Sample records for high administrative costs
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Predicting Future High-Cost Schizophrenia Patients Using High-Dimensional Administrative Data
Directory of Open Access Journals (Sweden)
Yajuan Wang
2017-06-01
Full Text Available BackgroundThe burden of serious and persistent mental illness such as schizophrenia is substantial and requires health-care organizations to have adequate risk adjustment models to effectively allocate their resources to managing patients who are at the greatest risk. Currently available models underestimate health-care costs for those with mental or behavioral health conditions.ObjectivesThe study aimed to develop and evaluate predictive models for identification of future high-cost schizophrenia patients using advanced supervised machine learning methods.MethodsThis was a retrospective study using a payer administrative database. The study cohort consisted of 97,862 patients diagnosed with schizophrenia (ICD9 code 295.* from January 2009 to June 2014. Training (n = 34,510 and study evaluation (n = 30,077 cohorts were derived based on 12-month observation and prediction windows (PWs. The target was average total cost/patient/month in the PW. Three models (baseline, intermediate, final were developed to assess the value of different variable categories for cost prediction (demographics, coverage, cost, health-care utilization, antipsychotic medication usage, and clinical conditions. Scalable orthogonal regression, significant attribute selection in high dimensions method, and random forests regression were used to develop the models. The trained models were assessed in the evaluation cohort using the regression R2, patient classification accuracy (PCA, and cost accuracy (CA. The model performance was compared to the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC model.ResultsAt top 10% cost cutoff, the final model achieved 0.23 R2, 43% PCA, and 63% CA; in contrast, the CMS-HCC model achieved 0.09 R2, 27% PCA with 45% CA. The final model and the CMS-HCC model identified 33 and 22%, respectively, of total cost at the top 10% cost cutoff.ConclusionUsing advanced feature selection leveraging detailed
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Reducing the cost of administrative justice
International Nuclear Information System (INIS)
Tourtellotte, J.R.
1982-01-01
In virtually every sector of government regulation, the complaint has been lodged that the costs of administrative justice are too high. These costs in time, money, resources, and productivity can have a profound effect on the individual consumer. When applied to an energy technology such as nuclear power, costs of administrative justice can transcent time and money to have even more profound and pervasive soeietal effects. Societal costs can be expressed in terms of their impact on important national concerns, that is, the standard of living, technological superiority, and the national energy equation. Some views are presented on the interests involved in the regulation of nuclear power and what can be done to bring those interests into better balance so as to reduce the cost of administrative justice
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45 CFR 1336.71 - Administrative costs.
2010-10-01
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Administrative costs. 1336.71 Section 1336.71... Administrative costs. Reasonable administrative costs of the RLF may be paid out of the loan fund. The grant award agreement between the Loan Administrator and ANA will set forth the allowable administrative costs...
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Mission possible: creating a technology infrastructure to help reduce administrative costs.
Alper, Michael
2003-01-01
Controlling administrative costs associated with managed care benefits has traditionally been considered a "mission impossible" in healthcare, with the unreasonably high cost of paperwork and administration pushing past the $420 billion mark. Why administrative costs remain a critical problem in healthcare while other industries have alleviated their administrative burdens must be carefully examined. This article looks at the key factors contributing to high administrative costs and how these costs can be controlled in the future with "mission possible" tools, including business process outsourcing, IT outsourcing, technology that helps to bring "consumerism" to managed care, and an IT infrastructure that improves quality and outcomes.
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24 CFR 583.135 - Administrative costs.
2010-04-01
... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Administrative costs. 583.135... Administrative costs. (a) General. Up to five percent of any grant awarded under this part may be used for the purpose of paying costs of administering the assistance. (b) Administrative costs. Administrative costs...
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24 CFR 511.71 - Administrative costs.
2010-04-01
... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Administrative costs. 511.71... Administration § 511.71 Administrative costs. (a) Maximum amount. Any grantee may use not to exceed 10 percent of... years for administrative costs eligible under paragraphs (b) and (c) of this section. Eligible grantees...
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Systematic review of drug administration costs and implications for biopharmaceutical manufacturing.
Tetteh, Ebenezer; Morris, Stephen
2013-10-01
The acquisition costs of biologic drugs are often considered to be relatively high compared with those of nonbiologics. However, the total costs of delivering these drugs also depend on the cost of administration. Ignoring drug administration costs may distort resource allocation decisions because these affect cost effectiveness. The objectives of this systematic review were to develop a framework of drug administration costs that considers both the costs of physical administration and the associated proximal costs; and, as a case example, to use this framework to evaluate administration costs for biologics within the UK National Health Service (NHS). We reviewed literature that reported estimates of administration costs for biologics within the UK NHS to identify how these costs were quantified and to examine how differences in dosage forms and regimens influenced administration costs. The literature reviewed were identified by searching the Centre for Review and Dissemination Databases (DARE, NHS EED and HTA); EMBASE (The Excerpta Medica Database); MEDLINE (using the OVID interface); Econlit (EBSCO); Tufts Medical Center Cost Effectiveness Analysis (CEA) Registry; and Google Scholar. We identified 4,344 potentially relevant studies, of which 43 studies were selected for this systematic review. We extracted estimates of the administration costs of biologics from these studies. We found evidence of variation in the way that administration costs were measured, and that this affected the magnitude of costs reported, which could then influence cost effectiveness. Our findings suggested that manufacturers of biologic medicines should pay attention to formulation issues and their impact on administration costs, because these affect the total costs of healthcare delivery and cost effectiveness.
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Administration costs of intravenous biologic drugs for rheumatoid arthritis
Soini, Erkki J; Leussu, Miina; Hallinen, Taru
2013-01-01
Background Cost-effectiveness studies explicitly reporting infusion times, drug-specific administration costs for infusions or real-payer intravenous drug cost are few in number. Yet, administration costs for infusions are needed in the health economic evaluations assessing intravenously-administered drugs. Objectives To estimate the drug-specific administration and total cost of biologic intravenous rheumatoid arthritis (RA) drugs in the adult population and to compare the obtained costs wit...
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7 CFR 277.9 - Administrative costs principles.
2010-01-01
... 7 Agriculture 4 2010-01-01 2010-01-01 false Administrative costs principles. 277.9 Section 277.9 Agriculture Regulations of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF... AGENCIES § 277.9 Administrative costs principles. (a) This section prescribes specific policies and...
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Administrative costs of property tax in the Czech Republic
Břetislav Andrlík
2010-01-01
The paper deals with the efficiency of property taxes in the tax system of the Czech Republic, focusing on the administrative costs of taxation on the timeline 2005 to 2008. It contains a theoretical definition of tax efficiency, and describes the types of costs connected with taxes. From this perspective it focuses on quantifying the direct administrative costs of inheritance tax, gift tax, property transfer tax and property tax. Direct measurement of administrative costs is done by using th...
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44 CFR 208.42 - Reimbursement for other administrative costs.
2010-10-01
... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Reimbursement for other administrative costs. 208.42 Section 208.42 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... SYSTEM Response Cooperative Agreements § 208.42 Reimbursement for other administrative costs. Costs...
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Administrative costs of property tax in the Czech Republic
Directory of Open Access Journals (Sweden)
Břetislav Andrlík
2010-01-01
Full Text Available The paper deals with the efficiency of property taxes in the tax system of the Czech Republic, focusing on the administrative costs of taxation on the timeline 2005 to 2008. It contains a theoretical definition of tax efficiency, and describes the types of costs connected with taxes. From this perspective it focuses on quantifying the direct administrative costs of inheritance tax, gift tax, property transfer tax and property tax. Direct measurement of administrative costs is done by using the method called WTE staff which classifies employees of regional financial institutions in separate groups and assigns each group a specific number of employees for each reference property taxes using the conversion factors. Then it defines the total expenditure of regional financial institutions using the coefficients for a particular monitored tax and it provides administrative costs as a percentage of property tax receipts. Finally, the results of measurements indicating the proposed amendment are discussed.
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A comparison of hospital administrative costs in eight nations: US costs exceed all others by far.
Himmelstein, David U; Jun, Miraya; Busse, Reinhard; Chevreul, Karine; Geissler, Alexander; Jeurissen, Patrick; Thomson, Sarah; Vinet, Marie-Amelie; Woolhandler, Steffie
2014-09-01
A few studies have noted the outsize administrative costs of US hospitals, but no research has compared these costs across multiple nations with various types of health care systems. We assembled a team of international health policy experts to conduct just such a challenging analysis of hospital administrative costs across eight nations: Canada, England, Scotland, Wales, France, Germany, the Netherlands, and the United States. We found that administrative costs accounted for 25.3 percent of total US hospital expenditures--a percentage that is increasing. Next highest were the Netherlands (19.8 percent) and England (15.5 percent), both of which are transitioning to market-oriented payment systems. Scotland and Canada, whose single-payer systems pay hospitals global operating budgets, with separate grants for capital, had the lowest administrative costs. Costs were intermediate in France and Germany (which bill per patient but pay separately for capital projects) and in Wales. Reducing US per capita spending for hospital administration to Scottish or Canadian levels would have saved more than $150 billion in 2011. This study suggests that the reduction of US administrative costs would best be accomplished through the use of a simpler and less market-oriented payment scheme. Project HOPE—The People-to-People Health Foundation, Inc.
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Optimization of administrative management costs
Podolchak, N.; Chepil, B.
2015-01-01
It is important to determine the optimal level of administrative costs in order to achieve main targets of any enterprise, to perform definite tasks, to implement these tasks and not to worsen condition and motivation of the workers. Also it is essential to remember about strategic goals in the area of HR on the long run. The refore, the main idea in using optimization model for assessing the effectiveness of management costs will be to find the minimum level of expenses within the given l...
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48 CFR 52.230-6 - Administration of Cost Accounting Standards.
2010-10-01
... Clauses 52.230-6 Administration of Cost Accounting Standards. As prescribed in 30.201-4(d)(1), insert the following clause: Administration of Cost Accounting Standards (JUN 2010) For the purpose of administering the Cost Accounting Standards (CAS) requirements under this contract, the Contractor shall take the...
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The Hidden Cost of Regulation: The Administrative Cost of Reporting Serious Reportable Events.
Blanchfield, Bonnie B; Acharya, Bijay; Mort, Elizabeth
2018-04-01
More than half of the 50 states (27) and the District of Columbia require reporting of Serous Reportable Events (SREs). The goal is to hold providers accountable and improve patient safety, but there is little information about the administrative cost of this reporting requirement. This study was conducted to identify costs associated with investigating and reporting SREs. This qualitative study used case study methods that included interviewing staff and review of data and documents to investigate each SRE occurring at one academic medical center during fiscal year 2013. A framework of tasks and a model to categorize costs was created. Time was summarized and costs were estimated for each SRE. The administrative cost to process 44 SREs was estimated at $353,291, an average cost of $8,029 per SRE, ranging $6,653 for an environmental-related SRE to $21,276 for a device-related SRE. Care management SREs occurred most frequently, costing an average $7,201 per SRE. Surgical SREs, the most expensive on average, cost $9,123 per SRE. Investigation of events accounted for 64.5% of total cost; public reporting, 17.2%; internal reporting, 10.2%; finance and administration, 6.0%; and 2.1%, other. Even with 26 states mandating reporting, the 17.2% incremental cost of public reporting is substantial. Policy makers should consider the opportunity costs of these resources, averaging $8,029 per SRE, when mandating reporting. The benefits of public reporting should be collectively reviewed to ensure that the incremental costs in this resource-constrained environment continue to improve patient safety and that trade-offs are acknowledged. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.
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49 CFR 92.35 - Interest, penalties and administrative costs.
2010-10-01
... accrue until payment is received. Interest shall be calculated only on the principal of the debt (simple... 49 Transportation 1 2010-10-01 2010-10-01 false Interest, penalties and administrative costs. 92... UNITED STATES BY SALARY OFFSET § 92.35 Interest, penalties and administrative costs. (a) Where a DOT...
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Evaluating the administration costs of biologic drugs: development of a cost algorithm.
Tetteh, Ebenezer K; Morris, Stephen
2014-12-01
Biologic drugs, as with all other medical technologies, are subject to a number of regulatory, marketing, reimbursement (financing) and other demand-restricting hurdles applied by healthcare payers. One example is the routine use of cost-effectiveness analyses or health technology assessments to determine which medical technologies offer value-for-money. The manner in which these assessments are conducted suggests that, holding all else equal, the economic value of biologic drugs may be determined by how much is spent on administering these drugs or trade-offs between drug acquisition and administration costs. Yet, on the supply-side, it seems very little attention is given to how manufacturing and formulation choices affect healthcare delivery costs. This paper evaluates variations in the administration costs of biologic drugs, taking care to ensure consistent inclusion of all relevant cost resources. From this, it develops a regression-based algorithm with which manufacturers could possibly predict, during process development, how their manufacturing and formulation choices may impact on the healthcare delivery costs of their products.
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2012-11-19
...; Information Collection; Cost Accounting Standards Administration AGENCY: Department of Defense (DOD), General... collection requirement concerning cost accounting standards administration. Public comments are particularly... Information Collection 9000- 0129, Cost Accounting Standards Administration by any of the following methods...
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Tax compliance costs: a business administration perspective
Eichfelder, Sebastian; Schorn, Michael
2009-01-01
The paper analyses the relationship of tax compliance costs and business strategy. Due to instruments, like information technology, simplified cash accounting or outsourcing compliance activities to tax advisers, private businesses have a set of strategies to optimize their tax compliance cost burden. Under the assumption of rational choice a private business should choose a cost-optimal administration strategy. In spite of that we find empirical evidence for small German businesses using onl...
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24 CFR 570.610 - Uniform administrative requirements and cost principles.
2010-04-01
... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Uniform administrative requirements and cost principles. 570.610 Section 570.610 Housing and Urban Development Regulations Relating to... GRANTS Other Program Requirements § 570.610 Uniform administrative requirements and cost principles. The...
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The Stickiness of Selling, General, and Administrative Costs in the Indonesian Companies
Directory of Open Access Journals (Sweden)
Benny Armanto
2014-04-01
Full Text Available Selling, general and administration costs are the main components in the Income Statement. A large number of permanent staff in sales and marketing department will make the company dominated by the fixed costs. This fact could lead to sticky cost behavior. In addition, role of the manager can also cause the cost stickiness. When the company’s revenue decreases, manager may delay to decrease the cost or not even decrease cost at all. The objective of the study is to determine whether cost stickiness of selling, general and administrative in the Indonesian listed companies. This study applied log-linear data panel regression with 3605 firm years that is listed in Indonesian Stock Exchange (BEI from 1993 – 2013. This study finds that selling, general, and administrative costs are sticky only for the manufacturing companies. Furthermore, the results show that adjustment of sales, general, and administrative costs delayed by the manager when revenue decreases, yet the cost stickiness will be reduced in the next period.
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34 CFR 690.10 - Administrative cost allowance to participating schools.
2010-07-01
... 34 Education 3 2010-07-01 2010-07-01 false Administrative cost allowance to participating schools. 690.10 Section 690.10 Education Regulations of the Offices of the Department of Education (Continued... General Definitions § 690.10 Administrative cost allowance to participating schools. (a) Subject to...
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Corporation Income Tax and Administrative Costs of the Public Sector
Directory of Open Access Journals (Sweden)
Břetislav Andrlík
2015-01-01
Full Text Available This contribution examines the issues of measurement of corporate income tax effectiveness in the circumstances of the Czech Republic, referred to as the tax on income of legal persons. The tax on income of legal persons represents a significant part of the public budget revenue, with the volume of collection of CZK 128,002 million in 2012. The theoretical basis for this contribution is the principle of tax system effectiveness, which is one of the principles characterizing a good tax system and is related to costs inherent in a tax system. The contribution defines two existing types of costs expended on the collection of taxes, i. e. administrative costs (direct or indirect and in theory describes excessive tax burden. In this contribution we shall focus on the measurement of direct administrative costs. The measurement of effectiveness of corporation income tax is performed with the use of the full-time equivalent (FTE method, which is based on the classification of revenue authorities’ staff according to their jobs and on the determination of conversion coefficients in order to identify costs related to the collection of a particular tax.A separate part of the article deals with measurement of administrative costs performed by the Organisation for Economic Co-operation and Development on the timeline ranging from year 2009 to 2011. The author of this article performed his own measurements concerning the direct administrative costs related to the collection of tax on income of legal persons in the Czech Republic. Results achieved in the respective monitored years are lower by the average (in the Czech Republic 2 percentage of ca 1.66 percentage points in relation to the average value of direct administrative costs of the Czech tax system.
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7 CFR 1219.52 - Control of administrative costs.
2010-01-01
... Board shall implement a system of cost controls based on normally accepted business practices to: (1... 7 Agriculture 10 2010-01-01 2010-01-01 false Control of administrative costs. 1219.52 Section 1219.52 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING...
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Cost-minimization of mabthera intravenous versus subcutaneous administration
Bax, P.; Postma, M.J.
2013-01-01
Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due
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31 CFR 205.18 - Are administrative costs subject to this part?
2010-07-01
... or other system under an approved cost allocation plan, the State will draw down funds to meet cash... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Are administrative costs subject to... Treasury-State Agreement § 205.18 Are administrative costs subject to this part? (a) A State and FMS may...
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24 CFR 570.206 - Program administrative costs.
2010-04-01
... preliminary surveys and analysis of market needs; (2) Site and utility plans, narrative descriptions of the... the salary, wages, and related costs of each person whose job includes any program administration...
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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.
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How health care reform can lower the costs of insurance administration.
Collins, Sara R; Nuzum, Rachel; Rustgi, Sheila D; Mika, Stephanie; Schoen, Cathy; Davis, Karen
2009-07-01
The United States leads all industrialized countries in the share of national health care expenditures devoted to insurance administration. The U.S. share is over 30 percent greater than Germany's and more than three times that of Japan. This issue brief examines the sources of administrative costs and describes how a private-public approach to health care reform--with the central feature of a national insurance exchange (largely replacing the present individual and small-group markets)--could substantially lower such costs. In three variations on that approach, estimated administrative costs would fall from 12.7 percent of claims to an average of 9.4 percent. Savings--as much as $265 billion over 2010-2020--would be realized through less marketing and underwriting, reduced costs of claims administration, less time spent negotiating provider payment rates, and fewer or standardized commissions to insurance brokers.
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76 FR 74806 - Adjustment of the Amount of an Administrative Costs Assessment
2011-12-01
... Costs Assessment AGENCY: Bureau of Reclamation, Interior. ACTION: Notice. SUMMARY: The Bureau of Reclamation (Reclamation, we, our, or us) is decreasing the amount of the administrative costs assessment set... latest required review, the current $290 administrative costs assessment is being decreased to $230...
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2013-02-28
...; Submission for OMB Review; Cost Accounting Standards Administration AGENCY: Department of Defense (DOD... collection requirement concerning cost accounting standards administration. A notice was published in the...- 0129, Cost Accounting Standards Administration by any of the following methods: Regulations.gov : http...
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25 CFR 122.8 - Administrative costs for management of the fund.
2010-04-01
... 25 Indians 1 2010-04-01 2010-04-01 false Administrative costs for management of the fund. 122.8 Section 122.8 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES MANAGEMENT OF OSAGE JUDGMENT FUNDS FOR EDUCATION § 122.8 Administrative costs for management of the fund. Funds...
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National Association of Student Financial Aid Administrators (NJ1), 2011
2011-01-01
The National Association of Student Financial Aid Administrators (NASFAA) recently conducted a survey on the 2009-10 award year Administrative Cost Allowances (ACA), which are funds used by colleges and universities to support operations and professional development. Specifically, ACA is often used in essential areas that support the day-to-day…
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24 CFR 1003.206 - Program administration costs.
2010-04-01
... reasonable administrative costs and carrying charges related to the planning and execution of community... this section and in § 1003.205—Eligible planning, urban environmental design and policy-planning... documents related to the program for submission to HUD; (vii) Coordinating the resolution of audit and...
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Ultra High Brightness/Low Cost Fiber Coupled Packaging, Phase II
National Aeronautics and Space Administration — High peak power, high efficiency, high reliability lightweight, low cost QCW laser diode pump modules with up to 1000W of QCW output become possible with nLight's...
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Administration and transaction cost estimates for a greenhouse gas offset system : final report
International Nuclear Information System (INIS)
2004-01-01
Canada's Climate Change Plan provides large final emitters (LFEs) with the option to meet their emission targets through the purchase of domestic greenhouse gas (GHG) offset credits. This paper presents the results of a study which identified and estimated transaction costs associated with an offset system. The cost to both proponents and governments were identified. The study also suggested ways to reduce administration and transaction costs through design options. The study considered projects involving agriculture, forests, landfill gas capture, renewable energy and energy efficiency within a potential domestic offset system. It was determined that average transaction costs per tonne range from $19 per tonne to $0.05 depending on the design choice and project type. Total administration costs did not vary more than 5 per cent between different design choices. The total system costs, which are the combination of all transaction and administration costs, are the best indicator for the potential of a project. Eight case studies were examined and costs per tonne were presented. According to the results, the best opportunities to reduce both transaction and administration costs are to choose a broad approach to baselines, boundaries and quantification; and, to allow pooling in the forestry and agriculture sectors. Transaction costs can be lowered further by reducing the frequency of monitoring and verification and allowing pre-2008 crediting. refs., tabs., figs
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Tax-tariff reform with costs of tax administration
DEFF Research Database (Denmark)
Munk, Knud Jørgen
on border taxes to finance its resource requirements. However, the theorem does not hold when taxation is associated with administrative costs. The present paper explores the implications of taking into account the costs of tax administration for optimal taxation and for desirable directions of tax......As is broadly recognized, the straightforward application of the Diamond-Mirrlees (1971) production efficiency theorem implies that when lump-sum taxation is not available, then it is optimal for the government in a small open economy to rely on taxes on the net demand of ouseholds rather than......-tariff reform in countries at different levels of economic development. The paper clarifies the reasons for, and lends support to, the criticism by Stiglitz (2003) of the IMF and the World Bank's recommendation to developing countries to adopt VAT to replace border taxes....
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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
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2011-08-31
... Costs Incurred at Marine Corps Logistics Base Barstow, CA AGENCY: Department of the Navy, DoD. ACTION... of response costs incurred by the DON at the Site. The proposed Administrative Settlement resolves... DEPARTMENT OF DEFENSE Department of the Navy Notice of Proposed Administrative Cost Recovery...
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42 CFR 417.564 - Apportionment and allocation of administrative and general costs.
2010-10-01
... general costs. 417.564 Section 417.564 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT... providing medical care. Enrollment, marketing, and other administrative and general costs that benefit the... benefit of which cannot be quantitatively measured (such as facility costs), the total allowable costs of...
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DEFF Research Database (Denmark)
Olsen, Jens; Jensen, Kenneth Forsstrøm; Olesen, Daniel Sloth
2018-01-01
AIM: Trastuzumab is available in an intravenous (iv.) and a subcutaneous (sc.) formulation. The objective of this study was to estimate the costs of administration of iv. and sc. trastuzumab treatment. MATERIALS & METHODS: Via interviews, we identified all the activities associated with iv. and sc....... administration. The outcome was time estimates. To estimate the administration costs, the time estimates were valued by average gross wages. RESULTS: The iv. administration takes longer time as infusion time is longer (25 or 85 min). The iv. administration is associated with higher cost for 17 cycles; €971...... (€1858 vs €887). CONCLUSION: sc. administration is associated with lower administration costs. Switching patients from iv. to sc. would make it possible to treat more patients without increasing the personnel resources....
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2010-10-01
... 45 Public Welfare 2 2010-10-01 2010-10-01 false What types of costs are subject to the... § 286.55 What types of costs are subject to the administrative cost limit on Tribal Family Assistance... tracking, data entry and monitoring, including personnel and other costs associated with the automation...
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2010-04-01
... EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROVISIONS GOVERNING THE SENIOR COMMUNITY SERVICE... documented distributions of actual time worked or other equitable cost allocation methods. (d) Specific costs... information; (2) Employment statistics information, including job listing information, job skills information...
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Directory of Open Access Journals (Sweden)
Mei Sheng Duh
2013-01-01
Full Text Available Background. The most common chemotherapies in metastatic soft tissue sarcoma (mSTS require intravenous (IV administration. This often requires patients to make multiple outpatient visits per chemotherapy cycle, possibly impeding patients’ daily activities and increasing caregiver burden and medical costs. This study investigated costs associated with IV cancer therapy administration in mSTS from the payer perspective of the health care system. Patients and Methods. From the Experian Healthcare database, 1,228 mSTS patients were selected. Data were analyzed on outpatient visits during 2005–2012 involving IV cancer therapy administration. Costs were estimated on a per patient per visit (PPPV and per patient per month (PPPM basis. Results. The mean (median cost of IV therapy was $2,427 ($1,532 PPPV and $5,468 ($4,310 PPPM, of which approximately 60% was IV drug costs. IV administration costs averaged $399 PPPV and $900 PPPM, representing 16.5% of total visit costs. Anthracycline and alkylating-agents-based therapies had the highest PPPV and PPPM IV administration costs, respectively (mean $479 and $1,336, resp.. Patients with managed care insurance had the highest IV administration costs (mean $504 PPPV; $1,120 PPPM. Conclusions. IV administration costs constitute a considerable proportion of the total costs of receiving an IV cancer therapy to treat mSTS.
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Guillén, Montserrat; Jarner, Søren Fiig; Nielsen, Jens Perch; Pérez-Marín, Ana M
2014-01-01
The impact of administrative costs on the distribution of terminal wealth is approximated using a simple formula applicable to many investment situations. We show that the reduction in median returns attributable to administrative fees is usually at least twice the amount of the administrative costs charged for most investment funds, when considering a risk-adjustment correction over a reasonably long-term time horizon. The example we present covers a number of standard cases and can be applied to passive investments, mutual funds, and hedge funds. Our results show investors the potential losses they face in performance due to administrative costs.
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The cost of implementing inpatient bar code medication administration.
Sakowski, Julie Ann; Ketchel, Alan
2013-02-01
To calculate the costs associated with implementing and operating an inpatient bar-code medication administration (BCMA) system in the community hospital setting and to estimate the cost per harmful error prevented. This is a retrospective, observational study. Costs were calculated from the hospital perspective and a cost-consequence analysis was performed to estimate the cost per preventable adverse drug event averted. Costs were collected from financial records and key informant interviews at 4 not-for profit community hospitals. Costs included direct expenditures on capital, infrastructure, additional personnel, and the opportunity costs of time for existing personnel working on the project. The number of adverse drug events prevented using BCMA was estimated by multiplying the number of doses administered using BCMA by the rate of harmful errors prevented by interventions in response to system warnings. Our previous work found that BCMA identified and intercepted medication errors in 1.1% of doses administered, 9% of which potentially could have resulted in lasting harm. The cost of implementing and operating BCMA including electronic pharmacy management and drug repackaging over 5 years is $40,000 (range: $35,600 to $54,600) per BCMA-enabled bed and $2000 (range: $1800 to $2600) per harmful error prevented. BCMA can be an effective and potentially cost-saving tool for preventing the harm and costs associated with medication errors.
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49 CFR 1018.30 - Interest, penalties, and administrative costs.
2010-10-01
... interest, penalties, and administrative costs on debts owed to the United States Government in accordance.... (e) Interest is computed only on the principal of the debt, and the interest rate remains fixed for.... (d) The Board shall assess interest based upon the rate of the current value of funds to the United...
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49 CFR 1017.14 - Interest, penalties, and administrative costs.
2010-10-01
... OFFSET FROM INDEBTED GOVERNMENT AND FORMER GOVERNMENT EMPLOYEES § 1017.14 Interest, penalties, and administrative costs. (a) The rate of interest assessed shall be the rate of the current value of funds to the U... of interest can be assessed if the Board can reasonably determine that a higher rate is necessary to...
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10 CFR 15.37 - Interest, penalties, and administrative costs.
2010-01-01
...) Interest is computed only on the principal of the debt and the interest rate remains fixed for the duration..., penalties, and administrative costs on debts owed to the United States Government in accordance with the...) The NRC shall waive collection of interest on the debt or any portion of the debt which is paid in...
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Directory of Open Access Journals (Sweden)
Pina Puntillo
2012-09-01
Full Text Available The concept of cost has been introduced in Italian Administration since the early nineties. There is a copious legislation referring directly or indirectly, to the need, as well as to the utility of measuring the costs of public administration, in deference, to a renewed interpretation of the constitutional principle of Good Performance in pursuance of Article. 97 of the Italian Constitution. The most recent and probably the most significant intervention at institutional level, is the implementation of fiscal federalism as provided by Law. 42, 2009. The core features of fiscal federalism are the transition from historical expenditure to standard costs as a criterion for determining financial needs of public bodies, together with the attempt to establish more meaningful accountability mechanisms, both to policy makers and to public management. The measurement of standard costs represents one of the pillars of fiscal federalism and it will be pursued using the mechanism of "best practice". Full implementation of fiscal federalism, therefore, requires the verification of the operating costs of all public administrations. According to statutory law, regions are also required to provide verification of operating costs, for the successful pursuing of fiscal federalism. The present research is going to assess the level of diffusion of cost accounting in Italian regional public administrations. The methodology used for this paper includes the analysis of regional law as well as interviews to the officials of accounting and auditing offices
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International Nuclear Information System (INIS)
Fares, Robert L.; King, Carey W.
2017-01-01
This paper analyzes the cost of transmission, distribution, and administration for U.S. investor-owned electric utilities. We analyze data reported to the Federal Energy Regulatory Commission (FERC) from 1994 to 2014 using linear regression to understand how the number of customers in a utility's territory, annual peak demand, and annual energy sales affect annual TD&A spending. Then, we use Edison Electric Institute data for 1960 to 1992 to show trends in TD&A spending between 1960 and 2014. We find that the number of customers in a utility's territory is the single best predictor for annual TD&A costs. Between 1994 and 2014, the average cost per customer was $119/Customer-Year for transmission, $291/Customer-Year for distribution, and $333/Customer-Year for utility administration. Total TD&A costs per customer have been approximately $700–$800/Customer-Year since 1960, but the cost per kWh of energy sold was significantly higher in the 1960s because the average customer used less than half as much energy annually versus 2014. Thus, TD&A costs per kWh are likely to increase if kWh energy sales decline in the future unless cost recovery is transitioned to a mechanism not based solely on kWh sales. - Highlights: • U.S. investor-owned electric utility delivery costs from 1960? 2014 are investigated. • Transmission, distribution, and utility administrative costs are analyzed separately. • The number of utility customers is the best predictor for annual delivery costs. • Delivery costs per kWh are likely to increase if kWh sales decrease in the future.
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Very Low-Cost, Rugged, High-Vacuum System for Mass Spectrometers, Phase II
National Aeronautics and Space Administration — NASA, the DoD, DHS, and commercial industry have a pressing need for miniaturized, rugged, low-cost, high vacuum systems. Recent advances in sensor technology at...
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2013-12-26
... and approve new strategies for innovative program designs that improve cost-effectiveness and... Standards and Disclosure Statement, the threshold for IHEs to comply with Cost Accounting Standards is... appropriately in place for equipment over the threshold of $5,000 would create an administrative burden the cost...
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National Aeronautics and Space Administration — NASA needs lower cost solar arrays with high performance for a variety of missions. While high efficiency, space-qualified solar cells are in themselves costly, >...
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34 CFR 226.23 - May charter schools use grant funds for administrative costs?
2010-07-01
... 34 Education 1 2010-07-01 2010-07-01 false May charter schools use grant funds for administrative... administrative costs? (a) Except as provided in paragraph (b) of this section, charter school subgrantees may use... OF ELEMENTARY AND SECONDARY EDUCATION, DEPARTMENT OF EDUCATION STATE CHARTER SCHOOL FACILITIES...
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The Economic Cost of "Clever" Tax Administration Ideas
Glenn Jenkins; Bahro BERHAN
2004-01-01
In the 1980's it was popular to introduce incentive systems for the promotion of taxpayer compliance. The partial VAT refunds for consumer purchases that are examined in this paper represent one of such schemes. The partial VAT refund system was an idea that was popular amongst professional tax administrators in the 1980s and as a consequence was implemented throughout Central America, Bolivia and Turkey. Such proposals were made with little or no research on the compliance or economic costs ...
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Memisoglu, Salih Pasa
2016-01-01
This study aims to determine the teachers' and administrators' perceptions of knowledge management competence in high school administration. The study was conducted using the screening model and the study group consisted of 162 teachers and 35 administrators working at eight high schools in Turkey. Administrators' knowledge management competence…
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Directory of Open Access Journals (Sweden)
Robertson M Clare
2011-04-01
Full Text Available Abstract Background Estimating costs is essential to the economic analysis of health care programs. Health care costs are often captured from administrative databases or by patient report. Administrative records only provide a partial representation of health care costs and have additional limitations. Patient-completed questionnaires may allow a broader representation of health care costs; however the validity and feasibility of such methods have not been firmly established. This study was conducted to assess the validity and feasibility of using a patient-completed questionnaire to capture health care use and costs for patients with osteoarthritis, and to compare the research costs of the data-capture methods. Methods We designed a patient questionnaire and applied it in a clinical trial. We captured equivalent data from four administrative databases. We evaluated aspects of the questionnaire's validity using sensitivity and specificity, Lin's concordance correlation coefficient (ρc, and Bland-Altman comparisons. Results The questionnaire's response rate was 89%. Acceptable sensitivity and specificity levels were found for all types of health care use. The numbers of visits and the majority of medications reported by patients were in agreement with the database-derived estimates (ρc > 0.40. Total cost estimates from the questionnaire agreed with those from the databases. Patient-reported co-payments agreed with administrative records with respect to GP office transactions, but not pharmaceutical co-payments. Research costs for the questionnaire-based method were less than one-third of the costs for the databases method. Conclusion A patient-completed questionnaire is feasible for capturing health care use and costs for patients with osteoarthritis, and data collected using it mostly agree with administrative databases. Caution should be exercised when applying unit costs and collecting co-payment data.
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2010-10-01
... unit general and administrative expenses to final cost objectives. 9904.410 Section 9904.410 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD, OFFICE OF FEDERAL PROCUREMENT POLICY, OFFICE OF MANAGEMENT AND BUDGET PROCUREMENT PRACTICES AND COST ACCOUNTING STANDARDS COST ACCOUNTING...
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J.A. Bikker; O.W. Steenbeek; F. Torracchi
2010-01-01
Administrative costs per participant appear to vary widely across pension funds in different countries. These costs are important because they reduce the rate of return on the investments of pension funds, and consequently raise the cost of retirement security. Using unique data on 90 pension funds over the period 2004-2008, this paper examines the impact of scale, the complexity of pension plans, and service quality on the administrative costs of pension funds, and compares those costs acros...
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20 CFR 641.856 - What functions and activities constitute costs of administration?
2010-04-01
..., including: (i) Accounting, budgeting, financial, and cash management functions; (ii) Procurement and purchasing functions; (iii) Property management functions; (iv) Personnel management functions; (v) Payroll... management of the program; and (5) Costs of information systems related to administrative functions (for...
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2012-09-25
... paid $150,000 attributable to the costs of marketing and selling the Properties; (b) The Bank will pay... ENVIRONMENTAL PROTECTION AGENCY [FRL-9720-7] Proposed CERCLA Administrative Cost Recovery... costs concerning the Buckbee-Mears Co. Superfund Site located in Cortland, Cortland County, New York...
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Hummingbird - A Very Low Cost, High Delta V Spacecraft for Solar System Exploration, Phase I
National Aeronautics and Space Administration — Based on Microcosm's development of a high delta-V small Earth observation spacecraft called NanoEye, with a planned recurring cost of $2 million, Microcosm will...
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National Research Council Canada - National Science Library
Schmit, Matt; Wheelock, Jason; Newman, David
2007-01-01
.... The Administration also plans to increase the size of the Army Reserve and National Guard. The cost of the Administration's proposal to increase the size of the armed forces depends on the personnel levels it is being measured against...
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Tseng, Phillip; Kaplan, Robert S; Richman, Barak D; Shah, Mahek A; Schulman, Kevin A
2018-02-20
Administrative costs in the US health care system are an important component of total health care spending, and a substantial proportion of these costs are attributable to billing and insurance-related activities. To examine and estimate the administrative costs associated with physician billing activities in a large academic health care system with a certified electronic health record system. This study used time-driven activity-based costing. Interviews were conducted with 27 health system administrators and 34 physicians in 2016 and 2017 to construct a process map charting the path of an insurance claim through the revenue cycle management process. These data were used to calculate the cost for each major billing and insurance-related activity and were aggregated to estimate the health system's total cost of processing an insurance claim. Estimated time required to perform billing and insurance-related activities, based on interviews with management personnel and physicians. Estimated billing and insurance-related costs for 5 types of patient encounters: primary care visits, discharged emergency department visits, general medicine inpatient stays, ambulatory surgical procedures, and inpatient surgical procedures. Estimated processing time and total costs for billing and insurance-related activities were 13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for a discharged emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgical procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. Of these totals, time and costs for activities carried out by physicians were estimated at a median of 3 minutes or $6.36 for a primary care visit, 3 minutes or $10.97 for an emergency department visit, 5 minutes or $13.29 for a general inpatient stay, 15 minutes or $51.20 for an ambulatory surgical procedure, and 15 minutes or $51.20 for an inpatient surgical procedure. Of
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No Child Left Behind and Administrative Costs: A Resource Dependence Study of Local School Districts
Neely, Stephen R.
2015-01-01
This study considers the impact of federal funding on the administrative expenditures of local school districts since the passage of the No-Child-Left-Behind (NCLB) Act of 2001. Under NCLB, federal education funds were made contingent upon a variety of accountability and reporting standards, creating new administrative costs and challenges for…
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Jiwani, Aliya; Himmelstein, David; Woolhandler, Steffie; Kahn, James G
2014-11-13
The United States' multiple-payer health care system requires substantial effort and costs for administration, with billing and insurance-related (BIR) activities comprising a large but incompletely characterized proportion. A number of studies have quantified BIR costs for specific health care sectors, using micro-costing techniques. However, variation in the types of payers, providers, and BIR activities across studies complicates estimation of system-wide costs. Using a consistent and comprehensive definition of BIR (including both public and private payers, all providers, and all types of BIR activities), we synthesized and updated available micro-costing evidence in order to estimate total and added BIR costs for the U.S. health care system in 2012. We reviewed BIR micro-costing studies across healthcare sectors. For physician practices, hospitals, and insurers, we estimated the % BIR using existing research and publicly reported data, re-calculated to a standard and comprehensive definition of BIR where necessary. We found no data on % BIR in other health services or supplies settings, so extrapolated from known sectors. We calculated total BIR costs in each sector as the product of 2012 U.S. national health expenditures and the percentage of revenue used for BIR. We estimated "added" BIR costs by comparing total BIR costs in each sector to those observed in existing, simplified financing systems (Canada's single payer system for providers, and U.S. Medicare for insurers). Due to uncertainty in inputs, we performed sensitivity analyses. BIR costs in the U.S. health care system totaled approximately $471 ($330 - $597) billion in 2012. This includes $70 ($54 - $76) billion in physician practices, $74 ($58 - $94) billion in hospitals, an estimated $94 ($47 - $141) billion in settings providing other health services and supplies, $198 ($154 - $233) billion in private insurers, and $35 ($17 - $52) billion in public insurers. Compared to simplified financing, $375
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2010-07-01
... charges and administrative costs will the Presidio Trust add to a debt? 1011.5 Section 1011.5 Parks... § 1011.5 What interest, penalty charges and administrative costs will the Presidio Trust add to a debt? (a) Interest. (1) The Presidio Trust will assess interest on all delinquent debts unless prohibited...
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Cost and Benefit Analysis of an Automated Nursing Administration System: A Methodology*
Rieder, Karen A.
1984-01-01
In order for a nursing service administration to select the appropriate automated system for its requirements, a systematic process of evaluating alternative approaches must be completed. This paper describes a methodology for evaluating and comparing alternative automated systems based upon an economic analysis which includes two major categories of criteria: costs and benefits.
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A Low-Cost, High-Precision Navigator, Phase II
National Aeronautics and Space Administration — Toyon Research Corporation proposes to develop and demonstrate a prototype low-cost precision navigation system using commercial-grade gyroscopes and accelerometers....
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The role of mental health and addiction among high-cost patients: a population-based study.
de Oliveira, Claire; Cheng, Joyce; Rehm, Jürgen; Kurdyak, Paul
2018-04-01
Previous work found that, among high-cost patients, those with a majority of mental health and addiction (MHA)-related costs (>50%) incur over 30% more costs than other high-cost patients. However, this work did not examine other high-cost patients in depth or whether they had any MHA-related costs. The objective of this analysis was to examine the role of MHA-related care among other high-cost patients. Using administrative healthcare data from Ontario, Canada, this study selected all patients in the 90th percentile of the cost distribution in 2012. It focused primarily on two groups based on the percentage of MHA-related costs relative to total costs: (1) high-cost patients with some MHA-related costs (0% > and cost patients with no MHA-related costs (0%). We examined socio-demographic and clinical characteristics, utilization and costs for both groups, and modeled patient-level costs using appropriate regression techniques. We also compared these groups with high-cost patients with a majority of MHA-related costs (>50%). High-cost patients with some MHA-related costs incurred over 40% more costs than those without ($27,883 vs $19,702). Patients with some MHA-related costs were older, lived in poorer neighborhoods, and had higher levels of comorbidity compared to those without. After controlling for relevant variables, having any type of MHA-related utilization increased costs by $2,698. Having a diagnosis of psychosis had a large impact on costs. This study did not examine children and adolescents. We were only able to account for 91% of all costs incurred by the public third-party payer; addiction-related costs from community-based agencies were not available. High-cost patients with MHA incur higher costs compared to those without. When considering interventions aimed at high-cost patients, policy-makers should consider their complex nature, specifically both their physical and MHA-related comorbidities.
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1992-02-16
3 0 B. Cost Accounting Standard 418 ..................................................... 3 1 1. D efinitio n s ...objective" as an activity for which a separate measurement of cost is desired. C. Horngren , Cost Accounting . A Managerial Emphasis 21 (5th ed. 1982...Segments and Business Unit General and Administrative Expenses to Final Cost Objectives 6. AUTHOR( S ) Stephen Thomas Lynch, Major 7. PERFORMING
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Washington Consulting Group, Inc., Washington, DC.
The seventh module in a 17-module self-instructional course on student financial aid administration (designed for novice student financial aid administrators and other personnel) teaches how to calculate the cost of attendance. It provides a systematic introduction to the management of federal financial aid programs authorized by the Higher…
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Bikker, J.A.; Steenbeek, O.W.; Torracchi, F.
2010-01-01
Administrative costs per participant appear to vary widely across pension funds in different countries. These costs are important because they reduce the rate of return on the investments of pension funds, and consequently raise the cost of retirement security. Using unique data on 90 pension funds
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Duke Univ., Durham, NC.
Presented in this document are data pertaining to maintenance and operations costs at colleges and universities in the southeastern region of the U.S. The major accounts included in the cost analysis are: (1) physical plant administration, (2) building maintenance, (3) custodial services, (4) utilities, (5) landscape and grounds maintenance, and…
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Kolaczinski, Jan H; Robinson, Emily; Finn, Timothy P
2011-10-01
Mass drug administration (MDA) of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs). Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan. A first round of antibiotic MDA was conducted in the highly trachoma endemic county of Mayom, Unity state, from June to August 2010. A core team of seven staff delivered the intervention, including recruitment and training of 44 supervisors and 542 community drug distributors. Using an ingredients approach, financial and economic costs were captured from the provider perspective in a detailed costing database. Overall, 123,760 individuals were treated for trachoma, resulting in an estimated treatment coverage of 94%. The economic cost per person treated was USD 1.53, excluding the cost of the antibiotic azithromycin. Ninety four per cent of the delivery costs were recurrent costs, with personnel and travel/transport costs taking up the largest share. In a remote setting and for the initial round, MDA of antibiotics was considerably more expensive than USD 0.5 per person treated, an estimate frequently quoted to advocate for integrated NTD control. Drug delivery costs in South Sudan are unlikely to decrease substantially during subsequent MDA rounds, as the major cost drivers were recurrent costs. MDA campaigns for delivery of one or more drugs in South Sudan should thus be budgeted at around USD 1.5 per person treated, at least until further costing data for delivery of other NTD drugs, singly or in combination, are available.
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Directory of Open Access Journals (Sweden)
Jan H Kolaczinski
2011-10-01
Full Text Available BACKGROUND: Mass drug administration (MDA of antibiotics is a key component of the so-called "SAFE" strategy for trachoma control, while MDA of anthelminthics provides the cornerstone for control of a number of other neglected tropical diseases (NTDs. Simultaneous delivery of two or more of these drugs, renowned as "integrated NTD control," is being promoted to reduce costs and expand intervention coverage. A cost analysis was conducted alongside an MDA campaign in a remote trachoma endemic area, to inform budgeting for NTD control in South Sudan. METHODS AND FINDINGS: A first round of antibiotic MDA was conducted in the highly trachoma endemic county of Mayom, Unity state, from June to August 2010. A core team of seven staff delivered the intervention, including recruitment and training of 44 supervisors and 542 community drug distributors. Using an ingredients approach, financial and economic costs were captured from the provider perspective in a detailed costing database. Overall, 123,760 individuals were treated for trachoma, resulting in an estimated treatment coverage of 94%. The economic cost per person treated was USD 1.53, excluding the cost of the antibiotic azithromycin. Ninety four per cent of the delivery costs were recurrent costs, with personnel and travel/transport costs taking up the largest share. CONCLUSIONS: In a remote setting and for the initial round, MDA of antibiotics was considerably more expensive than USD 0.5 per person treated, an estimate frequently quoted to advocate for integrated NTD control. Drug delivery costs in South Sudan are unlikely to decrease substantially during subsequent MDA rounds, as the major cost drivers were recurrent costs. MDA campaigns for delivery of one or more drugs in South Sudan should thus be budgeted at around USD 1.5 per person treated, at least until further costing data for delivery of other NTD drugs, singly or in combination, are available.
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VISIBLE COSTS AND HIDDEN COSTS IN THE BAKING INDUSTRY
Directory of Open Access Journals (Sweden)
Criveanu Maria
2013-04-01
Full Text Available Hidden costs are present in the activity of any company, hardly identified in the traditional administrative accounting. The high levels of the hidden costs and their unknown presence have serious consequences on the decisions made by the managers. This paper aims at presenting some aspects related to the hidden costs that occur in the activity of the companies in the baking industry and the possibilities to reduce their level.
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Rudoler, David; de Oliveira, Claire; Jacob, Binu; Hopkins, Melonie; Kurdyak, Paul
2018-01-01
The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.
