WorldWideScience

Sample records for greater cost savings

  1. Realized Cost Savings 2016

    Data.gov (United States)

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

  2. Invisible costs, visible savings.

    Science.gov (United States)

    Lefever, G

    1999-08-01

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

  3. FY 1997 cost savings report

    International Nuclear Information System (INIS)

    Sellards, J.B.

    1998-01-01

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

  4. 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

  5. The High Cost of Saving Energy Dollars.

    Science.gov (United States)

    Rose, Patricia

    1985-01-01

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

  6. 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...

  7. Action Program for Implementing Heat Savings in Greater Copenhagen

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen; Karlsson, Kenneth; Engell, Thomas

    1998-01-01

    This main report summarized the content of the three sub-report of the project, including the background for the project, the potentails for saving heat and the barriers for implementing these savings. Afterwards the report define the geographical area considered, as well as the present situation...

  8. Nuclear recycling: costs, savings, and safeguards

    International Nuclear Information System (INIS)

    Spinrad, B.I.

    1985-01-01

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

  9. 21 Cost-Saving Measures For The Judiciary

    Directory of Open Access Journals (Sweden)

    Jessica Vapnek

    2013-02-01

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

  10. Potential cost savings with terrestrial rabies control

    Directory of Open Access Journals (Sweden)

    Cherry Bryan

    2007-04-01

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

  11. 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)

  12. 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

  13. 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.

  14. Cost-saving production technologies and partial ownership

    OpenAIRE

    Juan Carlos Barcena-Ruiz; Norma Olaizola

    2007-01-01

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

  15. Towards Greater Harmonisation of Decommissioning Cost Estimates

    International Nuclear Information System (INIS)

    O'Sullivan, Patrick; ); Laraia, Michele; ); LaGuardia, Thomas S.

    2010-01-01

    The NEA Decommissioning Cost Estimation Group (DCEG), in collaboration with the IAEA Waste Technology Section and the EC Directorate-General for Energy and Transport, has recently studied cost estimation practices in 12 countries - Belgium, Canada, France, Germany, Italy, Japan, the Netherlands, Slovakia, Spain, Sweden, the United Kingdom and the United States. Its findings are to be published in an OECD/NEA report entitled Cost Estimation for Decommissioning: An International Overview of Cost Elements, Estimation Practices and Reporting Requirements. This booklet highlights the findings contained in the full report. (authors)

  16. Estimated Incident Cost Savings in Shipping Due to Inspections

    NARCIS (Netherlands)

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

    2010-01-01

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

  17. Estimated incident cost savings in shipping due to inspections

    NARCIS (Netherlands)

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

    2011-01-01

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

  18. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    M Weimar

    1998-12-10

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

  1. Users enlist consultants to calculate costs, savings

    Energy Technology Data Exchange (ETDEWEB)

    1982-05-24

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

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

    Science.gov (United States)

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

    2013-03-01

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

  3. Winglets Save Billions of Dollars in Fuel Costs

    Science.gov (United States)

    2010-01-01

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

  4. 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...

  5. 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...

  6. 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.

  7. 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...

  8. 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.

  9. 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.

  10. Incorrect storage of medicines and potential for cost savings

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. Foreign Direct Investment or External Debt and Domestic Saving: Which has Greater Impact on Growth

    Directory of Open Access Journals (Sweden)

    Horas Djulius

    2018-02-01

    Full Text Available The choice taken by developing countries in meeting the lack of development funds has a varying effect. This study clarifies the role of foreign direct investment (FDI compared to foreign loans and domestic savings in short- and long-term economic growth of Indonesia. Data were obtained from World Bank and Bank Indonesia and used in error correction model to explain the linkage between predictors and economic growth. We show that in the short run, the three explanatory variables significantly affect economic growth. In the long run, compared to FDI and foreign loans, domestic savings positively and significantly affect economic growth. This study emphasizes the importance of sustaining domestic savings to maintain the stability of economic fundamentals in the long term.DOI: 10.15408/etk.v17i1.7120

  3. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-03-01

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

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

    Science.gov (United States)

    McCullough, Pat

    2012-01-01

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

  6. 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

  7. 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

  8. 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

  9. 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...

  10. 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.

  11. 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

  12. 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

  13. External costs of nuclear: Greater or less than the alternatives?

    International Nuclear Information System (INIS)

    Rabl, Ari; Rabl, Veronika A.

    2013-01-01

    Since Fukushima many are calling for a shutdown of nuclear power plants. To see whether such a shutdown would reduce the risks for health and environment, the external costs of nuclear electricity are compared with alternatives that could replace it. The frequency of catastrophic nuclear accidents is based on the historical record, about one in 25 years for the plants built to date, an order of magnitude higher than the safety goals of the U.S. Nuclear Regulatory Commission. Impacts similar to Chernobyl and Fukushima are assumed to estimate the cost. A detailed comparison is presented with wind as alternative with the lowest external cost. The variability of wind necessitates augmentation by other sources, primarily fossil fuels, because storage at the required scale is in most regions too expensive. The external costs of natural gas combined cycle are taken as 0.6 €cent/kWh due to health effects of air pollution and 1.25 €cent/kWh due to greenhouse gases (at 25€/t CO 2 eq ) for the central estimate, but a wide range of different parameters is also considered, both for nuclear and for the alternatives. Although the central estimate of external costs of the wind-based alternative is higher than that of nuclear, the uncertainty ranges overlap. - Highlights: ► The external costs of nuclear electricity are compared with the alternatives. ► Frequency and cost of nuclear accidents based on Chernobyl and Fukushima. ► Detailed comparison with wind as alternative with the lowest external costs. ► High external cost of wind because of natural gas backup (storage too limited). ► External costs of wind higher than nuclear but uncertainty ranges overlap

  14. 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/

  15. 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).

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

    Science.gov (United States)

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

    2012-09-15

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

  17. 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.

  18. 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

  19. 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....

  20. 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

  1. 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

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

    Directory of Open Access Journals (Sweden)

    Julia K Ostermann

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

  3. 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

  4. 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.

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

    International Nuclear Information System (INIS)

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

    1987-01-01

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

  6. 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.

  7. 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

  8. 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...

  9. 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

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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

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

    Directory of Open Access Journals (Sweden)

    Dzhedzhula Viacheslav V.

    2014-01-01

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

  16. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-01

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

  19. 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.

  20. 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

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

    Science.gov (United States)

    Chen, Stephanie C; Pearson, Steven D

    2016-08-01

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

  2. Cost savings from performance-based maintenance contracting

    NARCIS (Netherlands)

    Straub, A.

    2009-01-01

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

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

    Data.gov (United States)

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

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

    Science.gov (United States)

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

    2017-06-01

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

  5. O and M outsourcing saving costs for IPPs

    International Nuclear Information System (INIS)

    Byerly, K.; Mason, J.

    1997-01-01

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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Daniel Rousse

    2012-08-01

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

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

    Science.gov (United States)

    Sebesta, James

    2010-01-01

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

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

    African Journals Online (AJOL)

    D. Husselmann

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

  10. 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.

  11. 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.

  12. 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

  13. 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...

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

    Directory of Open Access Journals (Sweden)

    Dennis Bialaszewski

    2013-06-01

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

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

    Science.gov (United States)

    Gross, Karen

    2011-01-01

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

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

    Science.gov (United States)

    Prada, Sergio I

    2017-12-01

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

  17. 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.

  18. 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.

  19. 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.

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

    International Nuclear Information System (INIS)

    Anthofer, J.

    1999-01-01

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

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

    International Nuclear Information System (INIS)

    Zvingilaite, Erika; Klinge Jacobsen, Henrik

    2015-01-01

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

  2. 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.

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

    International Nuclear Information System (INIS)

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

    1992-01-01

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

  4. 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.

  5. 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.

  6. 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

  7. 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.

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

    Science.gov (United States)

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

  9. 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...

  10. 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.

  11. 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.

  12. 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

  13. 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.

  14. 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

  15. 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

  16. 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)

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Scuffham Paul

    2007-03-01

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

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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%.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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%.

  5. 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

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

    Science.gov (United States)

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

    2015-11-01

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

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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).

  16. 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.

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    International Nuclear Information System (INIS)

    Sharma, V.; Kalsi, M.S.

    2005-01-01

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

  6. Clean air benefits and costs in the GVRD [Greater Vancouver Regional District

    International Nuclear Information System (INIS)

    Gislason, G.; Martin, J.; Williams, D.; Caton, B.; Rich, J.; Rojak, S.; Robinson, J.; Stuermer, A. von

    1994-01-01

    Air pollution is a major concern in the Greater Vancouver Regional District in British Columbia. An analysis was conducted to assess the costs and benefits of an innovative plan to reduce the emissions of five primary pollutants in the GVRD: nitrogen oxides (NOx), sulfur oxides (SOx), volatile organic compounds (VOCs), particulates, and CO. The study adopts a damage function approach in which the benefits of reduced emissions are given by the averted damages to human health, crops, and so on. Under a base case scenario, motor vehicle emission controls and additional measures proposed in the region's air quality management plan (AQMP) are projected to lead to emission reductions of 873,000 tonnes in the GVRD by the year 2020, compared to the emission level projected without intervention. The AQMP is projected to avert over its life some 2,800 premature deaths, 33,000 emergency room visits, 13 million restricted activity days, and 5 million symptoms. Crop losses due to ozone are projected to decrease by 1-4%/y over the next several decades due to the AQMP. Damage averted to materials and property per tonne of pollutant reduced ranges from $30 for VOC to $180 for particulates. Under base-case conservative assumptions, the AQMP generates $5.4 billion in benefits and $3.8 billion in costs, nearly 2/3 of which are paid by the industrial and commercial sectors. 1 tab

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  8. Energy and 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.

  9. 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.

  10. 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)

  11. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

  13. 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.

  14. 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

  15. 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.

  16. [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

  17. 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.

  18. 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

  19. 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.

  20. 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.  

  1. 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.

  2. 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.

  3. 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)

  4. 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.

  5. 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.

  6. Rising Use Of Observation Care Among The Commercially Insured May Lead to Total And Out-Of-Pocket Cost Savings.

    Science.gov (United States)

    Adrion, Emily R; Kocher, Keith E; Nallamothu, Brahmajee K; Ryan, Andrew M

    2017-12-01

    Proponents of hospital-based observation care argue that it has the potential to reduce health care spending and lengths-of-stay, compared to short-stay inpatient hospitalizations. However, critics have raised concerns about the out-of-pocket spending associated with observation care. Recent reports of high out-of-pocket spending among Medicare beneficiaries have received considerable media attention and have prompted direct policy changes. Despite the potential for changed policies to indirectly affect non-Medicare patients, little is known about the use of, and spending associated with, observation care among commercially insured populations. Using multipayer commercial claims for the period 2009-13, we evaluated utilization and spending among patients admitted for six conditions that are commonly managed with either observation care or short-stay hospitalizations. In our study period, the use of observation care increased relative to that of short-stay hospitalizations. Total and out-of-pocket spending were substantially lower for observation care, though both grew rapidly-and at rates much higher than spending in the inpatient setting-over the study period. Despite this growth, spending on observation care is unlikely to exceed spending for short-stay hospitalizations. As observation care attracts greater attention, policy makers should be aware that Medicare policies that disincentivize observation may have unintended financial impacts on non-Medicare populations, where observation care may be cost saving.

  7. 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.

  8. 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.…

  9. 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.

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

    Science.gov (United States)

    Denham, Charles R; Guilloteau, Franck R

    2012-09-01

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

  11. 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

  12. 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.

  13. 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

  14. 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...

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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

  1. Benefit-cost-risk analysis of alternatives for greater-confinement disposal of radioactive waste

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Peterson, J.M.

    1983-01-01

    Seven alternatives are included in the analysis: near-surface disposal; improved waste form; below-ground engineered structure; augered shaft; shale fracturing; shallow geologic repository; and high-level waste repository. These alternatives are representative generic facilities that span the range from low-level waste disposal practice to high-level waste disposal practice, tentatively ordered according to an expected increasing cost and/or effectiveness of confinement. They have been chosen to enable an assessment of the degree of confinement that represents an appropriate balance between public health and safety requirements and costs rather than identification of a specific preferred facility design. The objective of the analysis is to provide a comparative ranking of the alternatives on the basis of benefit-cost-risk considerations

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Greater healthcare utilization and costs among Black persons compared to White persons with aphasia in the North Carolina stroke belt.

    Science.gov (United States)

    Ellis, Charles; Hardy, Rose Y; Lindrooth, Richard C

    2017-05-15

    To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs. Hospital fixed effects were included to yield within-hospital estimates of disparities. GLM models demonstrated that Blacks with aphasia experienced 1.9days longer lengths of stay compared to Whites with aphasia after controlling for demographic characteristics, 1.4days controlling for stroke/illness severity, 1.2days controlling for observed hospital characteristics, and ~1 extra day controlling for unobserved hospital characteristics. Similarly, Blacks accrued ~$2047 greater total costs compared to Whites after controlling for demographic characteristics, $1659 controlling for stroke/illness severity, $1338 controlling for observed hospital characteristics, and ~$1311 greater total costs after controlling for unobserved hospital characteristics. In the acute hospital setting, Blacks with aphasia utilize greater hospital services during longer hospitalizations and at substantially higher costs in the state of NC. A substantial portion of the adjusted difference was related to the hospital treating the patient. However, even after controlling for the hospital, the differences remained clinically and statistically significant. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Cost-benefit analysis for invasive species control: the case of greater Canada goose Branta canadensis in Flanders (northern Belgium

    Directory of Open Access Journals (Sweden)

    Nikolaas Reyns

    2018-01-01

    Full Text Available Background Sound decisions on control actions for established invasive alien species (IAS require information on ecological as well as socio-economic impact of the species and of its management. Cost-benefit analysis provides part of this information, yet has received relatively little attention in the scientific literature on IAS. Methods We apply a bio-economic model in a cost-benefit analysis framework to greater Canada goose Branta canadensis, an IAS with documented social, economic and ecological impacts in Flanders (northern Belgium. We compared a business as usual (BAU scenario which involved non-coordinated hunting and egg destruction with an enhanced scenario based on a continuation of these activities but supplemented with coordinated capture of moulting birds. To assess population growth under the BAU scenario we fitted a logistic growth model to the observed pre-moult capture population. Projected damage costs included water eutrophication and damage to cultivated grasslands and were calculated for all scenarios. Management costs of the moult captures were based on a representative average of the actual cost of planning and executing moult captures. Results Comparing the scenarios with different capture rates, different costs for eutrophication and various discount rates, showed avoided damage costs were in the range of 21.15 M€ to 45.82 M€ under the moult capture scenario. The lowest value for the avoided costs applied to the scenario where we lowered the capture rate by 10%. The highest value occurred in the scenario where we lowered the real discount rate from 4% to 2.5%. Discussion The reduction in damage costs always outweighed the additional management costs of moult captures. Therefore, additional coordinated moult captures could be applied to limit the negative economic impact of greater Canada goose at a regional scale. We further discuss the strengths and weaknesses of our approach and its potential application to other

  9. Cost-benefit analysis for invasive species control: the case of greater Canada goose Branta canadensis in Flanders (northern Belgium)

    Science.gov (United States)

    Casaer, Jim; De Smet, Lieven; Devos, Koen; Huysentruyt, Frank; Robertson, Peter A.; Verbeke, Tom

    2018-01-01

    Background Sound decisions on control actions for established invasive alien species (IAS) require information on ecological as well as socio-economic impact of the species and of its management. Cost-benefit analysis provides part of this information, yet has received relatively little attention in the scientific literature on IAS. Methods We apply a bio-economic model in a cost-benefit analysis framework to greater Canada goose Branta canadensis, an IAS with documented social, economic and ecological impacts in Flanders (northern Belgium). We compared a business as usual (BAU) scenario which involved non-coordinated hunting and egg destruction with an enhanced scenario based on a continuation of these activities but supplemented with coordinated capture of moulting birds. To assess population growth under the BAU scenario we fitted a logistic growth model to the observed pre-moult capture population. Projected damage costs included water eutrophication and damage to cultivated grasslands and were calculated for all scenarios. Management costs of the moult captures were based on a representative average of the actual cost of planning and executing moult captures. Results Comparing the scenarios with different capture rates, different costs for eutrophication and various discount rates, showed avoided damage costs were in the range of 21.15 M€ to 45.82 M€ under the moult capture scenario. The lowest value for the avoided costs applied to the scenario where we lowered the capture rate by 10%. The highest value occurred in the scenario where we lowered the real discount rate from 4% to 2.5%. Discussion The reduction in damage costs always outweighed the additional management costs of moult captures. Therefore, additional coordinated moult captures could be applied to limit the negative economic impact of greater Canada goose at a regional scale. We further discuss the strengths and weaknesses of our approach and its potential application to other IAS. PMID

  10. 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

  11. 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.

  12. 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...

  13. 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

  14. 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)

  15. 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 ...

  16. 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.)

  17. Commercial Integrated Heat Pump with Thermal Storage --Demonstrate Greater than 50% Average Annual Energy Savings, Compared with Baseline Heat Pump and Water Heater (Go/No-Go) FY16 4th Quarter Milestone Report

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Bo [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Baxter, Van D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rice, C. Keith [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Abu-Heiba, Ahmad [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-03-01

    For this study, we authored a new air source integrated heat pump (AS-IHP) model in EnergyPlus, and conducted building energy simulations to demonstrate greater than 50% average energy savings, in comparison to a baseline heat pump with electric water heater, over 10 US cities, based on the EnergyPlus quick-service restaurant template building. We also assessed water heating energy saving potentials using ASIHP versus gas heating, and pointed out climate zones where AS-IHPs are promising.

