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

Science.gov (United States)

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

2009-01-01

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

Estimated incident cost savings in shipping due to inspections.

Science.gov (United States)

Knapp, Sabine; Bijwaard, Govert; Heij, Christiaan

2011-07-01

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

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

International Nuclear Information System (INIS)

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

2002-01-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

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

DEFF Research Database (Denmark)

Klinge Jacobsen, Henrik; Baldini, Mattia

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

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

Science.gov (United States)

Månsdotter, Anna; Lindholm, Lars; Winkvist, Anna

2007-06-01

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

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

Science.gov (United States)

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

2013-09-16

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

The total lifetime health cost savings of smoking cessation to society

DEFF Research Database (Denmark)

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

2005-01-01

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

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

Science.gov (United States)

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

2017-04-01

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

Potential Logistics Cost Savings from Engine Commonality

National Research Council Canada - National Science Library

Henderson, Robert L; Higer, Matthew W

2007-01-01

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

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.

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

International Nuclear Information System (INIS)

Hamamoto, Mitsutsugu

2013-01-01

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

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Science.gov (United States)

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

2016-01-01

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

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

Science.gov (United States)

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

2017-08-01

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

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

International Nuclear Information System (INIS)

DeMuth, S.

1998-01-01

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

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

Science.gov (United States)

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

2018-05-01

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

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

Science.gov (United States)

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

2015-02-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-08-01

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

Calculating cost savings in utilization management.

Science.gov (United States)

MacMillan, Donna

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-01-01

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

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

Science.gov (United States)

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

2016-06-23

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

Future cost savings from engineering innovations

International Nuclear Information System (INIS)

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

1987-01-01

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

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

International Nuclear Information System (INIS)

Qin, Chao; Saunders, Gordon; Loth, Eric

2017-01-01

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

Health care costs: saving in the private sector.

Science.gov (United States)

Robeson, F E

1979-01-01

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

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

Science.gov (United States)

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

2017-01-01

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

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

Directory of Open Access Journals (Sweden)

Andrea-Romana Prusa

2017-07-01

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

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

Science.gov (United States)

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

2017-07-01

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

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

Science.gov (United States)

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

2017-01-01

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

Potential Cost Savings Ideas for FAA and Users

Science.gov (United States)

1997-06-04

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

Faith community nursing: real care, real cost savings.

Science.gov (United States)

Yeaworth, Rosalee C; Sailors, Ronnette

2014-01-01

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

Energy Efficiency Improvement and Cost Saving Oportunities for the Concrete Industry

Energy Technology Data Exchange (ETDEWEB)

Kermeli, Katerina; Worrell, Ernst; Masanet, Eric

2011-12-01

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

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

Science.gov (United States)

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

2017-07-01

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

Cost savings from extended life nuclear plants

International Nuclear Information System (INIS)

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

1988-09-01

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

Caustic saving potentile in textile processing mills

International Nuclear Information System (INIS)

Latif, M.; Rehman, A.; Ghafar, A.; Hafeez, N.M.

2010-01-01

The textile processing industry of pakistan has great potential of improvement in resource consumption in various production processes. One major concern is the heavy usage of caustic soda (sodium hydroxide) especially during the mercerization process which incurs a significant cost to a textile processing mill. To reduce the unit fabric production cost and stay competitive, the industry need to minimize the caustic wastage and explore the caustic saving potential. This paper describe the detailed caustic consumption practices and saving potentials in woven textile sector based on the data base of 100 industries. Region wise caustic saving potential is also investigated . Three caustic conservation option including process improvement, reuse and recycling, and caustic recovery plants are discussed. Detailed technical and and financial requirements. saving potentials and paybacks of these options are provided. (author)

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

International Nuclear Information System (INIS)

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

1993-09-01

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

Assessing the cost saving potential of shared product architectures

DEFF Research Database (Denmark)

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

2016-01-01

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

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

Science.gov (United States)

Kibicho, Jennifer; Pinkerton, Steven D

2012-04-01

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

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

International Nuclear Information System (INIS)

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

2017-01-01

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

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

Science.gov (United States)

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

2014-07-01

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

Evidence for more cost-effective surveillance options for bovine spongiform encephalopathy (BSE) and scrapie in Great Britain.

Science.gov (United States)

Wall, Ben A; Arnold, Mark E; Radia, Devi; Gilbert, Will; Ortiz-Pelaez, Angel; Stärk, Katharina Dc; Van Klink, Ed; Guitian, Javier

2017-08-10

Transmissible spongiform encephalopathies (TSEs) are an important public health concern. Since the emergence of bovine spongiform encephalopathy (BSE) during the 1980s and its link with human Creutzfeldt-Jakob disease, active surveillance has been a key element of the European Union's TSE control strategy. Success of this strategy means that now, very few cases are detected compared with the number of animals tested. Refining surveillance strategies would enable resources to be redirected towards other public health priorities. Cost-effectiveness analysis was performed on several alternative strategies involving reducing the number of animals tested for BSE and scrapie in Great Britain and, for scrapie, varying the ratio of sheep sampled in the abattoir to fallen stock (which died on the farm). The most cost-effective strategy modelled for BSE involved reducing the proportion of fallen stock tested from 100% to 75%, producing a cost saving of ca GBP 700,000 per annum. If 50% of fallen stock were tested, a saving of ca GBP 1.4 million per annum could be achieved. However, these reductions are predicted to increase the period before surveillance can detect an outbreak. For scrapie, reducing the proportion of abattoir samples was the most cost-effective strategy modelled, with limited impact on surveillance effectiveness. This article is copyright of The Authors, 2017.

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-03-19

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

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

LENUS (Irish Health Repository)

Murphy, C L

2015-01-01

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

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

NARCIS (Netherlands)

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

2010-01-01

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

Incorrect storage of medicines and potential for cost savings

DEFF Research Database (Denmark)

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

2017-01-01

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

The impact on energy consumption of daylight saving clock changes

Energy Technology Data Exchange (ETDEWEB)

Hill, S.I.; Desobry, F. [Department of Engineering, University of Cambridge (United Kingdom); Garnsey, E.W. [Institute for Manufacturing, University of Cambridge (United Kingdom); Chong, Y.-F. [IPA Energy and Water Consulting (United Kingdom)

2010-09-15

The focus of this work is an investigation of the effect of prevailing time regime on energy consumption. In particular we perform analysis demonstrating potential energy savings which could be obtained were Great Britain to maintain daylight savings time (DST) over winter, instead of reverting to Greenwich mean time (GMT). We review the literature on the effect of DST on energy consumption and show that this indicates a justification for considering the issue. Our headline result is in agreement with many related studies in that advancing the clock by an hour in winter would lead to energy savings of at least 0.3% of daily demand in Great Britain. In deriving this result we have adopted methodologies currently used in load prediction, in particular Support Vector Regression, to estimate energy demand on a half-hourly basis. Corresponding cost savings are found to be higher (due to the nonlinear increase of costs) and we find them to be on the order of 0.6% over the months considered. In terms of environmental impact we find the saving to be approximately equivalent to 450,000 ton of CO{sub 2}. In deriving these results we adopt a conservative approach such that we consider them lower bounds on any true savings. (author)

The impact on energy consumption of daylight saving clock changes

International Nuclear Information System (INIS)

Hill, S.I.; Desobry, F.; Garnsey, E.W.; Chong, Y.-F.

2010-01-01

The focus of this work is an investigation of the effect of prevailing time regime on energy consumption. In particular we perform analysis demonstrating potential energy savings which could be obtained were Great Britain to maintain daylight savings time (DST) over winter, instead of reverting to Greenwich mean time (GMT). We review the literature on the effect of DST on energy consumption and show that this indicates a justification for considering the issue. Our headline result is in agreement with many related studies in that advancing the clock by an hour in winter would lead to energy savings of at least 0.3% of daily demand in Great Britain. In deriving this result we have adopted methodologies currently used in load prediction, in particular Support Vector Regression, to estimate energy demand on a half-hourly basis. Corresponding cost savings are found to be higher (due to the nonlinear increase of costs) and we find them to be on the order of 0.6% over the months considered. In terms of environmental impact we find the saving to be approximately equivalent to 450,000 ton of CO 2 . In deriving these results we adopt a conservative approach such that we consider them lower bounds on any true savings.

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

Science.gov (United States)

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

2018-05-18

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

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

Science.gov (United States)

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

2009-01-01

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

VA Telemedicine: An Analysis of Cost and Time Savings.

Science.gov (United States)

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

2016-03-01

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

Cost Savings for Manufacturing Lithium Batteries in a Flexible Plant

Energy Technology Data Exchange (ETDEWEB)

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

2015-06-01

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

Maintenance cost savings - snubber elimination with limit stops

International Nuclear Information System (INIS)

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

1993-01-01

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

Potential Cost Savings From Reduction of Regional Variation in Medicare Spending

Directory of Open Access Journals (Sweden)

Yunjie Song

2016-04-01

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

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

Science.gov (United States)

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

1998-07-01

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

Maintenance cost savings - snubber elimination with limit stops

International Nuclear Information System (INIS)

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

1995-01-01

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

Exergy costing for energy saving in combined heating and cooling applications

International Nuclear Information System (INIS)

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

2014-01-01

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

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

Science.gov (United States)

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

2017-04-01

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

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

Science.gov (United States)

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

2015-12-01

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

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

Science.gov (United States)

Dylst, Pieter; Vulto, Arnold; Simoens, Steven

2015-01-01

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

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

Directory of Open Access Journals (Sweden)

Matthias Stoll

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

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

Science.gov (United States)

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

2011-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

DEFF Research Database (Denmark)

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

2013-01-01

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

Autonomous hip exoskeleton saves metabolic cost of walking uphill.

Science.gov (United States)

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

2017-07-01

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

Modern methods of cost saving of the production activity in construction

Science.gov (United States)

Silka, Dmitriy

2017-10-01

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

Evaluation of energy and cost savings in mobile Cloud RAN

DEFF Research Database (Denmark)

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

2013-01-01

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

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

Directory of Open Access Journals (Sweden)

Govinda Mahajan

2017-11-01

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

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

DEFF Research Database (Denmark)

Zvingilaite, Erika; Klinge Jacobsen, Henrik

2015-01-01

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

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

Science.gov (United States)

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

2015-09-01

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

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

International Nuclear Information System (INIS)

Yuracko, K.L.

2000-01-01

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

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

Directory of Open Access Journals (Sweden)

Beecham Jennifer

2011-10-01

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

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

Directory of Open Access Journals (Sweden)

Scuffham Paul

2007-03-01

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

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

Science.gov (United States)

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

2010-04-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Van Geet, Otto

2017-04-24

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

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

Science.gov (United States)

2018-01-01

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

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

Science.gov (United States)

Song, Cuiying; Guan, Wei; Ma, Jihui

2018-01-01

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

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

Science.gov (United States)

Gates, W. R.

1983-02-01

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

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

Science.gov (United States)

Gates, W. R.

1983-01-01

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

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

Science.gov (United States)

Loew, Aviva; Jaramillo, Paulina; Zhai, Haibo

2016-10-01

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

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

Science.gov (United States)

2014-05-01

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

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

Science.gov (United States)

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

2018-02-08

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

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

Science.gov (United States)

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

2015-06-01

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

No nocturnal energetic savings in response to hard work in free-living great tits

NARCIS (Netherlands)

Wiersma, P; Tinbergen, JM

We measured energy expenditure in free-living great tits (Pares major) during the active (day) and the inactive period (night) with the aim of determining whether great tits compensate for energy costs made during periods of high activity in periods of low activity. If such compensation occurs,

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

Science.gov (United States)

Adesina, Adebiyi; Bollinger, Lori A

2013-01-01

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

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

Science.gov (United States)

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

2016-11-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

1992-12-01

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

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

Science.gov (United States)

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

2017-08-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-06-01

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

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

Directory of Open Access Journals (Sweden)

Anna Maria Jeszka

2015-09-01

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

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

Science.gov (United States)

Verguet, S; Walsh, J A

2010-06-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-12-31

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-02-15

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

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

International Nuclear Information System (INIS)

Kemp, A.G.; MacDonald, Bruce

1995-01-01

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

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

LENUS (Irish Health Repository)

Fenelon, C

2018-04-01

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

Energy Savings Lifetimes and Persistence

Energy Technology Data Exchange (ETDEWEB)

Hoffman, Ian M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schiller, Steven R. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Todd, Annika [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Billingsley, Megan A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Schwartz, Lisa C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2016-02-01

This technical brief explains the concepts of energy savings lifetimes and savings persistence and discusses how program administrators use these factors to calculate savings for efficiency measures, programs and portfolios. Savings lifetime is the length of time that one or more energy efficiency measures or activities save energy, and savings persistence is the change in savings throughout the functional life of a given efficiency measure or activity. Savings lifetimes are essential for assessing the lifecycle benefits and cost effectiveness of efficiency activities and for forecasting loads in resource planning. The brief also provides estimates of savings lifetimes derived from a national collection of costs and savings for electric efficiency programs and portfolios.

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

Science.gov (United States)

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

2014-12-02

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-06-01

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

Costs and benefits of bicycling investments in Portland, Oregon.

Science.gov (United States)

Gotschi, Thomas

2011-01-01

Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland's past and planned investments in bicycling relate to health and other benefits. Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model. By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used. This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

Energy Savings Measure Packages. Existing Homes

Energy Technology Data Exchange (ETDEWEB)

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

2011-11-01

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

Cost Savings through Innovation in Decontamination, Decommissioning, and Dismantlement

International Nuclear Information System (INIS)

Yancey, Neal A.

2003-01-01

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

The costs of the different pathways of electricity production and saving

International Nuclear Information System (INIS)

Dessus, B.

2012-01-01

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

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

International Nuclear Information System (INIS)

Tucker, Robert; Ward, John

2012-01-01

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

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

Directory of Open Access Journals (Sweden)

Hye Yeon Kim

2016-03-01

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

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

Science.gov (United States)

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

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

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

Directory of Open Access Journals (Sweden)

Santosh R. Ghimire

2017-03-01

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

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

Science.gov (United States)

Gates, W. R.

1983-02-01

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

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

Science.gov (United States)

Gates, W. R.

1983-01-01

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

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

Science.gov (United States)

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

2018-01-01

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

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

Science.gov (United States)

Karnon, Jonathan; Partington, Andrew

2015-12-01

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

EMC Phenomena in HEP Detectors: Prevention and Cost Savings

International Nuclear Information System (INIS)

Arteche, F.; Rivetta, C.

2006-01-01

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

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

Science.gov (United States)

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

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

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

Science.gov (United States)

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

2017-11-07

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

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

Directory of Open Access Journals (Sweden)

Lori A. Bollinger

2017-11-01

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

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

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Yi Yuyin

2018-03-01

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

Cost Savings Realized by Implementation of Routine Microbiological Identification by Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry.

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Tran, Anthony; Alby, Kevin; Kerr, Alan; Jones, Melissa; Gilligan, Peter H

2015-08-01

Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is an emerging technology for rapid identification of bacterial and fungal isolates. In comparison to conventional methods, this technology is much less labor intensive and can provide accurate and reliable results in minutes from a single isolated colony. We compared the cost of performing the bioMérieux Vitek MALDI-TOF MS with conventional microbiological methods to determine the amount saved by the laboratory by converting to the new technology. Identification costs for 21,930 isolates collected between April 1, 2013, and March 31, 2014, were directly compared for MALDI-TOF MS and conventional methodologies. These isolates were composed of commonly isolated organisms, including commonly encountered aerobic and facultative bacteria and yeast but excluding anaerobes and filamentous fungi. Mycobacterium tuberculosis complex and rapidly growing mycobacteria were also evaluated for a 5-month period during the study. Reagent costs and a total cost analysis that included technologist time in addition to reagent expenses and maintenance service agreement costs were analyzed as part of this study. The use of MALDI-TOF MS equated to a net savings of $69,108.61, or 87.8%, in reagent costs annually compared to traditional methods. When total costs are calculated to include technologist time and maintenance costs, traditional identification would have cost $142,532.69, versus $68,886.51 with the MALDI-TOF MS method, resulting in a laboratory savings of $73,646.18, or 51.7%, annually by adopting the new technology. The initial cost of the instrument at our usage level would be offset in about 3 years. MALDI-TOF MS not only represents an innovative technology for the rapid and accurate identification of bacterial and fungal isolates, it also provides a significant cost savings for the laboratory. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

24 CFR 221.1 - Savings clause.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Savings clause. 221.1 Section 221.1... MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER AUTHORITIES LOW COST AND MODERATE INCOME MORTGAGE INSURANCE-SAVINGS CLAUSE Eligibility Requirements-Low Cost Homes-Savings Clause § 221.1...

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

Science.gov (United States)

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

2016-02-01

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

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

Science.gov (United States)

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

2018-05-01

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

Cost effectiveness of recycling: A systems model

Energy Technology Data Exchange (ETDEWEB)

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

2013-11-15

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

Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

Science.gov (United States)

Peters, Ray DeV; Petrunka, Kelly; Khan, Shahriar; Howell-Moneta, Angela; Nelson, Geoffrey; Pancer, S Mark; Loomis, Colleen

2016-02-01

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

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.

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

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

Science.gov (United States)

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

2006-01-01

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

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

Science.gov (United States)

Rice, R. F.

1984-01-01

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

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

Science.gov (United States)

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

2014-01-01

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

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

NARCIS (Netherlands)

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

2016-01-01

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

[Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan].

Science.gov (United States)

Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

2012-01-01

DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year.

Estimation of cost-saving for reducing radioactive waste from nuclear medicine facilities by implementing decay in storage (DIS) in Japan

International Nuclear Information System (INIS)

Kida, Tetsuo; Hiraki, Hitoshi; Yamaguchi, Ichirou; Fujibuchi, Toshioh; Watanabe, Hiroshi

2012-01-01

DIS has not yet been implemented in Japan as of 2011. Therefore, even if risk was negligible, medical institutions have to entrust radioactive temporal waste disposal to Japan Radio Isotopes Association (JRIA) in the current situation. To decide whether DIS should be implemented in Japan or not, cost-saving effect of DIS was estimated by comparing the cost that nuclear medical facilities pay. By implementing DIS, the total annual cost for all nuclear medical facilities in Japan is estimated to be decreased to 30 million yen or less from 710 million yen. DIS would save 680 million yen (96%) per year. (author)

Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for Fleet Maintenance and Revitalization

Science.gov (United States)

2014-04-30

bäÉîÉåíÜ=^ååì~ä=^Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= qÜìêëÇ~ó=pÉëëáçåë= sçäìãÉ=ff= = Potential Cost Savings for Use of 3D Printing Combined With 3D...TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and...Chair: RADM David Lewis, USN Program Executive Officer, SHIPS Potential Cost Savings for Use of 3D Printing Combined With 3D Imaging and CPLM for

Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

Science.gov (United States)

Hegde, Vinayak A; Biederman, Robert WW; Mikolich, J Ronald

2017-01-01

BACKGROUND This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. METHODS AND RESULTS Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. CONCLUSIONS Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner. PMID:28579858

Cardiovascular Magnetic Resonance Imaging-Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study.

Science.gov (United States)

Hegde, Vinayak A; Biederman, Robert Ww; Mikolich, J Ronald

2017-01-01

This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR). In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Retrospective review of 361 consecutive patients (pts) who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98%) had diagnostic quality studies. Of the 361 pts, 350 (97%) had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%). The CMR exam resulted in a new diagnosis in 69 of 361 (27%) pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11%) pts and prevented additional diagnostic testing in 26 (7%) pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

Cardiovascular Magnetic Resonance Imaging—Incremental Value in a Series of 361 Patients Demonstrating Cost Savings and Clinical Benefits: An Outcome-Based Study

Directory of Open Access Journals (Sweden)

Vinayak A Hegde

2017-05-01

Full Text Available Background: This study was designed to assess the clinical impact and cost-benefit of cardiovascular magnetic resonance imaging (CMR. In the face of current health care cost concerns, cardiac imaging modalities have come under focused review. Data related to CMR clinical impact and cost-benefit are lacking. Methods and Results: Retrospective review of 361 consecutive patients (pts who underwent CMR exams was conducted. Indications for CMR were tabulated for appropriateness criteria. Components of the CMR exam were identified along with evidence of clinical impact. The cost of each CMR exam was ascertained along with cost savings attributable to the CMR exam for calculation of an incremental cost-effectiveness ratio. A total of 354 of 361 pts (98% had diagnostic quality studies. Of the 361 pts, 350 (97% had at least 1 published Appropriateness Criterion for CMR. A significant clinical impact attributable to CMR exam results was observed in 256 of 361 pts (71%. The CMR exam resulted in a new diagnosis in 69 of 361 (27% pts. Cardiovascular magnetic resonance imaging results avoided invasive procedures in 38 (11% pts and prevented additional diagnostic testing in 26 (7% pts. Comparison of health care savings using CMR as opposed to current standards of care showed a net cost savings of $833 037, ie, per patient cost savings of $2308. Conclusions: Cardiovascular magnetic resonance imaging provides diagnostic image quality in >98% of cases. Cardiovascular magnetic resonance imaging findings have documentable clinical impact on patient management in 71% of pts undergoing the exam, in a cost beneficial manner.

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

Science.gov (United States)

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

2016-02-01

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

Client-server computer architecture saves costs and eliminates bottlenecks

International Nuclear Information System (INIS)

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

1992-01-01

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

75 FR 34448 - Proposed CERCLA Administrative Cost Recovery Settlement; Great Lakes Container Corporation...

Science.gov (United States)

2010-06-17

... Settlement; Great Lakes Container Corporation Superfund Site, Coventry Rhode Island AGENCY: Environmental... and future response costs concerning the Great Lakes Container Corporation Superfund Site, located in...), Boston, MA 02109-3912, (617) 918-1216. Comments should reference the Great Lakes Container Corporation...

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

Science.gov (United States)

2009-09-01

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

10 CFR 436.20 - Net savings.

Science.gov (United States)

2010-01-01

... ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methodology and Procedures for Life Cycle Cost Analyses § 436.20 Net savings. For a retrofit project, net savings may be found by subtracting life cycle costs based on the proposed project from life cycle costs based on not having it. For a...

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

Science.gov (United States)

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

2013-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

None

1980-05-01

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

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

Science.gov (United States)

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

2014-12-01

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

Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries.

Science.gov (United States)

Seidman, Gabriel; Atun, Rifat

2017-04-13

Task shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings. Using the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC. We identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels. Task shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

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

Directory of Open Access Journals (Sweden)

Varsha Bangalee

2017-10-01

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

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

International Nuclear Information System (INIS)

Energy Smart Schools Team

2001-01-01

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

What Strategies Do Physicians and Patients Discuss to Reduce Out-of-Pocket Costs? Analysis of Cost-Saving Strategies in 1,755 Outpatient Clinic Visits.

