WorldWideScience

Sample records for costs and cost analysis

  1. Cost benefit analysis cost effectiveness analysis

    International Nuclear Information System (INIS)

    Lombard, J.

    1986-09-01

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

  2. Cost analysis guidelines

    International Nuclear Information System (INIS)

    Strait, R.S.

    1996-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  6. Ethics and Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Arler, Finn

    The purpose of this research report is threefold. Firstly, the author traces the origins and justification of cost-benefit analysis in moral and political philosophy. Secondly, he explain some of the basic features of cost-benefit analysis as a planning tool in a step-bystep presentation. Thirdly......, he presents and discusses some of the main ethical difficulties related to the use of cost-benefit analysis as a planning tool....

  7. Drilling cost analysis

    International Nuclear Information System (INIS)

    Anand, A.B.

    1992-01-01

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

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

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2008-01-01

    The importance of including user's costs in Life-Cycle Cost-Benefit analysis of structures is discussed in this paper. This is especially for bridges of great importance. Repair or/and failure of a bridge will usually result in user costs greater than the repair or replacement costs of the bridge...

  9. Brain network analysis: separating cost from topology using cost-integration.

    Directory of Open Access Journals (Sweden)

    Cedric E Ginestet

    Full Text Available A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i differences in weighted costs and (ii differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration.

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

    Science.gov (United States)

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

    2011-01-01

    A statistically principled way of conducting brain network analysis is still lacking. Comparison of different populations of brain networks is hard because topology is inherently dependent on wiring cost, where cost is defined as the number of edges in an unweighted graph. In this paper, we evaluate the benefits and limitations associated with using cost-integrated topological metrics. Our focus is on comparing populations of weighted undirected graphs that differ in mean association weight, using global efficiency. Our key result shows that integrating over cost is equivalent to controlling for any monotonic transformation of the weight set of a weighted graph. That is, when integrating over cost, we eliminate the differences in topology that may be due to a monotonic transformation of the weight set. Our result holds for any unweighted topological measure, and for any choice of distribution over cost levels. Cost-integration is therefore helpful in disentangling differences in cost from differences in topology. By contrast, we show that the use of the weighted version of a topological metric is generally not a valid approach to this problem. Indeed, we prove that, under weak conditions, the use of the weighted version of global efficiency is equivalent to simply comparing weighted costs. Thus, we recommend the reporting of (i) differences in weighted costs and (ii) differences in cost-integrated topological measures with respect to different distributions over the cost domain. We demonstrate the application of these techniques in a re-analysis of an fMRI working memory task. We also provide a Monte Carlo method for approximating cost-integrated topological measures. Finally, we discuss the limitations of integrating topology over cost, which may pose problems when some weights are zero, when multiplicities exist in the ranks of the weights, and when one expects subtle cost-dependent topological differences, which could be masked by cost-integration. PMID:21829437

  11. Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2010-01-01

    The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future.......The future use of Life-Cycle Cost-Benefit (LCCB) analysis is discussed in this paper. A more complete analysis including not only the traditional factors and user costs, but also factors which are difficult to include in the analysis is needed in the future....

  12. Instructional Cost Analysis: History and Present Inadequacies.

    Science.gov (United States)

    Humphrey, David A.

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

  13. Cost analysis and estimating tools and techniques

    CERN Document Server

    Nussbaum, Daniel

    1990-01-01

    Changes in production processes reflect the technological advances permeat­ ing our products and services. U. S. industry is modernizing and automating. In parallel, direct labor is fading as the primary cost driver while engineering and technology related cost elements loom ever larger. Traditional, labor-based ap­ proaches to estimating costs are losing their relevance. Old methods require aug­ mentation with new estimating tools and techniques that capture the emerging environment. This volume represents one of many responses to this challenge by the cost analysis profession. The Institute of Cost Analysis (lCA) is dedicated to improving the effective­ ness of cost and price analysis and enhancing the professional competence of its members. We encourage and promote exchange of research findings and appli­ cations between the academic community and cost professionals in industry and government. The 1990 National Meeting in Los Angeles, jointly spo~sored by ICA and the National Estimating Society (NES),...

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

    Science.gov (United States)

    Westlake, G E

    1983-03-01

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

  15. Cost and performance analysis of physical security systems

    International Nuclear Information System (INIS)

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

    1998-04-01

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

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

    Science.gov (United States)

    Thaduri, Ravi Kiran

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

  17. Integrated analysis considered mitigation cost, damage cost and adaptation cost in Northeast Asia

    Science.gov (United States)

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

    2015-12-01

    Various studies show that raising the temperature as well as storms, cold snap, raining and drought caused by climate change. And variety disasters have had a damage to mankind. The world risk report(2012, The Nature Conservancy) and UNU-EHS (the United Nations University Institute for Environment and Human Security) reported that more and more people are exposed to abnormal weather such as floods, drought, earthquakes, typhoons and hurricanes over the world. In particular, the case of Korea, we influenced by various pollutants which are occurred in Northeast Asian countries, China and Japan, due to geographical meteorological characteristics. These contaminants have had a significant impact on air quality with the pollutants generated in Korea. Recently, around the world continued their effort to reduce greenhouse gas and to improve air quality in conjunction with the national or regional development goals priority. China is also working on various efforts in accordance with the international flows to cope with climate change and air pollution. In the future, effect of climate change and air quality in Korea and Northeast Asia will be change greatly according to China's growth and mitigation policies. The purpose of this study is to minimize the damage caused by climate change on the Korean peninsula through an integrated approach taking into account the mitigation and adaptation plan. This study will suggest a climate change strategy at the national level by means of a comprehensive economic analysis of the impacts and mitigation of climate change. In order to quantify the impact and damage cost caused by climate change scenarios in a regional scale, it should be priority variables selected in accordance with impact assessment of climate change. The sectoral impact assessment was carried out on the basis of selected variables and through this, to derive the methodology how to estimate damage cost and adaptation cost. And then, the methodology was applied in Korea

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

    Science.gov (United States)

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

    2015-07-15

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

  19. Cost-effectiveness Analysis for Technology Acquisition.

    Science.gov (United States)

    Chakravarty, A; Naware, S S

    2008-01-01

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

  20. Learning Together; part 2: training costs and health gain - a cost analysis.

    Science.gov (United States)

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

    2017-01-01

    Learning Together is a complex educational intervention aimed at improving health outcomes for children and young people. There is an additional cost as two doctors are seeing patients together for a longer appointment than a standard general practice (GP) appointment. Our approach combines the impact of the training clinics on activity in South London in 2014-15 with health gain, using NICE guidance and standards to allow comparison of training options. Activity data was collected from Training Practices hosting Learning Together. A computer based model was developed to analyse the costs of the Learning Together intervention compared to usual training in a partial economic evaluation. The results of the model were used to value the health gain required to make the intervention cost effective. Data were returned for 363 patients booked into 61 clinics across 16 Training Practices. Learning Together clinics resulted in an increase in costs of £37 per clinic. Threshold analysis illustrated one child with a common illness like constipation needs to be well for two weeks, in one Practice hosting four training clinics for the clinics to be considered cost effective. Learning Together is of minimal training cost. Our threshold analysis produced a rubric that can be used locally to test cost effectiveness at a Practice or Programme level.

  1. 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.

  2. Cost benefit analysis vs. referenda

    OpenAIRE

    Martin J. Osborne; Matthew A. Turner

    2007-01-01

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

  3. An analysis of decommissioning costs

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  4. Costs and cost-effectiveness of periviable care.

    Science.gov (United States)

    Caughey, Aaron B; Burchfield, David J

    2014-02-01

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

  5. Cost and performance analysis of physical security systems

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  6. Incorporating psychological influences in probabilistic cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kujawski, Edouard; Alvaro, Mariana; Edwards, William

    2004-01-08

    Today's typical probabilistic cost analysis assumes an ''ideal'' project that is devoid of the human and organizational considerations that heavily influence the success and cost of real-world projects. In the real world ''Money Allocated Is Money Spent'' (MAIMS principle); cost underruns are rarely available to protect against cost overruns while task overruns are passed on to the total project cost. Realistic cost estimates therefore require a modified probabilistic cost analysis that simultaneously models the cost management strategy including budget allocation. Psychological influences such as overconfidence in assessing uncertainties and dependencies among cost elements and risks are other important considerations that are generally not addressed. It should then be no surprise that actual project costs often exceed the initial estimates and are delivered late and/or with a reduced scope. This paper presents a practical probabilistic cost analysis model that incorporates recent findings in human behavior and judgment under uncertainty, dependencies among cost elements, the MAIMS principle, and project management practices. Uncertain cost elements are elicited from experts using the direct fractile assessment method and fitted with three-parameter Weibull distributions. The full correlation matrix is specified in terms of two parameters that characterize correlations among cost elements in the same and in different subsystems. The analysis is readily implemented using standard Monte Carlo simulation tools such as {at}Risk and Crystal Ball{reg_sign}. The analysis of a representative design and engineering project substantiates that today's typical probabilistic cost analysis is likely to severely underestimate project cost for probability of success values of importance to contractors and procuring activities. The proposed approach provides a framework for developing a viable cost management strategy for

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

    International Nuclear Information System (INIS)

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

    1997-01-01

    Purpose: The median survival of well-selected patients with single-brain metastases treated with whole-brain irradiation and resection or radiosurgery is comparable, although a randomized trial of these two modalities has not been performed. In this era of cost containment, it is imperative that health-care professionals make fiscally prudent decisions. The present environment necessitates a critical appraisal of apparently equi-efficacious therapeutic modalities, and it is within this context that we present a comparison of the actual costs of resection and radiosurgery for brain metastases. Methods and Materials: Survival and quality of life outcome data for radiation alone or with surgery were obtained from two randomized trials, and radiosurgical results were obtained from a multiinstitutional analysis that specifically evaluated patients meeting surgical criteria. Only linear accelerator radiosurgery data were considered. Cost analysis was performed from a societal view point, and the following parameters were evaluated: actual cost, cost ratios, cost effectiveness, incremental cost effectiveness, cost utility, incremental cost utility, and national cost burden. The computerized billing records for all patients undergoing resection or radiosurgery for single-brain metastases from January 1989 to July 1994 were reviewed. A total of 46 resections and 135 radiosurgery procedures were performed. During the same time period, 454 patients underwent whole-brain radiation alone. An analysis of the entire bill was performed for each procedure, and each itemized cost was assigned a proportionate figure. The relative cost ratios of resection and radiosurgery were compared using the Wilcoxon rank sum test. Cost effectiveness of each modality, defined as the cost per year of median survival, was evaluated. Incremental cost effectiveness, defined as the additional cost per year of incremental gain in median survival, compared to the next least expensive modality, was also

  8. Social cost-benefit analysis and nuclear futures

    International Nuclear Information System (INIS)

    Pearce, D.W.

    1979-01-01

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

  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. 24 CFR 84.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

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

  11. 43 CFR 12.945 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

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

  12. 22 CFR 145.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

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

  13. Cost analysis of in vitro fertilization.

    Science.gov (United States)

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

    1995-08-01

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

  14. 40 CFR 35.6585 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  15. 7 CFR 550.47 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

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

  16. 29 CFR 95.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  17. 14 CFR 1274.506 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

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

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  19. 15 CFR 14.45 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

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

  20. 45 CFR 74.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

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

  1. 45 CFR 2543.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Cost and price analysis. 2543.45 Section 2543.45... ORGANIZATIONS Post-Award Requirements Property Standards § 2543.45 Cost and price analysis. Some form of cost or price analysis shall be made and documented in the procurement files in connection with every...

  2. 49 CFR 19.45 - Cost and price analysis.

    Science.gov (United States)

    2010-10-01

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

  3. 28 CFR 70.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  4. Cost-effectiveness analysis and innovation.

    Science.gov (United States)

    Jena, Anupam B; Philipson, Tomas J

    2008-09-01

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

  5. 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...

  6. Cost-benefit analysis and non-utilitarian ethics

    NARCIS (Netherlands)

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

    2012-01-01

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

  7. Incremental ALARA cost/benefit computer analysis

    International Nuclear Information System (INIS)

    Hamby, P.

    1987-01-01

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

  8. 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.

  9. 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

  10. Extensive analysis of hydrogen costs

    Energy Technology Data Exchange (ETDEWEB)

    Guinea, D M; Martin, D; Garcia-Alegre, M C; Guinea, D [Consejo Superior de Investigaciones Cientificas, Arganda, Madrid (Spain). Inst. de Automatica Industrial; Agila, W E [Acciona Infraestructuras, Alcobendas, Madrid (Spain). Dept. I+D+i

    2010-07-01

    Cost is a key issue in the spreading of any technology. In this work, the cost of hydrogen is analyzed and determined, for hydrogen obtained by electrolysis. Different contributing partial costs are taken into account to calculate the hydrogen final cost, such as energy and electrolyzers taxes. Energy cost data is taken from official URLs, while electrolyzer costs are obtained from commercial companies. The analysis is accomplished under different hypothesis, and for different countries: Germany, France, Austria, Switzerland, Spain and the Canadian region of Ontario. Finally, the obtained costs are compared to those of the most used fossil fuels, both in the automotive industry (gasoline and diesel) and in the residential sector (butane, coal, town gas and wood), and the possibilities of hydrogen competing against fuels are discussed. According to this work, in the automotive industry, even neglecting subsidies, hydrogen can compete with fossil fuels. Hydrogen can also compete with gaseous domestic fuels. Electrolyzer prices were found to have the highest influence on hydrogen prices. (orig.)

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

    International Nuclear Information System (INIS)

    Golder, W.

    1999-01-01

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

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

    Science.gov (United States)

    Gandjour, Afschin; Müller, Dirk

    2014-10-01

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

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

    Science.gov (United States)

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

    2011-02-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

  15. 41 CFR 105-72.505 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  16. 24 CFR 965.402 - Benefit/cost analysis.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Benefit/cost analysis. 965.402...-Owned Projects § 965.402 Benefit/cost analysis. (a) A benefit/cost analysis shall be made to determine... (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN...

  17. A Comparative Analysis of Activity-Based Costing and Traditional Costing

    OpenAIRE

    Derya Eren Akyol; Gonca Tuncel; G. Mirac Bayhan

    2007-01-01

    Activity-Based Costing (ABC) which has become an important aspect of manufacturing/service organizations can be defined as a methodology that measures the cost and performance of activities, resources and cost objects. It can be considered as an alternative paradigm to traditional cost-based accounting systems. The objective of this paper is to illustrate an application of ABC method and to compare the results of ABC with traditional costing methods. The results of the application highlight t...

  18. Cost analysis methodology of spent fuel storage

    International Nuclear Information System (INIS)

    1994-01-01

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

  19. Environmentally based Cost-Benefit Analysis

    International Nuclear Information System (INIS)

    Magnell, M.

    1993-11-01

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

  20. Model reduction by weighted Component Cost Analysis

    Science.gov (United States)

    Kim, Jae H.; Skelton, Robert E.

    1990-01-01

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

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

    Science.gov (United States)

    Savitz, Lucy A; Savitz, Samuel T

    2016-01-01

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

  2. Cost Analysis In A Multi-Mission Operations Environment

    Science.gov (United States)

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

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    1996-01-01

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

  4. Development of hospital data warehouse for cost analysis of DPC based on medical costs.

    Science.gov (United States)

    Muranaga, F; Kumamoto, I; Uto, Y

    2007-01-01

    To develop a data warehouse system for cost analysis, based on the categories of the diagnosis procedure combination (DPC) system, in which medical costs were estimated by DPC category and factors influencing the balance between costs and fees. We developed a data warehouse system for cost analysis using data from the hospital central data warehouse system. The balance data of patients who were discharged from Kagoshima University Hospital from April 2003 to March 2005 were determined in terms of medical procedure, cost per day and patient admission in order to conduct a drill-down analysis. To evaluate this system, we analyzed cash flow by DPC category of patients who were categorized as having malignant tumors and whose DPC category was reevaluated in 2004. The percentages of medical expenses were highest in patients with acute leukemia, non-Hodgkin's lymphoma, and particularly in patients with malignant tumors of the liver and intrahepatic bile duct. Imaging tests degraded the percentages of medical expenses in Kagoshima University Hospital. These results suggested that cost analysis by patient is important for hospital administration in the inclusive evaluation system using a case-mix index such as DPC.

  5. 38 CFR 49.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  6. 14 CFR 1260.145 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

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

  7. 40 CFR 30.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  8. 32 CFR 32.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

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

  9. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

    Science.gov (United States)

    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

  10. Summit Station Skiway Cost Analysis

    Science.gov (United States)

    2016-07-01

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

  11. QUANTIFYING BENEFITS FOR COST-BENEFIT ANALYSIS

    OpenAIRE

    Attila GYORGY; Nicoleta VINTILA; Florian GAMAN

    2014-01-01

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

  12. Combined multi-criteria and cost-benefit analysis

    DEFF Research Database (Denmark)

    Moshøj, Claus Rehfeld

    1996-01-01

    The paper is an introduction to both theory and application of combined Cost-Benefit and Multi-Criteria Analysis. The first section is devoted to basic utility theory and its practical application in Cost-Benefit Analysis. Based on some of the problems encountered, arguments in favour...... of the application of utility-based Multi-Criteria Analyses methods as an extension and refinement of the traditional Cost-Benefit Analysis are provided. The theory presented in this paper is closely related the methods used in the WARP software (Leleur & Jensen, 1989). The presentation is however wider in scope.......The second section introduces the stated preference methodology used in WARP to create weight profiles for project pool sensitivity analysis. This section includes a simple example. The third section discusses how decision makers can get a priori aid to make their pair-wise comparisons based on project pool...

  13. Development of cost-benefit analysis system

    International Nuclear Information System (INIS)

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

    2001-01-01

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

  14. Infrastructures and Life-Cycle Cost-Benefit Analysis

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    2012-01-01

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

  15. Cost-Benefit Analysis and the Democratic Ideal

    OpenAIRE

    Karine Nyborg; Inger Spangen

    1997-01-01

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

  16. Cost analysis of youth violence prevention.

    Science.gov (United States)

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

    2014-03-01

    Effective violence interventions are not widely implemented, and there is little information about the cost of violence interventions. Our goal is to report the cost of a brief intervention delivered in the emergency department that reduces violence among 14- to 18-year-olds. Primary outcomes were total costs of implementation and the cost per violent event or violence consequence averted. We used primary and secondary data sources to derive the costs to implement a brief motivational interviewing intervention and to identify the number of self-reported violent events (eg, severe peer aggression, peer victimization) or violence consequences averted. One-way and multi-way sensitivity analyses were performed. Total fixed and variable annual costs were estimated at $71,784. If implemented, 4208 violent events or consequences could be prevented, costing $17.06 per event or consequence averted. Multi-way sensitivity analysis accounting for variable intervention efficacy and different cost estimates resulted in a range of $3.63 to $54.96 per event or consequence averted. Our estimates show that the cost to prevent an episode of youth violence or its consequences is less than the cost of placing an intravenous line and should not present a significant barrier to implementation.

  17. Nuclear power company activity based costing management analysis

    International Nuclear Information System (INIS)

    Xu Dan

    2012-01-01

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

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

    OpenAIRE

    Vigren, Andreas

    2015-01-01

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

  19. Cost Analysis for Large Civil Transport Rotorcraft

    Science.gov (United States)

    Coy, John J.

    2006-01-01

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

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

    Kempers, Jari; Ketting, Evert; Lesco, Galina

    2014-07-21

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  3. Cost-benefit analysis: reality or illusion

    International Nuclear Information System (INIS)

    Tait, G.W.C.

    1980-01-01

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

  4. An analysis of nuclear power plant operating costs

    International Nuclear Information System (INIS)

    1988-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chandra Situmeang

    2018-02-01

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

  6. 22 CFR 226.45 - Cost and price analysis.

    Science.gov (United States)

    2010-04-01

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

  7. Cost-effectiveness analysis of sandhill crane habitat management

    Science.gov (United States)

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

    2013-01-01

    Invasive species often threaten native wildlife populations and strain the budgets of agencies charged with wildlife management. We demonstrate the potential of cost-effectiveness analysis to improve the efficiency and value of efforts to enhance sandhill crane (Grus canadensis) roosting habitat. We focus on the central Platte River in Nebraska (USA), a region of international ecological importance for migrating avian species including sandhill cranes. Cost-effectiveness analysis is a valuation process designed to compare alternative actions based on the cost of achieving a pre-determined objective. We estimated costs for removal of invasive vegetation using geographic information system simulations and calculated benefits as the increase in area of sandhill crane roosting habitat. We generated cost effectiveness values for removing invasive vegetation on 7 land parcels and for the entire central Platte River to compare the cost-effectiveness of management at specific sites and for the central Platte River landscape. Median cost effectiveness values for the 7 land parcels evaluated suggest that costs for creating 1 additional hectare of sandhill crane roosting habitat totaled US $1,595. By contrast, we found that creating an additional hectare of sandhill crane roosting habitat could cost as much as US $12,010 for some areas in the central Platte River, indicating substantial cost savings can be achieved by using a cost effectiveness analysis to target specific land parcels for management. Cost-effectiveness analysis, used in conjunction with geographic information systems, can provide decision-makers with a new tool for identifying the most economically efficient allocation of resources to achieve habitat management goals.

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

    Directory of Open Access Journals (Sweden)

    Emmanuel Chidiebere Eze

    2018-01-01

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

  9. Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

    Science.gov (United States)

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

    2009-02-01

    A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

  10. Permeable treatment wall design and cost analysis

    International Nuclear Information System (INIS)

    Manz, C.; Quinn, K.

    1997-01-01

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

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

    International Nuclear Information System (INIS)

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

    1997-02-01

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

  12. Cost benefit analysis for optimization of radiation protection

    International Nuclear Information System (INIS)

    Lindell, B.

    1984-01-01

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

  13. 76 FR 56413 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-09-13

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

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

    Science.gov (United States)

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

    2018-03-01

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

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

    Science.gov (United States)

    Vonflue, F. W.; Cooper, W.

    1980-01-01

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

  16. A managerial accounting analysis of hospital costs.

    Science.gov (United States)

    Frank, W G

    1976-01-01

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

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

    International Nuclear Information System (INIS)

    Hicks, M.J.

    1996-01-01

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

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

    National Research Council Canada - National Science Library

    Doyle, Michael C

    2005-01-01

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

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

    International Nuclear Information System (INIS)

    Shay, M.R.

    1990-04-01

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

  20. A cost analysis: processing maple syrup products

    Science.gov (United States)

    Neil K. Huyler; Lawrence D. Garrett

    1979-01-01

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

  1. COST MEASUREMENT AND COST MANAGEMENT IN TARGET COSTING

    Directory of Open Access Journals (Sweden)

    Moisello Anna Maria

    2012-07-01

    Full Text Available Firms are coping with a competitive scenario characterized by quick changes produced by internationalization, concentration, restructuring, technological innovation processes and financial market crisis. On the one hand market enlargement have increased the number and the segmentation of customers and have raised the number of competitors, on the other hand technological innovation has reduced product life cycle. So firms have to adjust their management models to this scenario, pursuing customer satisfaction and respecting cost constraints. In a context where price is a variable fixed by the market, firms have to switch from the cost measurement logic to the cost management one, adopting target costing methodology. The target costing process is a price driven, customer oriented profit planning and cost management system. It works, in a cross functional way, from the design stage throughout all the product life cycle and it involves the entire value chain. The process implementation needs a costing methodology consistent with the cost management logic. The aim of the paper is to focus on Activity Based Costing (ABC application to target costing process. So: -it analyzes target costing logic and phases, basing on a literary review, in order to highlight the costing needs related to this process; -it shows, through a numerical example, how to structure a flexible ABC model – characterized by the separation between variable, fixed in the short and fixed costs - that effectively supports target costing process in the cost measurement phase (drifting cost determination and in the target cost alignment; -it points out the effectiveness of the Activity Based Costing as a model of cost measurement applicable to the supplier choice and as a support for supply cost management which have an important role in target costing process. The activity based information allows a firm to optimize the supplier choice by following the method of minimizing the

  2. Costs Analysis of Iron Casts Manufacturing

    Directory of Open Access Journals (Sweden)

    S. Kukla

    2012-04-01

    Full Text Available The article presents the issues of costs analysis of iron casts manufacturing using automated foundry lines. Particular attention was paid to departmental costs, conversion costs and costs of in-plant transport. After the Pareto analysis had been carried out, it was possible to set the model area of the process and focus on improving activities related to finishing of a chosen group of casts. In order to eliminate losses, the activities realised in this domain were divided into activities with added value, activities with partially added value and activities without added value. To streamline the production flow, it was proposed to change the location of workstations related to grinding, control and machining of casts. Within the process of constant improvement of manufacturing processes, the aspect of work ergonomics at a workstation was taken into account. As a result of the undertaken actions, some activities without added value were eliminated, efficiency was increased and prime costs of manufacturing casts with regard to finishing treatment were lowered.

  3. Cost benefit analysis of power plant database integration

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  4. 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.

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

    Science.gov (United States)

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

    2018-03-01

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

  6. Digital vs conventional radiography: cost and revenue analysis

    International Nuclear Information System (INIS)

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

    1999-01-01

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

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

    Science.gov (United States)

    Moche, Joanne Spiers

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

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

    OpenAIRE

    Gonzalez-Feliu, Jesus

    2014-01-01

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

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

    Science.gov (United States)

    Kim, Jin Eun

    1977-01-01

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

  10. Japanese Cost Accounting Systems - analysis of the cost accounting systems of the Japanese cost accounting standard

    OpenAIRE

    Peter, Winter

    2005-01-01

    This paper aims at providing an insight into Japanese cost accounting. Firstly, the development of cost accounting in Japan is delineated. Subsequently, the cost accounting systems codified in the Japanese cost accounting standard are analysed based on the classification according to Hoitsch/Schmitz. Lastly, a critical appraisal of the cost accounting systems of the Japanese cost accounting standard as well as a comparison to German and American cost accounting systems are conducted.

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

    International Nuclear Information System (INIS)

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

    1993-01-01

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

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

    NARCIS (Netherlands)

    Wijnen, W. & Stipdonk, H.L.

    2016-01-01

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

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

    Science.gov (United States)

    Qi, Wei

    2017-11-01

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

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

    Science.gov (United States)

    Baltzer, H; Binhammer, P A

    2013-08-01

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

  15. FORECAST: Regulatory effects cost analysis software annual

    International Nuclear Information System (INIS)

    Lopez, B.; Sciacca, F.W.

    1991-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    C. Raineri

    2015-08-01

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

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

    International Nuclear Information System (INIS)

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

    1990-06-01

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

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

    African Journals Online (AJOL)

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

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

    Science.gov (United States)

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

    2002-08-01

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

  3. Exergy costs analysis of groundwater use and water transfers

    International Nuclear Information System (INIS)

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

    2016-01-01

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

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

    Science.gov (United States)

    2001-07-21

    APPENDIX A. ACRONYMS ACCES Attenuating Custom Communication Earpiece System ACEIT Automated Cost estimating Integrated Tools AFSC Air Force...documented in the ACEIT cost estimating tool developed by Tecolote, Inc. The factor used was 14 percent of PMP. 1.3 System Engineering/ Program...The data source is the ASC Aeronautical Engineering Products Cost Factor Handbook which is documented in the ACEIT cost estimating tool developed

  5. Cost-benefit and cost-efficiency analysis of the water footprint in Spain; Analisis coste-beneficio y coste-eficiencia de la Huella Hidrica en Espana

    Energy Technology Data Exchange (ETDEWEB)

    Sotelo Navalpotro, J. A.; Sotelo Perez, M.; Garcia Quiroca, F.

    2011-07-01

    We are increasingly needing ways to secure patterns of development that be sustainable, that is, environmentally, socially and economically appropriate for us and for future generations. Sustainability indicators are a promising tool that would allow us to land the concept, supporting the way in which decisions are made. In Spain there are few experiences on the subject. This paper presents the work carried out to develop sustainability indicators. Throughout the present study shows the importance of analysis of cost-benefit and cost efficiency in the assessment of the water footprint of Spain. (Author)

  6. Cost analysis of light water reactor power plants

    International Nuclear Information System (INIS)

    Mooz, W.E.

    1978-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Muh Nur Hatta

    2017-06-01

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

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

    Directory of Open Access Journals (Sweden)

    N. Y.

    2017-12-01

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

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

    Science.gov (United States)

    Geske, Terry G.

    1979-01-01

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

  10. Department of the Army Cost Analysis Manual

    National Research Council Canada - National Science Library

    1997-01-01

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

  11. Complete daVinci versus laparoscopic pyeloplasty: cost analysis.

    Science.gov (United States)

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

    2005-04-01

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

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

    International Nuclear Information System (INIS)

    Kawasaki, Hirotsugu

    2006-01-01

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

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

    Science.gov (United States)

    van Heugten, Caroline M; Geurtsen, Gert J; Derksen, R Elze; Martina, Juan D; Geurts, Alexander C H; Evers, Silvia M A A

    2011-06-01

    The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment. A cost-analysis was performed identifying costs of healthcare, informal care, and productivity losses. The costs in the year before the Brain Integration Programme (BIP) were compared with the costs in the year after the BIP using the following cost categories: care consumption, caregiver support, productivity losses. Dutch guidelines were used for cost valuation. Thirty-three cases participated (72% response). Mean age was 29.8 years, 59% traumatic brain injury. The BIP costs were €68,400. The informal care and productivity losses reduced significantly after BIP (p costs per patient were €48,449. After BIP these costs were €39,773; a significant reduction (p costs after the BIP advocates the allocation of resources and, from an economic perspective, favours reimbursement of the BIP costs by healthcare insurance companies. However, this cost-analysis is limited as it does not relate costs to clinical effectiveness. :

  14. Cost Analysis of NEDU’s Helium Reclaimer.

    Science.gov (United States)

    1981-09-01

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

  15. An Analysis Of Activity Based Costing Between Benefit And Cost For Its Implementation

    Directory of Open Access Journals (Sweden)

    Dadan Soekardan

    2015-08-01

    Full Text Available This research discusses how the importance of adopting activity-based costing for the company in order to carry out its business strategy. One objective is to implement activity based costing cost efficiency by cutting costs incurred for non-value added activity. But the phenomenon shows that there are still many companies organizations are not interested in adopting the activity based costing. This article also outlines the advantages and limitations in adopting activity based costing for the company.

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

    International Nuclear Information System (INIS)

    Fisher, K.; Clarke-Whistler, K.

    1995-01-01

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

  17. PPICA, Power Plant Investment Cost Analysis

    International Nuclear Information System (INIS)

    Lefevre, J.C.

    2002-01-01

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

  18. Cost-effectiveness Analysis with Influence Diagrams.

    Science.gov (United States)

    Arias, M; Díez, F J

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Nacef Tazi

    2017-02-01

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

  20. COSTS CALCULATION OF TARGET COSTING METHOD

    Directory of Open Access Journals (Sweden)

    Sebastian UNGUREANU

    2014-06-01

    Full Text Available Cost information system plays an important role in every organization in the decision making process. An important task of management is ensuring control of the operations, processes, sectors, and not ultimately on costs. Although in achieving the objectives of an organization compete more control systems (production control, quality control, etc., the cost information system is important because monitors results of the other. Detailed analysis of costs, production cost calculation, quantification of losses, estimate the work efficiency provides a solid basis for financial control. Knowledge of the costs is a decisive factor in taking decisions and planning future activities. Managers are concerned about the costs that will appear in the future, their level underpinning the supply and production decisions as well as price policy. An important factor is the efficiency of cost information system in such a way that the information provided by it may be useful for decisions and planning of the work.

