, Canada and Australia. Hypertension-related costs are classified according to four major cardiovascular events: (i) acute myocardial infarction; (ii) congestive heart failure; (iii) stroke; and (iv) renal failure, which was subdivided into renal failure treated by dialysis and renal failure treated by kidney transplantation. To make cross-country costs comparisons, we used the DRG codes used in the US and DRG-like codes from each country. US cost information was obtained from hypertension data available from the literature and health economics researchers. For costs in other countries, we consulted with national health economics experts in each country, used analyses by the Research Triangle Institute, and performed Medline and international literature searches. When available, we obtained information from the countries' public and private nationally representative data sources. For cross-country currency adjustments, all currencies were converted using the Purchasing Power Parities from the Organisation for Economic Cooperation and Development, and then converted into inflation-adjusted year 2000 US dollars. There exists considerable variation in hypertension-related costs from multinational clinical studies. This study documents that costs are generally higher in the US than in other countries; however, this is not always true. In particular, costs of treating heart failure in France and the costs of renal failure without transplantation in Germany and the UK are relatively high. While analysing multinational hypertensive cost data, this study also addresses the impact of cross-country cost variations on cost analyses. During the last decade, drug-development researchers have drawn extensively upon multinational trials to resolve enrollment problems and

  16. Patient level cost of diabetes self-management education programmes: an international evaluation.

    Science.gov (United States)

    Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan

    2017-06-04

    The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. © Article author(s) (or their employer

  17. Economic costs of minor depression: a population-based study.

    NARCIS (Netherlands)

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.

    2007-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs

  18. Economic costs of minor depression: a population-based study

    NARCIS (Netherlands)

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; de Graaf, R.; ten Have, M.; Beekman, A.T.F.

    2006-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n = 5504) the costs

  19. EVALUATION OF PENALTY FUNCTIONS FOR SEMI-GLOBAL MATCHING COST AGGREGATION

    Directory of Open Access Journals (Sweden)

    C. Banz

    2012-07-01

    Full Text Available The stereo matching method semi-global matching (SGM relies on consistency constraints during the cost aggregation which are enforced by so-called penalty terms. This paper proposes new and evaluates four penalty functions for SGM. Due to mutual dependencies, two types of matching cost calculation, census and rank transform, are considered. Performance is measured using original and degenerated images exhibiting radiometric changes and noise from the Middlebury benchmark. The two best performing penalty functions are inversely proportional and negatively linear to the intensity gradient and perform equally with 6.05% and 5.91% average error, respectively. The experiments also show that adaptive penalty terms are mandatory when dealing with difficult imaging conditions. Consequently, for highest algorithmic performance in real-world systems, selection of a suitable penalty function and thorough parametrization with respect to the expected image quality is essential.

  20. Cost, cost-efficiency and cost-effectiveness of integrated family planning and HIV services.

    Science.gov (United States)

    Shade, Starley B; Kevany, Sebastian; Onono, Maricianah; Ochieng, George; Steinfeld, Rachel L; Grossman, Daniel; Newmann, Sara J; Blat, Cinthia; Bukusi, Elizabeth A; Cohen, Craig R

    2013-10-01

    To evaluate costs, cost-efficiency and cost-effectiveness of integration of family planning into HIV services. Integration of family planning services into HIV care and treatment clinics. A cluster-randomized trial. Twelve health facilities in Nyanza, Kenya were randomized to integrate family planning into HIV care and treatment; six health facilities were randomized to (nonintegrated) standard-of-care with separately delivered family planning and HIV services. We assessed costs, cost-efficiency (cost per additional use of more effective family planning), and cost-effectiveness (cost per pregnancy averted) associated with the first year of integration of family planning into HIV care. More effective family planning methods included oral and injectable contraceptives, subdermal implants, intrauterine device, and female and male sterilization. We collected cost data through interviews with study staff and review of financial records to determine costs of service integration. Integration of services was associated with an average marginal cost of $841 per site and $48 per female patient. Average overall and marginal costs of integration were associated with personnel costs [initial ($1003 vs. $872) and refresher ($498 vs. $330) training, mentoring ($1175 vs. $902) and supervision ($1694 vs. $1636)], with fewer resources required for other fixed ($18 vs. $0) and recurring expenses ($471 vs. $287). Integration was associated with a marginal cost of $65 for each additional use of more effective family planning and $1368 for each pregnancy averted. Integration of family planning and HIV services is feasible, inexpensive to implement, and cost-efficient in the Kenyan setting, and thus supports current Kenyan integration policy.

  1. Evaluation of low-cost commercial-off-the-shelf autopilot systems for SUAS operations

    Science.gov (United States)

    Brown, Calvin Thomas

    With this increase in unmanned aircraft system (UAS) operations, there is a need for a structured process to evaluate different commercially available systems, particularly autopilots. The Remotely Operated Aircraft Management, Interpretation, and Navigation from Ground or ROAMING scale was developed to meet this need. This scale is a modification of the widely accepted Handling Qualities Rating scale developed by George Cooper and Robert Harper Jr. The Cooper-Harper scale allows pilots to rate a vehicle's performance in completing some task. Similarly, the ROAMING scale allows UAS operators to evaluate the management and observability of UAS in completing some task. The standardized evaluative process consists of cost, size, weight, and power (SWAP) analysis, ease of implementation through procedural description of setup, ROAMING scale rating, a slightly modified NASA TLX rating, and comparison of manual operation to autonomous operation of the task. This standard for evaluation of autopilots and their software will lead to better understanding of the workload placed on UAS operators and indicate where improvements to design and operational procedures can be made. An assortment of low-cost commercial-off-the-shelf (COTS) autopilots were selected for use in the development of the evaluation and results of these tests demonstrate the commonalities and differences in these systems.

  2. Guide for Conducting Benefit-Cost Evaluation of Realized Impacts of Public R&D Programs

    Energy Technology Data Exchange (ETDEWEB)

    Ruegg, Rosalie [TIA Consulting, Inc., Emerald Isle, NC (United States); Jordan, Gretchen B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2011-08-01

    This document provides guidance for evaluators who conduct impact assessments to determine the “realized” economic benefits and costs, energy, environmental benefits, and other impacts of the Office of Energy Efficiency and Renewable Energy’s (EERE) R&D programs. The focus of this Guide is on realized outcomes or impacts of R&D programs actually experienced by American citizens, industry, and others. Retrospective evaluations may be contrasted to prospective evaluations that reflect expected or potential outcomes only if assumptions hold. The retrospective approach described in this Guide is based on realized results only and the extent they can be attributed to the efforts of an R&D program. While it has been prepared specifically to guide retrospective benefit-cost analysis of EERE R&D Programs, this report may be used for similar analysis of other public R&D organizations.

  3. Study on the fuel cycle cost of gas turbine high temperature reactor (GTHTR300). Contract research

    Energy Technology Data Exchange (ETDEWEB)

    Takei, Masanobu; Katanishi, Shoji; Nakata, Tetsuo; Kunitomi, Kazuhiko [Japan Atomic Energy Research Inst., Oarai, Ibaraki (Japan). Oarai Research Establishment; Oda, Takefumi; Izumiya, Toru [Nuclear Fuel Industries, Ltd., Tokyo (Japan)

    2002-11-01

    In the basic design of gas turbine high temperature reactor (GTHTR300), reduction of the fuel cycle cost has a large benefit of improving overall plant economy. Then, fuel cycle cost was evaluated for GTHTR300. First, of fuel fabrication for high-temperature gas cooled reactor, since there was no actual experience with a commercial scale, a preliminary design for a fuel fabrication plant with annual processing of 7.7 ton-U sufficient four GTHTR300 was performed, and fuel fabrication cost was evaluated. Second, fuel cycle cost was evaluated based on the equilibrium cycle of GTHTR300. The factors which were considered in this cost evaluation include uranium price, conversion, enrichment, fabrication, storage of spent fuel, reprocessing, and waste disposal. The fuel cycle cost of GTHTR300 was estimated at about 1.07 yen/kWh. If the back-end cost of reprocessing and waste disposal is included and assumed to be nearly equivalent to LWR, the fuel cycle cost of GTHTR300 was estimated to be about 1.31 yen/kWh. Furthermore, the effects on fuel fabrication cost by such of fuel specification parameters as enrichment, the number of fuel types, and the layer thickness were considered. Even if the enrichment varies from 10 to 20%, the number of fuel types change from 1 to 4, the 1st layer thickness of fuel changes by 30 {mu}m, or the 2nd layer to the 4th layer thickness of fuel changes by 10 {mu}m, the impact on fuel fabrication cost was evaluated to be negligible. (author)

  4. California drug courts: outcomes, costs and promising practices: an overview of Phase II in a statewide study.

    Science.gov (United States)

    Carey, Shannon M; Finigan, Michael; Crumpton, Dave; Waller, Mark

    2006-11-01

    The rapid expansion of drug courts in California and the state's uncertain fiscal climate highlighted the need for definitive cost information on drug court programs. This study focused on creating a research design that can be utilized for statewide and national cost-assessment of drug courts by conducting in-depth case studies of the costs and benefits in nine adult drug courts in California. A Transactional Institutional Costs Analysis (TICA) approach was used, allowing researchers to calculate costs based on every individual's transactions within the drug court or the traditional criminal justice system. This methodology also allows the calculation of costs and benefits by agency (e.g., Public Defender's office, court, District Attorney). Results in the nine sites showed that the majority of agencies save money in processing an offender though drug court. Overall, for these nine study sites, participation in drug court saved the state over 9 million dollars in criminal justice and treatment costs due to lower recidivism in drug court participants. Based on the lessons learned in Phases I and II, Phase III of this study focuses on the creation of a web-based drug court cost self-evaluation tool (DC-CSET) that drug courts can use to determine their own costs and benefits.

  5. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.

    Science.gov (United States)

    Reed, Shelby D; Neilson, Matthew P; Gardner, Matthew; Li, Yanhong; Briggs, Andrew H; Polsky, Daniel E; Graham, Felicia L; Bowers, Margaret T; Paul, Sara C; Granger, Bradi B; Schulman, Kevin A; Whellan, David J; Riegel, Barbara; Levy, Wayne C

    2015-11-01

    Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable. We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs. The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system. The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The hidden costs: Identification of indirect costs associated with acute gastrointestinal illness in an Inuit community

    Science.gov (United States)

    Vriezen, Rachael; Edge, Victoria L.; Ford, James; Wood, Michele; Harper, Sherilee

    2018-01-01

    Background Acute gastrointestinal illness (AGI) incidence and per-capita healthcare expenditures are higher in some Inuit communities as compared to elsewhere in Canada. Consequently, there is a demand for strategies that will reduce the individual-level costs of AGI; this will require a comprehensive understanding of the economic costs of AGI. However, given Inuit communities’ unique cultural, economic, and geographic contexts, there is a knowledge gap regarding the context-specific indirect costs of AGI borne by Inuit community members. This study aimed to identify the major indirect costs of AGI, and explore factors associated with these indirect costs, in the Inuit community of Rigolet, Canada, in order to develop a case-based context-specific study framework that can be used to evaluate these costs. Methods A mixed methods study design and community-based methods were used. Qualitative in-depth, group, and case interviews were analyzed using thematic analysis to identify and describe indirect costs of AGI specific to Rigolet. Data from two quantitative cross-sectional retrospective surveys were analyzed using univariable regression models to examine potential associations between predictor variables and the indirect costs. Results/Significance The most notable indirect costs of AGI that should be incorporated into cost-of-illness evaluations were the tangible costs related to missing paid employment and subsistence activities, as well as the intangible costs associated with missing community and cultural events. Seasonal cost variations should also be considered. This study was intended to inform cost-of-illness studies conducted in Rigolet and other similar research settings. These results contribute to a better understanding of the economic impacts of AGI on Rigolet residents, which could be used to help identify priority areas and resource allocation for public health policies and programs. PMID:29768456

  7. Evaluation of environmental management cost estimating capabilities for the subject area ''Life-cycle economics for radioactive waste management and environmental remediation''

    International Nuclear Information System (INIS)

    Hombach, W.G.