Science.gov (United States)

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

2016-10-01

More than 1 in 4 Americans report difficulty paying medical bills. Cost-reducing strategies discussed during outpatient physician visits remain poorly characterized. We sought to determine how often patients and physicians discuss health care costs during outpatient visits and what strategies, if any, they discussed to lower patient out-of-pocket costs. Retrospective analysis of dialogue from 1,755 outpatient visits in community-based practices nationwide from 2010 to 2014. The study population included 677 patients with breast cancer, 422 with depression, and 656 with rheumatoid arthritis visiting 56 oncologists, 36 psychiatrists, and 26 rheumatologists, respectively. Thirty percent of visits contained cost conversations (95% confidence interval [CI], 28 to 32). Forty-four percent of cost conversations involved discussion of cost-saving strategies (95% CI, 40 to 48; median duration, 68 s). We identified 4 strategies to lower costs without changing the care plan. They were, in order of overall frequency: 1) changing logistics of care, 2) facilitating co-pay assistance, 3) providing free samples, and 4) changing/adding insurance plans. We also identified 4 strategies to reduce costs by changing the care plan: 1) switching to lower-cost alternative therapy/diagnostic, 2) switching from brand name to generic, 3) changing dosage/frequency, and 4) stopping/withholding interventions. Strategies were relatively consistent across health conditions, except for switching to a lower-cost alternative (more common in breast oncology) and providing free samples (more common in depression). Focus on 3 conditions with potentially high out-of-pocket costs. Despite price opacity, physicians and patients discuss a variety of out-of-pocket cost reduction strategies during clinic visits. Almost half of cost discussions mention 1 or more cost-saving strategies, with more frequent mention of those not requiring care-plan changes. © The Author(s) 2016.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-03-31

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

Option pricing: a flexible tool to disseminate shared savings contracts.

Science.gov (United States)

Friedberg, Mark W; Buendia, Anthony M; Lauderdale, Katherine E; Hussey, Peter S

2013-08-01

Due to volatility in healthcare costs, shared savings contracts can create systematic financial losses for payers, especially when contracting with smaller providers. To improve the business case for shared savings, we calculated the prices of financial options that payers can "sell" to providers to offset these losses. Using 2009 to 2010 member-level total cost of care data from a large commercial health plan, we calculated option prices by applying a bootstrap simulation procedure. We repeated these simulations for providers of sizes ranging from 500 to 60,000 patients and for shared savings contracts with and without key design features (minimum savings thresholds,bonus caps, cost outlier truncation, and downside risk) and under assumptions of zero, 1%, and 2% real cost reductions due to the shared savings contracts. Assuming no real cost reduction and a 50% shared savings rate, per patient option prices ranged from $225 (3.1% of overall costs) for 500-patient providers to $23 (0.3%) for 60,000-patient providers. Introducing minimum savings thresholds, bonus caps, cost outlier truncation, and downside risk reduced these option prices. Option prices were highly sensitive to the magnitude of real cost reductions. If shared savings contracts cause 2% reductions in total costs, option prices fall to zero for all but the smallest providers. Calculating the prices of financial options that protect payers and providers from downside risk can inject flexibility into shared savings contracts, extend such contracts to smaller providers, and clarify the tradeoffs between different contract designs, potentially speeding the dissemination of shared savings.

Refrigeration: Introducing energy saving opportunities for business

Energy Technology Data Exchange (ETDEWEB)

NONE

2006-04-15

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

Crushing leads to waste disposal savings for FUSRAP

Energy Technology Data Exchange (ETDEWEB)

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

1997-02-01

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

Energy conservation. Federal shared energy savings contracting

International Nuclear Information System (INIS)

Fultz, Keith O.; Milans, Flora H.; Kirk, Roy J.; Welker, Robert A.; Sparling, William J.; Butler, Sharon E.; Irwin, Susan W.

1989-04-01

A number of impediments have discouraged federal agencies from using shared energy savings contracts. As of November 30, 1988, only two federal agencies - the U.S. Postal Service (USPS) and the Department of the Army -had awarded such contracts even though they can yield significant energy and cost savings. The three major impediments we identified were uncertainty about the applicability of a particular procurement policy and practice, lack of management incentives, and difficulty in measuring energy and cost savings. To address the first impediment, the Department of Energy (DOE) developed a manual on shared energy savings contracting. The second impediment was addressed when the 100th Congress authorized incentives for federal agencies to enter into shared savings contracts. DOE addressed the third impediment by developing a methodology for calculating energy consumption and cost savings. However, because of differing methodological preferences, this issue will need to be addressed on a contract-by-contract basis. Some state governments and private sector firms are using performance contracts to reduce energy costs in their buildings and facilities. We were able to identify six states that were using performance contracts. Five have established programs, and all six states have projects under contract. The seven energy service companies we contacted indicated interest in federal shared energy savings contracting

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

Energy Technology Data Exchange (ETDEWEB)

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

2011-05-24

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

Energy/bandwidth-Saving Cooperative Spectrum Sensing for Two-hopWRAN

Directory of Open Access Journals (Sweden)

Ming-Tuo Zhou

2014-07-01

Full Text Available A two-hop wireless regional area network (WRAN providing monitoring services operating in Television White Space (TVWS, i.e., IEEE P802.22b, may employ a great number of subscriber customer-premises equipments (S-CPEs possibly without mains power supply, leading to requirement of cost-effective and power-saving design. This paper proposes a framework of cooperative spectrum sensing (CSS and an energy/bandwidth saving CSS scheme to P802.22b. In each round of sensing, S-CPEs with SNRs lower than a predefined threshold are excluded from reporting sensing results. Numerical results show that the fused missed-detection probability and false alarmprobability could remainmeeting sensing requirements, and the overall fused error probability changes very little. With 10 S-CPEs, it is possible to save more than 40% of the energy/bandwidth on a Rayleigh channel. The principle proposed can apply to other advanced sensing technologies capable of detecting primary signals with low average SNR.

Preventing Domestic Violence in Alberta: A Cost Savings Perspective

Directory of Open Access Journals (Sweden)

Lana Wells

2012-06-01

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

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

Energy Technology Data Exchange (ETDEWEB)

None, None

2005-05-01

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

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

Energy Technology Data Exchange (ETDEWEB)

2005-05-01

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

Study on measuring analysis for estimating effect of energy saving policy

Energy Technology Data Exchange (ETDEWEB)

Kim, Joong Ku; Park, Jeong Soon [Korea Energy Economics Institute, Euiwang (Korea)

1999-12-01

Since the study on measuring analysis for estimating effect of energy saving policy is too broad to implement all industries, so it limited its study only on manufacturing industry. This study is concentrated on its effort to measure energy saving using energy saving model by putting energy saving policy as an input and regarding its result as energy saving. It used B/C theory for positive analysis methodology and the result of analysis is investment effect on manufacturing industry. The total cost invested on manufacturing sector from 1982 to 1996 was 5,871 billion won based on constant cost in 1990, and the energy saving cost directly acquired from it reached 1,534.5 billion won based on constant cost in 1990, so B/C rate reached 2.56. Particularly, if you separated the amount supported by the government policy, energy saving support cost reached 3,904.2 billion won (based on constant cost in 1990) and the total benefit was 10,146.4 billion won (based on constant cost in 1990) by adding saving cost 9,997.9 billion won and environmental improvement effect 223.2 billion won. (author). 51 refs., 17 figs., 35 tabs.

Cost savings through innovative technologies

International Nuclear Information System (INIS)

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

1995-01-01

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

Saved costs model applied to a medical doctor's office in the labor ambient of a great construction Modelo de costes ahorrados aplicado a un consultorio médico en el ambiente laboral de una gran obra en construcción

Directory of Open Access Journals (Sweden)

Fernando Llorca Castro

2008-06-01

Full Text Available The benefits of supporting a medical service in the works place in construction, some times are difficult to realize for the administration department and they just see it as a requirement to obtain the permissions. The aim is to know, which are the suppositions of waiting times saved in the urgency services of the area, to have financial utility in the District C project, on having had a medical consultation in the place of work during 2005. For that, an economic evaluation has been made of cost minimization, where the available information has been obtained from the accounting, historical statistical information and generated for it and proposes a calculation model of saved time in Euros based on suppositions, taking salary hour of the workers as a shade price. The program generates financial utility with a time of wait in the Social Security corresponding assistance center of 165 minutes or 30 minutes for the different involved mutual, always for the cases catalogued as slight or moderate of work accidents with injury (WAI. Programs like this one in the place of great constructions can produce financial utilities, if the sanitary services ambient in which they are localized, allow it. The authorities must stimulate the companies to register better the waiting times and movements in cases of slight and moderated of WAI to be able to document the cost of these displacements.Los beneficios de mantener un servicio de consulta médica en las obras en construcción muchas veces son difíciles de percibir por parte de su administración que simplemente lo ven como un requisito más para obtener los permisos. El objetivo es establecer cuáles son los supuestos en tiempos de espera ahorrados en los servicios de urgencias de la zona, en que se produce utilidad financiera en el proyecto de la obra Distrito C, al haber mantenido una consulta médica en el sitio de la obra durante el año 2005. Para ello se ha realizado una evaluación económica del tipo

In-office diagnostic arthroscopy for knee and shoulder intra-articular injuries its potential impact on cost savings in the United States

Science.gov (United States)

2014-01-01

Background The purpose of this analysis was to determine whether in office diagnostic needle arthroscopy (Visionscope Imaging System [VSI]) can provide for improved diagnostic assessment and; more cost effective care. Methods Data on arthroscopy procedures in the US for deep seated pathology in the knee and shoulder were used (Calendar Year 2012). These procedures represent approximately 25-30% of all arthroscopic procedures performed annually. Sensitivities, specificities, positive predictive, and negative predictive values for MRI analysis of this deep seated pathology from systematic reviews and meta-analyses were used in assessing for false positive and false negative MRI findings. The costs of performing diagnostic and surgical arthroscopy procedures (using 2013 Medicare reimbursement amounts); costs associated with false negative findings; and the costs for treating associated complications arising from diagnostic and therapeutic arthroscopy procedures were then assessed. Results In patients presenting with medial meniscal pathology (ICD9CM diagnosis 836.0 over 540,000 procedures in CY 2012); use of the VSI system in place of MRI assessment (standard of care) resulted in a net cost savings to the system of $151 million. In patients presenting with rotator cuff pathology (ICD9CM 840.4 over 165,000 procedures in CY2012); use of VSI in place of MRI similarly saved $59 million. These savings were realized along with more appropriate care as; fewer patients were exposed to higher risk surgical arthroscopic procedures. Conclusions The use of an in-office arthroscopy system can: possibly save the US healthcare system money; shorten the diagnostic odyssey for patients; potentially better prepare clinicians for arthroscopic surgery (when needed) and; eliminate unnecessary outpatient arthroscopy procedures, which commonly result in surgical intervention. PMID:24885678

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

International Nuclear Information System (INIS)

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

2014-01-01

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

The Great Recession and Workers' Health Benefits.

Science.gov (United States)

Koh, Kanghyock

2018-03-01

During a recession, cost-sharing of employer-sponsored health benefits could increase to reduce labor costs in the U.S. Using a variation in the severity of recession shocks across industries, I find evidence that the enrollment rate of high deductible health plans (HDHPs) among workers covered by employer-sponsored health benefits increased more among firms in industries that experienced severe recession shocks. As potential mechanisms, I study employer-side and worker-side mechanisms. I find that employers changed health benefit offerings to force or incentivize workers to enroll in HDHPs. But I find little evidence of an increase in workers' demand for HDHPs due to a reduction in income. These results suggest that the HDHP enrollment rate increased during the Great Recession, as employers tried to save costs of offering health benefits. Copyright © 2018 Elsevier B.V. All rights reserved.

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-07-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-07-01

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

Energy efficiency improvement and cost saving opportunities forpetroleum refineries

Energy Technology Data Exchange (ETDEWEB)

Worrell, Ernst; Galitsky, Christina

2005-02-15

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-06-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-09-01

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

Dedicated orthogeriatric service saves the HSE a million euro

LENUS (Irish Health Repository)

Shanahan, E

2016-03-01

Hip fracture is common in older adults and is associated with high morbidity, mortality and significant health care costs. A pilot orthogeriatrics service was established in an acute hospital. We aimed to establish the cost effectiveness of this service. Length of hospital stay, discharge destination and rehabilitation requirements were analysed for a one year period and compared to patients who received usual care prior to the service. We calculated the costs incurred and savings produced by the orthogeriatric service. Median length of stay was reduced by 3 days (p=<0.001) saving €266,976. There was a 19% reduction in rehabilitation requirements saving €192,600. Median rehabilitation length of stay was reduced by 6.5 days saving €171,093. Reductions in long term care requirements led to savings of €10,934 per week. Costs to establish such a service amount to €171,564. The introduction of this service led to improved patient outcomes in a cost effective manner.

The health gains and cost savings of dietary salt reduction interventions, with equity and age distributional aspects

Directory of Open Access Journals (Sweden)

Nhung Nghiem

2016-05-01

Full Text Available Abstract Background A “diet high in sodium” is the second most important dietary risk factor for health loss identified in the Global Burden of Disease Study 2013. We therefore aimed to model health gains and costs (savings of salt reduction interventions related to salt substitution and maximum levels in bread, including by ethnicity and age. We also ranked these four interventions compared to eight other modelled interventions. Methods A Markov macro-simulation model was used to estimate QALYs gained and net health system costs for four dietary sodium reduction interventions, discounted at 3 % per annum. The setting was New Zealand (NZ (2.3 million adults, aged 35+ years which has detailed individual-level administrative cost data. Results The health gain was greatest for an intervention where most (59 % of the sodium in processed foods was replaced by potassium and magnesium salts. This intervention gained 294,000 QALYs over the remaining lifetime of the cohort (95 % UI: 238,000 to 359,000; 0.13 QALY per 35+ year old. Such salt substitution also produced the highest net cost-savings of NZ$ 1.5 billion (US$ 1.0 billion (95 % UI: NZ$ 1.1 to 2.0 billion. All interventions generated relatively larger per capita QALYs for men vs women and for the indigenous Māori population vs non-Māori (e.g., 0.16 vs 0.12 QALYs per adult for the 59 % salt substitution intervention. Of relevance to workforce productivity, in the first 10 years post-intervention, 22 % of the QALY gain was among those aged <65 years (and 37 % for those aged <70. Conclusions The benefits are consistent with the international literature, with large health gains and cost savings possible from some, but not all, sodium reduction interventions. Health gain appears likely to occur among working-age adults and all interventions contributed to reducing health inequalities.

Saving Energy. Managing School Facilities, Guide 3.

Science.gov (United States)

Department for Education and Employment, London (England). Architects and Building Branch.

This guide offers information on how schools can implement an energy saving action plan to reduce their energy costs. Various low-cost energy-saving measures are recommended covering heating levels and heating systems, electricity demand reduction and lighting, ventilation, hot water usage, and swimming pool energy management. Additional…

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

Directory of Open Access Journals (Sweden)

Korenromp Eline L

2012-03-01

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

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

International Nuclear Information System (INIS)

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

2013-01-01

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

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

Directory of Open Access Journals (Sweden)

Mashudu D. Mbedzi

2018-05-01

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

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

Science.gov (United States)

Kutscher, Beth; Meyer, Harris

2013-09-02

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

Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fiber in Canada

Science.gov (United States)

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

2015-01-01

Background: Type 2 diabetes (T2D) and cardiovascular disease (CVD) are leading causes of mortality and two of the most costly diet-related ailments worldwide. Consumption of fiber-rich diets has been repeatedly associated with favorable impacts on these co-epidemics, however, the healthcare cost-related economic value of altered dietary fiber intakes remains poorly understood. In this study, we estimated the annual cost savings accruing to the Canadian healthcare system in association with reductions in T2D and CVD rates, separately, following increased intakes of dietary fiber by adults. Methods: A three-step cost-of-illness analysis was conducted to identify the percentage of individuals expected to consume fiber-rich diets in Canada, estimate increased fiber intakes in relation to T2D and CVD reduction rates, and independently assess the potential annual savings in healthcare costs associated with the reductions in rates of these two epidemics. The economic model employed a sensitivity analysis of four scenarios (universal, optimistic, pessimistic, and very pessimistic) to cover a range of assumptions within each step. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8 million–$1.3 billion in CVD costs were calculated under a scenario where cereal fiber was used to increase current intakes of dietary fiber to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fiber consumption resulted in annual CAD$2.6 to $51.1 million savings for T2D and $4.6 to $92.1 million savings for CVD. Conclusion: Findings of this analysis shed light on the economic value of optimal dietary fiber intakes. Strategies to increase consumers’ general knowledge of the recommended intakes of dietary fiber, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of healthcare and related costs associated with T2D and CVD in Canada. PMID

Improving the thermal integrity of new single-family detached residential buildings: Documentation for a regional database of capital costs and space conditioning load savings

International Nuclear Information System (INIS)

Koomey, J.G.; McMahon, J.E.; Wodley, C.

1991-07-01

This report summarizes the costs and space-conditioning load savings from improving new single-family building shells. It relies on survey data from the National Association of Home-builders (NAHB) to assess current insulation practices for these new buildings, and NAHB cost data (aggregated to the Federal region level) to estimate the costs of improving new single-family buildings beyond current practice. Space-conditioning load savings are estimated using a database of loads for prototype buildings developed at Lawrence Berkeley Laboratory, adjusted to reflect population-weighted average weather in each of the ten federal regions and for the nation as a whole

How much electricity can we save by using direct current circuits in homes? Understanding the potential for electricity savings and assessing feasibility of a transition towards DC powered buildings

International Nuclear Information System (INIS)

Glasgo, Brock; Azevedo, Inês Lima; Hendrickson, Chris

2016-01-01

Highlights: • DC distribution systems are analyzed using monitored appliance and solar PV data. • DC-distributed PV energy generates savings under real-world load and solar profiles. • Savings from direct-DC are generally not cost-effective in current markets. • Non-technical hurdles remain before DC can be widely adopted in US homes. - Abstract: Advances in semiconductor-based power electronics and growing direct current loads in buildings have led researchers to reconsider whether buildings should be wired with DC circuits to reduce power conversions and facilitate a transition to efficient DC appliances. The feasibility, energy savings, and economics of such systems have been assessed and proven in data centers and commercial buildings, but the outcomes are still uncertain for the residential sector. In this work, we assess the technical and economic feasibility of DC circuits using data for 120 traditionally-wired AC homes in Austin, Texas to understand the effect of highly variable demand profiles on DC-powered residences, using appliance-level use and solar generation data, and performing a Monte Carlo simulation to quantify costs and benefits. Results show site energy savings between 9% and 20% when solar PV is distributed to all home appliances. When battery storage for excess solar energy is considered, these savings increase to 14–25%. At present DC equipment prices, converting all equipment to DC causes levelized annual costs of electricity to homeowners to roughly double. However, by converting only homes’ air conditioning condensing units to DC, the costs of direct-DC are greatly reduced and home site energy savings of 7–16% are generated. In addition to quantifying savings, we find major nontechnical barriers to implementing direct-DC in homes. These include a lack of standards for such systems, a relatively small market for DC appliances and components, utility programs designed for AC power, and a workforce unfamiliar with DC

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

Science.gov (United States)

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

2018-05-31

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

Ensuring Efficient Incentive and Disincentive Values for Highway Construction Projects: A Systematic Approach Balancing Road User, Agency and Contractor Acceleration Costs and Savings

Directory of Open Access Journals (Sweden)

Eul-Bum Lee

2018-03-01

Full Text Available United States State Highway Agencies (SHAs use Incentive/Disincentives (I/D to minimize negative impacts of construction on the traveling public through construction acceleration. Current I/D practices have the following short-comings: not standardized, over- or under-compensate contractors, lack of auditability result in disincentives that leave SHAs vulnerable to contractor claims and litigation and are based on agency costs/savings rather than contractor acceleration. Presented within this paper is an eleven-step I/D valuation process. The processes incorporate a US-nationwide RUC and agency cost calculation program, CA4PRS and a time-cost tradeoff I/D process. The incentive calculation used is the summation of the contractor acceleration and a reasonable contractor bonus (based on shared agency savings with an optional reduction of contractor’s own saving from schedule compression (acceleration. The process has a capability to be used both within the US and internationally with minor modifications, relies on historical costs, is simple and is auditable and repeatable. As such, it is a practical tool for optimizing I/D amounts and bridges the gap in existing literature both by its industry applicability, integrating the solution into existing SHA practices and its foundation of contractor acceleration costs.

Energy savings potential from energy-conserving irrigation systems

Energy Technology Data Exchange (ETDEWEB)

Wilfert, G.L.; Patton, W.P.; Harrer, B.J.; Clark, M.A.

1982-11-01

This report systematically compares, within a consistent framework, the technical and economic characteristics of energy-conserving irrigation systems with those of conventional irrigation systems and to determine total energy savings. Levelized annual costs of owning and operating both energy-conserving and conventional irrigation systems have been developed and compared for all 17 states to account for the differences in energy costs and irrigation conditions in each state. Market penetration of energy-conserving systems is assessed for those systems having lower levelized annual costs than conventional systems performing the same function. Annual energy savings were computed by matching the energy savings per system with an assumed maximum market penetration of 100 percent in those markets where the levelized annual costs of energy-conserving systems are lower than the levelized annual costs of conventional systems.

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.

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

Directory of Open Access Journals (Sweden)

Cristina Negrini

2017-10-01

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

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

Science.gov (United States)

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

2016-06-01

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

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

Science.gov (United States)

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

2001-10-01

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

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

Directory of Open Access Journals (Sweden)

Peter Ehrenkranz

2001-10-01

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

More than 30 per cent energy savings possible with LEDs in gerbera : substantial energy savings and little loss in production

NARCIS (Netherlands)

Helm, van der F.P.M.

2015-01-01

By installing LED-lighting and limiting it to 80 instead of 100 μmol gerbera growers can save 30 per cent on energy without any great loss in production, according to research. Light integration and interlighting don’t yet deliver any savings.

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

Energy Technology Data Exchange (ETDEWEB)

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

1999-07-01

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

Telephone-based disease management: why it does not save money.

Science.gov (United States)

Motheral, Brenda R

2011-01-01

To understand why the current telephone-based model of disease management (DM) does not provide cost savings and how DM can be retooled based on the best available evidence to deliver better value. Literature review. The published peer-reviewed evaluations of DM and transitional care models from 1990 to 2010 were reviewed. Also examined was the cost-effectiveness literature on the treatment of chronic conditions that are commonly included in DM programs, including heart failure, diabetes mellitus, coronary artery disease, and asthma. First, transitional care models, which have historically been confused with commercial DM programs, can provide credible savings over a short period, rendering them low-hanging fruit for plan sponsors who desire real savings. Second, cost-effectiveness research has shown that the individual activities that constitute contemporary DM programs are not cost saving except for heart failure. Targeting of specific patients and activity combinations based on risk, actionability, treatment and program effectiveness, and costs will be necessary to deliver a cost-saving DM program, combined with an outreach model that brings vendors closer to the patient and physician. Barriers to this evidence-driven approach include resources required, marketability, and business model disruption. After a decade of market experimentation with limited success, new thinking is called for in the design of DM programs. A program design that is based on a cost-effectiveness approach, combined with greater program efficacy, will allow for the development of DM programs that are cost saving.