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

    Science.gov (United States)

    2008-09-01

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

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

    Science.gov (United States)

    2008-12-01

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

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

    Science.gov (United States)

    2008-09-01

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

  1. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report.

  2. Waste Management Facilities Cost Information report for Greater-Than-Class C and DOE equivalent special case waste

    International Nuclear Information System (INIS)

    Feizollahi, F.; Shropshire, D.

    1993-07-01

    This Waste Management Facility Cost Information (WMFCI) report for Greater-Than-Class C low-level waste (GTCC LLW) and DOE equivalent special case waste contains preconceptual designs and planning level life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities needed for management of GTCC LLW and DOE equivalent waste. The report contains information on 16 facilities (referred to as cost modules). These facilities are treatment facility front-end and back-end support functions (administration support, and receiving, preparation, and shipping cost modules); seven treatment concepts (incineration, metal melting, shredding/compaction, solidification, vitrification, metal sizing and decontamination, and wet/air oxidation cost modules); two storage concepts (enclosed vault and silo); disposal facility front-end functions (disposal receiving and inspection cost module); and four disposal concepts (shallow-land, engineered shallow-land, intermediate depth, and deep geological cost modules). Data in this report allow the user to develop PLCC estimates for various waste management options. A procedure to guide the U.S. Department of Energy (DOE) and its contractor personnel in the use of estimating data is also included in this report

  3. 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

  4. 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

  5. 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

  6. 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

  7. Synergy effects of fluoxetine and variability in temperature lead to proportionally greater fitness costs in Daphnia: A multigenerational test.

    Science.gov (United States)

    Barbosa, Miguel; Inocentes, Núrya; Soares, Amadeu M V M; Oliveira, Miguel

    2017-12-01

    Increased variability in water temperature is predicted to impose disproportionally greater fitness costs than mean increase in temperature. Additionally, water contaminants are currently a major source of human-induced stress likely to produce fitness costs. Global change models forecast an increase in these two human-induced stressors. Yet, in spite the growing interest in understanding how organisms respond to global change, the joint fitness effects of water pollution and increased variability in temperature remain unclear. Here, using a multigenerational design, we test the hypothesis that exposure to high concentrations of fluoxetine, a human medicine commonly found in freshwater systems, causes increased lifetime fitness costs, when associated with increased variability in temperature. Although fluoxetine and variability in temperature elicited some fitness cost when tested alone, when both stressors acted together the costs were disproportionally greater. The combined effect of fluoxetine and variability in temperature led to a reduction of 37% in lifetime reproductive success and a 17.9% decrease in population growth rate. Interestingly, fluoxetine and variability in temperature had no effect on the probability of survival. Freshwater systems are among the most imperilled ecosystems, often exposed to multiple human-induced stressors. Our results indicate that organisms face greater fitness risk when exposed to multiple stressors at the same time than when each stress acts alone. Our study highlights the importance of using a multi-generational approach to fully understand individual environmental tolerance and its responses to a global change scenario in aquatic systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. 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

  9. 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.

  10. 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.

  11. 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.

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

    National Research Council Canada - National Science Library

    1998-01-01

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

  13. 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

  14. Improved Process Used to Treat Aqueous Mixed Waste Results in Cost Savings and Improved Worker Safety

    International Nuclear Information System (INIS)

    Hodge, D.S.; Preuss, D.E.; Belcher, K.J.; Rock, C.M.; Bray, W.S.; Herman, J.P.

    2006-01-01

    This paper describes an improved process implemented at Argonne National Laboratory (ANL) to treat aqueous mixed waste. This waste is comprised of radioactively-contaminated corrosive liquids with heavy metals. The Aqueous Mixed Waste Treatment System (AMWTS) system components include a reaction tank and a post-treatment holding tank with ancillary piping and pumps; and a control panel with pumping/mixing controls; tank level, temperature and pH/Oxidation Reduction Potential (ORP) indicators. The process includes a neutralization step to remove the corrosive characteristic, a chromium reduction step to reduce hexavalent chromium to trivalent chromium, and a precipitation step to convert the toxic metals into an insoluble form. Once the toxic metals have precipitated, the resultant sludge is amenable to stabilization and can be reclassified as a low-level waste if the quantity of leachable toxic metals, as determined by the TCLP, is below Universal Treatment Standards (UTS). To date, six batches in eight have passed the UTS. The AMWTS is RCRA permitted and allows for the compliant treatment of mixed waste prior to final disposal at a Department of Energy (DOE) or commercial radioactive waste disposal facility. Mixed wastes eligible for treatment include corrosive liquids (pH 12.5) containing EPA-regulated toxic metals (As, Ba, Pb, Cd, Cr, Ag, Se, Hg) at concentrations greater than the RCRA Toxicity Characteristic Leaching Procedure (TCLP) limit. The system has also been used to treat corrosive wastes with small quantities of fissionable materials. The AMWTS is a significant engineered solution with many improvements over the more labor intensive on-site treatment method being performed within a ventilation hood used previously. The previously used treatment system allowed for batch sizes of only 15-20 gallons whereas the new AMWTS allows for the treatment of batches up to 75 gallons; thereby reducing batch labor and supply costs by 40-60% and reducing analytical

  15. 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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Yi Yuyin

    2018-03-01

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

  18. Limited risk assessment and some cost/benefit considerations for greater confinement disposal compared to shallow land burial

    International Nuclear Information System (INIS)

    Hunter, P.H.; Lester, D.H.; Robertson, L.D.; Spaeth, M.E.; Stoddard, J.A.; Dickman, P.T.

    1984-09-01

    A limited risk assessment and some cost/benefit considerations of greater confinement disposal (GCD) compared to shallow land burial (SLB) are presented. This study is limited to an analysis of the postclosure phase of hypothetical GCD and SLB facilities. Selected release scenarios are used which bound the range of risks to a maximally exposed individual and a hypothetical population. Based on the scenario assessments, GCD had a significant risk advantage over SLB for normal exposure pathways at both humid and arid sites, particularly for the human intrusion scenario. Since GCD costs are somewhat higher than SLB, it is necessary to weigh the higher costs of GCD against the higher risks of SLB. In this regard, GCD should be pursued as an alternative to SLB for certain types of low-level waste, and as an alternative to processing for wastes requiring improved stabilization or higher integrity packaging to be compatible with SLB. There are two reasons for this conclusion. First, GCD might diminish public apprehension regarding the disposal of wastes perceived to be too hazardous for SLB. Second, GCD may be a relatively cost-effective alternative to various stabilization and packaging schemes required to meet 10 CFR 61 near-surface requirements as well as being a cost-effective alternative to deep geologic disposal. Radionuclide transport through the biosphere and resultant dose consequences were determined using the RADTRAN radionuclide transport code. 19 references, 4 figures, 5 tables

  19. 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.

  20. 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...

  1. 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.

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

    OpenAIRE

    Shreve, Cheney M.; Kelman, Ilan

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  5. Saving and costs of a Picture Archiving and Communication System in the Utrecht University Hospital

    NARCIS (Netherlands)

    Andriessen, J.H.T.H.; Haar Romenij, ter B.M.; Barneveld Binkhuysen, F.; Horst - Bruinsma, van der I.E.; Dwyer, S.J.; Jost, R.G.; Schneider, R.H.

    1989-01-01

    The evaluation of the Dutch PACS project comprises amongst other studies a comparison of the direct financial costs of the present conventional system and the PACSystem. This paper shows that the invest-ment costs of a PACSystem are presently substantially higher than of the present system. These

  6. Low-Cost In-Fill Installation for High-Energy-Saving, Dynamic Windows

    Science.gov (United States)

    2017-07-01

    increase 2% annually. This is consistent with national recognized energy prediction models. Electrical Labor costs: Electrical labor cost for wiring...Technology Description: ................................................................................................ 3 2.1.2 Energy Consumption ...22 Figure 15. Energy Consumption for the Calibration Period of 9/2/2015 - 9/16/2015

  7. Cost-Savings Achieved in Two Semesters through the Adoption of Open Educational Resources

    Science.gov (United States)

    Hilton, John Levi, III; Robinson, Jared; Wiley, David; Ackerman, J. Dale

    2014-01-01

    Textbooks represent a significant portion of the overall cost of higher education in the United States. The burden of these costs is typically shouldered by students, those who support them, and the taxpayers who fund the grants and student loans which pay for textbooks. Open educational resources (OER) provide students a way to receive…

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

    Directory of Open Access Journals (Sweden)

    Annie L. Andrews

    2012-01-01

    Full Text Available Objective. To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. Methods. Using 2009 South Carolina (SC Medicaid birth cohort (n=29,316, we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. Results. Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. Conclusions. For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

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

    Directory of Open Access Journals (Sweden)

    C. J. Ejieji

    2013-08-01

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

  14. Dry Kraft Pulping at Ambient Pressure for Cost Effective Energy Saving and Pollution Deduction

    Energy Technology Data Exchange (ETDEWEB)

    Yulin Deng; Art Ragauskas

    2012-08-28

    evaporated first under vacuum condition at low temperature. Then, the dry woodchips were baked at high temperature (120-130 C) at atmospheric pressure. The qualities of the pulp made with this method were improved compared to that made with method one. The pulp shows higher brightness and lower bulk than Kraft pulping. The tensile strength is significantly higher than the pulp made from the first method. Although the pulp is stronger than that of TMP pulp, it is still lower than conventional Kraft fiber. Method Three: The third dry method was done in a Kraft pulping digester at elevated pressure but without free liquid in the digester. With this method, pulp that has almost the same qualities as conventional Kraft pulp could be produced. The screen yield, Kappa number, fiber brightness, pulp strength and pulp bulk are almost identical to the conventional Kraft pulp. The key advantages of this dry pulping method include ca. 55 % of cooking energy saved during the pulping process, as high as 50 wt% of NaOH saving as well as 3 wt% of Na2S saving comparing to Kraft one. By analyzing fiber properties, yields, chemical and energy consumptions, we concluded that the dry pulping method based on Liquid Free Chemical Pulping, LFCP, could be very attractive for the pulp and paper industry. More fundamental studies and scale up trials are needed to fully commercialize the technology. We expect to conduct pilot trials between 12 to 24 months of period if the DOE or industry can provide continual research funding. Based on the technology we demonstrated in this report, several pilot trial facilities in the United States will be available after small modifications. For example, the Herty Foundation in Savannah, Georgia is one of these potential locations. DOE funding for continuous study and final lead to commercialization of the technique is important.

  15. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

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

  17. Evaluating C-RAN Fronthaul Functional Splits in Terms of Network Level Energy and Cost Savings

    DEFF Research Database (Denmark)

    Checko, Aleksandra; Popovska Avramova, Andrijana; Berger, Michael Stübert

    2016-01-01

    The placement of the complete baseband processing in a centralized pool results in high data rate requirement and inflexibility of the fronthaul network, which challenges the energy and cost effectiveness of the cloud radio access network (C-RAN). Recently, redesign of the C-RAN through functional...... split in the baseband processing chain has been proposed to overcome these challenges. This paper evaluates, by mathematical and simulation methods, different splits with respect to network level energy and cost efficiency having in the mind the expected quality of service.The proposed mathematical...... model quantifies the multiplexing gains and the trade-offs between centralization and decentralization concerning the cost of the pool, fronthaul network capacity and resource utilization. The event-based simulation captures the influence of the traffic load dynamics and traffic type variation...

  18. 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.

  19. Saving Money On Meds Cut your Rx costs with these tips.

    Science.gov (United States)

    Calandra, Robert

    2016-11-01

    With insurance deductibles and co-pays rising for some prescription medications and supplies, staying healthy is becoming more expensive for people with diabetes. But there are ways to trim costs without skimping on necessities. Start by being proactive and candid with your providers. Let your doctor, pharmacist, and diabetes educator know if there was an unexpected increase in your co-pay or if you need help paying for your prescriptions and supplies. They might point you toward free samples, discount coupons, and vouchers offered by pharmaceutical companies and device manufacturers. Read on for other cost- cutting tips.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-01

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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. How to save costs by reducing unnecessary testing: Lean thinking in clinical practice

    NARCIS (Netherlands)

    Vegting, I.L.; van Beneden, M.; Kramer, M.H.H.; Thijs, A.; Kostense, P.J.; Nanayakkara, P.W.B.

    2012-01-01

    Background: The burden of health care expenditure on national budgets has increased dramatically over the past decade. A pilot study in our hospital demonstrated that many unnecessary diagnostic tests were performed routinely. The aim of this study was to reduce the costs of unnecessary diagnostic

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    Science.gov (United States)

    We evaluated the impacts of domestic and agricultural rainwater harvesting (RWH) systems in three watersheds within the Albemarle-Pamlico river basin (southeastern U.S.) using life cycle assessment (LCA) and life cycle cost assessment. Life cycle impact assessment (LCIA) categori...

  9. Modeling fuel treatment impacts on fire suppression cost savings: A review

    Science.gov (United States)

    Matthew P. Thompson; Nathaniel M. Anderson

    2015-01-01

    High up-front costs and uncertain return on investment make it difficult for land managers to economically justify large-scale fuel treatments, which remove trees and other vegetation to improve conditions for fire control, reduce the likelihood of ignition, or reduce potential damage from wildland fire if it occurs. In the short-term, revenue from harvested forest...

  10. 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

  11. Margins in breast conserving surgery: The financial cost & potential savings associated with the new margin guidelines.

    Science.gov (United States)

    Singer, Lauren; Brown, Eric; Lanni, Thomas

    2016-08-01

    In this study, we compare the indications for re-excision, the findings of additional tumor in the re-excision specimen as they relate to margin status, and costs associated with re-excision based on recent new consensus statements. A retrospective analysis was performed on 462 patients with invasive breast carcinoma who underwent at least one lumpectomy between January 2011 and December 2013. Postoperative data was analyzed based on where additional disease was found, as it relates to the margin status of the initial lumpectomy and the additional direct costs associated with additional procedures. Of the 462 patients sampled, 149 underwent a re-excision surgery (32.2%). Four patients underwent mastectomy as their second operation. In the 40 patients with additional disease found on re-excision, 36 (90.0%) of them had a positive margin on their initial lumpectomy. None of the four mastectomy patients had residual disease. The mean cost of the initial lumpectomy for all 462 patients was $2118.01 plus an additional $1801.92 for those who underwent re-excision. A positive margin was most predictive of finding residual tumor on re-excision as would be expected. Using old criteria only 0.07% (4/61) of patients who had undergone re-excision with a 'clear' margin, had additional tumor found, at a total cost of $106,354.11. Thus, the new consensus guidelines will lead to less overall cost, at no clinical risk to patients while reducing a patient's surgical risk and essentially eliminating delays in adjuvant care. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-03-01

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

  13. [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.

  14. 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

  15. 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)

  16. DOD Civilian and Contractor Workforces: Additional Cost Savings Data and Efficiencies Plan are Needed

    Science.gov (United States)

    2016-10-01

    Enterprise-wide Contractor Manpower Reporting Application (ECMRA) across all its components, and which will continue to improve reporting of...costs: Not applicable yes (estimated) no (estimated) Source: GAO analysis of DOD’s February 2016 status report | GAO-17-128 aNumber of...and interviewed DOD officials. What GAO Recommends GAO previously recommended that DOD fully address ongoing section 955 requirements, such as

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

    International Nuclear Information System (INIS)

    Schmidt, C.; Heller, M.

    2003-01-01

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

  18. Server Operation and Virtualization to Save Energy and Cost in Future Sustainable Computing

    Directory of Open Access Journals (Sweden)

    Jun-Ho Huh

    2018-06-01

    Full Text Available Since the introduction of the LTE (Long Term Evolution service, we have lived in a time of expanding amounts of data. The amount of data produced has increased every year with the increase of smart phone distribution in particular. Telecommunication service providers have to struggle to secure sufficient network capacity in order to maintain quick access to necessary data by consumers. Nonetheless, maintaining the maximum capacity and bandwidth at all times requires considerable cost and excessive equipment. Therefore, to solve such a problem, telecommunication service providers need to maintain an appropriate level of network capacity and to provide sustainable service to customers through a quick network development in case of shortage. So far, telecommunication service providers have bought and used the network equipment directly produced by network equipment manufacturers such as Ericsson, Nokia, Cisco, and Samsung. Since the equipment is specialized for networking, which satisfied consumers with their excellent performances, they are very costly because they are developed with advanced technologies. Moreover, it takes much time due to the purchase process wherein the telecommunication service providers place an order and the manufacturer produces and delivers. Accordingly, there are cases that require signaling and two-way data traffic as well as capacity because of the diversity of IoT devices. For these purposes, the need for NFV (Network Function Virtualization is raised. Equipment virtualization is performed so that it is operated on an x86-based compatible server instead of working on the network equipment manufacturer’s dedicated hardware. By operating in some compatible servers, it can reduce the wastage of hardware and cope with the change thanks to quick hardware development. This study proposed an efficient system of reducing cost in network server operation using such NFV technology and found that the cost was reduced by 24

  19. The ability of land owners and their cooperatives to leverage payments greater than opportunity costs from conservation contracts.