    1995-01-01

    This paper provides a comprehensive perspective on the scope of Environmental Management (EM) activities and on the existing capability to estimate their costs. The scope is defined in terms of both activities and associated cost driving factors. The capability to estimate this scope was determined by evaluating existing cost estimating tools identified through a survey of the US Department of Energy (DOE), the US Department of Defense (DoD), the US Environmental Protection Agency, and private industry. This paper is largely based on the results of a report produced for the Office of the Secretary of Defense, US Department of Defense, entitled, Evaluation of Environmental Management Cost-Estimating Capabilities of Major Defense Acquisition Programs, March 22, 1995. The DoD sponsored report was designed to have a broad application relevant not only to DoD, but to other government agencies, and industry. In addition to DoD, it has particular application to DOE because significant portions of the analyses and data were derived from DOE environmental management databases, cost models, reports, and work breakdown structures. This paper provides the basis used and methodology employed to conduct an evaluations of selected EM cost estimating tools. The following topics are discussed: Life Cycle of EM Activities; Major Elements of EM Activities; Cost Tool Evaluation Matrix; Results of Cost Tool Evaluations; Cost Tool Development Plan

  8. Economic costs of minor depression: a population-based study

    NARCIS (Netherlands)

    Cuijpers, P.; Smit, H.F.E.; Oostenbrink, J.; Graaf, de R.; Have, M. ten; Beekman, A.T.F.

    2006-01-01

    Objective: Although the clinical relevance of minor depression has been demonstrated in many studies, the economic costs are not well explored. In this study, we examine the economic costs of minor depression. Method: In a large-scale, population-based study in the Netherlands (n ¼ 5504) the costs

  9. System Evaluations and Life-Cycle Cost Analyses for High-Temperature Electrolysis Hydrogen Production Facilities

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-01

    This report presents results of system evaluations and lifecycle cost analyses performed for several different commercial-scale high-temperature electrolysis (HTE) hydrogen production concepts. The concepts presented in this report rely on grid electricity and non-nuclear high-temperature process heat sources for the required energy inputs. The HYSYS process analysis software was used to evaluate both central plant designs for large-scale hydrogen production (50,000 kg/day or larger) and forecourt plant designs for distributed production and delivery at about 1,500 kg/day. The HYSYS software inherently ensures mass and energy balances across all components and it includes thermodynamic data for all chemical species. The optimized designs described in this report are based on analyses of process flow diagrams that included realistic representations of fluid conditions and component efficiencies and operating parameters for each of the HTE hydrogen production configurations analyzed. As with previous HTE system analyses performed at the INL, a custom electrolyzer model was incorporated into the overall process flow sheet. This electrolyzer model allows for the determination of the average Nernst potential, cell operating voltage, gas outlet temperatures, and electrolyzer efficiency for any specified inlet steam, hydrogen, and sweep-gas flow rates, current density, cell active area, and external heat loss or gain. The lifecycle cost analyses were performed using the H2A analysis methodology developed by the Department of Energy (DOE) Hydrogen Program. This methodology utilizes spreadsheet analysis tools that require detailed plant performance information (obtained from HYSYS), along with financial and cost information to calculate lifecycle costs. There are standard default sets of assumptions that the methodology uses to ensure consistency when comparing the cost of different production or plant design options. However, these assumptions may also be varied within the

  10. Evaluation of process costs for small-scale nitrogen removal from natural gas. Topical report, January 1989-December 1989

    International Nuclear Information System (INIS)

    Echterhoff, L.W.; Pathak, V.K.

    1991-08-01

    The report establishes the cost of producing pipeline quality gas on a small scale from high nitrogen subquality natural gas. Three processing technologies are evaluated: cryogenic, Nitrotec Engineering Inc.'s pressure swing adsorption (PSA), and lean oil absorption. Comparison of the established costs shows that the cryogenic process exhibits the lowest total plant investment for nitrogen feed contents up to about 22%, above which the PSA process exhibits the lowest investment cost. The lean oil process exhibits the highest total plant investment at the 25% nitrogen feed studied. Opposite to the total plant investment for the cryogenic process, the total plant investment for the PSA process decreases with increasing nitrogen content primarily due to increasing product gas compression requirements. The cryogenic process exhibits the lowest gas processing costs for the nitrogen content range under study. However, the difference between the gas processing costs for the PSA and cryogenic processes narrows as the nitrogen content approaches 15-25%. The lean oil gas processing cost is very high compared to both the cryogenic and PSA processes. The report verifies that nitrogen removal from natural gas is expensive, especially for small-scale applications, and several avenues are identified for improving the cryogenic and PSA technologies

  11. Economic costs of drug abuse: financial, cost of illness, and services.

    Science.gov (United States)

    Cartwright, William S

    2008-03-01

    This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.

  12. An Empirical Study on Marketing Effectiveness Evaluation of Green Food Industry

    OpenAIRE

    Yazhou Xiong; Qianxia Lu; Rui Wang

    2015-01-01

    This study aims to evaluate the marketing effectiveness of green food industry in Hubei Province via fuzzy comprehensive evaluation. Based on the cost basis of analysis of present situation, an evaluation system of marketing effectiveness evaluation on green food industry is established from three aspects, including the industry factor, policy factor and marketing performance factor. And fuzzy comprehensive evaluation method is used to make the quantitative research, analyze the major obstacl...

  13. A comparison of HFrEF vs HFpEF's clinical workload and cost in the first year following hospitalization and enrollment in a disease management program.

    Science.gov (United States)

    Murphy, T M; Waterhouse, D F; James, S; Casey, C; Fitzgerald, E; O'Connell, E; Watson, C; Gallagher, J; Ledwidge, M; McDonald, K

    2017-04-01

    Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EFHospitalizations, primary care, medications, and DMP workload with associated costs were evaluated assessing DMP clinic-visits, telephonic contact, medication changes over 1year using a mixture of casemix and micro-costing techniques. The total average annual cost per patient was marginally higher in patients with HFrEF €13,011 (12,011, 14,078) than HFpEF, €12,206 (11,009, 13,518). However, emergency non-cardiovascular admission rates and average cost per patient were higher in the HFpEF vs HFrEF group (0.46 vs 0.31 per patient/12months) & €655 (318, 1073) vs €584 (396, 812). In the first 3months of the outpatient HF-DMP the HFrEF population cost more on average €791 (764, 819) vs €693 (660, 728). There are greater short-term (3-month) costs of HFrEF versus HFpEF as part of a HF-DMP following an admission. However, long-term (3-12month) costs of HFpEF are greater because of higher non-cardiovascular rehospitalisations. As HFpEF becomes the dominant form of HF, more work is required in HF-DMPs to address prevention of non-cardiovascular rehospitalisations and to integrate hospital based HF-DMPs into primary healthcare structures. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  14. Online genetic counseling from the providers' perspective: counselors' evaluations and a time and cost analysis

    Science.gov (United States)

    Otten, Ellen; Birnie, Erwin; Ranchor, Adelita V; van Langen, Irene M

    2016-01-01

    Telemedicine applications are increasingly being introduced in patient care in various disciplines, including clinical genetics, mainly to increase access to care and to reduce time and costs for patients and professionals. Most telegenetics reports describe applications in large geographical areas, showing positive patients' and professionals' satisfaction. One economic analysis published thus far reported lower costs than in-person care. We hypothesized that telegenetics can also be beneficial from the professional's view in relatively small geographical areas. We performed a pilot study in the Northern Netherlands of 51 home-based online counseling sessions for cardiogenetic and oncogenetic cascade screening, and urgent prenatal counseling. Previously, we showed patient satisfaction, anxiety, and perceived control of online counseling to be comparable to in-person counseling. This study focuses on expectations, satisfaction, and practical evaluations of the involved counselors, and the impact in terms of time and costs. Most counselors expected disadvantages of online counseling for themselves and their patients, mainly concerning insufficient non-verbal communication; few expected advantages for themselves. Afterwards, counselors additionally raised the disadvantage of insufficient verbal communication, and reported frequent technical problems. Their overall mean telemedicine satisfaction itemscore was 3.38 before, and 2.95 afterwards, being afterwards slightly below the minimum level we set for a satisfactory result. We estimated reduced time and costs by online counseling with about 8% and 10–12%, respectively. We showed online genetic counseling to be effective, feasible and cost-efficient, but technical improvements are needed to increase counselors' satisfaction. PMID:26785833

  15. A conceptual framework for the evaluation of cost-effectiveness of projects to reduce GHG emissions and sequester carbon

    International Nuclear Information System (INIS)

    Sathaye, J.; Norgaard, R.; Makundi, W.

    1993-07-01

    This paper proposes a conceptual framework for evaluating the cost of projects to reduce atmospheric greenhouse gases (GHGs). The evaluation of cost-effectiveness should account for both the timing of carbon emissions and the damage caused by the atmospheric stock of carbon. We develop a conceptual basis to estimate the cost-effectiveness of projects in terms of the cost of reducing atmospheric carbon (CRAC) and other GHGs. CRAC accounts for the economic discount rate, alternative functional forms of the shadow price, the residence period of carbon in the atmosphere, and the multiple monetary benefits of projects. The last item is of particular importance to the developing countries

  16. [The evaluation of cost-effectiveness and cost-utility of valganciclovir for the prophylaxis of cytomegalovirus disease to 200 days after kidney transplantation].

    Science.gov (United States)

    Kawalec, Paweł; Holko, Przemysław; Szkultecka-Debek, Monika; Paszulewicz, Anna; Boratyńska, Maria; Głyda, Maciej; Ignacak, Ewa; Maks, Justyna; Russel-Szymczyk, Monika; Kaweczyńska-Lasoń, Aneta

    2013-06-01

    Standard procedure for cytomegalovirus disease (CMV) prophylaxis in kidney transplant patients was the administration of valganciclovir for up to 110 days after organ transplant. This prophylaxis has been extended up to 200 days in Poland since 2011. The decision was based on the results of clinical trials which showed significant clinical benefit in case of prolonged administration of the drug. The aim of the analysis was to provide the economic evaluation of extending the CMV prophylaxis with co-financed from public funds Valcyte (valganciclovirum; 60 tab. a 450 mg; Roche Polska Sp. z o.o.) from 110 to 200 days, in the high risk patients group after kidney transplant (seronegative recipient and infected donor, D+/R-). The analysis was performed from the Polish healthcare payer's perspective. All methods used in the following study were consistent with the Requirements of the Polish HTA Agency (AHTAPOL). The cost-effectiveness and the cost-utility analysis were performed on the basis of a randomised study which was identified as a result of the systematic search of the medical databases, comparing 200 days valgancyclovir administration with 100 days drug use as a prophylaxis of CMV disease in the patients group mentioned above. The Markov model was developed, simulating the disease evolution over time considering a high risk patient after kidney transplant treated with valgancicloviras the CMV disease prophylaxis. The disease period was divided into health states that are the most probable for this condition and the transitions probabilities between them were identified and assigned. Based on the clinical trial results, registry database of health conditions usability and experts' opinion, all health states (i.e. death, kidney transplant, CMV disease) were attributed with utilities and costs. The direct costs, important from the Polish healthcare payer's perspective, were included in the analysis. Extension of the proposed model in the series of one month time

  17. Probabilistic studies for safety at optimum cost

    International Nuclear Information System (INIS)

    Pitner, P.

    1999-01-01

    By definition, the risk of failure of very reliable components is difficult to evaluate. How can the best strategies for in service inspection and maintenance be defined to limit this risk to an acceptable level at optimum cost? It is not sufficient to design structures with margins, it is also essential to understand how they age. The probabilistic approach has made it possible to develop well proven concepts. (author)

  18. A RCT evaluating the effectiveness and cost-effectiveness of academic detailing versus postal prescribing feedback in changing GP antibiotic prescribing.

    LENUS (Irish Health Repository)

    Naughton, Corina

    2009-10-01

    The aim of this study is to evaluate the effectiveness of academic detailing (AD) plus postal prescribing feedback versus postal prescribing feedback alone in reducing: (i) the overall rate of antibiotic; and (ii) proportion of second-line antibiotic prescribing. In addition, the cost-effectiveness of an outreach prescriber adviser service versus a postal prescribing feedback service was evaluated.

  19. Effectiveness and cost-effectiveness of an awareness campaign for colorectal cancer: a mathematical modeling study.

    Science.gov (United States)

    Whyte, Sophie; Harnan, Susan

    2014-06-01

    A campaign to increase the awareness of the signs and symptoms of colorectal cancer (CRC) and encourage self-presentation to a GP was piloted in two regions of England in 2011. Short-term data from the pilot evaluation on campaign cost and changes in GP attendances/referrals, CRC incidence, and CRC screening uptake were available. The objective was to estimate the effectiveness and cost-effectiveness of a CRC awareness campaign by using a mathematical model which extrapolates short-term outcomes to predict long-term impacts on cancer mortality, quality-adjusted life-years (QALYs), and costs. A mathematical model representing England (aged 30+) for a lifetime horizon was developed. Long-term changes to cancer incidence, cancer stage distribution, cancer mortality, and QALYs were estimated. Costs were estimated incorporating costs associated with delivering the campaign, additional GP attendances, and changes in CRC treatment. Data from the pilot campaign suggested that the awareness campaign caused a 1-month 10 % increase in presentation rates. Based on this, the model predicted the campaign to cost £5.5 million, prevent 66 CRC deaths and gain 404 QALYs. The incremental cost-effectiveness ratio compared to "no campaign" was £13,496 per QALY. Results were sensitive to the magnitude and duration of the increase in presentation rates and to disease stage. The effectiveness and cost-effectiveness of a cancer awareness campaign can be estimated based on short-term data. Such predictions will aid policy makers in prioritizing between cancer control strategies. Future cost-effectiveness studies would benefit from campaign evaluations reporting as follows: data completeness, duration of impact, impact on emergency presentations, and comparison with non-intervention regions.