Savings impact of a corporate energy manager

International Nuclear Information System (INIS)

Sikorski, B.D.; O'Donnell, B.A.

1999-01-01

This paper discusses the cost savings impact of employing an energy manager with a 16,000-employee corporation. The corporation, Canada's second largest airline, is currently operating nearly 3,000,000 ft 2 of mixed-use facilities spread across the country, with an annual energy budget for ground facilities of over Cdn $4,000,000. This paper outlines the methodology used by the energy manager to deploy an energy management program over a two-year period between April 1995 and May 1997. The paper examines the successes and the lessons learned during the period and summarizes the costs and benefits of the program. The energy manager position was responsible for developing an energy history database with more than 100 active accounts and for monitoring and verifying energy savings. The energy manager implemented many relatively low-cost energy conservation measures, as well as some capital projects, during the first two years of the program. In total, these measures provided energy cost savings of $210,000 per year, or 5% of the total budget. In each case, technologies installed as part of the energy retrofit projects provided not only cost savings but also better control, reduced maintenance, and improved working conditions for employees

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

International Nuclear Information System (INIS)

Miller, Patrick; Olateju, Babatunde; Kumar, Amit

2012-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-05-15

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

Estimated cost savings associated with the transfer of office-administered specialty pharmaceuticals to a specialty pharmacy provider in a Medical Injectable Drug program.

Science.gov (United States)

Baldini, Christopher G; Culley, Eric J

2011-01-01

A large managed care organization (MCO) in western Pennsylvania initiated a Medical Injectable Drug (MID) program in 2002 that transferred a specific subset of specialty drugs from physician reimbursement under the traditional "buy-and-bill" model in the medical benefit to MCO purchase from a specialty pharmacy provider (SPP) that supplied physician offices with the MIDs. The MID program was initiated with 4 drugs in 2002 (palivizumab and 3 hyaluronate products/derivatives) growing to more than 50 drugs by 2007-2008. To (a) describe the MID program as a method to manage the cost and delivery of this subset of specialty drugs, and (b) estimate the MID program cost savings in 2007 and 2008 in an MCO with approximately 4.6 million members. Cost savings generated by the MID program were calculated by comparing the total actual expenditure (plan cost plus member cost) on medications included in the MID program for calendar years 2007 and 2008 with the total estimated expenditure that would have been paid to physicians during the same time period for the same medication if reimbursement had been made using HCPCS (J code) billing under the physician "buy-and-bill" reimbursement rates. For the approximately 50 drugs in the MID program in 2007 and 2008, the drug cost savings in 2007 were estimated to be $15.5 million (18.2%) or $290 per claim ($0.28 per member per month [PMPM]) and about $13 million (12.7%) or $201 per claim ($0.23 PMPM) in 2008. Although 28% of MID claims continued to be billed by physicians using J codes in 2007 and 22% in 2008, all claims for MIDs were limited to the SPP reimbursement rates. This MID program was associated with health plan cost savings of approximately $28.5 million over 2 years, achieved by the transfer of about 50 physician-administered injectable pharmaceuticals from reimbursement to physicians to reimbursement to a single SPP and payment of physician claims for MIDs at the SPP reimbursement rates.

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-12-15

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

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

Directory of Open Access Journals (Sweden)

Hurley Susan F

2007-01-01

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

Implementation of an optical diagnosis strategy saves costs and does not impair clinical outcomes of a fecal immunochemical test-based colorectal cancer screening program.

Science.gov (United States)

Vleugels, Jasper L A; Greuter, Marjolein J E; Hazewinkel, Yark; Coupé, Veerle M H; Dekker, Evelien

2017-12-01

 In an optical diagnosis strategy, diminutive polyps that are endoscopically characterized with high confidence are removed without histopathological analysis and distal hyperplastic polyps are left in situ. We evaluated the effectiveness and costs of optical diagnosis.  Using the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model, we simulated biennial fecal immunochemical test (FIT) screening in individuals aged 55 - 75 years. In this program, we compared an optical diagnosis strategy with current histopathology assessment of all diminutive polyps. Base-case assumptions included 76 % high-confidence predictions and sensitivities of 88 %, 91 %, and 88 % for endoscopically characterizing adenomas, sessile serrated polyps, and hyperplastic polyps, respectively. Outcomes were colorectal cancer burden, number of colonoscopies, life-years, and costs.  Both the histopathology strategy and the optical diagnosis strategy resulted in 21 life-days gained per simulated individual compared with no screening. For optical diagnosis, €6 per individual was saved compared with the current histopathology strategy. These cost savings were related to a 31 % reduction in colonoscopies in which histopathology was needed for diminutive polyps. Projecting these results onto the Netherlands (17 million inhabitants), assuming a fully implemented FIT-based screening program, resulted in an annual undiscounted cost saving of € 1.7 - 2.2 million for optical diagnosis.  Implementation of optical diagnosis in a FIT-based screening program saves costs without decreasing program effectiveness when compared with current histopathology analysis of all diminutive polyps. Further work is required to evaluate how endoscopists participating in a screening program should be trained, audited, and monitored to achieve adequate competence in optical diagnosis.

Multiple breeding in the Great Tit, II. The costs of rearing a second clutch

NARCIS (Netherlands)

Verhulst, S.

1998-01-01

1. Multiple breeding (raising more than one batch of young per breeding season) is a common life-history tactic, but little is known as yet of the accompanying costs and benefits. Second clutches of Great Tits, a facultative multiple breeder, were removed over three years to investigate the costs of

Multiple breeding in the Great Tit, II. The costs of rearing a second clutch

NARCIS (Netherlands)

Verhulst, S

1. Multiple breeding (raising more than one batch of young per breeding season) is a common life-history tactic, but little is known as yet of the accompanying costs and benefits. Second clutches of Great Tits, a facultative multiple breeder, were removed over three years to investigate the costs of

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

Science.gov (United States)

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

2013-12-01

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

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)

48 CFR 2448.104-3 - Sharing collateral savings.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Sharing collateral savings... DEVELOPMENT CONTRACT MANAGEMENT VALUE ENGINEERING 2448.104-3 Sharing collateral savings. (a) The authority of the HCA to determine that the cost of calculating and tracking collateral savings will exceed the...

Heat Saving Strategies in Sustainable Smart Energy Systems

DEFF Research Database (Denmark)

Lund, Henrik; Thellufsen, Jakob Zinck; Aggerholm, Søren

2014-01-01

This paper investigates to which extent heat should be saved rather than produced and to which extent district heating infrastructures, rather than individual heating solutions, should be used in future sustainable smart energy systems. Based on a concrete proposal to implement the Danish...... governmental 2050 fossil-free vision, this paper identifies marginal heat production costs and compares these to marginal heat savings costs for two different levels of district heating. A suitable least-cost heating strategy seems to be to invest in an approximately 50% decrease in net heat demands in new...... buildings and buildings that are being renovated anyway, while the implementation of heat savings in buildings that are not being renovated hardly pays. Moreover, the analysis points in the direction that a least-cost strategy will be to provide approximately 2/3 of the heat demand from district heating...

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

Directory of Open Access Journals (Sweden)

Ali Eskandarizadeh

2017-04-01

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

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

Science.gov (United States)

Department of Energy, Washington, DC.

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

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

Science.gov (United States)

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

2014-08-01

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

Great Lakes waters: radiation dose commitments, potential health effects, and cost-benefit considerations

International Nuclear Information System (INIS)

Ainsworth, E.J.

1977-07-01

In 1972, a Great Lakes Water Quality Agreement was signed by the United States and Canadian Governments. It was stipulated that the operation and effectiveness of the agreement were to be reviewed comprehensively in 1977. Aspects of the agreement concern nondegradation of Great Lakes waters and maintenance of levels of radioactivity or other potential pollutants at levels considered as low as practicable. A refined radioactivity objective of one millirem is proposed in the Water Quality Agreement. The implications of adoption of this objective are not known fully. The Division of Environmental Impact Studies was commissioned by ERDA's Division of Technology Overview to summarize the information available on the current levels of radioactivity in Great Lakes waters, compute radiation-dose commitment (integrated dose over 50 years after consumption of 2.2 liters of water of one year), and to comment on the feasibility and cost-benefit considerations associated with the refined one-millirem objective. Current levels of radioactivity in the waters of Lakes Michigan, Ontario, Erie, and Huron result in dose commitments in excess of 1 mrem for whole body and 6 mrem for bone. Future projections of isotope concentrations in Great lakes water indicate similar dose commitments for drinking water in the year 2050. Reduction of the levels of radioactivity in Great Lakes waters is not feasible, but cost-benefit considerations support removal of 226 Ra and 90 Sr through interceptive technology before water consumption. Adoption of the one-millirem objective is not propitious

Cost-of-illness analysis reveals potential healthcare savings with reductions in type 2 diabetes and cardiovascular disease following recommended intakes of dietary fibre in Canada

Directory of Open Access Journals (Sweden)

Mohammad eAbdullah

2015-08-01

Full Text Available Background: Consumption of fibre-rich diets is associated with favourable impacts on type 2 diabetes (T2D and cardiovascular disease (CVD, two of the most costly ailments worldwide, however the economic value of altered fibre intakes remains poorly understood. Methods: A cost-of-illness analysis was conducted to identify the percentage of adults expected to consume fibre-rich diets in Canada, estimate fibre intakes in relation to T2D and CVD reductions, and assess the potential annual savings in healthcare costs with reductions in rates of these two epidemics. Results: Non-trivial healthcare and related savings of CAD$35.9-$718.8 million in T2D costs and CAD$64.8-$1,295.7 million in CVD costs were calculated under a scenario where cereal fibre was used to increase current intakes of dietary fibre to the recommended levels of 38 g per day for men and 25 g per day for women. Each 1 g per day increase in fibre consumption resulted in annual CAD$2.6-$51.1 and $4.6-$92.1 million savings for T2D and CVD, respectively. Conclusions: Strategies to increase consumers’ knowledge of the recommended dietary fibre intakes, as part of healthy diet, and to facilitate stakeholder synergy are warranted to enable better management of costs associated with T2D and CVD in Canada.

Valuation of Travel Time Savings in Viewpoint of WTA

Science.gov (United States)

Shao, Chang-qiao; Liu, Yang; Liu, Xiao-ming

2014-01-01

In order to investigate the issues in measurement of value of travel time savings (VTTS), the willingness-to-accept (WTA) for the private car owner is studied by using surveyed data. It is convincing that trip purpose, trip length, time savings, cost savings, income, and allowance from employee have effects on the WTA. Moreover, influences of these variables are not the same for different trip purposes. For commuting trips, effects of income and allowance from employee are significant while time savings and cost savings are dominated for leisure and shopping trips. It is also found that WTA is much higher than expected which implies that there are a group of drivers who are not prone to switching to other trip modes other than passenger car. PMID:25530751

Valuation of travel time savings in viewpoint of WTA.

Science.gov (United States)

Shao, Chang-Qiao; Liu, Yang; Liu, Xiao-Ming

2014-01-01

In order to investigate the issues in measurement of value of travel time savings (VTTS), the willingness-to-accept (WTA) for the private car owner is studied by using surveyed data. It is convincing that trip purpose, trip length, time savings, cost savings, income, and allowance from employee have effects on the WTA. Moreover, influences of these variables are not the same for different trip purposes. For commuting trips, effects of income and allowance from employee are significant while time savings and cost savings are dominated for leisure and shopping trips. It is also found that WTA is much higher than expected which implies that there are a group of drivers who are not prone to switching to other trip modes other than passenger car.

Reactors Save Energy, Costs for Hydrogen Production

Science.gov (United States)

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-03-01

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

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

OpenAIRE

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

2015-01-01

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

Heat Saving Strategies in Sustainable Smart Energy Systems

Directory of Open Access Journals (Sweden)

Henrik Lund

2014-06-01

Full Text Available This paper investigates to which extent heat should be saved rather than produced and to which extent district heating infrastructures, rather than individual heating solutions, should be used in future sustainable smart energy systems. Based on a concrete proposal to implement the Danish governmental 2050 fossil-free vision, this paper identifies marginal heat production costs and compares these to marginal heat savings costs for two different levels of district heating. A suitable least-cost heating strategy seems to be to invest in an approximately 50% decrease in net heat demands in new buildings and buildings that are being renovated anyway, while the implementation of heat savings in buildings that are not being renovated hardly pays. Moreover, the analysis points in the direction that a least-cost strategy will be to provide approximately 2/3 of the heat demand from district heating and the rest from individual heat pumps.

Cost-Benefit of the energy saving in the bioclimatic designs; Costo-Beneficio del ahorro de energia en los disenos bioclimaticos

Energy Technology Data Exchange (ETDEWEB)

Lopez P, J. Manuel A. [Doble Dos Soluciones de Negocios, S.A. de C.V., Mexico, D.F. (Mexico); Morillon G, David; Rodriguez V, Luis [Instituto de Ingenieria de la UNAM, Mexico, D.F. (Mexico)

1999-07-01

Tools and criteria for the Cost-Benefit analysis from the energy saving in bioclimatic designs (BD) are presented, for which, a reference project is established and the costs and benefits of energy saving in BD with base in that project are evaluated. A case study is presented taking as reference the traditional design of the air conditioning of a building and with this base the estimation of cost-benefit of the same building is made, but with passive systems. The tools used are those that allow to consider related resources such as time and money; in that sense, are used criteria such as: Present value (PV), Equivalent Annual Cost (EAC) and the Cost of the Conserved Energy (CCE). The costs related to the construction, maintenance and operation of the design are taken into account. The differences between the reference design and the BD, established from the application of these criteria, allow to evaluate the economic margin of the BD as far as operation and maintenance is concerned. Finally the CCE of the bioclimatic measures is evaluated as an initiative of energy saving and the present value is calculated of the energy saving in the entire useful life of a bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio del ahorro de energia en disenos bioclimaticos (DB), para lo cual, se establece un proyecto de referencia y se evaluan los costos y beneficios del ahorro de energia en DB con base en ese proyecto. Se presenta el estudio de un caso tomando como referencia el dise tradicional de la climatizacion de un edificio y con base en este, se realiza la estimacion de costos y beneficios del mismo edificio, pero con sistemas pasivos. Las herramientas usadas, son aquellas que permiten considerar recursos relacionados como son tiempo y dinero; en ese sentido, se usan criterios como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia Conservada (CEC). Se toman en consideracion los costos relacionados

Measured energy savings from using night temperature setback

International Nuclear Information System (INIS)

Szydlowski, R.F.; Wrench, L.E.; O'Neill, P.J.

1993-01-01

The measured energy savings resulting from using night temperature setback in typical light-construction wooden office buildings was determined. Researchers installed monitoring equipment in a six-building sample of two-story wooden buildings at Fort Devens, Massachusetts. Data obtained during both single-setting and night-setback operating modes were used to develop models of each building's heat consumption as a function of the difference between inside and outside temperature. These models were used to estimate seasonal savings that could be obtained from the use of night-setback thermostat control. The measured savings in heating energy from using night temperature setback for the six Fort Devens buildings ranged from 14% to 25%; the mean savings was 19.2%. Based on an energy cost of $0.65/therm of natural gas, the estimated average cost savings of using automatic setback thermostats in these buildings is $780 per year per building

The Great Recession And Increased Cost Sharing In European Health Systems.

Science.gov (United States)

Palladino, Raffaele; Lee, John Tayu; Hone, Thomas; Filippidis, Filippos T; Millett, Christopher

2016-07-01

European health systems are increasingly adopting cost-sharing models, potentially increasing out-of-pocket expenditures for patients who use health care services or buy medications. Government policies that increase patient cost sharing are responding to incremental growth in cost pressures from aging populations and the need to invest in new health technologies, as well as to general constraints on public expenditures resulting from the Great Recession (2007-09). We used data from the Survey of Health, Ageing and Retirement in Europe to examine changes from 2006-07 to 2013 in out-of-pocket expenditures among people ages fifty and older in eleven European countries. Our results identify increases both in the proportion of older European citizens who incurred out-of-pocket expenditures and in mean out-of-pocket expenditures over this period. We also identified a significant increase over time in the percentage of people who incurred catastrophic health expenditures (greater than 30 percent of the household income) in the Czech Republic, Italy, and Spain. Poorer populations were less likely than those in the highest income quintile to incur an out-of-pocket expenditure and reported lower mean out-of-pocket expenditures, which suggests that measures are in place to provide poorer groups with some financial protection. These findings indicate the substantial weakening of financial protection for people ages fifty and older in European health systems after the Great Recession. Project HOPE—The People-to-People Health Foundation, Inc.

Valuation of Travel Time Savings in Viewpoint of WTA

Directory of Open Access Journals (Sweden)

Chang-qiao Shao

2014-01-01

Full Text Available In order to investigate the issues in measurement of value of travel time savings (VTTS, the willingness-to-accept (WTA for the private car owner is studied by using surveyed data. It is convincing that trip purpose, trip length, time savings, cost savings, income, and allowance from employee have effects on the WTA. Moreover, influences of these variables are not the same for different trip purposes. For commuting trips, effects of income and allowance from employee are significant while time savings and cost savings are dominated for leisure and shopping trips. It is also found that WTA is much higher than expected which implies that there are a group of drivers who are not prone to switching to other trip modes other than passenger car.

The costs of egg production and incubation in great tits (Parus major)

NARCIS (Netherlands)

Visser, M.E.; Lessells, C.M.

2001-01-01

The costs of egg production and incubation may have a crucial effect on avian reproductive decisions, such as clutch size and the timing of reproduction. We carried out a brood-size enlargement experiment on the great tit (Parus major), in which the birds had to lay and incubate extra eggs (full

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

Science.gov (United States)

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

1979-01-01

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

Cost inefficiency under financial strain: a stochastic frontier analysis of hospitals in Washington State through the Great Recession.

Science.gov (United States)

Izón, Germán M; Pardini, Chelsea A

2017-06-01

The importance of increasing cost efficiency for community hospitals in the United States has been underscored by the Great Recession and the ever-changing health care reimbursement environment. Previous studies have shown mixed evidence with regards to the relationship between linking hospitals' reimbursement to quality of care and cost efficiency. Moreover, current evidence suggests that not only inherently financially disadvantaged hospitals (e.g., safety-net providers), but also more financially stable providers, experienced declines to their financial viability throughout the recession. However, little is known about how hospital cost efficiency fared throughout the Great Recession. This study contributes to the literature by using stochastic frontier analysis to analyze cost inefficiency of Washington State hospitals between 2005 and 2012, with controls for patient burden of illness, hospital process of care quality, and hospital outcome quality. The quality measures included in this study function as central measures for the determination of recently implemented pay-for-performance programs. The average estimated level of hospital cost inefficiency before the Great Recession (10.4 %) was lower than it was during the Great Recession (13.5 %) and in its aftermath (14.1 %). Further, the estimated coefficients for summary process of care quality indexes for three health conditions (acute myocardial infarction, pneumonia, and heart failure) suggest that higher quality scores are associated with increased cost inefficiency.

Mass savings domain of plasma propulsion for LEO to GEO transfer

International Nuclear Information System (INIS)

Choueiri, E.Y.; Kelly, A.J.; Jahn, R.G.

1993-01-01

A parametric model is used to study the mass savings of plasma propulsion over advanced chemical propulsion for lower earth orbit (LEO) to geosynchronous orbit (GEO) transfer. Such savings are characterized by stringent requirements of massive payloads (O(10) metric tons) and high power levels (O(100) kW). Mass savings on the order of the payload mass are possible but at the expense of longer transfer times (8--20 months). Typical of the savings domain is the case of a self-field magnetoplasmadynamic (MPD) thruster running quasi-steadily, at an I s of 2000 s, with 600 kW of input power, raising a 50 metric ton satellite in 270 days. The initial mass at LEO will be 65 tons less than a 155 ton LO 2 /LH 2 advanced chemical high thrust spacecraft. An optimum I s can only be found if the cost savings associated with mass savings are counterbalanced by the cost losses incurred by longer transfer times. A simplistic cost model that illustrates the overall trends in the optimization yielded an optimum I s of about 2200 s for a cost effective baseline MPD system

Improved Safety and Cost Savings from Reductions in Cast-Saw Burns After Simulation-Based Education for Orthopaedic Surgery Residents.

Science.gov (United States)

Bae, Donald S; Lynch, Hayley; Jamieson, Katherine; Yu-Moe, C Winnie; Roussin, Christopher

2017-09-06

The purpose of this investigation was to characterize the clinical efficacy and cost-effectiveness of simulation training aimed at reducing cast-saw injuries. Third-year orthopaedic residents underwent simulation-based instruction on distal radial fracture reduction, casting, and cast removal using an oscillating saw. The analysis compared incidences of cast-saw injuries and associated costs before and after the implementation of the simulation curriculum. Actual and potential costs associated with cast-saw injuries included wound care, extra clinical visits, and potential total payment (indemnity and expense payments). Curriculum costs were calculated through time-derived, activity-based accounting methods. The researchers compared the costs of cast-saw injuries and the simulation curriculum to determine overall savings and return on investment. In the 2.5 years prior to simulation, cast-saw injuries occurred in approximately 4.3 per 100 casts cut by orthopaedic residents. For the 2.5-year period post-simulation, the injury rate decreased significantly to approximately 0.7 per 100 casts cut (p = 0.002). The total cost to implement the casting simulation was $2,465.31 per 6-month resident rotation. On the basis of historical data related to cast-saw burns (n = 6), total payments ranged from $2,995 to $25,000 per claim. The anticipated savings from averted cast-saw injuries and associated medicolegal payments in the 2.5 years post-simulation was $27,131, representing an 11-to-1 return on investment. Simulation-based training for orthopaedic surgical residents was effective in reducing cast-saw injuries and had a high theoretical return on investment. These results support further investment in simulation-based training as cost-effective means of improving patient safety and clinical outcomes. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Linking the Local and the Global. What Today’s Environmental Humanities Movement Can Learn from Their Predecessor’s Successful Leadership of the 1965–1975 War to Save the Great Barrier Reef

Directory of Open Access Journals (Sweden)

Iain McCalman

2017-10-01

Full Text Available For a decade from 1965–1975, an Australian poet, Judith Wright, and a Reef artist, John Busst, played a major role in helping to save the Great Barrier Reef. The Queensland State Government had declared its intention of mining up to eighty percent of the Reef’s corals for oil, gas, fertiliser and cement. The campaign of resistance led by these two humanists, in alliance with a forester, Dr. Len Webb, contributed substantively to the establishment of the Great Barrier Reef Marine Park in 1975 and to then to the Reef’s World Heritage listing in 1983 as ‘the most impressive marine environment in the world’. This paper explains the challenges facing today’s environmental scholars and activists as they attempt to replicate the success of their 1970s predecessors in helping to save the Great Barrier Reef from even graver and more immediate threats to its survival.