    Science.gov (United States)

    Lennox, Gareth D; Armsworth, Paul R

    2013-06-01

    In negotiations over land-right acquisitions, landowners have an informational advantage over conservation groups because they know more about the opportunity costs of conservation measures on their sites. This advantage creates the possibility that landowners will demand payments greater than the required minimum, where this minimum required payment is known as the landowner’s willingness to accept (WTA). However, in recent studies of conservation costs, researchers have assumed landowners will accept conservation with minimum payments. We investigated the ability of landowners to demand payments above their WTA when a conservation group has identified multiple sites for protection. First, we estimated the maximum payment landowners could potentially demand, which is set when groups of landowners act as a cooperative. Next, through the simulation of conservation auctions, we explored the amount of money above landowners’ WTA (i.e., surplus) that conservation groups could cede to secure conservation agreements, again investigating the influence of landowner cooperatives. The simulations showed the informational advantage landowners held could make conservation investments up to 42% more expensive than suggested by the site WTAs. Moreover, all auctions resulted in landowners obtaining payments greater than their WTA; thus, it may be unrealistic to assume landowners will accept conservation contracts with minimum payments. Of particular significance for species conservation, conservation objectives focused on overall species richness,which therefore recognize site complementarity, create an incentive for land owners to form cooperatives to capture surplus. To the contrary, objectives in which sites are substitutes, such as the maximization of species occurrences, create a disincentive for cooperative formation.

  20. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-07-01

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

  2. 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%

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

    International Nuclear Information System (INIS)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  5. Program Potential: Estimates of Federal Energy Cost Savings from Energy Efficient Procurement

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Margaret [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fujita, K. Sydny [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-09-17

    In 2011, energy used by federal buildings cost approximately $7 billion. Reducing federal energy use could help address several important national policy goals, including: (1) increased energy security; (2) lowered emissions of greenhouse gases and other air pollutants; (3) increased return on taxpayer dollars; and (4) increased private sector innovation in energy efficient technologies. This report estimates the impact of efficient product procurement on reducing the amount of wasted energy (and, therefore, wasted money) associated with federal buildings, as well as on reducing the needless greenhouse gas emissions associated with these buildings.

  6. Monitored retrievable storage and multi-purpose canister robotic applications: Feasibility, dose savings and cost analysis

    International Nuclear Information System (INIS)

    Bennett, P.C.

    1995-01-01

    Robotic automation is examined as a possible alternative to manual spent nuclear fuel, transport cask and Multi-Purpose Canister (MPC) handling at a Monitored Retrievable Storage (MRS) facility, and as an alternative to current MPC closure and welding methods at commercial nuclear reactor sites. Automation of key operational aspects is analyzed to determine equipment requirements, through-put times and equipment costs. The economic analysis approach is described, and economic and radiation dose impacts resulting from this automation are compared to manual handling methods. (author). 5 refs, 5 figs, 3 tabs

  7. Designing Green Networks and Network Operations Saving Run-the-Engine Costs

    CERN Document Server

    Minoli, Daniel

    2011-01-01

    In recent years the confluence of socio-political trends toward environmental responsibility and the pressing need to reduce Run-the-Engine (RTE) costs has given birth to a nascent discipline of Green IT. A clear and concise introduction to green networks and green network operations, this book examines analytical measures and discusses virtualization, network computing, and web services as approaches for green data centers and networks. It identifies some strategies for green appliance and end devices and examines the methodical steps that can be taken over time to achieve a seamless migratio

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

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Jian; Athalye, Rahul A.; Hart, Philip R.; Rosenberg, Michael I.; Xie, YuLong; Goel, Supriya; Mendon, Vrushali V.; Liu, Bing

    2013-08-30

    The purpose of this analysis is to assess the relative energy and energy cost performance of commercial buildings designed to meet the requirements found in the commercial energy efficiency provisions of the International Energy Conservation Code (IECC). Section 304(b) of the Energy Conservation and Production Act (ECPA), as amended, requires the Secretary of Energy to make a determination each time a revised version of ASHRAE Standard 90.1 is published with respect to whether the revised standard would improve energy efficiency in commercial buildings. As many states have historically adopted the IECC for both residential and commercial buildings, PNNL has evaluated the impacts of the commercial provisions of the 2006, 2009, and 2012 editions of the IECC. PNNL also compared energy performance with corresponding editions of ANSI/ASHRAE/IES Standard 90.1 to help states and local jurisdictions make informed decisions regarding model code adoption.

  9. Prime focus architectures for large space telescopes: reduce surfaces to save cost

    Science.gov (United States)

    Breckinridge, J. B.; Lillie, C. F.

    2016-07-01

    Conceptual architectures are now being developed to identify future directions for post JWST large space telescope systems to operate in the UV Optical and near IR regions of the spectrum. Here we show that the cost of optical surfaces within large aperture telescope/instrument systems can exceed $100M/reflection when expressed in terms of the aperture increase needed to over come internal absorption loss. We recommend a program in innovative optical design to minimize the number of surfaces by considering multiple functions for mirrors. An example is given using the Rowland circle imaging spectrometer systems for UV space science. With few exceptions, current space telescope architectures are based on systems optimized for ground-based astronomy. Both HST and JWST are classical "Cassegrain" telescopes derived from the ground-based tradition to co-locate the massive primary mirror and the instruments at the same end of the metrology structure. This requirement derives from the dual need to minimize observatory dome size and cost in the presence of the Earth's 1-g gravitational field. Space telescopes, however function in the zero gravity of space and the 1- g constraint is relieved to the advantage of astronomers. Here we suggest that a prime focus large aperture telescope system in space may have potentially have higher transmittance, better pointing, improved thermal and structural control, less internal polarization and broader wavelength coverage than Cassegrain telescopes. An example is given showing how UV astronomy telescopes use single optical elements for multiple functions and therefore have a minimum number of reflections.

  10. 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

  11. A protocol for sustained reduction of Total Parenteral Nutrition and cost savings by improvement of nutritional care in hospitals.

    Science.gov (United States)

    van Schaik, Rian; Van den Abeele, Kurt; Melsens, Glenn; Schepens, Peter; Lanssens, Truus; Vlaemynck, Bernadette; Devisch, Maria; Niewold, Theo A

    2016-10-01

    Malnutrition and the use of Total Parenteral Nutrition (TPN) contribute considerably to hospital costs. Recently, we reported on the introduction of malnutrition screening and monitoring of TPN use in our hospital, which resulted in a large (40%) reduction in TPN and improved quality of nutritional care in two years (2011/12). Here, we aimed to assure continuation of improved care by developing a detailed malnutrition screening and TPN use protocol involving instruction tools for hospital staff, while monitoring the results in the following two years (2013/14). A TPN decision tree for follow up of TPN in patients and a TP-EN instruction card for caregivers was introduced, showing TPN/EN introduction schedules based on the energy needs of patients according to EB guidelines, also addressing the risk of refeeding syndrome. TPN patients were monitored by dietitians and TPN usage and costs were presented to the (medical) staff. Screening and treatment of malnourished patients by dietitians is simultaneously ongoing. In 2014 48% of patients, hospitalized for at least 48 h, were screened on malnutrition, 17% of them were diagnosed at risk, 7.9% malnourished and treated by dietitians. TPN usage dropped by 53% and cost savings of 51% were obtained due to 50% decrease of TPN users in 2014 versus 2010. TPN over EN ratio dropped from 2.4 in 2010 to 1.2 in 2014. Sustained improvement of nutritional care and reduction of TPN usage and costs is possible by introduction of procedures embedded in the existing structures. Copyright © 2016 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

  12. A Time- and Cost-Saving Method of Producing Rat Polyclonal Antibodies

    International Nuclear Information System (INIS)

    Wakayama, Tomohiko; Kato, Yukio; Utsumi, Rie; Tsuji, Akira; Iseki, Shoichi

    2006-01-01

    Producing antibodies usually takes more than three months. In the present study, we introduce a faster way of producing polyclonal antibodies based on preparation of the recombinant oligopeptide as antigen followed by immunization of rats. Using this method, we produced antisera against two mouse proteins: ERGIC-53 and c-Kit. An expression vector ligated with a pair of complementary synthetic oligodeoxyribonucleotides encoding the protein was introduced into bacteria, and the recombinant oligopeptide fused with the carrier protein glutathione-S-transferase was purified. Wistar rats were immunized by injecting the emulsified antigen subcutaneously into the hind footpads, followed by a booster injection after 2 weeks. One week after the booster, the sera were collected and examined for the antibody titer by immunohistochemistry. Antisera with 1600-fold titer at the maximum were obtained for both antigens and confirmed for their specificity by Western blotting. Anti-ERGIC-53 antisera recognized acinar cells in the sublingual gland, and anti-c-Kit antisera recognized spermatogenic and Leydig cells in the testis. These antisera were applicable to fluorescent double immunostaining with mouse monoclonal or rabbit polyclonal antibodies. Consequently, this method enabled us to produce specific rat polyclonal antisera available for immunohistochemistry in less than one month at a relatively low cost

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

    Science.gov (United States)

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

    2015-08-01

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

  14. 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

  15. Regulatory and cost barriers are likely to limit biosimilar development and expected savings in the near future.

    Science.gov (United States)

    Grabowski, Henry G; Guha, Rahul; Salgado, Maria

    2014-06-01

    In March 2010 Congress established an abbreviated Food and Drug Administration approval pathway for biosimilars-drugs that are very similar but not identical to a reference biological product and cost less. Because bringing biosimilars to the market currently requires large investments of money, fewer biosimilars are expected to enter the biologics market than has been the case with generic drugs entering the small-molecule drug market. Additionally, given the high regulatory hurdles to obtaining interchangeability-which would allow pharmacists to substitute a biosimilar for its reference product, subject to evolving state substitution laws-most biosimilars will likely compete as therapeutic alternatives instead of as therapeutic equivalents. In other words, biosimilars will need to compete with their reference product on the basis of quality; price; and manufacturer's reputation with physicians, insurers, and patient groups. Biosimilars also will face dynamic competition from new biologics in the same therapeutic class-including "biobetters," which offer incremental improvements on reference products, such as extended duration of action. The prospects for significant cost savings from the use of biosimilars appear to be limited for the next several years, but their use should increase over time because of both demand- and supply-side factors. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  17. 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.

  18. 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.

  19. A stitch in time saves nine. The costs of postponing action in climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Steinshamn, Stein Ivar; Kvamsdal, Sturla F; Sandal, Leif K

    2011-07-01

    The main purpose of this report is to investigate the effects of postponing implementation of a carbon tax assuming that externalities associated with climate change and global warming is real. Failing to internalize these externalities will only lead to a suboptimal situation. The model applied to investigate these externalities starts with the basic relationships, namely supply and demand for fossil fuel, and an added damage term that accounts for the externality. The objective is then to maximize the sum of consumers' and producers' surplus adjusted for the externality. This must be done subject to the dynamic constraint derived from emissions of carbon associated with extraction and consumption of fossil fuel and the natural assimilation of carbon in the atmosphere. The model is solved as a closed loop feedback policy. First the optimal emission path is calculated, and then the corresponding tax path is found. As the externality dealt with here is a pure stock externality it turns out that the optimal tax is equal to the shadow cost of the pollutant. The dynamic equation for assimilation, or natural decay, of carbon is specified using a fairly sophisticated method, namely the ensemble Kalman filter. Given the relative simplicity of the model with only one type of production and one type of pollutant, this method is supposed to give a best possible estimate of the parameters in the assimilation function.The main message in this report is that it may possibly be very expensive to postpone implementation of a carbon tax as the tax rate may have to increase by up to 30 per cent and more for each year implementation is postponed in order to recover optimality in the most pessimistic cases. In the more optimistic cases an increase of down to 0.5 per cent per year may be sufficient.(eb)

  20. A stitch in time saves nine. The costs of postponing action in climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Steinshamn, Stein Ivar; Kvamsdal, Sturla F.; Sandal, Leif K.

    2011-07-01

    The main purpose of this report is to investigate the effects of postponing implementation of a carbon tax assuming that externalities associated with climate change and global warming is real. Failing to internalize these externalities will only lead to a suboptimal situation. The model applied to investigate these externalities starts with the basic relationships, namely supply and demand for fossil fuel, and an added damage term that accounts for the externality. The objective is then to maximize the sum of consumers' and producers' surplus adjusted for the externality. This must be done subject to the dynamic constraint derived from emissions of carbon associated with extraction and consumption of fossil fuel and the natural assimilation of carbon in the atmosphere. The model is solved as a closed loop feedback policy. First the optimal emission path is calculated, and then the corresponding tax path is found. As the externality dealt with here is a pure stock externality it turns out that the optimal tax is equal to the shadow cost of the pollutant. The dynamic equation for assimilation, or natural decay, of carbon is specified using a fairly sophisticated method, namely the ensemble Kalman filter. Given the relative simplicity of the model with only one type of production and one type of pollutant, this method is supposed to give a best possible estimate of the parameters in the assimilation function.The main message in this report is that it may possibly be very expensive to postpone implementation of a carbon tax as the tax rate may have to increase by up to 30 per cent and more for each year implementation is postponed in order to recover optimality in the most pessimistic cases. In the more optimistic cases an increase of down to 0.5 per cent per year may be sufficient.(eb)

  1. 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

  2. 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.

  3. 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)

  4. 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.

  5. The French nuclear power plant reactor building containment contributions of prestressing and concrete performances in reliability improvements and cost savings

    International Nuclear Information System (INIS)

    Rouelle, P.; Roy, F.

    1998-01-01

    The Electricite de France's N4 CHOOZ B nuclear power plant, two units of the world's largest PWR model (1450 Mwe each), has earned the Electric Power International's 1997 Powerplant Award. This lead NPP for EDF's N4 series has been improved notably in terms of civil works. The presentation will focus on the Reactor Building's inner containment wall which is one of the main civil structures on a technical and safety point of view. In order to take into account the necessary evolution of the concrete technical specification such as compressive strength low creep and shrinkage, the HSC/HPC has been used on the last N4 Civaux 2 NPP. As a result of the use of this type of professional concrete, the containment withstands an higher internal pressure related to severe accident and ensures higher level of leak-tightness, thus improving the overall safety of the NPP. On that occasion, a new type of prestressing has been tested locally through 55 C 15 S tendons using a new C 1500 FE Jack. These updated civil works techniques shall allow EDF to ensure a Reactor Containment lifespan for more than 50 years. The gains in terms of reliability and cost saving of these improved techniques will be developed hereafter

  6. Cost-Saving Early Diagnosis of Functional Pain in Nonmalignant Pain: A Noninferiority Study of Diagnostic Accuracy.

    Science.gov (United States)

    Cámara, Rafael J A; Merz, Christian; Wegmann, Barbara; Stauber, Stefanie; von Känel, Roland; Egloff, Niklaus

    2016-01-01

    Objectives. We compared two index screening tests for early diagnosis of functional pain: pressure pain measurement by electronic diagnostic equipment, which is accurate but too specialized for primary health care, versus peg testing, which is cost-saving and more easily manageable but of unknown sensitivity and specificity. Early distinction of functional (altered pain perception; nervous sensitization) from neuropathic or nociceptive pain improves pain management. Methods. Clinicians blinded for the index screening tests assessed the reference standard of this noninferiority diagnostic accuracy study, namely, comprehensive medical history taking with all previous findings and treatment outcomes. All consenting patients referred to a university hospital for nonmalignant musculoskeletal pain participated. The main analysis compared the receiver operating characteristic (ROC) curves of both index screening tests. Results. The area under the ROC curve for peg testing was not inferior to that of electronic equipment: it was at least 95% as large for finger measures (two-sided p = 0.038) and at least equally as large for ear measures (two-sided p = 0.003). Conclusions. Routine diagnostic testing by peg, which is accessible for general practitioners, is at least as accurate as specialized equipment. This may shorten time-to-treatment in general practices, thereby improving the prognosis and quality of life.

  7. Medical Care Expenditures for Individuals with Prediabetes: The Potential Cost Savings in Reducing the Risk of Developing Diabetes.

    Science.gov (United States)

    Khan, Tamkeen; Tsipas, Stavros; Wozniak, Gregory

    2017-10-01

    The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with diabetes. A cohort analysis of a commercially insured population was conducted using individual-level claims data from Truven Health MarketScan ® Lab Database to identify adults with prediabetes, track whether they develop diabetes, and compare medical expenditures for those who are newly diagnosed with diabetes to those who are not. This study then illustrates how reducing the risk of developing diabetes by participation in an evidence-based lifestyle change program could yield both positive net savings on medical care expenditures and return on investment (ROI). Annual expenditures are found to be nearly one third higher for those who develop diabetes in subsequent years relative to those who do not transition from prediabetes to diabetes, with an average difference of $2671 per year. At that cost differential, the 3-year ROI for a National DPP is estimated to be as high as 42%. The results show the importance and economic benefits of participation in lifestyle intervention programs to prevent or delay the onset of type 2 diabetes.

  8. 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.

  9. 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?

  10. Save Energy: Save Money!

    Science.gov (United States)

    Eccli, Eugene; And Others

    This publication is a collection of inexpensive energy saving tips and home improvements for home owners, particularly in low-income areas or in older homes. Section titles are: (1) Keeping Warm; (2) Getting Heat Where You Need It; (3) Using the Sun; (4) Furnaces, Stoves, and Fireplaces; (5) Insulation and Other Energy Needs; (6) Do-It-Yourself…

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

    Science.gov (United States)

    2014-01-01

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

  12. 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.