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

    Science.gov (United States)

    Barnett, Paul G

    2009-07-01

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

  1. Assessing the cost of electronic health records: a review of cost indicators.

    Science.gov (United States)

    Gallego, Ana Isabel; Gagnon, Marie-Pierre; Desmartis, Marie

    2010-11-01

    We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

  2. Using counterfactuals to evaluate the cost-effectiveness of controlling biological invasions.

    Science.gov (United States)

    McConnachie, Matthew M; van Wilgen, Brian W; Ferraro, Paul J; Forsyth, Aurelia T; Richardson, David M; Gaertner, Mirijam; Cowling, Richard M

    2016-03-01

    Prioritizing limited conservation funds for controlling biological invasions requires accurate estimates of the effectiveness of interventions to remove invasive species and their cost-effectiveness (cost per unit area or individual). Despite billions of dollars spent controlling biological invasions worldwide, it is unclear whether those efforts are effective, and cost-effective. The paucity of evidence results from the difficulty in measuring the effect of invasive species removal: a researcher must estimate the difference in outcomes (e.g. invasive species cover) between where the removal program intervened and what might have been observed if the program had not intervened. In the program evaluation literature, this is called a counterfactual analysis, which formally compares what actually happened and what would have happened in the absence of an intervention. When program implementation is not randomized, estimating counterfactual outcomes is especially difficult. We show how a thorough understanding of program implementation, combined with a matching empirical design can improve the way counterfactual outcomes are estimated in nonexperimental contexts. As a practical demonstration, we estimated the cost-effectiveness of South Africa's Working for Water program, arguably the world's most ambitious invasive species control program, in removing invasive alien trees from different land use types, across a large area in the Cape Floristic Region. We estimated that the proportion of the treatment area covered by invasive trees would have been 49% higher (5.5% instead of 2.7% of the grid cells occupied) had the program not intervened. Our estimates of cost per hectare to remove invasive species, however, are three to five times higher than the predictions made when the program was initiated. Had there been no control (counter-factual), invasive trees would have spread on untransformed land, but not on land parcels containing plantations or land transformed by

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

    Science.gov (United States)

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

    2016-02-29

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

  4. Discounting in the evaluation of the cost-effectiveness of a vaccination programme: A critical review.

    Science.gov (United States)

    Jit, Mark; Mibei, Walter

    2015-07-31

    Discounting future costs and health benefits usually has a large effect on results of cost-effectiveness evaluations of vaccination because of delays between the initial expenditure in the programme and the health benefits from averting disease. Most guidelines currently recommend discounting both costs and health effects at a positive, constant, common rate back to a common point in time. A review of 84 published economic evaluations of vaccines found that most of them apply these recommendations. However, both technical and normative arguments have been presented for discounting health at a different rate to consumption (differential discounting), discounting at a rate that changes over time (non-constant discounting), discounting intra-generational and inter-generational effects at a different rate (two-stage discounting), and discounting the health gains from an intervention to a different discount year from the time of intervention (delayed discounting). These considerations are particularly acute for vaccines, because their effects can occur in a different generation from the one paying for them, and because the time of vaccination, of infection aversion, and of disease aversion usually differ. Using differential, two-stage or delayed discounting in model-based cost-effectiveness evaluations of vaccination raises technical challenges, but mechanisms have been proposed to overcome them. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Life-cycle cost trade studies for hardness assurance

    International Nuclear Information System (INIS)

    Millward, D.G.

    1996-01-01

    Based on hardness assurance (HA) cost trade studies conducted on a low-cost/high-volume tactical military system with moderate radiation environments, conventional strategies for design hardening and HA can result in higher life-cycle costs (LCC) than alternate approaches. The trade studies used variables designed to investigate LCC as a function of several critical parameters, including semiconductor procurement option, system quantity, HA testing option,a nd other variables. An LCC model and sample problem are included to illustrate the key results. Following the results of the trade studies, limitations of the simplified cost model are presented, the relationship of these results to current procurement practices are discussed, and the application of the results to modern military and commercial systems is discussed

  6. Methodology for the cost evaluation of radioactive waste management routes

    International Nuclear Information System (INIS)

    Kowa, S.; Stenersen, F.; Shamsi, T.; Thiels, G.M.

    1990-01-01

    One of the significant aspects of radioactive waste management is cost. To determine plant costs for radioactive waste management routes, a method was developed by the Joint Venture Kraftanlagen Heidelberg (FRG) and Task R ampersand S (Italy) to perform a realistic, economic cost assessment of different waste management schemes. This assessment procedure was first developed for System Studies concerning the Management and Storage of radioactive waste in the frame of the 2nd R ampersand D program of the Commission of the European Communities (CEC) and is presently being applied in the 3rd R ampersand D program to assess the costs of different management schemes for LWR Waste and Zircaloy hulls. 9 refs., 4 figs., 3 tabs

  7. Long-term evaluation of benefits, harms, and cost-effectiveness of the National Bowel Cancer Screening Program in Australia: a modelling study.

    Science.gov (United States)

    Lew, Jie-Bin; St John, D James B; Xu, Xiang-Ming; Greuter, Marjolein J E; Caruana, Michael; Cenin, Dayna R; He, Emily; Saville, Marion; Grogan, Paul; Coupé, Veerle M H; Canfell, Karen

    2017-07-01

    No assessment of the National Bowel Screening Program (NBCSP) in Australia, which considers all downstream benefits, costs, and harms, has been done. We aimed to use a comprehensive natural history model and the most recent information about cancer treatment costs to estimate long-term benefits, costs, and harms of the NBCSP (2 yearly immunochemical faecal occult blood testing screening at age 50-74 years) and evaluate the incremental effect of improved screening participation under different scenarios. In this modelling study, a microsimulation model, Policy1-Bowel, which simulates the development of colorectal cancer via both the conventional adenoma-carcinoma and serrated pathways was used to simulate the NBCSP in 2006-40, taking into account the gradual rollout of NBCSP in 2006-20. The base-case scenario assumed 40% screening participation (currently observed behaviour) and two alternative scenarios assuming 50% and 60% participation by 2020 were modelled. Aggregate year-by-year screening, diagnosis, treatment and surveillance-related costs, resource utilisation (number of screening tests and colonoscopies), and health outcomes (incident colorectal cancer cases and colorectal cancer deaths) were estimated, as was the cost-effectiveness of the NBCSP. With current levels of participation (40%), the NBCSP is expected to prevent 92 200 cancer cases and 59 000 deaths over the period 2015-40; an additional 24 300 and 37 300 cases and 16 800 and 24 800 deaths would be prevented if participation was increased to 50% and 60%, respectively. In 2020, an estimated 101 000 programme-related colonoscopies will be done, associated with about 270 adverse events; an additional 32 500 and 49 800 colonoscopies and 88 and 134 adverse events would occur if participation was increased to 50% and 60%, respectively. The overall number needed to screen (NNS) is 647-788 per death prevented, with 52-59 colonoscopies per death prevented. The programme is cost

  8. Accounting for the inaccuracies in demand forecasts and construction cost estimations in transport project evaluation

    DEFF Research Database (Denmark)

    Salling, Kim Bang; Leleur, Steen

    2014-01-01

    For decades researchers have claimedthat particularly demand forecasts and construction cost estimations are assigned with/affected by a large degree of uncertainty. Massively, articles,research documents and reports agree that there exists a tendencytowards underestimating the costs...... in demand and cost estimations and hence the evaluation of transport infrastructure projects. Currently, research within this area is scarce and scattered with no commonagreement on how to embed and operationalise the huge amount of empiricaldata that exist within the frame of Optimism Bias. Therefore...... convertingdeterministic benefit-cost ratios (BCRs) into stochasticinterval results. A new data collection (2009–2013) forms the empirical basis for any risk simulation embeddedwithin the so-calledUP database (UNITE project database),revealing the inaccuracy of both construction costs and demandforecasts. Accordingly...

  9. [Methods for the costing process in the field of economic evaluation of a rehabilitation program for patients with chronic obstructive lung diseases].

    Science.gov (United States)

    Hessel, F P; Wittmann, M; Petro, W; Wasem, J

    2000-07-01

    Studies in health economics especially economic evaluations of health care technologies and programmes are getting more and more important. However, in Germany there are no established, validated and commonly used instruments for the costing process. For the economic evaluation of a rehabilitation programme for patients with chronic lung diseases such as asthma and chronic bronchitis we developed methods for identification, measurement and validation of resource use during the inpatient rehabilitation programme and during the outpatient follow-up period. These methods are based on methodological considerations as well as on practical experience from conducting a pilot study. With regard to the inpatient setting all relevant diagnostic and therapeutic resource uses could be measured basing on routine clinical documentation and validated by using the cost accounting of the clinic. For measuring the use of resources during the follow-up period in an outpatient setting no reliable administrative data are accessible. Hence, we compared a standardised retrospective patient questionnaire used in a 20-minute interview (n = 50) and a cost diary for the continuing documentation by the patient over a period of 4 weeks (n = 50). Both tools were useful for measuring all relevant resource uses in sufficient detail, but because of higher participation rates and lower dropouts the structured interview appears to be more suitable. Average total costs per month were 1591 DM (interview), respectively 1867 DM (cost diary). Besides productivity loss, costs for medication and GP visits caused the relatively highest resource uses. Practicable instruments were developed for the costing process as part of an economic evaluation in a German rehabilitation setting for pulmonary diseases. After individual modification, these could also be used for different indications and in other institutional settings.

  10. UNEP greenhouse gas abatement costing studies

    Energy Technology Data Exchange (ETDEWEB)

    Shakespeare Maya, R. (Southern Centre for Energy and Environment (Zimbabwe)); Muguti, E. (Ministry of Transport and Energy. Department of Energy (Zimbabwe)); Fenhann, J.; Morthorst, P.E. (Risoe National Laboratory. Systems Analysis Department (Denmark))

    1992-08-01

    The UNEP (United Nations Environment Programme) programme of Greenhouse Gas Abatement Costing Studies is intended to clarify the economic issues involved in assessing the costs of limiting emissions of greenhouse gases and to propose approaches to comparable costing studies. Phase 1 of the Zimbabwe country study describes the current energy situation in Zimbabwe related to the national economy, energy supply and demand and amounts of greenhouse gas emissions. Factors regarding the geography, (including a map illustrating the degree and character of land degradation by erosion) population, politics, international relations, land-use and management of the energy sector are dealt with in detail and the text is illustrated with data compiled from the study. It is estimated that Zimbabwe consumed 270.4 Tj of energy during 1988 and emitted 21.7 tonnes of carbon dioxide. An emission intensity of 80.2 tonnes/Tj for the whole economy and 63.6 tonnes/Tj for electric power generation alone was calculated. Forecasting for the year 2020 estimated carbon dioxide emission intensities of 73.5 tonnes/Tj for the whole economy and 43.7 tonnes for power generation. Net carbon dioxide emissions are predicted to be 30-42 tonnes during 2020. (AB).

  11. UNEP greenhouse gas abatement costing studies

    International Nuclear Information System (INIS)

    Shakespeare Maya, R.; Muguti, E.; Fenhann, J.; Morthorst, P.E.

    1992-08-01

    The UNEP (United Nations Environment Programme) programme of Greenhouse Gas Abatement Costing Studies is intended to clarify the economic issues involved in assessing the costs of limiting emissions of greenhouse gases and to propose approaches to comparable costing studies. Phase 1 of the Zimbabwe country study describes the current energy situation in Zimbabwe related to the national economy, energy supply and demand and amounts of greenhouse gas emissions. Factors regarding the geography, (including a map illustrating the degree and character of land degradation by erosion) population, politics, international relations, land-use and management of the energy sector are dealt with in detail and the text is illustrated with data compiled from the study. It is estimated that Zimbabwe consumed 270.4 Tj of energy during 1988 and emitted 21.7 tonnes of carbon dioxide. An emission intensity of 80.2 tonnes/Tj for the whole economy and 63.6 tonnes/Tj for electric power generation alone was calculated. Forecasting for the year 2020 estimated carbon dioxide emission intensities of 73.5 tonnes/Tj for the whole economy and 43.7 tonnes for power generation. Net carbon dioxide emissions are predicted to be 30-42 tonnes during 2020. (AB)

  12. Comparing Outcomes and Cost of 3 Surgical Treatments for Sagittal Synostosis: A Retrospective Study Including Procedure-Related Cost Analysis.