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Directory of Open Access Journals (Sweden)
Bottacchi Edo
2012-10-01
Full Text Available Abstract Background Stroke is one of the most relevant reasons of death and disability worldwide. Many cost of illness studies have been performed to evaluate direct and indirect costs of ischaemic stroke, especially within the first year after the acute episode, using different methodologies. Methods We conducted a longitudinal, retrospective, bottom-up cost of illness study, to evaluate clinical and economic outcomes of a cohort of patients affected by a first cerebrovascular event, including subjects with ischaemic, haemorrhagic or transient episodes. The analysis intended to detect direct costs, within 1, 2 and 3 years from the index event. Clinical patient data collected in regional disease registry were integrated and linked to regional administrative databases to perform the analysis. Results The analysis of costs within the first year from the index event included 800 patients. The majority of patients (71.5% were affected by ischaemic stroke. Overall, per patient costs were €7,079. Overall costs significantly differ according to the type of stroke, with costs for haemorrhagic stroke and ischaemic stroke amounting to €9,044 and €7,289. Hospital costs, including inpatient rehabilitation, were driver of expenditure, accounting for 89.5% of total costs. The multiple regression model showed that sex, level of physical disability and level of neurological deficit predict direct healthcare costs within 1 year. The analysis at 2 and 3 years (per patient costs: €7,901 and €8,874, respectively showed that majority of costs are concentrated in the first months after the acute event. Conclusions This cost analysis highlights the importance to set up significant prevention programs to reduce the economic burden of stroke, which is mostly attributable to hospital and inpatient rehabilitation costs immediately after the acute episode. Although some limitation typical of retrospective analyses the approach of linking clinical and
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International Nuclear Information System (INIS)
Primm, Trent; Guida, Tracey
2010-01-01
Under the auspices of the Global Threat Reduction Initiative Reduced Enrichment for Research and Test Reactors Program, the National Nuclear Security Administration/Department of Energy (NNSA/DOE) has, as a goal, to convert research reactors worldwide from weapons grade to non-weapons grade uranium. The High Flux Isotope Reactor (HFIR) at Oak Ridge National Lab (ORNL) is one of the candidates for conversion of fuel from high enriched uranium (HEU) to low enriched uranium (LEU). A well documented business model, including tasks, costs, and schedules was developed to plan the conversion of HFIR. Using Microsoft Project, a detailed outline of the conversion program was established and consists of LEU fuel design activities, a fresh fuel shipping cask, improvements to the HFIR reactor building, and spent fuel operations. Current-value costs total $76 million dollars, include over 100 subtasks, and will take over 10 years to complete. The model and schedule follows the path of the fuel from receipt from fuel fabricator to delivery to spent fuel storage and illustrates the duration, start, and completion dates of each subtask to be completed. Assumptions that form the basis of the cost estimate have significant impact on cost and schedule.
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Chiner, Eusebi; Fernández-Fabrellas, Estrella; Landete, Pedro; Novella, Laura; Ramón, Mercedes; Sancho-Chust, José Norberto; Senent, Cristina; Berraondo, Javier
2016-04-01
To compare clinical outcomes and costs between two administration strategies of omalizumab treatment. We evaluated two cohorts of patients with uncontrolled severe asthma over a 1-year period. Patients received the treatment in the primary care center in Hospital A and conventional hospital administration in Hospital B. We studied 130 patients, 86 in Hospital A and 44 in Hospital B, 30 men (24%) and 100 women (76%), age 50 ± 15 years, FEV1% 67 ± 22%, body mass index (BMI) 28 ± 6 kg/m(2), 639 ± 747 UI IgE/mL, followed for 24 ± 11 months (12-45), Asthma Control Test (ACT) score 12 ± 4 and Asthma Control Questionnaire (ACQ) 3 ± 2. There were no significant pretreatment differences between the groups in hospital admissions and emergency room visits in the previous year, nor in proportion of patients receiving oral steroids. Evaluations were performed at baseline and after 12 months of treatment, revealing significant differences in ACT (Ptravel costs were 35% lower in the ambulatory strategy adopted in Hospital A. The administration of omalizumab in ambulatory health centers achieved the same clinical results as a hospital administration strategy, but with lower costs. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.
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Retinopathy of prematurity: the high cost of screening regional and remote infants.
Yu, Tzu-Ying; Donovan, Tim; Armfield, Nigel; Gole, Glen A
2018-01-25
Demand for retinopathy of prematurity (ROP) screening is increasing for infants born at rural and regional hospitals where the service is not generally available. The health system cost for screening regional/remote infants has not been reported. The objective of this study is to evaluate the cost of ROP screening at a large centralized tertiary neonatal service for infants from regional/rural hospitals. This is a retrospective study to establish the cost of transferring regional/rural infants to the Royal Brisbane and Women's Hospital for ROP screening over a 28-month period. A total of 131 infants were included in this study. Individual infant costs were calculated from analysis of clinical and administrative records. Economic cost of ROP screening for all transfers from regional/rural hospitals to Royal Brisbane and Women's Hospital. The average economic cost of ROP screening for this cohort was AUD$5110 per infant screened and the total cost was AUD$669 413. The average cost per infant screened was highest for infants from a regional centre with a population of 75 000 (AUD$14 856 per child), which was also geographically furthest from Brisbane. No infant in this cohort transferred from a regional nursery reached criteria for intervention for ROP by standard guidelines. Health system costs for ROP screening of remote infants at a centralized hospital are high. Alternative strategies using telemedicine can now be compared with centralized screening. © 2018 Royal Australian and New Zealand College of Ophthalmologists.
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International Nuclear Information System (INIS)
Mitsutake, Naohiro; Oku, Shinya; Fujii, Ryo; Furui, Yuji; Yasunaga, Hideo
2008-01-01
PET (positron emission tomography) has been proved to be a powerful imaging tool in clinical oncology. The number of PET facilities in Japan has remarkably increased over the last decade. Furthermore, the approval of delivery fluorodeoxyglucose (FDG) in 2005 resulted in a tremendous expansion of the PET institutions without a cyclotron facility. The aim of this study was to conduct a cost analysis of PET institutions that utilized delivery FDG. Three PET facilities using delivery FDG were investigated about the costs for PET service. Fixed costs included depreciation costs for construction and medical equipments such as positron camera. Variable costs consisted of costs for medical materials including delivery FDG. The break-even point was analyzed in each of three institutions. In the three hospitals (A, B and C), the annual number of PET scan was 1,591, 1,637 and 914, while cost per scan was accounted as 110,262 yen, 111,091 yen, and 134,192 yen, respectively. The break-even point was calculated to be 2,583, 2,679 and 2,081, respectively. PET facilities utilizing delivery FDG seemed to have difficulty in business administration. Such a situation suggests the possibility that the current supply of PET facilities might exceed actual demand for the service. The efficiency of resource allocation should be taken into consideration in the future health service researches on PET. (author)
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Bell, Janice F; Krupski, Antoinette; Joesch, Jutta M; West, Imara I; Atkins, David C; Court, Beverly; Mancuso, David; Roy-Byrne, Peter
2015-06-01
To evaluate outcomes of a registered nurse-led care management intervention for disabled Medicaid beneficiaries with high health care costs. Washington State Department of Social and Health Services Client Outcomes Database, 2008-2011. In a randomized controlled trial with intent-to-treat analysis, outcomes were compared for the intervention (n = 557) and control groups (n = 563). A quasi-experimental subanalysis compared outcomes for program participants (n = 251) and propensity score-matched controls (n = 251). Administrative data were linked to describe costs and use of health services, criminal activity, homelessness, and death. In the intent-to-treat analysis, the intervention group had higher odds of outpatient mental health service use and higher prescription drug costs than controls in the postperiod. In the subanalysis, participants had fewer unplanned hospital admissions and lower associated costs; higher prescription drug costs; higher odds of long-term care service use; higher drug/alcohol treatment costs; and lower odds of homelessness. We found no health care cost savings for disabled Medicaid beneficiaries randomized to intensive care management. Among participants, care management may have the potential to increase access to needed care, slow growth in the number and therefore cost of unplanned hospitalizations, and prevent homelessness. These findings apply to start-up care management programs targeted at high-cost, high-risk Medicaid populations. © Health Research and Educational Trust.
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Low-cost high purity production
Kapur, V. K.
1978-01-01
Economical process produces high-purity silicon crystals suitable for use in solar cells. Reaction is strongly exothermic and can be initiated at relatively low temperature, making it potentially suitable for development into low-cost commercial process. Important advantages include exothermic character and comparatively low process temperatures. These could lead to significant savings in equipment and energy costs.
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Lo, Nathan C; Bogoch, Isaac I; Blackburn, Brian G; Raso, Giovanna; N'Goran, Eliézer K; Coulibaly, Jean T; Becker, Sören L; Abrams, Howard B; Utzinger, Jürg; Andrews, Jason R
2015-10-01
More than 1·5 billion people are affected by schistosomiasis or soil-transmitted helminthiasis. WHO's recommendations for mass drug administration (MDA) against these parasitic infections emphasise treatment of school-aged children, using separate treatment guidelines for these two helminthiases groups. We aimed to evaluate the cost-effectiveness of expanding integrated MDA to the entire community in four settings in Côte d'Ivoire. We extended previously published, dynamic, age-structured models of helminthiases transmission to simulate costs and disability averted with integrated MDA (of praziquantel and albendazole) for schistosomiasis and soil-transmitted helminthiasis. We calibrated the model to data for prevalence and intensity of species-specific helminth infection from surveys undertaken in four communities in Côte d'Ivoire between March, 1997, and September, 2010. We simulated a 15-year treatment programme with 75% coverage in only school-aged children; school-aged children and preschool-aged children; adults; and the entire community. Treatment costs were estimated at US$0·74 for school-aged children and $1·74 for preschool-aged children and adults. The incremental cost-effectiveness ratio (ICER) was calculated in 2014 US dollars per disability-adjusted life-year (DALY) averted. Expanded community-wide treatment was highly cost effective compared with treatment of only school-aged children (ICER $167 per DALY averted) and WHO guidelines (ICER $127 per DALY averted), and remained highly cost effective even if treatment costs for preschool-aged children and adults were ten times greater than those for school-aged children. Community-wide treatment remained highly cost effective even when elimination of helminth infections was not achieved. These findings were robust across the four diverse communities in Côte d'Ivoire, only one of which would have received annual MDA for both schistosomiasis and soil-transmitted helminthiasis under the latest WHO
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2010-04-01
...) In general. The Internal Revenue Service may grant a taxpayer's request for recovery of reasonable... Revenue Service or recovery of damages from the Internal Revenue Service under § 301.7433-2(e). (d) Costs... administrative costs within six months after such request is filed, the Internal Revenue Service's failure to...
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International Nuclear Information System (INIS)
Strauss, Jonathan B.; Chen, Sea S.; Shah, Anand P.; Coon, Alan B.; Dickler, Adam
2008-01-01
Purpose: Heterotopic ossification (HO), or abnormal bone formation, is a common sequela of total hip arthroplasty. This abnormal bone can impair joint function and must be surgically removed to restore mobility. HO can be prevented by postoperative nonsteroidal anti-inflammatory drug (NSAID) use or radiotherapy (RT). NSAIDs are associated with multiple toxicities, including gastrointestinal bleeding. Although RT has been shown to be more efficacious than NSAIDs at preventing HO, its cost-effectiveness has been questioned. Methods and Materials: We performed an analysis of the cost of postoperative RT to the hip compared with NSAID administration, taking into account the costs of surgery for HO formation, treatment-induced morbidity, and productivity loss from missed work. The costs of RT, surgical revision, and treatment of gastrointestinal bleeding were estimated using the 2007 Medicare Fee Schedule and inpatient diagnosis-related group codes. The cost of lost wages was estimated using the 2006 median salary data from the U.S. Census Bureau. Results: The cost of administering RT was estimated at $899 vs. $20 for NSAID use. After accounting for the additional costs associated with revision total hip arthroplasty and gastrointestinal bleeding, the corresponding estimated costs were $1,208 vs. $930. Conclusion: If the costs associated with treatment failure and treatment-induced morbidity are considered, the cost of NSAIDs approaches that of RT. Other NSAID morbidities and quality-of-life differences that are difficult to quantify add to the cost of NSAIDs. These considerations have led us to recommend RT as the preferred modality for use in prophylaxis against HO after total hip arthroplasty, even when the cost is considered
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Rajabi, A; Dabiri, A
2012-01-01
Activity Based Costing (ABC) is one of the new methods began appearing as a costing methodology in the 1990's. It calculates cost price by determining the usage of resources. In this study, ABC method was used for calculating cost price of remedial services in hospitals. To apply ABC method, Shahid Faghihi Hospital was selected. First, hospital units were divided into three main departments: administrative, diagnostic, and hospitalized. Second, activity centers were defined by the activity analysis method. Third, costs of administrative activity centers were allocated into diagnostic and operational departments based on the cost driver. Finally, with regard to the usage of cost objectives from services of activity centers, the cost price of medical services was calculated. The cost price from ABC method significantly differs from tariff method. In addition, high amount of indirect costs in the hospital indicates that capacities of resources are not used properly. Cost price of remedial services with tariff method is not properly calculated when compared with ABC method. ABC calculates cost price by applying suitable mechanisms but tariff method is based on the fixed price. In addition, ABC represents useful information about the amount and combination of cost price services.
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2010-04-01
... based on documented distributions of actual time worked or other equitable cost allocation methods. (3... (c) of this section for the administration of the WtW program and which are not related to the direct provision of services to participants. These costs can be both personnel and non-personnel and both direct...
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Effective Instructional Management: Perceptions and Recommendations from High School Administrators
Knechtel, Troy
2010-01-01
The two overarching research questions of this study are: What are the perceptions of high school administrators regarding the effectiveness of their current approach to instructional management? What recommendations do high school administrators have for effective strategies for instructional management? To answer these questions, a qualitative…
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Tunable Laser for High-Performance, Low-Cost Distributed Sensing Platform, Phase I
National Aeronautics and Space Administration — The proposed effort will establish technical feasibility of an approach to optimizing a low-cost, fast-sweeping tunable laser for distributed sensing. Multiple...
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2010-04-01
... any of the Acts which the Board administers. (b)(1) Simple interest shall be assessed once a month on... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Assessment or waiver of interest, penalties... waiver of interest, penalties, and administrative costs with respect to collection of certain debts. (a...
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Administrative Task Performance by Heads of Senior High Schools ...
African Journals Online (AJOL)
This study aimed at examining the administrative task performance of heads of senior high schools (SHS) in Ghana from the organising perspective. The study hypothesized that there is no statistically significant difference in the compliance level of organising as an administrative task performance by heads in the rural and ...
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High-cost users of medical care
Garfinkel, Steven A.; Riley, Gerald F.; Iannacchione, Vincent G.
1988-01-01
Based on data from the National Medical Care Utilization and Expenditure Survey, the 10 percent of the noninstitutionalized U.S. population that incurred the highest medical care charges was responsible for 75 percent of all incurred charges. Health status was the strongest predictor of high-cost use, followed by economic factors. Persons 65 years of age or over incurred far higher costs than younger persons and had higher out-of-pocket costs, absolutely and as a percentage of income, althoug...
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Langton, Julia M; Blanch, Bianca; Drew, Anna K; Haas, Marion; Ingham, Jane M; Pearson, Sallie-Anne
2014-12-01
There has been an increase in observational studies using health administrative data to examine the nature, quality, and costs of care at life's end, particularly in cancer care. To synthesize retrospective observational studies on resource utilization and/or costs at the end of life in cancer patients. We also examine the methods and outcomes of studies assessing the quality of end-of-life care. A systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (A Measurement Tool to Assess Systematic Reviews) methodology. We searched MEDLINE, Embase, CINAHL, and York Centre for Research and Dissemination (1990-2011). Independent reviewers screened abstracts of 14,424 articles, and 835 full-text manuscripts were further reviewed. Inclusion criteria were English-language; at least one resource utilization or cost outcome in adult cancer decedents with solid tumors; outcomes derived from health administrative data; and an exclusive end-of-life focus. We reviewed 78 studies examining end-of-life care in over 3.7 million cancer decedents; 33 were published since 2008. We observed exponential increases in service use and costs as death approached; hospital services being the main cost driver. Palliative services were relatively underutilized and associated with lower expenditures than hospital-based care. The 15 studies using quality indicators demonstrated that up to 38% of patients receive chemotherapy or life-sustaining treatments in the last month of life and up to 66% do not receive hospice/palliative services. Observational studies using health administrative data have the potential to drive evidence-based palliative care practice and policy. Further development of quality care markers will enhance benchmarking activities across health care jurisdictions, providers, and patient populations. © The Author(s) 2014.
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The health and cost implications of high body mass index in Australian defence force personnel
Directory of Open Access Journals (Sweden)
Peake Jonathan
2012-06-01
Full Text Available Abstract Background Frequent illness and injury among workers with high body mass index (BMI can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. Methods Personnel were grouped into cohorts according to the following ranges for (BMI: normal (18.5 − 24.9 kg/m2; n = 197, overweight (25–29.9 kg/m2; n = 154 and obese (≥30 kg/m2 with restricted body fat (≤28% for females, ≤24% for males (n = 148 and with no restriction on body fat (n = 180. Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions and administrative outcomes (e.g., discharge from service over one year. These data were then grouped and compared between the cohorts. Results The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p Conclusions High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.
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A case-mix classification system for explaining healthcare costs using administrative data in Italy.
Corti, Maria Chiara; Avossa, Francesco; Schievano, Elena; Gallina, Pietro; Ferroni, Eliana; Alba, Natalia; Dotto, Matilde; Basso, Cristina; Netti, Silvia Tiozzo; Fedeli, Ugo; Mantoan, Domenico
2018-03-04
The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local Health Trusts (LHTs) is based on a capitation system adjusted only for age, gender and area of residence. We applied a risk-adjustment system (Johns Hopkins Adjusted Clinical Groups System, ACG® System) in order to explain health care costs using routinely collected administrative data in the Veneto Region (North-eastern Italy). All residents in the Veneto Region were included in the study. The ACG system was applied to classify the regional population based on the following information sources for the year 2015: Hospital Discharges, Emergency Room visits, Chronic disease registry for copayment exemptions, ambulatory visits, medications, the Home care database, and drug prescriptions. Simple linear regressions were used to contrast an age-gender model to models incorporating more comprehensive risk measures aimed at predicting health care costs. A simple age-gender model explained only 8% of the variance of 2015 total costs. Adding diagnoses-related variables provided a 23% increase, while pharmacy based variables provided an additional 17% increase in explained variance. The adjusted R-squared of the comprehensive model was 6 times that of the simple age-gender model. ACG System provides substantial improvement in predicting health care costs when compared to simple age-gender adjustments. Aging itself is not the main determinant of the increase of health care costs, which is better explained by the accumulation of chronic conditions and the resulting multimorbidity. Copyright © 2018. Published by Elsevier B.V.
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2010-01-01
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false How will Commerce entities add interest, penalty charges, and administrative costs to a Commerce debt? 19.5 Section 19.5 Commerce and Foreign Trade Office of the Secretary of Commerce COMMERCE DEBT COLLECTION Procedures To Collect Commerce...
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Improving hospital cost accounting with activity-based costing.
Chan, Y C
1993-01-01
In this article, activity-based costing, an approach that has proved to be an improvement over the conventional costing system in product costing, is introduced. By combining activity-based costing with standard costing, health care administrators can better plan and control the costs of health services provided while ensuring that the organization's bottom line is healthy.
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Olomola, A.S.
1992-01-01
In Nigeria, small-scale farmers are reluctant to borrow from formal institutions because of high transaction costs. This paper examines the components and determinants of borrowing transaction costs and argues that unless the loan administrative strategies are simplified and channels of loan delivery diversified, farmers would continue to find it difficult to use formal loans. Borrowing transaction costs are defined as the administrative expenses and transportation cost incurred by borrowers ...
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Directory of Open Access Journals (Sweden)
Caitlin J McCabe
Full Text Available BACKGROUND: In HIV-infected pregnant women, viral suppression prevents mother-to-child HIV transmission. Directly observed highly-active antiretroviral therapy (HAART enhances virological suppression, and could prevent transmission. Our objective was to project the effectiveness and cost-effectiveness of directly observed administration of antiretroviral drugs in pregnancy. METHODS AND FINDINGS: A mathematical model was created to simulate cohorts of one million asymptomatic HIV-infected pregnant women on HAART, with women randomly assigned self-administered or directly observed antiretroviral therapy (DOT, or no HAART, in a series of Monte Carlo simulations. Our primary outcome was the quality-adjusted life expectancy in years (QALY of infants born to HIV-infected women, with the rates of Caesarean section and HIV-transmission after DOT use as intermediate outcomes. Both self-administered HAART and DOT were associated with decreased costs and increased life-expectancy relative to no HAART. The use of DOT was associated with a relative risk of HIV transmission of 0.39 relative to conventional HAART; was highly cost-effective in the cohort as a whole (cost-utility ratio $14,233 per QALY; and was cost-saving in women whose viral loads on self-administered HAART would have exceeded 1000 copies/ml. Results were stable in wide-ranging sensitivity analyses, with directly observed therapy cost-saving or highly cost-effective in almost all cases. CONCLUSIONS: Based on the best available data, programs that optimize adherence to HAART through direct observation in pregnancy have the potential to diminish mother-to-child HIV transmission in a highly cost-effective manner. Targeted use of DOT in pregnant women with high viral loads, who could otherwise receive self-administered HAART would be a cost-saving intervention. These projections should be tested with randomized clinical trials.
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McCabe, Caitlin J; Goldie, Sue J; Fisman, David N
2010-04-13
In HIV-infected pregnant women, viral suppression prevents mother-to-child HIV transmission. Directly observed highly-active antiretroviral therapy (HAART) enhances virological suppression, and could prevent transmission. Our objective was to project the effectiveness and cost-effectiveness of directly observed administration of antiretroviral drugs in pregnancy. A mathematical model was created to simulate cohorts of one million asymptomatic HIV-infected pregnant women on HAART, with women randomly assigned self-administered or directly observed antiretroviral therapy (DOT), or no HAART, in a series of Monte Carlo simulations. Our primary outcome was the quality-adjusted life expectancy in years (QALY) of infants born to HIV-infected women, with the rates of Caesarean section and HIV-transmission after DOT use as intermediate outcomes. Both self-administered HAART and DOT were associated with decreased costs and increased life-expectancy relative to no HAART. The use of DOT was associated with a relative risk of HIV transmission of 0.39 relative to conventional HAART; was highly cost-effective in the cohort as a whole (cost-utility ratio $14,233 per QALY); and was cost-saving in women whose viral loads on self-administered HAART would have exceeded 1000 copies/ml. Results were stable in wide-ranging sensitivity analyses, with directly observed therapy cost-saving or highly cost-effective in almost all cases. Based on the best available data, programs that optimize adherence to HAART through direct observation in pregnancy have the potential to diminish mother-to-child HIV transmission in a highly cost-effective manner. Targeted use of DOT in pregnant women with high viral loads, who could otherwise receive self-administered HAART would be a cost-saving intervention. These projections should be tested with randomized clinical trials.
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Activity-Based Costing: A Cost Management Tool.
Turk, Frederick J.
1993-01-01
In college and university administration, overhead costs are often charged to programs indiscriminately, whereas the support activities that underlie those costs remain unanalyzed. It is time for institutions to decrease ineffective use of resources. Activity-based management attributes costs more accurately and can improve efficiency. (MSE)
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Minimum Cost Nanosatellite Launch System, Phase I
National Aeronautics and Space Administration — Delta Velocity Corporation proposes the development of a very low cost, highly responsive nanosat launch system. We propose to develop an integrated propulsion...
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Capital cost: high and low sulfur coal plants-1200 MWe. [High sulfur coal
Energy Technology Data Exchange (ETDEWEB)
1977-01-01
This Commercial Electric Power Cost Study for 1200 MWe (Nominal) high and low sulfur coal plants consists of three volumes. The high sulfur coal plant is described in Volumes I and II, while Volume III describes the low sulfur coal plant. The design basis and cost estimate for the 1232 MWe high sulfur coal plant is presented in Volume I, and the drawings, equipment list and site description are contained in Volume II. The reference design includes a lime flue gas desulfurization system. A regenerative sulfur dioxide removal system using magnesium oxide is also presented as an alternate in Section 7 Volume II. The design basis, drawings and summary cost estimate for a 1243 MWe low sulfur coal plant are presented in Volume III. This information was developed by redesigning the high sulfur coal plant for burning low sulfur sub-bituminous coal. These coal plants utilize a mechanical draft (wet) cooling tower system for condenser heat removal. Costs of alternate cooling systems are provided in Report No. 7 in this series of studies of costs of commercial electrical power plants.
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23 CFR 140.505 - Reimbursable costs.
2010-04-01
... 23 Highways 1 2010-04-01 2010-04-01 false Reimbursable costs. 140.505 Section 140.505 Highways... Administrative Settlement Costs-Contract Claims § 140.505 Reimbursable costs. (a) Federal funds may participate in administrative settlement costs which are: (1) Incurred after notice of claim, (2) Properly...
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Burgess, James F; Shwartz, Michael; Stolzmann, Kelly; Sullivan, Jennifer L
2018-05-18
To examine the relationship between cost and quality in Veterans Health Administration (VA) nursing homes (called Community Living Centers, CLCs) using longitudinal data. One hundred and thirty CLCs over 13 quarters (from FY2009 to FY2012) were studied. Costs, resident days, and resident severity (RUGs score) were obtained from the VA Managerial Cost Accounting System. Clinical quality measures were obtained from the Minimum Data Set, and resident-centered care (RCC) was measured using the Artifacts of Culture Change Tool. We used a generalized estimating equation model with facilities included as fixed effects to examine the relationship between total cost and quality after controlling for resident days and severity. The model included linear and squared terms for all independent variables and interactions with resident days. With the exception of RCC, all other variables had a statistically significant relationship with total costs. For most poorer performing smaller facilities (lower size quartile), improvements in quality were associated with higher costs. For most larger facilities, improvements in quality were associated with lower costs. The relationship between cost and quality depends on facility size and current level of performance. © Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
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International Nuclear Information System (INIS)
Edwards, B.K.; Flaim, S.J.; Howitt, R.E.; Palmer, S.C.
1995-03-01
Irrigation is a major factor in the growth of US agricultural productivity, especially in western states, which account for more than 85% of the nation's irrigated acreage. In some of these states, almost all cropland is irrigated, and nearly 50% of the irrigation is done with electrically powered pumps. Therefore, even small increases in the cost of electricity could have a disproportionate impact on irrigated agriculture. This technical memorandum examines the impacts that could result from proposed changes in the power marketing programs of the Western Area Power Administration's Salt Lake City Area Office. The changes could increase the cost of power to all Western customers, including rural municipalities and irrigation districts that rely on inexpensive federal power to pump water. The impacts are assessed by translating changes in Western's wholesale power rate into changes in the cost of pumping water as an input for agricultural production. Farmers can adapt to higher electricity prices in many ways, such as (1) using different pumping fuels, (2) adding workers and increasing management to irrigate more efficiently, and (3) growing more drought-tolerant crops. This study projects several responses, including using less groundwater and planting fewer waterintensive crops. The study finds that when dependence on Western's power is high, the cost of power can have a major effect on energy use, agricultural practices, and the distribution of planted acreage. The biggest percentage changes in farm income would occur (1) in Nevada and Utah (however, all projected changes are less than 2% of the baseline) and (2) under the marketing alternatives that represent the lowest capacity and energy offer considered in Western's Electric Power Marketing Environmental Impact Statement. The aggregate impact on farm incomes and the value of total farm production would be much smaller than that suggested by the changes in water use and planted acreage
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Owens, Douglas K; Qaseem, Amir; Chou, Roger; Shekelle, Paul
2011-02-01
Health care costs in the United States are increasing unsustainably, and further efforts to control costs are inevitable and essential. Efforts to control expenditures should focus on the value, in addition to the costs, of health care interventions. Whether an intervention provides high value depends on assessing whether its health benefits justify its costs. High-cost interventions may provide good value because they are highly beneficial; conversely, low-cost interventions may have little or no value if they provide little benefit. Thus, the challenge becomes determining how to slow the rate of increase in costs while preserving high-value, high-quality care. A first step is to decrease or eliminate care that provides no benefit and may even be harmful. A second step is to provide medical interventions that provide good value: medical benefits that are commensurate with their costs. This article discusses 3 key concepts for understanding how to assess the value of health care interventions. First, assessing the benefits, harms, and costs of an intervention is essential to understand whether it provides good value. Second, assessing the cost of an intervention should include not only the cost of the intervention itself but also any downstream costs that occur because the intervention was performed. Third, the incremental cost-effectiveness ratio estimates the additional cost required to obtain additional health benefits and provides a key measure of the value of a health care intervention.
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Degli Esposti, Luca; Saragoni, Stefania; Buda, Stefano; Sturani, Alessandra; Degli Esposti, Ezio
2013-01-01
Diabetes is one of the most prevalent chronic diseases, and its prevalence is predicted to increase in the next two decades. Diabetes imposes a staggering financial burden on the health care system, so information about the costs and experiences of collecting and reporting quality measures of data is vital for practices deciding whether to adopt quality improvements or monitor existing initiatives. The aim of this study was to quantify the association between health care costs and level of glycemic control in patients with type 2 diabetes using clinical and administrative databases. A retrospective analysis using a large administrative database and a clinical registry containing laboratory results was performed. Patients were subdivided according to their glycated hemoglobin level. Multivariate analyses were used to control for differences in potential confounding factors, including age, gender, Charlson comorbidity index, presence of dyslipidemia, hypertension, or cardiovascular disease, and degree of adherence with antidiabetic drugs among the study groups. Of the total population of 700,000 subjects, 31,022 were identified as being diabetic (4.4% of the entire population). Of these, 21,586 met the study inclusion criteria. In total, 31.5% of patients had very poor glycemic control and 25.7% had excellent control. Over 2 years, the mean diabetes-related cost per person was: €1291.56 in patients with excellent control; €1545.99 in those with good control; €1584.07 in those with fair control; €1839.42 in those with poor control; and €1894.80 in those with very poor control. After adjustment, compared with the group having excellent control, the estimated excess cost per person associated with the groups with good control, fair control, poor control, and very poor control was €219.28, €264.65, €513.18, and €564.79, respectively. Many patients showed suboptimal glycemic control. Lower levels of glycated hemoglobin were associated with lower diabetes
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Cost Accounting: Production and Equipment Services.
Schmid, William T.
Cost accounting for audiovisual productions should include direct costs, and, in some cases, the media administrator may have to calculate a per-hour surcharge for general operating overhead as well. Such procedures enable the administrator to determine cost effectiveness, to control cost overruns, and to generate more staff efficiency. Cost…
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48 CFR 2131.205-71 - Reinsurer administrative expense costs.
2010-10-01
... REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 2131.205-71... as set forth in the contract is an allowable cost when documented through an internal accounting... expense costs. 2131.205-71 Section 2131.205-71 Federal Acquisition Regulations System OFFICE OF PERSONNEL...
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Directory of Open Access Journals (Sweden)
Williams Brian G
2005-12-01
Full Text Available Abstract Background The HIV epidemic has caused a dramatic increase in tuberculosis (TB in East and southern Africa. Several strategies have the potential to reduce the burden of TB in high HIV prevalence settings, and cost and cost-effectiveness analyses can help to prioritize them when budget constraints exist. However, published cost and cost-effectiveness studies are limited. Methods Our objective was to compare the cost, affordability and cost-effectiveness of seven strategies for reducing the burden of TB in countries with high HIV prevalence. A compartmental difference equation model of TB and HIV and recent cost data were used to assess the costs (year 2003 US$ prices and effects (TB cases averted, deaths averted, DALYs gained of these strategies in Kenya during the period 2004–2023. Results The three lowest cost and most cost-effective strategies were improving TB cure rates, improving TB case detection rates, and improving both together. The incremental cost of combined improvements to case detection and cure was below US$15 million per year (7.5% of year 2000 government health expenditure; the mean cost per DALY gained of these three strategies ranged from US$18 to US$34. Antiretroviral therapy (ART had the highest incremental costs, which by 2007 could be as large as total government health expenditures in year 2000. ART could also gain more DALYs than the other strategies, at a cost per DALY gained of around US$260 to US$530. Both the costs and effects of treatment for latent tuberculosis infection (TLTI for HIV+ individuals were low; the cost per DALY gained ranged from about US$85 to US$370. Averting one HIV infection for less than US$250 would be as cost-effective as improving TB case detection and cure rates to WHO target levels. Conclusion To reduce the burden of TB in high HIV prevalence settings, the immediate goal should be to increase TB case detection rates and, to the extent possible, improve TB cure rates, preferably
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PENETAPAN TARGET TERHADAP STICKINESS COST
Directory of Open Access Journals (Sweden)
Windyastuti Windyastuti
2017-03-01
Full Text Available This study aimed to analyze the influence of manager targeting to the stickiness cost. The research data was amanufacturing company’s financial statements during 1999-2011 published at BEI. The research data includedcost of sales, administration and general, net sales and Price Earnings Ratio (PER. This study used adynamic panel data regression analysis. The results showed that cost of sales, administration and general weresticky. Furthermore, manager targeting caused the stickiness degree of sales, administration and general costlower. Manager targeting changed the manager’s behavior. When the net sales declined, manager reduced theresource use drastically so the cost of sales, administration and general also decreased drastically.
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20 CFR 633.304 - Section 402 cost allocation.
2010-04-01
... accounted for as follows: (1) Administration. Administration costs consist of all direct and indirect costs... direct program administrative positions such as supervisors, program analysts, labor market analysts, and... to participants, classroom space and utility costs; job search assistance, labor market orientation...
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Directory of Open Access Journals (Sweden)
Wilma A Stolk
Full Text Available The Global Program to Eliminate Lymphatic Filariasis (LF has a target date of 2020. This program is progressing well in many countries. However, progress has been slow in some countries, and others have not yet started their mass drug administration (MDA programs. Acceleration is needed. We studied how increasing MDA frequency from once to twice per year would affect program duration and costs by using computer simulation modeling and cost projections. We used the LYMFASIM simulation model to estimate how many annual or semiannual MDA rounds would be required to eliminate LF for Indian and West African scenarios with varied pre-control endemicity and coverage levels. Results were used to estimate total program costs assuming a target population of 100,000 eligibles, a 3% discount rate, and not counting the costs of donated drugs. A sensitivity analysis was done to investigate the robustness of these results with varied assumptions for key parameters. Model predictions suggested that semiannual MDA will require the same number of MDA rounds to achieve LF elimination as annual MDA in most scenarios. Thus semiannual MDA programs should achieve this goal in half of the time required for annual programs. Due to efficiency gains, total program costs for semiannual MDA programs are projected to be lower than those for annual MDA programs in most scenarios. A sensitivity analysis showed that this conclusion is robust. Semiannual MDA is likely to shorten the time and lower the cost required for LF elimination in countries where it can be implemented. This strategy may improve prospects for global elimination of LF by the target year 2020.
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WHAT DRIVES HIGH COST OF FINANCE IN MOLDOVA?
Directory of Open Access Journals (Sweden)
Alexandru Stratan
2012-03-01
Full Text Available Why there are high costs to finance in Republic of Moldova? Is it a problem for business environment?These are the questions discussed in this paper. Following the well know Growth Diagnostics approach byHausmann, Rodrik and Velasco, authors assess the barriers and impediments to access to finance in Republic ofMoldova. Guided by international and national statistics we found evidence of poor intermediation, poorinstitutions, high level of inflation, and high collateral as major causes of high cost of financial resources inRepublic of Moldova. At the end of the study authors give policy recommendations identifying other related fieldsto be addressed.
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Cost optimisation studies of high power accelerators
Energy Technology Data Exchange (ETDEWEB)
McAdams, R.; Nightingale, M.P.S.; Godden, D. [AEA Technology, Oxon (United Kingdom)] [and others
1995-10-01
Cost optimisation studies are carried out for an accelerator based neutron source consisting of a series of linear accelerators. The characteristics of the lowest cost design for a given beam current and energy machine such as power and length are found to depend on the lifetime envisaged for it. For a fixed neutron yield it is preferable to have a low current, high energy machine. The benefits of superconducting technology are also investigated. A Separated Orbit Cyclotron (SOC) has the potential to reduce capital and operating costs and intial estimates for the transverse and longitudinal current limits of such machines are made.
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Pearson-Stuttard, Jonathan; Kypridemos, Chris; Collins, Brendan; Mozaffarian, Dariush; Huang, Yue; Bandosz, Piotr; Capewell, Simon; Whitsel, Laurie; Wilde, Parke; O'Flaherty, Martin; Micha, Renata
2018-04-01
Sodium consumption is a modifiable risk factor for higher blood pressure (BP) and cardiovascular disease (CVD). The US Food and Drug Administration (FDA) has proposed voluntary sodium reduction goals targeting processed and commercially prepared foods. We aimed to quantify the potential health and economic impact of this policy. We used a microsimulation approach of a close-to-reality synthetic population (US IMPACT Food Policy Model) to estimate CVD deaths and cases prevented or postponed, quality-adjusted life years (QALYs), and cost-effectiveness from 2017 to 2036 of 3 scenarios: (1) optimal, 100% compliance with 10-year reformulation targets; (2) modest, 50% compliance with 10-year reformulation targets; and (3) pessimistic, 100% compliance with 2-year reformulation targets, but with no further progress. We used the National Health and Nutrition Examination Survey and high-quality meta-analyses to inform model inputs. Costs included government costs to administer and monitor the policy, industry reformulation costs, and CVD-related healthcare, productivity, and informal care costs. Between 2017 and 2036, the optimal reformulation scenario achieving the FDA sodium reduction targets could prevent approximately 450,000 CVD cases (95% uncertainty interval: 240,000 to 740,000), gain approximately 2.1 million discounted QALYs (1.7 million to 2.4 million), and produce discounted cost savings (health savings minus policy costs) of approximately $41 billion ($14 billion to $81 billion). In the modest and pessimistic scenarios, health gains would be 1.1 million and 0.7 million QALYS, with savings of $19 billion and $12 billion, respectively. All the scenarios were estimated with more than 80% probability to be cost-effective (incremental cost/QALY cost-saving by 2031. Limitations include evaluating only diseases mediated through BP, while decreasing sodium consumption could have beneficial effects upon other health burdens such as gastric cancer. Further, the effect
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Brewe, Eric; Dou, Remy; Shand, Robert
2018-02-01
Although active learning is supported by strong evidence of efficacy in undergraduate science instruction, institutions of higher education have yet to embrace comprehensive change. Costs of transforming instruction are regularly cited as a key factor in not adopting active-learning instructional practices. Some cite that alternative methods to stadium-style, lecture-based education are not financially viable to an academic department. This paper examines that argument by presenting an ingredients approach to estimating costs of two instructional methods used in introductory university physics courses at a large public U.S. university. We use a metric common in educational economics, cost effectiveness (CE), which is the total cost per student passing the class. We then compare the CE of traditional, passive-learning lecture courses to those of a well-studied, active-learning curriculum (Modeling Instruction) as a way of evaluating the claim that active learning is cost prohibitive. Our findings are that the Modeling Instruction approach has a higher cost per passing student (MI = 1 ,030 /passing student vs Trad = 790 /passing student). These results are discussed from perspectives of university administrators, students, and taxpayers. We consider how MI would need to adapt in order to make the benefits of active learning (particularly higher pass rates and gains on multiple measured student outcomes) available in a cost-neutral setting. This approach aims to provide a methodology to better inform decision makers balancing financial, personnel, and curricular considerations.
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Directory of Open Access Journals (Sweden)
Eric Brewe
2018-02-01
Full Text Available Although active learning is supported by strong evidence of efficacy in undergraduate science instruction, institutions of higher education have yet to embrace comprehensive change. Costs of transforming instruction are regularly cited as a key factor in not adopting active-learning instructional practices. Some cite that alternative methods to stadium-style, lecture-based education are not financially viable to an academic department. This paper examines that argument by presenting an ingredients approach to estimating costs of two instructional methods used in introductory university physics courses at a large public U.S. university. We use a metric common in educational economics, cost effectiveness (CE, which is the total cost per student passing the class. We then compare the CE of traditional, passive-learning lecture courses to those of a well-studied, active-learning curriculum (Modeling Instruction as a way of evaluating the claim that active learning is cost prohibitive. Our findings are that the Modeling Instruction approach has a higher cost per passing student (MI=$1,030/passing student vs Trad=$790/passing student. These results are discussed from perspectives of university administrators, students, and taxpayers. We consider how MI would need to adapt in order to make the benefits of active learning (particularly higher pass rates and gains on multiple measured student outcomes available in a cost-neutral setting. This approach aims to provide a methodology to better inform decision makers balancing financial, personnel, and curricular considerations.
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Zaychenko, Irina; Borremans, Alexandra; Gutman, Svetlana
2018-03-01
The article describes the concept and types of administrative barriers encountered in various areas of the enterprise. The particularities of the Russian high-rise construction industry are described and a comparative analysis of administrative barriers in this sector is performed. The main stages and administrative procedures when the developers implement investment and construction projects in the field of high-rise construction are determined. The regulatory and legal framework for the implementation of investment and project activities in the high-rise construction industry has been studied and conclusions have been drawn on its low level of precision in the issue of the formation of competitive and efficient high-rise construction markets. The average number of administrative procedures for the implementation of the investment and construction project in the field of high-rise construction is determined. The factors preventing the reduction of administrative barriers in the high-rise construction industry are revealed.
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Accounts Payable Administrator | IDRC - International Development ...
International Development Research Centre (IDRC) Digital Library (Canada)
Job Summary An Accounts Payable Administrator is responsible for the processing of supplier invoices and grant payment requests (from the Grant Administration Division and regional offices for institutional recipients, participants, scholars, fellows and other awardees). Each Administrator looks after internal cost centers, ...
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What Contributes Most to High Health Care Costs? Health Care Spending in High Resource Patients.
Pritchard, Daryl; Petrilla, Allison; Hallinan, Shawn; Taylor, Donald H; Schabert, Vernon F; Dubois, Robert W
2016-02-01
U.S. health care spending nearly doubled in the decade from 2000-2010. Although the pace of increase has moderated recently, the rate of growth of health care costs is expected to be higher than the growth in the economy for the near future. Previous studies have estimated that 5% of patients account for half of all health care costs, while the top 1% of spenders account for over 27% of costs. The distribution of health care expenditures by type of service and the prevalence of particular health conditions for these patients is not clear, and is likely to differ from the overall population. To examine health care spending patterns and what contributes to costs for the top 5% of managed health care users based on total expenditures. This retrospective observational study employed a large administrative claims database analysis of health care claims of managed care enrollees across the full age and care spectrum. Direct health care expenditures were compared during calendar year 2011 by place of service (outpatient, inpatient, and pharmacy), payer type (commercially insured, Medicare Advantage, and Medicaid managed care), and therapy area between the full population and high resource patients (HRP). The mean total expenditure per HRP during calendar year 2011 was $43,104 versus $3,955 per patient for the full population. Treatment of back disorders and osteoarthritis contributed the largest share of expenditures in both HRP and the full study population, while chronic renal failure, heart disease, and some oncology treatments accounted for disproportionately higher expenditures in HRP. The share of overall expenditures attributed to inpatient services was significantly higher for HRP (40.0%) compared with the full population (24.6%), while the share of expenditures attributed to pharmacy (HRP = 18.1%, full = 21.4%) and outpatient services (HRP = 41.9%, full = 54.1%) was reduced. This pattern was observed across payer type. While the use of physician
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Medicaid care management: description of high-cost addictions treatment clients.
Neighbors, Charles J; Sun, Yi; Yerneni, Rajeev; Tesiny, Ed; Burke, Constance; Bardsley, Leland; McDonald, Rebecca; Morgenstern, Jon
2013-09-01
High utilizers of alcohol and other drug treatment (AODTx) services are a priority for healthcare cost control. We examine characteristics of Medicaid-funded AODTx clients, comparing three groups: individuals cost clients in the top decile of AODTx expenditures (HC; n=5,718); and 1760 enrollees in a chronic care management (CM) program for HC clients implemented in 22 counties in New York State. Medicaid and state AODTx registry databases were combined to draw demographic, clinical, social needs and treatment history data. HC clients accounted for 49% of AODTx costs funded by Medicaid. As expected, HC clients had significant social welfare needs, comorbid medical and psychiatric conditions, and use of inpatient services. The CM program was successful in enrolling some high-needs, high-cost clients but faced barriers to reaching the most costly and disengaged individuals. Copyright © 2013 Elsevier Inc. All rights reserved.
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National Aeronautics and Space Administration — Hypersonic vehicles require durable and cost-effective hot structures that do not impose weight penalties such as those associated with the use of non-structural...
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The High Direct Medical Costs of Prader-Willi Syndrome.
Shoffstall, Andrew J; Gaebler, Julia A; Kreher, Nerissa C; Niecko, Timothy; Douglas, Diah; Strong, Theresa V; Miller, Jennifer L; Stafford, Diane E; Butler, Merlin G
2016-08-01
To assess medical resource utilization associated with Prader-Willi syndrome (PWS) in the US, hypothesized to be greater relative to a matched control group without PWS. We used a retrospective case-matched control design and longitudinal US administrative claims data (MarketScan) during a 5-year enrollment period (2009-2014). Patients with PWS were identified by Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code 759.81. Controls were matched on age, sex, and payer type. Outcomes included total, outpatient, inpatient and prescription costs. After matching and application of inclusion/exclusion criteria, we identified 2030 patients with PWS (1161 commercial, 38 Medicare supplemental, and 831 Medicaid). Commercially insured patients with PWS (median age 10 years) had 8.8-times greater total annual direct medical costs than their counterparts without PWS (median age 10 years: median costs $14 907 vs $819; P < .0001; mean costs: $28 712 vs $3246). Outpatient care comprised the largest portion of medical resource utilization for enrollees with and without PWS (median $5605 vs $675; P < .0001; mean $11 032 vs $1804), followed by mean annual inpatient and medication costs, which were $10 879 vs $1015 (P < .001) and $6801 vs $428 (P < .001), respectively. Total annual direct medical costs were ∼42% greater for Medicaid-insured patients with PWS than their commercially insured counterparts, an increase partly explained by claims for Medicaid Waiver day and residential habilitation. Direct medical resource utilization was considerably greater among patients with PWS than members without the condition. This study provides a first step toward quantifying the financial burden of PWS posed to individuals, families, and society. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
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Xin, Haichang; Harman, Jeffrey S; Yang, Zhou
2014-01-01
This study examines whether high cost-sharing in physician care is associated with a differential impact on total care costs by health status. Total care includes physician care, emergency room (ER) visits and inpatient care. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies are a good strategy for controlling costs among chronically ill patients. This study used the 2007 Medical Expenditure Panel Survey data with a cross-sectional study design. Difference in difference (DID), instrumental variable technique, two-part model, and bootstrap technique were employed to analyze cost data. Chronically ill individuals' probability of reducing any overall care costs was significantly less than healthier individuals (beta = 2.18, p = 0.04), while the integrated DID estimator from split results indicated that going from low cost-sharing to high cost-sharing significantly reduced costs by $12,853.23 more for sick people than for healthy people (95% CI: -$17,582.86, -$8,123.60). This greater cost reduction in total care among sick people likely resulted from greater cost reduction in physician care, and may have come at the expense of jeopardizing health outcomes by depriving patients of needed care. Thus, these policies would be inappropriate in the short run, and unlikely in the long run to control health plans costs among chronically ill individuals. A generous benefit design with low cost-sharing policies in physician care or primary care is recommended for both health plans and chronically ill individuals, to save costs and protect these enrollees' health status.