  13. 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

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

    Directory of Open Access Journals (Sweden)

    Saeid Hamzeh

    2016-10-01

    Full Text Available Land suitability classification is important in planning and managing sustainable land use. Most approaches to land suitability analysis combine a large number of land and soil parameters, and are time-consuming and costly. In this study, a potentially useful technique (combined feature selection and fuzzy-AHP method to increase the efficiency of land suitability analysis was presented. To this end, three different feature selection algorithms—random search, best search and genetic methods—were used to determine the most effective parameters for land suitability classification for the cultivation of barely in the Shavur Plain, southwest Iran. Next, land suitability classes were calculated for all methods by using the fuzzy-AHP approach. Salinity (electrical conductivity (EC, alkalinity (exchangeable sodium percentage (ESP, wetness and soil texture were selected using the random search method. Gypsum, EC, ESP, and soil texture were selected using both the best search and genetic methods. The result shows a strong agreement between the standard fuzzy-AHP methods and methods presented in this study. The values of Kappa coefficients were 0.82, 0.79 and 0.79 for the random search, best search and genetic methods, respectively, compared with the standard fuzzy-AHP method. Our results indicate that EC, ESP, soil texture and wetness are the most effective features for evaluating land suitability classification for the cultivation of barely in the study area, and uses of these parameters, together with their appropriate weights as obtained from fuzzy-AHP, can perform good results for land suitability classification. So, the combined feature selection presented and the fuzzy-AHP approach has the potential to save time and money for land suitability classification.

  15. 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.

  16. Trouble Sleeping Associated With Lower Work Performance and Greater Health Care Costs: Longitudinal Data From Kansas State Employee Wellness Program.

    Science.gov (United States)

    Hui, Siu-kuen Azor; Grandner, Michael A

    2015-10-01

    To examine the relationships between employees' trouble sleeping and absenteeism, work performance, and health care expenditures over a 2-year period. Utilizing the Kansas State employee wellness program (EWP) data set from 2008 to 2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and health care costs as the outcomes. EWP participants (N = 11,698 in 2008; 5636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all P work performance ratings (all P health care costs (P work attendance, work performance, and health care costs.

  17. 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

  18. 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.

  19. 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

  20. Trouble Sleeping Associated with Lower Work Performance and Greater Healthcare Costs: Longitudinal Data from Kansas State Employee Wellness Program

    Science.gov (United States)

    Hui, Siu-kuen Azor; Grandner, Michael A.

    2015-01-01

    Objective To examine the relationships between employees’ trouble sleeping and absenteeism, work performance, and healthcare expenditures over a two year period. Methods Utilizing the Kansas State employee wellness program (EWP) dataset from 2008–2009, multinomial logistic regression analyses were conducted with trouble sleeping as the predictor and absenteeism, work performance, and healthcare costs as the outcomes. Results EWP participants (N=11,698 in 2008; 5,636 followed up in 2009) who had higher levels of sleep disturbance were more likely to be absent from work (all p performance ratings (all p performance, and healthcare costs. PMID:26461857

  1. Dark respiration of leaves and traps of terrestrial carnivorous plants: are there greater energetic costs in traps?

    Czech Academy of Sciences Publication Activity Database

    Adamec, Lubomír

    2010-01-01

    Roč. 5, č. 1 (2010), s. 121-124 ISSN 1895-104X Institutional research plan: CEZ:AV0Z60050516 Keywords : Aerobic respiration * metabolic costs * trap specialization Subject RIV: EF - Botanics Impact factor: 0.685, year: 2010

  2. 12 CFR 714.5 - What is required if you rely on an estimated residual value greater than 25% of the original cost...

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false What is required if you rely on an estimated residual value greater than 25% of the original cost of the leased property? 714.5 Section 714.5 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS LEASING § 714.5 What is...

  3. Scaling cost-sharing to wages: how employers can reduce health spending and provide greater economic security.

    Science.gov (United States)

    Robertson, Christopher T

    2014-01-01

    In the employer-sponsored insurance market that covers most Americans; many workers are "underinsured." The evidence shows onerous out-of-pocket payments causing them to forgo needed care, miss work, and fall into bankruptcies and foreclosures. Nonetheless, many higher-paid workers are "overinsured": the evidence shows that in this domain, surplus insurance stimulates spending and price inflation without improving health. Employers can solve these problems together by scaling cost-sharing to wages. This reform would make insurance better protect against risk and guarantee access to care, while maintaining or even reducing insurance premiums. Yet, there are legal obstacles to scaled cost-sharing. The group-based nature of employer health insurance, reinforced by federal law, makes it difficult for scaling to be achieved through individual choices. The Affordable Care Act's (ACA) "essential coverage" mandate also caps cost-sharing even for wealthy workers that need no such cap. Additionally, there is a tax distortion in favor of highly paid workers purchasing healthcare through insurance rather than out-of-pocket. These problems are all surmountable. In particular, the ACA has expanded the applicability of an unenforced employee-benefits rule that prohibits "discrimination" in favor of highly compensated workers. A novel analysis shows that this statute gives the Internal Revenue Service the authority to require scaling and to thereby eliminate the current inequities and inefficiencies caused by the tax distortion. The promise is smarter insurance for over 150 million Americans.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-07-01

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

  10. 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.

  11. Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care.

    LENUS (Irish Health Repository)

    Costelloe, L

    2012-02-01

    BACKGROUND: Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised. AIMS\\/METHODS: We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care. RESULTS: Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days. CONCLUSIONS: Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

  12. Water Saving and Cost Analysis of Large-Scale Implementation of Domestic Rain Water Harvesting in Minor Mediterranean Islands

    Directory of Open Access Journals (Sweden)

    Alberto Campisano

    2017-11-01

    Full Text Available This paper describes a novel methodology to evaluate the benefits of large-scale installation of domestic Rain Water Harvesting (RWH systems in multi-story buildings. The methodology was specifically developed for application to small settlements of the minor Mediterranean islands characterized by sharp fluctuations in precipitation and water demands between winter and summer periods. The methodology is based on the combined use of regressive models for water saving evaluation and of geospatial analysis tools for semi-automatic collection of spatial information at the building/household level. An application to the old town of Lipari (Aeolian islands showed potential for high yearly water savings (between 30% and 50%, with return on investment in less than 15 years for about 50% of the installed RWH systems.

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

    NARCIS (Netherlands)

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

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

  14. 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...

  15. 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.

  16. 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.

  17. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method.Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-10-21

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

  19. Medical cost savings for participants and nonparticipants in health risk assessments, lifestyle management, disease management, depression management, and nurseline in a large financial services corporation.

    Science.gov (United States)

    Serxner, Seth; Alberti, Angela; Weinberger, Sarah

    2012-01-01

    To compare changes in medical costs between participants and nonparticipants in five different health and productivity management (HPM) programs. Quasi-experimental pre/post intervention study. A large financial services corporation. A cohort population of employees enrolled in medical plans (n  =  49,723) [corrected]. A comprehensive HPM program, which addressed health risks, acute and chronic conditions, and psychosocial disorders from 2005 to 2007. Incentives were used to encourage health risk assessment participation in years 2 and 3. Program participation and medical claims data were collected for members at the end of each program year to assess the change in total costs from the baseline period. Analysis . Multivariate analyses for participation categories were conducted comparing baseline versus program year cost differences, controlling for demographics. All participation categories yielded a lower cost increase compared to nonparticipation and a positive return on investment (ROI) for years 2 and 3, resulting in a 2.45∶1 ROI for the combined program years. Medical cost savings exceeded program costs in a wide variety of health and productivity management programs by the second year.

  20. Potential cost savings by minimisation of blood sample delays on care decision making in urgent care services

    Directory of Open Access Journals (Sweden)

    David M.S. Bodansky

    2017-08-01

    Conclusion: Sample rejection rate is high and is associated with increased in-hospital stay and cost. Blood sampling technique impacts on rejection rates. Reduction in sample rejection rates in emergency care areas in acute hospitals has the potential to impact on patient flow and reduce cost.

  1. 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.

  2. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-28

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

  4. Guide to protect climate. Saving energy and cost, protecting climate; Der Klima-Knigge. Energie sparen, Kosten senken, Klima schuetzen

    Energy Technology Data Exchange (ETDEWEB)

    Griesshammer, Rainer

    2008-07-01

    As a climate protector you mustn't seat in the darkness. The author shows by much humour and esprit how simple it is to save energy. Who is willing to persue his every day tips, must not miss comfort and lowers even carbon dioxide emission. This is good for the environment and fills up the own purse. (orig./GL) [German] Als Klimaschuetzer braucht man nicht im Dunkeln zu sitzen. Mit viel Humor und Esprit zeigt Griesshammer, wie einfach Energie sparen sein kann. Wer seine Alltagstipps befolgt, muss auf keinen Komfort verzichten und mindert trotzdem den CO2-Ausstoss. Das nutzt der Umwelt und fuellt den eigenen Geldbeutel auf. (orig./GL)

  5. New environment-friendly and cost-saving fertiliser recommendation system for supporting sustainable agriculture in Hungary and beyond

    Directory of Open Access Journals (Sweden)

    Nándor FODOR

    2011-07-01

    Full Text Available In the current economic situation the former, intensive fertiliser recommendation system is unfit to help Hungarian farmers in their fertilising practice. The aim of the new system has been to apply the lowest possible NPK rates required to achieve safe and high yields as well as allowing minimal agricultural NP losses to surface and subsurface waters. The new system was developed by using the correlations revealed by analyzing the results of long-term fertilisation experiments set up in Hungary between 1960 and 2000. Several field experiments as well as comparative analyses confirmed the correctness of the basic principles as well as of the methods of calculating fertiliser rates of the new system. An estimated amount of 3,200,000 € was saved for the Hungarian farmers in 2007 alone by giving recommendations for more than 160,000 ha arable land applying the new system.

  6. 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

  7. Potential cost savings in waste incineration in grate furnaces; Kosteneinsparpotentiale bei der Verbrennung von Abfaellen in Rostfeuerungsanlagen

    Energy Technology Data Exchange (ETDEWEB)

    Wolf, C; Beckmann, R [Fraunhofer Inst. fuer Umwelt-, Sicherheits- und Energietechnik UMSICHT, Oberhausen (Germany). Abt. Abfall- und Kreislaufwirtschaft

    1998-09-01

    Shortage of public puts increased cost pressure on thermal treatment of waste. The specific operating cost of current projects is around 200 DM/t. The contribution outlines parameters that can help to reduce the operating and investment cost. This includes economic as well as technical parameters that directly influence plant operation. The analyses were carried out using the UMSICHT-owned calculation program GLOBUS which permits the conservative determination of the cost-determining plant cost as a function of sensitive influencing parameters. (orig./SR) [Deutsch] Nicht zuletzt aufgrund leerer oeffentlicher Kassen hat in den letzten Jahren ein Umdenken stattgefunden, das durch die Forderung nach umweltvertraeglichen Entsorgungsverfahren bei gleichzeitig moderaten Abfallgebuehren gepraegt ist. Somit hat fuer die thermische Abfallbehandlung der Kostendruck stark zugenommen. Fuer aktuelle Projekte werden spezifische Betriebskosten von etwa 200 DM/t erreicht. Der vorliegende Beitrag zeigt kostenwirksame Einflussgroessen auf, durch die eine Reduzierung der Betriebs- und Investitionskosten ermoeglicht wird. Dazu gehoeren sowohl abfallwirtschaftlicher Parameter als auch technische Groessen, die einen direkten Einfluss auf den Betrieb der Anlage besitzen. Die Analysen wurden mit dem UMSICHT-eigenen Kalkulationsprogramm GLOBUS durchgefuehrt, das die belastbare Ermittlung der fuer die Kostenseite bestimmenden Apparatekosten in Abhaengigkeit sensitiver Einflussgroessen erlaubt. (orig./SR)

  8. Net savings

    International Nuclear Information System (INIS)

    Roche, P.

    2001-01-01

    The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study was

  9. Net savings

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2001-02-01

    The state of e-commerce in the Canadian upstream oil and natural gas sector is examined in an effort to discover the extent to which the .com economy has penetrated the marketplace. The overall assessment is that although the situation varies from producer to producer and process to process, a bustling digital marketplace in the Canadian oil business has yet to emerge. Nevertheless, there are several examples of companies using e-business tools to minimize technology staffing and to eliminate wasteful practices. Initiatives cited include streamlining of supply chains to cut handling costs, using application service providers to trim information technology budgets, and adopting electronic joint interest billing to save on printing, postage and re-entering data. Most notable efforts have been made by companies such as BXL Energy Limited and Genesis Exploration Limited, both of which are boosting efficiency on the inside by contracting out data storage and software applications. For example, BXL has replaced its microfilm log library occupying six cabinets, and totalling about 9,000 lbs., by a fibre optic line. All applications can now be run from a laptop which weighs three to four pounds. In a similar vein, Genesis Exploration started using application service providers (ASPs) to avoid the cost and hassle of buying and maintaining major software applications in-house. By accessing the ASPs, Genesis staff can run software without buying or installing it on their own computers. In yet another example of cutting information technology costs, Pengrowth Corporation has its network administration done remotely over the Internet by Northwest Digital Systems (NWD). As far as the industry at large is concerned, the answer appears to be in a digital marketplace specifically tailored to the upstream sector's unique profile. As a start, a study is underway by Deloitte Consulting to explore producer interest in joining or founding an upstream digital marketplace. The study

  10. 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...

  11. Reducing Idle Power Consumption in Office Spaces Saves U.S. Navy in Energy Costs (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2014-04-01

    As part of a two-year project to demonstrate energy efficiency measures, renewable energy generation, and energy systems integration, the National Renewable Energy Laboratory (NREL) has identified advanced plug load controls as a promising technology for reducing energy use and related costs in the U.S. Navy's Naval Facilities Engineering Command (NAVFAC) office spaces.

  12. Environmental damage costs from airborne pollution of industrial activities in the greater Athens, Greece area and the resulting benefits from the introduction of BAT

    International Nuclear Information System (INIS)

    Mirasgedis, S.; Hontou, V.; Georgopoulou, E.; Sarafidis, Y.; Gakis, N.; Lalas, D.P.; Loukatos, A.; Gargoulas, N.; Mentzis, A.; Economidis, D.; Triantafilopoulos, T.; Korizi, K.; Mavrotas, G.

    2008-01-01

    Attributing costs to the environmental impacts associated with industrial activities can greatly assist in protecting human health and the natural environment as monetary values are capable of directly influencing technological and policy decisions without changing the rules of the market. This paper attempts to estimate the external cost attributable to the atmospheric pollution from 'medium and high environmental burden' industrial activities located in the greater Athens area and the benefits from Best Available Techniques (BAT) introduction. To this end a number of typical installations were defined to be used in conjunction with the Impact Pathway Approach developed in the context of the ExternE project to model all industrial sectors/sub-sectors located in the area of interest. Total environmental externalities due to air pollutants emitted by these industrial activities were found to reach 211 M Euro per year, associated mainly with human mortality and morbidity due to PM 10 emissions, as well as with climate change impacts due to CO 2 emissions for which non-metallic minerals and oil processing industries are the main sources. The results obtained can be used as the basis for an integrated evaluation of potential BAT, taking into account not only private costs and benefits but also the environmental externalities, thus leading to policy decisions that maximize social welfare in each industrial sector/sub-sector

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

    Energy Technology Data Exchange (ETDEWEB)

    Neelis, Maarten; Worrell, Ernst; Masanet, Eric

    2008-09-01

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

  14. Compendium of GAO’s Views on the Cost Saving Proposals of the Grace Commission. Volume 2. Individual Issue Analyses

    Science.gov (United States)

    1985-02-19

    fashion , linking it to other management processes such as budgeting and operational planning. III. GAO ASSESSMENT OF IMPLEMENTATION AUTHORITY...research which private industy is able to conduct on its own. Past GAO work has illustrated the costs of duplica- tion. A 1982 GAO report on UMTA...could be increased approximately $4.9 million, over 3 years, if the average concessioner franchise fee were increased from 2 to 4 percent of gross

  15. Emergency planning. Can the cost of remedial actions be compared to the value of the health effects they save

    International Nuclear Information System (INIS)

    Frittelli, L.; Tamburrano, A.