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

Science.gov (United States)

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

2013-01-01

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

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

International Nuclear Information System (INIS)

Jierree, C.; Ticknor, K.

1996-10-01

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

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

International Nuclear Information System (INIS)

Quevenco, Rodolfo

2015-01-01

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

Real-time pricing when some consumers resist in saving electricity

International Nuclear Information System (INIS)

Salies, Evens

2013-01-01

Successful real-time electricity pricing depends firstly upon consumers' willingness to subscribe to such terms and, secondly, on their ability to curb consumption levels. The present paper addresses both issues by considering consumers differentiated by their electricity saving costs, half of whom resist saving electricity. We demonstrate that when consumers are free to adopt real-time prices, producers prefer charging inefficient prices and, in so doing, discriminate against that portion of the consumer population which faces no saving costs. We also find that efficient marginal cost pricing is feasible, but is incompatible with mass adoption of real-time prices. - Highlights: • We model consumers switching from uniform to real-time electricity pricing (RTP). • Half the consumer population is pro-RTP and half resists saving electricity. • Efficient RTP is feasible but is incompatible with mass adoption

Risk transfer via energy-savings insurance

International Nuclear Information System (INIS)

Mills, Evan

2003-01-01

Among the key barriers to investment in energy efficiency are uncertainties about attaining projected energy savings and potential disputes over stipulated savings. The fields of energy management and risk management are thus intertwined. While many technical methods have emerged to manage performance risks (e.g. building diagnostics and commissioning), financial methods are less developed in the energy management arena than in other segments of the economy. Energy-savings insurance (ESI) - formal insurance of predicted energy savings - transfers and spreads both types of risk over a larger pool of energy efficiency projects and reduces barriers to market entry of smaller energy service firms who lack sufficiently strong balance sheets to self-insure the savings. ESI encourages those implementing energy-saving projects to go beyond standard measures and thereby achieve more significant levels of energy savings. Insurance providers are proponents of improved savings measurement and verification techniques, as well as maintenance, thereby contributing to national energy-saving objectives. If properly applied, ESI can potentially reduce the net cost of energy-saving projects by reducing the interest rates charged by lenders, and by increasing the level of savings through quality control. Governmental agencies have been pioneers in the use of ESI and could continue to play a role

Cost savings and enhanced hospice enrollment with a home-based palliative care program implemented as a hospice-private payer partnership.

Science.gov (United States)

Kerr, Christopher W; Donohue, Kathleen A; Tangeman, John C; Serehali, Amin M; Knodel, Sarah M; Grant, Pei C; Luczkiewicz, Debra L; Mylotte, Kathleen; Marien, Melanie J

2014-12-01

In the United States, 5% of the population is responsible for nearly half of all health care expenditures, with a large concentration of spending driven by individuals with expensive chronic conditions in their last year of life. Outpatient palliative care under the Medicare Hospice Benefit excludes a large proportion of the chronically ill and there is widespread recognition that innovative strategies must be developed to meet the needs of the seriously ill while reducing costs. This study aimed to evaluate the impact of a home-based palliative care program, implemented through a hospice-private payer partnership, on health care costs and utilization. This was a prospective, observational database study where insurance enrollment and claims data were analyzed. The study population consisted of Home Connections (HC) program patients enrolled between January 1, 2010 and December 31, 2012 who subsequently expired (n=149) and who were also Independent Health members. A control group (n=537) was derived using propensity-score matching. The primary outcome variable was overall costs within the last year of life. Costs were also examined at six months, three months, one month, and two weeks. Inpatient, outpatient, ancillary, professional, and pharmacy costs were compared between the two groups. Medical service utilization and hospice enrollment and length of stay were also evaluated. Cost savings were apparent in the last three months of life—$6,804 per member per month (PMPM) cost for palliative care participants versus $10,712 for usual care. During the last two weeks of life, total allowed PMPM was $6,674 versus $13,846 for usual care. Enhanced hospice entry (70% versus 25%) and longer length of stay in hospice (median 34 versus 9 days) were observed. Palliative care programs partnered with community hospice providers may achieve cost savings while helping provide care across the continuum.

Energy savings in CSFR - building sector

International Nuclear Information System (INIS)

Jacobsen, F.R.

1993-01-01

The Czechoslovak/Danish project on energy savings in buildings proves that it is possible to save up to 30% of the energy in buildings. 10% can be saved at an investment of 27 bill KCS. The total investment that is needed to save 30% is 140 bill KCS. Further energy savings can be obtained through more energy efficient supply systems. Information dissemination is important for the energy saving programme as are economic incentives. Investments in energy savings should be profitable for the investor, but this is not the case in the Czech and Slovak republics today. Changes are needed. Energy prices are still to low, compared to investment costs. Financial possibilities are not satisfactory for private investors. Price systems are not favourable to investment in energy savings. Training is needed for boiler men and energy consultants. Legislation is essential for the support of the full range of activities in the energy sector. Research and Development activities must back up the development of the sector. Pilot projects can illuminate the savings potential. The production of technical equipment for control and metering and production of insulation materials must be promoted. (AB)

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

Science.gov (United States)

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

2017-08-28

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

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

National Research Council Canada - National Science Library

Jaime, Richardo; Rupert, Joshua W

2007-01-01

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

Barriers to investments in energy saving technologies. Case study for the industry

NARCIS (Netherlands)

Masselink, Dirk Jan

2007-01-01

To realise future energy saving targets, the government needs to increase energy reduction rates. One option to increase energy savings is found in removing barriers to investments in cost-effective energy saving technologies. Many technologies save energ

Cost segregation of assets offers tax benefits.

Science.gov (United States)

Grant, D A

2001-04-01

A cost-segregation study is an asset-reclassification strategy that accelerates tax-depreciation deductions. By using this strategy, healthcare facility owners can lower their current income-tax liability and increase current cash flow. Simply put, certain real estate is reclassified from long-lived real property to shorter-lived personal property for depreciation purposes. Depreciation deductions for the personal property then can be greatly accelerated, thereby producing greater present-value tax savings. An analysis of costs can be conducted from either detailed construction records, when such records are available, or by using qualified appraisers, architects, or engineers to perform the allocation analysis.

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

National Research Council Canada - National Science Library

Williams, Robert J

2007-01-01

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

Financial Intermediation, House Prices and the Welfare Effects of the U.S. Great Recession

DEFF Research Database (Denmark)

Menno, Dominik Francesco; Oliviero, Tommaso

2014-01-01

drop in consumption than savers who relatively benefit from a redistribution of housing wealth during the recession. We show that the size of this redistribution mechanism would have been significantly lower if (i) mortgage spreads would have remained at the low pre-crisis levels during the recession......This paper quantifies how the welfare costs of the U.S. Great Recession are distributed across borrowing and saving U.S. households. For this purpose, we use a calibrated dynamic general equilibrium model of housing and household debt with shocks to aggregate income and shocks to the financial...... intermediation sector. The model matches the boom-bust cycle in house prices, the dynamics of household mortgage debt, and the increase in wealth inequality observed in the U.S. between 2001-2013. We find larger welfare costs of the Great Recession for borrowers than for savers. Borrowers experience a larger...

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

Science.gov (United States)

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

2018-04-01

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

Traffic-aware Elastic Optical Networks to leverage Energy Savings

DEFF Research Database (Denmark)

Turus, Ioan; Fagertun, Anna Manolova; Dittmann, Lars

2014-01-01

Because of the static nature of the deployed optical networks, large energy wastage is experienced today in production networks such as Telecom networks . With power-adaptive optical interfaces and suitable grooming procedures, we propose the design of more energy efficient transport networks....... Optical network reconfigurations are performed by GMPLS node controllers according to monitored traffic information. The investigated energy reduction strategies are simulated on two large scale transport networks (DT17 and COST37). The results show that the energy savings obtained by these strategies......-Europea n COST37 network, for both symbol-rate and modulation format adaptations significant savings are obtained . Mixed adaptation (jointly performing symbol-rate and modulation format adaptations) used together with optical grooming allows up to 4 4 % and 4 7 % power savings in DT17 and COST37 networks...

Cost-Related Medication Nonadherence and Cost-Saving Behaviors Among Patients With Glaucoma Before and After the Implementation of Medicare Part D.

Science.gov (United States)

Blumberg, Dana M; Prager, Alisa J; Liebmann, Jeffrey M; Cioffi, George A; De Moraes, C Gustavo

2015-09-01

Understanding factors that lead to nonadherence to glaucoma treatment is important to diminish glaucoma-related disability. To determine whether the implementation of the Medicare Part D prescription drug benefit affected rates of cost-related nonadherence and cost-reduction strategies in Medicare beneficiaries with and without glaucoma and to evaluate associated risk factors for such nonadherence. Serial cross-sectional study using 2004 to 2009 Medicare Current Beneficiary Survey data linked with Medicare claims. Coding to extract data started in January 2014 and analyses were performed between September and November of 2014. Participants were all Medicare beneficiaries, including those with a glaucoma-related diagnosis in the year prior to the collection of the survey data, those with a nonglaucomatous ophthalmic diagnosis in the year prior to the collection of the survey data, and those without a recent eye care professional claim. Effect of the implementation of the Medicare Part D drug benefit. The change in cost-related nonadherence and the change in cost-reduction strategies. Between 2004 and 2009, the number of Medicare beneficiaries with glaucoma who reported taking smaller doses and skipping doses owing to cost dropped from 9.4% and 8.2% to 2.7% (P cost did not improve in the same period (3.4% in 2004 and 2.1% in 2009; P = .12). After Part D, patients with glaucoma had a decrease in several cost-reduction strategies, namely price shopping (26.2%-15.2%; P cost-related nonadherence measures were female sex, younger age, lower income (implementation of Part D, there was a decrease in the rate that beneficiaries with glaucoma reported engaging in cost-saving measures. Although there was a decline in the rate of several cost-related nonadherence behaviors, patients reporting failure to fill prescriptions owing to cost remained stable. This suggests that efforts to improve cost-related nonadherence should focus both on financial hardship and medical

Energy saving estimation on radiation process

International Nuclear Information System (INIS)

Kaneko, Hideaki; Maekawa, H.; Ito, Y.; Nishikawa, I.; Fujii, H.; Murata, K.

1982-01-01

When the quantity of paint used for industrial coating is assumed to be 420,000 tons, it is estimated that the area being coated is 2.8 billion m 2 , the petroleum required for pretreatment steam, drying and baking is 1.68 million tons, and the required amount of energy saving is 120,000 tons per year in terms of petroleum. The authors examined how the adoption of electron beam curing for surface coating contributes to the energy saving. So far, it has been said that electron beam curing is more efficient than thermal or light curing in energy consumption, but the premise condition was not clear. The theoretical energy requirement for thermal curing, light curing and electron beam curing was calculated and compared. The comparison of the measured values was also performed. The amount of energy required for thermal curing, UV light curing and electron beam curing was roughly 100:10:1, and the cost of energy for them was 50:5:1. In spite of the large merit of electron beam curing, it has not spread as expected, because of the repayment cost of the facility and the cost of inert gas required for the process. Energy saving is brought about by electron beam curing, but the overall cost must be examined case by case. (Kako, I.)

Medical savings accounts make waves.

Science.gov (United States)

Gardner, J

1995-02-27

MSAs: the theory. Medical savings account legislation would allow consumers to set aside pre-tax dollars to pay for day-to-day healthcare costs. The accounts are to be backed up by a catastropic policy with a deductible roughly equal to the maximum amount allowed in the MSA. The aim is to reduce healthcare cost inflation by making consumers more aware of the costs of healthcare than they are under comprehensive policies and enabling them to shop for the lowest-cost, highest-quality care.

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

Science.gov (United States)

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

2003-09-01

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

Options for Water, Energy and Chemical Savings for Finitex, Cape Town

DEFF Research Database (Denmark)

Schneider, Zsig; Wenzel, Henrik

An analysis of the options identified for saving of water, energy and chemicals was conducted at Finitex, Cape Town on the 18th October 2002. Cost savings were calculated from an estimation of the reduction in cost of water, energy and chemical usage associated with various interventions. Capital...

Incorporating Non-energy Benefits into Energy Savings Performance Contracts

Energy Technology Data Exchange (ETDEWEB)

Larsen, Peter; Goldman, Charles; Gilligan, Donald; Singer, Terry

2012-06-01

This paper evaluates the issue of non-energy benefits within the context of the U.S. energy services company (ESCO) industry?a growing industry comprised of companies that provide energy savings and other benefits to customers through the use of performance-based contracting. Recent analysis has found that ESCO projects in the public/institutional sector, especially at K-12 schools, are using performance-based contracting, at the behest of the customers, to partially -- but not fully -- offset substantial accumulated deferred maintenance needs (e.g., asbestos removal, wiring) and measures that have very long paybacks (roof replacement). This trend is affecting the traditional economic measures policymakers use to evaluate success on a benefit to cost basis. Moreover, the value of non-energy benefits which can offset some or all of the cost of the non-energy measures -- including operations and maintenance (O&M) savings, avoided capital costs, and tradable pollution emissions allowances-- are not always incorporated into a formal cost-effectiveness analysis of ESCO projects. Nonenergy benefits are clearly important to customers, but state and federal laws that govern the acceptance of these types of benefits for ESCO projects vary widely (i.e., 0-100percent of allowable savings can come from one or more non-energy categories). Clear and consistent guidance on what types of savings are recognized in Energy Savings agreements under performance contracts is necessary, particularly where customers are searching for deep energy efficiency gains in the building sector.

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

International Nuclear Information System (INIS)

Sharma, V.; Kalsi, M.S.

2005-01-01

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

Energy savings in Polish buildings

Energy Technology Data Exchange (ETDEWEB)

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

1995-12-31

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

Principles of valuing business travel time savings

OpenAIRE

Fowkes, A.S.

2001-01-01

OVERVIEW\\ud \\ud There are two approaches to valuing travel time savings to business people. The first is that which has formed the basis of UK policy for about 30 years, and which is set out in Section 2. This takes the value of travel time savings on employer’s business as equal to the gross wage rate plus an allowance for other costs that the employer saves. These might include such things as desk space, computer, tools, uniform, protective clothing, travel expenses. These were investigated...

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

Science.gov (United States)

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

1979-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Polczer, S.; Marsters, S.

1999-10-01

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

Estimate of Cost-Effective Potential for Minimum Efficiency Performance Standards in 13 Major World Economies Energy Savings, Environmental and Financial Impacts

Energy Technology Data Exchange (ETDEWEB)

Letschert, Virginie E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Bojda, Nicholas [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ke, Jing [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McNeil, Michael A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2012-07-01

This study analyzes the financial impacts on consumers of minimum efficiency performance standards (MEPS) for appliances that could be implemented in 13 major economies around the world. We use the Bottom-Up Energy Analysis System (BUENAS), developed at Lawrence Berkeley National Laboratory (LBNL), to analyze various appliance efficiency target levels to estimate the net present value (NPV) of policies designed to provide maximum energy savings while not penalizing consumers financially. These policies constitute what we call the “cost-effective potential” (CEP) scenario. The CEP scenario is designed to answer the question: How high can we raise the efficiency bar in mandatory programs while still saving consumers money?

The use of generic drugs in prevention of chronic disease is far more cost-effective than thought, and may save money.

Science.gov (United States)

Shrank, William H; Choudhry, Niteesh K; Liberman, Joshua N; Brennan, Troyen A

2011-07-01

In this article we highlight the important role that medication therapy can play in preventing disease and controlling costs. Focusing on coronary artery disease, we demonstrate that prevention, with the appropriate use of generic medications, appears far more cost-effective than previously documented, and it may even save on costs. For example, an earlier study estimated that reducing blood pressure to widely established clinical guidelines in nondiabetic patients cost an estimated $52,983 per quality-adjusted life-year if a brand-name drug was used. However, we estimate that the cost is just $7,753 per quality-adjusted life-year at generic medication prices. As the nation attempts to find strategies to improve population health without adding to the unsustainably high cost of care, policy makers should focus on ensuring that patients have access to essential generic medications.

What actions in the domain of energy saving?

International Nuclear Information System (INIS)

Gourlia, J.P.; Richard, P.

2007-01-01

The energy saving potentialities are very often put forward to justify actions of mastery of energy demand. What are the possible substitutes and their result in terms of energy saving? What are the tools implemented and the services proposed by energy suppliers to end-users? What is the optimum mix between the regulatory measures and the market instruments to perform energy saving? What are the costs generated by such measures with respect to the expected results? How to sensibilize citizens to energy saving actions? These questions were debated during a round table which gathered 4 participants and two chairmen. (J.S.)

Heat Saving Strategies in Sustainable Smart Energy Systems

DEFF Research Database (Denmark)

Lund, Henrik; Thellufsen, Jakob Zinck; Aggerholm, Søren

that a least‐cost strategy will be to provide approximately 2/3 of the heat demand from district heating and the rest from individual heat pumps. Keywords: Energy Efficiency, Renewable energy, Heating strategy, Heat savings, District heating, Smart energy......One of the important issues related to the implementation of future sustainable smart energy systems based on renewable energy sources is the heating of buildings. Especially, when it comes to long‐term investment in savings and heating infrastructures it is essential to identify long‐term least......‐cost strategies. With Denmark as a case, this paper investigates to which extent heat should be saved rather than produced and to which extent district heating infrastructures, rather than individual heating solutions, should be used. Based on a concrete proposal to implement the Danish governmental long...

Impact of five years of rotavirus vaccination in Finland - And the associated cost savings in secondary healthcare.

Science.gov (United States)

Leino, Tuija; Baum, Ulrike; Scott, Peter; Ollgren, Jukka; Salo, Heini

2017-10-09

This study aimed to estimate the impact of the national rotavirus (RV) vaccination programme, starting 2009, on the total hospital-treated acute gastroenteritis (AGE) and severe RV disease burden in Finland during the first five years of the programme. This study also evaluated the costs saved in secondary healthcare by the RV vaccination programme. The RV related outcome definitions were based on ICD10 diagnostic codes recorded in the Care Register for Health Care. Incidences of hospitalised and hospital outpatient cases of AGE (A00-A09, R11) and RVGE (A08.0) were compared prior (1999-2005) and after (2010-2014) the start of the programme among children less than five years of age. The reduction in disease burden in 2014, when all children under five years of age have been eligible for RV vaccination, was 92.9% (95%CI: 91.0%-94.5%) in hospitalised RVGE and 68.5% (66.6%-70.3%) in the total hospitalised AGE among children less than five years of age. For the corresponding hospital outpatient cases, there was a reduction of 91.4% (82.4%-96.6%) in the RVGE incidence, but an increase of 6.3% (2.7%-9.9%) in the AGE incidence. The RV vaccination programme prevented 2206 secondary healthcare AGE cases costing €4.5 million annually. As the RV immunisation costs were €2.3 million, the total net savings just in secondary healthcare costs were €2.2 million, i.e. €33 per vaccinated child. The RV vaccination programme clearly controlled the severe, hospital-treated forms of RVGE. The total disease burden is a more valuable end point than mere specifically diagnosed cases as laboratory confirmation practises usually change after vaccine introduction. The RV vaccination programme annually pays for itself at least two times over. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

Science.gov (United States)

Wright, Trevor

2011-02-01

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

Energy Saving in an ETC Solar System to Produce High Temperature Water

Directory of Open Access Journals (Sweden)

Carlos J. Porras-Prieto

2018-04-01

Full Text Available The use of solar water heating systems (SWHS based on evacuated tube collectors (ETC has experienced rapid growth in the residential sector. In contrast, the implementation of these systems in the industrial sector is very limited, due in part to the demand of a higher temperature in water. Taking into account that the final energy of the industrial sector is similar to the residential sector, to increase the generation of renewable energy and energy saving in cities, efforts in this sector should be redoubled. Therefore, the present work characterises the behaviour of a SWHS-ETC with active circulation to produce hot water at 90 °C, determining its performance, energy saving and profitability in different scenarios in Europe. The annual energy savings generated by the SWHS Range between 741 and 435 kWh m−2 (reduction of emissions between 215 and 88 kg CO2 m−2. The results of the analysis of profitability, studying the variation of the conventional energy price, the cost of the investment, the useful life and the energy supplied, in thousands of scenarios, are a valuable tool for correct decision making, as they can be of great utility to increase the implementation of these systems in the industrial sector.

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

OpenAIRE

Anna Maria Jeszka

2015-01-01

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

PENENTUAN RUTE TRANSPORTASI TERPENDEK UNTUK MEMINIMALKAN BIAYA MENGGUNAKAN METODE SAVING MATRIKS

Directory of Open Access Journals (Sweden)

Noer Ikfan

2013-12-01

Full Text Available This paper presents a case study of vehicle routing problem at CV. Boang Shutlecocok which is engaged in the distribution of Shutlecock. To fulfill market demand, The company operates to transmit Shutlecock to every distributors throughout the eastern Java. Because of Shutlecock distribution is from warehouse to distributors and every distribution are quite far from the warehouse, so that causing the distribution cost incurred by CV. Boang Shuttlecock increased. In this study a method to implement VRP (Vehicle Routing Problem based on saving matrix, in which the method will provide the shortest route to minimize costs, distance and minimizing distribution time spent by the company. Before the implementation of saving matrix method on the company, total distribution costs incurred by the company amounted to Rp.5,882,771/period, after the VRP method applied, obtained a total cost of Rp.5,239,003/period, in order to obtain the distribution cost savings per period of Rp.643,764 or approximately 10.94%.