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Li, Jie; Hamilton, Ellie; Vaughn, Louette; Graiser, Michael; Renfroe, Heather; Lechowicz, Mary Jo; Langston, Amelia; Prichard, Jefferson Mark; Anderson, Darlene; Gleason, Charise; Lonial, Sagar; Flowers, Christopher R; Kaufman, Jonathan L; Waller, Edmund K
2011-10-01
Plerixafor is a recently Food and Drug Administration (FDA)-approved CXCR4 antagonist, which is combined with granulocyte-colony-stimulating factor (G-CSF) to facilitate stem cell mobilization of lymphoma and myeloma patients. To evaluate the effectiveness and the related costs of a "just-in-time" strategy of plerixafor administration, we performed a retrospective cohort study comparing 148 consecutive lymphoma and myeloma patients in whom mobilization was attempted during 2008 before the Food and Drug Administration (FDA) approval of plerixafor with 188 consecutive patients mobilized during 2009 after FDA approval. Plerixafor was administered to 64 of 188 patients considered to be at risk for mobilization failure due to either their medical history ("high risk," n = 23) or the occurrence of peripheral blood CD34+ count of fewer than 15 × 10(6) cells/L with a white blood cell count of greater than 10 × 10(9) cells/L after at least 5 days of G-CSF administration (just-in-time, n = 41). The success rates of collecting a minimum transplant CD34+ cell dose (≥2 × 10(6) cells/kg) or target cell dose (≥5 × 10(6) lymphoma or ≥10 × 10(6) CD34+ cells/kg myeloma) in the just-in-time patients compared favorably with the 36 poor mobilizers collected with G-CSF alone: 93% versus 72% and 42% versus 22%, respectively. The use of plerixafor in selected high-risk patients and poor mobilizers did not increase the total charges associated with stem cell collection when compared with poor mobilizers treated with G-CSF alone. The targeted use of plerixafor increased the overall success rate of mobilizing a minimum number of CD34+ cells from 93% to 98% in patients with hematologic malignancies scheduled for autotransplant and increased the overall charges associated with stem cell collection in all patients by an average of 17%. © 2011 American Association of Blood Banks.
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To Build or Not to Build: Addressing Facilities Needs While Controlling Costs
Kadamus, James A.
2015-01-01
When trustees, presidents, and senior college administrators meet, one topic dominates the conversation: how to keep education quality high and costs down. To keep quality high, college leaders need to have strong faculties and state-of-the-art facilities for teaching and research. Quality counts but it also costs, and that is where the pressures…
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A cost-benefit analysis of the Mexican Social Security Administration's family planning program.
Nortman, D L; Halvas, J; Rabago, A
1986-01-01
A cost-benefit analysis of the family planning program of the Mexican Social Security System (IMSS) was undertaken to test the hypothesis that IMSS's family planning services yield a net savings to IMSS by reducing the load on its maternal and infant care service. The cost data are believed to be of exceptionally high quality because they were empirically ascertained by a retrospective and prospective survey of unit time and personnel costs per specified detailed type of service in 37 IMSS hospitals and 16 clinics in 13 of Mexico's 32 states. Based on the average cost per case, the analysis disclosed that for every peso (constant 1983 currency) that IMSS spent on family planning services to its urban population during 1972-1984 inclusive, the agency saved nine pesos. The article concludes by raising the speculative question as to the proportion of the births averted by the IMSS family planning program that would have been averted in the absence of IMSS's family planning services.
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Low-cost high-quality crystalline germanium based flexible devices
Nassar, Joanna M.
2014-06-16
High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.
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Low-cost high-quality crystalline germanium based flexible devices
Nassar, Joanna M.; Hussain, Aftab M.; Rojas, Jhonathan Prieto; Hussain, Muhammad Mustafa
2014-01-01
High performance flexible electronics promise innovative future technology for various interactive applications for the pursuit of low-cost, light-weight, and multi-functional devices. Thus, here we show a complementary metal oxide semiconductor (CMOS) compatible fabrication of flexible metal-oxide-semiconductor capacitors (MOSCAPs) with high-κ/metal gate stack, using a physical vapor deposition (PVD) cost-effective technique to obtain a high-quality Ge channel. We report outstanding bending radius ~1.25 mm and semi-transparency of 30%.
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Cost/benefit of high technology in diagnostic radiology
Energy Technology Data Exchange (ETDEWEB)
Goethlin, J.H.
1987-08-01
High technology is frequently blamed as a main cause for the last decade's disproportionate rise in health expenditure. Total costs for all large diagnostic and therapeutic appliances are typically less than 1% of annual expenditure on health care. CT, DSA, MRI, interventional radiology, ESWL, US, mammography, computers in radiology and PACS may save 10-80% of total cost for diagnosis and treatment of disease. Expenditure on high technology is in general vastly overestimated. Because of its medical utility, a slower deployment cannot be desirable. (orig.)
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Cost/benefit of high technology in diagnostic radiology
International Nuclear Information System (INIS)
Goethlin, J.H.
1987-01-01
High technology is frequently blamed as a main cause for the last decade's disproportionate rise in health expenditure. Total costs for all large diagnostic and therapeutic appliances are typically less than 1% of annual expenditure on health care. CT, DSA, MRI, interventional radiology, ESWL, US, mammography, computers in radiology and PACS may save 10-80% of total cost for diagnosis and treatment of disease. Expenditure on high technology is in general vastly overestimated. Because of its medical utility, a slower deployment cannot be desirable. (orig.)
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Directory of Open Access Journals (Sweden)
Degli Esposti L
2013-05-01
Full Text Available Luca Degli Esposti,1 Stefania Saragoni,1 Stefano Buda,1 Alessandra Sturani,2 Ezio Degli Esposti11CliCon Srl, Health, Economics and Outcomes Research, Ravenna, Italy; 2Nephrology and Dialysis Unit, Santa Maria delle Croci Hospital, Ravenna, ItalyBackground: Diabetes is one of the most prevalent chronic diseases, and its prevalence is predicted to increase in the next two decades. Diabetes imposes a staggering financial burden on the health care system, so information about the costs and experiences of collecting and reporting quality measures of data is vital for practices deciding whether to adopt quality improvements or monitor existing initiatives. The aim of this study was to quantify the association between health care costs and level of glycemic control in patients with type 2 diabetes using clinical and administrative databases.Methods: A retrospective analysis using a large administrative database and a clinical registry containing laboratory results was performed. Patients were subdivided according to their glycated hemoglobin level. Multivariate analyses were used to control for differences in potential confounding factors, including age, gender, Charlson comorbidity index, presence of dyslipidemia, hypertension, or cardiovascular disease, and degree of adherence with antidiabetic drugs among the study groups.Results: Of the total population of 700,000 subjects, 31,022 were identified as being diabetic (4.4% of the entire population. Of these, 21,586 met the study inclusion criteria. In total, 31.5% of patients had very poor glycemic control and 25.7% had excellent control. Over 2 years, the mean diabetes-related cost per person was: €1291.56 in patients with excellent control; €1545.99 in those with good control; €1584.07 in those with fair control; €1839.42 in those with poor control; and €1894.80 in those with very poor control. After adjustment, compared with the group having excellent control, the estimated excess cost
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Low Cost Lithography Tool for High Brightness LED Manufacturing
Energy Technology Data Exchange (ETDEWEB)
Andrew Hawryluk; Emily True
2012-06-30
The objective of this activity was to address the need for improved manufacturing tools for LEDs. Improvements include lower cost (both capital equipment cost reductions and cost-ofownership reductions), better automation and better yields. To meet the DOE objective of $1- 2/kilolumen, it will be necessary to develop these highly automated manufacturing tools. Lithography is used extensively in the fabrication of high-brightness LEDs, but the tools used to date are not scalable to high-volume manufacturing. This activity addressed the LED lithography process. During R&D and low volume manufacturing, most LED companies use contact-printers. However, several industries have shown that these printers are incompatible with high volume manufacturing and the LED industry needs to evolve to projection steppers. The need for projection lithography tools for LED manufacturing is identified in the Solid State Lighting Manufacturing Roadmap Draft, June 2009. The Roadmap states that Projection tools are needed by 2011. This work will modify a stepper, originally designed for semiconductor manufacturing, for use in LED manufacturing. This work addresses improvements to yield, material handling, automation and throughput for LED manufacturing while reducing the capital equipment cost.
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High-Efficient Low-Cost Photovoltaics Recent Developments
Petrova-Koch, Vesselinka; Goetzberger, Adolf
2009-01-01
A bird's-eye view of the development and problems of recent photovoltaic cells and systems and prospects for Si feedstock is presented. High-efficient low-cost PV modules, making use of novel efficient solar cells (based on c-Si or III-V materials), and low cost solar concentrators are in the focus of this book. Recent developments of organic photovoltaics, which is expected to overcome its difficulties and to enter the market soon, are also included.
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Improvement of the cost-benefit analysis algorithm for high-rise construction projects
Directory of Open Access Journals (Sweden)
Gafurov Andrey
2018-01-01
Full Text Available The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the “Project analysis scenario” flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.
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Improvement of the cost-benefit analysis algorithm for high-rise construction projects
Gafurov, Andrey; Skotarenko, Oksana; Plotnikov, Vladimir
2018-03-01
The specific nature of high-rise investment projects entailing long-term construction, high risks, etc. implies a need to improve the standard algorithm of cost-benefit analysis. An improved algorithm is described in the article. For development of the improved algorithm of cost-benefit analysis for high-rise construction projects, the following methods were used: weighted average cost of capital, dynamic cost-benefit analysis of investment projects, risk mapping, scenario analysis, sensitivity analysis of critical ratios, etc. This comprehensive approach helped to adapt the original algorithm to feasibility objectives in high-rise construction. The authors put together the algorithm of cost-benefit analysis for high-rise construction projects on the basis of risk mapping and sensitivity analysis of critical ratios. The suggested project risk management algorithms greatly expand the standard algorithm of cost-benefit analysis in investment projects, namely: the "Project analysis scenario" flowchart, improving quality and reliability of forecasting reports in investment projects; the main stages of cash flow adjustment based on risk mapping for better cost-benefit project analysis provided the broad range of risks in high-rise construction; analysis of dynamic cost-benefit values considering project sensitivity to crucial variables, improving flexibility in implementation of high-rise projects.
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Energy Technology Data Exchange (ETDEWEB)
None
2012-01-01
REACT Project: The University of Houston will develop a low-cost, high-current superconducting wire that could be used in high-power wind generators. Superconducting wire currently transports 600 times more electric current than a similarly sized copper wire, but is significantly more expensive. The University of Houston’s innovation is based on engineering nanoscale defects in the superconducting film. This could quadruple the current relative to today’s superconducting wires, supporting the same amount of current using 25% of the material. This would make wind generators lighter, more powerful and more efficient. The design could result in a several-fold reduction in wire costs and enable their commercial viability of high-power wind generators for use in offshore applications.
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U.S. Department of Health & Human Services — Medicare certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor. The cost report contains provider...
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Reduced Cost Composite Hot Structures with Oxidation Protection, Phase I
National Aeronautics and Space Administration — Innovative, low cost high performance technologies are critical to the affordability of future space missions. Carbon/carbon (C/C) composites have significant...
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2010-07-01
... 34 Education 3 2010-07-01 2010-07-01 false May a State use the funds it receives from the GAP Program to pay administrative costs? 692.112 Section 692.112 Education Regulations of the Offices of the... Assistance and How May It Be Used? § 692.112 May a State use the funds it receives from the GAP Program to...
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Critical operations capabilities in a high cost environment: a multiple case study
Sansone, C.; Hilletofth, P.; Eriksson, D.
2018-04-01
Operations capabilities have been a popular research area for many years and several frameworks have been proposed in the literature. The current frameworks do not take specific contexts into consideration, for instance a high cost environment. This research gap is of particular interest since a manufacturing relocation process has been ongoing the last decades, leading to a huge amount of manufacturing being moved from high to low cost environments. The purpose of this study is to identify critical operations capabilities in a high cost environment. The two research questions were: What are the critical operations capabilities dimensions in a high cost environment? What are the critical operations capabilities in a high cost environment? A multiple case study was conducted and three Swedish manufacturing firms were selected. The study was based on the investigation of an existing framework of operations capabilities. The main dimensions of operations capabilities included in the framework were: cost, quality, delivery, flexibility, service, innovation and environment. Each of the dimensions included two or more operations capabilities. The findings confirmed the validity of the framework and its usefulness in a high cost environment and a new operations capability was revealed (employee flexibility).
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Cost-effective clinical pharmacy services in a veterans administration drop-in clinic.
Scrivens, J J; Magalian, P; Crozier, G A
1983-11-01
Services provided by a clinical pharmacist in a Veterans Administration outpatient clinic are described. Patients who come to the drop-in clinic for prescription refill authorization or medication-related problems are seen by a pharmacist rather than by a physician. The pharmacist interviews the patient, reviews the medical records and prescription and nonprescription drug profile, assesses appropriateness of current drug use, and records findings in the progress notes. The pharmacist may recommend presciption refill, change of medication or dosage, discontinuation, referral to a physician or nurse practitioner, follow-up appointments, or laboratory tests. The physician must countersign the pharmacist's prescriptions, referrals, and requests for laboratory tests. The clinical pharmacist's services reduced demand for physicians' time, allowed patients direct access to the health-care provider suited to deal with medication-related problems, and provided improved continuity of care. Potential benefits are cost savings from discontinuation of inappropriate drug therapy and from use of a pharmacist instead of a physician. The number of hospital admissions related to adverse drug reactions also may be reduced.
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Low-Cost Bio-Based Carbon Fibers for High Temperature Processing
Energy Technology Data Exchange (ETDEWEB)
Paul, Ryan Michael [GrafTech International, Brooklyn Heights, OH (United States); Naskar, Amit [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
2017-08-03
GrafTech International Holdings Inc. (GTI), under Award No. DE-EE0005779, worked with Oak Ridge National Laboratory (ORNL) under CRADA No. NFE-15-05807 to develop lignin-based carbon fiber (LBCF) technology and to demonstrate LBCF performance in high-temperature products and applications. This work was unique and different from other reported LBCF work in that this study was application-focused and scalability-focused. Accordingly, the executed work was based on meeting criteria based on technology development, cost, and application suitability. High-temperature carbon fiber based insulation is used in energy intensive industries, such as metal heat treating and ceramic and semiconductor material production. Insulation plays a critical role in achieving high thermal and process efficiency, which is directly related to energy usage, cost, and product competitiveness. Current high temperature insulation is made with petroleum based carbon fibers, and one goal of this protect was to develop and demonstrate an alternative lignin (biomass) based carbon fiber that would achieve lower cost, CO2 emissions, and energy consumption and result in insulation that met or exceeded the thermal efficiency of current commercial insulation. In addition, other products were targeted to be evaluated with LBCF. As the project was designed to proceed in stages, the initial focus of this work was to demonstrate lab-scale LBCF from at least 4 different lignin precursor feedstock sources that could meet the estimated production cost of $5.00/pound and have ash level of less than 500 ppm in the carbonized insulation-grade fiber. Accordingly, a preliminary cost model was developed based on publicly available information. The team demonstrated that 4 lignin samples met the cost criteria. In addition, the ash level for the 4 carbonized lignin samples was below 500 ppm. Processing as-received lignin to produce a high purity lignin fiber was a significant accomplishment in that most industrial
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Defense Finance and Accounting Service Administration of Unit Costs
National Research Council Canada - National Science Library
Lay, F
1996-01-01
...) of products or outputs produced. Audit Objectives. We conducted this part of our audit to find out whether unit costs for goods and services provided by DFAS were determined in accordance with DoD policies and based on actual costs incurred...
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Low–Cost Bio-Based Carbon Fiber for High-Temperature Processing
Energy Technology Data Exchange (ETDEWEB)
Naskar, Amit K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Akato, Kokouvi M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Tran, Chau D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Paul, Ryan M. [GrafTech International Holdings, Inc., Brooklyn Heights, OH (United States); Dai, Xuliang [GrafTech International Holdings, Inc., Brooklyn Heights, OH (United States)
2017-02-01
GrafTech International Holdings Inc. (GTI), worked with Oak Ridge National Laboratory (ORNL) under CRADA No. NFE-15-05807 to develop lignin-based carbon fiber (LBCF) technology and to demonstrate LBCF performance in high-temperature products and applications. This work was unique and different from other reported LBCF work in that this study was application-focused and scalability-focused. Accordingly, the executed work was based on meeting criteria based on technology development, cost, and application suitability. The focus of this work was to demonstrate lab-scale LBCF from at least 4 different precursor feedstock sources that could meet the estimated production cost of $5.00/pound and have ash level of less than 500 ppm in the carbonized insulation-grade fiber. Accordingly, a preliminary cost model was developed based on publicly available information. The team demonstrated that 4 lignin samples met the cost criteria, as highlighted in Table 1. In addition, the ash level for the 4 carbonized lignin samples were below 500 ppm. Processing asreceived lignin to produce a high purity lignin fiber was a significant accomplishment in that most industrial lignin, prior to purification, had greater than 4X the ash level needed for this project, and prior to this work there was not a clear path of how to achieve the purity target. The lab scale development of LBCF was performed with a specific functional application in mind, specifically for high temperature rigid insulation. GTI is currently a consumer of foreignsourced pitch and rayon based carbon fibers for use in its high temperature insulation products, and the motivation was that LBCF had potential to decrease costs and increase product competitiveness in the marketplace through lowered raw material costs, lowered energy costs, and decreased environmental footprint. At the end of this project, the Technology Readiness Level (TRL) remained at 5 for LBCF in high temperature insulation.
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Development of low-cost high-performance multispectral camera system at Banpil
Oduor, Patrick; Mizuno, Genki; Olah, Robert; Dutta, Achyut K.
2014-05-01
Banpil Photonics (Banpil) has developed a low-cost high-performance multispectral camera system for Visible to Short- Wave Infrared (VIS-SWIR) imaging for the most demanding high-sensitivity and high-speed military, commercial and industrial applications. The 640x512 pixel InGaAs uncooled camera system is designed to provide a compact, smallform factor to within a cubic inch, high sensitivity needing less than 100 electrons, high dynamic range exceeding 190 dB, high-frame rates greater than 1000 frames per second (FPS) at full resolution, and low power consumption below 1W. This is practically all the feature benefits highly desirable in military imaging applications to expand deployment to every warfighter, while also maintaining a low-cost structure demanded for scaling into commercial markets. This paper describes Banpil's development of the camera system including the features of the image sensor with an innovation integrating advanced digital electronics functionality, which has made the confluence of high-performance capabilities on the same imaging platform practical at low cost. It discusses the strategies employed including innovations of the key components (e.g. focal plane array (FPA) and Read-Out Integrated Circuitry (ROIC)) within our control while maintaining a fabless model, and strategic collaboration with partners to attain additional cost reductions on optics, electronics, and packaging. We highlight the challenges and potential opportunities for further cost reductions to achieve a goal of a sub-$1000 uncooled high-performance camera system. Finally, a brief overview of emerging military, commercial and industrial applications that will benefit from this high performance imaging system and their forecast cost structure is presented.
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High Channel Count, High Density Microphone Arrays for Wind Tunnel Environments, Phase I
National Aeronautics and Space Administration — The Interdisciplinary Consulting Corporation (IC2) proposes the development of high channel count, high density, reduced cost per channel, directional microphone...
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International Nuclear Information System (INIS)
Mitsutake, Naohiro; Fujii, Ryo; Oku, Shinya; Furui, Yuji; Yasunaga, Hideo
2007-01-01
The purpose of this study is to analyze the business administration of positron emission tomography (PET) facilities based on the survey of the price of PET cancer screening and cost analysis of PET examination. The questionnaire survey of the price of PET cancer screening was implemented for all PET facilities in Japan. Cost data of PET examination, including fixed costs and variable costs, were obtained from three different medical institutions. The marked price of the PET cancer screening was yen111,499 in average, and the most popular range of prices was between yen80,000 and yen90,000. Costs of PET per examination were accounted for yen110,675, yen79,158 and yen111,644 in facility A, B and C, respectively. The results suggested that facilities with two or more PET/CT per a cyclotron could only secure profits. In Japan, the boom in PET facility construction could not continue in accordance with increasing number of PET facilities. It would become more essential to analyze the appropriate distribution of PET facilities and the adequate amount of PET procedures from the perspective of efficient utilization of the PET equipments and supply of PET-related healthcare. (author)
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The costs and cost-efficiency of providing food through schools in areas of high food insecurity.
Gelli, Aulo; Al-Shaiba, Najeeb; Espejo, Francisco
2009-03-01
The provision of food in and through schools has been used to support the education, health, and nutrition of school-aged children. The monitoring of financial inputs into school health and nutrition programs is critical for a number of reasons, including accountability, transparency, and equity. Furthermore, there is a gap in the evidence on the costs, cost-efficiency, and cost-effectiveness of providing food through schools, particularly in areas of high food insecurity. To estimate the programmatic costs and cost-efficiency associated with providing food through schools in food-insecure, developing-country contexts, by analyzing global project data from the World Food Programme (WFP). Project data, including expenditures and number of schoolchildren covered, were collected through project reports and validated through WFP Country Office records. Yearly project costs per schoolchild were standardized over a set number of feeding days and the amount of energy provided by the average ration. Output metrics, such as tonnage, calories, and micronutrient content, were used to assess the cost-efficiency of the different delivery mechanisms. The average yearly expenditure per child, standardized over a 200-day on-site feeding period and an average ration, excluding school-level costs, was US$21.59. The costs varied substantially according to choice of food modality, with fortified biscuits providing the least costly option of about US$11 per year and take-home rations providing the most expensive option at approximately US$52 per year. Comparisons across the different food modalities suggested that fortified biscuits provide the most cost-efficient option in terms of micronutrient delivery (particularly vitamin A and iodine), whereas on-site meals appear to be more efficient in terms of calories delivered. Transportation and logistics costs were the main drivers for the high costs. The choice of program objectives will to a large degree dictate the food modality
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Watts, Caroline G; Cust, Anne E; Menzies, Scott W; Coates, Elliot; Mann, Graham J; Morton, Rachael L
2015-02-01
Regular surveillance of individuals at high risk for cutaneous melanoma improves early detection and reduces unnecessary excisions; however, a cost analysis of this specialized service has not been undertaken. To determine the mean cost per patient of surveillance in a high-risk clinic from the health service and societal perspectives. We used a bottom-up microcosting method to measure resource use in a consecutive sample of 102 patients treated in a high-risk hospital-based clinic in Australia during a 12-month period. Surveillance and treatment of melanoma. All surveillance and treatment procedures were identified through direct observation, review of medical records, and interviews with staff and were valued using scheduled fees from the Australian government. Societal costs included transportation and loss of productivity. The mean number of clinic visits per year was 2.7 (95% CI, 2.5-2.8) for surveillance and 3.8 (95% CI, 3.4-4.1) for patients requiring surgical excisions. The mean annual cost per patient to the health system was A $882 (95% CI, A $783-$982) (US $599 [95% CI, US $532-$665]); the cost discounted across 20 years was A $11,546 (95% CI, A $10,263-$12,829) (US $7839 [95% CI, US $6969-$8710]). The mean annual societal cost per patient (excluding health system costs) was A $972 (95% CI, A $899-$1045) (US $660 [95% CI, US $611-$710]); the cost discounted across 20 years was A $12,721 (95% CI, A $12,554-$14,463) (US $8637 [95% CI, US $8523-$9820]). Diagnosis of melanoma or nonmelanoma skin cancer and frequent excisions for benign lesions in a relatively small number of patients was responsible for positively skewed health system costs. Microcosting techniques provide an accurate cost estimate for the provision of a specialized service. The high societal cost reflects the time that patients are willing to invest to attend the high-risk clinic. This alternative model of care for a high-risk population has relevance for decision making about health policy.
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High costs of female choice in a lekking lizard.
Directory of Open Access Journals (Sweden)
Maren N Vitousek
2007-06-01
Full Text Available Although the cost of mate choice is an essential component of the evolution and maintenance of sexual selection, the energetic cost of female choice has not previously been assessed directly. Here we report that females can incur high energetic costs as a result of discriminating among potential mates. We used heart rate biologging to quantify energetic expenditure in lek-mating female Galápagos marine iguanas (Amblyrhynchus cristatus. Receptive females spent 78.9+/-23.2 kJ of energy on mate choice over a 30-day period, which is equivalent to approximately (3/4 of one day's energy budget. Females that spent more time on the territories of high-quality, high-activity males displayed greater energetic expenditure on mate choice, lost more mass, and showed a trend towards producing smaller follicles. Choosy females also appear to face a reduced probability of survival if El Niño conditions occur in the year following breeding. These findings indicate that female choice can carry significant costs, and suggest that the benefits that lek-mating females gain through mating with a preferred male may be higher than previously predicted.
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TAX ADMINISTRATION: SOME ISSUES AND TRENDS
Directory of Open Access Journals (Sweden)
MOGOIU CARMEN MIHAELA
2018-02-01
Full Text Available This paper presents a series of practices of tax administrations in different countries of the world, focusing on their functions, mission and responsibilities. Analyzing the main features of tax administrations across the globe, from emerging to top-level, allows self-assessments of their organizations' strengths and weaknesses to describe the current level and identify the steps needed to move to a new level of maturity but I believe that the applicability of best practice should be made after a rigorous analysis of the expected impact and there must be taken into account the differences in national institutional systems, customs, technological progress and the natural resources. A modern and performing tax administration must pay particular attention to the practice of self-evaluation and voluntary compliance, cost reduction and burden diminuation for taxpayers to provide the goods and services needed to increase the standard of living of citizens and ensure economic prosperity. The tax administration plays an important role in developing and modifying fiscal policies by working with other state institutions to monitor the positive or negative impact of fiscal policy and legislation on tax administration, recommending the necessary changes. Studying the best practices of tax administrations around the world can lead to the achievement and maintenance of a high degree of self-assessment and voluntary compliance of taxpayers' tax obligations - the primary objective of any tax administration.
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Energy Technology Data Exchange (ETDEWEB)
Lubliner, Michael [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Howard, Luke [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Hales, David [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Kunkle, Rick [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Gordon, Andy [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program; Spencer, Melinda [Building America Partnership for Improved Residential Construction, Olympia, WA (United States). Washington States Univ. Energy Program
2016-02-18
The Woods is a Habitat for Humanity (HFH) community of ENERGY STAR Homes Northwest (ESHNW)-certified homes located in the marine climate of Tacoma/Pierce County, Washington. This research report builds on an earlier preliminary draft 2014 BA report, and includes significant billing analysis and cost effectiveness research from a collaborative, ongoing Ductless Heat Pump (DHP)research effort for Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH. Tacoma Public Utilities (TPU) and Bonneville Power Administration (BPA). This report focuses on the results of field testing, modeling, and monitoring of ductless mini-split heat pump hybrid heating systems in seven homes built and first occupied at various times between September 2013 and October 2014. The report also provides WSU documentation of high-performance home observations, lessons learned, and stakeholder recommendations for builders of affordable high-performance housing such as HFH.
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45 CFR 30.18 - Interest, penalties, and administrative costs.
2010-10-01
... delinquency, or as otherwise provided by law. For debts not paid by the date specified in the written demand... direct (personnel, supplies, etc.) and indirect collection costs, including the cost of providing a... consideration of waiver if statute prohibits collection of the debt during this period. (i) Common law or other...
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Administrative stordriftsfordele ved kommunalre-formen i Danmark – sandede eller tilsandede?
Directory of Open Access Journals (Sweden)
Kurt Houlberg
2012-01-01
Full Text Available
The Danish Local Government Reform in 2007 reduced the number of municipalities from 271 to 98 and the number of Regions from 14 to 5 along with major changes in tasks, finances and the equalisation scheme. One of the objectives of the reform was to realize administrative economies of scale. Measured by administrative costs, this article concludes that the amalgamated municipalities so far have not realized the expected administrative economies of scale. It is, however, also shown that the potential economies of scale prior to the Reform was inflated in a Reform legitimating process. Before as well as after the Reform, administrative economies of scale exist if analysing on administrative costs. Technically administrative costs by decentralised agencies, however, cannot be calculated and are therefore not included in the analysis. Basing the analysis instead on administrative personnel, including administrative staff employed at schools, kindergartens etc., the conclusion is that larger municipalities do not spend less resources on administration than smaller municipalities.
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Low Cost, High Efficiency, High Pressure Hydrogen Storage
Energy Technology Data Exchange (ETDEWEB)
Mark Leavitt
2010-03-31
A technical and design evaluation was carried out to meet DOE hydrogen fuel targets for 2010. These targets consisted of a system gravimetric capacity of 2.0 kWh/kg, a system volumetric capacity of 1.5 kWh/L and a system cost of $4/kWh. In compressed hydrogen storage systems, the vast majority of the weight and volume is associated with the hydrogen storage tank. In order to meet gravimetric targets for compressed hydrogen tanks, 10,000 psi carbon resin composites were used to provide the high strength required as well as low weight. For the 10,000 psi tanks, carbon fiber is the largest portion of their cost. Quantum Technologies is a tier one hydrogen system supplier for automotive companies around the world. Over the course of the program Quantum focused on development of technology to allow the compressed hydrogen storage tank to meet DOE goals. At the start of the program in 2004 Quantum was supplying systems with a specific energy of 1.1-1.6 kWh/kg, a volumetric capacity of 1.3 kWh/L and a cost of $73/kWh. Based on the inequities between DOE targets and Quantum’s then current capabilities, focus was placed first on cost reduction and second on weight reduction. Both of these were to be accomplished without reduction of the fuel system’s performance or reliability. Three distinct areas were investigated; optimization of composite structures, development of “smart tanks” that could monitor health of tank thus allowing for lower design safety factor, and the development of “Cool Fuel” technology to allow higher density gas to be stored, thus allowing smaller/lower pressure tanks that would hold the required fuel supply. The second phase of the project deals with three additional distinct tasks focusing on composite structure optimization, liner optimization, and metal.
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Approaching hospital administration about adopting cooling technologies.
Kirkland, Lisa L; Parham, William M; Pastores, Stephen M
2009-07-01
The purpose of this article is to provide intensivists with information and examples regarding cooling technology selection, cost assessment, adaptation, barriers, and presentation to hospital administrators. A review of medical and business literature was conducted using the following search terms: technology assessment, organizational innovation, intensive care, critical care, hospital administration, and presentation to administrators. General recommendations for intensivists are made for assessing cooling technology with descriptions of common new technology implementation stages. A study of 16 hospitals implementing a new cardiac surgery technology is described. A description of successful implementation of an induced hypothermia protocol by one of the authors is presented. Although knowledgeable about the applications of new technologies, including cooling technology, intensivists have little guidance or training on tactics to obtain a hospital administration's funding and support. Intensive care unit budgets are usually controlled by nonintensivists whose interests are neutral, at best, to the needs of intensivists. To rise to the top of the large pile of requisition requests, an intensivist's proposal must be well conceived and aligned with hospital administration's strategic goals. Intensivists must understand the hospital acquisition process and administrative structure and participate on high-level hospital committees. Using design thinking and strong leadership skills, the intensivist can marshal support from staff and administrators to successfully implement cooling technology.
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Pro Linux System Administration
Turnbull, James
2009-01-01
We can all be Linux experts, provided we invest the time in learning the craft of Linux administration. Pro Linux System Administration makes it easy for small to medium--sized businesses to enter the world of zero--cost software running on Linux and covers all the distros you might want to use, including Red Hat, Ubuntu, Debian, and CentOS. Authors, and systems infrastructure experts James Turnbull, Peter Lieverdink, and Dennis Matotek take a layered, component--based approach to open source business systems, while training system administrators as the builders of business infrastructure. If
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Toward Low-Cost, High-Energy Density, and High-Power Density Lithium-Ion Batteries
Li, Jianlin; Du, Zhijia; Ruther, Rose E.; AN, Seong Jin; David, Lamuel Abraham; Hays, Kevin; Wood, Marissa; Phillip, Nathan D.; Sheng, Yangping; Mao, Chengyu; Kalnaus, Sergiy; Daniel, Claus; Wood, David L.
2017-09-01
Reducing cost and increasing energy density are two barriers for widespread application of lithium-ion batteries in electric vehicles. Although the cost of electric vehicle batteries has been reduced by 70% from 2008 to 2015, the current battery pack cost (268/kWh in 2015) is still >2 times what the USABC targets (125/kWh). Even though many advancements in cell chemistry have been realized since the lithium-ion battery was first commercialized in 1991, few major breakthroughs have occurred in the past decade. Therefore, future cost reduction will rely on cell manufacturing and broader market acceptance. This article discusses three major aspects for cost reduction: (1) quality control to minimize scrap rate in cell manufacturing; (2) novel electrode processing and engineering to reduce processing cost and increase energy density and throughputs; and (3) material development and optimization for lithium-ion batteries with high-energy density. Insights on increasing energy and power densities of lithium-ion batteries are also addressed.
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Davis, Charles R; Lynch, Erik J
2018-06-01
There is a significant disparity in roles, responsibilities, education, training, and expertise between the school nurse and building administrator. Because of this disparity, a natural chasm must be bridged to optimize student health, safety, well-being, and achievement in the classroom while meeting the individual needs of both professionals. This article constructs and presents a new school nurse-building administrator relationship model, the foundation of which is formed from the pioneering and seminal work on high-performance professional relationships and outcomes of Lewin and Drucker. The authors posit that this new model provides the framework for successful school nurse-building administrator interactions that will lead to optimal student outcomes.
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Automated packaging platform for low-cost high-performance optical components manufacturing
Ku, Robert T.
2004-05-01
Delivering high performance integrated optical components at low cost is critical to the continuing recovery and growth of the optical communications industry. In today's market, network equipment vendors need to provide their customers with new solutions that reduce operating expenses and enable new revenue generating IP services. They must depend on the availability of highly integrated optical modules exhibiting high performance, small package size, low power consumption, and most importantly, low cost. The cost of typical optical system hardware is dominated by linecards that are in turn cost-dominated by transmitters and receivers or transceivers and transponders. Cost effective packaging of optical components in these small size modules is becoming the biggest challenge to be addressed. For many traditional component suppliers in our industry, the combination of small size, high performance, and low cost appears to be in conflict and not feasible with conventional product design concepts and labor intensive manual assembly and test. With the advent of photonic integration, there are a variety of materials, optics, substrates, active/passive devices, and mechanical/RF piece parts to manage in manufacturing to achieve high performance at low cost. The use of automation has been demonstrated to surpass manual operation in cost (even with very low labor cost) as well as product uniformity and quality. In this paper, we will discuss the value of using an automated packaging platform.for the assembly and test of high performance active components, such as 2.5Gb/s and 10 Gb/s sources and receivers. Low cost, high performance manufacturing can best be achieved by leveraging a flexible packaging platform to address a multitude of laser and detector devices, integration of electronics and handle various package bodies and fiber configurations. This paper describes the operation and results of working robotic assemblers in the manufacture of a Laser Optical Subassembly
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Ilg, Annette M; Laviana, Aaron A; Kamrava, Mitchell; Veruttipong, Darlene; Steinberg, Michael; Park, Sang-June; Burke, Michael A; Niedzwiecki, Douglas; Kupelian, Patrick A; Saigal, Christopher
Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup. We constructed detailed process maps for provision of both HDR and LDR. Personnel, space, equipment, and material costs of each step were identified and used to derive capacity cost rates, defined as price per minute. Each capacity cost rate was then multiplied by the relevant process time and products were summed to determine total cost of care. The calculated cost to deliver HDR was greater than LDR by $2,668.86 ($9,538 vs. $6,869). The first and second HDR treatment day cost $3,999.67 and $3,955.67, whereas LDR was delivered on one treatment day and cost $3,887.55. The greatest overall cost driver for both LDR and HDR was personnel at 65.6% ($4,506.82) and 67.0% ($6,387.27) of the total cost. After personnel costs, disposable materials contributed the second most for LDR ($1,920.66, 28.0%) and for HDR ($2,295.94, 24.0%). With TDABC, the true costs to deliver LDR and HDR from the health system perspective were derived. Analysis by physicians and hospital administrators regarding the cost of care afforded redesign opportunities including delivering HDR as one implant. Our work underscores the need to assess clinical outcomes to understand the true difference in value between these modalities. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
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Evans, Sarah S; Gandhi, Arpita S; Clemmons, Amber B; DeRemer, David L
2017-08-01
Etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (EPOCH)-containing regimens are frequently utilized in non-Hodgkin's lymphoma, however, the incidence of febrile neutropenia (FN) in patients receiving inpatient versus outpatient EPOCH has not been described. Additionally, no comparisons have been made regarding financial implications of EPOCH administration in either setting. This study's primary objective was to compare hospital admissions for FN in patients receiving inpatient or outpatient EPOCH. A single-center, institutional review board-approved review was conducted for adults receiving EPOCH beginning January 2010. Clinical and financial data were collected through chart review and the institution's financial department. Descriptive statistics were utilized for analysis. A total of 25 patients received 86 cycles of an EPOCH-containing regimen (61 [70.9%] inpatient). Five (8.2%) inpatient cycles resulted in an admission for FN compared to 4 (16%) outpatient cycles. Prophylactic antifungal and antiviral agents were prescribed more often after inpatient cycles (>80%) compared to outpatient cycles (cost savings of approximately US$141 116 for both chemotherapy costs and hospital day avoidance. EPOCH-containing regimens can be safely administered in the outpatient setting, which may result in cost savings for healthcare institutions.
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The variation of acute treatment costs of trauma in high-income countries.
Willenberg, Lynsey; Curtis, Kate; Taylor, Colman; Jan, Stephen; Glass, Parisa; Myburgh, John
2012-08-21
In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age. The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the
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The variation of acute treatment costs of trauma in high-income countries
Directory of Open Access Journals (Sweden)
Willenberg Lynsey
2012-08-01
Full Text Available Abstract Background In order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries. Methods A systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS, per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities. Results A total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1% or charge estimate (25.9% for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701. However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS, surgical intervention, hospital and intensive care, length of stay, polytrauma and age. Conclusion The acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied
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Effect of bond administration on construction project delivery
Directory of Open Access Journals (Sweden)
Oke Ayodeji Emmanuel
2016-12-01
Full Text Available Construction bond administration involves management of bond issues from inception of obtaining bond from guarantor to the point of release of contractor by the client. This process has posted a lot of challenges to construction stakeholders; it is therefore, necessary to examine the relationship between bond administration and project success. Archival data of completed bonded building projects were gathered through a pro forma developed for this purpose. Using Pearson product moment of correlation, it was revealed that the cost of securing a construction bond has a positive and significant effect on the initial and final costs of the project, while the number of days needed to secure a construction bond has no significant effect on the initial and final durations of the construction project. In order to establish the relationship between project delivery indices of cost and time and the construction bond administration variables, iteration of linear regression was adopted to arrive at the best-fit equation. Factors affecting the cost of securing construction bonds from guarantors should be identified and given adequate attention by construction stakeholders in order to minimize the effect of construction bond administration on project delivery.
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Integrated cost estimation methodology to support high-performance building design
Energy Technology Data Exchange (ETDEWEB)
Vaidya, Prasad; Greden, Lara; Eijadi, David; McDougall, Tom [The Weidt Group, Minnetonka (United States); Cole, Ray [Axiom Engineers, Monterey (United States)
2007-07-01
Design teams evaluating the performance of energy conservation measures (ECMs) calculate energy savings rigorously with established modelling protocols, accounting for the interaction between various measures. However, incremental cost calculations do not have a similar rigor. Often there is no recognition of cost reductions with integrated design, nor is there assessment of cost interactions amongst measures. This lack of rigor feeds the notion that high-performance buildings cost more, creating a barrier for design teams pursuing aggressive high-performance outcomes. This study proposes an alternative integrated methodology to arrive at a lower perceived incremental cost for improved energy performance. The methodology is based on the use of energy simulations as means towards integrated design and cost estimation. Various points along the spectrum of integration are identified and characterized by the amount of design effort invested, the scheduling of effort, and relative energy performance of the resultant design. It includes a study of the interactions between building system parameters as they relate to capital costs. Several cost interactions amongst energy measures are found to be significant.The value of this approach is demonstrated with alternatives in a case study that shows the differences between perceived costs for energy measures along various points on the integration spectrum. These alternatives show design tradeoffs and identify how decisions would have been different with a standard costing approach. Areas of further research to make the methodology more robust are identified. Policy measures to encourage the integrated approach and reduce the barriers towards improved energy performance are discussed.
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CONSTRUCTION OF A DIFFERENTIAL ISOTHERMAL CALORIMETER OF HIGH SENSITIVITY AND LOW COST.
Trinca, RB; Perles, CE; Volpe, PLO
2009-01-01
CONSTRUCTION OF A DIFFERENTIAL ISOTHERMAL CALORIMETER OF HIGH SENSITIVITY AND LOW COST The high cost of sensitivity commercial calorimeters may represent an obstacle for many calorimetric research groups. This work describes (fie construction and calibration of a batch differential heat conduction calorimeter with sample cells volumes of about 400 mu L. The calorimeter was built using two small high sensibility square Peltier thermoelectric sensors and the total cost was estimated to be about...
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Bartsch, Sarah M; Hotez, Peter J; Hertenstein, Daniel L; Diemert, David J; Zapf, Kristina M; Bottazzi, Maria Elena; Bethony, Jeffrey M; Brown, Shawn T; Lee, Bruce Y
2016-04-27
Although mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated. We developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances. Considering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤ $790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤ $444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) versus annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0% and nearly eliminated hookworm infection in children. Using a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health
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Modular NanoSat Launcher Design for Lowest Mission Cost, Phase I
National Aeronautics and Space Administration — As minimum cost will be required for a dedicated NanoSat Launch Vehicle, a series and parallel staged, highly modular vehicle architecture is proposed for design...
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High-cost users of hospital beds in Western Australia: a population-based record linkage study.
Calver, Janine; Brameld, Kate J; Preen, David B; Alexia, Stoney J; Boldy, Duncan P; McCaul, Kieran A
2006-04-17
To describe how high-cost users of inpatient care in Western Australia differ from other users in age, health problems and resource use. Secondary analysis of hospital data and linked mortality data from the WA Data Linkage System for 2002, with cost data from the National Hospital Cost Data Collection (2001-02 financial year). Comparison of high-cost users and other users of inpatient care in terms of age, health profile (major diagnostic category) and resource use (annualised costs, separations and bed days). Older high-cost users (> or = 65 years) were not more expensive to treat than younger high-cost users (at the patient level), but were costlier as a group overall because of their disproportionate representation (n = 8466; 55.9%). Chronic stable and unstable conditions were a key feature of high-cost users, and included end stage renal disease, angina, depression and secondary malignant neoplasms. High-cost users accounted for 38% of both inpatient costs and inpatient days, and 26% of inpatient separations. Ageing of the population is associated with an increase in the proportion of high-cost users of inpatient care. High costs appear to be needs-driven. Constraining high-cost inpatient use requires more focus on preventing the onset and progression of chronic disease, and reducing surgical complications and injuries in vulnerable groups.
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The Bonneville Power Administration's geothermal program
International Nuclear Information System (INIS)
Darr, G.D.
1990-01-01
Despite being a power source with many desirable characteristics, geothermal has not been developed in the Pacific Northwest because of high costs, high risks, and the lack of a market for power. The region will require new power sources in the 1990s, and will need to know to what extent it can rely on geothermal. The Bonneville Power Administration has developed a geothermal RD and D program which includes a proposal to award power contracts to three pilot projects in the Northwest. Public outreach efforts, environmental base line studies, and economic and land use impact studies will also be undertaken. In this paper two projects already under way are discussed
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[Pay for performance explained by transaction costs theory].
Gorbaneff, Yuri; Cortes, Ariel; Torres, Sergio; Yepes, Francisco
2011-01-01
To evaluate the ability of transaction costs theory to explain incentives in the health care chain. We performed a case study of CPS, a health insurance company in Bogota (Colombia), which preferred not to publish its name. CPS moves in the environment of high transaction costs and uses the hybrid form of governance at the outpatient level. Incentive intensity, administrative control and the contract all agree with the theory. At the hospital level, the market is used, despite greater uncertainty. Because of the discrete form (1.0) of the incentives and the absence of administrative control, it is difficult for CPS to relate payment to hospital performance. Transaction costs theory explains the configuration of incentives. Another contribution made by this theory to the literature is the criterion to differentiate between the market and the hybrid. We propose that the market uses discrete-type (1.0) incentives, while the hybrid uses continuous, commission-like incentives. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.
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Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.
Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,
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Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.
2017-01-01
Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,
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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
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Social cost of heavy drinking and alcohol dependence in high-income countries.
Mohapatra, Satya; Patra, Jayadeep; Popova, Svetlana; Duhig, Amy; Rehm, Jürgen
2010-06-01
A comprehensive review of cost drivers associated with alcohol abuse, heavy drinking, and alcohol dependence for high-income countries was conducted. The data from 14 identified cost studies were tabulated according to the potential direct and indirect cost drivers. The costs associated with alcohol abuse, alcohol dependence, and heavy drinking were calculated. The weighted average of the total societal cost due to alcohol abuse as percent gross domestic product (GDP)--purchasing power parity (PPP)--was 1.58%. The cost due to heavy drinking and/or alcohol dependence as percent GDP (PPP) was estimated to be 0.96%. On average, the alcohol-attributable indirect cost due to loss of productivity is more than the alcohol-attributable direct cost. Most of the countries seem to incur 1% or more of their GDP (PPP) as alcohol-attributable costs, which is a high toll for a single factor and an enormous burden on public health. The majority of alcohol-attributable costs incurred as a consequence of heavy drinking and/or alcohol dependence. Effective prevention and treatment measures should be implemented to reduce these costs.
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24 CFR 85.22 - Allowable costs.
2010-04-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... TRIBAL GOVERNMENTS Post-Award Requirements Financial Administration § 85.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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43 CFR 12.62 - Allowable costs.
2010-10-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Cooperative... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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Individual social security accounts: issues in assessing administrative feasibility and costs.