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

    Science.gov (United States)

    Wijnen, Wim; Stipdonk, Henk

    2016-09-01

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

  2. THE ANALYSIS STRUCTURES OF THE COSTS AND OF THE RELATIONSHIP BETWEEN COSTS AND REVENUES IN THE SECTOR OF SEWERAGE AND WASTEWATER TREATMENT IN ROMANIA

    Directory of Open Access Journals (Sweden)

    FÜLÖP ÁRPÁD-ZOLTÁN

    2017-12-01

    Full Text Available The analysis of costs in relation to revenues by enterprises from the branch of water and sanitation in Romania is a necessity. Through this analysis, we can have a perspective on the costs and revenue generated by operators of water and sewage, wastewater treatment. In a previous research we realized this sectoral analysis for the activity of drinking water. In the present research do this sectoral analysis on the activity of sewage, wastewater treatment. This research gives us an overview of the costs that they generate the activity of the treatment plant and on the structure of costs in the formation of the tariff for sewage, wastewater treatment plant. This cost structure and the relationship between the cost and the tariff applied is presented at the level of the sector of activity. As a last step, I study the correlation of costs, company size, geographical area, number of employees, respectively the correlation of the tariff with these elements, respectively, with the elements of cost found in the accounts of these enterprises.

  3. 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)

  4. Cost benefit analysis of reactor safety systems

    International Nuclear Information System (INIS)

    Maurer, H.A.

    1984-01-01

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

  5. Cost-effective analysis of PET application in NSCLC

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  6. Design windows and cost analysis on helical reactors

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  7. POEM is a cost-effective procedure: cost-utility analysis of endoscopic and surgical treatment options in the management of achalasia.

    Science.gov (United States)

    Miller, Heidi J; Neupane, Ruel; Fayezizadeh, Mojtaba; Majumder, Arnab; Marks, Jeffrey M

    2017-04-01

    Achalasia is a rare motility disorder of the esophagus. Treatment is palliative with the goal of symptom remission and slowing the progression of the disease. Treatment options include per oral endoscopic myotomy (POEM), laparoscopic Heller myotomy (LM) and endoscopic treatments such as pneumatic dilation (PD) and botulinum toxin type A injections (BI). We evaluate the economics and cost-effectiveness of treating achalasia. We performed cost analysis for POEM, LM, PD and BI at our institution from 2011 to 2015. Cost of LM was set to 1, and other procedures are presented as percentage change. Cost-effectiveness was calculated based on cost, number of interventions required for optimal results for dilations and injections and efficacy reported in the current literature. Incremental cost-effectiveness ratio was calculated by a cost-utility analysis using quality-adjusted life year gained, defined as a symptom-free year in a patient with achalasia. Average number of interventions required was 2.3 dilations or two injections for efficacies of 80 and 61 %, respectively. POEM cost 1.058 times the cost of LM, and PD and BI cost 0.559 and 0.448 times the cost of LM. Annual cost per cure over a period of 4 years for POEM, and LM were consistently equivalent, trending the same as PD although this has a lower initial cost. The cost per cure of BI remains stable over 3 years and then doubles. The cost-effectiveness of POEM and LM is equivalent. Myotomy, either surgical or endoscopic, is more cost-effective than BI due to high failure rates of the economical intervention. When treatment is being considered BI should be utilized in patients with less than 2-year life expectancy. Pneumatic dilations are cost-effective and are an acceptable approach to treatment of achalasia, although myotomy has a lower relapse rate and is cost-effective compared to PD after 2 years.

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

    International Nuclear Information System (INIS)

    2011-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  10. Analysis of Cost Growth and Cost Composition in the Defense Aerospace Industry

    Science.gov (United States)

    1988-09-01

    Making. New York: Harcourt Brace Jovanovich, Inc., 1977. 16. Horngren , Charles T. Cost Accounting , A Managerial Emphasis. Englewood Cliffs NJ: Prentice...58 7. Scatter Plot of Cost /DL Hour Ratio, Data Set C ................ .................. 59 8. Scatter Plot of Cost /DL S Ratio, Data Set...C 62 9. Scatter Plot of Cost /DL S Ratio, Then-Year Dollars ................... .................... 63 10. Scatter Plot of OH/TC Ratio, Data Set C

  11. Costs and cost-effectiveness of pediatric inguinal hernia repair in Uganda.

    Science.gov (United States)

    Eeson, Gareth; Birabwa-Male, Doreen; Pennington, Mark; Blair, Geoffrey K

    2015-02-01

    Surgically treatable diseases contribute approximately 11% of disability-adjusted life years (DALYs) worldwide yet they remain a neglected public health priority in low- and middle-income countries (LMICs). Pediatric inguinal hernia is the most common congenital abnormality in newborns and a major cause of morbidity and mortality yet elective repair remains largely unavailable in LMICs. This study is aimed to determine the costs and cost-effectiveness of pediatric inguinal hernia repair (PIHR) in a low-resource setting. Medical costs of consecutive elective PIHRs were recorded prospectively at two centers in Uganda. Decision modeling was used to compare two different treatment scenarios (adoption of PIHR and non-adoption) from a provider perspective. A Markov model was constructed to estimate health outcomes under each scenario. The robustness of the cost-effectiveness results in the base case analysis was tested in one-way and probabilistic sensitivity analysis. The primary outcome of interest was cost per DALY averted by the intervention. Sixty-nine PIHRs were performed in 65 children (mean age 3.6 years). Mean cost per procedure was $86.68 US (95% CI 83.1-90.2 USD) and averted an average of 5.7 DALYs each. Incremental cost-effectiveness ratio was $12.41 per DALY averted. The probability of cost-effectiveness was 95% at a cost-effectiveness threshold of $35 per averted DALY. Results were robust to sensitivity analysis under all considered scenarios. Elective PIHR is highly cost-effective for the treatment and prevention of complications of hernia disease even in low-resource settings. PIHR should be prioritized in LMICs alongside other cost-effective interventions.

  12. Patient-physician discussions about costs: definitions and impact on cost conversation incidence estimates.

    Science.gov (United States)

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

    2016-03-31

    Nearly one in three Americans are financially burdened by their medical expenses. To mitigate financial distress, experts recommend routine physician-patient cost conversations. However, the content and incidence of these conversations are unclear, and rigorous definitions are lacking. We sought to develop a novel set of cost conversation definitions, and determine the impact of definitional variation on cost conversation incidence in three clinical settings. Retrospective, mixed-methods analysis of transcribed dialogue from 1,755 outpatient encounters for routine clinical management of breast cancer, rheumatoid arthritis, and depression, occurring between 2010-2014. We developed cost conversation definitions using summative content analysis. Transcripts were evaluated independently by at least two members of our multi-disciplinary team to determine cost conversation incidence using each definition. Incidence estimates were compared using Pearson's Chi-Square Tests. Three cost conversation definitions emerged from our analysis: (a) Out-of-Pocket (OoP) Cost--discussion of the patient's OoP costs for a healthcare service; (b) Cost/Coverage--discussion of the patient's OoP costs or insurance coverage; (c) Cost of Illness- discussion of financial costs or insurance coverage related to health or healthcare. These definitions were hierarchical; OoP Cost was a subset of Cost/Coverage, which was a subset of Cost of Illness. In each clinical setting, we observed significant variation in the incidence of cost conversations when using different definitions; breast oncology: 16, 22, 24% of clinic visits contained cost conversation (OOP Cost, Cost/Coverage, Cost of Illness, respectively; P cost conversation varied significantly depending on the definition used. Our findings and proposed definitions may assist in retrospective interpretation and prospective design of investigations on this topic.

  13. 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

  14. PLACE OF PRODUCTION COSTS SYSTEM ANALYSIS IN SYSTEM ANALYSIS

    Directory of Open Access Journals (Sweden)

    Mariia CHEREDNYCHENKO

    2016-12-01

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

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

    OpenAIRE

    Easter, K. William; Archibald, Sandra O.

    1998-01-01

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

  16. Analysis of Logistics Costs of the Ukrainian Semiconductor Industry

    Directory of Open Access Journals (Sweden)

    Popova Viktoriya D.

    2014-01-01

    Full Text Available The goal of the article is analysis of logistics costs in production of semiconductor materials using example of two Ukrainian enterprises. The article studies influence of logistics management and logistics costs upon formation of the final cost value (price of a commodity (service. It gives an assessment of logistics costs of Ukrainian semiconductor enterprises and establishes its structure by types of main expenditure items: material, transport, production and storehouse. It establishes the generalised quantitative structure of logistics costs of Ukrainian semiconductor enterprises with various forms of ownership under conditions of a situational growth of cost value of products and reduction of profitability of production, caused by common crisis tendencies in economy. Prospects of further studies in this direction are analysis of costs in production of semiconductor products and establishment of the specific feature of their grouping and classifying from the point of view of logistics and justification of the model of assessment of cost value of products, which takes into account mutually contradictory influence of direct logistics costs and logistics management upon the final result.

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

    International Nuclear Information System (INIS)

    Shropshire, D.; Feizollahi, F.

    1995-01-01

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

  18. Impact of Costing and Cost Analysis Methods on the Result of the Period: Methods Based on Partial Cost Theory

    Directory of Open Access Journals (Sweden)

    Toma Maria

    2017-01-01

    Looking from this perspective, in the present paper we have proposed that objectives, to approach the full cost calculation methods based on partial costs (direct-costing on the product or direct-costing evolved, and comparing them to determine the effect they have on the outcome of the period.

  19. Analysis of costs structure of the industrial enterprise

    Directory of Open Access Journals (Sweden)

    Yuriy V. Kovtunenko

    2014-12-01

    Full Text Available Costs are an important factor that affects the economic activities of an industrial enterprise, because they affect the profits of the enterprise on production efficiency and competitiveness. The article aims to summarize approaches of the definition of “costs”, classification costs of the enterprise according to different characteristics and cost structure of industrial enterprises. Each scientist has his own opinion on the choice of the structure and classification of costs, which is based on his own experience and experience of other scientists. Economically justified classification of costs is an important factor for analysis and costs accounting. This paper examines the concept of “costs” in the interpretation of various authors based on research of scientists that highlight the main features of the classification of costs, give the cost structure of industrial enterprises. Based on the study it can be concluded that the standard classification of costs is not for all companies. Therefore, it is necessary to develop a classification of costs according to the main features of the company.

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

    Science.gov (United States)

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

    2014-06-01

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

  1. An Analysis of Rocket Propulsion Testing Costs

    Science.gov (United States)

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

    2009-01-01

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

  2. Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis.

    Science.gov (United States)

    Gomez, G B; Dowdy, D W; Bastos, M L; Zwerling, A; Sweeney, S; Foster, N; Trajman, A; Islam, M A; Kapiga, S; Sinanovic, E; Knight, G M; White, R G; Wells, W A; Cobelens, F G; Vassall, A

    2016-12-01

    Despite improvements in treatment success rates for tuberculosis (TB), current six-month regimen duration remains a challenge for many National TB Programmes, health systems, and patients. There is increasing investment in the development of shortened regimens with a number of candidates in phase 3 trials. We developed an individual-based decision analytic model to assess the cost-effectiveness of a hypothetical four-month regimen for first-line treatment of TB, assuming non-inferiority to current regimens of six-month duration. The model was populated using extensive, empirically-collected data to estimate the economic impact on both health systems and patients of regimen shortening for first-line TB treatment in South Africa, Brazil, Bangladesh, and Tanzania. We explicitly considered 'real world' constraints such as sub-optimal guideline adherence. From a societal perspective, a shortened regimen, priced at USD1 per day, could be a cost-saving option in South Africa, Brazil, and Tanzania, but would not be cost-effective in Bangladesh when compared to one gross domestic product (GDP) per capita. Incorporating 'real world' constraints reduces cost-effectiveness. Patient-incurred costs could be reduced in all settings. From a health service perspective, increased drug costs need to be balanced against decreased delivery costs. The new regimen would remain a cost-effective option, when compared to each countries' GDP per capita, even if new drugs cost up to USD7.5 and USD53.8 per day in South Africa and Brazil; this threshold was above USD1 in Tanzania and under USD1 in Bangladesh. Reducing the duration of first-line TB treatment has the potential for substantial economic gains from a patient perspective. The potential economic gains for health services may also be important, but will be context-specific and dependent on the appropriate pricing of any new regimen.

  3. Cost-Benefit Analysis of Smart Grids Implementation

    International Nuclear Information System (INIS)

    Tomsic, Z.; Pongrasic, M.

    2014-01-01

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

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

    African Journals Online (AJOL)

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

  5. ANALYSIS OF THE COST OF THE DISEASE — PROBLEMS AND SOLUTIONS

    Directory of Open Access Journals (Sweden)

    V.V. Omel'yanovskii

    2011-01-01

    Full Text Available The article discusses the estimation of the disease value, which includes direct, indirect and «intangible» costs. Advantages and disadvantages of different approaches to cost accounting, including the method of direct costs microcalculation compared with established norms of reimbursement are presented. It is demonstrated that disease’s cost not only reveals the burden of a pathology, but also allows the State to rationally allocate resources. The authors conclude that lack of comparability of the results of studies with different approaches to cost accounting does not allow their use in health care management. To solve this problem is necessary to develop a common methodology for analyzing the cost of the disease.Key words: cost of illness study, clinical and economical analysis, direct cost, indirect cost, impalpable costs, microcalculation of costs, human capital method, friction costs method, absenteeism, presenteeism.

  6. Analysis and modeling of rail maintenance costs

    Directory of Open Access Journals (Sweden)

    Amir Ali Bakhshi

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-12-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses-where outcomes are considered separately, with their joint relationship under uncertainty ignored-lead to incorrect inference regarding preferred strategies. The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home (1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding transparent and robust joint comparison of costs and multiple

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

    Science.gov (United States)

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

    2012-10-01

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

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

    Science.gov (United States)

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

    2009-12-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  12. 76 FR 64931 - Building Energy Codes Cost Analysis

    Science.gov (United States)

    2011-10-19

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

  13. [Cost-effectiveness and cost-benefit analysis on strategy for preventing mother-to-child transmission of hepatitis B virus].

    Science.gov (United States)

    Cai, Y L; Zhang, S X; Yang, P C; Lin, Y

    2016-06-01

    Through cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and quantitative optimization analysis to understand the economic benefit and outcomes of strategy regarding preventing mother-to-child transmission (PMTCT) on hepatitis B virus. Based on the principle of Hepatitis B immunization decision analytic-Markov model, strategies on PMTCT and universal vaccination were compared. Related parameters of Shenzhen were introduced to the model, a birth cohort was set up as the study population in 2013. The net present value (NPV), benefit-cost ratio (BCR), incremental cost-effectiveness ratio (ICER) were calculated and the differences between CBA and CEA were compared. A decision tree was built as the decision analysis model for hepatitis B immunization. Three kinds of Markov models were used to simulate the outcomes after the implementation of vaccination program. The PMTCT strategy of Shenzhen showed a net-gain as 38 097.51 Yuan/per person in 2013, with BCR as 14.37. The universal vaccination strategy showed a net-gain as 37 083.03 Yuan/per person, with BCR as 12.07. Data showed that the PMTCT strategy was better than the universal vaccination one and would end with gaining more economic benefit. When comparing with the universal vaccination program, the PMTCT strategy would save 85 100.00 Yuan more on QALY gains for every person. The PMTCT strategy seemed more cost-effective compared with the one under universal vaccination program. In the CBA and CEA hepatitis B immunization programs, the immunization coverage rate and costs of hepatitis B related diseases were the most important influencing factors. Outcomes of joint-changes of all the parameters in CEA showed that PMTCT strategy was a more cost-effective. The PMTCT strategy gained more economic benefit and effects on health. However, the cost of PMTCT strategy was more than the universal vaccination program, thus it is important to pay attention to the process of PMTCT strategy and the universal

  14. Analysis of nuclear-power construction costs

    International Nuclear Information System (INIS)

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

    1988-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  16. Direct cost analysis of intensive care unit stay in four European countries: applying a standardized costing methodology.

    Science.gov (United States)

    Tan, Siok Swan; Bakker, Jan; Hoogendoorn, Marga E; Kapila, Atul; Martin, Joerg; Pezzi, Angelo; Pittoni, Giovanni; Spronk, Peter E; Welte, Robert; Hakkaart-van Roijen, Leona

    2012-01-01

    The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology. A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology was developed on the basis of the availability of data at the seven ICU departments. It entailed the application of the bottom-up approach for "hotel and nutrition" and the top-down approach for "diagnostics," "consumables," and "labor." Direct costs per ICU day ranged from €1168 to €2025. Even though the distribution of costs varied by cost component, labor was the most important cost driver at all departments. The costs for "labor" amounted to €1629 at department G but were fairly similar at the other departments (€711 ± 115). Direct costs of ICU days vary widely between the seven departments. Our standardized costing methodology could serve as a valuable instrument to compare actual cost differences, such as those resulting from differences in patient case-mix. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Cost effectiveness analysis in radiopharmacy

    International Nuclear Information System (INIS)

    Carpentier, N.; Verbeke, S.; Ducloux, T.

    1999-01-01

    Objective: to evaluate the cost effectiveness of radiopharmaceuticals and their quality control. Materials and methods: this retrospective study was made in the Nuclear Medicine Department of the University Hospital of Limoges. Radiopharmaceutical costs were obtained with adding the price of the radiotracer, the materials, the equipments, the labour, the running expenses and the radioisotope. The costs of quality control were obtained with adding the price of labour, materials, equipments, running expenses and the cost of the quality control of 99m Tc eluate. Results: during 1998, 2106 radiopharmaceuticals were prepared in the Nuclear Medicine Department. The mean cost effectiveness of radiopharmaceutical was 1430 francs (846 to 4260). The mean cost effectiveness of quality control was 163 francs (84 to 343). The rise of the radiopharmaceutical cost induced by quality control was 11%. Conclusion: the technical methodology of quality control must be mastered to optimize the cost of this operation. (author)

  18. Optimal Cost-Analysis and Design of Circular Footings

    Directory of Open Access Journals (Sweden)

    Prabir K. Basudhar

    2012-10-01

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

  19. Green Infrastructure Siting and Cost Effectiveness Analysis

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Parcel scale green infrastructure siting and cost effectiveness analysis. You can find more details at the project's website.

  20. Effectiveness and cost-effectiveness of antidepressants in primary care: a multiple treatment comparison meta-analysis and cost-effectiveness model.

    Directory of Open Access Journals (Sweden)

    Joakim Ramsberg

    Full Text Available OBJECTIVE: To determine effectiveness and cost-effectiveness over a one-year time horizon of pharmacological first line treatment in primary care for patients with moderate to severe depression. DESIGN: A multiple treatment comparison meta-analysis was employed to determine the relative efficacy in terms of remission of 10 antidepressants (citalopram, duloxetine escitalopram, fluoxetine, fluvoxamine mirtazapine, paroxetine, reboxetine, sertraline and venlafaxine. The estimated remission rates were then applied in a decision-analytic model in order to estimate costs and quality of life with different treatments at one year. DATA SOURCES: Meta-analyses of remission rates from randomised controlled trials, and cost and quality-of-life data from published sources. RESULTS: The most favourable pharmacological treatment in terms of remission was escitalopram with an 8- to 12-week probability of remission of 0.47. Despite a high acquisition cost, this clinical effectiveness translated into escitalopram being both more effective and having a lower total cost than all other comparators from a societal perspective. From a healthcare perspective, the cost per QALY of escitalopram was €3732 compared with venlafaxine. CONCLUSION: Of the investigated antidepressants, escitalopram has the highest probability of remission and is the most effective and cost-effective pharmacological treatment in a primary care setting, when evaluated over a one year time-horizon. Small differences in remission rates may be important when assessing costs and cost-effectiveness of antidepressants.

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

    NARCIS (Netherlands)

    van Heugten, Caroline M.; Geurtsen, Gert J.; Derksen, R. Elze; Martina, Juan D.; Geurts, Alexander C. H.; Evers, Silvia M. A. A.

    2011-01-01

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

  2. Cost estimation: An expert-opinion approach. [cost analysis of research projects using the Delphi method (forecasting)

    Science.gov (United States)

    Buffalano, C.; Fogleman, S.; Gielecki, M.

    1976-01-01

    A methodology is outlined which can be used to estimate the costs of research and development projects. The approach uses the Delphi technique a method developed by the Rand Corporation for systematically eliciting and evaluating group judgments in an objective manner. The use of the Delphi allows for the integration of expert opinion into the cost-estimating process in a consistent and rigorous fashion. This approach can also signal potential cost-problem areas. This result can be a useful tool in planning additional cost analysis or in estimating contingency funds. A Monte Carlo approach is also examined.

  3. Department of Energy Environmental Management cost infrastructure development program: Cost analysis requirements

    International Nuclear Information System (INIS)

    Custer, W.R. Jr.; Messick, C.D.

    1996-01-01

    This report was prepared to support development of the Department of Energy Environmental Management cost infrastructure -- a new capability to independently estimate and analyze costs. Currently, the cost data are reported according to a structure that blends level of effort tasks with product and process oriented tasks. Also. the budgetary inputs are developed from prior year funding authorizations and from contractor-developed parametric estimates that have been adjusted to planned funding levels or appropriations. Consequently, it is difficult for headquarters and field-level activities to use actual cost data and technical requirements to independently assess the costs generated and identify trends, potential cost savings from process improvements, and cost reduction strategies

  4. Cost Benefit Analysis: Bypass of Prešov city

    Directory of Open Access Journals (Sweden)

    Margorínová Martina

    2017-01-01

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

  5. Activity-based cost analysis in catheter-based angiography and interventional radiology

    International Nuclear Information System (INIS)

    Rautio, R.; Keski-Nisula, L.; Paakkala, T.

    2003-01-01

    The aim of this study was to analyse the costs of the interventional radiology unit and to identify the cost factors in the different activities of catheter-based angiographies and interventional radiology. In 1999 the number of procedures in the interventional radiological unit at Tampere University Hospital was 2968; 1601 of these were diagnostic angiographies, 526 endovascular and 841 nonvascular interventions. The costs were analysed by using Activity Based Cost (ABC) analysis. The budget of the interventional unit was approximately 1.8 million Euro. Material costs accounted for 67%, personnel costs for 17%, equipment costs for 14% and premises costs for 2% of this. The most expensive products were endografting of aortic aneurysms, with a mean price of 5291 Euro and embolizations of cerebral aneurysms (4472 Euro). Endografts formed 87.3% of the total costs in endografting and Guglielmi detachable coils accounted for 63.3% of the total costs in embolizations. The material costs formed the majority of the costs, especially in the newest and most complicated endovascular treatments. Despite the high cost of angiography equipment, its share of the costs is minor. In our experience ABC system is suitable for analysing costs in interventional radiology. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Pulkki-Brännström Anni-Maria

    2012-04-01

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

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

    Science.gov (United States)

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

    1996-05-01

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

  8. MEMS cost analysis from laboratory to industry

    CERN Document Server

    Freng, Ron Lawes

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  10. 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.

  11. Above Bonneville passage and propagation cost effectiveness analysis

    International Nuclear Information System (INIS)

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region

  12. Above Bonneville Passage and Propagation Cost Effectiveness Analysis.

    Energy Technology Data Exchange (ETDEWEB)

    Paulsen, C.M.; Hyman, J.B.; Wernstedt, K.

    1993-05-01

    We have developed several models to evaluate the cost-effectiveness of alternative strategies to mitigate hydrosystem impacts on salmon and steelhead, and applied these models to areas of the Columbia River Basin. Our latest application evaluates the cost-effectiveness of proposed strategies that target mainstem survival (e.g., predator control, increases in water velocity) and subbasin propagation (e.g., habitat improvements, screening, hatchery production increases) for chinook salmon and steelhead stocks, in the portion of the Columbia Basin bounded by Bonneville, Chief Joseph, Dworshak, and Hells Canyon darns. At its core the analysis primarily considers financial cost and biological effectiveness, but we have included other attributes which may be of concern to the region.

  13. Cost and cost-effectiveness of conventional and liquid-based ...

    African Journals Online (AJOL)

    Methods. The unit of effectiveness was defined as the number of cervical intraepithelial neoplasm (CIN) II or higher lesions detected. Costs were assessed retrospectively for the financial year (2010/11) from a laboratory service provider perspective. A cost-effectiveness analysis was performed by combining secondary data ...

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

    International Nuclear Information System (INIS)

    Tzemos, S.; Dippold, D.

    1986-01-01

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

  15. Cost analysis of microtia treatment in the Netherlands.

    Science.gov (United States)

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

    2017-09-01

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

  16. The costs and cost-effectiveness of an integrated sepsis treatment protocol.

    Science.gov (United States)

    Talmor, Daniel; Greenberg, Dan; Howell, Michael D; Lisbon, Alan; Novack, Victor; Shapiro, Nathan

    2008-04-01

    Sepsis is associated with high mortality and treatment costs. International guidelines recommend the implementation of integrated sepsis protocols; however, the true cost and cost-effectiveness of these are unknown. To assess the cost-effectiveness of an integrated sepsis protocol, as compared with conventional care. Prospective cohort study of consecutive patients presenting with septic shock and enrolled in the institution's integrated sepsis protocol. Clinical and economic outcomes were compared with a historical control cohort. Beth Israel Deaconess Medical Center. Overall, 79 patients presenting to the emergency department with septic shock in the treatment cohort and 51 patients in the control group. An integrated sepsis treatment protocol incorporating empirical antibiotics, early goal-directed therapy, intensive insulin therapy, lung-protective ventilation, and consideration for drotrecogin alfa and steroid therapy. In-hospital treatment costs were collected using the hospital's detailed accounting system. The cost-effectiveness analysis was performed from the perspective of the healthcare system using a lifetime horizon. The primary end point for the cost-effectiveness analysis was the incremental cost per quality-adjusted life year gained. Mortality in the treatment group was 20.3% vs. 29.4% in the control group (p = .23). Implementing an integrated sepsis protocol resulted in a mean increase in cost of approximately $8,800 per patient, largely driven by increased intensive care unit length of stay. Life expectancy and quality-adjusted life years were higher in the treatment group; 0.78 and 0.54, respectively. The protocol was associated with an incremental cost of $11,274 per life-year saved and a cost of $16,309 per quality-adjusted life year gained. In patients with septic shock, an integrated sepsis protocol, although not cost-saving, appears to be cost-effective and compares very favorably to other commonly delivered acute care interventions.

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

    Directory of Open Access Journals (Sweden)

    Hübner, Claudia

    2015-10-01

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

  18. Life-cycle analysis and external costs in transportation

    International Nuclear Information System (INIS)

    Delucchi, M.A.

    2002-01-01

    The assessment of greenhouse gas impacts in the US shows that against a baseline gasoline vehicle, the impact of including the full fuel cycle generally reduces the relative advantages of alternative transportation fuels. While a switch to diesel is estimated to save 30% as compared to gasoline, the savings from natural gas/LPG are (around 20%), for ethanol from corn (8%) and for battery electricity vehicles using power from coal (6%) are much smaller. This is largely due to the use of LCA rather than end-use comparisons. However, the results also show that there would be large savings from the use of ethanol from fuel cells using methanol (39%) or natural gas (50%), while ethanol from wood in a conventional engine appears to have the greatest savings (63%). In external costs of motor vehicle use, analysis results were presented for both air pollution and energy security impacts (including SPR, military expenditures, macro-economic costs and pecuniary costs) as well as water pollution, noise and congestion impacts. The results suggest that externalities amount to 1.2 US cents per mile travelled in gasoline powered vehicle. The most significant externality is related to air pollution. Costs associated with US defence, the SPR, and climate change are quite insignificant. The only other variable of significance is the impact on the economy, through the transfer of wealth outside the US (referred to as 'pecuniary externality') and the oil price shock impacts on the economy. A comparison of external costs and subsidies for different transportation modes in the US (gas or electric cars, transit bus, light rail, heavy rail) showed that subsidies available to public transit system greatly outweigh the benefit in reduced externalities avoided. In the comparison of social costs of transportation alternatives, differences in external cost, while not trivial, are outweighed by the differences in direct costs or in subsidies. (author)

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

    Science.gov (United States)

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

    2015-01-01

    Introduction Comparing multiple, diverse outcomes with cost-effectiveness analysis (CEA) is important, yet challenging in areas like palliative care where domains are unamenable to integration with survival. Generic multi-attribute utility values exclude important domains and non-health outcomes, while partial analyses—where outcomes are considered separately, with their joint relationship under uncertainty ignored—lead to incorrect inference regarding preferred strategies. Objective The objective of this paper is to consider whether such decision making can be better informed with alternative presentation and summary measures, extending methods previously shown to have advantages in multiple strategy comparison. Methods Multiple outcomes CEA of a home-based palliative care model (PEACH) relative to usual care is undertaken in cost disutility (CDU) space and compared with analysis on the cost-effectiveness plane. Summary measures developed for comparing strategies across potential threshold values for multiple outcomes include: expected net loss (ENL) planes quantifying differences in expected net benefit; the ENL contour identifying preferred strategies minimising ENL and their expected value of perfect information; and cost-effectiveness acceptability planes showing probability of strategies minimising ENL. Results Conventional analysis suggests PEACH is cost-effective when the threshold value per additional day at home ( 1) exceeds $1,068 or dominated by usual care when only the proportion of home deaths is considered. In contrast, neither alternative dominate in CDU space where cost and outcomes are jointly considered, with the optimal strategy depending on threshold values. For example, PEACH minimises ENL when 1=$2,000 and 2=$2,000 (threshold value for dying at home), with a 51.6% chance of PEACH being cost-effective. Conclusion Comparison in CDU space and associated summary measures have distinct advantages to multiple domain comparisons, aiding

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

    OpenAIRE

    Scott Farrow

    2013-01-01

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

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

    Science.gov (United States)

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

    1986-01-01

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

  2. Cost Improvement Analysis

    Science.gov (United States)

    1986-06-01

    Cc) Ul y Cli U;ra ISO or.) . ............ t cc fl .9 it it ý I oli CC) I it cli L3 I HIM .......... 114 t4l t.r IM...Burroughz Cost AFIT/LSQ AV785-6280 Curve Programs Prof. Jeff Daneman Z-100 Cost Curve ASD/ACCR AV785- 8583 Programs Capt Arthur Mills * *- PROGRAMS CONCEPT

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

    Directory of Open Access Journals (Sweden)

    Sailaja A

    2015-02-01

    Full Text Available Cost of Quality analysis is emerged as an effective tool for the industrial managers for pinpointing the deficiencies in the system as well as for identifying the improvement areas by highlighting the cost reduction opportunities. However , this analysis will be fully effective only if it is further extended to identify the cost incurred in ensuring quality in all areas of the supply chain including the hidden costs and costs of missed out opportunities. Most of the hidden elements of quality costs are difficult to track and not accounted by the traditional accounting tools. An exploratory analysis is made in this research to identify the hidden elements of quality costs in manufacturing industry. Further, the identified cost elements are classified into various groups for better analysis and, finally, prioritized to identify the vital few among them. Analytic Hierarchy Process (AHP technique which is one of the most popular Multi Criteria Decision Method (MCDM and Pareto analysis were used in this study for prioritizing the hidden quality cost elements based on their degree of impact on overall cost of quality. By this analysis, the key cost elements which are to be addressed to reduce the overall cost of quality are identified.

  4. Environmental cost/benefit analysis for fusion power plants

    International Nuclear Information System (INIS)

    Young, J.R.

    1976-11-01

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

  5. OOTW COST TOOLS

    Energy Technology Data Exchange (ETDEWEB)

    HARTLEY, D.S.III; PACKARD, S.L.

    1998-09-01

    This document reports the results of a study of cost tools to support the analysis of Operations Other Than War (OOTW). It recommends the continued development of the Department of Defense (DoD) Contingency Operational Support Tool (COST) as the basic cost analysis tool for 00TWS. It also recommends modifications to be included in future versions of COST and the development of an 00TW mission planning tool to supply valid input for costing.

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Lucas Miyake Okumura

    2016-05-01

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

  8. Cost analysis of energy storage systems for electric utility applications

    Energy Technology Data Exchange (ETDEWEB)

    Akhil, A. [Sandia National Lab., Albuquerque, NM (United States); Swaminathan, S.; Sen, R.K. [R.K. Sen & Associates, Inc., Bethesda, MD (United States)

    1997-02-01

    Under the sponsorship of the Department of Energy, Office of Utility Technologies, the Energy Storage System Analysis and Development Department at Sandia National Laboratories (SNL) conducted a cost analysis of energy storage systems for electric utility applications. The scope of the study included the analysis of costs for existing and planned battery, SMES, and flywheel energy storage systems. The analysis also identified the potential for cost reduction of key components.