    1981-01-01

    When an accidental release of radioactive material occurs the exposure of the people concerned can be reduced only by remedial actions, applied to individuals (evacuation) or their environment (e.g. by land interdiction, by impoundment of contaminated products). The adoption of remedial actions should be based on a balance between the damage they cause and the reduction in health effects they can achieve. In this paper a 'cost-effectiveness' analysis is attempted by comparing the costs of remedial actions with the monetary value of the collective dose avoided by them. Remedial actions are undertaken to prevent non-stochastic effects in the exposed population and to limit stochastic effects therein. The damage caused by the remedial actions is evaluated by taking into account the loss of value of interdicted property, the costs for decontaminating land and structures, the loss of income of evacuated people. The options in remedial actions (interdiction, decontamination, goods removal) which minimize the total costs are supposed to be adopted at every location. The collective effective dose equivalent avoided by the remedial actions is computed by taking into account the external exposure from the cloud and from the contaminated ground, and the internal exposure from material inhaled from the passing cloud or inhaled from matter resuspended after deposition on the ground. The extent of the resulting total damage (both economic and health aspects) is partly determined by the intervention level chosen for defining the time and space features of remedial actions. As a result, the total damage has a lower value for an intervention level of about 0.1 Sv for large and medium releases from a nuclear power plant in a not very highly developed site. For a contained release no value of the intervention level optimizes the balance between health and economic consequences. (author)

  16. Ownership, competition, and the adoption of new technologies and cost-saving practices in a fixed-price environment.

    Science.gov (United States)

    Hirth, R A; Chernew, M E; Orzol, S M

    2000-01-01

    Advances in medical technology have been implicated as the primary cause of rising health care expenditures. It is not yet known whether the increasing prevalence of managed care mechanisms, particularly capitation, will change substantially incentives for acquiring and using cost-increasing innovations. We examined the decisions of dialysis units (a set of providers that has faced capitation and real decreases in payment for several decades) with respect to use of cost-increasing technologies that enhance quality of care, cost-cutting practices that reduce quality of care, and amenities desired by patients that are unrelated to quality of care. We found that the dialysis payment system does not appear to have blocked access to a number of new, quality-enhancing technologies that were developed in the 1980s. However, facilities made adjustments along other valuable margins to facilitate adoption of these technologies; use of new technologies varied with numerous facility, regulatory, and case-mix characteristics including ownership, chain membership, size, market competition, and certificate of need programs. Interestingly, the trade-offs made by for-profit and nonprofit facilities when faced with fixed prices appeared quite different. For-profits tended to deliver lower technical quality of care but more amenities, while nonprofits favored technical quality of care over amenities. Our findings may have implications for the response of other types of health care providers to capitation and increasing economic constraints.

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

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Worrell, Ernst; Ruth, Michael

    2003-07-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Galitsky, Christina; Galitsky, Christina; Worrell, Ernst

    2008-01-01

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

  1. Forecasting how residential urban form affects the regional carbon savings and costs of retrofitting and decentralized energy supply

    International Nuclear Information System (INIS)

    Hargreaves, Anthony; Cheng, Vicky; Deshmukh, Sandip; Leach, Matthew; Steemers, Koen

    2017-01-01

    Highlights: • An innovative model for testing combinations of spatial planning and decentralised energy supply. • An improved method of modelling the spatial variability of energy consumption per dwelling type. • Shows how spatial planning would affect the future carbon reduction of decentralised supply. • Forecasts the future carbon reduction and costs of retrofitting and decentralised supply. • A method of forecasting how residential space would affect the suitability of decentralised supply. - Abstract: Low carbon energy supply technologies are increasingly used at the building and community scale and are an important part of the government decarbonisation strategy. However, with their present state of development and costs, many of these decentralised technologies rely on public subsidies to be financially viable. It is questionable whether they are cost effective compared to other ways of reducing carbon emissions, such as decarbonisation of conventional supply and improving the energy efficiency of dwellings. Previous studies have found it difficult to reliably estimate the future potential of decentralised supply because this depends on the available residential space which varies greatly within a city region. To address this problem, we used an integrated modelling framework that converted the residential density forecasts of a regional model into a representation of the building dimensions and land of the future housing stock. This included a method of estimating the variability of the dwellings and residential land. We present the findings of a case study of the wider south east regions of England that forecasted the impacts of energy efficiency and decentralised supply scenarios to year 2031. Our novel and innovative method substantially improves the spatial estimates of energy consumption compared to building energy models that only use standard dwelling typologies. We tested the impact of an alternative spatial planning policy on the future

  2. The interaction of the petroleum fiscal system and cost-savings in the UKCS: pre and post the 1993 budget

    International Nuclear Information System (INIS)

    Kemp, A.G.; MacDonald, B.

    1993-01-01

    In 1990 research was undertaken on a number of North Sea regulatory and fiscal issues. The work was financed by Shell Expro, BP, Esso, Phillips and Mobil. In 1991 and 1992 work continued on these subjects sponsored by the same group with the addition of Occidental (now EE Caledonia). In 1993 the programme examines the following subjects: the interaction of the fiscal system and cost cutting in the North Sea; the effects of the 1993 budget proposals on North Sea oil and gas; incremental investments in mature oil fields and the continuing fiscal problem with emphasis on the risk aspects; fiscal and financial aspects of field abandonment; fiscal aspects of the development of small accumulations employing transferable production facilities. (author)

  3. Cost of electricity generated and fuel saving of an optimized wind-diesel electricity supply for village in Tangier-area (Morocco)

    International Nuclear Information System (INIS)

    Nfaoui, H.; Buret, J.

    1996-01-01

    In several of the remote areas of Morocco, diesel generators are used to provide electrical power. Such systems are often characterized by poor efficiency and high maintenance costs. The integration of wind turbine with a diesel/battery hybrid system is becoming cost-effective in wind locations. In previous works (Nfaoul et al, 1990, 1994a, 1994b), the wind characteristics in Tangier-area were studied on the basis of 12 years (1978-1989) of hourly average wind speed data. A wind/diesel energy system with battery storage has been modelled using the Tangiers wind regime over a one year period (1989), and synthesized consumer load data based on the characteristics of typical usage of domestic appliances, along with the estimated working patterns of a local isolated community. In this work, we use a more realistic hourly consumer load, which is the result of an experiment realized in a Maroccan village using a diesel engine to provide electricity for lighting and audio-visual. The 1989 wind data were reworked for a large series of measurements (12 years). The optimum wind turbine size and the benefits of a storage system on fuel saving are also reviewed. This work is concerned with diesel fuel consumption: an optimum design of the considered system is to be found which minimises the cost energy generation over the equipments' lifetime. Given the economic assumption made (the most important being a fuel price of 4.5 Dh/litre and an interest rate of 5% net of inflation), the wind/diesel energy system has been shown to be competitive with diesel-only generation in the wind regime of the Tangier location for the cost per unit wind turbine swept area less than 3000 Dh/m 2 (8Dh=1$). (author)

  4. Technological support of tool wear resistant qualities and cost saving of process of planetary grinding of flat parts

    Science.gov (United States)

    Ivanova, T. N.; Lyupa, D. C.; Revenko, N. F.; Berkutova, T. A.; Silivanova, O. A.

    2018-03-01

    parameter Ra during the processing using the planetary grinding device is 35 - 40% less than when using the tool with the solid cutting surface. This phenomenon can be accounted for more uniform work of the cutting grains of the planetary grinding tool as the number of meetings of diamond grains with the surface being processed increases. At the same time, it should be noted that during the planetary grinding more intensive smoothing of tops of microroughnesses is observed that provides the creation of steadier cutting shape. The given method of calculation of cost value of grinding operation allows solving various manufacturing problems: to compare cost value of grinding different materials, grinding wheels of different parameters; to define the optimum grinding conditions.

  5. Real-World Clinical Effectiveness and Cost Savings of Liraglutide Versus Sitagliptin in Treating Type 2 Diabetes for 1 and 2 Years.

    Science.gov (United States)

    Li, Qian; Ganguly, Rahul; Ganz, Michael L; Gamble, Cory; Dang-Tan, Tam

    2018-06-01

    This study compared the clinical and economic outcomes of long-term use of liraglutide versus sitagliptin for the treatment of type 2 diabetes (T2DM) in real-world practice in the USA. We identified adult patients (≥ 18 years old) with T2DM who initiated liraglutide or sitagliptin in 2010-2014 using a large claims database. Quarterly glycemic control measures and annual healthcare costs were assessed during the 1st and 2nd years of persistent medication use. Their associations with medication use (liraglutide or sitagliptin) were estimated using multivariable regression models adjusted for patient demographic and clinical characteristics. A total of 3113 patients persistently used liraglutide (N = 493) or sitagliptin (N = 2620) for ≥ 1 year [mean age (standard deviation, SD): 53 (8.5) vs. 56 (9.7) years; 48.3% vs. 62.3% males; both p < 0.05]; 911 (including 113 liraglutide users) were persistent users for ≥ 2 years. During the 1st-year follow-up, liraglutide users (versus sitagliptin users, after adjustment) experienced larger glycated hemoglobin (HbA1c) reductions from baseline (ranging from 0.34%-point in quarter 1 to 0.21%-point in quarter 4); higher likelihoods of obtaining HbA1c reductions of ≥ 1%-points or ≥ 2%-points [odds ratios (ORs) range 1.47-2.04]; and higher likelihoods of reaching HbA1c goals of < 6.5% or < 7% (ORs range 1.51-2.12) (all p < 0.05). Liraglutide users also experienced HbA1c reductions from baseline in the 2nd-year follow-up (0.53-0.33%-point, all p < 0.05). Although liraglutide users incurred higher healthcare costs than sitagliptin users during the 1st-year follow-up, they had $2674 (per patient) lower all-cause medical costs (adjusted cost ratio: 0.67, p < 0.05) and similar total costs (all-cause and diabetes-related) in the 2nd year. Long-term use of liraglutide for 1 or 2 years was associated with better glycemic control than using sitagliptin. Savings in medical costs

  6. 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.

  7. An alternative perspective on how laboratory medicine can contribute to solve the health care crisis: a model to save costs by acquiring excellence in diagnostic systems.

    Science.gov (United States)

    Mussap, Michele

    2014-01-01

    The rapid escalation in health care costs has led to the idea to deliver better care at lower costs, reshaping the responsibilities of the health care system to achieve the goal of creating value for the patient. The pressure for fiscal containment and the progressive reduction in available health care resources originated very short term strategies consisting of abrupt reductions in expenditure, specifically in the provision of clinical pathology laboratory medicine services. However, the impact of laboratory test results on diagnostic and therapeutic interventions has increased enormously in the past decade, due to advances in personalized medicine and to the strictly correlated requirement to use new biomarkers with increasing sensitivity and specificity in clinical practice. In order to create savings by delivering better care there is the need to invest financial resources in purchasing high technology and new sophisticated tests and to promote the expertise of clinical pathologists and laboratory medicine professionals. This approach to creating value in patient health care is more productive and sustainable ethically, morally and economically as a long-term strategy. It can be successfully achieved by applying defined rules that make public-private cooperation clearer, skipping incompatible solutions such as transforming clinical laboratories to 'industrially productive premises', outsourcing laboratory medicine services and using central acquisition of diagnostic systems. © 2013.

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

    Science.gov (United States)

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

    2014-01-01

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

  9. Prevention of Biofouling in Hydrocarbons by Antimicrobial Vessel and Pipeline Coating for Cost Savings and an Increase in Safety and Reliability

    Directory of Open Access Journals (Sweden)

    Maximilian Lackner

    2013-04-01

    Full Text Available Hydrocarbons are prone to bacterial and fungal contamination. Bacteria and fungi live and proliferate in water droplets within the fuels and on surfaces surrounding them. This can cause corrosion in oil exploration and production, clogging of fuel lines in aviation and higher emissions in diesel combustion engines to state few examples. State-of-the-art is the addition of biocides to fuels, which is associated with several disadvantages like costs and environmental burden. A novel technology to prevent biofouling in hydrocarbons is presented here. By applying an anti-microbial coating to the surfaces of hydrocarbon processing units, pipelines, and fuel containers, microbial growth can effectively be reduced. The coating can be a paint or varnish, for instance, epoxy resin as already used in aircraft fuel tanks to today. It contains transition metal oxides, thus an acidic surface is produced. This acidic surface was shown to eliminate up to 109 colony forming units per milliliter (CFU.ml-1 of bacteria of the species of agrobacterium tumefaciens and others in diesel, kerosene, and biodiesel, where other anti-microbial coatings based on silver did not perform. The technology has the potential to bring huge cost savings to the oil and gas industry, alongside an increase in safety and equipment reliability.

  10. 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...

  11. 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.

  12. Risk assessment and management of brucellosis in the southern greater Yellowstone area (II): Cost-benefit analysis of reducing elk brucellosis prevalence.

    Science.gov (United States)

    Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant

    2016-11-01

    Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Bases of a fuel saving program for the passenger car traffic in Austria and benefit-cost-analysis of individual fuel economics. Grundlagen eines Energiesparkonzeptes fuer den PKW-Verkehr in Oesterreich und Nutzen-Kosten-Untersuchung einzelner Energiesparmassnahmen

    Energy Technology Data Exchange (ETDEWEB)

    Bruner-Newton, I.

    1979-01-01

    The influences on the fuel consumption of the individual automobile are investigated and their importance is appraised. From these data measures are derived to obtain a sensible fuel consumption. After a survey of conventional benefit-cost-analyses, guide lines for a benefit-cost-analyses of fuel economies in passenger car traffic are given. A target system is established which includes the most important criteria, which determine the total fuel consumption of passenger cars in Austria. Hereby it is possible to calculate the fuel saving potential of a certain measure. The economy of a measure is characterized by a benefit-cost-ratio. The developed methods of appraisal are applied to 14 measures and prove to be a suitable instrument for a systematic and comparable analyses of the individual measures. The measures are listed according to their economy when examining three different periods. It is shown which average annual fuel saving potential can be achieved by means of which annual costs.

  14. 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.

  15. PSAD-a monitoring and aid to diagnosis system participating in saving on maintenance and operation costs and for plant life extension

    International Nuclear Information System (INIS)

    Brasseur, S.; Morel, J.; Joussellin, A.

    1997-01-01

    Monitoring nuclear plants components enable to save on operation and maintenance costs by reducing incidents gravity and casual plant stoppages thank to early detection and fast diagnosis. Improving the knowledge of the behaviour of the plant will also allow to optimize maintenance and to increase plant life. In order to improve monitoring and diagnosis capabilities in nuclear power plants. Electricite de France (EDF) is extending the existing data processing chains towards automatic aided interpretation and diagnosis. Therefore, EDF has designed an integrated monitoring and diagnosis assistance system: PSAD-Poste de Surveillance et d'Aide au Diagnostic, including several monitoring functions of the main components. It integrates on-line monitoring, off-line diagnosis and knowledge based systems. PSAD stations provide homogeneous aids to diagnosis which enable plant personnel to pinpoint the mechanical behaviour of plant equipment. The objective of PSAD is to provide them with high-efficiency and user-friendly tools which can considerabily free them from routine tasks. The first version of the prototype is working on a French Plant. This version includes the software host structure and two monitoring functions: the Reactor Coolant Pumps and the Turbo-generator Monitoring functions. Internal Structures Monitoring function and Loose Parts Detection are still under development and should be integrated into PSAD prototype in 1998

  16. Cost saving synergistic shaft seal

    Science.gov (United States)

    Ludwig, L. P.; Strom, T. N.

    1976-01-01

    Segmented carbon rings, used to replace elastomeric seal lip, provide resistance to high temperatures generated in lubricating film. Machining and close manufacturing tolerances of conventional segmented seal are avoided by mounting segmented rings in elastomeric flex section.

  17. 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.

  18. Plerixafor mobilization leads to a lower ratio of CD34+ cells to total nucleated cells which results in greater storage costs.

    Science.gov (United States)

    Tanhehco, Yvette C; Adamski, Jill; Sell, Mary; Cunningham, Kathleen; Eisenmann, Christa; Magee, Deborah; Stadtmauer, Edward A; O'Doherty, Una

    2010-01-01

    Plerixafor (Mozobil, AMD3100) with granulocyte-colony stimulating factor (G-CSF) mobilizes more CD34+ cells/kg compared to G-CSF alone. Given that plerixafor enhances mobilization of multiple white blood cell lineages, we determined if more storage space is required for products collected from patients mobilized with plerixafor. A review of the medical records of 15 patients mobilized with chemotherapy and G-CSF (control) and 14 patients mobilized with plerixafor plus G-CSF (plerixafor) was performed. Data on demographics, baseline characteristics, CD34+ cells/kg, total nucleated cells, total mononuclear cells, total apheresis sessions, and total bags for storage were collected. Mean values were determined and compared using Student's t-test. We found that the proportion of CD34+ cells among total nucleated cells was less in the plerixafor group compared to the control group (P = 0.0427). More nucleated cells (10.7 x 10(10) vs. 7.1 x 10(10), P =0.0452) and mononuclear cells (9.7 x 10(10) vs. 5.9 x 10(10), P = 0.0059) were mobilized with plerixafor plus G-CSF. However, there was no significant difference in CD34+ cells/kg, total CD34+ cells or the proportion of mononuclear cells among total nucleated cells between the two groups. More storage bags were required for the plerixafor group compared to the control group (15 vs. 9, P = 0.0299). Mobilization with plerixafor plus G-CSF resulted in a smaller proportion of CD34+ cells collected and a greater number of storage bags. An increase in the number of bags required for stem cell storage may be logistically problematic and will also lead to increased costs for storage of stem cells.

  19. Cost-effectiveness of retreatment with varenicline after failure with or relapse after initial treatment for smoking cessation

    Directory of Open Access Journals (Sweden)

    Lieven Annemans

    2015-01-01

    Conclusion: This analysis suggests that in the long term, varenicline retreatment is a dominant intervention, meaning both greater health gains and greater costs saved, over other possible interventions and therefore should be considered as a standard option.