Olsen, K A; Salisbury, D L
1998-11-01
Whether to add individual accounts (IAs) to the Social Security system is a highly political issue. But almost lost in the debate so far have been any practical considerations about how to administer such accounts. Any discussion of whether to create individual accounts must also address the basic but critical questions of how they would work: Who would run them? What would they cost? Logistically, are they even possible? This EBRI Issue Brief provides an overview of the most salient administrative issues facing the current Social Security reform debate--issues that challenge proponents to carefully think through how their proposals could be implemented so as to achieve their policy goals. The options and difficulties in administering IAs raise concerns that cut across ideology. The object of this report is neither to dissuade the advocates nor support the critics of individual accounts. Rather, it is to bring practical considerations to a political debate that has largely ignored the pragmatic challenges of whether IAs would be too complex for participants to understand or too difficult for record keepers to administer. The major findings in this analysis include: Adding individual accounts to Social Security could be the largest undertaking in the history of the U.S. financial market, and no system to date has the capacity to administer such a system. The number of workers currently covered by Social Security--the largest single entitlement program in the nation--is at least four times higher than the combined number of all tax-favored employment-based retirement accounts in the United States, which are administered by hundreds of entities. Direct comparisons between employment-based retirement savings plans and Social Security reform are tenuous at best. Social Security covers workers and businesses that are disproportionately excluded from employment-based plans. Because of these differences, a system of individual Social Security accounts would be more
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High Thermal Conductivity and High Wear Resistance Tool Steels for cost-effective Hot Stamping Tools
Valls, I.; Hamasaiid, A.; Padré, A.
2017-09-01
In hot stamping/press hardening, in addition to its shaping function, the tool controls the cycle time, the quality of the stamped components through determining the cooling rate of the stamped blank, the production costs and the feasibility frontier for stamping a given component. During the stamping, heat is extracted from the stamped blank and transported through the tool to the cooling medium in the cooling lines. Hence, the tools’ thermal properties determine the cooling rate of the blank, the heat transport mechanism, stamping times and temperature distribution. The tool’s surface resistance to adhesive and abrasive wear is also an important cost factor, as it determines the tool durability and maintenance costs. Wear is influenced by many tool material parameters, such as the microstructure, composition, hardness level and distribution of strengthening phases, as well as the tool’s working temperature. A decade ago, Rovalma developed a hot work tool steel for hot stamping that features a thermal conductivity of more than double that of any conventional hot work tool steel. Since that time, many complimentary grades have been developed in order to provide tailored material solutions as a function of the production volume, degree of blank cooling and wear resistance requirements, tool geometries, tool manufacturing method, type and thickness of the blank material, etc. Recently, Rovalma has developed a new generation of high thermal conductivity, high wear resistance tool steel grades that enable the manufacture of cost effective tools for hot stamping to increase process productivity and reduce tool manufacturing costs and lead times. Both of these novel grades feature high wear resistance and high thermal conductivity to enhance tool durability and cut cycle times in the production process of hot stamped components. Furthermore, one of these new grades reduces tool manufacturing costs through low tool material cost and hardening through readily
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International Nuclear Information System (INIS)
Coy, Peter; Schaafsma, Joseph; Schofield, John A.
2000-01-01
Purpose: To compute cost-effectiveness/cost-utility (CE/CU) ratios, from the treatment clinic and societal perspectives, for high-dose palliative radiotherapy treatment (RT) for advanced non-small-cell lung cancer (NSCLC) against best supportive care (BSC) as comparator, and thereby demonstrate a method for computing CE/CU ratios when randomized clinical trial (RCT) data cannot be generated. Methods and Materials: Unit cost estimates based on an earlier reported 1989-90 analysis of treatment costs at the Vancouver Island Cancer Centre, Victoria, British Columbia, Canada, are updated to 1997-1998 and then used to compute the incremental cost of an average dose of high-dose palliative RT. The incremental number of life days and quality-adjusted life days (QALDs) attributable to treatment are from earlier reported regression analyses of the survival and quality-of-life data from patients who enrolled prospectively in a lung cancer management cost-effectiveness study at the clinic over a 2-year period from 1990 to 1992. Results: The baseline CE and CU ratios are $9245 Cdn per life year (LY) and $12,836 per quality-adjusted life year (QALY), respectively, from the clinic perspective; and $12,253/LY and $17,012/QALY, respectively, from the societal perspective. Multivariate sensitivity analysis for the CE ratio produces a range of $5513-28,270/LY from the clinic perspective, and $7307-37,465/LY from the societal perspective. Similar calculations for the CU ratio produce a range of $7205-37,134/QALY from the clinic perspective, and $9550-49,213/QALY from the societal perspective. Conclusion: The cost effectiveness and cost utility of high-dose palliative RT for advanced NSCLC compares favorably with the cost effectiveness of other forms of treatment for NSCLC, of treatments of other forms of cancer, and of many other commonly used medical interventions; and lies within the US $50,000/QALY benchmark often cited for cost-effective care
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20 CFR 632.38 - Classification of costs.
2010-04-01
... addition, 250 hours of youth try-out employment is considered an allowable training cost. Youth try-out... category as appropriate. (j) Unemployment compensation costs are allowable for administrative staff hired in accordance with the administrative provisions of this part, and for CSE participants. Unemployment...
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44 CFR 13.22 - Allowable costs.
2010-10-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 13.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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36 CFR 1207.22 - Allowable costs.
2010-07-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... GOVERNMENTS Post-Award Requirements Financial Administration § 1207.22 Allowable costs. (a) Limitation on use... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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The Capital Costs Conundrum: Why Are Capital Costs Ignored and What Are the Consequences?
Winston, Gordon C.
1993-01-01
Colleges and universities historically have ignored the capital costs associated with institutional administration in their estimates of overall and per-student costs. This neglect leads to distortion of data, misunderstandings, and uninformed decision making. The real costs should be recognized in institutional accounting. (MSE)
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Cost-Effectiveness Analysis in Practice: Interventions to Improve High School Completion
Hollands, Fiona; Bowden, A. Brooks; Belfield, Clive; Levin, Henry M.; Cheng, Henan; Shand, Robert; Pan, Yilin; Hanisch-Cerda, Barbara
2014-01-01
In this article, we perform cost-effectiveness analysis on interventions that improve the rate of high school completion. Using the What Works Clearinghouse to select effective interventions, we calculate cost-effectiveness ratios for five youth interventions. We document wide variation in cost-effectiveness ratios between programs and between…
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Quintana-Díaz, Manuel; Muñoz-Romo, Raúl; Gómez-Ramírez, Susana; Pavía, José; Borobia, Alberto M; García-Erce, José A; Muñoz, Manuel
2017-09-01
A fast-track anaemia clinic (FTAC) for the management of moderate-to-severe iron-deficiency anaemia (IDA) was established in our Emergency Department in 2010. In this FTAC, the replacement of packed red cell transfusion by ferric carboxymaltose administration was proven to be safe and effective. The aim of this study was a cost-analysis of IDA management in the FTAC, comparing this management with the previous standard care pathway consisting of packed red cell transfusion, if needed, and referral to outpatient specialised care. A cost study was performed for patients with IDA who were at risk of requiring transfusion (haemoglobin costs in the FTAC were compared to those theoretically incurred if these patients had been managed using the standard care pathway. In addition, a sensitivity analysis considering variations of up to ±30% in ferric carboxymaltose and packed red cell acquisition costs was performed (49 possible scenarios). Between 2012 and 2015, 238 IDA patients were treated in the FTAC. The average treatment cost was € 594±337/patient in the FTAC group and € 672±301/patient in the standard care pathway group, with a saving of € 78±28/patient (95% CI, 22-133; pcosts in the FTAC (€ 480-722/patient), compared with those of the standard care pathway (€ 550-794/patient), resulted in significant cost-savings for all studied scenarios (€ 51-104/patient; pcost-saving compared with the standard care pathway.
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Cost calculation and financial measures for high-level waste disposal business
International Nuclear Information System (INIS)
Sekiguchi, Hiromasa.
1987-01-01
A study is made on the costs for disposal of high-level wastes, centering on financial problems involving cost calculation for disposal business and methods and systems for funding the business. The first half of the report is focused on calculation of costs for disposal business. Basic equations are shown to calculate the total costs required for a disposal plant and the costs for disposal of one unit of high-level wastes. A model is proposed to calculate the charges to be paid by electric power companies to the plant for disposal of their wastes. Another equation is derived to calculate the disposal charge per kWh of power generation in a power plant. The second half of the report is focused on financial measures concerning expenses for disposal. A financial basis should be established for the implementation of high-level waste disposal. It is insisted that a reasonable method for estimating the disposal costs should be set up and it should be decided who will pay the expenses. Discussions are made on some methods and systems for funding the disposal business. An additional charge should be included in the electricity bill to be paid by electric power users, or it should be included in tax. (Nogami, K.)
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2010-07-01
... 39 Postal Service 1 2010-07-01 2010-07-01 false Costs. 491.5 Section 491.5 Postal Service UNITED... RATE COMMISSION § 491.5 Costs. The Postal Service's administrative costs in executing the garnishment action shall be added to each garnishment and the costs recovered shall be retained as offsetting...
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Sliver Solar Cells: High-Efficiency, Low-Cost PV Technology
Directory of Open Access Journals (Sweden)
Evan Franklin
2007-01-01
Full Text Available Sliver cells are thin, single-crystal silicon solar cells fabricated using standard fabrication technology. Sliver modules, composed of several thousand individual Sliver cells, can be efficient, low-cost, bifacial, transparent, flexible, shadow tolerant, and lightweight. Compared with current PV technology, mature Sliver technology will need 10% of the pure silicon and fewer than 5% of the wafer starts per MW of factory output. This paper deals with two distinct challenges related to Sliver cell and Sliver module production: providing a mature and robust Sliver cell fabrication method which produces a high yield of highly efficient Sliver cells, and which is suitable for transfer to industry; and, handling, electrically interconnecting, and encapsulating billions of sliver cells at low cost. Sliver cells with efficiencies of 20% have been fabricated at ANU using a reliable, optimised processing sequence, while low-cost encapsulation methods have been demonstrated using a submodule technique.
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Scalable Light Module for Low-Cost, High-Efficiency Light- Emitting Diode Luminaires
Energy Technology Data Exchange (ETDEWEB)
Tarsa, Eric [Cree, Inc., Goleta, CA (United States)
2015-08-31
During this two-year program Cree developed a scalable, modular optical architecture for low-cost, high-efficacy light emitting diode (LED) luminaires. Stated simply, the goal of this architecture was to efficiently and cost-effectively convey light from LEDs (point sources) to broad luminaire surfaces (area sources). By simultaneously developing warm-white LED components and low-cost, scalable optical elements, a high system optical efficiency resulted. To meet program goals, Cree evaluated novel approaches to improve LED component efficacy at high color quality while not sacrificing LED optical efficiency relative to conventional packages. Meanwhile, efficiently coupling light from LEDs into modular optical elements, followed by optimally distributing and extracting this light, were challenges that were addressed via novel optical design coupled with frequent experimental evaluations. Minimizing luminaire bill of materials and assembly costs were two guiding principles for all design work, in the effort to achieve luminaires with significantly lower normalized cost ($/klm) than existing LED fixtures. Chief project accomplishments included the achievement of >150 lm/W warm-white LEDs having primary optics compatible with low-cost modular optical elements. In addition, a prototype Light Module optical efficiency of over 90% was measured, demonstrating the potential of this scalable architecture for ultra-high-efficacy LED luminaires. Since the project ended, Cree has continued to evaluate optical element fabrication and assembly methods in an effort to rapidly transfer this scalable, cost-effective technology to Cree production development groups. The Light Module concept is likely to make a strong contribution to the development of new cost-effective, high-efficacy luminaries, thereby accelerating widespread adoption of energy-saving SSL in the U.S.
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13 CFR 303.5 - Eligible administrative expenses.
2010-01-01
.... 303.5 Section 303.5 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE PLANNING INVESTMENTS AND COMPREHENSIVE ECONOMIC DEVELOPMENT STRATEGIES § 303.5 Eligible administrative expenses. In accordance with applicable Federal cost principles, Planning Investments may be used...
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Directory of Open Access Journals (Sweden)
Soumya Balasubramanya
Full Text Available Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood.In this paper we calculate the actual cost of sludge management from onsite latrines, and identify the contributions that latrine owners are willing to make to finance the costs. A spreadsheet-based model is used to identify a cost-effective transport option, and to calculate the cost per household. Then a double-bound contingent valuation method is used to elicit from pit-latrine owners their willingness-to-pay to have sludge transported away. This methodology is employed for the case of a rural subdistrict in Bangladesh called Bhaluka, a unit of administration at which sludge management services are being piloted by the Government of Bangladesh.The typical sludge accumulation rate in Bhaluka is calculated at 0.11 liters/person/day and a typical latrine will need to be emptied approximately once every 3 to 4 years. The costs of emptying and transport are high; approximately USD 13 per emptying event (circa 14% of average monthly income; household contributions could cover around 47% of this cost. However, if costs were spread over time, the service would cost USD 4 per year per household, or USD 0.31 per month per household-comparable to current expenditures of rural households on telecommunications.This is one of few research papers that brings the costs of waste management together with financing of that cost, to provide evidence for an implementable solution. This framework can be used to identify cost effective sludge management options and private contributions towards that cost
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Balasubramanya, Soumya; Evans, Barbara; Hardy, Richard; Ahmed, Rizwan; Habib, Ahasan; Asad, N S M; Rahman, Mominur; Hasan, M; Dey, Digbijoy; Fletcher, Louise; Camargo-Valero, Miller Alonso; Chaitanya Rao, Krishna; Fernando, Sudarshana
2017-01-01
Proper management of fecal sludge has significant positive health and environmental externalities. Most research on managing onsite sanitation so far either simulates the costs of, or the welfare effects from, managing sludge in situ in pit latrines. Thus, designing management strategies for onsite rural sanitation is challenging, because the actual costs of transporting sludge for treatment, and sources for financing these transport costs, are not well understood. In this paper we calculate the actual cost of sludge management from onsite latrines, and identify the contributions that latrine owners are willing to make to finance the costs. A spreadsheet-based model is used to identify a cost-effective transport option, and to calculate the cost per household. Then a double-bound contingent valuation method is used to elicit from pit-latrine owners their willingness-to-pay to have sludge transported away. This methodology is employed for the case of a rural subdistrict in Bangladesh called Bhaluka, a unit of administration at which sludge management services are being piloted by the Government of Bangladesh. The typical sludge accumulation rate in Bhaluka is calculated at 0.11 liters/person/day and a typical latrine will need to be emptied approximately once every 3 to 4 years. The costs of emptying and transport are high; approximately USD 13 per emptying event (circa 14% of average monthly income); household contributions could cover around 47% of this cost. However, if costs were spread over time, the service would cost USD 4 per year per household, or USD 0.31 per month per household-comparable to current expenditures of rural households on telecommunications. This is one of few research papers that brings the costs of waste management together with financing of that cost, to provide evidence for an implementable solution. This framework can be used to identify cost effective sludge management options and private contributions towards that cost in other
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Patents associated with high-cost drugs in Australia.
Directory of Open Access Journals (Sweden)
Andrew F Christie
Full Text Available Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent register to identify all the granted patents that cover the active pharmaceutical ingredient of the high-cost drugs. Then, we classify the patents by type, and identify their owners. We find a mean of 49 patents associated with each drug. Three-quarters of these patents are owned by companies other than the drug's originator. Surprisingly, the majority of all patents are owned by companies that do not have a record of developing top-selling drugs. Our findings show that a multitude of players seek monopoly control over innovations to blockbuster drugs. Consequently, attempts to control drug costs by mitigating misuse of the patent system are likely to miss the mark if they focus only on the patenting activities of originators.
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Patents associated with high-cost drugs in Australia.
Christie, Andrew F; Dent, Chris; McIntyre, Peter; Wilson, Lachlan; Studdert, David M
2013-01-01
Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent register to identify all the granted patents that cover the active pharmaceutical ingredient of the high-cost drugs. Then, we classify the patents by type, and identify their owners. We find a mean of 49 patents associated with each drug. Three-quarters of these patents are owned by companies other than the drug's originator. Surprisingly, the majority of all patents are owned by companies that do not have a record of developing top-selling drugs. Our findings show that a multitude of players seek monopoly control over innovations to blockbuster drugs. Consequently, attempts to control drug costs by mitigating misuse of the patent system are likely to miss the mark if they focus only on the patenting activities of originators.
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2010-01-01
... 7 Agriculture 4 2010-01-01 2010-01-01 false SFMNP costs. 249.12 Section 249.12 Agriculture....12 SFMNP costs. (a) General. (1) Composition of allowable costs. In general, a cost item will be... administration and operation of the SFMNP. Allowable SFMNP costs may be classified as follows: (i) Food costs and...
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Cost Evaluation of a Government-Conducted Oral Cholera Vaccination Campaign-Haiti, 2013.
Routh, Janell A; Sreenivasan, Nandini; Adhikari, Bishwa B; Andrecy, Lesly L; Bernateau, Margarette; Abimbola, Taiwo; Njau, Joseph; Jackson, Ernsley; Juin, Stanley; Francois, Jeannot; Tohme, Rania A; Meltzer, Martin I; Katz, Mark A; Mintz, Eric D
2017-10-01
The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government's first vaccine campaign implemented in August-September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed-our analyses suggested that approximately 2.5-6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.
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Constitutional and administrative paradigms in judicial control over EU high and low politics
DEFF Research Database (Denmark)
Cebulak, Pola
2017-01-01
This article explores the particular tensions surrounding judicial review in EU external relations. The tensions are classified using a two-dimensional framework. Firstly, a distinction based on policy domains of high and low politics, which is derived from constitutional theory, and external...... to the CJEU; and secondly a distinction based on legitimizing paradigms of administrative (EU as effective global actor) or constitutional (judicial review as guarantee of fundamental rights) in character and determined by the Court itself. Even though one would expect a dominance of the administrative...... paradigm in the domain of high politics, the Court uses both the administrative and the constitutional paradigm in its external relations case-law. The decision on which of these becomes the guiding frame seems to depend more on the policy domain, and be made case by case, which suggests politically...
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The high cost of low-acuity ICU outliers.
Dahl, Deborah; Wojtal, Greg G; Breslow, Michael J; Holl, Randy; Huguez, Debra; Stone, David; Korpi, Gloria
2012-01-01
Direct variable costs were determined on each hospital day for all patients with an intensive care unit (ICU) stay in four Phoenix-area hospital ICUs. Average daily direct variable cost in the four ICUs ranged from $1,436 to $1,759 and represented 69.4 percent and 45.7 percent of total hospital stay cost for medical and surgical patients, respectively. Daily ICU cost and length of stay (LOS) were higher in patients with higher ICU admission acuity of illness as measured by the APACHE risk prediction methodology; 16.2 percent of patients had an ICU stay in excess of six days, and these LOS outliers accounted for 56.7 percent of total ICU cost. While higher-acuity patients were more likely to be ICU LOS outliers, 11.1 percent of low-risk patients were outliers. The low-risk group included 69.4 percent of the ICU population and accounted for 47 percent of all LOS outliers. Low-risk LOS outliers accounted for 25.3 percent of ICU cost and incurred fivefold higher hospital stay costs and mortality rates. These data suggest that severity of illness is an important determinant of daily resource consumption and LOS, regardless of whether the patient arrives in the ICU with high acuity or develops complications that increase acuity. The finding that a substantial number of long-stay patients come into the ICU with low acuity and deteriorate after ICU admission is not widely recognized and represents an important opportunity to improve patient outcomes and lower costs. ICUs should consider adding low-risk LOS data to their quality and financial performance reports.
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32 CFR 33.22 - Allowable costs.
2010-07-01
... accounting standards that comply with cost principles acceptable to the Federal agency. ... Post-Award Requirements Financial Administration § 33.22 Allowable costs. (a) Limitation on use of... allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind of organization...
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The effect of high-dose dronabinol (oral THC) maintenance on cannabis self-administration.
Schlienz, Nicolas J; Lee, Dustin C; Stitzer, Maxine L; Vandrey, Ryan
2018-06-01
There is a clear need for advancing the treatment of cannabis use disorders. Prior research has demonstrated that dronabinol (oral THC) can dose-dependently suppress cannabis withdrawal and reduce the acute effects of smoked cannabis. The present study was conducted to evaluate whether high-dose dronabinol could reduce cannabis self-administration among daily users. Non-treatment seeking daily cannabis users (N = 13) completed a residential within-subjects crossover study and were administered placebo, low-dose dronabinol (120 mg/day; 40 mg tid), or high-dose dronabinol (180-240 mg/day; 60-80 mg tid) for 12 consecutive days (order counterbalanced). During each 12-day dronabinol maintenance phase, participants were allowed to self-administer smoked cannabis containing <1% THC (placebo) or 5.7% THC (active) under forced-choice (drug vs. money) or progressive ratio conditions. Participants self-administered significantly more active cannabis compared with placebo in all conditions. When active cannabis was available, self-administration was significantly reduced during periods of dronabinol maintenance compared with placebo maintenance. There was no difference in self-administration between the low- and high-dose dronabinol conditions. Chronic dronabinol dosing can reduce cannabis self-administration in daily cannabis users and suppress withdrawal symptoms. Cannabinoid agonist medications should continue to be explored for therapeutic utility in the treatment of cannabis use disorders. Copyright © 2018 Elsevier B.V. All rights reserved.
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Summaria, Francesco; Ciaralli, Fabrizio; Mustilli, Marina; Sette, Antonella; Lanzillo, Chiara; Vasselli, Loredana
2013-01-01
The compliance to statins in secondary prevention is very low, increasing health-care costs principally for rehospitalization. To evaluate the cost of lack of persistence to statin therapy together with identification and cost-estimation of poor compliance. Retrospective observational study starting from administrative database analysis of statin prescription after myocardial infarction. Among 463 patients enrolled, 25.1% were never treated, 70.8% received statins regularly; 14.9% received only 1-2 prescriptions (spot prescription), and 12% were occasional users. Among the 288 nonoccasional users, we found a compliance rate of 80% only in the 59.7%. The cost analysis shows that 59.787,72 euros (23.4%) have been spent for patients with compliance of less than 80% (ineffective adherence). As the lower compliance affects the health-care costs, the identification of occasional users and spot prescriptions of the nonoccasional users, has a potential role in reducing medical expense with limited increase in costs.
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Phronesis, a diagnosis and recovery tool for system administrators
Haen, Christophe; Neufeld, Niko
The administration of a large computer infrastructure is a great challenge in many aspects and requires experts in various domains to be successful. One criterion to which the users of a data center are directly exposed is the availability of the infrastructure. A high availability comes at the cost of constant and performant monitoring solutions as well as experts ready to diagnose and solve the problems. It is unfortunately not always possible to have an expert team constantly on site. This work presents a tool which is meant to support system administrators in their tasks by diagnosing problems, offering recovery solutions, and acting as a history and knowledge database. We will first detail what large data centers are composed of and what are the various competences that are required in order to successfully administrate them. This will lead us to consider the problems that are traditionally encountered by the administrators. Those problems are at the source of this project, and we will define our goals f...
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High Accuracy, Miniature Pressure Sensor for Very High Temperatures, Phase I
National Aeronautics and Space Administration — SiWave proposes to develop a compact, low-cost MEMS-based pressure sensor for very high temperatures and low pressures in hypersonic wind tunnels. Most currently...
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29 CFR 97.22 - Allowable costs.
2010-07-01
... accounting standards that comply with cost principles acceptable to the Federal agency. [53 FR 8069, 8087... LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 97.22 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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21 CFR 1403.22 - Allowable costs.
2010-04-01
.... Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with cost... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1403...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...
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Miller, Daniel F; Fortier, Christopher R; Garrison, Kelli L
2011-02-01
Bar code medication administration (BCMA) technology is gaining acceptance for its ability to prevent medication administration errors. However, studies suggest that improper use of BCMA technology can yield unsatisfactory error prevention and introduction of new potential medication errors. To evaluate the incidence of high-alert medication BCMA triggers and alert types and discuss the type of nursing and pharmacy workarounds occurring with the use of BCMA technology and the electronic medication administration record (eMAR). Medication scanning and override reports from January 1, 2008, through November 30, 2008, for all adult medical/surgical units were retrospectively evaluated for high-alert medication system triggers, alert types, and override reason documentation. An observational study of nursing workarounds on an adult medicine step-down unit was performed and an analysis of potential pharmacy workarounds affecting BCMA and the eMAR was also conducted. Seventeen percent of scanned medications triggered an error alert of which 55% were for high-alert medications. Insulin aspart, NPH insulin, hydromorphone, potassium chloride, and morphine were the top 5 high-alert medications that generated alert messages. Clinician override reasons for alerts were documented in only 23% of administrations. Observational studies assessing for nursing workarounds revealed a median of 3 clinician workarounds per administration. Specific nursing workarounds included a failure to scan medications/patient armband and scanning the bar code once the dosage has been removed from the unit-dose packaging. Analysis of pharmacy order entry process workarounds revealed the potential for missed doses, duplicate doses, and doses being scheduled at the wrong time. BCMA has the potential to prevent high-alert medication errors by alerting clinicians through alert messages. Nursing and pharmacy workarounds can limit the recognition of optimal safety outcomes and therefore workflow processes
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Training Physicians to Provide High-Value, Cost-Conscious Care A Systematic Review
Stammen, L.A.; Stalmeijer, R.E.; Paternotte, E.; Pool, A.O.; Driessen, E.W.; Scheele, F.; Stassen, L.P.S.
2015-01-01
Importance Increasing health care expenditures are taxing the sustainability of the health care system. Physicians should be prepared to deliver high-value, cost-conscious care. Objective To understand the circumstances in which the delivery of high-value, cost-conscious care is learned, with a goal
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Controlling costs without compromising quality: paying hospitals for total knee replacement.
Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J
2010-10-01
Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.
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Endo, Akira; Shiraishi, Atsushi; Fushimi, Kiyohide; Murata, Kiyoshi; Otomo, Yasuhiro
2017-06-07
The aim of this study was to evaluate the associations of severe trauma patient volume with survival benefit and health care costs. The effect of trauma patient volume on survival benefit is inconclusive, and reports on its effects on health care costs are scarce. We conducted a retrospective observational study, including trauma patients who were transferred to government-approved tertiary emergency hospitals, or hospitals with an intensive care unit that provided an equivalent quality of care, using a Japanese nationwide administrative database. We categorized hospitals according to their annual severe trauma patient volumes [1 to 50 (reference), 51 to 100, 101 to 150, 151 to 200, and ≥201]. We evaluated the associations of volume categories with in-hospital survival and total cost per admission using a mixed-effects model adjusting for patient severity and hospital characteristics. A total of 116,329 patients from 559 hospitals were analyzed. Significantly increased in-hospital survival rates were observed in the second, third, fourth, and highest volume categories compared with the reference category [94.2% in the highest volume category vs 88.8% in the reference category, adjusted odds ratio (95% confidence interval, 95% CI) = 1.75 (1.49-2.07)]. Furthermore, significantly lower costs (in US dollars) were observed in the second and fourth categories [mean (standard deviation) for fourth vs reference = $17,800 ($17,378) vs $20,540 ($32,412), adjusted difference (95% CI) = -$2559 (-$3896 to -$1221)]. Hospitals with high volumes of severe trauma patients were significantly associated with a survival benefit and lower total cost per admission.
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High Efficiency, Low Cost Scintillators for PET
International Nuclear Information System (INIS)
Kanai Shah
2007-01-01
Inorganic scintillation detectors coupled to PMTs are an important element of medical imaging applications such as positron emission tomography (PET). Performance as well as cost of these systems is limited by the properties of the scintillation detectors available at present. The Phase I project was aimed at demonstrating the feasibility of producing high performance scintillators using a low cost fabrication approach. Samples of these scintillators were produced and their performance was evaluated. Overall, the Phase I effort was very successful. The Phase II project will be aimed at advancing the new scintillation technology for PET. Large samples of the new scintillators will be produced and their performance will be evaluated. PET modules based on the new scintillators will also be built and characterized
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Innovative High-Performance Deposition Technology for Low-Cost Manufacturing of OLED Lighting
Energy Technology Data Exchange (ETDEWEB)
Scott, David; Hamer, John
2017-06-30
In this project, OLEDWorks developed and demonstrated the innovative high-performance deposition technology required to deliver dramatic reductions in the cost of manufacturing OLED lighting in production equipment. The current high manufacturing cost of OLED lighting is the most urgent barrier to its market acceptance. The new deposition technology delivers solutions to the two largest parts of the manufacturing cost problem – the expense per area of good product for organic materials and for the capital cost and depreciation of the equipment. Organic materials cost is the largest expense item in the bill of materials and is predicted to remain so through 2020. The high-performance deposition technology developed in this project, also known as the next generation source (NGS), increases material usage efficiency from 25% found in current Gen2 deposition technology to 60%. This improvement alone results in a reduction of approximately $25/m2 of good product in organic materials costs, independent of production volumes. Additionally, this innovative deposition technology reduces the total depreciation cost from the estimated value of approximately $780/m2 of good product for state-of-the-art G2 lines (at capacity, 5-year straight line depreciation) to $170/m2 of good product from the OLEDWorks production line.
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Fundamental understanding and development of low-cost, high-efficiency silicon solar cells
Energy Technology Data Exchange (ETDEWEB)
ROHATGI,A.; NARASIMHA,S.; MOSCHER,J.; EBONG,A.; KAMRA,S.; KRYGOWSKI,T.; DOSHI,P.; RISTOW,A.; YELUNDUR,V.; RUBY,DOUGLAS S.
2000-05-01
The overall objectives of this program are (1) to develop rapid and low-cost processes for manufacturing that can improve yield, throughput, and performance of silicon photovoltaic devices, (2) to design and fabricate high-efficiency solar cells on promising low-cost materials, and (3) to improve the fundamental understanding of advanced photovoltaic devices. Several rapid and potentially low-cost technologies are described in this report that were developed and applied toward the fabrication of high-efficiency silicon solar cells.
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A plan for administrative computing at ANL FY1991 through FY1993
Energy Technology Data Exchange (ETDEWEB)
Caruthers, L.E. (ed.); O' Brien, D.E.; Bretscher, M.E.; Hischier, R.C.; Moore, N.J.; Slade, R.G.
1990-10-01
In July of 1988, Argonne National Laboratory management approved the restructuring of Computing Services into the Computing and Telecommunications Division, part of the Physical Research area of the Laboratory. One major area of the Computing and Telecommunications Division is Management Information Systems (MIS). A significant aspect of Management Information Systems' work is the development of proposals for new and enhanced administrative computing systems based on an analysis of informational needs. This document represent the outcome of the planning process for FY1991 through FY1993. The introduction of the FY1991 through FY1993 Long-Range Plan assesses the state of administrative computing at ANL and the implications of FY1991 funding recommendations. It includes a history of MIS planning for administrative data processing. This document discusses the strategy and goals which are an important part of administrative data processing plans for the Laboratory. It also describes the management guidelines established by the Administrative Data Processing Oversight Committee for the proposal and implementation of administrative computing systems. Summaries of the proposals for new or enhanced administrative computing systems presented by individual divisions or departments with assistance of Management Information Systems, to the Administrative Data Processing Oversight Committee are given. The detailed tables in this paper give information on how much the resources to develop and implement a given systems will cost its users. The tables include development costs, computing/operations costs, software and hardware costs, and efforts costs. They include both systems funded by Laboratory General Expense and systems funded by the users themselves.
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Novel Low Cost, High Reliability Wind Turbine Drivetrain
Energy Technology Data Exchange (ETDEWEB)
Chobot, Anthony; Das, Debarshi; Mayer, Tyler; Markey, Zach; Martinson, Tim; Reeve, Hayden; Attridge, Paul; El-Wardany, Tahany
2012-09-13
Clipper Windpower, in collaboration with United Technologies Research Center, the National Renewable Energy Laboratory, and Hamilton Sundstrand Corporation, developed a low-cost, deflection-compliant, reliable, and serviceable chain drive speed increaser. This chain and sprocket drivetrain design offers significant breakthroughs in the areas of cost and serviceability and addresses the key challenges of current geared and direct-drive systems. The use of gearboxes has proven to be challenging; the large torques and bending loads associated with use in large multi-MW wind applications have generally limited demonstrated lifetime to 8-10 years [1]. The large cost of gearbox replacement and the required use of large, expensive cranes can result in gearbox replacement costs on the order of $1M, representing a significant impact to overall cost of energy (COE). Direct-drive machines eliminate the gearbox, thereby targeting increased reliability and reduced life-cycle cost. However, the slow rotational speeds require very large and costly generators, which also typically have an undesirable dependence on expensive rare-earth magnet materials and large structural penalties for precise air gap control. The cost of rare-earth materials has increased 20X in the last 8 years representing a key risk to ever realizing the promised cost of energy reductions from direct-drive generators. A common challenge to both geared and direct drive architectures is a limited ability to manage input shaft deflections. The proposed Clipper drivetrain is deflection-compliant, insulating later drivetrain stages and generators from off-axis loads. The system is modular, allowing for all key parts to be removed and replaced without the use of a high capacity crane. Finally, the technology modularity allows for scalability and many possible drivetrain topologies. These benefits enable reductions in drivetrain capital cost by 10.0%, levelized replacement and O&M costs by 26.7%, and overall cost of
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Bevacizumab in Treatment of High-Risk Ovarian Cancer—A Cost-Effectiveness Analysis
Herzog, Thomas J.; Hu, Lilian; Monk, Bradley J.; Kiet, Tuyen; Blansit, Kevin; Kapp, Daniel S.; Yu, Xinhua
2014-01-01
Objective. The objective of this study was to evaluate a cost-effectiveness strategy of bevacizumab in a subset of high-risk advanced ovarian cancer patients with survival benefit. Methods. A subset analysis of the International Collaboration on Ovarian Neoplasms 7 trial showed that additions of bevacizumab (B) and maintenance bevacizumab (mB) to paclitaxel (P) and carboplatin (C) improved the overall survival (OS) of high-risk advanced cancer patients. Actual and estimated costs of treatment were determined from Medicare payment. Incremental cost-effectiveness ratio per life-year saved was established. Results. The estimated cost of PC is $535 per cycle; PCB + mB (7.5 mg/kg) is $3,760 per cycle for the first 6 cycles and then $3,225 per cycle for 12 mB cycles. Of 465 high-risk stage IIIC (>1 cm residual) or stage IV patients, the previously reported OS after PC was 28.8 months versus 36.6 months in those who underwent PCB + mB. With an estimated 8-month improvement in OS, the incremental cost-effectiveness ratio of B was $167,771 per life-year saved. Conclusion. In this clinically relevant subset of women with high-risk advanced ovarian cancer with overall survival benefit after bevacizumab, our economic model suggests that the incremental cost of bevacizumab was approximately $170,000. PMID:24721817
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28 CFR 43.1 - Administrative determination and assertion of claims.
2010-07-01
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Administrative determination and assertion of claims. 43.1 Section 43.1 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) RECOVERY OF COST OF HOSPITAL AND MEDICAL CARE AND TREATMENT FURNISHED BY THE UNITED STATES § 43.1 Administrative...
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DEFF Research Database (Denmark)
Lundqvist, C.; Beiske, A. G.; Reiertsen, O.
2014-01-01
Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... was the dominant cost during IDL (45 % of total costs), it represented only 6.4 % of the total for conventional treatment. IDL improves function but is not cost effective using recommended thresholds for cost/QALY in Norway.......Advanced-stage Parkinson's disease (PD) strongly affects quality of life (QoL). Continuous intraduodenal administration of levodopa (IDL) is efficacious, but entails high costs. This study aims to estimate these costs in routine care. 10 patients with advanced-PD who switched from oral medication...... to IDL were assessed at baseline, and subsequently at 3, 6, 9 and 12 months follow-up. We used the Unified PD Rating Scale (UPDRS) for function and 15D for Quality of Life (QoL). Costs were assessed using quarterly structured patient questionnaires and hospital registries. Costs per quality adjusted life...
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The high intensity solar cell: Key to low cost photovoltaic power
Sater, B. L.; Goradia, C.
1975-01-01
The design considerations and performance characteristics of the 'high intensity' (HI) solar cell are presented. A high intensity solar system was analyzed to determine its cost effectiveness and to assess the benefits of further improving HI cell efficiency. It is shown that residential sized systems can be produced at less than $1000/kW peak electric power. Due to their superior high intensity performance characteristics compared to the conventional and VMJ cells, HI cells and light concentrators may be the key to low cost photovoltaic power.
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45 CFR 1180.56 - Allowable costs.
2010-10-01
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Allowable costs. 1180.56 Section 1180.56 Public... by a Grantee General Administrative Responsibilities § 1180.56 Allowable costs. (a) Determination of costs allowable under a grant is made in accordance with government-wide cost principles in applicable...
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2010-01-01
... research and development except where: (1) A research or development activity of a basic or fundamental... with the applicable cost principles: (i) Cash; (ii) Personnel costs; (iii) The value of a service... circular of the Office of Management and Budget; (iv) Indirect costs or facilities and administrative costs...
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Capital and operating cost estimates for high temperature superconducting magnetic energy storage
International Nuclear Information System (INIS)
Schoenung, S.M.; Meier, W.R.; Fagaly, R.L.; Heiberger, M.; Stephens, R.B.; Leuer, J.A.; Guzman, R.A.
1992-01-01
Capital and operating costs have been estimated for mid-scale (2 to 200 Mwh) superconducting magnetic energy storage (SMES) designed to use high temperature superconductors (HTS). Capital costs are dominated by the cost of superconducting materials. Operating costs, primarily for regeneration, are significantly reduced for HTS-SMES in comparison to low temperature, conventional systems. This cost component is small compared to other O and M and capital components, when levelized annual costs are projected. In this paper, the developments required for HTS-SMES feasibility are discussed
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41 CFR 105-71.122 - Allowable costs.
2010-07-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... GOVERNMENTS 71.12-Post-Award Requirements/Financial Administration § 105-71.122 Allowable costs. (a... increment above allowable costs) to the grantee or subgrantee. (b) Applicable cost principles. For each kind...
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25 CFR 39.1002 - Allotment of education administrative funds.
2010-04-01
... 25 Indians 1 2010-04-01 2010-04-01 false Allotment of education administrative funds. 39.1002 Section 39.1002 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Administrative Cost Formula § 39.1002 Allotment of education administrative funds. The...
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Constitutional and administrative paradigms in judicial control over EU high and low politics
Directory of Open Access Journals (Sweden)
Cebulak Pola
2017-11-01
Full Text Available This article explores the particular tensions surrounding judicial review in EU external relations. The tensions are classified using a two-dimensional framework. Firstly, a distinction based on policy domains of high and low politics, which is derived from constitutional theory, and external to the CJEU; and secondly a distinction based on legitimizing paradigms of administrative (EU as effective global actor or constitutional (judicial review as guarantee of fundamental rights in character and determined by the Court itself. Even though one would expect a dominance of the administrative paradigm in the domain of high politics, the Court uses both the administrative and the constitutional paradigm in its external relations case-law. The decision on which of these becomes the guiding frame seems to depend more on the policy domain, and be made case by case, which suggests politically sensitive adjudication, rather than a coherent approach to legitimizing the nascent judicial review in EU external relations.
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Parents and the High Cost of Child Care: 2012 Report
Child Care Aware of America, 2012
2012-01-01
"Parents and the High Cost of Child Care: 2012 Report" presents 2011 data reflecting what parents pay for full-time child care in America. It includes average fees for both child care centers and family child care homes. Information was collected through a survey conducted in January 2012 that asked for the average costs charged for…
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Average System Cost Methodology : Administrator's Record of Decision.
Energy Technology Data Exchange (ETDEWEB)
United States. Bonneville Power Administration.
1984-06-01
Significant features of average system cost (ASC) methodology adopted are: retention of the jurisdictional approach where retail rate orders of regulartory agencies provide primary data for computing the ASC for utilities participating in the residential exchange; inclusion of transmission costs; exclusion of construction work in progress; use of a utility's weighted cost of debt securities; exclusion of income taxes; simplification of separation procedures for subsidized generation and transmission accounts from other accounts; clarification of ASC methodology rules; more generous review timetable for individual filings; phase-in of reformed methodology; and each exchanging utility must file under the new methodology within 20 days of implementation by the Federal Energy Regulatory Commission of the ten major participating utilities, the revised ASC will substantially only affect three. (PSB)
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10 CFR 600.222 - Allowable costs.
2010-01-01
... part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...
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Cost/CYP: a bottom line that helps keep CSM projects cost-efficient.
1985-01-01
In contraceptive social marketing (CSM), the objective is social good, but project managers also need to run a tight ship, trimming costs, allocating scarce funds, and monitoring their program's progress. 1 way CSM managers remain cost-conscious is through the concept of couple-years-of-protection (CYP). Devised 2 decades ago as an administrative tool to compare the effects of different contraceptive methods, CYP's uses have multiplied to include assessing program output and cost effectiveness. Some of the factors affecting cost/CYP are a project's age, sales volume, management efficiency, and product prices and line. These factors are interconnected. The cost/CYP figures given here do not include outlays for commodities. While the Agency for International Development's commodity costs alter slightly with each new purchase contrast, the agency reports that a condom costs about 4 cents (US), an oral contraceptive (OC) cycle about 12 cents, and a spermicidal tablet about 7 cents. CSM projects have relatively high start-up costs. Within a project's first 2 years, expenses must cover such marketing activities as research, packaging, warehousing, and heavy promotion. As a project ages, sales should grow, producing revenues that gradually amortize these initial costs. The Nepal CSM project provides an example of how cost/CYP can improve as a program ages. In 1978, the year sales began, the project's cost/CYP was about $84. For some time the project struggled to get its products to its target market and gradually overcome several major hurdles. The acquisition of jeeps eased distribution and, by adding another condom brand, sales were increased still more, bringing the cost/CYP down to $8.30 in 1981. With further sales increases and resulting revenues, the cost/CYP dropped to just over $7 in 1983. When the sales volume becomes large enough, CSM projects can achieve economies of scale, which greatly improves cost-efficiency. Fixed costs shrink as a proportion of total
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13 CFR 143.22 - Allowable costs.
2010-01-01
... to that circular 48 CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting... Financial Administration § 143.22 Allowable costs. (a) Limitation on use of funds. Grant funds may be used... grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a set of...
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29 CFR 1470.22 - Allowable costs.
2010-07-01
... to that circular 48 CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting... Financial Administration § 1470.22 Allowable costs. (a) Limitation on use of funds. Grant funds may be used... grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a set of...
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45 CFR 92.22 - Allowable costs.
2010-10-01
... to that circular 48 CFR Part 31. Contract Cost Principles and Procedures, or uniform cost accounting... Financial Administration § 92.22 Allowable costs. (a) Limitation on use of funds. Grant funds may be used... grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a set of...
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Japanese management. Implications for nursing administration.
Smith, H L; Reinow, F D; Reid, R A
1984-09-01
Does Japanese management possess sufficient practical validity to warrant retraining of nursing administrators and their staffs? Can Japanese management really address the complexities of contemporary nursing administration? Before espousing the benefits of Theory Z and implementing quality circles in your hospital, read this analysis of the advantages and disadvantages of Japanese management--the benefits can be substantial but so can the costs!
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Directory of Open Access Journals (Sweden)
Kenan Isik
2017-01-01
Full Text Available Cost is an important consideration when transferring a technology from research to industrial and educational use. In this paper, we introduce the design of an industrial grade series elastic actuator (SEA performed via re-engineering a research grade version of it. Cost-constrained design requires careful consideration of the key performance parameters for an optimal performance-to-cost component selection. To optimize the performance of the new design, we started by matching the capabilities of a high-performance SEA while cutting down its production cost significantly. Our posit was that performing a re-engineering design process on an existing high-end device will significantly reduce the cost without compromising the performance drastically. As a case study of design for manufacturability, we selected the University of Texas Series Elastic Actuator (UT-SEA, a high-performance SEA, for its high power density, compact design, high efficiency and high speed properties. We partnered with an industrial corporation in China to research the best pricing options and to exploit the retail and production facilities provided by the Shenzhen region. We succeeded in producing a low-cost industrial grade actuator at one-third of the cost of the original device by re-engineering the UT-SEA with commercial off-the-shelf components and reducing the number of custom-made parts. Subsequently, we conducted performance tests to demonstrate that the re-engineered product achieves the same high-performance specifications found in the original device. With this paper, we aim to raise awareness in the robotics community on the possibility of low-cost realization of low-volume, high performance, industrial grade research and education hardware.
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Innovative Applications of DoD Propulsion Technology for Low-Cost Satellite Missions, Phase II
National Aeronautics and Space Administration — We are proposing to leverage the Missile Defense Agency investments in high-performance propulsion systems for low-cost space missions with large Dv requirements,...
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Energy Technology Data Exchange (ETDEWEB)
Frew, Bethany A. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Clark, Kara [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bloom, Aaron P. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Milligan, Michael [National Renewable Energy Lab. (NREL), Golden, CO (United States)
2017-12-02
A common approach to regulating electricity is through auction-based competitive wholesale markets. The goal of this approach is to provide a reliable supply of power at the lowest reasonable cost to the consumer. This necessitates market structures and operating rules that ensure revenue sufficiency for all generators needed for resource adequacy purposes. Wholesale electricity markets employ marginal-cost pricing to provide cost-effective dispatch such that resources are compensated for their operational costs. However, marginal-cost pricing alone cannot guarantee cost recovery outside of perfect competition, and electricity markets have at least six attributes that preclude them from functioning as perfectly competitive markets. These attributes include market power, externalities, public good attributes, lack of storage, wholesale price caps, and ineffective demand curve. Until (and unless) these failures are ameliorated, some form of corrective action(s) will be necessary to improve market efficiency so that prices can correctly reflect the needed level of system reliability. Many of these options necessarily involve some form of administrative or out-of-market actions, such as scarcity pricing, capacity payments, bilateral or other out-of-market contracts, or some hybrid combination. A key focus with these options is to create a connection between the electricity market and long-term reliability/loss-of-load expectation targets, which are inherently disconnected in the native markets because of the aforementioned market failures. The addition of variable generation resources can exacerbate revenue sufficiency and resource adequacy concerns caused by these underlying market failures. Because variable generation resources have near-zero marginal costs, they effectively suppress energy prices and reduce the capacity factors of conventional generators through the merit-order effect in the simplest case of a convex market; non-convexities can also suppress prices.
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Cost of Mastitis in Scottish Dairy Herds with Low and High Subclinical Mastitis Problems
YALÇIN, Cengiz
2000-01-01
The aim of this study was to estimate the cost of mastitis and the contribution of each cost component of mastitis to the total mastitis induced cost in herds with low and high levels of subclinical mastitis under Scottish field conditions. It was estimated that mastitis cost £140 per cow/year to the average Scottish dairy farmer in 1996. However, this figure was as low as £69 per cow/year in herds with lower levels of subclinical mastitis, and as high as £228 cow/year in herds with high s...