  9. An analysis of electric utility embedded power supply costs

    International Nuclear Information System (INIS)

    Kahal, M.; Brown, D.

    1998-01-01

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

  10. Comparing the costs of three prostate cancer follow-up strategies: a cost minimisation analysis.

    Science.gov (United States)

    Pearce, Alison M; Ryan, Fay; Drummond, Frances J; Thomas, Audrey Alforque; Timmons, Aileen; Sharp, Linda

    2016-02-01

    Prostate cancer follow-up is traditionally provided by clinicians in a hospital setting. Growing numbers of prostate cancer survivors mean that this model of care may not be economically sustainable, and a number of alternative approaches have been suggested. The aim of this study was to develop an economic model to compare the costs of three alternative strategies for prostate cancer follow-up in Ireland-the European Association of Urology (EAU) guidelines, the National Institute of Health Care Excellence (NICE) guidelines and current practice. A cost minimisation analysis was performed using a Markov model with three arms (EAU guidelines, NICE guidelines and current practice) comparing follow-up for men with prostate cancer treated with curative intent. The model took a health care payer's perspective over a 10-year time horizon. Current practice was the least cost efficient arm of the model, the NICE guidelines were most cost efficient (74 % of current practice costs) and the EAU guidelines intermediate (92 % of current practice costs). For the 2562 new cases of prostate cancer diagnosed in 2009, the Irish health care system could have saved €760,000 over a 10-year period if the NICE guidelines were adopted. This is the first study investigating costs of prostate cancer follow-up in the Irish setting. While economic models are designed as a simplification of complex real-world situations, these results suggest potential for significant savings within the Irish health care system associated with implementation of alternative models of prostate cancer follow-up care.

  11. An Analysis of Rocket Propulsion Testing Costs

    Science.gov (United States)

    Ramirez, Carmen; Rahman, Shamim

    2010-01-01

    The primary mission at NASA Stennis Space Center (SSC) is rocket propulsion testing. Such testing is commonly characterized as one of two types: production testing for certification and acceptance of engine hardware, and developmental testing for prototype evaluation or research and development (R&D) purposes. For programmatic reasons there is a continuing need to assess and evaluate the test costs for the various types of test campaigns that involve liquid rocket propellant test articles. Presently, in fact, there is a critical need to provide guidance on what represents a best value for testing and provide some key economic insights for decision-makers within NASA and the test customers outside the Agency. Hence, selected rocket propulsion test databases and references have been evaluated and analyzed with the intent to discover correlations of technical information and test costs that could help produce more reliable and accurate cost projections in the future. The process of searching, collecting, and validating propulsion test cost information presented some unique obstacles which then led to a set of recommendations for improvement in order to facilitate future cost information gathering and analysis. In summary, this historical account and evaluation of rocket propulsion test cost information will enhance understanding of the various kinds of project cost information; identify certain trends of interest to the aerospace testing community.

  12. Cost-effectiveness of Human Papilloma Virus (HPV) vaccination in Nigeria: a decision analysis using pragmatic parameter estimates for cost and programme coverage.

    Science.gov (United States)

    Ekwunife, Obinna I; Lhachimi, Stefan K

    2017-12-08

    World Health Organisation recommends routine Human Papilloma Virus (HPV) vaccination for girls when its cost-effectiveness in the country or region has been duly considered. We therefore aimed to evaluate cost-effectiveness of HPV vaccination in Nigeria using pragmatic parameter estimates for cost and programme coverage, i.e. realistically achievable in the studied context. A microsimulation frame-work was used. The natural history for cervical cancer disease was remodelled from a previous Nigerian model-based study. Costing was based on health providers' perspective. Disability adjusted life years attributable to cervical cancer mortality served as benefit estimate. Suitable policy option was obtained by calculating the incremental costs-effectiveness ratio. Probabilistic sensitivity analysis was used to assess parameter uncertainty. One-way sensitivity analysis was used to explore the robustness of the policy recommendation to key parameters alteration. Expected value of perfect information (EVPI) was calculated to determine the expected opportunity cost associated with choosing the optimal scenario or strategy at the maximum cost-effectiveness threshold. Combination of the current scenario of opportunistic screening and national HPV vaccination programme (CS + NV) was the only cost-effective and robust policy option. However, CS + NV scenario was only cost-effective so far the unit cost of HPV vaccine did not exceed $5. EVPI analysis showed that it may be worthwhile to conduct additional research to inform the decision to adopt CS + NV. National HPV vaccination combined with opportunist cervical cancer screening is cost-effective in Nigeria. However, adoption of this strategy should depend on its relative efficiency when compared to other competing new vaccines and health interventions.

  13. Can a Costly Intervention Be Cost-effective?

    Science.gov (United States)

    Foster, E. Michael; Jones, Damon

    2009-01-01

    Objectives To examine the cost-effectiveness of the Fast Track intervention, a multi-year, multi-component intervention designed to reduce violence among at-risk children. A previous report documented the favorable effect of intervention on the highest-risk group of ninth-graders diagnosed with conduct disorder, as well as self-reported delinquency. The current report addressed the cost-effectiveness of the intervention for these measures of program impact. Design Costs of the intervention were estimated using program budgets. Incremental cost-effectiveness ratios were computed to determine the cost per unit of improvement in the 3 outcomes measured in the 10th year of the study. Results Examination of the total sample showed that the intervention was not cost-effective at likely levels of policymakers' willingness to pay for the key outcomes. Subsequent analysis of those most at risk, however, showed that the intervention likely was cost-effective given specified willingness-to-pay criteria. Conclusions Results indicate that the intervention is cost-effective for the children at highest risk. From a policy standpoint, this finding is encouraging because such children are likely to generate higher costs for society over their lifetimes. However, substantial barriers to cost-effectiveness remain, such as the ability to effectively identify and recruit such higher-risk children in future implementations. PMID:17088509

  14. A Cost Analysis of School-Based Lifestyle Interventions.

    Science.gov (United States)

    Oosterhoff, Marije; Bosma, Hans; van Schayck, Onno C P; Joore, Manuela A

    2018-05-31

    A uniform approach for costing school-based lifestyle interventions is currently lacking. The objective of this study was to develop a template for costing primary school-based lifestyle interventions and apply this to the costing of the "Healthy Primary School of the Future" (HPSF) and the "Physical Activity School" (PAS), which aim to improve physical activity and dietary behaviors. Cost-effectiveness studies were reviewed to identify the cost items. Societal costs were reflected by summing up the education, household and leisure, labor and social security, and health perspectives. Cost inputs for HPSF and PAS were obtained for the first year after implementation. In a scenario analysis, the costs were explored for a hypothetical steady state. From a societal perspective, the per child costs were €2.7/$3.3 (HPSF) and €- 0.3/$- 0.4 (PAS) per day during the first year after implementation, and €1.0/$1.2 and €- 1.3/$- 1.6 in a steady state, respectively (2016 prices). The highest costs were incurred by the education perspective (first year: €8.7/$10.6 (HPSF) and €4.0/$4.9 (PAS); steady state: €6.1/$7.4 (HPSF) and €2.1/$2.6 (PAS)), whereas most of the cost offsets were received by the household and leisure perspective (first year: €- 6.0/$- 7.3 (HPSF) and €- 4.4/$- 5.4 (PAS); steady state: €- 5.0/$- 6.1 (HPSF) and €- 3.4/$- 4.1 (PAS)). The template proved helpful for costing HPSF and PAS from various stakeholder perspectives. The costs for the education sector were fully (PAS) and almost fully (HPSF) compensated by the savings within the household sector. Whether the additional costs of HPSF over PAS represent value for money will depend on their relative effectiveness.

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

    OpenAIRE

    Clark, Roger Nelson

    1987-01-01

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

  16. Efficient Solutions and Cost-Optimal Analysis for Existing School Buildings

    Directory of Open Access Journals (Sweden)

    Paolo Maria Congedo

    2016-10-01

    Full Text Available The recast of the energy performance of buildings directive (EPBD describes a comparative methodological framework to promote energy efficiency and establish minimum energy performance requirements in buildings at the lowest costs. The aim of the cost-optimal methodology is to foster the achievement of nearly zero energy buildings (nZEBs, the new target for all new buildings by 2020, characterized by a high performance with a low energy requirement almost covered by renewable sources. The paper presents the results of the application of the cost-optimal methodology in two existing buildings located in the Mediterranean area. These buildings are a kindergarten and a nursery school that differ in construction period, materials and systems. Several combinations of measures have been applied to derive cost-effective efficient solutions for retrofitting. The cost-optimal level has been identified for each building and the best performing solutions have been selected considering both a financial and a macroeconomic analysis. The results illustrate the suitability of the methodology to assess cost-optimality and energy efficiency in school building refurbishment. The research shows the variants providing the most cost-effective balance between costs and energy saving. The cost-optimal solution reduces primary energy consumption by 85% and gas emissions by 82%–83% in each reference building.

  17. (Super Variable Costing-Throughput Costing)

    OpenAIRE

    Çakıcı, Cemal

    2006-01-01

    (Super Variable Costing-Throughput Costing) The aim of this study is to explain the super-variable costing method which is a new subject in cost and management accounting and to show it’s working practicly.Shortly, super-variable costing can be defined as a costing method which is use only direct material costs in calculate of product costs and treats all costs except these (direct labor and overhead) as periad costs or operating costs.By using super-variable costing method, product costs ar...

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

    Science.gov (United States)

    Yamasato, Kelly; Kaneshiro, Bliss; Salcedo, Jennifer

    2015-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Fernando Richartz

    2014-12-01

    Full Text Available This article has as objective mapping of scientific researches into costs behavior to identify its current scenario. The research on database provided a selection of relevant bibliographic portfolio, which had as a result 29 articles according to the research criteria defined in the study. From those, the articles from Anderson, Banker e Janakiraman (2003 were highlighted. Furthermore, Banker is considered to be the main author about costs behavior, its importance is noticed not only in the portfolio itself, but also, in its references. The most important periodic, either for its impact, or related to its number of articles publicized, is The Accounting Review. Finally, from the relationship between the most important articles about bibliometric analysis, featuring systemic analysis, the conclusion is that an important article about cost behavior has a quantitative approach (with the use of robust regression, recognize the existence of Sticky Costs (no matter which approach is in use, makes use of a variety of explanations (internal & external and add some variable or information for scientific evolution of the subject.

  20. Nuclear Power Plant Module, NPP-1: Nuclear Power Cost Analysis.

    Science.gov (United States)

    Whitelaw, Robert L.

    The purpose of the Nuclear Power Plant Modules, NPP-1, is to determine the total cost of electricity from a nuclear power plant in terms of all the components contributing to cost. The plan of analysis is in five parts: (1) general formulation of the cost equation; (2) capital cost and fixed charges thereon; (3) operational cost for labor,…

  1. Cost-Benefit Analysis and the Marginal Cost of Public Funds

    OpenAIRE

    Lundholm, Michael

    2005-01-01

    The marginal cost of public funds defined as the ratio between the shadow price of tax revenues and the population average of the social marginal utility of income, is analysed within an explicit cost–benefit context. It is shown that for an optimal tax system the measure is always equal to one. Benefit and cost measures congruent with this definition are derived. Under optimal taxes a positive net social benefit is a necessary and sufficient condition for a project that passes the cost–benef...

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

    Science.gov (United States)

    Tunis, Sandra L

    2009-01-01

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

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

    Science.gov (United States)

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

    2017-11-01

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

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

    National Research Council Canada - National Science Library

    Tan Torres Edejer, Tessa

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mohammad M. H. Abdullah

    2017-07-01

    Full Text Available Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D and incidence of cardiovascular disease (CVD following a low glycemic index (GI or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively. A four-step cost-of-illness analysis was conducted to: (1 estimate the proportions of individuals who are likely to consume pulses; (2 evaluate the reductions in established risk factors for T2D and CVD; (3 assess the percent reduction in incidences or complications of the diseases of interest; and (4 calculate the potential annual savings in relevant healthcare and related costs. A low GI or high fiber diet that includes pulses and 100 g/day pulse intake were shown to potentially yield Can$6.2 (95% CI $2.6–$9.9 to Can$62.4 (95% CI $26–$98.8 and Can$31.6 (95% CI $11.1–$52 to Can$315.5 (95% CI $110.6–$520.4 million in savings on annual healthcare and related costs of T2D and CVD, respectively. Specific provincial/territorial analyses suggested annual T2D and CVD related cost savings that ranged from up to Can$0.2 million in some provinces to up to Can$135 million in others. In conclusion, with regular consumption of pulse crops, there is a potential opportunity to facilitate T2D and CVD related socioeconomic cost savings that could be applied to Canadian healthcare or re-assigned to other priority domains. Whether these potential cost savings will be offset by other healthcare costs associated with longevity and diseases of the elderly is to be investigated over the long term.

  6. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

    Science.gov (United States)

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

    2016-01-01

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

  7. Aneurysm coil embolization: cost per volumetric filling analysis and strategy for cost reduction.

    Science.gov (United States)

    Wang, Charlie; Ching, Esteban Cheng; Hui, Ferdinand K

    2016-05-01

    One of the primary device expenditures associated with the endovascular treatment of aneurysms is that of detachable coils. Analyzing the cost efficiency of detachable coils is difficult, given the differences in design, implantable volume, and the presence of additives. However, applying a volume per cost metric may provide an index analogous to unit price found in grocery stores. The price information for 509 different coils belonging to 31 different coil lines, available as of September 2013, was obtained through the inventory management system at the study site, and normalized to the price of the least expensive coil. Values were used to calculate the logarithmic ratio of volume over cost. Operator choice among coil sizes can vary the material costs by five-fold in a hypothetical aneurysm. The difference in coil costs as a function of cost per volume of coil can vary tremendously. Using the present pricing algorithms, using the longest available length at a particular helical dimension and system yields improved efficiency. 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. Cost of illness and determinants of costs among patients with gout.

    Science.gov (United States)

    Spaetgens, Bart; Wijnands, José M A; van Durme, Caroline; van der Linden, Sjef; Boonen, Annelies

    2015-02-01

    To estimate costs of illness in a cross-sectional cohort of patients with gout attending an outpatient rheumatology clinic, and to evaluate which factors contribute to higher costs. Altogether, 126 patients with gout were clinically assessed. They completed a series of questionnaires. Health resource use was collected using a self-report questionnaire that was cross-checked with the electronic patient file. Productivity loss was assessed by the Work Productivity and Activity Impairment Questionnaire, addressing absenteeism and presenteeism. Resource use and productivity loss were valued by real costs, and annual costs per patient were calculated. Factors contributing to incurring costs above the median were explored using logistic univariable and multivariable regression analysis. Mean (median) annual direct costs of gout were €5647 (€1148) per patient. Total costs increased to €6914 (€1279) or €10,894 (€1840) per patient per year when adding cost for absenteeism or both absenteeism and presenteeism, respectively. Factors independently associated with high direct and high indirect costs were a positive history of cardiovascular disease, functional limitations, and female sex. In addition, pain, gout concerns, and unmet gout treatment needs were associated with high direct costs. The direct and indirect costs-of-illness of gout are primarily associated with cardiovascular disease, functional limitations, and female sex.

  9. [Hospital costs estimation by micro and gross-costing approaches].

    Science.gov (United States)

    Guerre, P; Hayes, N; Bertaux, A-C

    2018-03-01

    Cost analysis has become increasingly commonplace in healthcare facilities in recent years. Regardless of the aim, the first consideration for a hospital costing process is to determine the point of view, or perspective, to adopt. Should the cost figures reflect the healthcare facility's point of view or enlighten perspectives for the public health insurance system? Another consideration is in regard to the method to adopt, as there are several. The two most widely used methods to determine the costs of hospital treatments in France are the micro-costing method and the gross-costing method. The aims of this work are: (1) to describe each of these methods (e.g. data collection, assignment of monetary value to resource consumption) with their advantages and shortcomings as they relate to the difficulties encountered with their implementation in hospitals; (2) to present a review of the literature comparing the two methods and their possible combination; and (3) to propose ways to address the questions that need to be asked before compiling resource consumption data and assigning monetary value to hospital costs. A final diagram summarizes methodologies to be preferred according to the evaluation strategy and the impact on patient care. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  10. 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.

  11. A cost benefit analysis of outsourced laboratory services.

    Science.gov (United States)

    Bowers, J A

    1995-11-01

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

  12. Clinical benefits, costs, and cost-effectiveness of neonatal intensive care in Mexico.

    Directory of Open Access Journals (Sweden)

    Jochen Profit

    2010-12-01

    Full Text Available Neonatal intensive care improves survival, but is associated with high costs and disability amongst survivors. Recent health reform in Mexico launched a new subsidized insurance program, necessitating informed choices on the different interventions that might be covered by the program, including neonatal intensive care. The purpose of this study was to estimate the clinical outcomes, costs, and cost-effectiveness of neonatal intensive care in Mexico.A cost-effectiveness analysis was conducted using a decision analytic model of health and economic outcomes following preterm birth. Model parameters governing health outcomes were estimated from Mexican vital registration and hospital discharge databases, supplemented with meta-analyses and systematic reviews from the published literature. Costs were estimated on the basis of data provided by the Ministry of Health in Mexico and World Health Organization price lists, supplemented with published studies from other countries as needed. The model estimated changes in clinical outcomes, life expectancy, disability-free life expectancy, lifetime costs, disability-adjusted life years (DALYs, and incremental cost-effectiveness ratios (ICERs for neonatal intensive care compared to no intensive care. Uncertainty around the results was characterized using one-way sensitivity analyses and a multivariate probabilistic sensitivity analysis. In the base-case analysis, neonatal intensive care for infants born at 24-26, 27-29, and 30-33 weeks gestational age prolonged life expectancy by 28, 43, and 34 years and averted 9, 15, and 12 DALYs, at incremental costs per infant of US$11,400, US$9,500, and US$3,000, respectively, compared to an alternative of no intensive care. The ICERs of neonatal intensive care at 24-26, 27-29, and 30-33 weeks were US$1,200, US$650, and US$240, per DALY averted, respectively. The findings were robust to variation in parameter values over wide ranges in sensitivity analyses

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

    Science.gov (United States)

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

    2017-01-01

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

  14. A cost analysis of family planning in Bangladesh.

    Science.gov (United States)

    Fiedler, J L; Day, L M

    1997-01-01

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

  15. A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

    Directory of Open Access Journals (Sweden)

    CARDOS Ildiko Reka

    2010-07-01

    Full Text Available In the last years many organizations realized that market orientation is essential to their success. Satisfying the needs of customers, offering them products and services which meet their desires and demands, customer loyalty can increase profitability for long term. After analyzing the existing journal literature in this field we would like to emphasize that managerial accounting, cost calculation methods and techniques, the analysis of costs provides relevant information when analyzing the customer’s profitability. We pay special attention on cost systems. An activity based costing approach takes customer profitability to new levels of accuracy and usefulness, provides the basis for creating, communicating and delivering value to the customers.

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

    Science.gov (United States)

    Kombos, T; Suess, O; Brock, M

    2002-01-01

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

  17. Guidelines for cost control and analysis of cost-type research and development contracts

    Science.gov (United States)

    Sibbers, C. W.

    1981-01-01

    The cost information which should be obtained from a contractor(s) on a major, cost type research and development contract(s), and the analyses and effective use of these data are discussed. Specific type(s) of information which should be required, methods for analyzing such information, and methods for effectively using the results of such analyses to enhance NASA contract and project management are included. The material presented is based primarily on the principal methods which have been effectively used in the management of major cost type research and development contracts.

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

    Science.gov (United States)

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

    2018-03-01

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

  19. Special waste disposal in Austria - cost benefit analysis

    International Nuclear Information System (INIS)

    Kuntscher, H.

    1983-01-01

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

  20. Controlling Healthcare Costs: Just Cost Effectiveness or "Just" Cost Effectiveness?

    Science.gov (United States)

    Fleck, Leonard M

    2018-04-01

    Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.

  1. Laboratory cost control and financial management software.

    Science.gov (United States)

    Mayer, M

    1998-02-09

    Economical constraints within the health care system advocate the introduction of tighter control of costs in clinical laboratories. Detailed cost information forms the basis for cost control and financial management. Based on the cost information, proper decisions regarding priorities, procedure choices, personnel policies and investments can be made. This presentation outlines some principles of cost analysis, describes common limitations of cost analysis, and exemplifies use of software to achieve optimized cost control. One commercially available cost analysis software, LabCost, is described in some detail. In addition to provision of cost information, LabCost also serves as a general management tool for resource handling, accounting, inventory management and billing. The application of LabCost in the selection process of a new high throughput analyzer for a large clinical chemistry service is taken as an example for decisions that can be assisted by cost evaluation. It is concluded that laboratory management that wisely utilizes cost analysis to support the decision-making process will undoubtedly have a clear advantage over those laboratories that fail to employ cost considerations to guide their actions.

  2. Cost Estimation and Control for Flight Systems

    Science.gov (United States)

    Hammond, Walter E.; Vanhook, Michael E. (Technical Monitor)

    2002-01-01

    Good program management practices, cost analysis, cost estimation, and cost control for aerospace flight systems are interrelated and depend upon each other. The best cost control process cannot overcome poor design or poor systems trades that lead to the wrong approach. The project needs robust Technical, Schedule, Cost, Risk, and Cost Risk practices before it can incorporate adequate Cost Control. Cost analysis both precedes and follows cost estimation -- the two are closely coupled with each other and with Risk analysis. Parametric cost estimating relationships and computerized models are most often used. NASA has learned some valuable lessons in controlling cost problems, and recommends use of a summary Project Manager's checklist as shown here.

  3. The cost of systemic therapy for metastatic colorectal carcinoma in Slovenia: discrepancy analysis between cost and reimbursement

    International Nuclear Information System (INIS)

    Mesti, Tanja; Boshkoska, Biljana Mileva; Kos, Mitja; Tekavčič, Metka; Ocvirk, Janja

    2015-01-01

    The aim of the study was to estimate the direct medical costs of metastatic colorectal cancer (mCRC) treated at the Institute of Oncology Ljubljana and to question the healthcare payment system in Slovenia. Using an internal patient database, the costs of mCRC patients were estimated in 2009 by examining (1) mCRC direct medical related costs, and (2) the cost difference between payment received by Slovenian health insurance and actual mCRC costs. Costs were analysed in the treatment phase of the disease by assessing the direct medical costs of hospital treatment with systemic therapy together with hospital treatment of side effects, without assessing radiotherapy or surgical treatment. Follow-up costs, indirect medical costs, and nonmedical costs were not included. A total of 209 mCRC patients met all eligibility criteria. The direct medical costs of mCRC hospitalization with systemic therapy in Slovenia for 2009 were estimated as the cost of medications (cost of systemic therapy + cost of drugs for premedication) + labor cost (the cost of carrying out systemic treatment) + cost of lab tests + cost of imaging tests + KRAS testing cost + cost of hospital treatment due to side effects of mCRC treatment, and amounted to €3,914,697. The difference between the cost paid by health insurance and actual costs, estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009, was €1,900,757.80. The costs paid to the Institute of Oncology Ljubljana by health insurance for treating mCRC with systemic therapy do not match the actual cost of treatment. In fact, the difference between the payment and the actual cost estimated as direct medical costs of hospitalization of mCRC patients treated with systemic therapy at the Institute of Oncology Ljubljana in 2009 was €1,900,757.80. The model Australian Refined Diagnosis Related Groups (AR-DRG) for cost assessment in oncology being currently used

  4. Cost analysis, cost recovery, marketing and fee-based services a guide for the health sciences librarian

    CERN Document Server

    Wood, M Sandra

    2013-01-01

    This outstanding volume won the 1986 Ida and George Eliot Prize--awarded by the Medical Library Association for the work judged most effective in furthering medical librarianship. Library professionals review the controversy behind fee-for-service programs and provide a rationale for incorporating them into contemporary library philosophies of service. Some fee-based services are necessary for survival in a society that treats information as a marketable commodity; this comprehensive book gives practical advice on cost analysis, cost recovery and marketing of reference services, and presents i

  5. A cost-benefit analysis of The National Map

    Science.gov (United States)

    Halsing, David L.; Theissen, Kevin; Bernknopf, Richard

    2003-01-01

    The Geography Discipline of the U.S. Geological Survey (USGS) has conducted this cost-benefit analysis (CBA) of The National Map. This analysis is an evaluation of the proposed Geography Discipline initiative to provide the Nation with a mechanism to access current and consistent digital geospatial data. This CBA is a supporting document to accompany the Exhibit 300 Capital Asset Plan and Business Case of The National Map Reengineering Program. The framework for estimating the benefits is based on expected improvements in processing information to perform any of the possible applications of spatial data. This analysis does not attempt to determine the benefits and costs of performing geospatial-data applications. Rather, it estimates the change in the differences between those benefits and costs with The National Map and the current situation without it. The estimates of total costs and benefits of The National Map were based on the projected implementation time, development and maintenance costs, rates of data inclusion and integration, expected usage levels over time, and a benefits estimation model. The National Map provides data that are current, integrated, consistent, complete, and more accessible in order to decrease the cost of implementing spatial-data applications and (or) improve the outcome of those applications. The efficiency gains in per-application improvements are greater than the cost to develop and maintain The National Map, meaning that the program would bring a positive net benefit to the Nation. The average improvement in the net benefit of performing a spatial data application was multiplied by a simulated number of application implementations across the country. The numbers of users, existing applications, and rates of application implementation increase over time as The National Map is developed and accessed by spatial data users around the country. Results from the 'most likely' estimates of model parameters and data inputs indicate that

  6. Cost analysis of reliability investigations

    International Nuclear Information System (INIS)

    Schmidt, F.

    1981-01-01

    Taking Epsteins testing theory as a basis, premisses are formulated for the selection of cost-optimized reliability inspection plans. Using an example, the expected testing costs and inspection time periods of various inspection plan types, standardized on the basis of the exponential distribution, are compared. It can be shown that sequential reliability tests usually involve lower costs than failure or time-fixed tests. The most 'costly' test is to be expected with the inspection plan type NOt. (orig.) [de

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

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

    2017-03-20

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

  10. Flat plate vs. concentrator solar photovoltaic cells - A manufacturing cost analysis

    Science.gov (United States)

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

    1980-01-01

    The choice of which photovoltaic system (flat plate or concentrator) to use for utilizing solar cells to generate electricity depends mainly on the cost. A detailed, comparative manufacturing cost analysis of the two types of systems is presented. Several common assumptions, i.e., cell thickness, interest rate, power rate, factory production life, polysilicon cost, and direct labor rate are utilized in this analysis. Process sequences, cost variables, and sensitivity analyses have been studied, and results of the latter show that the most important parameters which determine manufacturing costs are concentration ratio, manufacturing volume, and cell efficiency. The total cost per watt of the flat plate solar cell is $1.45, and that of the concentrator solar cell is $1.85, the higher cost being due to the increased process complexity and material costs.

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

    Science.gov (United States)

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

    2018-05-01

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

  12. Bayesian models for cost-effectiveness analysis in the presence of structural zero costs.

    Science.gov (United States)

    Baio, Gianluca

    2014-05-20

    Bayesian modelling for cost-effectiveness data has received much attention in both the health economics and the statistical literature, in recent years. Cost-effectiveness data are characterised by a relatively complex structure of relationships linking a suitable measure of clinical benefit (e.g. quality-adjusted life years) and the associated costs. Simplifying assumptions, such as (bivariate) normality of the underlying distributions, are usually not granted, particularly for the cost variable, which is characterised by markedly skewed distributions. In addition, individual-level data sets are often characterised by the presence of structural zeros in the cost variable. Hurdle models can be used to account for the presence of excess zeros in a distribution and have been applied in the context of cost data. We extend their application to cost-effectiveness data, defining a full Bayesian specification, which consists of a model for the individual probability of null costs, a marginal model for the costs and a conditional model for the measure of effectiveness (given the observed costs). We presented the model using a working example to describe its main features. © 2013 The Authors. Statistics in Medicine published by John Wiley & Sons, Ltd.

  13. An Insight Into the Two Costing Technique: Absorption Costing and Marginal Costing

    Directory of Open Access Journals (Sweden)

    Mariam Nawaz

    2013-02-01

    Full Text Available This paper will investigate the controversy that is innate between the two costing techniques; Absorption Costing and Marginal Costing and would throw light on which costing technique better serves its purpose in helping management for decision making process and if Marginal Costing technique is concluded as better technique then why it should not be used for external reporting purpose. This paper will only crystallize and highlight the issues descriptively and will not resolve the issues that are inherent between the two costing techniques. The unique thing about this paper is that it is in favor of treating fixed cost as product cost that is it is supporting the advocates of Absorption Costing Technique but it is against to consider profit as a function of production rather it believes that profit should only be considered as function of sales for stock valuation and to help management in decision making process that is, regarding this point it is supporting advocates of Marginal Costing.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  15. RECTIFIED ETHANOL PRODUCTION COST ANALYSIS

    Directory of Open Access Journals (Sweden)

    Nikola J Budimir

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  17. Simulation-Based Approach to Operating Costs Analysis of Freight Trucking

    Directory of Open Access Journals (Sweden)

    Ozernova Natalja

    2015-12-01

    Full Text Available The article is devoted to the problem of costs uncertainty in road freight transportation services. The article introduces the statistical approach, based on Monte Carlo simulation on spreadsheets, to the analysis of operating costs. The developed model gives an opportunity to estimate operating freight trucking costs under different configuration of cost factors. Important conclusions can be made after running simulations regarding sensitivity to different factors, optimal decisions and variability of operating costs.

  18. [Cost-effectiveness analysis and diet quality index applied to the WHO Global Strategy].

    Science.gov (United States)

    Machado, Flávia Mori Sarti; Simões, Arlete Naresse

    2008-02-01

    To test the use of cost-effectiveness analysis as a decision making tool in the production of meals for the inclusion of the recommendations published in the World Health Organization's Global Strategy. Five alternative options for breakfast menu were assessed previously to their adoption in a food service at a university in the state of Sao Paulo, Southeastern Brazil, in 2006. Costs of the different options were based on market prices of food items (direct cost). Health benefits were estimated based on adaptation of the Diet Quality Index (DQI). Cost-effectiveness ratios were estimated by dividing benefits by costs and incremental cost-effectiveness ratios were estimated as cost differential per unit of additional benefit. The meal choice was based on health benefit units associated to direct production cost as well as incremental effectiveness per unit of differential cost. The analysis showed the most simple option with the addition of a fruit (DQI = 64 / cost = R$ 1.58) as the best alternative. Higher effectiveness was seen in the options with a fruit portion (DQI1=64 / DQI3=58 / DQI5=72) compared to the others (DQI2=48 / DQI4=58). The estimate of cost-effectiveness ratio allowed to identifying the best breakfast option based on cost-effectiveness analysis and Diet Quality Index. These instruments allow easy application easiness and objective evaluation which are key to the process of inclusion of public or private institutions under the Global Strategy directives.

  19. Algae Production from Wastewater Resources: An Engineering and Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Schoenung, Susan [Longitude 122 West, Inc.; Efroymson, Rebecca Ann [ORNL

    2018-03-01

    Co-locating algae cultivation ponds near municipal wastewater (MWW) facilities provides the opportunity to make use of the nitrogen and phosphorus compounds in the wastewater as nutrient sources for the algae. This use benefits MWW facilities, the algae biomass and biofuel or bioproduct industry, and the users of streams where treated or untreated waste would be discharged. Nutrient compounds can lead to eutrophication, hypoxia, and adverse effects to some organisms if released downstream. This analysis presents an estimate of the cost savings made possible to cultivation facilities by using the nutrients from wastewater for algae growth rather than purchase of the nutrients. The analysis takes into consideration the cost of pipe transport from the wastewater facility to the algae ponds, a cost factor that has not been publicly documented in the past. The results show that the savings in nutrient costs can support a wastewater transport distance up to 10 miles for a 1000-acre-pond facility, with potential adjustments for different operating assumptions.

  20. 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.