    Science.gov (United States)

    Garber, Sarah T; Karsy, Michael; Kestle, John R W; Siddiqi, Faizi; Spanos, Stephen P; Riva-Cambrin, Jay

    2017-10-01

    Neurosurgical techniques for repair of sagittal synostosis include total cranial vault (TCV) reconstruction, open sagittal strip (OSS) craniectomy, and endoscopic strip (ES) craniectomy. To evaluate outcomes and cost associated with these 3 techniques. Via retrospective chart review with waiver of informed consent, the last consecutive 100 patients with sagittal synostosis who underwent each of the 3 surgical correction techniques before June 30, 2013, were identified. Clinical, operative, and process of care variables and their associated specific charges were analyzed along with overall charge. The study included 300 total patients. ES patients had fewer transfusion requirements (13% vs 83%, P cost savings compared with the TCV reconstruction. The charges were similar to those incurred with OSS craniectomy, but patients had a shorter length of stay and fewer revisions. Copyright © 2017 by the Congress of Neurological Surgeons

  13. Cost of allogeneic and autologous blood transfusion in Canada. Canadian Cost of Transfusion Study Group.

    OpenAIRE

    Tretiak, R; Laupacis, A; Rivière, M; McKerracher, K; Souêtre, E

    1996-01-01

    OBJECTIVE: To determine the cost, from a societal perspective, of blood transfusion in Canada. STUDY DESIGN: Cost-structure analysis. SETTING: Data were collected from eight hospitals and from six blood centres operated by the Canadian Red Cross Society in four provinces. OUTCOME MEASURES: Costs associated with four stages of transfusion-- collection, production, distribution and delivery--in 1933 were assessed. Costs were divided into the following categories; personnel, purchases, external ...

  14. The longitudinal study of turnover and the cost of turnover in emergency medical services.

    Science.gov (United States)

    Patterson, P Daniel; Jones, Cheryl B; Hubble, Michael W; Carr, Matthew; Weaver, Matthew D; Engberg, John; Castle, Nicholas

    2010-01-01

    workforce measures--turnover rates and costs--where previously none have existed. Local EMS directors and policymakers at all levels of government may find the results and study methodology useful toward designing and evaluating programs targeting the EMS workforce.

  15. Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study

    Directory of Open Access Journals (Sweden)

    Cristiana M. Toscano

    2018-01-01

    Full Text Available The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1 peripheral neuropathy without ulcer, (2 non-infected foot ulcer, (3 infected foot ulcer, and (4 clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP (1 Int$ = 1.748 BRL. We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13% was for inpatient, and Int$ 333.5 million (87% for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients

  16. Annual Direct Medical Costs of Diabetic Foot Disease in Brazil: A Cost of Illness Study.

    Science.gov (United States)

    Toscano, Cristiana M; Sugita, Tatiana H; Rosa, Michelle Q M; Pedrosa, Hermelinda C; Rosa, Roger Dos S; Bahia, Luciana R

    2018-01-08

    The aim of this study was to estimate the annual costs for the treatment of diabetic foot disease (DFD) in Brazil. We conducted a cost-of-illness study of DFD in 2014, while considering the Brazilian Public Healthcare System (SUS) perspective. Direct medical costs of outpatient management and inpatient care were considered. For outpatient costs, a panel of experts was convened from which utilization of healthcare services for the management of DFD was obtained. When considering the range of syndromes included in the DFD spectrum, we developed four well-defined hypothetical DFD cases: (1) peripheral neuropathy without ulcer, (2) non-infected foot ulcer, (3) infected foot ulcer, and (4) clinical management of amputated patients. Quantities of each healthcare service was then multiplied by their respective unit costs obtained from national price listings. We then developed a decision analytic tree to estimate nationwide costs of DFD in Brazil, while taking into the account the estimated cost per case and considering epidemiologic parameters obtained from a national survey, secondary data, and the literature. For inpatient care, ICD10 codes related to DFD were identified and costs of hospitalizations due to osteomyelitis, amputations, and other selected DFD related conditions were obtained from a nationwide hospitalization database. Direct medical costs of DFD in Brazil was estimated considering the 2014 purchasing power parity (PPP) (1 Int$ = 1.748 BRL). We estimated that the annual direct medical costs of DFD in 2014 was Int$ 361 million, which denotes 0.31% of public health expenses for this period. Of the total, Int$ 27.7 million (13%) was for inpatient, and Int$ 333.5 million (87%) for outpatient care. Despite using different methodologies to estimate outpatient and inpatient costs related to DFD, this is the first study to assess the overall economic burden of DFD in Brazil, while considering all of its syndromes and both outpatients and inpatients. Although we

  17. Podoconiosis patients’ willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery

    Science.gov (United States)

    2014-01-01

    Background Podoconiosis is non-filarial elephantiasis of the lower legs. It is more commonly found in tropical Africa, Central and South America, and northwest India. In Ethiopia, a few non-governmental organizations provide free treatment to podoconiosis patients, but sustainability of free treatment and scale-up of services to reach the huge unmet need is challenged by resource limitations. We aimed to determine podoconiosis patient’s willingness to pay (WTP) for a treatment package (composed of deep cleaning of limbs with diluted antiseptic solution, soap, and water, bandaging, application of emollient on the skin, and provision of shoes), and factors associated with WTP in northwestern Ethiopia. Methods A cross-sectional study was conducted among randomly selected untreated podoconiosis patients (n = 393) in Baso Liben woreda, northwestern Ethiopia. The contingent valuation method was used with a pre-tested interviewer-administered questionnaire. Results The majority of podoconiosis patients (72.8%) were willing to pay for treatment services. The median WTP amount was 64 Birr (US$ 3.28) per person per year. More than one-third of patients (36.7%) were willing to pay at least half of the full treatment cost and 76.2% were willing to pay at least half of the cost of shoes. A multivariate analysis showed that having a higher monthly income, being a woman, older age, being aware of the role of shoes to prevent podoconiosis, and possession of a functional radio were significantly associated with higher odds of WTP. Conclusions The considerable WTP estimates showed that podoconiosis treatment could improve sustainability and service utilization. A subsidized cost recovery scheme could reduce treatment costs and more feasibility integrate podoconiosis treatment service with other NTDs and the government’s primary health care system. PMID:24642085

  18. Seven-year cost-effectiveness of ProDisc-C total disc replacement: results from investigational device exemption and post-approval studies.

    Science.gov (United States)

    Radcliff, Kris; Lerner, Jason; Yang, Chao; Bernard, Thierry; Zigler, Jack E

    2016-05-01

    OBJECTIVE The purpose of this study was to evaluate the 7-year cost-effectiveness of cervical total disc replacement (CTDR) versus anterior cervical discectomy and fusion (ACDF) for the treatment of patients with single-level symptomatic degenerative disc disease. A change in the spending trajectory for spine care is to be achieved, in part, through the selection of interventions that have been proven effective yet cost less than other options. This analysis complements and builds upon findings from other cost-effectiveness evaluations of CTDR through the use of long-term, patient-level data from a randomized study. METHODS This was a 7-year health economic evaluation comparing CTDR versus ACDF from the US commercial payer perspective. Prospectively collected health care resource utilization and treatment effects (quality-adjusted life years [QALYs]) were obtained from individual patient-level adverse event reports and SF-36 data, respectively, from the randomized, multicenter ProDisc-C total disc replacement investigational device exemption (IDE) study and post-approval study. Statistical distributions for unit costs were derived from a commercial claims database and applied using Monte Carlo simulation. Patient-level costs and effects were modeled via multivariate probabilistic analysis. Confidence intervals for 7-year costs, effects, and net monetary benefit (NMB) were obtained using the nonparametric percentile method from results of 10,000 bootstrap simulations. The robustness of results was assessed through scenario analysis and within a parametric regression model controlling for baseline variables. RESULTS Seven-year follow-up data were available for more than 70% of the 209 randomized patients. In the base-case analysis, CTDR resulted in mean per-patient cost savings of $12,789 (95% CI $5362-$20,856) and per-patient QALY gains of 0.16 (95% CI -0.073 to 0.39) compared with ACDF over 7 years. CTDR was more effective and less costly in 90.8% of probabilistic

  19. More Useful, or Not so Bad? Evaluating the Effects of Interventions to Reduce Perceived Cost and Increase Utility Value with College Physics Students

    Science.gov (United States)

    Rosenzweig, Emily Quinn

    2017-01-01

    In the present study I developed and evaluated the effects of two interventions designed to target students' motivation to learn in an introductory college physics course. One intervention was designed to improve students' perceptions of utility value and the other was designed to reduce students' perceptions of cost. Utility value and cost both…

  20. Cost of dengue outbreaks: literature review and country case studies.

    Science.gov (United States)

    Stahl, Hans-Christian; Butenschoen, Vicki Marie; Tran, Hien Tinh; Gozzer, Ernesto; Skewes, Ronald; Mahendradhata, Yodi; Runge-Ranzinger, Silvia; Kroeger, Axel; Farlow, Andrew

    2013-11-06

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

  1. Engineering Evaluation/Cost Analysis for Power Burst Facility (PER-620) Final End State and PBF Vessel Disposal

    Energy Technology Data Exchange (ETDEWEB)

    B. C. Culp

    2007-05-01

    Preparation of this engineering evaluation/cost analysis is consistent with the joint U.S. Department of Energy and U.S. Environmental Protection Agency Policy on Decommissioning of Department of Energy Facilities Under the Comprehensive Environmental Response, Compensation, and Liability Act, (DOE and EPA 1995) which establishes the Comprehensive Environmental, Response, Compensation, and Liability Act non-time critical removal action process as an approach for decommissioning. The scope of this engineering evaluation/cost analysis is to evaluate alternatives and recommend a preferred alternative for the final end state of the PBF and the final disposal location for the PBF vessel.

  2. Economic costs of motor vehicle emissions in China: a case study

    International Nuclear Information System (INIS)

    Xin Deng

    2006-01-01

    The last decade has witnessed a dramatic increase in the number of motor vehicles in China. Motor vehicles have become an increasingly important contributor to air pollution in major Chinese cities. While research interest in vehicular pollution in China has increased in recent years, there is little research on evaluating monetary costs of this pollution. This paper uses Beijing as a case study to evaluate the magnitudes of air pollution concerning motor vehicles. A monetary estimation of air pollution in regard to motor vehicles is presented on the basis of data for Beijing in 2000. Two methods - willingness-to-pay and human capital methods - are used to analyse the high and low points of estimation. (author)

  3. Incremental cost and cost-effectiveness of low-dose, high-frequency training in basic emergency obstetric and newborn care as compared to status quo: part of a cluster-randomized training intervention evaluation in Ghana.