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Political-administrative approaches towards energy-environment issues
International Nuclear Information System (INIS)
Degli Espinosa, P.
1992-01-01
A discussion is made of how Italian regional administrations could best approach the implementation of environmental strategies mirroring those proposed by the United Nations, especially those calling for a rapid reduction in carbon dioxide emissions to abate the risk of greenhouse gas induced climate change. Citing the current difficulties being had by the Italian national government in securing adequate funding to allow the fulfillment of already legislated and urgently needed energy conservation/environmental protection proposals, this paper calls for greater involvement and high level of social awareness on the part of regional governments. It is noted that, within the Italian context, the best approach towards the cost effective implementation of energy conservation/environmental protection strategies is to have a combined effort, involving municipally run power and gas utilities and transport departments acting together with concerned citizens, under the direct management of regional administrations
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Building Fit-for-Purpose Land Administration Systems
DEFF Research Database (Denmark)
Enemark, Stig; Bell, Keith; Lemmen, Christiaan
2014-01-01
Arguably sound land governance is the key to achieve sustainable development and to support the global agenda set by adoption of the Millennium Development Goals (MDGs). The operational component of land governance is the country specific land administration systems dealing with the four key...... functions of land tenure, land value, land, and land development. Land administration systems - whether highly advanced or very basic – require a land parcel framework to operate. Building such a land parcel framework – showing the way land is divided into parcels and plots for specific use and possession...... no. 60 on “Fit-for-Purpose Land Administration”. It is argued that the land parcel framework should be developed using a flexible and fit-for-purpose approach rather than being guided by costly field survey procedures or over-engineered technology solutions. When considering the resources...
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Low Cost, Low Power, High Sensitivity Magnetometer
2008-12-01
which are used to measure the small magnetic signals from brain. Other types of vector magnetometers are fluxgate , coil based, and magnetoresistance...concentrator with the magnetometer currently used in Army multimodal sensor systems, the Brown fluxgate . One sees the MEMS fluxgate magnetometer is...Guedes, A.; et al., 2008: Hybrid - LOW COST, LOW POWER, HIGH SENSITIVITY MAGNETOMETER A.S. Edelstein*, James E. Burnette, Greg A. Fischer, M.G
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Low-dosage epoetin in maintenance haemodialysis: costs and quality-of-life improvement.
Harris, D C
1994-01-01
Decisions about epoetin (recombinant human erythropoetin) dosage and target haematocrit in dialysis patients have been determined largely by the high acquisition cost of epoetin, but are made with incomplete knowledge about which target haematocrit gives the optimum clinical benefit. Haematopoietic response to epoetin may be determined by pharmacodynamic factors such as rate and frequency of administration, as well as by individual patient characteristics such as ethnicity. Resistance to epoetin may be due to iron or vitamin deficiency, natural or exogenous inhibitors of erythropoiesis and bone marrow fibrosis. The high acquisition cost of epoetin must be considered along with a number of other factors that can influence the true cost of epoetin treatment. Hidden costs of epoetin treatment include administration costs, changes in other treatments, extra laboratory tests and adverse events. Administration costs and extra laboratory surveillance add little to overall cost. Depletion of iron stores, hypertension, increased blood coagulability and reduced dialyser efficiency resulting from epoetin treatment may all add a small additional component to the true cost. Severe complications with significant cost implications are rare. Amongst the various components of true cost, only the acquisition cost can definitely be reduced by low dosage treatment. Balanced against the true and potential costs of epoetin are a number of benefits which can result in potential savings. The need for blood transfusion is all but abolished, avoiding the cost of transfusion and its complications. Sensitisation against histocompatibility antigens is reduced by avoiding transfusion, and so the waiting time for cadaveric transplantation may be reduced. Rates of hospitalisation for all causes, especially those associated with anaemia, may be reduced by epoetin treatment. By improving well-being, epoetin may allow patients to be transferred to minimal-care units or home where dialysis can be
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Low cost, high yield IFE reactors: Revisiting Velikhov's vaporizing blankets
International Nuclear Information System (INIS)
Logan, B.G.
1992-01-01
The performance (efficiency and cost) of IFE reactors using MHD conversion is explored for target blanket shells of various materials vaporized and ionized by high fusion yields (5 to 500 GJ). A magnetized, prestressed reactor chamber concept is modeled together with previously developed models for the Compact Fusion Advanced Rankine II (CFARII) MHD Balance-of-Plant (BoP). Using conservative 1-D neutronics models, high fusion yields (20 to 80 GJ) are found necessary to heat Flibe, lithium, and lead-lithium blankets to MHD plasma temperatures, at initial solid thicknesses sufficient to capture most of the fusion yield. Advanced drivers/targets would need to be developed to achieve a ''Bang per Buck'' figure-of-merit approx-gt 20 to 40 joules yield per driver $ for this scheme to be competitive with these blanket materials. Alternatively, more realistic neutronics models and better materials such as lithium hydride may lower the minimum required yields substantially. The very low CFARII BoP costs (contributing only 3 mills/kWehr to CoE) allows this type of reactor, given sufficient advances that non-driver costs dominate, to ultimately produce electricity at a much lower cost than any current nuclear plant
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38 CFR 43.22 - Allowable costs.
2010-07-01
... accounting standards that comply with cost principles acceptable to the Federal agency. ... Requirements Financial Administration § 43.22 Allowable costs. (a) Limitation on use of funds. Grant funds may... the grantee or subgrantee. (b) Applicable cost principles. For each kind of organization, there is a...
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7 CFR 3016.22 - Allowable costs.
2010-01-01
... uniform cost accounting standards that comply with cost principles acceptable to the Federal agency. ... Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF... GOVERNMENTS Post-Award Requirements Financial Administration § 3016.22 Allowable costs. (a) Limitation on use...
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45 CFR 1157.22 - Allowable costs.
2010-10-01
... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1157.22... cost principles. For each kind of organization, there is a set of Federal principles for determining...
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20 CFR 437.22 - Allowable costs.
2010-04-01
... CFR Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 437...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...
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45 CFR 1174.22 - Allowable costs.
2010-10-01
... Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1174...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...
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45 CFR 1183.22 - Allowable costs.
2010-10-01
... Part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply with... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 1183...) Applicable cost principles. For each kind of organization, there is a set of Federal principles for...
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43 CFR 12.927 - Allowable costs.
2010-10-01
... 48 CFR part 31, Contract Principles and Procedures or uniform cost accounting standards that comply... COST PRINCIPLES FOR ASSISTANCE PROGRAMS Uniform Administrative Requirements for Grants and Agreements... Circular A-87, Cost Principles for State and Local Governments. Non-profit organization OMB Circular A-122...
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A high-performance, low-cost, leading edge discriminator
Indian Academy of Sciences (India)
Abstract. A high-performance, low-cost, leading edge discriminator has been designed with a timing performance comparable to state-of-the-art, commercially available discrim- inators. A timing error of 16 ps is achieved under ideal operating conditions. Under more realistic operating conditions the discriminator displays a ...
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Many Mobile Health Apps Target High-Need, High-Cost Populations, But Gaps Remain.
Singh, Karandeep; Drouin, Kaitlin; Newmark, Lisa P; Lee, JaeHo; Faxvaag, Arild; Rozenblum, Ronen; Pabo, Erika A; Landman, Adam; Klinger, Elissa; Bates, David W
2016-12-01
With rising smartphone ownership, mobile health applications (mHealth apps) have the potential to support high-need, high-cost populations in managing their health. While the number of available mHealth apps has grown substantially, no clear strategy has emerged on how providers should evaluate and recommend such apps to patients. Key stakeholders, including medical professional societies, insurers, and policy makers, have largely avoided formally recommending apps, which forces patients to obtain recommendations from other sources. To help stakeholders overcome barriers to reviewing and recommending apps, we evaluated 137 patient-facing mHealth apps-those intended for use by patients to manage their health-that were highly rated by consumers and recommended by experts and that targeted high-need, high-cost populations. We found that there is a wide variety of apps in the marketplace but that few apps address the needs of the patients who could benefit the most. We also found that consumers' ratings were poor indications of apps' clinical utility or usability and that most apps did not respond appropriately when a user entered potentially dangerous health information. Going forward, data privacy and security will continue to be major concerns in the dissemination of mHealth apps. Project HOPE—The People-to-People Health Foundation, Inc.
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48 CFR 30.101 - Cost Accounting Standards.
2010-10-01
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.101 Cost Accounting Standards. (a... Accounting Standards (CAS) and to disclose in writing and follow consistently their cost accounting practices...
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48 CFR 30.603 - Changes to disclosed or established cost accounting practices.
2010-10-01
... established cost accounting practices. 30.603 Section 30.603 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.603 Changes to disclosed or established cost accounting practices. ...
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Sanders, Barbara P.; Edo-Matas, Diana; Custers, Jerome H. H. V.; Koldijk, Martin H.; Klaren, Vincent; Turk, Marije; Luitjens, Alfred; Bakker, Wilfried A. M.; Uytdehaag, Fons; Goudsmit, Jaap; Lewis, John A.; Schuitemaker, Hanneke
2013-01-01
There are two highly efficacious poliovirus vaccines: Sabin's live-attenuated oral polio vaccine (OPV) and Salk's inactivated polio vaccine (IPV). OPV can be made at low costs per dose and is easily administrated. However, the major drawback is the frequent reversion of the OPV vaccine strains to
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Public high school teachers opinions on school administrators supervision duty in Turkey
Directory of Open Access Journals (Sweden)
Nurhayat Celebi
2010-09-01
Full Text Available Supervision that has been conducted by public high school administrators plays a major role in the effectiveness of a school.Lack of having well defined criteria is thought to be causing some major problems in the educational environment. Subjectivity,administrative policy constraints, lack of teacher motivation and lack of job satisfaction are only a few examples of those kindsof problems. The study, which is based on the scanning model and a descriptive research, was performed on 303 teachersworking in randomly chosen high schools in the Bakırköy district of İstanbul. The data collection instrument was developed bythe researcher. The confirmatory factor analysis test was used to determine whether the scale confirm to the factor structureor not. It was noticed that the factor structure could be explained with 5 factor sub-dimensions, and accordingly, the measuringscale, which had been originally prepared in 45 items, was modified and reduced to 32 items. As a result of factor analysis, thefactors were confirmed as follows; “the leadership, supervision techniques, effective supervision, efficacy of administration andteaching quality”. All these factors are explain about 48 % for total test variance. Cronbach alpha internal consistency factorwhich has been calculated according to the reliability analysis and it’s value was ,90. Factor loadings of sub- dimensions arebetween ,41 and ,81. In accordance with the results, training programs must be applied regularly to the administrators in orderto enable them to acquire more supervision attitude and to increase the efficiency and quality levels of the schools
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Developing a standardized healthcare cost data warehouse.
Visscher, Sue L; Naessens, James M; Yawn, Barbara P; Reinalda, Megan S; Anderson, Stephanie S; Borah, Bijan J
2017-06-12
Research addressing value in healthcare requires a measure of cost. While there are many sources and types of cost data, each has strengths and weaknesses. Many researchers appear to create study-specific cost datasets, but the explanations of their costing methodologies are not always clear, causing their results to be difficult to interpret. Our solution, described in this paper, was to use widely accepted costing methodologies to create a service-level, standardized healthcare cost data warehouse from an institutional perspective that includes all professional and hospital-billed services for our patients. The warehouse is based on a National Institutes of Research-funded research infrastructure containing the linked health records and medical care administrative data of two healthcare providers and their affiliated hospitals. Since all patients are identified in the data warehouse, their costs can be linked to other systems and databases, such as electronic health records, tumor registries, and disease or treatment registries. We describe the two institutions' administrative source data; the reference files, which include Medicare fee schedules and cost reports; the process of creating standardized costs; and the warehouse structure. The costing algorithm can create inflation-adjusted standardized costs at the service line level for defined study cohorts on request. The resulting standardized costs contained in the data warehouse can be used to create detailed, bottom-up analyses of professional and facility costs of procedures, medical conditions, and patient care cycles without revealing business-sensitive information. After its creation, a standardized cost data warehouse is relatively easy to maintain and can be expanded to include data from other providers. Individual investigators who may not have sufficient knowledge about administrative data do not have to try to create their own standardized costs on a project-by-project basis because our data
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Cheap imports next ordeal for Europe's high-cost producers
International Nuclear Information System (INIS)
Chynoweth, E.
1993-01-01
About one-third of Europe's 34 cracker and downstream units lost money in the final quarter of 1992, says Chem Systems (London). Average return on capital employed is negative - at the same level as in the gloomy days of the early 1980s - yet average operating rates are 80% now, compared with 65% a decade ago. Margins at what Chem Systems calls leader cracks (naphtha-based units that use good modern practices) are DM42/m.t. ethylene, DM100/m.t. less than they were in 1991. The consultant firm's recent report, European Petrochemical Strategy in the 1990s, suggests closure of 5%-10% of high-cost production. But, Chem Systems director Roger Longley states: We are not advocating wholesale closure. There are a small number (of plants) where additional investment would not payback that would be economical to shut. Cost reduction through mergers and acquisitions and operational changes is much more important, especially from an international aspect, Longley says. One thing people do not fully appreciate is that Europe is a high-cost region for petrochemical production, he adds. Traditionally, Europe exports 5% of its ethylene output, now it needs to tolerate cheap imports
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40 CFR 31.22 - Allowable costs.
2010-07-01
... accounting standards that comply with cost principles acceptable to the Federal agency. ... Requirements Financial Administration § 31.22 Allowable costs. (a) Limitation on use of funds. Grant funds may... the grantee or sub-grantee. (b) Applicable cost principles. For each kind of organization, there is a...
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34 CFR 80.22 - Allowable costs.
2010-07-01
... CFR part 31. Contract Cost Principles and Procedures, or uniform cost accounting standards that comply... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 80.22... kind of organization, there is a set of Federal principles for determining allowable costs. For the...
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49 CFR 18.22 - Allowable costs.
2010-10-01
... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 18.22... cost principles. For each kind of organization, there is a set of Federal principles for determining...
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28 CFR 100.14 - Directly allocable costs.
2010-07-01
... in accordance with the accounting principles used by the carrier in the preparation of their... costs is the cost accounting period during which such costs are incurred and accumulated for... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Directly allocable costs. 100.14 Section...
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18 CFR 301.7 - Average System Cost methodology functionalization.
2010-04-01
... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Average System Cost... REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST METHODOLOGY FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER...
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Cost-effectiveness Analysis of Antipsychotic Combination Therapy in Schizophrenia Inpatients
Directory of Open Access Journals (Sweden)
Rizky Abdulah
2017-03-01
Full Text Available Schizophrenia is one of mental disorders with high cost and lifetime morbidity risk. Hence, it is necessary to analyze the cost-effectiveness of various combinations of antipsychotics. The aim of this study was to analyze the most cost-effective group of antipsychotic combinations in schizophrenia inpatients in West Java Psychiatric Hospital during 2012–2013. Data were collected retrospectively from medical record of patients who used antipsychotics clozapine-haloperidol or clozapine-risperidone therapy. Direct medical costs were obtained from antipsychotics costs, costs of medical treatment, medical expenses, hospitalization costs, and administrative costs. The results showed that the average cost-effectiveness ratio of antipsychotic clozapine-haloperidol was Rp126.898/day and Rp132.781/day for the combination of clozapine-haloperidol and clozapine-risperidone, respectively. Considering length of stay as the therapy effectiveness, it can be concluded that the combination of clozapine-haloperidol is more cost-effective than clozapine-risperidone.
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Northeast Commercial Fishing Vessel Cost Survey
National Oceanic and Atmospheric Administration, Department of Commerce — Typically, commercial fishing businesses incur three major types of costs: fixed or annual costs; which are incurred annually irrespective of whether any fishing...
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Considerations on a Cost Model for High-Field Dipole Arc Magnets for FCC
AUTHOR|(CDS)2078700; Durante, Maria; Lorin, Clement; Martinez, Teresa; Ruuskanen, Janne; Salmi, Tiina; Sorbi, Massimo; Tommasini, Davide; Toral, Fernando
2017-01-01
In the frame of the European Circular Collider (EuroCirCol), a conceptual design study for a post-Large Hadron Collider (LHC) research infrastructure based on an energy-frontier 100 TeV circular hadron collider [1]–[3], a cost model for the high-field dipole arc magnets is being developed. The aim of the cost model in the initial design phase is to provide the basis for sound strategic decisions towards cost effective designs, in particular: (A) the technological choice of superconducting material and its cost, (B) the target performance of Nb$_{3}$Sn superconductor, (C) the choice of operating temperature (D) the relevant design margins and their importance for cost, (E) the nature and extent of grading, and (F) the aperture’s influence on cost. Within the EuroCirCol study three design options for the high field dipole arc magnets are under study: cos − θ [4], block [5], and common-coil [6]. Here, in the advanced design phase, a cost model helps to (1) identify the cost drivers and feed-back this info...
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Considerations on a Cost Model for High-Field Dipole Arc Magnets for FCC
AUTHOR|(CDS)2078700; Durante, Maria; Lorin, Clement; Martinez, Teresa; Ruuskanen, Janne; Salmi, Tiina; Sorbi, Massimo; Tommasini, Davide; Toral, Fernando
2017-01-01
In the frame of the European Circular Collider (EuroCirCol), a conceptual design study for a post-Large Hadron Collider (LHC) research infrastructure based on an energy-frontier 100 TeV circular hadron collider [1]–[3], a cost model for the high-field dipole arc magnets is being developed. The aim of the cost model in the initial design phase is to provide the basis for sound strategic decisions towards cost effective designs, in particular: (A) the technological choice of superconducting material and its cost, (B) the target performance of Nb3Sn superconductor, (C) the choice of operating temperature (D) the relevant design margins and their importance for cost, (E) the nature and extent of grading, and (F) the aperture’s influence on cost. Within the EuroCirCol study three design options for the high field dipole arc magnets are under study: cos − θ [4], block [5], and common-coil [6]. Here, in the advanced design phase, a cost model helps to (1) identify the cost drivers and feed-back this informati...
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Energy Technology Data Exchange (ETDEWEB)
Stettenheim, Joel [Norwich Technologies, White River Junction, VT (United States)
2016-02-29
Norwich Technologies (NT) is developing a disruptively superior solar field for trough concentrating solar power (CSP). Troughs are the leading CSP technology (85% of installed capacity), being highly deployable and similar to photovoltaic (PV) systems for siting. NT has developed the SunTrap receiver, a disruptive alternative to vacuum-tube concentrating solar power (CSP) receivers, a market currently dominated by the Schott PTR-70. The SunTrap receiver will (1) operate at higher temperature (T) by using an insulated, recessed radiation-collection system to overcome the energy losses that plague vacuum-tube receivers at high T, (2) decrease acquisition costs via simpler structure, and (3) dramatically increase reliability by eliminating vacuum. It offers comparable optical efficiency with thermal loss reduction from ≥ 26% (at presently standard T) to ≥ 55% (at high T), lower acquisition costs, and near-zero O&M costs.
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Segmentation of low‐cost high efficiency oxide‐based thermoelectric materials
DEFF Research Database (Denmark)
Le, Thanh Hung; Van Nong, Ngo; Linderoth, Søren
2015-01-01
Thermoelectric (TE) oxide materials have attracted great interest in advanced renewable energy research owing to the fact that they consist of abundant elements, can be manufactured by low-cost processing, sustain high temperatures, be robust and provide long lifetime. However, the low conversion...... efficiency of TE oxides has been a major drawback limiting these materials to broaden applications. In this work, theoretical calculations are used to predict how segmentation of oxide and semimetal materials, utilizing the benefits of both types of materials, can provide high efficiency, high temperature...... oxide-based segmented legs. The materials for segmentation are selected by their compatibility factors and their conversion efficiency versus material cost, i.e., “efficiency ratio”. Numerical modelling results showed that conversion efficiency could reach values of more than 10% for unicouples using...
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Kawalec, Paweł; Holko, Przemysław; Szkultecka-Debek, Monika; Paszulewicz, Anna; Boratyńska, Maria; Głyda, Maciej; Ignacak, Ewa; Maks, Justyna; Russel-Szymczyk, Monika; Kaweczyńska-Lasoń, Aneta
2013-06-01
Standard procedure for cytomegalovirus disease (CMV) prophylaxis in kidney transplant patients was the administration of valganciclovir for up to 110 days after organ transplant. This prophylaxis has been extended up to 200 days in Poland since 2011. The decision was based on the results of clinical trials which showed significant clinical benefit in case of prolonged administration of the drug. The aim of the analysis was to provide the economic evaluation of extending the CMV prophylaxis with co-financed from public funds Valcyte (valganciclovirum; 60 tab. a 450 mg; Roche Polska Sp. z o.o.) from 110 to 200 days, in the high risk patients group after kidney transplant (seronegative recipient and infected donor, D+/R-). The analysis was performed from the Polish healthcare payer's perspective. All methods used in the following study were consistent with the Requirements of the Polish HTA Agency (AHTAPOL). The cost-effectiveness and the cost-utility analysis were performed on the basis of a randomised study which was identified as a result of the systematic search of the medical databases, comparing 200 days valgancyclovir administration with 100 days drug use as a prophylaxis of CMV disease in the patients group mentioned above. The Markov model was developed, simulating the disease evolution over time considering a high risk patient after kidney transplant treated with valgancicloviras the CMV disease prophylaxis. The disease period was divided into health states that are the most probable for this condition and the transitions probabilities between them were identified and assigned. Based on the clinical trial results, registry database of health conditions usability and experts' opinion, all health states (i.e. death, kidney transplant, CMV disease) were attributed with utilities and costs. The direct costs, important from the Polish healthcare payer's perspective, were included in the analysis. Extension of the proposed model in the series of one month time
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Mendez, Ian A; Gilbert, Ryan J; Bizon, Jennifer L; Setlow, Barry
2012-12-01
Alterations in cost-benefit decision making accompany numerous neuropsychiatric conditions, including schizophrenia, attention deficit hyperactivity disorder, and addiction. Central cholinergic systems have been linked to the etiology and/or treatment of many of these conditions, but little is known about the role of cholinergic signaling in cost-benefit decision making. The goal of these experiments was to determine how cholinergic signaling is involved in cost-benefit decision making, using a behavioral pharmacological approach. Male Long-Evans rats were trained in either "probability discounting" or "delay discounting" tasks, in which rats made discrete-trial choices between a small food reward and a large food reward associated with either varying probabilities of omission or varying delays to delivery, respectively. The effects of acute administration of different doses of nicotinic and muscarinic acetylcholine receptor agonists and antagonists were assessed in each task. In the probability discounting task, acute nicotine administration (1.0 mg/kg) significantly increased choice of the large risky reward, and control experiments suggested that this was due to robust nicotine-induced impairments in behavioral flexibility. In the delay discounting task, the muscarinic antagonists scopolamine (0.03, 0.1, and 0.3 mg/kg) and atropine (0.3 mg/kg) both significantly increased choice of the small immediate reward. Neither mecamylamine nor oxotremorine produced reliable effects on either of the decision making tasks. These data suggest that cholinergic receptors play multiple roles in decision making contexts which include consideration of reward delay or probability. These roles should be considered when targeting these receptors for therapeutic purposes.
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Laser cost experience and estimation
International Nuclear Information System (INIS)
Shofner, F.M.; Hoglund, R.L.
1977-01-01
This report addresses the question of estimating the capital and operating costs for LIS (Laser Isotope Separation) lasers, which have performance requirements well beyond the state of mature art. This question is seen with different perspectives by political leaders, ERDA administrators, scientists, and engineers concerned with reducing LIS to economically successful commercial practice, on a timely basis. Accordingly, this report attempts to provide ''ballpark'' estimators for capital and operating costs and useful design and operating information for lasers based on mature technology, and their LIS analogs. It is written very basically and is intended to respond about equally to the perspectives of administrators, scientists, and engineers. Its major contributions are establishing the current, mature, industrialized laser track record (including capital and operating cost estimators, reliability, types of application, etc.) and, especially, evolution of generalized estimating procedures for capital and operating cost estimators for new laser design
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28 CFR 100.16 - Cost estimate submission.
2010-07-01
..., quantity, and cost. (ii) Direct labor. Provide a time-phased (e.g., monthly, quarterly) breakdown of labor... estimates. (iii) Allocable direct costs. Indicate how allocable costs are computed and applied, including... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cost estimate submission. 100.16 Section...
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28 CFR 90.15 - Filing costs for criminal charges.
2010-07-01
... with the filing of criminal charges against the domestic violence offender, or the costs associated... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Filing costs for criminal charges. 90.15 Section 90.15 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) VIOLENCE AGAINST WOMEN The STOP...
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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.
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Low Cost Automated Manufacture of PV Array Technology (P-NASA12-007-1), Phase II
National Aeronautics and Space Administration — Spacecraft for NASA, DoD and commercial missions need higher power than ever before, with lower mass, compact stowage, and lower cost. While high efficiency,...
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National Aeronautics and Space Administration — DSS proposes to systematically mature, mitigate risk for; and perform hardware-based ground validations / demonstrations of a low-cost, high technology payoff,...
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Double Bag VARTM for High Temperature Composites, Phase I
National Aeronautics and Space Administration — Cost and size are limiting factors in efforts to produce high strength, high stiffness, and high temperature composite parts. To address these issues, new processes...
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Directory of Open Access Journals (Sweden)
Martijn Boon
Full Text Available Recent data shows that a neuromuscular block (NMB induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. However, there are limited data on the effect such practices on postoperative outcomes. We performed a retrospective analysis to compare unplanned 30-day readmissions in patients that received high-dose versus low-dose rocuronium administration during general anesthesia for laparoscopic retroperitoneal surgery. This retrospective cohort study was performed in the Netherlands in an academic hospital where routine high-dose rocuronium NMB has been practiced since July 2015. Charts of patients receiving anesthesia between January 2014 and December 2016 were searched for surgical cases receiving high-dose rocuronium and matched with respect to procedure, age, sex and ASA classification to patients receiving low-dose rocuronium. The primary post-operative outcome was unplanned 30-day readmission rate. There were 130 patients in each cohort. Patients in the high- and low-dose rocuronium cohorts received 217 ± 49 versus 37 ± 5 mg rocuronium, respectively. In the high-dose rocuronium group neuromuscular activity was consistently monitored; matched patients were unreliably monitored. All patients receiving high-dose rocuronium were reversed with sugammadex, while just 33% of matched patients were reversed with sugammadex and 20% with neostigmine; the remaining patients were not reversed. Unplanned 30-day readmission rate was significantly lower in the high-dose compared to the low-dose rocuronium cohort (3.8% vs. 12.7%; p = 0.03; odds ratio = 0.33, 95% C.I. 0.12-0.95. This small retrospective study demonstrates a lower incidence of unplanned readmissions within 30-days following laparoscopic retroperitoneal surgery with high-dose relaxant anesthesia and sugammadex reversal in comparison to low-dose relaxant anesthesia. Further prospective studies are needed in larger samples to corroborate our
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Boon, Martijn; Martini, Chris; Yang, H Keri; Sen, Shuvayu S; Bevers, Rob; Warlé, Michiel; Aarts, Leon; Niesters, Marieke; Dahan, Albert
2018-01-01
Recent data shows that a neuromuscular block (NMB) induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. However, there are limited data on the effect such practices on postoperative outcomes. We performed a retrospective analysis to compare unplanned 30-day readmissions in patients that received high-dose versus low-dose rocuronium administration during general anesthesia for laparoscopic retroperitoneal surgery. This retrospective cohort study was performed in the Netherlands in an academic hospital where routine high-dose rocuronium NMB has been practiced since July 2015. Charts of patients receiving anesthesia between January 2014 and December 2016 were searched for surgical cases receiving high-dose rocuronium and matched with respect to procedure, age, sex and ASA classification to patients receiving low-dose rocuronium. The primary post-operative outcome was unplanned 30-day readmission rate. There were 130 patients in each cohort. Patients in the high- and low-dose rocuronium cohorts received 217 ± 49 versus 37 ± 5 mg rocuronium, respectively. In the high-dose rocuronium group neuromuscular activity was consistently monitored; matched patients were unreliably monitored. All patients receiving high-dose rocuronium were reversed with sugammadex, while just 33% of matched patients were reversed with sugammadex and 20% with neostigmine; the remaining patients were not reversed. Unplanned 30-day readmission rate was significantly lower in the high-dose compared to the low-dose rocuronium cohort (3.8% vs. 12.7%; p = 0.03; odds ratio = 0.33, 95% C.I. 0.12-0.95). This small retrospective study demonstrates a lower incidence of unplanned readmissions within 30-days following laparoscopic retroperitoneal surgery with high-dose relaxant anesthesia and sugammadex reversal in comparison to low-dose relaxant anesthesia. Further prospective studies are needed in larger samples to corroborate our findings and
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Waldecker, Mark
2005-01-01
Education administrators make buying decisions for furniture based on many factors. Cost, durability, functionality, safety and aesthetics represent just a few. Those issues always will be important, but gaining greater recognition in recent years has been the role furniture plays in creating positive, high-performance learning environments. The…
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Cost optimization of load carrying thin-walled precast high performance concrete sandwich panels
DEFF Research Database (Denmark)
Hodicky, Kamil; Hansen, Sanne; Hulin, Thomas
2015-01-01
and HPCSP’s geometrical parameters as well as on material cost function in the HPCSP design. Cost functions are presented for High Performance Concrete (HPC), insulation layer, reinforcement and include labour-related costs. The present study reports the economic data corresponding to specific manufacturing......The paper describes a procedure to find the structurally and thermally efficient design of load-carrying thin-walled precast High Performance Concrete Sandwich Panels (HPCSP) with an optimal economical solution. A systematic optimization approach is based on the selection of material’s performances....... The solution of the optimization problem is performed in the computer package software Matlab® with SQPlab package and integrates the processes of HPCSP design, quantity take-off and cost estimation. The proposed optimization process outcomes in complex HPCSP design proposals to achieve minimum cost of HPCSP....
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Cost Earnings Data 1993 - Hawaii Longline
National Oceanic and Atmospheric Administration, Department of Commerce — These data were collected to support the first cost-earnings study of this fleet. Operational and vessel costs were collected by in-person interviews with vessel...
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DERAJAT COST STICKINESS SEKTOR PERBANKAN DAN PERTUMBUHAN EKONOMI
Directory of Open Access Journals (Sweden)
Windyastuti Windyastuti
2017-03-01
Full Text Available This study aimed to analyze the effects of the growth on the stickiness cost in banking sector. The research datawas banking financial statements during 2001-2013 published at the Indonesian Capital Market Directory.The data included administration and general cost, bank’s Income and growth. This study used a dynamicpanel data regression with ordinary least square (OLS estimation method. The results showed that cost ofadministration and general was sticky. Furthermore, the growth increased stickiness cost of administrationand general. The growth changed behavior of bank managers. When the growth increased, the bank managersincreased the amount of resources then administration and the general cost also increased although at the sametime banking income declined.
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High cost of nuclear power plants
International Nuclear Information System (INIS)
Bassett, C.
1978-01-01
Retroactive safety standards were found to account for over half the costs of a nuclear power plant and point up the need for an effective cost-benefit analysis of changes made by the Nuclear Regulatory Commission after construction has started. The author compared the Davis-Besse Unit No. 1 construction-cost estimates with the final-cost increases during a rate-case investigation in Ohio. He presents data furnished for ten of the largest construction contracts to illustrate the cost increases involving fixed hardware and intensive labor. The situation was found to repeat with other utilities across the country even though safeguards against irresponsible low bidding were introduced. Low bidding was found to continue, encouraged by the need for retrofitting to meet regulation changes. The average cost per kilowatt of major light-water reactors is shown to have increased from $171 in 1970 to $555 in 1977, while construction duration increased from 43.4 to 95.6 months during the same period
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Baudouin, Amandine; Fargier, Emilie; Cerruti, Ariane; Dubromel, Amélie; Vantard, Nicolas; Ranchon, Florence; Schwiertz, Vérane; Salles, Gilles; Souquet, Pierre-Jean; Thomas, Luc; Bérard, Frédéric; Nancey, Stéphane; Freyer, Gilles; Trillet-Lenoir, Véronique; Rioufol, Catherine
2017-06-01
In the context of health expenses control, reimbursement of high-cost medicines with a 'minor' or 'nonexistent' improvement in actual health benefit evaluated by the Haute Autorité de santé is revised by the decree of March 24, 2016 related to the procedure and terms of registration of high-cost pharmaceutical drugs. This study aims to set up the economic impact of this measure. A six months retrospective study was conducted within a French university hospital from July 1, 2015 to December 31, 2015. For each injectable high-cost anticancer drug prescribed to a patient with cancer, the therapeutic indication, its status in relation to the marketing authorization and the associated improvement in actual health benefit were examined. The total costs of these treatments, the cost per type of indication and, in the case of marketing authorization indications, the cost per improvement in actual health benefit were evaluated considering that all drugs affected by the decree would be struck off. Over six months, 4416 high-cost injectable anticancer drugs were prescribed for a total cost of 4.2 million euros. The costs of drugs with a minor or nonexistent improvement in actual benefit and which comparator is not onerous amount 557,564 euros. The reform of modalities of inscription on the list of onerous drugs represents a significant additional cost for health institutions (1.1 million euros for our hospital) and raises the question of the accessibility to these treatments for cancer patients. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.
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Discrete-choice modelling of patient preferences for modes of drug administration.
Tetteh, Ebenezer Kwabena; Morris, Steve; Titcheneker-Hooker, Nigel
2017-12-01
The administration of (biologically-derived) drugs for various disease conditions involves consumption of resources that constitutes a direct monetary cost to healthcare payers and providers. An often ignored cost relates to a mismatch between patients' preferences and the mode of drug administration. The "intangible" benefits of giving patients what they want in terms of the mode of drug delivery is seldom considered. This study aims to evaluate, in monetary terms, end-user preferences for the non-monetary attributes of different modes of drug administration using a discrete-choice experiment. It provides empirical support to the notion that there are significant benefits from developing patient-friendly approaches to drug delivery. The gross benefits per patient per unit administration is in the same order of magnitude as the savings in resource costs of administering drugs. The study argues that, as long as the underlying manufacturing science is capable, a patient-centred approach to producing drug delivery systems should be encouraged and pursued.
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Directory of Open Access Journals (Sweden)
Martial L Ndeffo Mbah
Full Text Available Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV infection in young women. Therefore, the treatment of Schistosoma haematobium with praziquantel could be a potential strategy for reducing HIV infection. Here we assess the potential cost-effectiveness of praziquantel as a novel intervention strategy against HIV infection.We developed a mathematical model of female genital schistosomiasis (FGS and HIV infections in Zimbabwe that we fitted to cross-sectional data of FGS and HIV prevalence of 1999. We validated our epidemic projections using antenatal clinic data on HIV prevalence. We simulated annual praziquantel administration to school-age children. We then used these model predictions to perform a cost-effectiveness analysis of annual administration of praziquantel as a potential measure to reduce the burden of HIV in sub-Saharan Africa.We showed that for a variation of efficacy between 30-70% of mass praziquantel administration for reducing the enhanced risk of HIV transmission per sexual act due to FGS, annual administration of praziquantel to school-age children in Zimbabwe could result in net savings of US$16-101 million compared with no mass treatment of schistosomiasis over a ten-year period. For a variation in efficacy between 30-70% of mass praziquantel administration for reducing the acquisition of FGS, annual administration of praziquantel to school-age children could result in net savings of US$36-92 million over a ten-year period.In addition to reducing schistosomiasis burden, mass praziquantel administration may be a highly cost-effective way of reducing HIV infections in sub-Saharan Africa. Program costs per case of HIV averted are similar to, and under some conditions much better than, other interventions that are currently implemented in Africa to reduce HIV transmission. As a cost-saving strategy, mass praziquantel administration should be prioritized
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CONTRACT ADMINISTRATIVE TRACKING SYSTEM (CATS)
The Contract Administrative Tracking System (CATS) was developed in response to an ORD NHEERL, Mid-Continent Ecology Division (MED)-recognized need for an automated tracking and retrieval system for Cost Reimbursable Level of Effort (CR/LOE) Contracts. CATS is an Oracle-based app...
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ADMINISTRATIVE EXPENDITURES OF SOCIAL SECURITY FUNDS IN UKRAINE
Directory of Open Access Journals (Sweden)
Nataliia Ivanchuk
2017-12-01
Full Text Available Along with the expenditures for social protection, social security funds finance administrative direction, which should correspond to the amount of functions performed by a particular fund. The purpose of the paper is to determine ways to reduce administrative expenditures of state social security funds in the conditions of reforming Ukrainian economy. For this purpose, the authors investigate distribution of the expenditures between social security funds, analyse dynamics and structure of assignments for fund administration, and suggest possible ways to rationalize maintenance cost for these institutions. Methodology. Administrative expenditures are an integral part of the cost of social security funds and include particular items of expenses in the budget of these institutions. Applying a systematic approach to calculating the administrative costs of social security funds of Ukraine the authors have taken into account the expenditures related to funding management, support for information systems, and organization of work with insured people. Results of the survey showed that in 2007–2016 Pension Fund of Ukraine incurred the largest part of social expenditures (more than 90% compared with other social insurance funds (less than 10%. At the same time, the administrative expenses were divided approximately into two halves between Pension Fund and other social security funds. In 2015, the government launched a reform of social insurance funds that aimed to reduce funds to three institutions but a decrease in the total amount of administrative expenditures has not been achieved yet. In addition, Pension Fund of Ukraine was least burdened with administrative expenses, while other social security funds with a relatively small share of social expenditures were burdened with administrative expenditures much more. Practical implications. Research showed that nowadays the existence of several social security funds in Ukraine is economically
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Food and Drug Administration Drug Approval Process: A History and Overview.
Williams, Christopher Ty
2016-03-01
In this article, the processing of investigational and new drug applications is described and the standard and expedited review processes are examined. The efforts of the US Food and Drug Administration to ensure greater agency transparency and fiscal responsibility and intensify oversight during the drug development and approval process are reviewed. Often attributed to a decrease in the number of uninsured adults, both the increase in prescription drug sales and the high costs associated with bringing a new drug to market highlight the necessity for a streamlined and cost-effective process to deliver these drugs safely and effectively. Copyright © 2016 Elsevier Inc. All rights reserved.
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International Nuclear Information System (INIS)
Wout, E.L.; Bever Donker, J.M. van.
1979-01-01
A five year planning is made in which the available money is distributed to the expected programmes. This five year plan is used as basis for working plan and budget for the next year. In the working plan all financial means are divided into kinds of costs, cost centres and cost units. Based on this working plan and the relevant budgets the tariffs are calculated per working centre (cost centre). The tariffs are fixed for a whole year. Up till now these tariffs are also basis for the cost unit accounting at the end of the year together with the results of the time registration. The estimated work shop services for the working centres are included in the tariffs. For the allocation of overhead costs ECN uses dynamic keys. Depreciation costs with respect to instruments, investments etc. are determined per working centre according to a computer programme. The cost unit related costs are charged directly to cost unit. This implies that project related in instruments are looked upon as running costs. In the future we will try to refine the present cost accounting system still further in this way that we will look upon a cost centre as a profit centre. Furthermore we will try to analyse the tariff and calculation deviations and under/over occupation deviations afterwards (post calculation). The information provided to the management knows a hierachic construction: project information to projectleader, programme (compound projects) information to programme coordinator, cost centre summary to department heads, attention area (compound programme) information to programme coordinator and managing director, ECN research (compound attention areas) information to general management, information re kind of costs to relevant persons, f.e. surveys of expenditure for part time personnel to personnel bureau. The information is provided by the department of Finance and Administrative Organisation. The entire scope of cost accounting is the responsibility of the head of the department
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Sarracanie, Mathieu; Lapierre, Cristen D.; Salameh, Najat; Waddington, David E. J.; Witzel, Thomas; Rosen, Matthew S.
2015-10-01
Magnetic Resonance Imaging (MRI) is unparalleled in its ability to visualize anatomical structure and function non-invasively with high spatial and temporal resolution. Yet to overcome the low sensitivity inherent in inductive detection of weakly polarized nuclear spins, the vast majority of clinical MRI scanners employ superconducting magnets producing very high magnetic fields. Commonly found at 1.5-3 tesla (T), these powerful magnets are massive and have very strict infrastructure demands that preclude operation in many environments. MRI scanners are costly to purchase, site, and maintain, with the purchase price approaching $1 M per tesla (T) of magnetic field. We present here a remarkably simple, non-cryogenic approach to high-performance human MRI at ultra-low magnetic field, whereby modern under-sampling strategies are combined with fully-refocused dynamic spin control using steady-state free precession techniques. At 6.5 mT (more than 450 times lower than clinical MRI scanners) we demonstrate (2.5 × 3.5 × 8.5) mm3 imaging resolution in the living human brain using a simple, open-geometry electromagnet, with 3D image acquisition over the entire brain in 6 minutes. We contend that these practical ultra-low magnetic field implementations of MRI (standards for affordable (<$50,000) and robust portable devices.
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Highly integrated image sensors enable low-cost imaging systems
Gallagher, Paul K.; Lake, Don; Chalmers, David; Hurwitz, J. E. D.
1997-09-01
The highest barriers to wide scale implementation of vision systems have been cost. This is closely followed by the level of difficulty of putting a complete imaging system together. As anyone who has every been in the position of creating a vision system knows, the various bits and pieces supplied by the many vendors are not under any type of standardization control. In short, unless you are an expert in imaging, electrical interfacing, computers, digital signal processing, and high speed storage techniques, you will likely spend more money trying to do it yourself rather than to buy the exceedingly expensive systems available. Another alternative is making headway into the imaging market however. The growing investment in highly integrated CMOS based imagers is addressing both the cost and the system integration difficulties. This paper discusses the benefits gained from CMOS based imaging, and how these benefits are already being applied.
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48 CFR 30.604 - Processing changes to disclosed or established cost accounting practices.
2010-10-01
... disclosed or established cost accounting practices. 30.604 Section 30.604 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION CAS Administration 30.604 Processing changes to disclosed or established cost accounting practices...
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Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique
International Nuclear Information System (INIS)
Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan
2015-01-01
Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system
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Cost Analysis of MRI Services in Iran: An Application of Activity Based Costing Technique.
Bayati, Mohsen; Mahboub Ahari, Alireza; Badakhshan, Abbas; Gholipour, Mahin; Joulaei, Hassan
2015-10-01
Considerable development of MRI technology in diagnostic imaging, high cost of MRI technology and controversial issues concerning official charges (tariffs) have been the main motivations to define and implement this study. The present study aimed to calculate the unit-cost of MRI services using activity-based costing (ABC) as a modern cost accounting system and to fairly compare calculated unit-costs with official charges (tariffs). We included both direct and indirect costs of MRI services delivered in fiscal year 2011 in Shiraz Shahid Faghihi hospital. Direct allocation method was used for distribution of overhead costs. We used micro-costing approach to calculate unit-cost of all different MRI services. Clinical cost data were retrieved from the hospital registering system. Straight-line method was used for depreciation cost estimation. To cope with uncertainty and to increase the robustness of study results, unit costs of 33 MRI services was calculated in terms of two scenarios. Total annual cost of MRI activity center (AC) was calculated at USD 400,746 and USD 532,104 based on first and second scenarios, respectively. Ten percent of the total cost was allocated from supportive departments. The annual variable costs of MRI center were calculated at USD 295,904. Capital costs measured at USD 104,842 and USD 236, 200 resulted from the first and second scenario, respectively. Existing tariffs for more than half of MRI services were above the calculated costs. As a public hospital, there are considerable limitations in both financial and administrative databases of Shahid Faghihi hospital. Labor cost has the greatest share of total annual cost of Shahid Faghihi hospital. The gap between unit costs and tariffs implies that the claim for extra budget from health providers may not be relevant for all services delivered by the studied MRI center. With some adjustments, ABC could be implemented in MRI centers. With the settlement of a reliable cost accounting system
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Comparison of high-speed transportation systems in special consideration of investment costs
Directory of Open Access Journals (Sweden)
R. Schach
2007-10-01
Full Text Available In this paper a substantial comparison of different high-speed transportation systems and an approach to stochastic cost estimations are provided. Starting from the developments in Europe, the high-speed traffic technical characteristics of high-speed railways and Maglev systems are compared. But for a comprehensive comparison more criterions must be included and led to a wider consideration and the development of a multi-criteria comparison of high-speed transportation systems. In the second part a stochastic approach to cost estimations of infrastructure projects is encouraged. Its advantages in comparison with the traditional proceeding are presented and exemplify the practical implementation.
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The cost of chronic constipation.
Pekmezaris, Renée; Aversa, Lorraine; Wolf-Klein, Gisele; Cedarbaum, Jesse; Reid-Durant, Marie
2002-01-01
This study investigates the cost of chronic constipation care. A consecutive sample of 31 chronically constipated elderly patients. A not-for-profit long-term care facility in New Hyde Park, New York. Patient demographics and functional status, including activity of daily living scores, diagnosis, and medications were recorded. All constipation medication costs were obtained using the average wholesale price obtained from the Redbook (November 1999). All subjects were closely monitored for constipation care during two shifts a day (from 7:00 AM to 11:00 PM), over a 6-week period resulting in the collection of 1,860 shift reports. Each component of constipation treatment cost, namely drugs and staff time for drug administration, was identified and analyzed. The average number of nursing interactions for constipation treatment was 23.3 per month. The average cost per day for care specifically for the treatment of constipation was 2.11 US dollars. Fleet Enema trade mark and milk of magnesia accounted for 49% of all treatments. Administration (staffing) costs accounted for 70% of total drug costs. Although laxatives are the most frequently prescribed drugs used in long-term care settings, drug utilization patterns and associated costs in the treatment of chronic constipation have not been systematically reported. Our study identified staffing as the major cost factor in constipation care.
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Costing in Radiotherapy. Chapter 18
International Nuclear Information System (INIS)
Zubizarreta, E.; Lievens, Y.; Levin, V.C.; Van Der Merwe, D.
2017-01-01
The available literature on the cost of radiotherapy yields a large variation in data related to the specifics of the methodology used (the viewpoint of the analysis, time frame, health care system, etc.) and to the cost components and radiotherapy activities included. To overcome this difficulty, the reimbursement paid by medical insurance is commonly used as a proxy for the actual radiotherapy costs. Costs, however, generally bear little or no resemblance to charges, as the latter also include allowances for non-capacity use and profit margins. Accurate resource cost data are therefore more valid and should ideally be used in the context of economic evaluations and public health provisions. In addition to the theoretical problems related to obtaining accurate costs, it is difficult to interpret cost data across country borders because of differences in economics. If this is already the case for high income countries, using these cost data for low and middle income countries (LMICs) is even more problematic. Thus, there clearly is a need for calculations performed from the viewpoint of LMICs to prevent misapprehensions based on conclusions derived from data from their high income counterparts. The IAEA endeavours to assist Member States in accumulating appropriate and sufficient cost data for the initiation or expansion of radiation oncology services. Although relatively simple and easy to understand, the IAEA has found that in many countries where it has been involved in the establishment of new radiotherapy departments, the basic principles of cost calculation for radiotherapy facilities were not followed by the local planners. Radiotherapy needs careful planning, organization and a strong quality assurance (QA) programme in order to deliver safe treatments, due to the complexity of the planning and treatment process and the possibility of systematic errors. Administrators should be aware that the cost of building a radiotherapy facility and buying machines
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Report #11-P-0333, July 14, 2011. ORD’s efforts to reduce its administrative costs are noteworthy, but ORD needs to improve its measurement mechanism for assessing the effectiveness of its initiatives to reduce administrative costs.