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

    Science.gov (United States)

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

    2012-09-15

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

  2. Tax compliance costs: A review of cost burdens and cost structures

    OpenAIRE

    Eichfelder, Sebastian; Vaillancourt, François

    2014-01-01

    Our paper provides a comprehensive report of empirical research on tax compliance costs. Compared to previous reviews, our focus is on average costs for sub-groups (individual taxpayers, small business-es, large businesses) and the composition of the cost burden with regards to different cost components(in-house time effort, external adviser costs, other monetary expenses), different taxes (e.g. income tax, value added tax) and different activities like tax accounting and tax planning. In add...

  3. Cost Analysis of Treating Neonatal Hypoglycemia with Dextrose Gel.

    Science.gov (United States)

    Glasgow, Matthew J; Harding, Jane E; Edlin, Richard

    2018-04-03

    To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. Australian New Zealand Clinical Trials Registry: ACTRN12608000623392. Copyright © 2018 Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

    Jacobs, D.G.

    1979-01-01

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

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

    International Nuclear Information System (INIS)

    Jacobs, D.G.

    1977-01-01

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

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

    International Nuclear Information System (INIS)

    Kennedy, David

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gafurov Andrey

    2018-01-01

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

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

    Science.gov (United States)

    Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir

    2018-03-01

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

  9. Unreliable trains and induced rescheduling; implications for cost-benefit analysis

    NARCIS (Netherlands)

    Tseng, Y.; Rietveld, P.; Verhoef, E.T.

    2012-01-01

    This paper is concerned with the assessment of generalized user cost reductions in the cost-benefit analysis (CBA) of transport policies that aim at reducing unreliability. In particular, we investigate the implications of railway passengers' anticipating departure behavior when train services were

  10. An Analysis of Missile Systems Cost Growth and Implementation of Acquisition Reform Initiatives Using a Hybrid Adjusted Cost Growth Model

    National Research Council Canada - National Science Library

    Abate, Christopher

    2004-01-01

    ...) data with a hybrid adjusted cost growth (ACG) model. In addition, an analysis of acquisition reform initiatives during the treatment period was conducted to determine if reform efforts impacted missile system cost growth. A pre-reform...

  11. Should Cost-Effectiveness Analysis Include the Cost of Consumption Activities? AN Empirical Investigation.

    Science.gov (United States)

    Adarkwah, Charles Christian; Sadoghi, Amirhossein; Gandjour, Afschin

    2016-02-01

    There has been a debate on whether cost-effectiveness analysis should consider the cost of consumption and leisure time activities when using the quality-adjusted life year as a measure of health outcome under a societal perspective. The purpose of this study was to investigate whether the effects of ill health on consumptive activities are spontaneously considered in a health state valuation exercise and how much this matters. The survey enrolled patients with inflammatory bowel disease in Germany (n = 104). Patients were randomized to explicit and no explicit instruction for the consideration of consumption and leisure effects in a time trade-off (TTO) exercise. Explicit instruction to consider non-health-related utility in TTO exercises did not influence TTO scores. However, spontaneous consideration of non-health-related utility in patients without explicit instruction (60% of respondents) led to significantly lower TTO scores. Results suggest an inclusion of consumption costs in the numerator of the cost-effectiveness ratio, at least for those respondents who spontaneously consider non-health-related utility from treatment. Results also suggest that exercises eliciting health valuations from the general public may include a description of the impact of disease on consumptive activities. Copyright © 2015 John Wiley & Sons, Ltd.

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

    International Nuclear Information System (INIS)

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

    1991-01-01

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

  13. Analysis of nuclear power plant construction costs

    International Nuclear Information System (INIS)

    1986-01-01

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

  14. Analysis of nuclear power plant construction costs

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

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

  15. The JPL Cost Risk Analysis Approach that Incorporates Engineering Realism

    Science.gov (United States)

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

    2006-01-01

    This paper discusses the JPL Cost Engineering Group (CEG) cost risk analysis approach that accounts for all three types of cost risk. It will also describe the evaluation of historical cost data upon which this method is based. This investigation is essential in developing a method that is rooted in engineering realism and produces credible, dependable results to aid decision makers.

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

    Science.gov (United States)

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

    1997-04-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  18. Cost risk analysis of radioactive waste management Preliminary study

    International Nuclear Information System (INIS)

    Forsstroem, J.

    2006-12-01

    This work begins with exposition of the basics of risk analysis. These basics are then applied to the Finnish radioactive waste disposal environment in which the nuclear power companies are responsible for all costs of radioactive waste management including longterm disposal of spent fuel. Nuclear power companies prepare cost estimates of the waste disposal on a yearly basis to support the decision making on accumulation of resources to the nuclear waste disposal fund. These cost estimates are based on the cost level of the ongoing year. A Monte Carlo simulation model of the costs of the waste disposal system was defined and it was used to produce preliminary results of its cost risk characteristics. Input data was synthesised by modifying the original coefficients of cost uncertainty to define a cost range for each cost item. This is a suitable method for demonstrating results obtainable by the model but it is not accurate enough for supporting decision making. Two key areas of further development were identified: the input data preparation and identifying and handling of (i.e. eliminating or merging) interacting cost elements in the simulation model. Further development in both of the mentioned areas can be carried out by co-operating with the power companies as they are the sources of the original data. (orig.)

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

    Science.gov (United States)

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

    2015-09-15

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

  20. Cost analysis and the practicing radiologist/manager: an introduction to managerial accounting.

    Science.gov (United States)

    Forman, H P; Yin, D

    1996-06-01

    Cost analysis is inherently one of the most tedious tasks falling on the shoulders of any manager. In today's world, whether in a service business such as radiology or medicine or in a product line such as car manufacturing, accurate cost analysis is critical to all aspects of management: marketing, competitive strategy, quality control, human resource management, accounting (financial), and operations management, to name but a few. This is a topic that we will explore with the intention of giving the radiologist/manager the understanding and the basic skills to use cost analysis efficiently, making sure that major financial decisions are being made with adequate cost information, and showing that cost accounting is really managerial accounting in that it pays little attention to the bottom line of financial statements but places much more emphasis on equipping managers with the information to determine budgets, prices, salaries, and incentives and influences capital budgeting decisions through an understanding of product profitability rather than firm profitability.

  1. Outline of cost-benefit analysis and a case study

    Science.gov (United States)

    Kellizy, A.

    1978-01-01

    The methodology of cost-benefit analysis is reviewed and a case study involving solar cell technology is presented. Emphasis is placed on simplifying the technique in order to permit a technical person not trained in economics to undertake a cost-benefit study comparing alternative approaches to a given problem. The role of economic analysis in management decision making is discussed. In simplifying the methodology it was necessary to restrict the scope and applicability of this report. Additional considerations and constraints are outlined. Examples are worked out to demonstrate the principles. A computer program which performs the computational aspects appears in the appendix.

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

    Science.gov (United States)

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

    2017-01-20

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

  3. THE COST OF PRODUCTION UNDER DIRECT COSTING AND ABSORPTION COSTING – A COMPARATIVE APPROACH

    Directory of Open Access Journals (Sweden)

    Bunea-Bontaş Cristina Aurora

    2013-04-01

    Full Text Available Managerial accounting has an important role in strategic management of a company, being designed especially for managers, in order to optimise their decision regarding operating activities. One of the objectives of managerial accounting is the cost calculation, for measuring inventory costs, and the costs and profitability of products and services. Cost calculation systems can vary in terms of which costs are assigned to cost objects, two significant calculation systems being adopted by the costing theory: full cost accounting, which includes all costs of production as product costs, and partial cost accounting, which includes only those costs that vary with output. This article provides a comparative approach regarding the differences between the calculation of the cost of production under direct costing and absorption costing. It also examines the implication of using each of these calculation systems on the financial position and financial performance of the companies reported on the statement of financial position and the income statement. Finally, the advantages of using direct costing for internal reporting are discussed, considering that this method is not acceptable for external reporting to stockholders and other external users.

  4. Terminal patients in Belgian nursing homes: a cost analysis.

    Science.gov (United States)

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

    2013-06-01

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

  5. Cost and outcome analysis of two alcohol detoxification services.

    Science.gov (United States)

    Parrott, Steve; Godfrey, Christine; Heather, Nick; Clark, Jenny; Ryan, Tony

    2006-01-01

    To examine the relationship between service use and outcomes (individual and wider consequences) using an economic analysis of a direct-access alcohol detoxification service in Manchester (the Smithfield Centre) and an NHS partial hospitalization programme in Newcastle upon Tyne (Newcastle and North Tyneside Drug and Alcohol Service, Plummer Court). A total of 145 direct-access admissions to the Smithfield Centre and 77 admissions to Plummer Court completed a battery of questionnaires shortly after intake and were followed up 6 months after discharge. Full economic data at follow-up were available for 54 Smithfield admissions and 49 Plummer Court admissions. Mean total cost of treatment per patient was pound1113 at the Smithfield Centre and pound1054 at Plummer Court in 2003-04 prices. Comparing the 6 months before treatment with the 6 months before follow-up, social costs fell by pound331 on average for each patient at Plummer Court but rose by pound1047 for each patient at the Smithfield Centre. When treatment costs and wider social costs were combined, the total cost to society at Smithfield was on average pound2159 per patient whilst at Plummer Court it was pound723 per patient. Combining the cost of treatment with drinking outcomes yielded a net cost per unit reduction in alcohol consumption of pound1.79 at Smithfield and pound1.68 at Plummer Court. Both services delivered a flexible needs-based service to very disadvantaged population at a reasonable cost and were associated with statistically significant reductions in drinking. For some patients, there was evidence of public sector resource savings but for others these detoxification services allowed those not previously in contact with services to meet health and social care needs. These patterns of cost through time are more complex than in previous evaluations of less severely dependent patients and difficult to predict from drinking patterns or patient characteristics. More research is required to judge

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

    International Nuclear Information System (INIS)

    1992-02-01

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

  7. Chapter 17. Engineering cost analysis

    Energy Technology Data Exchange (ETDEWEB)

    Higbee, Charles V.

    1998-01-01

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

  8. Management and cost accounting

    CERN Document Server

    Drury, Colin

    1992-01-01

    This third edition of a textbook on management and cost accounting features coverage of activity-based costing (ABC), advance manufacturing technologies (AMTs), JIT, MRP, target costing, life-cycle costing, strategic management accounting, total quality management and customer profitability analysis. Also included are revised and new end-of-chapter problems taken from past examination papers of CIMA, ACCA and ICAEW. There is increased reference to management accounting in practice, including many of the results of the author's CIMA sponsored survey, and greater emphasis on operational control and performance measurement.

  9. Cost-effectiveness Analysis Appraisal and Application: An Emergency Medicine Perspective.

    Science.gov (United States)

    April, Michael D; Murray, Brian P

    2017-06-01

    Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policymakers have any formal training in CEA methodology. This paper provides an introduction to the interpretation and use of CEA with a focus on application to emergency medicine problems and settings. It applies a previously published CEA to the hypothetical case of a patient presenting to the ED with chest pain who requires risk stratification. This paper uses a widely cited checklist to appraise the CEA. This checklist serves as a vehicle for presenting basic CEA terminology and concepts. General topics of focus include measurement of costs and outcomes, incremental analysis, and sensitivity analysis. Integrated throughout the paper are recommendations for good CEA practice with emphasis on the guidelines published by the U.S. Panel on Cost-Effectiveness in Health and Medicine. Unique challenges for emergency medicine CEAs discussed include the projection of long-term outcomes from emergent interventions, costing ED services, and applying study results to diverse patient populations across various ED settings. The discussion also includes an overview of the limitations inherent in applying CEA results to clinical practice to include the lack of incorporation of noncost considerations in CEA (e.g., ethics). After reading this article, emergency medicine leaders and researchers will have an enhanced understanding of the basics of CEA critical appraisal and application. The paper concludes with an overview of economic evaluation resources for readers interested in conducting ED-based economic evaluation

  10. The indirect costs of multiple sclerosis: systematic review and meta-analysis.

    Science.gov (United States)

    Stawowczyk, Ewa; Malinowski, Krzysztof Piotr; Kawalec, Paweł; Moćko, Paweł

    2015-01-01

    The aim of this systematic review is to collect and summarize all current data on the indirect costs related to absenteeism and presenteeism associated with multiple sclerosis. Searches were conducted using Medline, Embase and Centre for Reviews and Dissemination databases. All collected costs were recalculated to average annual cost per patient, expressed in 2014 prices US$ using the consumer price index and purchasing power parity (scenario 1) and expressed as proportion of specific gross domestic product in current local currency unit to adjust for country's development (scenario 2). Identified studies were then analyzed in order to assess their possible inclusion in the meta-analysis. The authors identified 63 records, of which 23 were eligible for meta-analysis. Overall indirect cost per patient calculated in scenario 1 was as high as US$20,167 with US$22,197 in Europe, US$17,382 in North America and US$153 in Asia. Overall indirect cost per patient calculated in scenario 2 was equal to US$16,939, with US$19,612 in Europe, US$11,592 in North America and US$899 in Asia. Overall indirect costs varied from US$3726 for patients with EDSS score less than 3 to US$19,264 for patients with Expanded Disability Status Scale score grater that 7. This review revealed the great economic burden of multiple sclerosis on society. The authors observed a great variety of the considered components of indirect costs and their definitions. Costs were higher for Europe than for other continents and were also higher for patients with a higher Expanded Disability Status Scale score.

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

    Science.gov (United States)

    Liu, C Carrie; Rudmik, Luke

    2016-10-01

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

  12. THE IMPACT OF THE CONVERSION OF HISTORICAL COST TO CORRECTED CURRENT COST ON RETURN ON ASSETS AND EQUITY: ANALYSIS FROM DUPONT SYSTEM.

    Directory of Open Access Journals (Sweden)

    Roberto Silva da Penha

    2013-12-01

    Full Text Available Historical cost is the most used form of accounting valuation, but it does not reflect the effect of currency in time. The Theory of Corrected Current Cost, albeit with limitations, may show evidence of real and relevant accounting information of the entity. In this context, a question can be formulated: What is the impact of the conversion of historical cost to corrected current cost in return on assets and equity? In order to answer this question, the DuPont system was applied in a model company as a tool for analysis. The results showed that the return of assets at historical cost and corrected current cost were 12.11% and 3.14%, respectively, a decrease of 74.07%, and the result of the return on equity, the historical cost and corrected current cost were 20.59% and 4.96%, respectively, decreased 75.91%. Based on these variations it is observed that the impacts of the conversion of the corrected current cost were significant,confirming the importance of the adoption of this practice, whenever possible.

  13. Design to Cost and Life Cycle Cost.

    Science.gov (United States)

    1980-07-01

    MANAGEMENT TASK ORIENTATED COST STRUCTURE 5. COSTS OF CONSTRUCTION INIFRA 2. COSTS DURING DEVELOPMENT -6. COSTS OF TRAINING 3. COSTS DURING TESi ...de r~duction des coats, ii faut disponer de ?!vyenr. performants d’eetimation des coats en main-d’oeuvre et en applrvininrinesent. Cam moyenm doivent

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

    International Nuclear Information System (INIS)

    Scarpa, C.

    1998-01-01

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

  15. 77 FR 1743 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2012-01-11

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

  16. 76 FR 7881 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2011-02-11

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

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

    Science.gov (United States)

    1997-09-01

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

  18. Total life-cycle cost analysis of conventional and alternative fueled vehicles

    International Nuclear Information System (INIS)

    Cardullo, M.W.

    1993-01-01

    Total Life-Cycle Cost (TLCC) Analysis can indicate whether paying higher capital costs for advanced technology with low operating and/or environmental costs is advantageous over paying lower capital costs for conventional technology with higher operating and/or environmental costs. While minimizing total life-cycle cost is an important consideration, the consumer often identifies non-cost-related benefits or drawbacks that make more expensive options appear more attractive. The consumer is also likely to heavily weigh initial capital costs while giving limited consideration to operating and/or societal costs, whereas policy-makers considering external costs, such as those resulting from environmental impacts, may reach significantly different conclusions about which technologies are most advantageous to society. This paper summarizes a TLCC model which was developed to facilitate consideration of the various factors involved in both individual and societal policy decision making. The model was developed as part of a US Department of Energy Contract and has been revised to reflect changes necessary to make the model more realistic. The model considers capital, operating, salvage, and environmental costs for cars, vans, and buses using conventional and alternative fuels. The model has been developed to operate on an IBM or compatible personal computer platform using the commercial spreadsheet program MicroSoft Excell reg-sign Version 4 for Windows reg-sign and can be easily kept current because its modular structure allows straightforward access to embedded data sets for review and update

  19. [Analysis of cost and efficiency of a medical nursing unit using time-driven activity-based costing].

    Science.gov (United States)

    Lim, Ji Young; Kim, Mi Ja; Park, Chang Gi

    2011-08-01

    Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adil Salam

    2012-10-01

    Full Text Available Cost estimation of new products has always been difficult as only few design, manufacturing and operational features will be known. In these situations, parametric or non-parametric methods are commonly used to estimate the cost of a product given the corresponding cost drivers. The parametric models use priori determined cost function where the parameters of the function are evaluated from historical data. Non-parametric methods, on the other hand, attempt to fit curves to the historic data without predetermined function. In both methods, it is assumed that the historic data used in the analysis is a true representation of the relation between the cost drivers and the corresponding costs. However, because of efficiency variations of the manufacturers and suppliers, changes in supplier selections, market fluctuations, and several other reasons, certain costs in the historic data may be too high whereas other costs may represent better deals for their corresponding cost drivers. Thus, it may be important to rank the historic data and identify benchmarks and estimate the target costs of the product based on these benchmarks. In this paper, a novel adaptation of cost drivers and cost data is introduced in order to use data envelopment analysis for the purpose of ranking cost data and identify benchmarks, and then estimate the target costs of a new product based on these benchmarks. An illustrative case study has been presented for the cost estimation of landing gears of an aircraft manufactured by an aerospace company located in Montreal, CANADA.

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

    Science.gov (United States)

    1988-01-01

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

  3. Food Irradiation Update and Cost Analysis

    Science.gov (United States)

    1991-11-01

    Natick). Significant contributions were made by Dr. Irwin Taub and Mr. Christopher Rees of the Technology Acquisition Division, Food Engineering...stability. 5 Food Irradiation Update C-ost Analysis I. Introduction In the book The Physioloqy of Taste (1825), one of the pioneers of gastronomy ...review of the utility that radiation preserved foods might offer the military food service system. To date, this technology has seen limited use in the

  4. Impacts of nuclear fuel cycle costs on nuclear power generating costs

    International Nuclear Information System (INIS)

    Bertel, E.; Naudet, G.

    1989-01-01

    Fuel cycle costs are one of the main parameters to evaluate the competitiveness of various nuclear strategies. The historical analysis based on the French case shows the good performances yet achieved in mastering elementary costs in order to limit global fuel cycle cost escalation. Two contrasted theoretical scenarios of costs evolution in the middle and long term have been determined, based upon market analysis and technological improvements expected. They are used to calculate the global fuel cycle costs for various fuel management options and for three strategies of nuclear deployment. The results illustrate the stability of the expected fuel cycle costs over the long term, to be compared to the high incertainty prevailing for fossil fueled plants. The economic advantages of advanced technologies such as MOX fueled PWRs are underlined

  5. Cost-Effectiveness/Cost-Benefit Analysis of Newborn Screening for Severe Combined Immune Deficiency in Washington State.

    Science.gov (United States)

    Ding, Yao; Thompson, John D; Kobrynski, Lisa; Ojodu, Jelili; Zarbalian, Guisou; Grosse, Scott D

    2016-05-01

    To evaluate the expected cost-effectiveness and net benefit of the recent implementation of newborn screening (NBS) for severe combined immunodeficiency (SCID) in Washington State. We constructed a decision analysis model to estimate the costs and benefits of NBS in an annual birth cohort of 86 600 infants based on projections of avoided infant deaths. Point estimates and ranges for input variables, including the birth prevalence of SCID, proportion detected asymptomatically without screening through family history, screening test characteristics, survival rates, and costs of screening, diagnosis, and treatment were derived from published estimates, expert opinion, and the Washington NBS program. We estimated treatment costs stratified by age of identification and SCID type (with or without adenosine deaminase deficiency). Economic benefit was estimated using values of $4.2 and $9.0 million per death averted. We performed sensitivity analyses to evaluate the influence of key variables on the incremental cost-effectiveness ratio (ICER) of net direct cost per life-year saved. Our model predicts an additional 1.19 newborn infants with SCID detected preclinically through screening, in addition to those who would have been detected early through family history, and 0.40 deaths averted annually. Our base-case model suggests an ICER of $35 311 per life-year saved, and a benefit-cost ratio of either 5.31 or 2.71. Sensitivity analyses found ICER values <$100 000 and positive net benefit for plausible assumptions on all variables. Our model suggests that NBS for SCID in Washington is likely to be cost-effective and to show positive net economic benefit. Published by Elsevier Inc.

  6. 78 FR 6140 - Discount Rates for Cost-Effectiveness Analysis of Federal Programs

    Science.gov (United States)

    2013-01-29

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

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

    Directory of Open Access Journals (Sweden)

    Ivica Županović

    2015-03-01

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

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

    Science.gov (United States)

    Sinkey, R G; Odibo, A O

    2018-05-22

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

  9. Cost Accounting and Analysis for University Libraries.

    Science.gov (United States)

    Leimkuhler, Ferdinand F.; Cooper, Michael D.

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

  10. An Insight Into the Two Costing Technique: Absorption Costing and Marginal Costing

    OpenAIRE

    Mariam Nawaz

    2013-01-01

    This paper will investigate the controversy that is innate between the two costing techniques; Absorption Costing and Marginal Costing and would throw light on which costing technique better serves its purpose in helping management for decision making process and if Marginal Costing technique is concluded as better technique then why it should not be used for external reporting purpose. This paper will only crystallize and highlight the issues descriptively and will not resolve the issues tha...

  11. Validation of the OpCost logging cost model using contractor surveys

    Science.gov (United States)

    Conor K. Bell; Robert F. Keefe; Jeremy S. Fried

    2017-01-01

    OpCost is a harvest and fuel treatment operations cost model developed to function as both a standalone tool and an integrated component of the Bioregional Inventory Originated Simulation Under Management (BioSum) analytical framework for landscape-level analysis of forest management alternatives. OpCost is an updated implementation of the Fuel Reduction Cost Simulator...

  12. Cost effects of Cu powder and bentonite on the disposal costs of an HLW repository in

    International Nuclear Information System (INIS)

    Kim, Sung Ki; Lee, Min Soo; Lee, Jong Youl; Choi, Heui Joo; Choi, Jong Won

    2008-01-01

    This paper provides the cost effect results of Cu powder and bentonite on the disposal cost for an HLW repository in Korea. In the cost analysis for both of these cost drivers, the price of Cu powder and the bentonite can affect the canister cost and the bentonite cost of the disposal holes as well as backfilling cost of the tunnels, respectively. Finally, we found that the unit cost of Cu and bentonite was the dominant cost drivers for the surface and underground facilities of an HLW repository. Therefore, an optimization of a canister and the layout of a disposal hole and disposal tunnels are essential to decrease the direct disposal cost of spent fuels. The disposal costs can be largely divided into two parts such as a surface facilities' cost and an underground facilities' cost. According to the KRS' cost analysis, the encapsulation material as well as the buffering and backfilling cost were the significant costs. Especially, a canister's cost was approximately estimated to be more than one fourth of the overall disposal costs. So it can be estimated that the unit cost of Cu powder is an important cost diver. Because the outer shell of the canister was made of Cu powder by a cold spray coating method. In addition, the unit cost of bentonite can also affect the buffering and the backfilling costs of the disposal holes and the disposal tunnels. But, these material costs will be highly expensive and unstable due to the modernization of the developing countries. So the studies for a material cost should be continued to identify the actual cost of an HLW repository

  13. Who Should Bear the Cost of Convenience? A Cost-effectiveness Analysis Comparing External Beam and Brachytherapy Radiotherapy Techniques for Early Stage Breast Cancer.

    Science.gov (United States)

    McGuffin, M; Merino, T; Keller, B; Pignol, J-P

    2017-03-01

    Standard treatment for early breast cancer includes whole breast irradiation (WBI) after breast-conserving surgery. Recently, accelerated partial breast irradiation (APBI) has been proposed for well-selected patients. A cost and cost-effectiveness analysis was carried out comparing WBI with two APBI techniques. An activity-based costing method was used to determine the treatment cost from a societal perspective of WBI, high dose rate brachytherapy (HDR) and permanent breast seed implants (PBSI). A Markov model comparing the three techniques was developed with downstream costs, utilities and probabilities adapted from the literature. Sensitivity analyses were carried out for a wide range of variables, including treatment costs, patient costs, utilities and probability of developing recurrences. Overall, HDR was the most expensive ($14 400), followed by PBSI ($8700), with WBI proving the least expensive ($6200). The least costly method to the health care system was WBI, whereas PBSI and HDR were less costly for the patient. Under cost-effectiveness analyses, downstream costs added about $10 000 to the total societal cost of the treatment. As the outcomes are very similar between techniques, WBI dominated under cost-effectiveness analyses. WBI was found to be the most cost-effective radiotherapy technique for early breast cancer. However, both APBI techniques were less costly to the patient. Although innovation may increase costs for the health care system it can provide cost savings for the patient in addition to convenience. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  14. Otoacoustic Emissions in Rural Nicaragua: Cost Analysis and Implications for Newborn Hearing Screening.

    Science.gov (United States)

    Wong, Lye-Yeng; Espinoza, Francisca; Alvarez, Karen Mojica; Molter, Dave; Saunders, James E

    2017-05-01

    Objective (1) Determine the incidence and risk factors for congenital hearing loss. (2) Perform cost analysis of screening programs. Study Design Proportionally distributed cross-sectional survey. Setting Jinotega, Nicaragua. Subjects and Methods Otoacoustic emissions (OAEs) were used to screen 640 infants home birth settings. Data on 15 risk factors were analyzed. Cost of 4 implementation strategies was studied: universal screening, screening at the regional health center (RHC), targeted screening, and screening at the RHC plus targeted screening. Cost-effectiveness analysis over 10 years was based on disability-adjusted life year estimates, with the World Health Organization standard of cost-effectiveness ratio (CER) / gross domestic product (GDP) births, 325 (50.8%) were in the RHC, 69 (10.8%) in the neonatal intensive care unit, and 29 (4.5%) at home. Family history and birth defect were significant in univariate analysis; birth defect was significant in multivariate analysis. Cost-effectiveness analysis demonstrated that OAE screening is cost-effective without treatment (CER/GDP = 0.06-2.00) and with treatment (CER/GDP = 0.58-2.52). Conclusions Our rate of OAE failures was comparable to those of developed countries and lower than hearing loss rates noted among Nicaraguan schoolchildren, suggesting acquired or progressive etiology in the latter. Birth defects and familial hearing loss correlated with OAE failure. OAE screening of infants is feasible and cost-effective in rural Nicaragua, although highly influenced by estimated hearing loss severity in identified infants and the high travel costs incurred in a targeted screening strategy.

  15. An Analysis of Aviation Maintenance Operations and Supporting Costs, and Cost Capturing Systems

    Science.gov (United States)

    2012-12-04

    the La Mesa Parent Teacher Association. = ^Åèìáëáíáçå=oÉëÉ~êÅÜ=mêçÖê~ã= do^ar^qb=p`elli=lc=_rpfkbpp=C=mr_if`=mlif`v= = - vii -= k^s^i=mlpqdo^ar^qb=p...host.uniroma3.it/facolta/ economia /db/materiali/insegnamenti/588_3930.pdf Cost Analysis Improvement Group (CAIG). (2007). Office of the Secretary of

  16. Health Care Analysis for the MCRMC Insurance Cost Model

    Science.gov (United States)

    2015-06-01

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

  17. A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada.

    Science.gov (United States)

    Jozaghi, Ehsan; Reid, Andrew A; Andresen, Martin A; Juneau, Alexandre

    2014-08-04

    Supervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada's capital city, Ottawa. The current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed. The sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases--when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent. Funded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain.

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

  19. Analysis of capital and operating costs associated with high level waste solidification processes

    International Nuclear Information System (INIS)

    Heckman, R.A.; Kniazewycz, B.G.

    1978-03-01

    An analysis was performed to evaluate the sensitivity of annual operating costs and capital costs of waste solidification processes to various parameters defined by the requirements of a proposed Federal waste repository. Five process methods and waste forms examined were: salt cake, spray calcine, fluidized bed calcine, borosilicate glass, and supercalcine multibarrier. Differential cost estimates of the annual operating and maintenance costs and the capital costs for the five HLW solidification alternates were developed

  20. Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures.

    Science.gov (United States)

    Neumann, Peter J; Anderson, Jordan E; Panzer, Ari D; Pope, Elle F; D'Cruz, Brittany N; Kim, David D; Cohen, Joshua T

    2018-01-18

    Background : We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life years (QALYs) gained and cost per disability-adjusted life year (DALY) averted. Methods : We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and  Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics including intervention type, sponsor, country, and primary disease, and also analysed the number of CEAs versus disease burden estimates for major diseases and conditions across three geographic regions. Results : We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth in publication rates for both literatures. Cost-per-QALY studies were most likely to examine pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found discrepancies in the number of published CEAs for certain diseases and conditions in certain regions, suggesting "under-studied" areas (e.g., cardiovascular disease in Southeast Asia, East Asia, and Oceania and "overstudied" areas (e.g., HIV in Sub Saharan Africa) relative to disease burden in those regions. Conclusions : The number of cost-per QALY and cost-per-DALY analyses has grown rapidly with applications to diverse interventions and diseases.  Discrepancies between the number of published studies and disease burden suggest funding opportunities for future cost-effectiveness research.

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

    Science.gov (United States)

    Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

    2016-01-01

    The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  2. An analysis of energy conservation measure costs

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  3. Cost-effectiveness analysis of rotavirus vaccination in Argentina.

    Science.gov (United States)

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

    2015-05-07

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

  4. Life cycle cost analysis of solar heating and DHW systems in residential buildings

    International Nuclear Information System (INIS)

    Colombo, R.; Gilliaert, D.

    1992-01-01

    Economic Life Cycle Cost Analysis (ELCCA) is an easy and friendly computer program, IBM compatible for economic evaluation of solar energy system which involves comparison of the capital and operating costs of a conventional system. In this section we would like to suggest the ELCCA-PC program as a new tools using life cycle cost analysis for annual and cumulative cash flow methodology that take into account all future expenses. ELCCA-PC program considers fixed and changeable items that are involved in installing the equipment such as interest of money borrowed, property and income taxes, current energy cost for electricity operating system, maintenance, insurance and fuel costs and other economic operating expenses. Moreover fraction of annual heating load supplied from solar system is considered in this analysis. ECC-PC program determines the yearly outflow of money over the period of an economic analysis that can be converted to a series of equal payments in today's money

  5. Cost-effectiveness analysis of treatments for vertebral compression fractures.

    Science.gov (United States)

    Edidin, Avram A; Ong, Kevin L; Lau, Edmund; Schmier, Jordana K; Kemner, Jason E; Kurtz, Steven M

    2012-07-01

    Vertebral compression fractures (VCFs) can be treated by nonsurgical management or by minimally invasive surgical treatment including vertebroplasty and balloon kyphoplasty. The purpose of the present study was to characterize the cost to Medicare for treating VCF-diagnosed patients by nonsurgical management, vertebroplasty, or kyphoplasty. We hypothesized that surgical treatments for VCFs using vertebroplasty or kyphoplasty would be a cost-effective alternative to nonsurgical management for the Medicare patient population. Cost per life-year gained for VCF patients in the US Medicare population was compared between operated (kyphoplasty and vertebroplasty) and non-operated patients and between kyphoplasty and vertebroplasty patients, all as a function of patient age and gender. Life expectancy was estimated using a parametric Weibull survival model (adjusted for comorbidities) for 858 978 VCF patients in the 100% Medicare dataset (2005-2008). Median payer costs were identified for each treatment group for up to 3 years following VCF diagnosis, based on 67 018 VCF patients in the 5% Medicare dataset (2005-2008). A discount rate of 3% was used for the base case in the cost-effectiveness analysis, with 0% and 5% discount rates used in sensitivity analyses. After accounting for the differences in median costs and using a discount rate of 3%, the cost per life-year gained for kyphoplasty and vertebroplasty patients ranged from $US1863 to $US6687 and from $US2452 to $US13 543, respectively, compared with non-operated patients. The cost per life-year gained for kyphoplasty compared with vertebroplasty ranged from -$US4878 (cost saving) to $US2763. Among patients for whom surgical treatment was indicated, kyphoplasty was found to be cost effective, and perhaps even cost saving, compared with vertebroplasty. Even for the oldest patients (85 years of age and older), both interventions would be considered cost effective in terms of cost per life-year gained.