Cost-benefit of energy saving in bioclimatic designs; Costo-beneficio del ahorro de energia en los disenos bioclimatios

Energy Technology Data Exchange (ETDEWEB)

Lopez P, J. Manuel A. [Doble dos soluciones de Negocios (Mexico); Morillon G, David; Rdriguez V, Luis [Universidad Autonoma de Mexico (Mexico)

2001-06-01

Tools and criteria for Cost-Benefit Analysis (ACB) of energy saving in bioclimatic designs (DB) are presented, for which a reference project is established. Based on the traditional design of air conditioning of a building and with the support of this one, the estimation of costs and benefits of the same building is made; but with passive systems. The tools used consider related resources such as time and money. Criteria are used such as: Present value (VP), Equivalent Annual Cost (EAC) and the Cost of the conserved Energy (CEC). The costs related to the construction, maintenance and operation of the design are taken into consideration. The differences between the design of reference and the Bioclimatic Design, established from the application of these criteria, allow evaluating the economic margin as far as operation and maintenance. Finally, the cost of the conserved energy of the bioclimatic measures is evaluated as an initiative for energy saving and calculates the present value from them in all of the period of useful life of the bioclimatic design. [Spanish] Se presentan herramientas y criterios para el analisis Costo-Beneficio (ACB) del ahorro de energia en los disenos bioclimaticos (DB), para lo cual se establece un proyecto de referencia. Basado en el diseno tradicional de la climatizacion de un edificio y con apoyo en este, se realiza la estimacion de costos y beneficios del mismo edificio; pero con sistema pasivos. Las herramientas usadas consideran recursos relacionados como son tiempo y dinero. Se usan criterios tales como: Valor Presente (VP), Costo Anual Equivalente (CAE) y el Costo de la Energia conservada (CEC). Se toman en consideracion los costos relacionados con la construccion, mantenimiento y operacion del diseno. Las diferencias entre el diseno de referencia y el Diseno Bioclimatico, establecidas a partir de la aplicacion de estos criterios, permiten evaluar el margen economico en cuanto a la operacion y el mantenimiento. Finalmente, se

Economics of a small wind pump system based on estimated petrol and diesel cost savings from use in Northern Nigeria

Directory of Open Access Journals (Sweden)

C. J. Ejieji

2013-08-01

Full Text Available Eleven years of daily wind records were analyzed for the estimation of available wind energy for water pumping at three selected locations in Northern Nigeria, namely Jos, Kano and Sokoto. This formed the basis for investigating the economics of the use of an imported small wind pump under a deregulated energy market environment. The estimated available energy for water pumping at the installation height of 9m was 190 kwh/m2/yr for Jos, 225 kwh/m2/yr for Kano and 348 kwh/m2/yr for Sokoto. The monetary value of the available wind energy was considered as saved energy cost. The saved cost was obtained in terms of the unsubsidized cost of the petrol and diesel that an internal combustion engine (ICE would consume to produce energy equivalent to the available wind energy. At the prevailing interest and inflation rates of 21.96 % and 12.1% respectively, and unsubsidized prices of N 131.32/l and N 140.23/l for petrol and diesel respectively, investment in the wind pump was not found to be economically competitive relative to using a pump with ICE prime mover at the three locations unless the cost of the pump was subsidized. For Sokoto, the estimated subsidy for initial cost of the wind pump required for the investment to be competitive relative to the use of a pump driven by a petrol ICE was 16%. Relative to a pump driven by a diesel ICE, the required subsidy was 24%. The corresponding subsidy estimates for Kano were 48 % and 51 % respectively. For Jos, it was 56% relative to the use of a pump driven by a petrol ICE and 60 % relative to that driven by a diesel ICE. Considering the potential environmental and social and environmental benefits however, subsidy support by government for local manufacturing of the pumps was recommended since shipping cost and custom tariff constituted over 36% of the initial cost of the wind pump.

Resource-saving policy in the context of technological updating of ferroalloy production

Directory of Open Access Journals (Sweden)

Yelena Anatolyevna Pozdnyakova

2011-06-01

Full Text Available This paper substantiates the need for technological modernization of ferroalloy production which should be based on energy- and resource-saving technologies. Lean-technology is considered as a tool for effective management of material costs organization. A search algorithm for ways to improve the manufacturing process of a company, with which usage the author suggests a number of areas that require optimization, was developed. Measures aimed at solving the problems of resource-saving at JSC "Klyuchevsky Ferroalloy Plant" were proposed: introduction of resource saving technologies, suggesting involvement in the production of non-liquid products and the use of process waste and upgrading of individual processes. As a result of the proposed activities, tangible results have been achieved: reducing production costs, saving raw materials, reducing storage costs and release of additional areas, decrease of production losses.

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

Science.gov (United States)

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

2017-06-01

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

[Electronic versus paper-based patient records: a cost-benefit analysis].

Science.gov (United States)

Neubauer, A S; Priglinger, S; Ehrt, O

2001-11-01

The aim of this study is to compare the costs and benefits of electronic, paperless patient records with the conventional paper-based charts. Costs and benefits of planned electronic patient records are calculated for a University eye hospital with 140 beds. Benefit is determined by direct costs saved by electronic records. In the example shown, the additional benefits of electronic patient records, as far as they can be quantified total 192,000 DM per year. The costs of the necessary investments are 234,000 DM per year when using a linear depreciation over 4 years. In total, there are additional annual costs for electronic patient records of 42,000 DM. Different scenarios were analyzed. By increasing the time of depreciation to 6 years, the cost deficit reduces to only approximately 9,000 DM. Increased wages reduce the deficit further while the deficit increases with a loss of functions of the electronic patient record. However, several benefits of electronic records regarding research, teaching, quality control and better data access cannot be easily quantified and would greatly increase the benefit to cost ratio. Only part of the advantages of electronic patient records can easily be quantified in terms of directly saved costs. The small cost deficit calculated in this example is overcompensated by several benefits, which can only be enumerated qualitatively due to problems in quantification.

10 CFR 436.21 - Savings-to-investment ratio.

Science.gov (United States)

2010-01-01

... is the ratio of the present value savings to the present value costs of an energy or water conservation measure. The numerator of the ratio is the present value of net savings in energy or water and non... conservation measure. The denominator of the ratio is the present value of the net increase in investment and...

Empirical Study on Annual Energy-Saving Performance of Energy Performance Contracting in China

Directory of Open Access Journals (Sweden)

Hongquan Ruan

2018-05-01

Full Text Available A lack of trust in Energy Service Company (ESCo is the most critical factor affecting the development of Energy Performance Contracting (EPC in China, compared with other constraints. One cannot easily estimate the energy-saving performance of an EPC project. Under that condition, lack of trust may cause the Energy-Consuming Unit (ECU to suspect the energy-saving performance promised by the ESCo, thus leaving potentially profitable projects without necessary funding. Currently, specific studies taking an across-projects viewpoint on annual energy-saving performance of EPC projects in multiple subsectors, objectively and quantitatively, are lacking. This paper studies the regression relationships of annual energy-saving quantity in terms of revamping cost and the regression relationships of annual cost saving in terms of revamping cost. The regression results show that there are statistically significant correlations in the above relationships in the nine subsectors investigated. This is significant for ESCos and ECUs, because knowledge on energy-saving performance could contribute to EPC investment decisions and trust relationships between ESCos and ECUs. Then, a multiple linear regression model of revamping cost is set up to analyze its influencing factors. The model indicates that the subsector the sample belongs to, financing, registered capital of the ESCo, and contract period have significant effects on revamping cost. Thus, policy implications regarding innovation of EE promotion technology, clarifying ESCos’ exit mechanism, innovation of financing mechanism, and improving the market credit environment for promoting investment in EPC projects, are provided.

The Model For Linking Savings And Credit Groups With Banks In ...

African Journals Online (AJOL)

The linkage program will greatly be enhanced if the design of the linkage encourages joint liability in loan repayment and if the savings instrument is adequately flexible such that groups can use part of the mandatory savings to repay loans when group income falls short of the group's financial obligations. Key Words: ...

Energy Smart Guide to Campus Cost Savings: Today's Trends in Project Finance, Clean Fuel Fleets, Combined Heat& Power, Emissions Markets

Energy Technology Data Exchange (ETDEWEB)

2003-07-01

The Energy Smart Guide to Campus Cost Savings covers today's trends in project finance, combined heat& power, clean fuel fleets and emissions trading. The guide is directed at campus facilities and business managers and contains general guidance, contact information and case studies from colleges and universities across the country.

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

International Nuclear Information System (INIS)

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

2015-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

Galitsky, Christina; Worrell, Ernst; Galitsky, Christina

2008-01-01

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

Do kidney transplantations save money? A study using a before-after design and multiple register-based data from Sweden.

Science.gov (United States)

Jarl, Johan; Desatnik, Peter; Peetz Hansson, Ulrika; Prütz, Karl Göran; Gerdtham, Ulf-G

2018-04-01

The health care costs of kidney transplantation and dialysis are generally unknown. This study estimates the Swedish health care costs of kidney transplantation and dialysis over 10 years from a health care perspective. A before-after design was used, in which the patients served as their own controls. Health care costs the year before transplantation were assumed to continue in the absence of a transplant and the cost savings was therefore calculated as the difference between the expected costs and the actual costs during the 10-year follow-up period. Factors associated with the size of the cost savings were studied using ordinary least-squares regression. Altogether 66-79% of the expected health care costs over 10 years were avoided through kidney transplantation, resulting in a cost savings of €380 000 (2012 price-year) per patient. Savings were the highest for successful transplantations, but on average the treatment was cost-saving also for patients who returned to dialysis. No gender or age differences could be found, with the exception of a higher cost of transplantation for children and a generally higher cost for younger compared with older patients on dialysis. A negative association was also found between age at the time of transplantation and the size of the cost savings for the younger part of the sample. Kidney transplantations have led to substantial cost savings for the Swedish health care system. An increase in donated kidneys has the potential to further reduce the cost of renal replacement therapy.

Should the decline in the personal saving rate be a cause for concern?

OpenAIRE

C. Alan Garner

2006-01-01

The personal saving rate has received particular attention recently because saving was negative in 2005 for the first time since the Great Depression. Although saving declined in other developed countries during this period, the U.S. decline was more pronounced than in most of these countries. ; A major concern is whether U.S. households are providing adequately for long-term needs, such as future retirement and medical expenses. In addition, low personal saving has created short-run concerns...

The Energy Savings and Environmental Benefits for Small and Medium Enterprises by Cloud Energy Management System

Directory of Open Access Journals (Sweden)

Yen-Chieh Tseng

2016-06-01

Full Text Available Small and medium enterprises (SMES play an important role in Taiwan’s economy. The reduction of energy costs and carbon dioxide (CO2 emissions are critical to preserving the environment. This paper uses the experimental results from 65 sites, gathered over two years since 2012, to determine how the integration of Internet communication, cloud computing technologies and a cloud energy management service (cloud EMS can reduce energy consumption by cost-effective means. The EMS has three levels: infrastructure as a service (IaaS, platform as a service (PaaS and software as a service (SaaS. Working jointly with ChungHwa Telecom, Taiwan’s leading telecom service provider, data from detection devices, control devices, air-conditioning and lighting systems are all uploaded to a cloud EMS platform, to give a so called intelligent energy management network application service platform (IEN-ASP. Various energy saving management functions are developed using this platform: (1 air conditioning optimization; (2 lighting system optimization; (3 scheduling control; (4 power billing control and (5 occupancy detection and timing control. Using the international performance measurement and verification protocol (IPMVP, the energy used at the test sites, before and after the use of the IEN-ASP, are compared to calculate the energy saved. The experimental results show that there is an average energy saving of 5724 kWh per year, which represents a saving ratio of 5.84%. This translates to a total reduction in CO2 emissions of 9,926,829 kg per year. Using the data collected, a regression model is used to demonstrate the correlation between the power that is consumed, the energy that is saved and the area of the sites. Another interesting result is that, if the experimental sites are maintained by experienced electricians or other personnel and EMS protocols are followed, the energy saving can be as great as 6.59%.

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

Science.gov (United States)

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

2016-09-01

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

Great hammerhead sharks swim on their side to reduce transport costs.

Science.gov (United States)

Payne, Nicholas L; Iosilevskii, Gil; Barnett, Adam; Fischer, Chris; Graham, Rachel T; Gleiss, Adrian C; Watanabe, Yuuki Y

2016-07-26

Animals exhibit various physiological and behavioural strategies for minimizing travel costs. Fins of aquatic animals play key roles in efficient travel and, for sharks, the functions of dorsal and pectoral fins are considered well divided: the former assists propulsion and generates lateral hydrodynamic forces during turns and the latter generates vertical forces that offset sharks' negative buoyancy. Here we show that great hammerhead sharks drastically reconfigure the function of these structures, using an exaggerated dorsal fin to generate lift by swimming rolled on their side. Tagged wild sharks spend up to 90% of time swimming at roll angles between 50° and 75°, and hydrodynamic modelling shows that doing so reduces drag-and in turn, the cost of transport-by around 10% compared with traditional upright swimming. Employment of such a strongly selected feature for such a unique purpose raises interesting questions about evolutionary pathways to hydrodynamic adaptations, and our perception of form and function.

Electric power production contra electricity savings

International Nuclear Information System (INIS)

Schleisner, L.; Grohnheit, P.E.; Soerensen, H.

1991-01-01

The expansion of electricity-producing plants has, in Denmark until now, taken place in accordance with the demand for electricity. Recently, it has been suggested that the cost of the further development of such systems is greater than the cost of instigating and carrying out energy conservation efforts. The aim of the project was to evaluate the consequences for power producing plants of a reduction of the electricity consumption of end-users. A method for the analysis of the costs involved in the system and operation of power plants contra the costs that are involved in saving electricity is presented. In developing a model of this kind, consideration is given to the interplay of the individual saving project and the existing or future electricity supply. Thus it can be evaluated to what extent it would be advisable to substitute investments in the development of the capacity of the power plants with investments in the reduction of electricity consumption by the end users. This model is described in considerable detail. It will be tested in representative situations and locations throughout the Nordic countries. (AB) 17 refs

Opportunities of energy saving in lighting systems for public buildings

Directory of Open Access Journals (Sweden)

Ayman Abd El-khalek

2017-03-01

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

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

Science.gov (United States)

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

2015-05-01

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

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

Directory of Open Access Journals (Sweden)

Marta Córdoba

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

Freshwater savings from marine protein consumption

International Nuclear Information System (INIS)

Gephart, Jessica A; Pace, Michael L; D’Odorico, Paolo

2014-01-01

Marine fisheries provide an essential source of protein for many people around the world. Unlike alternative terrestrial sources of protein, marine fish production requires little to no freshwater inputs. Consuming marine fish protein instead of terrestrial protein therefore represents freshwater savings (equivalent to an avoided water cost) and contributes to a low water footprint diet. These water savings are realized by the producers of alternative protein sources, rather than the consumers of marine protein. This study quantifies freshwater savings from marine fish consumption around the world by estimating the water footprint of replacing marine fish with terrestrial protein based on current consumption patterns. An estimated 7 600 km 3  yr −1 of water is used for human food production. Replacing marine protein with terrestrial protein would require an additional 350 km 3  yr −1 of water, meaning that marine protein provides current water savings of 4.6%. The importance of these freshwater savings is highly uneven around the globe, with savings ranging from as little as 0 to as much as 50%. The largest savings as a per cent of current water footprints occur in Asia, Oceania, and several coastal African nations. The greatest national water savings from marine fish protein occur in Southeast Asia and the United States. As the human population increases, future water savings from marine fish consumption will be increasingly important to food and water security and depend on sustainable harvest of capture fisheries and low water footprint growth of marine aquaculture. (paper)

Administrative waste in the U.S. health care system in 2003: the cost to the nation, the states, and the District of Columbia, with state-specific estimates of potential savings.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie; Wolfe, Sidney M

2004-01-01

This report provides nationwide and state-specific estimates of U.S. health care administration spending and potential savings in 2003 were the United States to institute a Canadian-style national health insurance system. The United States wastes more on health care bureaucracy than it would cost to provide health care to all its uninsured. Administrative expenses will consume at least dollar 399.4 billion of a total health expenditure of dollar 1,660.5 billion in 2003. Streamlining administrative overhead to Canadian levels would save approximately dollar 286.0 billion in 2003, dollar 6,940 for each of the 41.2 million Americans who were uninsured as of 2001. This is substantially more than would be needed to provide full insurance coverage. The cost of excess health bureaucracy in individual states is equally striking. For example, Massachusetts, with 560,000 uninsured state residents, could save about dollar 8,556 million in 2003 (dollar 16,453 per uninsured resident of that state) if it streamlined administration to Canadian levels. New Mexico, with 373,000 uninsured, could save dollar 1,500 million on health bureaucracy (dollar 4,022 per uninsured resident). Only a single-payer national health insurance system could garner these massive administrative savings, allowing universal coverage without any increase in total health spending. Because incremental reforms necessarily preserve the current fragmented and duplicative payment structure, they cannot achieve significant bureaucratic savings.

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

International Nuclear Information System (INIS)

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

2007-01-01

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

The value of retrofitting carbon-saving measures into fuel poor social housing

International Nuclear Information System (INIS)

Jenkins, D.P.

2010-01-01

With current fuel poverty and carbon-saving policies continuing to miss their targets in the UK, the synergy between the two problems is investigated to highlight an approach that could be mutually beneficial. Focussing on the 550,000 fuel poor socially housed dwellings in the UK, costs of between Pounds 3.9 and Pounds 17.5 bn are estimated as the required capital investment for achieving deep-cut carbon savings (defined as at least 50%) across this section of the housing stock, with a potential total annual carbon saving of 1.7 MtCO 2 . It is assumed that such costs would be largely (or totally) state-funded, though additional private investment could clearly increase the possible carbon savings across this section of the stock. The use of these socially housed fuel poor dwellings as low-carbon exemplars is discussed, and benefits for the private housing sector are postulated. The study also focuses on the problem of installing non-cost effective measures, i.e. technologies that would not currently be encouraged by existing subsidy schemes, but which might be necessary for achieving large carbon-saving targets.

Economic feasibility of sail power devices on Great Lakes bulk carriers

Energy Technology Data Exchange (ETDEWEB)

1982-03-24

Progress is reported in a project to determine whether retro-fitting existing Great Lakes bulk carriers with auxiliary sail powering devices is economically feasible. The approach being used is to apply known technology both in terms of sail devices and calculation methods to determine the amount of fuel that can be saved and the probable cost of the sail device. Progress includes the identification and collection of data needed to determine the state of the art as well as to model the problem. Several sail powering devices were compared and an unstayed cat rig was chosen for further analysis and its performance characteristics were incorporated into a computer model, which is flow charted. (LEW)

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-04-01

The U.S. Department of Energy’s Vehicle Technologies Office, Materials area commissioned a study to model and assess manufacturing economics of alternative design and production strategies for a series of lightweight vehicle concepts. The strategic targets were a 40% and a 45% mass reduction relative to a standard North American midsize passenger sedan at an effective cost of $3.42 per pound (lb) saved. The baseline vehicle was an average of several available vehicles in this class. Mass and cost breakdowns from several sources were used, including original equipment manufacturers’ (OEMs’) input through U.S. Department of Energy’s Vehicle Technologies Office programs and public presentations, A2Mac1 LLC’s teardown information, Lotus Engineering Limited and FEV, Inc. breakdowns in their respective lightweighting studies, and IBIS Associates, Inc.’s decades of experience in automotive lightweighting and materials substitution analyses. Information on lightweighting strategies in this analysis came from these same sources and the ongoing U.S. Department of Energy-funded Vehma International of America, Inc. /Ford Motor Company Multi-Material Lightweight Prototype Vehicle Demonstration Project, the Aluminum Association Transportation Group, and many United States Council for Automotive Research’s/United States Automotive Materials Partnership LLC lightweight materials programs.

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

Energy Technology Data Exchange (ETDEWEB)

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

2003-09-01

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

Pragmatic and cost efficient D and D

Energy Technology Data Exchange (ETDEWEB)

Morris, M. [Nuclear Fuel Services, Erwin, TN (United States)

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail.

Pragmatic and cost efficient D and D

International Nuclear Information System (INIS)

Morris, M.

1998-03-01

A great deal of effort is expended by remediation professionals in the pursuit of new technologies to assist them in performing their tasks more efficiently. These individuals understand the cost savings associated with volume reduction and waste minimization and routinely incorporate these practices into their planning. However, the largest cost component on many D and D projects is labor. Increasing the efficiency of work force utilization is frequently the most overlooked technique that can be instituted and which can easily offer major cost savings. Granted, some D and D jobs require highly specialized tools and equipment which are quite expensive. Decreasing these costs is often not an option or will yield minimal results. Conversely, the increase in worker efficiency can usually decrease costs dramatically. During the performance of the Safe Shutdown Project at the Fernald Environmental Management Project (the Fernald site), a process improvement initiative was instituted in support of the development of the Ten Year Plan. Costs associated with the removal of hundreds of thousands of pounds of nuclear material from formerly utilized equipment piping, and ductwork in nuclear facilities at the Fernald site were analyzed. This analysis indicated that the labor component was large enough to merit further inspection. A new approach to the activities was instituted and the results were significant. A macroscopic overview of all work activities utilized work evolution control (sequencing), building segmentation, and efficient use of engineering controls to streamline the D and D process. Overall costs on the first facility were reduced by over 20%. The increased labor efficiency resulted in decreased Personal Protective Equipment costs for field personnel. This approach will be discussed in detail

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

Science.gov (United States)

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

2013-01-01

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

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

Science.gov (United States)

Chen, Chih-Sheng; Lee, Da-Sheng

2011-01-01

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

A cost-saving statistically based screening technique for focused sampling of a lead-contaminated site

International Nuclear Information System (INIS)

Moscati, A.F. Jr.; Hediger, E.M.; Rupp, M.J.

1986-01-01

High concentrations of lead in soils along an abandoned railroad line prompted a remedial investigation to characterize the extent of contamination across a 7-acre site. Contamination was thought to be spotty across the site reflecting its past use in battery recycling operations at discrete locations. A screening technique was employed to delineate the more highly contaminated areas by testing a statistically determined minimum number of random samples from each of seven discrete site areas. The approach not only quickly identified those site areas which would require more extensive grid sampling, but also provided a statistically defensible basis for excluding other site areas from further consideration, thus saving the cost of additional sample collection and analysis. The reduction in the number of samples collected in ''clean'' areas of the site ranged from 45 to 60%

Assessment of compliance costs resulting from implementation of the proposed Great Lakes water quality guidance

International Nuclear Information System (INIS)

Fenner, K.; Podar, M.; Snyder, B.

1993-01-01

The primary purpose of the study was to develop an estimate of the incremental cost to direct dischargers resulting from the implementation of the proposed Great Lakes Water Quality Guidance (GLWQG). This estimate reflects the incremental cost of complying with permit requirements developed using the Implementation Procedures and water quality criteria proposed in the GLWQG versus permit requirements based on existing State water quality standards. Two secondary analyses were also performed, one to develop a preliminary estimate of the costs that would be incurred by indirect dischargers to publicly owned treatment works (POTWs), and another to evaluate the cost-effectiveness of the GLWQG. Finally, several sensitivity analyses were performed to evaluate the impact of several major assumptions on the estimated compliance costs. To estimate compliance costs, permit limitations and conditions based on existing State water quality standards were compared to water quality-based limitations and conditions based on the proposed GLWQG criteria and Implementation Procedures for a sample of plants. The control measures needed to comply with the proposed GLWQG-based effluent limitations were evaluated. Individual plant compliance costs were estimated for these control measures based on information on treatment technology and cost analyses available in the literature. An overall compliance cost was projected from the sample based on statistical methods

A CLS-based survivable and energy-saving WDM-PON architecture

Science.gov (United States)

Zhu, Min; Zhong, Wen-De; Zhang, Zhenrong; Luan, Feng

2013-11-01

We propose and demonstrate an improved survivable and energy-saving WDM-PON with colorless ONUs. It incorporates both energy-saving and self-healing operations. A simple effective energy-saving scheme is proposed by including an energy-saving control unit in the OLT and a control unit at each ONU. The energy-saving scheme realizes both dozing and sleep (offline) modes, which greatly improves the energy-saving efficiency for WDM-PONs. An intelligent protection switching scheme is designed in the OLT, which can distinguish if an ONU is in dozing/sleep (offline) state or a fiber is faulty. Moreover, by monitoring the optical power of each channel on both working and protection paths, the OLT can know the connection status of every fiber path, thus facilitating an effective protection switching and a faster failure recovery. The improved WDM-PON architecture not only significantly reduces energy consumption, but also performs self-healing operation in practical operation scenarios. The scheme feasibility is experimentally verified with 10 Gbit/s downstream and 1.25 Gbit/s upstream transmissions. We also examine the energy-saving efficiency of our proposed energy-saving scheme by simulation, which reveals that energy saving mainly arises from the dozing mode, not from the sleep mode when the ONU is in the online state.