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Methods for identifying 30 chronic conditions: application to administrative data.
Tonelli, Marcello; Wiebe, Natasha; Fortin, Martin; Guthrie, Bruce; Hemmelgarn, Brenda R; James, Matthew T; Klarenbach, Scott W; Lewanczuk, Richard; Manns, Braden J; Ronksley, Paul; Sargious, Peter; Straus, Sharon; Quan, Hude
2015-04-17
Multimorbidity is common and associated with poor clinical outcomes and high health care costs. Administrative data are a promising tool for studying the epidemiology of multimorbidity. Our goal was to derive and apply a new scheme for using administrative data to identify the presence of chronic conditions and multimorbidity. We identified validated algorithms that use ICD-9 CM/ICD-10 data to ascertain the presence or absence of 40 morbidities. Algorithms with both positive predictive value and sensitivity ≥70% were graded as "high validity"; those with positive predictive value ≥70% and sensitivity <70% were graded as "moderate validity". To show proof of concept, we applied identified algorithms with high to moderate validity to inpatient and outpatient claims and utilization data from 574,409 people residing in Edmonton, Canada during the 2008/2009 fiscal year. Of the 40 morbidities, we identified 30 that could be identified with high to moderate validity. Approximately one quarter of participants had identified multimorbidity (2 or more conditions), one quarter had a single identified morbidity and the remaining participants were not identified as having any of the 30 morbidities. We identified a panel of 30 chronic conditions that can be identified from administrative data using validated algorithms, facilitating the study and surveillance of multimorbidity. We encourage other groups to use this scheme, to facilitate comparisons between settings and jurisdictions.
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Low cost high performance uncertainty quantification
Bekas, C.
2009-01-01
Uncertainty quantification in risk analysis has become a key application. In this context, computing the diagonal of inverse covariance matrices is of paramount importance. Standard techniques, that employ matrix factorizations, incur a cubic cost which quickly becomes intractable with the current explosion of data sizes. In this work we reduce this complexity to quadratic with the synergy of two algorithms that gracefully complement each other and lead to a radically different approach. First, we turned to stochastic estimation of the diagonal. This allowed us to cast the problem as a linear system with a relatively small number of multiple right hand sides. Second, for this linear system we developed a novel, mixed precision, iterative refinement scheme, which uses iterative solvers instead of matrix factorizations. We demonstrate that the new framework not only achieves the much needed quadratic cost but in addition offers excellent opportunities for scaling at massively parallel environments. We based our implementation on BLAS 3 kernels that ensure very high processor performance. We achieved a peak performance of 730 TFlops on 72 BG/P racks, with a sustained performance 73% of theoretical peak. We stress that the techniques presented in this work are quite general and applicable to several other important applications. Copyright © 2009 ACM.
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Suppression of Noise to Obtain a High-Performance Low-Cost Optical Encoder
Directory of Open Access Journals (Sweden)
Sergio Alvarez-Rodríguez
2018-01-01
Full Text Available Currently, commercial encoders endowed with high precision are expensive sensors, and optical low-cost designs to measure the positioning angle have undesirable levels of system noise which reduce the good performance of devices. This research is devoted to the designing of mathematical filters to suppress noise in polarized transducers, in order to obtain high accuracy, precision, and resolution, along with an adaptive maximum response speed for low-cost optical encoders. This design was proved through a prototype inside a research platform, and experimental results show an accuracy of 3.9, a precision of 26, and a resolution of 17 [arc seconds], at least for the specified working conditions, for the sensing of the angular position of a rotary polarizer. From this work has been obtained a high-performance low-cost polyphase optical encoder, which uses filtering mathematical principles potentially generalizable to other inventions.
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Production of solidified high level wastes: a cost comparison of solidification processes
International Nuclear Information System (INIS)
1977-06-01
Differential cost estimates of the annual operating and maintenance costs and the capital costs for five HLW Waste Solidification Alternates were developed. The annual operating and maintenance cost estimates included the cost of labor, consumables, utilities, shipping casks, shipping and disposal at a federal repository. The capital cost included the cost of the component, installation and building. The differential cost estimates do not include equipment and facilities which are either shared with the reprocessing facility or are common between all of the alternates. Total annual cost differential between the five waste form alternates is summarized in tabular form. The Borosilicate Glass Alternate has the lowest total annual cost. The other alternates have higher costs which range from $6.6 M to $7.4 M per year higher than the Glass alternate with the Supercalcine being the highest cost at $7.4 M per year differential. The major items in the cost estimates are then disposal costs in the operating cost estimates and the HLW Storage Tanks in the capital cost estimates. The Supercalcine Multibarrier Alternate ships 180 canisters per year more than the other alternates and consequently has a significantly higher operating cost. However, off-setting this the Supercalcine Multibarrier Alternate does not require HLW Storage Tanks for decay because of the high heat conductivity of this product and correspondingly the capital cost for this alternate is significantly lower than the other alternates. The radiological risk values are correlated with the cost evaluation normalized to cost ($)/MWe-yr
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Low-cost, high-performance and efficiency computational photometer design
Siewert, Sam B.; Shihadeh, Jeries; Myers, Randall; Khandhar, Jay; Ivanov, Vitaly
2014-05-01
Researchers at the University of Alaska Anchorage and University of Colorado Boulder have built a low cost high performance and efficiency drop-in-place Computational Photometer (CP) to test in field applications ranging from port security and safety monitoring to environmental compliance monitoring and surveying. The CP integrates off-the-shelf visible spectrum cameras with near to long wavelength infrared detectors and high resolution digital snapshots in a single device. The proof of concept combines three or more detectors into a single multichannel imaging system that can time correlate read-out, capture, and image process all of the channels concurrently with high performance and energy efficiency. The dual-channel continuous read-out is combined with a third high definition digital snapshot capability and has been designed using an FPGA (Field Programmable Gate Array) to capture, decimate, down-convert, re-encode, and transform images from two standard definition CCD (Charge Coupled Device) cameras at 30Hz. The continuous stereo vision can be time correlated to megapixel high definition snapshots. This proof of concept has been fabricated as a fourlayer PCB (Printed Circuit Board) suitable for use in education and research for low cost high efficiency field monitoring applications that need multispectral and three dimensional imaging capabilities. Initial testing is in progress and includes field testing in ports, potential test flights in un-manned aerial systems, and future planned missions to image harsh environments in the arctic including volcanic plumes, ice formation, and arctic marine life.
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Repository emplacement costs for Al-clad high enriched uranium spent fuel
International Nuclear Information System (INIS)
McDonell, W.R.; Parks, P.B.
1994-01-01
A range of strategies for treatment and packaging of Al-clad high-enriched uranium (HEU) spent fuels to prevent or delay the onset of criticality in a geologic repository was evaluated in terms of the number of canisters produced and associated repository costs incurred. The results indicated that strategies in which neutron poisons were added to consolidated forms of the U-Al alloy fuel generally produced the lowest number of canisters and associated repository costs. Chemical processing whereby the HEU was removed from the waste form was also a low cost option. The repository costs generally increased for isotopic dilution strategies, because of the substantial depleted uranium added. Chemical dissolution strategies without HEU removal were also penalized because of the inert constituents in the final waste glass form. Avoiding repository criticality by limiting the fissile mass content of each canister incurred the highest repository costs
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13 CFR 305.5 - Project administration by District Organization.
2010-01-01
... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Project administration by District Organization. 305.5 Section 305.5 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION... business exists that could administer the Project in a more efficient or cost-effective manner than the...
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The Cost-Effectiveness of High-Risk Lung Cancer Screening and Drivers of Program Efficiency.
Cressman, Sonya; Peacock, Stuart J; Tammemägi, Martin C; Evans, William K; Leighl, Natasha B; Goffin, John R; Tremblay, Alain; Liu, Geoffrey; Manos, Daria; MacEachern, Paul; Bhatia, Rick; Puksa, Serge; Nicholas, Garth; McWilliams, Annette; Mayo, John R; Yee, John; English, John C; Pataky, Reka; McPherson, Emily; Atkar-Khattra, Sukhinder; Johnston, Michael R; Schmidt, Heidi; Shepherd, Frances A; Soghrati, Kam; Amjadi, Kayvan; Burrowes, Paul; Couture, Christian; Sekhon, Harmanjatinder S; Yasufuku, Kazuhiro; Goss, Glenwood; Ionescu, Diana N; Hwang, David M; Martel, Simon; Sin, Don D; Tan, Wan C; Urbanski, Stefan; Xu, Zhaolin; Tsao, Ming-Sound; Lam, Stephen
2017-08-01
Lung cancer risk prediction models have the potential to make programs more affordable; however, the economic evidence is limited. Participants in the National Lung Cancer Screening Trial (NLST) were retrospectively identified with the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. The high-risk subgroup was assessed for lung cancer incidence and demographic characteristics compared with those in the low-risk subgroup and the Pan-Canadian Early Detection of Lung Cancer Study (PanCan), which is an observational study that was high-risk-selected in Canada. A comparison of high-risk screening versus standard care was made with a decision-analytic model using data from the NLST with Canadian cost data from screening and treatment in the PanCan study. Probabilistic and deterministic sensitivity analyses were undertaken to assess uncertainty and identify drivers of program efficiency. Use of the risk prediction tool developed from the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial with a threshold set at 2% over 6 years would have reduced the number of individuals who needed to be screened in the NLST by 81%. High-risk screening participants in the NLST had more adverse demographic characteristics than their counterparts in the PanCan study. High-risk screening would cost $20,724 (in 2015 Canadian dollars) per quality-adjusted life-year gained and would be considered cost-effective at a willingness-to-pay threshold of $100,000 in Canadian dollars per quality-adjusted life-year gained with a probability of 0.62. Cost-effectiveness was driven primarily by non-lung cancer outcomes. Higher noncurative drug costs or current costs for immunotherapy and targeted therapies in the United States would render lung cancer screening a cost-saving intervention. Non-lung cancer outcomes drive screening efficiency in diverse, tobacco-exposed populations. Use of risk selection can reduce the budget impact, and
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49 CFR 639.21 - Determination of cost-effectiveness.
2010-10-01
... 49 Transportation 7 2010-10-01 2010-10-01 false Determination of cost-effectiveness. 639.21... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CAPITAL LEASES Cost-Effectiveness § 639.21 Determination of cost...-effectiveness comparison as described in this subpart, it may ask FTA to approve an alternate form of cost...
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5 CFR 838.241 - Cost-of-living adjustments.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.241... Affecting Employee Annuities Procedures for Computing the Amount Payable § 838.241 Cost-of-living... provide for cost-of-living adjustments on the former spouse's payment from employee annuity, the cost-of...
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Transmission line capital costs
International Nuclear Information System (INIS)
Hughes, K.R.; Brown, D.R.
1995-05-01
The displacement or deferral of conventional AC transmission line installation is a key benefit associated with several technologies being developed with the support of the U.S. Department of Energy's Office of Energy Management (OEM). Previous benefits assessments conducted within OEM have been based on significantly different assumptions for the average cost per mile of AC transmission line. In response to this uncertainty, an investigation of transmission line capital cost data was initiated. The objective of this study was to develop a database for preparing preliminary estimates of transmission line costs. An extensive search of potential data sources identified databases maintained by the Bonneville Power Administration (BPA) and the Western Area Power Administration (WAPA) as superior sources of transmission line cost data. The BPA and WAPA data were adjusted to a common basis and combined together. The composite database covers voltage levels from 13.8 to 765 W, with cost estimates for a given voltage level varying depending on conductor size, tower material type, tower frame type, and number of circuits. Reported transmission line costs vary significantly, even for a given voltage level. This can usually be explained by variation in the design factors noted above and variation in environmental and land (right-of-way) costs, which are extremely site-specific. Cost estimates prepared from the composite database were compared to cost data collected by the Federal Energy Regulatory Commission (FERC) for investor-owned utilities from across the United States. The comparison was hampered because the only design specifications included with the FERC data were voltage level and line length. Working within this limitation, the FERC data were not found to differ significantly from the composite database. Therefore, the composite database was judged to be a reasonable proxy for estimating national average costs
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Comparative evaluation of activity-based costing and variable costing: a case study at IPEN
International Nuclear Information System (INIS)
Esteves, Josefina Maria da Silva SILVA
2010-01-01
This research aims to compare the results with the application of Activity Based Costing and Variable Costing methods in an administrative unit of the Brazilian Federal Government: the Radiopharmacy Facility of IPEN (Institute for Energy and Nuclear Research), which produces radiopharmaceuticals products and develops R and D activities. Faced with the need to adopt a more economical and managerial public administration, this research has provided information to assess which of the two costing methods proves more suitable for cost management in that unit. The research is exploratory and a single-case study. We traced about 80% of material costs by observation 'in loco' of the entire manufacturing process of technetium generator, which represents the main product in terms of production volume and revenues. The results show that the Contribution Margin Variable Costing of 29.12% is very close to the operating income of 28.86%, ahead of support activities, obtained by ABC. It is also noted that the operational result of the product does not change by using either one or another costing method. In the two costing methods the end result is 24.20%. This occurs because the production is on demand. There is no inventory of finished product because it is radioactive. The research has revealed that both methods provide useful information for the management and optimization of costs and results of processes/activities, and that the two methods, in this case, may be used in an integrated and complementary approach, enabling to use the best information content of both. (author)
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Low-Cost High-Speed In-Plane Stroboscopic Micro-Motion Analyzer
Directory of Open Access Journals (Sweden)
Shashank S. Pandey
2017-11-01
Full Text Available Instrumentation for high-speed imaging and laser vibrometry is essential for the understanding and analysis of microstructure dynamics, but commercial instruments are largely unaffordable for most microelectromechanical systems (MEMS laboratories. We present the implementation of a very low cost in-plane micro motion stroboscopic analyzer that can be directly attached to a conventional probe station. The low-cost analyzer has been used to characterize the harmonic motion of 52.1 kHz resonating comb drive microactuators using ~50 ns pulsed light-emitting diode (LED stroboscope exposure times, producing sharp and high resolution (~0.5 μm device images at resonance, which rivals those of several orders of magnitude more expensive systems. This paper details the development of the high-speed stroboscopic imaging system and presents experimental results of motion analysis of example microstructures and a discussion of its operating limits. The system is shown to produce stable stroboscopic LED illumination to freeze device images up to 11 MHz.
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Process Approach to Cost of Quality
Directory of Open Access Journals (Sweden)
Katarzyna Szczepańska
2009-12-01
Full Text Available Contemporary understanding comprehending cost of quality is connected both with the sphere of the management, as well as the operational activity. Borders of considering the category of quality costs moved beyond the technical – technological area. Trial including costs let the quality for classifying them with reference to all action carried out in the modern enterprise. Standard models of quality costs and the activity – based costing appointed new prospects of economics of the quality in the business administration.
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[Predicting individual risk of high healthcare cost to identify complex chronic patients].
Coderch, Jordi; Sánchez-Pérez, Inma; Ibern, Pere; Carreras, Marc; Pérez-Berruezo, Xavier; Inoriza, José M
2014-01-01
To develop a predictive model for the risk of high consumption of healthcare resources, and assess the ability of the model to identify complex chronic patients. A cross-sectional study was performed within a healthcare management organization by using individual data from 2 consecutive years (88,795 people). The dependent variable consisted of healthcare costs above the 95th percentile (P95), including all services provided by the organization and pharmaceutical consumption outside of the institution. The predictive variables were age, sex, morbidity-based on clinical risk groups (CRG)-and selected data from previous utilization (use of hospitalization, use of high-cost drugs in ambulatory care, pharmaceutical expenditure). A univariate descriptive analysis was performed. We constructed a logistic regression model with a 95% confidence level and analyzed sensitivity, specificity, positive predictive values (PPV), and the area under the ROC curve (AUC). Individuals incurring costs >P95 accumulated 44% of total healthcare costs and were concentrated in ACRG3 (aggregated CRG level 3) categories related to multiple chronic diseases. All variables were statistically significant except for sex. The model had a sensitivity of 48.4% (CI: 46.9%-49.8%), specificity of 97.2% (CI: 97.0%-97.3%), PPV of 46.5% (CI: 45.0%-47.9%), and an AUC of 0.897 (CI: 0.892 to 0.902). High consumption of healthcare resources is associated with complex chronic morbidity. A model based on age, morbidity, and prior utilization is able to predict high-cost risk and identify a target population requiring proactive care. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.
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Price and utilization: why we must target both to curb health care costs.
Spiro, Topher; Lee, Emily Oshima; Emanuel, Ezekiel J
2012-10-16
The United States spends nearly $8000 per person on health care annually. Even for a wealthy country, this amount is substantially more than would be expected and 2.5 times the average spent by other Organization for Economic Cooperation and Development (OECD) countries. The growth rate of health care spending in the United States has also far outpaced that in all other high-income OECD countries since 1970, even accounting for population growth. This increase in health spending threatens to squeeze out critical investments in education and infrastructure. To successfully develop and implement policies that effectively address both the level and growth of U.S. health care costs, it is critical to first understand cost drivers. Many health policy and economics scholars have contributed to an ongoing debate on whether to blame high prices or high utilization of services for escalating health care spending in the United States. This paper argues that price and volume both contribute to high and increasing health care costs, along with high administrative costs, supply issues, and the fee-for-service payment system. Initial strategies to contain costs might include implementation and expansion of bundled payment systems and competitive bidding.
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Estimating preferences for modes of drug administration: The case of US healthcare professionals.
Tetteh, Ebenezer K; Morris, Steve; Titchener-Hooker, Nigel
2018-01-01
There are hidden drug administration costs that arise from a mismatch between end-user preferences and how manufacturers choose to formulate their drug products for delivery to patients. The corollary of this is: there are "intangible benefits" from considering end-user preferences in manufacturing patient-friendly medicines. It is important then to have some idea of what pharmaceutical manufacturers should consider in making patient-friendly medicines and of the magnitude of the indirect benefits from doing so. This study aimed to evaluate preferences of healthcare professionals in the US for the non-monetary attributes of different modes of drug administration. It uses these preference orderings to compute a monetary valuation of the indirect benefits from making patient-friendly medicines. A survey collected choice preferences of a sample of 210 healthcare professionals in the US for two unlabelled drug options. These drugs were identical except in the levels of attributes of drug administration. Using the choice data collected, statistical models were estimated to compute gross welfare benefits, measured by the expected compensating variation, from making drugs in a more patient-friendly manner. The monetary value of end-user benefits from developing patient-friendly drug delivery systems is: (1) as large as the annual acquisition costs per full treatment episode for some biologic drugs; and (2) likely to fall in the "high end" of the distribution of the direct monetary costs of drug administration. An examination of end-user preferences should help manufacturers make more effective and efficient use of limited resources for innovations in drug delivery system, or manufacturing research in general. Copyright © 2017 Elsevier Inc. All rights reserved.
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Transition-cost issues for a restructuring US electricity industry
Energy Technology Data Exchange (ETDEWEB)
NONE
1997-03-01
Utilities regulators can use a variety of approaches to calculate transition costs. We categorized these approaches along three dimensions. The first dimension is the use of administrative vs. market procedures to value the assets in question. Administrative approaches use analytical techniques to estimate transition costs. Market valuation relies on the purchase price of particular assets to determine their market values. The second dimension concerns when the valuation is done, either before or after the restructuring of the electricity industry. The third dimension concerns the level of detail involved in the valuation, what is often called top-down vs. bottom-up valuation. This paper discusses estimation approaches, criteria to assess estimation methods, specific approaches to estimating transition costs, factors that affect transition-cost estimates, strategies to address transition costs, who should pay transition costs, and the integration of cost recovery with competitive markets.
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Low cost photomultiplier high-voltage readout system
International Nuclear Information System (INIS)
Oxoby, G.J.; Kunz, P.F.
1976-10-01
The Large Aperture Solenoid Spectrometer (LASS) at Stanford Linear Accelerator Center (SLAC) requires monitoring over 300 voltages. This data is recorded on magnetic tapes along with the event data. It must also be displayed so that operators can easily monitor and adjust the voltages. A low-cost high-voltage readout system has been implemented to offer stand-alone digital readout capability as well as fast data transfer to a host computer. The system is flexible enough to permit use of a DVM or ADC and commercially available analogue multiplexers
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A low-cost, high-resolution, video-rate imaging optical radar
Energy Technology Data Exchange (ETDEWEB)
Sackos, J.T.; Nellums, R.O.; Lebien, S.M.; Diegert, C.F. [Sandia National Labs., Albuquerque, NM (United States); Grantham, J.W.; Monson, T. [Air Force Research Lab., Eglin AFB, FL (United States)
1998-04-01
Sandia National Laboratories has developed a unique type of portable low-cost range imaging optical radar (laser radar or LADAR). This innovative sensor is comprised of an active floodlight scene illuminator and an image intensified CCD camera receiver. It is a solid-state device (no moving parts) that offers significant size, performance, reliability, and simplicity advantages over other types of 3-D imaging sensors. This unique flash LADAR is based on low cost, commercially available hardware, and is well suited for many government and commercial uses. This paper presents an update of Sandia`s development of the Scannerless Range Imager technology and applications, and discusses the progress that has been made in evolving the sensor into a compact, low, cost, high-resolution, video rate Laser Dynamic Range Imager.
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78 FR 57445 - Charging Standard Administrative Fees for Nonprogram-Related Information
2013-09-18
... the Federal Register a schedule of standardized administrative fees we charge to recover the full cost... fee schedule is outdated and incongruent with the agency's current costs for this service. New... new standard fee on our most recent cost calculations for supplying this information and the standard...
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43 CFR 429.26 - When may Reclamation reduce or waive costs or fees?
2010-10-01
... Reductions or Waivers of Application Fees, Administrative Costs, and Use Fees § 429.26 When may Reclamation reduce or waive costs or fees? (a) As determined appropriate and approved and documented by the applicable Regional Director, the application fees may be waived, and charges for administrative costs or use...
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The Digital Administrative Document: an approximate path
Directory of Open Access Journals (Sweden)
Francesca Delneri
2017-09-01
Full Text Available If the road towards a progressive dematerialization of the administrative document is marked, the legislator is not always proceeding in a coherent, clear or complete way. The line of reasoning needs to be focused on the administration of documental heritage, training and preservation rather than on technological issues, involving actively local administration and taking on responsibilities on decisions, also on the relationship between costs and benefits. The way is hard due to the lack of debate and practical directions, where the preservation should not be considered as a commanding confirmation, but as an occasion to face complex and critical issues.
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A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.
Lungu, Elena R; Manti, Orlando J; Levine, Mitchell A H; Clark, Douglas A; Potashnik, Tanya M; McKinley, Carol I
2017-09-01
Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability. © 2017 Journal of Population Therapeutics and Clinical Pharmacology. All rights reserved.
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Command vector memory systems: high performance at low cost
Corbal San Adrián, Jesús; Espasa Sans, Roger; Valero Cortés, Mateo
1998-01-01
The focus of this paper is on designing both a low cost and high performance, high bandwidth vector memory system that takes advantage of modern commodity SDRAM memory chips. To successfully extract the full bandwidth from SDRAM parts, we propose a new memory system organization based on sending commands to the memory system as opposed to sending individual addresses. A command specifies, in a few bytes, a request for multiple independent memory words. A command is similar to a burst found in...
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Does the Bush Administration's climate policy mean climate protection?
International Nuclear Information System (INIS)
Blanchard, Odile; Perkaus, James F.
2004-01-01
The paper analyzes the two major components of the Bush Administration's climate policy, namely an emission intensity target and a technology strategy. The question is whether those components will generate net emission reductions that will contribute to the stabilization of the greenhouse gas concentration at a safe level in the long run. It comes out that the Bush Administration climate policy does not guarantee any meaningful contribution to climate protection. The lenient emission intensity target set by the Administration will most likely allow near term emissions to grow. In the long run, the Bush Administration places a big bet on future climate-friendly technological breakthroughs to cost-effectively compensate for the current and near term net emission increases. But the outcomes of those technological developments are uncertain in terms of emission reduction potential, cost, and timing. The way towards enhanced climate protection will most likely not come from the policies of the current Administration, but rather from the growing concern about the climate issue in Congress and at the state, corporate and civil society levels. These combined forces may raise the playing field at the federal level in the near future
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22 CFR 135.22 - Allowable costs.
2010-04-01
... Procedures, or uniform cost accounting standards that comply with cost principles acceptable to the Federal... AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial Administration § 135.22 Allowable... principles. For each kind of organization, there is a set of Federal principles for determining allowable...
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77 FR 50757 - Charging Standard Administrative Fees for Nonprogram-Related Information
2012-08-22
... are announcing the standardized administrative fees we will charge to recover our full cost of... will ensure fees are consistent and that we collect the full cost of supplying our information when a... standard fees that are calculated to reflect the full cost of providing information for nonprogram-related...
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Tas, Said
2017-01-01
The purpose of this research is to determine the effect of vocational high school administrators' leadership behaviors on teacher job satisfaction. The study group of the research consists of 21 technical teachers who work at vocational high schools in the city of Isparta. The data obtained have been analyzed by calculating the frequency,…
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Costs of a Hospital-Based, Ready-To-Use Syringe Delivery Programme
DEFF Research Database (Denmark)
Risør, Bettina Wulff; Vand, S; Lisby, M
2017-01-01
%) and at €20,905 (an increase of 228%) for the endoscopy department. The ready-to-use delivery program imposed an additional cost of €11.32 per day surgery operation and €2.41 per endoscopy procedure. Conclusion: This ready-to-use programme increased the cost of the medical handling process. This incremental......Objective: The risk of errors in the medication administration process is high. Applications of pre lled syringes may improve patient safety but could be more costly. The objective of this study was to assess the additional costs of a ready-to-use syringe delivery programme in comparison...... with a conventional delivery programme at day surgery and endoscopy departments at a large university hospital. Methods: The cost analysis used the hospital perspective and developed an “activity-based costing” model to assess the costs of medicine- handling activities. The model was calibrated with six-month data...
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Rahman, Momotazur; Keohane, Laura; Trivedi, Amal N; Mor, Vincent
2015-10-01
Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the rates at which participants who used three high-cost services switched between Medicare Advantage and traditional Medicare. We found that the switching rate from 2010 to 2011 away from Medicare Advantage and to traditional Medicare exceeded the switching rate in the opposite direction for participants who used long-term nursing home care (17 percent versus 3 percent), short-term nursing home care (9 percent versus 4 percent), and home health care (8 percent versus 3 percent). These results were magnified among people who were enrolled in both Medicare and Medicaid. Our findings raise questions about the role of Medicare Advantage plans in serving high-cost patients with complex care needs, who account for a disproportionately high amount of total health care spending. Project HOPE—The People-to-People Health Foundation, Inc.
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High level waste transport and disposal cost calculations for the United Kingdom
International Nuclear Information System (INIS)
Nattress, P.C.; Ward, R.D.
1992-01-01
Commercial nuclear power has been generated in the United Kingdom since 1962, and throughout that time fuel has been reprocessed giving rise to high level waste. This has been managed by storing fission products and related wastes as highly active liquor, and more recently by a program of vitrification and storage of the glass blocks produced. Government policy is that vitrified high level waste should be stored for at least 50 years, which has the technical advantage of allowing the heat output rate of the waste to fall, making disposal easier and cheaper. Thus, there is no immediate requirement to develop a deep geological repository in the UK, but the nuclear companies do have a requirement to make financial provision out of current revenues for high level waste disposal at a future repository. In 1991 the interested organizations undertook a new calculation of costs for such provisions, which is described here. The preliminary work for the calculation included the assumption of host geology characteristics, a compatible repository concept including overpacking, and a range of possible nuclear programs. These have differing numbers of power plants, and differing mixes of high level waste from reprocessing and spent fuel for direct disposal. An algorithm was then developed so that the cost of high level waste disposal could be calculated for any required case within a stated envelope of parameters. An Example Case was then considered in detail leading to the conclusion that a repository to meet the needs of a constant UK nuclear economy up to the middle of the next century would have a cash cost of UK Pounds 1194M (US$2011M). By simple division the cost to a kWh of electricity is UK Pounds 0.00027 (0.45 US mil). (author)
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Break-even Analysis: A Practical Tool for Administrators of Continuing Education.
Noel, James
1982-01-01
Explains how break-even analysis can help the continuing education administrator in planning by clarifying the relationship between costs, volume, and surplus revenues. Also explains the concepts of fixed, variable, and semivariable costs. (CT)
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The high intensity solar cell - Key to low cost photovoltaic power
Sater, B. L.; Goradia, C.
1975-01-01
This paper discusses the problems associated with conventional solar cells at high intensities and presents the design considerations and performance characteristics of the 'high intensity' (HI) solar cell which appears to eliminate the major problems. Test data obtained at greater than 250 AM1 suns gave a peak output power density of 2 W per sq cm at an efficiency exceeding 6% with an unoptimized cell operating at over 100 C. It appears that operation at 1000 AM1 suns at efficiencies greater than 10% is possible. At 1000 AM1 suns and 10% efficiency, the HI cell manufacturing cost is estimated to be $0.25/watt, with multi-megawatt annual production capability already existing within the industrial sector. A high intensity solar system was also analyzed to determine its cost effectiveness and to assess the benefits of further improving HI cell efficiency.
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Costs of hospital malnutrition.
Curtis, Lori Jane; Bernier, Paule; Jeejeebhoy, Khursheed; Allard, Johane; Duerksen, Donald; Gramlich, Leah; Laporte, Manon; Keller, Heather H
2017-10-01
Hospital malnutrition has been established as a critical, prevalent, and costly problem in many countries. Many cost studies are limited due to study population or cost data used. The aims of this study were to determine: the relationship between malnutrition and hospital costs; the influence of confounders on, and the drivers (medical or surgical patients or degree of malnutrition) of the relationship; and whether hospital reported cost data provide similar information to administrative data. To our knowledge, the last two goals have not been studied elsewhere. Univariate and multivariate analyses were performed on data from the Canadian Malnutrition Task Force prospective cohort study combined with administrative data from the Canadian Institute for Health Information. Subjective Global Assessment was used to assess the relationship between nutritional status and length of stay and hospital costs, controlling for health and demographic characteristics, for 956 patients admitted to medical and surgical wards in 18 hospitals across Canada. After controlling for patient and hospital characteristics, moderately malnourished patients' (34% of surveyed patients) hospital stays were 18% (p = 0.014) longer on average than well-nourished patients. Medical stays increased by 23% (p = 0.014), and surgical stays by 32% (p = 0.015). Costs were, on average, between 31% and 34% (p-values < 0.05) higher than for well-nourished patients with similar characteristics. Severely malnourished patients (11% of surveyed patients) stayed 34% (p = 0.000) longer and had 38% (p = 0.003) higher total costs than well-nourished patients. They stayed 53% (p = 0.001) longer in medical beds and had 55% (p = 0.003) higher medical costs, on average. Trends were similar no matter the type of costing data used. Over 40% of patients were found to be malnourished (1/3 moderately and 1/10 severely). Malnourished patients had longer hospital stays and as a result cost more than well
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Patents Associated with High-Cost Drugs in Australia
Christie, Andrew F.; Dent, Chris; McIntyre, Peter; Wilson, Lachlan; Studdert, David M.
2013-01-01
Australia, like most countries, faces high and rapidly-rising drug costs. There are longstanding concerns about pharmaceutical companies inappropriately extending their monopoly position by "evergreening" blockbuster drugs, through misuse of the patent system. There is, however, very little empirical information about this behaviour. We fill the gap by analysing all of the patents associated with 15 of the costliest drugs in Australia over the last 20 years. Specifically, we search the patent...
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The Future Train Wreck: Paying for Medical Costs for Higher Education's Retirees
Biggs, John H.
2006-01-01
Trustees and administrators today confront one of two problems with post-retirement medical care. First, if institutions provide no support for their retirees' medical care, they implicitly offer a powerful incentive for senior faculty to stay on. The compensation and opportunity costs of this effect are obviously very high. But, second, if they…
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Electric plant cost and power production expenses 1991
International Nuclear Information System (INIS)
1993-01-01
Electric Plant Cost and Power Production Expenses is prepared by the Survey Management Division; Office of Coal, Nuclear, Electric and Alternate Fuels (CNEAF); Energy Information Administration (EIA); US Department of Energy. This publication presents electric utility statistics on power production expenses and construction costs of electric generating plants. Data presented here are intended to provide information to the electric utility industry, educational institutions, Federal, State, and local governments, and the general public. These data are collected and published to fulfill data collection and dissemination responsibilities of the Energy Information Administration (EIA), as specified in the Federal Energy Administration Act (Public Law 93-275), as amended
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Electric plant cost and power production expenses 1990
International Nuclear Information System (INIS)
1992-06-01
Electric Plant Cost and Power Production Expenses is prepared by the Survey Management Division; Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA); US Department of Energy. This publication presents electric utility statistics on power production expenses and construction costs of electric generating plants. Data presented here are intended to provide information to the electric utility industry, educational institutions, Federal, State, and local governments, and the general public. These data are collected and published to fulfill data collection and dissemination responsibilities of the Energy Information Administration (EIA), as specified in the Federal Energy Administration Act (Public Law 93-275), as amended
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High Performance, Low Cost Hydrogen Generation from Renewable Energy
Energy Technology Data Exchange (ETDEWEB)
Ayers, Katherine [Proton OnSite; Dalton, Luke [Proton OnSite; Roemer, Andy [Proton OnSite; Carter, Blake [Proton OnSite; Niedzwiecki, Mike [Proton OnSite; Manco, Judith [Proton OnSite; Anderson, Everett [Proton OnSite; Capuano, Chris [Proton OnSite; Wang, Chao-Yang [Penn State University; Zhao, Wei [Penn State University
2014-02-05
Renewable hydrogen from proton exchange membrane (PEM) electrolysis is gaining strong interest in Europe, especially in Germany where wind penetration is already at critical levels for grid stability. For this application as well as biogas conversion and vehicle fueling, megawatt (MW) scale electrolysis is required. Proton has established a technology roadmap to achieve the necessary cost reductions and manufacturing scale up to maintain U.S. competitiveness in these markets. This project represents a highly successful example of the potential for cost reduction in PEM electrolysis, and provides the initial stack design and manufacturing development for Proton’s MW scale product launch. The majority of the program focused on the bipolar assembly, from electrochemical modeling to subscale stack development through prototyping and manufacturing qualification for a large active area cell platform. Feasibility for an advanced membrane electrode assembly (MEA) with 50% reduction in catalyst loading was also demonstrated. Based on the progress in this program and other parallel efforts, H2A analysis shows the status of PEM electrolysis technology dropping below $3.50/kg production costs, exceeding the 2015 target.
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A cost of sexual attractiveness to high-fitness females.
Directory of Open Access Journals (Sweden)
Tristan A F Long
2009-12-01
Full Text Available Adaptive mate choice by females is an important component of sexual selection in many species. The evolutionary consequences of male mate preferences, however, have received relatively little study, especially in the context of sexual conflict, where males often harm their mates. Here, we describe a new and counterintuitive cost of sexual selection in species with both male mate preference and sexual conflict via antagonistic male persistence: male mate choice for high-fecundity females leads to a diminished rate of adaptive evolution by reducing the advantage to females of expressing beneficial genetic variation. We then use a Drosophila melanogaster model system to experimentally test the key prediction of this theoretical cost: that antagonistic male persistence is directed toward, and harms, intrinsically higher-fitness females more than it does intrinsically lower-fitness females. This asymmetry in male persistence causes the tails of the population's fitness distribution to regress towards the mean, thereby reducing the efficacy of natural selection. We conclude that adaptive male mate choice can lead to an important, yet unappreciated, cost of sex and sexual selection.
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Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan
To evaluate the cost-effectiveness of an automated medication system (AMS) implemented in a Danish hospital setting. An economic evaluation was performed alongside a controlled before-and-after effectiveness study with one control ward and one intervention ward. The primary outcome measure was the number of errors in the medication administration process observed prospectively before and after implementation. To determine the difference in proportion of errors after implementation of the AMS, logistic regression was applied with the presence of error(s) as the dependent variable. Time, group, and interaction between time and group were the independent variables. The cost analysis used the hospital perspective with a short-term incremental costing approach. The total 6-month costs with and without the AMS were calculated as well as the incremental costs. The number of avoided administration errors was related to the incremental costs to obtain the cost-effectiveness ratio expressed as the cost per avoided administration error. The AMS resulted in a statistically significant reduction in the proportion of errors in the intervention ward compared with the control ward. The cost analysis showed that the AMS increased the ward's 6-month cost by €16,843. The cost-effectiveness ratio was estimated at €2.01 per avoided administration error, €2.91 per avoided procedural error, and €19.38 per avoided clinical error. The AMS was effective in reducing errors in the medication administration process at a higher overall cost. The cost-effectiveness analysis showed that the AMS was associated with affordable cost-effectiveness rates. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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22 CFR 226.27 - Allowable costs.
2010-04-01
... Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Financial and Program Management § 226.27 Allowable costs. For each kind... organizations is determined in accordance with the provisions of OMB Circular A-122, “Cost Principles for Non...
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Cost of schizophrenia in England.
Mangalore, Roshni; Knapp, Martin
2007-03-01
Despite the wide-ranging financial and social burdens associated with schizophrenia, there have been few cost-of-illness studies of this illness in the UK. To provide up-to-date, prevalence based estimate of all costs associated with schizophrenia for England. A bottom-up approach was adopted. Separate cost estimates were made for people living in private households, institutions, prisons and for those who are homeless. The costs included related to: health and social care, informal care, private expenditures, lost productivity, premature mortality, criminal justice services and other public expenditures such as those by the social security system. Data came from many sources, including the UK-SCAP (Schizophrenia Care and Assessment Program) survey, Psychiatric Morbidity Surveys, Department of Health and government publications. The estimated total societal cost of schizophrenia was 6.7 billion pounds in 2004/05. The direct cost of treatment and care that falls on the public purse was about 2 billion pounds; the burden of indirect costs to the society was huge, amounting to nearly 4.7 billion pounds. Cost of informal care and private expenditures borne by families was 615 million pounds. The cost of lost productivity due to unemployment, absence from work and premature mortality of patients was 3.4 billion pounds. The cost of lost productivity of carers was 32 million pounds. Estimated cost to the criminal justice system was about 1 million pounds. It is estimated that about 570 million pounds will be paid out in benefit payments and the cost of administration associated with this is about 14 million pounds. It is difficult to compare estimates from previous cost-of-illness studies due to differences in the methods, scope of analyses and the range of costs covered. Costs estimated in this study are detailed, cover a comprehensive list of relevant items and allow for different levels of disaggregation. The main limitation of the study is that data came from a
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Plan selection in Medicare Part D: Evidence from administrative data
Heiss, Florian; Leive, Adam; McFadden, Daniel; Winter, Joachim
2014-01-01
We study the Medicare Part D prescription drug insurance program as a bellwether for designs of private, non-mandatory health insurance markets, focusing on the ability of consumers to evaluate and optimize their choices of plans. Our analysis of administrative data on medical claims in Medicare Part D suggests that fewer than 25 percent of individuals enroll in plans that are ex ante as good as the least cost plan specified by the Plan Finder tool made available to seniors by the Medicare administration, and that consumers on average have expected excess spending of about $300 per year, or about 15 percent of expected total out-of-pocket cost for drugs and Part D insurance. These numbers are hard to reconcile with decision costs alone; it appears that unless a sizeable fraction of consumers place large values on plan features other than cost, they are not optimizing effectively. PMID:24308882
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Trajectory-Based Operations (TBO) Cost Estimation, Phase I
National Aeronautics and Space Administration — The Innovation Laboratory, Inc., proposes to build a tool to estimate airline costs under TBO. This tool includes a cost model that explicitly reasons about traffic...
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7 CFR 247.25 - Allowable uses of administrative funds and other funds.
2010-01-01
... subgrantees must comply with part 3019 of this title. State and local agencies may use procurement procedures... authority regarding the settlement of all contractual and administrative issues arising out of procurements... administrative funds provided to State and local agencies? Administrative funds may be used for costs that are...
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Using administrative data for longitudinal substance abuse research.
Evans, Elizabeth; Grella, Christine E; Murphy, Debra A; Hser, Yih-Ing
2010-04-01
The utilization of administrative data in substance abuse research has become more widespread than ever. This selective review synthesizes recent extant research from 31 articles to consider what has been learned from using administrative data to conduct longitudinal substance abuse research in four overlapping areas: (1) service access and utilization, (2) underrepresented populations, (3) treatment outcomes, and (4) cost analysis. Despite several notable limitations, administrative data contribute valuable information, particularly in the investigation of service system interactions and outcomes among substance abusers as they unfold and influence each other over the long term. This critical assessment of the advantages and disadvantages of using existing administrative data within a longitudinal framework should stimulate innovative thinking regarding future applications of administrative data for longitudinal substance abuse research purposes.
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Are PES connection costs too high?
International Nuclear Information System (INIS)
Scott, N.
1998-01-01
Windfarm developers often have good reason to question the costs they are quoted by their local distribution company for connection to the system, and these costs can now be challenged under the 'Competition in Connection' initiative. Econnect Ltd specialise in electrical connections for renewable generation throughout the UK and Europe, and have worked on many projects where alternative connections have been designed at more competitive prices. This paper provides some examples which illustrate the importance of acquiring a thorough understanding of all power system issues and PES concerns if the most cost-effective connection is to be realised. (Author)
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Membership Satisfaction and the Cost of Membership
DEFF Research Database (Denmark)
Eskildsen, Jacob Kjær; Kristensen, Kai
2011-01-01
This article suggests a framework for measuring membership satisfaction based on a literature study. The framework is tested on data from more than 8800 members from 29 different Danish unemployment insurance funds. The framework fits the data well and is able to explain 83% of the variation...... in membership satisfaction. Furthermore the cost of administration per member and membership satisfaction is found to be able to explain differences in membership loyalty when the 29 unemployment insurance funds are compared. Finally administration costs per member are found to be dependent on the number...
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MOTIVATION OF ADMINISTRATIVE ACTS – GUARANTEE OF GOOD ADMINISTRATION
Directory of Open Access Journals (Sweden)
Adelin Mihai ZĂGĂRIN
2018-05-01
Full Text Available The present article deals with the aspects of motivating administrative acts, both doctrinaire and practical, of jurisprudence. The duty of the administration to motivate its decisions is submitted in the Charter of Fundamental Rights of the European Union, art. 41. In the current European legal order, the rationale for administrative acts is considered and refers to one of the most important conditions of validity of the administrative act. The Romanian Constitution ensures and emphasizes the motivation, as it is imposed by the Charter. The realization of this fundamental right to motivate administrative acts is possible by calling upon a set of values from the administration, such as transparency, professionalism and the imposition of high quality standards. Motivation is achieved where we have a good administration, and whether citizens are, among other things, respected fundamental rights and freedoms, access to information is guaranteed and motivated their decisions. Although administrative normative acts are motivated by the administration, examples that show that individual ones are unmotivated or incompletely motivated are enough, which made the various employers legally answer for the non-motivation of their decisions to terminate work relationships with several of the employees. The motivation of administrative acts is necessary, mandatory and must be done with rigor. It is highlighted that inadequate, incomplete or vicious reasoning may result in suspension or even annulment of the administrative act by the court.
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5 CFR 847.705 - Cost-of-living adjustments.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 847.705... FUND INSTRUMENTALITIES Computation of Benefits Under the Retroactive Provisions § 847.705 Cost-of-living adjustments. Cost-of-living adjustments are applied to the rate payable to the retiree or survivor...
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7 CFR 550.47 - Cost and price analysis.
2010-01-01
... 7 Agriculture 6 2010-01-01 2010-01-01 false Cost and price analysis. 550.47 Section 550.47... OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS Management of Agreements Procurement Standards § 550.47 Cost and price analysis. Some form of cost or price analysis shall...
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50 CFR 37.46 - Cost reimbursement.
2010-10-01
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Cost reimbursement. 37.46 Section 37.46... NATIONAL WILDLIFE REFUGE, ALASKA General Administration § 37.46 Cost reimbursement. (a) Each applicant for or holder of a special use permit issued under this part shall reimburse the Department for its...
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20 CFR 632.37 - Allowable costs.
2010-04-01
... otherwise indicated below, direct and indirect costs shall be charged in accordance with 41 CFR 29-70 and 41... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Allowable costs. 632.37 Section 632.37 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR INDIAN AND NATIVE AMERICAN...
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41 CFR 105-72.307 - Allowable costs.
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Allowable costs. 105-72.307 Section 105-72.307 Public Contracts and Property Management Federal Property Management... Administration 72-UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER...
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Costs of occupational injuries and illnesses in Croatia.
Bađun, Marijana
2017-03-01
Apart from influencing the quality of life, occupational injuries and illnesses can pose a large economic burden to a society. There are many studies that estimate the costs of occupational injuries and illnesses in highly developed economies, but the evidence for other countries is scarce. This study aimed to estimate the financial costs of occupational injuries and illnesses to Croatian government and employers in 2015. Workers were excluded due to the lack of data. Costs were estimated by analysing available data sources on occupational health and safety. Financial costs were grouped in several categories: medical costs, productivity losses, disability pensions, compensation for physical impairment, administrative costs, and legal costs. Unlike in other studies, the costs of compliance with occupational safety and health regulations were also investigated. In 2015, financial costs to employers were twice higher than costs to the government (HRK 604.6 m vs HRK 297 m). Employers additionally covered around HRK 300 m of compliance costs. Taking into account that financial costs of occupational injuries and illnesses are significant, even without including the costs to workers, policy makers should put additional efforts into their prevention. A prerequisite is transparency in Croatian Health Insurance Fund's expenditures, as well as more detailed data on lost days from work by industries, causes of injury etc. Organisations in charge of occupational health and safety and policy makers should observe relevant statistics in monetary terms too.