  20. Potential energy savings from cool roofs in Spain and Andalusia

    International Nuclear Information System (INIS)

    Boixo, Sergio; Diaz-Vicente, Marian; Colmenar, Antonio; Castro, Manuel Alonso

    2012-01-01

    Cool roofs are an inexpensive method to save energy and to improve the comfort level in buildings in mild and hot climates. A high scale implementation of cool roofs in Andalusia, in the south of Spain, could potentially save 295,000 kWh per year, considering only residential buildings with flat roofs using electrical heating. At the current energy prices, consumers can save 59 million euros annually in electricity costs and the emission of 136,000 metric tons of CO 2 can be directly avoided every year from the production of that electricity. If radiative forcings are considered, Andalucía can potentially offset between 9.44 and 12 Mt of CO 2 . All the provinces in the rest of Spain are also studied in this paper. The biggest savings are achieved in Gran Canaria (48%), Tenerife (48%), Cádiz (36%), Murcia (33%), Huelva (30%), Málaga (29%), Almería (29%) and Sevilla (28%), where savings are greater than 2 euros per square meter of flat roof for old buildings with dark roofs. For the biggest cities the range of savings obtained are: between 7.4% and 11% in Madrid, between 12% and 18% in Barcelona and between 14% and 20% in Valencia. -- Highlights: ► We estimate potential savings in energy, CO 2 , and money for cool roofs in Spain (residential sector with flat roofs). ► Average savings are of around one euro per square meter in the biggest cities. ► Potential savings are of more than 2 €/m 2 in the hottest cities. ► In Andalusia the potential savings are 300 MWh, 60 millions euro and 136,000 tons of CO 2 per year. ► With forcings, the CO 2 equivalence of cool roofs in Andalusia is between 9 and 12 Mt.

  1. 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...

  2. DOD Commissaries and Exchanges: Plan and Additional Information Needed on Cost Savings and Metrics for DOD Efforts to Achieve Budget Neutrality

    Science.gov (United States)

    2016-11-14

    three mandated benchmarks for customer satisfaction , quality of products, and patron savings but does not define specific metrics for each of the...benchmarks. For example, DOD has not defined customer satisfaction relative to maintaining a “high level” of satisfaction or determined what results would...quality of products, and patron savings, the report does not define specific metrics to measure each of the benchmarks. Customer Satisfaction Surveys

  3. 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

  4. 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

  5. Cost-saving treatment strategies in in vitro fertilization: a combined economic evaluation of two large randomized clinical trials comparing highly purified human menopausal gonadotropin and recombinant follicle-stimulating hormone alpha.

    Science.gov (United States)

    Wechowski, Jaroslaw; Connolly, Mark; Schneider, Dirk; McEwan, Philip; Kennedy, Richard

    2009-04-01

    To assess the cost-effectiveness of two gonadotropin treatments that are available in the United Kingdom in light of limited public funding and the fundamental role of costs in IVF treatment decisions. An economic evaluation based on two large randomized clinical trials in IVF patients using a simulation model. Fifty-three fertility clinics in 13 European countries and Israel. Women indicated for treatment with IVF (N = 986), aged 18-38, participating in double-blind, randomized controlled trials. Highly purified menotropin (HP-hMG, Menopur) or recombinant follitropin alpha (rFSH, Gonal-F). Cost per IVF cycle and cost per live birth for HP-hMG and rFSH alpha. HP-hMG was more effective and less costly versus rFSH for both IVF cost per live birth and for IVF cost per baby (incremental cost-effectiveness ratio was negative). The mean costs per IVF treatment for HP-hMG and rFSH were 2408 pounds (95% confidence interval [CI], 2392 pounds, 2421 pounds) and 2660 pounds (95% CI 2644 pounds, 2678 pounds), respectively. The mean cost saving of 253 pounds per cycle using HP-hMG allows one additional cycle to be delivered for every 9.5 cycles. Treatment with HP-hMG was dominant compared with rFSH in the United Kingdom. Gonadotropin costs should be considered alongside live-birth rates to optimize outcomes using scarce health-care resources.

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

    Science.gov (United States)

    Seidman, Gabriel; Atun, Rifat

    2017-01-01

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

  7. 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…

  8. A participatory decision support tool to access costs and benefits or tourism development scenarios : application of the ADAPTIVE model to Greater Giyani, South Africa

    NARCIS (Netherlands)

    Henkens, R.J.H.G.; Tassone, V.C.; Grafakos, S.; Groot, de R.S.; Luttik, J.

    2007-01-01

    The tourism industry represents a thriving business and offers many opportunities for tourism development all around the world. Each development will have its economic, socio-cultural and ecological costs and benefits. Many of these are difficult to assess and to value, which often leads to

  9. 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.

  10. PCR diagnosis of tick-borne pathogens in Maharashtra state, India indicates fitness cost associated with carrier infections is greater for crossbreed than native cattle breeds.

    Directory of Open Access Journals (Sweden)

    Sunil W Kolte

    Full Text Available Tick-borne pathogens (TBP are responsible for significant economic losses to cattle production, globally. This is particularly true in countries like India where TBP constrain rearing of high yielding Bos taurus, as they show susceptibility to acute tick borne disease (TBD, most notably tropical theileriosis caused by Theileria annulata. This has led to a programme of cross breeding Bos taurus (Holstein-Friesian or Jersey with native Bos indicus (numerous breeds to generate cattle that are more resistant to disease. However, the cost to fitness of subclinical carrier infection in crossbreeds relative to native breeds is unknown, but could represent a significant hidden economic cost. In this study, a total of 1052 bovine blood samples, together with associated data on host type, sex and body score, were collected from apparently healthy animals in four different agro-climatic zones of Maharashtra state. Samples were screened by PCR for detection of five major TBPs: T. annulata, T. orientalis, B. bigemina, B. bovis and Anaplasma spp.. The results demonstrated that single and co-infection with TBP are common, and although differences in pathogen spp. prevalence across the climatic zones were detected, simplistic regression models predicted that host type, sex and location are all likely to impact on prevalence of TBP. In order to remove issues with autocorrelation between variables, a subset of the dataset was modelled to assess any impact of TBP infection on body score of crossbreed versus native breed cattle (breed type. The model showed significant association between infection with TBP (particularly apicomplexan parasites and poorer body condition for crossbreed animals. These findings indicate potential cost of TBP carrier infection on crossbreed productivity. Thus, there is a case for development of strategies for targeted breeding to combine productivity traits with disease resistance, or to prevent transmission of TBP in India for economic

  11. PCR diagnosis of tick-borne pathogens in Maharashtra state, India indicates fitness cost associated with carrier infections is greater for crossbreed than native cattle breeds.

    Science.gov (United States)

    Kolte, Sunil W; Larcombe, Stephen D; Jadhao, Suresh G; Magar, Swapnil P; Warthi, Ganesh; Kurkure, Nitin V; Glass, Elizabeth J; Shiels, Brian R

    2017-01-01

    Tick-borne pathogens (TBP) are responsible for significant economic losses to cattle production, globally. This is particularly true in countries like India where TBP constrain rearing of high yielding Bos taurus, as they show susceptibility to acute tick borne disease (TBD), most notably tropical theileriosis caused by Theileria annulata. This has led to a programme of cross breeding Bos taurus (Holstein-Friesian or Jersey) with native Bos indicus (numerous) breeds to generate cattle that are more resistant to disease. However, the cost to fitness of subclinical carrier infection in crossbreeds relative to native breeds is unknown, but could represent a significant hidden economic cost. In this study, a total of 1052 bovine blood samples, together with associated data on host type, sex and body score, were collected from apparently healthy animals in four different agro-climatic zones of Maharashtra state. Samples were screened by PCR for detection of five major TBPs: T. annulata, T. orientalis, B. bigemina, B. bovis and Anaplasma spp.. The results demonstrated that single and co-infection with TBP are common, and although differences in pathogen spp. prevalence across the climatic zones were detected, simplistic regression models predicted that host type, sex and location are all likely to impact on prevalence of TBP. In order to remove issues with autocorrelation between variables, a subset of the dataset was modelled to assess any impact of TBP infection on body score of crossbreed versus native breed cattle (breed type). The model showed significant association between infection with TBP (particularly apicomplexan parasites) and poorer body condition for crossbreed animals. These findings indicate potential cost of TBP carrier infection on crossbreed productivity. Thus, there is a case for development of strategies for targeted breeding to combine productivity traits with disease resistance, or to prevent transmission of TBP in India for economic benefit.

  12. Defense Sector Consolidation: Will Consolidation Within the Defense Sector Improve the Financial Performance of Defense Contractors While, Simultaneously Yielding Cost Savings to Taxpayers

    Science.gov (United States)

    2005-12-01

    Treaty USSR Union of Soviet Socialist Republics WACC Weighted Average Cost of Capital...a present value using the company’s weighted average cost of capital ( WACC ). Synergy: The Premium for Potential Success For the most part

  13. 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

  14. Cost and impact of scaling up interventions to save lives of mothers and children: taking South Africa closer to MDGs 4 and 5

    Directory of Open Access Journals (Sweden)

    Lumbwe Chola

    2015-04-01

    Full Text Available Background: South Africa has made substantial progress on child and maternal mortality, yet many avoidable deaths of mothers and children still occur. This analysis identifies priority interventions to be scaled up nationally and projects the potential maternal and child lives saved. Design: We modelled the impact of maternal, newborn and child interventions using the Lives Saved Tools Projections to 2015 and used realistic coverage increases based on expert opinion considering recent policy change, financial and resource inputs, and observed coverage change. A scenario analysis was undertaken to test the impact of increasing intervention coverage to 95%. Results: By 2015, with realistic coverage, the maternal mortality ratio (MMR can reduce to 153 deaths per 100,000 and child mortality to 34 deaths per 1,000 live births. Fifteen interventions, including labour and delivery management, early HIV treatment in pregnancy, prevention of mother-to-child transmission and handwashing with soap, will save an additional 9,000 newborns and children and 1,000 mothers annually. An additional US$370 million (US$7 per capita will be required annually to scale up these interventions. When intervention coverage is increased to 95%, breastfeeding promotion becomes the top intervention, the MMR reduces to 116 and the child mortality ratio to 23. Conclusions: The 15 interventions identified were adopted by the National Department of Health, and the Health Minister launched a campaign to encourage Provincial Health Departments to scale up coverage. It is hoped that by focusing on implementing these 15 interventions at high quality, South Africa will reach Millennium Development Goal (MDG 4 soon after 2015 and MDG 5 several years later. Focus on HIV and TB during early antenatal care is essential. Strategic gains could be realised by targeting vulnerable populations and districts with the worst health outcomes. The analysis demonstrates the usefulness of priority

  15. 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.

  16. Greater oil investment opportunities

    International Nuclear Information System (INIS)

    Arenas, Ismael Enrique

    1997-01-01

    Geologically speaking, Colombia is a very attractive country for the world oil community. According to this philosophy new and important steps are being taken to reinforce the oil sector: Expansion of the exploratory frontier by including a larger number of sedimentary areas, and the adoption of innovative contracting instruments. Colombia has to offer, Greater economic incentives for the exploration of new areas to expand the exploratory frontier, stimulation of exploration in areas with prospectivity for small fields. Companies may offer Ecopetrol a participation in production over and above royalties, without it's participating in the investments and costs of these fields, more favorable conditions for natural gas seeking projects, in comparison with those governing the terms for oil

  17. 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

  18. 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.

  19. Are Women Empowered to Save?

    Directory of Open Access Journals (Sweden)

    Frances Woolley

    2013-12-01

    Full Text Available Female economic empowerment – rising earnings, increased opportunities, greater labour force participation – has given many women the means to save. The shifting of responsibility for retirement security from employers and governments onto individuals has given women a reason to save. But are women actually saving? In this paper, we explore the relationship between the gender dynamics within a family and the accumulation of wealth. We find that little evidence in support of the conventional wisdom that families with a female financial manager save more and repay their debts more often. We find some evidence that male financial management leads to greater savings, and other evidence suggesting that savings patterns have a complex relationship with intra-family gender dynamics. El empoderamiento económico de la mujer – el aumento de los ingresos, mayores oportunidades, mayor participación laboral – ha dado a muchas mujeres los medios para ahorrar. Al pasar la responsabilidad de los ingresos de la jubilación de los empleadores y el gobierno a los individuos ha dado a las mujeres un motivo para ahorrar. ¿Pero realmente ahorran las mujeres? En este artículo se analizan las relaciones entre las dinámicas de género en una familia, y la acumulación de riqueza. Se ha llegado a la conclusión de que hay poca evidencia que apoye la creencia convencional de que las familias en las que una mujer gestiona las financias ahorran más y devuelven sus créditos más frecuentemente. Se ha encontrado alguna evidencia de que la gestión financiera por varones acarrea mayores ahorros, y otras evidencias que sugieren que los patrones de ahorro tienen una relación compleja con las dinámicas de género dentro de la familia.

  20. 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.

  1. Prevention program at construction worksites aimed at improving health and work ability is cost-saving to the employer: Results from an RCT

    NARCIS (Netherlands)

    Oude Hengel, K.M.; Bosmans, J.E.; Dongen, J.M. van; Bongers, P.M.; Beek, A.J. van der; Blatter, B.M.

    2014-01-01

    Background: To prolong sustainable healthy working lives of construction workers, a prevention program was developed which aimed to improve the health and work ability of construction workers. The objective of this study was to analyze the cost-effectiveness and financial return from the employers'

  2. E-Box. A residential gateway for cost saving and sustainability. Integration of Internet and ICT-networks for energy conservation services. Architecture and interface description of energy- and cost saving potential; E-Box. Een 'residential gateway' voor kostenbesparing en duurzaamheid. Integratie Internet en ICT-netwerken voor energiebesparingsdiensten. Architectuur en interface beschrijving Energie- en kostenbesparingspotentieel

    Energy Technology Data Exchange (ETDEWEB)

    Kamphuis, I.G. [ECN Duurzame Energie in de Gebouwde Omgeving DEGO, Petten (Netherlands)

    2003-01-01

    The results of a study on using new information and communication technology in small-scale energy management systems on the level of individual households are presented. Detailed requirements are formulated for such an energy management system. A hardware and software architecture is proposed based on existing standards for delivering service applications. A large part of the energy management functionality for such a E-box for energy efficiency and cost control has been implemented in a software prototype. The results of prototype simulation studies indicate that there is a cost saving potential and a potential for improved embedding of small scale, sustainable energy generators, if operations of appliances are co-ordinated in view of real-time market price signals. The potential (spread in cost plus or minus 15%) is highest for combined operation of small micro-CHP (Stirling motor powered or fuel cell installations) satisfying a house's heat demand with laundry washing and drying processes in a real time electricity pricing situation. A similar increase in cost effectiveness can be achieved, if buffering of energy-carriers (electricity or heat) is used. Possible market and business models for implementing the functionality of an E-box are dealt with and some possible implementation opportunities in a real-time price liberalised end user energy consumption market are discussed. [Dutch] De resultaten van een haalbaarheidsstudie naar de mogelijkheden van het gebruik van Internet-technologie en kleinschalige ICT-netwerken voor het opzetten van energie- en kosten-besparingsdiensten in woningen worden besproken. Vanuit de context van bestaande energie monitoring en management toepassingen in utiliteitsgebouwen wordt een vertaalslag gemaakt naar woningen. Aan de hand van een inventarisatie en definitie van een aantal voorbeeldtoepassingen is een globale vereistenspecificatie voor een energiemanagement systeem in woningen opgesteld. In deze vereistenspecificatie

  3. Evaluation of increased adherence and cost savings of an employer value-based benefits program targeting generic antihyperlipidemic and antidiabetic medications.

    Science.gov (United States)

    Clark, Bobby; DuChane, Janeen; Hou, John; Rubinstein, Elan; McMurray, Jennifer; Duncan, Ian

    2014-02-01

    A major employer implemented a change to its employee health benefits program to allow beneficiaries with diabetes or high cholesterol to obtain preselected generic antidiabetic or generic antihyperlipidemic medications with a zero dollar copayment. To receive this benefit, plan beneficiaries were required to participate in a contracted vendor's case management and/or wellness program.  To assess changes in medication adherence and the costs for generic antidiabetic and generic antihyperlipidemic medications resulting from participation in a zero copay (ZCP) program.   This was a retrospective pre-post comparison group study, evaluating adherence and cost. Participants using an antihyperlipidemic and/or antidiabetic medication during the study identification period and post-implementation period for the program were considered eligible for the study. Eligible beneficiaries who enrolled in the ZCP program during the post-implementation period were considered participants, while those who did not enroll during this period were considered nonparticipants. ZCP program participants and nonparticipants were matched via a 1-to-1 propensity scoring method using age, gender, comorbidity count, medication type (antihyperlipidemic, antidiabetic, or both), and baseline adherence as matching criteria. The proportion of days covered (PDC) metric expressed as a mean percentage was used to assess adherence to medication therapy, while payer cost was examined using prescription drug utilization expressed as per member per year (PMPY) and cost change per 30 days of medication expressed in dollars.   Among participants who were users of antidiabetic medications, the mean adherence rate was sustained from pre- to post-implementation (81.8% vs. 81.9%); however, it decreased in the matched nonparticipant group (81.9% vs. 73.1%). This difference in mean adherence over time between the participants and nonparticipants was statistically significant (0.1% vs. -8.8%, P  less than  0

  4. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Hangen, H.O. [comp.