Effects of heat and electricity saving measures in district-heated multistory residential buildings

International Nuclear Information System (INIS)

Truong, Nguyen Le; Dodoo, Ambrose; Gustavsson, Leif

2014-01-01

Highlights: • We analyzed the potential for energy savings in district heated buildings. • Measures that reduce more peak load production give higher primary energy savings. • Efficient appliances increase heat demand but give net primary energy savings. • Efficient appliances give the largest net primary energy savings. - Abstract: The effects of heat and electricity saving measures in district-heated buildings can be complex because these depend not only on how energy is used on the demand side but also on how energy is provided from the supply side. In this study, we analyze the effects of heat and electricity saving measures in multistory concrete-framed and wood-framed versions of an existing district-heated building and examine the impacts of the reduced energy demand on different district heat (DH) production configurations. The energy saving measures considered are for domestic hot water reduction, building thermal envelope improvement, ventilation heat recovery (VHR), and household electricity savings. Our analysis is based on a measured heat load profile of an existing DH production system in Växjö, Sweden. Based on the measured heat load profile, we model three minimum-cost DH production system using plausible environmental and socio-political scenarios. Then, we investigate the primary energy implications of the energy saving measures applied to the two versions of the existing building, taking into account the changed DH demand, changed cogenerated electricity, and changed electricity use due to heat and electricity saving measures. Our results show that the difference between the final and primary energy savings of the concrete-framed and wood-framed versions of the case-study building is minor. The primary energy efficiency of the energy saving measures depends on the type of measure and on the composition of the DH production system. Of the various energy saving measures explored, electricity savings give the highest primary energy savings

Saving, efficiency and management of electric sector demand

International Nuclear Information System (INIS)

Sanchez de Tembleque, L. J.

2007-01-01

Spanish economic model of development is based on energy consumption, and its main source is imported fossil fuels, which have some environmental and scarcity consequences in the mid term, among others. These problems could be reduced in two ways: economic activity reduction or energy efficiency improvement. In the presence of these possibilities, It may be desirable to bet for saving and energy efficiency, to maintain the economic development. This assignment analyzes the main available regulatory and social mechanisms to promote saving and energy efficiency in the power sector, like systems to internalize social costs in the electricity price, efficiency standards, and encourage the new saving culture. (Author) 15 refs

Savings in its sights for Somerset Trust.

Science.gov (United States)

Russell, Colin

2011-10-01

Colin Russell, healthcare specialist at Schneider Electric (pictured), explains how the company has recently worked with Taunton and Somerset NHS Foundation Trust to implement a major energy-saving project at the Trust's Musgrove Park Hospital in Taunton. He argues that, at a time when all areas of the service are being asked to reduce costs, such partnerships can potentially save the institution millions of pounds and significantly reduce carbon emissions, while "revitalising" parts of the NHS estate, and ensuring continuity of vital hospital services for facilities managers.

The effect of handover location on trauma theatre start time: An estimated cost saving of £131 000 per year.

Science.gov (United States)

Nahas, Sam; Ali, Adam; Majid, Kiran; Joseph, Roshan; Huber, Chris; Babu, Victor

2018-02-08

The National Health Service was estimated to be in £2.45 billion deficit in 2015 to 2016. Trauma theatre utilization and efficiency has never been so important as it is estimated to cost £15/minute. Structured questionnaires were given to 23 members of staff at our Trust who are actively involved in the organization or delivery of orthopaedic trauma lists at least once per week. This was used to identify key factors that may improve theatre efficiency. Following focus group evaluation, the location of the preoperative theatre meeting was changed, with all staff involved being required to attend this. Our primary outcome measure was mean theatre start time (time of arrival in the anaesthetic room) during the 1 month immediately preceding the change and the month following the change. Theatre start time was improved on average 24 minutes (1 month premeeting and postmeeting change). This equates to a saving of £360 per day, or £131 040 per year. Changing the trauma meeting location to a venue adjacent to the trauma theatre can improve theatre start times, theatre efficiency, and therefore result in significant cost savings. Copyright © 2018 John Wiley & Sons, Ltd.

Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

Directory of Open Access Journals (Sweden)

Jörg Tomeczkowski

Full Text Available OBJECTIVES: Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategyduring elective hip and knee replacement surgery. METHODS: Individual patients (N = 50,000 were simulated based on data from controlled trials, the German DRG institute (InEK and various publications and entered into a stochastic model (Monte-Carlo of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit, pneumonia treatment (€5,000, and length of stay (€300/day. Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. RESULTS: At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. CONCLUSIONS: EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

Potential cost saving of Epoetin alfa in elective hip or knee surgery due to reduction in blood transfusions and their side effects: a discrete-event simulation model.

Science.gov (United States)

Tomeczkowski, Jörg; Stern, Sean; Müller, Alfred; von Heymann, Christian

2013-01-01

Transfusion of allogeneic blood is still common in orthopedic surgery. This analysis evaluates from the perspective of a German hospital the potential cost savings of Epoetin alfa (EPO) compared to predonated autologous blood transfusions or to a nobloodconservationstrategy (allogeneic blood transfusion strategy)during elective hip and knee replacement surgery. Individual patients (N = 50,000) were simulated based on data from controlled trials, the German DRG institute (InEK) and various publications and entered into a stochastic model (Monte-Carlo) of three treatment arms: EPO, preoperative autologous donation and nobloodconservationstrategy. All three strategies lead to a different risk for an allogeneic blood transfusion. The model focused on the costs and events of the three different procedures. The costs were obtained from clinical trial databases, the German DRG system, patient records and medical publications: transfusion (allogeneic red blood cells: €320/unit and autologous red blood cells: €250/unit), pneumonia treatment (€5,000), and length of stay (€300/day). Probabilistic sensitivity analyses were performed to determine which factors had an influence on the model's clinical and cost outcomes. At acquisition costs of €200/40,000 IU EPO is cost saving compared to autologous blood donation, and cost-effective compared to a nobloodconservationstrategy. The results were most sensitive to the cost of EPO, blood units and hospital days. EPO might become an attractive blood conservation strategy for anemic patients at reasonable costs due to the reduction in allogeneic blood transfusions, in the modeled incidence of transfusion-associated pneumonia andthe prolongedlength of stay.

ANALYSIS OF ENERGY SAVING AND ENERGY EFFICIENCY ISSUES DURING OPERATION OF THE METRO ROLLING STOCK

Directory of Open Access Journals (Sweden)

A. V. Donchenko

2016-06-01

Full Text Available Purpose.Nowadays a problem of significant power consumption of the rolling stock during its operation is a current issue. In connection with staged electricity rates increase further development of the rail electric transport, including metro rolling stock is impossible without a use of modern energy saving solutions and energy-efficient systems. To solve the specified problem it is necessary to carry out analysis of measures and determine prospective directions in energy saving and increase of energy efficiency on the metro rolling stock. Methodology. Using methods of scientific analysis, generalization, comparative analysis, forecasting and using results of experimental studies, the authors determined main ways for reduction of energy consumption during operation of the metro rolling stock. Energy cost analysis for metro rolling stock of the public utility (PU «Kiev Metro» was carried out. A great number of research works of native and foreign authors concerning the above mentioned problem were analyzed. Findings. Principal directions in energy saving and increase of energy efficiency of the metro rolling stock are implementation of recuperation systems, energy storage systems and energy-efficient control systems. It was determined that implementation of recuperation and energy storage systems helps to save a considerable amount of energy, consumed for traction, but it involves substantial investments. It is pointed out that in current complicated conditions of economic development of Ukraine, use of energy-efficient control systems is a perspective direction in energy saving. Main advantage of this direction is the economic effect obtaining without significant investments. Originality. For the first time was performed potential assessment for energy saving as a result of energy-efficient control systems use at type routine rolling stock operation modes on sections «Khreschatik –Teatralnaya – Khreschatik» and «Shulyavskaya �

Risk transfer via energy savings insurance

Energy Technology Data Exchange (ETDEWEB)

Mills, Evan

2001-10-01

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

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

Science.gov (United States)

2010-05-01

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

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

Science.gov (United States)

2008-09-01

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

An actuarial analysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost.

Science.gov (United States)

Pyenson, Bruce S; Sander, Marcia S; Jiang, Yiding; Kahn, Howard; Mulshine, James L

2012-04-01

Lung cancer screening is not established as a public health practice, yet the results of a recent large randomized controlled trial showed that screening with low-dose spiral computed tomography reduces lung cancer mortality. Using actuarial models, this study estimated the costs and benefits of annual lung cancer screening offered as a commercial insurance benefit in the high-risk US population ages 50-64. Assuming current commercial reimbursement rates for treatment, we found that screening would cost about $1 per insured member per month in 2012 dollars. The cost per life-year saved would be below $19,000, an amount that compares favorably with screening for cervical, breast, and colorectal cancers. Our results suggest that commercial insurers should consider lung cancer screening of high-risk individuals to be high-value coverage and provide it as a benefit to people who are at least fifty years old and have a smoking history of thirty pack-years or more. We also believe that payers and patients should demand screening from high-quality, low-cost providers, thus helping set an example of efficient system innovation.

Adding A Dietician to the Liaison-Team after Discharge of Geriatric Patients at Nutritional Risk May Save Health Care Costs

DEFF Research Database (Denmark)

Pohju, Anne; Belqaid, Kerstin; Brandt, Christopher

2016-01-01

with (intervention group, IG) or without a dietitian (control group, CG). The IG received three home visits by the dietitian during a 12-week period. Data included in the economic analysis was time spent by the dietitian, use of oral nutritional supplements (ONS) and number of hospitalization days. Results......: Of the 71 included patients, 34 were in the IG, 30 patients received all three dietitian visits. Cumulated number of hospitalization days was 172 in the IG and 415 in the CG. Use of ONS was 48 % in the IG and 17% in the CG (P=0.001). Estimated cost for the dietitian and ONS combined in the IG was €9......,416 compared to €1,150 (ONS only) in the CG. For hospitalizations, estimated cost was €92,020 in the IG and €220,025 in the CG. Cost savings added up to €3,048 per patient in the IG. Conclusion: Adding a dietitian to a Danish geriatric discharge Liaison-Team decreased health care costs...

Do Medicaid home and community based service waivers save money?

Science.gov (United States)

Harrington, Charlene; Ng, Terence; Kitchener, Martin

2011-10-01

This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

Energy Extra: Energy Savings vs. Comfort - and the Effect of Humidity.

Science.gov (United States)

CEFP Journal, 1979

1979-01-01

Proper humidity will, in a large number of cases, save money for the user. This saving could show up directly because of reduced infiltration and lower thermostat settings. It could show up indirectly in reduced costs for maintenance and preservation and in increased productivity and decreased absenteeism. (Author)

The Three R's of Utility Savings: Rate Reduction, Rebates and Retrofit.

Science.gov (United States)

Petiunas, Raymond V.

1993-01-01

An effective way to increase electricity energy savings for school districts is to integrate rate case participation (rate reduction) with conservation and load-management efforts (rebates) and retrofit operations, to obtain a total energy cost reduction package. Describes how a Pennsylvania consortium of school districts saved its member…

Exemplary.... Nine examples to save energy and cost by intelligent engineering; Zur Nachahmung empfohlen.... Neun Faelle, in denen mit intelligenter Technik Energie und Kosten gespart werden

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-07-01

Contents: Daylighting and energy management, light offices by daylight guidance, fresh air after demand by frequency converters, saving heating cost by intelligent control, optimized lighting systems in schools, fresh air from an external provider and compressed air monitoring in a mine. (GL)

Integrated economic and life cycle assessment of thermochemical production of bioethanol to reduce production cost by exploiting excess of greenhouse gas savings

International Nuclear Information System (INIS)

Reyes Valle, C.; Villanueva Perales, A.L.; Vidal-Barrero, F.; Ollero, P.

2015-01-01

Highlights: • Assessment of economics and sustainability of thermochemical ethanol production. • Exploitation of excess CO 2 saving by either importing fossil energy or CO 2 trading. • Significant increase in alcohol production by replacing biomass with natural gas. • CO 2 emission trading is not cost-competitive versus import of fossil energy. • Lowest ethanol production cost for partial oxidation as reforming technology. - Abstract: In this work, two options are investigated to enhance the economics of the catalytic production of bioethanol from biomass gasification by exploiting the excess of CO 2 emission saving: (i) to import fossil energy, in the form of natural gas and electricity or (ii) to trade CO 2 emissions. To this end, an integrated life cycle and economic assessment is carried out for four process configurations, each using a different light hydrocarbon reforming technology: partial oxidation, steam methane reforming, tar reforming and autothermal reforming. The results show that for all process configurations the production of bioethanol and other alcohols significantly increases when natural gas displaces biomass, maintaining the total energy content of the feedstock. The economic advantage of the partial substitution of biomass by natural gas depends on their prices and this is explored by carrying out a sensitivity analysis, taking historical prices into account. It is also concluded that the trade of CO 2 emissions is not cost-competitive compared to the import of natural gas if the CO 2 emission price remains within historical European prices. The CO 2 emission price would have to double or even quadruple the highest CO 2 historical price for CO 2 emission trading to be a cost-competitive option

Evaluating direct energy savings and market transformation effects: A decade of technical design assistance in the northwestern USA

International Nuclear Information System (INIS)

Van Den Wymelenberg, Kevin; Brown, G.Z.; Burpee, Heather; Djunaedy, Ery; Gladics, Gunnar; Kline, Jeff; Loveland, Joel; Meek, Christopher; Thimmanna, Harshana

2013-01-01

This paper documents the direct energy savings and energy efficiency market transformation impacts of a multi-state design assistance program in the northwestern US. The paper addresses four specific aims. (1) It provides a conservative and justified estimate of the direct energy savings associated with design assistance activities of a market transformation program from 2001 to 2010. (2) It provides a rigorous methodology to evaluate direct energy savings associated with design assistance market transformation programs. (3) It provides a low-cost replicable method to predict energy savings in new buildings by evaluating the integrated design process. (4) It provides quantitative indicators useful for estimating indirect energy savings from market transformation. Applying the recommended analysis method and assuming a 12-year measure life, the direct energy savings of the population (626 buildings; 51,262,000 ft 2 ) is estimated as 45.3 aMW (average megawatts) (electric), and 265,738.089 therms (non-electric). If the entire program budget were divided into the electric savings only, the Lab Network cost per kWh saved ranged from $0.0016 to $0.003 using the recommended method and $0.0092/kWh using the most conservative method. These figures do not isolate contextual influences or represent total resource cost. Statistically significant correlations (r 2 =0.1−0.3) between integrated design scores and energy savings are reported. - Highlights: ► Estimated direct energy savings of a market transformation program are presented. ► A methodology to evaluate energy savings from multiple baselines is documented. ► Level of integrated design can be used to estimate energy savings in new buildings. ► Quantitative evaluation indicators of efficiency market transformation are provided. ► Electric energy saved from design assistance costs between $0.0016 and $0.0092/kWh.

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

Science.gov (United States)

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

2016-05-01

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

Site preparation savings through better utilization standards

Science.gov (United States)

W.F. Watson; B.J. Stokes; I.W. Savelle

1984-01-01

This reports preliminary paper results of a study to determine the savings in the cost of site preparation that can be accomplished by the intensive utiliiation of understory biomass. mechanized sys terns can potentially be used for recovering this material.

Estimation of resource savings due to fly ash utilization in road construction

Energy Technology Data Exchange (ETDEWEB)

Kumar, Subodh; Patil, C.B. [Centre for Energy Studies, Indian Institute of Technology, New Delhi 110016 (India)

2006-08-15

A methodology for estimation of natural resource savings due to fly ash utilization in road construction in India is presented. Analytical expressions for the savings of various resources namely soil, stone aggregate, stone chips, sand and cement in the embankment, granular sub-base (GSB), water bound macadam (WBM) and pavement quality concrete (PQC) layers of fly ash based road formation with flexible and rigid pavements of a given geometry have been developed. The quantity of fly ash utilized in these layers of different pavements has also been quantified. In the present study, the maximum amount of resource savings is found in GSB followed by WBM and other layers of pavement. The soil quantity saved increases asymptotically with the rise in the embankment height. The results of financial analysis based on Indian fly ash based road construction cost data indicate that the savings in construction cost decrease with the lead and the investment on this alternative is found to be financially attractive only for a lead less than 60 and 90km for flexible and rigid pavements, respectively. (author)

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

Energy Technology Data Exchange (ETDEWEB)

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

2017-09-29

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

Costs and benefits of rare earth screens

International Nuclear Information System (INIS)

Taylor, F.E.

1977-01-01

The British Institute of Radiology has submitted evidence (Royal Commission on Environmental Pollution, 1976, Sixth Report, Nuclear Power and the Environment. Cmnd 6618, HMSO, London) leading to the conclusion that the introduction of rare earth screens in medical radiography is not financially practical at present in the U.K. This conclusion is questioned. The cost of reducing the genetic dose from medical radiography should be compared with the costs of reducing that from other sources such as nuclear power wastes, since the risks are to future generations in both cases. The cost of reducing public exposure by the use of rare earth screens in U.K. hospitals is calculated to be about Pound1 per man-rad; a total annual genetic collective dose of nearly 300,000 man-rad could be saved. An anomalous situation is presented by the great discrepancies between this cost, and published estimates both of the cost of the detriment associated with the genetic collective dose and of the value incorporated into the design objective for nuclear reactors. (U.K.)

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

Energy Technology Data Exchange (ETDEWEB)

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

2010-12-15

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

Food Processing Contracts: Savings for Schools.

Science.gov (United States)

Van Egmond-Pannell, Dorothy

1983-01-01

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

Save Energy Now Assessments Results 2008 Detailed Report

Energy Technology Data Exchange (ETDEWEB)

Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Nimbalkar, Sachin U [ORNL; Quinn, James [U.S. Department of Energy; Glatt, Ms. Sandy [DOE Industrial Technologies Program; Orthwein, Mr. Bill [U.S. Department of Energy

2010-09-01

In October 2005, U.S. Department of Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy savings assessment. The approach for these assessments drew heavily on the existing resources of ITP's technology delivery component. Over the years, ITP Technology Delivery has worked with industry partners to assemble a suite of respected software tools, proven assessment protocols, training curricula, certified energy experts, and strong partnerships for deployment. The Save Energy Now assessments conducted in calendar year 2006 focused on natural gas savings and targeted many of the nation's largest manufacturing plants - those that consume at least 1 TBtu of energy annually. The 2006 Save Energy Now assessments focused primarily on assessments of steam and process heating systems, which account for an estimated 74% of all natural gas use by U.S. manufacturing plants. Because of the success of the Save Energy Now assessments conducted in 2006 and 2007, the program was expanded and enhanced in two major ways in 2008: (1) a new goal was set to perform at least 260 assessments; and (2) the assessment focus was expanded to include pumping, compressed air, and fan systems in addition to steam and process heating. DOE ITP also has developed software tools to assess energy efficiency improvement opportunities in pumping, compressed air, and fan systems. The Save Energy Now assessments integrate a strong training component designed to teach industrial plant personnel how to use DOE's opportunity assessment software tools. This approach has the advantages of promoting strong buy-in of plant personnel for the assessment and its outcomes and preparing them better to

Transaction costs of Tradable White Certificate schemes: The Energy Efficiency Commitment as case study

International Nuclear Information System (INIS)

Mundaca, Luis

2007-01-01

This paper analyses the nature and scale of transaction costs (TCs) borne by obliged parties under a 'Tradable White Certificate' (TWC) scheme. Taking the first phase of the Energy Efficiency Commitment (EEC1) in Great Britain as a case study, several sources of TCs were considered, such as search for information, persuasion of customers, negotiation with business partners, and measurement and verification activities. Information was obtained through interviews and a questionnaire distributed to obliged parties. Results show that the most significant sources of TCs were related to search for information, persuading customers and negotiating with managing agents/contractors to implement energy efficiency measures. Perceived high TCs related to contract negotiation and liability risks slightly reduced the low trading level. The scale of TCs was estimated to be around 10% and 30% of total investments costs for the lighting and insulation segments, respectively. The results indicate that, despite the presence and scale of TCs, the EEC1 scheme generated energy savings that yielded net societal benefits. Estimated financial benefits range from 0.6 to 6 p/kWh for insulation and lighting savings, respectively. When avoided external costs due to electricity savings are included, estimated economic benefits range from 3 to 8 p/kWh. Several lessons from the EEC1 can be drawn for TWC schemes. Among others, it is found that informative policy instruments to raise awareness among end-users are critical if a TWC scheme is to deliver cost-effective energy savings. In all, the nature and scale of TCs under TWC schemes will differ because of a number of endogenous and exogenous determinants

Transaction costs of Tradable White Certificate schemes: The Energy Efficiency Commitment as case study

Energy Technology Data Exchange (ETDEWEB)

Mundaca, Luis [International Institute for Industrial Environmental Economics at Lund University, Lund (Sweden)

2007-08-15

This paper analyses the nature and scale of transaction costs (TCs) borne by obliged parties under a ''Tradable White Certificate'' (TWC) scheme. Taking the first phase of the Energy Efficiency Commitment (EEC1) in Great Britain as a case study, several sources of TCs were considered, such as search for information, persuasion of customers, negotiation with business partners, and measurement and verification activities. Information was obtained through interviews and a questionnaire distributed to obliged parties. Results show that the most significant sources of TCs were related to search for information, persuading customers and negotiating with managing agents/contractors to implement energy efficiency measures. Perceived high TCs related to contract negotiation and liability risks slightly reduced the low trading level. The scale of TCs was estimated to be around 10% and 30% of total investments costs for the lighting and insulation segments, respectively. The results indicate that, despite the presence and scale of TCs, the EEC1 scheme generated energy savings that yielded net societal benefits. Estimated financial benefits range from 0.6 to 6 p/kWh for insulation and lighting savings, respectively. When avoided external costs due to electricity savings are included, estimated economic benefits range from 3 to 8 p/kWh. Several lessons from the EEC1 can be drawn for TWC schemes. Among others, it is found that informative policy instruments to raise awareness among end-users are critical if a TWC scheme is to deliver cost-effective energy savings. In all, the nature and scale of TCs under TWC schemes will differ because of a number of endogenous and exogenous determinants. (author)

Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

Energy Technology Data Exchange (ETDEWEB)

Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)

2017-07-05

After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in

Chinese hotel general managers' perspectives on energy-saving practices

Science.gov (United States)

Zhu, Yidan

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

Solar/Geothermal Saves Energy in Heating and Cooling of Greenhouses

Science.gov (United States)

Sanders, Matthew; Thompson, Mark; Sikorski, Yuri

2010-04-01

The steady increase in world population and problems associated with conventional agricultural practices demand changes in food production methods and capabilities. Locally grown food minimizes the transportation costs and gas emissions responsible for Global Warming. Greenhouses have the potential to be extremely ecologically friendly by greatly increasing yields per year and facilitating reduced pesticide use. Globally, there are 2.5 million acres of greenhouse cover, including 30,640 acres in North America. In Europe, greenhouses consume 10% of the total energy in agriculture. Most of that energy is utilized for heating. Heating and cooling amount to 35% of greenhouse production costs. This high percentage value can be partially attributed to currently poor insulation values. In moderate-to-cold climate zones, it can take up to 2,500 gallons of propane, currently costing around 5,000, to keep a 2,000 sq. ft. greenhouse producing all winter. Around 350 tons of CO2 per acre per year are released from these structures, contributing to global climate change. Reducing the energy needs of a greenhouse is the first step in saving money and the environment. Therefore, an efficient and environmentally friendly heating and cooling system selection is also crucial. After selecting appropriate energy sources, the next major concern in a greenhouse would be heat loss. Consequently, it is critically important to understand factors contributing to heat loss.