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Fanelli, Andrea; Ruggeri, Matteo; Basile, Michele; Cicchetti, Americo; Coluzzi, Flaminia; Della Rocca, Giorgio; Di Marco, Pierangelo; Esposito, Clelia; Fanelli, Guido; Grossi, Paolo; Leykin, Yigal; Lorini, Ferdinando Luca; Paolicchi, Adriana; Scardino, Marco; Corcione, Antonio
2016-02-01
The aim of this analysis is to evaluate the costs of 72-hour postoperative pain treatment in patients undergoing major abdominal, orthopedic and thoracic procedures in nine different Italian hospitals, defined as the cumulative cost of drugs, consumable materials and time required for anesthesiologists, surgeons and nurses to administer each analgesic technique. Nine Italian hospitals have been involved in this study through the administration of a questionnaire aimed to acquire information about the Italian clinical practice in terms of analgesia. This study uses activity-based costing (ABC) analysis to identify, measure and give value to the resources required to provide the therapeutic treatment used in Italy to manage the postoperative pain patients face after surgery. A deterministic sensitivity analysis (DSA) has been performed to identify the cost determinants mainly affecting the final cost of each treatment analyzed. Costs have been reclassified according to three surgical macro-areas (abdominal, orthopedic and thoracic) with the aim to recognize the cost associated not only to the analgesic technique adopted but also to the type of surgery the patient faced before undergoing the analgesic pathway. Fifteen different analgesic techniques have been identified for the treatment of moderate to severe pain in patients who underwent a major abdominal, orthopedic or thoracic surgery. The cheapest treatment actually employed is the oral administration "around the clock" (€ 8.23), whilst the most expensive is continuous peripheral nerve block (€ 223.46). The intravenous patient-controlled analgesia costs € 277.63. In terms of resources absorbed, the non-continuous administration via bolus is the gold standard in terms of cost-related to the drugs used (€ 1.28), and when administered pro re nata it also absorbs the lowest amount of consumables (€0.58€) compared to all other therapies requiring a delivery device. The oral analgesic administration pro re
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The cost of long-term follow-up of high-risk infants for research studies.
Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y
2015-10-01
Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
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5 CFR 838.735 - Cost-of-living adjustments.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.735... Awarding Former Spouse Survivor Annuities Payment Procedures § 838.735 Cost-of-living adjustments. (a) OPM applies cost-of-living adjustments to all former spouse survivor annuities in pay status at the time of...
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5 CFR 838.1017 - Cost-of-living adjustments.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments. 838.1017... Retirement Benefits § 838.1017 Cost-of-living adjustments. In cases where the court order apportions a... proper payment. That amount will be increased by future cost-of-living increases unless the court directs...
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The Costs of Critical Care Telemedicine Programs
Falk, Derik M.; Bonello, Robert S.; Kahn, Jeremy M.; Perencevich, Eli; Cram, Peter
2013-01-01
Background: Implementation of telemedicine programs in ICUs (tele-ICUs) may improve patient outcomes, but the costs of these programs are unknown. We performed a systematic literature review to summarize existing data on the costs of tele-ICUs and collected detailed data on the costs of implementing a tele-ICU in a network of Veterans Health Administration (VHA) hospitals. Methods: We conducted a systematic review of studies published between January 1, 1990, and July 1, 2011, reporting costs of tele-ICUs. Studies were summarized, and key cost data were abstracted. We then obtained the costs of implementing a tele-ICU in a network of seven VHA hospitals and report these costs in light of the existing literature. Results: Our systematic review identified eight studies reporting tele-ICU costs. These studies suggested combined implementation and first year of operation costs for a tele-ICU of $50,000 to $100,000 per monitored ICU-bed. Changes in patient care costs after tele-ICU implementation ranged from a $3,000 reduction to a $5,600 increase in hospital cost per patient. VHA data suggested a cost for implementation and first year of operation of $70,000 to $87,000 per ICU-bed, depending on the depreciation methods applied. Conclusions: The cost of tele-ICU implementation is substantial, and the impact of these programs on hospital costs or profits is unclear. Until additional data become available, clinicians and administrators should carefully weigh the clinical and economic aspects of tele-ICUs when considering investing in this technology. PMID:22797291
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Hosack, Mary Browne
This paper describes a practicum program that was developed to increase the effectiveness of the administrative team at one high school. A lack of communication skills had prevented the target group from working together as a team. Strategies included role-play activities, workshops, and communication skill-development meetings. A series of…
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International Nuclear Information System (INIS)
Thomas, W.E.
1976-04-01
This report discusses each of the components that affect the unit cost for enriched uranium; that is, ore costs, U 3 O 8 to UF 6 conversion cost, costs for enriching services, and changes in transaction tails assay. Historical trends and announced changes are included. Unit costs for highly enriched uranium (93.15 percent 235 U) and for low-enrichment uranium (3.0, 3.2, and 3.5 percent 235 U) are displayed as a function of changes in the above components and compared. It is demonstrated that the trends in these cost components will probably result in significantly less cost increase for highly enriched uranium than for low-enrichment uranium--hence favoring the High-Temperature Gas-Cooled Reactor
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High-Performance Fire Detector for Spacecraft, Phase I
National Aeronautics and Space Administration — The danger from fire aboard spacecraft is immediate with only moments for detection and suppression. Spacecraft are unique high-value systems where the cost of...
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Cost reduction for large turbine generator Pedestal in high seismic zone
International Nuclear Information System (INIS)
Sawhney, P.S.; Irani, P.; Pusheck, B.N.
1985-01-01
Turbine Generator Pedestals have generally been designed using reinforced concrete. For present day large turbine generators (1100 MWe class and above) with tall (about 80 feet) pedestals, the amount of reinforcing steel becomes quite large, especially for plants in high seismic zones. With the prime objective of cost reduction, an approach using steel/concrete composite design has been studied for a large BWR Turbine Generator pedestal with 0.3g peak ground acceleration. Large prefabricated steel modules were adopted for composite design and simplified construction. Design was based on the ACI and AISC codes. Costs and schedules were developed and compared with those for a conventionally designed reinforced concrete pedestal. Composite design was found to give considerable cost and schedule advantage over the conventional reinforced concrete design
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2010-10-01
... evaluation count towards the statutory cap on administrative costs? 2522.540 Section 2522.540 Public Welfare... measurement or evaluation count towards the statutory cap on administrative costs? No, the costs of performance measurement and evaluation do not count towards the statutory five percent cap on administrative...
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Compact High Performance Spectrometers Using Computational Imaging, Phase I
National Aeronautics and Space Administration — Energy Research Company (ERCo), in collaboration with CoVar Applied Technologies, proposes the development of high throughput, compact, and lower cost spectrometers...
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The costs of HIV/AIDS care at government hospitals in Zimbabwe
DEFF Research Database (Denmark)
Hansen, Kristian Schultz; Chapman, Glyn; Chitsike, Inam
2000-01-01
According to official figures, HIV infection in Zimbabwe stood at 700 000-1 000 000 in 1995, representing 7-10% of the population, with even higher expected numbers in 2000. Such high numbers will have far reaching effects on the economy and the health care sector. Information on costs of treatment...... and care of HIV/AIDS patients in health facilities is necessary in order to have an idea of the likely costs of the increasing number of HIV/AIDS patients. Therefore, the present study estimated the costs per in-patient day as well as per in-patient stay for patients in government health facilities...... an in-patient note review) to identify the direct treatment and diagnostic costs such as medication, laboratory tests and X-rays, and the standard step-down costing methodology to capture all the remaining resources used such as hospital administration, meals, housekeeping, laundry, etc. The findings...
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Ullman, Ellen
2013-01-01
Aware that rising costs could force some community colleges to compromise their long-standing open-door policies, administrators have put in place programs and incentives to offset the higher price of the average community college education. This article features ideas and programs to help struggling community colleges cope with rising costs such…
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School Administrators Can Make a Difference.
Geske, Terry G.
1981-01-01
To help administrators improve school efficiency in a time of financial constraints, this document reviews research on school productivity, points out possible improvements suggested by the research, and discusses several problems in measuring school costs and effectiveness. The author first explains the analytical concepts of school productivity,…
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STEM Faculty and Indirect Costs: What Administrators Need to Know
Gossman, Susan
2016-01-01
The focus of this single site, qualitative case study was on public research university STEM (science, technology, engineering and mathematics) faculty and their perspectives on, and behavior towards, indirect cost recovery. The explanatory scheme was derived from anthropological theory and incorporated organizational culture, resource dependency…
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28 CFR 70.45 - Cost and price analysis.
2010-07-01
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Cost and price analysis. 70.45 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.45 Cost and price analysis. Some form of cost or price analysis must be made and documented in the procurement files in connection...
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A scalable-low cost architecture for high gain beamforming antennas
Bakr, Omar; Johnson, Mark; Jungdong Park,; Adabi, Ehsan; Jones, Kevin; Niknejad, Ali
2010-01-01
Many state-of-the-art wireless systems, such as long distance mesh networks and high bandwidth networks using mm-wave frequencies, require high gain antennas to overcome adverse channel conditions. These networks could be greatly aided by adaptive beamforming antenna arrays, which can significantly simplify the installation and maintenance costs (e.g., by enabling automatic beam alignment). However, building large, low cost beamforming arrays is very complicated. In this paper, we examine the main challenges presented by large arrays, starting from electromagnetic and antenna design and proceeding to the signal processing and algorithms domain. We propose 3-dimensional antenna structures and hybrid RF/digital radio architectures that can significantly reduce the complexity and improve the power efficiency of adaptive array systems. We also present signal processing techniques based on adaptive filtering methods that enhance the robustness of these architectures. Finally, we present computationally efficient vector quantization techniques that significantly improve the interference cancellation capabilities of analog beamforming architectures. © 2010 IEEE.
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A scalable-low cost architecture for high gain beamforming antennas
Bakr, Omar
2010-10-01
Many state-of-the-art wireless systems, such as long distance mesh networks and high bandwidth networks using mm-wave frequencies, require high gain antennas to overcome adverse channel conditions. These networks could be greatly aided by adaptive beamforming antenna arrays, which can significantly simplify the installation and maintenance costs (e.g., by enabling automatic beam alignment). However, building large, low cost beamforming arrays is very complicated. In this paper, we examine the main challenges presented by large arrays, starting from electromagnetic and antenna design and proceeding to the signal processing and algorithms domain. We propose 3-dimensional antenna structures and hybrid RF/digital radio architectures that can significantly reduce the complexity and improve the power efficiency of adaptive array systems. We also present signal processing techniques based on adaptive filtering methods that enhance the robustness of these architectures. Finally, we present computationally efficient vector quantization techniques that significantly improve the interference cancellation capabilities of analog beamforming architectures. © 2010 IEEE.
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Global warming and carbon taxation. Optimal policy and the role of administration costs
International Nuclear Information System (INIS)
Williams, M.
1995-01-01
This paper develops a model relating CO 2 emissions to atmosphere concentrations, global temperature change and economic damages. For a variety of parameter assumptions, the model provides estimates of the marginal cost of emissions in various years. The optimal carbon tax is a function of the marginal emission cost and the costs of administering the tax. This paper demonstrates that under any reasonable assumptions, the optimal carbon tax is zero for at least several decades. (author)
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Taguchi Approach to Design Optimization for Quality and Cost: An Overview
Unal, Resit; Dean, Edwin B.
1990-01-01
Calibrations to existing cost of doing business in space indicate that to establish human presence on the Moon and Mars with the Space Exploration Initiative (SEI) will require resources, felt by many, to be more than the national budget can afford. In order for SEI to succeed, we must actually design and build space systems at lower cost this time, even with tremendous increases in quality and performance requirements, such as extremely high reliability. This implies that both government and industry must change the way they do business. Therefore, new philosophy and technology must be employed to design and produce reliable, high quality space systems at low cost. In recognizing the need to reduce cost and improve quality and productivity, Department of Defense (DoD) and National Aeronautics and Space Administration (NASA) have initiated Total Quality Management (TQM). TQM is a revolutionary management strategy in quality assurance and cost reduction. TQM requires complete management commitment, employee involvement, and use of statistical tools. The quality engineering methods of Dr. Taguchi, employing design of experiments (DOE), is one of the most important statistical tools of TQM for designing high quality systems at reduced cost. Taguchi methods provide an efficient and systematic way to optimize designs for performance, quality, and cost. Taguchi methods have been used successfully in Japan and the United States in designing reliable, high quality products at low cost in such areas as automobiles and consumer electronics. However, these methods are just beginning to see application in the aerospace industry. The purpose of this paper is to present an overview of the Taguchi methods for improving quality and reducing cost, describe the current state of applications and its role in identifying cost sensitive design parameters.
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48 CFR 30.102 - Cost Accounting Standards Board publication.
2010-10-01
... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Cost Accounting Standards... REGULATION GENERAL CONTRACTING REQUIREMENTS COST ACCOUNTING STANDARDS ADMINISTRATION General 30.102 Cost Accounting Standards Board publication. Copies of the CASB Standards and Regulations are printed in title 48...
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Compact, High Accuracy CO2 Monitor, Phase I
National Aeronautics and Space Administration — This Small Business Innovative Research Phase I proposal seeks to develop a low cost, robust, highly precise and accurate CO2 monitoring system. This system will...
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Compact, High Accuracy CO2 Monitor, Phase II
National Aeronautics and Space Administration — This Small Business Innovative Research Phase II proposal seeks to develop a low cost, robust, highly precise and accurate CO2 monitoring system. This system will...
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Federal Highway Administration 100-year coating study.
2012-11-01
The Federal Highway Administration 100-Year Coating Study was initiated in August 2009 to search for durable : coating systems at a reasonable cost. The objective of the study was to identify and evaluate coating materials that can : provide 100 year...
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SWaP Reduction for Lost-Cost Star Tracker
National Aeronautics and Space Administration — In the last two years, a low-cost star tracker has been developed for suborbital applications. Currently the system weighs ~9 lbm, uses ~16W and has a parts cost of...
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78 FR 68133 - Cost-of-Living Increases and Other Determinations for 2014; Correction
2013-11-13
... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2013-0057] Cost-of-Living Increases and Other Determinations for 2014; Correction AGENCY: Social Security Administration. ACTION: Notice; Correction. SUMMARY..., concerning the cost-of-living increase in Social Security benefits effective December 2013. The document...
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Directory of Open Access Journals (Sweden)
Francisco Santana de Souza
2007-12-01
Full Text Available This work aims to analyze the essential tools for the management of the ICMS (Value-Added Tax on Sales and Services. It was developed a calculation procedure of this tax which permits to demonstrate the importance of correctly perform fiscal and accounting entries. In order to demonstrate this calculation procedure, it was used Financial Mathematics concepts of simple interest and simple trade discount together with article 33, 1989 of ICMS Law of the State of São Paulo. It was concluded that it is essential to have a precise ICMS tributary administration, in order to firstly avoid contentious administrative tributary which would imply additional and unnecessary costs to the organization and secondly to use tax evasion correctly in order to avoid excessive taxes payment. Thus, the appropriate use of both instruments will reflect into a positive cash flow for the organization.
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2010-01-20
... extension of a previously approved information collection requirement concerning cost accounting standards... include pertinent rules and regulations related to the Cost Accounting Standards along with necessary... impact estimates and descriptions in cost accounting practices and also to provide information on CAS...
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41 CFR 105-54.304 - Cost guidelines.
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Cost guidelines. 105-54.304 Section 105-54.304 Public Contracts and Property Management Federal Property Management... Administration 54-ADVISORY COMMITTEE MANAGEMENT 54.3-Advisory Committee Procedures § 105-54.304 Cost guidelines...
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A Low-Cost Neutral Zinc-Iron Flow Battery with High Energy Density for Stationary Energy Storage.
Xie, Congxin; Duan, Yinqi; Xu, Wenbin; Zhang, Huamin; Li, Xianfeng
2017-11-20
Flow batteries (FBs) are one of the most promising stationary energy-storage devices for storing renewable energy. However, commercial progress of FBs is limited by their high cost and low energy density. A neutral zinc-iron FB with very low cost and high energy density is presented. By using highly soluble FeCl 2 /ZnBr 2 species, a charge energy density of 56.30 Wh L -1 can be achieved. DFT calculations demonstrated that glycine can combine with iron to suppress hydrolysis and crossover of Fe 3+ /Fe 2+ . The results indicated that an energy efficiency of 86.66 % can be obtained at 40 mA cm -2 and the battery can run stably for more than 100 cycles. Furthermore, a low-cost porous membrane was employed to lower the capital cost to less than $ 50 per kWh, which was the lowest value that has ever been reported. Combining the features of low cost, high energy density and high energy efficiency, the neutral zinc-iron FB is a promising candidate for stationary energy-storage applications. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
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An inventory of measures for internalising external costs in transport
Energy Technology Data Exchange (ETDEWEB)
Van Essen, H.; Nelissen, D.; Smit, M.; Van Grinsven, A.; Aarnink, S. [CE Delft, Delft (Netherlands); Breemersch, T. [Transport and Mobility Leuven TML, Leuven (Belgium); Martino, A.; Rosa, C.; Parolin, R. [Trasporti e Territorio TRT, Brussels (Belgium); Harmsen, J. [Sustainable Transport and Logistics TNO, Rotterdam (Netherlands)
2012-11-15
This study provides an overview of all existing and close to implementation pricing policies in transport. It supported the European Commission with the evaluation of existing pricing policies in the light of Article 11.4 of the revised Eurovignette Directive. The study covers all existing pricing instruments in all transport modes in all EU Member States. In addition it includes data on revenues and administrative costs and some comparisons across Member States and transport modes. The most recent data have been gathered: data for 2010 and where possible 2011. Also the link with external and infrastructure costs is discussed, and where possible, high level comparisons have been made.
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42 CFR 417.930 - Initial costs of operation.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Initial costs of operation. 417.930 Section 417.930... PREPAYMENT PLANS Administration of Outstanding Loans and Loan Guarantees § 417.930 Initial costs of operation. Under section 1305 of the PHS, loans and loan guarantees were awarded for initial costs of operation of...
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Triptans and migraine: advances in use, administration, formulation, and development.
Macone, Amanda E; Perloff, Michael D
2017-03-01
Recent triptan development has focused on new administration methods and formulations, triptan combination therapies, treatment in menstrually related migraines, and novel serotonin receptor subtype agonists (5HTf). Areas covered: Clinical triptan research related to migraine was reviewed, analyzing EMBASE and PUBMED data bases from 01/01/2011 to 06/29/2016, with a focus on clinical trials of class 1 or 2 level of evidence. There have been advances in drug combination therapies, as well as administration devices that aid in ease of use, increase efficacy, and decrease adverse reactions. Some new agents and devices have similar or less efficacy compared to previous generic triptan formulations. New agents have action at the 5HTf receptor subtype, and avoid vascular side effects of classic 5Ht1b/d agonists, however adverse reactions may limit their clinic use. Long half-life triptans, frovatriptan and naratriptan, do appear to have good benefit in menstral related migraine. Expert opinion: Recent advances in triptan development can offer some advantages to migraine therapy and patient preferences, but have a much higher cost compared to individual generic triptan agents. In the coming years, triptan advances with high efficacy, limiting ADRs and cost are welcomed, in this regard the 5HT1b/d triptans are already well established.
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Energy Technology Data Exchange (ETDEWEB)
NONE
1997-06-25
At the request of the Western Area Power Administration (Western), an audit of 17 areas was conducted with respect to possible overcharges on a power contract between Western and Basin Electric Power Cooperative (Basin), Contract No. DE-MP65-82WP-19001. The contract for Western`s purchase of electric power from Basin was entered into on April 15, 1982, and was in effect from January 1, 1986, through October 31, 1990. During this 58-month period, Basin billed Western approximately $197.6 million. Overall, it was found that Basin overcharged Western approximately $23.8 million. These overcharges occurred because Basin: (1) did not recognize or amortize as gain its overestimate of completion and correction costs for Antelope Valley Station (AVS) Unit 2; (2) did not amortize the gain on the sale/leaseback of AVS Unit 2 as an offset to lease costs; (3) billed Western prematurely for lease and interest costs; (4) overcharged for the cost of coal by including administrative and general expenses and profit, as well as incorrectly calculating discounts, royalty payments, and imputed interest costs; (5) made faulty calculations of amortization rates for deferred costs; (6) used a shorter depreciation period for AVS common facilities than it had used for other power plants; (7) retained tax benefit transfers; and (8) charged Western for interest and depreciation that had been paid by others. In addition to the $23.8 million in overcharges, interest accrued on the overcharges through December 31, 1996 was estimated to be approximately $22.1 million, resulting in a total of $45.9 million due Western.
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The hidden costs of installing xpert machines in a tuberculosis high ...
African Journals Online (AJOL)
The hidden costs of installing xpert machines in a tuberculosis high-burden country: experiences from Nigeria. Saddiq Tsimiri Abdurrahman, Nnamdi Emenyonu, Olusegun Joshua Obasanya, Lovett Lawson, Russell Dacombe, Muhammad Muhammad, Olanrewaju Oladimeji, Luis Eduardo Cuevas ...
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International Nuclear Information System (INIS)
Deng, Z; Wang, J; Zheng, J; Jing, H; Lu, Y; Ma, G; Liu, L; Liu, W; Zhang, Y; Wang, S
2008-01-01
In order to improve the cost performance of the present high-T c superconducting (HTS) Maglev vehicle system for practical application, the multi-pole permanent magnet guideway (PMG) concept was introduced. A well-known double-pole Halbach PMG was chosen as a representative of multi-pole PMGs to compare with traditional monopole PMGs from the point of view of levitation efficiency and cost. Experimental results show that YBCO bulks above the double-pole Halbach PMG can exhibit better load capability and guidance performance as well as dynamics stability at the applied working height between the bulk HTSC and the PMG due to a more reasonable magnetic field distribution at the working range of bulk HTSC. Furthermore, the double-pole PMG configuration can play a more important role in improving guidance performance due to the potential-well field configuration. By comparing with former 'century' PMGs, the double-pole Halbach PMG shows another remarkable advantage in reducing the cost of levitation. As another necessary issue, magnetic field homogeneity and the corresponding magnetic drag force of a double-pole Halbach PMG has been considered by experiment in spite of the above highlights. Synthetically, the multi-pole Halbach PMG design is concluded to be one important choice for future HTS Maglev vehicle applications because of its high efficiency and low cost.
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Chitre, S. R.
1978-01-01
The paper presents an experimentally developed surface macro-structuring process suitable for high volume production of silicon solar cells. The process lends itself easily to automation for high throughput to meet low-cost solar array goals. The tetrahedron structure observed is 0.5 - 12 micron high. The surface has minimal pitting with virtually no or very few undeveloped areas across the surface. This process has been developed for (100) oriented as cut silicon. Chemi-etched, hydrophobic and lapped surfaces were successfully texturized. A cost analysis as per Samics is presented.
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How does cognitive dissonance influence the sunk cost effect?
Directory of Open Access Journals (Sweden)
Chung SH
2018-03-01
Full Text Available Shao-Hsi Chung,1 Kuo-Chih Cheng2 1Department of Business Administration, Meiho University, Pingtung, Taiwan; 2Department of Accounting, National Changhua University of Education, Changhua City, Taiwan Background: The sunk cost effect is the scenario when individuals are willing to continue to invest capital in a failing project. The purpose of this study was to explain such irrational behavior by exploring how sunk costs affect individuals’ willingness to continue investing in an unfavorable project and to understand the role of cognitive dissonance on the sunk cost effect. Methods: This study used an experimental questionnaire survey on managers of firms listed on the Taiwan Stock Exchange and Over-The-Counter. Results: The empirical results show that cognitive dissonance does not mediate the relationship between sunk costs and willingness to continue an unfavorable investment project. However, cognitive dissonance has a moderating effect, and only when the level of cognitive dissonance is high does the sunk cost have significantly positive impacts on willingness to continue on with an unfavorable investment. Conclusion: This study offers psychological mechanisms to explain the sunk cost effect based on the theory of cognitive dissonance, and it also provides some recommendations for corporate management. Keywords: sunk costs, sunk cost effect, cognitive dissonance, behavior, unfavorable investment
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The High Rise Low Cost Housing : Sustainable Neighbourhood Elements (Green Elements) in Malaysia
Wahi, Noraziah; Mohamad, Ismail; Mohamad Zin, Rosli; Munikanan, Vikneswaran; Junaini, Syahrizan
2018-03-01
The sustainable development is a vital measure to alleviate the greenhouse gas effect, global warming and any other environment issues. The sustainable neighbourhood concept is not new in Malaysia, However, the concept still needs attention and awareness from the stakeholders. This paper discusses on the sustainable neighbourhood elements specifically green elements application on the high rise low cost housing in Malaysia. Malaysia should have focused sustainable neighbourhood planning and design especially on the high rise low cost housing therefore the future generation can be benefited from this type development.
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Good, Ryan J; Leroue, Matthew K; Czaja, Angela S
2018-06-07
Noninvasive positive pressure ventilation (NIPPV) is increasingly used in critically ill pediatric patients, despite limited data on safety and efficacy. Administrative data may be a good resource for observational studies. Therefore, we sought to assess the performance of the International Classification of Diseases, Ninth Revision procedure code for NIPPV. Patients admitted to the PICU requiring NIPPV or heated high-flow nasal cannula (HHFNC) over the 11-month study period were identified from the Virtual PICU System database. The gold standard was manual review of the electronic health record to verify the use of NIPPV or HHFNC among the cohort. The presence or absence of a NIPPV procedure code was determined by using administrative data. Test characteristics with 95% confidence intervals (CIs) were generated, comparing administrative data with the gold standard. Among the cohort ( n = 562), the majority were younger than 5 years, and the most common primary diagnosis was bronchiolitis. Most (82%) required NIPPV, whereas 18% required only HHFNC. The NIPPV code had a sensitivity of 91.1% (95% CI: 88.2%-93.6%) and a specificity of 57.6% (95% CI: 47.2%-67.5%), with a positive likelihood ratio of 2.15 (95% CI: 1.70-2.71) and negative likelihood ratio of 0.15 (95% CI: 0.11-0.22). Among our critically ill pediatric cohort, NIPPV procedure codes had high sensitivity but only moderate specificity. On the basis of our study results, there is a risk of misclassification, specifically failure to identify children who require NIPPV, when using administrative data to study the use of NIPPV in this population. Copyright © 2018 by the American Academy of Pediatrics.
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Schousboe, J T; Paudel, M L; Taylor, B C; Kats, A M; Virnig, B A; Dowd, B E; Langsetmo, L; Ensrud, K E
2017-03-01
Older women with pre-fracture slow walk speed, high body mass index, and/or a high level of multimorbidity have significantly higher health care costs after hip fracture compared to those without those characteristics. Studies to investigate if targeted health care interventions for these individuals can reduce hip fracture costs are warranted. The aim of this study is to estimate the associations of individual pre-fracture characteristics with total health care costs after hip fracture, using Study of Osteoporotic Fractures (SOF) cohort data linked to Medicare claims. Our study population was 738 women age 70 and older enrolled in Medicare Fee for Service (FFS) who experienced an incident hip fracture between January 1, 1992 and December 31, 2009. We assessed pre-fracture individual characteristics at SOF study visits and estimated costs of hospitalizations, skilled nursing facility and inpatient rehabilitation stays, home health care visits, and outpatient utilization from Medicare FFS claims. We used generalized linear models to estimate the associations of predictor variables with total health care costs (2010 US dollars) after hip fracture. Median total health care costs for 1 year after hip fracture were $35,536 (inter-quartile range $24,830 to $50,903). Multivariable-adjusted total health care costs for 1 year after hip fracture were 14 % higher ($5256, 95 % CI $156 to $10,356) in those with walk speed total health care costs after hip fracture in older women. Studies to investigate if targeted health care interventions for these individuals can reduce the costs of hip fractures are warranted.
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Analysis for the high-level waste disposal cost object
International Nuclear Information System (INIS)
Kim, S. K.; Lee, J. R.; Choi, J. W.; Han, P. S.
2003-01-01
The purpose of this study is to analyse the ratio of cost object in terms of the disposal cost estimation. According to the result, the ratio of operating cost is the most significant object in total cost. There are a lot of differences between the disposal costs and product costs in view of their constituents. While the product costs may be classified by the direct materials cost, direct manufacturing labor cost, and factory overhead the disposal cost factors should be constituted by the technical factors and the non-technical factors
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Case mix-adjusted cost of colectomy at low-, middle-, and high-volume academic centers.
Chang, Alex L; Kim, Young; Ertel, Audrey E; Hoehn, Richard S; Wima, Koffi; Abbott, Daniel E; Shah, Shimul A
2017-05-01
Efforts to regionalize surgery based on thresholds in procedure volume may have consequences on the cost of health care delivery. This study aims to delineate the relationship between hospital volume, case mix, and variability in the cost of operative intervention using colectomy as the model. All patients undergoing colectomy (n = 90,583) at 183 academic hospitals from 2009-2012 in The University HealthSystems Consortium Database were studied. Patient and procedure details were used to generate a case mix-adjusted predictive model of total direct costs. Observed to expected costs for each center were evaluated between centers based on overall procedure volume. Patient and procedure characteristics were significantly different between volume tertiles. Observed costs at high-volume centers were less than at middle- and low-volume centers. According to our predictive model, high-volume centers cared for a less expensive case mix than middle- and low-volume centers ($12,786 vs $13,236 and $14,497, P case mix at low-volume centers, which may lead to perceived poor performance at these centers. Copyright © 2016 Elsevier Inc. All rights reserved.
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48 CFR 1845.7101-3 - Unit acquisition cost.
2010-10-01
... production inventory and include programmed extra units to cover replacement during the fabrication process... ADMINISTRATION CONTRACT MANAGEMENT GOVERNMENT PROPERTY Forms Preparation 1845.7101-3 Unit acquisition cost. (a... production costs (for assets produced or constructed). (5) Engineering, architectural, and other outside...
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Melanoma costs: a dynamic model comparing estimated overall costs of various clinical stages.
Alexandrescu, Doru Traian
2009-11-15
adjuvant treatment with IFN-alpha ($75,955.18), palliative care ($14,500), and administration of chemotherapy ($1,967.10 for a triple combination of agents); there are even higher costs for biochemotherapy, the new tyrosine kinase and antiangiogenic drugs, and hospital treatment of neutropenic fever ($1,535.00 to $1,800.00/day). There is a significant cost decrement when melanoma is diagnosed at an earlier stage, with a T4b lesion being approximately 2200 percent more expensive to diagnose and treat than an early in situ melanoma and 1000 percent more expensive than a stage T1a tumor. Although a direct comparison with other cancers would require the use of the same dynamic model, it is apparent that the high costs of melanoma care places it at the top of the most expensive cancers to diagnose, follow, and treat. These high costs for advanced-stage melanoma warrant an increased emphasis on developing effective strategies for its early diagnosis and treatment.
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Ferhati, H.; Djeffal, F.
2017-12-01
In this paper, a new junctionless optical controlled field effect transistor (JL-OCFET) and its comprehensive theoretical model is proposed to achieve high optical performance and low cost fabrication process. Exhaustive study of the device characteristics and comparison between the proposed junctionless design and the conventional inversion mode structure (IM-OCFET) for similar dimensions are performed. Our investigation reveals that the proposed design exhibits an outstanding capability to be an alternative to the IM-OCFET due to the high performance and the weak signal detection benefit offered by this design. Moreover, the developed analytical expressions are exploited to formulate the objective functions to optimize the device performance using Genetic Algorithms (GAs) approach. The optimized JL-OCFET not only demonstrates good performance in terms of derived drain current and responsivity, but also exhibits superior signal to noise ratio, low power consumption, high-sensitivity, high ION/IOFF ratio and high-detectivity as compared to the conventional IM-OCFET counterpart. These characteristics make the optimized JL-OCFET potentially suitable for developing low cost and ultrasensitive photodetectors for high-performance and low cost inter-chips data communication applications.
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Cost-effectiveness of Crohn’s disease post-operative care
Wright, Emily K; Kamm, Michael A; Dr Cruz, Peter; Hamilton, Amy L; Ritchie, Kathryn J; Bell, Sally J; Brown, Steven J; Connell, William R; Desmond, Paul V; Liew, Danny
2016-01-01
AIM: To define the cost-effectiveness of strategies, including endoscopy and immunosuppression, to prevent endoscopic recurrence of Crohn’s disease following intestinal resection. METHODS: In the “POCER” study patients undergoing intestinal resection were treated with post-operative drug therapy. Two thirds were randomized to active care (6 mo colonoscopy and drug intensification for endoscopic recurrence) and one third to drug therapy without early endoscopy. Colonoscopy at 18 mo and faecal calprotectin (FC) measurement were used to assess disease recurrence. Administrative data, chart review and patient questionnaires were collected prospectively over 18 mo. RESULTS: Sixty patients (active care n = 43, standard care n = 17) were included from one health service. Median total health care cost was $6440 per patient. Active care cost $4824 more than standard care over 18 mo. Medication accounted for 78% of total cost, of which 90% was for adalimumab. Median health care cost was higher for those with endoscopic recurrence compared to those in remission [$26347 (IQR 25045-27485) vs $2729 (IQR 1182-5215), P cost by $1010 per patient over 18 mo. Active care was associated with 18% decreased endoscopic recurrence, costing $861 for each recurrence prevented. CONCLUSION: Post-operative management strategies are associated with high cost, primarily medication related. Calprotectin use reduces costs. The long term cost-benefit of these strategies remains to be evaluated. PMID:27076772
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Cost-effectiveness analysis of online hemodiafiltration versus high-flux hemodialysis
Directory of Open Access Journals (Sweden)
Ramponi F
2016-09-01
Full Text Available Francesco Ramponi,1,2 Claudio Ronco,1,3 Giacomo Mason,1 Enrico Rettore,4 Daniele Marcelli,5,6 Francesca Martino,1,3 Mauro Neri,1,7 Alejandro Martin-Malo,8 Bernard Canaud,5,9 Francesco Locatelli10 1International Renal Research Institute (IRRIV, San Bortolo Hospital, Vicenza, 2Department of Economics and Management, University of Padova, Padova, 3Department of Nephrology, San Bortolo Hospital, Vicenza, 4Department of Sociology and Social Research, University of Trento, FBK-IRVAPP & IZA, Trento, Italy; 5Europe, Middle East, Africa and Latin America Medical Board, Fresenius Medical Care,, Bad Homburg, Germany; 6Danube University, Krems, Austria; 7Department of Management and Engineering, University of Padova, Vicenza, Italy; 8Nephrology Unit, Reina Sofia University Hospital, Córdoba, Spain; 9School of Medicine, Montpellier University, Montpellier, France; 10Department of Nephrology, Manzoni Hospital, Lecco, Italy Background: Clinical studies suggest that hemodiafiltration (HDF may lead to better clinical outcomes than high-flux hemodialysis (HF-HD, but concerns have been raised about the cost-effectiveness of HDF versus HF-HD. Aim of this study was to investigate whether clinical benefits, in terms of longer survival and better health-related quality of life, are worth the possibly higher costs of HDF compared to HF-HD.Methods: The analysis comprised a simulation based on the combined results of previous published studies, with the following steps: 1 estimation of the survival function of HF-HD patients from a clinical trial and of HDF patients using the risk reduction estimated in a meta-analysis; 2 simulation of the survival of the same sample of patients as if allocated to HF-HD or HDF using three-state Markov models; and 3 application of state-specific health-related quality of life coefficients and differential costs derived from the literature. Several Monte Carlo simulations were performed, including simulations for patients with different
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An Analysis of Unit Costs at a Consolidated Supply Depot
1990-12-01
Not-For-Profit Setting,"The Accounting Review,July 1990. Horngren , C. T., Cost Accountinq:A Managerial Emphasis,3rd ed, Prentice-Hall Inc.,1972...sector has used concepts of unit costs for 4 decades. Any managerial or cost accounting text discusses in some length unit costs . For Defense contractors...the Cost Accounting Standards Board (CASB) provides guidance for contract costs . Unit costs include direct, indirect, and general and administrative
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Zhao, H; Ji, Z-H; Liu, C; Yu, X-Y
2015-04-02
Studies demonstrated that chronic high-dose homocysteine administration induced learning and memory impairment in animals. Atractylenolide III (Aen-III), a neuroprotective constituent of Atractylodis macrocephalae Koidz, was isolated in our previous study. In this study, we investigated potential benefits of Aen-III in preventing learning and memory impairment following chronic high-dose homocysteine administration in rats. Results showed that administration of Aen-III significantly ameliorated learning and memory impairment induced by chronic high-dose homocysteine administration in rats, decreased homocysteine-induced reactive oxygen species (ROS) formation and restored homocysteine-induced decrease of phosphorylated protein kinase C expression level. Moreover, Aen-III protected primary cultured neurons from apoptotic death induced by homocysteine treatment. This study provides the first evidence for the neuroprotective effect of Aen-III in preventing learning and impairment induced by chronic administration of homocysteine. Aen-III may have therapeutic potential in treating homocysteine-mediated cognitive impairment and neuronal injury. Copyright © 2015 IBRO. Published by Elsevier Ltd. All rights reserved.
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Lin, Ruilin; Xie, Jingchen; Jeng, Yoau-Chau; Wang, Zheng-Hong
2011-01-01
The purpose of this study is to explore the relationships between "job involvement" and "school administrative effectiveness" as perceived by junior high school administration teachers. The findings are as follows. (1) The current status of "job involvement" and "school administrative effectiveness" as…
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Steach, John C.
2011-01-01
This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…
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An improved set of standards for finding cost for cost-effectiveness analysis.
Barnett, Paul G
2009-07-01
Guidelines have helped standardize methods of cost-effectiveness analysis, allowing different interventions to be compared and enhancing the generalizability of study findings. There is agreement that all relevant services be valued from the societal perspective using a long-term time horizon and that more exact methods be used to cost services most affected by the study intervention. Guidelines are not specific enough with respect to costing methods, however. The literature was reviewed to identify the problems associated with the 4 principal methods of cost determination. Microcosting requires direct measurement and is ordinarily reserved to cost novel interventions. Analysts should include nonwage labor cost, person-level and institutional overhead, and the cost of development, set-up activities, supplies, space, and screening. Activity-based cost systems have promise of finding accurate costs of all services provided, but are not widely adopted. Quality must be evaluated and the generalizability of cost estimates to other settings must be considered. Administrative cost estimates, chiefly cost-adjusted charges, are widely used, but the analyst must consider items excluded from the available system. Gross costing methods determine quantity of services used and employ a unit cost. If the intervention will affect the characteristics of a service, the method should not assume that the service is homogeneous. Questions are posed for future reviews of the quality of costing methods. The analyst must avoid inappropriate assumptions, especially those that bias the analysis by exclusion of costs that are affected by the intervention under study.
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Administrative mechanics of research fuel transportation
International Nuclear Information System (INIS)
Harmon, Diane W.
1983-01-01
This presentation contains the discussion on the multitude of administrative mechanics that have to be meshed for the successful completion of a shipment of spent fuel, HEU or LEU in the research reactors fuel cycle. The costs associated with transportation may be the equivalent of 'a black hole', so an overview of cost factors is given. At the end one could find that this black hole factor in the budget is actually a bargain. The first step is the quotation phase. The cost variables in the quotation contain the cost of packaging i.e. containers; the complete routing of the packages and the materials. Factors that are of outmost importance are the routing restrictions and regulations, physical security regulations. All of this effort is just to provide a valid quotation not to accomplish the goal of completing a shipment. Public relations cannot be omitted either
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Administrative mechanics of research fuel transportation
Energy Technology Data Exchange (ETDEWEB)
Harmon, Diane W [Edlow International Company, Washington, DC (United States)
1983-09-01
This presentation contains the discussion on the multitude of administrative mechanics that have to be meshed for the successful completion of a shipment of spent fuel, HEU or LEU in the research reactors fuel cycle. The costs associated with transportation may be the equivalent of 'a black hole', so an overview of cost factors is given. At the end one could find that this black hole factor in the budget is actually a bargain. The first step is the quotation phase. The cost variables in the quotation contain the cost of packaging i.e. containers; the complete routing of the packages and the materials. Factors that are of outmost importance are the routing restrictions and regulations, physical security regulations. All of this effort is just to provide a valid quotation not to accomplish the goal of completing a shipment. Public relations cannot be omitted either.
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Cost-Effectiveness of Highly Active Antiretroviral Therapy in South Africa.
Directory of Open Access Journals (Sweden)
2005-12-01
Full Text Available BACKGROUND: Little information exists on the impact of highly active antiretroviral therapy (HAART on health-care provision in South Africa despite increasing scale-up of access to HAART and gradual reduction in HAART prices. METHODS AND FINDINGS: Use and cost of services for 265 HIV-infected adults without AIDS (World Health Organization [WHO] stage 1, 2, or 3 and 27 with AIDS (WHO stage 4 receiving HAART between 1995 and 2000 in Cape Town were compared with HIV-infected controls matched for baseline WHO stage, CD4 count, age, and socioeconomic status, who did not receive antiretroviral therapy (ART; No-ART group. Costs of service provision (January 2004 prices, US$1 = 7.6 Rand included local unit costs, and two scenarios for HAART prices for WHO recommended first-line regimens: scenario 1 used current South African public-sector ART drug prices of $730 per patient-year (PPY, whereas scenario 2 was based on the anticipated public-sector price for locally manufactured drug of $181 PPY. All analyses are presented in terms of patients without AIDS and patients with AIDS. For patients without AIDS, the mean number of inpatient days PPY was 1.08 (95% confidence interval [CI]: 0.97-1.19 for the HAART group versus 3.73 (95% CI: 3.55-3.97 for the No-ART group, and 8.71 (95% CI: 8.40-9.03 versus 4.35 (95% CI: 4.12-5.61, respectively, for mean number of outpatient visits PPY. Average service provision PPY was $950 for the No-ART group versus $1,342 and $793 PPY for the HAART group for scenario 1 and 2, respectively, whereas the incremental cost per life-year gained (LYG was $1,622 for scenario 1 and $675 for scenario 2. For patients with AIDS, mean inpatients days PPY was 2.04 (95% CI: 1.63-2.52 for the HAART versus 15.36 (95% CI: 13.97-16.85 for the No-ART group. Mean outpatient visits PPY was 7.62 (95% CI: 6.81-8.49 compared with 6.60 (95% CI: 5.69-7.62 respectively. Average service provision PPY was $3,520 for the No-ART group versus $1,513 and $964
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Cost-effectiveness of highly active antiretroviral therapy in South Africa.
Directory of Open Access Journals (Sweden)
Motasim Badri
2006-01-01
Full Text Available Little information exists on the impact of highly active antiretroviral therapy (HAART on health-care provision in South Africa despite increasing scale-up of access to HAART and gradual reduction in HAART prices.Use and cost of services for 265 HIV-infected adults without AIDS (World Health Organization [WHO] stage 1, 2, or 3 and 27 with AIDS (WHO stage 4 receiving HAART between 1995 and 2000 in Cape Town were compared with HIV-infected controls matched for baseline WHO stage, CD4 count, age, and socioeconomic status, who did not receive antiretroviral therapy (ART; No-ART group. Costs of service provision (January 2004 prices, USD 1 = 7.6 Rand included local unit costs, and two scenarios for HAART prices for WHO recommended first-line regimens: scenario 1 used current South African public-sector ART drug prices of $730 per patient-year (PPY, whereas scenario 2 was based on the anticipated public-sector price for locally manufactured drug of $181 PPY. All analyses are presented in terms of patients without AIDS and patients with AIDS. For patients without AIDS, the mean number of inpatient days PPY was 1.08 (95% confidence interval [CI]: 0.97-1.19 for the HAART group versus 3.73 (95% CI: 3.55-3.97 for the No-ART group, and 8.71 (95% CI: 8.40-9.03 versus 4.35 (95% CI: 4.12-5.61, respectively, for mean number of outpatient visits PPY. Average service provision PPY was $950 for the No-ART group versus $1,342 and $793 PPY for the HAART group for scenario 1 and 2, respectively, whereas the incremental cost per life-year gained (LYG was $1,622 for scenario 1 and $675 for scenario 2. For patients with AIDS, mean inpatients days PPY was 2.04 (95% CI: 1.63-2.52 for the HAART versus 15.36 (95% CI: 13.97-16.85 for the No-ART group. Mean outpatient visits PPY was 7.62 (95% CI: 6.81-8.49 compared with 6.60 (95% CI: 5.69-7.62 respectively. Average service provision PPY was $3,520 for the No-ART group versus $1,513 and $964 for the HAART group for scenario 1
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77 FR 67366 - Federal Acquisition Regulation; Information Collection; Travel Costs
2012-11-09
...; Information Collection; Travel Costs AGENCY: Department of Defense (DOD), General Services Administration (GSA... requirement concerning Travel Costs. Public comments are particularly invited on: Whether this collection of...- 0088, Travel Costs by any of the following methods: Regulations.gov : http://www.regulations.gov...
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Nwachukwu, Benedict U; Schairer, William W; So, Conan; Bernstein, Jaime L; Herndon, James; Dodwell, Emily R
2016-10-05
There was a dramatic increase in the volume of manuscripts submitted to The Journal of Bone & Joint Surgery (JBJS) between 2009 and 2012. This resulted in increased journal administrative costs. To offset this financial burden, in May 2013, JBJS started charging authors an administrative processing fee at the time of submission. The purpose of this study was to assess the impact of the administrative fee on the volume and characteristics of manuscripts submitted to JBJS. Our analysis included 866 manuscripts submitted to JBJS between November 2012 and November 2013. We compared manuscripts submitted 6 months prior to fee implementation and prior to the announcement (denoted as the baseline group), in the several months prior to fee implementation but after the fee implementation announcement (denoted as the fee announcement group), and in the 6 months after fee implementation (denoted as the fee implementation group). Manuscripts were reviewed for institutional and author demographic characteristics, as well as for general study characteristics. In the first full calendar year (2014) after the implementation of the fee, the annual volume of submissions to JBJS declined by 33.5% compared with the annual submission volume in 2010 to 2012. In a comparative analysis, the geographical region of origin (p = 0.003), level of evidence (p Reporting of funding information improved significantly between the baseline and fee implementation groups; in the post-fee implementation period, studies were more likely to have declared no external funding source (p = 0.001). The administrative processing fee at JBJS has been associated with a decrease in submission volume, but, overall, there has not been a change in the characteristics of studies submitted. However, decreased overall volume implies a decrease in the absolute number of high-level studies submitted to the journal. Administrative processing fees at high-volume journals may be a financially viable way to offset high
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Using the Black Scholes method for estimating high cost illness insurance premiums in Colombia
Directory of Open Access Journals (Sweden)
Liliana Chicaíza
2009-04-01
Full Text Available This article applied the Black-Scholes option valuation formula to calculating high-cost illness reinsurance premiums in the Colombian health system. The coverage pattern used in reinsuring high-cost illnesses was replicated by means of a European call option contract. The option’s relevant variables and parameters were adapted to an insurance market context. The premium estimated by the BlackScholes method fell within the range of premiums estimated by the actuarial method.
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48 CFR 1815.407 - Special cost or pricing areas.
2010-10-01
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Special cost or pricing... ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1815.407 Special cost or pricing areas. ...