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

    Science.gov (United States)

    Xiao, T.

    2012-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

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

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

    Science.gov (United States)

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

    2006-09-01

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

  9. Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland.

    Directory of Open Access Journals (Sweden)

    Themba G Ginindza

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

  10. Peranan Metode Activity Based Costing Dalam Menentukan Cost of Goods Manufactured

    OpenAIRE

    Martusa, Riki; Darma, Stephanus Ryan; Carolina, Verani

    2011-01-01

    The purpose of this research is to know production process of a textile company in Bandung and to analyze the comparison between cost of goods manufactured calculation methods, that applied in the company (traditional costing method) and Activity Based Costing (ABC) method. The obatained data was performed monthly during the year 2009. Based on analysis result, Cost Of Goods Manufactured calculation for unpattern material using ABC method resulted the Cost Of Goods Manufactured that is lower ...

  11. Cost and Price Collaboration

    Science.gov (United States)

    2016-04-30

    described below which relies on questionnaires administered to subject matter experts in both cost analysis and price analysis to determine the value of...additional reports or data that the price analyst used in determining their final negotiated position. The cost analyst section of the questionnaire...an analysis at the individual element level rather than at a total price level to determine the major changes from the awarded contract to the new

  12. Joint environmental and cost efficiency analysis of electricity generation

    International Nuclear Information System (INIS)

    Welch, Eric; Barnum, Darold

    2009-01-01

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

  13. Final Report: Hydrogen Storage System Cost Analysis

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-09-30

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

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

    Science.gov (United States)

    Custer, Brian; Hoch, Jeffrey S

    2009-01-01

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

  15. 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.

  16. Worldwide analysis of marine oil spill cleanup cost factors

    International Nuclear Information System (INIS)

    Etkin, D.S.

    2000-01-01

    The many factors that influence oil spill response costs were discussed with particular emphasis on how spill responses differ around the world because of differing cultural values, socio-economic factors and labor costs. This paper presented an analysis of marine oil spill cleanup costs based on the country, proximity to shoreline, spill size, oil type, degree of shoreline oiling and cleanup methodology. The objective was to determine how each factor impacts per-unit cleanup costs. Near-shore spills and in-port spills were found to be 4-5 times more expensive to clean than offshore spills. Responses to spills of heavy fuels also cost 10 times more than for lighter crudes and diesel. Spill responses for spills under 30 tonnes are 10 times more costly than on a per-unit basis, for spills of 300 tonnes. A newly developed modelling technique that can be used on different types of marine spills was described. It is based on updated cost data acquired from case studies of more than 300 spills in 40 countries. The model determines a per-unit cleanup cost estimation by taking into consideration oil type, location, spill size, cleanup methodology, and shoreline oiling. It was concluded that the actual spill costs are totally dependent on the actual circumstances of the spill. 13 refs., 10 tabs., 3 figs

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-03-11

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

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

    African Journals Online (AJOL)

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

  19. Cost analysis for final disposal of double-shell tank waste

    International Nuclear Information System (INIS)

    Seifert, T.W.; Markillie, K.D.

    1996-01-01

    The Cost Analysis For Final Disposal of Double-Shell Tank Waste provides the Department of Energy (DOE) and DOE contractors with a better understanding of costs associated with the transfer, storage, and treatment of liquid mixed wasted within the Double-Shell Tank System (DST). In order to evaluate waste minimization/pollution prevention ideas, it is necessary to have reliable cost data that can be used in cost/benefit analyses; preparation of funding requests and/or proposals; and provide a way for prioritizing and allocating limited resources. This cost per gallon rate will be used by DST waste generators to assess the feasibility of Pollution Prevention Opportunity Assessments (P20A) and to determine the cost avoidances or savings associated with the implementation of those P20As

  20. Analysis of public costs and risks in the Canadian nuclear industry

    International Nuclear Information System (INIS)

    Cantor, R.A.

    1985-01-01

    This dissertation evaluates selected aspects of the Canadian nuclear program in terms of their contribution to economic welfare. It concentrates on the diffusion of nuclear power in Canada, and measures the welfare implications within an ex post benefit-cost framework of the current generation of operating plants. This approach differs most significantly from prior research by focusing on the investment of public resources to pursue the management of the technological change and the importance of specific areas of uncertainty associated with the use of the technology. These areas of uncertainty are important for the understanding of policy actions which have altered the distribution of costs and risks in the industry, and would affect the relevance of the policies in another economic environment. The results of the benefit-cost analysis indicate that while the program has produced some possible regulatory outcomes, the social opportunity costs of the public investment have not been balanced by social benefits in the form of lower energy costs. Even under the most favorable assumptions used regarding the nuclear plants, the net social costs of the program are shown to be $10 billion in constant 1978 dollars and it is unlikely that the net benefits that have not been included in the analysis will yield a positive social gain in a welfare sense

  1. Pressure relieving support surfaces (PRESSURE) trial: cost effectiveness analysis.

    Science.gov (United States)

    Iglesias, Cynthia; Nixon, Jane; Cranny, Gillian; Nelson, E Andrea; Hawkins, Kim; Phillips, Angela; Torgerson, David; Mason, Su; Cullum, Nicky

    2006-06-17

    To assess the cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital. Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial. 11 hospitals in six UK NHS trusts. Intention to treat population comprising 1971 participants. Kaplan Meier estimates of restricted mean time to development of pressure ulcers and total costs for treatment in hospital. Alternating pressure mattresses were associated with lower overall costs (283.6 pounds sterling per patient on average, 95% confidence interval--377.59 pounds sterling to 976.79 pounds sterling) mainly due to reduced length of stay in hospital, and greater benefits (a delay in time to ulceration of 10.64 days on average,--24.40 to 3.09). The differences in health benefits and total costs for hospital stay between alternating pressure mattresses and alternating pressure overlays were not statistically significant; however, a cost effectiveness acceptability curve indicated that on average alternating pressure mattresses compared with alternating pressure overlays were associated with an 80% probability of being cost saving. Alternating pressure mattresses for the prevention of pressure ulcers are more likely to be cost effective and are more acceptable to patients than alternating pressure overlays.

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

    Science.gov (United States)

    Elliott, Ian A; Beech, Anthony R

    2013-06-01

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

  3. Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.

    Science.gov (United States)

    McBain, Ryan K; Salhi, Carmel; Hann, Katrina; Salomon, Joshua A; Kim, Jane J; Betancourt, Theresa S

    2016-05-01

    One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing functional impairment associated with psychological distress among war-affected young persons. A randomized controlled trial was conducted in Freetown, Sierra Leone, from July 2012 to July 2013. Participants (n = 436, aged 15-24) were randomized to YRI (n = 222) or care as usual (n = 214). Functional impairment was indexed by the World Health Organization Disability Assessment Scale; scores were converted to quality-adjusted life years (QALYs). An 'ingredients approach' estimated financial and economic costs, assuming a societal perspective. Incremental cost-effectiveness ratios (ICERs) were also expressed in terms of gains across dimensions of mental health and schooling. Secondary analyses explored whether intervention effects were largest among those worst-off (upper quartile) at baseline. Retention at 6-month follow-up was 85% (n = 371). The estimated economic cost of the intervention was $104 per participant. Functional impairment was lower among YRI recipients, compared with controls, following the intervention but not at 6-month follow-up, and yielded an ICER of $7260 per QALY gained. At 8-month follow-up, teachers' interviews indicated that YRI recipients observed higher school enrolment [P cost of $431 per additional school year gained, as well as better school attendance (P = 0.007, OR 34.9) and performance (P = 0.03, effect size = -1.31). Secondary analyses indicated that the intervention was cost-effective among those worst-off at baseline, yielding an ICER of $3564 per QALY gained. The YRI is not cost-effective at a willingness-to-pay threshold of three times average gross domestic product per capita. However, results indicate that

  4. 10 CFR 600.145 - Cost and price analysis.

    Science.gov (United States)

    2010-01-01

    ... DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative Requirements for Grants and Cooperative Agreements With Institutions of Higher Education, Hospitals, and Other... quotations submitted, market prices and similar indicia, together with discounts. Cost analysis is the review...

  5. 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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    International Nuclear Information System (INIS)

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

    2014-01-01

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

  8. Cost analysis of operating an all-digital radiology department

    International Nuclear Information System (INIS)

    Arenson, R.L.; Soshadri, S.B.; DeSimone, D.; Hiss, S.S.

    1988-01-01

    Using the current film system as a baseline, this study analyzes the cost of digital acquisition, transmission, archiving, and display of all images generated in our department. Two approaches are considered: (1) conventional x-ray films are digitized with a laser scanning film digitizer; (2) images are captured with a direct digital receptor and no film is created. In both approaches, images from digital modalities are acquired directly from the scanners. The cost of equipment and its maintenance, film, supplies, storage space, operations, personnel, and so forth are analyzed for all approaches. The annual cost of operating the film system is $2.5 million. The estimated annual cost is $2.3 million for the first digital approach, $1.8 million for the second. This analysis demonstrates that these digital approaches can be cost-effective, viable alternatives to film-bases systems

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

    Science.gov (United States)

    Slapak-Iacobelli, L; Wilde, A H

    1993-02-01

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

  10. A Nuclear Waste Management Cost Model for Policy Analysis

    Science.gov (United States)

    Barron, R. W.; Hill, M. C.

    2017-12-01

    Although integrated assessments of climate change policy have frequently identified nuclear energy as a promising alternative to fossil fuels, these studies have often treated nuclear waste disposal very simply. Simple assumptions about nuclear waste are problematic because they may not be adequate to capture relevant costs and uncertainties, which could result in suboptimal policy choices. Modeling nuclear waste management costs is a cross-disciplinary, multi-scale problem that involves economic, geologic and environmental processes that operate at vastly different temporal scales. Similarly, the climate-related costs and benefits of nuclear energy are dependent on environmental sensitivity to CO2 emissions and radiation, nuclear energy's ability to offset carbon emissions, and the risk of nuclear accidents, factors which are all deeply uncertain. Alternative value systems further complicate the problem by suggesting different approaches to valuing intergenerational impacts. Effective policy assessment of nuclear energy requires an integrated approach to modeling nuclear waste management that (1) bridges disciplinary and temporal gaps, (2) supports an iterative, adaptive process that responds to evolving understandings of uncertainties, and (3) supports a broad range of value systems. This work develops the Nuclear Waste Management Cost Model (NWMCM). NWMCM provides a flexible framework for evaluating the cost of nuclear waste management across a range of technology pathways and value systems. We illustrate how NWMCM can support policy analysis by estimating how different nuclear waste disposal scenarios developed using the NWMCM framework affect the results of a recent integrated assessment study of alternative energy futures and their effects on the cost of achieving carbon abatement targets. Results suggest that the optimism reflected in previous works is fragile: Plausible nuclear waste management costs and discount rates appropriate for intergenerational cost

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

    Directory of Open Access Journals (Sweden)

    Karol RÁSTOČNÝ

    2008-01-01

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

  12. Techno-Economic Feasibility And Cost Analysis Of Solar Water Pumping In Nigeria

    International Nuclear Information System (INIS)

    Okonta, A.D; Akinwumi, I.O; Siyanbola, W.O.

    2004-01-01

    Solar photovoltaic Water Pumping (PVP) system is becoming a reliable and cost effective method of supplying potable water to remote rural areas of developing countries. Whoever, the high initial investment cost has hindered it widespread application. This paper has reported the outcome of an economic feasibility and cost analysis survey carried out in Nigeria. It involved the administration of a validated set of questionnaires to randomly selected stratified respondents. The outcomes were analysed using graphical displays, a student t-test statistic and the Statistical Package for Social Sciences (SPSS Version 10.0) the survey showed that private investors sourced their funds mostly form commercial banks and through savings. They do not enjoy any government incentives or subsidy. It was found that he number of modules per system and borehole depths are the major initial cost components and that the mean cost of PVP system in Nigeria between 1999- 2003 is 31,690.91 U$$. The paper recommends the establishment and intensive monitoring of PVP pilot projects in different geographical zones of the country to provide the database for Life-cycle-cost analysis and as feedback for the further development of PVP systems in Nigeria

  13. Cost Analysis Sources and Documents Data Base Reference Manual (Update)

    Science.gov (United States)

    1989-06-01

    M: Refcrence Manual PRICE H: Training Course Workbook 11. Use in Cost Analysis. Important source of cost estimates for electronic and mechanical...Nature of Data. Contains many microeconomic time series by month or quarter. 5. Level of Detail. Very detailed. 6. Normalization Processes Required...Reference Manual. Moorestown, N.J,: GE Corporation, September 1986. 64. PRICE Training Course Workbook . Moorestown, N.J.: GE Corporation, February 1986

  14. Nuclear costs: indicators and uncertainties

    International Nuclear Information System (INIS)

    Leveque, Francois

    2013-01-01

    In order to identify whether it is better to build a gas plant, a nuclear plant or a wind farm, to identify the technology leading to the lowest KWh cost, to identify under which conditions nuclear production is profitable for a private investor, and to identify whether taking the dismantling cost and the waste storage cost into account modifies the nuclear competitiveness with respect to general interest, the author first discusses the different costs of the nuclear sector, their sensitivity to different factors. In a second part, he proposes a retrospective discussion of cost dynamics. Then, as nuclear technology seems characterized by always increasing costs, and as this trend may last, notably because of safety concerns, the author proposes an analysis of the poor competitiveness of nuclear with respect to its cost

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

    Science.gov (United States)

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

    2018-01-01

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

  16. The relationship between cost estimates reliability and BIM adoption: SEM analysis

    Science.gov (United States)

    Ismail, N. A. A.; Idris, N. H.; Ramli, H.; Rooshdi, R. R. Raja Muhammad; Sahamir, S. R.

    2018-02-01

    This paper presents the usage of Structural Equation Modelling (SEM) approach in analysing the effects of Building Information Modelling (BIM) technology adoption in improving the reliability of cost estimates. Based on the questionnaire survey results, SEM analysis using SPSS-AMOS application examined the relationships between BIM-improved information and cost estimates reliability factors, leading to BIM technology adoption. Six hypotheses were established prior to SEM analysis employing two types of SEM models, namely the Confirmatory Factor Analysis (CFA) model and full structural model. The SEM models were then validated through the assessment on their uni-dimensionality, validity, reliability, and fitness index, in line with the hypotheses tested. The final SEM model fit measures are: P-value=0.000, RMSEA=0.0790.90, TLI=0.956>0.90, NFI=0.935>0.90 and ChiSq/df=2.259; indicating that the overall index values achieved the required level of model fitness. The model supports all the hypotheses evaluated, confirming that all relationship exists amongst the constructs are positive and significant. Ultimately, the analysis verified that most of the respondents foresee better understanding of project input information through BIM visualization, its reliable database and coordinated data, in developing more reliable cost estimates. They also perceive to accelerate their cost estimating task through BIM adoption.

  17. Analysis of efficiency and marketing trends cost optimization in enterprises of baking branch

    Directory of Open Access Journals (Sweden)

    Lukan О.М.

    2017-06-01

    Full Text Available Today, at the bakery industry, little attention is paid to marketing activities. Limited financial resources and the lack of a comprehensive assessment of the effectiveness of marketing activities leads to a reduction in marketing budgets and a decrease in the profitability of the enterprise as a whole. Therefore, despite the complexity of conducting an analysis of the cost effectiveness of marketing activities, in market conditions it is necessary to control the level of costs and the formation of optimal marketing budgets. In the work it is determined that the main direction of marketing activity evaluation is the analysis of the cost effectiveness for its implementation. A scientific-methodical approach to the analysis of the effectiveness of marketing costs in the bakery industry is suggested. The analysis of the cost effectiveness of marketing activities on the basis of the assumption that marketing costs are a factor variable determining the patterns of changes in the values of the resulting indicators of financial and economic activities of the enterprise, such as net income from sales of products, gross profit, financial results from operating activities and net profit (losses. The main directions of optimization of marketing activities at bakery enterprises are given.

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

    International Nuclear Information System (INIS)

    Henschel, D.B.

    1991-01-01

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

  19. [Cost-effectiveness and cost-benefit analysis on the integrated schistosomiasis control strategies with emphasis on infection source in Poyang Lake region].

    Science.gov (United States)

    Lin, Dan-Dan; Zeng, Xiao-Jun; Chen, Hong-Gen; Hong, Xian-Lin; Tao, Bo; Li, Yi-Feng; Xiong, Ji-Jie; Zhou, Xiao-Nong

    2009-08-01

    To evaluate the cost-effectiveness and cost-benefit on the integrated schistosomiasis control strategies with emphasis on infection source, and provide scientific basis for the improvement of schistosomiasis control strategy. Aiguo and Xinhe villages in Jinxian County were selected as intervention group where the new comprehensive strategy was implemented, while Ximiao and Zuxi villages in Xinzi County served as control where routine control program was implemented. New strategy of interventions included removing cattle from snail-infested grasslands and providing farmers with farm machinery, improving sanitation by supplying tap water and building lavatories and methane gas tanks, and implementing an intensive health education program. Routine interventions were carried out in the control villages including diagnosis and treatment for human and cattle, health education, and focal mollusciciding. Data were collected from retrospective investigation and field survey for the analysis and comparison of cost-effectiveness and cost-benefit between intervention and control groups. The control effect of the intervention group was better than that of the control. The cost for 1% decrease of infection rate per 100 people, 100 cattle, and 100 snails in intervention group was 480.01, 6 851.24, and 683.63 Yuan, respectively, which were about 2.70, 4.37 and 20.25 times as those in the control respectively. The total cost/benefit ratio (BCR) was lower than 1 (0.94 in intervention group and 0.08 in the control). But the total benefit of intervention group was higher than that of the control from 2005 to 2008. The forecasting analysis indicated that the total BCR in intervention group would be 1.13 at the 4th year and all cost could be recalled. Sensitivity analysis revealed that the BCR in intervention group changed in the range around 1.0 and that of the control ranged blow 0.5. The cost-benefit of intervention group was evidently higher than that of the control. The integrated

  20. PV O&M Cost Model and Cost Reduction

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Andy

    2017-03-15

    This is a presentation on PV O&M cost model and cost reduction for the annual Photovoltaic Reliability Workshop (2017), covering estimating PV O&M costs, polynomial expansion, and implementation of Net Present Value (NPV) and reserve account in cost models.

  1. The cost analysis of hydrogen life cycle in China

    International Nuclear Information System (INIS)

    Yao, Fei; Jia, Yuan; Mao, Zongqiang

    2010-01-01

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

  2. Biological and chemical removal of Cr(VI) from waste water: cost and benefit analysis.

    Science.gov (United States)

    Demir, Aynur; Arisoy, Münevver

    2007-08-17

    The objective of the present study is cost and benefit analysis of biological and chemical removal of hexavalent chromium [Cr(VI)] ions. Cost and benefit analysis were done with refer to two separate studies on removal of Cr(VI), one of heavy metals with a crucial role concerning increase in environmental pollution and disturbance of ecological balance, through biological adsorption and chemical ion-exchange. Methods of biological and chemical removal were compared with regard to their cost and percentage in chrome removal. According to the result of the comparison, cost per unit in chemical removal was calculated 0.24 euros and the ratio of chrome removal was 99.68%, whereas those of biological removal were 0.14 and 59.3% euros. Therefore, it was seen that cost per unit in chemical removal and chrome removal ratio were higher than those of biological removal method. In the current study where chrome removal is seen as immeasurable benefit in terms of human health and the environment, percentages of chrome removal were taken as measurable benefit and cost per unit of the chemicals as measurable cost.

  3. U3O8 production cost analysis study

    International Nuclear Information System (INIS)

    1978-08-01

    This report presents the User's Manual for the computer program resulting from Bechtel's uranium production cost analysis. The model incorporates engineering and financial costs of sandstone mining and milling in the western United States. It does not consider exploration costs. The model was written in Fortran V, IBM compatible. Inputs from the user are such items as: ore grades, open pit or underground mines, acid or carbonate leach, and debt/equity ratio. The user may either input the desired discounted cash flow rate of return and obtain the necessary U 3 O 8 price, or input an estimated U 3 O 8 price and obtain the resulting discounted cash flow rate of return

  4. Risk factor and cost accounting analysis for dialysis patients in Taiwan.

    Science.gov (United States)

    Su, Bin-Guang; Tsai, Kai-Li; Yeh, Shu-Hsing; Ho, Yi-Yi; Liu, Shin-Yi; Rivers, Patrick A

    2010-05-01

    According to the 2004 US Renal Data System's annual report, the incidence rate of chronic renal failure in Taiwan increased from 120 to 352 per million populations between 1990 and 2003. This incidence rate is the highest in the world. The prevalence rate, which ranks number two in the world (Japan ranks number one), also increased from 384 to 1630 per million populations. Based on 2005 Taiwan national statistics, there were 52,958 end-stage renal disease (ESRD) patients receiving routine dialysis treatment. This number, which comprised less than 0.2% of the total population and consumed $2.6 billion New Taiwan dollars, was more than 6.12% of the total annual spending of national health insurance during 2005. Dialysis expenditures for patients with ESRD rank the highest among all major injuries (traumas) and diseases. This article identifies and discusses the risk factors associated with consumption of medical resources during dialysis. Instead of using reimbursement data to estimate cost, as seen in previous studies, this study uses cost data within organizations and focuses on evaluating and predicting the resource consumption pattern for dialysis patients with different risk factors. Multiple regression analysis was used to identify 23 risk factors for routine dialysis patients. Of these risk factors, six were associated with the increase of dialysis cost: age (i.e. 75 years old and older), liver function disorder, hypertension, bile-duct disorder, cancer and high blood lipids. Patients with liver function disorder incurred much higher costs for injection medication and supplies. Hypertensive patients incurred higher costs for injection medication, supplies and oral medication. Patients with bile-duct disorder incurred a significant difference in check-up costs (i.e. costs were higher for those aged 75 years and older than those who were younger than 30 years of age). Cancer patients also incurred significant differences in cost of medical supplies. Patients

  5. A MANAGERIAL AND COST ACCOUNTING APPROACH OF CUSTOMER PROFITABILITY ANALYSIS

    OpenAIRE

    PETE Stefan; CARDOS Ildiko Reka

    2010-01-01

    In the last years many organizations realized that market orientation is essential to their success. Satisfying the needs of customers, offering them products and services which meet their desires and demands, customer loyalty can increase profitability for long term. After analyzing the existing journal literature in this field we would like to emphasize that managerial accounting, cost calculation methods and techniques, the analysis of costs provides relevant information when analyzing the...

  6. Resources and transaction costs

    DEFF Research Database (Denmark)

    Foss, Kirsten; Foss, Nicolai Juul

    2005-01-01

    from resources depends on the property rights that he or she holds and on the transaction costs of exchanging, defining, and protecting them. While transaction costs are a major source of value dissipation, reducing such dissipation may create value. Implications for the RBV analysis of sustained...

  7. A Prospective Analysis of the Costs, Benefits, and Impacts of U.S. Renewable Portfolio Standards

    Energy Technology Data Exchange (ETDEWEB)

    Mai, Trieu [National Renewable Energy Lab. (NREL), Golden, CO (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States); Heeter, Jenny [National Renewable Energy Lab. (NREL), Golden, CO (United States); Keyser, David [National Renewable Energy Lab. (NREL), Golden, CO (United States); Krishnan, Venkat [National Renewable Energy Lab. (NREL), Golden, CO (United States); Macknick, Jordan [National Renewable Energy Lab. (NREL), Golden, CO (United States); Millstein, Dev [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2016-12-01

    This report evaluates the future costs, benefits, and other impacts of renewable energy used to meet current state renewable portfolio standards (RPSs). It also examines a future scenario where RPSs are expanded. The analysis examines changes in electric system costs and retail electricity prices, which include all fixed and operating costs, including capital costs for all renewable, non-renewable, and supporting (e.g., transmission and storage) electric sector infrastructure; fossil fuel, uranium, and biomass fuel costs; and plant operations and maintenance expenditures. The analysis evaluates three specific benefits: air pollution, greenhouse gas emissions, and water use. It also analyzes two other impacts, renewable energy workforce and economic development, and natural gas price suppression. This analysis finds that the benefits or renewable energy used to meet RPS polices exceed the costs, even when considering the highest cost and lowest benefit outcomes.

  8. 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.

  9. 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

  10. Wind Integration Cost and Cost-Causation: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, M.; Kirby, B.; Holttinen, H.; Kiviluoma, J.; Estanqueiro, A.; Martin-Martinez, S.; Gomez-Lazaro, E.; Peneda, I.; Smith, C.

    2013-10-01

    The question of wind integration cost has received much attention in the past several years. The methodological challenges to calculating integration costs are discussed in this paper. There are other sources of integration cost unrelated to wind energy. A performance-based approach would be technology neutral, and would provide price signals for all technology types. However, it is difficult to correctly formulate such an approach. Determining what is and is not an integration cost is challenging. Another problem is the allocation of system costs to one source. Because of significant nonlinearities, this can prove to be impossible to determine in an accurate and objective way.

  11. Cost-analysis of teledentistry in residential aged care facilities.

    Science.gov (United States)

    Mariño, Rodrigo; Tonmukayakul, Utsana; Manton, David; Stranieri, Andrew; Clarke, Ken

    2016-09-01

    The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional. It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident. Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination. © The Author(s) 2015.

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

    DEFF Research Database (Denmark)

    Manzo, Stefano; Salling, Kim Bang

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Juliana Gonçalves de Araujo

    2016-12-01

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

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

    Science.gov (United States)

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

    2009-05-01

    In 2005, the American Journal of Public Health published an article that indicated that 22% of the overall decline in youth smoking that occurred between 1999 and 2002 was directly attributable to the truth social marketing campaign launched in 2000. A remaining key question about the truth campaign is whether the economic investment in the program can be justified by the public health outcomes; that question is examined here. Standard methods of cost and cost-utility analysis were employed in accordance with the U.S. Panel on Cost-Effectiveness in Health and Medicine; a societal perspective was employed. During 2000-2002, expenditures totaled just over $324 million to develop, deliver, evaluate, and litigate the truth campaign. The base-case cost-utility analysis result indicates that the campaign was cost saving; it is estimated that the campaign recouped its costs and that just under $1.9 billion in medical costs was averted for society. Sensitivity analysis indicated that the basic determination of cost effectiveness for this campaign is robust to substantial variation in input parameters. This study suggests that the truth campaign not only markedly improved the public's health but did so in an economically efficient manner.

  15. NASA Instrument Cost/Schedule Model

    Science.gov (United States)

    Habib-Agahi, Hamid; Mrozinski, Joe; Fox, George

    2011-01-01

    NASA's Office of Independent Program and Cost Evaluation (IPCE) has established a number of initiatives to improve its cost and schedule estimating capabilities. 12One of these initiatives has resulted in the JPL developed NASA Instrument Cost Model. NICM is a cost and schedule estimator that contains: A system level cost estimation tool; a subsystem level cost estimation tool; a database of cost and technical parameters of over 140 previously flown remote sensing and in-situ instruments; a schedule estimator; a set of rules to estimate cost and schedule by life cycle phases (B/C/D); and a novel tool for developing joint probability distributions for cost and schedule risk (Joint Confidence Level (JCL)). This paper describes the development and use of NICM, including the data normalization processes, data mining methods (cluster analysis, principal components analysis, regression analysis and bootstrap cross validation), the estimating equations themselves and a demonstration of the NICM tool suite.

  16. Department of Defenses 2015 Retirement Plan Cost Analysis

    Science.gov (United States)

    2016-06-01

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

  17. Are breast biopsies adequately funded? A process cost and revenue analysis

    International Nuclear Information System (INIS)

    Hahn, M.; Fischbach, E.; Fehm, T.

    2011-01-01

    Purpose: The objective of the study was to determine whether the various breast biopsy procedures specified in the S 3 guidelines are sensibly represented within the current German health system as considered from a cost evaluation perspective. Materials and Methods: This prospectively designed multicenter study analyzed 221 breast biopsies at 7 institutions from 04/2006 to 01/2007. Core needle biopsies, vacuum-assisted biopsies and surgical open biopsies under sonographic or mammographic guidance were evaluated. During an analysis of process costs, the individual process steps were recorded in diagrammatic form and assigned to the true consumption of resources. The actual resource consumption costs were entered. A process-related breakeven analysis was conducted to check whether the reimbursement of individual biopsy types covers the costs. Results: Only sonographically guided core needle biopsy and surgical open biopsy are adequately reimbursed in the current German health system. All other breast biopsies indicate a negative profit margin. The principal reasons for underfunding are found in the area of reimbursement of investment and non-personnel costs. Conclusion: The reimbursement of breast biopsies must be improved in order to guarantee nationwide care of the population using the breast biopsy methods recommended in the S 3 guidelines and to avoid disincentives with respect to breast biopsy indications. (orig.)

  18. Cost-benefit analysis of telehealth in pre-hospital care.

    Science.gov (United States)

    Langabeer, James R; Champagne-Langabeer, Tiffany; Alqusairi, Diaa; Kim, Junghyun; Jackson, Adria; Persse, David; Gonzalez, Michael

    2017-09-01

    Objective There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. Methods Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention. The intervention consisted of telehealth-based consultation between the 911 patient and an EMS physician, to evaluate and triage the necessity for patient transport to a hospital emergency department (ED). Patients with non-urgent, primary care-related conditions were then scheduled and transported by alternative means to an affiliated primary care clinic. We measured CBA as both total cost savings and cost per ED visit averted, in US Dollars ($USD). Results In total, 5570 patients were treated over the first full 12 months with a telehealth-enabled care model. We found a 6.7% absolute reduction in potentially medically unnecessary ED visits, and a 44-minute reduction in total ambulance back-in-service times. The average cost for a telehealth patient was $167, which was a statistically significantly $103 less than the control group ( p cost savings from the societal perspective, or $2468 cost savings per ED visit averted (benefit). Conclusion Patient care enabled by telehealth in a pre-hospital environment, is a more cost effective alternative compared to the traditional EMS 'treat and transport to ED' model.

  19. ICRP-26; cost-benefit analysis and nuclear energy in developing countries

    International Nuclear Information System (INIS)

    Gupta, V.K.

    1978-01-01

    Cost of an operation and benefits accruing to the society are the basic parameters involved in cost-benefit analysis by using optimisation methodology. Relative importance of the costs imposed on human health by radiation exposure and other economic and social factors are to be considered. Formula to obtain the parameter in monetory terms with respect to the detriment represented by collective dose (Rs/man-rem or $/man-rem) is explained. The collective doses in the public domain and for the occupational workers are mentioned. Estimated monetory values assigned to detriment in different countries are discussed. In absence of accurately known parameters, in particular the economic parameter which is always subject to change, the cost benefit and optimisation exercises would give variable results. (B.G.W.)

  20. Electricity generation costs by source, and costs and benefits by substitutions of generation source

    International Nuclear Information System (INIS)

    Akimoto, Keigo; Oda, Junichiro; Sano, Fuminori

    2015-01-01

    After Fukushima-daiichi nuclear power accident, the Japanese government assessed the electricity generation costs by source in 2011. However, the conditions have been changing, and this study newly assessed the generation costs by source using new data. The generation costs for coal, oil, gas, nuclear, PV and wind power for 2013 and 2030 were estimated. According to the analysis, coal power is the cheapest when climate change damage costs are not considered, and nuclear power is the cheapest when the climate damage costs are considered. However, under the competitive electricity market in which power companies tend to invest in power plants with short-term payback investment preference, power companies will recognize higher costs of nuclear power particularly under highly uncertain nuclear regulation policies and energy policies. The policies to reduce the uncertainties are very important. (author)

  1. Tapping Transaction Costs to Forecast Acquisition Cost Breaches

    Science.gov (United States)

    2016-01-01

    experience a cost breach. In our medical example, we could use survival analysis to identify risk fac- tors, such as obesity , that might indicate a greater... exogenous variables on the probability of a dichotomous outcome, such as whether or not a cost breach occurs in any given program year. Logit is

  2. Costs and cost-efficacy analysis of the 2014 GESIDA/Spanish National AIDS Plan recommended guidelines for initial antiretroviral therapy in HIV-infected adults.