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

Science.gov (United States)

Maag, Elaine

2009-01-01

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

Energy, Pollutant Emissions and Other Negative Externality Savings from Curbing Individual Motorized Transportation (IMT: A Low Cost, Low Technology Scenario Analysis in Brazilian Urban Areas

Directory of Open Access Journals (Sweden)

Ursula Maruyama

2012-03-01

Full Text Available This article examines the inefficient use of resources in the Brazilian transportation system. The energy use growth and external cost generation in this essential economic sector are considerable, and the trend is towards an increasing problem in the coming years. The continued expansion of Brazilian cities and the increase in demand for mobility is a result of a substantial growth in the number of road transport users, as increased earnings enable lower income groups to acquire and use individual motorized means of transport. The aim of this paper is to estimate the potential gains from reducing individual motorized transport by the year 2020. This investigation concludes that in a conservationist scenario, by prioritizing low cost, low technology public policies—which include operation of Bus Rapid Transit systems, walking and cycling facilities and congestion charges, among others—it should be possible to save over USD 30 billion and USD 26 billion in external transportation and infrastructure costs, respectively, up to 2020. In addition, these public policies can save more than 35 million Tons of Oil Equivalents in energy consumption and avoid almost 4,000 thousand tons of local pollution emissions and 37,500 thousand tons of GHG emissions in the same period.

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

Energy Technology Data Exchange (ETDEWEB)

None

2013-10-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2013-10-01

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

Using Technology to Control Costs

Science.gov (United States)

Ho, Simon; Schoenberg, Doug; Richards, Dan; Morath, Michael

2009-01-01

In this article, the authors examines the use of technology to control costs in the child care industry. One of these technology solutions is Software-as-a-Service (SaaS). SaaS solutions can help child care providers save money in many aspects of center management. In addition to cost savings, SaaS solutions are also particularly appealing to…

Economic Energy Savings Potential in Federal Buildings

Energy Technology Data Exchange (ETDEWEB)

Brown, Daryl R.; Dirks, James A.; Hunt, Diane M.

2000-09-04

The primary objective of this study was to estimate the current life-cycle cost-effective (i.e., economic) energy savings potential in Federal buildings and the corresponding capital investment required to achieve these savings, with Federal financing. Estimates were developed for major categories of energy efficiency measures such as building envelope, heating system, cooling system, and lighting. The analysis was based on conditions (building stock and characteristics, retrofit technologies, interest rates, energy prices, etc.) existing in the late 1990s. The potential impact of changes to any of these factors in the future was not considered.

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

Science.gov (United States)

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

2014-07-01

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

Transaction costs of raising energy efficiency

Energy Technology Data Exchange (ETDEWEB)

Ostertag, K.

2003-07-01

Part of the debate evolves around the existence and importance of energy saving potentials to reduce CO{sub 2} emissions that may be available at negative net costs, implying that the energy cost savings of one specific technology can actually more than offset the costs of investing into this technology and of using it. This so called ''no-regret'' potential would comprise measures that from a pure economic efficiency point of view would be ''worth undertaking whether or not there are climate-related reasons for doing so''. The existence of the no-regret potential is often denied by arguing, that the economic evaluation of the energy saving potentials did not take into account transaction costs. This paper will re-examine in more detail the concept of transaction costs as it is used in the current debate on no-regret potentials (section 1). Four practical examples are presented to illustrate how transaction costs and their determinants can be identified, measured and possibly influenced (section 2). In order to link the presented cases to modelling based evaluation approaches the implications for cost evaluations of energy saving measures, especially in the context of energy system modelling, will be shown (section 3). (author)

Estimation of avoidable skin cancers and cost-savings to government associated with regulation of the solarium industry in Australia.

Science.gov (United States)

Hirst, Nicholas; Gordon, Louisa; Gies, Peter; Green, Adèle C

2009-03-01

In Australia there is growing concern about the expanding solarium industry, and the additive effect of persons seeking exposure to artificial ultraviolet radiation (UVR) against already intense background levels of solar UVR. We estimated the numbers of potential skin cancers prevented through regulation of solaria and the associated cost-savings to the Federal Government. A lifetime decision-analytic model was created using relative risk estimates based on a meta-analysis of the literature assessing the link between skin cancer risk and solarium use. The costs were limited to those incurred by Medicare Australia, for the medical care of individuals treated for skin cancer. With stricter regulations, we estimated between 18 and 31 melanomas, 200-251 squamous cell carcinomas and associated costs of $AU 256,054 would be avoided per 100,000 persons. Our base findings were sensitive to estimates for prevalence of use, skin cancer risk and discounting rates. Continued growth in the Australian solarium industry is likely to inflate the already substantial skin cancer burden. Subject to some limitations, our study indicates that by successfully enforcing solarium regulations to prohibit use by minors and by those with fair skin colour, the Federal Government could expect favourable cost and health benefits.

Reducing the cesarean delivery rates for breech presentations: administration of spinal anesthesia facilitates manipulation to cephalic presentation, but is it cost saving?

Science.gov (United States)

2014-01-01

Background External cephalic version (ECV) is infrequently performed and 98% of breech presenting fetuses are delivered surgically. Neuraxial analgesia can increase the success rate of ECV significantly, potentially reducing cesarean delivery rates for breech presentation. The current study aims to determine whether the additional cost to the hospital of spinal anesthesia for ECV is offset by cost savings generated by reduced cesarean delivery. Methods In our tertiary hospital, three variables manpower, disposables, and fixed costs were calculated for ECV, ECV plus anesthetic doses of spinal block, vaginal delivery and cesarean delivery. Total procedure costs were compared for possible delivery pathways. Manpower data were obtained from management payroll, fixed costs by calculating cost/lifetime usage rate and disposables were micro-costed in 2008, expressed in 2013 NIS. Results Cesarean delivery is the most expensive option, 11670.54 NIS and vaginal delivery following successful ECV under spinal block costs 5497.2 NIS. ECV alone costs 960.21 NIS, ECV plus spinal anesthesia costs 1386.97 NIS. The highest individual cost items for vaginal, cesarean delivery and ECV were for manpower. Expensive fixed costs for cesarean delivery included operating room trays and postnatal hospitalization (minimum 3 days). ECV with spinal block is cheaper due to lower expected cesarean delivery rate and its lower associated costs. Conclusions The additional cost of the spinal anesthesia is offset by increased success rates for the ECV procedure resulting in reduction in the cesarean delivery rate. PMID:24564984

Potential savings from redetermining disability among children receiving supplemental security income benefits.

Science.gov (United States)

Pulcini, Christian D; Kotelchuck, Milton; Kuhlthau, Karen A; Nozzolillo, Alixandra A; Perrin, James M

2012-01-01

To compare the costs of redetermining disability to potential savings in Supplemental Security Income payments associated with different strategies for implementing Continuing Disability Reviews (CDRs) among children potentially enrolled in SSI from 2012 to 2021. We reviewed publicly available reports from the Social Security Administration and Government Accountability Office to estimate costs and savings. We considered CDRs for children ages 1-17 years, excluding mandated low-birth weight and age 18 redeterminations that SSA routinely has performed. If in 2012 the Social Security Administration performs the same number of CDRs for children as in 2010 (16,677, 1% of eligibles) at a cessation rate of 15%, the agency would experience net savings of approximately $145 million in benefit payments. If CDR numbers increased to the greatest level ever (183,211, 22% of eligibles, in 1999) at the same cessation rate, the agency would save approximately $1.6 billion in benefit payments. Increasing the numbers of CDRs for children represents a considerable opportunity for savings. Recognizing the dynamic nature of disability, the agency could reassess the persistence of disability systematically; doing so could free up resources from children who are no longer eligible and help the agency better direct its benefits to recipients with ongoing disability and whose families need support to meet the extra costs associated with raising a child with a major disability. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Lauren Lapointe-Shaw

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

Evaluating the benefits of digital pathology implementation: Time savings in laboratory logistics.

Science.gov (United States)

Baidoshvili, Alexi; Bucur, Anca; van Leeuwen, Jasper; van der Laak, Jeroen; Kluin, Philip; van Diest, Paul J

2018-06-20

The benefits of digital pathology for workflow improvement and thereby cost savings in pathology, at least partly outweighing investment costs, are increasingly recognized. Successful implementations in a variety of scenarios start to demonstrate cost benefits of digital pathology for both research and routine diagnostics, contributing to a sound business case encouraging further adoption. To further support new adopters, there is still a need for detailed assessment of the impact this technology has on the relevant pathology workflows with emphasis on time saving. To assess the impact of digital pathology adoption on logistic laboratory tasks (i.e. not including pathologists' time for diagnosis making) in LabPON, a large regional pathology laboratory in The Netherlands. To quantify the benefits of digitization we analyzed the differences between the traditional analog and new digital workflows, carried out detailed measurements of all relevant steps in key analog and digital processes, and compared time spent. We modeled and assessed the logistic savings in five workflows: (1) Routine diagnosis, (2) Multi-disciplinary meeting, (3) External revision requests, (4) Extra stainings and (5) External consultation. On average over 19 working hours were saved on a typical day by working digitally, with the highest savings in routine diagnosis and multi-disciplinary meeting workflows. By working digitally, a significant amount of time could be saved in a large regional pathology lab with a typical case mix. We also present the data in each workflow per task and concrete logistic steps to allow extrapolation to the context and case mix of other laboratories. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Use staff wisely to save NHS money.

Science.gov (United States)

Moore, Alison

2015-12-09

The NHS could save up to £ 2 billion a year by improving workflow and containing workforce costs, according to Labour peer Lord Carter's review of NHS efficiency. Changes in areas such as rostering and management of annual leave must avoid increasing the pressure on staff.

78 FR 20097 - Energy Savings Performance Contracts

Science.gov (United States)

2013-04-03

... procedures, scope definition, Measurement and Verification (M&V), financing procurement, and definition of... government. More than $2.71 billion has been invested in Federal energy efficiency and renewable energy... more than $7.18 billion of cumulative energy cost savings for the Federal Government. While FEMP has...

Risk transfer via energy savings insurance; TOPICAL

International Nuclear Information System (INIS)

Mills, Evan

2001-01-01

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

Renewables, nuclear, or fossil fuels? Scenarios for Great Britain’s power system considering costs, emissions and energy security

International Nuclear Information System (INIS)

Pfenninger, Stefan; Keirstead, James

2015-01-01

Highlights: • We compare a large number of cost-optimal future power systems for Great Britain. • Scenarios are assessed on cost, emissions reductions, and energy security. • Up to 60% of variable renewable capacity is possible with little cost increase. • Higher shares require storage, imports or dispatchable renewables such as tidal range. - Abstract: Mitigating climate change is driving the need to decarbonize the electricity sector, for which various possible technological options exist, alongside uncertainty over which options are preferable in terms of cost, emissions reductions, and energy security. To reduce this uncertainty, we here quantify two questions for the power system of Great Britain (England, Wales and Scotland): First, when compared within the same high-resolution modeling framework, how much do different combinations of technologies differ in these three respects? Second, how strongly does the cost and availability of grid-scale storage affect overall system cost, and would it favor some technology combinations above others? We compare three main possible generation technologies: (1) renewables, (2) nuclear, and (3) fossil fuels (with/without carbon capture and storage). Our results show that across a wide range of these combinations, the overall costs remain similar, implying that different configurations are equally feasible both technically and economically. However, the most economically favorable scenarios are not necessarily favorable in terms of emissions or energy security. The availability of grid-scale storage in scenarios with little dispatchable generation can reduce overall levelized electricity cost by up to 50%, depending on storage capacity costs. The UK can rely on its domestic wind and solar PV generation at lower renewable shares, with levelized costs only rising more than 10% above the mean of 0.084 GBP/kWh for shares of 50% and below at a 70% share, which is 35% higher. However, for more than an 80% renewable

Seatbelt use to save money: Impact on hospital costs of occupants who are involved in motor vehicle crashes.

Science.gov (United States)

Han, Guang-Ming; Newmyer, Ashley; Qu, Ming

2017-03-01

Seatbelt use is the single most effective way to save lives in motor vehicle crashes (MVC). However, although safety belt laws have been enacted in many countries, seatbelt usage throughout the world remains below optimal levels, and educational interventions may be needed to further increase seatbelt use. In addition to reducing crash-related injuries and deaths, reduced medical expenditures resulting from seatbelt use are an additional benefit that could make such interventions cost-effective. Accordingly, the objective of this study was to estimate the correlation between seatbelt use and hospital costs of injuries involved in MVC. The data used in this study were from the Nebraska CODES database for motor vehicle crashes that occurred between 2004 and 2013. The hospital cost information and information about other factors were obtained by linking crash reports with hospital discharge data. A multivariable regression model was performed for the association between seatbelt use and hospital costs. Mean hospital costs were significantly lower among motor vehicle occupants using a lap-shoulder seatbelt ($2909), lap-only seatbelt ($2289), children's seatbelt ($1132), or booster ($1473) when compared with those not using any type of seatbelt ($7099). After adjusting for relevant factors, there were still significantly decreased hospital costs for motor vehicle occupants using a lap-shoulder seatbelt (84.7%), lap-only seatbelt (74.1%), shoulder-only seatbelt (40.6%), children's seatbelt (95.9%), or booster (82.8%) compared to those not using a seatbelt. Seatbelt use is significantly associated with reduced hospital costs among injured MVC occupants. The findings in this study will provide important educational information for emergency department nurses who can encourage safety belt use for vehicle occupants. Copyright © 2016. Published by Elsevier Ltd.

Cost Savings of Nuclear Power with Total Fuel Reprocessing

International Nuclear Information System (INIS)

Solbrig, Charles W.; Benedict, Robert W.

2006-01-01

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

Inbound freight: an untapped resource for saving money.

Science.gov (United States)

Kuehn, Kurt

2007-12-01

With all the responsibilities placed on materials managers, it is not surprising that some processes such as shipping are overlooked when it comes to cutting costs. But by taking a closer look at inbound freight costs, materials managers might discover an untapped resource for saving thousands, and in some cases millions, of dollars. Finding out how costs vary among vendors for shipping the same type of item can eliminate unnecessary freight charges. Initially, the process takes time, but the bottom line will be better for it.

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

Energy Technology Data Exchange (ETDEWEB)

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

2006-07-01

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

Do You Automate? Saving Time and Dollars

Science.gov (United States)

Carmichael, Christine H.

2010-01-01

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

Space system production cost benefits from contemporary philosophies in management and manufacturing

Science.gov (United States)

Rosmait, Russell L.

1991-01-01

The cost of manufacturing space system hardware has always been expensive. The Engineering Cost Group of the Program Planning office at Marshall is attempting to account for cost savings that result from new technologies in manufacturing and management. The objective is to identify and define contemporary philosophies in manufacturing and management. The seven broad categories that make up the areas where technological advances can assist in reducing space system costs are illustrated. Included within these broad categories is a list of the processes or techniques that specifically provide the cost savings within todays design, test, production and operations environments. The processes and techniques listed achieve savings in the following manner: increased productivity; reduced down time; reduced scrap; reduced rework; reduced man hours; and reduced material costs. In addition, it should be noted that cost savings from production and processing improvements effect 20 to 40 pct. of production costs whereas savings from management improvements effects 60 to 80 of production cost. This is important because most efforts in reducing costs are spent trying to reduce cost in the production.

Energy Savings from Industrial Water Reductions

Energy Technology Data Exchange (ETDEWEB)

Rao, Prakash; McKane, Aimee; de Fontaine, Andre

2015-08-03

Although it is widely recognized that reducing freshwater consumption is of critical importance, generating interest in industrial water reduction programs can be hindered for a variety of reasons. These include the low cost of water, greater focus on water use in other sectors such as the agriculture and residential sectors, high levels of unbilled and/or unregulated self-supplied water use in industry, and lack of water metering and tracking capabilities at industrial facilities. However, there are many additional components to the resource savings associated with reducing site water use beyond the water savings alone, such as reductions in energy consumption, greenhouse gas emissions, treatment chemicals, and impact on the local watershed. Understanding and quantifying these additional resource savings can expand the community of businesses, NGOs, government agencies, and researchers with a vested interest in water reduction. This paper will develop a methodology for evaluating the embedded energy consumption associated with water use at an industrial facility. The methodology developed will use available data and references to evaluate the energy consumption associated with water supply and wastewater treatment outside of a facility’s fence line for various water sources. It will also include a framework for evaluating the energy consumption associated with water use within a facility’s fence line. The methodology will develop a more complete picture of the total resource savings associated with water reduction efforts and allow industrial water reduction programs to assess the energy and CO2 savings associated with their efforts.

Defense Industry Restructuring: Updated Cost and Savings Information

National Research Council Canada - National Science Library

1998-01-01

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

An energy saving system for hospital laundries

Energy Technology Data Exchange (ETDEWEB)

Katsanis, J.S.; Tsarabaris, P.T.; Polykrati, A.D.; Proios, A.N. [National Technical Univ. of Athens, Athens (Greece). School of Electrical and Computer Engineering; Koufakis, E.I. [Public Power Corp. S.A., Crete (Greece)

2009-07-01

Hospital laundries are one of the largest consumers of water and electrical and thermal energy. This paper examined the energy savings achieved by a system using the hot wastewater from the washing process. Hospital laundries consume thermal energy using steam, which is produced in boilers by burning diesel oil or natural gas. Electrical energy for the mechanical drives, ventilation and also the lighting required in the laundry area are big consumers of energy. The paper presented the proposed system and discussed the parameters of the system and system dimensioning. The paper also provided and discussed an interpretation of steam and energy savings. The proposed system was considered to be economically viable, simple in its construction, installation and operation. From the application of the suggested system, the cost savings resulted in a satisfactory payback period for the capital invested of approximately three to five years. 14 refs., 4 tabs., 2 figs.

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

International Nuclear Information System (INIS)

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

2011-01-01

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

Enersave API: Android-based power-saving framework for mobile devices

Directory of Open Access Journals (Sweden)

A.M. Muharum

2017-06-01

Full Text Available Power consumption is a major factor to be taken into consideration when using mobile devices in the IoT field. Good Power management requires proper understanding of the way in which it is being consumed by the end-devices. This paper is a continuation of the work in Ref. [1] and proposes an energy saving API for the Android Operating System in order to help developers turn their applications into energy-aware ones. The main features heavily used for building smart applications, greatly impact battery life of Android devices and which have been taken into consideration are: Screen brightness, Colour scheme, CPU frequency, 2G/3G network, Maps, Low power localisation, Bluetooth and Wi-Fi. The assessment of the power-saving API has been performed on real Android devices and also compared to the most powerful power-saving applications – DU Battery Saver and Battery Saver 2016 – currently available on the Android market. Comparisons demonstrate that the Enersave API has a significant impact on power saving when incorporated in android applications. While DU Battery Saver and Battery Saver 2016 help saving 22.2% and 40.5% of the battery power respectively, the incorporation of the Enersave API in android applications can help save 84.6% of battery power.

No Cost – Low Cost Compressed Air System Optimization in Industry

Science.gov (United States)

Dharma, A.; Budiarsa, N.; Watiniasih, N.; Antara, N. G.

2018-04-01

Energy conservation is a systematic, integrated of effort, in order to preserve energy sources and improve energy utilization efficiency. Utilization of energy in efficient manner without reducing the energy usage it must. Energy conservation efforts are applied at all stages of utilization, from utilization of energy resources to final, using efficient technology, and cultivating an energy-efficient lifestyle. The most common way is to promote energy efficiency in the industry on end use and overcome barriers to achieve such efficiency by using system energy optimization programs. The facts show that energy saving efforts in the process usually only focus on replacing tools and not an overall system improvement effort. In this research, a framework of sustainable energy reduction work in companies that have or have not implemented energy management system (EnMS) will be conducted a systematic technical approach in evaluating accurately a compressed-air system and potential optimization through observation, measurement and verification environmental conditions and processes, then processing the physical quantities of systems such as air flow, pressure and electrical power energy at any given time measured using comparative analysis methods in this industry, to provide the potential savings of energy saving is greater than the component approach, with no cost to the lowest cost (no cost - low cost). The process of evaluating energy utilization and energy saving opportunities will provide recommendations for increasing efficiency in the industry and reducing CO2 emissions and improving environmental quality.

How rebates, copayments, and administration costs affect the cost-effectiveness of osteoporosis therapies.