    1997-12-31

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

  6. Determinants of success in Shared Savings Programs: An analysis of ACO and market characteristics.

    Science.gov (United States)

    Ouayogodé, Mariétou H; Colla, Carrie H; Lewis, Valerie A

    2017-03-01

    Medicare's Accountable Care Organization (ACO) programs introduced shared savings to traditional Medicare, which allow providers who reduce health care costs for their patients to retain a percentage of the savings they generate. To examine ACO and market factors associated with superior financial performance in Medicare ACO programs. We obtained financial performance data from the Centers for Medicare and Medicaid Services (CMS); we derived market-level characteristics from Medicare claims; and we collected ACO characteristics from the National Survey of ACOs for 215 ACOs. We examined the association between ACO financial performance and ACO provider composition, leadership structure, beneficiary characteristics, risk bearing experience, quality and process improvement capabilities, physician performance management, market competition, CMS-assigned financial benchmark, and ACO contract start date. We examined two outcomes from Medicare ACOs' first performance year: savings per Medicare beneficiary and earning shared savings payments (a dichotomous variable). When modeling the ACO ability to save and earn shared savings payments, we estimated positive regression coefficients for a greater proportion of primary care providers in the ACO, more practicing physicians on the governing board, physician leadership, active engagement in reducing hospital re-admissions, a greater proportion of disabled Medicare beneficiaries assigned to the ACO, financial incentives offered to physicians, a larger financial benchmark, and greater ACO market penetration. No characteristic of organizational structure was significantly associated with both outcomes of savings per beneficiary and likelihood of achieving shared savings. ACO prior experience with risk-bearing contracts was positively correlated with savings and significantly increased the likelihood of receiving shared savings payments. In the first year, performance is quite heterogeneous, yet organizational structure does not

  7. 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.

  8. Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom12

    Science.gov (United States)

    Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

    2015-01-01

    Background: The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). Objective: The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. Design: In this cross-sectional study of adults aged 39–79 y from the European Prospective Investigation into Cancer and Nutrition–Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom–based supermarket comparison website. Results: Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Conclusions: Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed. PMID:25926505

  9. Greater accordance with the Dietary Approaches to Stop Hypertension dietary pattern is associated with lower diet-related greenhouse gas production but higher dietary costs in the United Kingdom.

    Science.gov (United States)

    Monsivais, Pablo; Scarborough, Peter; Lloyd, Tina; Mizdrak, Anja; Luben, Robert; Mulligan, Angela A; Wareham, Nicholas J; Woodcock, James

    2015-07-01

    The Dietary Approaches to Stop Hypertension (DASH) diet is a proven way to prevent and control hypertension and other chronic disease. Because the DASH diet emphasizes plant-based foods, including vegetables and grains, adhering to this diet might also bring about environmental benefits, including lower associated production of greenhouse gases (GHGs). The objective was to examine the interrelation between dietary accordance with the DASH diet and associated GHGs. A secondary aim was to examine the retail cost of diets by level of DASH accordance. In this cross-sectional study of adults aged 39-79 y from the European Prospective Investigation into Cancer and Nutrition-Norfolk, United Kingdom cohort (n = 24,293), dietary intakes estimated from food-frequency questionnaires were analyzed for their accordance with the 8 DASH food and nutrient-based targets. Associations between DASH accordance, GHGs, and dietary costs were evaluated in regression analyses. Dietary GHGs were estimated with United Kingdom-specific data on carbon dioxide equivalents associated with commodities and foods. Dietary costs were estimated by using national food prices from a United Kingdom-based supermarket comparison website. Greater accordance with the DASH dietary targets was associated with lower GHGs. Diets in the highest quintile of accordance had a GHG impact of 5.60 compared with 6.71 kg carbon dioxide equivalents/d for least-accordant diets (P dietary costs, with the mean cost of diets in the top quintile of DASH scores 18% higher than that of diets in the lowest quintile (P < 0.0001). Promoting wider uptake of the DASH diet in the United Kingdom may improve population health and reduce diet-related GHGs. However, to make the DASH diet more accessible, food affordability, particularly for lower income groups, will have to be addressed.

  10. Integrated waste management system costs in a MPC system

    International Nuclear Information System (INIS)

    Supko, E.M.

    1995-01-01

    The impact on system costs of including a centralized interim storage facility as part of an integrated waste management system based on multi-purpose canister (MPC) technology was assessed in analyses by Energy Resources International, Inc. A system cost savings of $1 to $2 billion occurs if the Department of Energy begins spent fuel acceptance in 1998 at a centralized interim storage facility. That is, the savings associated with decreased utility spent fuel management costs will be greater than the cost of constructing and operating a centralized interim storage facility

  11. 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)

  12. Private Sector Savings

    Directory of Open Access Journals (Sweden)

    Pitonáková Renáta

    2018-03-01

    Full Text Available The majority of household savings are in the form of bank deposits. It is therefore of interest for credit institutions to tailor their deposit policy for getting finances from non-banking entities and to provide the private sector with the loans that are necessary for investment activities and consumption. This paper deals with the determinants of the saving rate of the private sector of Slovakia. Economic, financial and demographic variables influence savings. Growth of income per capita, private disposable income, elderly dependency ratio, real interest rate and inflation have a positive impact on savings, while increases in public savings indicate a crowding out effect. The inflation rate implies precautionary savings, and dependency ratio savings for bequest. There are also implications for governing institutions deciding on the implementation of appropriate fiscal and monetary operations.

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

    Directory of Open Access Journals (Sweden)

    Ahmad Hasan

    2014-03-01

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

  14. 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...

  15. 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)

  16. Hints on cost- and energy saving during lime-sand brick production; Hinweise zur Kosten- und Energieeinsparung bei der Kalksandstein-Produktion

    Energy Technology Data Exchange (ETDEWEB)

    Eden, W.

    2001-05-01

    The publication contains hints for reduction of energy consumption and cost in lime-sand brick production. The information was compiled by Bundesverband Kalksandsteinindustrie e.V. and was derived from technical discussions of the master seminars on production technology of the years 1995 - 2000, consultations form member organizations, or from other sources. [German] Diese Arbeit ist eine Zusammenstellung von Hinweisen zur Reduzierung des Energieverbrauchs und der Kostensenkung bei der KS-Produktion und soll eine Hilfestellung bei entsprechenden Rationalisierungsmassnahmen in den Mitgliedsunternehmen sein. Die hier aufgefuehrten Hinweise und Anregungen entstammen den Fachdiskussionen der Meisterseminare zur Produktionstechnik aus den Jahren 1995 bis 2000, Beratungsgespraechen fuer Mitgliedsunternehmen oder wurden dem Bundesverband Kalksandsteinindustrie eV freundlicherweise fuer die Gemeinschaftsarbeit zur Verfuegung gestellt. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-09-01

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

  18. Half dose sugammadex combined with neostigmine is non-inferior to full dose sugammadex for reversal of rocuronium-induced deep neuromuscular blockade: a cost-saving strategy.

    Science.gov (United States)

    Aouad, Marie T; Alfahel, Waseem S; Kaddoum, Roland N; Siddik-Sayyid, Sahar M

    2017-04-11

    Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB. This approach would reduce the cost of sugammadex while preserving its efficacy. Patients were randomly allocated to receive sugammadex 4 mg/kg (Group S) or sugammadex 2 mg/kg with neostigmine 50 μg/kg and glycopyrrolate 10 μg/kg (Group NS) for reversal of rocuronium deep NMB. The primary outcome was the percentage of patients who recovered to 90% Train of Four (TOF) ratio within 5 min. The non-inferiority margin was set at 10%. Twenty eight patients were enrolled in each group. The number of patients who reached 90% TOF ratio within 5 min was 27 out of 28 (96%) in group S versus 25 out of 28 (89%) in group NS by intention-to-treat (difference: 7%, 95% CI of the difference: -9% to 24%). The number of patients who reached 90% TOF ratio within 5 min was 26 out of 26 (100%) in group S versus 23 out of 25 (92%) in group NS by per-protocol (difference: 8%, 95% CI of the difference: -6% to 25%). Sugammadex 2 mg/kg with neostigmine 50 μg/kg was at worst 9% and 6% less effective than sugammadex 4 mg/kg by intention-to-treat and by per-protocol analysis respectively. Hence, the combination is non-inferior to the recommended dose of sugammadex. Clinicaltrials.gov NCT 02375217 , registered on February 11, 2015.

  19. Energy saving certificates

    International Nuclear Information System (INIS)

    2005-11-01

    The French ministry of economy, finances and industry and the French agency of environment and energy mastery (Ademe) have organized on November 8, 2005, a colloquium for the presentation of the energy saving certificates, a new tool to oblige the energy suppliers to encourage their clients to make energy savings. This document gathers the transparencies presented at this colloquium about the following topics: state-of-the-art and presentation of the energy saving certificates system: presentation of the EEC system, presentation of the EEC standard operations; the energy saving certificates in Europe today: energy efficiency commitment in UK, Italian white certificate scheme, perspectives of the different European systems. (J.S.)

  20. Spending to save

    DEFF Research Database (Denmark)

    Larsen, Anders

    2013-01-01

    the energy distribution companies meet their overall saving obligation, the net savings impact are about a third of the savings reported by the obligated parties. Further it was found that while energy savings in the public and business sector have a high net impact, some subsidies given under the EEO...... perspective. The evaluation has resulted in noticeable adjustments of the design of the Danish EEO, e.g. introduction of a 1 year payback-time limit for projects receiving subsidies, a minimum baseline for insulation products, and specification of documentation requirements....

  1. 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)

  2. 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...

  3. Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.

    Science.gov (United States)

    Donohue, Julie M; Fischer, Michael A; Huskamp, Haiden A; Weissman, Joel S

    2008-10-01

    To estimate potential savings associated with the Consumer Reports Best Buy Drugs program, a national educational program that provides consumers with price and effectiveness information on prescription drugs. National data on 2006 prescription sales and retail prices paid for angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-coA) reductase inhibitors (statins). We converted national data on aggregate unit sales of drugs in the four classes to defined daily doses (DDD) and estimated a range of potential savings from generic and therapeutic substitution. We estimated that $2.76 billion, or 7.83 percent of sales, could be saved if use of the drugs recommended by the educational program was increased. The recommended drugs' prices were 15-65 percent lower per DDD than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution. Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized. © Health Research and Educational Trust.

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

    Directory of Open Access Journals (Sweden)

    Deborah K Glencross

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

  5. Contract saving schemes

    NARCIS (Netherlands)

    Ronald, R.; Smith, S.J.; Elsinga, M.; Eng, O.S.; Fox O'Mahony, L.; Wachter, S.

    2012-01-01

    Contractual saving schemes for housing are institutionalised savings programmes normally linked to rights to loans for home purchase. They are diverse types as they have been developed differently in each national context, but normally fall into categories of open, closed, compulsory, and ‘free

  6. Measuring industrial energy savings

    International Nuclear Information System (INIS)

    Kelly Kissock, J.; Eger, Carl

    2008-01-01

    Accurate measurement of energy savings from industrial energy efficiency projects can reduce uncertainty about the efficacy of the projects, guide the selection of future projects, improve future estimates of expected savings, promote financing of energy efficiency projects through shared-savings agreements, and improve utilization of capital resources. Many efforts to measure industrial energy savings, or simply track progress toward efficiency goals, have had difficulty incorporating changing weather and production, which are frequently major drivers of plant energy use. This paper presents a general method for measuring plant-wide industrial energy savings that takes into account changing weather and production between the pre and post-retrofit periods. In addition, the method can disaggregate savings into components, which provides additional resolution for understanding the effectiveness of individual projects when several projects are implemented together. The method uses multivariable piece-wise regression models to characterize baseline energy use, and disaggregates savings by taking the total derivative of the energy use equation. Although the method incorporates search techniques, multi-variable least-squares regression and calculus, it is easily implemented using data analysis software, and can use readily available temperature, production and utility billing data. This is important, since more complicated methods may be too complex for widespread use. The method is demonstrated using case studies of actual energy assessments. The case studies demonstrate the importance of adjusting for weather and production between the pre- and post-retrofit periods, how plant-wide savings can be disaggregated to evaluate the effectiveness of individual retrofits, how the method can identify the time-dependence of savings, and limitations of engineering models when used to estimate future savings

  7. Honeywell starts energy-management service: savings guaranteed; BOSS replaced

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, R.

    1983-01-24

    Honeywell Inc. guarantees that its new Honeywell Service Link Operation (HSLO), a time-sharing service, will produce greater energy savings than its monthly fees. There are no front-end costs because the central computer is located at the supplier's Atlanta site, making energy management cost-affordable for facilities as small as 25,000 square feet. HSLO replaces Honeywell's Building Operations Service System (BOSS) that has a minimum-size requirement of 100,000 square feet. BOSS customers will be automatically changed to HSLO at no charge. All 21 regional computer centers will be available to users. Johnson Controls, Inc. also operates a time-sharing operation called Total Automated Building Services (TABS). (DCK)

  8. 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.

  9. Tankering Fuel: A Cost Saving Initiative

    Science.gov (United States)

    2011-05-01

    2.41075 RIO DE JANEIRO IAP SBGL OS 3.1867 Riyadh Mil Apt Saudi A OERY OS 2.5587 Riyadh Mil Apt Saudi A OERY OS 2.5396 ROANOKE RGNLWOODRUM FLD KROA...US NGB NORTHCOM Davis Monthan AFB KDMA AF Arizona US ACC NORTHCOM Davision Army Airfield ARMY Virginia US IMCOM NORTHCOM Des Moines ANG KDSM AF...Carolina US NULL NORTHCOM MCAS New River NAVY North Carolina US NULL NORTHCOM MCAS Yuma KYUM NAVY Arizona US NULL NORTHCOM MCB 29 Palms NAVY

  10. Energy & Cost Savings | Efficient Windows Collaborative

    Science.gov (United States)

    Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

  11. Realized Cost Savings and Avoidance Decisions

    Data.gov (United States)

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

  12. Computer tomography: a cost-saving examination?

    International Nuclear Information System (INIS)

    Barneveld Binkhuysen, F.H.; Puijlaert, C.B.A.J.

    1987-01-01

    The research concerns the influence of the body computer tomograph (BCT) on the efficiency in radiology and in the hospital as a whole in The Netherlands. Hospitals with CT are compared with hospitals without CT. In radiology the substitution effect is investigated, with use of the number of radiological performances per clinical patient as a parameter. This parameter proves to decrease in hospitals with a CT, in contrast to hospitals without a CT. The often-expressed opinion that the CT should specifically perform complementary examinations appears incorrect. As to the efficiency in the hospital this is related to the average hospital in-patient stay. The average hospital in-patient stay proves to be shorter in hospitals with a CT than in those without a CT. The CT has turned out to be a very effective expedient which unfortunately, however, is being used inefficiently in The Netherlands, owing to limited installation. 17 refs.; 6 figs.; 5 tabs

  13. Savings account for health care costs

    Science.gov (United States)

    ... have your employer put part of your pre-tax salary into an account. Your employer also may contribute to the account, and it is not part of your gross income. You do not need to file tax documents ...

  14. Outsourcing: A cost-savings perspective

    International Nuclear Information System (INIS)

    Riser, M.A.; McGough, M.E.

    1992-01-01

    What is outsourcing? There is no such word according to Webster's dictionary; however, as used in the business world, outsourcing is a partnership or contract by a corporation with a third party to have the third party completely manage a particular corporate function or operations area. A common example of outsourcing that occurs in today's commercial marketplace can be seen in the management information systems field. Many large corporations (i.e., banks, insurance companies, utilities, etc.) are required to maintain vast computer networks and information systems to process the voluminous amounts of information that flow through the company each day. This computer center maintenance is usually a support function to the business's main line of work, but it is a necessary tool to allow the corporation to function efficiently in today's information-dominated society. While it is a fact that information is a crucial part of any business operation, processing and distributing that information is not and need not be and usually hinders a company in effectively pursuing its main line of work (e.g., making electricity). One western nuclear utility has outsourced its vendor engineering services to free its engineers from the humdrum task of updating and maintaining vendor technical manual (VTM) information and to allow them to concentrate on maintaining the plant at power, thereby increasing the overall plant capacity rating (i.e., increased profits). Having correct and accurate technical manual information is important for proper plant maintenance; however, on a day-to-day basis, VTMs do not directly support the plant at power and are therefore just one more administrative nightmare a systems engineer or maintenance engineer must deal with in his job

  15. EFFECTIVE SAVINGS IN PRODUCTION TIMES AND COST

    African Journals Online (AJOL)

    ES OBE

    lamination process itself [5,6,7]. The purpose of this work is to fully expose, by means of experimental data, the ... takes staff to laminate such work piece (in cases of handlay-up processes) and machines. (for resin injection .... The unfinished layer of mat being laminated usually result in laminate products with rough surfaces ...

  16. Greater autonomy at work

    NARCIS (Netherlands)

    Houtman, I.L.D.

    2004-01-01

    In the past 10 years, workers in the Netherlands increasingly report more decision-making power in their work. This is important for an economy in recession and where workers face greater work demands. It makes work more interesting, creates a healthier work environment, and provides opportunities

  17. 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.