    Science.gov (United States)

    Blasco, Antonio Javier; Llibre, Josep M; Berenguer, Juan; González-García, Juan; Knobel, Hernando; Lozano, Fernando; Podzamczer, Daniel; Pulido, Federico; Rivero, Antonio; Tuset, Montserrat; Lázaro, Pablo; Gatell, Josep M

    2015-03-01

    GESIDA and the National AIDS Plan panel of experts suggest preferred (PR) and alternative (AR) regimens of antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2014. The objective of this study is to evaluate the costs and the efficiency of initiating treatment with these regimens. An economic assessment was made of costs and efficiency (cost/efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50 copies/mL at week 48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regimen was defined as the costs of ART and its consequences (adverse effects, changes of ART regimen, and drug resistance studies) during the first 48 weeks. The payer perspective (National Health System) was applied by considering only differential direct costs: ART (official prices), management of adverse effects, studies of resistance, and HLA B*5701 testing. The setting is Spain and costs correspond to those of 2014. A sensitivity deterministic analysis was conducted, building three scenarios for each regimen: base case, most favourable and least favourable. In the base case scenario, the cost of initiating treatment ranges from 5133 Euros for ABC/3TC+EFV to 11,949 Euros for TDF/FTC+RAL. The efficacy varies between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.89 for TDF/FTC/EVG/COBI. Efficiency, in terms of cost/efficacy, ranges from 7546 to 13,802 Euros per responder at 48 weeks, for ABC/3TC+EFV and TDF/FTC+RAL respectively. Considering ART official prices, the most efficient regimen was ABC/3TC+EFV (AR), followed by the non-nucleoside containing PR (TDF/FTC/RPV and TDF/FTC/EFV). The sensitivity analysis confirms the robustness of these findings. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Nuclear fuel cycle cost estimation and sensitivity analysis of unit costs on the basis of an equilibrium model

    International Nuclear Information System (INIS)

    Kim, S. K.; Ko, W. I.; You, S. R.; Gao, R. X.

    2015-01-01

    This paper examines the difference in the value of the nuclear fuel cycle cost calculated by the deterministic and probabilistic methods on the basis of an equilibrium model. Calculating using the deterministic method, the direct disposal cost and Pyro-SFR (sodium-cooled fast reactor) nuclear fuel cycle cost, including the reactor cost, were found to be 66.41 mills/kWh and 77.82 mills/kWh, respectively (1 mill = one thousand of a dollar, i.e., 10-3 $). This is because the cost of SFR is considerably expensive. Calculating again using the probabilistic method, however, the direct disposal cost and Pyro-SFR nuclear fuel cycle cost, excluding the reactor cost, were found be 7.47 mills/kWh and 6.40 mills/kWh, respectively, on the basis of the most likely value. This is because the nuclear fuel cycle cost is significantly affected by the standard deviation and the mean of the unit cost that includes uncertainty. Thus, it is judged that not only the deterministic method, but also the probabilistic method, would also be necessary to evaluate the nuclear fuel cycle cost. By analyzing the sensitivity of the unit cost in each phase of the nuclear fuel cycle, it was found that the uranium unit price is the most influential factor in determining nuclear fuel cycle costs.

  4. Nonintravenous rescue medications for pediatric status epilepticus: A cost-effectiveness analysis.

    Science.gov (United States)

    Sánchez Fernández, Iván; Gaínza-Lein, Marina; Loddenkemper, Tobias

    2017-08-01

    To quantify the cost-effectiveness of rescue medications for pediatric status epilepticus: rectal diazepam, nasal midazolam, buccal midazolam, intramuscular midazolam, and nasal lorazepam. Decision analysis model populated with effectiveness data from the literature and cost data from publicly available market prices. The primary outcome was cost per seizure stopped ($/SS). One-way sensitivity analyses and second-order Monte Carlo simulations evaluated the robustness of the results across wide variations of the input parameters. The most cost-effective rescue medication was buccal midazolam (incremental cost-effectiveness ratio ([ICER]: $13.16/SS) followed by nasal midazolam (ICER: $38.19/SS). Nasal lorazepam (ICER: -$3.8/SS), intramuscular midazolam (ICER: -$64/SS), and rectal diazepam (ICER: -$2,246.21/SS) are never more cost-effective than the other options at any willingness to pay. One-way sensitivity analysis showed the following: (1) at its current effectiveness, rectal diazepam would become the most cost-effective option only if its cost was $6 or less, and (2) at its current cost, rectal diazepam would become the most cost-effective option only if effectiveness was higher than 0.89 (and only with very high willingness to pay of $2,859/SS to $31,447/SS). Second-order Monte Carlo simulations showed the following: (1) nasal midazolam and intramuscular midazolam were the more effective options; (2) the more cost-effective option was buccal midazolam for a willingness to pay from $14/SS to $41/SS and nasal midazolam for a willingness to pay above $41/SS; (3) cost-effectiveness overlapped for buccal midazolam, nasal lorazepam, intramuscular midazolam, and nasal midazolam; and (4) rectal diazepam was not cost-effective at any willingness to pay, and this conclusion remained extremely robust to wide variations of the input parameters. For pediatric status epilepticus, buccal midazolam and nasal midazolam are the most cost-effective nonintravenous rescue

  5. Cost benefit analysis for occupational radiation exposure

    International Nuclear Information System (INIS)

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

    1978-01-01

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

  6. A cost and operational effectiveness analysis of alternative anti-surface warfare platforms

    OpenAIRE

    Skinner, Walter Mark.

    1993-01-01

    Approved for public release; distribution is unlimited. A Cost and Operational Effectiveness Analysis (COEA) is performed for three alternative anti-surface warfare (ASUW) platforms that will conduct operations in multi-service regional scenarios. Estimated program costs, historical cost variances, and measures of operational effectiveness are determined for each COEA alternative, and service life extension effects are examined. The data is merged in a mixed-integer optimization model, MPA...

  7. [Costing nuclear medicine diagnostic procedures].

    Science.gov (United States)

    Markou, Pavlos

    2005-01-01

    To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

  8. Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer.

    Science.gov (United States)

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

    2017-01-01

    Gastric cancer is the fifth most common malignancy and second leading cause of cancer-related mortality. Chemotherapy options for patients who fail first-line treatment are limited. Thus the objective of this study was to assess the cost-effectiveness of second-line treatment options for patients with advanced or metastatic gastric cancer. Cost-effectiveness analysis using a Markov model to compare the cost-effectiveness of six possible second-line treatment options for patients with advanced gastric cancer who have failed previous chemotherapy: irinotecan, docetaxel, paclitaxel, ramucirumab, paclitaxel plus ramucirumab, and palliative care. The model was performed from a third-party payer's perspective to compare lifetime costs and health benefits associated with studied second-line therapies. Costs included only relevant direct medical costs. The model assumed chemotherapy cycle lengths of 30 days and a maximum number of 24 cycles. Systematic review of literature was performed to identify clinical data sources and utility and cost data. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. The primary outcome measure for this analysis was the ICER between different therapies, where the incremental cost was divided by the number of QALYs saved. The ICER was compared with a willingness-to-pay (WTP) threshold that was set at $50,000/QALY gained, and an exploratory analysis using $160,000/QALY gained was also used. The model's robustness was tested by using 1-way sensitivity analyses and a 10,000 Monte Carlo simulation probabilistic sensitivity analysis (PSA). Irinotecan had the lowest lifetime cost and was associated with a QALY gain of 0.35 year. Docetaxel, ramucirumab alone, and palliative care were dominated strategies. Paclitaxel and the combination of paclitaxel plus ramucirumab led to higher QALYs gained, at an incremental cost of $86,815 and $1,056,125 per QALY gained, respectively. Based on our prespecified

  9. A cost-benefit analysis of spent fuel management

    International Nuclear Information System (INIS)

    Lamorlette, G.

    2001-01-01

    The back end of the fuel cycle is an area of economic risk for utilities having nuclear power plants to generate electricity. A cost-benefit analysis is a method by which utilities can evaluate advantages and drawbacks of alternative back end fuel cycle strategies. The present paper analyzes how spent fuel management can influence the risks and costs incurred by a utility over the lifetime of its power plants and recommends a recycling strategy. (author)

  10. 77 FR 43542 - Cost Accounting Standards: Cost Accounting Standards 412 and 413-Cost Accounting Standards...

    Science.gov (United States)

    2012-07-25

    ... rule that revised Cost Accounting Standard (CAS) 412, ``Composition and Measurement of Pension Cost... Accounting Standards: Cost Accounting Standards 412 and 413--Cost Accounting Standards Pension Harmonization Rule AGENCY: Cost Accounting Standards Board, Office of Federal Procurement Policy, Office of...

  11. 36 CFR 1210.45 - Cost and price analysis.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Cost and price analysis. 1210.45 Section 1210.45 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION... in various ways, including the comparison of price quotations submitted, market prices and similar...

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

    Science.gov (United States)

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

    2018-03-20

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

  13. Why Don't They Just Give Us Money? Project Cost Estimating and Cost Reporting

    Science.gov (United States)

    Comstock, Douglas A.; Van Wychen, Kristin; Zimmerman, Mary Beth

    2015-01-01

    Successful projects require an integrated approach to managing cost, schedule, and risk. This is especially true for complex, multi-year projects involving multiple organizations. To explore solutions and leverage valuable lessons learned, NASA's Virtual Project Management Challenge will kick off a three-part series examining some of the challenges faced by project and program managers when it comes to managing these important elements. In this first session of the series, we will look at cost management, with an emphasis on the critical roles of cost estimating and cost reporting. By taking a proactive approach to both of these activities, project managers can better control life cycle costs, maintain stakeholder confidence, and protect other current and future projects in the organization's portfolio. Speakers will be Doug Comstock, Director of NASA's Cost Analysis Division, Kristin Van Wychen, Senior Analyst in the GAO Acquisition and Sourcing Management Team, and Mary Beth Zimmerman, Branch Chief for NASA's Portfolio Analysis Branch, Strategic Investments Division. Moderator Ramien Pierre is from NASA's Academy for Program/Project and Engineering Leadership (APPEL).

  14. Life Cycle Assessment and Cost Analysis of Water and ...

    Science.gov (United States)

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

  15. Cost and effectiveness analysis on unmanned aerial vehicle (UAV) use at border security

    Science.gov (United States)

    Yilmaz, Bahadır.

    2013-06-01

    Drones and Remotely Piloted Vehicles are types of Unmanned Aerial Vehicles. UAVs began to be used with the war of Vietnam, they had a great interest when Israel used them in Bekaa Valley Operations of 1982. UAVs have been used by different countries with different aims with the help of emerging technology and investments. In this article, in the context of areas of UAV usage in national security, benefits and disadvantages of UAVs are put forward. Particularly, it has been evaluated on the basis of cost-effectiveness by focusing the use of UAV in the border security. UAVs have been studied by taking cost analysis, procurement and operational costs into consideration. Analysis of effectiveness has been done with illegal passages of people and drugs from flight times of UAVs. Although the procurement cost of the medium-level UAVs is low, its operational costs are high. For this reason, the idea of less costly alternative systems have been revealed for the border security. As the costs are reduced to acceptable level involving national security and border security in future with high-technology products in their structure, it will continue to be used in an increasing proportion.

  16. Cost-of-illness analysis. What room in health economics?

    Science.gov (United States)

    Tarricone, Rosanna

    2006-06-01

    Cost-of-illness (COI) was the first economic evaluation technique used in the health field. The principal aim was to measure the economic burden of illness to society. Its usefulness as a decision-making tool has however been questioned since its inception. The main criticism came from welfare economists who rejected COIs because they were not grounded in welfare economics theory. Other attacks related to the use of the human capital approach (HCA) to evaluate morbidity and mortality costs since it was said that the HCA had nothing to do with the value people attach to their lives. Finally, objections were made that COI could not be of any help to decision makers and that other forms of economic evaluation (e.g. cost-effectiveness, cost-benefit analysis) would be much more useful to those taking decisions and ranking priorities. Conversely, it is here suggested that COI can be a good economic tool to inform decision makers if it is considered from another perspective. COI is a descriptive study that can provide information to support the political process as well as the management functions at different levels of the healthcare organisations. To do that, the design of the study must be innovative, capable of measuring the true cost to society; to estimate the main cost components and their incidence over total costs; to envisage the different subjects who bear the costs; to identify the actual clinical management of illness; and to explain cost variability. In order to reach these goals, COI need to be designed as observational bottom-up studies.

  17. Cost-effectiveness analysis of radon remediation in schools

    International Nuclear Information System (INIS)

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

    2000-01-01

    Indoor radon is an important source of radiation dosage in the general population and has been recognised as a world-wide environmental and public health challenge. Governments in many Western and Eastern European and North American countries are undertaking active radon-risk reduction policies, including the remediation of existing residential and work place building stocks (1). These endeavours include a priority of remediating school buildings. Epidemiological and technical radon research has produced information which has enabled attention to be turned to specific effectiveness and optimisation questions regarding radon identification and remediation programmes in buildings, including schools. Decision making about policy implementation has been an integral part of these programmes and questions have been raised about the economic implications of the regulations and optimisation strategies for workplace action level policy (2,3). (the action level applied to schools is 400 Bq m -3 ). No previous study has estimated the cost-effectiveness of a radon remediation programme for schools using the methodological framework now considered appropriate in the economic evaluation of health interventions. It is imperative that this should be done, in order that the resources required to obtain health gain from radon remediation in schools can be systematically compared with equivalent data for other health interventions and radon remediation programmes. In this study a cost-effectiveness analysis of radon remediation in schools was undertaken, using the best available national data and information from Northamptonshire on the costs and effectiveness of radon identification and remediation in schools, and the costs and health impact of lung cancer cases. A model based on data from Northamptonshire is presented (where 6.3% of residential stock is over 200 Bq m -3 ). The resultant cost-effectiveness ratio was pound 7,550 per life year gained in pound 1997. Results from the

  18. Cost-benefit analysis for design of environmentally conscious manufacturing

    International Nuclear Information System (INIS)

    Matysiak, L.M.

    1993-01-01

    In recent years, much attention has been focused on reducing the environmental impacts of products and manufacturing processes. Concerned about rising compliance costs and stringent regulatory requirements, companies are carefully evaluating the environmental impacts of their products. In response, designers, engineers, and managers are beginning to use life-cycle analysis, design for environment techniques, and environmentally conscious manufacturing (ECM) as tools to help them to not only do what is best for the environment, but also to do what is best for their company. These tools are also a useful aid in evaluating the trade-offs that may exist between different product and process alternatives. However, how does one choose the optimal solution from these various product and process alternatives? Cost versus benefit analysis is an effective tool that can be used to evaluate various manufacturing alternatives and to choose a solution that is both cost effective and environmentally compatible. Many companies are beginning to use cost benefit analyses as a means to justify product or process modifications that result in a benefit to the environment

  19. Cost-volume-profit and net present value analysis of health information systems.

    Science.gov (United States)

    McLean, R A

    1998-08-01

    The adoption of any information system should be justified by an economic analysis demonstrating that its projected benefits outweigh its projected costs. Analysis differ, however, on which methods to employ for such a justification. Accountants prefer cost-volume-profit analysis, and economists prefer net present value analysis. The article explains the strengths and weaknesses of each method and shows how they can be used together so that well-informed investments in information systems can be made.

  20. Allocation base of general production costs as optimization of prime costs

    Directory of Open Access Journals (Sweden)

    Levytska I.O.

    2017-03-01

    Full Text Available Qualified management aimed at optimizing financial results is the key factor in today's society. Effective management decisions depend on the necessary information about the costs of production process in all its aspects – their structure, types, accounting policies of reflecting costs. General production costs, the so-called indirect costs that are not directly related to the production process, but provide its functioning in terms of supporting structural divisions and create the necessary conditions of production, play a significant role in calculating prime costs of goods (works, services. However, the accurate estimate of prime costs of goods (works, services should be determined with the value of indirect costs (in other words, general production costs, and properly determined with the base of their allocation. The choice of allocation base of general production costs is the significant moment, depending on the nature of business, which must guarantee fair distribution regarding to the largest share of direct expenses in the total structure of production costs. The study finds the essence of general production costs based on the analysis of key definitions of leading Ukrainian economists. The optimal allocation approach of general production costs is to calculate these costs as direct production costs within each subsidiary division (department separately without selecting a base as the main one to the their total amount.

  1. Cost and performance analysis of conceptual designs of physical protection systems

    International Nuclear Information System (INIS)

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

    1998-01-01

    CPA -- Cost and Performance Analysis -- is a methodology that joins Activity Based Cost (ABC) estimation with performance based analysis of physical protection systems. CPA offers system managers an approach that supports both tactical decision making and strategic planning. Current exploratory applications of the CPA methodology are addressing analysis of alternative conceptual designs. To support these activities, the original architecture for CPA, is being expanded to incorporate results from a suite of performance and consequence analysis tools such as JTS (Joint Tactical Simulation), ERAD (Explosive Release Atmospheric Dispersion) and blast effect models. The process flow for applying CPA to the development and analysis conceptual designs is illustrated graphically

  2. Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion

    Science.gov (United States)

    Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara

    2014-01-01

    In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…

  3. 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

  4. Cost-effectiveness analysis of the introduction of rotavirus vaccine in Iran.

    Science.gov (United States)

    Javanbakht, Mehdi; Moradi-Lakeh, Maziar; Yaghoubi, Mohsen; Esteghamati, Abdoulreza; Mansour Ghanaie, Roxana; Mahmoudi, Sussan; Shamshiri, Ahmad-Reza; Zahraei, Seyed Mohsen; Baxter, Louise; Shakerian, Sareh; Chaudhri, Irtaza; Fleming, Jessica A; Munier, Aline; Baradaran, Hamid R

    2015-05-07

    Although the mortality from diarrheal diseases has been decreasing dramatically in Iran, it still represents an important proportion of disease burden in children Rotavirus vaccines are among the most effective strategies against diarrheal diseases in specific epidemiological conditions. This study aimed to evaluate the cost-effectiveness of the introduction of rotavirus vaccine (3 doses of pentavalent RotaTeq (RV5)) in Iran, from the viewpoints of Iran's health system and society. The TRIVAC decision support model was used to calculate total incremental costs, life years (LYs) gained, and disability-adjusted life years (DALYs) averted due to the vaccination program. Necessary input data were collected from the most valid accessible sources as well as a systematic review and meta-analysis on epidemiological studies. We used WHO guidelines to estimate vaccination cost. An annual discount rate of 3% was considered for both health gain and costs. A deterministic sensitivity analysis was performed for testing the robustness of the models results. Our results indicated that total DALYs potentially lost due to rotavirus diarrhea within 10 years would be 138,161, of which 76,591 could be prevented by rotavirus vaccine. The total vaccination cost for 10 cohorts was estimated to be US$ 499.91 million. Also, US$ 470.61 million would be saved because of preventing outpatient visits and inpatient admissions (cost-saving from the society perspective). We estimated a cost per DALY averted of US$ 2868 for RV5 vaccination, which corresponds to a highly cost-effective strategy from the government perspective. In the sensitivity analysis, all scenarios tested were still cost-saving or highly cost-effective from the society perspective, except in the least favorable scenario and low vaccine efficacy and disease incidence scenario. Based on the findings, introduction of rotavirus vaccine is a highly cost-effective strategy from the government perspective. Introducing the vaccine to

  5. Least cost analysis of renewable energy projects

    International Nuclear Information System (INIS)

    Cosgrove-Davies, M.; Cabraal, A.

    1994-01-01

    This paper describes the methodology for evaluating dispersed and centralized rural energy options on a least cost basis. In defining the load to be served, each supply alternative must provide equivalent levels of service. The village to be served is defined by the number of loads, load density, distance from the nearest power distribution line, and load growth. Appropriate rural energy alternatives are identified and sized to satisfy the defined load. Lastly, a net present value analysis (including capital, installation, O and M, fuel, and replacement costs, etc.) is performed to identify the least cost option. A spreadsheet-based analytical tool developed by the World Bank's Asia Alternative Energy Unit (ASTAE) incorporates this approach and has been applied to compare photovoltaic solar home systems with other rural energy supply options in Indonesia. Load size and load density are found to be the critical factors in choosing between a grid and off-grid solution

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

    Directory of Open Access Journals (Sweden)

    Burhanuddin M. A.

    2011-01-01

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

  7. Phenotypic plasticity, costs of phenotypes, and costs of plasticity

    DEFF Research Database (Denmark)

    Callahan, Hilary S; Maughan, Heather; Steiner, Uli

    2008-01-01

    Why are some traits constitutive and others inducible? The term costs often appears in work addressing this issue but may be ambiguously defined. This review distinguishes two conceptually distinct types of costs: phenotypic costs and plasticity costs. Phenotypic costs are assessed from patterns...... of covariation, typically between a focal trait and a separate trait relevant to fitness. Plasticity costs, separable from phenotypic costs, are gauged by comparing the fitness of genotypes with equivalent phenotypes within two environments but differing in plasticity and fitness. Subtleties associated with both...... types of costs are illustrated by a body of work addressing predator-induced plasticity. Such subtleties, and potential interplay between the two types of costs, have also been addressed, often in studies involving genetic model organisms. In some instances, investigators have pinpointed the mechanistic...

  8. 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)

  9. Costing and performance in healthcare management

    OpenAIRE

    Tarricone, Rosanna; Torbica, Aleksandra

    2012-01-01

    This chapter describes and discusses the methods for cost analysis of healthcare services in order to assess and compare the economic value of health outputs at the level of healthcare organizations. The economic principles underpinning the assessment of the value of healthcare services – opportunity costs and shadow prices – are presented together with the management accounting approach to cost services. The key features of micro-costing and gross-costing are also discussed and their rele...

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

    Science.gov (United States)

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

    2008-05-01

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

  11. Do Medicare Advantage Plans Minimize Costs? Investigating the Relationship Between Benchmarks, Costs, and Rebates.

    Science.gov (United States)

    Zuckerman, Stephen; Skopec, Laura; Guterman, Stuart

    2017-12-01

    Medicare Advantage (MA), the program that allows people to receive their Medicare benefits through private health plans, uses a benchmark-and-bidding system to induce plans to provide benefits at lower costs. However, prior research suggests medical costs, profits, and other plan costs are not as low under this system as they might otherwise be. To examine how well the current system encourages MA plans to bid their lowest cost by examining the relationship between costs and bonuses (rebates) and the benchmarks Medicare uses in determining plan payments. Regression analysis using 2015 data for HMO and local PPO plans. Costs and rebates are higher for MA plans in areas with higher benchmarks, and plan costs vary less than benchmarks do. A one-dollar increase in benchmarks is associated with 32-cent-higher plan costs and a 52-cent-higher rebate, even when controlling for market and plan factors that can affect costs. This suggests the current benchmark-and-bidding system allows plans to bid higher than local input prices and other market conditions would seem to warrant. To incentivize MA plans to maximize efficiency and minimize costs, Medicare could change the way benchmarks are set or used.

  12. A cost-effectiveness threshold analysis of a multidisciplinary structured educational intervention in pediatric asthma.

    Science.gov (United States)

    Rodriguez-Martinez, Carlos E; Sossa-Briceño, Monica P; Castro-Rodriguez, Jose A

    2018-05-01

    Asthma educational interventions have been shown to improve several clinically and economically important outcomes. However, these interventions are costly in themselves and could lead to even higher disease costs. A cost-effectiveness threshold analysis would be helpful in determining the threshold value of the cost of educational interventions, leading to these interventions being cost-effective. The aim of the present study was to perform a cost-effectiveness threshold analysis to determine the level at which the cost of a pediatric asthma educational intervention would be cost-effective and cost-saving. A Markov-type model was developed in order to estimate costs and health outcomes of a simulated cohort of pediatric patients with persistent asthma treated over a 12-month period. Effectiveness parameters were obtained from a single uncontrolled before-and-after study performed with Colombian asthmatic children. Cost data were obtained from official databases provided by the Colombian Ministry of Health. The main outcome was the variable "quality-adjusted life-years" (QALYs). A deterministic threshold sensitivity analysis showed that the asthma educational intervention will be cost-saving to the health system if its cost is under US$513.20. Additionally, the analysis showed that the cost of the intervention would have to be below US$967.40 in order to be cost-effective. This study identified the level at which the cost of a pediatric asthma educational intervention will be cost-effective and cost-saving for the health system in Colombia. Our findings could be a useful aid for decision makers in efficiently allocating limited resources when planning asthma educational interventions for pediatric patients.

  13. A reactor-level analysis of busbar costs for US nuclear plants, 1970-2005

    International Nuclear Information System (INIS)

    Koomey, Jonathan; Hultman, Nathan E.

    2007-01-01

    We present a reactor-by-reactor analysis of historical busbar costs for 99 nuclear reactors in the United States, and compare those costs with recent projections for next-generation US reactors. We argue that cost projections far different from median historical costs require more justification than estimates that lie close to those medians. Our analysis suggests that some recent projections of capital costs, construction duration, and total operations and maintenance costs are quite low-far enough from the historical medians that additional scrutiny may be required to justify using such estimates in current policy discussions and planning

  14. 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.

  15. Applying Activity Based Costing (ABC) Method to Calculate Cost Price in Hospital and Remedy Services.

    Science.gov (United States)

    Rajabi, A; Dabiri, A

    2012-01-01

    Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  17. 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

  18. Exergy analysis and thermoeconomics in search of cost effective solutions Part 2: Thermoeconomics

    International Nuclear Information System (INIS)

    Tsatsaronis, G.; Krane, R.J.

    1993-01-01

    This paper briefly discusses the thermoeconomic evaluation and optimization of energy systems. The techniques involved are somewhat specialized and will not be described in detail here but will be summarized to the level necessary to discuss some applications and conclusions. More details on thermoeconomics are given in References [1] through [6]. Energy is not only a measure of the true thermodynamic value of an energy carrier but is also closely related to the economic value of the carrier since users pay only for the useful part of energy. A thermoeconomic analysis combines an energy analysis with an economic analysis at the component level. The objectives of a detailed thermoeconomic analysis include all the objectives of an energy analysis (see Part I of this paper) in addition to the following: To shed light on the cost formation process, and, thus, facilitate studies to effectively reduce the product costs in an energy system.To estimate economically optimal operating conditions for a given design configuration. To understand the interactions between the thermodynamic performance of each plant component and the cost of the final plant product(s). To calculate the production costs of various products generated in the same process. To enable cost minimization studies in very complex energy systems

  19. Costs of endometriosis in Austria: a survey of direct and indirect costs.

    Science.gov (United States)

    Prast, Johanna; Oppelt, Peter; Shamiyeh, Andreas; Shebl, Omar; Brandes, Iris; Haas, Dietmar

    2013-09-01

    The literature includes a wealth of medical data on endometriosis, but the economic significance of the condition has so far been neglected. An analysis of hospital costs for endometriosis in Austria was, therefore, carried out for economic purposes. Seventy-three patients with endometriosis were included in the study. A bottom-up approach was used to collect data on the average hospital costs of an endometriosis patient over a time period of 1 year. In addition, a prevalence approach was used that allows subsequent estimation of the total costs of endometriosis for the health-care system in Austria for that period. Retrospective questionnaire survey was conducted. The average annual costs of one case of endometriosis are 7,712, with 5,605.55 attributable to direct costs and 2,106.34 to indirect costs. This indicates an overall economic burden of 328 million. In-patient care (45 %) and loss of productivity (27 %) were identified as the major cost factors. The patients themselves pay for 13 % of the costs (through out-of-pocket payments). This study impressively demonstrates the financial burden on the economy and on each individually affected patient caused by the disease of endometriosis. The massive consumption of resources represents a high level of usage of the medical services provided. The question arises as to whether more timely diagnosis, followed by better-targeted treatment, might have the potential to reduce these costs. The overall economic burden of endometriosis in Austria is currently comparable with that of Parkinson's disease.

  20. 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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Ulla Bøgvad Kejser

    2011-03-01

    Full Text Available The Danish Ministry of Culture has funded a project to set up a model for costing preservation of digital materials held by national cultural heritage institutions. The overall objective of the project was to increase cost effectiveness of digital preservation activities and to provide a basis for comparing and estimating future cost requirements for digital preservation. In this study we describe an activity-based costing methodology for digital preservation based on the Open Archice Information System (OAIS Reference Model. Within this framework, which we denote the Cost Model for Digital Preservation (CMDP, the focus is on costing the functional entity Preservation Planning from the OAIS and digital migration activities. In order to estimate these costs we have identified cost-critical activities by analysing the functions in the OAIS model and the flows between them. The analysis has been supplemented with findings from the literature, and our own knowledge and experience. The identified cost-critical activities have subsequently been deconstructed into measurable components, cost dependencies have been examined, and the resulting equations expressed in a spreadsheet. Currently the model can calculate the cost of different migration scenarios for a series of preservation formats for text, images, sound, video, geodata, and spreadsheets. In order to verify the model it has been tested on cost data from two different migration projects at the Danish National Archives (DNA. The study found that the OAIS model provides a sound overall framework for the cost breakdown, but that some functions need additional detailing in order to cost activities accurately. Running the two sets of empirical data showed among other things that the model underestimates the cost of manpower-intensive migration projects, while it reinstates an often underestimated cost, which is the cost of developing migration software. The model has proven useful for estimating the

  3. Cost and cost effectiveness of vaginal progesterone gel in reducing preterm birth: an economic analysis of the PREGNANT trial.

    Science.gov (United States)

    Pizzi, Laura T; Seligman, Neil S; Baxter, Jason K; Jutkowitz, Eric; Berghella, Vincenzo

    2014-05-01

    Preterm birth (PTB) is a costly public health problem in the USA. The PREGNANT trial tested the efficacy of vaginal progesterone (VP) 8 % gel in reducing the likelihood of PTB among women with a short cervix. We calculated the costs and cost effectiveness of VP gel versus placebo using decision analytic models informed by PREGNANT patient-level data. PREGNANT enrolled 459 pregnant women with a cervical length of 10-20 mm and randomized them to either VP 8 % gel or placebo. We used a cost model to estimate the total cost of treatment per mother and a cost-effectiveness model to estimate the cost per PTB averted with VP gel versus placebo. Patient-level trial data informed model inputs and included PTB rates in low- and high-risk women in each study group at <28 weeks gestation, 28-31, 32-36, and ≥37 weeks. Cost assumptions were based on 2010 US healthcare services reimbursements. The cost model was validated against patient-level data. Sensitivity analyses were used to test the robustness of the cost-effectiveness model. The estimated cost per mother was $US23,079 for VP gel and $US36,436 for placebo. The cost-effectiveness model showed savings of $US24,071 per PTB averted with VP gel. VP gel realized cost savings and cost effectiveness in 79 % of simulations. Based on findings from PREGNANT, VP gel was associated with cost savings and cost effectiveness compared with placebo. Future trials designed to include cost metrics are needed to better understand the value of VP.

  4. Life-cycle cost analysis of adsorption cycles for desalination

    KAUST Repository

    Thu, Kyaw

    2010-08-01

    This paper presents the thermo-economic analysis of the adsorption desalination (AD) cycle that is driven by low-temperature waste heat from exhaust of industrial processes or renewable sources. The AD cycle uses an adsorbent such as the silica gel to desalt the sea or brackish water. Based on an experimental prototype AD plant, the life-cycle cost analysis of AD plants of assorted water production capacities has been simulated and these predictions are translated into unit cost of water production. Our results show that the specific energy consumption of the AD cycle is 1.38 kWh/m3 which is the lowest ever reported. For a plant capacity of 1000 m3/d, the AD cycle offers a unit cost of $0.457/m3 as compared to more than $0.9 for the average RO plants. Besides being cost-effective, the AD cycle is also environment-friendly as it emits less CO2 emission per m3 generated, typically 85% less, by comparison to an RO process. © 2010 Desalination Publications.