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48 CFR 1815.403 - Obtaining cost or pricing data.
2010-10-01
... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Obtaining cost or pricing... ADMINISTRATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Contract Pricing 1815.403 Obtaining cost or pricing data. ...
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High and rising health care costs.
Ginsburg, Paul B
2008-10-01
The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.
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Low Cost DIY Lenses kit For High School Teaching
Thepnurat, Meechai; Saphet, Parinya; Tong-on, Anusorn
2017-09-01
A set of lenses was fabricated from a low cost materials in a DIY (Do it yourself) process. The purpose was to demonstrate to teachers and students in high schools how to construct lenses by themselves with the local available materials. The lenses could be applied in teaching Physics, about the nature of a lens such as focal length and light rays passing through lenses in either direction, employing a set of simple laser pointers. This instrumental kit was made from a transparent 2 mm thick of acrylic Perspex. It was cut into rectangular pieces with dimensions of 2x15 cm2 and bent into curved shape by a hot air blower on a cylindrical wooden rod with curvature radii of about 3-4.5 cm. Then a pair of these Perspex were formed into a hollow thick lenses with a base supporting platform, so that any appropriate liquids could be filled in. The focal length of the lens was measured from laser beam drawing on a paper. The refractive index, n (n) of a filling liquid could be calculated from the measured focal length (f). The kit was low cost and DIY but was greatly applicable for optics teaching in high school laboratory.
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International Nuclear Information System (INIS)
Jardine, L.J.; Carlton, R.E.; Steindler, M.J.
1981-05-01
A comparative economic analysis was made of four solidification processes for liquid high-level radioactive waste. Two processes produced borosilicate glass monoliths and two others produced metal matrix composites of lead and borosilicate glass beads and lead and supercalcine pellets. Within the uncertainties of the cost (1979 dollars) estimates, the cost of the four processes was about the same, with the major cost component being the cost of the primary building structure. Equipment costs and operating and maintenance costs formed only a small portion of the building structure costs for all processes
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42 CFR 412.84 - Payment for extraordinarily high-cost cases (cost outliers).
2010-10-01
... obtains accurate data with which to calculate either an operating or capital cost-to-charge ratio (or both... outlier payments will be based on operating and capital cost-to-charge ratios calculated based on a ratio... outliers). 412.84 Section 412.84 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...
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Grant, Suzanne; Guthrie, Bruce
2018-04-01
Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings. Drawing on Strauss's negotiated order perspective, we examine ethnographically the achievement of safety across the medical-administrative boundary in key high-volume routines in UK general practice. We focus on two main issues. First, GPs engaged in strategies of demarcation by defining receptionist work as routine, unspecialised and dependent upon GP clinical knowledge and oversight as the safety net to deal with complexity and risk. Receptionists consented to this 'social closure' when describing their role, thus reinforcing the underlying inter-occupational relationship of medical domination. Second, in everyday practice, GPs and receptionists engaged in informal boundary-blurring to safely accommodate the complexity of everyday high-volume routine work. This comprised additional informal discretionary spaces for receptionist decision-making and action that went beyond the routine safety work formally assigned to them. New restratified intra-occupational hierarchies were also being created between receptionists based on the complexity of the safety work that they were authorised to do at practice level, with specialised roles constituting a new form of administrative 'professional project'. The article advances negotiated order theory by providing an in-depth examination of the ways in which medical-administrative boundary-making and boundary-blurring constitute distinct modes of safety in high
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Energy Technology Data Exchange (ETDEWEB)
Horowitz, K.; Woodhouse, M.; Lee, H.; Smestad, G.
2015-04-13
We present a bottom-up model of III-V multi-junction cells, as well as a high concentration PV (HCPV) module. We calculate $0.65/Wp(DC) manufacturing costs for our model HCPV module design with today’s capabilities, and find that reducing cell costs and increasing module efficiency offer the promising pathways for future cost reductions. Cell costs could be significantly reduced via an increase in manufacturing scale, substrate reuse, and improved manufacturing yields. We also identify several other significant drivers of HCPV module costs, including the Fresnel lens primary optic, module housing, thermal management, and the receiver board. These costs could potentially be lowered by employing innovative module designs.
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22 CFR 226.1002 - Local cost financing. [Reserved
2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Local cost financing. [Reserved] 226.1002 Section 226.1002 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS USAID-Specific Requirements § 226.1002 Local cost financing...
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Norplant's high cost may prohibit use in Title 10 clinics.
1991-04-01
The article discusses the prohibitive cost of Norplant for the Title 10 low-income population served in public family planning clinics in the U.S. It is argued that it's unfair for U.S. users to pay $350 to Wyeth- Ayerst when another pharmaceutical company provides developing countries with Norplant at a cost of $14 - 23. Although the public sector and private foundations funded the development, it was explained that the company needs to recoup the investment in training and education. Medicaid and third party payers such as insurance companies will reimburse for the higher price, but if the public sector price is lowered, then the company would not make a profit and everyone would have argued for the reimbursement at the lower cost. It was suggested that a boycott of American Home Products, Wyeth-Ayerst's parent company, be made. Public family planning providers who are particularly low in funding reflect that their budget of $30,000 would only provide 85 users, and identified in this circumstance by drug abusers and multiple pregnancy women, and the need for teenagers remains unfulfilled. Another remarked that the client population served is 4700 with $54,000 in funding, which is already accounted for. The general trend of comments was that for low income women the cost is to high.
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DEFF Research Database (Denmark)
Enemark, Stig
2014-01-01
Land administration systems are the operational tool for conceptualizing rights, restrictions and responsibilities (RRRs) in land. Each of the rights, restrictions and responsibilities encompasses a human rights dimension that relates to the overall national land policies and should be unfolded...... as more than just rhetoric. This paper attempts to analyse the aspects of human rights in relation to land administration systems with a special focus on developing countries struggling to build adequate systems for governing the rights, restrictions and responsibilities in land. Human rights....... This relates to national political arrangements and standards for good governance and land administration systems are highly instrumental in this regard. This paper introduces the relation between land administration and human rights. It is argued that human rights and land administration are closely linked...
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Directory of Open Access Journals (Sweden)
Charles I Nkeki
2014-11-01
Full Text Available This paper aim at studying a mean-variance portfolio selection problem with stochastic salary, proportional administrative costs and taxation in the accumulation phase of a defined contribution (DC pension scheme. The fund process is subjected to taxation while the contribution of the pension plan member (PPM is tax exempt. It is assumed that the flow of contributions of a PPM are invested into a market that is characterized by a cash account and a stock. The optimal portfolio processes and expected wealth for the PPM are established. The efficient and parabolic frontiers of a PPM portfolios in mean-variance are obtained. It was found that capital market line can be attained when initial fund and the contribution rate are zero. It was also found that the optimal portfolio process involved an inter-temporal hedging term that will offset any shocks to the stochastic salary of the PPM.
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Song, Yan; Dhodda, Raj; Zhang, Jun; Sydor, Jens
2014-05-01
In the recent past, we have seen an increase in the outsourcing of bioanalysis in pharmaceutical companies in support of their drug development pipeline. This trend is largely driven by the effort to reduce internal cost, especially in support of late-stage pipeline assets where established bioanalytical assays are used to analyze a large volume of samples. This article will highlight our perspective of how bioanalytical laboratories within pharmaceutical companies can be developed into the best partner in the advancement of drug development pipelines with high-quality support at competitive cost.
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Guelfucci, Florent; Kaneko, Yuko; Mahlich, Jörg; Sruamsiri, Rosarin
2018-06-01
To determine the cost of depression comorbidity among Japanese adults with rheumatoid arthritis (RA). A retrospective database study of 8968 patients diagnosed with RA between 2010 and 2015 and treated with any RA medication was conducted. Health care utilization characteristics were compared between patients with and without a comorbidity of depression. Propensity score matching was applied to ensure a balanced comparison between the two cohorts. The prevalence of a depression comorbidity was found for 5% of the total RA patients. This comorbidity was associated with 62% (56%) higher total outpatient visits and 66% (163%) higher rate of emergency room visits after 6 (12) months. Burden of depression among RA patients in Japan is relatively high and awareness for depression as a comorbidity of RA needs to be reinforced. Janssen Pharmaceutical KK.
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Raviotta, Jonathan M; Smith, Kenneth J; DePasse, Jay; Brown, Shawn T; Shim, Eunha; Nowalk, Mary Patricia; Wateska, Angela; France, Glenson S; Zimmerman, Richard K
2017-10-09
High-dose trivalent inactivated influenza vaccine (HD-IIV3) or recombinant trivalent influenza vaccine (RIV) may increase influenza vaccine effectiveness (VE) in adults with conditions that place them at high risk for influenza complications. This analysis models the public health impact and cost-effectiveness (CE) of these vaccines for 50-64year-olds. Markov model CE analysis compared 5 strategies in 50-64year-olds: no vaccination; only standard-dose IIV3 offered (SD-IIV3 only), only quadrivalent influenza vaccine offered (SD-IIV4 only); high-risk patients receiving HD-IIV3, others receiving SD-IIV3 (HD-IIV3 & SD-IIV3); and high-risk patients receiving HD-IIV3, others receiving SD-IIV4 (HD-IIV3 & SD-IIV4). In a secondary analysis, RIV replaced HD-IIV3. Parameters were obtained from U.S. databases, the medical literature and extrapolations from VE estimates. Effectiveness was measured as 3%/year discounted quality adjusted life year (QALY) losses avoided. The least expensive strategy was SD-IIV3 only, with total costs of $99.84/person. The SD-IIV4 only strategy cost an additional $0.91/person, or $37,700/QALY gained. The HD-IIV3 & SD-IIV4 strategy cost $1.06 more than SD-IIV4 only, or $71,500/QALY gained. No vaccination and HD-IIV3 & SD-IIV3 strategies were dominated. Results were sensitive to influenza incidence, vaccine cost, standard-dose VE in the entire population and high-dose VE in high-risk patients. The CE of RIV for high-risk patients was dependent on as yet unknown parameter values. Based on available data, using high-dose influenza vaccine or RIV in middle-aged, high-risk patients may be an economically favorable vaccination strategy with public health benefits. Clinical trials of these vaccines in this population may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
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2011-09-28
... single-family matrix in FHFA's Public Use Database (PUDB) to include data fields for the high-cost single... Use Database Incorporating High-Cost Single-Family Securitized Loan Data Fields and Technical Data... amended, it is necessary to revise the single-family matrix of FHFA's Public Use Database (PUDB) by adding...
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5 CFR 837.505 - Cost-of-living adjustments on Member annuities.
2010-01-01
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Cost-of-living adjustments on Member... Cost-of-living adjustments on Member annuities. (a) Applying cost-of-living adjustments to recomputed... appointive position subject to CSRS, will include the cost-of-living adjustments under section 8340 of title...
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AIRQino, a low-cost air quality mobile platform
Zaldei, Alessandro; Vagnoli, Carolina; Di Lonardo, Sara; Gioli, Beniamino; Gualtieri, Giovanni; Toscano, Piero; Martelli, Francesca; Matese, Alessandro
2015-04-01
Recent air quality regulations (Directive 2008/50/EC) enforce the transition from point-based monitoring networks to new tools that must be capable of mapping and forecasting air quality on the totality of land area, and therefore the totality of citizens. This implies new technologies such as models and additional indicative measurements, are needed in addition to accurate fixed air quality monitoring stations, that until now have been taken as reference by local administrators for the enforcement of various mitigation strategies. However, due to their sporadic spatial distribution, they cannot describe the highly resolved spatial pollutant variations within cities. Integrating additional indicative measurements may provide adequate information on the spatial distribution of the ambient air quality, also allowing for a reduction of the required minimum number of fixed sampling points, whose high cost and complex maintenance still remain a crucial concern for local administrators. New low-cost and small size sensors are becoming available, that could be employed in air quality monitoring including mobile applications. However, accurate assessment of their accuracy and performance both in controlled and real monitoring conditions is crucially needed. Quantifying sensor response is a significant challenge due to the sensitivity to ambient temperature and humidity and the cross-sensitivity to others pollutant species. This study reports the development of an Arduino compatible electronic board (AIRQino) which integrates a series of low-cost metal oxide and NDIR sensors for air quality monitoring, with sensors to measure air temperature, relative humidity, noise, solar radiation and vertical acceleration. A comparative assessment was made for CO2, CO, NO2, CH4, O3, VOCs concentrations, temperature and relative humidity. A controlled climatic chamber study (-80°C / +80°C) was performed to verify temperature and humidity interference using reference gas cylinders and
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High-Strain Composite Deployable Radiators for CubeSats, Phase I
National Aeronautics and Space Administration — In response to NASA's need for compact, lightweight and efficient, low-cost deployable radiators for CubeSats, Roccor proposes to develop a high-strain laminate...
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High Performance Hybrid Upper Stage for NanoLaunch Vehicles, Phase I
National Aeronautics and Space Administration — Parabilis Space Technologies, Inc. (Parabilis), in collaboration with Utah State University (USU), proposes a low cost, high performance launch vehicle upper stage...
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High Performance Hybrid Upper Stage for NanoLaunch Vehicles, Phase II
National Aeronautics and Space Administration — Parabilis Space Technologies, Inc (Parabilis), in collaboration with Utah State University (USU), proposes further development of a low-cost, high-performance launch...
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Activity-Based Costing Model for Assessing Economic Performance.
DeHayes, Daniel W.; Lovrinic, Joseph G.
1994-01-01
An economic model for evaluating the cost performance of academic and administrative programs in higher education is described. Examples from its application at Indiana University-Purdue University Indianapolis are used to illustrate how the model has been used to control costs and reengineer processes. (Author/MSE)
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Holt, Laura L.; Karr-Kidwell, PJ
An analysis of the problems pertaining to the adoption of a year-round calendar for high schools, along with the advantages of year-round education (YRE), are examined. It provides a literary review (including historical contexts), types of calendars, benefits, administrative problems, and societal benefits. For the study, 28 schools responded to…
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National Aeronautics and Space Administration — TRS Technologies, Inc. in collaboration with The Pennsylvania State University propose to develop new families of high temperature piezoelectric materials for...
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Concept of accounting high-school course book for the specialization "Public Administration"
Baranová, Petra
2015-01-01
This thesis deals with a proposal of high-school course book for the specialization "Public Administration". The aim of the thesis is to offer the textbook of accounting for public sector which covers the needs of both teachers and students. For this purpose, the survey was performed firstly. The respective survey showed that no suitable textbook had been available on the market. The teachers usually use the course book of P. Štohl. Both students and teachers agree on the requirements for thi...
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Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project
Shishko, Robert; Jorgensen, Edward J.
1996-01-01
This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).
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Costs of construction, operation and maintenance of nuclear power plants - determinant factors
International Nuclear Information System (INIS)
Silva, R.A. da
1981-01-01
A study about the construction costs of the Angra-1 nuclear power plant, including direct costs, equipment costs, installation and indirect costs such as: engineering, job-training and administration is presented. The operation and maintenance costs of the Angra-1 nuclear power plant and costs of energy generation are still studied. (E.G.) [pt
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Sustainable Administrative Reform Movements Policy in Joko Widodo's Administration
Directory of Open Access Journals (Sweden)
Yogi Suprayogi Sugandi
2017-05-01
Full Text Available Joko Widodo (Jokowi is a leader that is widely expected to transform Indonesia into a better country. Hopes and wishes were rising when he was elected as the president of Indonesia. This paper will describe various innovations undertaken before and after his presidential inauguration as well as the assorted innovations made in reforming the administration of his cabinet. As the president of Indonesia, Joko Widodo is required to realize the aspirations of the people in freeing the government from corruption, collusion, and nepotism. The management of ministerial and non-ministerial institutions becomes the very first crucial issue undertaken by Joko Widodo. This led to a polemic in regards to reducing or increasing the number of institutions, as the Jokowi administration actually increased the amount. In Susilo Bambang Yudhoyono's administration, several policies were made systematically and based on legislations that had been approved by the lagislature. Joko Widodo's administration in more partial in nature. The administrative reform program that is highly anticipated is the continuation of the Public Service Act. This law is a step forward from the administrative reform program that aims at the creation of good governance. Changes is career path, salary system, pension and benefits for civil servants, performance-based staffing are various efforts of sustainability carried out by Joko Widodo's administration.
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Museum genomics: low-cost and high-accuracy genetic data from historical specimens.
Rowe, Kevin C; Singhal, Sonal; Macmanes, Matthew D; Ayroles, Julien F; Morelli, Toni Lyn; Rubidge, Emily M; Bi, Ke; Moritz, Craig C
2011-11-01
Natural history collections are unparalleled repositories of geographical and temporal variation in faunal conditions. Molecular studies offer an opportunity to uncover much of this variation; however, genetic studies of historical museum specimens typically rely on extracting highly degraded and chemically modified DNA samples from skins, skulls or other dried samples. Despite this limitation, obtaining short fragments of DNA sequences using traditional PCR amplification of DNA has been the primary method for genetic study of historical specimens. Few laboratories have succeeded in obtaining genome-scale sequences from historical specimens and then only with considerable effort and cost. Here, we describe a low-cost approach using high-throughput next-generation sequencing to obtain reliable genome-scale sequence data from a traditionally preserved mammal skin and skull using a simple extraction protocol. We show that single-nucleotide polymorphisms (SNPs) from the genome sequences obtained independently from the skin and from the skull are highly repeatable compared to a reference genome. © 2011 Blackwell Publishing Ltd.
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Simplified High-Performance Roll Out Composite Magnetometer Boom, Phase I
National Aeronautics and Space Administration — In response to NASA's need for compact, low-cost deployable magnetometer booms for CubeSats, Roccor proposes to develop a Simple High-performance Roll-Out Composite...
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Cost-related model for transit rates in electric power distribution networks
International Nuclear Information System (INIS)
Collstrand, F.
1994-02-01
The planned deregulation of the swedish electrical power market will require a new structure of the electrical energy rates. In this report different models of transit rates are studied. The report includes studies of literature and a proposal to a rate structure and is made specifically for Malmoe Energi AB. The differences between various methods of calculating the transfer cost are illustrated. Further, the build-up of the tariff structure and its base elements are discussed. The costs are divided on different categories of costumers and shows the cost for each customer. The new regulations should apply simultaneously to all networks, independent of the voltage level. The transit cost should be based on a number of basic elements: capital cost, operation and maintenance, losses, measuring and administration. Capital cost and operation and maintenance should be charged as power fees, the loss cost as an energy fee and the measuring and administration cost as a fixed fee. The customer bill should be split into two parts, one for the transit cost and one for the energy usage. 15 refs., 37 tabs., 6 figs
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Directory of Open Access Journals (Sweden)
Son Nghiem
Full Text Available National health insurance is now common in most developed countries. This study reviews the evidence and synthesizes the cost-effectiveness information for national health insurance or disability insurance programs across high-income countries.A literature search using health, economics and systematic review electronic databases (PubMed, Embase, Medline, Econlit, RepEc, Cochrane library and Campbell library, was conducted from April to October 2015.Two reviewers independently selected relevant studies by applying screening criteria to the title and keywords fields, followed by a detailed examination of abstracts.Studies were selected for data extraction using a quality assessment form consisting of five questions. Only studies with positive answers to all five screening questions were selected for data extraction. Data were entered into a data extraction form by one reviewer and verified by another.Data on costs and quality of life in control and treatment groups were used to draw distributions for synthesis. We chose the log-normal distribution for both cost and quality-of-life data to reflect non-negative value and high skew. The results were synthesized using a Monte Carlo simulation, with 10,000 repetitions, to estimate the overall cost-effectiveness of national health insurance programs.Four studies from the United States that examined the cost-effectiveness of national health insurance were included in the review. One study examined the effects of medical expenditure, and the remaining studies examined the cost-effectiveness of health insurance reforms. The incremental cost-effectiveness ratio (ICER ranged from US$23,000 to US$64,000 per QALY. The combined results showed that national health insurance is associated with an average incremental cost-effectiveness ratio of US$51,300 per quality-adjusted life year (QALY. Based on the standard threshold for cost-effectiveness, national insurance programs are cost-effective interventions
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A low-cost, high-magnification imaging system for particle sizing applications
International Nuclear Information System (INIS)
Tipnis, Tanmay J; Lawson, Nicholas J; Tatam, Ralph P
2014-01-01
A low-cost imaging system for high magnification and high resolution was developed as an alternative to long-working-distance microscope-based systems, primarily for particle sizing applications. The imaging optics, comprising an inverted fixed focus lens coupled to a microscope objective, were able to provide a working distance of approximately 50 mm. The system magnification could be changed by using an appropriate microscope objective. Particle sizing was achieved using shadow-based techniques with the backlight illumination provided by a pulsed light-emitting diode light source. The images were analysed using commercial sizing software which gave the particle sizes and their distribution. A range of particles, from 6 to 8 µm to over 100 µm, was successfully measured with a minimum spatial resolution of approximately 2.5 µm. This system allowed measurement of a wide range of particles at a lower cost and improved operator safety without disturbing the flow. (technical design note)
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QUALITY ATTRIBUTES IN COST MANAGEMENT AND ACCOUNTING SUBJECTS: THE STUDENTS’ VIEWPOINT
Directory of Open Access Journals (Sweden)
Jucelia Appio Tibola
2012-11-01
Full Text Available The aim in this research is to identify the quality attributes students perceive in cost management and accounting subjects. The subjects were 126 students who took the subjects Cost Applied to Administration, Cost Accounting and Cost Analysis, corresponding to all students in the semester during which the research was undertaken. Thus, a census study was adopted. The research institution is a public university that offers graduate (M.Sc. and Ph.D. programs in Accountancy and Business Administration, particularly in the South of Brazil. An exploratory and qualitative research design was used in the first part and a descriptive and quantitative design in the second. Data were collected with the help of a structured questionnaire with open questions, applying the Critical Incident Technique. Content Analysis was used to classify and categorize the respondents’ answers into units of meaning. In the second phase, these categories were transformed into categorical variables and analyzed through statistical procedures. The results evidenced that the quality attributes constituted an Axis. In the Cost Analysis subjects, they privileged the lecturer’s quality. In Cost Accounting, the students evidenced the teacher’s commitment and the application of practical examples as a relevant attribute. In Cost Applied to Administration, the results indicated that understanding about the subject, clarification of doubts and the lecturer’s didactics served as quality attributes.
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Formation of costs of high-rise objects of housing and civil purpose based on enlarged norms
Vorotyntseva, Anna; Ovsiannikov, Andrei; Bolgov, Vladimir
2018-03-01
When determining the cost of capital construction objects, for purposes of pre-design workings out and purposes of initial maximum initial price determination on tenders, construction price norms are used (CPNs). Modern CPNs are not designed to determine the value of high-rise buildings. It is necessary to adapt modern CPNs to get opportunity for the possibility to take into account special cost factors in determining the cost of high-rise buildings. The main ways can be: selection of new representative objects or application of additional correction factors.
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22 CFR 226.45 - Cost and price analysis.
2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Cost and price analysis. 226.45 Section 226.45 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.45 Cost and price analysis. Some...
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Hawaii Bottomfish Cost-Earnings Survey 2010
National Oceanic and Atmospheric Administration, Department of Commerce — These data represent a cost-earnings study of the Main Hawaiian Islands bottomfish fishery for the 2010 operating year. Data collected include fisher classification,...
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Cost Earnings Data 2012 - Hawaii Longline
National Oceanic and Atmospheric Administration, Department of Commerce — The data collection project assessed the economic performance of Hawaii-based longline vessels that made trips in 2012. Operational and vessel costs were collected...
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Cost Earnings Data 2005 - Hawaii Longline
National Oceanic and Atmospheric Administration, Department of Commerce — The data collection project assessed the economic performance of Hawaii-based longline vessels that made trips in 2005. Operational and vessel costs were collected...
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The COST model for calculation of forest operations costs
Ackerman, P.; Belbo, H.; Eliasson, L.; Jong, de J.J.; Lazdins, A.; Lyons, J.
2014-01-01
Since the late nineteenth century when high-cost equipment was introduced into forestry there has been a need to calculate the cost of this equipment in more detail with respect to, for example, cost of ownership, cost per hour of production, and cost per production unit. Machine cost calculations
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Health insurance, cost expectations, and adverse job turnover.
Ellis, Randall P; Albert Ma, Ching-To
2011-01-01
Because less healthy employees value health insurance more than the healthy ones, when health insurance is newly offered job turnover rates for healthier employees decline less than turnover rates for the less healthy. We call this adverse job turnover, and it implies that a firm's expected health costs will increase when health insurance is first offered. Health insurance premiums may fail to adjust sufficiently fast because state regulations restrict annual premium changes, or insurers are reluctant to change premiums rapidly. Even with premiums set at the long run expected costs, some firms may be charged premiums higher than their current expected costs and choose not to offer insurance. High administrative costs at small firms exacerbate this dynamic selection problem. Using 1998-1999 MEDSTAT MarketScan and 1997 Employer Health Insurance Survey data, we find that expected employee health expenditures at firms that offer insurance have lower within-firm and higher between-firm variance than at firms that do not. Turnover rates are systematically higher in industries in which firms are less likely to offer insurance. Simulations of the offer decision capturing between-firm health-cost heterogeneity and expected turnover rates match the observed pattern across firm sizes well. 2010 John Wiley & Sons, Ltd.
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FlexSAR, a high quality, flexible, cost effective, prototype SAR system
Jensen, Mark; Knight, Chad; Haslem, Brent
2016-05-01
The FlexSAR radar system was designed to be a high quality, low-cost, flexible research prototype instrument. Radar researchers and practitioners often desire the ability to prototype new or advanced configurations, yet the ability to enhance or upgrade existing radar systems can be cost prohibitive. FlexSAR answers the need for a flexible radar system that can be extended easily, with minimal cost and time expenditures. The design approach focuses on reducing the resources required for developing and validating new advanced radar modalities. Such an approach fosters innovation and provides risk reduction since actual radar data can be collected in the appropriate mode, processed, and analyzed early in the development process. This allows for an accurate, detailed understanding of the corresponding trade space. This paper is a follow-on to last years paper and discusses the advancements that have been made to the FlexSAR system. The overall system architecture is discussed and presented along with several examples illustrating the system utility.
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5 CFR 591.220 - How does OPM calculate energy utility cost indexes?
2010-01-01
... cost indexes? 591.220 Section 591.220 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS ALLOWANCES AND DIFFERENTIALS Cost-of-Living Allowance and Post Differential-Nonforeign Areas Cost-Of-Living Allowances § 591.220 How does OPM calculate energy utility cost indexes? (a) OPM...
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Costs of reducing nutrient losses in Denmark
DEFF Research Database (Denmark)
Jacobsen, Brian H.; Abildtrup, Jens; Jensen, Jørgen Dejgård
to the eastern part of Denmark. The final plan for the Aquatic Environment III from 2004 included a 13% reduction of N-leaching until 2015 based on cost effective administrative measures like wetlands and catch crops. Also a tax on mineral phosphorus in feedstuffs was included in order to half the phosphorus......The economic calculations carried out prior to the Plan for the Aquatic Environment III included a comparison of regulation systems aimed at reducing nitrogen leaching, analyses of measures for reducing phosphorus losses and estimation of administrative costs. The conclusions were that taxation...... surplus. The measures in the Plan will have to be supplemented by more measures to meet the targets in the EU's Water Framework Directive....
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High Power, Thermally Optimized Blue Laser for Lidar, Phase I
National Aeronautics and Space Administration — To enable widespread and rapid airborne bathymetric lidar to adequate depths in many ocean regions a low-cost, rugged, and high energy pulsed laser source must be...
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High Power, Thermally Optimized Blue Laser for Lidar, Phase II
National Aeronautics and Space Administration — To enable widespread and rapid airborne bathymetric lidar to adequate depths in many ocean regions a low-cost, rugged, and high energy pulsed laser source must be...
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Constitutional and administrative paradigms in judicial control over EU high and low politics
Cebulak Pola
2017-01-01
This article explores the particular tensions surrounding judicial review in EU external relations. The tensions are classified using a two-dimensional framework. Firstly, a distinction based on policy domains of high and low politics, which is derived from constitutional theory, and external to the CJEU; and secondly a distinction based on legitimizing paradigms of administrative (EU as effective global actor) or constitutional (judicial review as guarantee of fundamental rights) in characte...
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Low-cost, High Flexibility I-V Curve Tracer for Photovoltaic Modules
DEFF Research Database (Denmark)
Ibirriaga, Julen Joseba Maestro; Pena, Xabier Miquelez de Mendiluce; Opritescu, Adrian
2010-01-01
This work presents the design, construction and test of an in-door low cost, high flexibility I-V curve tracer for photovoltaic modules. The tracer is connected to a Xenon lamp based flashing solar simulator. The designed tracer is able to deal with the very fast changing irradiation conditions...
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What factors increase the risk of incurring high market impact costs?
Bikker, Jacob A.; Spierdijk, Laura; van der Sluis, Pieter-Jelle
2010-01-01
This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world's second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker
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Communicating Value in Simulation: Cost-Benefit Analysis and Return on Investment.
Asche, Carl V; Kim, Minchul; Brown, Alisha; Golden, Antoinette; Laack, Torrey A; Rosario, Javier; Strother, Christopher; Totten, Vicken Y; Okuda, Yasuharu
2018-02-01
Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and the economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost-effectiveness to effectively communicate with administrators. At the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes," our breakout session critically evaluated the cost-benefit and return on investment of simulation. In this paper we provide an overview of some of the economic tools that a clinician may use to present the value of simulation training to financial officers and other administrators in the economic terms they understand. We also define three themes as a call to action for research related to cost-benefit analysis in simulation as well as four specific research questions that will help guide educators and hospital leadership to make decisions on the value of simulation for their system or program. © 2017 by the Society for Academic Emergency Medicine.
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Manual for Reducing Educational Unit Costs in Latin American Countries.
Centro Multinacional de Investigacion Educativa, San Jose (Costa Rica).
Designed for educational administrators, this manual provides suggestions for reducing educational unit costs in Latin America without reducing the quality of the education. Chapter one defines unit cost concepts and compares the costs of the Latin American countries. Chapter two deals with the different policies which could affect the principal…
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McFadden, Lisa M; Hoonakker, Amanda J; Vieira-Brock, Paula L; Stout, Kristen A; Sawada, Nicole M; Ellis, Jonathan D; Allen, Scott C; Walters, Elliot T; Nielsen, Shannon M; Gibb, James W; Alburges, Mario E; Wilkins, Diana G; Hanson, Glen R; Fleckenstein, Annette E
2011-01-01
Administration of high doses of methamphetamine (METH) causes persistent dopaminergic deficits in both nonhuman preclinical models and METH-dependent persons. Noteworthy, adolescent (i.e., postnatal day (PND) 40) rats are less susceptible to this damage than young adult (PND90) rats. In addition, biweekly treatment with METH, beginning at PND40 and continuing throughout development, prevents the persistent dopaminergic deficits caused by a “challenge” high-dose METH regimen when administered ...
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Tuffaha, Haitham W; Roberts, Shelley; Chaboyer, Wendy; Gordon, Louisa G; Scuffham, Paul A
2016-06-01
To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and quality-adjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being cost-effective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is cost-effective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.
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Inefficient national environmental regulation as a signal of high abatement costs
Energy Technology Data Exchange (ETDEWEB)
Steiner, U.
1997-12-31
This paper analyses the importance of informational asymmetries in international environmental regulation by use of a game theoretic approach of signaling games. More specific it analysis whether it is possible for a government to try to extract higher compensation in an international unidirectoral environmental problem. This may be possible when the national environmental regulation carries a signal of the cost of the regulated industry. In this case the government e.g. by means of inefficient environmental regulation on a national level may try to signal high abatement costs. In spite of the fact that many international environmental problems seem to be solvable by the use of financial payments there are only few examples that compensation payment arrangements have been implemented. As many countries and especially many polluting firms possess better information about abatement costs than the countries that receive the pollution, it is worthwhile to include asymmetric information. Consequently, this paper analyses whether the introduction of asymmetric information about abatement costs may bring forward incentives to misrepresent the true abatement cost in order to capture more compensation. If these incentives turn out to be present, it may explain some of the suspicion against using financial payment in order to induce other countries to join an agreement. The analysis shows that it may indeed be the case that the expected gain from cheating is so large that it gives incentives to use an inefficient national environmental policy. (au) 13 refs.
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COST EFFECTIVE AND HIGH RESOLUTION SUBSURFACE CHARACTERIZATION USING HYDRAULIC TOMOGRAPHY
2017-08-01
objective of this project is to provide the DoD and its remediation contractors with the HT technology for delineating the spatial distribution of...STATEMENT Approved for public release; distribution is unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Hydraulic Tomography ( HT ) is a high-resolution...performance of subsurface remedial actions at environmental sites. The good technical performance and cost-effectiveness of HT have been demonstrated in
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The effect of chain membership on hospital costs.
Menke, T J
1997-06-01
To compare the cost structures of hospitals in multihospital systems and independently owned hospitals. The American Hospital Association's Annual Survey from 1990 for data on hospital costs and attributes. Area characteristics came from the Area Resource File, and the Medicare case-mix index came from the Health Care Financing Administration. Data on wages are from the Bureau of the Census' State and Metropolitan Area Data Book. The Guide to Hospital Performance from HCIA, Inc. provided data on quality of care. Separate cost functions were estimated for chain and independent hospitals. Hybrid translog cost functions included measures of outputs, input prices, and hospital and area characteristics. The estimation method accounted for the simultaneous determination of costs and chain membership, and for any nonrandom selection of hospitals into chains. Several economic cost measures were calculated to compare the cost structures of the two types of hospitals. Data from all sources were merged at the hospital level to form the study sample. Hospitals in multihospital systems were less costly than independently owned hospitals. Among independent hospitals, for-profits had the highest costs. There were no statistically significant differences in costs by ownership among chain members. Economies of scale were enjoyed in both types of hospitals only at high volumes of output, while economies of scope occurred at all volumes for chain hospitals, but only at low and medium volumes for independent hospitals. This study provides support for the idea that growth of the multihospital system sector can provide a market solution to the problem of constraining costs. It does not, however, support the property rights theory that proprietary hospitals are more efficient than nonprofit hospitals.
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Frakt, Austin B; Pizer, Steven D; Hendricks, Ann M
2008-12-01
Medicare and the Veterans Health Administration (VA) both finance large outpatient prescription drug programs, though in very different ways. In the ongoing debate on how to control Medicare spending, some suggest that Medicare should negotiate directly with drug manufacturers, as the VA does. In this article we relate the role of interest groups to policy differences between Medicare and the VA and, in doing so, explain why such a large change to the Medicare drug program is unlikely. We argue that key policy differences are attributable to stable differences in interest group involvement. While this stability makes major changes in Medicare unlikely, it suggests the possibility of leveraging VA drug purchasing to achieve savings in Medicare. This could be done through a VA-administered drug-only benefit for Medicare-enrolled veterans. Such a partnership could incorporate key elements of both programs: capacity to accept large numbers of enrollees (like Medicare) and leverage to negotiate prescription drug prices (like the VA). Moreover, it could be implemented at no cost to the VA while achieving savings for Medicare and beneficiaries.
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Van Etten, P
1985-10-01
The approach of the New England Medical Center toward case management and increased productivity, and the role of the pharmacy within this system, are described by a chief hospital administrator. External pressures that caused the hospital to alter its management style included changes in reimbursement, hospital overuse, increased competition, and a surplus of physicians. Variations in medical practice that affected admission rates, length of stay, and use of ancillary services existed because clinical and financial data had not been integrated, so clinicians had no information on the economic consequences of their decisions. The solution offered to this problem was to decentralize resource-use decisions to increase clinician accountability. The goal of the case-management system is to reduce the cost of intermediate product (e.g., laboratory tests) use through increased productivity. The system provides pharmacy with a new power base if pharmacists can reduce overall costs by influencing prescribers to use cost-effective therapies. Pharmacy can increase its influence within the institution by forming new relationships with administrators, physicians, and nurses that broaden its impact on cost.
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DEFF Research Database (Denmark)
Soares, Tiago; Pereira, Fábio; Morais, Hugo
2015-01-01
The high penetration of distributed energy resources (DER) in distribution networks and the competitive environment of electricity markets impose the use of new approaches in several domains. The network cost allocation, traditionally used in transmission networks, should be adapted and used...... in the distribution networks considering the specifications of the connected resources. The main goal is to develop a fairer methodology trying to distribute the distribution network use costs to all players which are using the network in each period. In this paper, a model considering different type of costs (fixed......, losses, and congestion costs) is proposed comprising the use of a large set of DER, namely distributed generation (DG), demand response (DR) of direct load control type, energy storage systems (ESS), and electric vehicles with capability of discharging energy to the network, which is known as vehicle...
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Considerations for Assessing the Appropriateness of High-Cost Pediatric Care in Low-Income Regions
Directory of Open Access Journals (Sweden)
Andrew C. Argent
2018-03-01
Full Text Available It may be difficult to predict the consequences of provision of high-cost pediatric care (HCC in low- and middle-income countries (LMICs, and these consequences may be different to those experienced in high-income countries. An evaluation of the implications of HCC in LMICs must incorporate considerations of the specific context in that country (population age profile, profile of disease, resources available, likely costs of the HCC, likely benefits that can be gained versus the costs that will be incurred. Ideally, the process that is followed in decision making around HCC should be transparent and should involve the communities that will be most affected by those decisions. It is essential that the impacts of provision of HCC are carefully monitored so that informed decisions can be made about future provision medical interventions.
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42 CFR 423.800 - Administration of subsidy program.
2010-10-01
... 42 Public Health 3 2010-10-01 2010-10-01 false Administration of subsidy program. 423.800 Section 423.800 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Premiums and Cost...
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Development of the Treatment Inventory of Costs in Psychiatric Patients: TIC-P Mini and Midi.
Timman, Reinier; Bouwmans, Clazien; Busschbach, Jan J V; Hakkaart-van Roijen, Leona
2015-12-01
Medical costs of (psychiatric) illness can be validly measured with patient report questionnaires. These questionnaires comprise many detailed items resulting in lengthy administrations. We set out to find the minimal number of items needed to retrieve 80% and 90% of the costs as measured by the Treatment Inventory of Costs in Patients with psychiatric disorders (TIC-P). The TIC-P is a validated patient-reported outcome measure concerning the utilization of medical care and productivity losses. The present study focused on direct medical costs. We applied data of 7756 TIC-P administrations from three studies in patients with mental health care issues. Items that contribute least to the total cost were eliminated, providing that 80% and 90% of the total cost was retained. Average medical costs per patient were €658 over the last 4 weeks. The distribution of cost was highly skewed, and 5 of the 14 items of the TIC-P accounted for less than 10% of the total costs. The 80% Mini version of the TIC-P required five items: ambulatory services, private practice, day care, general hospital, and psychiatric clinic. The TIC-P Midi 90% inventory required eight items. Both had variance between the three samples in the optimal choice of the items. The number of items of the TIC-P can be reduced considerably while maintaining 80% and 90% of the medical costs estimated by the complete TIC-P. The reduced length makes the questionnaire more suitable for routine outcome monitoring. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
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78 FR 16808 - Connect America Fund; High-Cost Universal Service Support
2013-03-19
... USF/ ICC Transformation Order, including granting in part requests to modify the high cost loop... 27, 2013. The full text of this document is available for public inspection during regular business... following Internet address: http://transition.fcc.gov/Daily_Releases/Daily_Business/2013/db0227/FCC-13-16A1...
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What factors increase the risk of incurring high market impact costs?
Bikker, Jacob A.; Spierdijk, L.; van der Sluis, Pieter Jelle
2010-01-01
This article applies quantile regression to assess the factors that influence the risk of incurring high trading costs. Using data on the equity trades of the world’s second largest pension fund in the first quarter of 2002, we show that trade timing, momentum, volatility and the type of broker
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The Cost of Living in Ancient Greece
Directory of Open Access Journals (Sweden)
Roberto Morales Harley
2014-11-01
Full Text Available The paper focuses on the most relevant economic aspects of Ancient Greece, more specifically, 5th century BC Athens. It explores the Greek notion of economy, the monetary system, the financial administration and the labor market, in order to contextualize the cost of living. The examples on this matter take into account the products’ costs and the people’s wages.
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Case and Administrative Support Tools
Case and Administrative Support Tools (CAST) is the secure portion of the Office of General Counsel (OGC) Dashboard business process automation tool used to help reduce office administrative labor costs while increasing employee effectiveness. CAST supports business functions which rely on and store Privacy Act sensitive data (PII). Specific business processes included in CAST (and respective PII) are: -Civil Rights Cast Tracking (name, partial medical history, summary of case, and case correspondance). -Employment Law Case Tracking (name, summary of case). -Federal Tort Claims Act Incident Tracking (name, summary of incidents). -Ethics Program Support Tools and Tracking (name, partial financial history). -Summer Honors Application Tracking (name, home address, telephone number, employment history). -Workforce Flexibility Initiative Support Tools (name, alternative workplace phone number). -Resource and Personnel Management Support Tools (name, partial employment and financial history).
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High cost of stage IV pressure ulcers.
Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce
2010-10-01
The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars. Copyright © 2010 Elsevier Inc. All rights reserved.
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Evidence against the energetic cost hypothesis for the short introns in highly expressed genes
Directory of Open Access Journals (Sweden)
Niu Deng-Ke
2008-05-01
Full Text Available Abstract Background In animals, the moss Physcomitrella patens and the pollen of Arabidopsis thaliana, highly expressed genes have shorter introns than weakly expressed genes. A popular explanation for this is selection for transcription efficiency, which includes two sub-hypotheses: to minimize the energetic cost or to minimize the time cost. Results In an individual human, different organs may differ up to hundreds of times in cell number (for example, a liver versus a hypothalamus. Considered at the individual level, a gene specifically expressed in a large organ is actually transcribed tens or hundreds of times more than a gene with a similar expression level (a measure of mRNA abundance per cell specifically expressed in a small organ. According to the energetic cost hypothesis, the former should have shorter introns than the latter. However, in humans and mice we have not found significant differences in intron length between large-tissue/organ-specific genes and small-tissue/organ-specific genes with similar expression levels. Qualitative estimation shows that the deleterious effect (that is, the energetic burden of long introns in highly expressed genes is too negligible to be efficiently selected against in mammals. Conclusion The short introns in highly expressed genes should not be attributed to energy constraint. We evaluated evidence for the time cost hypothesis and other alternatives.
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75 FR 53135 - Federal Acquisition Regulation; Definition of Cost or Pricing Data
2010-08-30
...; Definition of Cost or Pricing Data AGENCIES: Department of Defense (DoD), General Services Administration... ``certified cost or pricing data'' and ``data other than certified cost or pricing data'', and to clarify requirements for submission of cost or pricing data. DATES: Effective Date: October 1, 2010. FOR FURTHER...
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Financial and Cost Aspects of Other Transactions
National Research Council Canada - National Science Library
1998-01-01
...." This report discusses the DoD administration of "other transactions." The second audit report will discuss the review of costs charged to the agreements by the "other transaction" participant...
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Assessment of Rheumatoid Arthritis Quality Process Measures and Associated Costs.
Brady, Brenna L; Tkacz, Joseph; Meyer, Roxanne; Bolge, Susan C; Ruetsch, Charles
2017-02-01
The objective was to examine the relationship between health care costs and quality in rheumatoid arthritis (RA). Administrative claims were used to calculate 8 process measures for the treatment of RA. Associated health care costs were calculated for members who achieved or did not achieve each of the measures. Medical, pharmacy, and laboratory claims for RA patients (International Classification of Diseases, Ninth Revision, Clinical Modification 714.x) were extracted from the Optum Clinformatics Datamart database for 2011. Individuals were predominately female and in their mid-fifties. Measure achievement ranged from 55.9% to 80.8%. The mean cost of care for members meeting the measure was $18,644; members who did not meet the measures had a mean cost of $14,973. Primary cost drivers were pharmacy and office expenses, accounting for 42.4% and 26.3% of total costs, respectively. Regression analyses revealed statistically significant associations between biologic usage, which was more prevalent in groups attaining measures, and total expenditure across all measures (Ps < 0.001). Pharmacy costs were similar between both groups. Individuals meeting the measures had a higher proportion of costs accounted for by office visits; those not meeting the measures had a higher proportion of costs from inpatient and outpatient visits. These findings suggest that increased quality may lead to lower inpatient and outpatient hospital costs. Yet, the overall cost of RA care is likely to remain high because of intensive pharmacotherapy regimens.
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Smoke-Free Medical Facility Campus Legislation: Support, Resistance, Difficulties and Cost
Directory of Open Access Journals (Sweden)
J. Gary Wheeler
2009-01-01
Full Text Available Although medical facilities restrict smoking inside, many people continue to smoke outside, creating problems with second-hand smoke, litter, fire risks, and negative role modeling. In 2005, Arkansas passed legislation prohibiting smoking on medical facility campuses. Hospital administrators (N=113 were surveyed pre- and post-implementation. Administrators reported more support and less difficulty than anticipated. Actual cost was 10-50% of anticipated cost. Few negative effects and numerous positive effects on employee performance and retention were reported. The results may be of interest to hospital administrators and demonstrate that state legislation can play a positive role in facilitating broad health-related policy change.
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Pierre, Pernilla Videhult; Engmér, Cecilia; Wallin, Inger; Laurell, Göran; Ehrsson, Hans
2009-02-01
High concentrations of the antioxidant thiosulfate reach scala tympani perilymph after i.v. administration in the guinea pig. Thiosulfate concentrations in perilymph remain elevated longer than in blood. This warrants further studies on the possibility of obtaining otoprotection by thiosulfate administration several hours before that of cisplatin without compromising the anticancer effect caused by cisplatin inactivation in the blood compartment. Thiosulfate may reduce cisplatin-induced ototoxicity, presumably by oxidative stress relief and formation of inactivate platinum complexes. This study aimed to explore to what extent thiosulfate reaches scala tympani perilymph after systemic administration in the guinea pig. Scala tympani perilymph (1 microl) was aspirated from the basal turn of each cochlea up to 3 h after thiosulfate administration (103 mg/kg b.w., i.v.). Blood samples were also taken. Thiosulfate was quantified by HPLC and fluorescence detection. Substantial thiosulfate concentrations were found in perilymph. The area under the concentration-time curve for thiosulfate in perilymph and blood was 3100 microMxmin and 6300 microMxmin, respectively. The highest thiosulfate concentrations in perilymph were found at the first sampling at about 10 min. Due to a more rapid elimination from blood, perilymph concentrations exceeded those of blood towards the end of the experiment.
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45 CFR 1301.32 - Limitations on costs of development and administration of a Head Start program.
2010-10-01
... direction; budgeting, accounting, and auditing; and management of purchasing, property, payroll and... costs are those costs related to the overall management of the program. These costs can be in both the personnel and non-personnel categories. (2) Grantees must charge the costs of organization-wide management...