Science.gov (United States)

Ferko, Nicole C; Borisova, Natalie; Airia, Parisa; Grima, Daniel T; Thompson, Melissa F

2012-11-01

Because of rising drug expenditures, cost considerations have become essential, necessitating the requirement for cost-effectiveness analyses for managed care organizations (MCOs). The study objective is to examine the impact of various drug-cost components, in addition to wholesale acquisition cost (WAC), on the cost-effectiveness of osteoporosis therapies. A Markov model of osteoporosis was used to exemplify different drug cost scenarios. We examined the effect of varying rebates for oral bisphosphonates--risedronate and ibandronate--as well as considering the impact of varying copayments and administration costs for intravenous zoledronate. The population modeled was 1,000 American women, > or = 50 years with osteoporosis. Patients were followed for 1 year to reflect an annual budget review of formularies by MCOs. The cost of therapy was based on an adjusted WAC, and is referred to as net drug cost. The total annual cost incurred by an MCO for each drug regimen was calculated using the net drug cost and fracture cost. We estimated cost on a quality adjusted life year (QALY) basis. When considering different rebates, results for risedronate versus ibandronate vary from cost-savings (i.e., costs less and more effective) to approximately $70,000 per QALY. With no risedronate rebate, an ibandronate rebate of approximately 65% is required before cost per QALY surpasses $50,000. With rebates greater than 25% for risedronate, irrespective of ibandronate rebates, results become cost-saving. Results also showed the magnitude of cost savings to the MCO varied by as much as 65% when considering no administration cost and the highest coinsurance rate for zoledronate. Our study showed that cost-effectiveness varies considerably when factors in addition to the WAC are considered. This paper provides recommendations for pharmaceutical manufacturers and MCOs when developing and interpreting such analyses.

About instrumental innovation. Energy saving certificates

International Nuclear Information System (INIS)

Baiz, Adam; Monnoyer-Smith, Laurence

2016-09-01

Energy saving certificates (in French CEE for certificats d'economie d'energie) have been implemented in 2006, and have proven to be a rather efficient tool of public policy, with a low cost, and a good social acceptability, notably due to its hybrid nature (incentive and coercive) in function of the targeted actors. Thus, this document addresses and discusses the interest of such instruments for the public environmental policy. It outlines that instruments tend to be always less coercive, and then comments the example of these energy saving certificates: brief presentation, discussion and explanation of their efficiency, multi-dimensional nature of this instrument, benefits of more or less coercive instruments depending on the actors (State, households, energy providers)

Household Savings

DEFF Research Database (Denmark)

Browning, Martin; Lusardi, Annamaria

suggested in the informal saving literature can be captured in the standard optimizing model. Particular attention is given to recent work on the precautionary motive and its implications for saving and consumption behavior. We also discuss the "behavioral" or "psychological" approach that eschews the use......In this survey, we review the recent theoretical and empirical literature on household saving and consumption. The discussion is structured around a list of motives for saving and how well the standard theory captures these motives. We show that almost all of the motives for saving that have been...

Exploiting Redundancy and Application Scalability for Cost-Effective, Time-Constrained Execution of HPC Applications on Amazon EC2

International Nuclear Information System (INIS)

Marathe, Aniruddha P.; Harris, Rachel A.; Lowenthal, David K.; Supinski, Bronis R. de; Rountree, Barry L.; Schulz, Martin

2015-01-01

The use of clouds to execute high-performance computing (HPC) applications has greatly increased recently. Clouds provide several potential advantages over traditional supercomputers and in-house clusters. The most popular cloud is currently Amazon EC2, which provides fixed-cost and variable-cost, auction-based options. The auction market trades lower cost for potential interruptions that necessitate checkpointing; if the market price exceeds the bid price, a node is taken away from the user without warning. We explore techniques to maximize performance per dollar given a time constraint within which an application must complete. Specifically, we design and implement multiple techniques to reduce expected cost by exploiting redundancy in the EC2 auction market. We then design an adaptive algorithm that selects a scheduling algorithm and determines the bid price. We show that our adaptive algorithm executes programs up to seven times cheaper than using the on-demand market and up to 44 percent cheaper than the best non-redundant, auction-market algorithm. We extend our adaptive algorithm to incorporate application scalability characteristics for further cost savings. In conclusion, we show that the adaptive algorithm informed with scalability characteristics of applications achieves up to 56 percent cost savings compared to the expected cost for the base adaptive algorithm run at a fixed, user-defined scale.

Exploring Demand Charge Savings from Commercial Solar

Energy Technology Data Exchange (ETDEWEB)

Darghouth, Naim [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Barbose, Galen [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Mills, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wiser, Ryan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Gagnon, Pieter [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bird, Lori [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2017-07-31

Commercial retail electricity rates commonly include a demand charge component, based on some measure of the customer’s peak demand. Customer-sited solar PV can potentially reduce demand charges, but the magnitude of these savings can be difficult to predict, given variations in demand charge designs, customer loads, and PV generation profiles. Moreover, depending on the circumstances, demand charges from solar may or may not align well with associated utility cost savings. Lawrence Berkeley National Laboratory (Berkeley Lab) and the National Renewable Energy Laboratory (NREL) are collaborating in a series of studies to understand how solar PV can reduce demand charge levels for a variety of customer types and demand charges designs. Previous work focused on residential customs with solar. This study, instead, focuses on commercial customers and seeks to understand the extent and conditions under which rooftop can solar reduce commercial demand charges. To answer these questions, we simulate demand charge savings for a broad range of commercial customer types, demand charge designs, locations, and PV system characteristics. This particular analysis does not include storage, but a subsequent analysis in this series will evaluate demand charge savings for commercial customers with solar and storage.

RESULTS FROM THE U.S. DOE 2006 SAVE ENERGY NOW ASSESSMENT INITIATIVE: DOE's Partnership with U.S. Industry to Reduce Energy Consumption, Energy Costs, and Carbon Dioxide Emissions

Energy Technology Data Exchange (ETDEWEB)

Wright, Anthony L [ORNL; Martin, Michaela A [ORNL; Gemmer, Bob [U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy; Scheihing, Paul [U.S. Department of Energy, Industrial Technologies Program; Quinn, James [U.S. Department of Energy

2007-09-01

In the wake of Hurricane Katrina and other severe storms in 2005, natural gas supplies were restricted, prices rose, and industry sought ways to reduce its natural gas use and costs. In October 2005, U.S. Department of Energy (DOE) Energy Secretary Bodman launched his Easy Ways to Save Energy campaign with a promise to provide energy assessments to 200 of the largest U.S. manufacturing plants. A major thrust of the campaign was to ensure that the nation's natural gas supplies would be adequate for all Americans, especially during home heating seasons. In a presentation to the National Press Club on October 3, 2005, Secretary Bodman said: 'America's businesses, factories, and manufacturing facilities use massive amounts of energy. To help them during this period of tightening supply and rising costs, our Department is sending teams of qualified efficiency experts to 200 of the nation's most energy-intensive factories. Our Energy Saving Teams will work with on-site managers on ways to conserve energy and use it more efficiently.' DOE's Industrial Technologies Program (ITP) responded to the Secretary's campaign with its Save Energy Now initiative, featuring a new and highly cost-effective form of energy assessments. The approach for these assessments drew heavily on the existing resources of ITP's Technology Delivery component. Over the years, ITP-Technology Delivery had worked with industry partners to assemble a suite of respected software decision tools, proven assessment protocols, training curricula, certified experts, and strong partnerships for deployment. Because of the program's earlier activities and the resources that had been developed, ITP was prepared to respond swiftly and effectively to the sudden need to promote improved industrial energy efficiency. Because of anticipated supply issues in the natural gas sector, the Save Energy Now initiative strategically focused on natural gas savings and targeted the

The energy saving manual; Das Energiesparbuch

Energy Technology Data Exchange (ETDEWEB)

Goetze, Monika; Pinn, Gudrun

2009-07-01

The constant increase in the cost of electric power, petroleum, gasoline and gas burden the household budget. At the same time, greenhouse gases are speeding up global warming alarmingly. It is time to reconsider our style of living. This guide presents simple and practical hints to reduce energy costs and protect the climate. Exemplary calculations show how up to 1100 Euro can be saved per household member and per annum. Subjects: Identifying fields of excess energy consumption; No wasting of electricity, heat, and warm water; Food, shopping and climate; Mobility and climate protection; How to establish an individual energy conservation profile. (orig.)

Economic feasibility of sail power devices on Great Lakes bulk carriers

Energy Technology Data Exchange (ETDEWEB)

None

1982-09-22

Three ships were examined, the ED RYERSON, the ST. CLAIR, and the STEWART CORT to determine if retro-fitting these ships with a 3000 sq ft soft sail cat rig is economically feasible. By using existing weather data taken from recorded observations on Lake Michigan and Lake Superior and known performance characteristics of both the sailplan and hull, a computer program was written to model the problem. Three cases for each ship were estimated. The first was the average fuel savings, second was an optimistic estimate of fuel savings, and the third was a pessimistic estimate of fuel savings. Several considerations had to be taken into account that had serious consequences for the economic viability of the idea. One was the fact that all of the aforementioned ships have self unloading equipment that require about 80% of the deck space to be clear. This limited the choice of sailplans to one per ship. Another consideration is that due to bridge clearance problems an air draft of less than 125' was required. These two factors limited the size and efficiency of the sail plan. The third consideration is that due to the very tight shipping channels on the Great Lakes, there is no provision for altering course to take advantage of prevailing winds in order to maximize the usefulness of the sail device. The sail device on the ED RYERSON does not seem to be economically feasible. Even at the lowest interest rate investigated in this study (8%) the average annual cost improves only in the optimistic estimates. At 12% interest even this slight advantage disappears. The sail devices on the STEWART CORT and ST. CLAIR seem to be marginally feasible at low interest rates and the present cost of fuel. The STEWART CORT seems to benefit most from the fitting of a sail device. A modest increase in fuel prices, perhaps possible, will make both of these ships look substantially better.

Quantifying the economic water savings benefit of water hyacinth ...

African Journals Online (AJOL)

Quantifying the economic water savings benefit of water hyacinth ... Value Method was employed to estimate the average production value of irrigation water, ... invasions of this nature, as they present significant costs to the economy and ...

Cost savings from nuclear regulatory reform: An econometric model

International Nuclear Information System (INIS)

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

1996-01-01

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

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

International Nuclear Information System (INIS)

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

2006-01-01

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

Saving in cycles: how to get people to save more money.

Science.gov (United States)

Tam, Leona; Dholakia, Utpal

2014-02-01

Low personal savings rates are an important social issue in the United States. We propose and test one particular method to get people to save more money that is based on the cyclical time orientation. In contrast to conventional, popular methods that encourage individuals to ignore past mistakes, focus on the future, and set goals to save money, our proposed method frames the savings task in cyclical terms, emphasizing the present. Across the studies, individuals who used our proposed cyclical savings method, compared with individuals who used a linear savings method, provided an average of 74% higher savings estimates and saved an average of 78% more money. We also found that the cyclical savings method was more efficacious because it increased implementation planning and lowered future optimism regarding saving money.

Education and empowerment of the nursing assistant: validating their important role in skin care and pressure ulcer prevention, and demonstrating productivity enhancement and cost savings.

Science.gov (United States)

Howe, Lynn

2008-06-01

This article details an educational program designed to utilize nonlicensed personnel (certified nursing assistants [CNAs] and nursing assistants [NAs]) in the prevention of pressure ulcers and improved skin care in a 250-bed acute care facility in a suburban setting. The article is divided into 2 parts: A and B. Part A addresses the educational program, which was part of a major initiative for improving patient outcomes that included a review and standardization of skin care products and protocols. Part B addresses productivity enhancement and cost savings experienced because of changing bathing and incontinence care products and procedures. The educational program included instruction on time-saving methods for increasing productivity in bathing and incontinence care, and effectively promoted the importance of proper skin care and pressure ulcer prevention techniques. Methods incorporated into the educational training targeted different reading and comprehension levels, ranging from the use of PowerPoint slides, hands-on return demonstration, and group discussion related to pressure ulcer staging and wound treatment. These educational methods provided the participants with significant reinforcement of each day's learning objectives. Productivity enhancement and cost savings are addressed in part B, as well as the results of a time-motion study. Because of the program, CNAs/NAs were empowered in their integral caregiver roles. This program was part of a larger, major process improvement initiative, but the rate of acquired pressure ulcers declined from 2.17% in 2002 to 1.71% in 2003. This educational program was considered a contributor to the improved patient outcomes.

Energy-saving methodology for material handling applications

Energy Technology Data Exchange (ETDEWEB)

Makris, P.A.; Makri, A.P.; Provatidis, C.G. [National Technical University of Athens, School of Mechanical Engineering, Mechanical Design and Control Systems Division, 9 Iroon Polytechniou Street, Zografou Campus, GR-15773 Athens (Greece)

2006-10-15

This paper presents an energy saving approach to the problem of order picking in warehousing environment, which is directly related to the well-known Traveling Salesman Problem (TSP). While the available heuristic algorithms for the order-picking problem search for the route that minimizes the travel time, here the problem is addressed from the energy saving point of view. In a few words, the least energy-consuming route is identified in order to quantify the trade off in time and energy between the fastest route and the most energy economic one. Keeping in mind that often energy is as important as time, especially during a low-demand period, the current paper sheds some light into a two dimensional way of addressing the warehouse material handling problem, which saves time as well as energy. A very interesting finding is that a relatively small loss of service time in many cases may lead to a significant decrease of consumed energy without any additional cost. (author)

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

Science.gov (United States)

Melnyk, Bernadette Mazurek; Feinstein, Nancy Fischbeck

2009-01-01

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

Cost-benefit of infection control interventions targeting methicillin-resistant Staphylococcus aureus in hospitals: systematic review.

Science.gov (United States)

Farbman, L; Avni, T; Rubinovitch, B; Leibovici, L; Paul, M

2013-12-01

Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) incur significant costs. We aimed to examine the cost and cost-benefit of infection control interventions against MRSA and to examine factors affecting economic estimates. We performed a systematic review of studies assessing infection control interventions aimed at preventing spread of MRSA in hospitals and reporting intervention costs, savings, cost-benefit or cost-effectiveness. We searched PubMed and references of included studies with no language restrictions up to January 2012. We used the Quality of Health Economic Studies tool to assess study quality. We report cost and savings per month in 2011 US$. We calculated the median save/cost ratio and the save-cost difference with interquartile range (IQR) range. We examined the effects of MRSA endemicity, intervention duration and hospital size on results. Thirty-six studies published between 1987 and 2011 fulfilled inclusion criteria. Fifteen of the 18 studies reporting both costs and savings reported a save/cost ratio >1. The median save/cost ratio across all 18 studies was 7.16 (IQR 1.37-16). The median cost across all studies reporting intervention costs (n = 31) was 8648 (IQR 2025-19 170) US$ per month; median savings were 38 751 (IQR 14 206-75 842) US$ per month (23 studies). Higher save/cost ratios were observed in the intermediate to high endemicity setting compared with the low endemicity setting, in hospitals with 6 months. Infection control intervention to reduce spread of MRSA in acute-care hospitals showed a favourable cost/benefit ratio. This was true also for high MRSA endemicity settings. Unresolved economic issues include rapid screening using molecular techniques and universal versus targeted screening. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Listening to the vocal citizens: how do politically active individuals choose between life saving programs?

Energy Technology Data Exchange (ETDEWEB)

Ramsberg, J. [Stockholm School of Economics, Stockholm (Sweden)

1998-07-01

Large disparities in the cost per life saved for different life saving interventions have been reported in many studies. According to some researchers, these differences reflect the public's preoccupation with selected qualitative aspects of risk. However, it is not obvious that these disparities reflect public preferences. In studies of the variation in cost per life saved the public accept, most respondents are willing to trade qualitative characteristics for lives saved, but there is a small but significant group of respondents who will not make the tradeoff, i.e. assign infinite value to one or more of the qualitative factors. It has been suggested that this group could be particularly vocal, which might account for the large variation in cost per life saved. In the first attempt to address this issue, a survey of people living under a power line in Stockholm was undertaken. This population was chosen because the local government had decided to remove the power line after being pressured by the citizens and on interest group. Tests of how more politically active individuals differ from less active were undertaken. Most importantly, it was found that more politically active respondents were less likely to trade qualitative characteristics for lives saved, but only for the risk in which they were active and only up to a point. There still was a group of respondents who were unwilling to make the tradeoff. (author)

Promoting cooperative federalism through state shared savings.

Science.gov (United States)

Weil, Alan

2013-08-01

The Affordable Care Act is transforming American federalism and creating strain between the states and the federal government. By expanding the scale of intergovernmental health programs, creating new state requirements, and setting the stage for increased federal fiscal oversight, the act has disturbed an uneasy truce in American federalism. This article outlines a policy proposal designed to harness cooperative federalism, based on the shared state and federal desire to control health care cost growth. The proposal, which borrows features of the Medicare Shared Savings Program, would provide states with an incentive in the form of an increased share of the savings they generate in programs that have federal financial participation, as long as they meet defined performance standards.

Comparison of Software Models for Energy Savings from Cool Roofs

Energy Technology Data Exchange (ETDEWEB)

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

2014-01-01

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

Targeting utility customers to improve energy savings from conservation and efficiency programs

International Nuclear Information System (INIS)

Taylor, Nicholas W.; Jones, Pierce H.; Kipp, M. Jennison

2014-01-01

Highlights: • Improving DSM program impacts by targeting high energy users. • DSM energy savings potential hinges on pre-participation performance. • Targeting can benefit different utilities and energy efficiency programs. • Overall performance can be improved by up to 250% via targeting strategies. - Abstract: Electric utilities, government agencies, and private interests in the US have committed and continue to invest substantial resources – including billions of dollars of financial capital – in the pursuit of energy efficiency and conservation through demand-side management (DSM) programs. While most of these programs are deemed to be cost effective, and therefore in the public interest, opportunities exist to improve cost effectiveness by targeting programs to those customers with the greatest potential for energy savings. This article details an analysis of three DSM programs offered by three Florida municipal electric utilities to explore such opportunities. First, we estimate programs’ energy savings impacts; second, we measure and compare energy savings across subgroups of program participants as determined by their pre-intervention energy performance, and third, we explore potential changes in program impacts that might be realized by targeting specific customers for participation in the DSM programs. All three programs resulted in statistically significant average (per-participant) energy savings, yet average savings varied widely, with the customers who performed best (i.e., most efficient) before the intervention saving the least energy and those who performed worst (i.e., least efficient) before the intervention saving the most. Assessment of alternative program participation scenarios with varying levels of customer targeting suggests that program impacts could be increased by as much as 80% for a professional energy audit program, just over 100% for a high-efficiency heat pump upgrade program, and nearly 250% for an attic insulation

Strategic planning for saving the lives of mothers, newborns and children and preventing stillbirths in KwaZulu-Natal province South Africa: modelling using the Lives Saved Tool (LiST).

Science.gov (United States)

McGee, Shelley-Ann; Chola, Lumbwe; Tugendhaft, Aviva; Mubaiwa, Victoria; Moran, Neil; McKerrow, Neil; Kamugisha, Leonard; Hofman, Karen

2016-01-19

KwaZulu-Natal province in South Africa has the largest population of children under the age of five and experiences the highest number of child births per annum in the country. Its population has also been ravaged by the dual epidemics of HIV and TB and it has struggled to meet targets for maternal and child mortality. In South Africa's federal system, provinces have decision-making power on the prioritization and allocation of resources within their jurisdiction. As part of strategic planning for 2015-2019, KwaZulu-Natal provincial authorities requested an assessment of current mortality levels in the province and identification and costing of priority interventions for saving additional maternal, newborn and child lives, as well as preventing stillbirths in the province. The Lives Saved Tool (LiST) was used to determine the set of interventions, which could save the most additional maternal and child lives and prevent stillbirths from 2015-2019, and the costs of these. The impact of family planning was assessed using two scenarios by increasing baseline coverage of modern contraception by 0.5 percentage points or 1 percentage point per annum. A total of 7,043 additional child and 297 additional maternal lives could be saved, and 2,000 stillbirths could be prevented over five years. Seventeen interventions account for 75% of additional lives saved. Increasing family planning contributes to a further reduction of up to 137 maternal and 3,168 child deaths. The set of priority interventions scaled up to achievable levels, with no increase in contraception would require an additional US$91 million over five years or US$1.72 per capita population per year. By increasing contraceptive prevalence by one percentage point per year, overall costs to scale up to achievable coverage package, decrease by US$24 million over five years. Focused attention on a set of key interventions could have a significant impact on averting stillbirths and maternal and neonatal mortality in

Demonstration of energy-saving construction works; Shoshigenka wo mezashita kenchiku koji no jissho kenkyu

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, T.; Yamagishi, M.; Kakimi, S. [Chubu Electric Power Co. Inc., Nagoya (Japan)

1997-11-01

Studies are conducted to promote energy-saving in construction works as part of environment protection programs. The first phase is for survey and analysis works for energy-saving in the current building design and construction works, and for processes, procedures and materials in model works (construction of sub-stations). The second phase is for studying energy-saving designs, materials and procedures, which are applied to model works, to assess their energy-saving effects , costs and applicability. The horizontally developed samples are prepared for the future development, based on the `continuous improvement of environment-management systems by establishing the PDCA cycles,` which is one of the basic requirements of the ISO14001 (environment management system). These efforts have reduced CO2 emissions associated with the manufacture of construction materials by 20%, mixed wastes by 45%, and plywood frame requirement by 70%. It is also confirmed that they can be realized at only around 3% higher cost. 9 refs., 10 figs., 3 tabs.

Sino-US cooperation in water saving technologies: essential international problems

Science.gov (United States)

The United States and China share many agricultural problems, but one of great importance is the need to produce more crop yield in the face of water scarcity. Common recognition of this problem led to the development of a joint Sino-US Water Saving Technologies Flagship project within the larger US...

Climate protection with rapid payback. Energy and CO2 savings potential of industrial insulation in EU27

Energy Technology Data Exchange (ETDEWEB)

Neelis, M.; Blinde, P.; Overgaag, M.; Deng, Y. [Ecofys Netherlands, Utrecht (Netherlands)

2012-06-15

This study aims to answer the following four questions: (1) What is the energy savings and CO2 emissions mitigation potential resulting from insulating currently uninsulated parts and from better maintenance of insulation systems?; (2) What are the energy savings and CO2 mitigation potential from improving current insulation to cost-effective levels? Cost-effective insulation in this study is defined as the insulation that minimises the sum of the costs of heat loss and the costs of insulation; (3) What is the energy savings and CO2 mitigation potential from improving current insulation beyond cost-effective levels to even more energy-efficient levels? Energy-efficient insulation in this study is defined as the insulation at which the sum of the costs of heat loss and the annualised insulation investments are equal to the costs of typical current insulation while offering an additional energy savings and CO2 mitigation potential; and (4) How can these potentials best be realised? This study investigates savings potentials from improved insulation in EU industry and the power sector under realistic market conditions. Nuclear power plants and power production by renewable sources were left outside the scope of this study as well as insulations of cold applications. Case studies of insulation projects have been used to compare energy loss and investments related to different levels of insulation. The analysis was performed for three temperature levels: <100C; 100-300C and >300C. Results at the level of the case studies were extrapolated to European level using data on current energy use. Other assumptions have been made where needed on the basis of literature and expert input. All potentials are based on a 9% discount rate, an average insulation lifetime of 15 years and a 2-3% per year increase of the price of energy net of inflation.