  18. 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

  19. 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

  20. 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

  1. Financial sustainability in savings and credit programmes.

    Science.gov (United States)

    Havers, M

    1996-05-01

    This article provides a framework for determining, justifying, and improving financial sustainability of savings and credit programs. Credit programs have income from interest and fees. Income must pay for the cost of funds, loan write-offs, operating costs, and inflation. Reference is made to Otero and Rhyne's four levels of self-sufficiency in credit programs. The Grameen Bank is an example of Level 3 and most credit unions are level 4. Nongovernmental groups in the United Kingdom are level 1 or 2. Experience has shown that removal of subsidies did not affect the quality of services or shift benefits away from the poor. Success in serving poorer people better is attributed 1) to more money being available for lending under tighter management practices, 2) to greater openness to a variety of clients from removal of subsidy restrictions, 3) to a shift to higher interest rates that eliminate richer borrowers, and 4) to a shift to serious collection of loans which is a disincentive to more privileged borrowers. Percentages of loan loss, administration costs, cost of funds, and inflation are useful in measuring the sustainability of credit programs. Interest and fee income must also be measured. Fee repayment rates do not have a common definition of arrears, default, and write-off. A simple measure is the percentage of total costs covered by income. The World Bank recommends the Subsidy Dependence Index. Women tend to be better at repaying loans. Loan size should be related to borrowers' ability to handle the amount of the loan. Low and subsidized interest rates deter depositors and attract richer borrowers. Poorer borrowers are attracted by access to credit and not the cost of credit. Interest rates should be based on market rates. The loan payment should be no longer than necessary. Small groups of borrowers can guarantee each others loans. Group-based loan schemes work best. NGOs must project an image of being serious about loan collections and must take action

  2. 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)

  3. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings Carga de morbilidad de la diarrea por rotavirus en Perú: la necesidad de una vacuna y su potencial de ahorro

    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.Objetivos. Evaluar la carga de morbilidad de la diarrea por rotavirus en Perú, la necesidad de una vacuna y el ahorro que esta podría proporcionar en este país. M

  4. The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children

    Science.gov (United States)

    Veerman, Lennert; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

    2018-01-01

    Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M–AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m2). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372–25,155); total cost-savings AUD126.3M (95% UI AUD58.7M–196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812–15,679); total cost-savings AUD90.9M (95% UI AUD44.3M–136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP. PMID:29762517

  5. The Potential Cost-Effectiveness and Equity Impacts of Restricting Television Advertising of Unhealthy Food and Beverages to Australian Children.

    Science.gov (United States)

    Brown, Vicki; Ananthapavan, Jaithri; Veerman, Lennert; Sacks, Gary; Lal, Anita; Peeters, Anna; Backholer, Kathryn; Moodie, Marjory

    2018-05-15

    Television (TV) advertising of food and beverages high in fat, sugar and salt (HFSS) influences food preferences and consumption. Children from lower socioeconomic position (SEP) have higher exposure to TV advertising due to more time spent watching TV. This paper sought to estimate the cost-effectiveness of legislation to restrict HFSS TV advertising until 9:30 pm, and to examine how health benefits and healthcare cost-savings differ by SEP. Cost-effectiveness modelling was undertaken (i) at the population level, and (ii) by area-level SEP. A multi-state multiple-cohort lifetable model was used to estimate obesity-related health outcomes and healthcare cost-savings over the lifetime of the 2010 Australian population. Incremental cost-effectiveness ratios (ICERs) were reported, with assumptions tested through sensitivity analyses. An intervention restricting HFSS TV advertising would cost AUD5.9M (95% UI AUD5.8M⁻AUD7M), resulting in modelled reductions in energy intake (mean 115 kJ/day) and body mass index (BMI) (mean 0.352 kg/m²). The intervention is likely to be cost-saving, with 1.4 times higher total cost-savings and 1.5 times higher health benefits in the most disadvantaged socioeconomic group (17,512 HALYs saved (95% UI 10,372⁻25,155); total cost-savings AUD126.3M (95% UI AUD58.7M⁻196.9M) over the lifetime) compared to the least disadvantaged socioeconomic group (11,321 HALYs saved (95% UI 6812⁻15,679); total cost-savings AUD90.9M (95% UI AUD44.3M⁻136.3M)). Legislation to restrict HFSS TV advertising is likely to be cost-effective, with greater health benefits and healthcare cost-savings for children with low SEP.

  6. Greater-confinement disposal

    International Nuclear Information System (INIS)

    Trevorrow, L.E.; Schubert, J.P.

    1989-01-01

    Greater-confinement disposal (GCD) is a general term for low-level waste (LLW) disposal technologies that employ natural and/or engineered barriers and provide a degree of confinement greater than that of shallow-land burial (SLB) but possibly less than that of a geologic repository. Thus GCD is associated with lower risk/hazard ratios than SLB. Although any number of disposal technologies might satisfy the definition of GCD, eight have been selected for consideration in this discussion. These technologies include: (1) earth-covered tumuli, (2) concrete structures, both above and below grade, (3) deep trenches, (4) augered shafts, (5) rock cavities, (6) abandoned mines, (7) high-integrity containers, and (8) hydrofracture. Each of these technologies employ several operations that are mature,however, some are at more advanced stages of development and demonstration than others. Each is defined and further described by information on design, advantages and disadvantages, special equipment requirements, and characteristic operations such as construction, waste emplacement, and closure

  7. 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.

  8. 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)

  9. How Palo Verde saved millions of dollars

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    In autumn 1992, Arizona Public Service adopted new project control procedures for outages at its three-unit Palo Verde PWR site, including: the switch to a PC-based environment; a new scheduling system; and the generation of improved graphics for decision making. Major cost savings were made and three further outages have now benefitted from the new systems. (author)

  10. 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.…

  11. 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...

  12. Cost justification of chiller replacement

    International Nuclear Information System (INIS)

    Baker, T.J.; Baumer, R.A.

    1993-01-01

    We often hear of products with paybacks that are too good to be true. Just a few weeks ago,a client received a recommendation from a national service company's local office. In the letter the company recommended that open-quotes due to the age and condition of the boiler ... that the school consider replacing the boiler... The cost for the new boiler can usually be recovered by lower fuel bills in 2 to 3 yearsclose quotes. This was for an installation in Southeast Texas where the boiler is only used 4 to 5 months per year. Analysis show the above claims to be nonsense. A new boiler would cost about $47,000 installed. Current total gas bills for the facility are $15,630 per year. They would have to shutoff the gas to the facility to have a three year payback. In fact, only two-thirds of the gas is used to heat the facility so we have only $10, 000 to write off against the new boiler. How much will the greater efficiency save? A 30% savings due to greater efficiency produces $3,000 per year in gas savings to offset the $47,000 cost, a 16 year payback. And much of the efficiency savings can be realized by adjusting the existing boiler. In another care a client wanted to investigate replacement of a twenty year old chiller plant with more efficient equipment. We investigated the project and determined that the payback would be greater than ten years. They did not operate the equipment during the summer and at less than 50% of capacity the balance of the year

  13. More features, greater connectivity.

    Science.gov (United States)

    Hunt, Sarah

    2015-09-01

    Changes in our political infrastructure, the continuing frailties of our economy, and a stark growth in population, have greatly impacted upon the perceived stability of the NHS. Healthcare teams have had to adapt to these changes, and so too have the technologies upon which they rely to deliver first-class patient care. Here Sarah Hunt, marketing co-ordinator at Aid Call, assesses how the changing healthcare environment has affected one of its fundamental technologies - the nurse call system, argues the case for wireless such systems in terms of what the company claims is greater adaptability to changing needs, and considers the ever-wider range of features and functions available from today's nurse call equipment, particularly via connectivity with both mobile devices, and ancillaries ranging from enuresis sensors to staff attack alert 'badges'.

  14. Sign Up for Savings.

    Science.gov (United States)

    Kennedy, Mike

    2002-01-01

    Discusses performance service contracts between educational facilities and energy services companies, in which the company provides the money for energy-efficiency improvements and the school pays the company an annual fee. The company guarantees the savings will meet or exceed the fee. (EV)

  15. Saving Malta's music memory

    OpenAIRE

    Sant, Toni

    2013-01-01

    Maltese music is being lost. Along with it Malta loses its culture, way of life, and memories. Dr Toni Sant is trying to change this trend through the Malta Music Memory Project (M3P) http://www.um.edu.mt/think/saving-maltas-music-memory-2/

  16. Save Our Water Resources.

    Science.gov (United States)

    Bromley, Albert W.

    The purpose of this booklet, developed as part of Project SOAR (Save Our American Resources), is to give Scout leaders some facts about the world's resources, the sources of water pollution, and how people can help in obtaining solutions. Among the topics discussed are the world's water resources, the water cycle, water quality, sources of water…

  17. Gun control saves lives

    African Journals Online (AJOL)

    gun control legislation. One study estimated that more than 4 500 lives were saved across five SA cities from 2001 to 2005.[5] Pro-gun interest groups seeking to promote gun ownership and diffusion have attacked these findings, suggesting that stricter gun control was only enacted in 2004 following the publication of ...

  18. 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...

  19. The greater picture

    CERN Multimedia

    Staff Association

    2013-01-01

    Strike of the European civil servants Two representatives of the CERN Staff Association, who attended a conference of Staff Committees of European Agencies in Brussels, participated in the strike of the European civil servants on 8th November. Indeed, more than 500 people were demonstrating in front of the Commission against the attacks on their working conditions.  By solidarity, our representatives joined them. The governments of the richest countries want large cuts in the Union European budget, especially in the administration costs, cuts of up to 15 billion, presently the European parliament does not follow. This could result in pension fund reforms, going from 1/3 2/3 repartition of the contributions to 1/2 1/2, which is unacceptable especially for low salaries. Besides, reduction of staff of 5 %, or even 15 % is seriously considered. 2004 saw already a diminution of the working conditions at the Union European, will 2013 make even more damages? The AASC (Assembly of Agency Staff Committe...

  20. Planning for greater confinement disposal

    International Nuclear Information System (INIS)

    Gilbert, T.L.; Luner, C.; Meshkov, N.K.; Trevorrow, L.E.; Yu, C.

    1985-01-01

    A report that provides guidance for planning for greater-confinement disposal (GCD) of low-level radioactive waste is being prepared. The report addresses procedures for selecting a GCD technology and provides information for implementing these procedures. The focus is on GCD; planning aspects common to GCD and shallow-land burial are covered by reference. Planning procedure topics covered include regulatory requirements, waste characterization, benefit-cost-risk assessment and pathway analysis methodologies, determination of need, waste-acceptance criteria, performance objectives, and comparative assessment of attributes that support these objectives. The major technologies covered include augered shafts, deep trenches, engineered structures, hydrofracture, improved waste forms, and high-integrity containers. Descriptive information is provided, and attributes that are relevant for risk assessment and operational requirements are given. 10 refs., 3 figs., 2 tabs

  1. 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.

  2. 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.

  3. Savings and Debts in Agriculture

    Directory of Open Access Journals (Sweden)

    Marina Luminita Sarbovan

    2012-05-01

    Full Text Available The savings and debts problematic bring us in front the Keynesian principles of supporting the global demand, so spectacular immortalized inside his “General Theory of Money. The architects of the European Union consider that production in agriculture and other economic branches is “ab initio” grounded on the credit mechanism administrated by banks: the present day approach of the agricultural process configured it as costly, owing a relatively medium to long term duration, and risky, making important the banking institution for mitigating such constrains. Romania fights for the ambitious goal of entering in the euro zone, and this target became even more challenging after the new EU Regulation No 1176/2011 on the prevention and correction of macroeconomic imbalances, which stipulates a safer surveillance for the member states. In fact, our country has to meet the exigencies of nominal and real convergence criteria, measured by the European scoreboard and relevant index.

  4. 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.

  5. 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.)

  6. 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 ...

  7. 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.

  8. Save energy - for industry

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    The article is an interview with Glenn Bjorklund, Vice President of SCalEd (Southern California Edison). The variations in Californian power demand and public electricity consumption habits are explained, together with types of power source used in electricity production. Questions are posed concerning SCalEd's energy saving strategy. The political implications of electricity charge changes are discussed. The planned energy resources for 1982-1992 are given with nuclear power being the largest contributor. (H.J.P./G.T.H.)

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. 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.)

  15. Greater Sudbury fuel efficient driving handbook

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-12-15

    Reducing the amount of fuel that people use for personal driving saves money, improves local air quality, and reduces personal contributions to climate change. This handbook was developed to be used as a tool for a fuel efficient driving pilot program in Greater Sudbury in 2009-2010. Specifically, the purpose of the handbook was to provide greater Sudbury drivers with information on how to drive and maintain their personal vehicles in order to maximize fuel efficiency. The handbook also provides tips for purchasing fuel efficient vehicles. It outlines the benefits of fuel maximization, with particular reference to reducing contributions to climate change; reducing emissions of air pollutants; safe driving; and money savings. Some tips for efficient driving are to avoid aggressive driving; use cruise control; plan trips; and remove excess weight. Tips for efficient winter driving are to avoid idling to warm up the engine; use a block heater; remove snow and ice; use snow tires; and check tire pressure. The importance of car maintenance and tire pressure was emphasized. The handbook also explains how fuel consumption ratings are developed by vehicle manufacturers. refs., figs.

  16. Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

    Directory of Open Access Journals (Sweden)

    Smita Nayak

    Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost-saving

  17. Entrepreneurial Saving Practices and Reinvestment

    NARCIS (Netherlands)

    Beck, Thorsten; Pamuk, Haki; Uras, Burak R.

    2017-01-01

    We use a novel enterprise survey to gauge the relationship between saving instruments and entrepreneurial reinvestment. We show that while most informal saving practices are not associated with a lower likelihood of reinvestment when compared with formal saving practices, there is a significantly

  18. Social Capital and Savings Behavior

    DEFF Research Database (Denmark)

    Newman, Carol; Tarp, Finn; Khai, Luu Duc

    In this paper, we analyze household savings in rural Vietnam paying particular attention to the factors that determine the proportion of savings held as formal deposits. Our aim is to explore the extent to which social capital can play a role in promoting formal savings behavior. Social capital...

  19. Saving water through global trade

    NARCIS (Netherlands)

    Chapagain, Ashok; Hoekstra, Arjen Ysbert; Savenije, H.H.G.

    2005-01-01

    Many nations save domestic water resources by importing water-intensive products and exporting commodities that are less water intensive. National water saving through the import of a product can imply saving water at a global level if the flow is from sites with high to sites with low water

  20. City-scale analysis of water-related energy identifies more cost-effective solutions.

    Science.gov (United States)

    Lam, Ka Leung; Kenway, Steven J; Lant, Paul A

    2017-02-01

    Energy and greenhouse gas management in urban water systems typically focus on optimising within the direct system boundary of water utilities that covers the centralised water supply and wastewater treatment systems, despite a greater energy influence by the water end use. This work develops a cost curve of water-related energy management options from a city perspective for a hypothetical Australian city. It is compared with that from the water utility perspective. The curves are based on 18 water-related energy management options that have been implemented or evaluated in Australia. In the studied scenario, the cost-effective energy saving potential from a city perspective (292 GWh/year) is far more significant than that from a utility perspective (65 GWh/year). In some cases, for similar capital cost, if regional water planners invested in end use options instead of utility options, a greater energy saving potential at a greater cost-effectiveness could be achieved in urban water systems. For example, upgrading a wastewater treatment plant for biogas recovery at a capital cost of $27.2 million would save 31 GWh/year with a marginal cost saving of $63/MWh, while solar hot water system rebates at a cost of $28.6 million would save 67 GWh/year with a marginal cost saving of $111/MWh. Options related to hot water use such as water-efficient shower heads, water-efficient clothes washers and solar hot water system rebates are among the most cost-effective city-scale opportunities. This study demonstrates the use of cost curves to compare both utility and end use options in a consistent framework. It also illustrates that focusing solely on managing the energy use within the utility would miss substantial non-utility water-related energy saving opportunities. There is a need to broaden the conventional scope of cost curve analysis to include water-related energy and greenhouse gas at the water end use, and to value their management from a city perspective. This

  1. Energy. Saving 'Private' Areva

    International Nuclear Information System (INIS)

    Dupin, Ludovic

    2015-01-01

    While Areva keeps on loosing money (billions of euros for 2014), the saving of this company is at stake. Staff is already planned to be reduced in La Hague, and other staff reductions might occur after the failure of a previous strategic plan. Various activities could be sold (dismantling, mining). The article outlines the difficult relationships between Areva and EDF and the problems also faced by EDF. Some actors think that Areva should remain independent from EDF in order to be free to compete on international bidding. The rapprochement between these two companies is said to be necessary for the Ministry but seems very difficult to achieve

  2. Water Saving for Development

    Science.gov (United States)

    Zacharias, Ierotheos

    2013-04-01

    The project "Water Saving for Development (WaS4D)" is financed by European Territorial Cooperational Programme, Greece-Italy 2007-2013, and aims at developing issues on water saving related to improvement of individual behaviors and implementing innovative actions and facilities in order to harmonize policies and start concrete actions for a sustainable water management, making also people and stakeholders awake to water as a vital resource, strategic for quality of life and territory competitiveness. Drinkable water saving culture & behavior, limited water resources, water supply optimization, water resources and demand management, water e-service & educational e-tools are the key words of WaS4D. In this frame the project objectives are: • Definition of water need for domestic and other than domestic purposes: regional and territorial hydro-balance; • promotion of locally available resources not currently being used - water recycling or reuse and rainwater harvesting; • scientific data implementation into Informative Territorial System and publication of geo-referred maps into the institutional web sites, to share information for water protection; • participated review of the regulatory framework for the promotion of water-efficient devices and practices by means of the definition of Action Plans, with defined targets up to brief (2015) and medium (2020) term; • building up water e-services, front-office for all the water issues in building agricultural, industrial and touristic sectors, to share information, procedures and instruments for the water management; • creation and publication of a user friendly software, a game, to promote sustainability for houses also addressed to young people; • creation of water info point into physical spaces called "Water House" to promote education, training, events and new advisory services to assist professionals involved in water uses and consumers; • implementation of participatory approach & networking for a