  5. Activity-based costing methodology as tool for costing in hematopathology laboratory.

    Science.gov (United States)

    Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

    2010-01-01

    Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  6. Guiding the Development and Use of Cost-Effectiveness Analysis in Education

    Science.gov (United States)

    Levin, Henry M.; Belfield, Clive

    2015-01-01

    Cost-effectiveness analysis is rarely used in education. When it is used, it often fails to meet methodological standards, especially with regard to cost measurement. Although there are occasional criticisms of these failings, we believe that it is useful to provide a listing of the more common concerns and how they might be addressed. Based upon…

  7. A cost-benefit analysis of landfill mining and material recycling in China

    International Nuclear Information System (INIS)

    Zhou, Chuanbin; Gong, Zhe; Hu, Junsong; Cao, Aixin; Liang, Hanwen

    2015-01-01

    Highlights: • Assessing the economic feasibility of landfill mining. • We applied a cost-benefit analysis model for landfill mining. • Four material cycling and energy recovery scenarios were designed. • We used net present value to evaluate the cost-benefit efficiency. - Abstract: Landfill mining is an environmentally-friendly technology that combines the concepts of material recycling and sustainable waste management, and it has received a great deal of worldwide attention because of its significant environmental and economic potential in material recycling, energy recovery, land reclamation and pollution prevention. This work applied a cost-benefit analysis model for assessing the economic feasibility, which is important for promoting landfill mining. The model includes eight indicators of costs and nine indicators of benefits. Four landfill mining scenarios were designed and analyzed based on field data. The economic feasibility of landfill mining was then evaluated by the indicator of net present value (NPV). According to our case study of a typical old landfill mining project in China (Yingchun landfill), rental of excavation and hauling equipment, waste processing and material transportation were the top three costs of landfill mining, accounting for 88.2% of the total cost, and the average cost per unit of stored waste was 12.7 USD ton −1 . The top three benefits of landfill mining were electricity generation by incineration, land reclamation and recycling soil-like materials. The NPV analysis of the four different scenarios indicated that the Yingchun landfill mining project could obtain a net positive benefit varying from 1.92 million USD to 16.63 million USD. However, the NPV was sensitive to the mode of land reuse, the availability of energy recovery facilities and the possibility of obtaining financial support by avoiding post-closure care

  8. A cost-benefit analysis of landfill mining and material recycling in China

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Chuanbin, E-mail: cbzhou@rcees.ac.cn; Gong, Zhe; Hu, Junsong; Cao, Aixin; Liang, Hanwen

    2015-01-15

    Highlights: • Assessing the economic feasibility of landfill mining. • We applied a cost-benefit analysis model for landfill mining. • Four material cycling and energy recovery scenarios were designed. • We used net present value to evaluate the cost-benefit efficiency. - Abstract: Landfill mining is an environmentally-friendly technology that combines the concepts of material recycling and sustainable waste management, and it has received a great deal of worldwide attention because of its significant environmental and economic potential in material recycling, energy recovery, land reclamation and pollution prevention. This work applied a cost-benefit analysis model for assessing the economic feasibility, which is important for promoting landfill mining. The model includes eight indicators of costs and nine indicators of benefits. Four landfill mining scenarios were designed and analyzed based on field data. The economic feasibility of landfill mining was then evaluated by the indicator of net present value (NPV). According to our case study of a typical old landfill mining project in China (Yingchun landfill), rental of excavation and hauling equipment, waste processing and material transportation were the top three costs of landfill mining, accounting for 88.2% of the total cost, and the average cost per unit of stored waste was 12.7 USD ton{sup −1}. The top three benefits of landfill mining were electricity generation by incineration, land reclamation and recycling soil-like materials. The NPV analysis of the four different scenarios indicated that the Yingchun landfill mining project could obtain a net positive benefit varying from 1.92 million USD to 16.63 million USD. However, the NPV was sensitive to the mode of land reuse, the availability of energy recovery facilities and the possibility of obtaining financial support by avoiding post-closure care.

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

    International Nuclear Information System (INIS)

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

    1976-01-01

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

  10. 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 ...

  11. Cost-effectiveness analysis of colon cancer treatments from MOSIAC and No. 16968 trials.

    Science.gov (United States)

    Wen, Feng; Yao, Ke; Du, Ze-Dong; He, Xiao-Feng; Zhang, Peng-Fei; Tang, Rui-Lei; Li, Qiu

    2014-12-21

    To compare XELOX and FOLFOX4 as colon cancer adjuvant chemotherapy based on MOSAIC and No. 16968 trails from Chinese cost-effectiveness perspective. A decision-analytic Markov model was developed to compare the FOLFOX4 and XELOX regimens based MOSAIC and No. 16968 trial. Five states were included in our Markov model: well (state 1), minor toxicity (state 2), major toxicity (state 3), quitting adjuvant chemotherapy (state 4), and death due to adjuvant chemotherapy (state 5). Transitions among the 5 states were assumed to be Markovian. Costs were calculated from the perspective of the Chinese health-care payer. The utility data were taken from published studies. Sensitivity analyses were used to explore the impact of uncertainty factors in this cost-effectiveness analysis. Total direct costs of FOLFOX4 and XELOX per patient were $19884.96 ± 4280.30 and $18113.25 ± 3122.20, respectively. The total fees related to adverse events per patient during the entire treatment were $204.75 ± 16.80 for the XELOX group, and $873.72 ± 27.60 for the FOLFOX4 group, and the costs for travel and absenteeism per patient were $18495.00 for the XELOX group and $21,352.68 for the FOLFOX4 group. The base-case analysis showed that FOLFOX4 was estimated to produce an additional 0.06 in quality adjusted life years (QALYs) at an additional cost of $3950.47 when compared to the XELOX regimen over the model time horizon. The cost per QALY gained was $8047.30 in the XELOX group, which was $900.98 less than in the FOLFOX4 group ($8948.28). The one way sensitivity analysis demonstrated that the utility for the well state and minor toxicity state greatly influenced the incremental cost-effectiveness ratio of FOLFOX4. In term of cost-comparison, XELOX is expected to dominate FOLFOX4 regimes; Therefore, XELOX provides a more cost-effective adjuvant chemotherapy for colon cancer patients in China.

  12. The indirect costs of ankylosing spondylitis: a systematic review and meta-analysis.

    Science.gov (United States)

    Malinowski, Krzysztof Piotr; Kawalec, Paweł

    2015-04-01

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

  13. The Cost Analysis of Corrosion Protection Solutions for Steel Components in Terms of the Object Life Cycle Cost

    Directory of Open Access Journals (Sweden)

    Kowalski Dariusz

    2017-09-01

    Full Text Available Steel materials, due to their numerous advantages - high availability, easiness of processing and possibility of almost any shaping are commonly applied in construction for carrying out basic carrier systems and auxiliary structures. However, the major disadvantage of this material is its high corrosion susceptibility, which depends strictly on the local conditions of the facility and the applied type of corrosion protection system. The paper presents an analysis of life cycle costs of structures installed on bridges used in the road lane conditions. Three anti-corrosion protection systems were considered, analyzing their essential cost components. The possibility of reducing significantly the costs associated with anti-corrosion protection at the stage of steel barriers maintenance over a period of 30 years has been indicated. The possibility of using a new approach based on the life cycle cost estimation in the anti-corrosion protection of steel elements is presented. The relationship between the method of steel barrier protection, the scope of repair, renewal work and costs is shown. The article proposes an optimal solution which, while reducing the cost of maintenance of road infrastructure components in the area of corrosion protection, allows to maintain certain safety standards for steel barriers that are installed on the bridge.

  14. The Cost Analysis of Corrosion Protection Solutions for Steel Components in Terms of the Object Life Cycle Cost

    Science.gov (United States)

    Kowalski, Dariusz; Grzyl, Beata; Kristowski, Adam

    2017-09-01

    Steel materials, due to their numerous advantages - high availability, easiness of processing and possibility of almost any shaping are commonly applied in construction for carrying out basic carrier systems and auxiliary structures. However, the major disadvantage of this material is its high corrosion susceptibility, which depends strictly on the local conditions of the facility and the applied type of corrosion protection system. The paper presents an analysis of life cycle costs of structures installed on bridges used in the road lane conditions. Three anti-corrosion protection systems were considered, analyzing their essential cost components. The possibility of reducing significantly the costs associated with anti-corrosion protection at the stage of steel barriers maintenance over a period of 30 years has been indicated. The possibility of using a new approach based on the life cycle cost estimation in the anti-corrosion protection of steel elements is presented. The relationship between the method of steel barrier protection, the scope of repair, renewal work and costs is shown. The article proposes an optimal solution which, while reducing the cost of maintenance of road infrastructure components in the area of corrosion protection, allows to maintain certain safety standards for steel barriers that are installed on the bridge.

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

    OpenAIRE

    Yaşar, R. Şebnem

    2017-01-01

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

  16. Cost-benefit analysis for environmental impacts and radwaste system for nuclear power plant

    International Nuclear Information System (INIS)

    Mun, K.N.; Yook, C.C.

    1982-01-01

    During operation of nuclear power plant, radioactive material is inevitably formed. This radioactive material must be safely processed by radwaste system so that essentially zero activity is released to the environment. However zero released activity is not really practicable and population doses resulted from released activity are proportional to total annual cost for the radwaste system. In this study, cost-benefit analysis for the radwaste system of the Korean Nuclear Units 5 and 6 is performed to evaluate the optimization between the total annual cost for the radwaste system and population doses within 80 km from the plants. From the analysis, the following results are obtained; 1. the total population dose is estimated 4.04 x 10 3 man-rem/year, 2. total annual cost for the radwaste system is required $ 1.74 x 10 6 , 3. cost-benefit ratio is estimated $ 429/man-rem. (Author)

  17. The application of cost-benefit analysis to the radiological protection of the public

    International Nuclear Information System (INIS)

    1980-03-01

    The subject of this document is the quantification of the potential harm caused to the general public by ionising radiation in normal operating circumstances. The object is to enable the health detriment from a practice involving exposure to ionising radiation to be directly compared with the costs of keeping the ensuing doses as low as reasonably achievable. Chapter headings include: development of radiological protection criteria; principles underlying the valuation of harm from radiation exposure; risk evaluation approach to costing of detriment; monetary valuations; distribution of costs and risk in time. Appendices cover the following: cost benefit analysis (principles); recommendations of ICRP on the use of cost benefit analysis; life valuation studies (review); application of cost benefit analysis to the value of the man sievert. (U.K.)

  18. CLIMATE CHANGE – BETWEEN COSTS AND BENEFITS

    Directory of Open Access Journals (Sweden)

    CARMEN VALENTINA RĂDULESCU

    2011-03-01

    Full Text Available Climate change – between costs and benefits. At global and regional levels the effects of climate change start to show up. While some of the countries make efforts to alleviate these effects and to find solutions, others are facing economic or political restrains that prevent them in applying the principle of common responsibility. The complex social, economic, and environmental implications of climate change’s effects focused a growing part of research on the analysis of costs and benefits. Although controversial, one of the methods used – the cost-benefit analysis – revealed that in most of the cases the prevention costs are lower than the costs of inaction. Prevention measures bring benefits by anticipating the impact and minimizing the risks for ecosystems and economy. The paper presents in its first part the controversies regarding the cost-benefit analysis, and continues, in the second part, with estimations on costs and benefits of certain policy instruments that target emission reduction.

  19. Single use disposable digital flexible ureteroscopes: an ex-vivo assessment and cost analysis.

    Science.gov (United States)

    Hennessey, D B; Fojecki, G; Papa, N; Lawrentschuk, N; Bolton, D

    2018-04-15

    The single use flexible ureteroscope (fURS), the LithoVue is an important recent development. We aim to measure the capability of this instrument and to assess if there is a benefit to switching to single use instruments. The LithoVue was compared to Olympus URF-V and Stortz Flex Xc ex-vivo. An analysis of reusable fURS usage was performed to evaluate damage, durability and maintenance costs. This was then compared to the projected costs of using single use instruments. Flexion, deflection and irrigation flow of the LithoVue was equivalent, if not better than reusable instruments. An analysis of 234 procedures with 7 new Olympus URF-V scopes, revealed 15 scope damages. Staghorn stones and lower pole/midzone stones were significant risk factors for damage, p=0.014. Once damage occurred, it was likely to occur again. Total repair costs were $162,628 (£92,411), the mean cost per case is $695 (£395). Factoring in the purchase cost, cleaning and repair costs, and the cumulative cost of 28 reusable fURS cases is approximately $50,000 (£28,412). If the LithoVue was priced at $1200 AUD, switching to a single use scope would cost approximately $35,000 (£19,888). The LithoVue is analogous to reusable fURS scopes in regard to standard technical metrics. Depending on its purchase cost it may also represent a cost saving for hospitals when compared to the cumulative costs of maintaining reusable fURS. Additionally, urologist may consider to use the scope in cases in which reusable scope damage is anticipated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  20. Specialty and full-service hospitals: a comparative cost analysis.

    Science.gov (United States)

    Carey, Kathleen; Burgess, James F; Young, Gary J

    2008-10-01

    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  1. Thermoeconomic cost analysis of CO_2 compression and purification unit in oxy-combustion power plants

    International Nuclear Information System (INIS)

    Jin, Bo; Zhao, Haibo; Zheng, Chuguang

    2015-01-01

    Highlights: • Thermoeconomic cost analysis for CO_2 compression and purification unit is conducted. • Exergy cost and thermoeconomic cost occur in flash separation and mixing processes. • Unit exergy costs for flash separator and multi-stream heat exchanger are identical. • Multi-stage CO_2 compressor contributes to the minimum unit exergy cost. • Thermoeconomic performance for optimized CPU is enhanced. - Abstract: High CO_2 purity products can be obtained from oxy-combustion power plants through CO_2 compression and purification unit (CPU) based on phase separation method. To identify cost formation process and potential energy savings for CPU, detailed thermoeconomic cost analysis based on structure theory of thermoeconomics is applied to an optimized CPU (with double flash separators). It is found that the largest unit exergy cost occurs in the first separation process while the multi-stage CO_2 compressor contributes to the minimum unit exergy cost. In two flash separation processes, unit exergy costs for the flash separator and multi-stream heat exchanger are identical but their unit thermoeconomic costs are different once monetary cost for each device is considered. For cost inefficiency occurring in CPU, it mainly derives from large exergy costs and thermoeconomic costs in the flash separation and mixing processes. When compared with an unoptimized CPU, thermoeconomic performance for the optimized CPU is enhanced and the maximum reduction of 5.18% for thermoeconomic cost is attained. To achieve cost effective operation, measures should be taken to improve operations of the flash separation and mixing processes.

  2. The relationship between cost system complexity, purposes of use, and cost system effectiveness

    NARCIS (Netherlands)

    Schoute, M.

    2009-01-01

    This paper uses survey data from 133 Dutch, medium-sized manufacturing firms to examine the associations between cost system complexity (in terms of the applied overhead absorption procedures), purposes of use, and cost system effectiveness. First, factor analysis identifies two underlying

  3. Costs and cost-effectiveness of delivering intermittent preventive treatment through schools in western Kenya

    Directory of Open Access Journals (Sweden)

    Jukes Matthew CH

    2008-09-01

    Full Text Available Abstract Background Awareness of the potential impact of malaria among school-age children has stimulated investigation into malaria interventions that can be delivered through schools. However, little evidence is available on the costs and cost-effectiveness of intervention options. This paper evaluates the costs and cost-effectiveness of intermittent preventive treatment (IPT as delivered by teachers in schools in western Kenya. Methods Information on actual drug and non-drug associated costs were collected from expenditure and salary records, government budgets and interviews with key district and national officials. Effectiveness data were derived from a cluster-randomised-controlled trial of IPT where a single dose of sulphadoxine-pyrimethamine and three daily doses of amodiaquine were provided three times in year (once termly. Both financial and economic costs were estimated from a provider perspective, and effectiveness was estimated in terms of anaemia cases averted. A sensitivity analysis was conducted to assess the impact of key assumptions on estimated cost-effectiveness. Results The delivery of IPT by teachers was estimated to cost US$ 1.88 per child treated per year, with drug and teacher training costs constituting the largest cost components. Set-up costs accounted for 13.2% of overall costs (equivalent to US$ 0.25 per child whilst recurrent costs accounted for 86.8% (US$ 1.63 per child per year. The estimated cost per anaemia case averted was US$ 29.84 and the cost per case of Plasmodium falciparum parasitaemia averted was US$ 5.36, respectively. The cost per case of anaemia averted ranged between US$ 24.60 and 40.32 when the prices of antimalarial drugs and delivery costs were varied. Cost-effectiveness was most influenced by effectiveness of IPT and the background prevalence of anaemia. In settings where 30% and 50% of schoolchildren were anaemic, cost-effectiveness ratios were US$ 12.53 and 7.52, respectively. Conclusion This

  4. Cost Benefit Analysis of Khaddar Industry: a Study on Comilla District

    Directory of Open Access Journals (Sweden)

    Shamimul Islam

    2015-01-01

    Full Text Available The study tries to findout the Cost Benefit Analysis (CBA of Khaddar industry. Comilla district is considered as the study area. Sample is selected purposively based on the stablishment available within the district. The collected data is analysed by using Microsoft Office Excel 2007 to calculate different statistical values used in this paper. All the possible techniques of Cost Benefit analysis are employed. The findings suggest that, in both the cases i.e., in case of Hand Loom as well as in case of Power Loom the expected return is very high. The value of Net Present Value (NPV, Benefit Cost Ratio (BCR and Internal Rate of Return (IRR suggest that, there is a very higher profitability in this sector. The IRR of the projects is 183 and 157 for Hand Loom and Power Loom respectively which is exceptionally very high. The higher value may due to low establishment costs and low maintenance costs for hand loom alternatively high productivity and comparatively lower operating costs for power loom industries.

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

    Directory of Open Access Journals (Sweden)

    Gabriel Otieno

    2016-03-01

    Full Text Available Malaria remains a leading cause of mortality and morbidity among the children under five and pregnant women in sub-Saharan Africa, but it is preventable and controllable provided current recommended interventions are properly implemented. Better utilization of malaria intervention strategies will ensure the gain for the value for money and producing health improvements in the most cost effective way. The purpose of the value for money drive is to develop a better understanding (and better articulation of costs and results so that more informed, evidence-based choices could be made. Cost effectiveness analysis is carried out to inform decision makers on how to determine where to allocate resources for malaria interventions. This study carries out cost effective analysis of one or all possible combinations of the optimal malaria control strategies (Insecticide Treated Bednets—ITNs, Treatment, Indoor Residual Spray—IRS and Intermittent Preventive Treatment for Pregnant Women—IPTp for the four different transmission settings in order to assess the extent to which the intervention strategies are beneficial and cost effective. For the four different transmission settings in Kenya the optimal solution for the 15 strategies and their associated effectiveness are computed. Cost-effective analysis using Incremental Cost Effectiveness Ratio (ICER was done after ranking the strategies in order of the increasing effectiveness (total infections averted. The findings shows that for the endemic regions the combination of ITNs, IRS, and IPTp was the most cost-effective of all the combined strategies developed in this study for malaria disease control and prevention; for the epidemic prone areas is the combination of the treatment and IRS; for seasonal areas is the use of ITNs plus treatment; and for the low risk areas is the use of treatment only. Malaria transmission in Kenya can be minimized through tailor-made intervention strategies for malaria control

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

    NARCIS (Netherlands)

    Kempers, J.; Ketting, E.; Lesco, G.

    2014-01-01

    BACKGROUND: Youth-friendly sexual and reproductive health services (YFHS) have high priority in many countries. Yet, little is known about the cost and cost-effectiveness of good quality YFHS in resource limited settings. This paper analyses retrospectively costs and potential cost-effectiveness of

  7. Cost accounting for the radiologist.

    Science.gov (United States)

    Gentili, Amilcare

    2014-05-01

    Cost accounting is the branch of managerial accounting that deals with the analysis of the costs of a product or service. This article reviews methods of classifying and allocating costs and relationships among costs, volume, and revenues. Radiology practices need to know the cost of a procedure or service to determine the selling price of a product, bid on contracts, analyze profitability, and facilitate cost control and cost reduction.

  8. Cost benefit analysis of two policy options for cannabis: status quo and legalisation.

    Science.gov (United States)

    Shanahan, Marian; Ritter, Alison

    2014-01-01

    To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal) and a legalised-regulated option was conducted. A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events). The results are expressed as a net social benefit (NSB). The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles) for the status quo was $294.6 million AUD ($201.1 to $392.7 million) not substantially different from the $234.2 million AUD ($136.4 to $331.1 million) for the legalised-regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised-regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case.

  9. Cost benefit analysis of two policy options for cannabis: status quo and legalisation.

    Directory of Open Access Journals (Sweden)

    Marian Shanahan

    Full Text Available AIMS: To date there has been limited analysis of the economic costs and benefits associated with cannabis legalisation. This study redresses this gap. A cost benefit analysis of two cannabis policy options the status quo (where cannabis use is illegal and a legalised-regulated option was conducted. METHOD: A cost benefit analysis was used to value the costs and benefits of the two policies in monetary terms. Costs and benefits of each policy option were classified into five categories (direct intervention costs, costs or cost savings to other agencies, benefits or lost benefits to the individual or the family, other impacts on third parties, and adverse or spill over events. The results are expressed as a net social benefit (NSB. FINDINGS: The mean NSB per annum from Monte Carlo simulations (with the 5 and 95 percentiles for the status quo was $294.6 million AUD ($201.1 to $392.7 million not substantially different from the $234.2 million AUD ($136.4 to $331.1 million for the legalised-regulated model which excludes government revenue as a benefit. When government revenue is included, the NSB for legalised-regulated is higher than for status quo. Sensitivity analyses demonstrate the significant impact of educational attainment and wellbeing as drivers for the NSB result. CONCLUSION: Examining the percentiles around the two policy options, there appears to be no difference between the NSB for these two policy options. Economic analyses are essential for good public policy, providing information about the extent to which one policy is substantially economically favourable over another. In cannabis policy, for these two options this does not appear to be the case.

  10. Risk-benefit analysis and cost-effectiveness analysis of lung cancer screening by spiral CT

    International Nuclear Information System (INIS)

    Iinuma, Takeshi

    1999-01-01

    Mass screening of lung cancer has been widely performed using indirect chest X-ray method in Japan. However reduction of the mortality for lung cancer is questioned. We have proposed that recently developed spiral CT should be adopted for the screening of lung cancer, since CT has an excellent detectability for small nodule. Lung Cancer Screening CT (LSCT) has been developed by author's group using spiral CT with low dose and light weight in order to make a mobile unit. In this paper risk-benefit analysis and cost-effectiveness analysis are described for the LSCT screening of lung cancer. As a risk, radiation carcinogenesis due to exposure from LSCT are compared with gain of life-expectancy by screening and men of 40 years or more and women of 45 years or more are justified. The cost per person-year is estimated for LSCT screening which is better than that of present method, although total cost is higher. The LSCT screening could be recommended if total cost is affordable. (author)

  11. Final Report: Hydrogen Production Pathways Cost Analysis (2013 – 2016)

    Energy Technology Data Exchange (ETDEWEB)

    James, Brian David [Strategic Analysis Inc., Arlington, VA (United States); DeSantis, Daniel Allan [Strategic Analysis Inc., Arlington, VA (United States); Saur, Genevieve [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2016-09-30

    This report summarizes work conducted under a three year Department of Energy (DOE) funded project to Strategic Analysis, Inc. (SA) to analyze multiple hydrogen (H2) production technologies and project their corresponding levelized production cost of H2. The analysis was conducted using the H2A Hydrogen Analysis Tool developed by the DOE and National Renewable Energy Laboratory (NREL). The project was led by SA but conducted in close collaboration with the NREL and Argonne National Laboratory (ANL). In-depth techno-economic analysis (TEA) of five different H2 production methods was conducted. These TEAs developed projections for capital costs, fuel/feedstock usage, energy usage, indirect capital costs, land usage, labor requirements, and other parameters, for each H2 production pathway, and use the resulting cost and system parameters as inputs into the H2A discounted cash flow model to project the production cost of H2 ($/kgH2). Five technologies were analyzed as part of the project and are summarized in this report: Proton Exchange Membrane technology (PEM), High temperature solid oxide electrolysis cell technology (SOEC), Dark fermentation of biomass for H2 production, H2 production via Monolithic Piston-Type Reactors with rapid swing reforming and regeneration reactions, and Reformer-Electrolyzer-Purifier (REP) technology developed by Fuel Cell Energy, Inc. (FCE).

  12. A cost-consequences analysis of a primary care librarian question and answering service.

    Directory of Open Access Journals (Sweden)

    Jessie McGowan

    Full Text Available BACKGROUND: Cost consequences analysis was completed from randomized controlled trial (RCT data for the Just-in-time (JIT librarian consultation service in primary care that ran from October 2005 to April 2006. The service was aimed at providing answers to clinical questions arising during the clinical encounter while the patient waits. Cost saving and cost avoidance were also analyzed. The data comes from eighty-eight primary care providers in the Ottawa area working in Family Health Networks (FHNs and Family Health Groups (FHGs. METHODS: We conducted a cost consequences analysis based on data from the JIT project. We also estimated the potential economic benefit of JIT librarian consultation service to the health care system. RESULTS: The results show that the cost per question for the JIT service was $38.20. The cost could be as low as $5.70 per question for a regular service. Nationally, if this service was implemented and if family physicians saw additional patients when the JIT service saved them time, up to 61,100 extra patients could be seen annually. A conservative estimate of the cost savings and cost avoidance per question for JIT was $11.55. CONCLUSIONS: The cost per question, if the librarian service was used at full capacity, is quite low. Financial savings to the health care system might exceed the cost of the service. Saving physician's time during their day could potentially lead to better access to family physicians by patients. Implementing a librarian consultation service can happen quickly as the time required to train professional librarians to do this service is short.

  13. A cost-benefit analysis of varicella vaccination in Aragón.

    Science.gov (United States)

    Peña Blasco, Guillermo; Blasco Pérez-Aramendía, M Jesús

    2017-10-01

    Varicella, a contagious and infectious disease that is usually benign in children, may become complicated among adults and vulnerable children and may even be life-threatening. There are effective vaccines. A retrospective study was conducted about costs and resulting hospitalizations related to this disease in the population of Aragón in the 2004-2014 period. Costs were compared to the expenses that would have been incurred if those people had received the vaccine and also to the expenses of vaccinating the 1-year-old population over the entire period. A cost-benefit analysis was done to assess the economic impact of varicella vaccination. Data for the 11-year period were provided by the Autonomous Community of Aragón (Spain) and included annual varicella incidence, hospital discharges of varicella cases, costs of primary health care visits and hospitalizations for each year, costs of each workday as per the minimum annual salary and of drugs used). Capitalized costs were estimated and compared to capitalized expenses of vaccination, and a sensitivity analysis was performed. A benefit-cost ratio of 1.6 was obtained considering that all children who had varicella had been vaccinated and had received a booster dose. A benefit-cost ratio of 1.24 was obtained considering that the vaccine had been administered to every 1-year-old individual at a price of EUR 28.59 per vaccine. Over the 11-year period, 53% of hospitalizations corresponded to children younger than 5 years old. Public campaigns for the immunization of children younger than 4 years old with 2 doses lead to cost savings and are cost-effective because the vaccine price results in a benefit-cost ratio greater than 1. A major reduction is expected in the number of hospitalizations among children aged 3-4 years. Sociedad Argentina de Pediatría

  14. A Cost-Effectiveness Analysis of Seminatural Wetlands and Activated Sludge Wastewater-Treatment Systems

    Science.gov (United States)

    Mannino, Ilda; Franco, Daniel; Piccioni, Enrico; Favero, Laura; Mattiuzzo, Erika; Zanetto, Gabriele

    2008-01-01

    A cost-effectiveness analysis was performed to evaluate the competitiveness of seminatural Free Water Surface (FWS) wetlands compared to traditional wastewater-treatment plants. Six scenarios of the service costs of three FWS wetlands and three different wastewater-treatment plants based on active sludge processes were compared. The six scenarios were all equally effective in their wastewater-treatment capacity. The service costs were estimated using real accounting data from an experimental wetland and by means of a market survey. Some assumptions had to be made to perform the analysis. A reference wastewater situation was established to solve the problem of the different levels of dilution that characterize the inflow water of the different systems; the land purchase cost was excluded from the analysis, considering the use of public land as shared social services, and an equal life span for both seminatural and traditional wastewater-treatment plants was set. The results suggest that seminatural systems are competitive with traditional biotechnological systems, with an average service cost improvement of 2.1-fold to 8-fold, according to the specific solution and discount rate. The main improvement factor was the lower maintenance cost of the seminatural systems, due to the self-regulating, low artificial energy inputs and the absence of waste to be disposed. In this work, only the waste-treatment capacity of wetlands was considered as a parameter for the economic competitiveness analysis. Other goods/services and environmental benefits provided by FWS wetlands were not considered.

  15. A cost-effect analysis of an intervention against radon in homes

    Directory of Open Access Journals (Sweden)

    Hein Stigum

    2009-10-01

    Full Text Available Background  Key words  : Radon exposure, lung cancer, cost-effect analysis, attributable risk, models-mathematical: Radon is a radioactive gas that may leak into buildings from the ground. Radon exposure is a risk factor for lung cancer. An intervention against radon exposure in homes may consist of locating homes with high radon exposure (above 200 Bq m-3 and improving these, and of protecting future houses. The purpose of this paper is to calculate the costs and the effects of this intervention. Methods: We performed a cost-effect analysis from the perspective of the society, followed by an uncertainty and sensitivity analysis. The distribution of radon levels in Norwegian homes is lognormal with mean=74.5 Bq/m3, and 7.6% above 200 Bq/m3. Results: The preventable attributable fraction of radon on lung cancer was 3.8% (95% uncertainty interval: 0.6%, 8.3%. In cumulative present values the intervention would cost $238 (145, 310 million and save 892 (133, 1981 lives, each life saved costs $0.27 (0.09, 0.9 million. The cost-effect ratio was sensitive to the radon risk, the radon exposure distribution, and the latency period of lung cancer. Together these three parameters explained 90% of the variation in the cost-effect ratio. Conclusions: Reducing the radon concentration in present and future homes to below 200 Bq/m3 will cost $0.27 (0.09, 0.9 million per life saved. The uncertainty in the estimated cost per life is large, mainly due to uncertainty in the risk of lung cancer from radon. Based on estimates from road construction, the Norwegian society has been willing to pay $1 million to save a life. We therefore conclude that the intervention against radon in homes is justifiable. The willingness to pay is also larger that the upper uncertainty limit of the cost per life. Our conclusion is therefore robust against the uncertainties in the parameters.

  16. Cost analysis of Navy acquisition alternatives for the NAVSTAR Global Positioning System

    Science.gov (United States)

    Darcy, T. F.; Smith, G. P.

    1982-12-01

    This research analyzes the life cycle cost (LCC) of the Navy's current and two hypothetical procurement alternatives for NAVSTAR Global Positioning System (GPS) user equipment. Costs are derived by the ARINC Research Corporation ACBEN cost estimating system. Data presentation is in a comparative format describing individual alternative LCC and differential costs between alternatives. Sensitivity analysis explores the impact receiver-processor unit (RPU) first unit production cost has on individual alternative LCC, as well as cost differentials between each alternative. Several benefits are discussed that might provide sufficient cost savings and/or system effectiveness improvements to warrant a procurement strategy other than the existing proposal.