    Science.gov (United States)

    Willcox, Michelle; Harrison, Heather; Asiedu, Amos; Nelson, Allyson; Gomez, Patricia; LeFevre, Amnesty

    2017-12-06

    Low-dose, high-frequency (LDHF) training is a new approach best practices to improve clinical knowledge, build and retain competency, and transfer skills into practice after training. LDHF training in Ghana is an opportunity to build health workforce capacity in critical areas of maternal and newborn health and translate improved capacity into better health outcomes. This study examined the costs of an LDHF training approach for basic emergency obstetric and newborn care and calculates the incremental cost-effectiveness of the LDHF training program for health outcomes of newborn survival, compared to the status quo alternative of no training. The costs of LDHF were compared to costs of traditional workshop-based training per provider trained. Retrospective program cost analysis with activity-based costing was used to measure all resources of the LDHF training program over a 3-year analytic time horizon. Economic costs were estimated from financial records, informant interviews, and regional market prices. Health effects from the program's impact evaluation were used to model lives saved and disability-adjusted life years (DALYs) averted. Uncertainty analysis included one-way and probabilistic sensitivity analysis to explore incremental cost-effectiveness results when fluctuating key parameters. For the 40 health facilities included in the evaluation, the total LDHF training cost was $823,134. During the follow-up period after the first LDHF training-1 year at each participating facility-approximately 544 lives were saved. With deterministic calculation, these findings translate to $1497.77 per life saved or $53.07 per DALY averted. Probabilistic sensitivity analysis, with mean incremental cost-effectiveness ratio of $54.79 per DALY averted ($24.42-$107.01), suggests the LDHF training program as compared to no training has 100% probability of being cost-effective above a willingness to pay threshold of $1480, Ghana's gross national income per capita in 2015. This

  4. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

    Science.gov (United States)

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-04-01

    It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

  5. A review on cost-effectiveness and cost-utility of psychosocial care in cancer patients

    Directory of Open Access Journals (Sweden)

    Femke Jansen

    2016-01-01

    Full Text Available Several psychosocial care interventions have been found effective in improving psychosocial outcomes in cancer patients. At present, there is increasingly being asked for information on the value for money of this type of intervention. This review therefore evaluates current evidence from studies investigating cost-effectiveness or cost-utility of psychosocial care in cancer patients. A systematic search was conducted in PubMed and Web of Science yielding 539 unique records, of which 11 studies were included in the study. Studies were mainly performed in breast cancer populations or mixed cancer populations. Studied interventions included collaborative care (four studies, group interventions (four studies, individual psychological support (two studies, and individual psycho-education (one study. Seven studies assessed the cost-utility of psychosocial care (based on quality-adjusted-life-years while three studies investigated its cost-effectiveness (based on profile of mood states [mood], Revised Impact of Events Scale [distress], 12-Item Health Survey [mental health], or Fear of Progression Questionnaire [fear of cancer progression]. One study did both. Costs included were intervention costs (three studies, intervention and direct medical costs (five studies, or intervention, direct medical, and direct nonmedical costs (three studies. In general, results indicated that psychosocial care is likely to be cost-effective at different, potentially acceptable, willingness-to-pay thresholds. Further research should be performed to provide more clear information as to which psychosocial care interventions are most cost-effective and for whom. In addition, more research should be performed encompassing potential important cost drivers from a societal perspective, such as productivity losses or informal care costs, in the analyses.

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

    Energy Technology Data Exchange (ETDEWEB)

    1977-06-01

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

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

    International Nuclear Information System (INIS)

    1977-06-01

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

  8. Cost effectiveness of home ultraviolet B phototherapy for psoriasis : economic evaluation of a randomised controlled trial (PLUTO study)

    NARCIS (Netherlands)

    Koek, Mayke B. G.; Sigurdsson, Vigfus; van Weelden, Huib; Steegmans, Paul H. A.; Bruijnzeel-Koomen, Carla A. F. M.; Buskens, Erik

    2010-01-01

    Objective To assess the costs and cost effectiveness of phototherapy with ultraviolet B light provided at home compared with outpatient ultraviolet B phototherapy for psoriasis. Design Cost utility, cost effectiveness, and cost minimisation analyses performed alongside a pragmatic randomised

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-01

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

  10. Economic evaluation of pressure ulcer care: a cost minimization analysis of preventive strategies.

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; Engelshoven, I. van; Ramshorst, B. van; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was

  11. Economic evaluation of pressure ulcer care : A Cost Minimization Analysis of Preventive Strategies

    NARCIS (Netherlands)

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; van Engelshoven, I.; van Ramshorst, B.; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was

  12. Women, Co-occurring Disorders, and Violence Study: evaluation design and study population.

    Science.gov (United States)

    McHugo, G J; Kammerer, N; Jackson, E W; Markoff, L S; Gatz, M; Larson, M J; Mazelis, R; Hennigan, K

    2005-03-01

    The Women, Co-occurring Disorders, and Violence Study (WCDVS) was a multi-site cooperative study to evaluate new service models for women with co-occurring mental health and substance use disorders and a history of physical and/or sexual abuse. Despite common features in the service interventions and evaluation procedures, diversity across the nine sites plus differences introduced by non-random assignment led to numerous methodological challenges. This article describes the design, measurement, and analysis decisions behind the WCDVS and lays the foundation for understanding participant-level outcomes and service costs. This article also describes the study population, as recruited and following attrition at the 6-month follow-up, in order to address the threat of selection bias to inferences drawn from this multi-site study.

  13. Evaluation of prescription indicators established by the WHO in Getúlio Vargas - RS

    Directory of Open Access Journals (Sweden)

    Andressa Tanise Vooss

    2011-06-01

    Full Text Available To evaluate the conditions of the services offered to the community regarding medications, the World Health Organization (WHO has developed the Medication Use Indicators, among them Prescription indicators. The objective of this study was to evaluate drug prescriptions in a Basic Health Care Center in Getúlio Vargas - RS, according to the Prescription Indicators recommended by the WHO. The data collection was performed with the use of a form and the prescriptions for June / July and November / December 2008 were evaluated. The average number of drugs prescribed was 2.03, and 72.8% of the drugs were prescribed by generic name, 80.3% were on the list of essential drugs, 21.7% were antibiotics and 2.4% were injectable drugs. The results were in accordance with WHO recommendations and were similar to those reported by other studies.Para avaliar as condições dos serviços prestados à população no que se refere aos medicamentos, a Organização Mundial da Saúde (OMS desenvolveu Indicadores do uso de Medicamentos, entre eles os de Prescrição. O objetivo da pesquisa foi avaliar prescrições medicamentosas de usuários de uma Unidade Básica de Saúde do município de Getúlio Vargas - RS conforme os Indicadores de Prescrição preconizados pela OMS. A coleta de dados foi realizada com uma ficha. Para isso houve acesso as prescrições atendidas no período de junho/julho e de novembro/dezembro de 2008. A média de medicamentos prescritos foi de 2,03, 72,8% dos medicamentos foram prescritos pelo nome genérico, 80,3% constavam na lista dos medicamentos essenciais, 21,7% eram antibióticos e 2,4% injetáveis. Observou-se que os resultados obtidos estão de acordo com os recomendados pela OMS e que foram similares a outros estudos.

  14. Cost-benefit analysis of the industrial evaluations employing radioactive tracer techniques in the sugar-cane industry

    International Nuclear Information System (INIS)

    Aguila, D.; Jerez, P.F.

    1998-01-01

    A practice with radioactivity is justifiable if the benefit that she brings is greater than the detriment to the health that provokes. This is achieved with an optimization of the radiological protection on the base of the principle ALARA (the dose must be at botommost level that reasonably could be reached). The cost-benefit analysis helps to take a decision of practice optimized to use. Based on the cost-benefit criterion in the framework of the industrial radioprotection, was accomplished an industrial evaluations study employing 99mT c and 1 31 I in industry Cuban sugar-bowl. The results of the analysis demonstrated that the use of the 99mT c as radiotracer is the better option to take

  15. Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

    Science.gov (United States)

    Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

    2009-02-01

    The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.

  16. 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...

  17. Life Cycle Costing in Sustainability Assessment—A Case Study of Remanufactured Alternators

    Directory of Open Access Journals (Sweden)

    Annekatrin Lehmann

    2011-11-01

    Full Text Available Sustainability is on the international agenda, and is a driver for industry in international competition. Sustainability encompasses the three pillars: environment, society and economy. To prevent shifting of burden, the whole life cycle needs to be taken into account. For the environmental dimension of sustainability, life cycle assessment (LCA has been practiced for a while and is a standardized method. A life cycle approach for the social and economic pillars of sustainability needs to be further developed. This paper investigates the application of life cycle costing (LCC as part of a wider sustainability assessment where also social life cycle assessment (SLCA and LCA are combined. LCA-type LCC is applied on a case study of remanufactured alternators. Remanufacturing of automobile parts is a fast growing important business with large potential for cost and resource savings. Three design alternatives for the alternator and three locations for the remanufacturing plant are evaluated. The remanufacturer perspective and the user perspective are investigated. The results for the LCA-type LCC show that the largest cost for the remanufacturer is the new parts replacing old warn parts. However, the user cost, and therein especially, cost for fuel used for the alternator’s power production dominates and should be the focus for further improvement. In conducting the case study, it was revealed that the connection between the LCA-type LCC results and the economic dimension of sustainability needs to be further investigated and defined. For this purpose, areas of protection for life cycle sustainability assessment and LCA-type LCC in particular need further development.

  18. Cost of dengue outbreaks: literature review and country case studies

    Science.gov (United States)

    2013-01-01

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

  19. Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.

    Science.gov (United States)

    Johnston, Marjorie C; Ludbrook, Anne; Jaffray, Mariesha A

    2012-01-01

    To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation. A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review. This was based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harmful effect, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation). The overall cost was £7457 million. Two alcohol harmful effects were not included in the overall cost by deprivation due to a lack of data. These were 'children's social work and hearing system' and the criminal justice system costs from 'alcohol-specific offences'. The included alcohol harmful effects demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%). The study found that the burden of alcohol harmful effects is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less-precise cost estimates.

  20. The cost-effectiveness of the Olweus Bullying Prevention Program: Results from a modelling study.

    Science.gov (United States)

    Beckman, Linda; Svensson, Mikael

    2015-12-01

    Exposure to bullying affects around 3-5 percent of adolescents in secondary school and is related to various mental health problems. Many different anti-bullying programmes are currently available, but economic evaluations are lacking. The aim of this study is to identify the cost effectiveness of the Olweus Bullying Prevention Program (OBPP). We constructed a decision-tree model for a Swedish secondary school, using a public payer perspective, and retrieved data on costs and effects from the published literature. Probabilistic sensitivity analysis to reflect the uncertainty in the model was conducted. The base-case analysis showed that using the OBPP to reduce the number of victims of bullying costs 131,250 Swedish kronor (€14,470) per victim spared. Compared to a relevant threshold of the societal value of bullying reduction, this indicates that the programme is cost-effective. Using a relevant willingness-to-pay threshold shows that the OBPP is a cost-effective intervention. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  1. Costs and financing of routine immunization: Approach and selected findings of a multi-country study (EPIC).

    Science.gov (United States)

    Brenzel, Logan; Young, Darwin; Walker, Damian G

    2015-05-07

    Few detailed facility-based costing studies of routine immunization (RI) programs have been conducted in recent years, with planners, managers and donors relying on older information or data from planning tools. To fill gaps and improve quality of information, a multi-country study on costing and financing of routine immunization and new vaccines (EPIC) was conducted in Benin, Ghana, Honduras, Moldova, Uganda and Zambia. This paper provides the rationale for the launch of the EPIC study, as well as outlines methods used in a Common Approach on facility sampling, data collection, cost and financial flow estimation for both the routine program and new vaccine introduction. Costing relied on an ingredients-based approach from a government perspective. Estimating incremental economic costs of new vaccine introduction in contexts with excess capacity are highlighted. The use of more disaggregated System of Health Accounts (SHA) coding to evaluate financial flows is presented. The EPIC studies resulted in a sample of 319 primary health care facilities, with 65% of facilities in rural areas. The EPIC studies found wide variation in total and unit costs within each country, as well as between countries. Costs increased with level of scale and socio-economic status of the country. Governments are financing an increasing share of total RI financing. This study provides a wealth of high quality information on total and unit costs and financing for RI, and demonstrates the value of in-depth facility approaches. The paper discusses the lessons learned from using a standardized approach, as well as proposes further areas of methodology development. The paper discusses how results can be used for resource mobilization and allocation, improved efficiency of services at the country level, and to inform policies at the global level. Efforts at routinizing cost analysis to support sustainability efforts would be beneficial. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. An evaluation of accounting-based finding costs as efficiency measures for oil and gas exploration

    International Nuclear Information System (INIS)

    Boynton, C.E. IV; Boone, J.P.

    1994-08-01

    The authors have operationalized firm-specific exploration efficiency as the difference between a firm-specific intercept estimated in a fixed-effects panel data Cobb-Douglas production frontier model and the maximum firm-specific intercept estimated in that model. The production model was estimated during two different time periods, 1982--1985 and 1989--1992, allowing efficiency to vary intertemporally. This efficiency estimate served as a benchmark against which they compared various measures of inverse finding costs. They assumed that the degree of association with an efficiency benchmark is an important attribute of any finding cost measure and that, further, the degree of association may be used as a metric for choosing between alternative finding cost measures. Accordingly, they evaluated the cross-sectional statistical association between estimated efficiency and alternative inverse finding cost measures. They discovered that the inverse finding cost measure that exhibited the strongest association with efficiency during the two time periods was a three-year moving-average finding cost which included exploration plus development expenditures as costs and reserve extensions and additions plus revisions as the units added

  3. An evaluation of accounting-based finding costs as efficiency measures for oil and gas exploration

    Energy Technology Data Exchange (ETDEWEB)

    Boynton, C.E. IV; Boone, J.P.