  17. Indirect health costs in ulcerative colitis and Crohn's disease: a systematic review and meta-analysis.

    Science.gov (United States)

    Kawalec, Paweł; Malinowski, Krzysztof Piotr

    2015-04-01

    The aim of this systematic review was to collect all current data on indirect costs related to inflammatory bowel disease as well as assessing homogeneity and comparability, and conducting a meta-analysis. Costs were collected using databases from Medline, Embase and Centre for Reviews and Dissemination databases, then average annual cost per patient was calculated and expressed in 2013-rate USD using the consumer price index and purchasing power parity (scenario 1) and then adjusted to specific gross domestic product (scenario 2) to make them comparable. The studies were then included in quantitative synthesis using the meta-analysis and bootstrap methods. This systematic review was carried out and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. From 18 publications, overall annual indirect costs per patient as a result of the quantitative synthesis among all studies eligible for meta-analysis ranged from US$2425.01-US$9622.15 depending on the scenario and model used for analysis. The cost of presenteeism was assessed in only two studies. Considering heterogeneity among all identified studies random-effect model presented the most accurate results of meta-analysis equal to US$7189.27 and US$9622.15 per patient per year for scenario 1 and scenario 2, respectively. This systematic review revealed the existence of a relatively small number of studies that reported on the great economic burden of the disease upon society. A great variety of methodologies and cost components resulted in a very large discrepancy in indirect costs and made meta-analysis difficult to perform, so two scenarios were considered and meta-analysis conducted in subgroups to make data more comparable.

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

    Directory of Open Access Journals (Sweden)

    Ekwunife Obinna Ikechukwu

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

    2016-01-01

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

  20. Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis

    Directory of Open Access Journals (Sweden)

    Ramponi F

    2016-09-01

    Full Text Available Francesco Ramponi,1,2 Claudio Ronco,1,3 Giacomo Mason,1 Enrico Rettore,4 Daniele Marcelli,5,6 Francesca Martino,1,3 Mauro Neri,1,7 Alejandro Martin-Malo,8 Bernard Canaud,5,9 Francesco Locatelli10 1International Renal Research Institute (IRRIV, San Bortolo Hospital, Vicenza, 2Department of Economics and Management, University of Padova, Padova, 3Department of Nephrology, San Bortolo Hospital, Vicenza, 4Department of Sociology and Social Research, University of Trento, FBK-IRVAPP & IZA, Trento, Italy; 5Europe, Middle East, Africa and Latin America Medical Board, Fresenius Medical Care,, Bad Homburg, Germany; 6Danube University, Krems, Austria; 7Department of Management and Engineering, University of Padova, Vicenza, Italy; 8Nephrology Unit, Reina Sofia University Hospital, Córdoba, Spain; 9School of Medicine, Montpellier University, Montpellier, France; 10Department of Nephrology, Manzoni Hospital, Lecco, Italy Background: Clinical studies suggest that hemodiafiltration (HDF may lead to better clinical outcomes than high-flux hemodialysis (HF-HD, but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD.Methods: The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1 estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2 simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3 application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different

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

    Science.gov (United States)

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

    2017-08-01

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

  2. Activity-based costing methodology as tool for costing in hematopathology laboratory

    Directory of Open Access Journals (Sweden)

    Gujral Sumeet

    2010-01-01

    Full Text Available Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL Settings and Design: Activity-based costing (ABC method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs, payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC, bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

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

    Directory of Open Access Journals (Sweden)

    Tsai-Yun Li

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

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

    Science.gov (United States)

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

    2012-03-01

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

  5. Cost Analysis and Policy Implications of a Pediatric Palliative Care Program.

    Science.gov (United States)

    Gans, Daphna; Hadler, Max W; Chen, Xiao; Wu, Shang-Hua; Dimand, Robert; Abramson, Jill M; Ferrell, Betty; Diamant, Allison L; Kominski, Gerald F

    2016-09-01

    In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. We assessed the change from before PFC enrollment to the enrolled period in 1) health care costs per enrollee per month (PEPM), 2) costs by service type and diagnosis category, and 3) health care utilization (days of inpatient care and length of hospital stay). A pre-post analysis compared enrollees' health care costs and utilization up to 24 months before enrollment with their costs during participation in the pilot, from January 2010 through December 2012. Analyses were conducted using paid Medicaid claims and program enrollment data. The average PEPM health care costs of program enrollees decreased by $3331 from before their participation in PFC to the enrolled period, driven by a reduction in inpatient costs of $4897 PEPM. PFC enrollees experienced a nearly 50% reduction in the average number of inpatient days per month, from 4.2 to 2.3. Average length of stay per hospitalization dropped from an average of 16.7 days before enrollment to 6.5 days while in the program. Through the provision of home-based therapeutic services, 24/7 access to medical advice, and enhanced, personally tailored care coordination, PFC demonstrated an effective way to reduce costs for children with life-limiting conditions by moving from costly inpatient care to more coordinated and less expensive outpatient care. PFC's home-based care strategy is a cost-effective model for pediatric palliative care elsewhere. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  6. Examining the effectiveness of municipal solid waste management systems: An integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan

    International Nuclear Information System (INIS)

    Weng, Yu-Chi; Fujiwara, Takeshi

    2011-01-01

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O and M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities.

  7. Telemedicine in the management of chronic pain: a cost analysis study.

    Science.gov (United States)

    Pronovost, Antoine; Peng, Philip; Kern, Ralph

    2009-08-01

    Telemedicine provides patients with easy and remote access to consultant expertise irrespective of geographic location. In a randomized controlled trial, this study has applied a rigorous costing methodology to the use of telemedicine in chronic pain management. We performed a randomized two-period crossover trial comparing in-person (IP) consultation with telemedicine (TM) consultation in the management of chronic pain. Over an 18-month period, 26 patients each completed two diaries capturing their direct and indirect travel costs, daily pain scores, and satisfaction with physician consultation. Costing models were developed to account for direct, indirect, fixed, and variable costs in order to perform break-even analyses. Sensitivity analysis was performed over a broad range of assumptions. Direct patient costs were significantly lower in the TM group than in the IP group, with median cost and interquartile range 133 dollars (28-377) vs 443 dollars (292-1075), respectively (P = 0.001). More patients were highly satisfied with the TM consultation than with the IP consultation (56 and 24%, respectively; P sensitivity analysis controlling for annual patient volume and round-trip distance indicated that TM remains cost-effective at volumes >50 patients/year or at round-trip distances >200 km. Telemedicine is cost-effective over a broad range of assumptions, including annual patient volumes, travel distance, fuel costs, amortization, and discount rates. This study provides data from a real-world setting to determine relevant thresholds and targets for establishing a TM program for patients who are undergoing chronic pain therapy.

  8. Micro-cost Analysis of ALK Rearrangement Testing by FISH to Determine Eligibility for Crizotinib Therapy in NSCLC: Implications for Cost Effectiveness of Testing and Treatment

    Science.gov (United States)

    Parker, David; Belaud-Rotureau, Marc-Antoine

    2014-01-01

    Break-apart fluorescence in situ hybridization (FISH) is the gold standard test for anaplastic lymphoma kinase (ALK) gene rearrangement. However, this methodology often is assumed to be expensive and potentially cost-prohibitive given the low prevalence of ALK-positive non-small cell lung cancer (NSCLC) cases. To more accurately estimate the cost of ALK testing by FISH, we developed a micro-cost model that accounts for all cost elements of the assay, including laboratory reagents, supplies, capital equipment, technical and pathologist labor, and the acquisition cost of the commercial test and associated reagent kits and controls. By applying a set of real-world base-case parameter values, we determined that the cost of a single ALK break-apart FISH test result is $278.01. Sensitivity analysis on the parameters of batch size, testing efficiency, and the cost of the commercial diagnostic testing products revealed that the cost per result is highly sensitive to batch size, but much less so to efficiency or product cost. This implies that ALK testing by FISH will be most cost effective when performed in high-volume centers. Our results indicate that testing cost may not be the primary determinant of crizotinib (Xalkori®) treatment cost effectiveness, and suggest that testing cost is an insufficient reason to limit the use of FISH testing for ALK rearrangement. PMID:25520569

  9. Micro-cost Analysis of ALK Rearrangement Testing by FISH to Determine Eligibility for Crizotinib Therapy in NSCLC: Implications for Cost Effectiveness of Testing and Treatment.

    Science.gov (United States)

    Parker, David; Belaud-Rotureau, Marc-Antoine

    2014-01-01

    Break-apart fluorescence in situ hybridization (FISH) is the gold standard test for anaplastic lymphoma kinase (ALK) gene rearrangement. However, this methodology often is assumed to be expensive and potentially cost-prohibitive given the low prevalence of ALK-positive non-small cell lung cancer (NSCLC) cases. To more accurately estimate the cost of ALK testing by FISH, we developed a micro-cost model that accounts for all cost elements of the assay, including laboratory reagents, supplies, capital equipment, technical and pathologist labor, and the acquisition cost of the commercial test and associated reagent kits and controls. By applying a set of real-world base-case parameter values, we determined that the cost of a single ALK break-apart FISH test result is $278.01. Sensitivity analysis on the parameters of batch size, testing efficiency, and the cost of the commercial diagnostic testing products revealed that the cost per result is highly sensitive to batch size, but much less so to efficiency or product cost. This implies that ALK testing by FISH will be most cost effective when performed in high-volume centers. Our results indicate that testing cost may not be the primary determinant of crizotinib (Xalkori(®)) treatment cost effectiveness, and suggest that testing cost is an insufficient reason to limit the use of FISH testing for ALK rearrangement.

  10. The cost of preventing undernutrition: cost, cost-efficiency and cost-effectiveness of three cash-based interventions on nutrition outcomes in Dadu, Pakistan.

    Science.gov (United States)

    Trenouth, Lani; Colbourn, Timothy; Fenn, Bridget; Pietzsch, Silke; Myatt, Mark; Puett, Chloe

    2018-07-01

    Cash-based interventions (CBIs) increasingly are being used to deliver humanitarian assistance and there is growing interest in the cost-effectiveness of cash transfers for preventing undernutrition in emergency contexts. The objectives of this study were to assess the costs, cost-efficiency and cost-effectiveness in achieving nutrition outcomes of three CBIs in southern Pakistan: a 'double cash' (DC) transfer, a 'standard cash' (SC) transfer and a 'fresh food voucher' (FFV) transfer. Cash and FFVs were provided to poor households with children aged 6-48 months for 6 months in 2015. The SC and FFV interventions provided $14 monthly and the DC provided $28 monthly. Cost data were collected via institutional accounting records, interviews, programme observation, document review and household survey. Cost-effectiveness was assessed as cost per case of wasting, stunting and disability-adjusted life year (DALY) averted. Beneficiary costs were higher for the cash groups than the voucher group. Net total cost transfer ratios (TCTRs) were estimated as 1.82 for DC, 2.82 for SC and 2.73 for FFV. Yet, despite the higher operational costs, the FFV TCTR was lower than the SC TCTR when incorporating the participation cost to households, demonstrating the relevance of including beneficiary costs in cost-efficiency estimations. The DC intervention achieved a reduction in wasting, at $4865 per case averted; neither the SC nor the FFV interventions reduced wasting. The cost per case of stunting averted was $1290 for DC, $882 for SC and $883 for FFV. The cost per DALY averted was $641 for DC, $434 for SC and $563 for FFV without discounting or age weighting. These interventions are highly cost-effective by international thresholds. While it is debatable whether these resource requirements represent a feasible or sustainable investment given low health expenditures in Pakistan, these findings may provide justification for continuing Pakistan's investment in national social safety

  11. Cost estimation tools in Germany and the UK. Comparison of cost estimates and actual costs

    International Nuclear Information System (INIS)

    Pfeifer, W.; Gordelier, S.; Drake, V.

    2005-01-01

    Full text: Accurate cost estimation for future decommissioning projects is a matter of considerable importance, especially for ensuring that sufficient funds will be available at the time of project implementation. This paper looks at the experience of cost estimation and real implementation outcomes from two countries, Germany and the UK, and draws lessons for the future. In Germany, cost estimates for the decommissioning of power reactors are updated every two years. For this purpose, the STILLKO program of the NIS Company is used. So far, Forschungszentrum Karlsruhe has successfully decommissioned two prototype reactor facilities. Re-cultivation of the premises has already been completed. At the moment, the activated components of the multi-purpose research reactor (MZFR), the first pressurized water reactor in Germany that was moderated and cooled with heavy water, and of the prototype fast breeder reactor (KNK) are being dismantled remotely. Consequently, vast experience exists in particular for the updating of total costs on the basis of actually incurred expenses. The further the dismantling work proceeds, the more reliable is the total cost estimate. Here, the development of the estimated MZFR decommissioning costs shall be presented and compared with the estimates obtained for a German reference PWR-type power reactor of 1200 MW. In this way: - common features of the prototype reactor and power reactor shall be emphasized, - several parameters leading to an increase in the estimated costs shall be highlighted, - cost risks shall be outlined with the remote dismantling of the reactor pressure vessel serving as an example, - calculation parameters shall be presented, and - recommendations shall be made for a consistent estimation of costs. The United Kingdom Atomic Energy Authority (UKAEA) has a major programme for the environmental remediation of its former research and development sites at Dounreay, Windscale, Harwell and Winfrith together with the need to

  12. Examining the effectiveness of municipal solid waste management systems: an integrated cost-benefit analysis perspective with a financial cost modeling in Taiwan.

    Science.gov (United States)

    Weng, Yu-Chi; Fujiwara, Takeshi

    2011-06-01

    In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management systems. In this paper, detailed cost/benefit items due to waste problems are particularly clarified. The stakeholders of MSW management systems, including the decision-makers of the municipalities and the citizens, are expected to reconsider the waste problems in depth and thus take wise actions with the aid of the proposed CBA framework. Secondly, focusing on the financial cost, this study develops a generalized methodology to evaluate the financial cost-effectiveness of MSW management systems, simultaneously considering the treatment technological levels and policy effects. The impacts of the influencing factors on the annual total and average financial MSW operation and maintenance (O&M) costs are analyzed in the Taiwanese case study with a demonstrative short-term future projection of the financial costs under scenario analysis. The established methodology would contribute to the evaluation of the current policy measures and to the modification of the policy design for the municipalities. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  13. [Analysis of costs and cost-effectiveness of preferred GESIDA/National AIDS Plan regimens for initial antiretroviral therapy in human immunodeficiency virus infected adult patients in 2013].

    Science.gov (United States)

    Blasco, Antonio Javier; Llibre, Josep M; Arribas, José Ramón; Boix, Vicente; Clotet, Bonaventura; Domingo, Pere; González-García, Juan; Knobel, Hernando; López, Juan Carlos; Lozano, Fernando; Miró, José M; Podzamczer, Daniel; Santamaría, Juan Miguel; Tuset, Montserrat; Zamora, Laura; Lázaro, Pablo; Gatell, Josep M

    2013-11-01

    The GESIDA and National AIDS Plan panel of experts have proposed "preferred regimens" of antiretroviral treatment (ART) as initial therapy in HIV infected patients for 2013. The objective of this study is to evaluate the costs and effectiveness of initiating treatment with these "preferred regimens". An economic assessment of costs and effectiveness (cost/effectiveness) was performed using decision tree analysis models. Effectiveness was defined as the probability of having viral load <50copies/mL at week48, in an intention-to-treat analysis. Cost of initiating treatment with an ART regime was defined as the costs of ART and its consequences (adverse effects, changes of ART regime and drug resistance analyses) during the first 48weeks. The perspective of the analysis is that of the National Health System was applied, only taking into account differential direct costs: ART (official prices), management of adverse effects, resistance studies, and determination of HLA B*5701. The setting is Spain and the costs are those of 2013. A sensitivity deterministic analysis was performed, constructing three scenarios for each regimen: baseline, most favourable, and most unfavourable cases. In the baseline case scenario, the cost of initiating treatment ranges from 6,747euros for TDF/FTC+NVP to 12,059euros for TDF/FTC+RAL. The effectiveness ranges between 0.66 for ABC/3TC+LPV/r and ABC/3TC+ATV/r, and 0.87 for TDF/FTC+RAL and ABC/3TC+RAL. Effectiveness, in terms of cost/effectiveness, varies between 8,396euros and 13,930euros per responder at 48weeks, for TDF/FTC/RPV and TDF/FTC+RAL, respectively. Taking ART at official prices, the most effective regimen was TDF/FTC/RPV, followed by the rest of non-nucleoside containing regimens. The sensitivity analysis confirms the robustness of these findings. Copyright © 2013 Elsevier España, S.L. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ucok Mulyo Sugeng

    2017-10-01

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

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

    OpenAIRE

    Jirsová, Karolína

    2017-01-01

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

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

    Science.gov (United States)

    Merry, Matthew; Boulware, David R

    2016-06-15

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

  17. 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

  18. Cost analysis of paroxetine versus imipramine in major depression.

    Science.gov (United States)

    Bentkover, J D; Feighner, J P

    1995-09-01

    A simulation decision analytical model was used to compare the annual direct medical costs of treating patients with major depression using the selective serotonin reuptake inhibitor (SSRI) paroxetine or the tricyclic antidepressant (TCA) imipramine. Medical treatment patterns were determined from focus groups of general and family practitioners and psychiatrists in Boston, Dallas and Chicago, US. Direct medical costs included the wholesale drug acquisition costs (based on a 6-month course of drug therapy), psychiatrist and/or general practitioner visits, hospital outpatient visits, hospitalisation and electroconvulsive therapy. Acute phase treatment failure rates were derived from an intention-to-treat analysis of a previously published trial of paroxetine, imipramine and placebo in patients with major depression. Maintenance phase relapse rates were obtained from a 12-month trial of paroxetine, supplemented from the medical literature. The relapse rates for the final 6 months of the year were obtained from medical literature and expert opinion. Direct medical costs were estimated from a health insurance claims database. The estimated total direct medical cost per patient was slightly lower using paroxetine ($US2348) than generic imipramine ($US2448) as first-line therapy. This result was sensitive to short term dropout rates but robust to changes in other major parameters, including hospitalisation costs and relapse rates. The financial benefit of paroxetine, despite its 15-fold higher acquisition cost compared with imipramine, is attributable to a higher rate of completion of the initial course of therapy and consequent reduced hospitalisation rates.

  19. COST BENEFIT ANALYSIS OF A DG INTEGRATED SYSTEM: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ch. V. S. S. SAILAJA

    2017-09-01

    Full Text Available Distributed Generation is capable of meeting the load of the consumers partially or completely. Depending on the type of DG involved it can be operated in interconnected mode and islanded mode. The availability of numerous alternatives present for the DG technologies and large initial investments necessitates a detailed cost benefit analysis for the implementation of DG technologies. In this work an attempt has been made to study the costs involved in implementing the DG technologies. A practical system having two kinds of distributed generation i.e., Diesel Generator and solar photovoltaic system for its back up purpose is considered. A detailed cost analysis of the two DG technologies is carried out.

  20. External costs of electricity

    International Nuclear Information System (INIS)

    Rabl, A.; Spadaro, J.V.

    2005-01-01

    This article presents a synthesis of the ExternE project (External costs of Energy) of the European community about the external costs of power generation. Pollution impacts are calculated using an 'impact pathways' analysis, i.e. an analysis of the emission - dispersion - dose-response function - cost evaluation chain. Results are presented for different fuel cycles (with several technological variants) with their confidence intervals. The environmental impact costs are particularly high for coal: for instance, in France, for coal-fired power plants it is of the same order as the electricity retail price. For natural gas, this cost is about a third of the one for coal. On the contrary, the environmental impact costs for nuclear and renewable energies are low, typically of few per cent of the electricity price. The main part of these costs corresponds to the sanitary impacts, in particular the untimely mortality. In order to avoid any controversy about the cost evaluation of mortality, the reduction of the expectation of life due to the different fuel cycles is also indicated and the risks linked with nuclear energy are presented using several comparisons. (J.S.)

  1. Forest fuel - economy and models for cost analysis

    International Nuclear Information System (INIS)

    Olsson, Anders.

    1991-01-01

    The purpose of this report is to develop guidelines for the R and D work within Skogskraft with the aim of improving the efficiency of the investigatory work. The report mainly concerns logging waste. The contents are as follows; Terminology - definitions: This section includes a brief description of wood fuels with regard to terminology, definitions, production and marketing. Units of measurement: Different units of measurement are descrived and their relationship to forestry, sawmills and consumers of wood fuels. An account is also given of effective thermal values and formulas for calculations of the energy content for different wood fuels. Calculation models, analyses: This section discusses different models and standards for calculating machine and manual costs. In addition, views are given on cost analysis and certain guidelines with regard to overhead costs. Actors and systems: There is a risk that technical problems receive a far too dominant role in relation to problems which concern organisation and structure. Consequently, it is important to define the actors and to illustrate the different driving forces and tensions that may occur. Seven different actors/interested parties have been described and analysed with regard to primary and secondary interests in ecological, technical and economic questions. Preparation of reports: Certain recommendations have been given with regard to formal requirements and quality requirements

  2. Counting the costs of accreditation in acute care: an activity-based costing approach.

    Science.gov (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey

    2015-09-08

    To assess the costs of hospital accreditation in Australia. Mixed methods design incorporating: stakeholder analysis; survey design and implementation; activity-based costs analysis; and expert panel review. Acute care hospitals accredited by the Australian Council for Health Care Standards. Six acute public hospitals across four States. Accreditation costs varied from 0.03% to 0.60% of total hospital operating costs per year, averaged across the 4-year accreditation cycle. Relatively higher costs were associated with the surveys years and with smaller facilities. At a national level these costs translate to $A36.83 million, equivalent to 0.1% of acute public hospital recurrent expenditure in the 2012 fiscal year. This is the first time accreditation costs have been independently evaluated across a wide range of hospitals and highlights the additional cost burden for smaller facilities. A better understanding of the costs allows policymakers to assess alternative accreditation and other quality improvement strategies, and understand their impact across a range of facilities. This methodology can be adapted to assess international accreditation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Estimating and understanding DOE waste management costs'

    International Nuclear Information System (INIS)

    Kang, J.S.; Sherick, M.J.

    1995-01-01

    This paper examines costs associated with cleaning up the US Department of Energy's (DOE's) nuclear facilities, with particular emphasis on the waste management program. Life-cycle waste management costs have been compiled and reported in the DOE Baseline Environmental Management Report (BEMR). Waste management costs are a critical issue for DOE because of the current budget constraints. The DOE sites are struggling to accomplish their environmental management objectives given funding scenarios that are well below anticipated waste management costs. Through the BEMR process, DOE has compiled complex-wide cleanup cost estimates and has begun analysis of these costs with respect to alternative waste management scenarios and policy strategies. From this analysis, DOE is attempting to identify the major cost drivers and prioritize environmental management activities to achieve maximum utilization of existing funding. This paper provides an overview of the methodology DOE has used to estimate and analyze some waste management costs, including the key data requirements and uncertainties

  4. Cost analysis of breast cancer diagnostic assessment programs.

    Science.gov (United States)

    Honein-AbouHaidar, G N; Hoch, J S; Dobrow, M J; Stuart-McEwan, T; McCready, D R; Gagliardi, A R

    2017-10-01

    Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies. We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January-31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital's finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs. For the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 ( p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50. It was feasible to use secondary financial data to retrieve the cost

  5. Costs of diarrheal disease and the cost-effectiveness of a rotavirus vaccination program in kyrgyzstan.

    Science.gov (United States)

    Flem, Elmira T; Latipov, Renat; Nurmatov, Zuridin S; Xue, Yiting; Kasymbekova, Kaliya T; Rheingans, Richard D

    2009-11-01

    We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

  6. Levelized cost of energy and sensitivity analysis for the hydrogen-bromine flow battery

    Science.gov (United States)

    Singh, Nirala; McFarland, Eric W.

    2015-08-01

    The technoeconomics of the hydrogen-bromine flow battery are investigated. Using existing performance data the operating conditions were optimized to minimize the levelized cost of electricity using individual component costs for the flow battery stack and other system units. Several different configurations were evaluated including use of a bromine complexing agent to reduce membrane requirements. Sensitivity analysis of cost is used to identify the system elements most strongly influencing the economics. The stack lifetime and round-trip efficiency of the cell are identified as major factors on the levelized cost of electricity, along with capital components related to hydrogen storage, the bipolar plate, and the membrane. Assuming that an electrocatalyst and membrane with a lifetime of 2000 cycles can be identified, the lowest cost market entry system capital is 220 kWh-1 for a 4 h discharge system and for a charging energy cost of 0.04 kWh-1 the levelized cost of the electricity delivered is 0.40 kWh-1. With systems manufactured at large scales these costs are expected to be lower.

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

    Science.gov (United States)

    Mercer, Nicola J

    2009-01-01

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

  8. 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

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  10. 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

  11. Cost Probability Analysis of China's Nuclear Fuel Cycle Transition

    International Nuclear Information System (INIS)

    Gao, R. X.; Ko, W. I.; Lee, S. H.

    2015-01-01

    The Chinese government has already determined to develop the closed nuclear fuel cycle, its long-term roadmap of spent fuel management has not been decided yet. Currently, it seems that China's booming economy gives abundant financial assurance to develop nuclear programs in full play according to its near-term national plans. However, the viability and sustainability of nuclear power always depends critically on its economics. Therefore, it is necessary to conduct a well focused cost-benefit and objective analysis of China's ongoing nuclear power programs with the future prospects. In this study, we conduct a comparative analysis of electricity generation cost in four reference nuclear fuel cycle transition scenarios by 2050. Direct disposal is assumed to produce the cheapest LCT as low as 62.688 mills/kWh compared to the other options. However, after performing a relative uncertainty study, the results show that the capital cost of reactor is the key cost component which leads to the cost gap

  12. Cost Probability Analysis of China's Nuclear Fuel Cycle Transition

    Energy Technology Data Exchange (ETDEWEB)

    Gao, R. X. [Univ. of Science and Technology, Daejeon (Korea, Republic of); Ko, W. I.; Lee, S. H. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-05-15

    The Chinese government has already determined to develop the closed nuclear fuel cycle, its long-term roadmap of spent fuel management has not been decided yet. Currently, it seems that China's booming economy gives abundant financial assurance to develop nuclear programs in full play according to its near-term national plans. However, the viability and sustainability of nuclear power always depends critically on its economics. Therefore, it is necessary to conduct a well focused cost-benefit and objective analysis of China's ongoing nuclear power programs with the future prospects. In this study, we conduct a comparative analysis of electricity generation cost in four reference nuclear fuel cycle transition scenarios by 2050. Direct disposal is assumed to produce the cheapest LCT as low as 62.688 mills/kWh compared to the other options. However, after performing a relative uncertainty study, the results show that the capital cost of reactor is the key cost component which leads to the cost gap.

  13. Optimizing cost-efficiency in mean exposure assessment--cost functions reconsidered.

    Science.gov (United States)

    Mathiassen, Svend Erik; Bolin, Kristian

    2011-05-21

    Reliable exposure data is a vital concern in medical epidemiology and intervention studies. The present study addresses the needs of the medical researcher to spend monetary resources devoted to exposure assessment with an optimal cost-efficiency, i.e. obtain the best possible statistical performance at a specified budget. A few previous studies have suggested mathematical optimization procedures based on very simple cost models; this study extends the methodology to cover even non-linear cost scenarios. Statistical performance, i.e. efficiency, was assessed in terms of the precision of an exposure mean value, as determined in a hierarchical, nested measurement model with three stages. Total costs were assessed using a corresponding three-stage cost model, allowing costs at each stage to vary non-linearly with the number of measurements according to a power function. Using these models, procedures for identifying the optimally cost-efficient allocation of measurements under a constrained budget were developed, and applied on 225 scenarios combining different sizes of unit costs, cost function exponents, and exposure variance components. Explicit mathematical rules for identifying optimal allocation could be developed when cost functions were linear, while non-linear cost functions implied that parts of or the entire optimization procedure had to be carried out using numerical methods.For many of the 225 scenarios, the optimal strategy consisted in measuring on only one occasion from each of as many subjects as allowed by the budget. Significant deviations from this principle occurred if costs for recruiting subjects were large compared to costs for setting up measurement occasions, and, at the same time, the between-subjects to within-subject variance ratio was small. In these cases, non-linearities had a profound influence on the optimal allocation and on the eventual size of the exposure data set. The analysis procedures developed in the present study can be used

  14. Analysis the Appropriate using Standard Costing Applying in Land Cost Component of Real Estate Development Activities: A Case Study of PT Subur Agung

    Directory of Open Access Journals (Sweden)

    Elfrida Yanti

    2011-05-01

    Full Text Available Standard cost is generally used by manufacturing business, which direct material, labor, and factory overhead are cleared allocated. On real estate business in this case PT Subur Agung use standard cost based on three costs, raw land, land improvement and interest expense categories instead of direct material, direct labor and overhead. Developer use these cost to predict the project cost and estimate the pre-selling price, in accordance with the cost estimation classification matrix, the variance range is in the expected accuracy rate by testing the variance percentage between standard cost and actual cost. The additional similar projects in PT Subur Agung also follow the same scope. All these evidences have proved the appropriate using standard costing in land cost component of real estate development activities but how it applies this article will analyze in this particular project with using descriptive and exploratory method. The analysis started by knowing the conceptual situation of PT Subur Agung and the data was presented in tables and calculation with detail explanation. 

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

    CERN Document Server

    Baio, Gianluca; Heath, Anna

    2017-01-01

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

  16. A parametric cost model for estimating operating and support costs of US Navy (non-nuclear) surface ships

    OpenAIRE

    Brandt, James M.

    1999-01-01

    Approved for public release; distribution is unlimited With few effective decision-making tools to assess the affordability of major weapon systems, management of total ownership costs is continually misunderstood. Cost analysis provides a quick and reliable assessment of affordability. Because there is no standardized method for calculating reliable estimates of operating and support (O&S) costs (the principal component of total ownership cost), this thesis formulates a parametric cost mo...

  17. A systematic review of the cost and cost-effectiveness of electronic discharge communications.

    Science.gov (United States)

    Sevick, Laura K; Esmail, Rosmin; Tang, Karen; Lorenzetti, Diane L; Ronksley, Paul; James, Matthew; Santana, Maria; Ghali, William A; Clement, Fiona

    2017-07-02

    The transition between acute care and community care can be a vulnerable period in a patients' treatment due to the potential for postdischarge adverse events. The vulnerability of this period has been attributed to factors related to the miscommunication between hospital-based and community-based physicians. Electronic discharge communication has been proposed as one solution to bridge this communication gap. Prior to widespread implementation of these tools, the costs and benefits should be considered. To establish the cost and cost-effectiveness of electronic discharge communications compared with traditional discharge systems for individuals who have completed care with one provider and are transitioning care to a new provider. We conducted a systematic review of the published literature, using best practices, to identify economic evaluations/cost analyses of electronic discharge communication tools. Inclusion criteria were: (1) economic analysis and (2) electronic discharge communication tool as the intervention. Quality of each article was assessed, and data were summarised using a component-based analysis. One thousand unique abstracts were identified, and 57 full-text articles were assessed for eligibility. Four studies met final inclusion criteria. These studies varied in their primary objectives, methodology, costs reported and outcomes. All of the studies were of low to good quality. Three of the studies reported a cost-effectiveness measure ranging from an incremental daily cost of decreasing average discharge note completion by 1 day of $0.331 (2003 Canadian), a cost per page per discharge letter of €9.51 and a dynamic net present value of €31.1 million for a 5-year implementation of the intervention. None of the identified studies considered clinically meaningful patient or quality outcomes. Economic analyses of electronic discharge communications are scarcely reported, and with inconsistent methodology and outcomes. Further studies are needed

  18. THE ANALYSIS OF FINANCIAL EQUILIBRIUM THROUGH THE COST OF THE INVESTED CAPITAL

    Directory of Open Access Journals (Sweden)

    MELANIA ELENA MICULEAC

    2016-10-01

    Full Text Available The financial equilibrium of a company can be analyzed through the cost of the invested capital. It is the most pragmatic approach of the financial equilibrium analysis because it takes into account the cost of invested resources, their capacity to account return. I suggest a model to approach the analysis of the balanced average cost of the invested capital using the method of chain substitutions. I reached the conclusion that the main consequence of changes in the balanced average cost of the capital is on the company’s value.

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

    Directory of Open Access Journals (Sweden)

    Swinburn Boyd

    2009-11-01

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

  20. Transaction Costs For Innovations Diffusion

    Directory of Open Access Journals (Sweden)

    Ilya A. Romanov

    2012-10-01

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