    1994-08-01

    The authors have operationalized firm-specific exploration efficiency as the difference between a firm-specific intercept estimated in a fixed-effects panel data Cobb-Douglas production frontier model and the maximum firm-specific intercept estimated in that model. The production model was estimated during two different time periods, 1982--1985 and 1989--1992, allowing efficiency to vary intertemporally. This efficiency estimate served as a benchmark against which they compared various measures of inverse finding costs. They assumed that the degree of association with an efficiency benchmark is an important attribute of any finding cost measure and that, further, the degree of association may be used as a metric for choosing between alternative finding cost measures. Accordingly, they evaluated the cross-sectional statistical association between estimated efficiency and alternative inverse finding cost measures. They discovered that the inverse finding cost measure that exhibited the strongest association with efficiency during the two time periods was a three-year moving-average finding cost which included exploration plus development expenditures as costs and reserve extensions and additions plus revisions as the units added.

  4. PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

    Science.gov (United States)

    Picchio, M; Mansueto, M; Crivellaro, C; Guerra, L; Marcelli, S; Arosio, M; Sironi, S; Gianolli, L; Grimaldi, A; Messa, C

    2012-06-01

    Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

  5. Nuclear thermal propulsion engine cost trade studies

    International Nuclear Information System (INIS)

    Paschall, R.K.

    1993-01-01

    The NASA transportation strategy for the Mars Exploration architecture includes the use of nuclear thermal propulsion as the primary propulsion system for Mars transits. It is anticipated that the outgrowth of the NERVA/ROVER programs will be a nuclear thermal propulsion (NTP) system capable of providing the propulsion for missions to Mars. The specific impulse (Isp) for such a system is expected to be in the 870 s range. Trade studies were conducted to investigate whether or not it may be cost effective to invest in a higher performance (Isp>870 s) engine for nuclear thermal propulsion for missions to Mars. The basic cost trades revolved around the amount of mass that must be transported to low-earth orbit prior to each Mars flight and the cost to launch that mass. The mass required depended on the assumptions made for Mars missions scenarios including piloted/cargo flights, number of Mars missions, and transit time to Mars. Cost parameters included launch cost, program schedule for development and operations, and net discount rate. The results were very dependent on the assumptions that were made. Under some assumptions, higher performance engines showed cost savings in the billions of dollars; under other assumptions, the additional cost to develop higher performance engines was not justified

  6. Financial cost of amyotrophic lateral sclerosis: a case study.

    Science.gov (United States)

    Obermann, M; Lyon, M

    2015-03-01

    There are only a few recently published reports of the cost of amyotrophic lateral sclerosis (ALS) care in the United States. Our objectives were to: 1) report annual and disease-duration costs; 2) provide costs related to specific care and services; 3) present costs by payor; and 4) identify strategies and resources that can be offered to patients to assist with the financial burden of ALS. Over a 10-year period (2001-2010), all expenses related to the cost of care for an individual patient were collected concurrently and then analyzed in 2012. Results showed that total disease-duration costs were $1,433,992 (85% paid by insurance, 9% paid by family, 6% paid by charities). The highest costs were for in-home caregivers ($669,150), ventilation ($212,430) and hospital care ($114,558). In conclusion, this case study illustrates costs of care for ALS as a burden for patients that may impact treatment decisions. Charity organizations and insurance case-managers provide services to patients that can help reduce this burden. Costs for specific services as well as resources identified by this study offer physicians and other healthcare providers data-based cost of care information and strategies to share with their patients.

  7. A time-cost augmented economic evaluation of oral deferasirox versus infusional deferoxamine [corrected] for patients with iron overload in South Korea.

    Science.gov (United States)

    Kim, Jinhyun; Kim, Younhee

    2009-01-01

    This study aims to conduct an economic evaluation of oral deferasirox (DSX) compared with infusional deferoxamine (DFO) in patients with transfusional iron overload. Depending on the methods for measuring time-cost and convenience associated with the mode of administration, either cost-utility analysis or cost-effectiveness analysis was undertaken. The difference in compliance rate between DSX and DFO was applied. Although the drug cost of DSX was US$124,070 higher than that of DFO (US$96,039 vs. US$220,199), all other costs were lower in patients with DSX than in patients with DFO. In the cost-utility analysis, DSX resulted in US$3197 savings with a gain of 2.63 quality-adjusted life-years per patient. The result of the cost-effectiveness analysis also showed that DSX dominated DFO. With a considerable improvement in convenience and injection time rather than efficacy, DSX is considered as a dominant therapy for patients with iron overload.

  8. Cost and effectiveness evaluation of prophylactic HPV vaccine in developing countries.

    Science.gov (United States)

    Termrungruanglert, Wichai; Havanond, Piyalamporn; Khemapech, Nipon; Lertmaharit, Somrat; Pongpanich, Sathirakorn; Khorprasert, Chonlakiet; Taneepanichskul, Surasak

    2012-01-01

    Approximately 80% of cervical cancer cases occur in developing countries. In Thailand, cervical cancer has been the leading cancer in females, with an incidence of 24.7 cases per 100,000 individuals per year. We constructed a decision model to simulate the lifetime economic impact for women in the context of human papillomavirus (HPV) infection prevention. HPV-related diseases were of interest: cervical cancer, cervical intraepithelial neoplasia, and genital warts. The two strategies used were 1) current practice and 2) prophylactic quadrivalent vaccine against HPV types 6, 11, 16, and 18. We developed a Markov simulation model to evaluate the incremental cost-effectiveness ratio of prophylactic HPV vaccine. Women transition through a model either healthy or developing HPV or its related diseases, or die from cervical cancer or from other causes according to transitional probabilities under the Thai health-care context. Costs from a provider perspective were obtained from King Chulalongkorn Memorial Hospital. Costs and benefits were discounted at 3% annually. Compared with no prophylactic HPV vaccine, the incremental cost-effectiveness ratio was 160,649.50 baht per quality-adjusted life-year. The mortality rate was reduced by 54.8%. The incidence of cervical cancer, cervical intraepithelial neoplasia grade 1, cervical intraepithelial neoplasia grade 2/3, and genital warts was reduced by up to 55.1%. Compared with commonly accepted standard thresholds recommended by the World Health Organization Commission on Macroeconomics and Health, the nationwide coverage of HPV vaccination in girls is likely to be cost-effective in Thailand. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Wineries Evaluation of Costs and Benefits of Sustainability Certification Program: The Case of Terra Vitis in France.

    Science.gov (United States)

    Jourjon, Frederique; Chou, Hsia-Chi; Gezart, Anna; Kadison, Amy E; Martinat, Lea; Pomarici, Eugenio; Vecchio, Riccardo

    2016-01-01

    The current paper analyses the evaluation of the costs and benefits of French wineries (N=69) participating in the sustainability program Terra Vitis, a widespread environmental certification scheme within the French wine industry. An online questionnaire was sent to all Terra Vitis participants, in order to analyse the evaluation of economic costs and benefits (together with environmental benefits) as perceived by wineries. Our findings reveal that older participants in the scheme (over 5 years), firms with higher export share (>40% of annual turnover) and cooperative wineries tend to be keener to assign a positive evaluation to the benefits/costs ratio in both the vineyard and the winery. In the context of increasing concerns regarding the economic and environmental performance of the French agricultural sector, such findings and also the patent research could be useful for policy makers and entrepreneurs in defining mainstream normative and corporate strategies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Plant evaluation activities and O and M cost reduction in U.S

    International Nuclear Information System (INIS)

    Itoh, Takeshi

    1998-01-01

    Although some nuclear power plants face the possibility of premature retirement, most nuclear power plants have achieved substantial reductions in costs, mainly in O and M costs, and appear to be competitive with new gas and coal fired power plants. Improving competitiveness of existing nuclear power plants in the United States has primarily been driven by the electric utility self assessment activities. However, the background of this activity has been provided by the activities of NRC, INPO, NEI, EUCG and other activities being conducted for improvement of the nuclear power industry as a whole. Utility companies that are in the forefront of this activity have already achieved the reductions in staffing and outage time that are generally known to be effective for reducing O and M costs and are moving forward with rationalization and cost reductions in other areas. However, these electric utility companies are also achieving high safety and reliability. The staff of these electric utility companies have a high degree of autonomy, self motivation and self critical attitude and the staffing of these companies is a numerically small elite. This culture is supported by the self evaluation activity established by each company and is nurtured and supported by the management system. This appears to be one of the major elements in cost reduction. As this is based on U.S. information, differences in the system, society and culture in other nations mean that these findings may not be directly applicable. However, from the point of view of the prospects of nuclear power, these findings have an important meaning. This meaning is that the achievements in the United States of cost reduction activities centering on O and M costs are an important experience for other countries including Japan in reestablishing the economic competitiveness of nuclear power. (author)

  11. Clinical Evaluation and Cost-Effectiveness Analysis of Serum Tumor Markers in Lung Cancer

    Directory of Open Access Journals (Sweden)

    Rong Wang

    2013-01-01

    Full Text Available The detection of serum tumor markers is valuable for the early diagnosis of lung cancer. Tumor markers are frequently used for the management of cancer patients. However, single markers are less efficient but marker combinations increase the cost, which is troublesome for clinics. To find an optimal serum marker combination panel that benefits the patients and the medical management system as well, four routine lung cancer serum markers (SCCA, NSE, CEA, and CYFRA21-1 were evaluated individually and in combination. Meanwhile, the costs and effects of these markers in clinical practice in China were assessed by cost-effectiveness analysis. As expected, combinations of these tumor markers improved their sensitivity for lung cancer and different combination panels had their own usefulness. NSE + CEA + CYFRA21-1 was the optimal combination panel with highest Youden’s index (0.64, higher sensitivity (75.76%, and specificity (88.57%, which can aid the clinical diagnosis of lung cancer. Nevertheless, the most cost-effective combination was SCCA + CEA, which can be used to screen the high-risk group.

  12. Cost evaluation of reproductive and primary health care mobile service delivery for women in two rural districts in South Africa.

    Directory of Open Access Journals (Sweden)

    Kathryn Schnippel

    Full Text Available Cervical cancer screening is a critical health service that is often unavailable to women in under-resourced settings. In order to expand access to this and other reproductive and primary health care services, a South African non-governmental organization established a van-based mobile clinic in two rural districts in South Africa. To inform policy and budgeting, we conducted a cost evaluation of this service delivery model.The evaluation was retrospective (October 2012-September 2013 for one district and April-September 2013 for the second district and conducted from a provider cost perspective. Services evaluated included cervical cancer screening, HIV counselling and testing, syndromic management of sexually transmitted infections (STIs, breast exams, provision of condoms, contraceptives, and general health education. Fixed costs, including vehicle purchase and conversion, equipment, operating costs and mobile clinic staffing, were collected from program records and public sector pricing information. The number of women accessing different services was multiplied by ingredients-based variable costs, reflecting the consumables required. All costs are reported in 2013 USD.Fixed costs accounted for most of the total annual costs of the mobile clinics (85% and 94% for the two districts; the largest contributor to annual fixed costs was staff salaries. Average costs per patient were driven by the total number of patients seen, at $46.09 and $76.03 for the two districts. Variable costs for Pap smears were higher than for other services provided, and some services, such as breast exams and STI and tuberculosis symptoms screening, had no marginal cost.Staffing costs are the largest component of providing mobile health services to rural communities. Yet, in remote areas where patient volumes do not exceed nursing staff capacity, incorporating multiple services within a cervical cancer screening program is an approach to potentially expand access to

  13. Study of a very low cost air combat maneuvering trainer aircraft

    Science.gov (United States)

    Hill, G. C.; Bowles, J. V.

    1976-01-01

    A very low cost aircraft for performing Air Combat Maneuvering (ACM) training was studied using the BD-5J sport plane as a point of departure. The installation of a larger engine and increased fuel capacity were required to meet the performance and mission objectives. Reduced wing area increased the simulation of the ACM engagement, and a comparison with current tactical aircraft is presented. Other factors affecting the training transfer are considered analytically, but a flight evaluation is recommended to determine the concept utility.

  14. The cost of making wine: A Tuscan case study based on a full cost approach

    Directory of Open Access Journals (Sweden)

    Enrico Marone

    2017-12-01

    Full Text Available This article׳s aim is to identify and quantify the connection between a winery business typology and its production cost per bottle to create benchmarks for managerial and organisational choices. Accounting data from wineries in representative areas of the Tuscan wine sector were collected with direct, face-to-face interviews. The data were processed using a cost accounting model elaborated by UniCeSV (Centre for the Strategic Development of the Wine Sector, University of Florence to classify costs according to production phases and production factors. The study was completed using a hierarchical cluster analysis (HCA approach to investigate the relation between cost structures and business typologies. The implementation of the cost accounting model and the HCA showed a strong relationship between how wineries are organised and how costs are structured. Moreover, the weight of geographical localisation (i.e., belonging to a specific denomination of origin has proved to be a key determinant in the shape of the cost structures of wineries. Keywords: Wine production, Full cost analysis, Clustering

  15. Safety evaluations under the proposed US Safe Cosmetics and Personal Care Products Act of 2013: animal use and cost estimates.

    Science.gov (United States)

    Knight, Jean; Rovida, Costanca

    2014-01-01

    The proposed Safe Cosmetics and Personal Care Products Act of 2013 calls for a new evaluation program for cosmetic ingredients in the US, with the new assessments initially dependent on expanded animal testing. This paper considers possible testing scenarios under the proposed Act and estimates the number of test animals and cost under each scenario. It focuses on the impact for the first 10 years of testing, the period of greatest impact on animals and costs. The analysis suggests the first 10 years of testing under the Act could evaluate, at most, about 50% of ingredients used in cosmetics. Testing during this period would cost about $ 1.7-$ 9 billion and 1-11.5 million animals. By test year 10, alternative, high-throughput test methods under development are expected to be available, replacing animal testing and allowing rapid evaluation of all ingredients. Given the high cost in dollars and animal lives of the first 10 years for only about half of ingredients, a better choice may be to accelerate development of high-throughput methods. This would allow evaluation of 100% of cosmetic ingredients before year 10 at lower cost and without animal testing.

  16. Assessing the Costs and Benefits of Resilience Investments: Tennessee Valley Authority Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Allen, Melissa R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilbanks, Thomas J. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Preston, Benjamin L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kao, Shih-Chieh [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Bradbury, James [U.S. Department of Energy (DOE), Office of Energy Policy and Systems Analysis (EPSA), Washington, DC (United States)

    2017-01-01

    This report describes a general approach for assessing climate change vulnerabilities of an electricity system and evaluating the costs and benefits of certain investments that would increase system resilience. It uses Tennessee Valley Authority (TVA) as a case study, concentrating on the Cumberland River basin area on the northern side of the TVA region. The study focuses in particular on evaluating risks associated with extreme heat wave and drought conditions that could be expected to affect the region by mid-century. Extreme climate event scenarios were developed using a combination of dynamically downscaled output from the Community Earth System Model and historical heat wave and drought conditions in 1993 and 2007, respectively.

  17. Cost optimisation studies of high power accelerators

    Energy Technology Data Exchange (ETDEWEB)

    McAdams, R.; Nightingale, M.P.S.; Godden, D. [AEA Technology, Oxon (United Kingdom)] [and others

    1995-10-01

    Cost optimisation studies are carried out for an accelerator based neutron source consisting of a series of linear accelerators. The characteristics of the lowest cost design for a given beam current and energy machine such as power and length are found to depend on the lifetime envisaged for it. For a fixed neutron yield it is preferable to have a low current, high energy machine. The benefits of superconducting technology are also investigated. A Separated Orbit Cyclotron (SOC) has the potential to reduce capital and operating costs and intial estimates for the transverse and longitudinal current limits of such machines are made.

  18. Dissecting Costs of CT Study: Application of TDABC (Time-driven Activity-based Costing) in a Tertiary Academic Center.

    Science.gov (United States)

    Anzai, Yoshimi; Heilbrun, Marta E; Haas, Derek; Boi, Luca; Moshre, Kirk; Minoshima, Satoshi; Kaplan, Robert; Lee, Vivian S

    2017-02-01

    The lack of understanding of the real costs (not charge) of delivering healthcare services poses tremendous challenges in the containment of healthcare costs. In this study, we applied an established cost accounting method, the time-driven activity-based costing (TDABC), to assess the costs of performing an abdomen and pelvis computed tomography (AP CT) in an academic radiology department and identified opportunities for improved efficiency in the delivery of this service. The study was exempt from an institutional review board approval. TDABC utilizes process mapping tools from industrial engineering and activity-based costing. The process map outlines every step of discrete activity and duration of use of clinical resources, personnel, and equipment. By multiplying the cost per unit of capacity by the required task time for each step, and summing each component cost, the overall costs of AP CT is determined for patients in three settings, inpatient (IP), outpatient (OP), and emergency departments (ED). The component costs to deliver an AP CT study were as follows: radiologist interpretation: 40.1%; other personnel (scheduler, technologist, nurse, pharmacist, and transporter): 39.6%; materials: 13.9%; and space and equipment: 6.4%. The cost of performing CT was 13% higher for ED patients and 31% higher for inpatients (IP), as compared to that for OP. The difference in cost was mostly due to non-radiologist personnel costs. Approximately 80% of the direct costs of AP CT to the academic medical center are related to labor. Potential opportunities to reduce the costs include increasing the efficiency of utilization of CT, substituting lower cost resources when appropriate, and streamlining the ordering system to clarify medical necessity and clinical indications. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  19. Progress report on the investigation of nuclear plant costs

    International Nuclear Information System (INIS)

    Kent, G.F.

    1987-01-01

    Over the past few years, many studies have been performed in an effort to understand, evaluate, and explain the reasons for the substantial increases in nuclear plant costs, as well as for the divergence between predicted and actual costs. Concerns regarding these cost increases is shared by utility owners, engineer/constructors, and public utility commissions. The future use of nuclear power depends on the ability of the industry to control these costs while maintaining safety. Stone and Webster Engineering Corporation (SWEC) has responded to this concern by initiating an internal study to evaluate, quantify, and explain the factors influencing this cost growth. Previously, a conceptual approach was presented in which three explanatory variables or factors were used as surrogates for the many variables that affected plant cost. This paper presents a progress report of that continuing study

  20. The social costs of production and the structure of technology in the Brazilian ethanol industry: A cost-benefit analysis and an infant industry evaluation, 1978-1987

    International Nuclear Information System (INIS)

    Rask, K.N.

    1991-01-01

    Only one country, Brazil, has developed an economy-wide liquid fuel industry which directly substitutes for gasoline. The experience of sugar-cane-based ethanol production in Brazil provides an important case study in the economic efficiency of this petroleum substitute. Partial equilibrium cost-benefit analysis is used to evaluate the net social benefits of ethanol production over the decade beginning in 1978. Ethanol production from the southern region of Brazil is found to be an economically efficient substitute for petroleum when world oil prices are over $20 per barrel. Ethanol production in the northern Brazil has never been economic and will not be until oil prices rise above $40 per barrel. The second half of this thesis uses applied production analysis to determine the source of the ethanol unit cost reductions. For sugar-cane production, a modified symmetric generalized McFadden cost function which includes fixed factors of production is estimated. There is little evidence of technical progress and no evidence of increasing returns to scale in sugar-cane production

  1. Engineering Evaluation/Cost Analysis for Decommissioning of the Engineering Test Reactor Complex

    International Nuclear Information System (INIS)

    A. B. Culp

    2006-01-01

    Preparation of this Engineering Evaluation/Cost Analysis is consistent with the joint U.S. Department of Energy and U.S. Environmental Protection Agency Policy on Decommissioning of Department of Energy Facilities Under the Comprehensive Environmental Response, Compensation, and Liability Act, which establishes the Comprehensive Environmental Response, Compensation, and Liability Act non-time-critical removal action (NTCRA) process as an approach for decommissioning

  2. Engineering Evaluation/Cost Analysis for Decommissioning of the Engineering Test Reactor Complex

    Energy Technology Data Exchange (ETDEWEB)

    A. B. Culp

    2006-10-01

    Preparation of this Engineering Evaluation/Cost Analysis is consistent with the joint U.S. Department of Energy and U.S. Environmental Protection Agency Policy on Decommissioning of Department of Energy Facilities Under the Comprehensive Environmental Response, Compensation, and Liability Act, which establishes the Comprehensive Environmental Response, Compensation, and Liability Act non-time-critical removal action (NTCRA) process as an approach for decommissioning.

  3. A novel low cost pulse excitation source to study trap spectroscopy of persistent luminescent materials

    Science.gov (United States)

    Chandrasekhar, Ngangbam; Singh, Nungleppam Monorajan; Gartia, R. K.

    2018-04-01

    Luminescent techniques require one or the other source of excitations which may vary from high cost X-rays, γ-rays, β-rays etc. to low cost LED. Persistent luminescent materials or Glow-in-the-Dark phosphors are the optical harvesters which store the optical energy from day light illuminating a whole night. They are so sensitive that they can be excited even with the low light of firefly. Therefore, instead of using a high cost excitation source authors have developed a low cost functioning of excitation source controlling short pulses of LED to excite persistent phosphors with the aid of ExpEYES Junior (Hardware/software framework developed by IUAC, New Delhi). Using this, the authors have excited the sample under investigation upto 10 ms. Trap spectroscopy of the pre-excited sample with LED is studied using Thermoluminescence (TL) technique. In this communication, development of the excitation source is discussed and demonstrate the its usefulness in the study of trap spectroscopy of commercially available CaS:Eu2+, Sm3+. Trapping parameters are also evaluated using Computerized Glow Curve Deconvolution (CGCD) technique.

  4. Costs of biodiesel supply chain in Latvia

    International Nuclear Information System (INIS)

    Birzietis, G.; Kunkule, D.

    2003-01-01

    Biodiesels has already become reality in Latvia, but still not are extensively used due to number of reasons. Cost reduction would be one of the most efficient tools that could encourage wider use of biodiesel. Identifying costs in biodiesel supply chain and evaluating their weight in total cost of final product is the first step to finding most costly elements and potential for cost reduction. General cost breakdown in final price is calculated and analysed in this study (authors)

  5. The Quality of Cost-Utility Analyses in Orthopedic Trauma.

    Science.gov (United States)

    Nwachukwu, Benedict U; Schairer, William W; O'Dea, Evan; McCormick, Frank; Lane, Joseph M

    2015-08-01

    As health care in the United States transitions toward a value-based model, there is increasing interest in applying cost-effectiveness analysis within orthopedic surgery. Orthopedic trauma care has traditionally underemphasized economic analysis. The goals of this review were to identify US-based cost-utility analysis in orthopedic trauma, to assess the quality of the available evidence, and to identify cost-effective strategies within orthopedic trauma. Based on a review of 971 abstracts, 8 US-based cost-utility analyses evaluating operative strategies in orthopedic trauma were identified. Study findings were recorded, and the Quality of Health Economic Studies (QHES) instrument was used to grade the overall quality. Of the 8 studies included in this review, 4 studies evaluated hip and femur fractures, 3 studies analyzed upper extremity fractures, and 1 study assessed open tibial fracture management. Cost-effective interventions identified in this review include total hip arthroplasty (over hemiarthroplasty) for femoral neck fractures in the active elderly, open reduction and internal fixation (over nonoperative management) for distal radius and scaphoid fractures, limb salvage (over amputation) for complex open tibial fractures, and systems-based interventions to prevent delay in hip fracture surgery. The mean QHES score of the studies was 79.25 (range, 67-89). Overall, there is a paucity of cost-utility analyses in orthopedic trauma; however, the available evidence suggests that certain operative interventions can be cost-effective. The quality of these studies, however, is fair, based on QHES grading. More attention should be paid to evaluating the cost-effectiveness of operative intervention in orthopedic trauma. Copyright 2015, SLACK Incorporated.

  6. QUALICOPC: Birinci basamak sağlik hizmetlerini kalite, maliyet ve aşitlik açisindan değerlendiren çok ülkeli bir çalişma* = QUALICOPC: a multi-country study evaluating quality, costs and equity in primary care.

    NARCIS (Netherlands)

    Akman, M.; Kalaça, S.; Sargin, M.; Tuncel, B.; Ünlüoğlu, I.; Uğurlu, M.; Schäfer, W.L.A.; Boerma, W.G.W.; Groenewegen, P.P.

    2012-01-01

    Objectives: The QUALICOPC (Quality and Costs of Primary Care in Europe) study aims to evaluate the performance of primary care systems in Europe in terms of quality, equity and costs. QUALICOPC is funded by the European Commission under the "Seventh Framework Program". In this article the

  7. Economic evaluation of pressure ulcer care: A Cost Minimization Analysis of Preventive Strategies

    OpenAIRE

    Schuurman, J.P.; Schoonhoven, L.; Defloor, T.; van Engelshoven, I.; van Ramshorst, B.; Buskens, E.

    2009-01-01

    The purpose of this study was to determine the cost for prevention and treatment of pressure ulcers from a hospital perspective and to identify the least resource-intensive pressure ulcer prevention strategy. Cost analyses were examined from a hospital perspective using direct costs. The study was carried out alongside a prospective cohort study on the incidence and risk factors for pressure ulcers. Two large teaching hospitals in the Netherlands with (partly) opposing approaches in preventio...

  8. Cost-effectiveness analysis alongside a pilot study of prophylactic negative pressure wound therapy.

    Science.gov (United States)

    Heard, Christopher; Chaboyer, Wendy; Anderson, Vinah; Gillespie, Brigid M; Whitty, Jennifer A

    2017-02-01

    Negative pressure wound therapy (NPWT) is increasingly used prophylactically following surgery despite limited evidence of clinical or cost-effectiveness. To evaluate whether NPWT is cost-effective compared to standard care, for the prevention of surgical site infection (SSI) in obese women undergoing elective caesarean section, and inform development of a larger trial. An economic evaluation was conducted alongside a pilot randomised controlled trial at one Australian hospital, in which women were randomised to NPWT (n = 44) or standard care (n = 43). A public health care provider perspective and time horizon to four weeks post-discharge was adopted. Cost-effectiveness assessment was based on incremental cost per SSI prevented and per quality-adjusted life year (QALY) gained. Patients receiving NPWT each received health care costing AU$5887 (±1038) and reported 0.069 (±0.010) QALYs compared to AU$5754 (±1484) and 0.066 (±0.010) QALYs for patients receiving standard care. NPWT may be slightly more costly and more effective than standard care, with estimated incremental cost-effectiveness ratios (ICERs) of AU$1347 (95%CI dominant- $41,873) per SSI prevented and AU$42,340 (95%CI dominant- $884,019) per QALY gained. However, there was considerable uncertainty around these estimates. NPWT may be cost-effective in the prophylactic treatment of surgical wounds following elective caesarean section in obese women. Larger trials could clarify the cost-effectiveness of NPWT as a prophylactic treatment for SSI. Sensitive capture of QALYs and cost offsets will be important given the high level of uncertainty around the point estimate cost-effectiveness ratio which was close to conventional thresholds. ACTRN12612000171819. Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  9. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling.

    Directory of Open Access Journals (Sweden)

    Viviane Hénaux

    Full Text Available Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20% of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3-9.0 million € (i.e. 25-56% decrease. Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

  10. Evaluation of the cost-effectiveness of bovine brucellosis surveillance in a disease-free country using stochastic scenario tree modelling.

    Science.gov (United States)

    Hénaux, Viviane; Calavas, Didier

    2017-01-01

    Surveillance systems of exotic infectious diseases aim to ensure transparency about the country-specific animal disease situation (i.e. demonstrate disease freedom) and to identify any introductions. In a context of decreasing resources, evaluation of surveillance efficiency is essential to help stakeholders make relevant decisions about prioritization of measures and funding allocation. This study evaluated the efficiency (sensitivity related to cost) of the French bovine brucellosis surveillance system using stochastic scenario tree models. Cattle herds were categorized into three risk groups based on the annual number of purchases, given that trading is considered as the main route of brucellosis introduction in cattle herds. The sensitivity in detecting the disease and the costs of the current surveillance system, which includes clinical (abortion) surveillance, programmed serological testing and introduction controls, were compared to those of 19 alternative surveillance scenarios. Surveillance costs included veterinary fees and laboratory analyses. The sensitivity over a year of the current surveillance system was predicted to be 91±7% at a design prevalence of 0.01% for a total cost of 14.9±1.8 million €. Several alternative surveillance scenarios, based on clinical surveillance and random or risk-based serological screening in a sample (20%) of the population, were predicted to be at least as sensitive but for a lower cost. Such changes would reduce whole surveillance costs by 20 to 61% annually, and the costs for farmers only would be decreased from about 12.0 million € presently to 5.3-9.0 million € (i.e. 25-56% decrease). Besides, fostering the evolution of the surveillance system in one of these directions would be in agreement with the European regulations and farmers perceptions on brucellosis risk and surveillance.

  11. Benefit-cost assessment programs: Costa Rica case study

    International Nuclear Information System (INIS)

    Clark, A.L.; Trocki, L.K.

    1991-01-01

    An assessment of mineral potential, in terms of types and numbers of deposits, approximate location and associated tonnage and grades, is a valuable input to a nation's economic planning and mineral policy development. This study provides a methodology for applying benefit-cost analysis to mineral resource assessment programs, both to determine the cost effectiveness of resource assessments and to ascertain future benefits to the nation. In a case study of Costa Rica, the benefit-cost ratio of a resource assessment program was computed to be a minimum of 4:1 ($10.6 million to $2.5 million), not including the economic benefits accuring from the creation of 800 mining sector and 1,200 support services jobs. The benefit-cost ratio would be considerably higher if presently proposed revisions of mineral policy were implemented and benefits could be defined for Costa Rica

  12. Designer's unified cost model

    Science.gov (United States)

    Freeman, William T.; Ilcewicz, L. B.; Swanson, G. D.; Gutowski, T.

    1992-01-01

    A conceptual and preliminary designers' cost prediction model has been initiated. The model will provide a technically sound method for evaluating the relative cost of different composite structural designs, fabrication processes, and assembly methods that can be compared to equivalent metallic parts or assemblies. The feasibility of developing cost prediction software in a modular form for interfacing with state of the art preliminary design tools and computer aided design programs is being evaluated. The goal of this task is to establish theoretical cost functions that relate geometric design features to summed material cost and labor content in terms of process mechanics and physics. The output of the designers' present analytical tools will be input for the designers' cost prediction model to provide the designer with a data base and deterministic cost methodology that allows one to trade and synthesize designs with both cost and weight as objective functions for optimization. The approach, goals, plans, and progress is presented for development of COSTADE (Cost Optimization Software for Transport Aircraft Design Evaluation).

  13. The Potential to Forgo Social Welfare Gains through Over reliance on Cost Effectiveness/Cost Utility Analyses in the Evidence Base for Public Health

    International Nuclear Information System (INIS)

    Cohen, D.R.; Patel, N.

    2010-01-01

    Economic evaluations of clinical treatments most commonly take the form of cost effectiveness or cost utility analyses. This is appropriate since the main sometimes the only benefit of such interventions is increased health. The majority of economic evaluations in public health, however, have also been assessed using these techniques when arguably cost benefit analyses would in many cases have been more appropriate, given its ability to take account of non health benefits as well. An examination of the non health benefits from a sample of studies featured in a recent review of economic evaluations in public health illustrates how over focusing on cost effectiveness/cost utility analyses may lead to forgoing potential social welfare gains from programmes in public health. Prior to evaluation, programmes should be considered in terms of the potential importance of non health benefits and where these are considerable would be better evaluated by more inclusive economic evaluation techniques.

  14. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

  15. A capital cost reduction study on the fast breeder reactor plant

    International Nuclear Information System (INIS)

    Taniyama, H.; Kamei, M.; Moriyama, M.

    1991-01-01

    A capital cost reduction study has been performed for large fast breeder reactor designs. The primary objective of this study is to show a trend of capital cost reduction between FBR plants at the prototype stage, the demonstration stage, and the future commercialization stage. For the FBR plant at the demonstration stage a construction cost comparison with a light water reactor has also been performed, and the target cost of FBR of below 1.5 times that of the light water reactor cost was achieved. To extend the capital cost reduction study, a feasibility study was made to achieve a capital cost of an FBR less than that of a light water reactor. The recommended design is shown as a future commercialization FBR design concept. (author)

  16. On the “cost-optimal levels” of energy performance requirements and its economic evaluation in Italy

    Directory of Open Access Journals (Sweden)

    Lamberto Tronchin

    2014-10-01

    Full Text Available The European energy policies about climate and energy package, known as the “20-20-20” targets define ambitious, but achievable, national energy objectives. As regards the Directives closely related to the 2020 targets, the EU Energy Performance of Buildings Directive (EPBD Recast- DIR 2010/31/EU is the main European legislative instrument for improving the energy performance of buildings, taking into account outdoor climatic and local conditions, as well as indoor climate requirements and cost-effectiveness. The EPBD recast now requests that Member States shall ensure that minimum energy performance requirements for buildings are set “with a view to achieving cost-optimal levels”. The cost optimum level shall be calculated in accordance with a comparative methodology framework, leaving the Member States to determine which of these calculations is to become the national benchmark against which national minimum energy performance requirements will be assessed. The European standards (ENs- Umbrella Document V7 (prCEN/TR 15615 are intended to support the EPBD by providing the calculation methods and associated material to obtain the overall energy performance of a building. For Italy the Energy Performance of Building Simulations EPBS must be calculated with standard UNITS 11300. The energy building behaviour is referred to standard and not to real use, nor climate or dynamic energy evaluation. Since retrofitting of existing buildings offers significant opportunities for reducing energy consumption and greenhouse gas emissions, a case study of retrofitting is described and the CostOptimal Level EU procedure in an Italian context is analysed. Following this procedure, it is shown not only that the energy cost depends on several conditions and most of them are not indexed at national level but also that the cost of improvement depends on local variables and contract tender. The case study highlights the difficulties to apply EU rules, and

  17. Cost-Effectiveness Evaluation of Etoricoxib versus Celecoxib and Nonselective NSAIDs in the Treatment of Ankylosing Spondylitis in Norway

    Directory of Open Access Journals (Sweden)

    Jeroen P. Jansen

    2011-01-01

    Full Text Available Objectives. To evaluate the cost-effectiveness of etoricoxib (90 mg relative to celecoxib (200/400 mg, and the nonselective NSAIDs naproxen (1000 mg and diclofenac (150 mg in the initial treatment of ankylosing spondylitis in Norway. Methods. A previously developed Markov state-transition model was used to estimate costs and benefits associated with initiating treatment with the different competing NSAIDs. Efficacy, gastrointestinal and cardiovascular safety, and resource use data were obtained from the literature. Data from different studies were synthesized and translated into direct costs and quality adjusted life years by means of a Bayesian comprehensive decision modeling approach. Results. Over a 30-year time horizon, etoricoxib is associated with about 0.4 more quality adjusted life years than the other interventions. At 1 year, naproxen is the most cost-saving strategy. However, etoricoxib is cost and quality adjusted life year saving relative to celecoxib, as well as diclofenac and naproxen after 5 years of follow-up. For a willingness-to-pay ceiling ratio of 200,000 Norwegian krones per quality adjusted life year, there is a >95% probability that etoricoxib is the most-cost-effective treatment when a time horizon of 5 or more years is considered. Conclusions. Etoricoxib is the most cost-effective NSAID for initiating treatment of ankylosing spondylitis in Norway.

  18. Assessment of international mitigation costing studies in developing countries

    International Nuclear Information System (INIS)

    Halsnaes, K.

    1995-01-01

    The establishment of the Framework Convention on Climate change has motivated a large number of mitigation costing studies of developing countries. A variety of modelling approaches and input assumptions have been employed, and studies have been carried out by a range of institutions, including international research institutions, consultants and national organisations. This paper attempts to bring together the main results and characteristics of some of the major recent studies. In spite of the diversity of teams involved in the studies, the similarities in scenario definitions and in the bottom-up approach used for the energy sector analysis, enable some key macro indicators and results of the studies to be compared. Two main coordinated country study efforts have been carried out: by the Lawrence Berkeley Laboratory (LBL) and by UNEP collaborating Centre on Energy and Environment (UCCEE). The results and methodological framework of these country studies are assessed in relation to similar country study activities for China, West Africa and South East Asia in order to evaluate possible common conclusions. (au) 13 refs

  19. Using the Kaldor-Hicks Tableau Format for Cost-Benefit Analysis and Policy Evaluation

    Science.gov (United States)

    Krutilla, Kerry

    2005-01-01

    This note describes the Kaldor-Hicks (KH) tableau format as a framework for distributional accounting in cost-benefit analysis and policy evaluation. The KH tableau format can serve as a heuristic aid for teaching microeconomics-based policy analysis, and offer insight to policy analysts and decisionmakers beyond conventional efficiency analysis.

  20. Long-dated evaluation of the external costs of the nuclear; L'evaluation des couts externes a long terme de la filiere nucleaire: interets et limites

    Energy Technology Data Exchange (ETDEWEB)

    Le Dars, A.; Schneider, T

    2002-09-01

    Since the middle of the years 1990, the European Commission developed an ''ExternE'' methodology to propose an homogenous evaluation of the sanitary and environmental external costs of the various energy sectors in Europe. This document discusses the taking into account of the long-dated and analyzes the interests and the limits of the monetary evaluation, in terms of external costs, of the nuclear choice. It is organized in three chapters: 1. a presentation and a discussion on the various evaluation of the ''ExternE'' methodology; 2. a description of the available methods for the monetary evaluation of the long-dated impacts and more particularly the analysis of the monetary values actualization principle; 3. highlighted of the impacts for which the monetary evaluations exist. (A.L.B.)